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

{"title":"Predictive Biomarkers for Post-thrombotic Syndrome (PTS).","authors":"Oscar Moreno, Nathaniel Parchment, Kate Micallef, Sabrina Rocco, Amber Clay, Catherine Luke, Kiran Kumar, Jorge H Ulloa, Thomas Wakefield, Andrea Obi, Peter Henke","doi":"10.1016/j.jvsv.2025.102325","DOIUrl":"https://doi.org/10.1016/j.jvsv.2025.102325","url":null,"abstract":"<p><p>Post-thrombotic syndrome (PTS) is a long-term sequela of Deep venous thrombosis (DVT). This review summarizes the best currently available biomarker candidates to identify high-risk progression patients. We examined indexed literature, including clinical studies and review articles, to identify biomarkers indicating the progression of DVT to PTS. Among the most studied biomarkers, associations between PTS and ICAM-1 and IL-10 were consistently found to be associated with PTS development, whereas D-Dimer, CRP, and IL-6 showed inconsistent results. Other less-studied biomarkers, including cell adhesion molecules, adipokines, thrombotic/fibrinolytic molecules, and novel imaging modalities, have been associated with PTS. Further clinical research on PTS biomarkers is warranted with standardized study designs to compare outcomes. A panel of biomarkers adjusted by age and BMI, including inflammatory (IL-10), coagulation (D-dimer), adhesion (ICAM-1), remodeling (MMP-1/8), and metabolic molecules (adiponectin/leptin) in conjunction with imaging, is recommended for future studies.</p>","PeriodicalId":17537,"journal":{"name":"Journal of vascular surgery. Venous and lymphatic disorders","volume":" ","pages":"102325"},"PeriodicalIF":2.8,"publicationDate":"2025-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145137909","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":"Early and Late Outcomes of Patients Treated with Graft Replacement of the Inferior Vena Cava for Malignant Disease: A Single Center Experience Over Three Decades.","authors":"Taleen A MacArthur, Bernardo C Mendes, Jill J Colglazier, David M Nagorney, Randall R DeMartino, Peter Gloviczki, Manju Kalra, Mark J Truty, Todd E Rasmussen, Fahad Shuja, Melinda S Schaller, Kenneth J Cherry, Thomas C Bower","doi":"10.1016/j.jvsv.2025.102326","DOIUrl":"https://doi.org/10.1016/j.jvsv.2025.102326","url":null,"abstract":"<p><strong>Objective: </strong>To describe early and late outcomes of segmental resection and graft replacement of the inferior vena cava (IVC) for malignant disease over three decades.</p><p><strong>Methods: </strong>All patients who had IVC resection with graft replacement from 1990-2024 at a single institution were retrospectively reviewed. Patients with tangential excision and primary or patch venorrhaphy were excluded. End-points were early (<30 days) mortality, major adverse events (MAE), graft-related complications, primary patency, overall survival, and freedom from local recurrence.</p><p><strong>Results: </strong>One hundred sixty-seven patients (54% female; mean age at operation 55 ±14 years) had IVC resection and graft replacement. Primary IVC leiomyosarcoma occurred in 69 patients (41%) and other secondary malignancies in 97 (58%). Pre-operative performance status (ECOG) was good or excellent in 153 patients (92%). Resection of multiple IVC segments was required in 94 patients (56%), 41 who needed renal vein reconstruction or implantation (25%) and 6 (3.6%) who had hepatic vein implantation. Graft replacement was with ringed PTFE in 163 patients (98%). Two patients died from intraoperative hemorrhage. Six others died within four months, three were procedure-related. One or more MAEs occurred in 28 patients (17%). Intraabdominal hemorrhage requiring transfusion was the most common complication, occuring in ten patients (5.9%). Only one patient each developed permanent renal or liver failure. Two patients (1.2%) had asymptomatic subsegmental pulmonary emboli. Over a mean follow-up of 5.5 +/- 5.8 years (median 3.2 [1.2, 7.5] years), 10 patients experienced graft occlusion (5.9%). Two occlusions were within one month of graft placement, two were within one year, and 6 were over one year, with one at 23 years post-op. Four patients had stents placed to treat asymptomatic high grade stenoses, one early and three late. There were four graft infections, all related to small bowel leaks. Median overall survival was 52% and 36% at five and ten years, respectively (range 0-27 years). Freedom from local recurrence was 85%, 71%, and 54% at 1-, 5- and 10-years. Kaplan-Meier estimates of IVC graft primary patency were 96%, 95%, and 88% at 1-, 5-, and 10-years.