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

{"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}

{"title":"Limb volumetry using an iPad-based three-dimensional scanner for assessment of edema","authors":"Seshadri Raju MD,&nbsp;Sara Matheson BS,&nbsp;Slade Smith BS,&nbsp;Jack Owens BS,&nbsp;Vijay M. Adaikkappan BS","doi":"10.1016/j.jvsv.2025.102275","DOIUrl":"10.1016/j.jvsv.2025.102275","url":null,"abstract":"<div><h3>Objective</h3><div>Quantifying limb edema is challenging owing to the lack of an easily accessible clinical technique. This study evaluates the reproducibility of an iPad-based three-dimensional (3D) scanning system for lower limb volumetry and identifies factors influencing measurement variability.</div></div><div><h3>Methods</h3><div>Twenty limbs from 10 healthy volunteers were scanned using an iPad-based Structure Sensor and software. Initial scans followed standard manufacturer instructions, but high variance rendered data unsuitable for clinical use. To improve accuracy, a standardized scanning protocol was developed, incorporating anatomical calibration, scanning distance standardization, and scanning time control. A 254-mm calf segment was defined using a 3D marker placed on the medial malleolus to ensure consistent volume measurement. The scanning distance was fixed between 50 and 59 cm to reduce zoom parallax errors, and scans were conducted after 3 <span>pm</span> to minimize diurnal volume fluctuations. Multiple technicians performed repeat scans on the same limb to assess intraobserver and interobserver scan reliability.</div></div><div><h3>Results</h3><div>Implementing the standardized protocol significantly decreased measurement variability. Defining a consistent anatomical scan region improved reproducibility, with the mean volume difference decreasing from 4.7% ± 3.6% to 2.1% ± 1.6%. Standardizing scanning distance reduced zoom-related errors, improving measurement consistency from 2.6% ± 1.5% to 2.0% ± 1.2% (<em>P</em> = .037). Time standardization further optimized accuracy, yielding a final mean volume difference of 1.8% ± 0.9%. No statistically significant differences were observed between measurements taken by different technicians (<em>P</em> &gt; .05), demonstrating high interobserver reliability.</div></div><div><h3>Conclusions</h3><div>iPad-based 3D scanning provides a clinically reliable and cost-effective method of lower limb volumetry. The standardized protocol as described improves scan accuracy and reproducibility. Future studies should evaluate this method in a clinical population to validate its usefulness in disease assessment and progression tracking.</div></div>","PeriodicalId":17537,"journal":{"name":"Journal of vascular surgery. Venous and lymphatic disorders","volume":"13 5","pages":"Article 102275"},"PeriodicalIF":2.8,"publicationDate":"2025-06-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144248485","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":"Vacuum-assisted thrombectomy of massive inferior vena cava thrombosis","authors":"Salvatore Silipigni MD ,&nbsp;Alberto Stagno MD ,&nbsp;Agatino Cacciola MD ,&nbsp;Francesco Costa MD, PhD ,&nbsp;Antonio Micari MD, PhD ,&nbsp;Antonio Bottari MD","doi":"10.1016/j.jvsv.2025.102273","DOIUrl":"10.1016/j.jvsv.2025.102273","url":null,"abstract":"","PeriodicalId":17537,"journal":{"name":"Journal of vascular surgery. Venous and lymphatic disorders","volume":"13 5","pages":"Article 102273"},"PeriodicalIF":2.8,"publicationDate":"2025-06-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144248520","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":"Evaluation of factors underlying differences in venous thromboembolism rates between Black and White patients","authors":"Mary S. Lin MD ,&nbsp;Shalini Sahoo MA ,&nbsp;Hilary Hayssen MD ,&nbsp;Minerva Mayorga-Carlin MPH ,&nbsp;Brian Englum MD ,&nbsp;Tariq Siddiqui MS ,&nbsp;Phuong Nguyen PhD ,&nbsp;Yelena Yesha PhD ,&nbsp;John D. Sorkin MD, PhD ,&nbsp;Brajesh K. Lal MD","doi":"10.1016/j.jvsv.2025.102270","DOIUrl":"10.1016/j.jvsv.2025.102270","url":null,"abstract":"<div><h3>Objective</h3><div>In the United States, the incidence of hospital-associated venous thromboembolism (VTE) has been found to be higher among Blacks compared with Whites. However, the reason for this difference is not well-understood. Here, we utilize a large, nationwide cohort to evaluate the clinical factors that may contribute to the difference in rates of VTE in Black vs White patients.