Phlebology最新文献

{"title":"Complication rate with the 1940-nm versus 1470-nm wavelength laser.","authors":"Hak Hong Keo, Karoline Gondek, Nicolas Diehm, Christoph Leib, Heiko Uthoff, Rolf P Engelberger, Daniel Staub","doi":"10.1177/02683555241301192","DOIUrl":"https://doi.org/10.1177/02683555241301192","url":null,"abstract":"<p><strong>Background: </strong>We hypothesized, that endovenous laser ablation (EVLA) with the highly water specific 1940-nm wavelength laser would reduce ablation-related thrombus extension (ARTE) incidence compared to the less specific 1470-nm laser.</p><p><strong>Materials and methods: </strong>Between February 2017 to March 2023 we identified a consecutive series of patients undergoing EVLA from the prospectively ongoing VEINOVA registry. Patients were treated with the 1940-nm or 1470-nm laser. Demographic data and outcome data were used for this retrospective analysis.</p><p><strong>Results: </strong>From a total of 3055 EVLA, 2006 procedures were performed with the1470-nm and 1049 with the 1940-nm laser. At 2-6 days follow- up visit (follow up visit 1), all ARTE occurred in 18 (0.9%) of all procedures with the 1470-nm and in 1 (0.1%) with the 1940-nm laser (<i>p</i> = 0.023). DVT was similar in both groups (0.3% vs 0.2%, <i>p</i> = 0.784). Phlebitis occurred in 67 (3.3%) of all procedures with the 1470-nm and in 2 (0.2%; <i>p</i> = 0.003) with the 1940-nm laser and paresthesia in 99 (4.9%) versus 5 (0.5%; <i>p</i> < 0.001), respectively. At 5-6 weeks follow-up (follow up visit 2), all ARTE occurred in 27 (1.4%) of all procedures with the 1470-nm and in 4 (0.4%; <i>p</i> = 0.010) with the 1940-nm laser. DVT was similar in both groups (0.7% vs 0.4%; <i>p</i> = 0.846). Phlebitis occurred in 97 (4.8%) of all procedures with the 1470-nm and in 9 (0.9%; <i>p</i> < 0.001) with the 1940-nm laser and paresthesia in 194 (9.7%) versus 35 (3.3%; <i>p</i> < 0.001), respectively. Occlusion rate was in both groups similar (99.8% vs 99.6%).</p><p><strong>Conclusion: </strong>EVLA using the 1940-nm laser appears to be safe with lower ARTE incidence than using the 1470-nm laser. Phlebitis and paresthesia occurred less frequent with the 1940-nm than with the 1470-nm laser, thus favoring the use of the 1940-nm laser.</p>","PeriodicalId":94350,"journal":{"name":"Phlebology","volume":" ","pages":"2683555241301192"},"PeriodicalIF":0.0,"publicationDate":"2024-11-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142635707","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":"Will a patient information brochure increase acceptance of Omani women with varicose veins to be examined by a male surgeon ?- A prospective randomized single blinded study.","authors":"Ghaitha Al Mahruqi, Mouzan Al Ghaithi, Edwin Stephen, Hanan Al Mawaali, Ibrahim Abdelhedy","doi":"10.1177/02683555241299679","DOIUrl":"https://doi.org/10.1177/02683555241299679","url":null,"abstract":"<p><p>Varicose veins are not uncommon among Omani women. As currently there are no female vascular surgeons, it has been noticed in our outpatient clinic that a number of them are reluctant to be examined by a male vascular surgeon, have a duplex ultrasound done and therefore a management plan cannot be made in this subset. This study is a first of its kind in Oman, looking at the impact of a patient information booklet about varicose veins etiology, symptoms, signs, assessment and management, on the attitude of a female patient's acceptance towards examination by a male surgeon in the presence of a chaperone.</p>","PeriodicalId":94350,"journal":{"name":"Phlebology","volume":" ","pages":"2683555241299679"},"PeriodicalIF":0.0,"publicationDate":"2024-11-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142635709","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":"Thermal imaging as a diagnostic tool for superficial venous insufficiency - a systematic review.","authors":"Marwah Salih, Sarah Salih, Benedict R H Turner, Sarah Onida, Alun H Davies","doi":"10.1177/02683555241301194","DOIUrl":"https://doi.org/10.1177/02683555241301194","url":null,"abstract":"<p><strong>Objectives: </strong>Evaluation of the literature assessing the use of thermography, a non-invasive imaging modality that detects pathological temperature variation, in recognising superficial venous insufficiency (SVI).</p><p><strong>Methods: </strong>A systematic review was conducted according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Articles were screened by two individuals and data was subsequently extracted. Methodological quality was assessed with Cochrane's risk of bias tool.</p><p><strong>Results: </strong>Four studies comprising 363 patients were included. Three studies identified increased temperature uptake in veins with incompetent valves on venous duplex (<i>p</i> < .05). One study reported sensitivity and specificity of thermal imaging in SVI as 98.30% (95% CI, 95.2%-99.4%) and 100% (95% CI 85.7%-100%) respectively.