N. Montelione, Alessandra Scotto di Uccio, V. Catanese, F. Codispoti, Alessandro Ciolli, Julia Paolini, Alessandra Panichelli, Francesco Spinelli, F. Stilo
{"title":"Surgical treatment of Nutcracker Syndrome","authors":"N. Montelione, Alessandra Scotto di Uccio, V. Catanese, F. Codispoti, Alessandro Ciolli, Julia Paolini, Alessandra Panichelli, Francesco Spinelli, F. Stilo","doi":"10.4081/vl.2024.12259","DOIUrl":"https://doi.org/10.4081/vl.2024.12259","url":null,"abstract":"The objective of this paper is to report early and mid-term outcomes of the surgical treatment Nutcracker Syndrome (NCS) in a single-center prospective study. Between January 2019 and September 2023, five patients with symptomatic NCS were treated at our center using left renal vein caudal transposition on the inferior vena cava, conducted through a midline incision of approximately 12 cm and a transperitoneal technique. Patient characteristics, presentation, length of hospital stay, and complications were analyzed. All diagnoses were established after clinical evaluation, ultrasound scanning, and radiological investigations, which confirmed left renal vein compression between the aorta and the Superior Mesenteric Artery (SMA). The average operating time was 159 minutes, with an average blood loss of 205 mL. There was no need for blood transfusions. Intensive care stay was not required and there were no early complications. The mean length of stay was 3.5 days. At a mean follow-up of 18.8 months, one patient reported persistent hematuria, and therefore underwent a secondary procedure, which incorporated patch venoplasty using the great saphenous vein. In our experience, left renal vein transposition appears to be a safe and effective procedure for the surgical management of severe NCS.","PeriodicalId":506330,"journal":{"name":"Veins and Lymphatics","volume":"9 6","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-05-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140985260","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":"When Lymphatics, the Devil and Maleficent Melanoma meet","authors":"Giancarlo Pansini","doi":"10.4081/vl.2024.12207","DOIUrl":"https://doi.org/10.4081/vl.2024.12207","url":null,"abstract":"The subject of lymphatics and cancer had been in the air for a lot of time. The Editor, Paolo Zamboni, came up at first with the idea of writing about this issue and was good enough to ask me to attempt this work after I provided him with images of mesenteric, intestinal and hepatic metastases from a young patient I treated for a malignant melanoma of the skin, in the last year of my surgical practice.","PeriodicalId":506330,"journal":{"name":"Veins and Lymphatics","volume":"102 5-6","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-02-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139849232","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":"When Lymphatics, the Devil and Maleficent Melanoma meet","authors":"Giancarlo Pansini","doi":"10.4081/vl.2024.12207","DOIUrl":"https://doi.org/10.4081/vl.2024.12207","url":null,"abstract":"The subject of lymphatics and cancer had been in the air for a lot of time. The Editor, Paolo Zamboni, came up at first with the idea of writing about this issue and was good enough to ask me to attempt this work after I provided him with images of mesenteric, intestinal and hepatic metastases from a young patient I treated for a malignant melanoma of the skin, in the last year of my surgical practice.","PeriodicalId":506330,"journal":{"name":"Veins and Lymphatics","volume":" 21","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-02-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139789440","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":"Ultrasound guided full mechanical thrombectomy of a floating thrombus in the common femoral vein","authors":"D. Baccellieri, V. Ardita, Sarah Tinaglia","doi":"10.4081/vl.2023.12169","DOIUrl":"https://doi.org/10.4081/vl.2023.12169","url":null,"abstract":"A Floating Venous Thrombus (FVT) in the deep venous system has a high potential to cause pulmonary embolization. There are no defined criteria for treatments described in the literature, which range from anticoagulation and fibrinolytic treatments, through open or endovascular thrombectomies, to more invasive procedures such as surgical interruption with ligation of the venous system. Catheter-directed thrombolysis is effective for treatment of venous clots, but it is associated with increased risk of bleeding. Mechanical thrombectomy currently represents a valid therapeutic option without the need for lytic therapy and with excellent short and medium-term results. We herein present a technical note through an explicative case of a patient with an FVT located in the left common femoral vein who underwent to percutaneous venous mechanical thrombectomy (ClotTriever, Inari Medical, Irvine, CA, USA) under ultrasound guidance without an intravascular ultrasound check. At the end of the treatment, venography and duplex ultrasound scan showed ilio-femoral patency without residual thrombus. No further procedures were needed and the patient was discharged two days post-intervention with oral anticoagulation and compression therapy with stockings.","PeriodicalId":506330,"journal":{"name":"Veins and Lymphatics","volume":"55 3","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-12-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139146599","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}
