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Varicose veins

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https://www.readbyqxmd.com/read/28219692/prevention-of-thromboembolic-complications-in-patients-with-superficial-vein-thrombosis-given-rivaroxaban-or-fondaparinux-the-open-label-randomised-non-inferiority-surprise-phase-3b-trial
#1
Jan Beyer-Westendorf, Sebastian M Schellong, Horst Gerlach, Eberhard Rabe, Jeffrey I Weitz, Katja Jersemann, Kurtulus Sahin, Rupert Bauersachs
BACKGROUND: Superficial-vein thrombosis can lead to deep-vein thrombosis and pulmonary embolism. Rivaroxaban, an oral factor Xa inhibitor, might simplify treatment compared with fondaparinux because it does not require daily subcutaneous injection and is cheaper. We compared efficacy outcomes in patients with superficial-vein thrombosis and additional risk factors given either rivaroxaban or fondaparinux to assess whether rivaroxaban is non-inferior to fondaparinux in the prevention of thromboembolic complications...
February 16, 2017: Lancet Haematology
https://www.readbyqxmd.com/read/28219004/doppler-ultrasonography-of-the-lower-extremity-arteries-anatomy-and-scanning-guidelines
#2
Ji Young Hwang
Doppler ultrasonography of the lower extremity arteries is a valuable technique, although it is less frequently indicated for peripheral arterial disease than for deep vein thrombosis or varicose veins. Ultrasonography can diagnose stenosis through the direct visualization of plaques and through the analysis of the Doppler waveforms in stenotic and poststenotic arteries. To perform Doppler ultrasonography of the lower extremity arteries, the operator should be familiar with the arterial anatomy of the lower extremities, basic scanning techniques, and the parameters used in color and pulsed-wave Doppler ultrasonography...
January 18, 2017: Ultrasonography
https://www.readbyqxmd.com/read/28217989/comparison-of-endovenous-radiofrequency-ablation-laser-ablation-foam-sclerotherapy-and-surgical-stripping-for-great-saphenous-varicose-veins-extended-5-year-follow-up-of-a-rct
#3
Martin Lawaetz, Julie Serup, Birgit Lawaetz, Lars Bjoern, Allan Blemings, Bo Eklof, Lars Rasmussen
BACKGROUND: This study compares the outcome 5 years after treatment of varicose veins with endovenous radiofrequency ablation (RFA), endovenous laser ablation (EVLA), ultrasound guided foam sclerotherapy (UGFS) or high ligation and stripping (HL/S) by assessing technical efficacy, clinical recurrence and the rate of reoperations. METHODS: Five hundred patients (580 legs) with Great Saphenous Vein (GSV) reflux and varicose veins were randomized to one of the 4 treatments...
February 17, 2017: International Angiology: a Journal of the International Union of Angiology
https://www.readbyqxmd.com/read/28214492/youtube-as-a-source-of-patient-information-for-varicose-vein-treatment-options
#4
Trevor M Y Kwok, Animesh A Singla, Kevin Phang, Annie Y S Lau
OBJECTIVE: The purpose of this study was to analyze the quality of content and potential sources of bias in videos available on YouTube pertaining to interventional treatment for varicose veins. METHODS: Searches were performed on YouTube to identify videos pertaining to interventional treatment for varicose veins. Videos that met eligibility criteria were analyzed and rated according to predetermined criteria by two independent assessors, with a third independent assessor to resolve any discrepancy...
March 2017: Journal of Vascular Surgery. Venous and Lymphatic Disorders
https://www.readbyqxmd.com/read/28214491/relationship-between-patient-reported-symptoms-limitations-in-daily-activities-and-psychological-impact-in-varicose-veins
#5
Rajiv Mallick, Brajesh Kumar Lal, Claire Daugherty
OBJECTIVE: The objective of this study was to evaluate the relationship between patient-reported symptoms, functional limitations, and psychological impact of varicose veins (VVs) vs pathophysiologic mechanism, incorporating demographic and behavioral factors. METHODS: We conducted a pooled analysis from two clinical studies (Efficacy and Safety Study of Polidocanol Injectable Foam for the Treatment of Saphenofemoral Junction Incompetence [VANISH-1] and Polidocanol Endovenous Microfoam Versus Vehicle for the Treatment of Saphenofemoral Junction Incompetence [VANISH-2]) in patients with VVs (superficial venous reflux only)...
