NELSON DE LUCCIA
Projetos de Pesquisa
Unidades Organizacionais
Departamento de Cirurgia, Faculdade de Medicina - Docente
Instituto Central, Hospital das Clínicas, Faculdade de Medicina
LIM/02 - Laboratório de Anatomia Médico-Cirúrgica, Hospital das Clínicas, Faculdade de Medicina - Líder
Instituto Central, Hospital das Clínicas, Faculdade de Medicina
LIM/02 - Laboratório de Anatomia Médico-Cirúrgica, Hospital das Clínicas, Faculdade de Medicina - Líder
72 resultados
Resultados de Busca
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- Analysis of the Correlation Between Central Obesity and Abdominal Aortic Diseases(2019) APOLONI, Rafael Correa; ZERATI, Antonio Eduardo; WOLOSKER, Nelson; SAES, Glauco Fernandes; WOLOSKER, Marina; CURADO, Taina; PUECH-LEAO, Pedro; LUCCIA, Nelson DeBackground: Atherosclerosis and abdominal aortic aneurysms (AAAs) have several similar risk factors but different pathogenesis. Inflammation of the arteries is common to both. Central obesity can act as an endocrine organ through the secretion of inflammatory cytokines, and the perivascular fat has a local effect that could contribute to diseases of the abdominal aorta. Although the relation between central obesity and atherosclerosis occlusive arterial disease has been demonstrated, the correlation with AAA has conflicting results. The aim of this study was to analyze the correlation between central obesity and the presence of abdominal aortic diseases using computed tomography. Methods: Six hundred thirty-nine consecutive patients classified into 3 groups (AAA, aortic atherosclerotic occlusive disease (AAOD), and without aortic disease [control group]) who underwent computed tomography had the aorta diameter, the visceral fat area (VFA), and the subcutaneous fat area (SFA) measured at the level of third and fourth lumbar vertebrae. Results: VFA showed no difference between the groups. SFA was lower in atherosclerotic group (AAOD) than control (P < 0.01 in general and P < 0.04 in male). In AAA group, we found in men that the first tertile of aorta diameter had higher VFA than third tertile (P = 0.02). Conclusions: There was no difference in VFA between patients in AAA, AAOD, and without aortic disease groups. In men with aneurysm, there was an inverse relationship between VFA and aortic diameter. In AAOD, visceral to subcutaneous ratio is higher due to lower SFA.
bookPart Tratamento minimamente invasivo da doença arterial periférica(2016) ZERATI, Antonio Eduardo; LUCCIA, Nelson de; WOLOSKER, NelsonconferenceObject The End of Wire Wrapping: A Technique to Avoid Intertwining Preloaded Guidewires for Endovascular Aortic Arch Repair(2022) QUEIROZ, Andre B.; SIQUEIRA, Jose; MOTA, Rodrigo S.; LUCCIA, Nelson De; MULATTI, Grace C.; PASSOS, Luiz S.- Open and endovascular repair of juxtarenal abdominal aortic aneurysms: a systematic review(2014) BELCZAK, Sergio Quilici; LANZIOTTI, Luiz; BOTELHO, Yuri; AUN, Ricardo; SILVA, Erasmo Simao da; PUECH-LEAO, Pedro; LUCCIA, Nelson deThis systematic review focuses on the 30-day mortality associated with open surgery and fenestrated endografts for short-necked (<15 mm) juxtarenal abdominal aortic aneurysms. A search for studies published in English and indexed in the PubMed and Medline electronic databases from 2002 to 2012 was performed, using ""juxtarenal abdominal aortic aneurysm"" and ""treatment"" as the main keywords. Among the 110 potentially relevant studies that were initially identified, eight were in accordance with the inclusion criteria in the analysis. Similar outcomes for open and endovascular repair were observed for 30-day mortality. No differences were observed regarding the secondary outcomes (duration of surgery, hospital stay, postoperative renal dysfunction and late mortality), except that the late mortality rate was significantly higher for the patients treated with open repair after a median follow-up of 24 months. Fenestrated endografting is a viable alternative to conventional surgery in juxtarenal abdominal aortic aneurysms with a proximal neck <15 mm.
