International Angiology最新文献

{"title":"Enhancing identification and treatment of patients with concomitant chronic venous insufficiency and diabetes mellitus. A modified Delphi study from the CODAC (ChrOnic venous disease and Diabetes Advisory Council) group.","authors":"Ahmet K Bozkurt, Marie J VAN Rijn, Eliete Bouskela, Giacomo Gastaldi, Frederic Glauser, Hermann Haller, Juan Rosas-Saucedo, Daniel Zingg, Alessandra Calabrese, Eberhard Rabe, Armando Mansilha","doi":"10.23736/S0392-9590.23.05061-7","DOIUrl":"10.23736/S0392-9590.23.05061-7","url":null,"abstract":"<p><strong>Background: </strong>Chronic venous insufficiency (CVI) and diabetes mellitus (DM) pose significant burdens to patients and healthcare systems. While the two diseases share a number of commonalities in risk factors and pathophysiology, they are often assessed and managed separately. This can lead to a worsening of comorbidities and limitations in a patient's quality of life. This project aims to develop recommendations to enhance the identification and treatment of patients with concomitant CVI and DM.</p><p><strong>Methods: </strong>Using a modified Delphi method, a panel of experts developed 38 Likert Scale and two multiple choice questions across six key themes. These were used to form an online survey which was disseminated through a convenience sampling approach to CVI and DM healthcare professionals across Europe, Central America, South America, and the Middle East. The threshold for consensus was set at ≥75%.</p><p><strong>Results: </strong>A total of 238 responses were received. 27/38 statements attained >90% agreement, nine of 38 attained between 75-90%, and two failed to meet the threshold (<75%). The awareness around the impact of the two diseases was high, but a gap was highlighted in the identification of patients with concomitant CVI and DM.</p><p><strong>Conclusions: </strong>The high level of agreement shows that healthcare professionals are aware of the gaps in identification and treatment of patients with concomitant CVI and DM, and of the need to approach this as a combined therapy area. An algorithm is proposed to help the identification of at-risk patients and to provide recommendations on the management of patients with concomitant disease.</p>","PeriodicalId":13709,"journal":{"name":"International Angiology","volume":" ","pages":"427-435"},"PeriodicalIF":1.4,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"92153677","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Early experience of thalidomide therapy for high-grade peripheral and facial arteriovenous malformations.","authors":"Lawrence Nip, Nicholas Evans, Suparna Bali, Colin Hopper, Anthie Papadopoulou, Mohamed Khalifa, George Hamilton, Chung S Lim, Jocelyn Brookes","doi":"10.23736/S0392-9590.23.05111-8","DOIUrl":"10.23736/S0392-9590.23.05111-8","url":null,"abstract":"<p><strong>Background: </strong>Arteriovenous malformations (AVMs) are developmental defects in the vascular system with abnormal connections between arteries and veins. A minority of AVMs are characterized by aggressive growth and continue to proliferate despite maximal surgical and interventional therapy. We report our outcomes with the use of thalidomide as the only UK specialist center adopting this novel approach for the management of AVMs refractory to conventional therapy.</p><p><strong>Methods: </strong>This was a retrospective case series which included only complex and proliferative AVM lesions (Schobinger grade III and IV). All patients prescribed thalidomide on a compassionate basis between September 2006 and August 2022 after attempts at embolosclerotherapy without satisfactory response were reviewed.</p><p><strong>Results: </strong>Eleven patients were included in our study. The median total duration of thalidomide use was 10 months. Two thirds of patients with pain (six of nine) reported an improvement, three quarters reported a reduction in swelling (six of eight) and all who presented with bleeding reported improvement in overall volume or frequency (four of four). Over the study period, 45% achieved a non-proliferative state with no further target vessel demonstrable on angiography. Mild, tolerable side effects such as fatigue were common (73%). There was only one major adverse reaction (neutropenia) necessitating cessation of therapy.