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

{"title":"Information for Readers","authors":"","doi":"10.1016/S2213-333X(25)00059-9","DOIUrl":"10.1016/S2213-333X(25)00059-9","url":null,"abstract":"","PeriodicalId":17537,"journal":{"name":"Journal of vascular surgery. Venous and lymphatic disorders","volume":"13 3","pages":"Article 102224"},"PeriodicalIF":2.8,"publicationDate":"2025-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143807172","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":"Retrospective study of hypersensitivity reactions in patients undergoing cyanoacrylate closure of lower extremity superficial veins","authors":"Jiwoo Lee MS ,&nbsp;Chien Yi Maximilian Png MD ,&nbsp;Bianca Mulaney-Topkar MD, MS, MPH ,&nbsp;Davis Waller MD ,&nbsp;Vishu Chandrasekhar BS ,&nbsp;Julianne Stoughton MD","doi":"10.1016/j.jvsv.2025.102246","DOIUrl":"10.1016/j.jvsv.2025.102246","url":null,"abstract":"<div><h3>Objective</h3><div>Chronic venous insufficiency affects more than 25 million adults in the United States, who initially presents with varicose veins. Although thermal-based, minimally invasive endovenous procedures exist, there has been a recent advent of non-thermal endovenous methods for vein ablation such as cyanoacrylate closure (CAC) with the VenaSeal Closure System, which decreases the risk of thermal injury. This study aimed to determine the incidence, onset, duration, and severity of hypersensitivity reactions (HSRs) following CAC, as well as identify risk factors for the development of HSRs.</div></div><div><h3>Methods</h3><div>This study was conducted at the Massachusetts General Brigham health care system and included 122 patients with 193 veins treated between 2018 and 2022. Patients aged 18 years and older with symptomatic, incompetent superficial lower extremity veins, including the great saphenous vein, small saphenous vein, and anterior accessory saphenous vein, were included. Data on patient demographics, clinical history, procedure details, and post-procedural duplex ultrasound results were collected.</div></div><div><h3>Results</h3><div>In this cohort, the incidence of HSRs was 21.2%. Symptom onset occurred on average 7.6 days post-procedure (standard deviation, 7.4 days) with most patients experiencing mild (76%) or moderate (24%) symptoms that resolved without intervention, with non-steroidal anti-inflammatory drugs, or with steroid treatment. There was a significantly higher risk of HSRs with younger age (<em>P</em> = .0372), female sex (<em>P</em> = .0025), and history of allergies (<em>P</em> = .0049). Longer veins (<em>P</em> = .0205) and greater saphenous veins (<em>P</em> = .0388) had stronger associations with HSRs. The overall postoperative closure rate after CAC procedure was 99.5%, without a significant difference between patients with and without HSRs.</div></div><div><h3>Conclusions</h3><div>HSRs are a potential adverse complication of the CAC procedure, with most cases being self-limited and affecting individuals who are younger, are female, and have a history of allergies. These findings suggest the need for careful patient selection and counseling during consideration of the CAC procedure for the treatment of chronic venous insufficiency.</div></div>","PeriodicalId":17537,"journal":{"name":"Journal of vascular surgery. Venous and lymphatic disorders","volume":"13 4","pages":"Article 102246"},"PeriodicalIF":2.8,"publicationDate":"2025-04-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144031984","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":"Efficacy of ultrasound-guided foam sclerotherapy in the healing of venous leg ulcers","authors":"Rashad A. Bishara RPVI, MS, FRCS ,&nbsp;Ahmed Gaweesh MSc, MD ,&nbsp;Ihab Nabil Hanna MSc, MD ,&nbsp;Ahmed K. Allam MSc, MD ,&nbsp;Mohamed R. Moabed EFVES ,&nbsp;Sherif Essam MD, FRCSI ,&nbsp;Wassila Taha MSc, RPVI ,&nbsp;Alun H. Davies MA, DM, FRCS, DSc, FHEA, FEBVS, FACPh, FLSW, FMedSci ,&nbsp;Joseph Shalhoub PhD, FRCS, FEBVS","doi":"10.1016/j.jvsv.2025.102244","DOIUrl":"10.1016/j.jvsv.2025.102244","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Background&lt;/h3&gt;&lt;div&gt;Ultrasound-guided foam sclerotherapy (UGFS) for treating the refluxing venous network beneath and in the vicinity of venous leg ulcers (VLUs) has been used widely.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Objective&lt;/h3&gt;&lt;div&gt;This trial aimed to assess the efficacy and safety of UGFS for treating VLUs (ISRCTN18090073).