Phlebology最新文献

{"title":"Dermatophlebology: Understanding dermal responses to venous disease.","authors":"Ronald Bush","doi":"10.1177/02683555241239721","DOIUrl":"10.1177/02683555241239721","url":null,"abstract":"<p><p>Dermatophlebology refers to the study of dermal alterations that occur with transmitted high venous pressure. These changes may range from telangiectasia, complex dermal vascular conditions, and all changes in Clinical Etiology Anatomical Pathophysiology classes IV-VI. Understanding the underlying pathophysiology is essential to treating the skin manifestations of venous disease.</p>","PeriodicalId":94350,"journal":{"name":"Phlebology","volume":" ","pages":"133-136"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142038163","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":"Mechanochemical chemically assisted ablation of varicose veins for venous insufficiency: American vein and lymphatic society position statement.","authors":"John Blebea, Eri Fukaya, Keith S Moore, Fedor Lurie","doi":"10.1177/02683555241276554","DOIUrl":"10.1177/02683555241276554","url":null,"abstract":"<p><p><b>Background:</b> Mechanical occlusion chemically assisted ablation (MOCA) of incompetent saphenous veins has been utilized since its FDA approval in 2008. However, only recently have longer-term three and 5 year clinical follow up data become available. This updated information necessitates a societal update to guide treatment and ensure optimal patient outcomes. <b>Method:</b> The American Vein and Lymphatic Society convened an expert panel to write a Position Statement with explanations and recommendations for the appropriate use of MOCA for patients with venous insufficiency. <b>Result:</b> This Position Statement was produced by the expert panel with recommendations for appropriate use, treatment technique, outcomes review, and potential adverse events. These recommendations were reviewed, edited, and approved by the Guidelines Committee of the Society. <b>Conclusions:</b> MOCA is effective in alleviating symptoms and a safe treatment option for venous insufficiency. It obviates the need for tumescent anesthesia, has less procedural discomfort and lower risk of thermal nerve or skin injury. It may be used in both the below knee distal GSV as well as the SSV. However, it is associated with significantly lower rates of vessel closure and higher recanalization rates compared to both RFA and EVLA and is less cost effective than thermal techniques. It is an available option for those in whom thermal ablation is not suitable.</p>","PeriodicalId":94350,"journal":{"name":"Phlebology","volume":" ","pages":"104-109"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142020089","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":"Nonpelvic comorbid symptoms of 45 patients with pain of pelvic venous origin, before and after treatment.","authors":"Steven J Smith, B Holly Smith, Michael J Sichlau, Brenda Chen, Dacre Knight, Peter C Rowe","doi":"10.1177/02683555241273109","DOIUrl":"10.1177/02683555241273109","url":null,"abstract":"<p><strong>Objective: </strong>To report the prevalence and severity of nonpelvic symptoms for patients with venous-origin chronic pelvic pain (VO-CPP) and to describe outcomes after pelvic vein stenting and embolization.</p><p><strong>Methods: </strong>We retrospectively reviewed outcomes of 45 women with VO-CPP who underwent treatment with iliac vein stenting and/or embolization. Patients completed symptom-severity questionnaires before and after treatment that assessed for pelvic pain, and multiple other symptoms, including brain fog, anxiety, depression, musculoskeletal pain, fatigue, migraines and more.</p><p><strong>Results: </strong>Patient age ranged from 18 to 65 years. The prevalence of common symptoms was as follows: migraines, 69%; brain fog, 76%; anxiety attacks, 58%; excess sweating, 64%; hip pain, 73%; diarrhea, 62%; constipation, 76%; and abdominal bloating, 82%. After treatment, most symptom scores improved by more than 50%; exceptions were excessive sweating (41% improvement) and bloating (47% improvement). Prevalence of individual symptoms that bundle into POTS ranged from 29% to 76%, where symptom improvement ranged from 23% to 59% after treatment. Overlapping individual symptoms characteristic of fibromyalgia and myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) were present in 64% to 82% of patients and all improved by 49% to 63% after treatment.</p><p><strong>Conclusions: </strong>Pelvic venous flow abnormality is linked causally to a spectrum of interrelated symptoms, of which many can be bundled into named syndromes of unknown cause. With catheter- based treatment of pelvic venous pooling, nonpelvic symptom and syndrome scores improved.