Phlebology最新文献

{"title":"A randomized controlled study to evaluate the safety and feasibility of concomitant transluminal injection of foam sclerosant combined with endovenous laser ablation in patients with incompetent small saphenous veins.","authors":"Satoshi Watanabe, Atsunori Okamura, Mutsumi Iwamoto, Akinori Sumiyoshi, Kota Tanaka, Heitaro Watanabe, Yoshitaka Iwanaga, Katsuomi Iwakura","doi":"10.1177/02683555241276709","DOIUrl":"10.1177/02683555241276709","url":null,"abstract":"<p><strong>Objectives: </strong>To compare foam sclerotherapy through the access sheath (transluminal foam sclerotherapy [TLFS]) combined with endovenous laser ablation (EVLA) with EVLA alone in terms of safety and one-year venous clinical severity score (VCSS) changes in patients with small saphenous vein incompetence.</p><p><strong>Methods: </strong>During EVLA, the sheath tip was placed around the targeted tributary vein, and the sclerosant was injected via the side port. Outcomes assessed at 1 day, 1 week, 1 month, and 1 year included VCSS changes, residual or recurrent reflux, the need for secondary interventions, and other related complications.</p><p><strong>Results: </strong>The change in VCSS did not reach the minimum clinically important difference. Otherwise, TLFS reduced residual or recurrent reflux of the tributary using the TLFS (3/74 legs) compared with the EVLA alone (12/77 legs) (<i>p</i> = .027).</p><p><strong>Conclusions: </strong>TLFS is a safe and feasible procedure that reduces residual or recurrent reflux of the tributary vein compared with truncal EVLA alone.</p>","PeriodicalId":94350,"journal":{"name":"Phlebology","volume":" ","pages":"116-125"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142116799","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 open vein hypothesis - is it the whole story?","authors":"Benedict Rh Turner, Marwah Salih, Jessica Shea, Adam M Gwozdz, Alun H Davies","doi":"10.1177/02683555241271914","DOIUrl":"10.1177/02683555241271914","url":null,"abstract":"","PeriodicalId":94350,"journal":{"name":"Phlebology","volume":" ","pages":"63-65"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141997167","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":"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":"Efficacy of ultrasound in the evaluation of iliac vein stenting.","authors":"Hannah Clode, Elizabeth Brooke Spencer, Jacqueline Nelson, Elisabeth S Horne","doi":"10.1177/02683555241276565","DOIUrl":"10.1177/02683555241276565","url":null,"abstract":"<p><p><b>Objectives:</b> The current study evaluated the efficacy of iliac and IVC ultrasound alone for follow-up evaluation of iliac vein stents in patients with pelvic venous disorders or iliac occlusion from chronic deep vein thrombosis. <b>Methods:</b> A retrospective single site cohort study was conducted by evaluating the most recent 100 iliac vein and inferior vena cava ultrasounds in patients who had undergone iliac vein stenting. Inclusion criteria included a history of iliac vein stent placement. Exclusion criteria included patients under 18-years-old, duplicates of the same patient, and pregnancy at the time of ultrasound. The degree of visualization for color flow, gray scale, and phasicity were determined and classified into the following categories: complete, partial, or none. In addition, each chart was assessed for external compression, in-stent narrowing, and requirements for further imaging. <b>Results:</b> Of the 100 iliac vein and IVC ultrasounds assessed in this review, 99 of the ultrasounds were sufficient for evaluation during follow-up visits without requiring further investigation. Within this study cohort, the average follow-up time was 22 months. The average participant body mass index was 27.6. One iliac vein and IVC ultrasound was considered inadequate for follow-up evaluation and required further imaging. <b>Conclusion:</b> The use of iliac and IVC venous doppler ultrasound alone in the follow-up evaluation of iliac stent patency is effective and noninvasive and avoids unnecessary radiation exposure and cost.</p>","PeriodicalId":94350,"journal":{"name":"Phlebology","volume":" ","pages":"110-115"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142074920","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":"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":"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":"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}