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

{"title":"Twelve-Month Results of Cyanoacrylate Closure in Patients with Venous Leg Ulceration.","authors":"Kathleen Gibson, Manjit Gohel, Ahmed Kayssi, Joseph Sabat, Nicolas Néaume, Leigh Ann O'Banion, Paul Gagne, Misaki Kiguchi, Neil M Khilnani, Raghu Kolluri, Nicholas Salkowski, Daniel J Denmark, Alun H Davies","doi":"10.1016/j.jvsv.2026.102635","DOIUrl":"https://doi.org/10.1016/j.jvsv.2026.102635","url":null,"abstract":"<p><strong>Importance: </strong>Venous leg ulceration (VLU) is a major cause of patient distress and healthcare burden. Previous studies have highlighted the importance of early endovenous ablation of superficial venous reflux to expedite healing and prevent recurrence, but the optimal venous ablation modality is unclear.</p><p><strong>Objective: </strong>The aim of this study was to evaluate the effectiveness and safety of cyanoacrylate closure in patients with VLU.</p><p><strong>Design: </strong>A global, prospective, single-arm observational study was conducted in 17 centers across the United States and Europe. A total of 125 participants with VLU were included and treated with the VenaSeal closure system, in addition to standard wound therapy, including multilayered compression. Adjuvant treatments to varicosities, perforators or the sub-ulcer plexus were left to the discretion of treating clinicians. The primary outcome was VLU healing through 12 months. Secondary outcomes included time to ulcer recurrence, anatomic vein closure, target limb adverse events, and changes in quality-of-life measures.</p><p><strong>Results: </strong>One hundred twenty-five participants with VLU and saphenous vein reflux were enrolled. The mean (± standard deviation) age was 67.9 ± 14.76 years, with 38.4% females and an overall mean BMI of 32.4± 9.35. Concomitant foam sclerotherapy treatments were performed in 19.7% (31/157) of target veins. At 12 months, ulcer healing was 81.3% and ulcer recurrence was 17.0%. The median time to ulcer healing was 92 days (95% CI 74, 137). Anatomic vein closure was successful in 82.7% of all target veins. CEC-adjudicated AE and SAEs included: 2 granulomas, 1 hypersensitivity reaction, and 4 cases of phlebitis of the treated limb. Healthcare services utilized outside of the index procedure yielded 0.12 adjunctive therapies per vein-year. Venous-specific and generic QoL scores showed sustained improvement compared to baseline scores.</p><p><strong>Conclusion: </strong>VenaSeal effectively eliminated saphenous reflux in patients with VLU. The ulcer healing rate was high, and the recurrence rate was low. Complication rates were also low and QoL improved.</p>","PeriodicalId":17537,"journal":{"name":"Journal of vascular surgery. Venous and lymphatic disorders","volume":" ","pages":"102635"},"PeriodicalIF":3.1,"publicationDate":"2026-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149128085","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":"One-year Outcomes of Mechanical Thrombectomy and Catheter-Directed Thrombolysis in Acute Pulmonary Embolism.","authors":"Bright Benfor, Pallavi Gorantla, Sri Achanta, Eric K Peden","doi":"10.1016/j.jvsv.2026.102636","DOIUrl":"https://doi.org/10.1016/j.jvsv.2026.102636","url":null,"abstract":"<p><strong>Background: </strong>While anticoagulation remains the standard of care for acute pulmonary embolism, mechanical thrombectomy (MT) and catheter-directed thrombolysis (CDT) have emerged as effective interventional options for rapid clot removal. However, their comparative outcomes remain incompletely defined. This study aimed to compare the outcomes of MT and CDT for acute PE at a tertiary referral center in the United States.</p><p><strong>Methods: </strong>We conducted a retrospective cohort study of all patients who underwent MT or CDT for acute PE across a single hospital system between January 2021 and April 2025. Patients were stratified into MT and CDT groups based on the treatment received. Baseline characteristics, procedural data, and clinical outcomes were analyzed. The primary outcome was 30-day mortality. Secondary outcomes included length of hospital stay, major adverse events, reintervention, and PE recurrence. Patients were followed for up to one year or until death.