Your browser doesn't support javascript.
Show: 20 | 50 | 100
Results 1 - 20 de 108
Int. j. odontostomatol. (Print) ; 14(3): 373-379, 2020. tab, graf
Article in English | LILACS | ID: biblio-1114910


Benign oral vascular lesions are anomalies characterized by the blood vessels proliferation or malformation and the treatment with the sclerosing agent ethanolamine oleate acts irrigating the vessel producing a sterile inflammatory response. The objective of this study was to report and discuss the results from treatment of benign oral vascular lesions with non-diluted ethanolamine oleate through the analysis of clinical records. The sample was composed by the selection of twenty-six patients (12 male and 14 female), with oral vascular malformations. All lesions were treated with intralesional injections of undiluted ethanolamine oleate. These patients attended in Oral Medicine outpatient clinic of the Federal University of Paraná between the years of 2011 to 2015. The average age was 60.65 years, with a higher prevalence for women. The majority of the individuals had one lesion and its location was mostly in the lower lip. The main complaint was about a physical discomfort. The lesions had the average size of 6.52 mm and received a median number of 2.32 applications. Only one patient reported feeling pain in the postoperative week. In most cases the resolution of the lesion was considered partial. Follow-up was obtained up to one month after the end of treatment. The sclerotherapy with undiluted ethanolamine oleate shows acceptable results in the treatment of small benign oral vascular lesions with a few minor side effects.

Las lesiones vasculares orales benignas son anomalías caracterizadas por la proliferación o malformación de los vasos sanguíneos y el tratamiento con el agente esclerosante etanolamina oleato actúa irrigando el vaso produciendo una respuesta inflamatoria estéril. El objetivo de este estudio fue informar y discutir los resultados del tratamiento de lesiones vasculares orales benignas con oleato de etanolamina no diluido a través del análisis de historias clínicas. La muestra estuvo compuesta por la selección de veintiséis pacientes (12 hombres y 14 mujeres), con malformaciones vasculares orales. Todas las lesiones fueron tratadas con inyecciones intralesionales de oleato de etanolamina sin diluir. Estos pacientes acudieron a la clínica ambulatoria de Medicina Oral de la Universidad Federal de Paraná entre los años 2011 a 2015. La edad promedio fue de 60,65 años, con una mayor prevalencia para las mujeres. La mayoría de los individuos tenían una lesión y su ubicación era principalmente en el labio inferior. La queja principal era sobre una molestia física. Las lesiones tenían un tamaño promedio de 6,52 mm y recibieron una mediana de 2,32 aplicaciones. Solo un paciente informó haber sentido dolor en la semana postoperatoria. En la mayoría de los casos, la resolución de la lesión se consideró parcial. El seguimiento se obtuvo hasta un mes después del final del tratamiento. La escleroterapia con oleato de etanolamina sin diluir muestra resultados aceptables en el tratamiento de pequeñas lesiones vasculares orales benignas con algunos efectos secundarios menores.

Humans , Male , Female , Child , Adolescent , Adult , Middle Aged , Aged , Young Adult , Oleic Acids/administration & dosage , Sclerotherapy/methods , Ethanolamine/administration & dosage , Vascular Malformations/therapy , Mouth Diseases/therapy , Sclerosing Solutions/administration & dosage , Blood Vessels/abnormalities , Mouth Neoplasms/therapy , Injections, Intralesional , Follow-Up Studies , Treatment Outcome , Patient Satisfaction , Hemangioma/therapy , Lip/blood supply
An. bras. dermatol ; 94(5): 521-526, Sept.-Oct. 2019. tab, graf
Article in English | LILACS | ID: biblio-1054866


Abstract Background The use of monoethanolamine oleate 5% is effective for the treatment of vascular malformations with low blood flow. Objectives To report a case series of vascular malformations in the mouth and oral cavity treated with monoethanolamine oleate 5%. Methods A retrospective descriptive study was performed in electronic patient charts covering seven years. Patient demographics, diagnostic resources, lesion site, size, and number of applications of monoethanolamine oleate 5% were collected. Results A total of 21 vascular malformations were recorded, located mostly on the lower lip (52.3%) and resolved in a single application in 14 patients. The authors found 19 patients treated with sclerotherapy. Thirteen were women and six were men, with a mean age of 61 years. Study limitation Small sample size. Conclusions Sclerotherapy is an effective treatment for vascular malformations of the lips and oral cavity, with resolution after only one or two applications (n = 16).

Humans , Male , Female , Adult , Middle Aged , Aged , Aged, 80 and over , Young Adult , Sclerosing Solutions/administration & dosage , Oleic Acids/administration & dosage , Sclerotherapy/methods , Vascular Malformations/therapy , Mouth Diseases/therapy , Time Factors , Injections, Intralesional , Retrospective Studies , Treatment Outcome , Esthetics , Lip/blood supply , Lip/pathology , Mouth Diseases/pathology
J. vasc. bras ; 18: e20190049, 2019. graf
Article in Portuguese | LILACS | ID: biblio-1040373


A insuficiência venosa crônica (IVC) não só representa um prejuízo na qualidade de vida (QV), como também gera um ônus aos recursos de saúde pública. A escleroterapia ecoguiada com espuma (EEE) vem se mostrando uma boa opção, porém, seu real impacto na QV ainda é incerto. Apresentamos aqui os resultados dos primeiros 27 casos de um estudo prospectivo longitudinal não controlado para avaliação da clínica e QV submetidos a EEE em portadores de IVC CEAP C4 a C6 com contraindicação de cirurgia convencional, com avaliação seriada da clínica por meio do Venous Clinical Severity Score (VCSS) e da QV com o questionário Assessment of Burden Chronic Disease - Venous (ABC-V). Observamos redução do VCSS de 22,2% (p < 0,001) na primeira semana e do score ABC-V de 37,8% (p = 0,003) no primeiro trimestre

