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

{"title":"Corrigendum.","authors":"","doi":"10.1016/j.jvsv.2024.102008","DOIUrl":"10.1016/j.jvsv.2024.102008","url":null,"abstract":"","PeriodicalId":17537,"journal":{"name":"Journal of vascular surgery. Venous and lymphatic disorders","volume":" ","pages":"102008"},"PeriodicalIF":2.8,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12014314/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142801455","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 randomized, controlled noninferiority study of adjustable compression wraps compared with inelastic multilayer bandaging used in the intensive complex decongestive therapy of lower leg lymphedema","authors":"Anett Reisshauer MD ,&nbsp;Emmanouil Tsatrafilis MD ,&nbsp;Simone Kornappel MD ,&nbsp;Doerte Huscher PhD ,&nbsp;Max E. Liebl MD, MaHM","doi":"10.1016/j.jvsv.2025.102214","DOIUrl":"10.1016/j.jvsv.2025.102214","url":null,"abstract":"<div><h3>Objective</h3><div>We evaluated the noninferiority of adjustable compression wraps compared with inelastic multilayer bandaging in reducing lower leg volume during intensive complex decongestive therapy in patients with bilateral, symmetrical lymphedema. Secondary outcomes included application time, patient comfort, and side effects.</div></div><div><h3>Methods</h3><div>A prospective, randomized controlled noninferiority trial was conducted on 24 patients with stage II to III bilateral leg lymphedema during a 10-day intensive complex decongestive therapy. Each patient received adjustable compression wraps on a randomized side, while the contralateral leg was treated with inelastic multilayer bandages. The primary outcome was the difference in volume reduction, measured by perometer for lower leg volume, with a predefined noninferiority margin of 50 mL. Application time was measured. Subjective parameters were assessed with visual analogue scales (range, 0-100).</div></div><div><h3>Results</h3><div>Adjustable compression wraps were noninferior to inelastic multilayer bandages with a mean difference in volume reduction of 9.45 mL (95% confidence interval −30.40 to 49.26), with respect to the a priori defined noninferiority margin of 50 mL. In a subsequent test of superiority, intraindividual differences did not differ significantly (<em>P</em> = .629). Adjustable compression wraps took significantly less time to apply (8.4 minutes; <em>P</em> &lt; .001), and patients rated them as more comfortable (median visual analogue scale difference, 30; <em>P</em> &lt; .001). Both compression methods reduced skin tightness significantly, with no notable differences between treatments. Adjustable compression wraps showed fewer side effects, and 83.3% of participants indicated they would continue using them. No adverse events were attributed to the compression wraps.</div></div><div><h3>Conclusions</h3><div>Adjustable compression wraps proved to be an effective, noninferior alternative to inelastic multilayer bandages for reducing lower leg volume in the intensive complex decongestion therapy, although superiority could not be demonstrated. Their advantages include shorter application time and improved patient comfort. The potential for self-management makes them a promising option for lymphedema therapy, provided patients receive adequate training.</div></div>","PeriodicalId":17537,"journal":{"name":"Journal of vascular surgery. Venous and lymphatic disorders","volume":"13 4","pages":"Article 102214"},"PeriodicalIF":2.8,"publicationDate":"2025-02-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143523804","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 the diagnostic accuracy of contrast enhanced ultrasonography in chronic iliac venous obstruction","authors":"Taimur Saleem MD, FACS,&nbsp;Seshadri Raju MD, FACS","doi":"10.1016/j.jvsv.2024.102001","DOIUrl":"10.1016/j.jvsv.2024.102001","url":null,"abstract":"<div><h3>Objective</h3><div>The noninvasive diagnosis of chronic iliac vein obstruction can be challenging. Noninvasive modalities are available, but each has its own merits and drawbacks. Intravascular ultrasound (IVUS) is considered the diagnostic reference standard, but it is invasive. The role of contrast-enhanced ultrasonography in chronic iliac vein obstruction has so far not been studied.