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Superficial venous

James C Barton, Jackson Clayborn Barton, Luigi F Bertoli
BACKGROUND: We sought to learn more about the utility and safety of implanted ports for monthly immunoglobulin G infusions in adults with primary immune deficiency. METHODS: We reviewed charts of adults who were referred to a single practice during the interval 2006-2016 for evaluation and management of frequent or severe upper and lower respiratory tract and other infections, subnormal total immunoglobulin G or immunoglobulin G subclasses, and suboptimal responses to polyvalent pneumococcal polysaccharide vaccinations; were diagnosed to have primary immune deficiency; and were advised to undergo immunoglobulin G therapy...
March 1, 2018: Journal of Vascular Access
Alexandra Yannoutsos, Julie Malloizel-Delaunay, Emilie Tournier, Abdelaziz Abid, Alessandra Bura-Rivière
In this observation, we report an unusual presentation of a pilomatricoma in an 8-year-old girl who was initially referred to the department of vascular medicine for diagnosis and care of a suspected mixed lymphatic venous malformation. The lesion on her left shoulder presented as a giant bluish-purple red solitary mass, painful and rapidly growing, measuring 7 cm in anteroposterior diameter. This mass did not present the typical characteristics of a lymphatic venous malformation but exhibited warning signs of malignancy on clinical examination and imaging...
February 27, 2018: American Journal of Dermatopathology
Shan Zhu, Yuanbo Liu, Mengqing Zang, Bo Chen, Shanshan Li, Bingjian Xue, Tinglu Han
OBJECTIVE: This clinical study describes a reconstructive method for facial soft-tissue defects that uses the pre-expanded forehead flap and minimizes donor site morbidities. METHODS: The surgery was subdivided into 3 stages. First stage, an appropriately sized expander was buried underneath the forehead. Second stage, after adequate inflation of the expander, a forehead flap based on the frontal branches of the superficial temporal artery was raised, and the distal portion of the flap was used to reconstruct the facial defect...
March 8, 2018: Journal of Craniofacial Surgery
Sergio Gianesini, Francesco Sisini, Erica Menegatti, Giovanni Di Domenico, Mauro Gambaccini, Savino Occhionorelli, Paolo Zamboni
Background In physiology, velocity of the deep venous compartment is higher than the one in the saphenous compartment which is higher than the one in the tributaries. Considering that velocity variation is associated with changes in the pressure gradient, aim of the present study is to assess changes in venous kinetics in case of superficial chronic venous disease, so to provide further clues in venous drainage direction determination. Methods Venous ultrasound scanning was performed on 40 lower limbs of 28 chronic venous disease patients (C2-6Ep,As,Pr)...
January 1, 2018: Phlebology
Misaki M Kiguchi, Ellen D Dillavou
Open saphenous removal, phlebectomy, and venous ligation were historic mainstays of surgical treatment of venous disease. Duplex ultrasound has become standard to diagnose venous insufficiency. Percutaneous modalities have allowed treatments to include thermal and nonthermal endovenous ablation. These treatments vary in preoperative planning, procedural steps, and postprocedural care, but all are safe and effective. An individualized approach should be taken in determining which modality is offered to each patient...
April 2018: Surgical Clinics of North America
Raudel Garcia, Nicos Labropoulos
Venous diseases are highly prevalent, mostly caused by valve incompetence and/or obstruction of the vein lumen. Signs and symptoms are diverse and unspecific. Careful clinical assessment and imaging interpretation are crucial to diagnosis. Duplex ultrasound is the first choice and often the gold standard imaging technique for this purpose, providing information on the anatomy and function of the veins. This article describes the sonographic anatomic and hemodynamic criteria used for the diagnosis of venous reflux, venous obstruction, and the most frequent complications after interventions in the superficial, perforating, and deep venous systems...
April 2018: Surgical Clinics of North America
Walid El Kininy, Shane Davy, Leo Stassen, Denis Stephen Barry
Variations in the relationship of the retromandibular vein to the facial nerve have been widely reported due to their relevance for surgical approaches in parotid, osteotomy and mandibular condyle surgery. In the context of the retromandibular retroparotid approach, remaining deep to the retromandibular vein is advised to decrease the likelihood of encountering the facial nerve during mandibular condyle surgery. In the present report, an unusual variant of the superficial temporal vein lying superficial to the facial nerve is described...