Chronic Venous Insufficiency (CVI) is not only detrimental to patients' Quality of Life (QoL) but also places a considerable burden on public health resources. Ultrasound guided foam sclerotherapy (USFS) is a good treatment option, but its effect on patients' QOL is still unclear. This article presents the results from the first 27 patients in a prospective, longitudinal, non-controlled study for evaluation of the clinical and QOL impact of USFS treatment for CEAP C4 to C6 grade CVI with contraindications for open surgery. Clinical symptoms were measured with the Venous Clinical Severity Score (VCSS) and QOL by the Assessment of Burden Chronic Disease - Venous questionnaire (ABC-V). We observed 22.2% reductions in VCSS (p<0.001) in the first week after the procedure, and a 37.8% reduction in ABC-V scores (p=0.03) over the first 3 months

Quality of Life , Venous Insufficiency/therapy , Sclerotherapy/adverse effects , Sclerotherapy/methods , Lower Extremity , Prospective Studies , Surveys and Questionnaires , Treatment Outcome , /therapeutic use
Clinics ; 74: e704, 2019. tab, graf
Article in English | LILACS | ID: biblio-1019706


OBJECTIVES: This pilot study investigated the safety and efficacy of a novel shunt surgery combined with foam sclerotherapy of varices in patients with prehepatic portal hypertension. METHODS: Twenty-seven patients who were diagnosed with prehepatic portal hypertension and underwent shunt surgeries were divided into three groups by surgery type: shunt surgery alone (Group A), shunt surgery and devascularization (Group B), and shunt surgery combined with foam sclerotherapy (Group C). Between-group differences in operation time, intraoperative blood loss, portal pressure decrease, postoperative complications, rebleeding rates, encephalopathy, mortality rates and remission of gastroesophageal varices were compared. RESULTS: Groups A, B and C had similar operation times, intraoperative bleeding, and portal pressure decrease. The remission rates of varices differed significantly (p<0.001): one patient in Group A and 6 patients in Group B had partial response, and all 9 patients in Group C had remission (2 complete, 7 partial). Two Group A patients and one Group B patient developed recurrent gastrointestinal bleeding postoperatively within 12 months. No postoperative recurrence or bleeding was observed in Group C, and no sclerotherapy-related complications were observed. CONCLUSIONS: Shunt surgery combined with foam sclerotherapy obliterates varices more effectively than shunt surgery alone does, decreasing the risk of postoperative rebleeding from residual gastroesophageal varices. This novel surgery is safe and effective with good short-term outcomes.

Humans , Male , Female , Child , Adolescent , Adult , Middle Aged , Young Adult , Esophageal and Gastric Varices/surgery , Sclerotherapy/methods , Hypertension, Portal/surgery , Postoperative Complications , Sclerotherapy/adverse effects , Pilot Projects , Retrospective Studies , Postoperative Hemorrhage/etiology , Gastrointestinal Hemorrhage/etiology , Intraoperative Complications
Rev. Assoc. Med. Bras. (1992) ; 64(12): 1117-1121, Dec. 2018. tab
Article in English | LILACS | ID: biblio-976808


SUMMARY OBJECTIVE: We aimed to evaluate the efficacy of liquid or foam sclerotherapy of varicose veins using venous clinical severity scores and possible complications. METHODS: A total of 318 patients (268 females, 50 males) who were treated with liquid or foam sclerotherapy between January 2012 and December 2012 were included in this study. RESULTS: Skin necrosis was observed in only 6 patients (1. 8%), thrombophlebitis in 10 patients (3. 1%), and hyperpigmentation in 18 patients (5. 6%) in this study group. The mean venous clinical severity score was calculated as: pain score, 1. 23 ± 0.88; varicose vein score,1.85 ± 0. 8; edema score, 0.64 ± 0.77). Pain and edema decreased at the control examination, 1 month after completion of sclerotherapy sessions. Varicose veins completely disappeared after sclerotherapy. While the decrease in edema in the foam sclerotherapy group was significantly less (P<0.001), the decline in pain showed an increasing trend (P=0.069). While skin necrosis did not develop after foam sclerotherapy, rates of pigmentation and local thrombophlebitis were similar (P>0.05). CONCLUSION: In conclusion, we observed that both sclerotherapy methods are effective with a low rate of complications, alleviating the complaints of patients with small varicose veins, and providing considerable improvement in venous clinical severity scores.

RESUMO OBJETIVO: Nosso objetivo foi avaliar a eficácia de líquido ou espuma na escleroterapia de varizes por meio de escores de gravidade clínica venosa e possíveis complicações. MÉTODOS: Um total de 318 pacientes (268 do sexo feminino, 50 do sexo masculino) tratados com escleroterapia com espuma ou líquido entre janeiro de 2012 e dezembro de 2012 foi incluído neste estudo. RESULTADOS: Necrose da pele foi observada em apenas seis pacientes (1,8%), tromboflebite em dez pacientes (3,1%) e hiperpigmentação em 18 pacientes (5,6%) neste grupo de estudo. A média do escore de gravidade clínica venosa foi calculado como: dor pontuação 1,23±0,88, veia varicosa pontuação 1,85±0,8, edema pontuação 0,64±0,77. Dor e edema reduzido no exame de controle um mês após a conclusão das sessões de escleroterapia. Varizes desapareceram completamente após a escleroterapia. Enquanto a diminuição do edema no grupo de escleroterapia com espuma foi significativamente menor (P<0,001), o decréscimo do nível de dor mostrou uma tendência a ser maior (P=0,069). Ainda que necrose da pele não tenha se desenvolvido após escleroterapia com espuma, as taxas de pigmentação e tromboflebite local foram semelhantes (P>0,05). CONCLUSÃO: Observou-se que ambos os métodos de escleroterapia são eficazes, com baixa taxa de complicações, aliviando as queixas de pacientes com varizes pequenas, e proporcionando uma melhora considerável nos escores de gravidade clínica venosa.

