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

{"title":"Frequency of left common iliac vein compression in asymptomatic adolescents and young adults","authors":"Kevin Wang MD ,&nbsp;Luie Siegel BA ,&nbsp;Alexis Betancourt MD ,&nbsp;Nicole A. Keefe MD ,&nbsp;Gloria Salazar MD ,&nbsp;Sydney Browder BS ,&nbsp;William A. Marston MD","doi":"10.1016/j.jvsv.2025.102282","DOIUrl":"10.1016/j.jvsv.2025.102282","url":null,"abstract":"<div><h3>Objective</h3><div>Venous compression at the iliac confluence is a reported risk factor for deep vein thrombosis, with venous stenting as the standard management for relieving this compression. Kibbe et al demonstrated that left common iliac vein (LCIV) compression is present in 35.3% of asymptomatic patients. However, this study included only adults with an average age of 40 years. The iliac vein confluence in patients under 21 years with no symptoms attributable to venous disease was evaluated in this study. The study goal is to determine prevalence of LCIV narrowing in patients under age 21 years, and as such, assist in determining the appropriate treatment for iliac vein compression in this patient population.</div></div><div><h3>Methods</h3><div>A retrospective review of patients aged 13-20 undergoing abdominal/pelvic computed tomography (CT) imaging for nonvascular indications was performed. This group was compared with patients aged 35 to 65 years undergoing CT imaging for similar reasons. Axial CT images were reviewed by two independent examiners to identify the diameter of the noncompressed left and right CIVs below the confluence and the diameter of the LCIV at the site of compression between the right common iliac artery and spine.</div></div><div><h3>Results</h3><div>A total of 122 patients aged 13 to 20 years were identified with high-quality CT imaging and no venous symptoms for image review. Mean LCIV diameter was 12.7 ± 2.5 mm, and mean right CIV diameter was 13.1 ± 2.2 mm. The diameter of the LCIV at the confluence was 4.2 ± 1.8 mm, resulting in a mean diameter stenosis of the LCIV of 69.4% ± 12.6%. In this population, 55.7% of patients were found to have ≥70% stenosis of the LCIV on CT imaging compared with 1.7% of patients aged 35 to 65 years (<em>P</em> &lt; .001). There was no statistical difference in the percentage of LCIV stenosis in young patients based on body mass index, gender, race, or ethnicity.</div></div><div><h3>Conclusions</h3><div>Severe compression of the LCIV at the iliac confluence was identified in over 50% of asymptomatic patients aged 13 to 20 years on CT imaging performed for nonvascular reasons. This suggests that narrowing of the LCIV is a normal anatomic finding in this age group. The incidence of severe compression is significantly lower in older asymptomatic persons. In young persons, the high incidence of iliac vein compression on CT imaging suggests that this finding may not be a significant risk factor for deep vein thrombosis or limb symptoms, questioning the need for routine intervention for compression correction in this patient population.</div></div>","PeriodicalId":17537,"journal":{"name":"Journal of vascular surgery. Venous and lymphatic disorders","volume":"13 6","pages":"Article 102282"},"PeriodicalIF":2.8,"publicationDate":"2025-06-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144368940","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":"Venous bypass using the internal jugular vein as the outflow tract for treating central venous stenosis and cephalic arch stenosis in hemodialysis access","authors":"Mo Wang MD ,&nbsp;Peng Lu MD ,&nbsp;Quanming Li MD ,&nbsp;Chang Shu MD ,&nbsp;Yang Zhou MD ,&nbsp;Tun Wang MD","doi":"10.1016/j.jvsv.2025.102280","DOIUrl":"10.1016/j.jvsv.2025.102280","url":null,"abstract":"<div><h3>Objective</h3><div>Central venous stenosis (CVS) and cephalic arch stenosis (CAS) remain significant issues in the long-term management of hemodialysis access. Surgical bypass serves as a crucial option for symptom relief and access preservation when endovascular treatments fail. This study aimed to evaluate the effectiveness and safety of using the internal jugular vein (IJV) as the outflow tract in bypass surgery for CVS and CAS.</div></div><div><h3>Methods</h3><div>From December 2021 to September 2024, 21 patients undergoing hemodialysis who developed CVS (n = 15) or CAS (n = 6), were undertaken. Extra-anatomic venous bypass using the IJV were performed. Before surgical bypass, all patients had computed tomography angiography (CTA) and bilateral venograms of the upper central venous system. Color Doppler ultrasound was used to measure flow volume. A literature review was conducted to analyze the outcomes of previous studies that using venous bypass for the treatment of CVS in patients with upper extremity hemodialysis access.