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Patients with peripheral artery disease and generalized atherosclerosis are at high risk of cardiovascular and limb complications, affecting both quality of life and longevity. Lower limb atherosclerotic disease is associated with high cardiovascular morbidity and mortality and adequate management is founded on treatments involving patient-dependent factors, such as lifestyle changes, and physician-dependent factors, such as clinical treatment, endovascular treatment, or conventional surgery. Medical management of peripheral artery disease is multifaceted, and its most important elements are reduction of cholesterol level, antithrombotic therapy, control of arterial blood pressure, control of diabetes, and smoking cessation. Adhesion to this regime can reduce complications related to the limbs, such as chronic limb-threatening ischemia, that can result in amputation, and the systemic complications of atherosclerosis, such as stroke and myocardial infarction., Competing Interests: Conflicts of interest: No conflicts of interest declared concerning the publication of this article., (Copyright© 2024 The authors.)

Deep vein thrombosis is one of the main causes of inpatient and outpatient morbidity, both in medical and surgical patients, significantly impacting mortality statistics and requiring prompt diagnosis so that treatment can be initiated immediately. This document was prepared and reviewed by 11 specialists certified by the Brazilian Society of Angiology and Vascular Surgery, who searched the main databases for the best evidence on the diagnostic (physical examination, imaging) and therapeutic approaches (heparin, coumarins, direct oral anticoagulants, fibrinolytics) to the disease., Competing Interests: Conflicts of interest: No conflicts of interest declared concerning the publication of this article., (Copyright© 2024 The authors.)

Extracranial cerebrovascular disease has been the subject of intense research throughout the world, and is of paramount importance for vascular surgeons. This guideline, written by the Brazilian Society of Angiology and Vascular Surgery (SBACV), supersedes the 2015 guideline. Non-atherosclerotic carotid artery diseases were not included in this document. The purpose of this guideline is to bring together the most robust evidence in this area in order to help specialists in the treatment decision-making process. The AGREE II methodology and the European Society of Cardiology system were used for recommendations and levels of evidence. The recommendations were graded from I to III, and levels of evidence were classified as A, B, or C. This guideline is divided into 11 chapters dealing with the various aspects of extracranial cerebrovascular disease: diagnosis, treatments and complications, based on up-to-date knowledge and the recommendations proposed by SBACV., Competing Interests: Conflicts of interest: No conflicts of interest declared concerning the publication of this article., (Copyright© 2024 The authors.)

The diabetic foot interacts with anatomical, vascular, and neurological factors that challenge clinical practice. This study aimed to compile the primary scientific evidence based on a review of the main guidelines, in addition to articles published on the Embase, Lilacs, and PubMed platforms. The European Society of Cardiology system was used to develop recommendation classes and levels of evidence. The themes were divided into six chapters (Chapter 1 - Prevention of foot ulcers in people with diabetes; Chapter 2 - Pressure relief from foot ulcers in people with diabetes; Chapter 3 -Classifications of diabetic foot ulcers; Chapter 4 - Foot and peripheral artery disease; Chapter 5 - Infection and the diabetic foot; Chapter 6 - Charcot's neuroarthropathy). This version of the Diabetic Foot Guidelines presents essential recommendations for the prevention, diagnosis, treatment, and follow-up of patients with diabetic foot, offering an objective guide for medical practice., Competing Interests: Conflicts of interest: No conflicts of interest declared concerning the publication of this article., (Copyright© 2024 The authors.)

