Samuel Martins Moreira

Bio: Samuel Martins Moreira is an academic researcher from Federal University of São Paulo. The author has contributed to research in topics: Stent & Angioplasty. The author has an hindex of 6, co-authored 30 publications receiving 131 citations.

Randomized comparison of distal and proximal cerebral protection during carotid artery stenting.

Abstract: Objectives This study sought to randomly compare cerebral protection with ANGIOGUARD (Cordis Corporation, Bridgewater, New Jersey) with Mo.Ma (Invatec/Medtronic Vascular Inc, Santa Rosa, California) during carotid artery stenting (CAS), using diffusion-weighted magnetic resonance imaging (DW-MRI) to detect new ischemic cerebral lesions. The number, size, and location of lesions were analyzed. Background The choice of the type of cerebral protection during CAS is controversial. Methods From July 2008 to July 2011, 60 patients undergoing CAS were randomized to ANGIOGUARD or Mo.Ma, distributed by chance, 30 patients for each group. All patients underwent DW-MRI before and after CAS. An independent neuroradiologist blinded to the cerebral protection used analyzed the images. Univariate and multivariate logistic models were fitted to analyze new ischemic lesions. Alternatively, a propensity score approach was used to reduce the bias due to differences between the groups. For the number of lesions, we used Poisson regression models. Results New ischemic lesions seen on DW-MRI were present in 63.3% of the ANGIOGUARD group versus 66.7% of the Mo.Ma cohort (p = 0.787). The number of ischemic cerebral lesions per patient, when present, was significantly lower in the Mo.Ma group (a median of 6 lesions per patient vs. a median of 10 in the ANGIOGUARD, p Conclusions New ischemic lesions seen on DW-MRI were present in both groups in >60%, but the number of lesions per patient was greater in the ANGIOGUARD group. No death or disabling stroke occurred during at least 1 year of follow-up in both cohorts.

First-in-man assessment of the InSeal VCD, a novel closure device for large puncture accesses.

Abstract: Aims To demonstrate the feasibility and efficacy of the novel InSeal VCD for the closure of large puncture holes following percutaneous structural interventions. Methods and results Prospective, non-randomised, single-arm, single-centre study with a series of patients submitted to endovascular treatment of abdominal and thoracic aortic aneurysm as well as transcatheter aortic valve implantation in whom the InSeal VCD was used to close the access site. These patients were followed up for one year with clinical examination, ankle-brachial index and Doppler ultrasound. The primary endpoint was the occurrence of major vascular complications at the puncture site. From a total of nine patients screened, seven were selected to receive the InSeal VCD. Technical and therapeutic successes were achieved in all cases. The sheath profiles used in these procedures ranged from 18 Fr to 25 Fr. No major vascular complications were observed during the follow-up period. Average ankle-brachial index pre-intervention and at one-month follow-up were 0.85 and 0.82, respectively. Conclusions The InSeal VCD was shown to be effective in achieving acute and chronic haemostasis after usage of higher profile endovascular devices in this study. These results translated into no clinical complications up to one-year clinical follow-up.

Tratamento endovascular das doenças da aorta torácica: análise dos resultados de um centro

Abstract: OBJETIVO: Analisar os resultados do tratamento de uma serie consecutiva de pacientes submetidos a tratamento endovascular de doencas da aorta toracica. Foram observados o sucesso tecnico, o sucesso terapeutico, a morbimortalidade e a taxa de complicacoes perioperatorias e de reintervencoes. MATERIAIS E METODOS: Estudo retrospectivo, realizado em um centro de referencia, no periodo de janeiro de 2010 a julho de 2011, em que foram analisados pacientes submetidos a correcao endovascular de doencas da aorta toracica. A populacao foi dividida em dois grupos: grupo 1 (G1) - aneurismas de aorta toracica verdadeiros, ulcera aortica e pseudoaneurisma; grupo 2 (G2) - disseccao aortica tipo B cronica. RESULTADOS: Em um total de 55 pacientes tratados, 29 pertenciam ao G1 e 26, ao G2. As idades medias foram 66,8 ± 10 e 56,4 ± 7 anos, respectivamente. Os sucessos tecnico e terapeutico foram, respectivamente, 86,3% e 68,6% no G1 e 100% e 74% no G2. A mortalidade perioperatoria foi 10,3% no G1 e 7,6% no G2, com taxa de mortalidade anual de 10,3% no G1 e de 19,3% no G2. As taxas de reintervencoes foram 10,3% e 15,3%, respectivamente. CONCLUSAO: Em nosso estudo, o tratamento endovascular das doencas da aorta toracica demonstrou ser um metodo viavel e associado a aceitaveis taxas de complicacoes.