March 2017: Journal of Vascular Surgery. Venous and Lymphatic Disorders
https://www.readbyqxmd.com/read/28214489/ablation-of-the-great-saphenous-vein-with-nontumescent-n-butyl-cyanoacrylate-versus-endovenous-laser-therapy
#6
İsmail Koramaz, Helin El Kılıç, Fatih Gökalp, Macit Bitargil, Nilüfer Bektaş, Ersoy Engin, Mehmet Taşkın Egici, Ahmet Kürşat Bozkurt
OBJECTIVE: The endovenous application of n-butyl cyanoacrylate (NBCA) is a new nontumescent ablation technique for the treatment of venous insufficiency. The aim of this study was to retrospectively compare an NBCA-based ablation method with endovenous laser ablation (EVLA) for the management of incompetent great saphenous veins. METHODS: Between May 2013 and August 2014, there were 339 patients with incompetent varicose veins who were treated with either the endovenous application of NBCA (VariClose Vein Sealing System [VVSS]; Biolas, Ankara, Turkey) or EVLA...
March 2017: Journal of Vascular Surgery. Venous and Lymphatic Disorders
https://www.readbyqxmd.com/read/28195304/association-between-psychological-health-and-wound-complications-after-surgery
#7
P Britteon, N Cullum, M Sutton
BACKGROUND: Surgical wound complications remain a major cause of morbidity, leading to higher costs and reduced quality of life. Although psychological health is widely considered to affect wound healing, the evidence on wound outcomes after surgery is mixed. Studies generally focus on small samples of patients undergoing a specific procedure and have limited statistical power. METHODS: This study investigated the relationship between three different measures of anxiety and/or depression and seven adverse surgical outcomes using observational data collected before and after surgery between 2009 and 2011...
February 14, 2017: British Journal of Surgery
https://www.readbyqxmd.com/read/28181899/-guideline-on-the-treatment-of-recurrent-varicose-veins-supplement-to-the-dutch-guideline-on-venous-disease
#8
K P de Roos, J A Lawson, M T W Gaastra, C H A Wittens
The Dutch Guideline on Venous disease was lacking a section on recurrent varicose veins. The newly issued supplement on recurrent varicose veins fills this gap and provides clinicians with solutions concerning the management of patients with recurrent varicose veins following earlier treatment. Because venous disease is nowadays considered to be an ongoing disease, patients with this disorder will often require life-long care and different treatment than patients who have never been treated before.
2017: Nederlands Tijdschrift Voor Geneeskunde
https://www.readbyqxmd.com/read/28166694/novel-developments-in-foam-sclerotherapy-focus-on-varithena%C3%A2-polidocanol-endovenous-microfoam-in-the-management-of-varicose-veins
#9
Phoebe Star, David E Connor, Kurosh Parsi
Scope Varithena® is a recently approved commercially available drug/delivery unit that produces foam using 1% polidocanol for the management of varicose veins. The purpose of this review is to examine the benefits of foam sclerotherapy, features of the ideal foam sclerosant and the strengths and limitations of Varithena® in the context of current foam sclerotherapy practices. Method Electronic databases including PubMed, Medline (Ovid) SP as well as trial registries and product information sheets were searched using the keywords, 'Varithena', 'Varisolve', 'polidocanol endovenous microfoam', 'polidocanol' and/or 'foam sclerotherapy/sclerosant'...
