Phlebology最新文献

{"title":"The role of D-dimer and fibrinogen testing in catheter-directed thrombolysis with urokinase for deep venous thrombosis.","authors":"Qiang Liu,&nbsp;Liang Chen,&nbsp;Zhengyu Wang,&nbsp;Zhiqing Peng,&nbsp;Wei Chen,&nbsp;Yucheng Pan,&nbsp;Yongli Wang,&nbsp;Yan Sha","doi":"10.1177/02683555231176911","DOIUrl":"https://doi.org/10.1177/02683555231176911","url":null,"abstract":"<p><strong>Background: </strong>During catheter-directed thrombolysis (CDT), D-dimer (D-D) are generated in large quantities and fibrinogen (FIB) is continuously consumed. Reduction of FIB increases the risk of bleeding. However, there are currently few studies on the relationship between D-D and FIB concentrations during CDT.</p><p><strong>Objectives: </strong>To evaluate the relationship of D-D and FIB concentrations during CDT with urokinase for deep venous thrombosis (DVT).</p><p><strong>Method: </strong>17 patients with lower limb DVT were enrolled and treated with CDT. The concentrations of plasma D-D and FIB were measured every 8 h during thrombolysis. The degree of thrombolysis was evaluated, the change rules of D-D and FIB concentrations were analyzed, and the change curve graphs were drawn. The \"thrombus volume,\" \"thrombolysis time,\" \"thrombolysis ratio,\" \"D-D peak,\" \"D-D rising speed,\" \"FIB falling speed,\" and \"duration of D-D elevation\" were calculated in each patient. The mixed model was used to simulate the time change trend of the plasma D-D and FIB concentrations. Pearson method and linear regression were used to analyze the correlation and linear relationship, respectively.</p><p><strong>Results: </strong>The D-D concentration first increased rapidly and then decreased gradually, and the FIB concentration continued to decrease during thrombolysis. The rate of the decline of FIB varies with the urokinase dose. The thrombus volume is positively correlated with D-D rising speed, duration of D-D elevation, D-D peak, and FIB falling speed; the D-D rising speed is positively correlated with the D-D peak and FIB falling speed; and the D-D peak is positively correlated with the FIB falling speed. The correlation coefficients were all statistically significant (<i>p</i> < 0.05). Efficacy reached level I-II in 76.5% patients. No major bleeding occurred in any of the patients.</p><p><strong>Conclusion: </strong>During CDT with urokinase for DVT, the concentrations of D-D and FIB show specific changes, and there are some specific relationships between each other. Understanding these changes and relationships may be helpful to adjust the thrombolysis time and urokinase dose more rationally.</p>","PeriodicalId":20139,"journal":{"name":"Phlebology","volume":"38 6","pages":"389-397"},"PeriodicalIF":1.7,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9733729","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Reply of letter to the editor: Assessment and grading of pigmentation in chronic venous insufficiency in Phlebology 2020.","authors":"Satyendra K Tiwary, Praveen Kg Kumar, Neeraj Dhameeja, Puneet Kumar, Ajay K Khanna, Soumya Khanna","doi":"10.1177/02683555231175021","DOIUrl":"10.1177/02683555231175021","url":null,"abstract":"","PeriodicalId":20139,"journal":{"name":"Phlebology","volume":"38 6","pages":"419-420"},"PeriodicalIF":1.7,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10111383","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Saphenous vein aneurysms characterization and treatment: A 36-year single center experience.","authors":"Oscar Moreno,&nbsp;Kiran Kumar,&nbsp;Thomas Wakefield,&nbsp;Andrea Obi","doi":"10.1177/02683555231181858","DOIUrl":"https://doi.org/10.1177/02683555231181858","url":null,"abstract":"<p><strong>Background: </strong>Superficial vein aneurysms (SVA) are rare vascular pathologies associated with trauma, chronic venous disease, and venous malformation.</p><p><strong>Method: </strong>We retrospectively reviewed cases of SVA treated from 1986 to 2022.</p><p><strong>Results: </strong>Out of 2463 venous procedures, 16 patients were found with 19 GSV and 1 SSV aneurysms, with 88% presenting with a palpable mass. Varicose veins were noted in 94% of patients, 81% had concomitant reflux, 15% had thrombus within the aneurysm sac, and 19% demonstrated multiple aneurysms. All patients underwent ligation and excision. Post-procedure, 55% of patients received anticoagulants, and 85% received compression. Mean follow-up was 19.4 months, with no aneurysm recurrence. We propose a modification to the current SVA classification.