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

{"title":"Long-term outcomes of electrocoagulation versus radiofrequency thermoablation for varicose veins","authors":"Fábio Henrique Rossi MD, PhD,&nbsp;Camila Baumann Beteli MD, PhD,&nbsp;Miguel Monteiro Tannus MD","doi":"10.1016/j.jvsv.2025.102245","DOIUrl":"10.1016/j.jvsv.2025.102245","url":null,"abstract":"<div><h3>Objective</h3><div>Thermoablation is increasingly being used as an alternative to traditional surgery for treating primary varicose veins. Electrocoagulation ablation (EA) of the great saphenous vein (GSV) has demonstrated effectiveness and safety comparable with that of radiofrequency ablation (RFA); however, its long-term outcomes have not been investigated previously.</div></div><div><h3>Methods</h3><div>This study involves a long-term follow-up of patients who participated in a double-blind, randomized clinical trial. Individuals with lower limb varicose veins and incompetence of GSV were randomly assigned to two treatment groups: EA and RFA. Follow-up assessments were scheduled at 1 week, 3 months, 6 months, and annually thereafter. The primary outcome measured was GSV occlusion, evaluated through postoperative duplex ultrasound examination. Secondary outcomes included the complication rate and improvements in quality of life, assessed using the Aberdeen Varicose Vein Questionnaire score.</div></div><div><h3>Results</h3><div>A total of 57 patients were included, which involved a cumulative 85 treated GSVs; 42 veins were treated with EA and 43 with RFA. At the 1-week, 3-month, and 6-month follow-ups, there were no statistically significant differences between the two groups regarding GSV occlusion rates (<em>P</em> = .430, <em>P</em> = .157, and <em>P</em> = .157, respectively), complication rates (<em>P</em> = .717, <em>P</em> = .317, and <em>P</em> = .320, respectively), or improvements in quality-of-life scores (<em>P</em> = .540, <em>P</em> = .786, and <em>P</em> = .401, respectively). After a median follow-up duration of 4.8 years (95% confidence interval, 4.5-5.1 years), data for 59 procedures (69.4%) were available, showing occlusion rates of 89.7% for the EA group (n = 29) and 66.7% for the RFA group (n = 30) (<em>P</em> = .001). There were no procedure-related complications (<em>P</em> = .127) and no significant differences in the Aberdeen Varicose Vein Questionnaire scores (<em>P</em> = .345) between the two groups analyzed.</div></div><div><h3>Conclusions</h3><div>EA has demonstrated effectiveness and safety for ablation of the GSV, achieving a higher rate of venous occlusion compared with RFA in the long-term follow-up. Additionally, the occurrence of complications and the impact on symptoms and quality of life were comparable between the two methods during long-term follow-up.</div></div>","PeriodicalId":17537,"journal":{"name":"Journal of vascular surgery. Venous and lymphatic disorders","volume":"13 5","pages":"Article 102245"},"PeriodicalIF":2.8,"publicationDate":"2025-04-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144010824","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":"Deep vein thrombosis caused by a giant uterine myoma.","authors":"Juan Yang, Xu Li, Fang Liu, Hua Yi Zhang","doi":"10.1016/j.jvsv.2025.102243","DOIUrl":"https://doi.org/10.1016/j.jvsv.2025.102243","url":null,"abstract":"","PeriodicalId":17537,"journal":{"name":"Journal of vascular surgery. Venous and lymphatic disorders","volume":" ","pages":"102243"},"PeriodicalIF":2.8,"publicationDate":"2025-04-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144017341","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":"Investigating the necessity of bilateral common femoral vein ultrasound in patients with unilateral symptomatic deep venous thrombosis.","authors":"Moira A McGevna, Molly Ratner, Giancarlo Speranza, Keerthi B Harish, Mikel Sadek, Glenn R Jacobowitz, Karan Garg, Thomas S Maldonado, Caron B Rockman","doi":"10.1016/j.jvsv.2025.102242","DOIUrl":"10.1016/j.jvsv.2025.102242","url":null,"abstract":"<p><strong>Objective: </strong>Venous duplex ultrasound (VDUS) examinationis the accepted initial imaging study to rule out lower extremity deep venous thrombosis (DVT). In accordance with the Intersocietal Accreditation Commission vascular laboratory policies, many institutions require technicians to additionally assess the asymptomatic contralateral common femoral vein (CFV). There is conflicting literature on whether this policy is needed. Therefore, the aim of this study was to investigate the utility of examining the asymptomatic contralateral CFV in patients undergoing a unilateral lower extremity VDUS to rule out DVT by (1) defining the prevalence of DVT in the contralateral asymptomatic limb and (2) identifying risk factors that predispose patients to develop a DVT in the asymptomatic limb.