&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Methods&lt;/h3&gt;&lt;div&gt;This study is a multicenter randomized controlled trial. Consenting eligible participants were randomized into two groups: group A received UGFS for the distal refluxing network of veins (eg, ulcer bed venous plexus), in addition to standard care, and group B received standard care alone. Standard care included compression therapy, wound care, ablation of superficial reflux, and recanalization of proximal deep venous obstruction when appropriate. Patients were followed weekly until complete ulcer healing was achieved. All participants will be followed for ≥12 months from the point of randomization to allow calculation of total ulcer-free days during the study period and assess for the recurrence of ulceration from the time of ulcer healing and quality of life measures. The primary outcome was the time to ulcer healing. Secondary outcomes were the rate of ulcer healing, Venous Clinical Severity Score, and patient-reported health-related quality of life.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Results&lt;/h3&gt;&lt;div&gt;The study was terminated early for efficacy at the planned interim analysis when one-half the number of patients had completed follow-up. A total of 71 patients, 6 with bilateral VLUs, were recruited. After accounting for dropouts and losses to follow-up, 65 VLUs were available for analysis. Both groups were similar at baseline regarding demographic factors, risk factors, history of deep vein thrombosis, previous venous interventions, and ulcer size. The time to complete ulcer healing was significantly shorter in group A, who received UGFS, as compared with group B, who did not receive UGFS (median, 35 days [interquartile range, 22 days] vs median, 56 days [interquartile range, 58 days]; &lt;em&gt;P&lt;/em&gt; = .008). Additionally, more ulcers achieved complete healing within 3 months in group A compared with group B (28/29 [97%] vs 27/36 [75%]; &lt;em&gt;P&lt;/em&gt; = .01). Multivariate regression analysis showed a significant effect of UGFS on healing time (&lt;em&gt;P&lt;/em&gt; = .004). Group A showed a significantly more rapid reduction in ulcer size (&lt;em&gt;P&lt;/em&gt; &lt; .0001). There was a significant improvement in the Venous Clinical Severity Score after treatment in both groups A and B (&lt;em&gt;P&lt;/em&gt; &lt; .0001).&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Conclusions&lt;/h3&gt;&lt;div&gt;Although both groups benefited from standard care for treating VLUs, the addition of UGFS improved treatment outcomes significantly. UGFS accelerated the healing process, resulting in a shorter time to complete ulcer healing and a higher rate of ulcers achieving complete healing within 3 months. These findings suggest that UGFS is a valuable adjunctive treatment for VLUs, enhancing the e","PeriodicalId":17537,"journal":{"name":"Journal of vascular surgery. Venous and lymphatic disorders","volume":"13 4","pages":"Article 102244"},"PeriodicalIF":2.8,"publicationDate":"2025-04-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143975098","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":"Thigh muscle pump function during ambulation","authors":"Roman A. Tauraginskii MD ,&nbsp;Fedor Lurie MD, PhD, RPVI, RVT, FSVS ,&nbsp;Anna Borde PhD ,&nbsp;Sergei Simakov PhD, DSc ,&nbsp;Denis Borsuk MD, PhD, DSc","doi":"10.1016/j.jvsv.2025.102248","DOIUrl":"10.1016/j.jvsv.2025.102248","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Objective&lt;/h3&gt;&lt;div&gt;It is generally accepted that blood flow in the superficial venous system of the lower extremity is anterograde whether the body is at rest (lying, sitting, or standing) or in motion (walking). However, it has been shown that during locomotion, anterograde blood flow in the superficial veins from the calf to the thigh was not observed. Instead, the blood flowed towards the intramuscular veins of the lower leg. The purpose of this study was to determine the pressure gradient directing the blood flow in the thigh venous network during ambulation.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Methods&lt;/h3&gt;&lt;div&gt;Sixteen healthy volunteers (legs) were enrolled in the study. Venous pressure was measured in the great saphenous vein (GSV) at the upper and distal thigh and in the intermuscular vein of the posterior thigh during treadmill walking at 30, 45 and 60 stride cycles min&lt;sup&gt;−1&lt;/sup&gt;. The blood flow rate in the common femoral artery was measured by duplex ultrasound at rest and immediately following each exercise test.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Results&lt;/h3&gt;&lt;div&gt;Fourteen lower extremities were included in the analysis; two were excluded due to technical failure. A pressure gradient (PG) directed from the superficial to the intermuscular vein was observed for the majority the stride cycle time. The magnitude of the PG from the superficial to the intermuscular vein was found to be considerably higher than the PG observed between knee and groin GSV levels. The GSV pressure averaged over the cycle time was found to be similar at the knee and groin levels, irrespective of walking frequency.