March 3, 2018: Folia Morphologica (Warsz)
David Zopfs, Simon Lennartz, Kai Laukamp, Nils Große Hokamp, Anastasios Mpotsaris, David Maintz, Jan Borggrefe, Victor Neuhaus
OBJECTIVES: To compare virtual monoenergetic images (VMI) reconstructed from venous phase Dual-Layer CT (DLCT) with polyenergetic images (PI) of DLCT-Angiography (DLCT-A) regarding vessel contrast and image quality especially in sight to atherosclerotic carotid artery stenosis. METHODS & MATERIALS: 25 DLCT-A and 55 venous phase DLCT were analyzed in this retrospective study. For objective analysis PI and VMI (40-120 keV) were assessed comparing attenuation, standard deviation, signal-/contrast- to noise ratios (SNR, CNR) in the common carotid artery (CCA), vertebral artery, sternocleidomastoid muscle and air...
March 2018: European Journal of Radiology
Ralph Gnannt, Nicolas Waespe, Michael Temple, Afsaneh Amirabadi, Kuan Liu, Leonardo R Brandão, Bairbre L Connolly
BACKGROUND: Peripherally inserted central catheters (PICCs) are associated with superficial and deep venous thrombosis of the arm. OBJECTIVE: The purpose of this study was to analyze the sequelae of repeated upper limb PICC insertions in children, in terms of the frequency of upper limb thrombosis in this patient group. MATERIALS AND METHODS: The study population included all children who underwent their first successful arm PICC insertion between January 2010 and December 2015...
February 27, 2018: Pediatric Radiology
Marcello Di Nisio, Iris M Wichers, Saskia Middeldorp
BACKGROUND: The optimal treatment of superficial thrombophlebitis (ST) of the legs remains poorly defined. While improving or relieving the local painful symptoms, treatment should aim at preventing venous thromboembolism (VTE), which might complicate the natural history of ST. This is the third update of a review first published in 2007. OBJECTIVES: To assess the efficacy and safety of topical, medical, and surgical treatments for ST of the leg in improving local symptoms and decreasing thromboembolic complications...
February 25, 2018: Cochrane Database of Systematic Reviews
James Taylor, Caitlin W Hicks, Jennifer A Heller
OBJECTIVE: Pregnancy has significant effects on the lower extremity venous system. Increasing venous pressure and blood volume, in combination with reduced flow rates within the deep veins, predisposes pregnant women to both primary and secondary chronic venous insufficiency (CVI). This review article highlights the specific physiologic and hemodynamic changes that occur during pregnancy and examines the nonpharmacologic, pharmacologic, and invasive interventions that are appropriate for both prophylaxis and treatment of CVI and venous thromboembolism (VTE)...
March 2018: Journal of Vascular Surgery. Venous and Lymphatic Disorders
Myriam L Montminy, Arjun Jayaraj, Seshadri Raju
BACKGROUND: Surgical techniques to address various components of chronic venous disease are rapidly evolving. Their efficacy and generally good results in treating superficial venous reflux (SVR) have been documented and compared in patients presenting with pain and swelling. A growing amount of literature is now available suggesting their efficacy in patients with venous leg ulcer (VLU). This review attempts to summarize the efficacy and limitations of commonly used venous interventions in the treatment of SVR and incompetent perforator veins (IPVs) in patients with VLU...
February 13, 2018: Journal of Vascular Surgery. Venous and Lymphatic Disorders
Erica L Bartlett, Dmitry Zavlin, Zachery K Menn, Aldona J Spiegel
BACKGROUND:  Flap congestion is a frequently described intraoperative complication during autologous breast reconstruction with abdominal perforator flaps, which, if not addressed, can lead to detrimental results such as flap failure. Here, we describe our institution's algorithm of intraoperative salvage of congested flaps and present their outcomes. METHODS:  All patient charts from 2002 to 2016 of a single plastic surgeon were reviewed for patients who underwent deep inferior epigastric perforator flap breast reconstruction resulting in 602 patients and 831 flaps...
February 16, 2018: Journal of Reconstructive Microsurgery
Annika Senghaas, Thomas Kremer, Volker J Schmidt, Leila Harhaus, Christoph Hirche, Ulrich Kneser, Amir K Bigdeli
Despite considerable advances in reconstructive surgery, massive abdominal wall defects continue to pose a significant surgical challenge. We report the case of a 72-year-old morbidly obese female patient with Clostridium septicum-related gas gangrene of the abdominal wall. After multidisciplinary treatment and multiple extensive debridements, a massive full-thickness defect (40 cm × 35 cm) of the right abdominal wall was present. The abdominal contents were covered with a resorbable mesh to prevent evisceration...
