Um novo substituto vascular: arterioplastia femoral em cães com remendo de membrana de biopolímero de cana-de-açúcar - avaliação hemodinâmica e histopatológica / A new vascular substitute: femoral artery angioplasty in dogs using sugarcane biopolymer membrane patch - hemodynamic and histopathologic evaluation / A new vascular substitute: femoral artery angioplasty in dogs using sugarcane biopolymer membrane patch - hemodynamic and histopathologic evaluation

CONTEXTO: A obtenção de um substituto arterial ideal para o emprego nas reconstruções das artérias de pequeno e médio calibre é ainda o principal objetivo da maioria das pesquisas científicas desenvolvidas no campo dos substitutos vasculares. A membrana de biopolímero de cana-de-açúcar pode ser de grande utilidade para a realização das reconstruções arteriais em vasos de calibre inferior a 4 mm e assim permitir o tratamento de doenças que afetam milhões de pessoas no Brasil e em todo o mundo. OBJETIVO: Avaliar do ponto de vista hemodinâmico e histopatológico o comportamento da membrana do biopolímero de cana-de-açúcar quando utilizada com remendo em arterioplastias femorais em cães. MÉTODO: Oito cães adultos mestiços sob anestesia geral foram submetidos no Núcleo de Cirurgia Experimental do Centro de Ciências da Saúde-UFPE a velocimetria Doppler percutânea das artérias femorais direita e esquerda para controle pré-operatório. Sob condições de assepsia e anti-sepsia, os cães foram submetidos a arterioplastia femoral bilateral com remendos da membrana de biopolímero de cana-de-açúcar no lado esquerdo e de PTFE expandido (e-PTFE) no lado direito. Na primeira semana pós-operatória, os cães foram submetidos a avaliação clínica diária e semanal a partir do oitavo dia. A avaliação clínica consistiu no exame dos pulsos femorais, na avaliação da marcha e na observação da presença de tumor pulsátil, hematoma ou hemorragia e infecção da ferida operatória. Após 180 dias das arterioplastias, sob anestesia geral, procedeu-se nova fluxometria Doppler percutânea das artérias femorais. Os animais foram submetidos à dissecção das artérias femorais, medido o diâmetro arterial e realizada velocimetria Doppler trans-operatória em pontos proximal e distal à arterioplastia. A seguir foi realizada laparotomia e exposição da aorta abdominal para acesso arteriográfico. Os segmentos das artérias femorais com os remendos foram retirados para estudo histopatológico...

BACKGROUND: Achievement of an ideal arterial substitute to be used in the reconstruction of small- and medium-caliber arteries is still the main objective of most scientific research studies developed in the area of vascular substitutes. Sugarcane biopolymer membrane could be extremely useful to perform vascular reconstruction in arteries with diameter smaller than 4 mm, allowing treatment of diseases that affect millions of people in Brazil and worldwide. OBJECTIVE: To evaluate the hemodynamic and histopathologic behavior of sugarcane biopolymer membrane when used as a patch in femoral artery angioplasty in dogs. METHOD: Eight adult mongrel dogs, under general anesthesia, underwent percutaneous Doppler velocimetry of the left and right femoral arteries for preoperative control at the Health Sciences Center Experimental Research Laboratory of Universidade Federal de Pernambuco. After being disinfected, the dogs underwent femoral artery patch angioplasty using a sugarcane membrane biopolymer patch on the left side and an expanded PTFE (e-PTFE) patch on the right side. The dogs underwent daily clinical evaluation for the first week and weekly thereafter. Clinical evaluation consisted of an examination of femoral artery pulses, gait assessment and verification as to whether there was any pulsatile tumor, bruising, hemorrhage or surgical wound infection. One hundred and eighty days after the angioplasties, percutaneous Doppler velocimetry of the femoral arteries was performed under general anesthesia. Next, the dogs underwent dissection of the femoral arteries, measurement of the arterial diameter and perioperative Doppler velocimetry proximally and distally to the artery angioplasty. Laparotomy was then performed to expose the abdominal aorta for angiographic access. The femoral artery segments with patches were harvested for histopathologic analysis, and the animals were sacrificed under a toxic dosage of anesthetic. RESULTS: At 180...

Arma branca retida em aorta abdominal superior / Retained blade in upper abdominal aorta

Abdominal aorta wounds carries a high immediate mortality. Few patients reach hospital care alive. There are no reports on Medline (1969-2002) about aortic wounds of foreign body with retention. A case with upper abdominal aortic wound with an inlaid blade is reported. The retained blade fixed the stomach to the surgical field, difficulting the vascular control, leading to an unconventional approach and allowing extensive contamination. The patient developed multiple organ dysfunction and died at fifth postoperative day. Singularities of an inlaid knife in upper abdominal aorta and changes in traditional approach are discussed. The authors assumed that the inlaid knife decreased the bleeding, allowing the patient arrival to the hospital, but worsened the approach to the aorta wound.