Armando Mansilha

Faculty of Medicine of University of Porto · Angiology and Vascular Surgery

Resumen La Unión Europea de Médicos Especialistas (UEMS) fue creada en 1958, y desde el año 2005 posee una sección independiente para la cirugía vascular (Section and Board of Vascular Surgery [SBVS]). Según sus estatutos el objetivo principal de la SBVS es garantizar los más altos estándares de atención en el campo de la cirugía vascular en los pa...

Em Portugal, a relação entre o número de aneurismas da aorta abdominal (AAA) tratados e a população total é das mais baixas descritas na literatura. Este fenómeno poderá ser justificado pelo défice de diagnóstico ou pela reduzida prevalência da doença na nossa população. Até à data, nenhum rastreio populacional sistemático foi realizado em Portugal...

A origem aberrante da artéria subclávia direita é uma das anomalias mais comuns do arco aórtico, ocorre em aproximadamente 0,5‐1% da população.

p> Introduction: To evaluate the results of the abdominal aortic aneurism endovascular treatment (EVAR), percutaneously and with local anesthesia, according to the concept of one day surgery. Material and Methods: Unicentric, retrospective analysis of patients with aorto-iliac aneurysmal disease, consecutively treated by EVAR with percutaneous acce...

Raynaud's phenomenon is a common clinical disorder characterized by recurrent vasospasm episodes of digital arteries, arterioles, pre-capillary and post-capillary venules triggered by exposure to cold or emotional stress. RP can be classified as primary (idiopathic), or secondary to several diseases or conditions. The pathogenesis of RP is still no...

About 75% of the Abdominal Aortic Aneurysms (AAA) are currently repaired by endovacular means (EVAR). Aneurysm sac shrinkage post-EVAR represents the principal marker of absence of rupture or mortality aneurysm related. However, in about 40% of cases aneurysm sac does not shrink or even enlarges. Several pre-operative risk factors may predict aneur...

A doença venosa crónica (DVC) é a patologia vascular mais frequente, com uma prevalência estimada nos países ocidentais de 40% nas mulheres e 17% nos homens. Os recursos humanos, técnicos e orçamentais necessários para permitir o tratamento de uma patologia tão prevalente são enormes. Torna‐se, assim, imperativo conhecer as consequências da DVC e r...

Aim: The aim of this study was to evaluate macrovascular endothelial dysfunction and microvascular damage as clinical markers of peripheral microangiopathy in patients with Raynaud's phenomenon (RP). Patients and methods: Seventy-seven secondary RP with systemic sclerosis, 32 primary RP and 34 healthy controls were included in our study. Seconda...

The authors present a case report of 72 years‐old male patient, who had two isolated saccular abdominal aneurysms, one aneurysm of the left common iliac artery of 3 cm of diameter involving the iliac bifurcation, corrected by endovascular embolization with multiple coils of the ipsilateral internal iliac artery with subsequent placement of a iliac...

The authors describe a rare case report of a septic embolism to a lower limb, a mycotic superior mesenteric artery aneurysm and a hemorrhagic stroke derived from a large mobile vegetation in an ascending aortic graft.

Introduction In order to enhance the preventive surgical technique of stroke, carotid endarterectomy, several studies have been performed to clarify the anesthetic technique that relates best results with respect to morbidity, mortality, hemodynamic instability, need to use shunt, costs, cognitive function and cardiovascular outcomes. Aim This rev...

The authors present a rare case-report of a 33 years old, male patient with a saccular aneurysm of the right renal artery with 2.1 cm. The carried out treatment to exclude the aneurysm was done by placing a self-expanding open cells with 5×20 mm in the aneurysm neck and coils embolization, released through the mesh of the stent. During follow-up, t...

Aortocaval fistulas are rare complications of abdominal aortic aneurysms (AAA) and are often associated with significant mobi-mortality. The authors present a case report of a patient who comes to our hospital and an AAA of 6.9 cm and an associated aortocaval fistula were diagnosed. We performed its urgent surgical correction by open repair, were a...

Secondary aorto-enteric fistulas are a rare but potentially fatal complication after abdominal aortic surgery and remain one of the most challenging vascular disease. The authors present a case report of a female patient with past history of aortic reconstruction surgery (aortobifemoral bypass, performed 6 years previously) for treatment of periphe...

Our objective was to review the linguistic validation of the 20 item-ChronIc Venous dIsease quality-of-life Questionnaire (CIVIQ-20) in the countries that have used it since its publication in 1996. Seventeen linguistic versions of CIVIQ-20 were validated using forward/backward methodology in patients presenting with chronic venous disease, stages...

Diabetic foot ulcers and their consequences do not only represent a major tragedy for the patient and his/her family, but also place a significant burden on the healthcare systems and society in general. Diabetic patients may develop foot ulcers due to neuropathy (autonomic, sensory, and motor deficits), angiopathy or both. As a result of the addit...

In adaptation to arterial obstruction and consequent ischemia, organisms induce the arteriogenic and angiogenic mechanisms in order to improve blood supply to tissues. However, 25% of the patients with peripheral arterial disease will have a deterioration of their condition, suggesting failure of the adaptative processes. These mechanisms are extre...

Splenic artery aneurysms, although they are the most common splanchnic aneurysms, they have a prevalence of only 0,01%. In this context the authors present a case report of a 41 years female patient with a splenic artery aneurysm of 20x29mm, treated by deployment of a covered self-expandable stent (Gore® Viabahn®). It is performed a literature revi...

