Phlebology最新文献

{"title":"From innovation to standard: Proprietary foam Sclerotherapy's rise as a pillar in venous disease treatment.","authors":"Edward M Boyle, James D Albert, James D Fonger","doi":"10.1177/02683555251353009","DOIUrl":"10.1177/02683555251353009","url":null,"abstract":"","PeriodicalId":94350,"journal":{"name":"Phlebology","volume":" ","pages":"2683555251353009"},"PeriodicalIF":0.0,"publicationDate":"2025-06-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144337408","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":"1% polidocanol endovenous microfoam (Varithena^TM) for the treatment of chronic venous disease: A position statement from the American vein and lymphatic society.","authors":"Mark H Meissner, Michael Di Iorio, Alun Davies","doi":"10.1177/02683555251353150","DOIUrl":"https://doi.org/10.1177/02683555251353150","url":null,"abstract":"<p><p>BackgroundA variety of minimally invasive thermal and non-thermal techniques to treat superficial truncal vein reflux have been introduced over the past 2 decades. Among these has been polidocanol endovenous microfoam (PEM, VarithenaTM). This position statement reviews the clinical results of the use of PEM in chronic venous disease as well as those situations where PEM may have distinct advantages over other endovenous modalities.MethodAn expert panel of the American Vein and Lymphatic Society reviewed the literature, focusing on the clinical outcomes and unique advantages associated with the use of PEM.ResultIn vitro, ex vivo, and clinical studies have shown PEM to have greater stability and efficacy than physician compounded foam, while other studies have demonstrated saphenous closure rates and clinical outcomes similar to those achieved with thermal ablation. Despite the benefits across the spectrum of chronic venous disease, PEM may have advantages in minimizing the risk of nerve injury associated with treatment of the below knee reflux, treating venous ulcers, and managing recurrent varicose veins and difficult saphenous anatomy due to tortuosity or intraluminal synechia.ConclusionAs the only FDA approved foam sclerosant, PEM provides flexibility in treating patients with standard, variant, and recurrent venous anatomy. The American Vein and Lymphatic Society supports PEM as a safe and effective treatment option for the treatment of C2-C6 disease associated with superficial venous reflux.</p>","PeriodicalId":94350,"journal":{"name":"Phlebology","volume":" ","pages":"2683555251353150"},"PeriodicalIF":0.0,"publicationDate":"2025-06-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144334761","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":"Accuracy of transvaginal duplex ultrasound compared to catheter venography for the identification of pelvic vein incompetence.","authors":"Daxina Bhatt, Shaneel Patel, David Riding, Katja Norse, Stephen Butterfield, Dare Seriki, Ganapathy Anantha-Krishnan, Jonathan Ghosh","doi":"10.1177/02683555251353550","DOIUrl":"https://doi.org/10.1177/02683555251353550","url":null,"abstract":"<p><p>ObjectiveChronic pelvic pain (CPP) is a debilitating condition affecting a quarter of premenopausal women and has been associated with pelvic vein incompetence (PVI). Catheter venography (CV) is the standard investigation, although transvaginal duplex (TVDU) ultrasound has emerged as a promising alternative. The accuracy of TVDU compared to CV is undefined and the optimal reflux time measured by TVDU to diagnose PVI is unknown. This study aimed to establish the diagnostic accuracy of TVDU in those with suspected PVI.MethodsThis cohort study included women enrolled into a randomised controlled trial comparing pelvic vein embolisation to no treatment, who underwent both TVDU and CV. Three consultant vascular interventional radiologists, blinded to TVDU results, independently reviewed catheter venograms. Reflux in bilateral ovarian and internal iliac veins was reported as a binary outcome. Pelvic reflux times, in both supine and semi-standing positions, were retrieved from TVDU reports. Diagnostic accuracy of TVDU was assessed using CV as the comparator. Sensitivity, specificity and area under the ROC curve (AUC) were calculated.Results124 pelvic veins were analysed in 31 women. For a diagnostic reflux time threshold of 500 ms, TVDU had a sensitivity of 64% and specificity of 78% (AUI 0.71,95%CI 0.66-0.76). For a threshold of 700 ms, TVDU had a sensitivity of 74% and a specificity of 78% (AUI 0.76,95%CI 0.71-0.80). For a threshold of 700 ms, TVDU performed semi-standing had a sensitivity of 78% and specificity of 78% (AUC of 0.78,95%CI 0.72-0.84) as compared to TVDU performed supine which had a sensitivity of 70% and specificity of 78% (AUC 0.74,95%CI 0.67-0.80).ConclusionsTVDU demonstrates good diagnostic accuracy for PVI using a 700 ms reflux time threshold. Performing the test in a semi-standing position optimises accuracy. TVDU has potential as a diagnostic tool and may eliminate unnecessary invasive investigations, thus preserving catheter venography for intention to treat.