Phlebology最新文献

{"title":"Comparing anesthesia protocols in high intensity focused ultrasound treatments: The HIFU-pain study.","authors":"Paolo Casoni, Emanuele Nanni, Matteo Pizzamiglio, Daniele Bissacco","doi":"10.1177/02683555241308044","DOIUrl":"10.1177/02683555241308044","url":null,"abstract":"<p><p>Backgroundto compare different anesthesia protocols during High Intensity Focused Ultrasound (HIFU) for saphenous trunk (GSV/SSV) and/or varicosities incompetence treatment.Material and methodspatients with GSV/SSV incompetence with varicose veins underwent HIFU under different anesthesia protocols. The primary endpoint was the pain score during HIFU using a 10-point scale.ResultsOut of 262 legs analyzed, main pain score was 1.03 ± 1.27. Intradermal + oral anesthesia treatments resulted in less procedural pain if compared with intradermal ± perivenous protocols (1.30 ± 0.19 vs 0.81 ± 0.09; <i>p</i> = .001). Conversely, perivenous injection decrease early complete recanalization rate.ConclusionThese preliminary results suggest that HIFU is an almost pain-free procedure. Procedural pain could be further minimized by using specific intradermal + oral anesthesia treatments, despite perivenous anesthetic could improve postoperative outcomes.</p>","PeriodicalId":94350,"journal":{"name":"Phlebology","volume":" ","pages":"358-364"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142820497","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 pattern of the distribution of incompetent segments within the great saphenous vein at C2 lower extremity: A report conforming to the 2024 IAC standards and guidelines.","authors":"Ki-Pyo Hong, Hyo-Hyun Kim, Do-Kyun Kim","doi":"10.1177/02683555241308043","DOIUrl":"10.1177/02683555241308043","url":null,"abstract":"<p><p>ObjectivesTo analyze the distribution of incompetent segments in the great saphenous vein (GSV) in Clinical, Etiological, Anatomical, Pathophysiological (CEAP) classification C2 limbs to provide a reference for appropriate diagnosis and treatment planning.MethodsWe analyzed the distributions of incompetent segments in the GSVs of the C2 lower extremity undergoing duplex ultrasound from September 2017 to December 2023. The examined segments were the saphenofemoral junction (SFJ), GSV at the proximal thigh, GSV at the knee, and GSV below the knee.ResultsA total of 696 lower limbs from 540 patients (male 256, female 440) was analyzed. The mean age was 56 (ranging from 18 to 86), and the mean body mass index (BMI) was 24.0 kg/m². There were 15 types of distribution of incompetent segments within the GSV, with the most common type (32.6%) being reflux from the SFJ to the GSV below the knee. Among the lower limbs with reflux at the SFJ, GSV at the proximal thigh or knee was competent in 10% of lower limbs. In the lower limbs with reflux at the proximal thigh GSV, 26% did not have reflux at the SFJ. The presence of reflux in each segment did not differ by sex, but those with reflux in the below-knee segment were older than those without reflux(<i>p</i> = .003). In each of the three segments above the knee, limbs with reflux had a higher BMI than those without reflux.ConclusionsThe most common distribution type was reflux from the SFJ to the below-knee segment, although this only accounted for about one-third of the cases. Various distribution types of incompetent segments within the GSV were identified, suggesting that reflux testing in multiple segments according to the latest guidelines for ultrasound examination of the lower extremity veins is necessary to avoid unnecessary treatment of segments without reflux.</p>","PeriodicalId":94350,"journal":{"name":"Phlebology","volume":" ","pages":"353-357"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142804220","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 diverse technical choices during the implantation of the totally implantable venous access ports: A review.","authors":"Jingjin Wu, Li Zhang, Xiaojian Jia, Yunchuan Mu, Caiyou Ding, Yanbo Lou","doi":"10.1177/02683555241307760","DOIUrl":"10.1177/02683555241307760","url":null,"abstract":"<p><p>Although the implantation of the totally implantable venous access ports globally is increasingly sophisticated, there is still a dearth of absolute standardization in the technical choice of each surgical step, with numerous technologies demonstrating significant applicability. This review comprehensively summarizes the diverse choices of implantation procedural techniques related to the pocket location, vein access, port specification, catheterization method, puncture guidance, single-incision technique, catheter tip positioning method, port fixation, skin closure, and first-use period. The aim is to provide surgeons with alternative options when they encounter different problems in each procedure due to the diverse clinical characteristics of patients during venous port implantation.