Browsing by Author "Meireles, N"
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- Um Caso de Tromboembolismo ParadoxalPublication . Pelicano, NJ; Sousa, L; Meireles, N; Banazol, N; Bandeira Costa; Bico, P; Quininha, J
- Falso Aneurisma Traumático da Aorta Infrarenal. A Propósito de um Caso ClínicoPublication . Albino, JP; Garcia, AC; Meireles, NAbdominal aortic pseudoaneurysms are rare, particularly when they are related to blunt abdominal trauma. The authors report the clinical case of a 65 years old man with an abdominal aortic pseudoaneurysm related to a blunt abdominal trauma, that occurred three years ago. The patient complained of a diffuse abdominal pain, increased while walking. The diagnosis was confirmed by angiography and by angio-CT. An aortic resection and interposition graft was performed, according to the age of the patient and the low operative risk. A discussion on the therapeutic option was made, followed by a revision of the literature on the subject, and the authors conclude by emphasizing the need of a detection of this type of pathology, particularly in patients who had suffered in the past violent trauma.
- Lesões Traumáticas Iatrogénicas das Veias Femorais no Decurso da Cirurgia de VarizesPublication . Albino, JP; Meireles, N; Martins, J; Silva Castro, J; Duarte, J; Gonçalves, A; Amaral, C; Bettencourt, V; Gonçalves, D; Mota Capitão, L; Carvalho, STraumatic lesions of the femoral veins during varicose veins surgery are very uncommon and they raise several therapeutic difficulties. They occur in 1/1000 cases of varicose veins operated. The authors describe four cases of lesions of this type that were seen and treated for the last six years, probably because there was an increase in the number of varicose veins operated on in the Lisbon area. The authors discuss the surgical options and they concluded that these complications can be minimized with good anatomical and surgical skills, specially of the saphenous-femoral and saphenous-popliteal junctions.
- Síndrome de Churg-Strauss, Aneurismas Femorais Venosos e Tromboembolismo PulmonarPublication . Meireles, N; Ferreira, E; Silva Castro, J; Amaral, C; Sobrinho, G; Franca, T; Albino, JP; Carvalho, CSOBJECTIVE: Venous aneurysms of the lower limbs are rare. When they involve the deep venous system, they can be associated with deep venous thrombosis and pulmonary embolism. The authors report the case of a 63-year-old women evaluated by duplex imaging and venography, in the context of a pulmonary embolism, and detected bilateral large aneurysms of the femoral veins (5 cm in the right femoral vein and 4 cm in the left femoral vein). The aneurysms were located at the bifurcation of the common femoral vein with the superficial and profound veins. METHOD: The right aneurysm was partially thrombosed. The patient was asymptomatic in the lower-limb extremities. After a period of anticoagulation, the authors proceeded to surgically excise the right aneurysm and replaced the venous system using a polytetrafluoroethylene (PTFE) graft with the construction of an a-v fistula. RESULT: The patient had no complications in the postoperative period and her 8-month follow-up examination revealed no symptoms, not even leg edema. The duplex scan showed patency of the graft. She continued with oral anticoagulation. The histologic examination revealed an eosinophilic inflammatory reaction of the vein wall, compatible with the diagnosis of Churg-Strauss syndrome. CONCLUSION: The authors conclude that they have probably described the first case in the international literature of a venous aneurysm with a Churg-Strauss syndrome and pulmonary embolism.
- A Transposição Valvular nos Doentes com Úlceras dos Membros Inferiores Consequentes a Síndromes Pós-TrombóticosPublication . Albino, JP; Ferreira, E; Castro, JM; Duarte, JN; Gonçalves, D; Sobrinho, G; Meireles, NVenous ulcers in patients with post thrombotic syndromes are complex situations with multiple therapeutic options. They are responsible for high morbidity rates, conservative treatment is very slow and recurrences are very common. Deep venous reconstructive surgery is an alternative, but it should be based on the morphologic and functional aspects of the venous system and only adopted after a very careful study, including venography. The authors describe a morphological "pattern", found in some of these patients and related to the competence of the saphenous femoral junction, rendering possible to perform a valvular transposition. Seven patients with post thrombotic ulcers who have been treated during the last 6 years in which the pattern already described was detect, underwent a transposition of the superficial femoral vein, to the great saphenous vein and when necessary complemented with skyn grafts. Before the operation all patients had ulcers with more than 3 cm in size (3.2-5.4 cm) and with more than 4 months duration (4-16 months). All ulcers healed in the postoperative period (mean time 28 days). All patients have been reevaluated in 2003 and it was diagnosed the thrombosis of two procedures, one of them with the recurrence of the ulcer who healed with conservative treatment. The authors consider this method as a very easy technique to perform, although rarely used, and a valid alternative in a highly selected group of patients.