</p><p><strong>Results: </strong>A total of 724 patients were included: 569 (79%) underwent MT and 155 (21%) received CDT. The mean age was 63 ± 16 years, and 49% were female. Most patients (76%) were classified as intermediate-high risk, with a mean right ventricle to left ventricle (RV/LV) ratio of 1.5 ± 0.5. Bilateral or saddle embolism was present in 93% of cases. Patients in the MT group were more likely to have a simplified PE severity index (sPESI) > 0 (73% vs. 60%, p < 0.001). Age, rates of cancer, chronic cardiopulmonary disease, and concurrent deep vein thrombosis were similar between groups. Median procedure duration was longer for MT (66 minutes, IQR 46-89) than CDT (58 minutes, IQR 40-77; p = 0.003). Median postoperative length of stay was 3 days in both groups. MT was associated with a higher incidence of intraoperative adverse cardiac events (2.5% vs. 0%, p = 0.048), while CDT was associated with higher ICU admission rates (83% vs. 36%, p < 0.001). However, thirty-day mortality was similar between groups (CDT: 2.6% vs. MT: 4.6%; p = 0.27). Additionally, the one-year incidences of CTEPH (MT: 4.5% vs. CDT: 3.4%, p=0.69), PE recurrence (MT: 4.4% vs CDT: 2.5%, p=0.31) and all-cause mortality (MT:7.8% vs. CDT: 5.8%, p=0.41) were not statistically significant between MT and CDT respectfully.</p><p><strong>Conclusion: </strong>In this retrospective cohort, MT and CDT for acute PE showed statistically comparable mortality, CTEPH, and PE recurrence rates at one-year. MT was associated with higher intraoperative cardiac complications, whereas CDT required more frequent ICU admission.</p>","PeriodicalId":17537,"journal":{"name":"Journal of vascular surgery. Venous and lymphatic disorders","volume":" ","pages":"102636"},"PeriodicalIF":3.1,"publicationDate":"2026-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149111523","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":"Analysis of real-world multicenter experience with the large-bore CLEANER-Vac Thrombectomy System: An analysis of 200 patients.","authors":"Sameh Sayfo, Charbel Y Ishak, Ilan Rzadkowolsky-Raoli, Mel M Ghaleb, Peter Stibbs, Holly Harrison, Susan Powell, Jacqueline Finley","doi":"10.1016/j.jvsv.2026.102634","DOIUrl":"10.1016/j.jvsv.2026.102634","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Venous thromboembolism (VTE), encompassing deep vein thrombosis and pulmonary embolism, represents a significant clinical entity associated with elevated morbidity and mortality rates. Conventional therapeutic approaches, such as systemic anticoagulation and thrombolytic agents, frequently yield suboptimal thrombus resolution. Mechanical thrombectomy has introduced a paradigm shift, enabling expeditious thrombus extraction while mitigating the chronic outcomes of suboptimally treated VTE and sequelae inherent to fibrinolytic therapies. The CLEANER Vac Thrombectomy System (Argon Medical Devices) is designed for controlled percutaneous venous thrombectomy.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;To evaluate the real-world procedural efficacy, safety profile, and clinical utility of the CLEANER Vac system in a multicenter cohort comprising 200 patients presenting with symptomatic venous thrombus.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;This retrospective, multicenter investigation included data from 200 patients who underwent intervention between October 2024 and January 2026 across 26 U.S. institutions. Eligible participants were adults aged ≥18 years with imaging-confirmed acute (&lt;14 days) or subacute (14-28 days) VTE. Primary end points included thrombus clearance efficacy, segmented venous involvement, estimated blood loss, and intraprocedural adverse event incidence.