PhlebologyPub Date : 2025-01-04DOI: 10.1177/02683555241312780
Apostolos G Pitoulias, Nefeli Andrioti Petropoulou, Vangelis Bontinis, Dimitrios A Chatzelas, Alkis Bontinis, Adriana Thano, Georgios A Pitoulias
{"title":"Ultrasonography in the diagnosis of pelvic vein insufficiency, a systematic review and meta-analysis.","authors":"Apostolos G Pitoulias, Nefeli Andrioti Petropoulou, Vangelis Bontinis, Dimitrios A Chatzelas, Alkis Bontinis, Adriana Thano, Georgios A Pitoulias","doi":"10.1177/02683555241312780","DOIUrl":"https://doi.org/10.1177/02683555241312780","url":null,"abstract":"<p><strong>Objective: </strong>To perform a systematic review and meta-analysis to investigate the efficacy of ultrasonography in the diagnosis of pelvic vein insufficiency (PVI).</p><p><strong>Results: </strong>Seven studies comprised of 802 patients were included. Of these studies, 5 utilised transvaginal ultrasound (TVU), 1 utilised transabdominal ultrasound (TAU) and 1 utilised both ultrasounds as diagnostic tool .The overall pooled sensitivity and specificity was 0.96 and 0.84 respectively. The sensitivity and specificity for TVU were 0.96 and 0.86. The pooled sensitivities between studies employing a <7 mm cutoff in pelvic veins' diameter (PVD) and those employing a >7 mm threshold were 0.99 and 0.94 while the pooled specificities were 0.75 and 0.96 respectively.</p><p><strong>Conclusion: </strong>The evidence supports the efficacy of ultrasonography in the diagnosis of PVI. A threshold of up to 6 mm in PVD yielded excellent sensitivity outcomes, but it is at the expense of specificity. This meta analysis suggests that a PVD threshold of 7 mm should be employed as a cutoff point in the diagnosis of PVI, displaying both excellent sensitivity and specificity outcomes.</p>","PeriodicalId":94350,"journal":{"name":"Phlebology","volume":" ","pages":"2683555241312780"},"PeriodicalIF":0.0,"publicationDate":"2025-01-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142928969","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":"Retrospective chart review of venous thromboembolism incidence and management in rural patients undergoing varicose vein treatment.","authors":"Shivani Thakur, Kamalpreet Kaur, Sandhini Agarwal, Fatima Zabiba, Hussein Maatouk, Ahmed Zabiba, Jasmin Dominguez Cervantes, Tiffany Huang, Ahmadzaki Arjmand, Ahmadzakaria Arjmand, Keshav Kumar","doi":"10.1177/02683555241313272","DOIUrl":"https://doi.org/10.1177/02683555241313272","url":null,"abstract":"<p><strong>Purpose: </strong>Determine the rate of incidence, risk factors, and management for developing venous thromboembolism (VTE) in patients undergoing radiofrequency ablation (RFA) and ultrasound-guided foam sclerotherapy (UGFS) for varicose veins.</p><p><strong>Methods: </strong>All charts of patients undergoing venous ablation from 2016 to 2023 were reviewed at a rural vein treatment clinic. The incidence of VTE was noted and a chart review was completed to identify risk factors for VTE, EHIT score, EFIT score, and management.</p><p><strong>Results: </strong>Patients underwent 14,172 UGFS procedures and 4865 RFAs. VTE was noted in 45 patients (0.24%), with no pulmonary embolisms and no fatal outcomes among the patient population. Patients diagnosed with VTE had a median CEAP score of 3 and a modified Caprini risk score of 7.2. Increased risk of VTE was noted in patients with prior history of DVT, patients undergoing UGFS, patients with higher Caprini scores. 90% of patients diagnosed with VTE had a prior history of DVT (<i>p</i> < 0.05). Patients who received UGFS treatments had a higher modified Caprini Risk Score than patients who received an RFA and UGFS, 8.7 and 6.8 respectively (<i>p</i> < 0.05). Increased risk of VTE was noted in patients with swollen legs prior to treatment (0.92%), visible varicose veins (0.92%), obesity (0.49%), and surgery within the prior 3 months to vein treatment (0.41%).</p><p><strong>Conclusion: </strong>The modified Caprini score is a useful tool for risk stratification for VTE and its incidence is low for patients undergoing RFA and UGFS. Prior history of VTE represents a significant risk for recurrence in patients undergoing RFA and UGFS.</p>","PeriodicalId":94350,"journal":{"name":"Phlebology","volume":" ","pages":"2683555241313272"},"PeriodicalIF":0.0,"publicationDate":"2025-01-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142923670","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}
PhlebologyPub Date : 2024-12-26DOI: 10.1177/02683555241309808
Todd Cartee, Daniel P Friedmann, John Blebea, Stephen Daugherty, Satish Vayuvegula, Vineet Mishra
