Publications by authors named "João Alegrio"

3 Publications

  • Page 1 of 1

Carotid Paraganglioma - Classical Surgical Technique.

Rev Port Cir Cardiotorac Vasc 2017 Jul-Dec;24(3-4):123

Centro Hospitalar Universidade Coimbra, Portugal.

Introduction: A carotid body tumor is a rare neoplasm, generally benign, that predominantly affects people between their fourth and fith decades of life. It manifests as a pulsatile and generally painless cervical mass with firm consistency, located below the angle of the jaw. Clinically it can cause localized pain, dysphagia, hiccups, hoarseness and hypersensitive carotid body syndrome. Surgery is the treatment of choice, bearing in mind the possibility of malignant transformation, peritumoral invasion and metastasis. The most widely-used technique is surgical resection, with or without concomitant preoperative endovascular embolisation. Overall complication rates, stroke rates between 0 and 8% and cranial nerve palsy less than 1% to 49%. Mortality rates vary from 0 to 3%.

Methods: Clinical case of a 69 years old male patient diagnosed with a carotid body tumor in a routine ultrasound exam. The patient was asyntomatic. Complementary exams were then conducted - CT scan and MRI supported the diagnosis. Neck CT scan: Well defined, nodular formation, enhanced after intravenous contrast, localized on the jugular-carotid region, with an aproximate diameter of 36 mm. Neck MRI: Expansive heterogenous solid lesion, localized on carotid bulb, well defined, enhanced after intravenous contrast, compatible with carotid paraganglioma - Shamblin's II.

Results: Patient was submited to a complete surgical classic ressection of the tumor, without any previously procedure. Proximal dissection was made with a help of a nose and ear surgeon. No post-surgery complications, except wound infection at week 3. No nerve damage.

Conclusion: Follow up to 1 year without any complain and no lesions. In an era of multiple techniques there should always be a place for classic, well planned surgeries.
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May 2019

Abdominal Aortic Aneurysm in Women: Retrospective Analysis of the Cases that Undergo Surgical Repair.

Rev Port Cir Cardiotorac Vasc 2017 Jul-Dec;24(3-4):150

CHUC, Portugal.

Introduction: The prevalence of infra-renal aortic abdominal aneurysms (AAA) is about 3 to 4 times higher in men, with a recommendation I 1a for screening men > 65y. Althoug women only represente 20% of the total AAAs they have a significant higher rupture rate - threefold higher - and a worse outcome after ruptured AAA repair. Screening is not consensual but can be recommended for women > 65y who have smoked or have a family history of AAA. Against screening is the fact that the AAA in women have not only a lower incidence but also a late presentation (>80y) but references have been made to the fact that smoking became popular more than 30 years after than men and so the effects just now can start to be seen.

Methods: A retrospective review was made to all women with an infra- renal AAA who undergo a surgical treatment, elective or urgent, in the past 7 years (January 2010 - August 2017) in our hospital. Information was obtained through the clinical process. It was made an evaluation of the demographic information and anatomic features.

Results: 15 cases were reviewed, 4 elective and 11 ruptured surgical repairs. The mean age was 74 and only 4 women were more than 80 years old, with a minium age of 57. More than half the patients were previously diagnosis with hypertension but only 30% had high cholesterol. Only one was a known smoker. None had a diagnosis of cardiac disease. One had a sintomatic cerebrovascular disease. Within the elective cases, all open repair, the intra-hospitalar mortality was zero with a mean stay of 7,5 days. The ruptured cases, 1 endovascular, had a perioperative mortality of 50% The mean aortic diametre at rupture was less than 6 cm.

Conclusion: Data supports the evidence of the morbidity of a ruptured AAA and the high intra-hospitalar mortality in women. Early detection and elective repair should be considered. Sex-specific research is needed to provide the best medical treatment.
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May 2019

[Dysphagia lusoria - a clinical report].

Rev Port Cir Cardiotorac Vasc 2013 Jul-Sep;20(3):163-5

Serviço de Angiologia e Cirurgia Vascular do Centro Hospitalar e Universitário de Coimbra, Portugal.

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June 2015