Phlebology最新文献

{"title":"The effects of blood flow on the structure of venous thrombi.","authors":"Maxim E Shaydakov, Jose A Diaz","doi":"10.1177/02683555261416662","DOIUrl":"https://doi.org/10.1177/02683555261416662","url":null,"abstract":"<p><p>ObjectivesThrombolytic therapy can eliminate thrombotic masses from the deep veins, but its effectiveness is not always predictable. We hypothesize that blood flow may influence the composition of an acute venous thrombus contributing to unpredictable outcomes. The aim of the study was to take advantage of two available well-established models to compare venous thrombus composition under flow and stasis conditions in vivo.MethodsC57BL/6 mice, 10-12 weeks old, weighing 20-25g, were used in electrolytic (EIM) and ligation (LM) models of VT. Four groups (n = 5) were used to compare the structure of acute (Day (2) and subacute (Day (6) thrombus in the EIM and LM. Venous thrombus was harvested for thrombus weight (TW) measurement and histology. Expression of PAI-1, t-PA, u-PA, and alfa-2-antiplasmin in the vein wall and D-dimer levels in plasma were investigated at Day 2 and 6.ResultsAcute venous thrombus within the EIM was significantly smaller compared to LM (6.2 ± 3.6 vs 26.2 ± 3.6, <i>P < .05</i>). Thrombus formed within the EIM had a significantly higher amount of plasminogen, especially on the surface and in the tail of the thrombus. In addition, a significantly higher concentration of circulating D-Dimer was found within the EIM.ConclusionsRegional venous blood flow pattern may significantly affect the structure and composition of the venous thrombotic masses. Non-occlusive thrombus has a higher potential to be targeted by the fibrinolytic system and fibrinolytic therapy due to a higher plasminogen content and accessibility for plasminogen activators.</p>","PeriodicalId":94350,"journal":{"name":"Phlebology","volume":" ","pages":"2683555261416662"},"PeriodicalIF":1.5,"publicationDate":"2026-01-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145936858","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":"The use of glove drains in lipedema liposuction: A technical note and preliminary observations.","authors":"Agostino Bruno, Matteo Cilluffo","doi":"10.1177/02683555251413901","DOIUrl":"https://doi.org/10.1177/02683555251413901","url":null,"abstract":"<p><p>BackgroundLipedema is a chronic disorder involving abnormal accumulation of subcutaneous fat, primarily in the lower limbs. Liposuction is an effective treatment, but postoperative complications such as fluid retention and seroma formation are common. While the use of surgical drains is well established in other areas of plastic surgery, their role in lipedema liposuction remains unclear.MethodsThis prospective observational study involved 50 consecutive patients with stage II or III lipedema who underwent lower leg liposuction. A novel passive drainage technique was used, involving glove drains fashioned from sterile, powder-free nitrile gloves and inserted through existing liposuction incisions. Drain duration, postoperative swelling, and complications, particularly seroma formation, were evaluated.ResultsAll patients completed follow-up with no major complications. Glove drains remained in place for an average of 2.4 ± 0.5 days. Only 2 patients (4%) developed seromas requiring single aspiration. No infections, hematomas, or lymphatic complications were recorded. Patients reported reduced swelling and discomfort compared to historical cases without drains.ConclusionPassive glove drains appear to be a simple, safe, and effective method to manage postoperative fluid collections after lipedema liposuction of the lower legs. The technique may lower the risk of seroma formation and promote early recovery, characterized by reduced postoperative edema, improved patient comfort, and an uncomplicated short-term postoperative course. Further controlled studies are needed to validate these findings and establish standardized drainage protocols in lipedema surgery.</p>","PeriodicalId":94350,"journal":{"name":"Phlebology","volume":" ","pages":"2683555251413901"},"PeriodicalIF":1.5,"publicationDate":"2026-01-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145907420","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":"Treatment of supratrochlear and supraorbital veins with long-pulsed 1064-nm Nd: YAG laser: A single-arm prospective pilot study.","authors":"Aline Faria Lamaita, Samantha Neves, Flávia Magalhães Silveira Magella Oliveira, Roberto Augusto Caffaro, Viviane Santana da Silva, Camilla Moreira Ribeiro, Rodrigo Kikuchi, Tainá Ribeiro de Azevedo, Isabela Zampirolli Leal, Walkiria Hueb Bernardi, Eduardo