</p><p><strong>Conclusion: </strong>IVC resection and graft replacement for malignant disease is safe, durable, and provides excellent local control of the tumor, offering a chance for long-term survival in select patients.</p>","PeriodicalId":17537,"journal":{"name":"Journal of vascular surgery. Venous and lymphatic disorders","volume":" ","pages":"102326"},"PeriodicalIF":2.8,"publicationDate":"2025-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145113695","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":"Tibial vein thrombosis after foam sclerotherapy: A single-institution case series.","authors":"Jack K Donohue, Emily Mosher, Michael Knapp, Nuzhat Kabir, Nishant Agrawal, Robert Handzel, Natalie D Sridharan, Eric S Hager","doi":"10.1016/j.jvsv.2025.102319","DOIUrl":"10.1016/j.jvsv.2025.102319","url":null,"abstract":"<p><strong>Objective: </strong>Ultrasound-guided foam sclerotherapy is commonly used for superficial venous disease but carries a small risk of deep vein thrombosis (DVT). The management of tibial vein thrombosis after sclerotherapy remains controversial, with practices ranging from anticoagulation and antiplatelet therapy to observation alone. We sought to characterize the natural history of tibial DVTs identified after foam sclerotherapy and evaluate outcomes based on management strategy.</p><p><strong>Methods: </strong>We retrospectively analyzed patients who underwent physician-compounded foam sclerotherapy (Asclera) at a multi-institutional health care system between January 2016 and January 2022 and developed duplex-diagnosed tibial DVT. Patients underwent standardized follow-up duplex examinations at approximately 2, 4, and 6 weeks after the procedure. Thrombus evolution (resolution, reduction, stability, enlargement, propagation, and embolization) and clinical symptoms were recorded. Outcomes were compared across management groups: antiplatelet therapy, anticoagulation, and observation. Statistical analyses used Kruskal-Wallis and χ² tests.</p><p><strong>Results: </strong>Of 877 foam sclerotherapy patients, 622 had follow-up imaging, and 54 patients (55 legs; 9%) developed tibial DVT, forming the study cohort (median age 53 years; 51% female). At initial duplex ultrasound imaging (median 14 days postprocedure), all thrombi were ipsilateral to treatment, with concurrent proximal DVT in 5 cases (4 popliteal and 1 femoral; 9%). Initial management of the tibial thrombus included antiplatelet therapy (55%), anticoagulation (26%), or observation (20%). At final follow-up (median 35 days), thrombus completely resolved in 53%, decreased in 20%, and remained stable in 27%. No patients had enlargement or pulmonary embolism. Symptom resolution was achieved in 87% of patients, with no significant differences between management strategies.</p><p><strong>Conclusions: </strong>In our series, tibial DVTs after foam sclerotherapy demonstrate a benign clinical course regardless of management strategy. Routine anticoagulation or antiplatelet therapy may not be necessary in asymptomatic patients with isolated distal thrombus. Prospective studies are required to confirm these findings and guide evidence-based recommendations.