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

{"title":"Perforation from an Inferior Vena Cava Filter with six legs.","authors":"Hua Yi Zhang, Dong Zhe Chai, Xin Wei Zhou","doi":"10.1016/j.jvsv.2025.102229","DOIUrl":"https://doi.org/10.1016/j.jvsv.2025.102229","url":null,"abstract":"","PeriodicalId":17537,"journal":{"name":"Journal of vascular surgery. Venous and lymphatic disorders","volume":" ","pages":"102229"},"PeriodicalIF":2.8,"publicationDate":"2025-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143663665","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":"UTILITY OF VENOACTIVE COMPOUNDS IN POST-THROMBOTIC SYNDROME: A SYSTEMATIC REVIEW.","authors":"Monika L Gloviczki, Julianne Stoughton, Alessandra Puggioni, Peter Gloviczki, Joseph D Raffetto","doi":"10.1016/j.jvsv.2025.102228","DOIUrl":"https://doi.org/10.1016/j.jvsv.2025.102228","url":null,"abstract":"<p><strong>Background: </strong>Post-thrombotic syndrome (PTS) has been highly prevalent, over 50% of the patients develop PTS following lower extremity acute deep vein thrombosis (DVT). Venoactive compounds (VACs) have been recommended for decades for patients with chronic venous insufficiency (CVI), including PTS. The objective of our study was to perform a systematic review to determine the quality of evidence on the utility of VACs for both prevention and treatment of PTS.</p><p><strong>Methods: </strong>A systematic review was conducted searching the literature between 1/1/1980 and 7/14/2023 for venoactive drugs or medications, DVT and PTS using PubMed, Medline, life science journals and Cochrane library. Only randomized controlled trials (RCTs) published in English were included in this review. The PRISMA Guidelines and the revised Cochrane risk-of-bias tool for RCTs were used.</p><p><strong>Results: </strong>Ninety-four references were identified, eleven RCTs fulfilled the inclusion criteria. VAC's administered were diosmin, hidrosmin/rutosides, micronized purified flavonoid fraction (MPFF), and sulodexide. The studies included a highly variable proportion of patients with PTS (8.6% to 100%). Some older studies omitted details of the methodology. Two studies suggested benefit of diosmin and MPFF as adjunctive treatment to rivaroxaban in the prevention of PTS and showed low or unclear risk of bias. Evaluation of RCTs for treatment of post-thrombotic CVI found low or unclear risk of bias in 81.6% to 85.7%. All studies suggested that VACs were beneficial for PTS treatment, they improved venous symptoms, decreased edema, and aided healing of venous ulcers.</p><p><strong>Conclusions: </strong>This systematic review found that VACs had at least moderate quality of evidence in improving venous symptoms, decreasing edema, and accelerating venous ulcer healing. Two pilot RCTs of higher quality suggested usefulness of diosmin and MPFF as adjunctive treatment to rivaroxaban therapy to reduce the incidence of PTS and improve deep vein recanalization. Since most RCTs were published over two decades ago, and several lacked the required precision in reporting, new high quality, low bias RCTs are needed to assess the role of specific VACs for both prevention and treatment of PTS.</p>","PeriodicalId":17537,"journal":{"name":"Journal of vascular surgery. Venous and lymphatic disorders","volume":" ","pages":"102228"},"PeriodicalIF":2.8,"publicationDate":"2025-03-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143657613","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":"Noncontrast magnetic resonance imaging-based evaluation of quality of life in secondary upper extremity lymphedema.","authors":"Takashi Kageyama, Toko Miyazaki, Hayahito Sakai, Reiko Tsukuura, Takumi Yamamoto","doi":"10.1016/j.jvsv.2025.102220","DOIUrl":"10.1016/j.jvsv.2025.102220","url":null,"abstract":"<p><strong>Purpose: </strong>Noncontrast magnetic resonance imaging (NMRI) has emerged as an efficient tool for evaluating fluid infiltration in upper extremity lymphedema (UEL). This study aimed to examine the relationship between quality of life (QOL) in UEL and regional fluid infiltration on NMRI.</p><p><strong>Methods: </strong>A single-center retrospective observational study was conducted involving 65 patients with secondary UEL who underwent NMRI and ICG-L between 2017 and 2021. The presence of NMRI findings (reticular, thin stripe, thick stripe, multiple stripes, and honeycomb) in six regions of the upper arm and the NMRI stage were compared with Lymphedema Quality of Life Score (LeQOLiS), Quick Disabilities of the Arm, Shoulder and Hand (DASH) scores, ICG-L stage, International Society of Lymphology stage, and UEL index.</p><p><strong>Results: </strong>NMRI patterns were observed in 276 of 390 regions (70.8%) of 62 of 65 patients (95.4%). Thin stripe was most significantly associated with the greatest number of items (7/10) constituting the LeQOLiS score. Thick stripe had the most significant relationships with heaviness (r_s = 0.40; P < .001) and distention (r_s = 0.29; P = .021), and multiple stripes had the most significantly associated with the appearance distortion (r_s = 0.37; P = .002). The hand localization of thin stripe was significantly correlated with worsening of the greatest number of 7 of 11 items on the Quick DASH, and the upper arm localization of thin stripe was related with 4 of 10 LeQOLiS items. The higher NMRI stage was associated significantly with the deterioration of the total score (P = .012) and six items in the LeQOLiS and two items on the Quick DASH. A higher NMRI stage had significant correlations with the advancement of the ICG-L stage and UEL index (r_s = 0.83 [P < .001] and r_s = 0.65 [P < .001], respectively).