Phlebology最新文献

{"title":"Evaluation of the accuracy and reproducibility of large language models (ChatGPT, DeepSeek, Gemini) in responding to patient-centered lipedema questions.","authors":"Rabia Sanır, Esra Nur Türkmen, Esra Giray, Figen Ayhan, Gülseren Akyüz","doi":"10.1177/02683555261490374","DOIUrl":"https://doi.org/10.1177/02683555261490374","url":null,"abstract":"<p><p>BackgroundLipedema is a frequently misdiagnosed chronic condition that significantly impacts patients' quality of life. As artificial intelligence (AI)-based large language models (LLMs) become increasingly integrated into healthcare communication, their accuracy and consistency in providing patient-centered information require thorough evaluation, especially in rare diseases like lipedema. Therefore, this study aimed to evaluate the accuracy and reproducibility of responses generated by ChatGPT, DeepSeek, and Gemini to questions frequently asked by patients with lipedema.MethodsThis cross-sectional study assessed the accuracy and reproducibility of responses generated by ChatGPT, DeepSeek, and Gemini to 25 commonly asked lipedema-related questions. Each model was queried twice in separate sessions, and answers were evaluated by three independent experts using a four-point rating scale. To ensure the objectivity and consistency of expert evaluations, inter-rater agreement was assessed using Cohen's kappa coefficient.ResultsDeepSeek achieved the highest proportion of comprehensive and correct responses (72%), followed by Gemini (64%) and ChatGPT (56%). Accuracy varied across content categories, with notable limitations particularly in treatment, follow-up, and maintenance questions. Reproducibility analysis revealed that DeepSeek produced the most consistent responses across sessions, while ChatGPT and Gemini showed more variability, particularly in treatment and quality-of-life questions. Cohen's kappa values indicated high inter-rater agreement overall, with perfect agreement in some categories for ChatGPT and DeepSeek.ConclusionsLLMs can provide generally accurate and consistent responses to patient-centered questions about lipedema, particularly in areas related to general information and diagnosis. However, reduced accuracy and reproducibility in complex clinical domains suggest that expert oversight is essential when using these tools for patient education.</p>","PeriodicalId":94350,"journal":{"name":"Phlebology","volume":" ","pages":"2683555261490374"},"PeriodicalIF":1.5,"publicationDate":"2026-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149032508","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":"Are anamnesis, examination and/or technical investigations of the skin and subcutaneous adipose tissue able to discriminate between lipedema and women without leg affections?","authors":"Erika Mendoza, Felix Amsler","doi":"10.1177/02683555261487488","DOIUrl":"https://doi.org/10.1177/02683555261487488","url":null,"abstract":"<p><p>IntroductionAfter unification of diagnostic criteria for lipedema through guidelines and consensus documents as a fat-disproportion between abdomen and extremities with pain in the affected area, reduced by compression, expensive treatment options like liposuction should be reserved to affected women. Whilst the diagnosis of lipedema is obviously clinic, technical investigations or clear cut-offs shall help avoiding misuse of resources. The aim of this study was to find differentiation criteria between lipedema (LIP) controls (CO).MethodsInvestigator initiated exploratory investigation of 20 women per group, with interim analysis after completion of investigation of 10 women per group. 