Phlebology最新文献

{"title":"The impact of ankle movements on venous return flow: A comparative study.","authors":"Yun Cao, JinFeng He, Xufeng Chen, Lei Jing, JiaWen Qiu, YuJuan Geng, Feng Chen, GuoZhen Sun, XueLi Ji","doi":"10.1177/02683555241264914","DOIUrl":"10.1177/02683555241264914","url":null,"abstract":"<p><strong>Objective: </strong>To compare the haemodynamic effects of different ankle movements combined ankle and toe movements on the femoral vein of the lower extremity.</p><p><strong>Methods: </strong>28 healthy volunteers participated in the study. Doppler ultrasound was used to measure peak systolic velocity and time-averaged mean velocity of the common femoral vein during ankle dorsiflexion, ankle dorsiflexion with simultaneous toe extension, ankle plantarflexion, and ankle plantarflexion with simultaneous toe flexion.</p><p><strong>Results: </strong>In comparison to the resting state, both ankle alone or ankle combined with toe movement showed statistically significant differences (<i>p</i> < .01). However, there were no significant difference in the velocity of the common femoral vein between ankle alone and ankle combined with toe movement (<i>p</i> > .05). It is noteworthy that dorsiflexion of the ankle resulted in the highest peak velocity of blood flow.</p><p><strong>Conclusion: </strong>The impact of ankle movement, with or without toe movement, the velocity of the common femoral vein is not significantly correlated.</p>","PeriodicalId":94350,"journal":{"name":"Phlebology","volume":" ","pages":"676-682"},"PeriodicalIF":0.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141725471","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":"Corrigendum to \"VenaBlock^® and VenaSeal^® class III cyanoacrylate products are effective and safe in varicose vein treatment\".","authors":"","doi":"10.1177/02683555241264093","DOIUrl":"https://doi.org/10.1177/02683555241264093","url":null,"abstract":"","PeriodicalId":94350,"journal":{"name":"Phlebology","volume":"39 10","pages":"723"},"PeriodicalIF":0.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142592440","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":"Guidelines for management of actual or suspected inadvertent intra-arterial injection of sclerosants.","authors":"Kurosh Parsi, Marianne De Maeseneer, Andre M van Rij, Christopher Rogan, Wendy Bonython, John A Devereux, Christopher K Lekich, Michael Amos, Ahmet Kursat Bozkurt, David E Connor, Alun H Davies, Sergio Gianesini, Kathleen Gibson, Peter Gloviczki, Anthony Grabs, Lorena Grillo, Franz Hafner, David Huber, Mark Iafrati, Mark Jackson, Ravul Jindal, Adrian Lim, Fedor Lurie, Lisa Marks, Pauline Raymond-Martimbeau, Peter Paraskevas, Albert-Adrien Ramelet, Rodrigo Rial, Stefania Roberts, Carlos Simkin, Paul K Thibault, Mark S Whiteley","doi":"10.1177/02683555241260926","DOIUrl":"10.1177/02683555241260926","url":null,"abstract":"<p><strong>Background: </strong>Inadvertent intra-arterial injection of sclerosants is an uncommon adverse event of both ultrasound-guided and direct vision sclerotherapy. This complication can result in significant tissue or limb loss and significant long-term morbidity.</p><p><strong>Objectives: </strong>To provide recommendations for diagnosis and immediate management of an unintentional intra-arterial injection of sclerosing agents.</p><p><strong>Methods: </strong>An international and multidisciplinary expert panel representing the endorsing societies and relevant specialities reviewed the published biomedical, scientific and legal literature and developed the consensus-based recommendations.