</p><p><strong>Methods: </strong>We retrospectively reviewed the results of all unilateral lower extremity VDUS examinations performed on inpatients and outpatients from January 2023 to July 2023. Patient data, including age, sex, symptoms, risk factors for DVT, and indications for the study, were collected. The primary outcome was the frequency of DVT in the asymptomatic contralateral CFV. Categorical and continuous data were compared using the χ² and Student t tests, respectively. For all tests, a P value of less than .05 was considered statistically significant.</p><p><strong>Results: </strong>We identified 371 patients (170 inpatient and 201 outpatient) with unilateral DVT symptoms who underwent VDUS examination during the study period. Right leg symptoms were present in 186 patients (50%) and left leg symptoms were present in 185 patients (50%). The overall incidence of acute DVT in the symptomatic limb was 17% (17.4% outpatient vs 16.5% inpatient; P = .NS). Outpatients were more likely to have superficial venous thrombosis (7.0% vs 0.6%; P = .002) and chronic venous changes (25.4% vs 1.2%; P < .001) in the symptomatic limb. Of the DVTs in the symptomatic limb, 59% were documented in the calf veins, 25% in the proximal veins, and 16% in both the proximal and calf veins. There were no incidences of bilateral DVT in our cohort. Moreover, none of the patients had a DVT isolated to the contralateral CFV.</p><p><strong>Conclusions: </strong>Scanning the asymptomatic contralateral CFV may not be necessary for patients undergoing unilateral VDUS examination for symptomatic DVT, regardless of thrombotic risk factors. A single-extremity study suffices in most cases; if implemented, this strategy will improve vascular laboratory efficiency and decrease costs without a decrease in DVT detection.</p>","PeriodicalId":17537,"journal":{"name":"Journal of vascular surgery. Venous and lymphatic disorders","volume":" ","pages":"102242"},"PeriodicalIF":2.8,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12099866/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143780401","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":"Coil occlusion combined with sclerotherapy versus N-butyl-2-cyanoacrylate embolization in patients with pelvic venous disorders: a single-center retrospective study.","authors":"Hossam Zaghloul, Mahmoud Nasser, Hisham Abd El-Mawgoud, Baker Ghoneim, Mohammed Ali","doi":"10.1016/j.jvsv.2025.102241","DOIUrl":"10.1016/j.jvsv.2025.102241","url":null,"abstract":"<p><strong>Background: </strong>Pelvic venous disorder (PeVD) is increasingly diagnosed with different modalities of treatment.</p><p><strong>Methods: </strong>This is a retrospective study in which we compared using metallic coil combined with sclerosant foam and N-butyl-2-cyanoacrylate in female patients with PeVD in terms of clinical and technical success as well as safety. Adult patients with symptoms suggestive of primary PeVD and confirmed with Doppler ultrasound examination and/or venography were eligible for the study. Secondary PeVD and lost follow-up were excluded.</p><p><strong>Results: </strong>This study included 167 patients who were treated with coil and sclerotherapy (n = 87; group I) or N-butyl-2-cyanoacrylate (n = 80; group II) embolization. Immediate postoperative veins' closure was achieved in all patients in the two groups. At the 6-month follow-up, there was a statistically significantly higher occlusion rate in group I (100% compared with 93.8% in group II, P = .018) with five new cases of recanalization. The 6-month visual analog scale score was lower in group I (median of 1 and mean of 1.14 ± 0.904) than group II (median of 2 and mean of 1.7 ± 1.32), with a statistically significant difference (P = .005).</p><p><strong>Conclusions: </strong>The study emphasizes the potential advantages of the sclerosant foam and metallic coil combination in achieving favorable outcomes for patients with PeVD.