Arteriovenous fistulae of the superficial temporal artery are rare, and their principal cause is traumas. Complications include pulsatile mass, headache, hemorrhage and deformities that compromise esthetics. Treatment can be performed using conventional surgery or endovascular methods. The authors describe a case of a 44-year-old male patient who developed a large pulsating mass, extending from the preauricular region to the right parietotemporal and frontal regions after a motorcycle accident. The treatment chosen was complete surgical removal of the pulsatile mass and ligature of the vessels feeding the fistula. ResumoAs fístulas arteriovenosas de artéria temporal superficial são raras, sendo o trauma sua etiologia principal. Suas complicações incluem massa pulsátil, cefaleia, hemorragia e deformidade estética. O tratamento pode ser realizado por cirurgia convencional ou endovascular. Os autores relatam o caso de um paciente de 44 anos que evoluiu com massa pulsátil extensa desde região pré-auricular até região parietotemporal e frontal direita após acidente motociclístico. Optou-se por remoção cirúrgica completa da massa pulsátil e ligadura dos vasos nutridores da fístula.Palavras-chave: fístula arteriovenosa; artéria temporal superficial; trauma.
Background Chronic Venous Disease (CVD) is the main cause of chronic leg ulcers. Varicose veins are the most frequent cause of venous leg ulcers (VLU). 50.9% of Brazilian women have varicose veins and ulcer prevalence is as high as 4%. Ultrasound-guided foam sclerotherapy (UGFS) is a low-cost treatment option for varicose veins. Objectives To analyze UGFS outcomes in patients with VLU. Methods Prospective consecutive single center cohort study. Patients with great saphenous vein (GSV) reflux and VLU were treated and followed-up for 180 days. The following were studied: quality of life (QoL), disease severity, healing, and elimination of GSV reflux. The Aberdeen questionnaire, a venous clinical severity score, and Duplex scanning (DS) results were analyzed. Results 22 patients aged 35 to 70 years were treated. There was improvement in quality of life, disease severity reduced, and ulcer diameter reduced (p < 0.001; ANOVA). 77.27% of VLU healed completely (95%CI: 59.76-94.78%). The dimensions of 20/22 VLU reduced (90.91%; 95%CI: 78.9-100%). GSV reflux was eliminated in 63.64% (95%CI: 43.54-83.74%). Men had greater QoL benefit and women had more complications. There were no severe complications. The VLU that had healed completely at the end of the study were smaller at baseline than those that did not completely heal. The GSV that were completely occluded at the end of the study were smaller at baseline than those that were not completely occluded (p < 0.05; Mann-Whitney). Conclusion The results suggest that most patients benefited from UGFS.
Radial artery aneurysms are rare and mostly secondary to traumatic events (posttraumatic pseudoaneurysms). Radial artery aneurysms should be treated due to the high risk of embolization, thrombosis, and compression of adjacent nerves. The authors describe a case of a 49-year-old patient complaining of a progressively growing tumor in the left wrist after a dog bite. The tumor proved to be a true posttraumatic aneurysm. Treatment consisted of removal of the aneurysm sac and ligation of the radial artery.Keywords: aneurysm; radial artery; wounds and injuries. ResumoOs aneurismas de artéria radial são raros, sendo, na maioria das vezes, pseudoaneurismas pós-traumáticos. Os aneurismas de artéria radial devem ser tratados devido ao risco de embolização, trombose e compressão de estruturas nervosas adjacentes. Os autores relatam o caso de um paciente de 49 anos referindo tumoração de crescimento progressivo em punho esquerdo após mordedura canina, sendo diagnosticado aneurisma verdadeiro de artéria radial pós-traumático. Optou-se pela ressecção do saco aneurismático e ligadura da artéria radial.Palavras-chave: aneurisma; artéria radial; ferimentos e lesões.
Recent studies have identified adipose tissue as a new source of mesenchymal stem cells for therapy. The purpose of this study was to investigate the therapy with rat adipose derived stromal cells (ASC) in a rat model of healed myocardial infarction (MI). ASC from inguinal subcutaneous adipose tissue of male Wistar rats were isolated by enzymatic digestion and filtration. Cells were then cultured until passage 3. Four weeks after ligation of the left coronary artery of female rats, a suspension of either 100µl with PBS + Matrigel + 2 x 106 ASC labeled with Hoechst (n=11) or 100µ;l of PBS + Matrigel (n=10) was injected along the borders of the ventricular wall scar tissue. A sham operated group (n=5) was submitted to the same surgical procedure except permanent ligation of left coronary artery. Cardiac performance was assessed by electro and echocardiogram. Echo was performed prior to injections (baseline-BL) and six weeks after injections (follow-up - FU), and values after treatment were normalized by values obtained before treatment. Hemodynamic measurements were performed 6 weeks after injections. All data are expressed as mean ± SEM. Student's paired or unpaired T test was used to compare the same group in two different times or two distinct groups, while two way ANOVA was used to compare more than two groups along different times and p was set at <0.05. All infarcted animals exhibited cardiac function impairment. Ejection fraction (EF), shortening fractional area (SFA) and left ventricular akynesia (LVA) were similar between infarcted groups before treatment. Six weeks after therapy, ASC group showed significant improvement in all three Echo indexes in comparison to vehicle group. In non-anesthetized animals dp/dt+ was also significantly higher in ASC when compared to vehicle. In agreement with functional improvement scar area was diminished in the ASC group. We conclude that ASC stabilize cardiac function in infarcted rats when administered directly to the myocardium.
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