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

{"title":"Mechanical Thrombectomy and Catheter Directed Thrombolysis Utilization in Patients with Deep Vein Thrombosis: Analysis of a database of a tertiary hospital.","authors":"Alexandr Kuperin, Evgeny Seliverstov, Evgeny An, Igor Lebedev, Igor Zolotukhin","doi":"10.1016/j.jvsv.2025.102200","DOIUrl":"https://doi.org/10.1016/j.jvsv.2025.102200","url":null,"abstract":"<p><strong>Purpose: </strong>The aim of the study was to assess the mechanical thrombectomy (MT) and the catheter directed thrombolysis (CDT) utilization in patients with deep vein thrombosis (DVT) in tertiary care.</p><p><strong>Materials and methods: </strong>We conducted a single-center retrospective cohort study. Tertiary hospital database from January 2022 to December 2023 was analyzed. All the records of patients referred for DVT were extracted. The collected data included general patient's information, medical history, results of physical examination, duplex ultrasound, laboratory analysis, etc. We assessed indications and contraindications for MT and CDT considering possible benefits and risks. We have identified patients who could be eligible for this technique.</p><p><strong>Results: </strong>A total of 2427 patients with DVT were referred to hospital from January 2022 to December 2023. Among them, 961 patients (39.6%) had no indications for hospital admission or refused it and were recommended to receive anticoagulation on an outpatient basis, while 1466 patients (60.4%) were admitted to hospital. Among the hospitalized patients, 1277 had proximal DVT and 189 had distal DVT. The number of patients with iliofemoral DVT was 451 (18.6%). We found only 82 (3.4%) cases that could be potentially eligible for endovascular thrombectomy considering all possible indications and contraindications. Two attempts and fourteen successful procedures were conducted during the period of the study.</p><p><strong>Conclusions: </strong>The number of patients with DVT who could be eligible for MT and CDT in a tertiary hospital is low.</p>","PeriodicalId":17537,"journal":{"name":"Journal of vascular surgery. Venous and lymphatic disorders","volume":" ","pages":"102200"},"PeriodicalIF":2.8,"publicationDate":"2025-01-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143074945","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":"PROMISING RESULTS OF ULTRASOUND GUIDED FOAM SCLEROTHERAPY FOR TREATING CHRONIC VENOUS ULCERS.","authors":"A C C Bacelar, E M Netto, N Barreto, R Neves, C Heine, P Botelho, C S C B Almeida, E Ramalho, R Aras","doi":"10.1016/j.jvsv.2025.102198","DOIUrl":"https://doi.org/10.1016/j.jvsv.2025.102198","url":null,"abstract":"<p><strong>Background: </strong>Despite advances in wound care, the dressing and management of chronic ulcers on lower limbs (LL) remains unsatisfactory. The simplicity, cost-efficiency, and diverse application possibilities of ultrasound guided foam sclerotherapy make it an attractive and effective approach to treat patients with no access or contraindications to more invasive methods.</p><p><strong>Objective: </strong>To evaluate the healing rate of chronic venous ulcers (CEAP C6) in patients treated with ultrasound guided foam sclerotherapy.</p><p><strong>Method: </strong>From January 2018 to December 2020, 279 patients (336 legs) classified at the first consultation as stage 6 for CEAP (clinical, etiological, anatomical, pathophysiological classification) were followed during treatment of axial venous reflux in saphenous and tributary veins with Polidocanol (Aethosxysklerol^R) foam and evaluated at 52 weeks for complete healing rates or ≥ 50% ulcer size reduction, using Kaplan-Meier statistics and Cox regression to study the influence of covariates.</p><p><strong>Results: </strong>Average age of the 279 patients was 55 years. Of these, 156 (56%) showed complete healing in 52 weeks and 89 (32%) had a wound area reduction above 50%. Ulcer size severity, lymphedema and reduced dorsiflexion of the ankle were significantly associated with healing difficulty. Time of ulcer progression up to beginning of treatment (p < 0.01), ulcer size (p = 0.01), lymphedema (p = 0.006), reduced dorsiflexion of the ankle (p = 0.01) and age equal to or greater than 65 years (p = 0.003) were significantly associated with difficulty in healing. Patients with a mean Venous Clinical Severity Score (VCSS) of 18.7 had a better prognosis (18.7 vs 22.5; p<0.001).