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Castro-Ferreira R, Barreira R, Mendes P, Couto P, Peixoto F, Aguiar M, Neto M, Rolim D, Pinto J, Freitas A, Dias PG, Mansilha A, Teixeira JF, Sampaio SM, Leite-Moreira A. First Population-Based Screening of Abdominal Aortic Aneurysm in Portugal. Ann Vasc Surg 2019; 59:48-53. [DOI: 10.1016/j.avsg.2018.12.091] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2018] [Revised: 12/03/2018] [Accepted: 12/15/2018] [Indexed: 01/08/2023]
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Castro-Ferreira R, Dias PG, Sampaio SM, Teixeira JF, Lachat M. Simplified hybrid repair with true lumen recycling for retrograde renovisceral perfusion in a complex chronic aortic dissection. J Vasc Surg Cases Innov Tech 2018; 4:226-230. [PMID: 30175296 PMCID: PMC6116411 DOI: 10.1016/j.jvscit.2018.03.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2018] [Accepted: 03/16/2018] [Indexed: 01/16/2023] Open
Abstract
A 59-year-old man was referred with complicated chronic type B aortic dissection. Despite the false lumen's being dominant in terms of caliber and limb perfusion, visceral arteries originated in a 9-mm true lumen. A staged approach was performed: open aortobi-iliac bypass with preservation of both lumens to the infrarenal aorta, with reinforcement of the aorta and anastomosis with Dacron (wrap technique); exclusion of the dissection by endografting all of the false lumen with three successive thoracic endoprostheses; and maintenance of true lumen perfusion using two periscopes with self-expanding nitinol stents. The patient remains asymptomatic after 1 year of follow-up.
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Affiliation(s)
- Ricardo Castro-Ferreira
- Serviço de Angiologia e Cirurgia Vascular, Centro Hospitalar de São João, Porto, Portugal.,Departamento de Cirurgia e Fisiologia, Unidade de Investigação Cardiovascular, Faculdade de Medicina da Universidade do Porto, Porto, Portugal
| | - Paulo Gonçalves Dias
- Serviço de Angiologia e Cirurgia Vascular, Centro Hospitalar de São João, Porto, Portugal
| | - Sérgio Moreira Sampaio
- Serviço de Angiologia e Cirurgia Vascular, Centro Hospitalar de São João, Porto, Portugal.,Centro de Investigação em Tecnologias e Serviços de Saúde, Faculdade de Medicina da Universidade do Porto, Porto, Portugal
| | - José Fernando Teixeira
- Serviço de Angiologia e Cirurgia Vascular, Centro Hospitalar de São João, Porto, Portugal
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Castro‐Ferreira R, Mendes P, Couto P, Barreira R, Peixoto F, Aguiar M, Neto M, Rolim D, Pinto J, Freitas A, Gonçalves Dias P, Moreira Sampaio S, Leite‐Moreira A, Mansilha A, Teixeira JF. Rastreio populacional de aneurisma da aorta abdominal em Portugal – o imperativo da sua realização. Angiologia e Cirurgia Vascular 2016. [DOI: 10.1016/j.ancv.2016.09.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
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Braz AC, Castro-Ferreira R, Gonçalves Dias P, Moreira Sampaio S, Teixeira JF. Quality of life and aortobifemoral bypass: The importance of hypogastric arteries. Rev Port Cir Cardiotorac Vasc 2016; 23:145-151. [PMID: 29103222] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Received: 12/18/2016] [Indexed: 06/07/2023]
Abstract
INTRODUCTION The aortobifemoral bypass (AFB) is one of the best options to revascularize patients with Aortoiliac Occlusive Disease (AIOD). The impact of this procedure in sexual function (SF) is unpredictable, with 0 to 80% of the patients reporting sexual dysfunction (SD) after surgery. The aim of this study was to evaluate SD after AFB and to assess the importance of patent hypogastric arteries before the procedure. METHODS The study includes only male population submitted to AFB due to AIOD from between January 2013 and March 2016 in Centro Hospital São João (CHSJ). Patients with major amputations after the surgery or dead were excluded. The development of SD was evaluated by phone call. The quality of life before and after the procedure was evaluated by a standardized index score questionnaire (15D). Pre-operative patency of hypogastric arteries was appraised by assessing the patients imaging file. The arteries with direct anterograde flow were considered patent. RESULTS Of a total of 53 patients, 40 were included in the study - 37% reported worsening, 26% improved and 37% didn't notice any change in SF after surgery. Exclusion causes were intrahospital death (5.7%), natural cause death (9.4%) and major amputation (11.3%). If at least one of the hypogastric arteries was patent before surgery, 51.1% described worsening in SF compared to only 7.1% in the group with no sustained anterograde flow to the hypogastric arteries (p<0.001). The majority of the group (92.1%), wasn't warned of the possibility of SD after surgery, being that 26.3% of these would have refused the procedure if they knew. CONCLUSION SD is a prevalent and often overlooked complication after open aortoiliac revascularization and it remains a major taboo in the surgeon/patient relation. The existence of at least one hypogastric artery with preserved anterograde flow before surgery can strongly predict a higher risk of SD after surgery.
