Navegando por Palavras-chave "varicose veins"
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- ItemAcesso aberto (Open Access)Avaliação da bomba muscular da panturrilha em pacientes portadores de varizes primárias dos membros inferiores através da pletismografia a ar(Sociedade Brasileira de Angiologia e de Cirurgia Vascular (SBACV), 2007-03-01) Sacchi, André de Araújo; Castro, Aldemar Araujo [UNIFESP]; Pitta, Guilherme Benjamin Brandão; Miranda Junior, Fausto [UNIFESP]; Universidade Federal de Campina Grande Universidade Federal de Campina Grande; Universidade Estadual de Ciências da Saúde de Alagoas Escola de Ciências Médicas de Alagoas Departamento de Medicina Social; Universidade Federal de São Paulo (UNIFESP)OBJECTIVE: This article aims at assessing the influence of calf muscle vein reflux (suraland genicular veins) on calf muscle pump function in patients with primary varicose veins of the lower limbs. METHODS: Cross-sectional and prospective study assessing 120 patients divided into two groups (60 subjects each) by physical examination, duplex scan and air plethysmography. The first group showed calf muscle venous reflux, whereas the second group presented absence of reflux. Both groups were examined by air plethysmography to verify calf pump function through measurement of ejection fraction, residual volume fraction, ejected volume and venous filling index in both limbs. RESULTS: In the group of patients with reflux, ejection fraction indexes lower than 60% (p < 0.001) were found in 82.3% (left leg) and 74.6% (right leg) of cases. Levels of residual volume fraction greater than 60% were identified in 62.5% (left leg, p= 0.015) and in 86.7% (right leg, p = 0.014) of assessed cases. There was no statistically significant variation concerning the venous filling index between groups with or without reflux, with p= 0.140 in both legs. Of all patients, 63.6% had calf vein reflux (left leg) and 61.8% (right leg) had ejection volume greater than 150 mL (p = 0.001). CONCLUSIONS: The calf pump function decreased in both lower limbs, due to presence of calf muscle vein reflux (genicular and sural veins).
- ItemAcesso aberto (Open Access)Avaliação da insuficiência da veia safena magna com classificação C2 e C3 (CEAP) pela pletismografia a ar e pelo eco-Doppler colorido(Sociedade Brasileira de Angiologia e de Cirurgia Vascular (SBACV), 2012-09-01) Seidel, Amélia Cristina [UNIFESP]; Rossetti, Leandro Pablos; Juliano, Yara [UNIFESP]; Novo, Neil Ferreira [UNIFESP]; Miranda Jr, Fausto [UNIFESP]; UEM Curso de Medicina; UEM curso de Medicina; Universidade Federal de São Paulo (UNIFESP); Universidade de Santo Amaro Departamento de Saúde PúblicaBACKGROUND: With the presence of venous reflux, there is need evaluate the clinical severity by quantifying the hemodynamic effect of venous incompetence and definition of their anatomical distribution. OBJECTIVE: To determine and correlate the degree of reflux of the greater saphenous vein (insufficiency) in a clinical CEAP C2/C3 by air plethysmography and color Doppler ultrasonography. METHODS: We prospectively investigated 87 limbs with reflux of the greater saphenous vein as ascertained by Doppler ultrasound and 32 limbs without signs or symptoms of the venous disease. All patients underwent clinical examinations using air plethysmography and Doppler ultrasound of the lower limbs. The parameters used with the Doppler ultrasound were: the diameter of the saphenous vein (seven levels) and the speed and time of reflux. In the plethysmography, the venous filling index, ejection fraction and residual volume fraction were also considered. RESULTS: Of the 119 limbs, 61 were class C2. In comparing the diameters of the vein of the control group with the study group there were statistically significant differences. There was an exception at the malleolus level. Using the Spearman correlation to analyze the indices for the plethysmography and Doppler ultrasound it showed some difference, but the coefficient of determination (r²) showed that they were weak. CONCLUSIONS: The parameters of the plethysmography did not correlate with the degree of reflux in the greater saphenous vein. There was a very weak correlation between their values, time and speed of reflux. Only the venous filling index correlated with venous reflux. The ejection fraction and residual volume fraction were not important for discrimination of clinical severity.
