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

{"title":"Safety and efficacy of endovenous ablation in patients with a history of deep vein thrombosis","authors":"","doi":"10.1016/j.jvsv.2024.101898","DOIUrl":"10.1016/j.jvsv.2024.101898","url":null,"abstract":"<div><h3>Objective</h3><p>Endovenous ablation is the standard of care for patients with symptomatic superficial venous insufficiency. For patients with a history of deep vein thrombosis (DVT), concern exists for an increased risk of postprocedural complications, particularly venous thromboembolism. The objective of this study was to evaluate the safety and efficacy of endovenous thermal ablation in patients with a history of DVT.</p></div><div><h3>Methods</h3><p>The national Vascular Quality Initiative Varicose Vein Registry was queried for superficial venous procedures performed from January 2014 to July 2021. Limbs treated with radiofrequency or laser ablation were compared between patients with and without a DVT history. The primary safety end point was incident DVT or endothermal heat-induced thrombosis (EHIT) II-IV in the treated limb at &lt;3 months of follow-up. The secondary safety end points included any proximal thrombus extension (ie, EHIT I-IV), major bleeding, hematoma, pulmonary embolism, and death due to the procedure. The primary efficacy end point was technical failure (ie, recanalization at &lt;1 week of follow-up). Secondary efficacy end points included the risk of recanalization over time and the postprocedural change in quality-of-life measures. Outcomes stratified by preoperative use of anticoagulation (AC) were also compared among those with prior DVT.</p></div><div><h3>Results</h3><p>Among 33,892 endovenous thermal ablations performed on 23,572 individual patients aged 13 to 90 years, 1698 patients (7.2%) had a history of DVT. Patients with prior DVT were older (<em>P</em> &lt; .001), had a higher body mass index (<em>P</em> &lt; .001), were more likely to be male at birth (<em>P</em> &lt; .001) and Black/African American (<em>P</em> &lt; .001), and had greater CEAP classifications (<em>P</em> &lt; .001). A history of DVT conferred a higher risk of new DVT (1.4% vs 0.8%; <em>P</em> = .03), proximal thrombus extension (2.3% vs 1.6%; <em>P</em> = .045), and bleeding (0.2% vs 0.04%; <em>P</em> = .03). EHIT II-IV, pulmonary embolism, and hematoma risk did not differ by DVT history (<em>P</em> = NS). No deaths from treatment occurred in either group. Continuing preoperative AC in patients with prior DVT did not change the risk of any complications after endovenous ablation (<em>P</em> = NS) but did confer an increased hematoma risk among all endovenous thermal ablations and surgeries (<em>P</em> = .001). Technical failure was similar between groups (2.0% vs 1.2%; <em>P</em> = .07), although a history of DVT conferred an increased recanalization risk over time (hazard ratio, 1.90; 95% confidence interval, 1.46, 2.46; <em>P</em> &lt; .001). The groups had comparable improvements in postprocedural venous clinical severity scores and Heaviness, Aching, Swelling, Throbbing, and Itching scores (<em>P</em> = NS).</p></div><div><h3>Conclusions</h3><p>Endovenous thermal ablation for patients with a history of DVT was effective. However,","PeriodicalId":17537,"journal":{"name":"Journal of vascular surgery. Venous and lymphatic disorders","volume":null,"pages":null},"PeriodicalIF":2.8,"publicationDate":"2024-04-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2213333X24002166/pdfft?md5=6bf9db45ff6da45a9400b564bf4e423c&pid=1-s2.0-S2213333X24002166-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140781865","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":"Single-session catheter-directed lysis using adjunctive clot fragmentation with power pulse spray only is a fast, safe, and effective option for acute pulmonary embolism","authors":"Laurencia Villalba MD, FRACS, FACP ,&nbsp;Raeed Deen MD, MMedStats ,&nbsp;Brendan Tonson-Older MChD, PhD ,&nbsp;Cartan Costello MB, BCD, BAO, FCICM","doi":"10.1016/j.jvsv.2024.101899","DOIUrl":"10.1016/j.jvsv.2024.101899","url":null,"abstract":"<div><h3>Objective</h3><p>Single-session, catheter-directed thrombolysis (CDT) with adjunctive power pulse spray (PPS) only, without thrombectomy, was evaluated for its safety and effectiveness. We performed a single-center, retrospective analysis of prospectively collected data.