</p><p><strong>Conclusions: </strong>The greater total number of thin stripes in the upper limb has potential as an indicator of overall deterioration of quality of life in UEL patients. The hand and upper arm localization of thin stripe had significant associations with hand-related functional disability and lymphedema-specific symptoms, respectively.</p>","PeriodicalId":17537,"journal":{"name":"Journal of vascular surgery. Venous and lymphatic disorders","volume":" ","pages":"102220"},"PeriodicalIF":2.8,"publicationDate":"2025-03-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143573210","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":"Efficacy study of lymphaticovenular anastomosis via the lymphosome-based four-incision approach for lower limb lymphedema.","authors":"Chen Yang, Gejia Ma, Xuchuan Zhou, Aoshuang Qin, Bin Liu","doi":"10.1016/j.jvsv.2025.102221","DOIUrl":"10.1016/j.jvsv.2025.102221","url":null,"abstract":"<p><strong>Objective: </strong>Lower limb lymphedema (LLL) is a chronic condition with impaired lymphatic drainage. Lymphaticovenular anastomosis (LVA) is a promising microsurgical treatment for LLL. Refined surgical techniques, such as optimal incision placement and precise lymphatic vessel identification, are essential for better clinical outcomes. For patients with LLL, we performed an LVA via the lymphosome-based four-incision approach. We standardized incision positioning and identified lymphatic vessels for LVA to improve surgical outcomes.</p><p><strong>Methods: </strong>A retrospective study was conducted on 59 patients with LLL who underwent LVA. Among them, 32 patients in the study group received LVA using the four-incision approach, and 27 patients in the control group underwent LVA with empirically determined incision placement. All patients were followed up for 12 months after the operation. The outcome measures included the number of lymphatic-to-venous anastomoses, surgical duration, Lymphedema Functioning, Disability, and Health Questionnaire for Lower Limb Lymphedema and Lower Extremity Lymphedema Index, Patient Health Questionnaire-9 items, and subcutaneous thickness.</p><p><strong>Results: </strong>At the 6-month and 12-month follow-ups, there was a significant interaction between the two groups of patients in terms of Lower Extremity Lymphedema Index and Lymphedema Functioning, Disability, and Health Questionnaire for Lower Limb Lymphedema (P < .05). The Patient Health Questionnaire-9 items showed no interaction between the two groups (P > .05). After treatment, the subcutaneous thickness in the study group was lower than that in the control group (P < .05). There were no significant differences between the two groups regarding surgical duration and the number of lymphatic-to-venous anastomoses (P > .05).</p><p><strong>Conclusions: </strong>LVA via the lymphosome-based four-incision approach can significantly enhance the quality of life, limb volume, and subcutaneous thickness in patients with LLL. This study presents new incision selection criteria for LVA and underlines the necessity of comprehensively addressing patients' mental health.</p>","PeriodicalId":17537,"journal":{"name":"Journal of vascular surgery. Venous and lymphatic disorders","volume":" ","pages":"102221"},"PeriodicalIF":2.8,"publicationDate":"2025-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143567480","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":"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 noninferiority 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":"10.1016/j.jvsv.2025.102214","url":null,"abstract":"<p><strong>Objective: </strong>We evaluated the noninferiority of adjustable compression wraps compared with 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 noninferiority trial was conducted on 24 patients with stage II to 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 predefined noninferiority margin of 50 mL. Application time was measured. Subjective parameters were assessed with visual analogue scales (range, 0-100).