{"title":"Recurrent and refractory lower limbs lymphedema in psoriatic arthritis: a case description and literature review","authors":"B. Maranini, G. Ciancìo, M. Tessari, M. Govoni","doi":"10.4081/vl.2021.10079","DOIUrl":"https://doi.org/10.4081/vl.2021.10079","url":null,"abstract":"Lymphedema is an uncommon extra-articular complication of rheumatoid arthritis (RA), but it can also be associated with psoriatic arthritis (PsA), although rarely. While lymphedema associated with RA is well characterized in literature, only few cases have been described among patients with PsA. Upper limbs are the most common sites involved, with asymmetric pattern, even if some patients may present lower limb oedema, or progressive bilateral oedema. \u0000Chronic established lymphoedema deriving from lymphatic vessel dysfunction should be clearly distinct from inflammatory distal pitting edema (IDPE), resulting from tenosynovitis and frequently encountered in PsA. In contrast to lymphedema, the latter condition generally presents an excellent response to steroid therapy, therefore it is essential to recognize the exact etiology of lymphoedema to approach the correct treatment. Here we report a case of lower limbs lymphedema in PsA and review the available literature upon the topic.","PeriodicalId":421508,"journal":{"name":"Veins and Lymphatics","volume":"36 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-12-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"131801542","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Multiple sclerosis and venous angioplasty for chronic cerebrospinal venous insufficiency: a case control study with ten years follow-up with patients at their own control","authors":"P. Bavera","doi":"10.4081/vl.2021.10143","DOIUrl":"https://doi.org/10.4081/vl.2021.10143","url":null,"abstract":"Progressive Neurological Diseases (PND) and Chronic Cerebrospinal Venous Insufficiency (CCSVI) and Multiple Sclerosis (MS) have two terms in common: “progressive and chronic” and shortly mean that there is no definitive therapy, at the moment. \u0000The clinical aspects are built on symptoms, upon which the definition of “progression” is based and hence classified. Changement and worsening of symptoms, allow classification of the disease and adjustments are effectively an “up to date” of the disease itself. \u0000We here resume the ten-year survey of 482 Multiple Sclerosis (MS)-affected patients (314 females, 168 males; mean age =37.8), classified by their Neurology Physicians as Relapse-Remitting (RR), according to the Kurtzke Expanded Disability Status Scale (EDSS), monitoring the parallel presence of CCSVI with clinical MS progression. \u0000Results are present from two homogeneous Relapse-Remitting MS groups of patients divided as “treated and non-treated for CCSVI” with vein angioplasty (vPTA). Furthermore, a Patient’s self-classification based upon symptoms in presence of CCSVI, up to now never implemented, was developed on the basis of both clinical and Duplex vascular issues. \u0000 ","PeriodicalId":421508,"journal":{"name":"Veins and Lymphatics","volume":"42 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-12-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"123386125","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"What are the ideal characteristics of a venous stent?","authors":"I. Massi, P. Zamboni","doi":"10.4081/vl.2021.9739","DOIUrl":"https://doi.org/10.4081/vl.2021.9739","url":null,"abstract":"Historically, the stents used in the venous system were not dedicated scaffolds. They were largely adapted arterial stents. An essential feature of a venous stent is compliance, in order to adapt its crosssectional area to the vein. It should also be crush resistant, corrosion resistant and fatigue resistant. The material should be radiopaque, for follow-up. Another characteristic of the ideal venous stent is flexibility, to adapt its shape to the vein, not vice versa. The scaffold should be uncovered too, in order to avoid the occlusion of collaterals. The ideal venous stent should not migrate, so it is necessary a large diameter and a long length. The radial force is important to prevent migration. However, current stents derived from arterial use display high radial force, which could affect the patency of the thin venous wall. Alternatively, if the stent has an anchor point, that permits a passive anchoring, the radial force required to avoid migration will be lower. Dedicated venous stents were not available until very recently. Furthermore, there is a preclinical study about a new compliant nitinol stent, denominated Petalo CVS. Out of the commonest causes of large veins obstruction, dedicated venous stent could also treat other diseases described more recently, such as the jugular variant of the Eagle syndrome, JEDI syndrome and jugular lesions of the chronic cerebrospinal venous insufficiency that result unfavorable for angioplasty according to Giaquinta classification.","PeriodicalId":421508,"journal":{"name":"Veins and Lymphatics","volume":"17 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-06-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"123566851","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
C. Beggs, V. Tavoni, E. Menegatti, M. Tessari, R. Ragazzi, A. Malagoni, L. Giovanardi