</p>","PeriodicalId":17537,"journal":{"name":"Journal of vascular surgery. Venous and lymphatic disorders","volume":" ","pages":"102241"},"PeriodicalIF":2.8,"publicationDate":"2025-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143753460","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 comparison and AGREE II analysis of the revised Society for Vascular Surgery/American Venous Forum/American Vein and Lymphatic Society and European Society for Vascular Surgery clinical practice guidelines in the management of varicose veins.","authors":"Alexandra Tedesco, Thomas F O'Donnell, Isaac Gendelman, Payam Salehi","doi":"10.1016/j.jvsv.2025.102238","DOIUrl":"10.1016/j.jvsv.2025.102238","url":null,"abstract":"<p><strong>Objective: </strong>The aim of this study was to compare the Society for Vascular Surgery/American Venous Forum/American Vein and Lymphatic Society (SVS/AVF/AVLS) and the European Society for Vascular Surgery (ESVS) revised Clinical Practice Guidelines (CPGs) for treatment of C2 varicose veins (VVs) by an analysis of content, methodology, level of evidence, and strength of evidence as well as by Appraisal of Guidelines for Research and Evaluation II (AGREE II) analysis.</p><p><strong>Methods: </strong>The 2022 SVS/AVF/AVLS guidelines for VVs were compared with the 2022 ESVS CPGs on VVs for: specific methodology, evidence development, strength of recommendation, and level (quality) of evidence. Additionally, an AGREE II analysis was performed to compare the two guidelines. These guidelines were scored on six different domains as well as overall quality using a 7-point Likert scale according to the AGREE II methodology.</p><p><strong>Results: </strong>The two CPGs differed in methodology and scope of content. The two guidelines varied significantly on their ratings of levels of evidence as well as their overall strengths of recommendations. The AGREE II analysis found that both guidelines scored as high quality in the domains of scope and purpose, stakeholder involvement, rigor of development, clarity of presentation, editorial independence, and overall assessment. For the domain of applicability, ESVS guidelines (65.28%) scored significantly higher than SVS/AVF/AVLS guidelines (51.39%; P ≤ .05).</p><p><strong>Conclusions: </strong>Although the methodology differed significantly between both guidelines, the overall conclusions remained similar, and both guidelines were rated as high quality by AGREE II analysis.</p>","PeriodicalId":17537,"journal":{"name":"Journal of vascular surgery. Venous and lymphatic disorders","volume":" ","pages":"102238"},"PeriodicalIF":2.8,"publicationDate":"2025-03-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12032890/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143743308","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":"Advancing opportunity and representation in the American Venous Forum.","authors":"Lucy Yang, Ruth L Bush, Kathleen Ozsvath, Misty D Humphries, Karem Harth","doi":"10.1016/j.jvsv.2025.102239","DOIUrl":"10.1016/j.jvsv.2025.102239","url":null,"abstract":"<p><strong>Objective: </strong>Diversity, equity, and inclusion (DEI) within the physician workforce is critical to establishing a diverse provider network that accurately represents the patient population served by vascular surgeons. Vascular surgery remains a largely male-dominated surgical specialty, and the number of women in leadership positions in academic surgical specialties continues to be disproportionate. The representation of women in leadership roles differs across vascular surgery societies. The goal of this study is to provide an update on the representation of women and incorporation of DEI topics at American Venous Forum (AVF) annual meetings and across committees.</p><p><strong>Methods: </strong>A retrospective review was conducted of available scientific meeting programs and abstracts presented at the AVF from 2010 to 2023. The time period was divided into before 2019 and after 2019, as this was the year that the Society for Vascular Surgery established the Task Force on DEI. Women's participation and DEI domains were documented for each year. A two-sample unpaired t-test was used to compare mean percentages.</p><p><strong>Results: </strong>Specifically, within the AVF, women's representation across all roles (presenters, senior authors, moderators, committee chairs, committee members, and officers) has increased when comparing prior years (2010-2019) with a more recent time period (2020-2023). The largest increase was observed for moderators (12.6% vs 30.2%; +17.6%), and the smallest increase was observed for presenters (21.1% vs 28.9%; +7.8%). When comparing the same time periods, the mean percentage of DEI domains (access to care, race and ethnicity, gender, age, health literacy, and socioeconomic status) highlighted in research presentations at AVF annual meetings has increased numerically over time but is not statistically significant except for the DEI domain of age (1.34% vs 3.28%; P = .0008).