</p>","PeriodicalId":17537,"journal":{"name":"Journal of vascular surgery. Venous and lymphatic disorders","volume":" ","pages":"102319"},"PeriodicalIF":2.8,"publicationDate":"2025-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145113707","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":"Longitudinal impact of Intersocietal Accreditation Commission vein treatment center accreditation on practice patterns, safety metrics, and patient outcomes","authors":"Fedor Lurie MD, PhD ,&nbsp;Mohamed Osman MD ,&nbsp;Marlin Schul MD ,&nbsp;Jeffery P. Schoonover MD ,&nbsp;Kelly Hallett RVT, CCT ,&nbsp;Mary Beth Farrell CNMT ,&nbsp;Mark H. Meissner MD","doi":"10.1016/j.jvsv.2025.102315","DOIUrl":"10.1016/j.jvsv.2025.102315","url":null,"abstract":"<div><h3>Objective</h3><div>With health care rapidly expanding and patient accessibility needs increasing, there has been an influx of providers often lacking formal training in venous disease management. The aim of this study was to determine if centers that participate in an accreditation program exhibit increased quality, safety outcomes, and overall practice standards.</div></div><div><h3>Methods</h3><div>Of 325 accredited vein centers, 287 underwent reaccreditation within 3 years. Fifty-nine of them were compliant with Intersocietal Accreditation Commission (IAC) standards at the time of initial accreditation. Fifty-nine IAC-accredited centers participated in the American Vein and Lymphatic Society Pro Vein registry and had patient-level data. Sixteen were initially compliant with IAC standards (group 1; 4977 patients) and 43 had deficiencies (group 2; 11,179 patients). A stratified before-and-after design was used to analyze center-level and patient-level data (demographics, body mass index, and disease severity scores [Clinical-Etiological-Anatomical-Pathophysiological and revised Venous Clinical Severity Score (VCSS)]. Primary outcomes included compliance with IAC standards, treatment results (eg, VCSS changes, complications, endothermal heat-induced thrombosis &gt;2), and interventional practice patterns, such as intervention rate and Utilization Index.</div></div><div><h3>Results</h3><div>Of the 287 IAC-accredited vein centers who pursued reaccreditation, 59 were compliant initially and at reaccreditation. The remaining centers (n = 229) had multiple deficiencies, with safety issues persisting in some centers at reaccreditation. Before accreditation, group 2 centers treated younger, lower body mass index patients with less severe disease, and group 1 centers saw more advanced cases. Over time, group 2 centers began treating more severe cases. Group 1 had higher intervention rates and lower use indices before accreditation. Post-treatment complication and endothermal heat-induced thrombosis rates were low and similar across both groups. Group 1 showed a greater VCSS score change after treatment, partly owing to higher baseline scores. Over time, group 2 showed a decrease in Utilization Index, without a post-treatment decrease in the revised VCSS change aligning with group 1, indicating improved practice patterns after accreditation.</div></div><div><h3>Conclusions</h3><div>IAC accreditation plays a meaningful role in standardizing and improving the quality of outpatient venous care. It promotes safer procedural environments, encourages more selective use of interventions, and is associated with improved clinical outcomes—particularly among initially noncompliant centers. These findings support the expansion of accreditation programs and underscore their importance in maintaining high standards of care in an increasingly heterogeneous field.</div></div>","PeriodicalId":17537,"journal":{"name":"Journal of vascular surgery. Venous and lymphatic disorders","volume":"14 1","pages":"Article 102315"},"PeriodicalIF":2.8,"publicationDate":"2025-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145081067","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":"SAVVE US pivotal study of patients with severe chronic insufficiency due to deep valvular venous reflux: One-year results after VenoValve implantation.","authors":"Cassius Iyad Ochoa Chaar, Eric K Peden, Eric S Hager, Claire L Griffin, Matthew R Smeds","doi":"10.1016/j.jvsv.2025.102314","DOIUrl":"10.1016/j.jvsv.2025.102314","url":null,"abstract":"<p><strong>Objective: </strong>Failure of deep venous valves and associated reflux leads to the progression of chronic venous insufficiency (CVI), culminating in painful, clinically challenging, and costly leg ulcers. Traditional CVI treatments have primarily focused on symptom management, or interventions for superficial veins. This study aimed to show that bioprosthetic valve implantation yields clinically meaningful health improvements and offers a safe and effective treatment for deep venous CVI by addressing the root cause of the condition.