</p>","PeriodicalId":94350,"journal":{"name":"Phlebology","volume":" ","pages":"300-313"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142831610","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":"Sub-ulcer foam sclerotherapy in patients with venous ulceration: A randomized controlled trial.","authors":"Toni Pihlaja, Pasi Ohtonen, Pekka Romsi, Matti Pokela","doi":"10.1177/02683555241304030","DOIUrl":"10.1177/02683555241304030","url":null,"abstract":"<p><p>PurposeThis trial analyzed the effect of sub-ulcer foam sclerotherapy in patients with venous leg ulcer (VLU).DesignRandomized controlled trial.MethodsThis trial recruited patients with VLUs to receive either sub-ulcer foam sclerotherapy and compression therapy (study group) or compression therapy only (control group). The primary outcome of this study was the change in the venous ulcer area at 4 weeks. The feasibility, safety, and complications of the sub-ulcer foam sclerotherapy were recorded.ResultsOf 23 patients included, 12 were randomized to study group and 11 to control group. Preoperatively, the average ulcer areas were 5.8 cm² in both groups. At 4 weeks, the average reductions in ulcer areas were 4.0 cm² (SD 3.1) in the study group (95% CI 2.0 to 5.9, <i>p</i> = .001) and 2.0 cm² (SD 3.1) in the control group (95% CI: -0.1 to 4.1, <i>p</i> = .051). No differences in complications were recorded.ConclusionsAt 1-month sub-ulcer foam sclerotherapy and compression therapy reduced the ulcer area statistically significantly, whereas compression therapy alone did not. Sub-ulcer foam sclerotherapy could be a good addition to superficial venous insufficiency treatment in patients with VLU.ClinicalTrials.gov identifier NCT03795064.</p>","PeriodicalId":94350,"journal":{"name":"Phlebology","volume":" ","pages":"324-329"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142735472","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":"Endovenous treatment for varicose veins of the lower limbs: Comparative histological evaluation of different techniques.","authors":"Luca Palombi, Alberto Caggiati, Pier Giovanni Bianchi, Monica Morelli, Fabio Martinelli, Elisabetta Merenda","doi":"10.1177/02683555241304572","DOIUrl":"10.1177/02683555241304572","url":null,"abstract":"<p><p>BackgroundIn recent years, tumescent ablative techniques have been joined by non-tumescent ablative techniques. The aim of the research is to study and compare the effects produced by the different endovascular ablative techniques, from the histological point of view, at the level of the venous wall (endothelium, tunica media and adventitia).MethodThe study involves the use of three ablative endovascular techniques (EVLA, MOCA, CGO) on bench for the treatment of the great saphenous vein. The bench procedure was performed in the same way as described in the instructions for use (IFU) of the technical specifications. Tissue samples were formalin-fixed and paraffin-embedded (FFPE). They were stained with hematoxylin and eosin and, in a case, with anti-ERG antibody (MA5-26,245, Termo Fisher).ResultNo perivascular tissue was present. No hematoma or perforation of the vein wall was observed. Histopathological changes after EVLA indicated that the intima including the endothelium and sub-endothelium was completely necrotized. It was observed that the thermal-energy-induced injury in the intima did not reach deeper than the media. Overview shows that in this case the damage is homogenously spread along the entire perimeter. The most evident change in the sample treated with mechanical-chemical ablation (MOCA) technique was the endothelial damage with loss of endothelial cells. Specifically, with the ERG immunostaining it was possible to observe the presence of numerous nuclei exposed towards the lumen of the vein. In the sample treated with cyanoacrylate (CGO), no significant structural alterations were observed. However, an almost complete collapse of the endoluminal walls and the presence of cyanoacrylate residues were observed.ConclusionDifferent histological patterns characterize the individual treatments. However, all techniques have a common feature: the damage is not transmural and the three different layers of the venous walls are always recognizable.