</div></div><div><h3>Results</h3><div>Technical success was achieved in all cases. Fifteen cases presented with CVS (11 men and 4 women, with a mean age of 56 ± 11 years [range, 37-82 years]) were treated by six surgical approaches include cephalic vein to contralateral-IJV bypass (n = 3), axillary vein to contralateral-IJV bypass (n = 5), external jugular vein to contralateral-IJV bypass (n = 2), IJV to contralateral-IJV bypass (n = 2), axillary vein to ipsilateral-IJV bypass (n = 1), cephalic vein to ipsilateral-IJV bypass (n = 1), and arteriovenous graft to ipsilateral-IJV bypass (n = 1). The median follow-up was 22 months (interquartile range, 12-24 months). The primary patency rate and secondary patency were 79% and 79% at 1 year and 65% and 79% at 2 years. Six patients presented with CAS (2 men and 4 women, with a mean age of 51 ± 9 years [range, 38 to 59 years]) and were treated by cephalic vein to ipsilateral-IJV bypass (n = 6). The median follow-up was 22 months (interquartile range, 15-26 months). The primary patency rate and secondary patency were 100% and 100% at 1 year and 60% and 60% at 2 years. All patients showed significant symptom improvement postoperation, with no perioperative mortality.</div></div><div><h3>Conclusions</h3><div>Extra-anatomic venous bypass using the IJV as outflow tract is an effective and safe alternative, providing good graft patency and low postoperative complications during midterm follow-up. Careful selection of inflow and outflow tracts is crucial for optimal outcomes.</div></div>","PeriodicalId":17537,"journal":{"name":"Journal of vascular surgery. Venous and lymphatic disorders","volume":"13 6","pages":"Article 102280"},"PeriodicalIF":2.8,"publicationDate":"2025-06-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144484835","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":"Rationale for glue embolization rather than foam sclerosis in the endovascular treatment of pelvic reservoir in pelvic venous disorders","authors":"Romaric Loffroy MD, PhD","doi":"10.1016/j.jvsv.2025.102216","DOIUrl":"10.1016/j.jvsv.2025.102216","url":null,"abstract":"","PeriodicalId":17537,"journal":{"name":"Journal of vascular surgery. Venous and lymphatic disorders","volume":"13 4","pages":"Article 102216"},"PeriodicalIF":2.8,"publicationDate":"2025-06-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144270685","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":"Natural course of portal vein aneurysm - does morphology matter?","authors":"Admir Kurtcehajic PhD,&nbsp;Enver Zerem MD,&nbsp;Suad Kunosic PhD,&nbsp;Ervin Alibegovic MD,&nbsp;Predrag Jovanovic MD,&nbsp;Ahmed Hujdurovic PhD","doi":"10.1016/j.jvsv.2025.102231","DOIUrl":"10.1016/j.jvsv.2025.102231","url":null,"abstract":"","PeriodicalId":17537,"journal":{"name":"Journal of vascular surgery. Venous and lymphatic disorders","volume":"13 4","pages":"Article 102231"},"PeriodicalIF":2.8,"publicationDate":"2025-06-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144270686","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":"Events of Interest","authors":"","doi":"10.1016/S2213-333X(25)00102-7","DOIUrl":"10.1016/S2213-333X(25)00102-7","url":null,"abstract":"","PeriodicalId":17537,"journal":{"name":"Journal of vascular surgery. Venous and lymphatic disorders","volume":"13 4","pages":"Article 102267"},"PeriodicalIF":2.8,"publicationDate":"2025-06-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144271561","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":"Information for Readers","authors":"","doi":"10.1016/S2213-333X(25)00101-5","DOIUrl":"10.1016/S2213-333X(25)00101-5","url":null,"abstract":"","PeriodicalId":17537,"journal":{"name":"Journal of vascular surgery. Venous and lymphatic disorders","volume":"13 4","pages":"Article 102266"},"PeriodicalIF":2.8,"publicationDate":"2025-06-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144271560","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":"Commentary on compression after radiofrequency ablation: Limitations and research gaps","authors":"Yang Xiao PhD,&nbsp;Shi Hongshuo PhD,&nbsp;Liu Guobin PhD","doi":"10.1016/j.jvsv.2025.102218","DOIUrl":"10.1016/j.jvsv.2025.102218","url":null,"abstract":"","PeriodicalId":17537,"journal":{"name":"Journal