</p>","PeriodicalId":94350,"journal":{"name":"Phlebology","volume":" ","pages":"66-79"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141915010","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":"Standardizing practice patterns for venous insufficiency ultrasound.","authors":"Donna Kelly, Sherry Scovell","doi":"10.1177/02683555241276556","DOIUrl":"10.1177/02683555241276556","url":null,"abstract":"<p><strong>Background: </strong>This study aimed to evaluate the variability in practice patterns associated with the performance of duplex ultrasound (DUS) for venous insufficiency.</p><p><strong>Methods: </strong>Sonographers participated in a survey regarding patient positioning and method of augmentation as well as the availability of ergonomic equipment for DUS.</p><p><strong>Results: </strong>DUS was performed in RT position by 41% of sonographers versus standing position in 40%. In 18% of laboratories, if the RT position did not demonstrate reflux, the study was repeated in the standing position. An automated cuff inflation device was used as the primary method of augmentation in only 22% of practices.</p><p><strong>Conclusions: </strong>There is a lack of standardization for the performance parameters of patient position and method of augmentation in VDU, which may lead to variation in the results between sonographers and institutions.</p>","PeriodicalId":94350,"journal":{"name":"Phlebology","volume":" ","pages":"126-132"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142142278","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":"Endovenous thermal ablation mid-term outcomes for the treatment of large diameter incompetent great saphenous veins.","authors":"Christos Karathanos, Konstantinos Spanos, Konstantinos Batzalexis, Athanasios Chaidoulis, Konstantinos Tzimas-Dakis, Georgios Volakakis, George Kouvelos, Miltiadis Matsagas, Athanasios D Giannoukas","doi":"10.1177/02683555241272971","DOIUrl":"10.1177/02683555241272971","url":null,"abstract":"<p><strong>Introduction: </strong>The aim of this study was to assess the efficacy and safety of endovenous thermal ablation (EVTA) in treating large diameter, ≥12 mm, incompetent great saphenous vein (GSV) in comparison to smaller ones.</p><p><strong>Methods: </strong>A retrospective comparative study was undertaken including 196 patients (205 limbs) undergoing EVTA. According to maximum GSV diameter patients were divided into two groups (group A <12 mm, group B ≥12 mm). Primary outcome was anatomic success defined as absence of reflux of GSV. Secondary outcomes were complications, postoperative pain using the 10-cm Visual Analog Scale (VAS) and improvement of Venous Clinical Severity Score (VCSS) and Chronic Venous Insufficiency Quality-of-Life Questionnaire (CΙVIQ-20) scores assessed at 7- days, 1 month, 12 months and 24 months postoperatively.</p><p><strong>Results: </strong>118 patients with GSV diameter <12 mm (group A) and 87 with GSV diameter ≥12 mm (group B) were included. Patients' demographics, CEAP classification and length of ablated vein did not differ between the groups. Preoperative VCSS and VAS pain score were significant greater in group B (6.03 vs 6.94, <i>p</i> = .04 and 5.21 vs 5.77, <i>p</i> = .032, respectively). No differences in adverse events were observed post-operatively among groups. GSV occlusion rate at 1 month was 98.3% (SE 1.3%) in group A and 96.5 % (2.2%) in group B (<i>p</i> = .3), at 12 months 95.7% (SE 2%) and 94.2% (SE 2.8%) (<i>p</i> = .5), and at 24 months 94% (SE 2.4%) and 93.1% (SE 3%) (<i>p</i> = .4) respectively. Both groups experienced significant and similar improvement in their VCSSs and CIVIQ scores postoperatively. In a subgroup analysis among different EVTA and GSV >12 mm, 1470 nm endovenous laser ablation (EVLA) and radiofrequency ablation (RFA) showed comparable results in terms of occlusion rates, complications, VCSS and CIVIQ scores.</p><p><strong>Conclusions: </strong>Endovenous thermal ablation techniques are efective and safe in the treatment of GSV incompetence regardless the diameter of the GSV. Both 1470 nm EVLA and RFA techniques performed similar outcomes.</p>","PeriodicalId":94350,"journal":{"name":"Phlebology","volume":" ","pages":"95-103"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142006214","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":"10.1177/02683555251324282","DOIUrl":"https://doi.org/10.1177/02683555251324282","url":null,"abstract":"","PeriodicalId":94350,"journal":{"name":"Phlebology","volume":" ","pages":"2683555251324282"},"PeriodicalIF":0.0,"publicationDate":"2025-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143525760","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":"Antithrombotic therapies for patients with acute iliofemoral deep vein thrombosis following endovenous recanalization: A single-center study and literature review.","authors":"Nedaa Skeik, Rina Li, Ellen Cravero, Bjorn Engstrom, Jesse Manunga","doi":"10.1177/02683555251321903","DOIUrl":"https://doi.org/10.1177/02683555251321903","url":null,"abstract":"<p><strong>Objectives: </strong>There is no consensus regarding the optimal antithrombotic therapy following endovenous recanalization. We aim to assess the effectiveness of anticoagulant, antiplatelet, or combination therapy to provide evidence-based recommendations for antithrombotic therapy following interventional procedures.