January 1, 2017: Phlebology
https://www.readbyqxmd.com/read/28140311/-wandering-spleen-an-unusual-cause-of-acute-abdomen
#10
Laura Mattioni, María Elena Peña, Maximiliano Ringa, Francisco Schlottmann, Gustavo Bugari
Wandering spleen syndrome is a rare condition in which absence or laxity of splenic fixing elements predisposes to an unusual location in the abdomen and an increasing risk of twisting and infarction. Its etiology may be congenital or acquired and clinical presentation is variable. Diagnosis is based on clinical suspicion, laboratory and imaging. Surgery is the only definitive treatment for this pathology. We report the case of a 23 year old woman with a history of recurrent episodes of abdominal pain in the left upper quadrant since childhood...
2017: Medicina
https://www.readbyqxmd.com/read/28139903/endovenous-laser-ablation-in-patients-with-severe-primary-chronic-venous-insufficiency
#11
Vladimir Starodubtsev, Mikhail Lukyanenko, Andrey Karpenko, Pavel Ignatenko
BACKGROUND: The aim of study was to estimate the safety and efficacy of using laser wavelength of 1560 nm with the foam sclerotherapy (FS) of varicose veins (VVs) for the treatment of severe primary chronic venous insufficiency (CVI, C4-C6) in patients with different diameters of the proximal segment (DPS) of the great saphenous vein (GSV). METHODS: We have separated the patients into two groups depending on the size of GSV: group 1 (281 cases; DPS of GSV less than 15 mm) and group 2 (210 cases; DPS of GSV more than 15 mm)...
January 31, 2017: International Angiology: a Journal of the International Union of Angiology
https://www.readbyqxmd.com/read/28134021/endovenous-laser-treatment-of-groin-and-popliteal-varicose-veins-recurrence
#12
Alvise Cavallini, Daniela Marcer, Salvatore Ferrari Ruffino
Objectives Recurrent varicose veins following surgery is a common, complex and costly problem in vascular surgery. Treatment for RVV is technically more difficult to perform and patient satisfaction is poorer than after primary interventions. Nevertheless, traditional vein surgery has largely been replaced by percutaneous office-based procedures, and the patients with recurrent varicose veins have not benefited from the same advantages. In this paper, we propose an endovascular laser treatment that allows reducing the invasiveness and complications in case of SFJ and SPJ reflux after ligation and stripping of the great and small saphenous vein...
January 1, 2017: Phlebology
https://www.readbyqxmd.com/read/28134020/femoral-vein-valve-incompetence-as-a-risk-factor-for-junctional-recurrence
#13
Sergio Gianesini, Savino Occhionorelli, Erica Menegatti, Anna Maria Malagoni, Mirko Tessari, Paolo Zamboni
Background Recurrent varicose veins occur up to 80% of procedures. The sapheno-femoral junction can be involved in more than 50% of cases. A detailed pathophysiological explanation of the phenomenon is still missing. The aim of the present work is to evaluate the role of femoral vein incompetence as risk factor for sapheno-femoral junction recurrence. Methods Three-hundred-eighty-one patients presenting an incompetent great saphenous vein system and eventually also an incompetent femoral tract (C2-6EpAsdPr) underwent a great saphenous vein high ligation with flush ligation also of the incompetent tributaries along the leg, sparing the saphenous trunk...
January 1, 2017: Phlebology
https://www.readbyqxmd.com/read/28134019/superficial-vein-thrombosis-in-non-varicose-veins-of-the-lower-limbs-and-thrombophilia
#14
Gabriella Lucchi, Salvino Bilancini, Sandro Tucci, Massimo Lucchi
Objectives Superficial vein thrombosis in non-varicose veins of the lower limbs is rather frequent and may be underestimated. This study aims to evaluate the prevalence of inherited or acquired thrombophilia in a sample of outpatients with the disease. Method An observational study was conducted on 73 consecutive superficial vein thrombosis patients tested for inherited or acquired thrombophilia. Results Sixty of 73 patients with superficial vein thrombosis completed the testing protocol, while 13 dropped out; 46 of 60 patients were found to have a thrombophilia (76...
