Journal of vascular surgery. Venous and lymphatic disorders最新文献

{"title":"Corrigendum.","authors":"","doi":"10.1016/j.jvsv.2024.102008","DOIUrl":"10.1016/j.jvsv.2024.102008","url":null,"abstract":"","PeriodicalId":17537,"journal":{"name":"Journal of vascular surgery. Venous and lymphatic disorders","volume":" ","pages":"102008"},"PeriodicalIF":2.8,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142801455","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A randomized controlled non-inferiority study of adjustable compression wraps compared with inelastic multilayer bandaging used in the intensive complex decongestive therapy of lower leg lymphedema.","authors":"Anett Reisshauer, Emmanouil Tsatrafilis, Simone Kornappel, Doerte Huscher, Max E Liebl","doi":"10.1016/j.jvsv.2025.102214","DOIUrl":"https://doi.org/10.1016/j.jvsv.2025.102214","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate non-inferiority of adjustable compression wraps compared to inelastic multilayer bandaging in reducing lower leg volume during intensive complex decongestive therapy in patients with bilateral, symmetrical lymphedema. Secondary outcomes included application time, patient comfort, and side effects.</p><p><strong>Methods: </strong>A prospective, randomized controlled non-inferiority trial was conducted on 24 patients with stage II-III bilateral leg lymphedema during a 10-day intensive complex decongestive therapy. Each patient received adjustable compression wraps on a randomized side, while the contralateral leg was treated with inelastic multilayer bandages. The primary outcome was the difference in volume reduction, measured by perometer for lower leg volume, with a pre-defined non-inferiority margin of 50 ml. Application time was measured. Subjective parameters were assessed with visual analogue scales (VAS, range 0-100).</p><p><strong>Results: </strong>Adjustable compression wraps were non-inferior to inelastic multilayer bandages with a mean difference in volume reduction of 9.45 ml [-30.40, 49.26], with respect to the a priori defined non-inferiority margin of 50 ml. In a subsequent test on superiority, intraindividual differences did not differ significantly (p=0.629). Adjustable compression wraps took significantly less time to apply (8.4 minutes; p < 0.001), and patients rated them as more comfortable (median VAS-difference 30; p < 0.001). Both compression methods significantly reduced skin tightness, with no notable differences between treatments. Adjustable compression wraps showed fewer side effects, and 83.3% of participants indicated they would continue using them. No adverse events were attributed to the compression wraps.</p><p><strong>Conclusions: </strong>Adjustable compression wraps proved to be an effective, non-inferior alternative to inelastic multilayer bandages for reducing lower leg volume in the intensive complex decongestion therapy, while superiority could not be demonstrated. Their advantages include shorter application time and improved patient comfort. Its potential for self-management makes them a promising option for lymphedema therapy, provided patients receive adequate training.</p>","PeriodicalId":17537,"journal":{"name":"Journal of vascular surgery. Venous and lymphatic disorders","volume":" ","pages":"102214"},"PeriodicalIF":2.8,"publicationDate":"2025-02-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143523804","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Ultrasound-guided foam sclerotherapy of the saphenous trunks is associated with a low 5-years recurrence rate and improved quality of life in patients with chronic venous disease: a multicenter study.","authors":"Fabrizio Mariani, Ludovico Carbone, Giampaolo Sozio, Rosaria Massaroni, Eleonora Andreucci, Valerio Bianchi, Matteo Bucalossi","doi":"10.1016/j.jvsv.2025.102212","DOIUrl":"https://doi.org/10.1016/j.jvsv.2025.102212","url":null,"abstract":"<p><strong>Objective: </strong>The study attempts to test whether ultrasound-guided foam sclerotherapy (UGFS) is a durable treatment for incompetent great saphenous vein (GSV) and incompetent small saphenous vein (SSV) in primary chronic venous disease (CVD), CEAP clinical grade 2-4 disease. Secondary endpoints are to evaluate its safety in terms of complications, to compare patients' quality of life before and after the treatment, and to identify risk factors that may predict recurrence of CVD after UGFS.