- ItemAcesso aberto (Open Access)Gestação e varizes de membros inferiores: prevalência e fatores de risco(Sociedade Brasileira de Angiologia e de Cirurgia Vascular (SBACV), 2010-06-01) Barros Junior, Newton de [UNIFESP]; Perez, Maria Del Carmen Janeiro [UNIFESP]; Amorim, Jorge Eduardo de [UNIFESP]; Miranda Junior, Fausto [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)Background: During and after pregnancy, lower limb varicose disease presents specific features that have influenced the conduction of studies designed to provide a better understanding of the condition. Such features include the appearance of lower limb varicose veins, their early development and intensity, and their rapid regression after delivery. Objective: To assess the prevalence of lower limb varicose disease during pregnancy and to identify the main associated risk factors. Prevalence of varicose disease during pregnancy is high, affecting almost 70% of pregnant women considering all types of varicose disease. This high prevalence is mainly caused by the increase in the estrogen and progesterone levels during pregnancy. Material and method: We analyzed 352 pregnant women during prenatal follow-up. The subjects were randomly selected during a 14-month period. Varicose disease was clinically identified and classified according to Widmer's criteria: trunk varicose veins, reticular varicose veins, and telangiectasias; being reclassified according to the criteria of the CEAP clinical classification. The results of prevalence and risk factors were statistically analyzed using univariate and multivariate analyses. Results: Considering all types of varicose veins, prevalence of varicose disease was 72.7% (256 pregnant women). Only 27.3% (96) of pregnant women did not have varicose disease (C0), and this group was considered the control group. After multivariate analysis, the main risk factors were: family history and pregnant women's age. Conclusion: The high prevalence of varicose disease and the associated risk factors suggest the need of providing the health professionals involved in women's health care, especially during the fertile period, with information on this disease.
- ItemAcesso aberto (Open Access)Implementação financeira e o impacto do mutirão de cirurgias de varizes, após a criação do Fundo de Ações Estratégias e Compensação (FAEC)(Sociedade Brasileira de Angiologia e de Cirurgia Vascular (SBACV), 2011-12-01) Souza, Maira Oliveira; Miranda Júnior, Fausto [UNIFESP]; Poli de Figueiredo, Luiz Francisco [UNIFESP]; Pitta, Guilherme Benjamin Brandão; Aragão, José Aderval [UNIFESP]; Sociedade Brasileira de Angiologia e de Cirurgia Vascular; Universidade Federal de São Paulo (UNIFESP); Universidade de São Paulo (USP); UNCISAL; Universidade Tiradentes Faculdade de MedicinaBACKGROUND: In spite of the fact that the number of surgeries presented by the elective surgery task force did not entirely reflect the reality, it is possible to declare that the financial implementation of the Brazilian Ministry of Health has been significative, as well as the increasing number of varicose vein surgeries, especially after the creation of the Strategic Actions and Compensation Fund (FAEC). OBJECTIVE: To evaluate the application of financial investment in the Ministry of Health campaign for varicose vein surgery. METHODS: A transversal study of retrospective nature has been conducted, using information available at the Data Processing Department of the National Healthcare System database (DATASUS). All the authorization of hospital internment from the inferior member varicose vein surgeries, financed by the Brazilian Ministry of Health from January 1998 to December 2004, have been included in the research. RESULTS: In 1998, before the implementation of the elective surgery task force, 23,531 varicose vein surgeries have been performed, and R$ 5,819,033.27 invested. After the creation of the FAEC, 457,026 inferior member varicose vein surgeries have been performed from 1999 to 2004, and R$ 187,760,196.81 were invested with an average of R$ 31,293,336.13 per year. CONCLUSION: Thus, it is possible to conclude that the bigger investment from the Brazilian Ministry of Health, represented by the implementation of the elective surgery task forces by the FAEC, has been responsible for increasing the number of varicose vein surgeries all around Brazil.
