Phlebology最新文献

{"title":"Rethinking compression therapy: From resting pressure to global dynamic actions.","authors":"Giovanni Mosti","doi":"10.1177/02683555261494672","DOIUrl":"https://doi.org/10.1177/02683555261494672","url":null,"abstract":"<p><p>BackgroundCompression therapy has traditionally been regarded as a treatment for venous disease. However, growing experimental and clinical evidence shows that its effects extend beyond the venous system, influencing tissue fluid balance, lymphatic function, arterial perfusion, microcirculation, and inflammation. This suggests that its clinical benefits arise from a global effect on the compressed structures rather than from isolated vascular effects.Study Aimto highlight two key concepts: first, that the effects of compression depend not only on resting pressure but also on its dynamic behavior and stiffness; and second, that compression acts simultaneously on all structures within the compressed segment, irrespective of the primary clinical indication.MethodsWe critically reviewed and integrated evidence from experimental studies, imaging, clinical investigations, randomized controlled trials, systematic reviews, consensus documents, and international guidelines into a mechanism-based framework. Rather than adopting a disease-oriented approach, the review organized the evidence around the biological targets through which compression exerts its therapeutic effects.ResultsCompression therapy works by delivering a controlled mechanical stimulus to the entire compressed segment, thereby improving venous hemodynamics, lymphatic drainage, microvascular function, and arterial perfusion, while regulating inflammation. These interconnected mechanisms explain the efficacy of compression across different vascular disorders. Therapeutic benefit depends on compression characteristics, including not only interface pressure but, most importantly, material stiffness, dynamic pressure changes during movement, treatment duration, and patient adherence. The review also shows that much of the heterogeneity in the literature reflects methodological limitations rather than conflicting biological effects.ConclusionsCompression therapy should be viewed as a biomechanical intervention that restores tissue homeostasis, with vascular changes reflecting coordinated downstream responses. This integrated framework offers a unifying explanation of its biological effects, supports individualized treatment planning, and identifies priorities for improving the design and interpretation of future clinical studies.</p>","PeriodicalId":94350,"journal":{"name":"Phlebology","volume":" ","pages":"2683555261494672"},"PeriodicalIF":1.5,"publicationDate":"2026-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149121656","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":"Twenty-four-hour lactate dynamics and adverse in-hospital outcomes in acute pulmonary embolism treated with systemic thrombolysis: A retrospective cohort study.","authors":"Orkun Eray Terzi, Gülgün Çetintaş Afşar, Ersin Akpınar, Büşra Yıldırım Kafalı, Seyhan Dülger","doi":"10.1177/02683555261493219","DOIUrl":"https://doi.org/10.1177/02683555261493219","url":null,"abstract":"<p><p>ObjectivesAdmission lactate carries prognostic information in acute pulmonary embolism (PE), but the value of its early change in patients receiving systemic thrombolysis is unclear. We examined the association between 24-h lactate dynamics and an adverse in-hospital clinical course.MethodsIn this retrospective single-centre cohort, 40 consecutive adults who received systemic alteplase for acute PE (2024-2025) were analysed. In 35 patients the 24-h sample followed thrombolysis. The primary outcome was a composite adverse event (complicated or fatal clinical course). Admission (T0) and 24-h (T24) lactate, absolute Δ lactate and percentage clearance were assessed by ROC analysis and Firth-penalised logistic regression with 2000-resample bootstrap internal validation.ResultsThe composite event occurred in 12 patients (30%). Admission lactate did not discriminate the outcome (AUC 0.56), whereas Δ lactate and percentage clearance did (AUC 0.88 for both; 95% CI 0.76-0.99 and 0.77-0.99, respectively; DeLong <i>p</i> = 0.84, the two AUCs did not differ). A Δ ≥ 0 mmol/L identified an adverse course with a sensitivity of 0.75 and a specificity of 0.82, and a T24 ≥ 4 mmol/L gave a specificity of 1.00. The association of Δ lactate persisted after adjustment for age and showed minimal optimism on bootstrap internal validation.ConclusionsIn this selected cohort receiving systemic thrombolysis, admission lactate did not reproduce the discrimination reported in broader PE populations, whereas 24-h lactate dynamics showed a stronger association with the adverse in-hospital course. Δ lactate should be regarded as a marker of concurrent severity rather than a predictor of treatment response; the candidate thresholds are hypothesis-generating and require prospective validation.