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;The study cohort had a mean age of 64.5 (range, 25-90) years, with a gender distribution of 52% female (n = 104) and 48% male (n = 96). An average of 2.2 venous segments were treated per patient (range, 1-5). Mean preprocedure clot burden was 88.0%, which decreased to 10.5% postprocedure, culminating in a mean thrombus clearance of 88.0%. Overall, 76.0% of patients (n = 152) achieved ≥90% clot resolution. Adjunctive rotational maceration was used in 30% of cases, balloon venoplasty in 38%, and stent placement in 15%. Mean device utilization time was 8.0 minutes, with an average of 2.4 device passes per patient. Mean estimated blood loss was 320 (range, 50-750) mL. The overall complication rate was 2.4% (n = 5), consisting exclusively of minor access-site hematomas not attributed to the device. No serious adverse events were device-attributable within the 200-patient cohort. Procedures were predominantly classified as peripheral venous interventions (70%), with the remaining 30% encompassing alternative indications (eg, in-stent restenosis and transjugular intrahepatic portosystemic shunt revisions).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;In this cohort of 200 patients, the CLEANER Vac system demonstrated high procedural efficacy (88.0% mean clot clearance, 76% achieving ≥90% resolution) and a favorable overall safety profile. The findings support the potential role of this system in enabling rapid, single-session VTE treatment with constrained hemorrhagic liability and morbidity compared with catheter-directed thrombolysis. Prospective","PeriodicalId":17537,"journal":{"name":"Journal of vascular surgery. Venous and lymphatic disorders","volume":" ","pages":"102634"},"PeriodicalIF":3.1,"publicationDate":"2026-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149075060","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":"Mechanical thrombectomy for post-thrombotic venous obstruction is associated with venous wound healing.","authors":"Nicolas J Mouawad, Steven Abramowitz, Atif Baqai, Angelo Marino","doi":"10.1016/j.jvsv.2026.102625","DOIUrl":"10.1016/j.jvsv.2026.102625","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate the association between mechanical thrombectomy (MT)-combined with standard wound care and adjunctive endovenous interventions, as indicated-and venous wound healing in patients with post-thrombotic venous obstruction.</p><p><strong>Methods: </strong>This multicenter, retrospective analysis included adults with venous wounds secondary to lower-extremity deep vein thrombosis. MT was performed with one or more of the following devices (Inari Medical): ClotTriever System, ClotTriever BOLD catheter, or VenaCore catheter in native vessels, or RevCore catheter (Inari Medical) within occluded stents. Adjunctive venoplasty and stenting were performed as indicated. Standard wound care continued until wound healing or latest follow-up. Technical success was defined as crossing the lesion and deploying the study device; clinical success as any decrease from baseline in wound area.</p><p><strong>Results: </strong>Twenty-two patients with 37 wounds on 29 limbs were treated between August 2021 and September 2024. Mean age was 59.0 ± 12.8 years, and 72.7% were male. More than half had failed conservative wound care before referral; three had been referred for amputation. Median wound duration was 13.0 [interquartile range (IQR), 6.3-45.0] months. Technical success was achieved in 100% of cases; all procedures were single session, with 91.7% performed outpatient. Stenting was performed in 15 of 29 limbs (51.7%) and venoplasty in 23 of 29 (79.3%). Among the 14 limbs without new stenting at the index procedure, two underwent MT alone and 11 received adjunctive venoplasty only. No adjunctive thrombolytics were used. Hospital stay (median, 2; IQR, 2-2.75 days) was required following six procedures. At latest follow-up (median, 2.8; IQR, 2.0-3.5 months), all wounds were healed or healing, meeting the clinical success definition. Among the 25 wounds with available area data, mean wound area decreased from 22.0 ± 30.9 cm² at baseline to 5.1 ± 20.8 cm², with a mean per-wound area reduction of 91.4%; 76% (19/25) fully healed, and the remaining wounds showed a mean per-wound area reduction of 65.6%.</p><p><strong>Conclusions: </strong>In this multicenter retrospective analysis, all patients with post-thrombotic venous wounds were healed or healing at latest follow-up after MT, with a 91% mean per-wound area reduction. These findings suggest that MT-combined with standard wound care and adjunctive endovenous interventions as indicated-may play an important role in treating recalcitrant post-thrombotic venous wounds.