14 LIP and 12 CO were investigated with QOL-questionnaires (CIVIQ and Lymph), Wunstorf-Vein-Office anamnesis questionnaire, Visual Analogue Scale (VAS) of spontaneous pain, Pain under manual investigation, pain under compression cuffs, ultrasound of skin and subcutaneous fat tissue, share-wave-elastography, water content of skin (LymphScanner) and stiffness of skin (FibroScanner).ResultsStatistical evaluation between LIP and CO presented significant differences for all parameters excepting share-wave-elastography, water content and stiffness of the skin. Differences between controls and Lipedema were achieved with p < .0001 for the Wunstorf-Vein-Questionnaire, with p < .001 for CIVIQ (cut-off >40 Points for LIP), compression cuff (cut-off <60mmHG), with p < .01 Skin thickness (skin lateral thigh >2.1 mm in LIP), fat tissue thickness (ankle >18 mm).ConclusionThis first analysis could establish a series of clear cut-off values between lipedema and controls for medical history parameters (existence of pain and compliance with compression garments), pain sensitivity to palpation and pressure, and the results of at least one quality-of-life questionnaire (CIVIQ better than Lymph-QOL) and promising cut-offs for objective, technically measurable parameters, such as skin and subcutaneous fat thickness. The possibility to discriminate between lipedema and lipohypertrophy will be assessed in the second part of the investigation.</p>","PeriodicalId":94350,"journal":{"name":"Phlebology","volume":" ","pages":"2683555261487488"},"PeriodicalIF":1.5,"publicationDate":"2026-09-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149019454","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":"SkinFibroMeter in lower extremity lymphedema assessment: Reliability, correlation with ultrasound, and the determination of minimal detectable change.","authors":"Elif Duygu-Yildiz, Samet Genez, Serkan Sevim, Beyza Özcan, Gozde Tekin, Nuriye Özengin","doi":"10.1177/02683555261491461","DOIUrl":"https://doi.org/10.1177/02683555261491461","url":null,"abstract":"<p><p>ObjectivesThis study aimed to determine the inter- and intra-rater reliabilities of the SkinFibroMeter in individuals with lower extremity lymphedema. The secondary aim was to examine its correlation with skin/subcutaneous tissue thickness and establish minimal detectable change (MDC₉₅) values.MethodsThirty lower extremities with physician-diagnosed lymphedema were included in this cross-sectional study. Tissue stiffness was assessed at standardized anatomical sites using the SkinFibroMeter® by four raters with varying clinical experience. Skin and subcutaneous tissue thickness were measured at the same points via ultrasound (US). Inter- and intra-rater reliabilities were evaluated using intraclass correlation coefficients (ICC), and the standard error of measurement and MDC₉₅ were calculated.ResultsParticipants had a mean age of 68 ± 11.9 years, a mean BMI of 34.0 ± 6.0 kg/m², and a mean limb volume of 10,020 ± 3,148 mL. Intra-rater reliability ranged from moderate to excellent (ICC = 0.600-0.976), while inter-rater reliability varied by site (ICC = 0.647-0.941), with the highest agreement at 20 cm above the patella and the lowest at the foot dorsum. Bland-Altman analysis confirmed acceptable absolute agreement across rater pairs with negligible systematic bias. Low-to-moderate positive correlations were observed between the indentation values of the SkinFibroMeter and skin thickness (r = 0.377-0.556, <i>p</i> < .05), whereas negative correlations were found with subcutaneous thickness at several points (r = -0.508 to -0.421, <i>p</i> < .05). No statistically significant correlation was found between localized stiffness and total limb volume (r = -0.023, <i>p</i> = .907). MDC₉₅ values ranged from 0.013 to 0.158.ConclusionThe SkinFibroMeter demonstrates acceptable clinical reliability, with values representing a complex interplay of dermal thickness, interstitial hydration, and tissue compliance rather than global limb size or pure fibrosis. This is the first study to establish MDC₉₅ thresholds, providing clinicians with reference baselines for treatment-related changes. Future studies should incorporate larger, stage-homogeneous cohorts using 3D scanning and shear-wave elastography for comprehensive tissue characterization.