of vascular surgery. Venous and lymphatic disorders","volume":"13 4","pages":"Article 102218"},"PeriodicalIF":2.8,"publicationDate":"2025-06-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144270720","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":"Successful treatment of severe venous leg ulcers and diabetic foot ulcers using ozone","authors":"Giuseppe Masiello MD ,&nbsp;Marianno Franzini MD ,&nbsp;Umberto Tirelli MD ,&nbsp;Tommaso Richelmi MD ,&nbsp;Luigi Valdenassi MD ,&nbsp;Francesco Vaiano MD ,&nbsp;Salvatore Chirumbolo PhD","doi":"10.1016/j.jvsv.2025.102278","DOIUrl":"10.1016/j.jvsv.2025.102278","url":null,"abstract":"<div><h3>Background</h3><div>Venous leg ulcers (VLUs) and diabetic foot ulcers (DFUs) are chronic wounds associated with significant morbidity, high recurrence rates, and poor healing outcomes. Conventional treatments often fail to achieve satisfactory results, leading to prolonged pain, infection risks, and reduced quality of life. Oxygen-ozone therapy (OOT) has emerged as a potential adjunct to conventional wound care, with antimicrobial, anti-inflammatory, and tissue-regenerating properties. This study evaluates the efficacy of OOT in treating severe VLUs and DFUs.</div></div><div><h3>Methods</h3><div>A total of 25 patients (mean age, 57.2 ± 10.51) with refractory VLUs (n = 18) or DFUs (n = 7) received OOT alongside standard care. Treatment protocols included major autohemotherapy (O₂-O₃-MAHT), topical ozone application, and localized ozone injections. Clinical assessments included pain scoring (Numeric Rating Scale), microbiological evaluations, and logistic regression analysis to determine healing rates.</div></div><div><h3>Results</h3><div>At 4 weeks, pain scores decreased by 73.27% (<em>P</em> &lt; .0001), and 92% of septic lesions showed negative bacterial cultures. Logistic regression analysis indicated a significant improvement in healing rates (<em>P</em> &lt; .0001), with 80% of patients achieving complete wound closure. Inflammatory markers were reduced, and tissue regeneration was enhanced.</div></div><div><h3>Conclusions</h3><div>OOT demonstrated substantial efficacy in reducing infection, alleviating pain, and promoting wound healing in patients with severe VLUs and DFUs, restoring their healthy, normal limbs. These findings support the use of OOT as a valuable adjunctive treatment. Further large-scale, randomized trials are needed to optimize treatment protocols and confirm long-term benefits.</div></div>","PeriodicalId":17537,"journal":{"name":"Journal of vascular surgery. Venous and lymphatic disorders","volume":"13 6","pages":"Article 102278"},"PeriodicalIF":2.8,"publicationDate":"2025-06-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144302399","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":"Vein-first embolization is superior to transarterial approach in type IIIb arteriovenous malformations","authors":"Jun Gon Kim MD ,&nbsp;Sang Yub Lee MD ,&nbsp;Kwang Bo Park MD ,&nbsp;Dongho Hyun MD ,&nbsp;Sung Wook Shin MD ,&nbsp;Sung Ki Cho MD ,&nbsp;Hong Suk Park MD ,&nbsp;Sung Wook Choo MD ,&nbsp;Young Soo Do MD","doi":"10.1016/j.jvsv.2025.102274","DOIUrl":"10.1016/j.jvsv.2025.102274","url":null,"abstract":"<div><h3>Objective</h3><div>To propose a modified treatment concept for type IIIb arteriovenous malformation (AVM), involving a vein-first (VF) strategy that focuses on direct puncture and coil embolization of dilated veins, followed by ethanol injection from the vein to feeding arteries. This retrospective study evaluated the safety and efficacy of this approach.</div></div><div><h3>Methods</h3><div>A total of 117 patients (55 males; median age, 27 years) with type IIIb AVMs were retrospectively reviewed. Patients were divided into two groups: a transarterial (TA) embolization-dominant group and a VF group, which underwent direct puncture of veins with coil embolization followed by ethanol injection. AVM characteristics, embolization techniques, number of treatment sessions, angiographic outcomes, and procedure-related adverse events were analyzed.</div></div><div><h3>Results</h3><div>A total of 515 procedures were performed: 117 in the VF group (n = 41) and 343 in the TA group (n = 76). No significant differences in demographics or AVM characteristics were found. The VF group achieved significantly better treatment outcomes than the TA group (88% vs 51% achieving &gt;90% lesion improvement; <em>P</em> = .001). The VF group required a median of 4.2 treatment sessions per patient vs 4.5 in the TA group, and used 129 mL vs 141 mL of ethanol; those differences were not statistically significant. Procedure-related adverse events were significantly lower in the VF group (11%) than in the TA group (22.3%; <em>P</em> = .0009).