</p><p><strong>Methods: </strong>Multicenter retrospective cohort study on 346 patients. The sclerosing agent was sodium tetradecyl sulfate (STS) in foam. The foam was prepared with the double-syringe technique (liquid-to-gas CO₂O_{2 30:70} ratio 1:4). The sclerosing agent concentrations were 1% for saphenous trunk diameter 4-7 mm, 3% for saphenous trunk >7 mm. STS was injected directly into the GSV/SSV, achieving a total maximum volume of 10 ml per session. A median of 2 sessions were performed (range 1-5).</p><p><strong>Results: </strong>205 patients were categorized as CEAP C2 (59.2%), while 141 (40.8%) had worse CVD (CEAP≥3). Median follow-up was 60 (range 6-60) months. At the end of follow-up, 296 (85.5%) patients had no truncal reflux, with a five-year disease-free time (between last procedure and evidence of recurrent disease) of 77.7 ± 2.16%. GSV and SSV showed similar five-year recurrence-free time rates (69.9% vs. 76.8%, p ns), whereas patients with a diameter of the saphenous trunk ≤ 8 mm had lower recurrence than those with > 8 mm (91.3% vs. 46%, p <0.0001). 90 (26%) patients showed CVD recurrence, occurring in a median time of 48 months. A further UGFS treatment was needed in 50 symptomatic patients (14.4%), resulting in 80% success rate. At univariate analysis, large diameter of the saphenous trunk (p < 0.0001), male sex (p 0.030) and higher number of treatment sessions (p 0.009) were identified as significant prognostic factors for recurrence. Immediate complications occurred in 3.7% of patients: 7 headache, 6 visual disturbances. Endovenous foam-induced thrombosis was detected in 6 patients (2.8%) a week after treatment. Cutaneous hyperpigmentation appeared in 37 patients (10.7%). Post-treatment r-VCSS and CIVIQ-14 scores were significantly lower than before treatment (p<0.001).</p><p><strong>Conclusions: </strong>UGFS of the GSV/SSV is effective, safe in the long term and well accepted by patients. UGFS is a viable option to surgery and endovenous thermal or non-thermal ablation in the treatment of saphenous trunk incompetence (CEAP clinical grade 2 to 4).</p>","PeriodicalId":17537,"journal":{"name":"Journal of vascular surgery. Venous and lymphatic disorders","volume":" ","pages":"102212"},"PeriodicalIF":2.8,"publicationDate":"2025-02-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143472757","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Unveiling the Relationship Between Pain and Bacterial Load in Venous Ulcers with Implications in Targeted Treatment.","authors":"Alisha R Oropallo, Priscilla J Lee, Amit Rao, Micaela D Gray","doi":"10.1016/j.jvsv.2025.102213","DOIUrl":"https://doi.org/10.1016/j.jvsv.2025.102213","url":null,"abstract":"<p><strong>Objective: </strong>The relationship between bacteria and venous ulceration pain is well-established and primarily attributable to inflammatory pathways. Fluorescence imaging detects clinically significant bacterial loads and biofilm in real-time at the bedside, informing its elimination in an objective manner. We sought to explore the regional co-localization of bacterial fluorescence signals and patient-reported venous ulceration pain, and if objectively targeted bacterial removal can reduce wound-associated pain.</p><p><strong>Methods: </strong>We evaluated 46 adults with venous ulceration of the lower extremity self-reporting a wound-associated pain score ≥4 on a scale of 1-10. Before any treatments were performed (e.g., debridement), patients rated their pain during the study visit, and fluorescence images were captured. Regions of pain and positive fluorescence signals were sketched onto a printed wound image. Fluorescence imaging was repeated post-procedurally, and patients re-rated their pain either at the end of the study visit or over the phone the following day. Semi-quantitative analysis involved visual estimation of the percentage overlap between regions of fluorescence and pain in the wound bed. Wilcoxon matched pairs signed rank tests and Mann-Whitney t-tests assessed changes in pain scores post-procedurally.</p><p><strong>Results: </strong>Fluorescence from elevated bacterial loads and biofilm was present in every venous ulcer assessed, usually covering up to 50% of the wound bed and commonly colonizing the wound edges. Regions of pain were more extensive than regions of fluorescence within the wound bed, and some degree of overlap was identified in 40/46 patients (87%). This overlap was often substantial (29 patients with >25% overlap and 16 with >50% overlap). Overall mean pain scores were 8.17 pre-procedurally and 6.87 post-procedurally, corresponding to a 1.30-point reduction that was highly statistically significant (p<0.0001). Pain score reduction was higher when patients re-rated their pain 1-day post-debridement (3.40-point reduction, p=0.004).