{"title":"Spectral characteristics of the internal jugular vein and central venous pressure pulses: a proof of concept study","authors":"C. Beggs, V. Tavoni, E. Menegatti, M. Tessari, R. Ragazzi, A. Malagoni, L. Giovanardi","doi":"10.4081/VL.2021.9732","DOIUrl":"https://doi.org/10.4081/VL.2021.9732","url":null,"abstract":"In this proof-of-concept study the impact of central venous pressure (CVP) on internal jugular veins cross-sectional area (CSA) and blood flow time-average velocity (TAV) was evaluated in eight subjects, with the aim of understanding the drivers of the jugular venous pulse. CVP was measured using a central venous catheter while CSA variation and TAV along a cardiac cycle were acquired using ultrasound. Analysis of CVP, CSA and TAV time-series signals revealed TAV and CSA to lag behind CVP by on average 0.129 s and 0.138 s, with an inverse correlation between CSA and TAV (r= –0.316). The respective autocorrelation signals were strongly correlated (mean r=0.729-0.764), with mean CSA periodicity being 1.062 Hz. Fourier analysis revealed the frequency spectrums of CVP, TAV and CSA signals to be dominated by frequencies at approximately 1 and 2 Hz, with those >1 Hz greatly attenuated in the CSA signal. Because the autocorrelograms and periodograms of the respective signals were aligned and dominated by the same underlying frequencies, this suggested that they are more easily interpreted in the frequency domain rather than the time domain.","PeriodicalId":421508,"journal":{"name":"Veins and Lymphatics","volume":"24 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-03-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"127388108","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Jia-hao Zhou, S. Richard, Yin-sheng Deng, Jiang Ming, Zhuang Yan
{"title":"Contrast-enhanced encephalopathy and massive cerebral edema after endovascular coiling of cerebral aneurysm. A case report","authors":"Jia-hao Zhou, S. Richard, Yin-sheng Deng, Jiang Ming, Zhuang Yan","doi":"10.4081/VL.2021.9767","DOIUrl":"https://doi.org/10.4081/VL.2021.9767","url":null,"abstract":"Contrast-induced encephalopathy (CIEP) is a rare complication after endovascular therapy. The etiology of CIEP is still a matter of debate. We present a rare occurrence of CIEP in a known hypertensive and type 2 diabetic patient after endovascular coiling of cerebral aneurysm with oculomotor nerve palsy. A 68-year old female presented with seven days history of headache and left ptosis or blepharoptosis with mild mydriasis. The headaches were localized mainly at the left side of the nose, orbit, and upper forehead while the left ptosis was associated with blurred vision. Computed tomography angiography revealed an aneurysm in between the C4 segment of the left internal carotid artery (ICA) and the bifurcation of the left posterior communicating artery. Digital subtraction angiography further confirmed the aneurysm. We used the transarterial approach to assess the aneurysm and subsequent coiling. Iohexol (Omnipaque) contrast agent was used during the endovascular procedure. The patient’s condition deteriorated into acute confusion state with cardinal symptomology of CIEP immediately after the operation. Computed tomography scan revealed cortical contrast enhancement in the vascular territory of the ICA as well as edema. Her symptomatology resolved 48 hours after treated with anticonvulsants, intracranial pressure reduction and hydration. Chronic hypertension as well as type 2 diabetics may be critical predisposing factors to CIEP. CIEP should be suspected in patients presenting with acute confusion state after endovascular therapy. Massive edema with ischemic brain changes in white matter of the brain before endovascular procedure should rise suspicion of CIEP. Introduction Contrast-induced encephalopathy (CIEP) is a rare complication after endovascular therapy.1-5 The precise etiological mechanisms via which this occur is still a matter of debate.2,4 Nevertheless, osmotic disruption of the blood-brain barrier (BBB) arising from repeated contrast injections into a single vessel has been speculated as a cause of this complication.3,4,6 Chronic hypertension, transient ischemia attack, compromised cerebral autoregulation, renal failure, enormous contrast volumes, selective vertebralbasilar arteriography (VAG) and male gender have been implicated as predisposing factors of CIEP.5,7-10 The symptomatology of CIEP often commence during the procedure but become apparent few hours after the procedure.5 Most symptoms are typically self-limiting, resolving within 2-4 days of onset.3,11,12 Nevertheless, full recovery may take as long as few weeks in a few patients.3,12 Anomalous cortical contrast enhancement with mild to severe edema, subarachnoid contrast enhancement, as well as striatal contrast enhancement are the typical postprocedural CT findings.2,9,12 Adequate hydration with intravenous crystalloids as well as anticonvulsants are the supportive treatment modalities for this post procedural complication.5,13 The observation of CIEP in a known hypertensi","PeriodicalId":421508,"journal":{"name":"Veins and Lymphatics","volume":"57 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-03-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"129996214","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
K. Takada, Yukari Nakajima, T. Urai, Kanae Mukai, Kimi Asano, M. Okuwa, J. Sugama, T. Nakatani