</p><p><strong>Conclusions: </strong>Although there have been positive improvements in the proportion of women in leadership roles at the AVF, the integration of DEI domains at AVF annual meetings continues to show slow progress. This study reflects an opportunity for AVF leaders and councils to prioritize strategies to incorporate important DEI domains into our annual meetings and mission-related efforts. Intentional progress in these areas will ultimately contribute to more successfully carrying out the AVF Core Values (VEINS: Values and integrity, Education, Inclusivity, equity, diversity, Nurturing, Scientific excellence and research).</p>","PeriodicalId":17537,"journal":{"name":"Journal of vascular surgery. Venous and lymphatic disorders","volume":" ","pages":"102239"},"PeriodicalIF":2.8,"publicationDate":"2025-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12063108/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143730596","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":"Efficacy of ultrasound-guided microwave ablation for vascular malformations in children.","authors":"Shuting Huang, Fenglin Xu, Xin Li, Hongxia Zhang, Jingyu Chen, Zhenzhen Zhao, Jun Zhang, Liang Peng, Xiangru Kong","doi":"10.1016/j.jvsv.2025.102240","DOIUrl":"10.1016/j.jvsv.2025.102240","url":null,"abstract":"<p><strong>Objective: </strong>The aim of this study was to report our center's experience in treating pediatric vascular malformations using ultrasound-guided microwave ablation.</p><p><strong>Methods: </strong>Twenty-two symptomatic children with vascular malformations underwent ultrasound-guided microwave ablation. All patients received ultrasound follow-up after microwave ablation, whereas magnetic resonance imaging follow-up was conducted depending on the disease's condition. The Visual Analog Scale and the PedsQL4.0 Chinese Version was utilized to assess the changes in pain severity, limb motion evaluation, and quality of life before and after treatment.</p><p><strong>Results: </strong>The study included 22 cases, comprising four arteriovenous malformations, nine venous malformations, two diffuse microcystic lymphatic malformations, two cases of Klippel-Trenaunay syndrome, and five cases of fibro adipose vascular anomaly. All children presented with pain at the affected site (22 cases; 100%). The malformations were located in the limbs in 17 cases (77%), subcutaneous and intramuscular tissues of the buttocks in one case (4.5%), subcutaneous tissue of the abdominal wall in one case (4.5%), and retroperitoneal in three cases (14%). All 22 patients (100%) experienced pain. Additionally, 20 cases (91%) exhibited swelling at the affected site or developed swelling after physical activity. Limb hypertrophy was observed in five cases (23%), whereas another five cases (23%) showed signs of limb atrophy. Joint mobility restrictions were present in four cases (18%). Among these 22 patients, 17 cases (77.3%) experienced complete resolution of pain and local lesion appearance changes, whereas four cases (18.2%) reported pain relief. However, in one case (4.5%) of Klippel-Trenaunay syndrome, postoperative improvement was observed at the treatment site, but a new centripetal malformation developed within the treated region. This patient subsequently underwent surgical intervention, resulting in an improvement in clinical symptoms. The pre-treatment malformation volume was 209.85 ± 343.17 cm³, which reduced to 32.95 ± 66.04 cm³ 1 year after ablation. The volume reduction was statistically significant (t = 2.374; P = .026; P < .05), with an average volume reduction rate of 85.51%. No major complications were found, such as nerve damage or skin burns.</p><p><strong>Conclusions: </strong>Ultrasound-guided microwave ablation is a relatively safe and effective technique for treating pediatric vascular malformations. Further multicenter studies are recommended to validate these findings.</p>","PeriodicalId":17537,"journal":{"name":"Journal of vascular surgery. Venous and lymphatic disorders","volume":" ","pages":"102240"},"PeriodicalIF":2.8,"publicationDate":"2025-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12056401/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143730598","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":"Efficacy of family presence in the operating room during endovenous treatment: An EFFORT prospective observational study.","authors":"Kilsoo Yie, A-Rom Shin, Eun-Hee Jeong, Bo-Mi Kim, Eun-Jung Hwang","doi":"10.1016/j.jvsv.2025.102237","DOIUrl":"10.1016/j.jvsv.2025.102237","url":null,"abstract":"<p><strong>Background: </strong>Varicose vein treatments are increasingly using ambulatory endovenous procedures under local anesthesia. Despite their safety and feasibility, these procedures may induce significant psychological distress, a concern not currently addressed by exist guidelines. This study investigates the necessity for family presence (FP) during endovenous procedures and its effects on the disease treatment process, hypothesizing that FP can provide emotional support and enhance patient trust in medical staff.