</p><p><strong>Results: </strong>Actual and suspected cases of an intra-arterial sclerosant injection should be immediately transferred to a facility with a vascular/interventional unit. Digital Subtraction Angiography (DSA) is the key investigation to confirm the diagnosis and help select the appropriate intra-arterial therapy for tissue ischaemia. Emergency endovascular intervention will be required to manage the risk of major limb ischaemia. This includes intra-arterial administration of vasodilators to reduce vasospasm, and anticoagulants and thrombolytic agents to mitigate thrombosis. Mechanical thrombectomy, other endovascular interventions and even open surgery may be required. Lumbar sympathetic block may be considered but has a high risk of bleeding. Systemic anti-inflammatory agents, anticoagulants, and platelet inhibitors and modifiers would complement the intra-arterial endovascular procedures. For risk of minor ischaemia, systemic oral anti-inflammatory agents, anticoagulants, vasodilators and antiplatelet treatments are recommended.</p><p><strong>Conclusion: </strong>Inadvertent intra-arterial injection is an adverse event of both ultrasound-guided and direct vision sclerotherapy. Medical practitioners performing sclerotherapy must ensure completion of a course of formal training (specialty or subspecialty training, or equivalent recognition) in the management of venous and lymphatic disorders (phlebology), and be personally proficient in the use of duplex ultrasound in vascular (both arterial and venous) applications, to diagnose and provide image guidance to venous procedure. Expertise in diagnosis and immediate management of an intra-arterial injection is essential for all practitioners performing sclerotherapy.</p>","PeriodicalId":94350,"journal":{"name":"Phlebology","volume":" ","pages":"683-719"},"PeriodicalIF":0.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141753783","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":"Photoplethysmography-based assessment of varicose vein-related risk factors, exercise health beliefs, and venous refill time in healthcare professionals working in operating rooms and outpatient clinics.","authors":"Gökçe Şirin, Selda Karaveli Cakir, Sinem Eryiğit, Hasan Toz, Osman Pirhan, Semra Erpolat Taşabat, İlknur Çalişkan","doi":"10.1177/02683555241258308","DOIUrl":"10.1177/02683555241258308","url":null,"abstract":"<p><strong>Bacground: </strong>Impaired venous return is observed in healthcare professionals who spend long periods standing and sitting. This descriptive cross-sectional study was conducted to evaluate varicose vein-related risk factors, exercise health beliefs, and venous refill time in healthcare professionals working in operating rooms and outpatient clinics by photoplethysmography.</p><p><strong>Method: </strong>The study sample consisted of 100 healthcare professionals without a diagnosis of peripheral venous insufficiency. Data were collected using a descriptive characteristics form, the Health Belief Model Scale for Exercise, the Short-Form McGill Pain Questionnaire, and photoplethysmography.</p><p><strong>Result: </strong>This study found that OR nurses had shorter venous refill times and experienced more pain due to prolonged standing, despite their high health beliefs about exercise.</p><p><strong>Conclusion: </strong>Healthcare professionals working in operating rooms should be screened for venous insufficiency and trained regarding the practices to prevent venous insufficiency, such as lying down, elevating legs, and using elastic stockings.</p>","PeriodicalId":94350,"journal":{"name":"Phlebology","volume":" ","pages":"651-659"},"PeriodicalIF":0.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141422398","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 treatment for varicose veins of the lower limbs: Comparative histological evaluation of different techniques.","authors":"Luca Palombi, Alberto Caggiati, Pier Giovanni Bianchi, Monica Morelli, Fabio Martinelli, Elisabetta Merenda","doi":"10.1177/02683555241304572","DOIUrl":"https://doi.org/10.1177/02683555241304572","url":null,"abstract":"<p><strong>Background: </strong>In recent years, tumescent ablative techniques have been joined by non-tumescent ablative techniques. The aim of the research is to study and compare the effects produced by the different endovascular ablative techniques, from the histological point of view, at the level of the venous wall (endothelium, tunica media and adventitia).