Phlebology最新文献

{"title":"Evaluation of clinical and ultrasonographic prognostic factors for detection of iliac venous obstructions in patients with advanced chronic venous insufficiency.","authors":"Viviane Chaib Gomes Stegun, Patrick Bastos Metzger, Ana Amélia Carvalho Melo Cavalcante, Thaís Lye Okamoto Yamakami, Fabio Henrique Rossi","doi":"10.1177/02683555251326040","DOIUrl":"10.1177/02683555251326040","url":null,"abstract":"<p><p>ObjectiveThis study evaluated clinical and ultrasonographic prognostic factors correlated with iliac venous obstructions (IVO) in patients with advanced chronic venous insufficiency (CVI).MethodsSixty-six patients with CVI were classified into Group I (CEAP C1-C2) or Group II (CEAP C3-C6) and categorized by IVO severity (<50%, 50%-79%, ≥80%). Factors analyzed included age, gender, ethnicity, body mass index (BMI), diabetes, deep vein thrombosis (DVT) history, limb laterality, and reflux in superficial, deep, and perforator venous systems. Multivariate logistic regression identified associations, with odds ratios (OR) calculated at a 95% confidence interval.ResultsPatients in both groups were predominantly female, white, and of similar age. Group I patients had higher BMI and lower abdominal circumference than Group II. Arterial hypertension was common in both groups, but deep vein thrombosis history was absent in Group I and present in 27.45% of Group II. Venous reflux was more frequent in Group II (74.5%) compared to Group I (36.7%). Regarding severity of IVO in Group II, 50% of limbs had <50% obstruction, 26.5% of limbs had 50%-79% obstruction, and 23.5% of limbs had ≥80% obstruction. Left limb was more frequently affected (70.58%) in significant obstructions found in Group II. Positive correlations were observed between IVO, non-recanalized DVT, and venous obstruction severity. Reflux in the deep venous system was a significant predictor for severe IVO in advanced chronic venous insufficiency patients (OR = 3.7, <i>p</i> = .02).ConclusionsDeep venous reflux was shown to be a prognostic factor for detecting critical IVO in patients with advanced CVI. History of DVT, presence of reflux in the venous system of the lower limbs and non-recanalized DVT in advanced chronic venous insufficiency patients indicate the need for screening for IVO additional cross-sectional imaging.</p>","PeriodicalId":94350,"journal":{"name":"Phlebology","volume":" ","pages":"600-608"},"PeriodicalIF":1.5,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143653107","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":"Breaking the cycle: Addressing the drucebo effect in lymphedema care.","authors":"Roberto Tedeschi","doi":"10.1177/02683555251326698","DOIUrl":"10.1177/02683555251326698","url":null,"abstract":"<p><p>The drucebo effect, a lesser-known counterpart to the nocebo effect, arises from negative perceptions specifically related to medical interventions and healthcare settings. This phenomenon can significantly influence the management of lymphedema, a chronic and often debilitating condition characterized by fluid retention and tissue swelling. The drucebo effect not only exacerbates symptom perception but also negatively impacts adherence to therapy and overall patient prognosis. This report explores the mechanisms underlying the drucebo effect in lymphedema management, the role of healthcare provider communication, and strategies to mitigate its impact. Addressing the drucebo effect is critical to optimizing therapeutic outcomes and enhancing patient satisfaction.</p>","PeriodicalId":94350,"journal":{"name":"Phlebology","volume":" ","pages":"638-640"},"PeriodicalIF":1.5,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143607597","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":"Computed tomography pulmonary angiography for detection of pulmonary embolisms in Chinese patients.","authors":"Zhen-Yi Jin, Chun-Min Li, Jia-Hao Wen, Hua-Liang Ren","doi":"10.1177/02683555251363305","DOIUrl":"https://doi.org/10.1177/02683555251363305","url":null,"abstract":"<p><p>ObjectiveTo describe the trends in computed tomography pulmonary angiography (CTPA) utilization and pulmonary embolism (PE) positivity rate among patients at a tertiary hospital in China between January 2018 and December 2021 and explore the incidence of isolated PE.MethodsA total