February 16, 2018: Microsurgery
Jamie Vatish, Nusrat Iqbal, Viswa Retnasingam Rajalingam, Alok Tiwari
OBJECTIVES: The purpose of this study was to evaluate whether anticoagulation (warfarin or direct oral inhibitors) affected the success of endovenous treatment. METHODS: Patients taking anticoagulation (warfarin or direct oral inhibitors) undergoing endovenous treatment in the form of endovenous laser ablation (EVLA) were matched against controls for sex, age, leg, and vein. Data were collected prospectively between January 2012 and March 2017. The primary endpoint was failure of treatment at 6-week postoperative duplex scan...
January 1, 2018: Vascular and Endovascular Surgery
Ulka Sachdev, Lena Vodovotz, Julie Bitner, Derek Barclay, Ruben Zamora, Jinling Yin, Richard L Simmons, Yoram Vodovotz
OBJECTIVE: Chronic venous insufficiency (CVI) affects 25 million adults in the United States. Little emphasis has been placed on inflammatory changes associated with CVI. We hypothesize that in patients with early to mid-stage benign varicose vein disease, differences in circulating inflammatory mediators will be manifested in blood draining the involved area vs circulating blood in control subjects. METHODS: Patients undergoing either endovenous ablation or sclerotherapy for Clinical, Etiology, Anatomy, and Pathophysiology clinical class 3 to 5 disease underwent phlebotomy from regional veins at the time of the procedure...
February 10, 2018: Journal of Vascular Surgery. Venous and Lymphatic Disorders
Ivy N Haskins, Jihad Kudsi, Kathleen Hayes, Richard L Amdur, Paul P Lin, Khashayar Vaziri
BACKGROUND: Surgical residency training programs in the United States are modeled on the principle of graduated responsibility. Residents are given greater responsibility and autonomy in the operating room and during perioperative care as they gain surgical skills and progress through their training. The impact of this method of surgical training on patient outcomes remains unknown. The purpose of this study is to compare early patient morbidity and mortality after bariatric surgery in cases with and without resident participation using the American College of Surgeons National Surgical Quality Improvement Program database...
March 2018: Journal of Surgical Research
Katsuhiro Mizutani, Masahiro Toda, Yumi Yajima, Takenori Akiyama, Hirokazu Fujiwara, Kazunari Yoshida, Masahiro Jinzaki
OBJECTIVES: Functional venous anatomy in the brain has been mostly understood from the morphological and embryological points of view and no published study has directly evaluated the blood flow volume of cerebral small veins. We developed a method to directly evaluate the relative blood volume in small venous channels using multi-detector computed tomography (CT) and applied it to evaluate the blood volume in each tributary of the cavernous sinus, which plays an important role in cerebral venous drainage...
February 6, 2018: Clinical Neurology and Neurosurgery
Gianfranco Varetto, Lorenzo Gibello, Edoardo Frola, Alessandra Trevisan, Andrea Trucco, Luigi Contessa, Pietro Rispoli
OBJECTIVES: The traditional surgical approach to the treatment of the superficial venous insufficiency requires at least 12 h of post-operative monitoring and this often means the necessity of an overnight hospitalization. The introduction of new, less invasive techniques (i.e endovenous laser ablation) reduces the hospitalization stay in a Day Surgery setting. However, the increasing skills of the operators and the patient's selection, allows to propose endovenous laser ablation in an Outpatient setting...
February 2, 2018: International Journal of Surgery
Frances Tian, Katherine R Mazurek, Robert N Malinak, Steven M Dean, Benjamin H Kaffenberger
Trousseau syndrome is a rare phenomenon in cancer patients characterized by superficial migratory thrombophlebitis. In this brief report, the authors describe three recent case presentations of patients without a prior history of cancer who were treated for cellulitis prior to be admitted to the hospital. All three patients were found to have "negative" testing on venous duplex scanning. Communication with the technicians and additional clinical and laboratory evaluations confirmed Trousseau syndrome as well as an underlying hematologic cancer in each patient...
December 2017: Journal of Clinical and Aesthetic Dermatology
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