{"title":"Ultrasound-guided foam sclerotherapy using physician-compounded foam: Position statement from the American vein and lymphatic society.","authors":"Todd Cartee, Daniel P Friedmann, John Blebea, Stephen Daugherty, Satish Vayuvegula, Vineet Mishra","doi":"10.1177/02683555241309808","DOIUrl":"10.1177/02683555241309808","url":null,"abstract":"<p><p><b>Background:</b> Chronic venous disease has a major impact on the quality of life of millions of patients. Large randomized controlled trials have established ultrasound-guided foam sclerotherapy (UGFS) as a safe and effective treatment option for both saphenous vein insufficiency and tributary disease. Ultrasound guidance is a critical component of sclerotherapy of non-visible veins.<b>Method:</b> An expert panel of the American Vein and Lymphatic Society (AVLS) was convened to review the literature and write a Position Statement with recommendations for the use of UGFS with physician-compounded foam for patients with venous insufficiency.<b>Result:</b> Consensus recommendations from the expert panel highlight the advantages and safety of high-quality physician-compounded foam. These recommendations were reviewed, edited and approved by the Guidelines Committee of the AVLS.<b>Conclusion:</b> UGFS with in-office, physician-compounded foam is a safe primary treatment option for varicose, tributary, and truncal veins of the lower extremities and is an important adjunct therapy for tributary disease following or concomitant to endovenous ablation procedures.</p>","PeriodicalId":94350,"journal":{"name":"Phlebology","volume":" ","pages":"2683555241309808"},"PeriodicalIF":0.0,"publicationDate":"2024-12-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142901544","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}
PhlebologyPub Date : 2024-12-23DOI: 10.1177/02683555241311445
Sergey G Gavrilov, Yekaterina P Moskalenko, Valery M Kulikov, Sergey V Chubchenko, Anatoly V Karalkin
{"title":"Protocol for duplex ultrasound study of the pelvic veins in women.","authors":"Sergey G Gavrilov, Yekaterina P Moskalenko, Valery M Kulikov, Sergey V Chubchenko, Anatoly V Karalkin","doi":"10.1177/02683555241311445","DOIUrl":"https://doi.org/10.1177/02683555241311445","url":null,"abstract":"<p><p>The article presents the technique of duplex ultrasound study (DUS) of the pelvic veins in patients with pelvic venous disorders (PeVDs). It provides basics of anatomy of pelvic veins and describes hemodynamic and anatomical parameters that should be assessed during DUS of pelvic veins.</p>","PeriodicalId":94350,"journal":{"name":"Phlebology","volume":" ","pages":"2683555241311445"},"PeriodicalIF":0.0,"publicationDate":"2024-12-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142883892","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}
PhlebologyPub Date : 2024-12-21DOI: 10.1177/02683555241310749
Ömer Faruk Bucak
{"title":"Unveiling global interest in lymphedema: A decade of search data through google trends global interest in lymphedema: A google trends analysis.","authors":"Ömer Faruk Bucak","doi":"10.1177/02683555241310749","DOIUrl":"https://doi.org/10.1177/02683555241310749","url":null,"abstract":"<p><strong>Introduction: </strong>The increasing reliance on Internet search engines for health-related queries requires a thorough evaluation of the public's engagement with medical information. This study aims to analyze global trends in interest in lymphedema over the past decade using Google Trends (GT).</p><p><strong>Methods: </strong>A physiatrist with expertise in lymphedema management identified and analyzed 12 key search terms according to the International Society of Lymphology (ISL) guidelines. These terms included 'lymphedema swelling', 'lymphedema treatment', 'lymphedema stages', 'compression therapy for lymphedema', 'manual lymphatic drainage (MLD)', 'complete decongestive therapy (CDT)', 'pneumatic compression pump', 'lymphovenous anastomosis (LVA)', 'lymphedema surgery', 'liposuction for lymphedema', 'lymphedema prevention' and 'post-cancer lymphedema'. GT data was collected using filters set to 'web search', 'all categories', and 'worldwide' to provide a comprehensive overview. The analysis was conducted for two five-year intervals: 1 September 2014 to 31 August 2019 and 1 September 2019 to 31 August 2024. Relative search volume (RSV) was calculated for each term and compared to quantify changes over time.</p><p><strong>Results: </strong>Significant increases in search activity were observed for 'lymphedema swelling', 'lymphedema treatment', 'lymphedema stages', 'manual lymphatic drainage', 'lymphedema surgery', and 'post-cancer lymphedema' in the second period (<i>p</i> = 0.001 for each). The average GT score increased from 19 in 2014-2019 to 29 in 2019-2024 (<i>p</i> = 0.001), reflecting a significant increase in public awareness and interest.</p><p><strong>Conclusion: </strong>The study shows a significant increase in global public interest in lymphedema and its minimally invasive treatments over the past 5 years, suggesting a growing awareness of the condition. These findings highlight the need for improved patient education and research to meet the increasing demand for lymphedema care.