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Affiliation(s)
| | | | - Paulo Gonçalves Dias
- Serviço de Angiologia e Cirurgia Vascular do Centro Hospitalar São João, Porto, Portugal
| | - Sérgio Moreira Sampaio
- Serviço de Angiologia e Cirurgia Vascular do Centro Hospitalar São João, Porto; Departamento de Ciências da Informação e Decisão em Saúde, Portugal
| | - José Fernando Teixeira
- Serviço de Angiologia e Cirurgia Vascular do Centro Hospitalar São João, Porto, Portugal
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Castro‐Ferreira R, Freitas A, Oliveira‐Pinto J, Rolim D, Vidoedo J, Alves Silva E, Marinho A, Abreu R, Coelho A, Gonçalves Dias P, Leite‐Moreira A, Sampaio S, Mansilha A, Teixeira JF. Cirurgia de varizes em Portugal: que outcomes interessa avaliar? Angiologia e Cirurgia Vascular 2015. [DOI: 10.1016/j.ancv.2015.07.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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Castro‐Ferreira R, Neiva‐Sousa M, Sampaio S, Gonçalves Dias P, da Costa‐Pereira A, Freitas A. Dez anos de tratamento de aneurismas da aorta abdominal – exclusão endovascular vs. cirurgia aberta nas diferentes regiões portuguesas. Angiologia e Cirurgia Vascular 2015. [DOI: 10.1016/j.ancv.2014.11.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
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Dias-Neto M, Ramos JF, Dias PG, Sampaio S, Rocha E Silva A, Freitas A, Teixeira JF. [TEVAR: a strategy for the diversity of thoracic aorta disease. Series of cases and national prospect]. Rev Port Cir Cardiotorac Vasc 2014; 21:43-54. [PMID: 25596395] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Received: 03/18/2014] [Indexed: 06/04/2023]
Abstract
OBJECTIVE To assess endovascular treatment of thoracic aorta diseases in a national centre of angiology and vascular surgery. To quantify the national registry of TEVAR's. MATERIAL AND METHODS This unicentric and retrospective study included patients submitted to TEVAR until the end of 2012. Twenty-seven patients were considered high-risk for conventional surgery: 14 degenerative thoracic aorta aneurysms or pseudoaneurysms (10 assymptomatic), 1 ruptured thoracoabdominal aneurysm, 5 aortabronchial/aortoesophageal fistulas, 3 complicated dissections, 2 penetrating atherosclerotic ulcer/intramural hematoma, 1 traumatic laceration and 1 embolization from aortic plaque. Eighteen (67%) were emergent/urgent procedures. RESULTS At the institutional level, immediate technical success was achieved in all cases; average follow up was 24 months (0-97). Thirty days and 24 months global mortality was, respectively, 4% (6% for emergent/urgent procedures and 0% for elective procedures) and 13%. Aortic-related mortality was similar. One case of paraplegia and 2 of case of stoke were registered. Endoleak was present in 4 patients. Survival free from aneurysmal sac expansion (aneurysm, pseudoaneurysm or dissection, n=16) was 88% at 30 days. Survival free from aortic reintervention was 93% at 30 days and 81% at 24 months. Nationally, TEVAR registries triplicated from 2007 top 2010. CONCLUSION These results favour the actual tendency to consider TEVAR as a first-line solution for several thoracic aortic diseases.
