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
11 resultados
Resultados de Busca
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- 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.
- Impact of the period of the day on all-cause mortality and major cardiovascular complications after arterial vascular surgeries(2023) ARTIOLI, Thiago; GUALANDRO, Danielle Menosi; CARDOZO, Francisco Akira Malta; ROJAS, Maria Carmen Escalante; CALDERARO, Daniela; YU, Pai Ching; CASELLA, Ivan Benaduce; LUCCIA, Nelson de; CARAMELLI, BrunoBackgroundConflicting results are reported about daytime variation on mortality and cardiac outcomes after non-cardiac surgeries. In this cohort study, we evaluate whether the period of the day in which surgeries are performed may influence all-cause mortality and cardiovascular outcomes in patients undergoing non-cardiac arterial vascular procedures. Methods1,267 patients who underwent non-cardiac arterial vascular surgeries between 2012 and 2018 were prospectively included in our cohort and categorized into two groups: morning (7 a.m. to 12 a.m., 79%) and afternoon/night (12:01 p.m. to 6:59 a.m. in the next day, 21%) surgeries. Primary endpoint was all-cause mortality within 30 days and one year. Secondary endpoints were the incidence of perioperative myocardial injury/infarction (PMI), and the incidence of major adverse cardiac events (MACE, including acute myocardial infarction, acute heart failure, arrhythmias, cardiovascular death) at hospital discharge. ResultsAfter adjusting for confounders in the multivariable Cox proportional regression, all-cause mortality rates at 30 days and one year were higher among those who underwent surgery in the afternoon/night (aHR 1.6 [95%CI 1.1-2.3], P = 0.015 and aHR 1.7 [95%CI 1.3-2.2], P < 0.001, respectively). Afternoon/night patients had higher incidence of PMI (aHR 1.4 [95%CI 1.1-1.7], P < 0.001). There was no significant difference in the incidence of MACE (aHR 1.3 [95%CI 0.9-1.7], P = 0.074). ConclusionsIn patients undergoing arterial vascular surgery, being operated in the afternoon/night was independently associated with increased all-cause mortality rates and incidence of perioperative myocardial injury/infarction.
conferenceObject Short Neck Ruptured Aortic Aneurysms Treated With Standard Endovascular Repair(2023) MULATTI, Grace Carvajal; CUNHA, Priscilla Matos; TEIXEIRA, Eduardo Corvello; MORAES, Tayrine Mazotti de; QUEIROZ, Andre Brito; PUECH-LEAO, Pedro; LUCCIA, Nelson De- The Distensibility of the Human Vena Cava and Its Importance to In Vitro Studies of Venous Compression Syndromes: A Search for a Suitable Polymer for 3-Dimensional Printing(2023) PUECH-LEAO, Pedro; TORRES, Inez O.; SILVA, Erasmo S. da; CESTARI, Ismar N.; CESTARI, Idagene A.; ROSA, Jhenyfer M. da; NAHAS, William C.; LUCCIA, Nelson DeBackground: Venous compression syndromes are clinical conditions in which the large veins are compressed by other anatomical structures. Laboratory simulations may help us better understand the hemodynamics in venous compressions by creating situations similar to those seen in vivo. The aim of this study is to produce a model of the caval bifurcation using a polymer with distensibility similar to the human vena cava. Methods: Fragments of the inferior vena cava were collected from 13 deceased kidney donors (aged 15-37 years) and were tested for deformation (strain) when subjected to distension at 50 N/cm2. Strips of 5 different polymers-thermic polyurethane and Agilus30 with Vero Magenta (AV) (in 3 different hardnesses) and silicone-were subjected to the same biomechanical tests and compared with the vena cava. A model of the caval bifurcation was produced with 3-D printing. Results: The deformation (strain) of the vena cava wall was 0.16 & PLUSMN; 0.9 when submitted to stress close to 50 N/cm2. Silicone showed a strain higher than the standard deviation of venous fragments. The strain of AV resin 95 Shore was lower than the standard deviation of the venous fragments. AV Resins 70 and 85 Shore showed strains within the standard deviation of the venous specimen, with 70 Shore being closest to the mean venous strain. Therefore, this material was selected for modeling the caval bifurcation. The computed tomography scan image generated a computer model of the caval bifurcation and was printed in 3 dimensions. In addition, the segments of 2 adjacent vertebrae were also printed to reference the compression site. Conclusions: The 3-D printing of large veins can produce models with anatomy and biome-chanics similar to those of human veins and opens a field of investigation into the hemody-namics of venous compression syndromes. Polymers with Shore A70 appear to have biomechanical properties similar to those of the vena cava wall. The model obtained in this study can be used in several in vitro studies of May-Thurner Syndrome.