Humans , Male , Female , Adolescent , Adult , Young Adult , Varicose Veins/therapy , Sclerotherapy/methods , Varicose Veins/complications , Severity of Illness Index , Pain Measurement , Sclerotherapy/adverse effects , Retrospective Studies , Treatment Outcome , Pain, Procedural , Middle Aged
J. vasc. bras ; 17(4): 341-347, out.-dez. 2018. ilus
Article in Portuguese | LILACS | ID: biblio-969241


A escleroterapia continua sendo um dos procedimentos mais executados pelos cirurgiões vasculares brasileiros. O conhecimento das suas complicações é imprescindível para que possamos evitá-las. Os efeitos colaterais graves desse método de tratamento para as telangiectasias dos membros inferiores são raros e frequentemente associados a um erro técnico ou à dosagem injetada. São predominantemente locais, apresentando-se, algumas vezes, como uma situação de difícil resolução. Relatamos um caso de formação de necrose cutânea após escleroterapia química com glicose hipertônica (75%) e sua cicatrização utilizando preparação tópica contendo vaselina e glicose 60%, cujo resultado estético foi satisfatório

Sclerotherapy remains one of the procedures most frequently performed by Brazilian vascular surgeons. Knowledge of its complications is indispensable to enable us to avoid them. The severe side effects of this method of treatment for telangiectasias of the lower limbs are rare and are often associated with technical errors or the dose injected. Complications are predominantly local, but are sometimes difficult to resolve. We report a case of formation of cutaneous necrosis after chemical sclerotherapy using hypertonic glucose (75%), which healed when treated with a topical preparation containing vaseline and 60% glucose, with satisfactory esthetic results

Humans , Female , Middle Aged , Telangiectasis/diagnosis , Glucose , Necrosis/complications , Petrolatum/therapeutic use , Sclerosing Solutions/therapeutic use , Skin Ulcer/diagnosis , Skin Ulcer/therapy , Varicose Veins/therapy , Wound Healing , Fibrosis , Sclerotherapy/methods , Echocardiography, Doppler, Color/methods , Lower Extremity , Erythema
Rev. méd. Chile ; 145(10): 1336-1341, oct. 2017. tab, graf
Article in Spanish | LILACS | ID: biblio-902448


Management of gastrointestinal bleeding caused by fundal varices is particularly difficult to manage. The options are: transjugular intrahepatic portosystemic shunt (TIPS), endoscopic injection of cyanoacrylate or balloon-occluded retrograde transvenous obliteration (BRTO). We report a 63 year-old male with a cirrhosis caused by hepatitis C and a 66 year-old female with a cirrhosis caused by a non-alcoholic steatohepatitis. Both patients had a gastrointestinal bleeding caused by fundal varices and were treated with sclerotherapy with cyanoacrylate assisted with BRTO. Flow was interrupted in the gastro-renal shunt by a femoral access in both patients. The male patient had a new bleeding two months later and died. In the female patient an endosonography performed nine months after the procedure showed absence of remaining varices.

Humans , Male , Female , Middle Aged , Aged , Esophageal and Gastric Varices/therapy , Sclerotherapy/methods , Cyanoacrylates/therapeutic use , Balloon Occlusion/methods , Gastrointestinal Hemorrhage/therapy , Portal Vein , Portacaval Shunt, Surgical , Esophageal and Gastric Varices/complications , Reproducibility of Results , Treatment Outcome , Fatal Outcome , Gastrointestinal Hemorrhage/etiology , Liver Cirrhosis/complications
J. vasc. bras ; 16(4): f:270-l:275, out.-dez. 2017. ilus
Article in Portuguese | LILACS | ID: biblio-880665


Contexto: Úlceras são a resultante final de varizes associadas a refluxo de veias safenas. Objetivo: Demonstrar a possibilidade de associar dois procedimentos, a escleroterapia com espuma de veias safenas e o enxerto de pele parcial, para o tratamento de pacientes com úlceras venosas relacionadas a refluxo de veias safenas. Métodos: Foram tratados 20 membros em 20 pacientes, todos com ulcerações relacionadas a refluxo de veias safenas. Realizamos o enxerto de pele expandida, seguido da escleroterapia ecoguiada com espuma de polidocanol nas veias associadas às úlceras, através de punção ou dissecção da veia. Resultados: Em todos os casos, houve melhora dos sintomas relacionados à úlcera e cicatrização da lesão. Em 11 casos, obtivemos a viabilidade do enxerto de pele por completo; em quatro casos, houve cicatrização de cerca de 50% da lesão; e nos cinco casos restantes, houve cicatrização de aproximadamente 75% da lesão. A primeira ultrassonografia de controle revelou esclerose completa dos vasos tratados em 19 dos 20 casos e esclerose parcial sem refluxo detectável em um caso. Na segunda ultrassonografia, realizada após 45 dias, observamos esclerose completa de 15 casos; em cinco casos, houve esclerose parcial, dos quais três sem refluxo detectável e dois com refluxo em segmentos isolados associados a varizes. A complicação mais frequente foi a pigmentação nos trajetos venosos, observada em 13 pacientes. Um caso apresentou trombose assintomática de veias musculares da perna. Conclusão: Essa associação de procedimentos consiste em uma opção válida com potencial para promover um tratamento mais breve e de menor custo

