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Varicose ulcer

Joseph D Raffetto
Chronic venous disease and venous leg ulceration are a common disease affecting millions of individuals. The fundamental problem is venous hypertension with resultant clinical manifestations of venous disease including varicose veins, skin changes, and venous leg ulceration. The pathophysiology leading to venous hypertension is complex and multifactorial, involving genetic predisposition, environmental factors, hormones, endothelial dysfunction, inflammatory cells and molecules and activation on the endothelium and vein wall, and disturbances in the balance of cytokines and matrix metalloproteinases...
April 2018: Surgical Clinics of North America
Leelavathy Budamakuntla, Eswari Loganathan, Sacchidananda A Sarvajnamurthy, H V Nataraj
Introduction and Objectives: The restoration of the epithelium after injury takes place by migration of epithelial cells adjoining a wound or by centrifugal migration from hair follicles. To evaluate the feasibility and potential healing capacity of scalp follicular unit grafts transplanted into the wound bed of chronic leg ulcers. Materials and Methods: Patients with chronic nonhealing ulcers of more than 6 weeks duration were selected for the study. Those with infected ulcers and uncontrolled diabetes were excluded from the study...
October 2017: Journal of Cutaneous and Aesthetic Surgery
Djordje Radak, Igor Atanasijevic, Mihailo Neskovic, Esma Isenovic
Chronic venous disease (CVeD) is a highly prevalent condition in the general population, and it has a significant impact on quality of life. While it is usually manifested by obvious signs, such as varicose veins and venous ulcers, other symptoms of the disease are less specific. Among the other symptoms, which include heaviness, swelling, muscle cramps and restless legs, pain is the symptom that most frequently compels CVeD patients to seek medical aid. However, there is a substantial discrepancy between pain severity and clinically detectable signs of CVeD, questioned by several opposing studies...
February 8, 2018: Current Vascular Pharmacology
Jean-Philippe Galanaud, Laurent Bertoletti, Maria Amitrano, Carmen Fernández-Capitán, José María Pedrajas, Vladimir Rosa, Manuel Barrón, Alicia Lorenzo, Olga Madridano, Isabelle Quéré, Susan R Kahn, Paolo Prandoni, Manuel Monreal
In patients with deep-vein thrombosis (DVT) in the lower limbs, venous ulcer is the most debilitating and end-stage clinical expression of the post-thrombotic syndrome (PTS). To date, risk factors for PTS-related ulcer in DVT patients have not been identified.We used the international observational RIETE registry to assess the evolution of PTS signs and symptoms during a 3-year follow-up period and to identify independent predictors of PTS ulcer at 1 year in patients with acute DVT.Among 1,866 eligible patients, cumulative rates of PTS ulcer at 1, 2 and 3 years were 2...
February 2018: Thrombosis and Haemostasis
İlker Akar, İlker İnce, Cemal Aslan, İsmail Benli, Osman Demir, Nuray Altındeger, Abdullah Dogan, Mehmet Ceber
Objectives Vascular endothelial dysfunction leads to the emerging of free oxygen radicals, deficiency of antioxidant system, forming of oxidative stress, inflammatory processes and release of proinflammatory cytokines. These things play big role in the development of primary varicose veins. Prolidase has been reported as an indicator of oxidative stress in diabetes, diabetic neuropathy, non-ulcerous dyspepsia, osteoporosis, polycystic over syndrome and many other diseases. The aim of this study is to evaluate the oxidative stress at venous insufficiency and to provide preliminary knowledge about the role of prolidase enzyme in varicose vein formation...
January 1, 2017: Vascular
Giovanni Turtulici, Ermenegildo Furino, Giorgia Dedone, Riccardo Sartoris, Jeries Zawaideh, Aldo Fischetti, Enzo Silvestri, Gennaro Quarto
AIM: The aim of our study was to evaluate the efficacy of a new treatment of recurrent varicose vein after stripping of the great saphenous vein with rigid radiofrequency needles. MATERIAL OF STUDY: 37 patients enrolled (11 males and 26 females). 10 patients had recurrent varicose veins for the presence of residual reflux in the Saphenous-Femoral Junction (SFJ) stump, whilst 21 patients for the presence of a single or multiple re-chanalized and refluxing perforator veins, and 6 had mixed rechanalization due to perforator veins and refluxing saphenous stump...
2017: Annali Italiani di Chirurgia
Emma Dabbs, Alina Sheikh, David Beckett, Mark S Whiteley
This case study reports the diagnosis and treatment of a lower limb venous ulcer with abnormal underlying venous pathology. One male patient presented with bilateral varicose veins and a right lower limb ulcer. Upon investigation, full-leg duplex ultrasonography revealed total incompetence of the great saphenous vein in the left leg. In the right leg, duplex ultrasonography showed proximal incompetence of the small saphenous vein, and dilation of the anterior accessory saphenous vein, which remained competent...