</p>","PeriodicalId":17537,"journal":{"name":"Journal of vascular surgery. Venous and lymphatic disorders","volume":" ","pages":"102625"},"PeriodicalIF":3.1,"publicationDate":"2026-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149008625","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":"Society for Vascular Surgery Vascular Quality Initiatives contemporary benchmarks: Varicose vein treatments.","authors":"Cassius Iyad Ochoa Chaar, Nicholas Wells, Jennifer L Ellis, Nicholas H Osborne, Peter F Lawrence, Thomas F O'Donnell, Nikolaos Zacharias, Jens Eldrup-Jorgensen","doi":"10.1016/j.jvsv.2026.102619","DOIUrl":"10.1016/j.jvsv.2026.102619","url":null,"abstract":"<p><strong>Background: </strong>Venous ablation is the main procedural treatment of patients with varicose veins. This study provides benchmark outcomes and utilization trends for thermal and nonthermal ablations for patients with varicose veins undergoing initial treatment in the Vascular Quality Initiative registry.</p><p><strong>Methods: </strong>The Vascular Quality Initiative Varicose Veins Registry was queried for patients treated between 2014 and 2025 at a truncal vein with no previous varicose venous treatment. Patients were stratified by index intervention into thermal or nonthermal ablation groups. Primary outcomes included improvement in Venous Clinical Severity Score (VCSS) and patient-reported outcomes assessed by Heaviness, Achiness, Swelling, Throbbing, and Itching (HASTI).</p><p><strong>Results: </strong>Among 44,883 patients undergoing 71,889 procedures, 38,978 (86.8%) were treated with ablation as the primary procedure. Thermal ablation declined from 91.5% to 53.0% of procedures (P < .001), whereas nonthermal ablation increased from 0% to 30.9% (P < .001) over the duration of the study. Ligation and stripping increased in the registry but remained low (0%-2.3%; P < .001). After exclusions, 23,598 patients undergoing initial truncal vein ablation were analyzed, including 21,920 (92.9%) thermal and 1678 (7.1%) nonthermal ablation. Patients undergoing thermal ablation were younger, had lower body mass index, had fewer previous deep vein thrombosis, were less likely to receive pre-/perioperative anticoagulation, and more often had deep venous reflux. Patients treated with nonthermal ablations were more likely to be male and had more baseline ulceration but lower baseline HASTI scores, underwent fewer concomitant procedures, and more frequently underwent treatment of truncal veins other than the great saphenous vein. Thermal ablation had fewer systemic complications (0.3% vs 0.7%; P = .007), whereas local complication rates were similar between groups. Thermal ablation produced greater mean improvements in VCSS (-4.3 vs -3.2; P < .001) and HASTI (-6.9 vs -3.8; P < .001) post-treatment. In addition, a higher proportion of patients treated with thermal ablation reported improvement in VCSS (83.9% vs 74.6%; P < .001) and HASTI (86.3% vs 71.3%; P < .001).</p><p><strong>Conclusions: </strong>Venous ablations improve symptoms of venous insufficiency in the majority of patients treated as measured by clinical severity scores and patient-reported outcomes. Complications are minor and infrequent regardless of the ablation modality.</p>","PeriodicalId":17537,"journal":{"name":"Journal of vascular surgery. Venous and lymphatic disorders","volume":" ","pages":"102619"},"PeriodicalIF":3.1,"publicationDate":"2026-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148990634","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":"Depressed inflammatory mediators may suggest immunologic dysregulation in advanced venous disease.","authors":"Breauna Franklin, Bowen Xie, Edwyn Assaf, Lena Vodovotz, Yingze Zhang, Rabih Chaer, Ulka Sachdev","doi":"10.1016/j.jvsv.2026.102624","DOIUrl":"10.1016/j.jvsv.2026.102624","url":null,"abstract":"<p><strong>Objective: </strong>Venous ulcer disease is slow to heal, recurs frequently, and represents a significant burden to the global health care system. In similar diseases such as diabetic foot ulcers, a lack of a robust inflammatory response frustrates wound healing. We do not know if a similar phenomenon occurs in venous ulcer. In this study, we used circulating plasma cytokine concentrations to understand how inflammation might link with venous leg ulcer. We hypothesized that venous leg ulcers may be associated with a less robust inflammatory response in regard to T-cell activity, which could explain, in part, their refractory nature, acknowledging the influence of factors such as obesity, venous hypertension, and pelvic outflow obstruction.