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Affiliation(s)
- Marina Dias-Neto
- Serviço de Angiologia e Cirurgia Vascular do Centro Hospitalar de S. João, Center for Research in Health Technologies and Information Systems (CINTESIS), Departmento de Ciências de Informação e Decisão em Saúde (CIDES) da Faculdade de Medicina da Universidade do Porto, Porto, Portugal
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Dias PG, Sampaio SM, Silva A, Almeida P, Roncon Albuquerque R. [Endovascular aneurysms repair: 100 consecutive cases outcome analysis]. Rev Port Cir Cardiotorac Vasc 2010; 17:157-161. [PMID: 21842027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
OBJECTIVE To evaluate the effectiveness and clinical outcomes of endovascular aneurysm repair in a single regional centre Methods: The medical records one hundred consecutive patients who underwent elective endovascular repair of nonruptured infra-renal abdominal aortic aneurysm were retrospectively reviewed. The assessed outcomes were all-cause mortality, aneurysm-related mortality, incidence of perioperative complications and reinterventions. Patient demographics and procedure characteristics were also analysed. RESULTS The patient's mean age was 74.4 years-old. There was a male preponderance, with only 5 women treated. Two-thirds were American Society of Anesthesiologists (ASA) class ≥3. Loco-regional blockade was the anaesthetic technique most commonly used (65%). There were no perioperative deaths. Medical complications occurred in 10.3% of cases, pulmonary and cardiac being the most frequent. The 30-day reintervention rate was 6.1% (SE: 2.4%). The overall median hospital length of stay was 5 days. At 8 years, all cause mortality was 28.5%(SE: 8.5%) and aneurysm-related death was 1.3% (SE: 1.3%). During the follow-up period, 87.9% (SE: 3.7%) of patients remained free from reintervention CONCLUSIONS In our institution, EVAR is associated with no early mortality and significantly good perioperative outcomes such as low rate of systemic complications, minimal blood loss, low rate of postoperative mechanical ventilation use and short hospital stay. Although the high reintervention rate for EVAR has been confirmed in several studies, our study did not find such a high need for secondary procedures. We found a durable benefit since aneurysm-related mortality is very low and late overall survival is similar to other reports. In this study's setting, our findings support endovascular management of large AAAs.
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Affiliation(s)
- P G Dias
- Serviço de Angiologia e Cirurgia Vascular do Hospital de São João e Centro de Bioestatística e Informática Médica, Faculdade de Medicina da Universidade do Porto; Centro de Investigação em Tecnologias e Sistemas de Informação em Saúde (CINTESIS)
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Dias PG, Meira JA, Lima JC, Vidoedo JC, Sampaio SM, Albuquerque RR. [Extensive vertebral erosion due to an abdominal aortic aneurysm]. Rev Port Cir Cardiotorac Vasc 2009; 16:237-238. [PMID: 20526479] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/29/2023]
Affiliation(s)
- P G Dias
- Serviço de Cirurgia Vascular do H. S. João, Porto
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Vidoedo J, Cerqueira A, Sampaio S, Vilaça I, Toledo T, Gonçalves Dias P, de Carvalho J, Meira J, de Albuquerque R. [Carotid eversion endarterectomy: retrospective analysis]. Rev Port Cir Cardiotorac Vasc 2006; 13:211-5. [PMID: 17308627] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/14/2023]
Abstract
The aim of this study was to report the initial experience with eversion carotid endarterectomy technique at our department. We undertook a retrospective analysis of prospectively collected data on all carotid endarterectomies performed since January 2004 to March 2006. A comparison between both groups - eversion endarterectomy (EE) and conventional endarterectomy (CE) - was done using a statistical software package. A total of 150 consecutive carotid endarterectomies were performed, 26 (17 %) of them being done using EE. Median age for all patients was 69 [52 - 89] years old with a clear male predominance (n=119; 79,3%). Cardiovascular risk factors were distributed as follows: hypertension, 126 (84%); diabetes, 40 (26,7%); dyslipidaemia, 105 (70%); tobacco smoking, 44 (29,3%). There were proportionately more patients on the EE group submitted to simultaneous CABG (30,8 % vs. 8,8 %; p=0,043) and asymptomatic for previous neurological events (53,9 %vs. 27,3%; p=0,05). There was one case of cervical haematoma reported for the EE technique. Neither neurological morbidity nor deaths were reported within this group. In the CE group the mortality was 0,8 % (1 patient) and the neurological morbidity (either stroke or TIA) was 2,4 % (3 patients). The overall stroke and death rate combining both groups was 2,7 %. Outcome differences between EE and CE patients were nonsignificant, even on multivariate analysis. Eversion carotid endarterectomy is a safe procedure that might be considered as a valid option to conventional endarterectomy.