</p><p><strong>Methods: </strong>This single-center, prospective observational study, conducted from September 2022 to March 2024, enrolled 175 patients scheduled for outpatient endovenous treatments. Participants were divided based on their preference for FP during the surgery into FP (n = 61 [34.9%]) and no FP (NFP) (n = 114 [65.1%]) groups. The primary outcome was the influence of preoperative anxiety on the preference for FP, with secondary outcomes focusing on its impact on perioperative pain and postoperative satisfaction. Data collection followed the STROBE guidelines for observational studies, with preoperative anxiety assessed using a modified Amsterdam Preoperative Anxiety and Information Scale (mAPAIS).</p><p><strong>Results: </strong>There were no significant demographic or clinical differences between the FP and NFP groups. In the NFP group, common reasons for declining FP included concerns about displaying anxiety (36%) and a perceived lack of necessity (29.8%). The FP group reported significantly higher mAPAIS scores (5.2±1.7 vs 4.4±1.5; P = .003) and a stronger preference for FP (3.4±1.1 vs 2.1±0.8; P = .001). Logistic regression analysis identified higher preoperative anxiety as a significant predictor of opting for FP (odds ratio, 1.41; 95% confidence interval, 1.07-1.88; P = .015). Most FP patients (78.7%) and guardians (85.2%) reported reduced anxiety, enhanced emotional support, and greater trust in the medical team. However, FP did not affect perioperative pain (P = .52) or postoperative 3-month satisfaction scores (P = .42). Adverse events led to FP discontinuation in two cases (3.3%) (one owing to nausea and one owing to syncope in the family members).</p><p><strong>Conclusions: </strong>FP during endovenous procedures plays a crucial role in reducing preoperative anxiety and enhancing patient comfort. These findings suggest the potential for integrating FP into clinical guidelines for minimally invasive procedures, promoting a more patient-centered approach in surgical care. Future studies should investigate the conditions under which FP is most beneficial, taking into account both patient preferences and procedural specifics.</p>","PeriodicalId":17537,"journal":{"name":"Journal of vascular surgery. Venous and lymphatic disorders","volume":" ","pages":"102237"},"PeriodicalIF":2.8,"publicationDate":"2025-03-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12032898/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143710430","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":"Comparative early outcomes following primary radiofrequency ablation and polidocanol microfoam ablation of symptomatic, incompetent small saphenous veins.","authors":"Mokhshan Ramachandran, Peter F Lawrence, Steven M Farley, David A Rigberg, Johnathon Rollo, Vincent L Rowe, Juan Carlos Jimenez","doi":"10.1016/j.jvsv.2025.102234","DOIUrl":"10.1016/j.jvsv.2025.102234","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Radiofrequency ablation (RFA) of symptomatic, incompetent small saphenous veins (SSVs) is supported by clinical practice guidelines, but polidocanol microfoam ablation (MFA) is not addressed in these guidelines owing to the absence of high-quality clinical data. However, some anatomical variations and clinical scenarios in patients with SSV reflux may be associated with equivalent or superior results when MFA is used compared with RFA. This study aims to compare early outcomes after the treatment of SSV incompetence in patients with Clinical-Etiology-Anatomy-Pathophysiology (CEAP) 2 class to 6 disease using either RFA or MFA.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;A retrospective review of a prospectively maintained database was conducted among patients who underwent treatment of incompetent SSVs with either RFA or MFA. Limbs that underwent concomitant phlebectomy were included. All patients underwent postoperative duplex ultrasound at 48 to 72 hours and at least one follow-up visit by a vascular surgery provider. Primary outcomes were immediate SSV closure and ablation-related thrombus extension. Secondary outcomes analyzed included demographic data, CEAP clinical class, Venous Clinical Severity Score (VCSS), deep venous thrombosis, and adverse events.