- Cateteres venosos totalmente implantáveis: histórico, técnica de implante e complicações(2017) ZERATI, Antonio Eduardo; WOLOSKER, Nelson; LUCCIA, Nelson de; PUECH-LEÃO, PedroAbstract Access to the venous system is of vital importance for diagnosis and treatment of patients with the most varied range of clinical conditions, whether for taking blood samples or for infusion of solutions. In 1616, Harvey described the circulatory system on the basis of studies in animals and 4 decades later Sir Christopher Wren conducted the first intravenous infusions in living beings. Since then there has been constant evolution in access technique and infusion devices. Of particular note is the creation of long-term catheters in the 1970s, particularly totally implantable devices, which revolutionized cancer treatment, increasing both safety and comfort for oncology patients. The objectives of this article are to review historical data on vascular access and discuss the implantation technique and the main complications associated with procedures for placement and use of totally implantable venous access devices.
- Experimental implantation of an arterial substitute made of silicone reinforced with polyester fabric in rabbits(2017) RIBAS, Laila Massad; TORRES, Inez Ohashi; APPOLONIO, Fernanda; ROSA, Karina Paula Domingos; ESPIRITO-SANTO, Fabio Rodrigues Ferreira do; LUCCIA, Nelson DeOBJECTIVES: The aim of this study was to analyze silicone tubes with an internal diameter of 4 mm as a possible material for vascular prostheses. METHODS: Grafts were implanted into the infrarenal aortas of 33 rabbits. Fluoroscopic examinations were performed within 150 days after surgical implantation. Sample grafts were analyzed via electron microscopy to evaluate the eventual endothelialization of the prostheses. RESULTS: The patency rates of the prostheses were 87% (+/- 6.7%) after 30 days, 73% (+/- 9.3%) after 60 days and 48% (+/- 12%) after 120 days. The material presented characteristics that support surgical implantation: good tolerance promoted by polyester tear reinforcement, ease of postoperative removal and a lack of pseudoaneurysms. However, intimal hyperplasia was a limiting factor for the patency rate. CONCLUSIONS: We concluded that polydimethylsiloxane has limited potential as an alternative material for small vascular prostheses.
- Paraplegia of Lower Limbs Caused by a Segmental Thrombosis of the Descending Thoracic Aorta Reversed with Endovascular Treatmentd-A Case Report and Literature Review(2018) LEIDERMAN, Dafne Braga Diamante; WOLOSKER, Nelson; OLIVEIRA, Marcos Vieira de Melo; CARVALHO, Heitor Andrei Miranda de; BARAO, Felipe Trajano de Freitas; ZERATI, Antonio Eduardo; LUCCIA, Nelson De; PUECH-LEAO, PedroBackground: Transient paraplegia of the lower limbs is a rare condition and, when has a vascular etiology, is usually associated with thromboembolic events, aortic dissection, aortic aneurysms, or as a complication of the surgical correction of those diseases. There is no case reported of acute paraplegia caused by a segmental thrombotic subocclusion of the descending thoracic aorta. Case Report: We report a not yet described clinical situation of a young patient (51 years) admitted to the emergency care department for treatment of systemic arterial hypertension of difficult control with 4 antihypertensive medication classes. At the intensive care unit for treatment with intravenous antihypertensive medication, the patient evolved with acute paraplegia and a segmental thrombotic subocclusion of the descending thoracic aorta was diagnosed. He was submitted to endovascular treatment with total recovery of the deficits. Conclusions: The previously normal descending thoracic aorta may be a site of segmental thrombosis and may lead to paraplegia. Early endovascular treatment can reverse this type of situation.