</p><p><strong>Conclusion: </strong>Thermal imaging could act as a screening tool in SVI. This review highlights a lack of high-quality prospective studies evaluating the role of thermal imaging as a diagnostic tool that could expedite the assessment of patients.</p>","PeriodicalId":94350,"journal":{"name":"Phlebology","volume":" ","pages":"2683555241301194"},"PeriodicalIF":0.0,"publicationDate":"2024-11-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142635708","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":"Prevalence and risk factors of hospital acquired venous thromboembolism.","authors":"Hai-Lei Li, He Zhang, Yiu Che Chan, Stephen W Cheng","doi":"10.1177/02683555241297566","DOIUrl":"https://doi.org/10.1177/02683555241297566","url":null,"abstract":"<p><strong>Objectives: </strong>To investigate the prevalence, clinical characteristics and risk factors of hospital acquired venous thromboembolism (HA-VTE) in a Chinese Hospital.</p><p><strong>Methods: </strong>Retrospective analysis of patients diagnosed as HA-VTE in a single institution from January 2016 to December 2022 was performed. Patients with VTE prior to admission or within 48 h after admission were excluded. Demographic data of patients was retrieved from the electronic medical database, and parameters affecting the occurrence of HA-VTE were analyzed.</p><p><strong>Results: </strong>4,022 patients from 321,997 episodes of medical admissions were diagnosed as VTE. Among these, 952 (23.7%) fulfilled the criteria of HA-VTE, corresponding to an incidence of 0.296%. 76% of patients presented with HA-deep vein thrombosis (DVT) alone, 13% presented with isolated HA-pulmonary embolism (PE), and 11% presented with concomitant HA- DVT and PE. Risk factor analyses showed statistically higher incidence in patients with elder age (67.5 ± 15.5 vs 48.3 ± 17.2 years, <i>p</i> < .001), male gender (0.346% vs 0.262%, <i>p</i> < .001), malignancy (0.513% vs 0.252%, <i>p</i> < .001), trauma (0.659% vs 0.28%, <i>p</i> < .001), emergency admission (0.664% vs 0.186%, <i>p</i> < .001), ICU stay (2.981% vs 0.226%, <i>p</i> < .001), and patients undergoing major surgery (0.702% vs 0.176%, <i>p</i> < .001). Patients with HA-VTE had longer hospital stay (22.5 ± 26.6 vs 7.21 ± 9.23 days, <i>p</i> < .001) and higher mortality rate (8.51% vs 1.01%, <i>p</i> < .001). The crude incidence rate of HA-VTE increased annually from 0.75 per 1,000 patients in 2016 to 5.89 per 1,000 patients in 2022. The subspecialties with the highest incidence rate of HA-VTE were cardiovascular surgery (1.40%), neurosurgery (1.10%), and respiratory medicine (0.72%).</p><p><strong>Conclusion: </strong>This is one of the few large scale studies to show that HA-VTE, accounting for nearly one quarter of all VTE events, occurs in 0.296% of adult hospitalizations. Patients with elder age, malignancy, ICU stay, and undergoing major surgery require more intensive HA-VTE surveillance and prevention.</p>","PeriodicalId":94350,"journal":{"name":"Phlebology","volume":" ","pages":"2683555241297566"},"PeriodicalIF":0.0,"publicationDate":"2024-11-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142585120","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 disease progression in western Europe (VENPRO): A prospective cohort study.","authors":"Daniel Westby, Mahtab Nezafat, Katherine McKnight, Megan Power Foley, Tayyaub Mansoor, Ahmmad Alfaith, Aoife Lowery, Stewart R Walsh","doi":"10.1177/02683555241298028","DOIUrl":"https://doi.org/10.1177/02683555241298028","url":null,"abstract":"<p><p><b>Objective:</b> A prospective cohort study aimed to determine factors which influence the progression of chronic venous disease (CVD) in an attempt to aid in the early identification of those at patients who are likely to benefit from early intervention.<b>Methods:</b> A prospective cohort study of patients referred to tertiary vascular services with varicose veins over 7 years was conducted. The primary outcome measure was the rate of disease progression from time of referral to time of consultation. The secondary outcome measure was to the rate of venous complications during the same time period.<b>Results:</b> 1000 patients from routine varicose vein waiting lists were included in the study. The mean waiting time was 2.96 ± 1.25 years. The majority of patients were female (73% versus 27%), and the average age was 57.8 ± 14.7 years. One fifth of the cohort developed a complication or showed evidence of disease progression. Logistic regression showed that advancing age and previous episodes of cellulitis are significant risk factors for the development of CVD progression.<b>Conclusions:</b> Varicose veins are more than a cosmetic issue and can be associated with substantial health and economic costs. Continuous identification of risk factors will enable clinicians to implement treatment strategies earlier for at risk patients.