BRENO BOUERI AFFONSO
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4
Projetos de Pesquisa
Unidades Organizacionais
Instituto de Radiologia, Hospital das Clínicas, Faculdade de Medicina - Médico
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bookPart Radiologia intervencionalista e cirurgia endovascular(2016) NASSER, Felipe; AFFONSO, Breno Boueri; LEAL FILHO, Joaquim Maurício da Motta- Predictive factors for pelvic magnetic resonance in response to arterial embolization of a uterine leiomyoma(2014) ZLOTNIK, Eduardo; DE LORENZO MESSINA, Marcos; NASSER, Felipe; AFFONSO, Breno Boueri; BARONI, Ronaldo Hueb; WOLOSKER, Nelson; BARACAT, Edmund ChadaOBJECTIVE: Minimally invasive methods are used as alternatives to treat leiomyomas and include uterine artery embolization, which has emerged as a safe, effective method. This study aims to evaluate the magnetic resonance imaging predictors for a reduction in leiomyoma volume in patients undergoing uterine artery embolization. METHODS: This prospective longitudinal study was performed at a university hospital. We followed 50 symptomatic premenopausal women with uterine leiomyomas who underwent uterine artery embolization. We examined 179 leiomyomas among these patients. Magnetic resonance imaging was performed one month before and six months after uterine artery embolization. Two radiologists who specialized in abdominal imaging independently interpreted the images. Main Outcome Measures: The magnetic resonance imaging parameters were the uterus and leiomyomas volumes, their localizations, contrast perfusion pattern and node-to-muscle ratio. RESULTS: Six months after treatment, the average uterine volume reduction was 38.91%, and the leiomyomas were reduced by 55.23%. When the leiomyomas were submucosal and/or had a higher node-to-muscle ratio in the T2 images, the volume reduction was even greater (greater than 50%). Other parameters showed no association. CONCLUSIONS: We conclude that symptomatic uterine leiomyomas in patients undergoing uterine artery embolization exhibit volume reductions greater than 50% by magnetic resonance imaging when the leiomyomas are submucosal and/or had a high node-to-muscle ratio in the T2 images.
- Persistent Left Superior Vena Cava(2014) MOTTA-LEAL-FILHO, Joaquim M.; MOTTA, Carlos A. O.; PILAN, Bruna F.; AFFONSO, Breno B.
- Evaluation of Morphological and Clinical Factors Related to Failure of Percutaneous Treatment with Thrombin Injection of Femoral Pseudoaneurysms from Cardiac Catheterization(2019) LEITE, Tulio Fabiano de Oliveira; BORTOLINI, Edgar; LINARD, Bruno; BOUERI, Breno Affonso; CARNEVALE, Francisco Cesar; NOMURA, Cesar Higa; LEAL FILHO, Joaquim Mauricio da MottaBackground: Ultrasound-guided thrombin injection (UGTI) has become the method of choice in the treatment of pseudoaneurysm caused by endovascular procedures because it is minimally invasive, costs less, and effective, with short hospitalization time. The objective was identify the morphological aspects of femoral pseudoaneurysms and clinical aspects of patients that may lead to the failure of UGTI in femoral pseudoaneurysms after cardiac catheterization. Population and Method: From December 2012 to December 2016, 60 patients with pseudoaneurysms caused by cardiac catheterization were referred to the interventional radiology unit to be treated with UGTI. Medical charts were retrospectively reviewed for comorbidities, use of antiplatelet agents, anticoagulation, indication of cardiac catheterization, and so forth. Morphological aspects of the pseudoaneurysms such as volume, diameter (anteroposterior, laterolateral, and longitudinal), length, and diameter of the neck were analyzed. Results: Technical success of UGTI was achieved in 100%. No clinical aspects of the patients were statistically significant for UGTI failure in occlusion of the pseudoaneurysms. For morphological aspects of pseudoaneurysm: anteroposterior (P = 0.029), longitudinal (P = 0.020), and neck diameters (P = 0.004) were statistically significant for UGTI failure. Logistic regression analysis for longitudinal diameter showed that for each centimeter, there was a 2.66 chance of failure of pseudoaneurysm thrombosis in a single thrombin injection session (95% confidence interval: 1.33-5.30). For longitudinal and neck diameters greater than 1.8 cm and 0.55 cm, respectively, there is a greater probability of needing more than one UGTI session for complete thrombosis. Conclusions: Among variables, the longitudinal dimension was more significant, and in a larger diameter, the treatment with thrombin injection presented greater complexity.