</p><p><strong>Methods: </strong>SAVVE (Surgical Antireflux Venous Valve Endoprosthesis) was a prospective, single-arm, multicenter study to evaluate the performance of a bioprosthetic venous valve device (VenoValve; enVVeno Medical), for femoral vein implantation in patients with venous disease (Clinical-Etiology-Anatomy-Pathophysiology clinical classifications C4b, C4c, C5, and C6) unresponsive to standard care. Outcome measures included duplex-derived reflux time, the Revised Venous Clinical Severity Score (rVCSS), pain, disease-specific (VEINES-QoL/Sym) and general health-related quality of life (EuroQol 5 Dimensions) measures, technical success of device implantation, ulcer healing (C6 patients), and ulcer recurrence (in C5 and C6 patients). Clinically meaningful improvement was defined as a decrease in rVCSS of at least 3 points.</p><p><strong>Results: </strong>Between October 2021 and September 2023, 75 patients were enrolled (median age, 65 years; interquartile range, 57-70 years) at 23 institutions. Of the enrolled patients, 61 (81.3%) were men and 16 (21.3%) were Black, Hispanic, or Latino. The device was implanted in 73 patients (97.3%). At 6 months, 23 of 67 implanted patients (34.3%) had a 30% or greater improvement in duplex-derived reflux time. Average rVCSS score improvements were clinically meaningful and statistically significant at 3, 6, and 12 months. At 12 months, 84.6% of implanted patients achieved clinically meaningful improvement, with an average improvement of 7.9 points in rVCSS. Statistically significant improvements in pain and health-related quality of life were reported through 12 months of follow-up. Among patients with C6 disease, healing was observed for 91.6% of ulcers that had a duration of less than 12 months. No unanticipated device-related adverse events were reported. The perioperative major adverse events rate was 30.7% with no mortality. Most patients with major adverse events achieved clinically meaningful improvement in symptoms.</p><p><strong>Conclusions: </strong>Implantation of the bioprosthetic venous valve yielded important clinical and health-related quality of life benefits in patients with severe CVI.</p>","PeriodicalId":17537,"journal":{"name":"Journal of vascular surgery. Venous and lymphatic disorders","volume":" ","pages":"102314"},"PeriodicalIF":2.8,"publicationDate":"2025-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145064814","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":"Paradigm shift and long-term results in the diagnosis and treatment of pelvic venous disorder.","authors":"Fabio Henrique Rossi, Antonio Massamitsu Kambara","doi":"10.1016/j.jvsv.2025.102318","DOIUrl":"10.1016/j.jvsv.2025.102318","url":null,"abstract":"<p><strong>Objective: </strong>Pelvic venous disorder (PeVD) is a heterogeneous condition with a range of presentations, including chronic pelvic pain (CPP), hematuria, flank pain, dyspareunia, pelvic, and lower extremity varicose veins. The clinical, anatomical, and hemodynamic diversity of PeVD complicates standardized management. We developed a personalized diagnostic and therapeutic protocol and evaluated its long-term outcomes.</p><p><strong>Methods: </strong>Patients presenting with CPP, with or without symptoms of renal or iliac vein obstruction, visual analogue scale (VAS) for pain of >5, and gonadal or pelvic varicose vein incompetence underwent one of the following procedures based on their anatomical, and hemodynamic profiles: (1) ovarian and pelvic varicose vein embolization, (2) spermatic vein embolization, (3) iliac vein stenting, or (4) renal vein stenting. Procedures were performed with intraoperative venography and intravascular ultrasound assessment.