Background: Ulcers are the end result of varicose veins associated with reflux in saphenous veins. Objective: To demonstrate the possibility of combining two procedures, foam sclerotherapy of saphenous veins and skin grafting, to treat patients with venous ulcers related to reflux in saphenous vein. Methods: 20 limbs were treated in 20 patients. All patients had ulcers related to saphenous vein reflux. We performed the grafting with expanded skin, followed by administration of ultrasound guided polidocanol foam sclerotherapy in veins associated with ulcers, accessed by puncture or dissection of the vein. Results: In all cases there was improvement of ulcer-related symptoms and healing of the lesion. In 11 cases we achieved full skin grafting viability. In four cases there was healing of about 50% of the lesion and in the other five cases approximately 75% of the lesion healed. The first control ultrasonographic examination revealed complete sclerosis of the vessels treated in 19 of 20 cases, with partial sclerosis in one case, but no detectable reflux. The second ultrasonographic examination performed at 45 days showed complete sclerosis in 15 cases. In five cases there was partial sclerosis, without detectable reflux in three and with reflux in isolated segments associated with varicose veins in two. The most common complication was pigmentation along vein paths, observed in 13 patients. In one case there was asymptomatic thrombosis of muscle veins of the leg. Conclusion: This combination of procedures is a valid option, with the potential to provide quicker and less expensive treatment

Humans , Male , Female , Saphenous Vein/surgery , Sclerotherapy/methods , Skin Transplantation/methods , Varicose Ulcer/therapy , Dissection/methods , Leg Ulcer/therapy , Lower Extremity/surgery , Treatment Outcome , Varicose Veins/therapy
Rev. Col. Bras. Cir ; 44(5): 511-520, Sept.-Oct. 2017.
Article in English | LILACS | ID: biblio-896620


ABSTRACT Chronic venous insufficiency is characterized by cutaneous alterations caused by venous hypertension; in severe forms, it progresses to lower limb ulcers. Lower limb varicose veins are the main cause of chronic venous insufficiency, and the classic treatment includes surgery and compressive therapy. Minimally invasive alternative treatments for varicose veins include new techniques such as venous thermal ablation using laser or radiofrequency. The use of different methods depends on clinical and anatomical factors. Ultrasound-guided foam sclerotherapy is the venous injection of sclerosing foam controlled by Doppler ultrasound. Sclerotherapy is very useful to treat varicose veins, and probably, is cheaper than other methods. However, until the present, it is the less studied method.

RESUMO A insuficiência venosa crônica é caracterizada por alterações cutâneas decorrentes da hipertensão venosa que, nas formas graves, evoluem com úlceras nos membros inferiores. As varizes dos membros inferiores são a causa mais frequente de insuficiência venosa crônica, que tem como tratamentos clássicos a cirurgia de varizes e a terapia compressiva. Novas técnicas de termo-ablação venosa por laser e radiofrequência são alternativas minimamente invasivas para o tratamento de varizes. A aplicabilidade dos diferentes métodos é limitada por requisitos anatômicos e clínicos. A escleroterapia ecoguiada com espuma consiste na injeção endovenosa da espuma esclerosante monitorada pelo Ultrassom Doppler. A escleroterapia tem grande aplicabilidade para tratamento das varizes e, provavelmente, é mais barato que outros métodos. Entretanto é, até o momento, o método menos estudado.

Humans , Venous Insufficiency/therapy , Venous Insufficiency/diagnostic imaging , Sclerotherapy/methods , Ultrasonography, Interventional , Severity of Illness Index , Chronic Disease
An. bras. dermatol ; 92(4): 484-491, July-Aug. 2017. tab, graf
Article in English | LILACS | ID: biblio-887013


Abstract: Background: Varicose veins and the complications of venous disease are common disorders in humans. Objective: To study the effects of bleomycin as a potential new sclerosing agent and its adverse events in treating varicose veins. Methods: Bleomycin-loaded liposomes 0.1ml was injected in the dorsal ear veins of white New Zealand rabbits. Sodium tetradecyl sulfate was used as a positive control. Normal saline was used as negative control. The blood vessels of the treated ears were photographed before and at one hour and two, eight and 45 days after treatment. Biopsies from the treated areas were obtained for histological examination. Blood samples were collected to determine any possible toxicity. Results: Bleomycin by itself was ineffective; therefore, liposomes were used as a vector to deliver bleomycin to the vein lumen. Subsequently, bleomycin started showing its sclerosing effects. Toxicity monitoring showed no apparent hematologic, pulmonary, hepatic or renal toxicities. This study revealed that bleomycin induced vasculitis, which led to vascular occlusion, which was observed on day 1 and day 8. No bleomycin-related injury was noted by histopathological examination of lung sections. The calculation of the lung/body weight coefficient indicated that edema was present in the experimental groups compared with the negative and positive controls. Study limitations: Relatively small number of experimental animals used. Conclusions: This study showed that bleomycin-loaded liposomes were able to induce vasculitis and vascular occlusion without any toxicity or complications. It might be useful, hence, to treat patients suffering from Varicose veins and other ectatic vascular diseases with this agent.

Animals , Rabbits , Sclerosing Solutions/pharmacology , Sodium Tetradecyl Sulfate/administration & dosage , Varicose Veins/therapy , Bleomycin/pharmacology , Sclerotherapy/methods , Antibiotics, Antineoplastic/administration & dosage , Sclerosing Solutions/administration & dosage , Sclerosing Solutions/adverse effects , Vasculitis/chemically induced , Vasculitis/drug therapy , Veins/drug effects , Bleomycin/administration & dosage , Disease Models, Animal , Drug Evaluation, Preclinical , Injections, Intravenous , Liposomes
J. vasc. bras ; 16(3): f:239-l:243, jul.-set. 2017. ilus, graf
Article in Portuguese | LILACS | ID: biblio-877019