</p><p><strong>Conclusion: </strong>The prevalence of multiple aneurysms suggests the need for complete limb imaging in affected patients. Surgical management of SVA was effective in preventing SVA recurrence, while the proposed classification modification will aid in future SVA management.</p>","PeriodicalId":20139,"journal":{"name":"Phlebology","volume":"38 6","pages":"410-416"},"PeriodicalIF":1.7,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9790408","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Ultrasound-guided percutaneous laser ablation of tributary varicose veins using a slim-type radial fiber.","authors":"Junichi Utoh,&nbsp;Yoshiharu Tsukamoto","doi":"10.1177/02683555231179821","DOIUrl":"https://doi.org/10.1177/02683555231179821","url":null,"abstract":"<p><strong>Objective: </strong>This study presents the efficacy of ultrasound-guided percutaneous laser ablation of tributary varicose veins using a slim-type radial 2-ring fiber.</p><p><strong>Methods: </strong>One thousand consecutive patients who underwent endovenous laser ablation (EVLA) of incompetent saphenous veins were included. The tributary varicose veins were punctured with a 16G venule needle and ablated with a 1470 nm laser system and a slim-type radial 2-ring fiber with a diameter of 1.27 mm. The EVLA was performed with a power of 5W and linear endovenous energy density of around 30 J/cm.</p><p><strong>Results: </strong>Percutaneous varicose ablation was safely performed in 939 legs with an average of 5.9 times punctures per leg. No skin burn or nerve injury was observed after varicose ablation. Ultrasonography revealed complete occlusion of the treated veins 1 month after EVLA.</p><p><strong>Conclusions: </strong>This study suggests that percutaneous varicose ablation with a slim-type radial 2-ring fiber is a safe and effective alternative to cover the weak point of ambulatory phlebectomy.</p>","PeriodicalId":20139,"journal":{"name":"Phlebology","volume":"38 6","pages":"404-409"},"PeriodicalIF":1.7,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9725909","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Selected phlebological abstracts.","authors":"Lowell S Kabnick,&nbsp;Katheen Ozsvath,&nbsp;Jorge H Ulloa","doi":"10.1177/02683555231180392","DOIUrl":"https://doi.org/10.1177/02683555231180392","url":null,"abstract":"Endovenous closure of refluxing superficial veins has been proved to substantially improve patients’ health-related quality of life. Despite the transition from inpatient to outpatient ablation procedures, these minimally invasive techniques can still lead to the loss of working days and economic disability. The authors’ aim of this study was to compare the time to return to work after treatment between two techniques of superficial vein closure: radiofrequency ablation (RFA) and cyanoacrylate adhesive closure (CAC). The authors performed a multi-institutional retrospective review of actively employed patients with CEAP class 2 to 5 disease who had undergone closure of their truncal veins. The patients who had undergone RFA were compared with those who had undergone CAC. The primary end point was the time to return to work. The secondary end points included infection, thrombophlebitis, and postprocedure deep vein thrombosis. A total of 97 patients were included in the study cohort, of whom 58 had undergone RFA and 39 CAC. Most of the patients in the cohort had had CEAP class 2 disease (60%). The patients in the RFA group were more frequently men (57% vs 33%). Significantly more patients who had undergone CAC had had postprocedure thrombophlebitis (5% vs 33%). The mean time to return to work was significantly shorter for the CAC group than for the RFA group (0.8 ± 1.4 days vs 1.3 ± 1.4 days). On multivariate analysis, the treatment modality was the only modifiable factor in the time to return to work. The authors concluded that RFA and CAC have both been shown to be safe and effective treatments to eliminate truncal venous insufficiency. Despite the significantly higher rates of postprocedure thrombophlebitis, the CAC patients were able to return to work significantly more quickly, reducing the opportunity cost of missed workdays, compared with RFA.","PeriodicalId":20139,"journal":{"name":"Phlebology","volume":"38 6","pages":"421-423"},"PeriodicalIF":1.7,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9735631","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Histopathological analysis of vascular malformations.","authors":"Calver Pang,&nbsp;Jeries Abu-Hanna,&nbsp;Chung Sim Lim,&nbsp;Jocelyn Brookes,&nbsp;Janice Tsui,&nbsp;George Hamilton,&nbsp;Louisa Onuba,&nbsp;Florence Deroide","doi":"10.1177/02683555231175022","DOIUrl":"https://doi.org/10.1177/02683555231175022","url":null,"abstract":"<p><strong>Objective: </strong>To propose and develop a histopathological criteria to help diagnose vascular malformations.