</p><p><strong>Results: </strong>Between January 2012 and May 2022, 175 patients with PeVD were treated, of whom 146 cases (83.4%) were followed for >2 years (mean, 110.0 ± 1.6 months). Treatment methods included iliac vein stenting (78 cases [53.4%]), ovarian vein embolization (45 cases [30.8%]), spermatic vein embolization (17 cases [11.7%]), and renal vein stenting (6 cases [4.1%]). Preoperative and postoperative VAS scores and Short Form-36 quality-of-life scores were as follows: iliac vein stenting: VAS, 8.1 ± 1.8 to 2.89 ± 1.7 (P < .001); Short Form-36, 35.8 ± 23.4 to 78.4 ± 11.8 (P < .001); ovarian vein embolization: VAS, 8.5 ± 1.5 to 3.1 ± 1.1 (P < .001); Short Form-36, 36.7 ± 22.6 to 74.7 ± 11.8 (P < .001); spermatic vein embolization, VAS, 8.3 ± 1.1 to 3.1 ± 0.4 (P < .001); Short Form-36, 33.8 ± 33.8 to 77.4 ± 13.7 (P < .002); renal vein stenting, VAS, 8.7 ± 0.9 to 1.8 ± 1.1 (P < .001); Short Form-36, 48.45 ± 33.8 to 79.4 ± 10.9 (P < .001). Complications included two cases (4.4%) of intraoperative, asymptomatic gonadal vein bleeding with very low-volume static contrast extravasation, which were managed conservatively. The reintervention rates after primary treatment were as follows: iliac vein stenting 10.2%, ovarian vein embolization 13.3%, spermatic vein embolization 0%, and renal vein stenting 16.6%.</p><p><strong>Conclusions: </strong>PeVD is a heterogeneous clinical condition requiring thorough preoperative assessment of reflux and venous obstruction. Although isolated CPP often benefits from gonadal and pelvic vein embolization, most patients with CPP related to chronic venous disease or renal vein symptoms improve with iliac or renal vein stenting alone, avoiding posterior gonadal vein embolization.</p>","PeriodicalId":17537,"journal":{"name":"Journal of vascular surgery. Venous and lymphatic disorders","volume":" ","pages":"102318"},"PeriodicalIF":2.8,"publicationDate":"2025-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145065117","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":"Comparison of long-term outcomes and quality of life following radiofrequency ablation, endovenous laser ablation, and N-butyl cyanoacrylate treatment of greater saphenous vein insufficiency","authors":"Hasan Toz MD,&nbsp;Yusuf Kuserli MD","doi":"10.1016/j.jvsv.2025.102316","DOIUrl":"10.1016/j.jvsv.2025.102316","url":null,"abstract":"<div><h3>Objective</h3><div>To compare the long-term clinical outcomes and quality of life after radiofrequency ablation (RFA), endovenous laser ablation (EVLA), and N-butyl cyanoacrylate (NBCA) treatments in patients with chronic venous insufficiency.</div></div><div><h3>Methods</h3><div>This retrospective study included 600 patients treated with RFA, EVLA, or NBCA for chronic venous insufficiency at a single center between February 2015 and February 2025. Patients were divided into 3 groups of 200 according to the treatment modality. Clinical and procedural parameters, complication rates, pain scores, time to return to daily activities, Venous Clinical Severity Scores (VCSS), and great saphenous vein (GSV) occlusion rates were compared among groups.</div></div><div><h3>Results</h3><div>Statistically significant differences were found among the groups regarding complication rates, pain scores at 6 hours, procedure duration, time to return to daily activities, long-term GSV occlusion, and 5-year VCSS values (all <em>P</em> &lt; .05). Complication-free rates were highest in the RFA group (89.5%), followed by NBCA (86.0%), and were lowest in the EVLA group (69.0%) (<em>P</em> &lt; .001). EVLA had more frequent pigmentation, paresthesia, and phlebitis. NBCA had the shortest procedure time (13.7 minutes) and the greatest postprocedural pain and delayed return to daily activities. At 5 years, RFA showed the highest GSV occlusion rate (88.4%), whereas NBCA and EVLA had lower rates (70.6% and 75.0%, respectively) (<em>P</em> &lt; .001). VCSS values at 5 years were more favorable in the RFA and NBCA groups compared with the EVLA group (<em>P</em> = .036).</div></div><div><h3>Conclusions</h3><div>All three endovenous techniques are effective and safe for the treatment of GSV insufficiency. However, the choice of modality should consider differences in complication rates, patient comfort, and long-term vein occlusion outcomes.