The Brazilian Society of Angiology and Vascular Surgery has set up a committee to provide new evidence-based recommendations for patient care associated with chronic venous insufficiency. Topics were divided in five groups: 1. Classification, 2. Diagnosis, 3. Conservative or non-invasive treatment, 4. Invasive treatment and 5. Treatment of small vessels. This last series is closely related to the activities of Brazilian angiologists and vascular surgeons, who are heavily involved in the treatment of small superficial veins. These guidelines are intended to assist in clinical decision-making for attending physicians and health managers. The decision to follow a guideline recommendation should be made by the responsible physician on a case-by-case basis taking into account the patient's specific condition, as well as local resources, regulations, laws, and clinical practice recommendations., Competing Interests: Conflicts of interest: Rodrigo Kikuchi: Founding partner Instituto de Excelência Vascular, Sigvaris educational fund, Essity educational fund, speaker Icone Medical, speaker Venosan, speaker Vydence, Servier research fund, founding partner Conecta Medico. Fabrício Rodrigues Santiago: Speaker Servier, Bayer, Pfizer. Felipe Coelho Neto: Founding partner FleboCurso, speaker Bayer, Daiichi Sankyo. The remaining authors declare no conflict of interest., (Copyright© 2023 The authors.)

Trauma is a leading cause of death, permanent disability, and health care cost worldwide. The young and economically active are the most affected population. Exsanguination due to noncompressible torso hemorrhage is one of the most frequent causes of early death, posing a significant challenge to trauma and vascular surgeons. The possibility of limb loss due to vascular injuries must also be considered. In recent decades, the approach to vascular injuries has been significantly modified. Angiotomography has become the standard method for diagnosis, endovascular techniques are currently incorporated in treatment, and damage control, such as temporary shunts, is now the preferred approach for the patients sustaining physiological derangement. Despite the importance of this topic, few papers in the Brazilian literature have offered guidelines on vascular trauma. The Brazilian Society of Angiology and Vascular Surgery has developed Projetos Diretrizes (Guideline Projects), which includes this publication on vascular trauma. Since treating trauma patients is a multidisciplinary effort, the Brazilian Trauma Society (SBAIT) was invited to participate in this project. Members of both societies reviewed the literature on vascular trauma management and together wrote these guidelines on vascular injuries of neck, thorax, abdomen, and extremities., Competing Interests: Conflicts of interest: No conflicts of interest declared concerning the publication of this article., (Copyright© 2023 The authors.)

The 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., Competing Interests: Conflicts of interest: No conflicts of interest declared concerning the publication of this article., (Copyright© 2023 The authors.)

Chronic kidney disease is a worldwide public health problem, and end-stage renal disease requires dialysis. Most patients requiring renal replacement therapy have to undergo hemodialysis. Therefore, vascular access is extremely important for the dialysis population, directly affecting the quality of life and the morbidity and mortality of this patient population. Since making, managing and salvaging of vascular accesses falls within the purview of the vascular surgeon, developing guideline to help specialists better manage vascular accesses for hemodialysis if of great importance. Thus, the objective of this guideline is to present a set of recommendations to guide decisions involved in the referral, evaluation, choice, surveillance and management of complications of vascular accesses for hemodialysis., Competing Interests: Conflicts of interest: No conflicts of interest declared concerning the publication of this article., (Copyright© 2023 The authors.)

Treatment of lower limb chronic venous disease has progressed exponentially over recent decades. The advances achieved have made it possible to develop a proposal for a systematized intravenous laser ablation technique - assisted total thermal ablation (ATTA). The technique constitutes a standardized method for management of axial or tributary veins that are varicosed or esthetically unappealing, whether in the lower limbs or other areas, that can be performed on an outpatient or day-hospital basis. This article describes the processes for preoperative preparation and detailed marking, the materials needed, venous access, anesthesia, calculation of power and energy, the ablation technique itself, follow-up, and adverse events. The ATTA technique is proposed as a tool for treatment of chronic venous disease and of esthetically unappealing veins, suggesting possible extension of the applications for lasers beyond trunk veins to any vein that can be punctured., Competing Interests: Conflicts of interest: MAM received fees for participating in events from Bayer, Pfizer, Ache and Sanofi., (Copyright© 2022 The authors.)