</p><p><strong>Methods: </strong>All patients who underwent surgical resection and had a confirmed histopathological diagnosis of vascular malformations from 01 March 2018-26 February 2020 were included. A criteria based on 10 parameters was developed to help diagnose vascular malformations. Discrepancies between clinical and histopathological diagnosis were evaluated.</p><p><strong>Results: </strong>A total of 18 cases were identified. There was a discrepancy between the clinical diagnosis and the initially reported histopathological diagnosis in 16 cases (88.9%). This was reduced to 7 (38.9%) and 6 cases (33.3%) with first and second time revised histopathological analysis using proposed criteria.</p><p><strong>Conclusions: </strong>The discrepancy between clinical and histopathological diagnoses of vascular malformations has highlighted the requirement of an agreed criteria for histopathologists to help formulate their diagnosis. The proposed criteria may be used as a guide in addressing this and guide treatment and improve clinical practice.</p>","PeriodicalId":20139,"journal":{"name":"Phlebology","volume":"38 6","pages":"370-379"},"PeriodicalIF":1.7,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10093902","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effect of dysmorphic plantar arch on venous hemodynamics of the lower limb.","authors":"Laure Tsimba,&nbsp;Didier Rastel,&nbsp;Emilie Dechandon,&nbsp;Patrick Vincent,&nbsp;Céline Micholet,&nbsp;Cyril Chaigneau,&nbsp;Stéphane Avril,&nbsp;Miquel Aguirre","doi":"10.1177/02683555231176940","DOIUrl":"https://doi.org/10.1177/02683555231176940","url":null,"abstract":"<p><strong>Background: </strong>The role of the plantar venous pump (PVP) on venous return is evident but the effects of the foot morphology have never been characterized properly.</p><p><strong>Method: </strong>52 healthy volunteers-26 with normal plantar arch (control) and 26 with dysmorphic plantar arch (in two subgroups: 13 flat feet, 13 hollow feet)-were included. Using Doppler ultrasound, we measured the diameter and the peak systolic velocity in the large veins of the lower limb after PVP stimulation by manual compression and bodyweight transfer.</p><p><strong>Result: </strong>The mean peak systolic velocity of the studied veins varied from 12.2 cm/s to 41.7 cm/s in the control group and from 10.9 cm/s to 39.1 cm/s in the dysmorphic plantar group. The foot arch morphology did not affect significantly the venous blood flows, except in the great saphenous vein during manual compression.</p><p><strong>Conclusion: </strong>The plantar morphology did not induce a significant increase of venous blood velocity resulting from PVP stimulation.</p>","PeriodicalId":20139,"journal":{"name":"Phlebology","volume":"38 6","pages":"380-388"},"PeriodicalIF":1.7,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9731819","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Leg volume reduction during tiptoe movement is caused by venous ejection and calf muscle contraction.","authors":"Kotaro Suehiro,&nbsp;Noriyasu Morikage,&nbsp;Takasuke Harada,&nbsp;Yuriko Takeuchi,&nbsp;Soichi Ike,&nbsp;Ryo Otsuka,&nbsp;Ryunosuke Sakamoto,&nbsp;Hiroshi Kurazumi,&nbsp;Ryo Suzuki,&nbsp;Kimikazu Hamano","doi":"10.1177/02683555231179548","DOIUrl":"https://doi.org/10.1177/02683555231179548","url":null,"abstract":"<p><strong>Objectives: </strong>To clarify the cause of leg volume reduction during tiptoe movement in the standing position.</p><p><strong>Methods: </strong>The right legs of 20 participants were assessed. The participants performed tiptoe movement in the supine position, and then stood up and performed the tiptoe movement and ankle dorsiflexion. Leg volume changes were recorded continuously using air plethysmography.</p><p><strong>Results: </strong>Differences between leg volume changes due to tiptoe movement and the refilling volumes were not significantly different between the supine (59 mL) and standing (49 mL) positions, indicating that this amount of motion artifact was included in the downward trace recorded by tiptoe movement in the standing position.