Ramacciotti","doi":"10.1177/02683555251413899","DOIUrl":"https://doi.org/10.1177/02683555251413899","url":null,"abstract":"<p><p>BackgroundSupratrochlear and supraorbital veins are a frequent cosmetic concern in aesthetic dermatology, with limited efficacy/safety prospective data on noninvasive treatments. The long-pulsed 1064-nm Nd:YAG laser offers deeper tissue penetration and low melanin absorption, potentially enabling safe and effective management of these vessels.MethodsThis prospective, single-center pilot study included 10 adult patients with visible supratrochlear and supraorbital veins deemed aesthetically undesirable. All participants underwent two sessions of long-pulsed 1064-nm Nd:YAG laser treatment (6-mm spot, 70-90 J/cm², 40 ms) at 30-days intervals, with dynamic skin cooling. The primary efficacy outcome was the quantitative ultrasonographic analysis of venous caliber reduction. Co-primary outcomes included blinded evaluator photographic assessments and safety evaluation. Secondary outcomes comprised patient-reported outcomes via a satisfaction questionnaire.ResultsUltrasonographic measurements demonstrated a significant reduction in venous caliber after treatment (0.17 ± 0.05 cm vs 0.12 ± 0.05 cm; <i>p</i> < 0.001). No significant differences were detected by blinded evaluators between pre- and post-treatment photographs (κ = 0.176). No skin alterations occurred at any time point. Nine patients (90%) rated the results as \"very good\" or \"excellent,\" with none rating them as \"poor\" or \"very poor\".ConclusionLong-pulsed 1064-nm Nd:YAG laser treatment of supratrochlear and supraorbital veins led to a significant ultrasonographic reduction in venous caliber and high patient satisfaction without adverse cutaneous effects.</p>","PeriodicalId":94350,"journal":{"name":"Phlebology","volume":" ","pages":"2683555251413899"},"PeriodicalIF":1.5,"publicationDate":"2026-01-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145907418","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":"Diagnostic value of the wells score for lower extremity deep vein thrombosis in hospitalized patients: A case-control study.","authors":"Saeed Kargar-Soleimanabad, Sajjad Najafi, Masoud Ahmadi, Farnaz Godazandeh","doi":"10.1177/02683555251409995","DOIUrl":"https://doi.org/10.1177/02683555251409995","url":null,"abstract":"<p><p>BackgroundDeep vein thrombosis (DVT) remains a frequent and potentially life-threatening complication among hospitalized patients, necessitating timely diagnosis. The Wells score is widely used for assessing DVT probability; however, its performance in inpatient populations remains uncertain. This study aimed to evaluate the diagnostic accuracy of the Wells criteria for lower extremity DVT among hospitalized patients.MethodsIn this case-control study conducted at two teaching hospitals between 2017 and 2020, 240 patients with confirmed DVT were compared with 240 age- and sex-matched controls without DVT. All participants underwent standardized clinical evaluation and duplex ultrasonography within 24 h of admission. Wells scores were calculated based on predefined clinical parameters. Sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) were determined.ResultsOf 480 participants (mean age 51.9 ± 11.6 years; 54.4% female), DVT was confirmed in 240 (50%). A Wells score ≥2 classified patients as likely DVT. This threshold yielded a sensitivity of 86.3%, specificity of 70.0%, PPV of 74.2%, and NPV of 83.8%. Significant predictors included recent surgery or prolonged hospitalization (<i>p</i> < 0.001), calf swelling >3 cm (<i>p</i> < 0.001), and pitting edema confined to the symptomatic leg (<i>p</i> < 0.001).ConclusionThe Wells criteria demonstrated good sensitivity and moderate specificity for diagnosing DVT in hospitalized patients, supporting their role as an initial clinical assessment tool. However, they should not replace confirmatory testing such as ultrasonography or D-dimer assays. Larger multicenter studies are warranted to further validate these findings.</p>","PeriodicalId":94350,"journal":{"name":"Phlebology","volume":" ","pages":"2683555251409995"},"PeriodicalIF":1.5,"publicationDate":"2026-01-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145902134","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":"Treatment of anterior saphenous vein incompetence with mechanochemical endovenous ablation.","authors":"Marianne E Witte, Suzanne Holewijn, Michel M P J Reijnen, Clark J Zeebregts","doi":"10.1177/02683555251413984","DOIUrl":"https://doi.org/10.1177/02683555251413984","url":null,"abstract":"<p><p>BackgroundMechanochemical endovenous ablation (MOCA) is an established non-thermal technique for treating varicose veins of the great and small saphenous veins, GSV and SSV, with diameters under 12 