</div></div>","PeriodicalId":17537,"journal":{"name":"Journal of vascular surgery. Venous and lymphatic disorders","volume":"14 1","pages":"Article 102316"},"PeriodicalIF":2.8,"publicationDate":"2025-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145065135","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":"Long-term outcomes of radiofrequency ablation versus cyanoacrylate closure for isolated small saphenous vein insufficiency: A comparative study","authors":"Hyangkyoung Kim MD, PhD ,&nbsp;Sungsin Cho MD, PhD ,&nbsp;Se Jun Kim MD ,&nbsp;Jin Hyun Joh MD, PhD","doi":"10.1016/j.jvsv.2025.102317","DOIUrl":"10.1016/j.jvsv.2025.102317","url":null,"abstract":"<div><h3>Background</h3><div>Endovenous ablation is widely recommended for treating small saphenous vein (SSV) insufficiency, but isolated SSV (iSSV) reflux remains less frequently studied, especially in comparative settings. This study aimed to evaluate the clinical and anatomical outcomes of radiofrequency ablation (RFA) and cyanoacrylate closure (CAC) in patients with iSSV insufficiency.</div></div><div><h3>Methods</h3><div>A retrospective review was conducted using prospectively collected data from patients undergoing either modality for iSSV. Preoperative duplex ultrasound examination assessed anatomical patterns and reflux. Ablation strategies were tailored to anatomical variations. Follow-up duplex ultrasound examinations were performed at 6 months, 12 months, and up to 24 months in some patients (median follow-up, 12 months; range, 6-24 months). Outcomes included procedure time, vein occlusion rate, symptom improvement, complications, and changes in the Venous Clinical Severity Score and Aberdeen Varicose Vein Questionnaire.</div></div><div><h3>Results</h3><div>A total of 379 limbs in 306 patients were treated (85 with RFA and 294 with CAC). CAC had a longer procedure time than RFA (<em>P</em> &lt; .001) and a higher occlusion rate at follow-up (99.3% vs 91.8%; <em>P</em> = .006). Both groups showed significant improvement in Venous Clinical Severity Score, Aberdeen Varicose Vein Questionnaire score, and pain scores (<em>P</em> &lt; .001). Sural nerve injury occurred in two limbs treated with RFA and none with cyanoacrylate. Thrombus extension into the deep vein occurred in both groups, without a significant difference.</div></div><div><h3>Conclusions</h3><div>Both RFA and CAC were effective and safe for treating iSSV insufficiency. Tailoring treatment to individual venous anatomy may improve outcomes and minimize complications such as sural nerve injury.</div></div>","PeriodicalId":17537,"journal":{"name":"Journal of vascular surgery. Venous and lymphatic disorders","volume":"14 1","pages":"Article 102317"},"PeriodicalIF":2.8,"publicationDate":"2025-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145065152","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":"Disaster-associated venous thromboembolism countermeasures in Japan: Insights from past major earthquakes.","authors":"Keisuke Kamada, Eri Fukaya, Eriko Iwata, Daiki Uchida, Makoto Mo, Kazuhiko Hanzawa, Shinsaku Ueda, Nobuyoshi Azuma","doi":"10.1016/j.jvsv.2025.102312","DOIUrl":"10.1016/j.jvsv.2025.102312","url":null,"abstract":"<p><p>Japan experiences more than 1000 perceptible earthquakes annually, including major events such as the 2011 Great East Japan Earthquake and the 1995 Great Hanshin-Awaji Earthquake. These events lead to a documented increase in cardiovascular events, particularly venous thromboembolism (VTE), including pulmonary embolism and deep vein thrombosis (DVT). Disaster-associated VTE is influenced by Virchow's triad: hemodynamic stasis, hypercoagulability, and endothelial injury. The incidence of DVT after earthquakes ranges from 10% to 30%, often developing 1 to 2 weeks post disaster. Early interventions in evacuation shelters to prevent venous stasis and hypercoagulability are critical. Left untreated, DVT can progress to pulmonary embolism, which may be fatal; however, most cases are preventable through timely intervention and improved shelter environments. Various organizations, including the Disaster Medical Assistance Team, the Japan Medical Association Team, and local institutions, contribute to disaster medical responses. In 2016, the Disaster Countermeasure Committee was established by the Japanese Society of Phlebology to lead VTE prevention efforts, including DVT screening, compression stocking distribution, public awareness campaigns, and promoting cardboard beds to enhance shelter conditions. In preparation for future large-scale disasters, it is vital to share evidence-based knowledge with health care professionals and the public to decrease the burden of disaster-associated VTE.