</p>","PeriodicalId":94350,"journal":{"name":"Phlebology","volume":" ","pages":"2683555261493219"},"PeriodicalIF":1.5,"publicationDate":"2026-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149076946","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The effect of compression stockings on patients with lower extremity venous ulcers: A meta-analysis.","authors":"Huan Wang, Jianmei Gong, Dongmei Han, Xiaoyuan Wang, Haifeng Cheng, Wenna Ou","doi":"10.1177/02683555261493226","DOIUrl":"https://doi.org/10.1177/02683555261493226","url":null,"abstract":"&lt;p&gt;&lt;p&gt;ObjectiveThis study aims to systematically evaluate the efficacy and safety of compression stockings compared with other active compression modalities and surgical interventions in the management of venous leg ulcers, and to explore the impacts of intervention duration, reported compression pressure, and comparator heterogeneity on pooled outcomes.MethodsLiterature searches were conducted in eight databases for randomized controlled trials on the effects of compression stockings in patients with venous leg ulcers. The search period was from the database establishment to April 20, 2026. Two researchers independently screened the literature, extracted data, and evaluated methodological quality according to inclusion and exclusion criteria, and then performed a Meta-analysis.ResultsA total of 12 randomized controlled trials involving 1206 patients were ultimately included. Meta-analysis results demonstrated that the patients in the compression stocking group had higher ulcer healing rates compared to the control group [&lt;i&gt;RR&lt;/i&gt; = 1.39, 95%&lt;i&gt;CI&lt;/i&gt; (1.11, 1.74), &lt;i&gt;P =&lt;/i&gt; .004], a greater reduction in ulcer wound area [&lt;i&gt;MD&lt;/i&gt; = 5.10, 95%&lt;i&gt;CI&lt;/i&gt; (1.60, 8.60), &lt;i&gt;P&lt;/i&gt; &lt; .01], and lower ulcer recurrence rates [&lt;i&gt;RR&lt;/i&gt; = 0.56, 95%&lt;i&gt;CI&lt;/i&gt; (0.37, 0.84), &lt;i&gt;P&lt;/i&gt; &lt; .01]. Subgroup analyses indicated that intervention duration could potentially have a modifying effect: interventions lasting ≤12 weeks showed beneficial outcomes, but longer-duration treatments did not, though the between-subgroup difference test did not yield a significant result. Subgroup analysis stratified by stocking layer type found that two-layer compression stockings delivered significant healing benefits, although the between-subgroup difference test did not return a significant result. Sensitivity analysis, which excluded two studies using atypical comparators, confirmed that the healing-rate result was robust. However, no statistically significant differences were observed in adverse event incidence or ulcer healing time between the compression stocking group and the control group [&lt;i&gt;RR&lt;/i&gt; = 0.87, 95%&lt;i&gt;CI&lt;/i&gt; (0.63, 1.20), &lt;i&gt;P&lt;/i&gt; = .40] and [&lt;i&gt;MD&lt;/i&gt; = -1.19, 95%&lt;i&gt;CI&lt;/i&gt; (-6.85, 4.47), &lt;i&gt;P&lt;/i&gt; = .68], respectively. The evidence quality for the indicators of adverse event incidence was of moderate quality, while the rest were of low quality.ConclusionBased on limited evidence, compared with other compression modalities, compression stockings are associated with higher ulcer healing rates, greater wound area reduction, lower recurrence rates, and have favourable safety profiles. However, compression stockings do not outperform other compression modalities across all measured outcomes, as no significant difference was observed in healing time. These findings should be interpreted with caution, due to substantial heterogeneity among included studies, under-reporting of actual compression pressure, and insufficient documentation of baseline ulcer characteristics ","PeriodicalId":94350,"journal":{"name":"Phlebology","volume":" ","pages":"2683555261493226"},"PeriodicalIF":1.5,"publicationDate":"2026-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149070880","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":"Diagnostic