</p><p><strong>Conclusions: </strong>Leg volume reduction during tiptoe movement in the standing position included a significant amount of motion artifacts. Therefore, it may be difficult to accurately measure the ejection volume using tiptoe movement in the standing position.</p>","PeriodicalId":20139,"journal":{"name":"Phlebology","volume":"38 6","pages":"398-403"},"PeriodicalIF":1.7,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9732297","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Radiofrequency ablation of the great saphenous vein; does the choice of monopolar or bipolar catheters affect outcomes?","authors":"Adem I Diken,&nbsp;Sertan Özyalçın,&nbsp;İzzet Hafez,&nbsp;Utku Alemdaroğlu,&nbsp;Hüseyin A Tünel,&nbsp;Onur Hanedan","doi":"10.1177/02683555231174997","DOIUrl":"https://doi.org/10.1177/02683555231174997","url":null,"abstract":"<p><strong>Objectives: </strong>Radiofrequency-based procedure is one of the leading methods of endovenous thermal ablation. The most fundamental difference with regards to currently available radiofrequency ablation systems is the way of electric current flow given to the vein wall; bipolar segmental and monopolar ablation. This study aimed to compare the monopolar ablation method with conventional bipolar segmental endovenous radiofrequency ablation method for the management of incompetent saphenous veins.</p><p><strong>Methods: </strong>Between November 2019 and November 2021, 121 patients with incompetent varicose veins who were treated either with the F-Care/monopolar (<i>N</i> = 49) or ClosureFast/bipolar (<i>N</i> = 72) were included in the study. A single extremity of each patient with isolated great saphenous vein insufficiency was enrolled. The differences between the two groups in demographic parameters, disease severity, treated veins, peri- and postoperative complications, and treatment efficacy indicators were retrospectively evaluated.</p><p><strong>Results: </strong>There was no statistically significant difference between the groups regarding demographic parameters, disease severity, and treated veins in preoperative period (<i>p</i> > 0,05). The average procedural time was 21.4 ± 4 minutes in the monopolar group, while it was 17.1 ± 3 minutes in the bipolar group. In both groups, the venous clinical severity scores declined significantly compared with the preoperative period, however; there was no difference between groups (<i>p</i> > 0,05). The occlusion rate of the saphenofemoral junction and proximal saphenous vein after 1 year was 94.1% in the bipolar group and 91.8% in the monopolar group (<i>p</i> = 0.4) while there was a significant difference in the occlusion rate of the shaft and distal part of the saphenous vein (93.2% in the bipolar group and 80.4% in the monopolar group, <i>p</i> = 0.04). Postoperative complications (bruising and skin pigmentation) were slightly higher in the bipolar group (<i>p</i> = 0.02, <i>p</i> = 0.01).</p><p><strong>Conclusions: </strong>Both systems are effective in treating the venous insufficiency of the lower extremity. Monopolar system revealed a better early postoperative course with similar occlusion rate of the proximal part of saphenous vein compared with bipolar system, however; the occlusion of the lower half of the saphenous vein was significantly lower which may negatively affect long-term occlusion rates and recurrence of the disease.</p>","PeriodicalId":20139,"journal":{"name":"Phlebology","volume":"38 6","pages":"361-369"},"PeriodicalIF":1.7,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9737225","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Improving venous symptoms in C0s-C1s patients after multicomponent diosmin-based preparation: Initial experience.","authors":"Michele Greco,&nbsp;Daniele Bissacco","doi":"10.1177/02683555231169088","DOIUrl":"https://doi.org/10.1177/02683555231169088","url":null,"abstract":"<p><p>The use of drug therapies in patients with chronic venous disease (CVD) remains a topic of debate regarding safety, compliance, and effectiveness. Although the beneficial effects of molecules like diosmin have been established in patients with chronic venous insufficiency (CVI) of C3-C6 classes, the evidence for its use in C0-C1 patients is not well documented. This report aims to describe and analyze the positive impact of a new diosmin-based drug therapy on a population of C0-C1 patients in terms of relief of venous symptoms.</p>","PeriodicalId":20139,"journal":{"name":"Phlebology","volume":"38 5","pages":"348-351"},"PeriodicalIF":1.7,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9534814","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}