</p><p><strong>Methods: </strong>An Institutional Review Board approved, retrospective study of patients presented to our facility with iliofemoral venous thrombosis requiring thrombolysis and/or thrombectomy with or without venous angioplasty/stenting between January 1, 2010 and April 1, 2023. Incidence of vein or stent patency, thrombosis, and bleeding were considered primary endpoints and were compared between patients on anticoagulant, antiplatelet, or combination therapies at each post-interventional surveillance, up to five visits.</p><p><strong>Results: </strong>The cohort yielded 128 patients, including 116 adults and 12 minors. We identified a notable trend in the post-recanalization medical routines of patients: those initially prescribed combination therapy post-procedure eventually transitioned to either exclusive anticoagulant or antiplatelet therapy. The initial combination antithrombotic therapy was associated with trends towards higher vein patency (59% vs 47% with anticoagulant vs 25% antiplatelet, <i>p</i> = .3), less recurrent vein and stent thrombosis (46% vs 54% with anticoagulants vs 100% antiplatelet, <i>p</i> = .10), and overall low major bleeding complications (3.2% vs 6.8% anticoagulant, <i>p</i> = .5) at first follow-up compared to those on anticoagulant or antiplatelet regimens alone.</p><p><strong>Conclusion: </strong>Although the optimal post-interventional antithrombotic therapy remains uncertain, combination therapy was associated with trends towards higher vein patency and lower recurrent thrombosis, with low overall major bleeding complications at the first follow-up visit following interventions. Future studies encompassing larger and more diverse populations are essential to corroborate the findings presented in this report and offer valuable insights for optimizing the management of patients with this condition.</p>","PeriodicalId":94350,"journal":{"name":"Phlebology","volume":" ","pages":"2683555251321903"},"PeriodicalIF":0.0,"publicationDate":"2025-02-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143451363","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":"Lipedema awareness in fibromyalgia.","authors":"Elzem Bolkan Günaydın, Zeliha Ünlü, Saime Ay, Tolga Oğuz Karapınar","doi":"10.1177/02683555251321042","DOIUrl":"https://doi.org/10.1177/02683555251321042","url":null,"abstract":"<p><strong>Objectives: </strong>To evaluate the presence of lipedema and lipedema-related factors in fibromyalgia patients.</p><p><strong>Methods: </strong>The study included 100 female patients over the age of 18 who met the fibromyalgia diagnostic criteria. The patients were evaluated for the presence/stages of lipedema. The body mass index (BMI), waist-hip ratio, waist-height ratio, and presence of hematoma tendency/telangiectasias were recorded. Patients were asked to mark the severity of their pain (widespread/on lipedema) on a 10 cm visual analog scale (VAS). The ACR 2016 Fibromyalgia Diagnostic Criteria, The Beck Depression Inventory (BDI), and The Revised Fibromyalgia Impact Questionnaire were applied.</p><p><strong>Results: </strong>Lipedema was observed in 50% of the patients (58% Stage 1 lipedema). In the lipedema group, age, duration of fibromyalgia diagnosis, hematoma tendency/presence of telangiectasias (for all; <i>p</i> < .001), menopausal status (<i>p</i> = .004), BDI score (<i>p</i> = .04), BMI (<i>p</i> = .02), history of medication for fibromyalgia (<i>p</i> = .01) were higher, and age at menarche (<i>p</i> = .01) was lower. Lipedema stage was moderately positively correlated with BMI, number of pregnancies (for both; r:0.53 <i>p</i> < .001) and waist-height ratio (r:0.43 <i>p</i>:0.002), while VAS-lipedema pain intensity was strongly positively correlated with VAS-widespread pain intensity (r:0.62 <i>p</i> < .001), and moderately positively correlated with symptom severity score (r:0.55 <i>p</i> < .001), BMI (r:0.54 <i>p</i> < .001), and fibromyalgia severity score (r:0.51 <i>p</i> < .001). Long fibromyalgia diagnosis time (<i>p</i>: 0.005), and low age at menarche (<i>p</i>: 0.05) were significant risk factors for the presence of lipedema.</p><p><strong>Conclusions: </strong>Lipedema is common in fibromyalgia patients. Long fibromyalgia diagnosis time and low age at menarche are significant risk factors for the presence of lipedema.