Taisto Sarkola, M. Lipsanen‐Nyman, Hannu Jalanko, Eero Jokinen
{"title":"Vascular structure and stiffness in pediatric Mulibrey nanism using ultra-high frequency ultrasound","authors":"Taisto Sarkola, M. Lipsanen‐Nyman, Hannu Jalanko, Eero Jokinen","doi":"10.4081/vl.2023.11826","DOIUrl":"https://doi.org/10.4081/vl.2023.11826","url":null,"abstract":"Mulibrey nanism (MUL) is a disorder with growth delay and congestive heart failure determining prognosis. We aimed to delineate arterial and venous morphology, and arterial stiffness in a representative pediatric MUL cohort. Twenty-three MUL and 23 individually sex and age-matched healthy controls were prospectively assessed in a cross-sectional study with ultra-high frequency ultrasound (48-70 MHz). Heart failure was present in 7 MUL patients, with severe congestive heart failure in 2. Pericardiectomy had been performed in 6 MUL. Arterial lumen diameters and arterial wall layer thickness (intima-media thickness and adventitia thickness) were smaller in MUL patients, but appropriate for body size when compared with controls. Systolic and diastolic blood pressure, aortic and carotid compliance, stiffness as well as central aortic pulsed wave velocity were all similar in MUL compared with controls. Plasma pro-BNP levels were variably elevated (>300 ng/L) in 9/23 MUL patients and in 4/18 MUL patients older than 5 years of age. Internal jugular vein (mean difference 0.054 mm, CI95% 0.024-0.084) and cubital vein (0.046 mm, CI95% 0.013 - 0.078) total wall thickness was elevated in MUL compared with controls. There were no statistically significant relations between vascular parameters and clinical or laboratory signs of heart failure or pericardiectomy. Arterial lumen, wall layer thickness and stiffness are appropriate for body size in MUL, and like healthy controls. Mild venous wall thickening in the upper body region may be due to increased venous pressures related to remodelling caused by diastolic heart failure.","PeriodicalId":506330,"journal":{"name":"Veins and Lymphatics","volume":"54 ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-11-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139204462","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":"AngioJetTM rheolytic thrombectomy with covered balloon-expandable stent deployment in a superior vena cava syndrome: a case report","authors":"A. Cosacco, G. Zenunaj, Luca Traina","doi":"10.4081/vl.2023.11992","DOIUrl":"https://doi.org/10.4081/vl.2023.11992","url":null,"abstract":"The Superior Vena Cava Syndrome (SVCS) is a rare mediastinal syndrome, frequently due to compression by a mediastinal malignant leading to venous flow obstruction through the Superior Vena Cava (SVC) towards the heart. The symptoms may consist of edema of the upper body and distended veins, dyspnea up to a life-threatening condition. Restoring the SVC flow by endovascular means can be beneficial in order to achieve a rapid relief of the clinical symptoms. A 51-year-old male with a recent diagnosis of squamous cell lung tumor diagnosis presented to the emergency department with persistent cough, neck and face swelling, and distended jugular veins on clinical examination. No dyspnea and normal vital parameters were reported. Computed Tomography angiography (CT) examination demonstrated thrombosis of subclavian veins and SVC due to compression by malignancy. Compression also involved the right upper lobar bronchus. Through a percutaneous transvenous right humeral access, phlebography confirmed total occlusion of the right subclavian vein, brachiocephalic venous trunk, and superior vena cava. We performed AngioJetTM (Boston Scientific, Marlborough, MA, USA) rheolytic endovascular thrombectomy. The phlebography demonstrated the unlying hemodynamic stenosis due to the ab-extrinsic compression and underwent stenting with a covered balloon-expandable stent. The final phlebography confirmed the patency of the stent and restoration of venous flow. Although there was a complete recovery of the symptoms, the patient died from respiratory complications caused by malignancy involvement. AngioJetTM mechanical thrombectomy and covered balloon-expandable stent deployment is a useful solution for SVCS to quickly achieve relief of the clinical symptoms. There are few case series where thrombectomy and primary stent placement are studied. Further follow-up studies are needed to understand the patency of treated vessels better.","PeriodicalId":506330,"journal":{"name":"Veins and Lymphatics","volume":"58 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-11-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139205038","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":"Is there any clinical reason to administer anticoagulant therapy to patients with the Jugular Vein Nutcracker syndrome?","authors":"Enrico Nastro Siniscalchi, G. Raffa","doi":"10.4081/vl.2023.12088","DOIUrl":"https://doi.org/10.4081/vl.2023.12088","url":null,"abstract":"Not available.","PeriodicalId":506330,"journal":{"name":"Veins and Lymphatics","volume":"33 12","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-11-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139245730","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}