value of neutrophil-to-lymphocyte ratio for identifying severe great saphenous vein reflux in patients with chronic venous insufficiency: A retrospective cohort study.","authors":"Kübra Gözaçık Karakoç, Tamer Cebe, Anıl Akbaş, Gökhan Karakoç","doi":"10.1177/02683555261490785","DOIUrl":"https://doi.org/10.1177/02683555261490785","url":null,"abstract":"<p><p>ObjectivesThe role of inflammatory markers in chronic venous insufficiency (CVI) has been examined primarily within the CEAP clinical classification framework or at a disease-present versus disease-absent level. CEAP, however, is weighted toward symptoms and skin findings and does not directly reflect the underlying hemodynamic severity of reflux. This study evaluated the diagnostic accuracy and optimal cutoff values of five preoperative inflammatory markers in differentiating severe (Grade IV; reflux time ≥4 s) from moderate (Grade III; reflux time >1 to <4 s) great saphenous vein reflux through direct pairwise comparison.MethodsThis single-center retrospective cohort study enrolled 597 consecutive patients (Grade III: 412; Grade IV: 185) operated on for CVI. White blood cell count (WBC), neutrophil-to-lymphocyte ratio (NLR), platelet count (PLT), platelet-to-lymphocyte ratio (PLR), and C-reactive protein (CRP) were analyzed with group comparisons, Benjamini-Hochberg-adjusted correlation analysis, multivariable linear regression, and receiver operating characteristic (ROC) curve analysis with DeLong pairwise testing.ResultsAll five markers were significantly elevated in the Grade IV group (<i>p</i> < 0.001 for each). NLR achieved the highest discriminative performance (area under the curve [AUC]: 0.95; cutoff ≥2.20; sensitivity 83.8%; specificity 90.3%) and was significantly superior to all other markers, including CRP, on DeLong testing (<i>p</i> < 0.001). Performance was preserved after excluding patients with ulceration (C5-C6; AUC: 0.96). NLR also exhibited the strongest correlations with reflux duration (ρ = 0.57) and Venous Clinical Severity Score (VCSS; ρ = 0.54). In the multivariable model, NLR was the strongest independent predictor of VCSS (B = 3.54; 95% confidence interval: 2.99-4.09; adjusted R² = 0.416).ConclusionsNLR - calculable from a routine complete blood count at no additional cost - distinguished severe great saphenous vein reflux with high accuracy and may serve as an accessible adjunctive marker for preoperative severity assessment. Prospective multicenter validation is warranted.</p>","PeriodicalId":94350,"journal":{"name":"Phlebology","volume":" ","pages":"2683555261490785"},"PeriodicalIF":1.5,"publicationDate":"2026-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149070862","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":"Regular NSAID prescription after treatment for varicose veins: a feasibility study.","authors":"WeiYing Chua, Abduraheem Mohamed, Bharadhwaj Ravindhran, Arthur Jun Ming Lim, Melanie Chin Ning Liu, Annabel Howitt, Daniel Carradice, George Smith, Ian Chetter","doi":"10.1177/02683555261493250","DOIUrl":"https://doi.org/10.1177/02683555261493250","url":null,"abstract":"<p><p>IntroductionThe National Health Service (NHS) in England performs more than 35,000 varicose veins procedures annually to treat superficial venous incompetence (SVI). Around 1 in 10 patients experience significant pain in the first post-procedural week, which frequently affects quality of life (QoL). This feasibility study aimed to assess the effectiveness of routinely prescribed non-steroidal anti-inflammatory drugs (NSAIDs) for pain management following treatment for SVI, and to examine the feasibility of conducting a randomised controlled trial (RCT).MethodsEligible patients undergoing endovenous thermal ablation (EVTA) and/or concomitant phlebectomy for SVI were enrolled. Patients in the intervention group were prescribed Ibuprofen three times daily for five days following treatment. A 1:1 propensity score matched cohort using the nearest neighbour method with a calliper of 0.2 was derived from participants enrolled in a previous trial. Feasibility outcomes included the eligibility rate, recruitment rate, study completion rate, diary completion rate, and intervention adherence rate. Clinical outcomes included daily post-procedural visual analogue scale (VAS) pain scores recorded over seven days and NSAID-related adverse effects documented in patient pain diaries.ResultsOf the 56 patients assessed for study participation, the