</p>","PeriodicalId":94350,"journal":{"name":"Phlebology","volume":" ","pages":"2683555261491461"},"PeriodicalIF":1.5,"publicationDate":"2026-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149009663","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":"A novel Doppler ultrasound approach for phenotypic assessment and follow-up of Klippel-Trénaunay syndrome: A retrospective multicenter study.","authors":"Dan Li, Hui Yang, Jiana Li, Xiaoyun Tan, Zhenyin Liu, Jiejun Xia, Jing Zhang, Yin Xia, Jianzhong Huang, Honghui Su","doi":"10.1177/02683555261490370","DOIUrl":"https://doi.org/10.1177/02683555261490370","url":null,"abstract":"<p><p>BackgroundKlippel-Trénaunay syndrome (KTS) is a rare congenital vascular malformation disorder involving complex venous, lymphatic, and soft-tissue abnormalities. Doppler ultrasound (DUS) is widely used for vascular assessment, but the relationship between ultrasound-derived features and venous clinical severity in KTS remains insufficiently defined.MethodsThis retrospective multicenter study included 58 patients with clinically diagnosed KTS involving 63 affected lower extremities between January 2020 and December 2022. We evaluated whether selected DUS-derived features were associated with venous clinical severity assessed using CEAP class and VCSS. Associations were analyzed using Kendall's tau-b correlation and exploratory generalized additive models.ResultsDeep venous anomalies were identified in 25 of 63 affected extremities (39.7%). The LMV was detected in 60 extremities (95.2%), with a mean diameter of 5.23 mm. Posture-dependent venous caliber or visualization changes were observed in nine extremities (14.3%). VCSS increased across CEAP classes (<i>p</i> < .001). LMV diameter showed a moderate positive correlation with VCSS (tau = 0.338, <i>p</i> < .001). In the exploratory GAM, LMV diameter showed a possible nonlinear association with VCSS, with higher scores observed around and above an approximately 5-mm reference point (<i>p</i> = .049). Morphologic lymphatic malformation was also associated with higher VCSS after adjustment for model covariates (beta = 2.23, <i>p</i> = .020).ConclusionsDUS-derived features, particularly LMV diameter and morphologic lymphatic malformation, were associated with venous clinical severity in lower-limb KTS. Supine-standing DUS additionally demonstrated posture-dependent venous caliber or visualization changes in a subset of extremities. These findings support standardized DUS as a useful imaging approach for phenotypic assessment and follow-up in KTS, while the exploratory LMV diameter reference point requires prospective validation.</p>","PeriodicalId":94350,"journal":{"name":"Phlebology","volume":" ","pages":"2683555261490370"},"PeriodicalIF":1.5,"publicationDate":"2026-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149003139","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":"Mechanical thrombectomy as a safe alternative to catheter directed thrombolysis for upper extremity DVT.","authors":"Alexandra Tsirigoti, Domenico Baccellieri, Ferdinando B A Valente, Vincenzo Ardita, Vasileios Bouris, Georgios Tzavellas, Dimitrios Papastavrou, Efthymios D Avgerinos","doi":"10.1177/02683555261491465","DOIUrl":"10.1177/02683555261491465","url":null,"abstract":"<p><p>BackgroundUpper extremity deep vein thrombosis (UEDVT) has been widely managed with anticoagulation and selectively with catheter directed thrombolysis (CDT) targeting prompt venous recanalization. CDT, however, comes with a bleeding risk and complex perioperative logistics. Percutaneous mechanical thrombectomy (MT) devices may simplify the procedure. However their safety and efficacy remain unknown.MethodsThe records of 14 consecutive patients with symptomatic UEDVT who underwent MT at two tertiary European centers were reviewed (2020-2025). Subclavian vein thrombosis was the principal anatomical criterion for inclusion. MT was considered primarily in young, active individuals and athletes and in patients with persistent symptoms despite anticoagulation, with symptom duration not exceeding 3 weeks. Three different devices were used for MT: The ClotTriever system (Inari Medical, Irvine, CA), the Aspirex Mechanical Aspiration Thrombectomy System (Straub Medical, Wangs, Switzerland) and the Penumbra System (Penumbra Inc, Alameda, California, USA), with or without subsequent first rib resection and venoplasty. Preoperative demographics, intraoperative details, in-hospital and follow up complications, venous patency and symptomatic relief data were collected for descriptive analysis.ResultsSingle session MT through basilic or brachial vein access was performed and successfully completed in all 14 patients (mean age 30.57 ± 11.01, 8 males). No major postoperative adverse events were noted and the patients were discharged within 1.7 ± 1.20 days on low molecular weight heparin. One patient experienced 30-day rethrombosis. Among the 14 patients, 6 patients underwent subsequent first rib resection. Patients received full anticoagulation for 3-6 months. At an average 26.07 ± 13.5 month follow up, 9 out of 14 patients were completely free of symptoms without UEDVT recurrence.ConclusionFor the management of symptomatic UEDVT, mechanical thrombectomy using current technologies is feasible with high technical and clinical success. Larger series are required to validate our results.