</p><p><strong>Conclusions: </strong>We can conclude that thalidomide is able to reduce the symptom burden for patients with complex and proliferative AVMs that were refractory to established treatment modalities. Adverse effects are common, but the benefit achieved from taking thalidomide in otherwise treatment resistant cases outweighs the risks, most of which are manageable.</p>","PeriodicalId":13709,"journal":{"name":"International Angiology","volume":" ","pages":"448-456"},"PeriodicalIF":1.4,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71521330","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Lower extremity arterial disease perspective: IUA consensus document on \"lead management\". Part 1.","authors":"Pier Luigi Antignani, Mauro Gargiulo, Giacomo Gastaldi, Arkadiusz Jawien, Armando Mansilha, Pavel Poredos","doi":"10.23736/S0392-9590.23.05110-6","DOIUrl":"10.23736/S0392-9590.23.05110-6","url":null,"abstract":"<p><p>Atherosclerotic cardiovascular disease (ASCVD) is defined as coronary heart disease (CHD), cerebrovascular disease, or lower extremity arterial disease (LEAD) also named peripheral arterial disease (PAD). ASCVD is considered to be of atherosclerotic origin and is the leading cause of morbidity and mortality mainly for individuals with diabetes mellitus (DM). In this consensus document of the International Union of Angiology the authors discuss epidemiology, risk factors, primary and secondary prophylaxis, the correlation between diabetes mellitus and LEAD, conservative and surgical treatment.</p>","PeriodicalId":13709,"journal":{"name":"International Angiology","volume":" ","pages":"382-395"},"PeriodicalIF":1.4,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41199838","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"PREVAIT after modern open surgery and endothermal ablation: a systematic review.","authors":"Mariana Miranda, Joel Sousa, Armando Mansilha","doi":"10.23736/S0392-9590.23.05082-4","DOIUrl":"10.23736/S0392-9590.23.05082-4","url":null,"abstract":"<p><strong>Introduction: </strong>Presence of varices after operative treatment (PREVAIT) is a common finding after varicose vein surgery, and has been shown to significantly reduce the quality of life of those it affects. As such, long-term results after varicose vein interventions have to be taken into account when choosing a technique. This study aims to systematically review current evidence on the recurrence of varicose veins after three different techniques: conventional surgery (HLS), endovenous laser ablation (EVLA) and radiofrequency ablation (RFA).</p><p><strong>Evidence acquisition: </strong>A literature search was performed on the PubMed and Web of Science databases, which returned 546 studies. Fourteen studies were included. Data were extracted using predefined forms.</p><p><strong>Evidence synthesis: </strong>A total of 2795 patients were included, for a total of 3056 legs treated. 503 legs (16.5%) were treated by HLS, 1791 (58.6%) by EVLA and 762 (25.0%) by RFA. PREVAIT was reported in 34.4% for patients treated by HLS, for a mean follow-up comprised between 18 months and 5 years; 16.6% by EVLA, for a mean follow-up between 112 days and 5 years and 6.7% of those treated by RFA, for a mean follow-up between 106 days and 5 years. Regarding patterns of recurrence, the development of new varicose veins was the most commonly reported mechanism of recurrence after HLS (range: 29.8-91%) and EVLA (range: 40-81.6%), but not RFA, where recanalization of the occluded saphenous trunk accounted for up to 67.0% of the cases. Only one study reported quality of life related recurrence, and included patients treated by HLS and EVLA, but not RFA. Aberdeen Varicose Vein Questionnaire (AVVQ) score, physical functioning domains of the SF-36 score and patient satisfaction were significantly worse in patients with clinical recurrence. Re-intervention rates after recurrence were reported in 5 studies, ranging between 7.7% and 37.7% for HLS and 0-57.0% for EVLA. Only one study reported data on re-intervention for RFA patients, which was 6.67%.