2017: SAGE Open Medical Case Reports
M Kanapathy, R Simpson, L Madden, C Thrasivoulou, A Mosahebi, D L Becker, T Richards
BACKGROUND: Leg ulceration is a feared complication of venous insufficiency. It is not known whether varicose veins predispose skin to poor wound healing. The expression pattern of gap junctional protein connexin, a known marker of poor wound healing, was investigated across various stages of venous disease. METHODS: Patients undergoing intervention for varicose veins were assessed according to the Clinical Etiologic Anatomic Pathophysiologic (CEAP) classification of varicose veins...
January 2018: British Journal of Surgery
Sabrina Johanna Swoboda, Hauke Schumann, Dimitra Kiritsi
We present the case of a 58-year-old man who presented to our wound care centre with a 7 -month history of a progressive unilateral leg ulcer. He reported intermittent, heavy bleeding at the ulcer. The duplex sonography showed a bilateral incompetence of the saphenofemoral junctions and the entire course of the great saphenous veins and, surprisingly, also a bilateral reversed arterial-like pulsating flow in the great and small saphenous veins as well as in the deep veins of the lower extremities. During cardiac examination by auscultation and echocardiography, we detected a previously undescribed severe tricuspid insufficiency with strongly reduced systolic ejection of both the left and the right ventricle and repercussions on the peripheral venous system as a cause for the pulsating veins...
November 7, 2017: International Wound Journal
Manash Ranjan Sahoo, Leesa Misra, Sumeet Deshpande, Sambit Kumar Mohanty, Santosh Kumar Mohanty
AIM: Aim of this study is to evaluate the results of Subfascial Endoscopic Perforator Surgery(SEPS) in treating varicose veins in 2nd trimester of pregnancy for below knee perforator incompetence. MATERIALS AND METHODS: A case series was undertaken at our institute from the period January 2010 to January 2014 on 45 pregnant women. Pregnant women with failed conservative management for varicose veins were subjected to SEPS in 2nd trimester Perioperative parameters like operative time, intraoperative complications, post-operative complications, hospital stay, pain relief, ulcer healing duration and recurrence rate were studied...
October 23, 2017: Journal of Minimal Access Surgery
Igor A Zolotukhin, Evgeny I Seliverstov, Yuri N Shevtsov, Ilona P Avakiants, Aleksey S Nikishkov, Andrey M Tatarintsev, Alexander I Kirienko
OBJECTIVE/BACKGROUND: The aim was to establish the prevalence of chronic venous disease (CVD) and its risk factors in the general population. METHODS: This was a population based, cross sectional study. In total, 703 residents aged > 18 years from the rural community of Kryukovo (Central Russia) were enrolled. Medical history was taken and clinical examination performed, documenting venous signs/symptoms. The CEAP classification of the most affected limb was used...
December 2017: European Journal of Vascular and Endovascular Surgery
Guilherme Camargo Gonçalves de-Abreu, Otacílio de Camargo, Márcia Fayad Marcondes de-Abreu, José Luís Braga de-Aquino
Chronic venous insufficiency is characterized by cutaneous alterations caused by venous hypertension; in severe forms, it progresses to lower limb ulcers. Lower limb varicose veins are the main cause of chronic venous insufficiency, and the classic treatment includes surgery and compressive therapy. Minimally invasive alternative treatments for varicose veins include new techniques such as venous thermal ablation using laser or radiofrequency. The use of different methods depends on clinical and anatomical factors...
September 2017: Revista do Colégio Brasileiro de Cirurgiões
Krishna Prasad Bellam Premnath, Binu Joy, Vijayakumar Akondi Raghavendra, Ajith Toms, Teena Sleeba
Various treatment methods are available for the treatment of varicose veins, and there has been a recent surge in the usage of cyanoacrylate glue for treating varicose veins. Purpose To investigate the technical possibility, efficiency and safety of cyanoacrylate adhesive embolization and sclerotherapy using commonly available n-butyl cyanoacrylate glue for the treatment of primary varicose veins due to great saphenous vein reflux with or without incompetent perforators. Materials and Methods One hundred forty-five limbs of 124 patients with varicose veins due to great saphenous vein reflux were subjected to cyanoacrylate adhesive embolization and sclerotherapy - adhesive embolization of great saphenous vein in the thigh and perforators using cyanoacrylate followed by sclerotherapy of any residual varicose veins in the leg...