eligibility rate was 88% (n = 49) and the recruitment rate was 73% (n-36). The study completion rate was 69% (n-25). The diary completion rate was 50% (n = 18). The intervention adherence rate was 6-% (n = 15). There were no statistically significant differences in median pain scores between the two groups. No major NSAID-related adverse effects were reported.ConclusionRoutine post-procedural NSAID use was not associated with a statistically significant reduction in pain following EVTA and phlebectomy for SVI. However, this study demonstrated the feasibility of conducting an adequately powered RCT of NSAIDs for pain management following treatment for SVI and generated data to inform the design of such a trial.</p>","PeriodicalId":94350,"journal":{"name":"Phlebology","volume":" ","pages":"2683555261493250"},"PeriodicalIF":1.5,"publicationDate":"2026-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149070868","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The impact of \"flush\" endovenous laser ablation on thromboembolic risk: a retrospective safety analysis.","authors":"Gokhan Arslan, Tuna Demirkiran, Yigit Tokgoz, Zahir Kilic, Gizem Isik Okten, Isil Tasoz Ozdas, Kubilay Karabacak","doi":"10.1177/02683555261493243","DOIUrl":"https://doi.org/10.1177/02683555261493243","url":null,"abstract":"<p><p>ObjectiveEndovenous laser ablation (EVLA) is standard for superficial venous insufficiency. This retrospective study evaluates the safety profile of \"flush\" EVLA, assessing whether thermal ablation directly at the saphenofemoral junction (SFJ) increases postoperative thromboembolic complications like deep vein thrombosis (DVT) and pulmonary embolism (PE).MethodsWe retrospectively analyzed 501 patients (281 female; mean age 45.8 ± 8.2 years) undergoing \"flush\" EVLA via a 1470-nm dual-radial laser (ELVeS Radial 2ring™, Biolitec) between February 2023 and June 2025. Unlike traditional sub-junctional positioning, laser delivery was initiated flush with the SFJ origin under tumescent anesthesia. Postoperative chemical anticoagulation was routinely omitted. Patients wore Class 2 compression stockings and were followed for six months. Systemic thromboembolic events were tracked nationwide using the National Electronic Health Record Database (e-Nabız), which mandatorily integrates data across all public, university, and private healthcare facilities in Turkiye to ensure complete cross-institutional complication ascertainment.ResultsNo patient developed DVT or PE during six-month follow-up (0% incidence). One patient (0.2%) experienced localized superficial thrombosis in a calf tributary at day 10, successfully managed via ambulatory phlebectomy without systemic sequelae. Low-grade endovenous heat-induced thrombosis (EHIT Class 1-2) occurred in 12 patients (2.4%) and resolved spontaneously. This absence of major thromboembolic phenomena confirms a favorable safety profile.Conclusion\"Flush\" EVLA using a 1470-nm dual-radial catheter is safe and carries a negligible risk of major thromboembolic events. Eliminating the proximal saphenous stump at the SFJ line does not increase DVT or PE incidence, even without chemical anticoagulation. The utilization of nationwide integrated digital tracking further validates the longitudinal completeness of outcome ascertainment.</p>","PeriodicalId":94350,"journal":{"name":"Phlebology","volume":" ","pages":"2683555261493243"},"PeriodicalIF":1.5,"publicationDate":"2026-09-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149067095","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":"Transdermal 1064-NM ND:YAG laser for reticular veins larger than 4 mm: ONE-YEAR outcomes and seven-year follow-up.","authors":"Julio Cesar Bajerski, Camila Biedler Giordani, Fabricio Rodrigues Santiago, Luiza Brum Borges, Elias Arcenio Neto, Rodrigo Kikuchi, Jaber Nashat Saleh, Rafael Stevan Noel, Renan Camargo Puton, Mateus Picada Correa","doi":"10.1177/02683555261493221","DOIUrl":"https://doi.org/10.1177/02683555261493221","url":null,"abstract":"<p><p>ObjectivesTo evaluate the efficacy, safety, and long-term durability of transdermal 1064-nm Nd:YAG laser treatment, alone or combined with liquid sclerotherapy, for varicose veins ≥4 mm in diameter.MethodsThis prospective cohort study included 25 patients treated between May 2017 and November 2024. Assessment and follow-up were performed using Doppler ultrasound, augmented reality, phleboscopy, and standardized photography. Treatment was delivered with