</p>","PeriodicalId":94350,"journal":{"name":"Phlebology","volume":" ","pages":"2683555251321042"},"PeriodicalIF":0.0,"publicationDate":"2025-02-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143416471","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":"Preferences of continuing care service options for patients with venous leg ulcer: A discrete choice experiment.","authors":"Panpan Zhou, Fei Gu, Xian Wang, Zheng Huang, Jinzhi Yu, Meng Li","doi":"10.1177/02683555251319839","DOIUrl":"https://doi.org/10.1177/02683555251319839","url":null,"abstract":"<p><p><b>Objective:</b> The purpose of this study was to determine the preferences of patients with venous leg ulcer for wound continuing care programs. <b>Methods:</b> A discrete choice experiment was conducted among patients with venous leg ulcer in three large tertiary hospitals in Shanghai, China. Conditional logit analysis was used to estimate the preference weights for wound continuing care services. <b>Results:</b> A total of 223 VLU patients were surveyed, and 201 valid questionnaires were collected, with a validity rate of 90.1%. The modes of care delivery, service type, consistency of caregiver, and additional services were important considerations for patients when choosing wound continuing care options. Of these, community health service center and wound specialist nurses were preferred, as were options with the same caregiver providing services, online platform appointments, and the inclusion of additional services, while western care and make an appointment in-person at the clinic were relatively less attractive for patients. <b>Conclusion:</b> These results reflect patients' needs and preferences in different aspects and provide valuable references for healthcare organizations and care providers. Patient preferences are deemed as one of the multiple factors that necessitate consideration in the distribution of medical resources. They are integrated with various aspects of deliberations, including geographical location, health conditions, and economic status, so as to construct a comprehensive perspective.</p>","PeriodicalId":94350,"journal":{"name":"Phlebology","volume":" ","pages":"2683555251319839"},"PeriodicalIF":0.0,"publicationDate":"2025-02-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143384953","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 outcomes following treatment for small saphenous vein insufficiency: An AVLS PRO venous registry study.","authors":"Carlos Echevarria, Sherry Scovell, John Blebea, Micah Thornton, Julianne Stoughton","doi":"10.1177/02683555251317854","DOIUrl":"https://doi.org/10.1177/02683555251317854","url":null,"abstract":"<p><strong>Background: </strong>Compared to the great saphenous vein, there is a relative paucity of data in the literature focused on treating the small saphenous vein (SSV). Our goal was to evaluate and analyze national registry data related to the diagnosis and treatment of the SSV and identify practice patterns and clinical outcomes.</p><p><strong>Method: </strong>Subjects undergoing SSV interventions between April 2014 and March 2023 were identified in the AVLS PRO Venous Registry. Data points included Clinical, Etiological, Anatomical, Pathological (CEAP) classifications; Venous Clinical Severity Score (VCSS), Venous Quality of Life (VVSymQ®) instrument scores, Heaviness, Aching, Swelling, Throbbing, Itching (HASTI) symptoms, and Short Form Health Survey (SF-36.) Duplex ultrasound findings included vein diameter, length, and the overall recanalization rate.</p><p><strong>Result: </strong>A total of 92,175 SSV interventions were identified. Over two-thirds of subjects presented with a CEAP classification of C3 (31%) and C4 (C4 40%). Clinical results demonstrated significant improvement immediately after treatment in the first month and maintained beneficial results at 1 year or longer (<i>p</i> < 0.001.) This improvement was reflected in the significant decrease in VCSS scores (6 ± 3.4 to 5 ± 2.9; <i>p</i> < 0.0001), VVSymQ (9.5 ± 6.0 to 5.9 ± 4.4; <i>p</i> < 0.0001), and HASTI (9.4 ± 5.9 to 6.6 ± 5.2; <i>p</i> < 0.0001). The recanalization rate at any follow-up was 3%; 48% of those occurring within the first year. Predictors associated with recanalization were larger vein diameter (mean 4.0 mm, 95% CI 3.9-4.1, <i>p</i> < 0.0001) and shorter SSV length (mean 15.27 mm, 95 % CI 14.4-16.1, <i>p</i> < 0.0001).</p><p><strong>Conclusion: </strong>Treatment of SSV insufficiency improved clinical outcomes by both patient and physician-derived outcome measures. Only 3% of SSV demonstrated recanalization, and nearly half occurred within the first year following the procedure. Predictors of recanalization included larger pre-procedure vein diameters and treatment of a shorter length of SSV.</p>","PeriodicalId":94350,"journal":{"name":"Phlebology","volume":" ","pages":"2683555251317854"},"PeriodicalIF":0.0,"publicationDate":"2025-02-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143191441","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}