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Between March 2018 and July 2024, 182 SSVs treated for symptomatic reflux with either RFA (n = 120) or MFA (n = 62) were identified. Age, gender, body mass index, reflux times, and SSV diameters were similar between both groups. The mean preoperative VCSSs were 9.4 ± 3.0 and 10.8 ± 3.7 in the RFA and MFA groups, respectively (P = .05). More venous ulcers were present at the time of MFA (n = 16 [26%]) than RFA (n = 14 [12%]) (P = .015). Median follow-up was 164.5 days in the RFA cohort and 156 days after MFA. Symptomatic improvement after RFA and MFA was 91% and 88%, respectively. The mean postoperative VCSS decreased from 9.4 to 7.3 in the RFA group (P &lt; .001) and from 10.9 to 9.2 after MFA (P &lt; .001). Immediate vein closure was achieved in 98% of limbs in both groups; two late recanalizations occurred after MFA, but none after RFA. The number of ulcers healed at last follow-up was greater after MFA (n = 13 [81%] vs n = 10 [71%]; P = .02). The incidence of ablation-related thrombus extension was 4.8% (n = 3) after MFA and 1.7% (n = 2) after RFA (P = .52). One gastrocnemius deep venous thrombosis occurred in the MFA group. No pulmonary emboli or central nervous complications occurred. All adverse thrombotic events were asymptomatic and resolved with short-term anticoagulation. Superficial phlebitis was higher after MFA (n = 11 [17.7%] vs n = 5 [4.2%]; P = .002) One postoperative sural neuralgia occurred after RFA.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;RFA and MFA are both safe and effective treatments for patients with symptomatic, incompetent SSVs. Both resulted in excellent clinical relief and early truncal vein closure rates. The number of u","PeriodicalId":17537,"journal":{"name":"Journal of vascular surgery. Venous and lymphatic disorders","volume":" ","pages":"102234"},"PeriodicalIF":2.8,"publicationDate":"2025-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12017923/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143692496","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":"A venous hemodynamic model and measurement of venous reflux in the lower limb during walking-Proof of concept.","authors":"Oscar Maleti, Marzia Lugli, Giorgio Bergamo, Andrew Nicolaides","doi":"10.1016/j.jvsv.2025.102236","DOIUrl":"10.1016/j.jvsv.2025.102236","url":null,"abstract":"<p><strong>Objective: </strong>Air plethysmography (APG) is an established plethysmographic method of measuring leg volume changes in absolute units (mL or mL/s) during tiptoeing. However, tiptoe movements use different muscles from walking and the question of how physiological APG measurements during tiptoeing are has never been answered. The recent development of a commercially available wireless APG enables one to obtain measurements during walking. The aim of our pilot study was to (a) validate a venous hemodynamic model of blood volume changes in the leg during walking and (b) determine the magnitude of reflux per step in patients with venous reflux using this model.</p><p><strong>Methods: </strong>A total of 20 limbs were included in this study. Ten patients with 10 limbs that had axial reflux in the deep veins on duplex scanning without any outflow obstruction or residual thrombosis on venography were selected. Standard measurements were initially made using tiptoeing as the form of exercise. Venous volume measurements made when walking was the exercise were volume on standing (V₀) in milliliters, volume at steady state when walking (V_ss) in milliliters, residual volume fraction during steady state as a percentage, ejection fraction (EF) as a percentage and inflow into the leg (I), which included reflux and arterial inflow in mL/step.</p><p><strong>Results: </strong>There was an exponential reduction in volume during the first 7 to 9 steps, indicating a constant EF and supported the assumptions for the volume hemodynamic model. V₀, EF, and I were higher in limbs with reflux compared with limbs without reflux by 67% (P < .007), 44% (P = .009), and 156% (P < .001) respectively.</p><p><strong>Conclusions: </strong>The results of this pilot study indicate that the model and method used provide a practical noninvasive method of measuring reflux during walking. The increase in V₀ and EF indicates a compensatory mechanism. This is the first time such a measurement has been possible because of the availability of wireless air plethysmography. It offers an opportunity for further studies to answer questions such as what the effect of iliac stenting or valvuloplasty are on reflux during walking.</p>","PeriodicalId":17537,"journal":{"name":"Journal of vascular surgery. Venous and lymphatic disorders","volume":" ","pages":"102236"},"PeriodicalIF":2.8,"publicationDate":"2025-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143692472","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}