ANDRE ECHAIME VALLENTSITS ESTENSSORO
Projetos de Pesquisa
Unidades Organizacionais
Instituto Central, Hospital das Clínicas, Faculdade de Medicina - Médico
LIM/02 - Laboratório de Anatomia Médico-Cirúrgica, Hospital das Clínicas, Faculdade de Medicina
LIM/02 - Laboratório de Anatomia Médico-Cirúrgica, Hospital das Clínicas, Faculdade de Medicina
7 resultados
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bookPart Aneurisma arteriais periféricos(2017) ESTENSSORO, André Echaime Vallentsits; FARJALLAT, Marina ArtimonteconferenceObject 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, NelsonbookPart Hipertensão renovascular(2017) FARJALLAT, Marina Artimonte; ESTENSSORO, André Echaime Vallentsits- Natural History of Splanchnic Artery Aneurysms(2021) BATAGINI, Nayara Cioffi; CONSTANTIN, Bruno Donega; KIRKSEY, Lee; ESTENSSORO, Andre Echaime Vallentsits; PUECH-LEAO, Pedro; LUCCIA, Nelson De; SILVA, Erasmo Simao daIntroduction: Splanchnic artery aneurysms (SAAs) represent a rare and potential life-threatening disease with a documented incidence of 0.1-2.0%. The risk of rupture and the diameter to recommend surgery are still controversial. The purpose of this study was to review surveillance computed tomography scans (CTs) at a high-volume institution in order to better define the natural history of the SAA. Methods: Between January 2000 and February 2019, all SAAs patients in follow-up at a single center institution were selected for analysis. CTs from patients managed nonoperatively and CTs before surgery from patients submitted to surgery were studied. The first CTs were used to determine aneurysm size, morphology, and anatomic characteristics, and the last CTs performed during nonoperative follow-up were used to compare the diameter with the previous CTs. Primary endpoint included growth rate for all SAAs location, and secondary endpoint included the clinical or anatomical characteristic associated with a faster growth rate. Results: In total, 116 consecutive patients were identified with SAAs and 74 patients with 87 SAAs who had at least 2 CTs during follow-up were analyzed. From those 74 patients, 12 were submitted to surgery and only their preoperative CTs were analyzed. The SAAs' locations were: splenic (55.4%), hepatic (12.2%), superior mesenteric artery (17.6%), celiac trunk (27.0%), gastric and gastroepiploic arteries (1.4%), pancreaticoduodenal and gastroduodenal arteries (4.1%). The median follow-up for all patients was 46.7 months (+/- 35.3), and the median of growth for all aneurysms was 0.63 mm/year (+/- 2.19). Only the splenic aneurysms presented growth with statistic significance of 1.08 mm per/year (+/- 1.99) (P < 0.001). Only portal hypertension showed statistically significance to splenic aneurysm growth (P = 0.002). Multivariate analysis for variables associated with splenic aneurysm growth >= 1 mm/year showed that portal hypertension was the only variable with statistical significance (P < 0.01, IC 95% 2.0-186.9, beta = 19.5). Conclusions: Although longer-term follow-up and larger sample size are needed to better understand the natural history of SAAs, the majority of SAAs tends to remain stable in size through follow-up. Portal hypertension was the only risk factor found for true splenic aneurysm growth, and so those patients must have a closer follow-up.
- The similarities and differences among patients with abdominal aortic aneurysms referred to a tertiary hospital and found at necropsy(2015) SILVA, Erasmo S. da; GORNATI, Vitor C.; CASELLA, Ivan B.; AUN, Ricardo; ESTENSSORO, Andre E. V.; PUECH-LEAO, Pedro; LUCCIA, Nelson DeObjective: To analyze the characteristics of patients with abdominal aortic aneurysms referred to a tertiary center and to compare with individuals with abdominal aortic aneurysm found at necropsy. Methods: We have retrospectively analyzed the medical records of 556 patients with abdominal aortic aneurysm and 102 cases abdominal aortic aneurysm found at necropsy. Results: At univariated analysis, hypertension, tobacco use and maximum diameter were significant risk factors for symptomatic aneurysm, while diabetes tended to be a protective factor for rupture. By logistic regression analysis, the largest transverse diameter was the only one significantly associated with abdominal aortic aneurysm rupture (p<.0001, odds ratio 1.7, 95% confidence interval 1.481-1.951). Intact abdominal aortic aneurysm found at necropsy showed similarities with outpatients in relation to abdominal aortic aneurysm diameter and risk factors. Conclusion: Intact abdominal aortic aneurysm at necropsy and at outpatients setting showed similarities that confirmed that abdominal aortic aneurysm repair is less offered to women, and they died more frequently with intact abdominal aortic aneurysm from other causes.
- 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, NelsonBackground: 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.
bookPart Cirurgia de Urgência no Aneurisma da Aorta Abdominal(2013) AUN, Ricardo; ESTENSSORO, André Echaime Vallentsits; LEDERMAN, Alex; MIOTTO NETTO, Boulanger