</p><p><strong>Conclusion: </strong>Most patients with chronic venous ulcers (CEAP 6) treated with foam sclerotherapy achieved healing or significant improvement within 52 weeks. Healing was highly influenced by time until treatment, ulcer size, reduced dorsiflexion of the ankle and/or lymphedema presence and use of compression therapy.</p>","PeriodicalId":17537,"journal":{"name":"Journal of vascular surgery. Venous and lymphatic disorders","volume":" ","pages":"102198"},"PeriodicalIF":2.8,"publicationDate":"2025-01-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143074956","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 preliminary experience on the efficacy, safety, and short-term results in the treatment of acute bilateral iliofemoral deep vein thrombosis with the Angiojet rheolytic thrombectomy.","authors":"Görkem Yiğit, Ufuk Türkmen","doi":"10.1016/j.jvsv.2025.102192","DOIUrl":"10.1016/j.jvsv.2025.102192","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to examine the early clinical outcomes of AngioJet rheolytic thrombectomy (RT) in patients with acute bilateral iliofemoral deep vein thrombosis (IFDVT), with a specific focus on the incidence of post-thrombotic syndrome.</p><p><strong>Methods: </strong>From March 2021 to August 2023, 16 consecutive patients with acute bilateral IFDVT treated with AngioJet RT at our center were evaluated. Primary outcomes include patency of the target veins, development of post-thrombotic syndrome, recurrent DVT, and procedure-related death. Secondary outcomes included minor or major bleeding, acute kidney injury, documented hemoglobinuria, cardiac event, pulmonary embolism, limb loss, and death.</p><p><strong>Results: </strong>The mean age of the patients was 69 ± 12 years (range, 53-87 years). Malignancy and recent major surgery were the most prevalent risk factors, each observed in 25% of patients (n = 4). Technical success, complete clot removal, and alleviation of symptoms were achieved in all patients (n = 16; 100%). In one-quarter of the patients (n = 4), transient hemoglobinuria was observed following the procedure. This complication resolved spontaneously after adequate fluid replenishment. Minor bleeding occurred in three patients (19%), whereas no patients had major bleeding complication. There was one postoperative acute kidney injury and transient bradycardia (6%). Three patients died after the procedures (19%). One patient (6%) developed postoperative massive pulmonary embolism. The mean follow-up was 11 ± 6 months (range, 5-19 months). The primary patency rate was 92% and 91%, respectively, 6 and 12 months after procedures. One patient had reocclusion during the follow-up.</p><p><strong>Conclusions: </strong>AngioJet RT applied to patients with bilateral IFDVT provides a promising picture, providing a patent vein lumen with high procedural success and achieving convincing early symptomatic improvement in severely symptomatic patients with impaired quality of life. In this early case series, the feasibility of the AngioJet device in elderly cases appears to be a significant problem. Therefore, patient selection is essential.</p>","PeriodicalId":17537,"journal":{"name":"Journal of vascular surgery. Venous and lymphatic disorders","volume":" ","pages":"102192"},"PeriodicalIF":2.8,"publicationDate":"2025-01-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143007753","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":"The value of nonenhanced magnetic resonance imaging in the grading of primary lower extremity lymphedema.","authors":"Jia Guo, Xingpeng Li, Mengke Liu, Wenbin Shen, Yunlong Yue, Rengui Wang","doi":"10.1016/j.jvsv.2025.102168","DOIUrl":"10.1016/j.jvsv.2025.102168","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;The International Society of Lymphology proposed a grading standard for lymphedema in 2020 based on the percent increase in the volume of the affected limb compared to that of the healthy limb. However, this method is cumbersome and time consuming to measure and calculate, and a standardized formula across different institutions is not available. Therefore, the aim of this study was to investigate the value of nonenhanced magnetic resonance imaging (MRI) for grading primary lower extremity lymphedema (PLEL).