- Dissecção espontânea do tronco celíaco: qual a melhor abordagem terapêutica?(2013) GALASTRI, Francisco Leonardo; NASSER, Felipe; AFFONSO, Breno Boueri; AMORIM, Jorge Eduardo de; TRAVASSOS, Fabiellen BerzoiniSpontaneous dissection of visceral arteries is a quite rare event. Sudden abdominal pain in the epigastrium is the most frequent symptom. Advances in imaging techniques have made it easier to establish the diagnosis of this event, increasing the incidence of dissections of visceral arteries. Conservative medical treatment, surgical revascularization, and endovascular therapy are the three treatment options available. We report two cases of patients with spontaneous dissection of the celiac trunk that received different treatments based on clinical presentation and imaging studies. We also conducted a literature review on this disease.
- Safety, efficacy, and prognostic factors in endovascular treatment of pelvic congestion syndrome(2014) NASSER, Felipe; CAVALCANTE, Rafael N.; AFFONSO, Breno B.; MESSINA, Marcos L.; CARNEVALE, Francisco C.; GREGORIO, Miguel A. deObjective: To evaluate the safety and effectiveness of transcatheter embolization using coils for treatment of pelvic congestion syndrome (PCS) and to elucidate prognostic factors for clinical success. Methods: Data were retrospectively analyzed from 113 women with PCS who underwent endovascular embolization of ovarian and pelvic varicose veins at Hospital Clinic Universitario, Zaragoza, Spain between January 2001 and January 2011. Pain score was evaluated before and after the procedure via a visual analog scale (VAS). Associated symptoms (dysmenorrhea, dyspareunia, urinary urgency, and lower limb symptoms) were also evaluated. Patients were followed up for 12 months. Results: The technical and clinical success was 100%. At 12 months, 53% of patients had no pelvic pain and 47% reported a reduction in pelvic pain. The average VAS was 7.34 before the procedure and 0.47 at 12 months. Complete relief of pain and associated symptoms was achieved for 37% of patients. Urinary urgency, lower limb symptoms, and vulvar and lower limbs varicosities were prognostic factors related to incomplete treatment success. The global complication rate was low (5/113,4.4%). Conclusion: Transcatheter embolization was a safe and effective treatment for PCS. Lower limb symptoms, urinary urgency, and varicosities were associated with incomplete clinical success.
- Pulmonary arteriovenous malformations: diagnostic and treatment characteristics(2019) SALIBE-FILHO, William; PILOTO, Bruna Mamprim; OLIVEIRA, Ellen Pierre de; CASTRO, Marcela Araujo; AFFONSO, Breno Boueri; MOTTA-LEAL-FILHO, Joaquim Mauricio da; BORTOLINI, Edgar; TERRA-FILHO, MarioObjective: To present a case series of pulmonary arteriovenous malformations (PAVMs), describing the main clinical findings, the number/location of pulmonary vascular abnormalities, the clinical complications, and the treatment administered. Methods: This was a retrospective observational study evaluating patients with PAVM divided into two groups: hereditary hemorrhagic telangiectasia (HHT); and idiopathic PAVM (iPAVM). Results: A total of 41 patients were selected for inclusion, but only 33 had PAVMs. After clinical evaluation, 27 and 6 were diagnosed with HHT and iPAVM, respectively. In the HHT group, the mean age was 49.6 years and 88.9% were female. In that group, 4 patients had an SpO(2) of < 90% and the most common clinical finding was epistaxis. In the iPAVM group, the mean age was 48.1 years and 83.3% were female. In that group, 3 patients had an SpO(2) of < 90%. Computed tomographic pulmonary angiography showed that most of the PAVMs were in the lower lobes: 56.4% in the HHT group and 85.7% in the iPAVM group. Embolization was performed in 23 patients (in both groups). At this writing, 10 patients are scheduled to undergo the procedure. One of the patients who underwent embolization was subsequently referred for pulmonary resection. Conclusions: In both of the PAVM groups, there was a predominance of women and of fistulas located in the lower lobes. Few of the patients had respiratory symptoms, and most had an SpO(2) > 90%. The treatment chosen for all patients was percutaneous transcatheter embolization.
bookPart Radiologia Vascular Intervencionista(2013) CARNEVALE, Francisco César; NASSER, Felipe; MOREIRA, Airton Mota; AFFONSO, Breno Boueri; ZURSTRASSEN, Charles EdouardbookPart Angiografia(2017) NASSER, Felipe; AFFONSO, Breno Boueri