</div></div><div><h3>Conclusions</h3><div>The VF strategy for type IIIb AVM achieved better outcomes and fewer adverse events than conventional TA embolization technique.</div></div>","PeriodicalId":17537,"journal":{"name":"Journal of vascular surgery. Venous and lymphatic disorders","volume":"13 5","pages":"Article 102274"},"PeriodicalIF":2.8,"publicationDate":"2025-06-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144248521","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":"Peripheral thrombus extension is associated with increased risk of recurrent deep venous thrombosis in patients undergoing percutaneous thrombectomy for iliofemoral deep venous thrombosis","authors":"Moira A. McGevna BA ,&nbsp;Molly Ratner MD ,&nbsp;Caron B. Rockman MD ,&nbsp;Thomas S. Maldonado MD ,&nbsp;Keerthi B. Harish MD, MBA ,&nbsp;Anil Hingorani MD ,&nbsp;Glenn R. Jacobowitz MD ,&nbsp;Mikel Sadek MD ,&nbsp;Todd Berland MD ,&nbsp;Karan Garg MD","doi":"10.1016/j.jvsv.2025.102277","DOIUrl":"10.1016/j.jvsv.2025.102277","url":null,"abstract":"<div><h3>Objective</h3><div>Patients presenting with iliofemoral deep venous thrombosis (DVT) often undergo percutaneous thrombectomy intending to prevent post-thrombotic syndrome. However, the relationship between the extent of DVT and outcomes after thrombectomy has not been explored. The objective of this study was to compare rates of post-thrombectomy DVT recurrence between patients with isolated iliofemoral DVT and patients with iliofemoral DVT and extension more peripherally.</div></div><div><h3>Methods</h3><div>We conducted a single-center, retrospective analysis of all patients who underwent thrombectomy for iliofemoral DVT from 2014 to 2023. Patients were stratified into two cohorts: (1) iliofemoral DVT without popliteal/tibial extension or (2) iliofemoral DVT with popliteal/tibial extension. The primary outcome was acute DVT recurrence and multivariable analysis was performed to identify risk factors for recurrence. The χ² test and <em>t</em> test were calculated for categorical and continuous data, respectively. Kaplan-Meier analysis was used to compare rates of acute DVT and chronic venous changes postoperatively. A <em>P</em> value of &lt;.05 was considered statistically significant.</div></div><div><h3>Results</h3><div>We identified 222 patients during the study period (76 isolated iliofemoral DVT vs 146 iliofemoral DVT with peripheral extension) with a median follow-up of 19 months. Patients who presented with iliofemoral DVT with peripheral extension were more likely to be older (57 years vs 50 years; <em>P</em> = .004), have hypertension (64% vs 41%; <em>P</em> = .001) or hyperlipidemia (58% vs 40%; <em>P</em> = .01), and to have had surgery within the prior 6 months (29% vs 17%; <em>P</em> = .04). Among the female patients, those on hormone therapy were more likely to have isolated iliofemoral DVT (17% vs 3%; <em>P</em> &lt; .001). Patients with iliofemoral DVT with peripheral extension had a greater chance of developing recurrent acute DVT (48% vs 20%; <em>P</em> &lt; .001) and chronic venous changes (51% vs 30%; <em>P</em> = .004) during follow-up. Multivariable analysis showed a significant correlation between iliofemoral DVT with peripheral extension (odds ratio, 3.8; 95% confidence interval, 1.7-8.7; <em>P</em> = .001) and acute DVT recurrence. There were no differences in the rates of reintervention or death.</div></div><div><h3>Conclusions</h3><div>A more extensive peripheral thrombus burden was associated with higher rates of follow-up DVT recurrence in patients undergoing thrombectomy for iliofemoral DVT. These findings suggest that such patients may require closer follow-up and more aggressive anticoagulation therapy postoperatively. Moreover, our results provide a framework for further studies to specifically study the role peripheral thrombus may play in venous hemodynamics and the development of recurrent DVT and, ultimately, post-thrombotic syndrome.</div></div>","PeriodicalId":17537,"journal":{"name":"Journal of vascular surgery. Venous and lymphatic disorders","volume":"13 5","pages":"Article 102277"},"PeriodicalIF":2.8,"publicationDate":"2025-06-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144248519","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}