{"title":"Effects of inhibition of lymphangiogenesis by the vascular endothelial growth factor receptor 3 (VEGFR-3) inhibitor, MAZ51 on full thickness wounds in mice","authors":"K. Takada, Yukari Nakajima, T. Urai, Kanae Mukai, Kimi Asano, M. Okuwa, J. Sugama, T. Nakatani","doi":"10.4081/VL.2021.9385","DOIUrl":"https://doi.org/10.4081/VL.2021.9385","url":null,"abstract":"We herein used MAZ51 to inhibit lymphangiogenesis and aimed to clarify the effect of inhibition of lymphangiogenesis on wound healing. BALB/c male mice were divided into two groups: the control group which was injected the dimethyl sulfoxide (DMSO), the experiment group was injected MAZ51 in the DMSO. All wounds were observed for 15 days and the wound areas were measured. Tissue samples were harvested on day 3, 7, 9, 11, 13 and 15, and subjected to immunostaining of blood vessels and lymphatic vessels. There are no significant differences between two groups in the wound area, the number of blood vessels and lymphatic vessels. The number of blood vessels peaked on day 7 in both groups as with previous studies, while the number of lymphatic vessels peaked on 13 or 15 in both groups. This result revealed delayed lymphangiogenesis in comparison with previous studies. The wound healing process in the control and experiment groups were similar, but both groups seemed delayed lymphangiogenesis comparing with previous studies. Injections of MAZ51 or/and DMSO did not affect angiogenesis, while they may affect lymphangiogenesis.","PeriodicalId":421508,"journal":{"name":"Veins and Lymphatics","volume":"21 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"117198181","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
G. Guarnera, P. Zamboni, O. Nelzén, F. Mannello, A. Andriessen
{"title":"Pending questions in venous ulcers management. Report from a Symposium of the World Union of Wound Healing Societies International Congress","authors":"G. Guarnera, P. Zamboni, O. Nelzén, F. Mannello, A. Andriessen","doi":"10.4081/vl.2020.9206","DOIUrl":"https://doi.org/10.4081/vl.2020.9206","url":null,"abstract":"Venous ulcers represent the most frequent ulcers and have a high clinical and socioeconomic significance. Nevertheless, pending questions remain on epidemiology, genetic and biomolecular mechanisms, contraindications and risk factors of compression therapy, role of pharmacological therapy. Overall prevalence in the range of 1-2% and point prevalence of 0.08-0.6% can be reduced if risk factors are identified and treated early. In this context, analysis of factor XIII and hemocromatosis gene polymorphisms, with the C282Y and H63D variants, may be of great importance. Also MMP12 gene polymorphism and the imbalance between matrix metalloproteinases and their tissue inhibitors are able to impair wound healing via deleterious degradation process of extra-cellular matrix. From a therapeutic point of view, conflicting recommendations exist on relative contraindications, risks and adverse events of compression therapy. Some studies showed that the administration of pentoxyphilline, Micronized purified flavonoid fraction (MPFF) and sulodexide was effective in accelerating ulcer healing, but there is no data on the duration of treatment, recurrence rates and cost-effectiveness relation-","PeriodicalId":421508,"journal":{"name":"Veins and Lymphatics","volume":"196 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-11-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"130477887","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Gaspare Aselli’s serendipity","authors":"A. Macciò","doi":"10.4081/vl.2020.9255","DOIUrl":"https://doi.org/10.4081/vl.2020.9255","url":null,"abstract":"This paper is part of the monographic issue: ‘Did the Masters of the past know the future? History and update of Italian Phlebolymphology’ \u0000Guest editor: Alberto Macciò (Phlebology - Part I edited by G. Agus; Phlebology - Part II edited by P. Bonadeo; Lymphology edited by F. Boccardo)","PeriodicalId":421508,"journal":{"name":"Veins and Lymphatics","volume":"68 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"128638913","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Sergio Bertini Curri","authors":"Enrico Oliva","doi":"10.4081/vl.2020.9251","DOIUrl":"https://doi.org/10.4081/vl.2020.9251","url":null,"abstract":"This paper is part of the monographic issue: ‘Did the Masters of the past know the future? History and update of Italian Phlebolymphology’ \u0000Guest editor: Alberto Macciò (Phlebology - Part I edited by G. Agus; Phlebology - Part II edited by P. Bonadeo; Lymphology edited by F. Boccardo)","PeriodicalId":421508,"journal":{"name":"Veins and Lymphatics","volume":"27 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"123875955","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Umberto Fox","authors":"Giuliano Antonio Lucani","doi":"10.4081/vl.2020.9257","DOIUrl":"https://doi.org/10.4081/vl.2020.9257","url":null,"abstract":"This paper is part of the monographic issue: ‘Did the Masters of the past know the future? History and update of Italian Phlebolymphology’ \u0000Guest editor: Alberto Macciò (Phlebology - Part I edited by G. Agus; Phlebology - Part II edited by P. Bonadeo; Lymphology edited by F. Boccardo)","PeriodicalId":421508,"journal":{"name":"Veins and Lymphatics","volume":"70 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"115909143","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}