</p>","PeriodicalId":17537,"journal":{"name":"Journal of vascular surgery. Venous and lymphatic disorders","volume":" ","pages":"102312"},"PeriodicalIF":2.8,"publicationDate":"2025-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145040454","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 cardiovascular impact of chronic venous disease: A systematic review and meta-analysis.","authors":"Maria Lourdes Del Río-Solá, Noelia Cenizo-Revuelta, Laura Saiz Viloria, Miguel Martin Pedrosa, Jose Antonio González-Fajardo","doi":"10.1016/j.jvsv.2025.102310","DOIUrl":"10.1016/j.jvsv.2025.102310","url":null,"abstract":"<p><strong>Objective: </strong>To systematically evaluate the association between chronic venous disease (CVD) and cardiovascular (CV) risk, including major CV events and traditional risk factors, across diverse populations and study designs.</p><p><strong>Methods: </strong>A systematic review was conducted following PRISMA guidelines. PubMed, Scopus, and Web of Science were searched from January 2011 to March 2025 using Medical Subject Headings terms and free-text keywords. Inclusion criteria encompassed observational human studies evaluating the relationship between CVD and CV outcomes or risk factors. Data extraction was performed independently by two reviewers. Thematic analysis and coding of extracted data were supported using ATLAS.ti software. Twenty studies met the inclusion criteria, including cohort, cross-sectional, and case-control designs.</p><p><strong>Results: </strong>Seventeen of the 20 studies (85%) reported a significant association between CVD and at least one CV outcome, such as coronary artery disease, stroke, peripheral arterial disease, heart failure, or CV mortality. Odds and hazard ratios ranged from 1.3 to 3.8, with higher Clinical-Etiological-Anatomical-Physiological classes (C3-C6) consistently linked with greater CV risk. Eight studies identified greater higher prevalence of traditional risk factors-including hypertension, diabetes, obesity, and dyslipidemia-in patients with CVD. Two studies provided mechanistic insights, highlighting systemic inflammation and endothelial dysfunction as potential shared pathways. Population-based analyses with multivariable adjustments confirmed the independent nature of the association. A meta-analysis of six studies encompassing 393,875 individuals and 55,356 CV events was conducted. The pooled odds ratio for CV events in patients with CVD was 0.92 (95% confidence interval, 0.14-1.69), reaching statistical significance (P = .021). An adjusted expected odds ratio of 2.50 (95% confidence interval, 1.15-5.44) further reinforced the strength of the association. Heterogeneity was high (I² = 98%), but no publication bias was detected. Visual exploration through Galbraith, L'Abbé, and funnel plots supported the consistency of the findings.</p><p><strong>Conclusions: </strong>CVD is independently associated with increased CV morbidity and mortality, particularly in patients with moderate to severe disease. These findings suggest that CVD may serve as a clinical marker of systemic vascular dysfunction and support its inclusion in CV risk assessment frameworks. The quantitative synthesis confirms a significant association and highlights the importance of early CV screening in patients with CVD.</p>","PeriodicalId":17537,"journal":{"name":"Journal of vascular surgery. Venous and lymphatic disorders","volume":" ","pages":"102310"},"PeriodicalIF":2.8,"publicationDate":"2025-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145006314","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}