</p>","PeriodicalId":94350,"journal":{"name":"Phlebology","volume":" ","pages":"2683555261491465"},"PeriodicalIF":1.5,"publicationDate":"2026-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149003205","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 different modifications of the Caprini risk score in bariatric surgery.","authors":"Alexander G Khitaryan, Alexey A Orekhov, Elena Y Kirtanasova, Vladislav P Evdokimov, Valeriya V Kozlova, Kirill V Lobastov","doi":"10.1177/02683555261490352","DOIUrl":"https://doi.org/10.1177/02683555261490352","url":null,"abstract":"<p><p>BackgroundBariatric surgery is associated with an increased risk of postoperative venous thromboembolism (VTE). This study aimed to compare the predictive accuracy of the Caprini risk score (CRS 2005, 2010, and a population-specific version) for postoperative VTE in obese patients undergoing bariatric surgery.MethodsA prospective observational study was conducted from 2020 to 2025, involving 120 patients aged 26-75 years with obesity (BMI, 35-85 kg/m²) undergoing laparoscopic bariatric surgery. VTE risk factors were assessed, including visceral fat area by computed tomography, estimated fat apron weight (FAW), severe obstructive sleep apnea (sOSA), CO₂-pneumoperitoneum pressure, and popliteal vein blood flow measured intraoperatively via Doppler ultrasound scan. The primary outcome combined asymptomatic and symptomatic deep vein thrombosis (DVT) and symptomatic pulmonary embolism (PE) within 30 days postoperatively.ResultsThe incidence of postoperative VTE was 5.0% (95% CI, 2.3-10.5%), including one symptomatic PE (0.8%). Regression analysis identified CRS 2010, the estimated FAW, and sOSA as significant predictors of VTE. In the modified CRS, a FAW ≥11 kg was assigned 1 point, and the presence of sOSA was assigned 3 points. The improved predictive accuracy was observed with the CRS 2010, considering sOSA (AUC, 0.866; 95% CI, 0.794-0.939) and sOSA with FAW (AUC, 0.862; 95% CI, 0.784-0.939). The optimal cut-off value was ≥12 points (sensitivity 83%, specificity 81%).ConclusionsIn bariatric surgery, CRS 2010 with sOSA and FAW showed a potential improvement in predicting postoperative VTE, with scores ≥12 indicating the highest risk. Although these findings remain preliminary and require further validation.</p>","PeriodicalId":94350,"journal":{"name":"Phlebology","volume":" ","pages":"2683555261490352"},"PeriodicalIF":1.5,"publicationDate":"2026-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149003166","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":"Impact of adjunctive venoactive drug therapy on symptom relief and quality of life following radiofrequency ablation for symptomatic great saphenous vein incompetence.","authors":"Mingyang Shen, Maozhen Chen, Xiaoqiang Li","doi":"10.1177/02683555261490787","DOIUrl":"https://doi.org/10.1177/02683555261490787","url":null,"abstract":"<p><p>ObjectiveTo examine the association between postoperative adjuvant venoactive drug (VAD) use and symptom relief and quality of life (QoL) in patients undergoing radiofrequency ablation (RFA) for symptomatic varicose veins of the great saphenous vein (GSV).MethodsThis retrospective cohort study screened 565 consecutive patients who underwent RFA for symptomatic GSV varicose veins between June 2022 and June 2024. After application of the eligibility criteria, 500 patients were included and classified according to postoperative VAD use into a standard-care group (<i>n</i> = 250) and a standard-care plus VAD group (<i>n</i> = 250). Postoperative complication rates, Venous Clinical Severity Score (VCSS), Numeric Rating Scale (NRS), and Chronic Venous Insufficiency Questionnaire (CIVIQ) scores were compared.ResultsThe