</p><p><strong>Method: </strong>The study involves the use of three ablative endovascular techniques (EVLA, MOCA, CGO) on bench for the treatment of the great saphenous vein. The bench procedure was performed in the same way as described in the instructions for use (IFU) of the technical specifications. Tissue samples were formalin-fixed and paraffin-embedded (FFPE). They were stained with hematoxylin and eosin and, in a case, with anti-ERG antibody (MA5-26,245, Termo Fisher).</p><p><strong>Result: </strong>No perivascular tissue was present. No hematoma or perforation of the vein wall was observed. Histopathological changes after EVLA indicated that the intima including the endothelium and sub-endothelium was completely necrotized. It was observed that the thermal-energy-induced injury in the intima did not reach deeper than the media. Overview shows that in this case the damage is homogenously spread along the entire perimeter. The most evident change in the sample treated with mechanical-chemical ablation (MOCA) technique was the endothelial damage with loss of endothelial cells. Specifically, with the ERG immunostaining it was possible to observe the presence of numerous nuclei exposed towards the lumen of the vein. In the sample treated with cyanoacrylate (CGO), no significant structural alterations were observed. However, an almost complete collapse of the endoluminal walls and the presence of cyanoacrylate residues were observed.</p><p><strong>Conclusion: </strong>Different histological patterns characterize the individual treatments. However, all techniques have a common feature: the damage is not transmural and the three different layers of the venous walls are always recognizable.</p>","PeriodicalId":94350,"journal":{"name":"Phlebology","volume":" ","pages":"2683555241304572"},"PeriodicalIF":0.0,"publicationDate":"2024-11-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142776096","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":"Sub-ulcer foam sclerotherapy in patients with venous ulceration: A randomized controlled trial.","authors":"Toni Pihlaja, Pasi Ohtonen, Pekka Romsi, Matti Pokela","doi":"10.1177/02683555241304030","DOIUrl":"https://doi.org/10.1177/02683555241304030","url":null,"abstract":"<p><strong>Purpose: </strong>This trial analyzed the effect of sub-ulcer foam sclerotherapy in patients with venous leg ulcer (VLU).</p><p><strong>Design: </strong>Randomized controlled trial.</p><p><strong>Methods: </strong>This trial recruited patients with VLUs to receive either sub-ulcer foam sclerotherapy and compression therapy (study group) or compression therapy only (control group). The primary outcome of this study was the change in the venous ulcer area at 4 weeks. The feasibility, safety, and complications of the sub-ulcer foam sclerotherapy were recorded.</p><p><strong>Results: </strong>Of 23 patients included, 12 were randomized to study group and 11 to control group. Preoperatively, the average ulcer areas were 5.8 cm² in both groups. At 4 weeks, the average reductions in ulcer areas were 4.0 cm² (SD 3.1) in the study group (95% CI 2.0 to 5.9, <i>p</i> = .001) and 2.0 cm² (SD 3.1) in the control group (95% CI: -0.1 to 4.1, <i>p</i> = .051). No differences in complications were recorded.</p><p><strong>Conclusions: </strong>At 1-month sub-ulcer foam sclerotherapy and compression therapy reduced the ulcer area statistically significantly, whereas compression therapy alone did not. Sub-ulcer foam sclerotherapy could be a good addition to superficial venous insufficiency treatment in patients with VLU.ClinicalTrials.gov identifier NCT03795064.