</p><p><strong>Results: </strong>Adjustable compression wraps were noninferior to inelastic multilayer bandages with a mean difference in volume reduction of 9.45 mL (95% confidence interval -30.40 to 49.26), with respect to the a priori defined noninferiority margin of 50 mL. In a subsequent test of superiority, intraindividual differences did not differ significantly (P = .629). Adjustable compression wraps took significantly less time to apply (8.4 minutes; P < .001), and patients rated them as more comfortable (median visual analogue scale difference, 30; P < .001). Both compression methods reduced skin tightness significantly, 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, noninferior alternative to inelastic multilayer bandages for reducing lower leg volume in the intensive complex decongestion therapy, although superiority could not be demonstrated. Their advantages include shorter application time and improved patient comfort. The 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-year recurrence rate and improved quality of life in patients with chronic venous disease: A multicenter study","authors":"Fabrizio Mariani MD ,&nbsp;Ludovico Carbone MD ,&nbsp;Giampaolo Sozio MD ,&nbsp;Rosaria Massaroni MD ,&nbsp;Eleonora Andreucci MD ,&nbsp;Valerio Bianchi MD ,&nbsp;Matteo Bucalossi MD","doi":"10.1016/j.jvsv.2025.102212","DOIUrl":"10.1016/j.jvsv.2025.102212","url":null,"abstract":"<div><h3>Objective</h3><div>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), Clinical-Etiology-Anatomy-Pathophysiology (CEAP) clinical grade 2 to 4 disease. Secondary end points 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.</div></div><div><h3>Methods</h3><div>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 of 1:4). The sclerosing agent concentrations were 1% for saphenous trunk diameter 4 to 7 mm, 3% for saphenous trunk of &gt;7 mm. Sodium tetradecyl sulfate was injected directly into the GSV/SSV, achieving a total maximum volume of 10 mL per session. A median of two sessions was performed (range, 1-5).</div></div><div><h3>Results</h3><div>In this cohort, 205 patients were categorized as CEAP C2 (59.2%), and 141 (40.8%) had worse CVD (CEAP ≥3). The median follow-up was 60 months (range, 6-60 months). At the end of follow-up, 296 patients (85.5%) had no truncal reflux, with a 5-year disease-free time (between last procedure and evidence of recurrent disease) of 77.7 ± 2.16%. GSV and SSV showed similar 5-year recurrence-free time rates (69.9% vs 76.8%; <em>P</em> = ns), whereas patients with a diameter of the saphenous trunk of ≤8 mm had lower recurrence than those with &gt;8 mm (91.3% vs 46%; <em>P</em> &lt; .0001). Ninety patients (26%) showed CVD recurrence, occurring at a median of 48 months. A further UGFS treatment was needed in 50 symptomatic patients (14.4%), resulting in an 80% success rate. At univariate analysis, large diameter of the saphenous trunk (<em>P</em> &lt; .0001), male sex (<em>P</em> = .030) and greater number of treatment sessions (<em>P</em> = .009) were identified as significant prognostic factors for recurrence. Immediate complications occurred in 3.7% of patients: seven headache and six visual disturbances. Endovenous foam-induced thrombosis was detected in six patients (2.8%) 1 week after treatment. Cutaneous hyperpigmentation appeared in 37 patients (10.7%). Post-treatment revised Venous Clinical Severity Score and Chronic Venous Disease Quality of Life Questionnaire 14 scores were significantly lower than before treatment (<em>P</em> &lt; .001).</div></div><div><h3>Conclusions</h3><div>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 nonthermal ablation in the treatment of saphenous trunk incompetence (CEAP clinical grade 2-4).</div></div>","PeriodicalId":17537,"journal":{"name":"Journal of vascular surgery. Venous and lymphatic disorders","volume":"13 4","pages":"Article 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":"OA","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 MD ,&nbsp;Priscilla J. Lee BS ,&nbsp;Amit Rao MD ,&nbsp;Micaela D. Gray MSc","doi":"10.1016/j.jvsv.2025.102213","DOIUrl":"10.1016/j.jvsv.2025.102213","url":null,"abstract":"<div><h3>Objective</h3><div>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.</div></div><div><h3>Methods</h3><div>We evaluated 46 adults with venous ulceration of the lower extremity self-reporting a wound-associated pain score of ≥4 on a scale of 1 to 10. Before any treatments were performed (eg, 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 rerated their pain either at the end of the study visit or over the phone the following day. Semiquantitative 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 <em>t</em> tests assessed changes in pain scores post procedurally.</div></div><div><h3>Results</h3><div>Fluorescence from elevated bacterial loads and biofilm was present in every venous ulcer assessed, usually covering ≤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 of 46 patients (87%). This overlap was often substantial (29 patients with &gt;25% overlap and 16 with &gt;50% overlap). Overall mean pain scores were 8.17 before the procedure and 6.87 after the procedure, corresponding with a 1.30-point reduction that was highly statistically significant (<em>P</em> &lt; .0001). Pain score reduction was higher when patients rerated their pain 1 day after debridement (3.40-point reduction; <em>P</em> = .004).</div></div><div><h3>Conclusions</h3><div>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 after 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.</div></div>","PeriodicalId":17537,"journal":{"name":"Journal of vascular surgery. Venous and lymphatic disorders","volume":"13 4","pages":"Article 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":"OA","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}