</p></div><div><h3>Methods</h3><p>Patients with high-risk or intermediate-risk pulmonary embolism (PE) who met the inclusion criteria and underwent a single session of CDT-PPS were included in the study. The primary outcomes assessed were technical and clinical success and major adverse events. Secondary outcomes included effectiveness based on pre- and postintervention clinical examination, radiographic findings, and reversal of right ventricular dysfunction at 48 hours and 4 weeks after discharge on echocardiography and computed tomography pulmonary angiography. The length of stay in the intensive care unit and overall admission were also analyzed. A return to premorbid exercise tolerance was evaluated at 12 months after the procedure.</p></div><div><h3>Results</h3><p>Between May 2016 and January 2023, 104 patients at the Wollongong Hospital were diagnosed with high- or intermediate-risk PE and underwent CDT-PPS. Of the 104 patients, 49 (47%) were considered to have high-risk PE and 55 (53%) intermediate-risk PE. Eleven patients (11%) had absolute contraindications and 49 patients (47%) had relative contraindications to systemic thrombolysis. Technical success was achieved in 102 patients (98%). Survival was 99% at 48 hours, 96% at 4 weeks, and 91% at 12 months. At 4 weeks, echocardiography showed 98% of patients had no evidence of right heart dysfunction, and computed tomography pulmonary angiography showed complete resolution of PE in 72%. There were no major adverse events at 48 hours. The median intensive care unit length of stay was 1 day, and the overall length of stay was 6 days. At 12 months, 96% had returned to their premorbid status.</p></div><div><h3>Conclusions</h3><p>The CDT-PPS technique is fast, safe, and effective in the treatment of high- and intermediate-risk PE, even in patients with a high bleeding risk, and should be considered as first-line management when the skills and resources are available. Further multicenter prospective studies are needed to corroborate these results.</p></div>","PeriodicalId":17537,"journal":{"name":"Journal of vascular surgery. Venous and lymphatic disorders","volume":null,"pages":null},"PeriodicalIF":3.2,"publicationDate":"2024-04-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2213333X24002178/pdfft?md5=6df6f1bf93022df4069ea44d2c1aca66&pid=1-s2.0-S2213333X24002178-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140764461","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":"Overlapping lockup lymphovenous anastomosis: Responding to comments by Depypere et al","authors":"Youmao Zheng BA ,&nbsp;Liqi Yi BA ,&nbsp;Cheng Wang BA ,&nbsp;Shilin Gu BA ,&nbsp;Chong Liu MD","doi":"10.1016/j.jvsv.2024.101847","DOIUrl":"10.1016/j.jvsv.2024.101847","url":null,"abstract":"","PeriodicalId":17537,"journal":{"name":"Journal of vascular surgery. Venous and lymphatic disorders","volume":null,"pages":null},"PeriodicalIF":3.2,"publicationDate":"2024-04-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2213333X24001343/pdfft?md5=09863148ccfd9c70dd1b4dea4bd2acc8&pid=1-s2.0-S2213333X24001343-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140851450","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":"The value of the dermal rim sign on nonenhanced magnetic resonance imaging for predicting dermal backflow in patients with primary lower extremity lymphedema","authors":"","doi":"10.1016/j.jvsv.2024.101890","DOIUrl":"10.1016/j.jvsv.2024.101890","url":null,"abstract":"<div><h3>Purpose</h3><p>The dermal rim sign (DRS) on nonenhanced magnetic resonance imaging has been shown to predict dermal backflow (DBF) in patients with secondary upper limb lymphedema. However, whether the DRS has the same effects on primary lower extremity lymphedema (PLEL) has not been clearly reported. Therefore, this study aimed to explore whether the DRS can be used to diagnose DBF on lymphoscintigraphy in patients with PLEL.</p></div><div><h3>Methods</h3><p>A total of 94 patients who were diagnosed with PLEL were recruited for this retrospective study from January 2022 to December 2023. All the patients were divided into two groups according to the lymphoscintigraphy findings: no DBF and DBF. The magnetic resonance imaging data of the two groups were recorded and statistically compared for the following indicators: range of lymphedema involvement (left, right, whole lower limbs, only thigh, only calf and ankle), signs of lymphedema (notable thickening of skin, parallel line sign, grid sign, honeycomb sign, band sign, lymph lake sign, crescent sign, DRS), and lymphedema measurement (skin thickness, band width). The DRS is characterized by notable thickening of the skin plus the grid sign and/or honeycomb sign, plus the band sign.