</div></div><div><h3>Methods</h3><div>This is a single-center retrospective study. Thirty-nine patients, suspected to have chronic iliac venous obstruction, underwent unenhanced ultrasonography, contrast-enhanced ultrasonography with Lumason, and IVUS on the same day.</div></div><div><h3>Results</h3><div>Most of the data set was female, had post thrombotic lesions, and belonged to CEAP Class C4 or higher. The intraclass correlation coefficient (kappa, average measures) between enhanced and unenhanced ultrasonography was 0.9 (95% confidence interval [CI], 0.87-0.92), indicative of very good agreement. However, the correlation coefficients between enhanced ultrasonography and IVUS and unenhanced ultrasonography and IVUS were 0.6 (95% CI, 0.16-0.67) and 0.5 (95% CI, 0.37-0.75), respectively, indicative of less optimal agreement. Considering IVUS as the reference standard, diagnostic accuracies for ultrasonography for external iliac vein with and without Lumason use were 71.3% and 71.4%, respectively. Diagnostic accuracies for ultrasonography for common iliac vein with and without Lumason use were 53.2% and 56.7%, respectively, when compared with IVUS.</div></div><div><h3>Conclusions</h3><div>The measures of diagnostic accuracy of contrast-enhanced ultrasonography and unenhanced ultrasonography are similar to each other in the diagnosis of chronic iliac vein obstruction when compared with a reference standard such as IVUS. Further studies are needed to delineate the complimentary value of contrast-enhanced ultrasonography in the diagnosis of chronic iliac vein obstruction.</div></div>","PeriodicalId":17537,"journal":{"name":"Journal of vascular surgery. Venous and lymphatic disorders","volume":"13 3","pages":"Article 102001"},"PeriodicalIF":2.8,"publicationDate":"2025-02-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143476800","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":"Ultrasound-guided foam sclerotherapy of the saphenous trunks is associated with a low 5-year recurrence rate and improved quality of life in patients with chronic venous disease: A multicenter study","authors":"Fabrizio Mariani MD ,&nbsp;Ludovico Carbone MD ,&nbsp;Giampaolo Sozio MD ,&nbsp;Rosaria Massaroni MD ,&nbsp;Eleonora Andreucci MD ,&nbsp;Valerio Bianchi MD ,&nbsp;Matteo Bucalossi MD","doi":"10.1016/j.jvsv.2025.102212","DOIUrl":"10.1016/j.jvsv.2025.102212","url":null,"abstract":"<div><h3>Objective</h3><div>The study attempts to test whether ultrasound-guided foam sclerotherapy (UGFS) is a durable treatment for incompetent great saphenous vein (GSV) and incompetent small saphenous vein (SSV) in primary chronic venous disease (CVD), Clinical-Etiology-Anatomy-Pathophysiology (CEAP) clinical grade 2 to 4 disease. Secondary end points are to evaluate its safety in terms of complications, to compare patients' quality of life before and after the treatment, and to identify risk factors that may predict recurrence of CVD after UGFS.</div></div><div><h3>Methods</h3><div>Multicenter retrospective cohort study on 346 patients. The sclerosing agent was sodium tetradecyl sulfate (STS) in foam. The foam was prepared with the double-syringe technique (liquid-to-gas CO₂O_{2 30:70} ratio of 1:4). The sclerosing agent concentrations were 1% for saphenous trunk diameter 4 to 7 mm, 3% for saphenous trunk of &gt;7 mm. Sodium tetradecyl sulfate was injected directly into the GSV/SSV, achieving a total maximum volume of 10 mL per session. A median of two sessions was performed (range, 1-5).