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;This retrospective study included 124 consecutive patients with unilateral PLEL from 2021 to 2023. All patients were categorized into three groups, mild (n = 43), moderate (n = 41), and severe (n = 40), according to the 2020 International Society of Lymphology grading standard. From the lymphedema involvement range (vertical range: whole lower extremity, only thigh, only calf and ankle; transversal range: ≤25% of the cross-section, 26%-50%, 51%-75%, and &gt;75%), MRI signs of lymphedema (parallel lines sign, grid sign, honeycomb sign, band sign, crescent sign, lymphatic lake sign, and nebula sign), and lymphedema measurements (total diameter, total circumference, and total area of the affected limb; diameter and area of the bone, muscle, subcutaneous fat, and subcutaneous soft tissues on the affected limb; circumference of the bone and muscle on the affected limb; thickness of skin; thickness of band sign; thickness of crescent sign) were recorded and statistically analysed in the three groups of patients.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;The statistically significant differences in the indicators among the three groups were as follows: vertical and transversal ranges of lymphedema, parallel lines sign, grid sign, honeycomb sign, band sign, crescent sign, and lymphatic lake sign, total diameter, total circumference, total area, diameter and area of the subcutaneous fat, diameter and area of the subcutaneous soft tissues, thickness of skin, thickness of band sign and crescent sign (P &lt; .05). The receiver operating characteristic curve showed that the highest area under the curve for each parameter for identifying patients in the mild and nonmild (including moderate and severe) groups was in the following order: diameter of the subcutaneous fat &gt; area of the subcutaneous fat &gt; thickness of the skin (P &lt; .05). The receiver operating characteristic curve showed that the highest under the curve for each parameter used to identify patients in the severe and nonsevere (including mild and moderate) groups was in the following order: diameter of the subcutaneous fat &gt; area of the subcutaneous fat &gt; thickness of the crescent sign.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;The parallel lines sign is a characteristic indicator for diagnosing patients with a mild disease, the grid sign is a characteristic indicator for diagnosing patients with a moderate disease, the lymphatic lake sign and crescent sig","PeriodicalId":17537,"journal":{"name":"Journal of vascular surgery. Venous and lymphatic disorders","volume":" ","pages":"102168"},"PeriodicalIF":2.8,"publicationDate":"2025-01-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143007755","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":"Plasma D-dimer changes and clinical value in acute lower extremity deep venous thrombosis treated with catheter-directed thrombolysis.","authors":"Jixu Wang, Yide Zheng, Yongzhong Yu, Xiaowen Fan, Shaofei Xu","doi":"10.1016/j.jvsv.2025.102167","DOIUrl":"10.1016/j.jvsv.2025.102167","url":null,"abstract":"<p><strong>Objective: </strong>This study sought to investigate the changes in plasma D-dimer levels during catheter-directed thrombolysis (CDT) in patients with acute lower extremity deep venous thrombosis (DVT), analyze imaging results, and assess their clinical implications.</p><p><strong>Methods: </strong>We retrospectively analyzed 62 patients diagnosed with acute lower extremity DVT who underwent CDT between March 2019 and December 2022. Plasma D-dimer levels were measured before CDT, at regular intervals after CDT, and at the end of CDT. Lower limb venography was performed every 2 days during CDT to assess the thrombus clearance rate and level of thrombus dissolution. Statistical analyses were conducted to observe the D-dimer concentration changes and analyze the correlation between D-dimer concentration and thrombus clearance rate. Additionally, a receiver operating characteristic curve was constructed to determine the diagnostic performance of D-dimer in assessing the efficacy of thrombolysis, including the calculation of the area under the curve, sensitivity, specificity, and optimal cut-off value.