Tratamento endovascular de estenose de artéria renal em rim transplantado

Introdução: a estenose de artéria renal transplantada (EART) é a complicação vascular mais frequente do transplante renal. O diagnóstico é realizado através da arteriografia e o tratamento consiste na angioplastia transluminal percutânea (ATP). Objetivo: avaliar o sucesso clínico, a patência primária e secundária da ATP, bem como a sobrevida dos pacientes após o tratamento endovascular. Métodos: análise retrospectiva dos pacientes com EART tratados por ATP no período de janeiro de 2008 a dezembro de 2016 no Hospital Universitário Walter Cantídio. Resultados: 28 pacientes foram tratados por EART através do método endovascular. A pressão diastólica reduziu de 91,62 mmHg para 76 mmHg, em média, após 6 meses do tratamento (p<0,05). Observou-se uma redução nos níveis de creatinina após 3, 6 e 24 meses da angioplastia (p=0,005). As taxas de patência primária em 1, 3, 6, 12 e 24 meses foram de 89,3% +/- 5,8%, 85,6% +/- 6,7%, 81,8% +/- 7,4%, 78,1% +/-7,9% e 68,9% +/- 9,3%, respectivamente. A taxa de patência secundária foi de 100%. A taxa de sobrevida em 1, 3, 6, 12 e 24 meses foi de 96,4% +/- 3,5%, 96,4% +/-3,5%, 92,6% +/- 5,1%, 92,6% +/- 5,1% e 83,8% +/- 7,5%, respectivamente. Conclusão: o tratamento endovascular de EART apresenta boas taxas de patências primária e secundária e é efetivo em restaurar e manter a função renal em dois anos

Correção endovascular de pseudo-aneurisma traumático de artéria carótida comum direita, abordagem retrógrada

A lesão traumática cervical é a principal causa de pseudoaneurismas carotídeos devido à perda da integridade da parede arterial e consequente hemorragia contida pelas estruturas adjacentes. Relatamos o caso de paciente, sexo feminino, 73 anos, desnutrida, portadora de doença renal crônica, que após tentativa de inserção de cateter em veia jugular direita, apresentou hematoma expansível em região cervical ipsilateral, sem comprometimento hemodinâmico ou de vias aéreas. A angiotomografia de vasos cervicais elucidou a presença de pseudo-aneurisma de artéria carótida comum direita de difícil abordagem cirúrgica. Tendo em vista as comorbidades e o alto risco cirúrgico da paciente, decidiu-se a abordagem endovascular e aposição de stent recoberto. A abordagem anterógrada, mais comum nesses casos, não foi possível pela dificuldade técnica causada por arco aórtico tipo 3, sendo realizado a abordagem cervical com punção retrógrada da artéria carótida comum e liberação de stent recoberto. A paciente recebeu alta do hospital com terapia antiplaquetária sem qualquer disfunção neurológica e a exclusão completa do pseudoaneurisma

Left subclavian artery stenting: an option for the treatment of the coronary-subclavian steal syndrome

Introduction: The subclavian steal syndrome is characterized by the vertebral artery flow inversion, due to a stenotic lesion in the origin of the subclavian artery. The Coronary-subclavian Steal Syndrome is a variation of the Subclavian Steal Syndrome and is characterized by inversion of flow in the Internal Thracic artery that has been used as conduct in a myocardial revascularization. Its diagnosis must be suspected in patients with difference in pulse and arterial pressure in the upper limbs, that present with angina pectoris and that have done a myocardial revascularization. Its treatment must be a surgical bypass or a transluminal angioplasty. Objective: The objective is to show the left subclavian artery stenting as a safe and effective method to treat the coronary-subclavian steal syndrome. Methods: Historical prospective, non-randomized trial, through revision of the hospital records of the patients treated with the stenting of the left subclavian artery, from January 2006 to September 2012. Results: In the mentioned period, 4.291 miocardial revascularizations were performed with the use of the left mammary artery, and 16 patients were identified to have the Coronary-subclavian steal syndrome. All of them were submitted to endovascular treatment. The success rate was 100%; two patients experienced minor complications; none of them presented with major complications. Eleven of the 16 patients had ultrassonographic documentation of patent stent for at least one year; two patients lost follow up and other two died. Conclusion: The stenting of the left subclavian artery is a good option for the treatment of the Coronary-subclavian Steal Syndrome, with high level of technical and clinical success

NEOTROPICAL ALIEN MAMMALS: a data set of occurrence and abundance of alien mammals in the Neotropics

Biological invasion is one of the main threats to native biodiversity. For a species to become invasive, it must be voluntarily or involuntarily introduced by humans into a nonnative habitat. Mammals were among first taxa to be introduced worldwide for game, meat, and labor, yet the number of species introduced in the Neotropics remains unknown. In this data set, we make available occurrence and abundance data on mammal species that (1) transposed a geographical barrier and (2) were voluntarily or involuntarily introduced by humans into the Neotropics. Our data set is composed of 73,738 historical and current georeferenced records on alien mammal species of which around 96% correspond to occurrence data on 77 species belonging to eight orders and 26 families. Data cover 26 continental countries in the Neotropics, ranging from Mexico and its frontier regions (southern Florida and coastal-central Florida in the southeast United States) to Argentina, Paraguay, Chile, and Uruguay, and the 13 countries of Caribbean islands. Our data set also includes neotropical species (e.g., Callithrix sp., Myocastor coypus, Nasua nasua) considered alien in particular areas of Neotropics. The most numerous species in terms of records are from Bos sp. (n = 37,782), Sus scrofa (n = 6,730), and Canis familiaris (n = 10,084); 17 species were represented by only one record (e.g., Syncerus caffer, Cervus timorensis, Cervus unicolor, Canis latrans). Primates have the highest number of species in the data set (n = 20 species), partly because of uncertainties regarding taxonomic identification of the genera Callithrix, which includes the species Callithrix aurita, Callithrix flaviceps, Callithrix geoffroyi, Callithrix jacchus, Callithrix kuhlii, Callithrix penicillata, and their hybrids. This unique data set will be a valuable source of information on invasion risk assessments, biodiversity redistribution and conservation-related research. There are no copyright restrictions. Please cite this data paper when using the data in publications. We also request that researchers and teachers inform us on how they are using the data