</p>","PeriodicalId":94350,"journal":{"name":"Phlebology","volume":" ","pages":"2683555241304030"},"PeriodicalIF":0.0,"publicationDate":"2024-11-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142735472","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":"Complication rate with the 1940-nm versus 1470-nm wavelength laser.","authors":"Hak Hong Keo, Karoline Gondek, Nicolas Diehm, Christoph Leib, Heiko Uthoff, Rolf P Engelberger, Daniel Staub","doi":"10.1177/02683555241301192","DOIUrl":"https://doi.org/10.1177/02683555241301192","url":null,"abstract":"<p><strong>Background: </strong>We hypothesized, that endovenous laser ablation (EVLA) with the highly water specific 1940-nm wavelength laser would reduce ablation-related thrombus extension (ARTE) incidence compared to the less specific 1470-nm laser.</p><p><strong>Materials and methods: </strong>Between February 2017 to March 2023 we identified a consecutive series of patients undergoing EVLA from the prospectively ongoing VEINOVA registry. Patients were treated with the 1940-nm or 1470-nm laser. Demographic data and outcome data were used for this retrospective analysis.</p><p><strong>Results: </strong>From a total of 3055 EVLA, 2006 procedures were performed with the1470-nm and 1049 with the 1940-nm laser. At 2-6 days follow- up visit (follow up visit 1), all ARTE occurred in 18 (0.9%) of all procedures with the 1470-nm and in 1 (0.1%) with the 1940-nm laser (<i>p</i> = 0.023). DVT was similar in both groups (0.3% vs 0.2%, <i>p</i> = 0.784). Phlebitis occurred in 67 (3.3%) of all procedures with the 1470-nm and in 2 (0.2%; <i>p</i> = 0.003) with the 1940-nm laser and paresthesia in 99 (4.9%) versus 5 (0.5%; <i>p</i> < 0.001), respectively. At 5-6 weeks follow-up (follow up visit 2), all ARTE occurred in 27 (1.4%) of all procedures with the 1470-nm and in 4 (0.4%; <i>p</i> = 0.010) with the 1940-nm laser. DVT was similar in both groups (0.7% vs 0.4%; <i>p</i> = 0.846). Phlebitis occurred in 97 (4.8%) of all procedures with the 1470-nm and in 9 (0.9%; <i>p</i> < 0.001) with the 1940-nm laser and paresthesia in 194 (9.7%) versus 35 (3.3%; <i>p</i> < 0.001), respectively. Occlusion rate was in both groups similar (99.8% vs 99.6%).</p><p><strong>Conclusion: </strong>EVLA using the 1940-nm laser appears to be safe with lower ARTE incidence than using the 1470-nm laser. Phlebitis and paresthesia occurred less frequent with the 1940-nm than with the 1470-nm laser, thus favoring the use of the 1940-nm laser.</p>","PeriodicalId":94350,"journal":{"name":"Phlebology","volume":" ","pages":"2683555241301192"},"PeriodicalIF":0.0,"publicationDate":"2024-11-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142635707","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Will a patient information brochure increase acceptance of Omani women with varicose veins to be examined by a male surgeon ?- A prospective randomized single blinded study.","authors":"Ghaitha Al Mahruqi, Mouzan Al Ghaithi, Edwin Stephen, Hanan Al Mawaali, Ibrahim Abdelhedy","doi":"10.1177/02683555241299679","DOIUrl":"https://doi.org/10.1177/02683555241299679","url":null,"abstract":"<p><p>Varicose veins are not uncommon among Omani women. As currently there are no female vascular surgeons, it has been noticed in our outpatient clinic that a number of them are reluctant to be examined by a male vascular surgeon, have a duplex ultrasound done and therefore a management plan cannot be made in this subset. This study is a first of its kind in Oman, looking at the impact of a patient information booklet about varicose veins etiology, symptoms, signs, assessment and management, on the attitude of a female patient's acceptance towards examination by a male surgeon in the presence of a chaperone.</p>","PeriodicalId":94350,"journal":{"name":"Phlebology","volume":" ","pages":"2683555241299679"},"PeriodicalIF":0.0,"publicationDate":"2024-11-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142635709","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Thermal imaging as a diagnostic tool for superficial venous insufficiency - a systematic review.","authors":"Marwah Salih, Sarah Salih, Benedict R H Turner, Sarah Onida, Alun H Davies","doi":"10.1177/02683555241301194","DOIUrl":"https://doi.org/10.1177/02683555241301194","url":null,"abstract":"<p><strong>Objectives: </strong>Evaluation of the literature assessing the use of thermography, a non-invasive imaging modality that detects pathological temperature variation, in recognising superficial venous insufficiency (SVI).