</div></div><div><h3>Methods</h3><div>We analyzed consecutive first hospital admissions of Black and White patients to all Veterans Affairs facilities from January 2016 to December 2021. We first compared VTE rates between White and Black patients within 90 days of hospital admission, identified 11 potential confounders for the relationship between race and VTE, and used these to develop a series of adjusted logistic regression models predicting the development of VTE. Odds ratios (ORs) obtained from these models were compared to examine the relationship between race, potential confounding variables, and VTE.</div></div><div><h3>Results</h3><div>The study cohort consisted of 142,456 patients (mean age, 54 years; 84.7% male), of whom 28.5% (n = 40,632) were Black and 71.5% (n = 101,824) were White. Of the cohort, 2.4% developed a VTE within 90 days (n = 3455), and the rate of VTE was higher in Black patients (2.7%) compared with White patients (2.3%; <em>P</em> &lt; .001). A total of 12 models were developed to examine individual confounders of the relationship between race and VTE. In all models, Black race was associated with increased odds of VTE (OR, 1.06-1.17). The strength of this association remained unchanged in the range of OR 1.13 to 1.16 after adjusting for major covariates including social deprivation index, blood type, and surgery type. When adjusting for hemoglobin, the OR for the association between Black race and VTE was reduced. An inverse correlation was observed between Black race and hemoglobin, with Pearson and Spearman correlation coefficients of −0.17 and −0.180, respectively.</div></div><div><h3>Conclusions</h3><div>In this cohort of hospitalized patients, Black race is a major risk factor for VTE, independent of social deprivation, blood type, and surgery. This effect may be modulated by hemoglobin, suggesting a potential clinical etiology underlying the trends observed between VTE and race.</div></div>","PeriodicalId":17537,"journal":{"name":"Journal of vascular surgery. Venous and lymphatic disorders","volume":"13 5","pages":"Article 102270"},"PeriodicalIF":2.8,"publicationDate":"2025-05-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144173901","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":"Oral sirolimus therapy for patients with complex low-flow vascular malformations","authors":"Rebecca Nisbet MSc ,&nbsp;Calver Pang MBChB ,&nbsp;Nicholas Evans RN, MSc ,&nbsp;Ahmed Belhadj MD ,&nbsp;Mohamed Khalifa FRCR ,&nbsp;Anthie Papadopoulou FPCR ,&nbsp;Tejinder Randhawa MSc ,&nbsp;Jocelyn Brookes FRCR ,&nbsp;Chung Sim Lim PhD, FRCS","doi":"10.1016/j.jvsv.2025.102261","DOIUrl":"10.1016/j.jvsv.2025.102261","url":null,"abstract":"<div><h3>Background</h3><div>The evidence on the efficacy and safety of sirolimus therapy in patients with low-flow vascular malformations (LFVMs) has indicated its potential benefit in extensive and complicated lesions. This study aimed to assess the efficacy and safety of oral sirolimus therapy on complex LFVM patients when standard treatment alone was inadequate.</div></div><div><h3>Methods</h3><div>This was a retrospective study of all adult patients with diagnosed LFVMs who were treated with oral sirolimus where standard therapy was inadequate in a single specialist center from May 1, 2016, to April 30, 2023. Demographic and clinical data including patient reported responses, visual analogue scores for pain and adverse effects, and quality of life (QoL) scores (Short Form-36) were reviewed.