- ItemAcesso aberto (Open Access)Prevalence of varicose veins and venous anatomy in patients without truncal saphenous reflux(W B Saunders Co Ltd, 2004-10-01) Seidel, Amélia Cristina [UNIFESP]; Miranda Junior, Fausto [UNIFESP]; Juliano, Yara [UNIFESP]; Novo, Neil Ferreira [UNIFESP]; Santos, J. H. dos; Souza, D. F. de; Universidade Estadual de Maringá (UEM); Universidade Federal de São Paulo (UNIFESP); Santo Amaro Univ; Maringa Reg HospObjectives. To determine the prevalence and distribution of primary venous re truncal saphenous reflux.Design. Prospective cohort study.Patients and methods. One thousand and seven hundred and twelve patients with suspected venous disease were examined by duplex ultrasonography. Seven hundred and thirty-five patients had primary varicose veins with competent saphenous trunks. Limbs With truncal saphenous reflux, deep vein reflux or obstruction, previous injection sclerotherapy or vein surgery, arterial disease and inflammation of non-venous origin were excluded from further consideration. the CEAP classification system was used for clinical staging. Systematic duplex ultrasound examination was undertaken to assess the distribution a incompetent saphenous tributaries.Results. the prevalence of primary reflux with competent saphenous trunks was 43%. Reflux of GSV calf tributaries was the most common. the majority of the limbs (96%) belonged to chronic venous disease classes C1 and C2 of the CEAP classification.Conclusions. Superficial venous reflux causing varicose veins in the presence competent saphenous trunks is very prevalent in this series in contrast to other studies, presumably reflecting differing patient populations. Our data clearly show that varicose veins may occur in any vein and do not depend on truncal saphenous incompetence. Careful duplex ultrasound evaluation allows the pattern of venous reflux to be established in this group of patient ensuring appropriate management of varices.
- ItemAcesso aberto (Open Access)Tratamento combinado da cirurgia de varizes com a escleroterapia de telangiectasias dos membros inferiores no mesmo ato(Sociedade Brasileira de Angiologia e de Cirurgia Vascular (SBACV), 2006-03-01) Gaspar, Ricardo José [UNIFESP]; Medeiros, Charles Angotti Furtado de; Universidade Federal de São Paulo (UNIFESP); Universidade Estadual de Campinas (UNICAMP)OBJECTIVES: Chemical sclerotherapy is the most traditional treatment to eliminate telangiectasias. For several decades, it has been carried out in the office, although it has a high index of treatment dropout for being a painful, long and, therefore, little efficient treatment. Most of these patients also present insufficient varicose veins, which require phlebectomy and are candidates for surgery. The aim of this paper is to describe the combined treatment including varicose vein surgery and sclerotherapy for telangiectasias at the same procedure. METHODS: From January 1998 to March 2002, 213 patients (426 lower limbs) with telangiectasias were treated by means of hypertonic glucose infusion during the varicose vein surgery. RESULTS: More than 90% of the patients reported high indices of aesthetic satisfaction. The complementary sclerotherapy was necessary in 165 patients to have full aesthetic satisfaction during follow-up. Any cases of superficial thrombophlebitis or of deep venous thrombosis were reported. There were no serious complications either. In 10% of cases, small drainage of residual microthrombus was necessary. The index of hyperchromic spots did not exceed 3%. Only one patient developed a small ulcer in the back of the foot (0.2%), which spontaneously healed. CONCLUSIONS: Combined treatment including surgery with sclerotherapy for varicose veins and lower extremity telangiectasias is an alternative for patients who desire faster and painless results. Multiple session sclerotherapy with hypertonic glucose is a safe and efficient procedure.
- ItemAcesso aberto (Open Access)Válvulas da veia braquial comum: estudo anatômico(Sociedade Brasileira de Angiologia e de Cirurgia Vascular (SBACV), 2007-03-01) Santos, Carlos Adriano Silva dos; Poli de Figueiredo, Luiz Francisco [UNIFESP]; Gusmão, Luiz Carlos Buarque de; Pitta, Guilherme Benjamin Brandão; Miranda Junior, Fausto [UNIFESP]; Universidade Estadual de Ciências da Saúde de Alagoas Hospital-Escola Dr. José Carneiro; Universidade Federal de São Paulo (UNIFESP); Universidade Federal de Alagoas Departamento de Morfologia; UNCISAL Departamento de CirurgiaBACKGROUND: A great part of venous insufficiencies is due to valve incompetence. Valved venous grafts in the insufficient segment are a surgical alternative. OBJECTIVE: To describe the anatomy of the common brachial vein valves. METHODS: We used 30 male corpses of varied races with their upper limbs articulated to the trunk. They were preserved in formol and fixed in a 10% formol solution. Exclusion criteria were presence of disarticulation in one limb or deforming alterations in the topography of assessed structures. RESULTS: The total number of identified valves was 28 in the right arm and 33 in the left arm, 15 of them in the right proximal segment and 21 in the left proximal segment. More than 91% of the valves were bicuspid and parietal. CONCLUSION: We conclude that the common brachial vein often presents bicuspid and parietal valves.