</p>","PeriodicalId":94350,"journal":{"name":"Phlebology","volume":" ","pages":"2683555241310749"},"PeriodicalIF":0.0,"publicationDate":"2024-12-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142873810","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":"Correlation between popliteal vein functional diameter and the severity of chronic venous disease.","authors":"Hao Liu, Liheng Li, Wenjiang Wei, Yinghong Tang, Lina Liu, Chengjiang Xiao","doi":"10.1177/02683555241310531","DOIUrl":"https://doi.org/10.1177/02683555241310531","url":null,"abstract":"<p><strong>Objective: </strong>This study measured the diameter change of the popliteal vein under a rated pressure gradient and evaluated the relationship between popliteal vein functional diameter and severity of chronic venous disease.</p><p><strong>Methods: </strong>Ultrasound examination was performed on 173 lower limbs of 173 patients admitted from June 2023 to January 2024. The diameter of the popliteal vein was measured before and after compression with the thigh inflatable cuff. The correlation between popliteal vein functional diameter and venous clinical severity score ( VCSS ) was statistically analyzed.</p><p><strong>Results: </strong>Venous clinical severity score values ranged from 1 to 28 (median 7). The Spearman correlation analysis between venous clinical severity score and functional diameter had an rs value of -0.222, <i>p</i> (double-tailed) < .001. The correlation between VCSS and popliteal vein diameter variation index yielded rs = -0.633, <i>p</i> (double-tailed) < .001.</p><p><strong>Conclusion: </strong>This study found that popliteal vein functional diameter negatively correlated with the severity of chronic venous disease. Popliteal vein functional diameter and diameter variation index can be used as disease-specific indicators to quantify the severity of chronic venous disease. <b>(Clinicaltrials.gov Identifier: NCT06175481)</b>.</p>","PeriodicalId":94350,"journal":{"name":"Phlebology","volume":" ","pages":"2683555241310531"},"PeriodicalIF":0.0,"publicationDate":"2024-12-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142873809","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}
PhlebologyPub Date : 2024-12-19DOI: 10.1177/02683555241310358
Antonio Marsocci, Sheila Santandrea, Elena Lanfranchi, Danilo Donati, Roberto Tedeschi
{"title":"Beyond water: 3D laser scanning offers a cutting-edge alternative for upper limb volume assessment.","authors":"Antonio Marsocci, Sheila Santandrea, Elena Lanfranchi, Danilo Donati, Roberto Tedeschi","doi":"10.1177/02683555241310358","DOIUrl":"https://doi.org/10.1177/02683555241310358","url":null,"abstract":"<p><strong>Objectives: </strong>The primary aim of this study was to evaluate the reliability and efficiency of a 3D laser scanner as a tool for volumetric measurement of the upper limbs, comparing it with the gold standard method of non-reflux water displacement. The study sought to determine whether the 3D scanner could serve as a reliable and time-efficient alternative in clinical settings, particularly for managing conditions like lymphedema.</p><p><strong>Methods: </strong>A total of 30 healthy participants (18 women, 12 men) were recruited, and volumetric measurements were taken using both the 3D scanner and water displacement methods. Inter-rater and intra-rater reliability were calculated using the Intraclass Correlation Coefficient (ICC), and agreement between the methods was assessed using a Bland-Altman plot. The time required for each measurement and data processing were recorded and compared between the two methods.</p><p><strong>Results: </strong>The 3D scanner demonstrated excellent inter-rater (ICC = 0.995) and intra-rater (ICC = 0.991) reliability, surpassing the water displacement method (ICC = 0.973 and 0.968, respectively). The Bland-Altman plot showed good agreement between the two methods, with only two measurements outside the 95% confidence limits. However, the 3D scanner required significantly more time for both measurement and data processing (28.55 seconds and 120 seconds, respectively) compared to water displacement (9.64 seconds).</p><p><strong>Conclusions: </strong>The 3D scanner offers high reliability and precision for upper limb volumetric measurements, potentially improving clinical management of conditions such as lymphedema. Despite longer acquisition times, its accuracy and versatility make it a promising tool for future clinical use, especially in scenarios where precise monitoring is crucial.</p>","PeriodicalId":94350,"journal":{"name":"Phlebology","volume":" ","pages":"2683555241310358"},"PeriodicalIF":0.0,"publicationDate":"2024-12-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142866731","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}