</div></div><div><h3>Results</h3><div>We included 55 LFVM patients (14 with syndromic disease and 41 with nonsyndromic) with a median age of 41 years (range, 23-72 years). While on sirolimus, 32 patients (58.2%) experienced some improvement with a nonsignificant higher percentage of nonsyndromic patients experiencing some improvements (<em>P</em> = .6478). There was a nonsignificant improvement in the quality of life scores for physical problems, energy/fatigue, and pain. There was also a nonsignificant increase in anxiety and depression scores. There was a significant decrease in the lesion size (<em>P</em> = .0004). Two patients reported a cessation of cellulitis episodes, and eight patients reported a partial or complete reduction in bleeding from their malformation or rectal bleeding. The most common side effects reported were mouth ulcers (54.5%), fatigue (29.1%), headache (25.5%), gastrointestinal problems (25.5%), and rash (12.7%); only five patients (9.1%) did not report any side effects. No significant difference was found between the side effects reported by syndromic and nonsyndromic patients.</div></div><div><h3>Conclusions</h3><div>Oral sirolimus therapy was clinically effective and safe in patients with complex LFVMs when standard therapy alone was inadequate. Further studies with longer follow-up are needed to evaluate oral sirolimus therapy in LFVM patients.</div></div>","PeriodicalId":17537,"journal":{"name":"Journal of vascular surgery. Venous and lymphatic disorders","volume":"13 5","pages":"Article 102261"},"PeriodicalIF":2.8,"publicationDate":"2025-05-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144120134","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":"Four-year outcomes following endovascular treatment in patients with post-thrombotic syndrome of the lower extremities","authors":"Lin Zhang MM,&nbsp;Wei Song MD,&nbsp;Zheng Chen MD,&nbsp;Chuli Jiang MD,&nbsp;Yu Zhao MD, PhD,&nbsp;Fenghe Li MD, PhD","doi":"10.1016/j.jvsv.2025.102260","DOIUrl":"10.1016/j.jvsv.2025.102260","url":null,"abstract":"<div><h3>Objective</h3><div>This study aimed to evaluate the safety and efficacy of endovascular treatment for post-thrombotic syndrome (PTS) in the lower extremities, and to identify risk factors contributing to in-stent restenosis.</div></div><div><h3>Methods</h3><div>Patients with PTS who underwent endovascular treatment at our institution from May 2016 to April 2022 were included in this study. Clinical symptoms were systematically assessed using the Villalta score, the Clinical, Etiological, Anatomical, and Pathophysiological (CEAP) classification, and the Venous Clinical Severity Score. Primary and secondary patency rates were assessed by duplex ultrasound examination. Risk factors associated with in-stent restenosis were analyzed using univariate and multivariate Cox regression models. A repeated measures analysis of variance was conducted to compare clinical symptom scores before and after treatment.</div></div><div><h3>Results</h3><div>A total of 115 patients were included in the study. The median follow-up duration was 48 months (range, 24-65 months). The primary patency rates at 3 months, 6 months, 1 year, 2 years, 3 years, and 4 years were 92.2% ± 2.5%, 88.7% ± 3.0%, 81.7% ± 3.6%, 73.9% ± 4.1%, 66.6% ± 4.5%, and 65.3% ± 4.6%, respectively. Stent restenosis was observed in 38 patients. At 1 year postoperatively, the Venous Clinical Severity Score exhibited a significant reduction of 7.0 (95% confidence interval [CI]. 6.0-8.0; <em>P</em> &lt; .001) relative to preoperative levels. The Villalta score demonstrated a significant decrease of 11.4 (95% CI, 9.4-13.5; <em>P</em> &lt; .001) compared with preoperative levels. Cox regression analysis indicated that a CEAP classification of C5 or C6 (hazard ratio, 2.24; 95% CI, 1.18-4.25; <em>P</em> = .014) was associated with stent restenosis.