of 4378 patients who underwent CTPA examinations between January 2018 and December 2021 were included in the study, retrospectively. The demographic characteristics and PE positivity rate of the included population were compared each year. The incidence of deep venous thrombosis (DVT)-related and isolated PEs and the relationship between the two were explored.ResultsThe mean age of the included patients was 63.0 ± 14.9 years. A total of 1905 (43.5%) patients were male. CTPA showed positive PE results in 901 (20.6%) patients. There was no statistical difference in terms of sex (<i>p</i> = 0.078) and age (<i>p</i> = 0.225) or PE positivity rate (<i>p</i> = 0.393) among the included individuals in each year. DVT-related PE occurred more often, manifested as central (<i>p</i> = 0.003) and multiple (<i>p</i> = 0.007) PE, when compared to isolated PE.ConclusionIn a retrospective study conducted at a tertiary hospital in China, the CTPA positivity rate for PE was 20.6%. There was no statistical difference in the annual PE positivity rate. The clinical features of patients with DVT-related PE were more severe than of those with isolated PE.</p>","PeriodicalId":94350,"journal":{"name":"Phlebology","volume":" ","pages":"2683555251363305"},"PeriodicalIF":1.5,"publicationDate":"2025-08-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144985109","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":"Comparative analysis of ChatGPT and Google Gemini in creating patient education materials for lower extremity varicose veins and deep vein thrombosis.","authors":"Jing Huang, Zhoupeng Wu","doi":"10.1177/02683555251375253","DOIUrl":"https://doi.org/10.1177/02683555251375253","url":null,"abstract":"<p><p>ObjectivesThis study compares the effectiveness of ChatGPT and Google Gemini in creating educational materials for patients with varicose veins and deep vein thrombosis of the lower extremities.MethodsIn this cross-sectional study, we used ChatGPT and Google Gemini to generate patient education materials for the two conditions. The materials were evaluated based on word count, sentence length, ease of understanding (using the Flesch-Kincaid calculator), similarity (analyzed with Quillbot), and reliability (assessed with a modified DISCERN score). Statistical analysis was performed using the unpaired t-test and Pearson correlation coefficient.ResultsThe analysis found no significant differences between the materials produced by ChatGPT and Google Gemini regarding readability, word count, sentence length, or reliability. Correlation analysis showed a positive relationship in usability scores between the two tools, while reliability scores were negatively correlated. However, these correlations were not statistically significant.ConclusionChatGPT and Google Gemini are equally effective in creating educational materials for patients with varicose veins and deep vein thrombosis of the lower extremities.</p>","PeriodicalId":94350,"journal":{"name":"Phlebology","volume":" ","pages":"2683555251375253"},"PeriodicalIF":1.5,"publicationDate":"2025-08-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144985040","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":"Barriers and factors associated with physical activity in patients with chronic venous insufficiency.","authors":"Wagner Jorge Ribeiro Domingues, Max Duarte Oliveira, Paulo Lucas da Silva E Silva, Priscilla Ribeiro Dos Santos Campelo, Neivaldo José Nazaré Dos Santos, Stephanie Vitória Alves Dos Santos, Guilherme Arêas, Caroline Ferraz Simões","doi":"10.1177/02683555251375154","DOIUrl":"https://doi.org/10.1177/02683555251375154","url":null,"abstract":"<p><p>BackgroundPersonal and environmental barriers can make it difficult to engage in physical activity. In people with chronic venous insufficiency (CVI), these barriers may exacerbate physical inactivity, but it is not known whether they are independently associated with physical activity levels in addition to clinical and sociodemographic factors.ObjectiveTo analyze the barriers and factors that are associated with the level of physical activity in patients with CVI.MethodsThis cross-sectional study included 97 participants, CVI patients with Clinical-Etiology-Anatomy-Pathology (CEAP) C3 to C6 (69.1% women 58.9 ± 10.7 years; 51.5% C5-C6 in CEAP classification). Personal