Correção endovascular do aneurisma da aorta abdominal: análise dos resultados de único centro

Abstract: OBJETIVO: Avaliar os resultados clinicos imediatos e em medio prazo do tratamento endovascular em pacientes portadores de aneurisma da aorta abdominal em um centro de referencia para doencas cardiovasculares. MATERIAIS E METODOS: Estudo retrospectivo de uma serie de pacientes submetidos a tratamento endovascular de aneurisma da aorta abdominal, no periodo de janeiro de 2009 a julho de 2010. Foram avaliados as caracteristicas demograficas, o sucesso tecnico, o sucesso terapeutico, a morbimortalidade, as complicacoes e a taxa de reintervencoes perioperatorias imediatos, e apos um ano de acompanhamento. RESULTADOS: Foram analisados 102 pacientes consecutivos com idade media de 72 ± 9 anos, sendo 79% deles do sexo masculino. Houve sucesso tecnico em 97,1% e exito terapeutico em 81% dos casos. A mortalidade perioperatoria foi de 0,9% e a anual, de 7,8%. Foram necessarias reintervencoes em 18,8% dos pacientes durante o seguimento. CONCLUSAO: Em nosso estudo, os resultados obtidos justificam a realizacao desse procedimento nos pacientes com anatomia adequada.

Hybrid treatment of aortic arch disease.

Abstract: Introducao: O manejo das doencas da aorta toracica que envolvem a aorta ascendente, arco aortico e aorta toracica descendente constituem um desafio tecnico e e uma area em constante desenvolvimento e inovacao. Objetivo: Analisar os resultados iniciais e a medio prazo do tratamento hibrido das doencas do arco aortico. Metodos: Estudo retrospectivo de procedimentos realizados no periodo de janeiro de 2010 a dezembro de 2012, em que foram analisados o sucesso tecnico e terapeutico, a morbimortalidade, os desfechos neurologicos, a taxa de vazamentos e de reintervencoes. Resultados: Em um total de 95 pacientes tratados por doencas da aorta toracica no periodo, 18 realizaram o tratamento hibrido e adentraram neste estudo. A idade media foi de 62,3 anos. O sexo masculino esteve presente em 66,7%. O sucesso tecnico e terapeutico foi de 94,5% obe 83,3%, respectivamente. A mortalidade perioperatoria foi de 11,1%. Nao houve obito durante o acompanhamento de 1 ano. A taxa de reintervencao foi de 16,6%, devido a 2 casos de endoleak tipo Ia e um caso de endoleak tipo 2. Nao foi observada oclusao dos enxertos anatomicos ou extra-anatomicos durante o periodo de seguimento. Conclusao: O tratamento hibrido das doencas do arco aortico demonstrou ser uma alternativa viavel a cirurgia convencional. As taxas de sucesso terapeutico e de reintervencoes demonstram a necessidade do seguimento clinico rigoroso desses pacientes a longo prazo.

2017 ESC Guidelines on the Diagnosis and Treatment of Peripheral Arterial Diseases, in collaboration with the European Society for Vascular Surgery (ESVS) : Document covering atherosclerotic disease of extracranial carotid and vertebral, mesenteric, renal, upper and lower extremity arteries

Abstract: 2017 ESC Guidelines on the Diagnosis and Treatment of Peripheral Arterial Diseases, in collaboration with the European Society for Vascular Surgery (ESVS) : Document covering atherosclerotic disease of extracranial carotid and vertebral, mesenteric, renal, upper and lower extremity arteries

Two-year outcomes after conventional or endovascular repair of abdominal aortic aneurysms

Abstract: BACKGROUND: Two randomized trials have shown better outcomes with elective endovascular repair of abdominal aortic aneurysms than with conventional open repair in the first month after the procedure We investigated whether this advantage is sustained beyond the perioperative period METHODS: We conducted a multicenter, randomized trial comparing open repair with endovascular repair in 351 patients who had received a diagnosis of abdominal aortic aneurysm of at least 5 cm in diameter and who were considered suitable candidates for both techniques Survival after randomization was calculated with the use of Kaplan-Meier analysis and compared with the use of the log-rank test on an intention-to-treat-basis RESULTS: Two years after randomization, the cumulative survival rates were 896 percent for open repair and 897 percent for endovascular repair(difference, -01 percentage point; 95 percent confidence interval, -68 to 67 percentage points) The cumulative rates of aneurysm-related death were 57 percent for open repair and 21 percent for endovascular repair(difference, 37 percentage points; 95 percent confidence interval, -05 to 79 percentage points) This advantage of endovascular repair over open repair was entirely accounted for by events occurring in the perioperative period, with no significant difference in subsequent aneurysm-related mortality The rate of survival free of moderate or severe complications was also similar in the two groups at two years(at 659 percent for open repair and 656 percent for endovascular repair; difference, 03 percentage point; 95 percent confidence interval, -100 to 106 percentage points) CONCLUSIONS: The perioperative survival advantage with endovascular repair as compared with open repair is not sustained after the first postoperative year

[2017 ESC Guidelines on the Diagnosis and Treatment of Peripheral Arterial Diseases, in collaboration with the European Society for Vascular Surgery (ESVS)]

Abstract: [2017 ESC Guidelines on the Diagnosis and Treatment of Peripheral Arterial Diseases, in collaboration with the European Society for Vascular Surgery (ESVS)]