</div></div><div><h3>Conclusions</h3><div>Endovascular treatment, with favorable long-term patency rates, is a safe and effective approach for managing PTS. CEAP classification of C5 or C6 has been identified as a risk factor for stent restenosis.</div></div>","PeriodicalId":17537,"journal":{"name":"Journal of vascular surgery. Venous and lymphatic disorders","volume":"13 5","pages":"Article 102260"},"PeriodicalIF":2.8,"publicationDate":"2025-05-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144086437","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":"Incidence, predictors, and clinical outcomes of thrombus propagation in patients with acute isolated calf muscle venous thrombosis","authors":"Yifei Bai MD ,&nbsp;Xu Geng MD ,&nbsp;Zhongzhi Jia PhD ,&nbsp;Tongqing Xue PhD ,&nbsp;Kai Wang PhD","doi":"10.1016/j.jvsv.2025.102259","DOIUrl":"10.1016/j.jvsv.2025.102259","url":null,"abstract":"<div><h3>Objective</h3><div>The goal of this study was to evaluate the incidence, predictors, and clinical outcomes of thrombus propagation in patients with isolated calf muscle venous thrombosis (CMVT).</div></div><div><h3>Methods</h3><div>This retrospective observational study included all consecutive hospitalized patients who were diagnosed with isolated CMVT between January 1, 2022, and August 1, 2024. Data on demographics, comorbidities, laboratory biomarkers, and management strategies were collected. The primary end point was the incidence of thrombus propagation (defined as either a previously localized thrombi within the muscular calf veins that was found to extend to the axis calf veins or proximal veins of the ipsilateral extremity or as a thrombus that had clearly extended but remained confined to the muscular calf veins) during follow-up. Secondary end points included the incidence of venous thromboembolism (VTE) recurrence (defined as the formation of a new thrombus [ipsilateral or contralateral deep vein thrombosis or pulmonary embolism] confirmed by imaging during follow-up after complete resolution of the original CMVT), bleeding events, rehospitalization, and death.</div></div><div><h3>Results</h3><div>Among the 459 patients included in this study, the incidence of CMVT propagation was 8.7% (n = 40). Independent predictors of thrombus propagation were immobilization (odds ratio [OR]; 3.06 [95% confidence interval, 1.04-8.99]; <em>P</em> = .042), history of VTE (OR, 4.31 [95% CI, 1.42-13.05]; <em>P</em> = .010), and elevated D-dimer level (OR, 1.06 [95% CI, 1.02-1.09]; <em>P</em> = .003). The mean time to propagation was 9.3 ± 5.2 days. VTE recurrence rates were 2.5% (n = 1) in patients with propagation and 1.7% (n = 7) in patients without propagation (<em>P</em> = .702). Major bleeding events occurred in 5.0% of patients (n = 2) with propagation and in 3.1% of patients (n = 13) without propagation (<em>P</em> = .519). During the follow-up period, no patients were rehospitalized or died owing to VTE events.</div></div><div><h3>Conclusions</h3><div>Thrombus propagation in patients with isolated CMVT is uncommon and generally not fatal. Predictors of CMVT propagation include immobilization, history of VTE, and elevated D-dimer level. These findings may help to identify patients with a significant risk of CMVT propagation.</div></div>","PeriodicalId":17537,"journal":{"name":"Journal of vascular surgery. Venous and lymphatic disorders","volume":"13 5","pages":"Article 102259"},"PeriodicalIF":2.8,"publicationDate":"2025-05-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144008560","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":"Congenital arteriovenous malformation of the left hip","authors":"Hua Yi Zhang MD,&nbsp;Dong Zhe Chai MD","doi":"10.1016/j.jvsv.2025.102257","DOIUrl":"10.1016/j.jvsv.2025.102257","url":null,"abstract":"","PeriodicalId":17537,"journal":{"name":"Journal of vascular surgery. Venous and lymphatic disorders","volume":"13 5","pages":"Article 102257"},"PeriodicalIF":2.8,"publicationDate":"2025-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144031281","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}