</p><p><strong>Conclusions: </strong>Recurrence is a reliable indicator of long-term efficacy of a varicose vein treatment and appears to occur more frequently after HLS. Although there are several mechanisms of recurrence, the development of new varicose veins was the most commonly observed. There is clear heterogeneity among definitions of recurrence and follow-up periods in literature.</p>","PeriodicalId":13709,"journal":{"name":"International Angiology","volume":" ","pages":"436-447"},"PeriodicalIF":1.4,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41118250","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Diagnostic criteria for Buerger's disease: International Consensus of VAS - European Independent Foundation in Angiology/Vascular Medicine.","authors":"Bahare Fazeli, Pavel Poredos, Matija Kozak, Zsolt Pecsvarady, Mariella Catalano, Mussaad M Al Salman, Louay Altarazi, Abrar A Ali, Abul H Bashar, Kursat Bozkurt, Daniel Cacione, Benjamin Chua, Ivan Cvjetko, Sanjay Desai, Dilek Erer, Katalin Farkas, Phaniraj Gaddikeri, Georgios Geroulakos, Orkut Guclu, Emad Hussein, Mihai Ionac, Takehisa Iwai, Oguz Karahan, Daniel Kashani, Albert Kota, Knut Kroger, Emre Kubat, Prabhu P Kumar, Werner Lang, Kirill Lobastov, Rafal Malecki, Antonella Marcoccia, Alper Ozbakkaloglu, Sandeep R Pandey, Malay Patel, Adil Polat, Angampally Rajeev, Hassan Ravari, Vimalin Samuel, Gerit Schernthaner, Dheepak Selvaraj, Umut S Sanri, Nuttawut Sermsathanasawadi, Hiva Sharebiani, Agata Stanek, Edwin Stephen, Andrzej Szuba, Wassila Taha, Hossein Taheri, Jean-Claude Wautrecht, Hendro S Yuwono, Mustafa H Zor, Aaron Liew","doi":"10.23736/S0392-9590.23.05098-8","DOIUrl":"10.23736/S0392-9590.23.05098-8","url":null,"abstract":"<p><p>Buerger's disease (BD) remains a debilitating condition and early diagnosis is paramount for its effective management. Despite many published diagnostic criteria for BD, selective criteria have been utilized in different vascular centers to manage patients with BD worldwide. A recent international Delphi Consensus Study on the diagnostic criteria of BD showed that none of these published diagnostic criteria have been universally accepted as a gold standard. Apart from the presence of smoking, these published diagnostic criteria have distinct differences between them, rendering the direct comparison of patient outcomes difficult. Hence, the expert committees from the Working Group of the VAS-European Independent Foundation in Angiology/Vascular Medicine critically reviewed the findings from the Delphi study and provided practical recommendations on the diagnostic criteria for BD, facilitating its universal use. We recommend that the 'definitive' diagnosis of BD must require the presence of three features (history of smoking, typical angiographic features and typical histopathological features) and the use of a combination of major and minor criteria for the 'suspected' diagnosis of BD. The major criterion is the history of active tobacco smoking. The five minor criteria are disease onset at age less than 45 years, ischemic involvement of the lower limbs, ischemic involvement of one or both of the upper limbs, thrombophlebitis migrans and red-blue shade of purple discoloration on edematous toes or fingers. We recommend that a 'suspected' diagnosis of BD is confirmed in the presence of a major criterion plus four or more minor criteria. In the absence of the major criterion or in cases of fewer than four minor criteria, imaging and laboratory data could facilitate the diagnosis. Validation studies on the use of these major and minor criteria are underway.