Contexto: A escleroterapia com espuma de polidocanol guiada por ultrassom tem sido utilizada no tratamento de pacientes com úlceras venosas. É um procedimento minimamente invasivo e de fácil execução, porém apresenta taxas de recidiva elevadas. Objetivos: Relatar a evolução a curto e médio prazo de pacientes com úlcera venosa tratados com escleroterapia com espuma de polidocanol guiada por ultrassom. Métodos: Foram reavaliados 19 pacientes submetidos ao tratamento de escleroterapia com espuma de polidocanol guiada por ultrassom no período de janeiro de 2013 a dezembro de 2014. Foram analisados tempo de cicatrização da úlcera, melhora de sintomas clínicos, recanalização das veias tratadas, recidiva dos sintomas e da úlcera venosa. Resultados: Foram analisados 15 pacientes do sexo feminino (78,9%) e quatro do sexo masculino (21,1%). A média geral de idade foi de 53 anos. O tempo de seguimento dos pacientes variou de 448 dias a 1.276 dias (média de 791 dias). O tempo médio de presença das úlceras foi de 53 meses. Na avaliação pós-procedimento, foram observadas recanalização total em 15,7%, recanalização parcial em 21% e oclusão em 47,3% das veias tratadas. Apenas em um caso foi observada recidiva da úlcera. Pela avaliação das médias do Venous Clinical Severity Score (VCSS), houve diferença significativa antes e após o procedimento, com variação entre os grupos de 11,2 (p < 0,01). Conclusões: A escleroterapia por espuma guiada por ultrassom apresenta altas taxas de sucesso terapêutico, com índices de cicatrização de úlceras venosas elevados

Background: Ultrasound-guided polidocanol foam sclerotherapy is used to treat patients with venous ulcers. It is a minimally invasive procedure and is simple to perform, but it has high relapse rates. Objectives: To report short to medium term results in patients with venous ulcers treated using ultrasound-guided polidocanol foam sclerotherapy. Methods: A sample of 19 patients who had been treated with ultrasound-guided polidocanol foam sclerotherapy between January 2013 and December 2014 were followed-up. Time taken for ulcers to heal, improvement of clinical symptoms, recanalization of treated veins, and relapse of symptoms and of venous ulcers were analyzed. Results: Fifteen of the patients analyzed were female (78.9%) and four were male (21.1%). Overall mean age was 53 years. Follow-up times ranged from 448 days to 1,276 days (mean of 791 days). The mean duration of active ulcers was 53 months. At postoperative follow-up assessments, total recanalization was observed in 15.7%, partial recanalization in 21%, and occlusion in 47.3% of the veins that had been treated. There was only one case of ulcer relapse. Analysis of mean Venous Clinical Severity Scores (VCSS) revealed a significant difference from before to after the procedure, with a variation of 11.2 (p < 0.01). Conclusions: Ultrasound-guided foam sclerotherapy has high rates of therapeutic success and achieves high rates of venous ulcer healing

Humans , Male , Female , Lower Extremity , Patients , Sclerotherapy/methods , Ultrasonics/methods , Varicose Ulcer/therapy , Diagnosis , Epidemiology, Descriptive , Health Profile , Lower Extremity , Prevalence , Quality of Life , Recurrence , Risk Factors , Saphenous Vein/physiopathology , Treatment Outcome , Ultrasonography, Doppler/methods , Venous Insufficiency/etiology , Venous Insufficiency/physiopathology
Medicina (B.Aires) ; 76(6): 373-375, dic. 2016. ilus
Article in Spanish | LILACS | ID: biblio-841613


Las várices gástricas están presentes en cerca de un tercio de los pacientes con hipertensión portal y el sangrado de las mismas representa una causa significativa de mortalidad. El tratamiento de primera línea es la obturación con N-butil-2-cianoacrilato, que si bien es seguro no está libre de complicaciones. Presentamos el caso de un paciente de 61 años de edad con antecedente de cirrosis criptogénica que se presentó a la consulta febril, taquicárdico e hipoxémico después de la obturación endoscópica con N-butil-2-cianoacrilato. Las imágenes mostraron embolia pulmonar bilateral del material obturante. El objetivo de este trabajo es destacar las manifestaciones clínicas y las imágenes de esta situación para ayudar a su diagnóstico precoz y diferenciarla de otras entidades que requieren un tratamiento específico.

Gastric varices occur in one-third of patients with portal hypertension. Bleeding from gastric varices remains a significant cause of death. Currently the first-line of treatment for gastric varices is endoscopic obliteration with N-butyl-2-cyanoacrylate. Though relatively safe, this option has several well-known complications. We report the case of a 61-year-old male patient with cryptogenic cirrhosis, who presented with fever, tachycardia and hypoxemia after endoscopic obliteration with N-butyl-2-cyanoacrylate. Radiographic findings were consistent with pulmonary embolism of the sclerosing substance. The aim of this case report is to emphasize the clinical and radiological findings of this complication in order to distinguish it from other similar medical conditions and prevent a delay in diagnosis.

Humans , Male , Middle Aged , Pulmonary Embolism/etiology , Sclerosing Solutions/adverse effects , Esophageal and Gastric Varices/therapy , Enbucrilate/adverse effects , Pulmonary Embolism/diagnostic imaging , Angiography , Tomography, X-Ray Computed , Sclerotherapy/adverse effects , Sclerotherapy/methods , Gastroscopy/adverse effects , Gastroscopy/methods , Injections
Rev. bras. cir. plást ; 31(3): 405-416, 2016. tab
Article in English, Portuguese | LILACS | ID: biblio-2313