a 1064-nm Nd:YAG laser using 6- or 9-mm spot sizes, fluences of 50-100 J/cm², and pulse durations of 40-60 ms. Adjunctive liquid sclerotherapy was used when complete vein obliteration was not achieved. Outcomes were evaluated up to 1 year and, when available, at 7 years.ResultsTwenty-five patients were included, 88% of whom were women. Mean pre-treatment vein diameter was 5.66 mm. At 1 year, complete vein occlusion was achieved in 44% of patients, while 44% showed diameter reduction and absence of reflux. Persistent reflux was observed in 12%, although all remained asymptomatic. Mean vein diameter decreased from 5.66 mm to 2.16 mm (<i>p</i> < 0.05). Hyperpigmentation occurred in 24% of patients and matting in 8%; no burns, ulcerations, deep vein thrombosis, or other major adverse events were observed. All patients reported symptomatic improvement, and 94% were satisfied or very satisfied with the aesthetic outcome. Seven-year follow-up was available for nine patients. Mean vein diameter decreased from 6.1 mm to 2.34 mm (<i>p</i> = 0.0016), and 88.9% had no reflux in the treated vein.ConclusionsTransdermal 1064-nm Nd:YAG laser treatment, alone or combined with liquid sclerotherapy, was associated with significant and durable reduction in vein diameter, high patient satisfaction, and a low complication rate. These findings support its use as a treatment option for selected large varicose veins.</p>","PeriodicalId":94350,"journal":{"name":"Phlebology","volume":" ","pages":"2683555261493221"},"PeriodicalIF":1.5,"publicationDate":"2026-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149043063","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":"Clinical and ultrasonographic predictors of incompetent perforating veins in patients undergoing endovenous treatment for varicose veins.","authors":"Yasuhiko Ibaragi, Seiya Kikuchi, Kanshi Komatsu","doi":"10.1177/02683555261493234","DOIUrl":"https://doi.org/10.1177/02683555261493234","url":null,"abstract":"<p><p>ObjectivesIncompetent perforating veins (IPVs) are important contributors to chronic venous disease (CVD), yet their clinical significance remains incompletely understood. This study aimed to evaluate the clinical and ultrasonographic characteristics associated with IPVs in patients undergoing endovenous treatment for varicose veins.MethodsA retrospective analysis was conducted on 192 limbs treated between 2021 and 2025. Limbs were categorized into IPV-positive and IPV-negative groups based on duplex ultrasonography. Clinical severity was assessed using the Clinical-Etiological-Anatomical-Pathophysiological (CEAP) classification. Multivariable logistic regression and receiver operating characteristic (ROC) analysis were performed to identify predictors of IPV presence.ResultsAmong 192 limbs, IPVs were identified in 102 (53.1%). Multivariable analysis identified saphenofemoral junction (SFJ) diameter as an independent predictor of IPV (Odds Ratio [OR]: 1.26; 95% CI: 1.08-1.49; <i>p</i> = 0.005). ROC analysis revealed an optimal cutoff for SFJ diameter of 7.75 mm for predicting IPV (Area Under the Curve [AUC]: 0.646; sensitivity 65.0%, specificity 65.2%). CEAP classification was numerically higher in the IPV-positive group (3.11 vs 2.86), although the difference was not statistically significant (<i>p</i> = 0.379).ConclusionSFJ diameter was independently associated with IPV presence and may serve as a practical ultrasonographic marker for identifying perforator incompetence in patients with varicose veins. Standardized duplex ultrasonography, including assessment of SFJ diameter, may facilitate objective treatment planning.</p>","PeriodicalId":94350,"journal":{"name":"Phlebology","volume":" ","pages":"2683555261493234"},"PeriodicalIF":1.5,"publicationDate":"2026-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149067048","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":"Modification of endothermal heat-induced thrombosis follow-up strategy using a risk stratification model after endovenous thermal ablation.","authors":"Yifan Fan, Xuefeng Tian, Xianyu Hu, Xu Zhang, Long Wang, Bo Liu, Yi Liu, Huan Ouyang, Zhiyong Chen, Binshan Zha","doi":"10.1177/02683555261493216","DOIUrl":"https://doi.org/10.1177/02683555261493216","url":null,"abstract":"<p><p>ObjectiveTo develop and validate a risk stratification model that identifies varicose vein patients at high risk of Endothermal Heat-Induced Thrombosis (EHIT) following thermal ablation to guide optimized surveillance and