observation group had a significantly lower total complication rate (3.60% vs 12.80%, <i>P</i> < 0.05). VCSS scores at 1 week and 3 months and NRS scores at 1 day, 1 week, and 3 months were lower in the observation group (<i>P</i> < 0.05). CIVIQ scores were significantly higher in the observation group at 3 months and 1 year postoperatively (<i>P</i> < 0.05). Exploratory subgroup analyses showed generally consistent between-group patterns across the predefined age, disease-duration, and sex subgroups. ConclusionAdjunctive VAD therapy following GSV RFA was associated with fewer postoperative complications, lower VCSS and NRS scores, and higher CIVIQ scores. These findings support further prospective evaluation of VAD therapy as an adjunct to postoperative management.</p>","PeriodicalId":94350,"journal":{"name":"Phlebology","volume":" ","pages":"2683555261490787"},"PeriodicalIF":1.5,"publicationDate":"2026-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148993440","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":"Exercise-based interventions for prevention and management of deep vein thrombosis: A systematic review.","authors":"Maria Lourdes Del Río Solá, Ana Pérez Jiménez, Sandra Pérez Fernández","doi":"10.1177/02683555261490372","DOIUrl":"https://doi.org/10.1177/02683555261490372","url":null,"abstract":"<p><p>ObjectiveTo evaluate the effectiveness and safety of exercise-related interventions for the prevention and management of deep vein thrombosis (DVT).Data sourcesPubMed, Web of Science, and Google Scholar were searched from inception to 31 December 2024 using terms related to exercise, physical activity, DVT, and venous thromboembolism. Reference lists of eligible studies and relevant systematic reviews were also screened. English- and Spanish-language studies were considered.Review methods11 primary studies, reported in 12 publications, met the eligibility criteria: seven evaluated preventive strategies or venous-haemodynamic outcomes in participants without established DVT, three evaluated mobilisation or supervised exercise following objectively confirmed acute DVT, and one evaluated supervised exercise in established post-thrombotic syndrome. Two reviewers independently extracted study characteristics, interventions, comparators, outcomes, safety data, and results. Risk of bias was assessed using design-specific tools, and findings were synthesized narratively by clinical setting.Data synthesisExercise interventions produced favourable changes in surrogate lower-limb venous-haemodynamic measures, while regular sports participation was associated with lower odds of a first venous thrombosis. In acute DVT, mobilisation alongside anticoagulation and compression did not appear to increase thromboembolic complications. Symptomatic improvements could not be separated from compression, and supervised exercise did not improve recanalisation. In established post-thrombotic syndrome, supervised exercise improved disease-specific quality of life, although the reduction in Villalta score was not statistically significant. No universal start time was established. Evidence was limited by small samples, heterogeneity, and methodological concerns.ConclusionsExercise may favourably modify surrogate venous haemodynamics. In selected patients with acute DVT receiving anticoagulation and compression, mobilisation did not appear to increase thromboembolic complications, although its independent effects and optimal timing remain uncertain. Supervised exercise may improve disease-specific quality of life in established post-thrombotic syndrome. Larger randomized trials using standardized interventions and clinically relevant outcomes are required.