</p></div><div><h3>Results</h3><p>The following statistically significant differences in the following indicators were found between the two groups (<em>P</em> &lt; .05): notable skin thickening, parallel line sign, grid sign, honeycomb sign, band sign, DRS, skin thickness, and band width. The sensitivity, specificity, and accuracy for predicting for DBF with the DRS was 82%, 64%, and 77%, respectively.</p></div><div><h3>Conclusions</h3><p>This study confirmed good consistency between the DRS and DBF from the perspective of imaging. This tool is suitable for children, adolescents, and patients with contraindications to lymphoscintigraphy. The DRS has important value in assessing the severity of PLEL. The DRS is suggested for the clinical use of combined surgical treatment of PLEL.</p></div>","PeriodicalId":17537,"journal":{"name":"Journal of vascular surgery. Venous and lymphatic disorders","volume":null,"pages":null},"PeriodicalIF":2.8,"publicationDate":"2024-04-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2213333X24002063/pdfft?md5=e45d6ef612ed2ef5414be36dc5d4b1a6&pid=1-s2.0-S2213333X24002063-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140792404","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":"Longitudinal assessment of health-related quality of life and clinical outcomes with at home advanced pneumatic compression treatment of lower extremity lymphedema","authors":"Frank T. Padberg Jr. MD ,&nbsp;Areck Ucuzian MD, PhD ,&nbsp;Hasan Dosluoglu MD ,&nbsp;Glenn Jacobowitz MD ,&nbsp;Thomas F. O'Donnell MD","doi":"10.1016/j.jvsv.2024.101892","DOIUrl":"10.1016/j.jvsv.2024.101892","url":null,"abstract":"<div><h3>Objective</h3><p>This prospective, longitudinal, pragmatic study describes at home treatment with a proprietary advanced pneumatic compression device (APCD) for patients with lower extremity lymphedema (LED).</p></div><div><h3>Methods</h3><p>Following institutiona review board approval, four participating Veterans Affairs centers enrolled LED patients from 2016 to 2022. The primary outcome measures were health-related quality of life (HR-QoL) questionnaires (lymphedema quality of life-leg and the generic SF-36v2) obtained at baseline and 12, 24, and 52 weeks. The secondary outcome measures were limb circumference, cellulitis events, skin quality, and compliance with APCD and other compression therapies.</p></div><div><h3>Results</h3><p>Because a portion of the trial was conducted during the coronavirus disease 2019 pandemic, 179 patients had 52 weeks of follow-up, and 143 had complete measurements at all time points. The baseline characteristics were a mean age of 66.9 ± 10.8 years, 91% were men, and the mean body mass index was 33.8 ± 6.9 kg/m². LED was bilateral in 92.2% of the patients. Chronic venous insufficiency or phlebolymphedema was the most common etiology of LED (112 patients; 62.6%), followed by trauma or surgery (20 patients; 11.2%). Cancer treatment as a cause was low (4 patients; 2.3%). Patients were classified as having International Society for Lymphology (ISL) stage I (68.4%), II (27.6%), or III (4.1%). Of the primary outcome measures, significant improvements were observed in all lymphedema quality of life-leg domains of function, appearance, symptoms, and emotion and the overall score after 12 weeks of treatment (<em>P</em> &lt; .0001) and through 52 weeks of follow-up. The SF-36v2 demonstrated significant improvement in three domains at 12 weeks and in the six domains of physical function, bodily pain, physical component (<em>P</em> &lt; .0001), social functioning (<em>P</em> = .0181), role-physical (<em>P</em> &lt; .0005), and mental health (<em>P</em> &lt; .0334) at 52 weeks. An SF-36v2 score &lt;40 indicates a substantial reduction in HR-QoL in LED patients compared with U.S. norms. Regarding the secondary outcome measures at 52 weeks, compared with baseline, the mean limb girth decreased by 1.4 cm (<em>P</em> &lt; .0001). The maximal reduction in mean limb girth was 1.9 cm (6.0%) at 12 weeks in ISL stage II and III limbs. New episodes of cellulitis in patients with previous episodes (21.4% vs 6.1%, <em>P</em> = .001) were reduced. The 75% of patients with skin hyperpigmentation at baseline decreased to 40% (<em>P</em> &lt; .01) at 52 weeks. At 52 weeks, compliance, defined as use for 5 to 7 days per week, was reported for the APCD by 72% and for elastic stockings by 74%.