</p><p><strong>Methods: </strong>Human subjects with Clinical, Etiology, Anatomy, and Pathophysiology clinical class C2 to C6 chronic venous disease undergoing treatment, and control subjects without venous insufficiency were included. Demographic information, including age, gender, race/ethnicity, and comorbidities, were recorded. Descriptive statistics were calculated for each group. Plasma was obtained from venipuncture in treated and control subjects for isolation of cytokines using enzyme-linked immunosorbent assay and multiplex techniques with a focus on interferon-gamma (IFN-γ), interleukin-12 (IL-12), and IL-2 levels, which are associated with T-cell activity. Multiple linear regression was used to correlate cytokine level with clinical disease status, focusing on correlations with IL-2, which can help determine T-cell fate.</p><p><strong>Results: </strong>Subjects with C2 to C4 disease demonstrated significantly elevated plasma levels of the T-cell associated cytokines IFN-γ, IL-12p70, and IL-2 compared with both control subjects and those subjects with C5 to C6 disease. Multilinear regression suggested that presentation with C2 to C4 disease, IFN-γ, and IL-12p70 concentrations significantly predicted IL2 concentration, whereas Venous Clinical Severity Score scores, age, sex, diabetes mellitus, and smoking did not.</p><p><strong>Conclusions: </strong>Higher cytokine levels were primarily seen in subjects with varicose veins (C2-C4) as opposed to those with chronic wounds (C5-C6) which supports a reason why venous leg ulcer healing may stall. IL-2 is a regulator of T-cell activity and as not only diminished in venous ulcer disease but was also correlated with other T-cell mediators such as IFN-γ and IL-12p70. T-cell exhaustion, characterized by a declining immune response in the setting of antigen hyperstimulation and a reduced ability to carry out essential immune functions, may be a reason, explain these findings. Targeting T helper cell activity may be a future therapeutic avenue for managing severe chronic venous disease.</p>","PeriodicalId":17537,"journal":{"name":"Journal of vascular surgery. Venous and lymphatic disorders","volume":" ","pages":"102624"},"PeriodicalIF":3.1,"publicationDate":"2026-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148990652","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":"Histologic validation of quantitative magnetic resonance relaxation time biomarkers for thrombus chronicity: A feasibility study.","authors":"Eniko Pomozi, Caroline Jordan, Alexander Crichton, Judit Csore, Deborah Vela, Christof Karmonik, Trisha Roy","doi":"10.1016/j.jvsv.2026.102620","DOIUrl":"10.1016/j.jvsv.2026.102620","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Medical anticoagulation remains the standard treatment for venous thromboembolism, but mechanical thrombectomy is increasingly used in selected patients. Patient selection remains limited because thrombus age, composition, organization, and fibrosis are difficult to determine before intervention.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;To evaluate whether quantitative magnetic resonance imaging (MRI) relaxation times correlate with histologic thrombus composition and remodeling in freshly retrieved ex vivo human venous thrombi.