</p><p><strong>Methods: </strong>A systematic review was conducted according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Articles were screened by two individuals and data was subsequently extracted. Methodological quality was assessed with Cochrane's risk of bias tool.</p><p><strong>Results: </strong>Four studies comprising 363 patients were included. Three studies identified increased temperature uptake in veins with incompetent valves on venous duplex (<i>p</i> < .05). One study reported sensitivity and specificity of thermal imaging in SVI as 98.30% (95% CI, 95.2%-99.4%) and 100% (95% CI 85.7%-100%) respectively.</p><p><strong>Conclusion: </strong>Thermal imaging could act as a screening tool in SVI. This review highlights a lack of high-quality prospective studies evaluating the role of thermal imaging as a diagnostic tool that could expedite the assessment of patients.</p>","PeriodicalId":94350,"journal":{"name":"Phlebology","volume":" ","pages":"2683555241301194"},"PeriodicalIF":0.0,"publicationDate":"2024-11-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142635708","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prevalence and risk factors of hospital acquired venous thromboembolism.","authors":"Hai-Lei Li, He Zhang, Yiu Che Chan, Stephen W Cheng","doi":"10.1177/02683555241297566","DOIUrl":"https://doi.org/10.1177/02683555241297566","url":null,"abstract":"<p><strong>Objectives: </strong>To investigate the prevalence, clinical characteristics and risk factors of hospital acquired venous thromboembolism (HA-VTE) in a Chinese Hospital.</p><p><strong>Methods: </strong>Retrospective analysis of patients diagnosed as HA-VTE in a single institution from January 2016 to December 2022 was performed. Patients with VTE prior to admission or within 48 h after admission were excluded. Demographic data of patients was retrieved from the electronic medical database, and parameters affecting the occurrence of HA-VTE were analyzed.</p><p><strong>Results: </strong>4,022 patients from 321,997 episodes of medical admissions were diagnosed as VTE. Among these, 952 (23.7%) fulfilled the criteria of HA-VTE, corresponding to an incidence of 0.296%. 76% of patients presented with HA-deep vein thrombosis (DVT) alone, 13% presented with isolated HA-pulmonary embolism (PE), and 11% presented with concomitant HA- DVT and PE. Risk factor analyses showed statistically higher incidence in patients with elder age (67.5 ± 15.5 vs 48.3 ± 17.2 years, <i>p</i> < .001), male gender (0.346% vs 0.262%, <i>p</i> < .001), malignancy (0.513% vs 0.252%, <i>p</i> < .001), trauma (0.659% vs 0.28%, <i>p</i> < .001), emergency admission (0.664% vs 0.186%, <i>p</i> < .001), ICU stay (2.981% vs 0.226%, <i>p</i> < .001), and patients undergoing major surgery (0.702% vs 0.176%, <i>p</i> < .001). Patients with HA-VTE had longer hospital stay (22.5 ± 26.6 vs 7.21 ± 9.23 days, <i>p</i> < .001) and higher mortality rate (8.51% vs 1.01%, <i>p</i> < .001). The crude incidence rate of HA-VTE increased annually from 0.75 per 1,000 patients in 2016 to 5.89 per 1,000 patients in 2022. The subspecialties with the highest incidence rate of HA-VTE were cardiovascular surgery (1.40%), neurosurgery (1.10%), and respiratory medicine (0.72%).</p><p><strong>Conclusion: </strong>This is one of the few large scale studies to show that HA-VTE, accounting for nearly one quarter of all VTE events, occurs in 0.296% of adult hospitalizations. Patients with elder age, malignancy, ICU stay, and undergoing major surgery require more intensive HA-VTE surveillance and prevention.</p>","PeriodicalId":94350,"journal":{"name":"Phlebology","volume":" ","pages":"2683555241297566"},"PeriodicalIF":0.0,"publicationDate":"2024-11-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142585120","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}