使用波利多卡诺内腔微泡沫处理血管内凝血的早期经验:风险因素分析。

Mariam Mesa-Damiano, Francisco J Melesio, Jailenne I Quiñones-Rodriguez, Rafael D Malgor, Limael E Rodriguez
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引用次数: 0

摘要

目的:我们进行了一项单中心回顾性队列研究,以确定在临床实践中观察到的使用多聚甲酚静脉内微泡沫(PEM 1%,VarithenaTM [polidocanol injectable microfoam],Boston Scientific,Marlborough,Mass)导致血管内凝血(IC)发生率增加的潜在风险因素:观察2021年12月至2024年1月期间在一家私人血管外科门诊接受polidocanol静脉内微泡沫(PEM)治疗的慢性静脉功能不全患者(n = 119),以确定IC发生的潜在风险因素。这些患者被分为两组:IC组(16人)与非IC组(103人)。在治疗后 2-6 周内,消融术后早期治疗部位疼痛和刺激症状加重,并在随后的随访中抽出凝固物的患者符合研究标准,被纳入 IC 组。此外,研究人员还利用去身份化的病历记录分析了患者的人口统计学特征、合并症和双相超声报告:研究期间共有 119 名患者接受了治疗,平均年龄为 62 岁。最常见的性别是女性,占 66%(78 人),最大的种族是拉丁裔,占 60%(71 人)。总体而言,13%(n = 16)的患者出现了血管内凝血。IC发生的平均时间为消融术后45天(范围:7-106天)。两组患者(IC 组和非 IC 组)在年龄、性别、种族或 VCSS 指数评分方面没有差异。单变量分析显示,发生 IC 的患者的 PEM 注射量低于非 IC 患者(4.1 mL vs 6.3 mL,P = .04)。研究还发现,GSV 的高反流(>1800 毫秒)和拉丁裔也是重要的风险因素。在对这些因素进行多变量分析评估时,较低的 PEM 注射量是唯一一个对 IC 的发生仍有显著影响的因素(p = .006):结论:较低的polidocanol静脉内微泡沫注射量是发生血管内凝血的风险因素。需要进一步研究,以确定每段治疗静脉的理想注射量。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Early experience managing intravascular coagulum using polidocanol endovenous microfoam: Risk factor analysis.

Objective: A single-center retrospective cohort study was conducted to identify potential risk factors that lead to increased incidence of intravascular coagulum (IC) observed in clinical practice using polidocanol endovenous microfoam (PEM 1%, VarithenaTM [polidocanol injectable microfoam], Boston Scientific, Marlborough, Mass).

Methods: Patients (n = 119) who received polidocanol endovenous microfoam (PEM) treatment for chronic venous insufficiency between December 2021 and January 2024 at a private outpatient vascular surgery clinic were observed to identify potential risk factors in the development of IC. The patients were stratified into two groups: IC (n = 16) versus non-IC (n = 103). Patients who returned with increased pain and irritation at the treatment site in the early post ablation period within 2-6 weeks of treatment and had coagulum aspirated at the subsequent follow-up visit met the study criteria and were included in the IC group. In addition, patient demographics, comorbidities, and duplex ultrasound reports were analyzed using deidentified chart records.

Results: There were 119 patients treated in the study period with a mean age of 62 years. Females were the most common sex 66% (n = 78) and Latinos represented the largest ethnicity 60% (n = 71). Overall, 13% (n = 16) of the patients developed an intravascular coagulum. The mean time to onset of IC was 45 days (range: 7-106 days) post-ablation. There was no difference between the groups (IC vs non-IC) for age, sex, ethnicity, or index VCSS scores. On univariate analysis, patients who developed IC had lower PEM injection volumes when compared to non-IC patients (4.1 vs 6.3 mL, p = .04). High reflux at the GSV (>1800 ms) and Latino ethnicity were also found to be significant risk factors. When these factors were evaluated in multivariate analysis, lower PEM injection volumes was the only factor that remained significant for the development of IC (p = .006).

Conclusion: Lower polidocanol endovenous microfoam injection volumes is a risk factor for developing intravascular coagulum. Further studies are needed to identify the ideal injection volume per segment of vein treated.

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