Innominate artery aneurysms are extremely rare. The authors present a case report of a 22-year-old patient, in whom was accidently discovered an innominate artery aneurysm of 52 mm, 10 years after a blunt thoraco-abdominal trauma caused by a high energy running over by a motorcycle. For the exclusion of the aneurysm, the patient was successfully su...

The popliteal and femoral aneurysms are the most prevalent peripheral artery aneurysms. The authors present a case report of a 61 years-old male patient, in a context of marked swelling of the right lower limb. A duplex ultrasonography was performed, which diagnosed the presence of a right popliteal phlebothrombosis subsequent to compression caused...

The factorial instability of the CIVIQ-20 social dimension in different populations has necessitated the development of a new stable questionnaire to interpret results from international studies. Construction of a stable and psychometrically validated questionnaire from CIVIQ-20. METHODS AND MAJOR FINDINGS: A prospective, international study was us...

Deep vein thrombosis is a common and important disease that occurs in individuals with known or unknown risk factors. Its pathogenesis is multifactorial and includes genetic and acquired factors. Two types of genetic defects can cause venous thrombosis: mutations that result in deficiency of natural inhibitors of coagulation and mutations that incr...

Raynaud´s Phenomenon (RP) is a common clinical disorder, manifested by recurrent vasospasm of fingers and toes, often triggered by exposure to cold temperatures or emotional stress. It can be primary (idiopathic) or secondary to several diseases or conditions, including connective tissue diseases such as systemic sclerosis. The pathogenesis of RP i...

The efficacy of carotid endarterectomy (CEA) in preventing the stroke in patients with symptomatic and asymptomatic carotid stenosis has been established in different multicentre randomised controlled trials. CEA under local anaesthesia versus general anaesthesia has been associated with potential benefits concerning reduction in the odds of stroke...

The efficacy of carotid endarterectomy (CEA) in preventing a stroke in patients with asymptomatic carotid stenosis has been well established in ACAS and ACST trials. This intervention can only be justified if the perioperative stroke/myocardial infarction and death rate is lower than “best medical treatment” alone. This review will analyse the publ...

To review the psychometric validation of the Chronic Venous dIsease quality of life Questionnaire (CIVIQ-20) in the countries that have used it since 1996. Prospective, clinical, international study in 18 countries. Patients with venous disease of the lower limb in the clinical, aetiological, anatomical and pathophysiological (CEAP) clinical stages...

Background. A mutation in the coagulation FXIII has been described: a G to T transition in exon 2 of the FXIII A-subunit gene, which results in the substitution of Leucine for Valine at amino acid position 34 (FXIII Val34Leu). The higher level of activity of the Leu34 enzyme would be expected to be associated with increased resistance of the fibrin...

BACKGROUND:The effect of carotid endarterectomy in lowering the risk of stroke ipsilateral to severe atherosclerotic carotid-artery stenosis is offset by complications during or soon after surgery. We compared surgery under general anaesthesia with that under local anaesthesia because prediction and avoidance of perioperative strokes might be easie...

Raynaud’s syndrome is named after Maurice Raynaud, who first identified it in 1862 [12]. It is characterized by recurrent episodes of digital numbness, tingling and a skin tricolour sequence:pal- lor, cyanosis and rubor. Formerly subcategorized into Raynaud’s disease and Raynaud’s phenomenon Raynaud’s disease is a benign form with no underlying dis...

We report two cases of severe trauma of the upper limb requiring arterial revascularization. A brachio-brachial inverted saphenous bypass graft was done in both cases. Graft rupture attributed to local infection occurred at fourth post-operative week. Pseudomonas aeruginosa was isolated from the surgical wound in the first case and Acinetobacter ba...

Objective: To evaluate the association between the Factor V Leiden (FV R506Q) and prothrombin gene (FII G20210A) mutations and deep venous thrombosis (DVT) in young people. Methods: Blood samples were drawn from 199 subjects: 100 healthy controls and 99 unselected patients, with an objectively documented first episode of DVT under 40 years old. DNA...

To determine the incidence of deep venous thrombosis (DVT) recurrence in young people, and its association with some genetic polymorphisms (FV G1691A, FII G20210A, MTHFR C677T, PAI-1 4G/5G). Prospective cohort study. A database was established prospectively to follow-up a cohort of unselected patients who had had a first episode of objectively prov...

Objective: To evaluate the association between the 4G/5G polymorphism in the promoter of the plasminogen activator inhibitor-1 (PAI-1) gene and deep venous thrombosis (DVT) in young people. Methods: Prevalence of the 4G/5G polymorphism was investigated using DNA analysis in a population of 81 consecutive and unrelated patients with an objectively d...

Recently a new identified genetic variant in the 3'-untranslated region of the prothrombin gene (G20210A allele) associated with increased plasma prothrombin levels has been linked to an increased risk of venous thromboembolism (VTE). To determine the importance of this G20210A allele as a causative risk factor for VTE in the general population, we...

Recently a new identified genetic variant in the 3′-untranslated region of the prothrombin gene (G20210A allele) associated with increased plasma prothrombin levels has been linked to an increased risk of venous thromboembolism (VTE). To determine the importance of this G20210A allele as a causative risk factor for VTE in the general population, we...

PURPOSE. To evaluate the association between the C677T mutation in the 5,10-methylenetetrahydrofolate reductase (MTHFR) gene and deep venous thrombosis (DVT) in young people. METHODS. The prevalence of the C677T mutation in the MTHFR gene was investigated in a population of 97 consecutive and unrelated patients with an objectively documented first...