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Affiliation(s)
- José Vidoedo
- Serviço de Angiologia e Cirurgia Vascular do Hospital de S. João, Porto
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Martins P, Machado A, Alves AD, Valente P, Dias PG. [Tuberculosis: a forgotten challenge]. ACTA MEDICA PORT 1997; 10:517-21. [PMID: 9341047] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
Tuberculosis continues to be a serious problem in public health even thought eh causative bacillus was discovered over 100 years ago. The authors present a clinical case that illustrates the current concern regarding the disease. The case concerns a child of emigrant parents, who are drug addicts and whose illness has not been fully ascertained. The child was hospitalised at three and an half months with fever, malnutrition, opisthotonos and hepatosplenomegaly. After the diagnosis of disseminated tuberculosis affecting the central nervous system, treatment was started with five antituberculosis drugs and with corticosteroids. Respiration improved favourably, but after 19 days the patient suffered a partial tonic-clonic seizure. Subsequently, hydrocephalus was observed and a shunt was applied. Bacteriological examination of the gastric aspirate showed a strain of Mycobacterium tuberculosis resistant to isoniazid and streptomycin. In the eight month of therapeutics, three antituberculosis drugs were still being administered, the shunt was still present and the patient showed a severe psychomotor retardation. The child belonged to a risk group and presented a serious form of tuberculosis with multidrug-resistance, illustrating that this group of children is particularly vulnerable and reflect transmission of this illness among adults.
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Affiliation(s)
- P Martins
- Serviço de Pediatria, Hospital Distrital de Cascais
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Dias PG. [Anti-hepatitis B and anti-Haemophilus influenzae type b vaccines]. ACTA MEDICA PORT 1997; 10:129-38. [PMID: 9235843] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
The epidemiologic aspects of hepatitis B are analysed. The author proposes the vaccination of all children, risk groups and teenagers. Also the high incidence of Haemophilus influenzae infections in Portugal justifies the use of an anti-Hib vaccine administered to all children under 5 years, preferentially in the first year of life.
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Affiliation(s)
- P G Dias
- Unidade de Doenças Infecciosas, Serviço de Pediatria, Hospital de Santa Maria, Lisboa
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Reis H, Dias PG, Teixeira F. [The Jirgl test and the choroid melanin reaction in the differential diagnosis of neonatal obstructive jaundice]. Rev Port Pediatr Pueric 1969; 32:33-9. [PMID: 5810342] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
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Dias PG. [Therapy for acute bronchitis]. Rev Port Pediatr Pueric 1968; 31:291-304. [PMID: 5733544] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
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Pinto LM, Fino D, Dias PG. [Acute gastroenteritis. Review of 1,230 cases]. Rev Port Pediatr Pueric 1967; 30:368-378. [PMID: 5613877] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/21/2023]
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Dias PG, Escabelado MA. [Analysis of the acidification function of the renal tubule by a short test with arginine hydrochloride]. Rev Port Pediatr Pueric 1966; 29:331-76. [PMID: 5998285] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
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