</p>","PeriodicalId":94350,"journal":{"name":"Phlebology","volume":" ","pages":"2683555241298028"},"PeriodicalIF":0.0,"publicationDate":"2024-11-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142585130","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":"Action of high intensity focused ultrasound (HIFU) ablation on the venous wall: Histopathological analysis, insights, and perspectives.","authors":"Paolo Casoni, Daniele Bissacco, Matteo Pizzamiglio, Emanuele Nanni, Luigi Serra","doi":"10.1177/02683555241297215","DOIUrl":"https://doi.org/10.1177/02683555241297215","url":null,"abstract":"<p><p>In the medical field, ultrasound is commonly used for diagnostic imaging due to its ability to provide real-time images. However, High-Intensity Focused Ultrasound (HIFU) is also used for other clinical purposes, such as thermal tissue ablation. In the case of varicose veins, the potential role and benefits of HIFU have been known for a long time despite in-vivo results have mostly been preliminary and experimental, particularly regarding its effect on venous wall. The aim of this brief report is to describe how HIFU acts on venous wall in human incompetent great saphenous veins.</p>","PeriodicalId":94350,"journal":{"name":"Phlebology","volume":" ","pages":"2683555241297215"},"PeriodicalIF":0.0,"publicationDate":"2024-10-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142549938","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":"An open label, single-centric, post market clinical study to evaluate the safety and efficacy of a new antimicrobial wound dressing (VELVERT) as an adjuvant therapy in the treatment of venous leg ulcer.","authors":"Sudhir Kumar, Suvash Sahu, Shivam Sharma","doi":"10.1177/02683555241288729","DOIUrl":"https://doi.org/10.1177/02683555241288729","url":null,"abstract":"<p><strong>Objectives: </strong>An open label, single-centric, post market clinical study was undertaken to evaluate the safety and efficacy of a new antimicrobial wound dressing (VELVERT) as an adjuvant therapy in the treatment of venous leg ulcer (VLU).</p><p><strong>Methods: </strong>Patients with VLU of grade C-5 according to CEAP classification and above were evaluated using doppler ultra sound. The efficacy of new antimicrobial wound dressing (VELVERT) was assessed in terms of wound area reduction within a time frame of 60 days and surgeon questioners. Patients were evaluated for VELVERT safety and pain level on a scale of 0-10 Numeric Pain Chart. Presence of micro-organism load was monitored at regular time interval.</p><p><strong>Results: </strong>VELVERT treatment was effective as 71.43% reduction in the ulcer area was observed. After 60 days, a total of 9 (45%) patients had complete ulcer closure. A remarkable decrease in the severity of pain was observed with 11 (55%) patients expressing no pain at the EOT. Swab test showed negative result for micro-organism growth. No serious adverse events were observed during the trial.</p><p><strong>Conclusion: </strong>The data indicates that VELVERT is an effective treatment for VLUs and showed the potential in the wound care of VLUs.</p>","PeriodicalId":94350,"journal":{"name":"Phlebology","volume":" ","pages":"2683555241288729"},"PeriodicalIF":0.0,"publicationDate":"2024-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142396560","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":"Improvement of quality of life in women ≤ 25-years-old with chronic pelvic pain following stenting of nonthrombotic iliac vein compression.","authors":"Elizabeth Brooke Spencer, Ariana Schuelke, Kyra Porter, Jacqueline Nelson, Elisabeth S Horne","doi":"10.1177/02683555241287312","DOIUrl":"10.1177/02683555241287312","url":null,"abstract":"<p><strong>Objectives: </strong>Stenting of nonthrombotic iliac vein compression for chronic pelvic pain (CPP) is controversial, especially in young populations. The current study evaluated the effects of iliac vein stenting on CPP through the assessment of quality-of-life (QoL) and pain scores in female patients ≤25-year-old.</p><p><strong>Methods: </strong>A retrospective single site cohort study was conducted for 30 female patients who were treated with left common iliac vein (LCIV) stenting for CPP. QoL was assessed before and after stenting using the following assessments: International Pelvic Pain Society (IPPS), Pelvic Congestion Syndrome (PCS), Pelvic Pain and Urinary Urgency Frequency (PUF), Rome III IBS, ancillary symptoms assessment, and pain scores. Secondary evaluation of the accuracy of radiologic interpretations of iliac vein compression on CT and MRI was also performed. Finally, commonly associated comorbidities within this population were assessed.