Phlebology最新文献

{"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><p>ObjectivesStenting 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.MethodsA 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.ResultsPatient 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.ConclusionSignificant 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":"243-254"},"PeriodicalIF":0.0,"publicationDate":"2025-05-01","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":"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":"10.1177/02683555241297566","url":null,"abstract":"<p><p>ObjectivesTo investigate the prevalence, clinical characteristics and risk factors of hospital acquired venous thromboembolism (HA-VTE) in a Chinese Hospital.MethodsRetrospective 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.Results4,022 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%).ConclusionThis 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":"266-274"},"PeriodicalIF":0.0,"publicationDate":"2025-05-01","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":"Selected phlebological abstracts.","authors":"Lowell S Kabnick, Kathleen Ozsvath, Jorge H Ulloa","doi":"10.1177/02683555251331734","DOIUrl":"10.1177/02683555251331734","url":null,"abstract":"","PeriodicalId":94350,"journal":{"name":"Phlebology","volume":" ","pages":"294-295"},"PeriodicalIF":0.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143766292","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":"First registry of patients treated with foam sclerotherapy using a new automated microfoam preparation device (2021-2022).","authors":"Enric Roche, Cristina Marqués","doi":"10.1177/02683555241287393","DOIUrl":"10.1177/02683555241287393","url":null,"abstract":"<p><p><b>Objectives:</b> To present results for the use of an automated microfoam preparation system (AMPS) in the treatment of varicose veins in a real-world setting.<b>Method:</b> We performed a descriptive study based on a prospective database of patients treated with foam sclerotherapy between February 2021 and December 2022. Polidocanol foam was prepared using a capsule containing sterile air or a low-nitrogen mix. We recorded volume per session, percentage of sclerosing drug, number of sessions, release of thrombus entrapment, complications, and adverse events. A univariate descriptive analysis was performed using Stata V.16.<b>Results:</b> Over a 23-month period, 185 patients (84.9% women, 15.1% men) underwent 685 sessions. Median age was 51.6 years (range, 16-79 years). Thread veins were the condition treated in 68.9% of sessions, tributaries in 7.2%, and truncal veins in 22.6%. The average volume per session was as follows: thread veins, 8 mL; great saphenous vein (GSV), 6.9 mL; and small saphenous vein (SSV), 4.3 mL. The average drug concentration was as follows: thread veins, 0.18%; GSV, 1.49%; and SSV, 1.63%. The average number of sessions was 3.4 for thread veins, 2 for tributaries, 2.7 for the GSV, and 2.9 for the SSV. The occlusion rate at 15 months was 93.2% (41/43) for the great saphenous vein and 86% (13/15) for the small saphenous vein. We recorded a total of 21 complications (3.1% of sessions), 14 of which were minor complications (2% sessions), and 7 moderate adverse events (1% of sessions).<b>Conclusions:</b> This new device is highly versatile and can be used for preparing foam at all concentrations. It contributes to a high rate of occlusion in saphenous trunks, with a minimal number of sessions required for thread veins indicating that the system is a favorable option in the treatment of venous diseases. Additionally, the low frequency of residual pigmentation may be attributed to the system's ability to tailor the foam concentration to the individual case, thus supporting optimal outcomes.</p>","PeriodicalId":94350,"journal":{"name":"Phlebology","volume":" ","pages":"235-242"},"PeriodicalIF":0.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142335876","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":"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":"292-293"},"PeriodicalIF":0.0,"publicationDate":"2025-05-01","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":"10.1177/02683555241301194","url":null,"abstract":"<p><p>ObjectivesEvaluation of the literature assessing the use of thermography, a non-invasive imaging modality that detects pathological temperature variation, in recognising superficial venous insufficiency (SVI).MethodsA 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.ResultsFour 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.ConclusionThermal 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":"223-227"},"PeriodicalIF":0.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11994872/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142635708","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","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":"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":"275-282"},"PeriodicalIF":0.0,"publicationDate":"2025-05-01","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":"Total energy output from an endovenous laser ablation (EVLA) console does not vary between continuous or pulsed use, despite observed variations.","authors":"Oscar F Berhanu, Mark S Whiteley","doi":"10.1177/02683555251336642","DOIUrl":"https://doi.org/10.1177/02683555251336642","url":null,"abstract":"<p><p>BackgroundEndovenous laser ablation (EVLA) in truncal veins uses a constant power and smooth pull-back. In short veins (ie: incompetent perforator veins or neovascular tissue) power can be pulsed, allowing tissue cooling between pulses and reduction of thermal spread, protecting surrounding tissues. Power meter measurements suggest it takes over 2 seconds for a diode laser to reach 90% of maximum power output. Hence pulses shorter than 2 seconds might result in less energy being deposited into target tissues than indicated on the console. The aim of this study is to compare the power emitted from the tip of the laser device during continuous or pulsed use to that displayed on the console.MethodsA 600 micron radial fibre connected to a 1470 nm EVLA diode console was fired at 10 W onto a sensor connected to a power meter, until 100 J had been emitted, for each of the following: continuous; pulsed 1 sec on, 1 sec off; pulsed 0.5 sec on, 1 sec off. Each was repeated 5 times, and the power recorded every 0.1 sec.ResultsThe power meter recorded reduced peak powers in the pulsed experiments as expected, due to delay in reaching maximum output. However, all three protocols resulted in 94% of the total energy being emitted from the tip of the EVLA device. Analysis of the power data suggested that there was a delay in the power being recorded by the sensor and power meter both when activating and deactivating the laser.ConclusionPulsing the laser power did not affect the total energy emitted from the tip of the EVLA device. The delay in reaching maximum power recorded by the power meter appears to be due to a sensor delay responding to incident laser energy, rather than the output from the laser diode and console.</p>","PeriodicalId":94350,"journal":{"name":"Phlebology","volume":" ","pages":"2683555251336642"},"PeriodicalIF":0.0,"publicationDate":"2025-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144030520","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 treating incompetent perforator veins.","authors":"Paolo Casoni, Emanuele Nanni, Matteo Pizzamiglio, Daniele Bissacco","doi":"10.1177/02683555251338767","DOIUrl":"https://doi.org/10.1177/02683555251338767","url":null,"abstract":"<p><p>BackgroundTo describe and analyze technical and clinical outcomes of High Intensity Focused Ultrasound (HIFU) in treating perforator veins (PVs) pathological incompetence.Material and MethodsPatients with isolated PVs incompetence determining varicose veins underwent focal HIFU of the PV. The primary endpoint was the rate of PV shrinkage or closure after 1 year.Resultsfrom December 2021 to January 2025, 467 legs in 416 patients were treated with HIFU. Among these, 25 pathological isolated PVs in 25 patients were treated and included in the analysis. No new PV pathological reflux was seen in 90.8%, 92.8%, 90%, and 100% of patients at 1 week, 3 months, 6 months, and 12 months from HIFU, respectively.ConclusionHIFU could be a valid alternative in treating PVs. Due to the pivotal nature of these data, further studies are needed to strengthen the results and compare HIFU with other methods.</p>","PeriodicalId":94350,"journal":{"name":"Phlebology","volume":" ","pages":"2683555251338767"},"PeriodicalIF":0.0,"publicationDate":"2025-04-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144057252","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":"Spaghetti with meatballs or noodles: Microscopic structure of sclerosant-induced thrombus, sclerocoagulum and superficial venous thrombosis.","authors":"Osvaldo Cooley Andrade, David Ewan Connor, Elton Chee, John W Weisel, Kurosh Parsi","doi":"10.1177/02683555251336929","DOIUrl":"https://doi.org/10.1177/02683555251336929","url":null,"abstract":"<p><p>ObjectiveTo characterise the microscopic structure of thrombus induced by direct effect of sclerosants (sclerothrombus) compared with that of post-sclerotherapy retained coagulum (trapped blood; sclerocoagulum) and thrombus in acute superficial venous thrombosis (SVT).MethodsScanning electron microscopy (SEM) and fluorescence microscopy were used to assess the structural architecture of thrombus samples. Sclerothrombus samples were generated <i>in vitro</i> following incubation of whole blood or platelet-rich plasma with detergent sclerosants sodium tetradecyl sulphate (STS) or polidocanol (POL). Sclerocoagulum samples were collected from patients treated for varicose veins with STS 1.5% foam. Samples of naturally occurring thrombus were collected from patients with SVT.ResultsAcute sclerothrombus contained a mesh-like distribution of branched fibrin fibers dispersed with red cells and microparticles. STS-induced sclerothrombus showed thicker fibrin strands with less branching and contained more microparticles when compared to POL-induced clots. Sclerothrombus at 1 week exhibited a fibrin sponge structure. Sclerocoagulum showed a disorganised distribution of thin, tortuous and branching fibers containing large gaps dispersed with haemolysed red cells and cell debris. SVT contained a smooth fibrin mesh of relatively thick fibrin strands with scarce branching and fewer microparticles.ConclusionThe three entities of sclerothrombus, sclerocoagulum and SVT are distinct and distinguishable entities. Whilst sclerothrombus and SVT demonstrate features of a fibrin clot, sclerocoagulum is haemolysed blood containing disorganised fibrin strands.</p>","PeriodicalId":94350,"journal":{"name":"Phlebology","volume":" ","pages":"2683555251336929"},"PeriodicalIF":0.0,"publicationDate":"2025-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144016252","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}