</p><p><strong>Results: </strong>During CDT for acute lower extremity DVT, plasma D-dimer levels rapidly increased, peaking on CDT day 1, and then gradually decreased, followed by a rapid decline, but remained slightly elevated compared with normal levels. There was a positive correlation between D-dimer levels and thrombolysis efficacy (r = 0.809; P = .00). The linear regression equation for this correlation was Y = 0.161 + 0.028X. The area under the curve of D-dimer was 0.95, with a cut-off value of 9.935 mg/L (sensitivity, 93.2%; specificity, 95.4%).</p><p><strong>Conclusions: </strong>Plasma D-dimer concentration can serve as an indicator for evaluating the efficacy of thrombolysis during CDT in acute lower extremity DVT.</p>","PeriodicalId":17537,"journal":{"name":"Journal of vascular surgery. Venous and lymphatic disorders","volume":" ","pages":"102167"},"PeriodicalIF":2.8,"publicationDate":"2025-01-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143007754","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":"Computed tomography scanning in the diagnosis of lower extremity phlebolymphedema.","authors":"David Thaggard, Thomas Powell, Arjun Jayaraj","doi":"10.1016/j.jvsv.2024.102166","DOIUrl":"10.1016/j.jvsv.2024.102166","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Objectives: &lt;/strong&gt;Phlebolymphedema, the most common cause of secondary lymphedema in Western societies, seldom gets the attention it deserves. Diagnosis is often missed and when evaluated is through lymphoscintigraphy (LSG) which is cumbersome. This study aims to assess the role of computed tomography (CT) scanning in the diagnosis of phlebolymphedema of the lower extremities by comparing CT characteristics with the International Society of Lymphology (ISL) grading system and LSG.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;Patients presenting with chronic venous disease who underwent a CT scan and LSG of the lower extremities (diagnostic testing) formed the study cohort. Three assessors blinded to the patients' ISL stage and LSG results evaluated the CT for skin thickening (present/absent), subcutaneous interstitial edema (honeycombing; graded 0-2), and muscle compartment (MC) edema (graded 0-2), in the thigh (20 cm above apex of patella), leg (10 cm below apex of patella), and ankle (5 cm above lateral malleolus). Agreement from two of the three raters determined the value used for analysis. Additionally, the final score used for each variable for each limb was determined by taking the most severe value of the three levels. The three CT variables were then compared independently and together with ISL stage and LSG to determine their diagnostic potential for phlebolymphedema. Also assessed was the severity of each CT variable across each limb in addition to the evaluation of the extent of their inter-rater agreement.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Of the 35 patients (50 limbs), 28 were female, with left laterality noted in 22 limbs. Clinical, Etiological, Anatomical, and Pathophysiological clinical class for the cohort included C0 to 2, 4 limbs (8%); C3, 13 limbs (26%); C4, 17 limbs (34%); C5, 9 limbs (18%); and C6, 7 limbs (14%). Thirty-one limbs underwent stenting for chronic iliofemoral venous obstruction after having failed conservative therapy. Of the 50 limbs, 8 (16%) were ISL stage 0, 10 (20%) ISL stage 1, 2 (4%) ISL stage 2, and 30 (60%) ISL stage 3. With LSG, 6 (12%) had a normal study, 21 (42%) mild disease, 0 (0%) moderate disease, and 23 (46%) severe disease. Correlation between LSG and ISL stage was poor (r = 0.18; P = .20). With ISL stage as a reference, the sensitivity, specificity, and accuracy of CT in diagnosing phlebolymphedema were as follows: skin thickening (95%/75%/92%), honeycombing (100%/0%/84%), MC edema (100%/0%/84%), any one CT variable (100%/0%/84%), any two CT variables (100%/0%/84%), and all three CT variables (93%/63%/88%). With LSG as a reference, the sensitivity, specificity, and accuracy of CT in diagnosing phlebolymphedema were as follows: skin thickening (82%/0%/72%), honeycombing (100%/0%/88%), MC edema (100%/0%/88%), any one CT variable (100%/0%/88%), any two CT variables (100%/0%/88%), and all three CT variables (82%/0%/72%). For CT variables, there was no significant difference between skin thickening ","PeriodicalId":17537,"journal":{"name":"Journal of vascular surgery. Venous and lymphatic disorders","volume":" ","pages":"102166"},"PeriodicalIF":2.8,"publicationDate":"2025-01-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142931942","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":"Symptomatic hepatic arterioportal fistula-related portal vein hypertension","authors":"Tianshi Lyu MD,&nbsp;Yong Xie MD,&nbsp;Kang She MD,&nbsp;Li Song MD,&nbsp;Yinghua Zou MD,&nbsp;Jian Wang MD","doi":"10.1016/j.jvsv.2024.101888","DOIUrl":"10.1016/j.jvsv.2024.101888","url":null,"abstract":"","PeriodicalId":17537,"journal":{"name":"Journal of vascular surgery. Venous and lymphatic disorders","volume":"13 1","pages":"Article 101888"},"PeriodicalIF":2.8,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140779784","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":"Addressing comments by Daungsupawong et al on ChatGPT's responses regarding radiofrequency ablation for varicose veins","authors":"Muhammad Anees MBBS,&nbsp;Fareed Ahmed Shaikh MBBS, MRCSEd, FCPS","doi":"10.1016/j.jvsv.2024.101999","DOIUrl":"10.1016/j.jvsv.2024.101999","url":null,"abstract":"","PeriodicalId":17537,"journal":{"name":"Journal of vascular surgery. Venous and lymphatic disorders","volume":"13 1","pages":"Article 101999"},"PeriodicalIF":2.8,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11764702/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142950751","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":"Social disparities in pulmonary embolism and deep vein thrombosis during the coronavirus disease 2019 pandemic from the Nationwide inpatient Sample","authors":"Matthew Leverich MS,&nbsp;Ahmed M. Afifi MD,&nbsp;Meghan Wandtke Barber MD,&nbsp;Ali Baydoun BS,&nbsp;Joseph Sferra MD, MBA,&nbsp;Gang Ren PhD,&nbsp;Munier Nazzal MD, MBA, MEd","doi":"10.1016/j.jvsv.2024.101961","DOIUrl":"10.1016/j.jvsv.2024.101961","url":null,"abstract":"<div><h3>Objectives</h3><div>Studies have shown that coronavirus disease 2019 (COVID-19) is associated with a hypercoagulable state. Studies have yet to examine the interconnectedness between COVID-19, hypercoagulability, and socioeconomics. The aim of this work was to investigate socioeconomic factors that may be associated with pulmonary embolism (PE), deep vein thrombosis (DVT), and COVID-19 in the United States.</div></div><div><h3>Methods</h3><div>We performed a 1-year (2020) analysis of the National Inpatient Sample database. We identified all adult patients diagnosed with COVID-19, acute PE, or acute DVT using unweighted samples. We calculated the correlation and odds ratio (OR) between COVID-19 and (1) PE and (2) DVT. We executed a univariate analysis followed by a multivariate analysis to examine the effect of different factors on PE and DVT during the COVID-19 pandemic.</div></div><div><h3>Results</h3><div>We identified 322,319 patients with COVID-19; 78,101 and 67,826 patients were identified with PE and DVT, respectively. PE and DVT, as well as inpatient mortality associated with both conditions, are significantly correlated with COVID-19. The OR between COVID-19 and PE was 2.04, while the OR between COVID-19 and DVT was 1.44. Using multivariate analysis, COVID-19 was associated with a higher incidence of PE (coefficient, 2.05) and DVT (coefficient, 1.42). Other factors that were significantly associated (<em>P</em> &lt; .001) with increased incidence of PE and DVT along with their coefficients, respectively, include Black race (95% confidence interval [CI], 1.23-1.14), top quartile income (95% CI, 1.08-1.16), west region (95% CI, 1.10-1.04), urban teaching facilities (95% CI, 1.09-1.63), large bed size hospitals (95% CI, 1.08-1.29), insufficient insurance (95% CI, 1.88-2.19), hypertension (95% CI, 1.24-1.32), and obesity (95% CI, 1.41-1.25). Factors that were significantly associated (<em>P</em> &lt; .001) with decreased incidence of PE and DVT along with their coefficients, respectively, include Asians/Pacific Islanders (95% CI, 0.52-0.53), female sex (95% CI, 0.79-0.74), homelessness (95% CI, 0.62-0.61), and diabetes mellitus (0.77-0.90).