TAIS BUGS WAKASSA

(Fonte: Lattes)
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Instituto Central, Hospital das Clínicas, Faculdade de Medicina
LIM/02 - Laboratório de Anatomia Médico-Cirúrgica, Hospital das Clínicas, Faculdade de Medicina

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  • article 2 Citação(ões) na Scopus
    Clinical Efficacy of Successful Angioplasty in Critical Ischemia-A Cohort Study
    (2014) WAKASSA, Tais Bugs; BENABOU, Joseph Elias; PUECH-LEAO, Pedro
    Background: To evaluate the impact of percutaneous angioplasty (PA), objectively assessed with duplex-ultrasound, on 3-year clinical outcome. Methods: Thirty-nine patients with atherosclerotic disease successfully treated by PA were included (40 limbs). All patients had critical ischemia with rest pain and ischemic ulcers due to infrainguinal obstructions alone. The patients were submitted to duplex ultrasound examination on the day before and on the first or second day after the procedure. Peak systolic velocities (PSV) were recorded in the anterior tibial, posterior tibial, and fibular arteries at the level of distal third of the leg. All patients were followed for 3 years. Comparison between groups with good and bad results were based on perioperative VPS gradient (GPSV) of the mean of the VPS in the 3 arteries. After 3 years, a good result was defined as a patient having no pain and complete healing of a previous ulcer or minor amputations. Results: Mean age was 68.5 +/- 8.1 years with no difference in demographic characteristics (P > 0.05). In 26 cases, the long-term result was good. Healing time ranged from 4 to 130 weeks (median 26.5). Bad long-term results were observed in 12 cases. Two lesions remained un-healed despite patent angioplasty. In 10 cases, a second procedure was carried out (repeat angioplasty in 6 and bypass in 4). TransAtlantic Inter-Society Consensus (TASC) II category A/B registered better clinical success then TASC II category C/D (P < 0.05) at 1-year follow-up but not at 3 years (P = 0.36). Two-year limb salvage was 92.5% +/- 4.2%. Primary patency was 52.5% +/- 9.5% at 3 years. GVPS was 21.9 cm/sec in the good results group and 24.7 cm/sec in the bad results group (P > 0.05). The quality of the initial result, as measured by GPSV, was not associated with long-term success (P > 0.05). Conclusions: An initially successful procedure indicated by the degree of increased flow is not related to long-term durability and ulcer healing.
  • conferenceObject
    Long-term Results of Endovascular Treatment of Chronic Type B Aortic Dissection by Closure of the Primary Tear
    (2023) ESTENSSORO, Andre E. V.; PUECH-LEAO, Pedro; WAKASSA, Tais B.; CASELLA, Ivan Benaduce; DELUCCIA, Nelson
  • article 5 Citação(ões) na Scopus
    Long-term Results of Endovascular Treatment of Chronic Type B Aortic Dissection by Closure of the Primary Tear
    (2020) PUECH-LEAO, Pedro; V, Andre Echaime Estenssoro; WAKASSA, Tais Bugs; CASELLA, Ivan Benaduce; DELUCCIA, Nelson
    Background: The role of thoracic endovascular aortic repair (TEVAR) in the treatment of chronic type B aortic dissection is controversial. Some advocate open surgery, based on the premise that all tears must be treated, and others prefer branched endografts with the same premise. However, TEVAR, with closure of the primary tear in the thorax, has shown good results in some centers. This single-center cohort study was designed to contribute to the knowledge of the long-term evolution (mean, 4.8 years) of the patients submitted to endovascular closure of the proximal intimal tear. Methods: A total of 36 patients with asymptomatic chronic aortic dissection had a successful closure of the primary tear by TEVAR and were followed up for a median time of 57.2 months. Results: In 75% of the cases, there was stabilization or decrease in the maximum diameter. Twenty-five percent had diameter increase in the thoracic or abdominal aorta and indication for one or more additional procedures. One patient refused a second procedure and died from rupture one month after the last evaluation; this was the only case of rupture in the series. One patient died of unrelated cause before having been submitted to a second procedure. Thirty-four patients survived without diameter increase in the follow-up period. Conclusions: Chronic type B aortic dissections can be successfully treated by the coverage of the proximal tear with an endograft. Patients shall be followed carefully, and 25% of them will require one or more additional procedures to achieve a good result.