</p>","PeriodicalId":13709,"journal":{"name":"International Angiology","volume":"42 5","pages":"396-401"},"PeriodicalIF":1.4,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138444587","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Intraoperative predictors of in-hospital mortality after open repair of ruptured abdominal aortic aneurysms.","authors":"Nicola Troisi,&nbsp;Giulia Bertagna,&nbsp;Athanasios Saratzis,&nbsp;Simone Guadagni,&nbsp;Fabrizio Minichilli,&nbsp;Daniele Adami,&nbsp;Mauro Ferrari,&nbsp;Raffaella Berchiolli","doi":"10.23736/S0392-9590.23.04941-6","DOIUrl":"https://doi.org/10.23736/S0392-9590.23.04941-6","url":null,"abstract":"<p><strong>Background: </strong>Several models and scores have been released to predict early mortality in patients undergoing surgery for a ruptured abdominal aortic aneurysm (rAAA). These scores included above all preoperative factors and they could be useful to deny surgical repair. The aim of the study was to evaluate intraoperative predictors of in-hospital mortality in patients undergoing open surgical repair (OSR) for a rAAA.</p><p><strong>Methods: </strong>Between January 2007 and December 2020, 265 patients were admitted at our tertiary referral hospital for a rAAA. Two-hundred-twenty-two patients underwent OSR. Intra-operative factors were analyzed by means of univariate analysis (step 1). Associations of procedure variables with in-hospital mortality rates were sought based on a multivariate Cox regression analysis (step 2).</p><p><strong>Results: </strong>Overall, in-hospital mortality rate was 28.8% (64 cases). Multivariate Cox regression analysis reported that operation time >240 minutes (P=0.032, OR 2.155, CI 95% 1.068-4.349), and hemoperitoneum (P<0.001, OR 3.582, CI 95% 1.749-7.335) were negative predictive factors for in-hospital mortality. Patency of at least one hypogastric artery (P=0.010; OR 0.128, CI 95% 0.271-0.609), and infrarenal clamping (P=0.001; OR 0.157, CI 95% 0.052-0.483) had a protective role in reducing in-hospital mortality rate.</p><p><strong>Conclusions: </strong>Operation time >240 minutes, and hemoperitoneum affected in-hospital mortality in patients undergoing OSR for rAAA. Patency of at least one hypogastric artery, and infrarenal clamping had a protective role. Further studies are needed to validate these outcomes. A validated predictive model could be useful to help the physicians in communication with patients' relatives.</p>","PeriodicalId":13709,"journal":{"name":"International Angiology","volume":"42 4","pages":"310-317"},"PeriodicalIF":1.4,"publicationDate":"2023-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9901937","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Factors associated with difficulty in stenting the chronic iliofemoral venous obstruction.","authors":"Moustafa Elfeky,&nbsp;Mohammad E Barbati,&nbsp;Karina Schleimer,&nbsp;Alexander Gombert,&nbsp;Long Piao,&nbsp;Soroosh Shekarchian,&nbsp;Michael Jacobs,&nbsp;Mahmood Razavi,&nbsp;Houman Jalaie","doi":"10.23736/S0392-9590.23.05001-0","DOIUrl":"10.23736/S0392-9590.23.05001-0","url":null,"abstract":"<p><strong>Background: </strong>The main aim of this article is to investigate the causes of technical failure during endovascular recanalization in patients with post-thrombotic syndrome with occluded iliofemoral veins and to suggest alternative techniques to improve outcomes in such challenging cases.</p><p><strong>Methods: </strong>Between November 2015 and August 2020, 230 patients (274 limbs) treated in our institution with symptomatic chronic iliofemoral venous obstruction underwent endovascular recanalization with angioplasty and stent placement. Overall, the initial attempt was unsuccessful in 15 limbs. We retrospectively analyzed the basic demographic and health characteristics of the involved patients and evaluated the endovascular procedures and techniques that resulted in a successful second intervention.</p><p><strong>Results: </strong>The first attempts at endovascular intervention were unsuccessful in 15 of the 274 limbs (5.4%). Failures were attributed to hostile groin areas in intravenous drug abusers caused by multiple punctures in six cases. In addition, five interventions failed due to prior surgery at the site of venous occlusion and in retroperitoneal space, three patients due to severe stent deformity, and one patient due to congenital venous aplasia. Of the 15 patients, 11 underwent a subsequent attempt that included six successful recanalizations. The mean follow-up time of the six patients with successful recanalization was 27 months (5-62 months). The primary, assisted primary and secondary patency rates were 83.3%, 100%, and 100%, respectively. The remaining five patients, in whom the second recanalization attempt failed, received conservative treatment.