mm. However, its safety and efficacy in treating anterior saphenous vein (ASV) incompetence remain unclear. This study evaluated the feasibility, safety, and effectiveness of MOCA for ASV reflux.MethodsIn this prospective single-centre registry, 30 patients with symptomatic ASV incompetence underwent MOCA using the ClariVein® system. Anatomical success, clinical improvement (VCSS), pain scores, return to normal activities, and complications were assessed at 30-days and 12-months follow-up. Procedural duration and duplex ultrasound results were also recorded.ResultsTechnical success was achieved in 93.3% (28/30) of patients. Median procedure time was 9.0 min (IQR 7.0-11.5). Median peri-procedural and postoperative pain scores were 3.0 and 1.0, respectively, and most patients resumed normal activities within 1 day. At 30 days, anatomical success was 96.3%, and median VCSS improved from 5.0 to 3.0. At 12 months, duplex ultrasound was available in 25 patients, with evaluable data in 23. Complete occlusion was observed in 82.6%, partial in 4.3%, and no occlusion in 13.0%. Minor complications occurred in 25.0%, and one deep vein thrombosis was recorded. At 1 year, the mean AVVQ score improved by 6.7 points, and RAND-36 scores showed favourable outcomes in pain (81), mental health (85), and general health (64).ConclusionMOCA with the ClariVein® system appears safe, effective, and well-tolerated for ASV incompetence. Larger studies with longer follow-up are warranted.</p>","PeriodicalId":94350,"journal":{"name":"Phlebology","volume":" ","pages":"2683555251413984"},"PeriodicalIF":1.5,"publicationDate":"2026-01-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145902186","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":"Patients with primary varicose veins have few venous valves in the proximal femoral vein and great saphenous vein: A cadaveric and ultrasound examination of living subjects.","authors":"Hiroki Mitsuoka, Chihiro Yodogawa, Takahiro Arima, Sora Wanibuchi, Munekazu Naito, Akio Kodama","doi":"10.1177/02683555251413953","DOIUrl":"https://doi.org/10.1177/02683555251413953","url":null,"abstract":"<p><p>ObjectivesThe pathogenesis of primary varicose veins (PVVs) is multifactorial and remains incompletely understood; however, venous valve dysfunction is recognized as a key factor. Previous studies have suggested racial differences in the prevalence and distribution of venous valves in the proximal femoral vein; however, no data are available for the Japanese population. This study aimed to clarify the prevalence and number of venous valves in the proximal femoral vein and great saphenous vein (GSV) in Japanese individuals and determine whether patients with PVVs have fewer venous valves than healthy individuals.MethodsA cadaveric study of 59 individuals (median age, 87 years) and an ultrasound study involving 52 healthy volunteers (median age, 26 years) and 106 patients with PVVs (median age, 72 years) were conducted. Venous valves were assessed in segments A (from the confluence of the inferior epigastric vein to the saphenofemoral junction [SFJ]) and B (GSV within 4 cm distal to the SFJ).ResultsIn cadavers and volunteers, venous valves were identified in approximately 60% of segment A and nearly all of segment B, with no significant differences between the two groups. Conversely, patients with PVVs had significantly fewer venous valves in both segments A (right, 0.22 vs 0.54, <i>p</i> < .001; left, 0.31 vs 0.56, <i>p</i> = .005) and B (right, 1.29 vs 1.50, <i>p</i> = .034; left, 1.32 vs 1.52, <i>p</i> = .028) than volunteers. In several PVVs, only the venous sinus without valve leaflets was detectable by ultrasonography.ConclusionsPatients with PVVs had significantly fewer venous valves in the proximal femoral vein and GSV than healthy subjects, suggesting that valve deficiency, possibly including congenital factors, may contribute to PVV development. This study provides the first detailed data on venous valve distribution in Japanese individuals. More studies are needed to confirm these findings and clarify clinical implications.