</p>","PeriodicalId":94350,"journal":{"name":"Phlebology","volume":" ","pages":"330-338"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142776096","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":"Review of the literature on the use of contrast-enhanced ultrasound (CEUS) in vascular malformations.","authors":"A Achiti, C Seinturier, S Blaise","doi":"10.1177/02683555241308317","DOIUrl":"10.1177/02683555241308317","url":null,"abstract":"<p><p>IntroductionVascular malformations (VascM) are difficult to diagnose and manage because of their heterogeneous presentations. Ultrasound represents the first imaging exam for patients with vascular malformations. In some cases, additional and sometimes functional imaging will be necessary to confirm the diagnosis or to highlight a vascular network of drainage. Doppler ultrasound could be not enough and a certain number of complementary examinations are then required. Contrast-enhanced ultrasound (CEUS) is used in current practice in the vascular field and in particular the monitoring of aortic stents.MethodWe present here the interest of using CEUS in VascM through a review of the literature. The search was carried out from Pubmed from 1975 to 2023 using the following keywords « vascular malformation » and « contrast enhanced ultrasound » / « venous malformation\" and \"contrast enhanced ultrasound\"/ \"venous malformation and contrast enhanced ultrasound\".ResultsThe first search found 887 articles. Among them, 124 articles were retained after the selection of the formats. After reading the abstracts, only 9 articles were retained due to the non-selection of articles dealing with other explorations or irrelevance, as they did not deal with vascular malformation. At the end, 17 articles were selected.Discussion and conclusionCEUS allows very usefull dynamic analysis of the perfusion in the diagnosis of VascM . CEUS with time analysis is a promising imaging method for the evaluation of perfusion before and after percutaneous treatment of vascular malformations. Area under the curve reduction indicates therapy-induced changes in perfusion. Nevertheless, CEUS is not yet a standardized test for diagnosing or characterizing peripheral vascular malformations. However, its safety allows it to be used for the diagnosis and even the follow up of the VascM. Unfortunately, we haven't been able to find any randomized studies comparing CESU with other techniques.</p>","PeriodicalId":94350,"journal":{"name":"Phlebology","volume":" ","pages":"314-323"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142831606","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":"A long-term follow-up study of the changes in localized intravascular coagulation-related indexes after sclerotherapy of venous malformation.","authors":"Miao Zheng, Hai-Yan Zhong, Yi-Ran Sun, Ming-Li Zou, Yong-Pei Chen, Si-Ming Yuan","doi":"10.1177/02683555241308086","DOIUrl":"10.1177/02683555241308086","url":null,"abstract":"<p><p>ObjectiveLocalized intravascular coagulation (LIC) is a unique phenomenon associated with venous malformations (VMs). This study investigated the changes in LIC related indexes following sclerotherapy of VMs and its correlation with therapeutic efficacy.MethodsFrom August 2019 to September 2023, patients who met the following criteria were enrolled into this study: (1) individuals with venous malformations accompanied by LIC; (2) those who had undergone a minimum of three sclerotherapy sessions; (3) blood coagulation function tests were conducted prior to each treatment; and (4) magnetic resonance imaging (MRI) scans were conducted both before and after three times of treatment. Those who fail to meet with the previous inclusion criteria were excluded. The coagulation profile prior to each sclerotherapy treatments was assessed. The therapeutic outcomes were evaluated at the end of treatment.ResultsA total of 21 patients were enrolled into the study, with the age ranging from 4 to 61 years old. Elevated D-dimer levels, with or without a decrease in fibrinogen (FIB) and an increase in fibrin degradation products (FDP) are clinical features of VMs with LIC. The coagulation indexes tend to settle down with several sclerotherapy treatments. There were 5 cases in the significantly improved group, 13 cases in the improved group, and 3 cases in the no improved group when it came to efficacy assessment. The better therapeutic efficacy is more pronounced the improvement of LIC.ConclusionsLIC gradually returns to normal during sclerotherapy, and the degree of recovery is directly related to the treatment's efficacy. One useful metric to evaluate the effectiveness of sclerotherapy for VMs is the improvement of LIC.</p>","PeriodicalId":94350,"journal":{"name":"Phlebology","volume":" ","pages":"345-352"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142808969","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":"Early experience managing intravascular coagulum using polidocanol endovenous microfoam: Risk factor analysis.","authors":"Mariam Mesa-Damiano, Francisco J Melesio, Jailenne I Quiñones-Rodriguez, Rafael D Malgor, Limael E Rodriguez","doi":"10.1177/02683555241308074","DOIUrl":"10.1177/02683555241308074","url":null,"abstract":"<p><p>ObjectiveA single-center retrospective cohort study was conducted to identify potential risk factors that lead to increased incidence of intravascular coagulum (IC) observed in clinical practice using polidocanol endovenous microfoam (PEM 1%, Varithena^TM [polidocanol injectable microfoam], Boston Scientific, Marlborough, Mass).MethodsPatients (<i>n</i> = 119) who received polidocanol endovenous microfoam (PEM) treatment for chronic venous insufficiency between December 2021 and January 2024 at a private outpatient vascular surgery clinic were observed to identify potential risk factors in the development of IC. The patients were stratified into two groups: IC (<i>n</i> = 16) versus non-IC (<i>n</i> = 103). Patients who returned with increased pain and irritation at the treatment site in the early post ablation period within 2-6 weeks of treatment and had coagulum aspirated at the subsequent follow-up visit met the study criteria and were included in the IC group. In addition, patient demographics, comorbidities, and duplex ultrasound reports were analyzed using deidentified chart records.ResultsThere were 119 patients treated in the study period with a mean age of 62 years. Females were the most common sex 66% (<i>n</i> = 78) and Latinos represented the largest ethnicity 60% (<i>n</i> = 71). Overall, 13% (<i>n</i> = 16) of the patients developed an intravascular coagulum. The mean time to onset of IC was 45 days (range: 7-106 days) post-ablation. There was no difference between the groups (IC vs non-IC) for age, sex, ethnicity, or index VCSS scores. On univariate analysis, patients who developed IC had lower PEM injection volumes when compared to non-IC patients (4.1 vs 6.3 mL, <i>p</i> = .04). High reflux at the GSV (>1800 ms) and Latino ethnicity were also found to be significant risk factors. When these factors were evaluated in multivariate analysis, lower PEM injection volumes was the only factor that remained significant for the development of IC (<i>p</i> = .006).ConclusionLower polidocanol endovenous microfoam injection volumes is a risk factor for developing intravascular coagulum. Further studies are needed to identify the ideal injection volume per segment of vein treated.</p>","PeriodicalId":94350,"journal":{"name":"Phlebology","volume":" ","pages":"365-370"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142840721","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":"Does ablation of non-incompetent veins in the leg reduce recurrence?","authors":"Jessica Bowie, Marwah Salih, Sarah Onida, Alun H Davies","doi":"10.1177/02683555251347050","DOIUrl":"https://doi.org/10.1177/02683555251347050","url":null,"abstract":"","PeriodicalId":94350,"journal":{"name":"Phlebology","volume":" ","pages":"2683555251347050"},"PeriodicalIF":0.0,"publicationDate":"2025-05-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144176267","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":"Bibliometric analysis of ultrasonographic research on deep vein thrombosis.","authors":"Hui Qin, Jing Zhou, Yue Zhang, Pan Hu, Ying Sun","doi":"10.1177/02683555251345066","DOIUrl":"https://doi.org/10.1177/02683555251345066","url":null,"abstract":"<p><p>BackgroundDeep vein thrombosis (DVT) is a significant health concern, early diagnosis and treatment are essential for reducing morbidity and mortality. Over recent years, ultrasound has become the preferred diagnostic tool for DVT due to its non-invasive nature, real-time imaging capability, and high accuracy. This study aims to assess the state of ultrasound-based DVT research through bibliometric analysis.MethodsA bibliometric analysis was conducted on publications related to ultrasonographic research in DVT between 1995 and 2024. Data were retrieved from the Web of Science Core Collection using specific search terms. The analysis employed tools such as VOSviewer, R-bibliometrix, and CiteSpace to assess publication trends, country and institutional contributions, collaboration networks, and emerging research topics.ResultsA total of 10,669 publications were identified, with an annual growth rate of 12.61%. The USA had the highest number of publications (2689), and Harvard University was the most productive institution with 470 publications. The most prolific author was Gary S. Mintz (96). The leading journal in the field was the <i>Journal of Vascular Surgery</i>, with 261 publications. Keyword analysis identified \"thrombosis,\" \"ultrasound,\" and \"diagnosis\" as central themes. The frequency of these keywords indicates that the research primarily focuses on various aspects of thrombosis formation mechanisms, diagnosis, management, prevention, and treatment.ConclusionThis bibliometric study provides a comprehensive overview of the growing field of ultrasound-based DVT research, highlighting key contributions from leading countries and institutions. The continued advancement of imaging technologies and a focus on personalized treatments are expected to drive future research.</p>","PeriodicalId":94350,"journal":{"name":"Phlebology","volume":" ","pages":"2683555251345066"},"PeriodicalIF":0.0,"publicationDate":"2025-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144121922","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}