INTRODUÇÃO: Conduziu-se revisão sistemática retrospectiva da literatura incluindo estudos relatando o uso de picibanil para tratar malformações linfáticas (ML). MÉTODOS: A pesquisa foi realizada com estudos publicados no PubMed de janeiro de 1990 a 14 de abril de 2013. Na estratégia de busca, usou-se os descritores "OK-432" ou "Picibanil" e "lymphatic malformation". Os seguintes elementos foram comparados aos de outras modalidades relatadas e, então, compilados: mecanismo de ação, indicações, contraindicações, eficácia, administração, efeitos colaterais, complicações, vantagens e desvantagens. RESULTADOS: Foram encontrados 44 estudos, 27 dos quais atenderam aos critérios de inclusão. O picibanil é uma preparação liofilizada de uma cepa de baixa virulência de Streptococcus pyogenes inativada pela penicilina G. Seu mecanismo de ação ainda não definido claramente, mas especula-se que provoque uma resposta inflamatória controlada com adesão das paredes dos cistos. O picibanil é indicado quase que unanimemente para o tratamento da ML macrocística, cuja resposta é mais efetiva do que em lesões microcísticas ou mistas. Em geral, o picibanil é administrado por meio de punção com visualização direta ou guiada por ultrassonografia, com o paciente sob anestesia geral. A preparação comumente utilizada consiste em 0,1 mg de picibanil em 10 ml de soro fisiológico. Os efeitos colaterais são, em geral, leves; sendo dor, inchaço e febre os mais frequentemente relatados. CONCLUSÃO: Os estudos apresentam pouca evidência científica. A revisão sistemática identificou que o picibanil é útil no tratamento da ML de qualquer tipo, mas tem resultados melhores em lesões macrocísticas. A eficácia foi comparável à de outras terapias. Não foi apresentada nenhuma contraindicação específica. Embora o mecanismo de ação ainda não tenha sido determinado, o picibanil trata-se de opção de tratamento.

INTRODUCTION: We performed a retrospective systematic review of studies reporting the use of Picibanil for treatment of lymphatic malformations (LMs). METHODS: We searched the PubMed database for available studies, including those published between January 1990 and April 14, 2013. The search strategy involved the use of the keywords "OK-432" or "Picibanil" and "lymphatic malformation." Information was compiled regarding the reported mechanism of action, indications, contraindications, efficacy, administration, side effects, complications, and advantages and disadvantages compared to those of other modalities. RESULTS: Forty-four studies were found, of which 27 fulfilled the inclusion criteria. Picibanil is a lyophilized preparation of a low-virulence strain of Streptococcus pyogenes inactivated with penicillin G. Its mechanism of action is unclear, but it has been speculated that it causes a controlled inflammatory response with adhesion of cyst walls. Picibanil is almost unanimously indicated for the treatment of macrocystic LMs, which show a greater effectiveness response compared to that shown by microcystic or mixed LMs. Picibanil is usually administered by puncturing, either with direct visualization or guided by ultrasound, with the patient under general anesthesia. The most widely used preparation comprises 0.1 mg of Picibanil in 10 mL of saline. Side effects are mostly mild, with pain, swelling, and fever being the most frequently reported. CONCLUSION: The studies had low scientific evidence. A systematic review found that Picibanil is useful against any LM, with better results in macrocystic lesions. Efficacy was comparable to that of other therapies. No specific contraindication was presented. Although the mechanism of action has not been established, the inclusion of Picibanil as a treatment option is warranted.

Humans , History, 21st Century , Picibanil , Streptococcus pyogenes , Therapeutics , Sclerotherapy , Efficacy , Treatment Outcome , Infusions, Intralesional , Lymphatic Abnormalities , Systematic Review , Lymphoid Tissue , Picibanil/adverse effects , Picibanil/therapeutic use , Picibanil/pharmacology , Streptococcus pyogenes/drug effects , Streptococcus pyogenes/pathogenicity , Therapeutics/adverse effects , Therapeutics/methods , Sclerotherapy/adverse effects , Sclerotherapy/methods , Efficacy/methods , Infusions, Intralesional/adverse effects , Infusions, Intralesional/methods , Lymphatic Abnormalities/complications , Lymphatic Abnormalities/pathology , Lymphatic Abnormalities/therapy , Lymphoid Tissue/abnormalities , Lymphoid Tissue/growth & development , Lymphoid Tissue/pathology
Rev. Salusvita (Online) ; 35(1): 85-93, 2016. ilus
Article in Portuguese | LILACS | ID: lil-788582


Introdução: o hemangioma oral é um tumor vascular benigno caracterizado pela proliferação de vasos sanguíneos. Apresenta-se normalmente como mancha ou nódulo arroxeado, cuja coloração varia do vermelho intenso ao roxo, de acordo com a localização e a profundidade no tecido. As principais queixas dos pacientes portadores de hemangiomas são relacionadas ao distúrbio estético, interferências na função mastigatória e, se estiver em área susceptível a trauma, ao risco de hemorragias. O tratamento pode ser através de uma excisão cirúrgica, bem como métodos menos invasivos como a escleroterapia por fármacos, a laserterapia e a crioterapia. Objetivo: relatar um caso de escleroterapia de hemangiomaoral em mucosa jugal tratado no Serviço de Diagnóstico Histopatológico do Curso de Odontologia da Universidade do Vale do Itajaí. Método: o tratamento preconizado foi a escleroterapia pelo fármaco oleato de monoetanolamina a 5% diluído em soro fisiológico, em três aplicações intralesionais. Resultado e conclusão: a terapia esclerosante descrita apresentou-se como técnica segura e confortável ao paciente, tanto economicamente quanto clinicamente, quando utilizada com um correto diagnóstico.

Introduction: oral hemangioma is a benign vascular tumor characterized by proliferation of blood vessels. Usually appears as purplish spot or nodule, whose color ranges from deep red to purple, according to the location and depth in the tissue. The main complaints of patients with hemangiomas are related to the esthetic disturbance, interference with chewing and if it is located in an area prone to trauma, the risk of bleeding. Treatment can be by surgical excision as well as less invasive methods such as sclerotherapy by drugs, laser therapy and criotherapy. Objective: to report a case of sclerotherapy of an oral hemangioma in the oral mucosa treated in the Diagnostic Histopathology Service of the Dental School at the University of Vale do Itajai. Method: the treatment of the sclerotherapy was done using 5% ethanolamine oleate diluted in saline solution in three intralesional applications. Result and conclusion: sclerosing therapy applied to oral hemangiomas shows up a safe and comfortable technique to the patient both economically and clinically when used consistently with a correct diagnosis.