</p>","PeriodicalId":94350,"journal":{"name":"Phlebology","volume":" ","pages":"2683555251353550"},"PeriodicalIF":0.0,"publicationDate":"2025-06-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144334762","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":"Secondary thigh telangiectasias after endovenous laser ablation of the great saphenous vein.","authors":"D Borsuk, V Kozlova, A Fokin, R Tauraginskii, M Galchenko, K Lobastov","doi":"10.1177/02683555251351368","DOIUrl":"https://doi.org/10.1177/02683555251351368","url":null,"abstract":"<p><p>ObjectivesTo assess the incidence of secondary telangiectasias (TAEs) after endovenous laser ablation (EVLA) of the great saphenous vein (GSV) and discuss the possible risk factors for its development.MethodThis prospective observational study enrolled 123 lower limbs of 103 patients with varicose veins of C2 or C4 clinical classes who underwent EVLA of the GSV trunk from the saphenofemoral junction to the below knee level without simultaneous removal of varicose tributaries and/or perforating veins. The primary outcome was the occurrence and amount of secondary TAEs (matting) that developed at the medial aspect of the thigh along the treated GSV within a 3-month follow-up. The assessment was made by analysis of before and after photos by three experienced surgeons using a four-point scale. Fleiss' Kappa was used to measure the agreement between the assessors.ResultsSecondary TAE development was reported in 26 limbs (21.1%; 95% CI, 15.0-29.0%). Almost perfect agreement was observed between assessors for any matting (κ = 0.92; <i>p</i> < .0001) and different amounts of it (κ = 0.93, κ = 0.90, κ = 0.85, and κ = 1.00 for the score of 0, 1, 2, and 3, respectively). The most prevalent was a low amount of new TAEs (score of 1 in 17.9%). The only significant difference between the patients with and without secondary TAEs was age: 52.5 (IQR, 43-61) versus 40 (IQR, 34-53) years old.ConclusionsIn most cases (96,8%), secondary TAEs are either absent or could be found in a low amount. Older patients are more predisposed to its development.</p>","PeriodicalId":94350,"journal":{"name":"Phlebology","volume":" ","pages":"2683555251351368"},"PeriodicalIF":0.0,"publicationDate":"2025-06-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144268282","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":"Incidence and management of symptomatic pelvic venous disorders in patients with lower extremity varicose veins.","authors":"Christos Dimopoulos, Ioannis Papastefanou, Panagiotis Theodoridis, Nikolaos Iatrou, Theodosios Bisdas","doi":"10.1177/02683555251351184","DOIUrl":"https://doi.org/10.1177/02683555251351184","url":null,"abstract":"<p><p>BackgroundPelvic venous disorders (PeVD) are a recognized cause of venous origin chronic pelvic pain (VO-CPP) in women. However, the prevalence and management of PeVD in patients with lower extremity varicose veins remain understudied. This study assesses the incidence of PeVD among women with superficial venous insufficiency (SVI) and evaluates the role of transvaginal ultrasound (TVUS) as a screening tool.MethodsA retrospective analysis was conducted on 350 female patients with SVI (CEAP C2-C6) from January 2021 to December 2023. SVI was confirmed by duplex ultrasound (DUS). All patients were evaluated for CPP at the initial visit. In those with CPP, pelvic symptom management preceded any lower limb intervention. Symptomatic patients were assessed using the Pelvic Venous Congestion Symptom Scale (PVCSS), Visual Analog Scale (VAS), and TVUS for features suggestive of PeVD. In confirmed cases, diagnostic venography and ovarian vein embolization were performed, followed by saphenous vein ablation.ResultsPeVD was identified in 11% (37/350) of patients. TVUS revealed pelvic varicosities, ovarian veins dilation >6 mm, and reflux, confirmed by venography. Of the 37 patients, 41% (15/37) underwent embolization, while 59% opted for conservative management. Post-treatment, median PVCSS scores improved from 20 to 2 (<i>p</i> < 0.001), and VAS scores from 8 to 0 (<i>p</i> < 0.001), indicating significant symptom relief. Mean follow-up was 17 months, with assessments at 1, 6, and 12 months. Reintervention-free survival was 86.7%.ConclusionApproximately one in 10 women with SVI have symptomatic PeVD, highlighting the importance of targeted screening. TVUS serves as a useful non-invasive diagnostic tool. Further studies are needed to clarify optimal treatment strategies and long-term outcomes in this population.