PhlebologyPub Date : 2024-12-18DOI: 10.1177/02683555241308699
Alptekin Yasim, Erdinc Eroglu, Mehmet Acipayam, Murat Ari
{"title":"Eight year results of patients with varicose vein underwent endovenous occlusion using n-butyl cyanoacrylate.","authors":"Alptekin Yasim, Erdinc Eroglu, Mehmet Acipayam, Murat Ari","doi":"10.1177/02683555241308699","DOIUrl":"https://doi.org/10.1177/02683555241308699","url":null,"abstract":"<p><strong>Objective: </strong>To present the 8-year results of 180 patients on whom we performed endovenous occlusion using N-butyl cyanoacrylate in 2014.</p><p><strong>Methods: </strong>We have previously published the 30-month results for 168 patients available for follow-up. Thirteen more patients were lost to follow-up in the 8-year research period. The remaining 155 patients underwent clinical examinations and their Venous Clinical Severity Score (VCSS) values were recorded. Doppler ultrasonography was performed, and whether the saphenous vein was occluded, or whether partial or complete recanalization were present was evaluated.</p><p><strong>Results: </strong>The mean age of the 155 patients we were able to follow-up was 47.4 ± 11.8 years. Sixty-eight of the patients were men, and 87 were women. Mean VCSS scores were 10.2 before the procedure, 2.7 at 30 months, and 2.6 ± 0.7 at 8 years. Complete recanalization was observed in seven patients over the 8 years, and partial recanalization in six. Occlusion rates were 94.1% at 30 months and 91.7% at 8 years.</p><p><strong>Conclusion: </strong>The long-term results of the use of N-butyl cyanoacrylate in the treatment of patients with varices are highly satisfying in terms of a high ablation rate.</p>","PeriodicalId":94350,"journal":{"name":"Phlebology","volume":" ","pages":"2683555241308699"},"PeriodicalIF":0.0,"publicationDate":"2024-12-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142857473","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}
PhlebologyPub Date : 2024-12-17DOI: 10.1177/02683555241309797
Marwah Salih, Hussein Elghazaly, Sarah Salih, Sarah Onida, Alun H Davies
{"title":"A systematic review and meta-analysis assessing the impact of pentoxifylline on the healing and recurrence of venous leg ulcers.","authors":"Marwah Salih, Hussein Elghazaly, Sarah Salih, Sarah Onida, Alun H Davies","doi":"10.1177/02683555241309797","DOIUrl":"https://doi.org/10.1177/02683555241309797","url":null,"abstract":"<p><strong>Introduction: </strong>Venous leg ulcers (VLU) are the most severe manifestation of venous insufficiency and carry a poor prognosis because of delayed healing and recurrent ulceration. Pentoxifylline (PTX) is an example of a vasoactive medication that can be used alongside compression therapy to help improve ulcer healing rates. A previous review highlighted improved healing of VLU with PTX, although no analysis was made for complete ulcer healing and recurrence following treatment.</p><p><strong>Methods: </strong>A systematic review was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. The EMBASE, MEDLINE and Cochrane databases were searched for all relevant English-language human studies between January 1980 and August 2023. Two independent authors screened and reviewed all articles for inclusion, performed data extraction and assessed methodological quality according to Cochrane's risk of bias tool. Primary outcomes included complete ulcer healing and recurrence rates in the ipsilateral limb.</p><p><strong>Results: </strong>Ten studies were eligible for analysis, of which nine were randomised trials and one was an observational cohort study. There were a total of 1,025 participants, with 515 having received PTX. In those receiving 1200 mg PTX, venous leg ulcers healed in 62% (315 participants). Compared to controls, PTX administration was associated with a significantly higher likelihood of complete ulcer healing (OR 2.56, 95% CI 1.97-3.32, <i>p</i> < .001). The rate and time of ulcer recurrence were not recorded in any of the studies included.</p><p><strong>Conclusion: </strong>The evidence demonstrates that PTX may have a significant beneficial impact on the rate of complete ulcer healing. Little evidence is currently present in the literature evaluating the recurrence rates of ulcers following PTX treatment. Large scale, high quality RCTs with an adequate follow-up period are needed to evaluate this and assess whether treatment with PTX shows a significant benefit in prevention of recurrence in venous ulcers.</p>","PeriodicalId":94350,"journal":{"name":"Phlebology","volume":" ","pages":"2683555241309797"},"PeriodicalIF":0.0,"publicationDate":"2024-12-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142848786","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}