Humans , Male , Middle Aged , Hemangioma/diagnosis , Hemangioma/therapy , Sclerotherapy/methods
J. vasc. bras ; 14(3): 258-261, July-Sep. 2015. graf
Article in Portuguese | LILACS | ID: lil-763080


A escleroterapia com espuma guiada por ultrassom tem ganhado espaço no tratamento da insuficiência venosa crônica secundária a varizes dos membros inferiores. Trata-se de procedimento ambulatorial, de baixo custo e sem necessidade de afastamento das atividades habituais. Apresenta bons resultados clínicos, especialmente nos estágios mais avançados da doença. Quando bem aplicada, apresenta baixas taxas de complicações maiores. Porém, a técnica apresenta altas taxas de recanalização no médio e longo prazo, e seu mecanismo ainda não é totalmente compreendido. O presente artigo descreve um caso de fístula arteriovenosa em segmento de recanalização de veia safena magna, após escleroterapia com espuma guiada por ultrassom, e identificada por exame ultrassonográfico de vigilância pós-procedimento.

Ultrasound-guided foam sclerotherapy has become widespread in the treatment of chronic venous insufficiency secondary to varicose veins. It is a low-cost, outpatient procedure that does not require medical leave. It has demonstrated good clinical results, especially in the more advanced stages of the disease. When employed correctly, it results in low rates of major complications. However, the technique exhibits high recanalization rates over mid and long-term follow up. Additionally, the recanalization mechanism has not yet been explained. This article describes an arteriovenous fistula in a recanalized segment of great saphenous vein previously treated with ultrasound-guided foam sclerotherapy that was detected during post-procedure follow-up with ultrasound.

Humans , Female , Aged, 80 and over , Arteriovenous Fistula/drug therapy , Venous Insufficiency/therapy , Sclerotherapy/methods , Lower Extremity , Time Factors , Ultrasonography, Interventional , Ultrasonography, Doppler/methods
J. vasc. bras ; 14(2): 145-152, Apr.-June 2015. tab, ilus
Article in English | LILACS | ID: lil-756464


BACKGROUND: Ultrasound-guided foam sclerotherapy plays a major role in treatment of chronic venous insufficiency, providing clinical and hemodynamic improvement to patients undergoing treatment.OBJECTIVES: To examine the relationships between venous refilling time and impact of venous disease on quality of life and between changes in venous refilling time and improvement of symptoms after ultrasound-guided foam sclerotherapy for chronic venous insufficiency. METHODS: Thirty-two patients classified as C4, C5 or C6 answered a questionnaire on quality of life and symptoms and their venous filling time was measured using photoplethysmography before and 45 days after treatment of chronic venous insufficiency with ultrasound-guided foam sclerotherapy.RESULTS: Statistically significant improvements were observed in quality of life scores and in venous filling time and in the following symptoms: aching, heavy legs, restless legs, swelling, burning sensations, and throbbing (p<0.0001). A similar improvement was also seen in the work and social domains of quality of life (p<0.0001).CONCLUSIONS: As confirmed by questionnaire scores and venous refilling times, ultrasound-guided foam sclerotherapy demonstrated efficacy and resulted in high satisfaction levels and low rates of major complications.

CONTEXTO: A escleroterapia com espuma guiada por ultrassom (EGUS) ocupa lugar de destaque no tratamento da insuficiência venosa crônica (IVC), proporcionando melhora clínica e hemodinâmica aos pacientes submetidos ao tratamento.OBJETIVOS: Verificar a correlação entre dados obtidos por questionário de qualidade de vida e de sintomas com dados obtidos por fotopletismografia (FPG), antes e depois do tratamento por escleroterapia com espuma guiada por ultrassom (EGUS) da insuficiência venosa crônica (IVC). MÉTODOS: Um grupo de 32 pacientes, classificados como C4, C5 e C6, foi submetido à aplicação de questionário de qualidade de vida e sintomas, sendo aferido o tempo de enchimento venoso (TEV) por FPG antes e 45 dias depois do tratamento da IVC através de EGUS. O teste do sinal foi utilizado para análise estatística da melhora dos escores dos questionários e do TEV. O teste de McNemar foi utilizado para avaliação da melhora nos sintomas e do impacto do tratamento nas atividades laborais e sociais dos pacientes.RESULTADOS: Houve melhora nos escores dos questionários de qualidade de vida e no TEV, com significância estatística (p<0,0001). Houve melhora estatisticamente significativa nos sintomas: dor, cansaço, edema, queimação, pernas inquietas e latejamento (p<0,0001). Incremento na qualidade laboral e social após o tratamento apresentou melhora estatisticamente significativa (p<0,0001). Não ocorreram complicações maiores ou efeitos adversos nesta série.CONCLUSÕES: A EGUS mostrou-se eficaz, com alto índice de satisfação e baixas taxas de complicacões maiores, ratificada pelos escores dos questionários e pelos TEVs aferidos pela FPG.

Humans , Male , Female , Middle Aged , Sclerotherapy/methods , Photoplethysmography/methods , Venous Insufficiency/therapy , Quality of Life , Lower Extremity , Surveys and Questionnaires , Statistical Analysis , Sclerosing Solutions/therapeutic use , Ultrasonography, Doppler, Color/methods , Varicose Veins
J. vasc. bras ; 14(2): 153-160, Apr.-June 2015. tab, ilus
Article in English | LILACS | ID: lil-756467


BACKGROUND: The lower limb edema observed in normal people at the end of their working days can vary in intensity and frequency depending on the predominant working positions required to perform different jobs. OBJECTIVES: To compare lower limb volumes of volunteers allocated to three study groups, depending on the predominant positions in which they work. METHODS: Volumetric assessments were conducted of both lower limbs of 51 people free from vascular disease, allocated to three groups of 17 individuals each by predominant working position: sitting, static standing or alternating between the two. Volumes were measured at the start and at the end of the working day and the differences in volumes were calculated for each group. Means and frequencies were compared using appropriate inferential statistics and correlation coefficients were calculated. RESULTS: The groups were homogenous in terms of sex distribution, age, skin color and BMI. The volumetric data from measurements taken before starting work revealed significant differences between all three groups. Volunteers who predominantly worked sitting down had largest volumes, followed by those who remained standing for long periods and then those who varied between these positions. The frequency of lower limb volume increase > 100 mL was significantly higher in the group of people who worked sitting down and maintained this position for long periods. CONCLUSIONS: Postural edema is more common among people who work sitting down for long periods, among whom it appears that there is a cumulative effect from the position, since they exhibit larger lower limb volumes at the start of the day.