</p>","PeriodicalId":94350,"journal":{"name":"Phlebology","volume":" ","pages":"2683555261490372"},"PeriodicalIF":1.5,"publicationDate":"2026-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148993460","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":"Exercise interventions for lower limb lymphedema: A scoping review of intervention characteristics and outcomes.","authors":"Cansu Sahbaz Pirincci, Aysegul Dulger, Esma Demir, Serap Cinar, Serife Aydin, Tugba Ozcan, Emine Cihan","doi":"10.1177/02683555261487774","DOIUrl":"https://doi.org/10.1177/02683555261487774","url":null,"abstract":"<p><p>This scoping review aimed to summarize the existing evidence regarding exercise interventions in individuals with lower limb lymphedema (LLL), focusing on intervention characteristics, outcome measures, and reported effects.MethodsA scoping review was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR). This study was conducted using a scoping review design to examine the existing literature on the effects of exercise interventions in LLL between January 1, 2016, and March 1, 2026. Studies investigating any type of exercise intervention in adults with primary or secondary LLL were included. Data on study characteristics, participant demographics, exercise protocols, outcome measures, and key findings were extracted and synthesized descriptively.ResultsEighteen studies investigating exercise interventions for lower limb lymphedema were included. Most participants were women with secondary lymphedema following gynecological cancer treatment. Exercise, frequently combined with compression or complex decongestive therapy, was associated with reductions in limb volume and edema, as well as improvements in pain, functional capacity, walking performance, and quality of life. Preventive exercise programs also reduced the incidence or delayed the onset of lymphedema in several studies. Across all included studies, exercise was well tolerated, with no evidence of lymphedema exacerbation or serious adverse events. However, substantial heterogeneity was observed in exercise protocols, intervention duration, and outcome measures.ConclusionThe studies reviewed in this review demonstrate that exercise is a safe, feasible, and effective approach to managing lower-extremity lymphedema. Active exercise combined with compression therapy significantly reduces edema volume.</p>","PeriodicalId":94350,"journal":{"name":"Phlebology","volume":" ","pages":"2683555261487774"},"PeriodicalIF":1.5,"publicationDate":"2026-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148979168","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":"Inferior vena cava agenesis: Clinical presentation, imaging characteristics, and midterm outcomes with a proposed diagnostic algorithm.","authors":"Ayşegül Durmaz, Mustafa Canikoğlu, Özgür Barış, Özgür Çakır, Tülay Çardaközü, Şadan Yavuz","doi":"10.1177/02683555261486520","DOIUrl":"https://doi.org/10.1177/02683555261486520","url":null,"abstract":"<p><p>ObjectiveInferior vena cava agenesis (IVCA) is a rare developmental venous anomaly associated with proximal deep vein thrombosis (DVT) in young patients. Evidence guiding diagnostic and therapeutic strategies remains limited. We evaluated clinical presentation, imaging characteristics, management approaches, and midterm outcomes of patients with IVCA.MethodsWe performed a retrospective review of patients diagnosed with IVCA between January 2020 and January 2025 at a tertiary referral center. Demographics, thrombotic events, imaging findings, associated anomalies, treatment strategies, and follow-up outcomes were analyzed descriptively.ResultsEight patients were identified (87.5% male; mean age 35.8 ± 13.1 years). Six (75%) were symptomatic, most commonly with lower-extremity swelling (50%) and pain (37.5%). Iliofemoral DVT occurred in two patients (25%); superficial thrombophlebitis occurred in one (12.5%). Pulmonary embolism was not observed. Diagnosis was established primarily by computed tomography (87.5%). Anatomical subtypes included infrarenal (50%), complete (37.5%), and suprarenal agenesis (12.5%). One patient had thrombophilia with associated cardiac and renal anomalies. Over a mean follow-up of 3.5 ± 2.33 years, no recurrent DVT or new venous insufficiency occurred.ConclusionsIVCA should be suspected in young patients presenting with unexplained proximal DVT. Cross-sectional imaging is essential for definitive diagnosis. Individualized, risk-adapted management appears safe in the midterm; however, standardized therapeutic guidelines are lacking.</p>","PeriodicalId":94350,"journal":{"name":"Phlebology","volume":" ","pages":"2683555261486520"},"PeriodicalIF":1.5,"publicationDate":"2026-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148979172","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}