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Conclusions&lt;/h3&gt;&lt;div&gt;During natural ambulation, the resulting PG was directed from superficial to intermuscular veins for the majority of the stride cycle time. The thigh muscle pump functions as a flow diverter pump, redirecting blood flow from the superficial to the intramuscular venous networks via perforating veins.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Clinical Relevance&lt;/h3&gt;&lt;div&gt;This report addresses the mechanical aspects of the thigh muscle pump during human locomotion, specifically treadmill walking. The study establishes a correlation between the stride cycle and venous pressure changes within the thigh intermuscular and superficial venous network. The study demonstrated that the direction of blood flow from superficial veins is not anterograde; rather, the primary route for blood outflow from the superficial venous network at the thigh level is towards intramuscular veins through perforating veins. The aforementioned data, when considered alongside recently published data regarding calf muscle pump function, strongly suggest that the physiologic direction of blood flow in perforating veins is only from superficial to deep veins. Conversely, the occurrence of reverse flow should be regarded as pathological, even if observed in a healthy subject with so-called bi-directional perforating veins. The role of bi-directional perforating veins has been a topic of lon","PeriodicalId":17537,"journal":{"name":"Journal of vascular surgery. Venous and lymphatic disorders","volume":"13 4","pages":"Article 102248"},"PeriodicalIF":2.8,"publicationDate":"2025-04-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144016384","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 hemodynamic characteristics of iliac vein in chronic venous disease and iliac vein compression syndrome patients using magnetic resonance image: A prospective study","authors":"Tianchen Xie MD ,&nbsp;Xingyu Su PhD ,&nbsp;Yan Shan PhD, MD ,&nbsp;Min Zhou PhD, MD ,&nbsp;Yong Ding PhD, MD ,&nbsp;Xu Li PhD, MD ,&nbsp;Zhenyu Zhou PhD, MD ,&nbsp;Sheng Fang MD ,&nbsp;Chenghao Yang MD ,&nbsp;Zhenyu Shi MD, PhD","doi":"10.1016/j.jvsv.2025.102247","DOIUrl":"10.1016/j.jvsv.2025.102247","url":null,"abstract":"<div><h3>Objective</h3><div>The purpose of this study was to explore the characteristics of hemodynamic parameters of iliac vein of patients with chronic venous disease (CVD) using two-dimensional (2D)-phase contrasted (PC) and four-dimensional (4D)-Flow magnetic resonance imaging (MRI) and to test the diagnostic and grading efficiency of 2D-PC and 4D-Flow MRI in CVD and iliac vein compression syndrome (IVCS).</div></div><div><h3>Methods</h3><div>Consecutive patients with CVD diagnosed in the outpatient department from 2023 to 2024 were enrolled in this study. Demographic data and medical records of the patients were also collected. The CEAP classification, Villalta score, and Venous Clinical Severity Score (VCSS) were used to evaluate the severity of lower limb symptoms. After computational tomography venography (CTV) scans to verify iliac vein compression, every patient underwent 2D-PC and 4D-Flow MRI scanning. Circle CVI42 software was used to perform data post processing. The inferior vena cava (IVC), common iliac vein (CIV), and common femoral vein (CFV) were chosen to acquire hemodynamic parameters by MRI. The hemodynamic parameter included flow rate (FR) per cardiac cycle, FR per minute, peak flow velocity (FV) and minimum FV measured by 2D-PC MRI and FR per cardiac cycle, peak FV and pressure gradient measured by 4D-Flow MRI. We analyzed the consistency of hemodynamic parameters between 2D-PC and 4D-Flow MRI, the differences in hemodynamic parameters between symptomatic and asymptomatic limbs and limbs with and without iliac vein compression, and the correlation between parameters and severity of symptoms.