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- Common Carotid Artery Occlusion: A Single-Center Experience in 40 Cases(2016) BELCZAK, Sergio; MULATTI, Grace Carvajal; ABRAO, Sergio Ricardo; SILVA, Erasmo Simao da; AUN, Ricardo; PUECH-LEAO, Pedro; LUCCIA, Nelson deThe incidence of common carotid artery occlusion (CCAO) is approximately 3% in patients who undergo angiography for symptomatic cerebrovascular disease; however, few studies have reported on management of this condition. The objective of this article was to analyze risk factors, therapeutic options, and clinical benefits of surgical treatment at a hospital in the city of Sao Paulo, Brazil. Data were collected from medical records of 40 patients with CCAO who were treated from June 2002 to October 2013. Results were analyzed retrospectively. Most of the patients were men (63.0%), who were significantly younger than women. Most of the participants had hypertension (90.0%), and more than half had a history of smoking (52.5%). The mean number of coexisting comorbidities/risk factors was 2.9 +/- 1.0. Half of our sample had ipsilateral patent internal and external carotid artery, and 32.5% presented with an occluded internal carotid artery and a patent external artery. Patients with both an internal and an external occluded carotid artery (12.5%) were significantly older. Contralateral arteriosclerosis was observed in 65% of the patients, mainly represented by 50 to 90% stenosis. Most patients were symptomatic (67.5%), and hemiparesis was the most common symptom (55.0%) found. Most (77.5%) of the patients underwent the medical treatment; one out of three endovascular approaches failed. During the mean follow-up of 55 +/- 43 months (range, 2-136 months), 17.5% of the patients died within 4 days after surgical repair and after along 123 months of clinical follow-up. Coexisting comorbidities/risk factors were significantly associated with fatal outcomes, such as acute myocardial infarction. This study provides scientific evidences on treatment and outcomes of CCAO.
- Endovascular repair of ascending aorta pseudoaneurysm post-extracorporeal membrane oxygenation cannulation during pulmonary transplant(2023) KANAMORI, Lucas Ruiter; MULATTI, Grace Carvajal; BARROS, Taina Curado Gomes de; ABDALLA, Luis Gustavo; BIHAN, David Costa de Souza Le; LUCCIA, Nelson DeWe demonstrated an endovascular technique excluding an ascending aorta pseudoaneurysm using an aortic extension. A 32-year-old woman, 3 years after lung transplantation with extracorporeal membrane oxygenation presented with an ascending aortic pseudoaneurysm. Vascular surgery was consulted after open repair was deemed high risk. An aortic extension stent graft was placed in a hybrid operating room with the aid of intraoperative transesophageal echocardi-ography. Ascending aorta pseudoaneurysms are complex and life-threatening complications. Traditional repair involves high surgical and anesthetic risks whereas endovascular treatment is technically feasible.