January 1, 2017: Phlebology
Krishna Prasad Bp, Binu Joy, Ajith Toms, Teena Sleeba
Recurrent lower limb venous insufficiency is often a challenge in clinical practice and is most commonly due to incompetent perforators. Many of these patients do not have adequate symptom relief with compression and require some form of treatment for incompetent perforator interruption. Various treatment methods have been tried with different efficiencies. Objective To evaluate the feasibility, efficiency and safety of an outpatient combined cyanoacrylate adhesion-sodium tetradecyl sulphate sclerotherapy for treatment of patients with symptoms of persistent or recurrent lower limb venous insufficiency secondary to incompetent perforators...
January 1, 2017: Phlebology
Matheus Bertanha, Marcone Lima Sobreira, Paula Angelelli Bueno Camargo, Rafael Elias Farres Pimenta, Jamil Victor Oliveira Mariúba, Regina Moura, Vanderlei Salvador Bagnato, Winston Bonetti Yoshida
The endovenous laser ablation (EVLA) of the insufficient saphenous vein has similar results to open conventional surgery, but less morbidity. The echo-guided polidocanol foam sclerotherapy technique has been used for the same purpose. The combined techniques may play a role for more severe diseases, such as those with varicose ulcers. An EVLA device (called VELAS) has been developed in the Optics and Photonics Research Center of USP-São Carlos in agreement with FMB-UNESP. In this study, we present the preliminary results of the VELAS device (MMO 980nm diode) in patients with chronic venous ulcer, associated with echo-guided polidocanol foam sclerotherapy for the treatment of varicosities...
May 2017: Revista do Colégio Brasileiro de Cirurgiões
Barbara Ney, Rolf P Engelberger, Amin Dabiri, Jean-François Lüthi, Andreas Erdmann, Caroline Krieger, Sébastien Déglise, Thierry Merminod, Philippe Kern, Lucia Mazzolai
Interventional treatment of venous insufficiency has been revolutionized by endovascular techniques. Some of these techniques, and particularly thermal ablation (endovenous laser, radiofrequency) are now recommended as first-line therapy in the latest international guidelines. This is because of less post-operative pain, a shorter leave from employment and similar or lower recurrence rate. Endovenous techniques allow safer and more efficient treatment of certain particular conditions : small saphenous vein, ulcers, and recurrent varicose veins...
March 15, 2017: Revue Médicale Suisse
Xin Li, Lin Fan, Shiyan Ren, Xianlun Li
BACKGROUND: Foam sclerotherapy (FS) is a safe and effective approach for managing patients with varicose veins and venous ulcers in lower extremities. But, recanalization of the ablated varicose veins and phlebitis are common postoperative complications that jeopardize its clinical effects. We hypothesize that ligation of the ablated varicose veins after FS will improve the outcomes of patients with varicose veins and venous ulcer. This study was aimed to evaluate the clinical efficacy of ligation after FS in comparison with FS alone for the management of patients with varicose veins and venous ulcers in lower extremities...
November 2017: Annals of Vascular Surgery
Joel M Crawford, Brajesh K Lal, Walter N Durán, Peter J Pappas
Our understanding of the pathophysiologic process of venous ulceration has dramatically increased during the past two decades because of dedicated, venous-specific basic science research. Currently, the mechanisms regulating venous ulceration are a combination of macroscopic and microscopic pathologic processes. Macroscopic alterations refer to pathologic processes related to varicose vein formation, vein wall architecture, and cellular abnormalities that impair venous function. These processes are primarily caused by genetic factors that lead to the destruction of normal vein wall architecture and venous hypertension...
July 2017: Journal of Vascular Surgery. Venous and Lymphatic Disorders
S Keisin Wang, Natalie A Drucker, Alok K Gupta, Francis E Marshalleck, Michael C Dalsing
OBJECTIVE: A dearth of information exists in the literature regarding current practice in the management of Klippel-Trénaunay syndrome (KTS), a rare condition. We review and describe the etiology, diagnosis, and treatment of KTS. METHODS: Relevant data were synthesized from a Medline review using a combination of the keyterms "Klippel" and "Trénaunay." The majority of hits described singular case reports and were subsequently excluded. The remaining papers were then reviewed and included on the basis of the quality of evidence and the authors' discretion...
July 2017: Journal of Vascular Surgery. Venous and Lymphatic Disorders
William A Marston, Jason Crowner, Ana Kouri, Corey A Kalbaugh
BACKGROUND: The Effect of Surgery and Compression on Healing and Recurrence (ESCHAR) trial previously reported that patients with venous leg ulcers treated with saphenous stripping experienced a significantly reduced incidence of ulcer recurrence compared with patients treated with compression therapy. Most patients with leg ulcers and saphenous insufficiency are currently treated with endovenous thermal ablation (EVTA), but little information is available on the long-term results after EVTA in Clinical, Etiology, Anatomy, and Pathophysiology (CEAP) clinical class 5 (C5) and class 6 (C6) patients...
July 2017: Journal of Vascular Surgery. Venous and Lymphatic Disorders
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