</div></div><div><h3>Results</h3><div>A total of 34 individuals, including three healthy volunteers, 15 patients with CVD and iliac vein compression, and 16 patients with CVD without IVCS, were enrolled in this study. Hemodynamic parameters measured by 2D-PC and 4D-Flow MRI complied with the flow rate conservation and maintained consistency (<em>P</em> &lt; .01). There was a statistically significant difference in the FR of the CIV and FR difference between the CIV and CFV measured by 2D-PC and 4D-Flow MRI between symptomatic and asymptomatic limbs (2D-PC MRI: FR of CIV: 6.0 ± 3.1 vs 8.5 ± 5.1; <em>P</em> = .01; FR difference: 1.6 ± 2.1 vs 3.6 ± 4.3; <em>P</em> = .01) (4D-Flow MRI: FR of CIV: 6.9 ± 2.8 vs 8.7 ± 4.2; <em>P</em> = .04; FR difference: 3.0 ± 2.8 vs 4.8 ± 3.5; <em>P</em> = .05), and limbs with and without iliac vein compression (2D-PC MRI: FR of CIV: 5.3 ± 3.0 vs 7.6 ± 4.4; <em>P</em> = .03; FR difference: 1.3 ± 2.7 vs 2.8 ± 3.4; <em>P</em> = .04) (4D-Flow MRI FR of CIV: 6.1 ± 2.6 vs 8.2 ± 3.7; <em>P</em> &lt; .01; FR difference: 2.1 ± 3.7 vs 4.6 ± 3.1; <em>P</em> = .04). The FR of the CIV and the FR difference between the CIV and CFV were negatively correlated with symptom severity in all affected limbs (2D-PC MRI: FR of CIV: <em>P</em> &lt; .01; r = −0.3; FR difference: <em>P</em> = .03; r = −0.3). There was a potential neg","PeriodicalId":17537,"journal":{"name":"Journal of vascular surgery. Venous and lymphatic disorders","volume":"13 5","pages":"Article 102247"},"PeriodicalIF":2.8,"publicationDate":"2025-04-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144006678","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":"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 MD ,&nbsp;Xu Li MD ,&nbsp;Fang Liu MD ,&nbsp;Hua Yi Zhang MD","doi":"10.1016/j.jvsv.2025.102243","DOIUrl":"10.1016/j.jvsv.2025.102243","url":null,"abstract":"","PeriodicalId":17537,"journal":{"name":"Journal of vascular surgery. Venous and lymphatic disorders","volume":"13 4","pages":"Article 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 BA ,&nbsp;Molly Ratner MD ,&nbsp;Giancarlo Speranza MD, MBA ,&nbsp;Keerthi B. Harish MD, MBA ,&nbsp;Mikel Sadek MD ,&nbsp;Glenn R. Jacobowitz MD ,&nbsp;Karan Garg MD ,&nbsp;Thomas S. Maldonado MD ,&nbsp;Caron B. Rockman MD","doi":"10.1016/j.jvsv.2025.102242","DOIUrl":"10.1016/j.jvsv.2025.102242","url":null,"abstract":"<div><h3>Objective</h3><div>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.</div></div><div><h3>Methods</h3><div>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 <em>t</em> tests, respectively. For all tests, a <em>P</em> value of less than .05 was considered statistically significant.</div></div><div><h3>Results</h3><div>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; <em>P</em> = .NS). Outpatients were more likely to have superficial venous thrombosis (7.0% vs 0.6%; <em>P</em> = .002) and chronic venous changes (25.4% vs 1.2%; <em>P</em> &lt; .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.</div></div><div><h3>Conclusions</h3><div>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.</div></div>","PeriodicalId":17537,"journal":{"name":"Journal of vascular surgery. Venous and lymphatic disorders","volume":"13 4","pages":"Article 102242"},"PeriodicalIF":2.8,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","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":"","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 MD ,&nbsp;Mahmoud Nasser MD ,&nbsp;Hisham Abd El-Mawgoud MD ,&nbsp;Baker Ghoneim MD, FRCS ,&nbsp;Mohammed Ali MD","doi":"10.1016/j.jvsv.2025.102241","DOIUrl":"10.1016/j.jvsv.2025.102241","url":null,"abstract":"<div><h3>Background</h3><div>Pelvic venous disorder (PeVD) is increasingly diagnosed with different modalities of treatment.</div></div><div><h3>Methods</h3><div>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.</div></div><div><h3>Results</h3><div>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, <em>P</em> = .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 (<em>P</em> = .005).</div></div><div><h3>Conclusions</h3><div>The study emphasizes the potential advantages of the sclerosant foam and metallic coil combination in achieving favorable outcomes for patients with PeVD.</div></div>","PeriodicalId":17537,"journal":{"name":"Journal of vascular surgery. Venous and lymphatic disorders","volume":"13 4","pages":"Article 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 MD ,&nbsp;Thomas F. O’Donnell MD ,&nbsp;Isaac Gendelman MD ,&nbsp;Payam Salehi MD, PhD","doi":"10.1016/j.jvsv.2025.102238","DOIUrl":"10.1016/j.jvsv.2025.102238","url":null,"abstract":"<div><h3>Objective</h3><div>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.</div></div><div><h3>Methods</h3><div>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.</div></div><div><h3>Results</h3><div>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%; <em>P</em> ≤ .05).</div></div><div><h3>Conclusions</h3><div>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.</div></div>","PeriodicalId":17537,"journal":{"name":"Journal of vascular surgery. Venous and lymphatic disorders","volume":"13 4","pages":"Article 102238"},"PeriodicalIF":2.8,"publicationDate":"2025-03-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","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":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}