</p><p><strong>Conclusion: </strong>We observed that fluorescence signals from clinically significant bacterial colonization and biofilms were commonly present in painful venous lower extremity ulcerations. Regions of patient-reported pain and positive fluorescence frequently overlapped, suggesting a relationship between the two. Wound-associated pain scores were significantly and immediately reduced following objectively targeted bacterial removal via real-time fluorescence imaging, with an even greater reduction observed by the next day. Understanding the association between chronic bacterial presence and pain in venous ulcers can inform treatment and management strategies, potentially enhancing patient quality of life and satisfaction, promoting healing, and reducing complications.</p>","PeriodicalId":17537,"journal":{"name":"Journal of vascular surgery. Venous and lymphatic disorders","volume":" ","pages":"102213"},"PeriodicalIF":2.8,"publicationDate":"2025-02-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143472759","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Applicability of ESCHAR and EVRA Trials to the Real-world Population of Patients With Venous Ulcers","authors":"Quynhdiem Lam MD ,&nbsp;Kelly Hallett RVT, CCT ,&nbsp;Allie Staats MD (Candidate) ,&nbsp;Erin Sheehan MD (Candidate) ,&nbsp;Fedor Lurie MD, PhD, RPVI, RVT, FSVS","doi":"10.1016/j.jvsv.2024.102047","DOIUrl":"10.1016/j.jvsv.2024.102047","url":null,"abstract":"","PeriodicalId":17537,"journal":{"name":"Journal of vascular surgery. Venous and lymphatic disorders","volume":"13 2","pages":"Article 102047"},"PeriodicalIF":2.8,"publicationDate":"2025-02-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143394547","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Ethanol Permanent Ablation of Head and Neck Low-Flow Venous Malformations","authors":"Wayne Yakes MD, FSIR, FCIRSE","doi":"10.1016/j.jvsv.2024.102076","DOIUrl":"10.1016/j.jvsv.2024.102076","url":null,"abstract":"","PeriodicalId":17537,"journal":{"name":"Journal of vascular surgery. Venous and lymphatic disorders","volume":"13 2","pages":"Article 102076"},"PeriodicalIF":2.8,"publicationDate":"2025-02-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143394570","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparison of Artificial Intelligence Versus Radiologist Interpretation of Right Ventricular to Left Ventricular Ratio for Pulmonary Embolism Response Team Activations at a Tertiary Referral Center","authors":"Jacob Shapiro MD","doi":"10.1016/j.jvsv.2024.102058","DOIUrl":"10.1016/j.jvsv.2024.102058","url":null,"abstract":"","PeriodicalId":17537,"journal":{"name":"Journal of vascular surgery. Venous and lymphatic disorders","volume":"13 2","pages":"Article 102058"},"PeriodicalIF":2.8,"publicationDate":"2025-02-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143394600","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Does High-quality Intervention for Varicose Veins Reduce Progression Towards Complications in the Long Term?","authors":"Annabel Howitt MBBCH, MRCS","doi":"10.1016/j.jvsv.2024.102068","DOIUrl":"10.1016/j.jvsv.2024.102068","url":null,"abstract":"","PeriodicalId":17537,"journal":{"name":"Journal of vascular surgery. Venous and lymphatic disorders","volume":"13 2","pages":"Article 102068"},"PeriodicalIF":2.8,"publicationDate":"2025-02-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143394730","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Information for Readers","authors":"","doi":"10.1016/S2213-333X(25)00018-6","DOIUrl":"10.1016/S2213-333X(25)00018-6","url":null,"abstract":"","PeriodicalId":17537,"journal":{"name":"Journal of vascular surgery. Venous and lymphatic disorders","volume":"13 2","pages":"Article 102184"},"PeriodicalIF":2.8,"publicationDate":"2025-02-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143395614","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Events of Interest","authors":"","doi":"10.1016/S2213-333X(25)00019-8","DOIUrl":"10.1016/S2213-333X(25)00019-8","url":null,"abstract":"","PeriodicalId":17537,"journal":{"name":"Journal of vascular surgery. Venous and lymphatic disorders","volume":"13 2","pages":"Article 102185"},"PeriodicalIF":2.8,"publicationDate":"2025-02-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143395615","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}