</p>","PeriodicalId":94350,"journal":{"name":"Phlebology","volume":" ","pages":"2683555251351184"},"PeriodicalIF":0.0,"publicationDate":"2025-06-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144268280","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":"Quantifying superficial vein morphology with near-infrared imaging during venous congestion.","authors":"Henrique Silva, Carlota Rezendes","doi":"10.1177/02683555251348754","DOIUrl":"https://doi.org/10.1177/02683555251348754","url":null,"abstract":"<p><p>The venous system plays a key role in clinical practice but remains underassessed due to the limited accessibility of conventional imaging tools. Near-infrared reflection illumination (NIRI) devices (\"vein finders\"), though recently introduced to assist venipuncture, have potential for broader vascular assessment. Our aim was to investigate the feasibility of a NIRI device to quantify the morphology of superficial hand veins and evaluate their response to a transient hemodynamic stress induced by suprasystolic limb occlusion. The dorsal hand veins of 14 healthy adults (21.5 ± 4.2 y.o.) were continuously recorded during a procedure consisting of a 5 min baseline, 3 min arm occlusion (200 mmHg), and 3 min recovery phases. Morphological parameters including vein width, branching angles, asymmetry indices, junctional exponent deviation, and optimality ratio, were extracted from three metacarpal veins and their tributaries. Nonparametric statistics were used to compare parameters between phases (<i>p</i> < .05). Occlusion led to a significant increase in the width of both receiving and tributary veins (<i>p</i> < .001), reflecting venous pooling. However, branching geometry remained largely unchanged, suggesting structural resilience. Junctional exponent deviation remained low, in agreement with Murray's law. Near-infrared vein finders enable real-time, non-invasive assessment of superficial venous morphology and compliance. Their sensitivity to dynamic vascular changes, combined with potential for integration with automated analysis tools, supports their broader use in vascular diagnostics, preoperative planning, and bedside monitoring.</p>","PeriodicalId":94350,"journal":{"name":"Phlebology","volume":" ","pages":"2683555251348754"},"PeriodicalIF":0.0,"publicationDate":"2025-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144268281","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":"Corrigendum to \"Regarding: 899 serious adverse events including 13 deaths, 7 strokes, 211 thromboembolic events, and 482 immune reactions: The untold story of cyanoacrylate adhesive closure. Parsi K et al.\"","authors":"","doi":"10.1177/02683555251346418","DOIUrl":"https://doi.org/10.1177/02683555251346418","url":null,"abstract":"","PeriodicalId":94350,"journal":{"name":"Phlebology","volume":" ","pages":"2683555251346418"},"PeriodicalIF":0.0,"publicationDate":"2025-06-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144259819","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":"Safety and efficacy of flush endovenous ablation of the great saphenous vein: A retrospective study.","authors":"Ahmed Azhar Ali, Ahmad ElGhamrey, Omar Ahmed AbuAlata, Ehab M Saad, Hossam ElWakeel","doi":"10.1177/02683555251348768","DOIUrl":"https://doi.org/10.1177/02683555251348768","url":null,"abstract":"<p><p><b>Aim:</b> To assess the safety and efficacy of endovenous ablation of great saphenous varicose veins with flush ablation at the saphenofemoral junction.<b>Methods:</b> A retrospective study was conducted on consecutive patients with varicose veins related to the great saphenous vein (GSV) and undergoing endovenous thermal ablation between January 2020 and July 2024. All patients underwent either endovenous laser or microwave ablation. Primary endpoints included technical success and absence of endothermal heat-induced thrombosis (EHIT) ≥ 2. Secondary endpoints included deep vein thrombosis (DVT), pulmonary embolism (PE), recurrence, days to return to normal daily activity, and reintervention. Follow-up was performed at 1 week, 6 months, and annually thereafter. Technical success was defined as successful flush catheter placement at the SFJ under duplex guidance. Recurrence was assessed through clinical examination and duplex ultrasound.<b>Results:</b> 69 patients (79 limbs) were included with a mean age of 39.1 ± 12.5 y, and 30 were of male sex (43.5%). Technical success was achieved in all limbs. EHIT ≥2 was not documented at the first postoperative outpatient visit, and no DVT or PE were noted during follow-up (20.4 ± 11 months). Recurrence was documented in 2 limbs (2.5%). One limb required surgical reintervention, and the days to return to daily activity recorded a median of 15 days (IQR 10 - 30).<b>Conclusion:</b> Flush endovenous ablation may be a safe and effective technique for treating great saphenous varicose veins, demonstrating a low incidence of recurrence and deep vein thrombosis while maintaining high technical and clinical success rates. Our findings contribute to the growing body of evidence supporting flush ablation strategies and highlight the need for further research to optimise procedural guidelines.