</p></div><div><h3>Conclusions</h3><p>This longitudinal study of Veterans Affairs patients with LED demonstrated improved generic and disease-specific HR-QoL through 52 weeks with at home use of an APCD. Limb girth, cellulitis episodes,","PeriodicalId":17537,"journal":{"name":"Journal of vascular surgery. Venous and lymphatic disorders","volume":null,"pages":null},"PeriodicalIF":3.2,"publicationDate":"2024-04-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2213333X24002087/pdfft?md5=b1f6aa40a0cb0bb7b66065368dbd7e60&pid=1-s2.0-S2213333X24002087-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140770340","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":"Changes in Interface Pressure of Multilayer Compression After 1 Week","authors":"Antonios Gasparis,&nbsp;Ismene Germanakos,&nbsp;Nicos Labropoulos","doi":"10.1016/j.jvsv.2024.101756","DOIUrl":"https://doi.org/10.1016/j.jvsv.2024.101756","url":null,"abstract":"","PeriodicalId":17537,"journal":{"name":"Journal of vascular surgery. Venous and lymphatic disorders","volume":null,"pages":null},"PeriodicalIF":3.2,"publicationDate":"2024-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2213333X2400009X/pdfft?md5=c8e6d0bfe264c21d037572b6b51e2e83&pid=1-s2.0-S2213333X2400009X-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140554412","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":"Clinical Factors Impacting Differences in Rates of Venous Thromboembolism Black and White Veterans","authors":"Hilary Hayssen ,&nbsp;Shalini Sahoo ,&nbsp;Brian Englum ,&nbsp;Minerva Mayorga-Carlin ,&nbsp;Tariq Siddiqui ,&nbsp;Phuong Nguyen ,&nbsp;Aman Kankaria ,&nbsp;Yelena Yesha ,&nbsp;John Sorkin ,&nbsp;Brajesh Lal","doi":"10.1016/j.jvsv.2024.101757","DOIUrl":"https://doi.org/10.1016/j.jvsv.2024.101757","url":null,"abstract":"","PeriodicalId":17537,"journal":{"name":"Journal of vascular surgery. Venous and lymphatic disorders","volume":null,"pages":null},"PeriodicalIF":3.2,"publicationDate":"2024-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2213333X24000106/pdfft?md5=c2f1cd7c74abdb08cf313a27ae44cdb2&pid=1-s2.0-S2213333X24000106-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140554413","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":"Usage of Virtual Reality Headsets During Office-Based Procedures to Lower Patient Anxiety and Pain","authors":"Harsna Chahal,&nbsp;Judith Lin","doi":"10.1016/j.jvsv.2024.101804","DOIUrl":"https://doi.org/10.1016/j.jvsv.2024.101804","url":null,"abstract":"","PeriodicalId":17537,"journal":{"name":"Journal of vascular surgery. Venous and lymphatic disorders","volume":null,"pages":null},"PeriodicalIF":3.2,"publicationDate":"2024-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2213333X2400057X/pdfft?md5=e45df18f09b56b944c0873fa22ed0648&pid=1-s2.0-S2213333X2400057X-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140554443","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 and Security of Combined 1470 EVLA + Foam Sclerotherapy on the Management of C4 to C6 Patients","authors":"Erasto Aldrett,&nbsp;Nora Enid Lecuona","doi":"10.1016/j.jvsv.2024.101806","DOIUrl":"https://doi.org/10.1016/j.jvsv.2024.101806","url":null,"abstract":"","PeriodicalId":17537,"journal":{"name":"Journal of vascular surgery. Venous and lymphatic disorders","volume":null,"pages":null},"PeriodicalIF":3.2,"publicationDate":"2024-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2213333X24000593/pdfft?md5=e4a504401f91e3d6b74f2b1c3cd50271&pid=1-s2.0-S2213333X24000593-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140554920","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":"In Vivo Evaluation of Safety and Performance of a Novel Microbubble-enhanced Ultrasound Pharmaco-mechanical Procedure in an Acute Porcine DVT Model","authors":"William Marston ,&nbsp;Craig Nichols ,&nbsp;John Ranshaw ,&nbsp;Jacob Ruprecht ,&nbsp;Daniel Estay","doi":"10.1016/j.jvsv.2024.101796","DOIUrl":"https://doi.org/10.1016/j.jvsv.2024.101796","url":null,"abstract":"","PeriodicalId":17537,"journal":{"name":"Journal of vascular surgery. Venous and lymphatic disorders","volume":null,"pages":null},"PeriodicalIF":3.2,"publicationDate":"2024-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2213333X24000490/pdfft?md5=5a07abca42bd22f64cae3146eab2be2c&pid=1-s2.0-S2213333X24000490-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140554239","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}