</p>","PeriodicalId":94350,"journal":{"name":"Phlebology","volume":" ","pages":"2683555251413953"},"PeriodicalIF":1.5,"publicationDate":"2026-01-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145902100","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":"In Memoriam Olle Nelzen.","authors":"Niels Bækgaard, Marianne De Maeseneer","doi":"10.1177/02683555251413031","DOIUrl":"https://doi.org/10.1177/02683555251413031","url":null,"abstract":"","PeriodicalId":94350,"journal":{"name":"Phlebology","volume":" ","pages":"2683555251413031"},"PeriodicalIF":1.5,"publicationDate":"2026-01-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145893566","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":"High intensity focused ultrasound in small saphenous vein incompetence: a pilot feasibility study.","authors":"Paolo Casoni, Emanuele Nanni, Matteo Pizzamiglio, Daniele Bissacco","doi":"10.1177/02683555251413661","DOIUrl":"https://doi.org/10.1177/02683555251413661","url":null,"abstract":"<p><p>BackgroundThis study explores the effectiveness of High Intensity Focused Ultrasound (HIFU) in treating incompetence of the small saphenous vein (SSV).Materials and methodsPatients diagnosed with SSV incompetence received HIFU treatment. The primary outcome measured was the rate of SSV competent shrinkage or closure after 1 year.ResultsAmong the 292 legs treated with HIFU for chronic venous disease, 15 (5.1%) were for SSV incompetence. Quality of life, assessed using the CIVIQ-20, showed a significant improvement at 3 months post-treatment, decreasing from 38.9 ± 9.1 to 24.3 ± 2.0 (p < .01). The rVCSS also improved, declining from 6.5 ± 1.7 to 5.0 ± 1.0, although this change was not statistically significant (p = ns). All SSVs were closed or competent with evidence of shrinkage at 1 week, 3 months, 6 months, and 1 year following HIFU. No recurrent varicose veins were identified during the follow-up period.ConclusionThese initial findings indicate that HIFU may be an effective option for addressing SSV incompetence. Additional studies are necessary to compare this method with other treatments and to evaluate long-term results with a more robust patient cohort.</p>","PeriodicalId":94350,"journal":{"name":"Phlebology","volume":" ","pages":"2683555251413661"},"PeriodicalIF":1.5,"publicationDate":"2025-12-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145835869","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 is the recommended compression pressure for different clinical indications?","authors":"Giovanni Mosti, Jean Patrick Benigni, Alberto Caggiati","doi":"10.1177/02683555251410002","DOIUrl":"https://doi.org/10.1177/02683555251410002","url":null,"abstract":"<p><p>IntroductionCompression pressure is the key factor determining effectiveness in compression therapy for venous and lymphatic disorders. Despite its clinical importance, few studies report the actual applied pressure, and national standards for compression classes differ. This review aims to identify the optimal compression pressure at different stages of venous disease.MethodsA literature search was conducted in PubMed, Scopus, and Web of Science (January 1980-October 2025) using MeSH terms related to compression therapy and chronic venous disease, edema, thrombosis, post-thrombotic syndrome, lipedema, and lymphedema. Only English-language studies reporting compression pressure or class were included.ResultsLow pressures (10-21 mmHg) are enough to relieve symptoms in CEAP C0s-C1. For uncomplicated varicose veins (C2), 18-32 mmHg offers optimal symptom control. In venous edema (C3), pressures of 15-21 mmHg help prevent edema, while around 40 mmHg is more effective for treatment. Lipodermatosclerosis (C4) requires about 40 mmHg, and healed ulcers (C5) benefit from pressures greater than 30 mmHg to prevent recurrence, although compliance decreases with higher pressures. Active ulcers (C6) heal fastest under 40-50 mmHg, preferably with short-stretch materials or adjustable wraps. For lymphedema, effective reduction occurs at more than 50 mmHg (up to 120 mmHg briefly), while in the maintenance phase, 23-32 mmHg with flat-knit garments may be enough. Data on thrombosis, post-thrombotic syndrome, and post-procedure compression remain inconsistent.ConclusionsOptimal compression pressure depends on disease severity. Early CVD stages and lipedema benefit from a compression pressure <30 mmHg, while severe venous or lymphatic disease requires ≥40 mmHg. Standardized reporting and pressure-based recommendations are essential to improve therapeutic consistency and patient outcomes.</p>","PeriodicalId":94350,"journal":{"name":"Phlebology","volume":" ","pages":"2683555251410002"},"PeriodicalIF":1.5,"publicationDate":"2025-12-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145812589","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":"Microplastics and nanoplastics: Emerging roles in atheromas, venous, and lymphatic disorders.","authors":"Benedict R H Turner, Matti Jubouri, Alun H Davies, Mark A Sephton","doi":"10.1177/02683555251409989","DOIUrl":"https://doi.org/10.1177/02683555251409989","url":null,"abstract":"","PeriodicalId":94350,"journal":{"name":"Phlebology","volume":" ","pages":"2683555251409989"},"PeriodicalIF":1.5,"publicationDate":"2025-12-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145812628","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}