</div></div><div><h3>Conclusions</h3><div>In the Nationwide Inpatient Sample, COVID-19 is correlated positively with venous thromboembolism, including its subtypes, PE and DVT. Using a multivariate analysis, Black race, male sex, top quartile income, west region, urban teaching facilities, large bed size hospitals, and insufficient social insurance were associated significantly with an increased incidence of PE and DVT. Asians/Pacific Islanders, female sex, homelessness, and diabetes mellitus were significantly associated decreased incidence of PE and DVT.</div></div>","PeriodicalId":17537,"journal":{"name":"Journal of vascular surgery. Venous and lymphatic disorders","volume":"13 1","pages":"Article 101961"},"PeriodicalIF":2.8,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11764060/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141907001","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":"Multidisciplinary approach to hand arteriovenous malformations: Treatment strategies and clinical outcomes - insights from a 25-year experience at a single vascular anomalies center","authors":"Yong Deok Lee MD ,&nbsp;Sang Yub Lee MD, PhD ,&nbsp;Dong-Ik Kim MD ,&nbsp;Kwang Bo Park MD ,&nbsp;Shin Seok Yang MD ,&nbsp;Yang-Jin Park MD ,&nbsp;So Young Lim MD ,&nbsp;Ji Hye Hwang MD ,&nbsp;Keon-Hee Yoo MD ,&nbsp;Hee Young Ju MD ,&nbsp;Young Soo Do MD","doi":"10.1016/j.jvsv.2024.101964","DOIUrl":"10.1016/j.jvsv.2024.101964","url":null,"abstract":"<div><h3>Objective</h3><div>Hand arteriovenous malformations (AVMs) are extremely difficult to manage for their functional importance and cosmetic disfiguration. A single-center retrospective study was conducted to identify long-term outcomes of multidisciplinary team management of hand AVMs.</div></div><div><h3>Methods</h3><div>Institutional review board approved this retrospective study. Multidisciplinary vascular anomalies center data was reviewed from 1995 to 2023. Patient demographics, Schobinger’s AVM stage, sclerotherapy details, surgical history, and adverse events after sclerotherapy were reviewed.</div></div><div><h3>Results</h3><div>A total of 150 patients with hand AVMs visited our hospital from 1995 to 2023, with a mean age of 33 years (range, 1-75 years), and 91 were females. Forty-four patients were Schobinger stage II, and 106 were stage III. Sclerotherapy was performed on 101 patients (67%) with 320 sessions. Angiographic devascularization rates after sclerotherapy were: 16 with 100%, 30 with over 90%, 34 with 50% to 90%, 15 with 0% to 50%, and six showed aggravation. Sclerotherapy-related adverse events occurred in 123 of 320 sessions (39%), with 112 minor and 11 major events. Fifteen patients (15%) eventually underwent amputation surgery a mean of 1618 days after sclerotherapy for necrosis (n = 3) and delayed complications (n = 12). Thirteen patients (9%) underwent primary surgical amputation for ulcers or bleeding (all Schobinger stage III). Thirty-six patients (24%) were followed without any procedure.</div></div><div><h3>Conclusions</h3><div>Multidisciplinary management of hand AVMs shows varied long-term outcomes. Although sclerotherapy is effective for many patients, it carries a significant risk of adverse events. The necessity for amputation in some cases highlights the severity of advanced AVMs and the need for individualized treatment approaches.</div></div>","PeriodicalId":17537,"journal":{"name":"Journal of vascular surgery. Venous and lymphatic disorders","volume":"13 1","pages":"Article 101964"},"PeriodicalIF":2.8,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11764611/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142108793","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}