JOSE GUILHERME MENDES PEREIRA CALDAS
Projetos de Pesquisa
Unidades Organizacionais
Instituto de Radiologia, Hospital das Clínicas, Faculdade de Medicina - Médico
LIM/45 - Laboratório de Fisiopatologia Neurocirúrgica, Hospital das Clínicas, Faculdade de Medicina
LIM/45 - Laboratório de Fisiopatologia Neurocirúrgica, Hospital das Clínicas, Faculdade de Medicina
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- Is more evidence needed for thrombectomy in basilar artery occlusion? The BASICS and BEST meta-analytical approaches(2021) SOLLA, Davi J. Fontoura; ARGOLO, Felipe Coelho; BUDOHOSKI, Karol P.; KOLIAS, Angelos G.; CALDAS, Jose Guilherme M. P.; OLIVEIRA-FILHO, Jamary
- Carotid Artery Atherosclerotic Profile as a Progression Marker for Cardiovascular Disease(2021) AGUIAR, Guilherme Brasileiro de; CALDAS, Jose Guilherme Mendes PereiraY
- Multiple and mirror intracranial aneurysms: study of prevalence and associated risk factors(2021) ROSI JUNIOR, Jefferson; SANTOS, Alexandra Gomes dos; SILVA, Saul Almeida da; IGLESIO, Ricardo Ferrareto; CALDAS, Jose Guillherme Mendes Pereira; RABELO, Nicollas Nunes; TEIXEIRA, Manoel Jacobsen; PREUL, Mark C.; SPETZLER, Robert F.; FIGUEIREDO, Eberval GadelhaObjective Multiple intracranial aneurysms (MIA) account for 30% of all intracranial aneurysms, while mirror aneurysms, a subgroup of MIA, are present in 5% of all patients with cerebral aneurysms. We investigated the risk factors associated with the presence of multiple and mirror intracranial aneurysms. Methods 1404 patients, 314 males (22.4%) and 1090 female (77.6%) were enrolled for this study. Diagnosis was performed with a digital subtraction angiography (DSA). Multiplicity was defined as the presence of two or more aneurysms and mirror aneurysms as one pair of aneurysms involving bilateral corresponding arteries. Patients were followed-up from September 2009 till August 2018. Individuals' characteristics such as sex, age, smoking, hypertension and use of contraceptives were evaluated. Results Five hundred and twelve patients (36.4%) were diagnosed with MIA, approximately 4%/year. We observed 203 pairs of mirror aneurysms, accounting for 406 aneurysms (13% of the population). There was an increased frequency of females with multiple (p < 0.001, OR = 1.883, 95% CI = 1.386-2.560) and mirror aneurysms (p < 0.001, OR = 2.828, 95% CI = 1.725-4.636). Smoking was associated with multiplicity (p< 0.001, OR = 1.458, 95% CI = 1.160-1.833), as well as advanced age (p < 0.001, OR = 1.938, 95% CI = 1.438-2.611), but there was no significant relation with presence of mirror aneurysms. We observed higher frequency of baby aneurysms (<3mm) in the group of patients with MIA, while giant aneurysms (>25 mm) were most found in patients with only one aneurysm (p < 0.001). No differences between patients who used contraceptives against patients who did not use were found (p = 0.600). Conclusions Gender and smoking, known risk factors to the development of a single intracranial aneurysm, are proportionally increased in patients with MIA. Hypertension and oral contraceptives were not associated with multiplicity.
- Atlas condemned to hold up the celestial heavens and bailout the mechanical thrombectomy failures in stroke?(2021) PAGIOLA, Igor; FRUDIT, Michel Eli; CALDAS, Jose Guilherme Mendes Pereira
- Comparison of surgical and endovascular treatments for fusiform intracranial aneurysms: systematic review and individual patient data meta-analysis(2021) TELLES, Joao Paulo Mota; SOLLA, Davi Jorge Fontoura; YAMAKI, Vitor Nagai; RABELO, Nicollas Nunes; SILVA, Saul Almeida da; CALDAS, Jose Guilherme Pereira; TEIXEIRA, Manoel Jacobsen; ROSI JUNIOR, Jefferson; FIGUEIREDO, Eberval GadelhaFusiform intracranial aneurysms (FIA) are associated with significant morbidity and mortality. We carried out a systematic review and meta-analysis of individual participant data with propensity score adjustment to compare the functional and angiographic outcomes between surgical and endovascular approaches to FIA. We conducted a systematic review for articles on the treatment of FIA with individual patient-level detailing. Data from patients treated for FIA in our institution from 2010 to 2018 were also collected. The primary studied outcome was morbidity, and secondary outcomes were angiographic results and retreatment. Propensity score-adjusted mixed-effects logistic regression models evaluated treatment options, stratified by anatomical location. Compiling original and published data, there were 312 cases, of which 79 (25.3%) had open surgery, and 233 (74.5%) were treated with endovascular procedures. There were no differences between treatment groups, for neither cavernous ICA (OR 1.04, 95% CI 0.05-23.6) nor supraclinoid aneurysms (OR 7.82, 95% CI 0.65-94.4). Both size (OR 1.11, 95% CI 1.03-1.19) and initial mRS (OR 2.0, 95% CI 1.2-3.3) were risk factors for morbidity, independent of location. Neither age nor rupture status influenced the odds of posterior morbidity. Unfavorable angiographic outcomes were more common in the endovascular group for supraclinoid and vertebrobasilar aneurysms (chi(2), P < 0.01). There were no differences between morbidity of surgical and endovascular treatments for FIA, regardless of aneurysm location. Size and initial mRS were correlated with functional outcomes, whereas age and rupture status were not. Microsurgery seems to yield better long-term angiographic results compared to endovascular procedures.