</p><p><strong>Conclusions: </strong>Recanalization failure is rare in chronic venous obstruction patients. Severe stent deformities have the lowest chance of successful second intervention. Patients with a hostile groin or prior open surgeries at the occlusion site may be considered for reintervention with a success rate of nearly 50%.</p>","PeriodicalId":13709,"journal":{"name":"International Angiology","volume":"42 4","pages":"337-343"},"PeriodicalIF":1.4,"publicationDate":"2023-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9891901","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparison of angiography and ultrasound for femoropopliteal angioplasty: decision-making and 12-month outcomes.","authors":"Yuchi Zou,&nbsp;Qiang Tong,&nbsp;Xuehu Wang,&nbsp;Chuli Jiang,&nbsp;Zheng Qin,&nbsp;Yu Zhao,&nbsp;Jun Cheng","doi":"10.23736/S0392-9590.23.05064-2","DOIUrl":"https://doi.org/10.23736/S0392-9590.23.05064-2","url":null,"abstract":"<p><strong>Background: </strong>This study aimed to investigate whether intravascular ultrasound (IVUS) combined with angiography during percutaneous transluminal angioplasty impacts treatment strategies and the 12-month patency of the femoropopliteal artery, compared to angiography alone.</p><p><strong>Methods: </strong>This retrospective, single-center study enrolled 137 patients who underwent a femoropopliteal endovascular intervention between February 2020 and May 2021. Among these interventions, 43 were guided by IVUS combined with angiography and the remaining 94 were guided by angiography only. Treatment strategies and 12-month patency were analyzed in both groups. Multivariable analysis was performed to clarify the predictors of restenosis within 12 months.</p><p><strong>Results: </strong>Primary patency at 12 months was significantly higher in the IVUS group than in the angiography group (56.4% vs. 76.7%, P=0.047). The reference diameter on IVUS images was greater than that on angiography images. Therefore, the IVUS group presented a higher balloon-to-vessel ratio [1.0 (0.97, 1.01) vs. 1.06 (1.0.1.25)]. More adjunctive stents were required in the angiography group. However, more dissections were performed in the IVUS group, with no difference in flow-limiting dissections between groups. Target disease length (odds ratio 1.02, P=0.021) and balloon-to-vessel ratio (odds ratio 0.01, P=0.021) were independent predictors of restenosis.</p><p><strong>Conclusions: </strong>Compared with angiography guidance alone, IVUS guidance for femoropopliteal artery-related treatment can significantly increase primary patency. This finding may be explained by the selection of larger balloons in IVUS and the resulting sufficient plaque compression and elastic membrane stretch. Moreover, IVUS was shown to detect more non-flow-limiting dissections than angiography.</p>","PeriodicalId":13709,"journal":{"name":"International Angiology","volume":"42 4","pages":"327-336"},"PeriodicalIF":1.4,"publicationDate":"2023-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10335450","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"International Union of Angiology consensus document on vascular compression syndromes.","authors":"Mario D'Oria,&nbsp;Petar Zlatanovic,&nbsp;Anthony Anthony,&nbsp;Anahita Dua,&nbsp;Alyssa M Flores,&nbsp;Adam Tanious,&nbsp;Alejandro Rodríguez Morata,&nbsp;Alba Scerrati,&nbsp;Domenico Baccellieri,&nbsp;Federico Biscetti,&nbsp;Giulia Baldazzi,&nbsp;Giorgio Mantovani,&nbsp;Indrani Sen,&nbsp;Javier Peinado Cebrian,&nbsp;Joao Rocha-Neves,&nbsp;Joel Sousa,&nbsp;Lazar Davidovic,&nbsp;Michal Juszynski,&nbsp;Miroslav Markovic,&nbsp;Mar Oller Grau,&nbsp;Mirko Tessari,&nbsp;Niamh Hynes,&nbsp;Peter Gloviczki,&nbsp;Palma Shaw,&nbsp;Paolo Zamboni,&nbsp;Robert Hinchliffe,&nbsp;Roberta Ricci,&nbsp;Sherif Sultan,&nbsp;Yogesh Acharya,&nbsp;Nicola Troisi,&nbsp;Pier Luigi Antignani,&nbsp;Armando