</div></div><div><h3>Results</h3><div>In this cohort, 205 patients were categorized as CEAP C2 (59.2%), and 141 (40.8%) had worse CVD (CEAP ≥3). The median follow-up was 60 months (range, 6-60 months). At the end of follow-up, 296 patients (85.5%) had no truncal reflux, with a 5-year disease-free time (between last procedure and evidence of recurrent disease) of 77.7 ± 2.16%. GSV and SSV showed similar 5-year recurrence-free time rates (69.9% vs 76.8%; <em>P</em> = ns), whereas patients with a diameter of the saphenous trunk of ≤8 mm had lower recurrence than those with &gt;8 mm (91.3% vs 46%; <em>P</em> &lt; .0001). Ninety patients (26%) showed CVD recurrence, occurring at a median of 48 months. A further UGFS treatment was needed in 50 symptomatic patients (14.4%), resulting in an 80% success rate. At univariate analysis, large diameter of the saphenous trunk (<em>P</em> &lt; .0001), male sex (<em>P</em> = .030) and greater number of treatment sessions (<em>P</em> = .009) were identified as significant prognostic factors for recurrence. Immediate complications occurred in 3.7% of patients: seven headache and six visual disturbances. Endovenous foam-induced thrombosis was detected in six patients (2.8%) 1 week after treatment. Cutaneous hyperpigmentation appeared in 37 patients (10.7%). Post-treatment revised Venous Clinical Severity Score and Chronic Venous Disease Quality of Life Questionnaire 14 scores were significantly lower than before treatment (<em>P</em> &lt; .001).</div></div><div><h3>Conclusions</h3><div>UGFS of the GSV/SSV is effective, safe in the long term and well-accepted by patients. UGFS is a viable option to surgery and endovenous thermal or nonthermal ablation in the treatment of saphenous trunk incompetence (CEAP clinical grade 2-4).</div></div>","PeriodicalId":17537,"journal":{"name":"Journal of vascular surgery. Venous and lymphatic disorders","volume":"13 4","pages":"Article 102212"},"PeriodicalIF":2.8,"publicationDate":"2025-02-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143472757","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":"Unveiling the relationship between pain and bacterial load in venous ulcers with implications in targeted treatment","authors":"Alisha R. Oropallo MD ,&nbsp;Priscilla J. Lee BS ,&nbsp;Amit Rao MD ,&nbsp;Micaela D. Gray MSc","doi":"10.1016/j.jvsv.2025.102213","DOIUrl":"10.1016/j.jvsv.2025.102213","url":null,"abstract":"<div><h3>Objective</h3><div>The relationship between bacteria and venous ulceration pain is well-established and primarily attributable to inflammatory pathways. Fluorescence imaging detects clinically significant bacterial loads and biofilm in real time at the bedside, informing its elimination in an objective manner. We sought to explore the regional co-localization of bacterial fluorescence signals and patient-reported venous ulceration pain, and if objectively targeted bacterial removal can reduce wound-associated pain.</div></div><div><h3>Methods</h3><div>We evaluated 46 adults with venous ulceration of the lower extremity self-reporting a wound-associated pain score of ≥4 on a scale of 1 to 10. Before any treatments were performed (eg, debridement), patients rated their pain during the study visit, and fluorescence images were captured. Regions of pain and positive fluorescence signals were sketched onto a printed wound image. Fluorescence imaging was repeated post procedurally, and patients rerated their pain either at the end of the study visit or over the phone the following day. Semiquantitative analysis involved visual estimation of the percentage overlap between regions of fluorescence and pain in the wound bed. Wilcoxon matched pairs signed rank tests and Mann-Whitney <em>t</em> tests assessed changes in pain scores post procedurally.</div></div><div><h3>Results</h3><div>Fluorescence from elevated bacterial loads and biofilm was present in every venous ulcer assessed, usually covering ≤50% of the wound bed and commonly colonizing the wound edges. Regions of pain were more extensive than regions of fluorescence within the wound bed, and some degree of overlap was identified in 40 of 46 patients (87%). This overlap was often substantial (29 patients with &gt;25% overlap and 16 with &gt;50% overlap). Overall mean pain scores were 8.17 before the procedure and 6.87 after the procedure, corresponding with a 1.30-point reduction that was highly statistically significant (<em>P</em> &lt; .0001). Pain score reduction was higher when patients rerated their pain 1 day after debridement (3.40-point reduction; <em>P</em> = .004).