and environmental barriers to physical activity were assessed by questionnaire. Objective time spent in physical activity was measured using a triaxial accelerometer. Sociodemographic and clinical characteristics were self-reported. Simple and multiple logistic regression was used to examine the association of age with measures of functional capacity, adjusting for sociodemographic, behavioral, clinical, and anthropometric factors. Statistical significance was accepted at <i>p</i> < 0.05.ResultsOlder people with chronic venous insufficiency had greater personal barriers (lack of time and exercise-induced pain) and environmental barriers (unfavorable climate and lack of green spaces) to physical activity (<i>p</i> < 0.05). After adjustment, physical activity showed a negative association with age (β = -0.022; 95% CI: -0.041 to -0.004) and the absence of a companion (β = -0.001; 95% CI: -0.002 to 0.000), and a positive association with the presence of another health condition (β = 0.001; 95% CI: 0.040 to 0.209). and anthropometrics.ConclusionOur results showed that older patients with CVI face greater personal and environmental barriers to physical activity, such as pain, lack of time, unfavorable weather, and lack of green space. In addition, older age and the absence of a companion were associated with lower levels of physical activity.</p>","PeriodicalId":94350,"journal":{"name":"Phlebology","volume":" ","pages":"2683555251375154"},"PeriodicalIF":1.5,"publicationDate":"2025-08-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144985021","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":"Therapeutic efficacy of the polidocanol versus pingyangmycin in the treatment of maxillofacial vascular disorders.","authors":"Jing Yang, Zhi Tan, Qirong Liu, Li Shen, Hao Zhang, Ping Liu","doi":"10.1177/02683555251365067","DOIUrl":"https://doi.org/10.1177/02683555251365067","url":null,"abstract":"<p><p>ObjectiveTo study the clinical therapeutic effect of polidocanol injection in the treatment of maxillofacial vascular disorders, and to compare the therapeutic effect with that of Pingyangmycin.MethodsA total of 300 patients with maxillofacial vascular abnormalities from March 14, 2021 to January 9, 2022 were selected from a hospital and divided into hemangioma group, lymphatic vessel malformation group and venous malformation group. The treatment was divided into two groups: Pingyangmycin and polidocanol injection. By comparing the pain coefficient, adverse reactions, therapeutic effect and the effect of the two drugs on cells, the therapeutic effect and safety of the two drugs were comprehensively analyzed.ResultsUnder the same conditions, the infiltration rates of 5-bromodeoxyuracil into lymphoendothelial cells with different concentrations of polidocanol injection were 0.62%, 0.59%, 0.36%, 0.18% and 0.15%, respectively, which were better than Pingyangmycin. The protein kinase C expression levels of polidocanol injection with different concentrations were 1.01, 1.21, 1.02, 0.75 and 0.61, respectively, which were better than Pingyangmycin. The adverse reaction rate, cure rate, effective rate and total effective rate of hemangioma patients treated with polidocanol injection were 88.64%, 80.77%, 94.23% and 100.00%, respectively. The adverse reaction rate, cure rate, effective rate and total effective rate were 91.30%, 71.74%, 84.78% and 95.65%, respectively. The adverse reaction rate, cure rate, effective rate and total effective rate of venous malformation patients were 90.00%, 92.00%, 98.00% and 100.00%, respectively. The adverse reaction rate, cure rate, effective rate and total effective rate of hemangioma patients treated with Pingyangmycin were 92.59%, 64.81%, 88.89% and 98.15%, respectively. The adverse reaction rate, cure rate, effective rate and total effective rate of patients with lymphatic vessel malformation were 94.00%, 54.00%, 84.00% and 94.00% respectively. The adverse reaction rate, cure rate, effective rate and total effective rate of venous malformation patients were 95.83%, 75.00%, 91.67% and 100.00%, respectively.ConclusionPolidocanol injection is better than Pingyangmycin in the treatment of maxillofacial vascular disorders, and the drug is milder, less adverse reactions and higher safety.