Mansilha,&nbsp;Pedro P Komlos","doi":"10.23736/S0392-9590.23.05100-3","DOIUrl":"https://doi.org/10.23736/S0392-9590.23.05100-3","url":null,"abstract":"<p><p>Vascular compression syndromes (VCS) are rare diseases, but they may cause significant symptoms interfering with the quality of life (QoL) of patients who are often in their younger age. Given their infrequent occurrence, multiform clinical and anatomical presentation, and absence of dedicated guidelines from scientific societies, further knowledge of these conditions is required to investigate and treat them using modern imaging and surgical (open or endovascular) techniques. This consensus document will focus on known VCS, affecting the arterial and venous system. The position paper, written by members of International Union of Angiology (IUA) Youth Committee and senior experts, will show an overview of pathophysiology, diagnostic, and therapeutical approaches for patients with VCS. Furthermore, this document will provide also unresolved issues that require more research that need to be addressed in the future.</p>","PeriodicalId":13709,"journal":{"name":"International Angiology","volume":"42 4","pages":"282-309"},"PeriodicalIF":1.4,"publicationDate":"2023-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9902989","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Transformational features of the vein wall during a long-term period of endovenous laser ablation using 1910 nm laser radiation. Results of in-vivo experiments.","authors":"Sergey A Artemov,&nbsp;Alexander N Belyaev,&nbsp;Olga S Bushukina,&nbsp;Vasiliy I Davydkin,&nbsp;Svetlana A Khrushchalina,&nbsp;Sergey V Kostin,&nbsp;Polina A Ryabochkina,&nbsp;Alina D Taratynova","doi":"10.23736/S0392-9590.23.05013-7","DOIUrl":"https://doi.org/10.23736/S0392-9590.23.05013-7","url":null,"abstract":"<p><strong>Background: </strong>In this paper, results of in-vivo experiments on the animals of endovenous laser ablation (EVLA) using laser radiation with the wavelength 1910 nm are reported. The results of histological studies of the vein segments removed immediately after the procedure and in a long-term period (30 days and 3 months) are presented. Their structural transformation and the obliteration degree of the vein lumen using different values of the linear energy density of laser radiation (LEED=7.5; 15; 20 J/cm) are estimated.</p><p><strong>Methods: </strong>Edilbay breed of sheep (males) were used as experimental animals. Laser radiation with a wavelength of λ=1910 nm and power of Р<inf>rad</inf> = 1.5, 3, 4 W was used for EVLA experiments, and speed of fiber traction (v) was 2 mm/s. 8 days after EVLA stitches and an elastic bandage were removed. Animals were observed for 3 months in the vivarium. Animals have duplex ultrasound scanning of coagulation veins under anesthesia, after analysis vein segments were excised for histological examination. As a result, the damage degree to the vein wall tissues (intima, media, adventitia) and peri-venous tissues was revealed.</p><p><strong>Results: </strong>It is shown that in the long-time period, the intima and partial muscle layer transformed to connective tissue. EVLA using laser radiation with a higher value of LEED led to the growth of connective tissue, oedema of all vein layers and peri-venous tissue. The lumen closure occurred due to clot and the vein wall transformation, a maximum value was 25% using LEED=20 J/cm.</p><p><strong>Conclusions: </strong>The connective-tissue transformation of the coagulated vein occurs in a long-term period and more pronounced for higher LEED. However, features of vein hemodynamics of animals and differences between the clot formation process of human varicose veins and healthy animal veins lead to incomplete occlusion. These features should be taken into account during extrapolation results of experiments on animals in clinical practice.</p>","PeriodicalId":13709,"journal":{"name":"International Angiology","volume":"42 4","pages":"362-370"},"PeriodicalIF":1.4,"publicationDate":"2023-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9905286","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}