Influence of the greater saphenous vein graft quality in the early patency of infrainguinal revascularizations

Objectives: The authors evaluate the quality of the greater saphenous veins used in lower limb revascularization at the moment of their implantation, using a semiquantitative histopathological method, relating the vein quality with patient's sex and age, as well as the influence on early patenct rates. Method: A total of 144 veins of 144 patients were studied, 88 male and 56 female, with a mean age of 65,7 years. The vein was stained with hematoxylin-eosin. The degree of intimal hyperplasia and hypertrophy of the longitudinal and circular muscular layers of the media were analyzed. The quality of the vein was classified, by adding the grades of each layer, into good, regular and questionable quality. Results: As to quality, 82 veins (57 por cento) were classified as good, 49 (34 por cento) as regular and 13 (9 por cento) as questionable. In six months, the primary patency of good quality veinsas 80,5 por cento, that of regularuality veins was 79,6 por cento and the patency of questionable quality veins was 84,6 por cento. Conclusion: No differences were seen in vein quality, either in the individual evaluation of each layer or in the global evaluation of the three layers, regarding the patient's sex and age. No differences was observed regarding the patency of the grafts...

Embolia mesentérica / Mesenteric artery embolism

A case of mesenteric artery embolism is presented in which prompt diagnosis and adequate treatment by embolectomy of the superior mesenteric artery was successful. The importance of a prompt diagnosis and treatment as the keys to success in the management of visceral embolism is emphasized. The new therapeutic alternatives, as the intra-arterial infusion of low-dose streptokinase, are discussed

Fístula arteriovenosa pélvica congênita, uma causa pouco comun de dor pélvico / Congenital pelvic-arterio-venous fistula: an unusual cause of pelvic pain

The authors report a case of pelvic congenital arteriovenous fistula from a 37 year old woman. They discuss the diagnosis and therapeutic options for this problem, reviewing the litterature on the subject.

Riscos do uso de anticoagulante oral após embolectomia arterial / The risks of the use of oral anticoagulant after arterial embolectomy

Os autores comparam as complicaçöes de uma série de 32 pacientes com embolia arterial de origem cardíaca, dos quais 15 receberam anticoagulante oral (ACO) a longo prazo e 17 näo receberam anticoagulante. O tempo médio de seguimento foi de 24,7 meses (7 a 51 meses). No grupo que usou ACO ocorreu uma embolia recidivante e cinco episódios de sangramento, dos quais dois fatais. No grupo que näo recebeu ACO ocorreram dois episódios de embolia, ambas tratadas com sucesso. Os autores concluem que o risco de complicaçöes graves e óbitos foi muito mais alto nos pacientes anticoagulados. No nosso meio, näo usar ACO pode ser mais prudente que usá-lo em condiçöes precárias