</p>","PeriodicalId":94350,"journal":{"name":"Phlebology","volume":" ","pages":"2683555251365067"},"PeriodicalIF":1.5,"publicationDate":"2025-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144985008","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":"Factors affecting adherence to compression therapy in postoperative patients with lower limb varicose veins.","authors":"Xue Xiong, Lei Huang, Ailing Hu, Lijuan Liu, Yaoyao Gong, Dongzhe Cui, Hai-Lei Li","doi":"10.1177/02683555251372216","DOIUrl":"https://doi.org/10.1177/02683555251372216","url":null,"abstract":"<p><p>ObjectiveTo investigate the current status and determinants of compression therapy adherence among postoperative patients with lower limb varicose veins.MethodsA consecutive cohort of patients undergoing operation for lower limb varicose veins at a single center between September 2022 and September 2024 were included in this study. Demographic data including sex, age, comorbidities and type of surgical treatment were retrieved. A cross-sectional survey using a questionnaire incorporating self-management capacity scale, venous clinical severity score, and use of Graduate Compression Stocking (GCS) Wearing Compliance Scale to evaluate the adherence of compression therapy. Univariate and multiple linear regression analyses were performed to identify the factors affecting adherence to compression therapy.ResultsA total of 456 patients (173 males, 37.9%) with a mean age of 55.37 ± 12.70 years were included during the study period. The distribution of clinical symptoms according to clinical, etiological, anatomic, pathophysiological (CEAP) classification was as follows: C2 in 48 patients (10.5%), C3 in 95 (20.8%), C4 in 291 (63.8%), C5 in 14 (3.1%), and C6 in 8 (1.8%). Traditional high ligation and stripping (HL/S) procedure was performed in 80 patients (17.5%), radiofrequency ablation (RFA) in 225 (49.3%), and mixed procedures in 151 patients (33.2%). The average adherence questionnaire score for GCS wearing among the patients after surgery was 26.51 ± 6.64 points, corresponding to a mean adherence rate of 60.25%. Multivariate regression analysis identified that male gender (<i>p <</i> .001), advanced age (<i>p</i> =.002), lower educational level (<i>p <</i> .001), occupation of physical work (<i>p <</i> .001), and poor self-management ability (<i>p <</i> .001) were associated with a lower adherence to compression therapy.ConclusionIn our study, the adherence rate of compression therapy was only 60.25% at 1 month after operation in patients with lower limb varicose veins. And gender, age, educational attainment, occupational type, and self-management capacity were the main factors affecting compression adherence.</p>","PeriodicalId":94350,"journal":{"name":"Phlebology","volume":" ","pages":"2683555251372216"},"PeriodicalIF":1.5,"publicationDate":"2025-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144985081","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":"Quality assessment of online health resources for lipedema: A multimetric analysis.","authors":"Agustin N Posso, Maria J Escobar-Domingo, Audrey Mustoe, Micaela Tobin, James E Fanning, Dhruv Singhal, Bernard T Lee","doi":"10.1177/02683555251372218","DOIUrl":"https://doi.org/10.1177/02683555251372218","url":null,"abstract":"<p><p>ObjectiveThe incidence of lipedema is poorly described due to its confusion with lymphedema. Patient education is crucial for treatment and prevention strategies but also for improving healthcare outcomes. This study assessed and compared the quality of English and Spanish online resources for patients suffering from lipedema using a multimetric approach.MethodsA deidentified Google search using the terms \"lipedema\" and \"lipedema español\" was conducted. The first 10 academic/organizational websites in each language were selected. Quality assessment was performed using the Patient Education and Materials Assessment Tool (PEMAT), Cultural Sensitivity Assessment Tool (CSAT), Simple Measure of Gobbledygook (SMOG), and facticity criteria to evaluate understandability and actionability, cultural sensitivity, readability, and factual quality, respectively.ResultsEnglish webpages scored 73.70% for understandability and 35.0% for actionability, while Spanish webpages scored 75.05% and 21.0%, respectively; no significant differences were found between languages in