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Papers by Giuliano de Almeida Sandri

Journal of endovascular therapy : an official journal of the International Society of Endovascular Specialists, 2018

To describe a modified up-and-over access technique for treatment of iliac artery aneurysms in pa... more To describe a modified up-and-over access technique for treatment of iliac artery aneurysms in patients with prior bifurcated stent-grafts for endovascular aneurysm repair (EVAR). This technique uses a coaxial 12-F flexible sheath that is docked with a through-and-through wire into a 7-F sheath advanced from the contralateral femoral approach. This maneuver allows both sheaths to be moved as a unit while maintaining position of the apex of the system as it loops over the flow divider, avoiding damage to or displacing the extant endograft. Once the 12-F sheath is positioned in the iliac limb of the aortic stent-graft and secured in place with the through-and-through wire, the repair is extended into the internal iliac artery using a bridging stent-graft or covered stent introduced via a coaxial sheath. The up-and-over technique with a flexible 12-F sheath mated with a 7-F sheath from the opposite side allows bilateral femoral access to be used for iliac branch device placement after ...

The Journal of cardiovascular surgery, 2017

Endovascular aortic repair (EVAR) has been accepted as the first treatment option in most patient... more Endovascular aortic repair (EVAR) has been accepted as the first treatment option in most patients with infrarenal and thoracic aortic aneurysms. Advantages include its minimal invasive approach and lower risk of mortality and morbidity compared to open surgical repair. In patients with complex aneurysms involving side branches, novel techniques of parallel, fenestrated and branched endografts have expanded the indications of EVAR. Preoperative planning is of paramount importance to achieve technical success and to minimize risks of these procedures. In most centers, anatomical measurements are based on helical computed tomography angiography and/or magnetic resonance angiography. This article summarizes the most important aspects on planning standard and complex EVAR to treat aortic aneurysms and dissections.

Jornal Vascular Brasileiro, 2011

A insuficiência venosa crônica é um grave problema de saúde pública no mundo, consumindo grandes ... more A insuficiência venosa crônica é um grave problema de saúde pública no mundo, consumindo grandes quantias de recursos e causando grande prejuízo na qualidade de vida dos pacientes portadores de suas formas mais avançadas. A cirurgia para o tratamento de obstruções no sistema venoso profundo não foi incorporada à prática da maioria dos cirurgiões vasculares, ficando restrita a poucos centros em alguns países. Com o advento da cirurgia endovascular, a possibilidade de tratar alguns tipos de lesões obstrutivas por uma técnica minimamente invasiva e com resultados promissores renova o interesse da comunidade vascular pelas formas mais complexas de doença venosa.

Vascular and Endovascular Surgery, Nov 1, 2010

Objective: To compare the results of percutaneous transluminal angioplasty (PTA) and bypass graft... more Objective: To compare the results of percutaneous transluminal angioplasty (PTA) and bypass graft surgery (BGS) for the treatment of infrapopliteal lesions in individuals presenting with critical limb ischemia (CLI). Method: A total of 48 infrapopliteal PTAs and 50 infrapopliteal BGS were compared retrospectively. All grafts used nonreversed saphenous vein in a single length as a substitute. Results: Secondary patency and limb salvage rates in 24 months for the surgical group were 64.7% and 73.2%, respectively. For PTA group, these values were 63.7% and 68.2%, without differences between groups (log rank; P ¼ .45 and .39, respectively). Bypass graft surgery presented better results of secondary patency (72.9% vs 57.1%) and limb salvage (83.5% vs 53.6%) than PTA for patients with Transatlantic Inter-Society Consensus (TASC) D lesions (P ¼ .04 and P ¼ .01, respectively). Conclusions: Both BGS and PTA provided similar results of patency and limb salvage for individuals with infrapopliteal atherosclerotic disease presenting with CLI. Bypass graft surgery had better results than PTA when TASC D lesions were present.

European Journal of Vascular and Endovascular Surgery, 2014

WHAT THIS PAPER ADDS This study adds to the data regarding open revascularization surgery for CLI... more WHAT THIS PAPER ADDS This study adds to the data regarding open revascularization surgery for CLI using an alternative vein conduit.

Vascular and endovascular surgery, 2010

To compare the results of percutaneous transluminal angioplasty (PTA) and bypass graft surgery (B... more To compare the results of percutaneous transluminal angioplasty (PTA) and bypass graft surgery (BGS) for the treatment of infrapopliteal lesions in individuals presenting with critical limb ischemia (CLI). A total of 48 infrapopliteal PTAs and 50 infrapopliteal BGS were compared retrospectively. All grafts used nonreversed saphenous vein in a single length as a substitute. Secondary patency and limb salvage rates in 24 months for the surgical group were 64.7% and 73.2%, respectively. For PTA group, these values were 63.7% and 68.2%, without differences between groups (log rank; P = .45 and .39, respectively). Bypass graft surgery presented better results of secondary patency (72.9% vs 57.1%) and limb salvage (83.5% vs 53.6%) than PTA for patients with Transatlantic Inter-Society Consensus (TASC) D lesions (P = .04 and P = .01, respectively). Both BGS and PTA provided similar results of patency and limb salvage for individuals with infrapopliteal atherosclerotic disease presenting wi...

Jornal Vascular Brasileiro, 2012

Patients with chronic kidney disease stage 5 are generally treated by hemodialysis, preferentiall... more Patients with chronic kidney disease stage 5 are generally treated by hemodialysis, preferentially performed via an arteriovenous fistula (AVF). We report the case of a 58-year-old male patient with diabetes mellitus, hypertension and end-stage renal disease in whom hemodialysis was conducted via a long-term catheter. His medical record described numerous central venous cannulations and several AVF creations. The patient developed subclinical subclavian stenosis that required creation of a new vascular access route. The purpose of this case report is to describe treatment of subclavian vein stenosis during AVF creation.

European Journal of Vascular and Endovascular Surgery, 2011

Objective: To describe bypass to perigeniculate vessels for limb salvage. Design: Retrospective c... more Objective: To describe bypass to perigeniculate vessels for limb salvage. Design: Retrospective cohort study. Material and methods: Between 1995 and 2009, 47 bypass procedures to perigeniculate collateral arteries were performed in 46 patients (15 women, 31 men; median age, 68 years). All patients presented with critical ischaemia (tissue loss in 87.5%, rest pain in 12.5%). Mean ankle brachial index was 0.27 AE 0.17. The site of distal anastomosis was the descending genicular artery (DGA) in 23 bypasses (1 bilateral) and the medial sural artery (MSA) in 24. Proximal anastomosis was to the external iliac artery in 2 cases, common femoral artery in 23 cases, superficial femoral artery in 8 cases, deep femoral artery in 8 cases, above-knee poplitaeal artery in 2 cases, and previous graft in 4 cases. Results: There were four deaths during the immediate postoperative period. Mean follow-up duration was 27 months. Ten patients required major amputation. Mean ankle brachial index post-operatively was 0.60 AE 0.21. At 3 years, primary patency was 74.7 AE 7%, secondary patency was 83.4 AE 8%, and the limb salvage and survival rates were 73.5 AE 7% and 77.4 AE 7%, respectively. Conclusion: Bypass to perigeniculate arteries is a viable treatment option for critical limb ischaemia in selected patients. ª

Objetivos: Determinar a prevalência de aneurisma da aorta abdominal na população da cidade de Vit... more Objetivos: Determinar a prevalência de aneurisma da aorta abdominal na população da cidade de Vitória (ES) e associar com possíveis fatores de risco.