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;Fourteen fresh human venous thrombi retrieved during clinical intervention were imaged ex vivo at 9.4 T before formalin fixation. T&lt;sub&gt;1&lt;/sub&gt; relaxation times were measured using rapid acquisition with relaxation enhancement, T&lt;sub&gt;2&lt;/sub&gt; using multislice multiecho imaging, and T&lt;sub&gt;2&lt;/sub&gt;∗ using multigradient echo imaging. Digitized histology slides were analyzed with pixel-thresholding to quantify red blood cell (RBC), fibrin/platelet, and collagen/extracellular matrix (ECM) content. Fibrosis and organization were scored semiquantitatively. Associations between clinical thrombus age, MRI relaxation times, and histologic parameters were assessed using Spearman correlations and Mann-Whitney U tests.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Of 14 patients, 11 thrombi were retrieved within 14 days of symptom onset or presentation, whereas three had longer intervals of 36, 73, and 104 days. Mean patient age was 58.9 ± 13.6 years, and mean body mass index was 31.0 ± 5.3 kg/m&lt;sup&gt;2&lt;/sup&gt;. Median relaxation times were 1719.2 ms for T&lt;sub&gt;1&lt;/sub&gt;, 81.1 ms for T&lt;sub&gt;2&lt;/sub&gt;, and 9.48 ms for T&lt;sub&gt;2&lt;/sub&gt;∗. Increasing thrombus age correlated with shorter T&lt;sub&gt;2&lt;/sub&gt; (r = -0.676; P = .00792) and T&lt;sub&gt;2&lt;/sub&gt;∗ (r = -0.676; P = .0194), but not with T&lt;sub&gt;1&lt;/sub&gt; (r = +0.330; P = .249). T&lt;sub&gt;1&lt;/sub&gt; showed a strong inverse correlation with RBC content (r = -0.765; P = .00143). Histologic composition was heterogeneous, with RBC content ranging from 1% to 89%, fibrin/platelet content from 10% to 65%, and collagen/ECM content from 0% to 89%. Thrombi ≥14 days had lower T&lt;sub&gt;2&lt;/sub&gt; values than thrombi &lt;14 days (58.5 vs 83.4 ms; P = .0360). Fibrotic thrombi had higher collagen/ECM content (39.0% vs 0.0%; P = .00078), were older (25 vs 4 days; P = .0111), had lower RBC content (17.3% vs 64.0%; P = .0166), and showed higher organization scores (3.0 vs 0.5; P = .00453).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;Quantitative MRI relaxation times reflect distinct thrombus phenotypes. T&lt;sub&gt;1&lt;/sub&gt; primarily captures RBC-rich composition, whereas T&lt;sub&gt;2&lt;/sub&gt; and T&lt;sub&gt;2&lt;/sub&gt;∗ reflect thrombus age, organization, and fibrotic remodeling. This histology-validated ex vivo high-field-strength framework may provide a basis for prospective validation at clinically available lower field strengths, with the ultimate goal of evaluating MRI-based patient selection for venous thrombectomy.&lt;/p&gt;&lt;p&gt;&lt;strong","PeriodicalId":17537,"journal":{"name":"Journal of vascular surgery. Venous and lymphatic disorders","volume":" ","pages":"102620"},"PeriodicalIF":3.1,"publicationDate":"2026-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148982739","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":"Multicentric, randomized, open-label, three-arm postmarketing clinical study of VELVERT with single- and four-layer compression, for venous leg ulcer.","authors":"Sandeep Mahapatra, A Anusha, K Athirath Reddy, Nutan Kumar Aggarwal, Pallavi Agarwal, Rachna Chaurasia, Sudhir Kumar","doi":"10.1016/j.jvsv.2026.102621","DOIUrl":"10.1016/j.jvsv.2026.102621","url":null,"abstract":"<p><strong>Background: </strong>Venous leg ulcers (VLUs) are chronic, slow-healing wounds related to chronic venous insufficiency, and they represent a significant clinical and economic burden. Despite compression therapy being the standard of care, healing remains suboptimal in many patients, necessitating improved wound-care strategies.</p><p><strong>Objective: </strong>To evaluate the comparative efficacy, safety, and clinical performance of VELVERT (Datt Mediproducts Private Limited) advanced wound-care dressing alone, VELVERT combined with VELSOFT (Datt Mediproducts Private Limited) compression bandage, and the VELFOUR (Datt Mediproducts Private Limited) four-layer compression system in the management of VLUs.</p><p><strong>Methods: </strong>This randomized, interventional, open-label, multicentric clinical study was conducted at MLB Medical College, Jhansi, and Nizam Institute of Medical Sciences, Hyderabad. Sixty-six subjects were enrolled, of whom 61 completed treatments through day 60 or until complete wound healing. Primary end points included complete wound closure, percentage wound size reduction, and microbiological assessment. Secondary end points were pain intensity, safety, and the number of dressings required for healing.