</p><p><strong>Results: </strong>Patient reported outcomes in 30 iliac vein stent patients demonstrated improvements in QoL post-stenting as demonstrated through significant reductions in IPPS, PCS, and pain scores (<i>p</i> = .0103, .0156, and .0092, respectively). Many of the cross-sectional imaging studies that were read by the interpreting radiologist as normal or mild compression were later identified as moderate or severe by the interventional radiologist clinically evaluating the patient. These patients went on to show significant compression on venography and intravascular ultrasound with associated clinical improvement after stenting.</p><p><strong>Conclusion: </strong>Significant improvements in QoL were identified in young women with CPP after LCIV stenting. Similarities in the clinical presentation of common comorbidities and misinterpretation of cross-sectional imaging studies may make the identification of pelvic venous disease more challenging. Our findings endorse the need for further research on stenting in young women with venous origin CPP through comparative outcomes studies and blinded randomized controlled trials.</p>","PeriodicalId":94350,"journal":{"name":"Phlebology","volume":" ","pages":"2683555241287312"},"PeriodicalIF":0.0,"publicationDate":"2024-10-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142378771","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":"Effectiveness and safety of detachable fibered coils as a single therapy for embolization in venous origin chronic pelvic pain.","authors":"Rubén Rodríguez Carvajal, Pablo E Bretos-Azcona, Rocío Láinez Rube, María Teresa Hernández Carbonell, Ana Margarita Ruales Romero","doi":"10.1177/02683555241288725","DOIUrl":"https://doi.org/10.1177/02683555241288725","url":null,"abstract":"<p><strong>Objectives: </strong>To investigate the effectiveness and safety of endovascular treatment by embolization with detachable fibered coils of insufficient pelvic veins, as the primary cause of Venous Origin Chronic Pelvic Pain (VOCPP).</p><p><strong>Methods: </strong>This observational, retrospective study analyzes data from the PELVIC registry from 2014 to 2022. Sociodemographic, diagnostic, preoperative, intraoperative, and postoperative follow-up variables were reported.</p><p><strong>Results: </strong>A total of 255 patients were included, with follow-up periods up to 5 years. The study's effectiveness was significant with a 60% decrease in pelvic pain at the first follow-up after treatment measured by a Visual Analogue Scale (<i>p</i> = 0.001). There were also decreases in the severity levels of dyspareunia (<i>p</i> = 0.03), dysmenorrhea (<i>p</i> = 0.12) and presence of Pelvic Venous Disorders symptoms in general (-43.8%; <i>p</i> = 0.001). No major adverse events were recorded. Only 5 patients (2%) experimented technical issues in coil implantation, all of them solved in situ.</p><p><strong>Conclusion: </strong>The treatment of VOCPP by embolization with detachable fibered coils has proven to be an effective and safe option for insufficient pelvic veins.</p>","PeriodicalId":94350,"journal":{"name":"Phlebology","volume":" ","pages":"2683555241288725"},"PeriodicalIF":0.0,"publicationDate":"2024-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142368147","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":"Challenging conventions: Reconsidering the indication for endovenous ablation in CEAP 2 patients.","authors":"Hakan Guven, Temmuz Taner, Mustafa Selcuk Atasoy","doi":"10.1177/02683555241260542","DOIUrl":"10.1177/02683555241260542","url":null,"abstract":"<p><strong>Introduction: </strong>Endovenous ablation may not always be necessary for every patient with chronic venous insufficiency who has an indication for endovenous ablation. This study investigates whether compression stockings and Daflon^® can be as effective for some patients with CEAP two in chronic venous insufficiency.</p><p><strong>Methods: </strong>In this study, 137 patients who had endovenous ablation indication received plethysmographical hemodynamic tests and were divided into two groups. Group 1 had normal venous hemodynamics and received compression stockings and Daflon^®. Group 2 had abnormal function and received laser ablation. All patients were reevaluated after 6 months.</p><p><strong>Results: </strong>The study showed that there was no statistically significant difference between Groups 1 and 2 in the 6th month measurements after the treatments.</p><p><strong>Conclusion: </strong>As a result, we do not find it appropriate and do not recommend that every patient with complaints of chronic venous insufficiency and an indication for endovenous ablation undergo ablation without evaluating lower extremity venous hemodynamics.</p>","PeriodicalId":94350,"journal":{"name":"Phlebology","volume":" ","pages":"636-644"},"PeriodicalIF":0.0,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141312738","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}