CONTEXTO: Como a úlcera é uma grave complicação da insuficiência venosa crônica, é necessário o conhecimento amplo de sua fisiopatologia. A ultrassonografia Doppler venosa é o exame complementar mais adequado, que possibilita o estudo do sistema venoso superficial e profundo, sua anatomia e fisiologia. Trabalhos recentes valorizam o refluxo em Veia Poplítea como importante fator para o desenvolvimento deste quadro clínico. OBJETIVOS: Avaliar o refluxo em segmento venoso femoropoplíteo em pacientes com úlcera varicosa. TIPO DE ESTUDO: Estudo de prevalência. MÉTODOS: Cento e quatro pacientes apresentando 118 membros inferiores com úlcera varicosa. Procedimentos: exame de ultrassonografia Doppler venosa do membro acometido, observado o refluxo no segmento venoso femoropoplíteo e diâmetro da Veia Poplítea. Variáveis: Primária: refluxo no segmento venoso femoropoplíteo. Secundária: diâmetro da Veia Poplítea. RESULTADOS: A presença de refluxo no segmento venoso femoropoplíteo foi observada em 56 (47,45%) dos 118 membros com úlcera varicosa, examinados em 104 pacientes. O diâmetro médio da Veia Poplítea foi de 1,14 cm, sendo o diâmetro médio normal da população 0,6 cm. CONCLUSÃO: O refluxo venoso no segmento venoso femoropoplíteo é um importante fator na avaliação do prognóstico destes pacientes, o aumento de diâmetro da Veia Poplítea reflete a magnitude da insuficiência venosa.

BACKGROUND: Ulcer is a severe complication from chronic venous insufficiency; thus, its pathophysiology needs to be deeply understood. Venous Doppler ultrasonography is the most appropriate complementary imaging study, enabling the study of the superficial and deep venous system, the diameter and flow of the veins. Recent studies have suggested that popliteal vein reflux is an important factor for the development of ulceration. OBJECTIVE: To evaluate the venous reflux of the femoral popliteal segment in patients with venous ulcers. STUDY DESIGN: Prevalence study. METHODS: Involving 104 patients with 118 lower extremities with venous ulcers. Patients underwent Doppler ultrasonography of the affected limb showing the venous reflux of the femoral popliteal segment and popliteal vein diameter. Primary variable was venous reflux in the femoral popliteal segment; and secondary variable was diameter of the popliteal vein. RESULTS: Venous reflux in the femoral popliteal segment was observed in 56 of the 118 limbs with venous ulcer (47.45%) in 104 patients. The mean diameter of the popliteal vein was 1.14 cm, whereas 0.6 cm was the normal mean diameter of the population. CONCLUSION: Venous reflux in the femoral popliteal segment is a major factor in assessing the prognosis of these patients. Increased diameter of the popliteal vein reflects the magnitude of venous insufficiency.

Insulinomas are rare endocrine tumors with an estimated incidence of 1(one) per million. Optimal therapy for all islet tumors of the pancreas is curative surgical resection. However, previous reports have show that, in the absence of preoparative localization, insulinoma may not be found intraoperatively in about 20% of patients. With current imaging technology, including serial computed tomography (CT), magnetic resonance imaging (MRI) and ultrasonography, localization of insulinomas less than 2cm remains inadequate. This case report shows that selective intraarterial calcium injection with hepatic venous sampling for insulin levels measured is a efficient technique for the localization of insulinomas.

Our objective is to report a case of a patient with a descending thoracic aortic aneurysm and chronic aortic dissection, who was submitted to an endovascular treatment. A 68-year-old male with coronary artery disease and hypertension, with no history of trauma, diabetes or smoking. He had myocardial infarction ten years ago. Under general anesthesia, the left femoral artery was surgically exposed and the left braquial artery was catheterized with a "pigtail" catheter, under Seldinger technique. The proximal 46mm/Æ and distal 34mm/Æ stent-graft was placed just distal to the origen of the left subclavian artery. Control arteriography showed that the lesion was completely excluded. The patient was discharged seven days after the surgery, when a computed tomographic control, was performed showing a sustained aneurysm exclusion and a satisfactory endovascular position.