</p>","PeriodicalId":94350,"journal":{"name":"Phlebology","volume":" ","pages":"2683555251348768"},"PeriodicalIF":0.0,"publicationDate":"2025-06-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144251688","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":"Comparison of gait parameters, functionality and health status in patients with lower extremity lymphedema and healthy controls.","authors":"Ezgi Ergin, Didem Karadibak, Merve Celik","doi":"10.1177/02683555251348774","DOIUrl":"https://doi.org/10.1177/02683555251348774","url":null,"abstract":"<p><p>ObjectivesTo compare gait parameters, functionality (muscle strength, balance, exercise capacity) and health status (kinesiophobia, fatigue, quality of life) in lower extremity lymphedema patients and healthy controls and to determine correlations between exercise capacity, gait parameters, muscle strength, balance, quality of life and lymphedema severity.MethodsTwenty-two lymphedema patients and 20 healthy controls participated in the study. Participants' demographic and medical characteristics were recorded. Muscle strength, endurance, balance, functional exercise capacity, gait parameters, kinesiophobia, fatigue and quality of life were assessed with dynamometer, 30-s chair stand test, Biodex, 6-min walk test (6MWT), 8-m test (8-MWT), Tampa Scale, Fatigue Severity Scale and Short Form-36, respectively.ResultsLymphedema patients had lower muscle strength and endurance, 6MWT distance, speed, cadence and stride length, 8-mWT speed, cadence and left stance phase, and higher swing phase-left and single support phase-right compared to healthy controls (<i>p</i> < .05). Balance parameters were worse in lymphedema patients compared to healthy controls (<i>p</i> < .05). Quality of life was lower and kinesiophobia and fatigue levels were higher in lymphedema patients compared to healthy controls (<i>p</i> < .05). Significant correlations were found between 6MWT distance, speed and stride length, 8-mWT speed and stride lengths and lymphedema severity, muscle strength, balance, and quality of life (<i>p</i> < .05). Multiple regression analyses identified balance and lymphedema severity as predictors for 6MWT distance, speed, and stride length.ConclusionsLymphedema patients have reduced muscle strength, exercise capacity, quality of life, and increased kinesiophobia and fatigue. Lymphedema negatively impacts gait and balance. Gait parameters are correlated with muscle strength, balance, quality of life and lymphedema severity in lymphedema patients.</p>","PeriodicalId":94350,"journal":{"name":"Phlebology","volume":" ","pages":"2683555251348774"},"PeriodicalIF":0.0,"publicationDate":"2025-06-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144236366","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":"Venous hemodynamics in active and passive calf movements in healthy adults.","authors":"Luiz Fernando Lima Albernaz, Marcondes Antônio de Medeiros Figueiredo, Daiane Taís Schlindwein Albernaz, Fabricio Rodrigues Santiago, Mateus Lusa Bordin, Yung-Wei Chi","doi":"10.1177/02683555251348755","DOIUrl":"https://doi.org/10.1177/02683555251348755","url":null,"abstract":"<p><p>ObjectiveThe physiological effects produced by the calf pump are essential in multiple aspects of vascular health, and their absence leads to stasis which directly relates to venous insufficiency. Therefore, muscle activity has been considered a key element in calf pump function. In the present study, we used a mechanical foot board with passive range of motion including stimulated dorsiflexion and plantar flexion and compared the hemodynamic effects to those obtained during active voluntary movement.Methods11 healthy adult volunteers participated in an intervention study. In Intervention 1, the participants performed voluntary dorsiflexion and plantar flexion, and in Intervention 2, the same participants used the passive PumpCare^® device (OAK Healthtech, Brazil). Both legs were examined, but data were collected from the right leg. Femoral vein blood flow was assessed by ultrasound, and venous pump capacity (V₀) by photoplethysmography. Anthropometric data were collected to investigate their correlation with femoral vein blood volume.ResultsThe mean femoral vein blood flow was 286 mL/min with active calf movements and 288 mL/min with passive calf movements (<i>p</i> = .929). Flow peaks were produced during dorsiflexion, that is, during stretching of the posterior muscle groups, returning to baseline levels after stopping the movement in both interventions. The mean maximal venous pump capacity measured by photoplethysmography was 3.7% with active calf movements and 3.5% with passive calf movements (<i>p</i> = .141).ConclusionIn this study, passive calf movements were able to promote a mean femoral vein volume flow comparable to the physiological effect produced by active calf movements in healthy adults. This appears to contradict the current understanding of the importance of calf muscle contraction in producing venous return.</p>","PeriodicalId":94350,"journal":{"name":"Phlebology","volume":" ","pages":"2683555251348755"},"PeriodicalIF":0.0,"publicationDate":"2025-06-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144228220","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}