</p><p><strong>Results: </strong>At day 60, mean wound size reduction was 57.72% in the VELVERT group (n = 22), 67.03% in the VELVERT + VELSOFT group (n = 20), and 65.79% in the VELFOUR group (n = 19). Overall, 42.6% of participants achieved complete wound closure, with the highest rate in the VELVERT + VELSOFT group (50.0%), followed by the VELFOUR (42.1%) and VELVERT (36.4%) groups. Complete microbial clearance occurred in the VELVERT and VELVERT + VELSOFT groups, whereas minimal residual microbial growth was observed in the VELFOUR group. Pain scores improved significantly across all groups. Adverse events were infrequent, mild to moderate, and unrelated to the study devices.</p><p><strong>Conclusions: </strong>All three treatment strategies improved wound healing, pain, and infection control. VELVERT combined with VELSOFT demonstrated the most consistent clinical benefits, including greater wound size reduction, the highest wound closure rate, complete microbial clearance, and an excellent safety profile. These findings support VELVERT with VELSOFT, and VELVERT alone, as effective and well-tolerated compression-based wound-care options for VLUs.</p>","PeriodicalId":17537,"journal":{"name":"Journal of vascular surgery. Venous and lymphatic disorders","volume":" ","pages":"102621"},"PeriodicalIF":3.1,"publicationDate":"2026-09-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148963546","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":"Reply.","authors":"Jeeyoung Min, Sang Woo Park","doi":"10.1016/j.jvsv.2026.102618","DOIUrl":"10.1016/j.jvsv.2026.102618","url":null,"abstract":"","PeriodicalId":17537,"journal":{"name":"Journal of vascular surgery. Venous and lymphatic disorders","volume":" ","pages":"102618"},"PeriodicalIF":3.1,"publicationDate":"2026-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148920088","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":"Association between pain, body mass index, and clinical characteristics in lipedema: Segmental analysis using bioimpedance.","authors":"Jubiza Pusic, Sofía Mora, Patricia Froes Meyer","doi":"10.1016/j.jvsv.2026.102585","DOIUrl":"10.1016/j.jvsv.2026.102585","url":null,"abstract":"<p><strong>Objective: </strong>We aimed to evaluate the association between pain, body mass index (BMI), clinical stage, and morphological type in women with lipedema, using segmental bioimpedance to correlate with clinical symptoms.</p><p><strong>Methods: </strong>We conducted a cross-sectional observational study of adult women with a confirmed clinical diagnosis of lipedema. We collected clinical variables, body composition by multifrequency bioimpedance, and pain intensity (visual analog scale 0-10). We examined associations between clinical and biophysical parameters using correlation analyses and group comparisons based on data distribution.</p><p><strong>Results: </strong>Pain was present in most participants, regardless of BMI, clinical stage, or morphological type. Pain showed the strongest associations with touch hypersensitivity and leg heaviness. Bioimpedance measurements indicated notably higher fat accumulation in the lower limbs, whereas lean mass remained relatively preserved. BMI did not accurately reflect functional severity.</p><p><strong>Conclusions: </strong>In lipedema, pain correlates more closely with clinical symptoms such as touch hypersensitivity and leg heaviness than with morphological parameters or BMI; however, these symptoms are nonspecific and should be interpreted as exploratory findings rather than diagnostic markers. Segmental bioimpedance adds descriptive value to clinical stratification and supports multidisciplinary management, whereas early recognition of lipedema should continue to rely on established clinical diagnostic criteria.</p>","PeriodicalId":17537,"journal":{"name":"Journal of vascular surgery. Venous and lymphatic disorders","volume":" ","pages":"102585"},"PeriodicalIF":3.1,"publicationDate":"2026-07-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148584809","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}