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The evolution of management of type B aortic dissection in a series of 100 cons...

Lopes, Alice; Pedro, Luís M; Melo, Ryan; Moutinho, Mariana; Sobrinho, Gonçalo; Amorim, Pedro; Silvestre, Luís; Fernandes E Fernandes, Ruy

Introduction and objectives: Management of aortic dissection is rapidly evolving. The present study aims to assess paradigm shifts in type B aortic dissection (TBAD) treatment modalities and their outcomes according to clinical presentation and type of treatment. We also aim to assess the impact of endovascular technology in TBAD management in order to define organizational strategies to provide an integrated c...


A systematic review and meta-analysis of the incidence of acute aortic dissecti...

Melo, Ryan; Oliveira Mourão, Mariana; Caldeira, Daniel; Alves, Mariana; Lopes, Alice; Duarte, António; Fernandes E Fernandes, Ruy; Pedro, Luís M

Objective: To perform a systematic review and meta-analysis of all population-based studies reporting on incidence of acute aortic dissections (AADs). Methods: We searched the MEDLINE, EMBASE, CENTRAL, and Open Grey databases from inception to August 2020 for population-based studies reporting on the incidence of AAD. A systematic review was conducted following the PRISMA guidelines using a registered protocol ...


Incidence of acute aortic dissections in patients with out of hospital cardiac ...

Melo, Ryan; Machado, Carolina; Caldeira, Daniel; Alves, Mariana; Lopes, Alice; Serrano, Maria; Fernandes E Fernandes, Ruy; Pedro, Luís M

Objectives: Acute Aortic dissection (AAD) may present as out-of-hospital cardiac arrest (OHCA). However, the incidence of this presentation is not well known. Our aim was to perform a systematic review and meta-analysis of all observational studies reporting on the incidence of AAD in patients with OHCA. Methods: We searched MEDLINE, CENTRAL, PsycInfo, Web of Science Core Collection and OpenGrey databases from ...


The impact of the proctor assistance for a safe learning curve in the developme...

Melo, Ryan; Fernandes E Fernandes, Ruy; Salvado, Margarida; Duarte, Antonio; Lopes, Alice; Verhoeven, Eric; Fernandes E Fernandes, Jose; Pedro, Luís M

Introduction: Initiating an endovascular aortic program for treatment of complex aortic aneurysms with fenestrated and branched grafts (FB-EVAR) is challenging. Using a Proctor is one option for training and development of the team. However, this approach has not been formally analyzed. The aim of this study was to analyze the learning curve and the effect of the Proctor regarding safety and effectiveness in FB...


Incidence and prevalence of thoracic aortic aneurysms: a systematic review and ...

Melo, Ryan; Duarte, Gonçalo Silva; Lopes, Alice; Alves, Mariana; Caldeira, Daniel; Fernandes E Fernandes, Ruy; Pedro, Luís M

Thoracic aortic aneurysms (TAA) may grow asymptomatically until they rupture, with a mortality over 90%. The true incidence and prevalence of this condition is uncertain and epidemiologic data is scarce, understudied and dispersed. Therefore, we aimed to conduct a systematic review and meta-analysis of the incidence and prevalence of TAAs in population-based studies. We searched MEDLINE, EMBASE and CENTRAL from...


Microbial evolution of vascular graft infections in a tertiary hospital based o...

Melo, Ryan; Martins, Beatriz; Pedro, Diogo Mendes; Mimoso Santos, Carla; Duarte, António; Fernandes E Fernandes, Ruy; Garrido, Pedro; Pedro, Luís M

Background: Vascular graft infections are a serious complication in vascular surgery. Correct antibiotic therapy targeted to the most likely infecting species is essential to treat these patients, although the bacterial epidemiology and pathogenesis are still not completely understood. We analyzed the behavior of vascular graft infections and the microbiologic patterns of resistance. Methods: A 10-year (2008-20...


Adaptations in the Vascular Surgery Department of the CHULN during the COVID-19...

Duarte, António; Melo, Ryan; Lopes, Alice; Rato, João; Rodrigues, Marta; Henriques, Mickael; Gomes, Miguel; Pinto, Vanda; Ribeiro, Karla; Silva, Emanuel

With the onset of the SARS-CoV-2 pandemic in early 2020, health services and personnel adapted their resources to mitigate and control the outbreak. These needs inevitably led to adaptations in most medical and surgical departments, including in our Vascular Surgery department. As we are facing a second outbreak of this pandemic, with unpredictable outcomes and repercussions in health services, it is crucial to...


Clinical aspects and present challenges of the seat belt aorta

Melo, Ryan; Amorim, Pedro; Soares, Tony; Fernandes E Fernandes, Ruy; Ministro, Augusto; Garrido, Pedro; Fernandes e Fernandes, José; Pedro, Luís M

Objective: Seat belt aorta is rare and difficult to manage. The lack of data and follow-up increases the complexity of treating such patients. We aimed to create a decision algorithm by reviewing our current experience and analyzing the presentation and management of our patients. Methods: We performed a descriptive case series based on retrospective analysis of all consecutive patients admitted with the diagno...


A single-center experience in the eversion femoral endarterectomy

Soares, Tony; Amorim, Pedro; Manuel, Viviana; Lopes, Alice; Fernandes E Fernandes, Ruy; Martins, Carlos; Pedro, Luís M

Objectives: Endarterectomy is the treatment of choice for arterial occlusive disease of the femoral bifurcation. Longitudinal arteriotomy and prosthetic patch angioplasty is the standard technique but, due to the increasing concerns with prosthetic-related infections and multidrug-resistant pathogens our group adopted an alternative approach. We present our experience with eversion femoral endarterectomy. Metho...


Clinical outcomes of aortic arch hybrid repair in a real-world single-center ex...

Soares, Tony; Melo, Ryan; Amorim, Pedro; Ministro, Augusto; Sobrinho, Gonçalo; Silvestre, Luís; Fernandes E Fernandes, Ruy; Martins, Carlos

Objective: Aortic arch aneurysmal disease remains a therapeutic challenge. For patients unsuitable for standard open surgery, hybrid repair with debranching of the supra-aortic arteries followed by thoracic endovascular grafting has been shown to be an effective solution. The aim of this study was to report the clinical outcomes of a single-institution experience using hybrid aortic arch repair. Methods: The ca...


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