This research analysed the spatiotemporal distribution of triatomines infected by trypanosomatid parasites in an endemic region for Chagas disease, in the state of Pernambuco, Northeastern Brazil. The database included the total number of triatomines captured from intradomicile and peridomicile areas, as well as the infection rate (IR) by trypanosomatid. The G i ∗ by Getis-Ord method was used to statistically identify significant concentration clusters and the IR of triatomines by trypanosomatids. A generalized linear regression model with a binomial distribution was used to evaluate the probability of finding an IR by trypanosomatids. Overall, of 4,800 triatomines examined, trypanosomatid forms similar to Trypanosoma cruzi were detected in 10.29% of them, and the majority of positive specimens (98.17%) were collected at intradomicile. The geospatial analyses identified triatomines clusters in intradomicile and peridomicile environments. According to the logistic regression data for species (Panstrongylus lutzi, P. megistus, Triatoma brasiliensis and T. pseudomaculata), the probability of detection of T. cruzi infection remains constant in up to 50 specimens examined or more. The findings of this research revealed a scenario never studied in this area through this type of spatiotemporal analysis, which is essential to identify areas of vulnerability for the occurrence of these vectors and consequently for Chagas disease., (© 2021 Wiley-VCH GmbH.)

Brazil accounts for around 20% of all animal species, but these are constantly threatened by illegal anthropic activities. Unfortunately, animal dealers are totally unaware of the sanitary risks among wild animals, or that occurrences of parasites in these animals are bioindicators for their current sanitary status within the ecosystem in which they live. This status is an important parameter with regard to assessing the spreading of pathogens. Therefore, the aim of this study was to perform a survey of zoonotic parasites in carnivores and non-human primates that are illegally traded in Brazil. Between June 2016 and July 2017, 43 wild animals (20 carnivores and 23 non-human primates) were presented at the Wild Animal Screening Center of Sergipe (CETAS/SE). Fecal and blood samples were obtained and analyzed to detect occurrences of pathogens of medical and veterinary importance, such as Cryptosporidium spp., Giardia spp., Dirofilaria immitis , Leishmania infantum, Leishmania braziliensis, Toxoplasma gondii , Trypanosoma cruzi and gastrointestinal helminths. Out of all the animals analyzed, 55.8% (24/43) were found to be positive for at least one parasite species, i.e. 41.7% and 58.3% of the carnivores and non-human primates, respectively. However, all the animals were negative for D. immitis , L. braziliensis and T. cruzi . These findings demonstrate that illegally traded wild animals may represent a risk to public health because of absence of sanitary control during their transportation. Therefore, preventive measures might be employed to avoid infection of these animals and people in close contact with them., Competing Interests: Conflict of interests: No conflict of interests declared concerning the publication of this article., (Copyright Lima et al.)

This narrative review covers the life-threatening thromboembolic events associated with SARS-CoV-2 infection/COVID-19. It addresses the physical changes that cause vascular and arterial damage to limbs, laboratory management of coagulation, and management of anticoagulation. COVID-19's relationship with deep venous thrombosis and arterial thrombosis is also emphasized. The main thromboembolic events described in the literature are illustrated with examples from our experience with COVID-19 patients., Competing Interests: Conflicts of interest: JCPO, WJBA, MAM and FLE are speakers from the pharmaceutical industry., (Copyright© 2021 The Authors.)

Leg ulcers are the most common cutaneous complication of sickle cell disease. These lesions occur mainly in homozygous forms, are slow to heal and often relapse, causing negative physical, emotional, and economic impacts. In this paper, we discuss the clinical presentation, diagnosis, and pathophysiology of sickle cell leg ulcers and their implications for treatment., Competing Interests: Conflicts of interest: No conflicts of interest declared concerning the publication of this article.