- Biomechanical Properties and Microstructural Analysis of the Human Nonaneurysmal Aorta as a Function of Age, Gender and Location: An Autopsy Study(2015) NINOMIYA, Otavio Henrique; MONTEIRO, Jose Augusto Tavares; HIGUCHI, Maria de Lourdes; PUECH-LEAO, Pedro; LUCCIA, Nelson de; RAGHAVAN, Madhavan Lakshmi; SILVA, Erasmo Simao daIntroduction: The biomechanical failure properties and histological composition of the human nonaneurysmal aorta were studied. Methods: Twenty-six human aortas were harvested from fresh cadavers at autopsy. A total of 153 circumferentially oriented strips were obtained from the aortas for biomechanical and histological studies. Results: The failure load (6.18 +/- 2.03 vs. 4.85 +/- 2.04 N; p = 0.001), failure tension (19.88 +/- 9.05 vs. 14.53 +/- 7 N/cm; p = 0.001), failure strain (0.66 +/- 0.31 vs. 0.49 +/- 0.25; p = 0.003) and amount of elastic fibers (19.39 +/- 15.57 vs. 14.06 +/- 9.5%; p = 0.011) were all significantly higher for the thoracic than the abdominal aorta. There was a significant negative correlation between age and failure load (R = -0.35; p < 0.0001), failure stress (R = -0.63; p < 0.0001), failure tension (R = -0.52; p < 0.0001) and failure strain (R = -0.8; p < 0.0001). Male aortas had a higher failure load and failure tension than female aortas. Conclusion: The thoracic aorta has a higher strength and elasticity than the abdominal aorta. The elderly have weaker and stiffer aortas than the young. Male aortas are stronger than female aortas. (C) 2016 S. Karger AG, Basel
- Imaging Signs of May-Thurner Syndrome in Asymptomatic Patients: Computed Tomography Angiography Analysis of Kidney Donors(2023) LOPES, Daniel F.; ZERATI, Antonio E.; LUCCIA, Nelson De; NAHAS, William C.; PUECH-LEAO, PedroBackground: The current study aimed to evaluate the distance between the right common iliac artery (RCIA) and lumbar vertebra in asymptomatic patients in order to determine whether such distance was statistically correlated with the left common iliac vein (LCIV) diameter (LCIVD) and to investigate if both measures were related to demographic characteristics and anthropometric data, such as sex, age, height, and body mass index (BMI).Methods: In this descriptive and uncontrolled anatomic study, data from high-definition computed tomography (CT) angiography images of living kidney donors without a medical history of chronic venous insufficiency or past deep vein thrombosis (DVT) were analyzed. The RCIA crossed over the LCIV in 311 individuals, who were then included in this study. CT scans were reviewed to measure (1) the narrowest space between the RCIA and fifth lumbar vertebral body and (2) the LCIVD. Measures were subjected to normality tests and were divided according to the sex of the study population. Correlations of measures with age, BMI, and height were calculated.Results: Of the 311 patients analyzed, 66.6% (n = 207) were female. The mean lumbar vertebral bodyeiliac artery distance (LVBIAD) was 7.2 mm, whereas the mean LCIVD was 8.5 mm; both were higher in men (P < 0.001). The statistical analysis of LVBIAD and LCIVD distributions revealed no normality pattern (P < 0.05). The analysis of the correlation between them showed a weak statistically significant relationship with age. A linear regression model considering the normality percentile interval indicated a strong positive correlation between LVBIAD and LCIVD (R2 = 0.884).Conclusions: The LVBIAD was <5 mm and <3 mm in 25% and 5% of asymptomatic individ-uals, respectively. The LCIVD correlated with the space between the RCIA and lumbar vertebra. The distance between the RCIA and lumbar vertebra and the LCIVD were higher in male sub-jects and older patients, but did not correlate with BMI and height.
- Type II Endoleaks, Left-Arm Complications, and Need of Revascularization after Left Subclavian Artery Coverage for Thoracic Aortic Aneurysms Endovascular Repair: A Systematic Review(2017) BELCZAK, Sergio Quilici; SILVA, Erasmo Simao; KLAJNER, Rafael; PUECH-LEAO, Pedro; LUCCIA, Nelson DeBackground: The status of the left arm, the need of revascularization, and the occurrence of type II endoleakes from de left subclavian artery (LSA) after intention LSA coverage for thoracic aortic aneurysm endovascular repair need to be better understood. This systematic review was developed for contributing with such issue. Methods: Systematic literature review of studies published from January 2000 through December 2015 identified 7 studies comprising 201 patients submitted to elective endovascular repair for thoracic aortic aneurysms requiring intentional LSA coverage. Outcomes of interest included left-arm complications (ischemia, symptoms of claudication, and subclavian steal syndrome [SSS]) requiring postoperative revascularization of LSA, as well as endoleaks from the subclavian artery requiring postoperative embolization of LSA. Results: Left-arm complication rate was 4.5% (9 patients), requiring postoperative revascularization of LSA in 1 case (0.5%) of SSS. Type II endoleaks from the subclavian artery requiring postoperative embolization of LSA were reported in 2 cases (1.0%). Conclusions: Low-quality evidence suggests very low rates of arm complications with need of LSA revascularization and of type II endoleaks requiring embolization in elective endovascular treatment of thoracic aortic aneurysms with intentional coverage of LSA without prophylactic revascularization of LSA.