</div></div><div><h3>Conclusions</h3><div>We observed that fluorescence signals from clinically significant bacterial colonization and biofilms were commonly present in painful venous lower extremity ulcerations. Regions of patient-reported pain and positive fluorescence frequently overlapped, suggesting a relationship between the two. Wound-associated pain scores were significantly and immediately reduced after objectively targeted bacterial removal via real-time fluorescence imaging, with an even greater reduction observed by the next day. Understanding the association between chronic bacterial presence and pain in venous ulcers can inform treatment and management strategies, potentially enhancing patient quality of life and satisfaction, promoting healing, and reducing complications.</div></div>","PeriodicalId":17537,"journal":{"name":"Journal of vascular surgery. Venous and lymphatic disorders","volume":"13 4","pages":"Article 102213"},"PeriodicalIF":2.8,"publicationDate":"2025-02-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143472759","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":"Adverse Reactions to Endovascular Treatment for Varicose Veins - Cyanoacrylate Closure vs Thermal Ablation","authors":"Kazuyo Sujino ,&nbsp;Mitsumi Yamashita ,&nbsp;Takaya Murayama MD, PhD","doi":"10.1016/j.jvsv.2024.102046","DOIUrl":"10.1016/j.jvsv.2024.102046","url":null,"abstract":"","PeriodicalId":17537,"journal":{"name":"Journal of vascular surgery. Venous and lymphatic disorders","volume":"13 2","pages":"Article 102046"},"PeriodicalIF":2.8,"publicationDate":"2025-02-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143394480","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":"Exploring Seasonal Variability in Endovenous Ablation Outcomes for Chronic Venous Insufficiency","authors":"Kristine So MD ,&nbsp;Ahsan Zil-E-Ali MBBS, MPH ,&nbsp;Faisal Aziz MD (Distinguished Fellow-AVF)","doi":"10.1016/j.jvsv.2024.102082","DOIUrl":"10.1016/j.jvsv.2024.102082","url":null,"abstract":"","PeriodicalId":17537,"journal":{"name":"Journal of vascular surgery. Venous and lymphatic disorders","volume":"13 2","pages":"Article 102082"},"PeriodicalIF":2.8,"publicationDate":"2025-02-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143394482","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":"Applicability of ESCHAR and EVRA Trials to the Real-world Population of Patients With Venous Ulcers","authors":"Quynhdiem Lam MD ,&nbsp;Kelly Hallett RVT, CCT ,&nbsp;Allie Staats MD (Candidate) ,&nbsp;Erin Sheehan MD (Candidate) ,&nbsp;Fedor Lurie MD, PhD, RPVI, RVT, FSVS","doi":"10.1016/j.jvsv.2024.102047","DOIUrl":"10.1016/j.jvsv.2024.102047","url":null,"abstract":"","PeriodicalId":17537,"journal":{"name":"Journal of vascular surgery. Venous and lymphatic disorders","volume":"13 2","pages":"Article 102047"},"PeriodicalIF":2.8,"publicationDate":"2025-02-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143394547","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":"Ethanol Permanent Ablation of Head and Neck Low-Flow Venous Malformations","authors":"Wayne Yakes MD, FSIR, FCIRSE","doi":"10.1016/j.jvsv.2024.102076","DOIUrl":"10.1016/j.jvsv.2024.102076","url":null,"abstract":"","PeriodicalId":17537,"journal":{"name":"Journal of vascular surgery. Venous and lymphatic disorders","volume":"13 2","pages":"Article 102076"},"PeriodicalIF":2.8,"publicationDate":"2025-02-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143394570","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":"Comparison of Artificial Intelligence Versus Radiologist Interpretation of Right Ventricular to Left Ventricular Ratio for Pulmonary Embolism Response Team Activations at a Tertiary Referral Center","authors":"Jacob Shapiro MD","doi":"10.1016/j.jvsv.2024.102058","DOIUrl":"10.1016/j.jvsv.2024.102058","url":null,"abstract":"","PeriodicalId":17537,"journal":{"name":"Journal of vascular surgery. Venous and lymphatic disorders","volume":"13 2","pages":"Article 102058"},"PeriodicalIF":2.8,"publicationDate":"2025-02-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143394600","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}