Ticks and fleas are arthropods widely distributed around the world involved in the transmission of various vector-borne diseases (VBDs), including Brazilian Spotted Fever (BSF), Baggio-Yoshinari Syndrome and the plague, with outstanding consequences for the public health. The aim of this study was to investigate the presence of Rickettsia spp., Borrelia spp. and Yersinia pestis in arthropods collected from dogs, cats and horses living in the state of Pernambuco, Northeastern Brazil. From January 2017 to April 2019, ectoparasites were collected, morphologically identified and molecularly analysed through PCR and sequencing. In total 401 specimens were collected from 86 animals, being 68% (n = 273) and 32% (n = 128) from rural and urban areas, respectively. The most commonly detected species were the ticks Dermacentor nitens, Amblyomma sculptum, Rhipicephalus sanguineus sensu lato (s.l.), Rhipicephalus microplus, and Amblyomma ovale, and the fleas Ctenocephalides felis and Ctenocephalides canis. DNA of Rickettsia felis was detected in D. nitens collected from horses, and C. felis, and R. sanguineus s.l. collected from dogs. All samples scored negative for Borrelia spp. and Y. pestis DNA. This study provides valuable data on ectoparasite fauna from domestic animals and identifies the circulation of a zoonotic pathogen (i.e., R. felis) in the population of the arthropods assessed. Therefore, preventive measures should be adopted in order to reduce the risk of occurrence of neglected VBD caused by this pathogen in animal and human hosts.

Background: Many dialysis patients do not have the necessary conditions for construction of a native arteriovenous fistula (AVF). Expanded Polytetrafluoroethylene (ePTFE) vascular prostheses are the most widely-used option, but it is known that they are inferior to native vein AVFs., Objectives: To identify a graft with superior performance to ePTFE, comparing their results with those of AVFs made from bovine mesenteric arteries treated with L-Hydro technology (Labcor Laboratories ® )., Methods: A prospective and controlled study of 10 patients with AVFs constructed with ePTFE and 10 patients with L-Hydro bioprostheses, matched for comorbidities. The variables studied were: primary patency, assisted primary patency, and secondary patency, surgical manipulability, and prevalence of infections. The performance of prostheses was assessed by duplex-scan and repeated consultations with health professionals at hemodialysis clinics. The chi-square test was used for statistical analysis., Results: After 1 year of postoperative follow-up, secondary and primary patency rates were higher for L-Hydro than ePTFE AVFs. Fewer interventions were needed to maintain AVF patency in the L-Hydro AVF group. The most common complication was graft thrombosis, which was more frequent in the ePTFE group. While the figures indicate more favorable outcomes in the L-Hydro AVFs, this could not be confirmed with the statistical treatment employed., Conclusions: The L-Hydro graft appears to be a valuable alternative option for AVFs, since it seems to require fewer interventions to maintain patency when compared to ePTFE grafts., Competing Interests: Conflicts of interest: No conflicts of interest declared concerning the publication of this article.

Kingfishers comprise about 115 species of the family Alcedinidae, and are an interesting group for cytogenetic studies, for they are among birds with most heterogeneous karyotypes. However, cytogenetics knowledge in Kingfishers is extremely limited. Thus, the aim of this study was to describe the karyotype structure of the Ringed Kingfisher ( Megaceryle torquata Linnaeus, 1766) and Green Kingfisher ( Chloroceryle americana Gmelin, 1788) and also compare them with related species in order to identify chromosomal rearrangements. The Ringed Kingfisher presented 2n = 84 and the Green Kingfisher had 2n = 94. The increase of the chromosome number in the Green Kingfisher possibly originated by centric fissions in macrochromosomes. In addition, karyotype comparisons in Alcedinidae show a heterogeneity in the size and morphology of macrochromosomes, and chromosome numbers ranging from 2n = 76 to 132. Thus, it is possible chromosomal fissions in macrochromosomes resulted in the increase of the diploid number, whereas chromosome fusions have originated the karyotypes with low diploid number.

Competing Interests: Conflito de interesse: Os autores declararam não haver conflitos de interesse que precisam ser informados.