understandability (p = .970) and actionability (p = .895). A significantly higher proportion of Spanish resources was found to be culturally sensible than English resources (90% vs 70%; p < .001). However, no significant differences were found in the cultural sensitivity score (English 2.87 vs Spanish 3.01; p = .677). The grade reading level for Spanish materials was significantly lower compared to English materials (11.08 vs 13.45; p = .006). Factual quality was low across both languages according to the facticity framework, though English materials scored higher than Spanish (2.20 vs 1.00; p = .051).ConclusionOur results suggest that online English and Spanish materials on lipedema have inadequate actionability, facticity, and reading grade levels for patients. Nonetheless, the levels of understandability and cultural sensitivity are acceptable. Enhancing the quality of online health literature for lipedema patients presents an opportunity to alleviate psychosocial burdens and address misconceptions.</p>","PeriodicalId":94350,"journal":{"name":"Phlebology","volume":" ","pages":"2683555251372218"},"PeriodicalIF":1.5,"publicationDate":"2025-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144984980","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":"Shocking evidence to diminish fibrosis after lipedema reductive surgery.","authors":"Andrés Reyes Valdivia, Celso Chuquisana","doi":"10.1177/02683555251369082","DOIUrl":"https://doi.org/10.1177/02683555251369082","url":null,"abstract":"","PeriodicalId":94350,"journal":{"name":"Phlebology","volume":" ","pages":"2683555251369082"},"PeriodicalIF":1.5,"publicationDate":"2025-08-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144818986","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":"Factors influencing the extent of contralateral iliac vein orifice overlap by iliac vein stents.","authors":"Liang-Peng Wang, Zi-Hui Chen, Min-Yong Peng, Chao Li, Wen Huang","doi":"10.1177/02683555251365132","DOIUrl":"https://doi.org/10.1177/02683555251365132","url":null,"abstract":"<p><p>ObjectiveTo evaluate the factors influencing the extent of contralateral iliac vein orifice coverage by stents extending into the inferior vena cava (IVC) in patients with iliac vein compression syndrome (IVCS).MethodsThis retrospective study included 150 patients with IVCS who underwent unilateral stent placement between September 2018 and October 2020. Diagnosis was based on clinical symptoms, venography showing ≥50% iliac vein narrowing, and exclusion of thrombosis or external compression. Patients received either a braided Wallstent or a laser-cut Smart Control stent. Three-dimensional rotational venography was used in all cases, and intravascular ultrasound (IVUS) was performed in selected patients to guide stent sizing and placement. Postoperative imaging was used to measure stent protrusion into the IVC, iliac vein-IVC angulation, and the percentage of contralateral vein orifice obstruction. Univariate and multivariate regression analyses were conducted to identify factors associated with orifice coverage.ResultsUnivariate analysis showed that stent protrusion length, lateral angulation between the iliac vein and IVC, and stent type were significantly associated with orifice coverage (all <i>p</i> < .001). Age, sex, stent diameter, and anteroposterior angulation were not significant predictors. Multivariate analysis confirmed that stent protrusion length was the strongest predictor (β = 0.595, <i>p</i> < .001), followed by stent type (β = 0.249, <i>p</i> < .001) and lateral angulation (β = -0.242, <i>p</i> = .002), with the model explaining 76.6% of the variation in orifice coverage.ConclusionThe degree of contralateral iliac vein orifice coverage in IVCS is primarily determined by the stent's protrusion length into the IVC, the lateral angulation of the affected iliac vein relative to the IVC, and the mechanical design of the stent. These findings highlight the importance of individualized stent selection and precise deployment to minimize contralateral venous obstruction.</p>","PeriodicalId":94350,"journal":{"name":"Phlebology","volume":" ","pages":"2683555251365132"},"PeriodicalIF":1.5,"publicationDate":"2025-08-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144796605","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}