CONTEXTO: O edema de membros inferiores (MMII) de indivíduos normais, que se observa ao final da jornada de trabalho, pode ser mais intenso e frequente conforme a postura laboral prevalente no exercício da profissão. OBJETIVOS: Comparar os volumes dos MMII de indivíduos alocados em três grupos, conforme a postura laboral prevalente adotada ao longo do dia trabalho.MÉTODOS: Realizadas avaliações volumétricas de ambos os MMII de 51 indivíduos sem doença vascular, que foram alocados em três grupos de 17 indivíduos, considerando a postura prevalente: sentada, ortostática estática e alternada. As volumetrias foram realizadas no início e no término do dia trabalhado, e calculou-se a diferença dos volumes aferidos em cada grupo. Foram utilizadas as estatísticas inferenciais adequadas para comparações de médias e de frequências, e para determinação de coeficientes de correlação.RESULTADOS: Os grupos se mostraram homogêneos em relação a gênero, idade, grupo étnico e IMC. Dados das volumetrias realizadas no início do dia revelaram diferenças significativas entre os três grupos, indicando maiores volumes em indivíduos que trabalham predominantemente sentados, seguidos daqueles que trabalham em pé e dos que alternam essas posições. A frequência de MMII com aumento de volume > 100 mL foi significativamente maior no grupo dos que trabalham sentados, adotando essa posição por longo tempo.CONCLUSÕES: O edema postural é mais frequente naqueles que trabalham sentados por longo tempo, nos quais parece ocorrer, inclusive, efeito cumulativo dessa postura, já que apresentam volumes significativamente maiores já ao início do dia.

Humans , Male , Female , Middle Aged , Edema , Venous Insufficiency/complications , Lower Extremity , Occupational Health , Posture/physiology , Body Mass Index , Ethnic Groups , Sclerotherapy/methods , Statistical Analysis , Varicose Veins/complications , Varicose Veins/diagnosis , Working Conditions
Rev. chil. pediatr ; 85(6): 714-719, dic. 2014. ilus
Article in Spanish | LILACS | ID: lil-734813


Lymphangiomas are a common form of vascular malformation of the lymphatic vessels, mainly in the head and neck region. Most cases are progressive evolution and require a multidisciplinary approach. Currently, the first therapeutic option is sclerotherapy, leaving surgery for the treatment of remaining lesions. Objective: To present a case of facial lymphatic malformation (LM) treated with sclerotherapy, surgery and orthodontics in a 15-year follow up. Case report: A one-year-old female patient who consulted health professionals due to a progressive volume increase of the soft parts of her right cheek. The imaging study confirmed the diagnosis of microcystic lymphatic malformation. It was managed with OK-432 sclerotherapy and Bleomycin. At 2 years of age, the patient response was considered adequate; an intralesional submandibular surgical excision was then performed, with partial resection of the lesion. The biopsy confirmed the diagnosis of microcystic LM. Six months after, a re-resection was planned using the same approach and removing the remaining lesion, with favorable development until the age of 9 years when the patient required surgery and orthodontic management due to intraoral recurrence. No major developments until the age of 13 when a new orthodontic surgery and handling are planned to perform right oral commissure suspension. Conclusion: LM management by sclerotherapy, surgery, and orthodontics has shown the advantages of a multidisciplinary long-term treatment in this case.

El linfangioma corresponde a una malformación vascular de los vasos linfáticos, preferentemente de la región de cabeza y cuello. La mayoría de los casos son de evolución progresiva y requieren un manejo multidisciplinario. Actualmente la primera opción terapéutica es la esclerosis, reservando la cirugía para el tratamiento de las lesiones remanentes. Objetivo: Presentar un caso de malformación linfática (ML) facial, tratado con escleroterapia, cirugía y ortodoncia en un seguimiento a 15 años. Caso clínico: Paciente de sexo femenino que consulta al año de edad por aumento de volumen progresivo de partes blandas en su mejilla derecha. El estudio de imágenes confirmó el diagnóstico de Malformación Linfática microquística. Se manejó con esclerosis seriada con OK-432 y Bleomicina. A los 2 años de edad se consideró que la respuesta era adecuada, y se procedió a realizar extirpación quirúrgica intralesional submandibular, con resección parcial de la lesión. La biopsia confirmó el diagnóstico de ML microquística. Seis meses después se planificó nueva resección utilizando el mismo abordaje y extirpando lesión remanente, con evolución favorable hasta la edad de 9 años en que requiere cirugía y manejo por ortodoncia, por recidiva de lesión a nivel intraoral. Evolución favorable hasta que a la edad de 13 años se planifica nueva cirugía y manejo por ortodoncia para suspender la comisura bucal derecha. Conclusión: El manejo de la ML mediante escleroterapia, cirugía, y ortodoncia muestra en este caso las ventajas de un tratamiento multidisciplinarion a largo plazo.

Adolescent , Child , Child, Preschool , Female , Humans , Infant , Facial Neoplasms/therapy , Lymphangioma/therapy , Lymphatic Abnormalities/therapy , Sclerotherapy/methods , Bleomycin/administration & dosage , Follow-Up Studies , Facial Neoplasms/diagnosis , Facial Neoplasms/pathology , Lymphangioma/diagnosis , Lymphangioma/pathology , Lymphatic Abnormalities/diagnosis , Lymphatic Abnormalities/pathology , Orthodontics, Corrective/methods , Picibanil/administration & dosage