anticoagulation strategies.MethodsIn this single-center retrospective cohort study, a total of 525 affected limbs treated by radiofrequency and microwave ablation were included. Patients were randomly assigned to a training cohort (n = 368) and a validation cohort (n = 157) in a 7:3 ratio. Preoperative clinical data, including Great saphenous vein (GSV) diameter, reflux time, sex, and Clinical Etiology Anatomy Pathophysiology (CEAP) classification, were analyzed. Predictors were identified through Spearman correlation and χ² tests. The model's performance was assessed using C-index and confusion matrix in the validation cohort. All data analysis and visualization were performed using R software, with a p-value below 0.05 considered statistically significant.ResultsEHIT occurred in 24 patients (overall rate: 4.57%) at 1 week postoperatively. Of these, 21 were EHIT class I and 3 were EHIT class II. Significant predictors included GSV diameter, reflux time, CEAP classification and sex. The logistic regression model demonstrated strong calibration and discrimination (C-index = 0.853 in train cohort), with an optimal risk threshold of 5.4% established for risk stratification. In the validation cohort, the model achieved 79.61% accuracy, 100% sensitivity, and 78.8% specificity. A web-based calculator was developed to assist clinicians in estimating individual EHIT risk and guiding surveillance strategies.ConclusionWe identified sex, GSV diameter, reflux time, and CEAP classification as predictors and developed a logistic model with a 5.4% risk threshold for EHIT stratification. For patients classified as average-risk, omission of routine ultrasound surveillance could be considered, whereas high-risk patients may benefit from intensified ultrasound surveillance and extended anticoagulation, but external multicenter validation is required before adoption in clinical practice.</p>","PeriodicalId":94350,"journal":{"name":"Phlebology","volume":" ","pages":"2683555261493216"},"PeriodicalIF":1.5,"publicationDate":"2026-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149043052","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":"Clinical study of neuromuscular electrical stimulator for prevention of intraoperative lower extremity deep vein thrombosis in patients undergoing lithotomy position surgery.","authors":"Yaning Zhao, Zengyan Wang, Wen Ke","doi":"10.1177/02683555261490357","DOIUrl":"https://doi.org/10.1177/02683555261490357","url":null,"abstract":"<p><p><b>Objectives:</b> To investigate the efficacy and safety of neuromuscular electrical stimulation (NMES) for preventing lower-extremity deep venous thrombosis (DVT) during lithotomy position surgery. <b>Methods:</b> Seventy-six patients receiving lithotomy position surgery were randomized equally into control and experimental groups (n = 38 each). The control group received standard intraoperative thromboprophylaxis; the experimental group added intraoperative NMES on the basis of standard prophylaxis. We compared perioperative plasma D-dimer, popliteal vein diameter and blood flow velocity, 24-h postoperative DVT incidence after fascial closure, and NMES-related adverse events between groups. <b>Results:</b> The incidence of deep vein thrombosis in the lower extremities 24 hours after fascial closure was lower in the experimental group than in the control group (χ² = 4.145, <i>p</i> = .042); Following surgery, the popliteal vein blood flow velocity in both lower limbs of the experimental group was significantly faster than that of the control group (<i>p</i> < 0.05), while there was no significant difference in the diameter of the popliteal veins between the two groups; there was no statistically significant difference in plasma D-dimer levels between the two groups (<i>p</i> > .05), and no adverse events related to the use of the neuromuscular stimulator occurred in the experimental group. <b>Conclusions:</b> The use of a neuromuscular electrical stimulator during surgery in patients undergoing lithotomy position procedures can accelerate the venous flow rate of lower limb veins, alleviate venous stasis in the lower limbs caused by the placement of lithotomy positions, and help to prevent the occurrence of DVT.</p>","PeriodicalId":94350,"journal":{"name":"Phlebology","volume":" ","pages":"2683555261490357"},"PeriodicalIF":1.5,"publicationDate":"2026-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149043078","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}