article 0 Citação(ões) na Scopus Successful endovascular correction of common carotid pseudoaneurysm secondary to Behcet's disease: case report and review of the literature(2020) SILVA, C. B. R.; REBOUCAS, J. C.; NUNES, S. L. O.; LUCCIA, N. de; PEREIRA, R. M. R.Behcet's disease (BD) is a chronic, multisystemic, inflammatory disease characterised by recurrent mucocutaneous, ocular, musculoskeletal, central nervous system, gastrointestinal and vascular manifestations, which may affect blood vessels of any size (1). Venous involvement is more common, but arterial involvement accounts for the major cause of mortality (2, 3). Choosing the adequate technique for correcting aneurysms in BD and the timing to do it is still challenging. The authors report a case of 37-year-old male patient with common carotid pseudoaneurysm at the time of diagnosis, which was successfully treated by an endovascular stent placement after adequate immunosuppression. A review of the literature about this issue was also done.- Brazilian Society for Angiology and Vascular Surgery guidelines on abdominal aortic aneurysm(2023) MULATTI, Grace Carvajal; JOVILIANO, Edwaldo Edner; PEREIRA, Adamastor Humberto; FIORANELLI, Alexandre; PEREIRA, Alexandre Araujo; BRITO-QUEIROZ, Andre; RISTOW, Arno Von; FREIRE, Lucas Marcelo Dias; FERREIRA, Marcelo Martins da Volta; LOURENCO, Marco; LUCCIA, Nelson De; SILVEIRA, Pierre Galvagni; YOSHIDA, Ricardo de Alvarenga; FIDELIS, Ronald Jose Ribeiro; BOUSTANY, Sharbel Mahfuz; ARAUIO, Walter Junior Boim de; OLIVEIRA, Julio Cesar Peclat deThe Brazilian Society of Angiology and Vascular Surgery, through the Guidelines Project, presents new Abdominal Aortic Aneurysm Guidelines, on the subject of care for abdominal aortic aneurysm patients. Its development prioritized descriptive guidelines, using the EMBASE, LILACS, and PubMed databases. References include randomized controlled trials, systematic reviews, meta-analyses, and cohort studies. Quality of evidence was evaluated by a pair of coordinators, aided by the RoB 2 Cochrane tool and the Newcastle Ottawa Scale forms. The subjects include juxtarenal aneurysms, infected aneurysms, and new therapeutic techniques, especially endovascular procedures. The current version of the guidelines include important recommendations for the primary topics involving diagnosis, treatment, and follow-up for abdominal aortic aneurysm patients, providing an objective guide for medical practice, based on scientific evidence and widely available throughout Brazil.
- Vascular surgery in the most populous state in the Amazon: socio-professional profile and aspirations of the specialty(2021) REIS, José Maciel Caldas dos; SANTOS, Deivid Ramos dos; TORRES, Inez Ohashi; DE LUCCIA, NelsonAbstract Background There is a dearth of studies conducted to understand the socio-professional profile of the vascular surgery specialty and the population demands of specific regions, which are needed to support creation of care policies and direct infrastructure improvements in healthcare. Objectives The purpose of this study was to describe the socio-professional profile of vascular surgeons in the state of Pará, Brazil, to guide creation of tools for professional improvement. Methods A cross-sectional, self-report survey was conducted in Pará using a questionnaire comprising 30 questions covering six main topics. Results All vascular surgeons actively practicing in the state participated in this study. The total number of specialists was 59, with 71.2% working in the greater Belém area and 16.9% exclusively practicing in the interior of the state. The mean age of these professionals was 48 ± 11.1 years, 86.4% of respondents were men, 64.4% of surgeons had completed medical residency, and 96.6% (n=57) of the surgeons would like to improve their skills in venous surgery, echo-guided vascular access, and endovascular surgery. The method of professional improvement of greatest interest was simulation courses (hands-on), endorsed by 93% of the participants. Conclusions Pará has 59 vascular surgeons. These professionals mainly work in the greater Belém (71.2%), in hospitals (100%) or in private clinics or offices (94.9%), performing a wide range of procedures, including venous and arterial surgery, amputations, and provision of hemodialysis access. More than 90% of these surgeons were satisfied professionally and reported that they would choose the specialty again. However, 22% had a pessimistic view of the specialty’s future. The vast majority of professionals (96.6%) consider that training or a continuing education program are necessary.