January 1, 2017: Phlebology
https://www.readbyqxmd.com/read/28127790/size-of-sclerosing-foams-prepared-by-ultrasound-mechanical-agitation-and-the-handmade-tessari-method-for-treatment-of-varicose-veins
#15
Costantino Davide Critello, Antonino S Fiorillo, Thomas J Matula
OBJECTIVES: Sclerotherapy is a therapeutic method used in the treatment of varicose veins and works by occluding damaged blood vessels with a chemical solution. Foam sclerotherapy is an attractive treatment because the results are more effective than those obtained by using liquid sclerosants. However, serious neurologic complications, which are likely related to air embolism, have been reported after treatment with foams generated by the handmade method (Tessari technique) most often used clinically...
January 27, 2017: Journal of Ultrasound in Medicine: Official Journal of the American Institute of Ultrasound in Medicine
https://www.readbyqxmd.com/read/28123979/minimally-invasive-treatments-for-perforator-vein-insufficiency
#16
REVIEW
Gokhan Kuyumcu, Gloria Maria Salazar, Anand M Prabhakar, Suvranu Ganguli
Incompetent superficial veins are the most common cause of lower extremity superficial venous reflux and varicose veins; however, incompetent or insufficient perforator veins are the most common cause of recurrent varicose veins after treatment, often unrecognized. Perforator vein insufficiency can result in pain, skin changes, and skin ulcers, and often merit intervention. Minimally invasive treatments have replaced traditional surgical treatments for incompetent perforator veins. Current minimally invasive treatment options include ultrasound guided sclerotherapy (USGS) and endovascular thermal ablation (EVTA) with either laser or radiofrequency energy sources...
December 2016: Cardiovascular Diagnosis and Therapy
https://www.readbyqxmd.com/read/28119106/comparison-of-ultrasound-guided-endovenous-laser-ablation-and-radiofrequency-for-the-varicose-veins-treatment-an-updated-meta-analysis
#17
REVIEW
Zhiguang He, Chenhong Zheng, Hongpeng Zhang, Ming-An Yu
PURPOSE: To investigate and compare the relative efficacy, recurrence and complications of endovenous laser ablation (EVLA) and radiofrequency ablation (RFA) for the treatment of varicose veins patients. METHODS: Searches were applied to the Cochrane Library as well as MEDLINE, EMBASE, BIOSIS databases. 12 articles published in English (10 randomized controlled trials and 2 cohort study) were identified from specialized trails. Fixed effect model and Random effect model were applied to compare the vein ablated length, pain scores (3days and 10days), quality of Life, occlusion, over all complication, thrombophlebitis, haematoma and recanalization between the EVLA and RFA group...
January 21, 2017: International Journal of Surgery
https://www.readbyqxmd.com/read/28116936/-superficial-venous-thrombosis-a-state-of-art
#18
Tamás Sándor
For a long time superficial thrombophlebitis has been thought to be a rather benign condition. Recently, when duplex ultrasound technique is used for the diagnosis more and more often, the disease is proved to be more dangerous than anticipated. Thrombosis propagates to the deep veins in 6-44% and pulmonary embolism was observed on the patients in 1,5-33%. We can calculate venous thromboembolic complications on every fourth patient. Diagnosis is clinical, but duplex ultrasound examination is mandatory, for estimation of the thrombus extent, for exclusion of the deep venous thrombosis and for follow up...
January 2017: Orvosi Hetilap
https://www.readbyqxmd.com/read/28114848/improvement-in-patient-reported-outcomes-of-varicose-veins-following-treatment-with-polidocanol-endovenous-microfoam
#19
Brajesh K Lal, Rajiv Mallick, David Wright
Objective To evaluate the relationship between patient-reported symptoms and functional and psychological impact of varicose veins following treatment with polidocanol endovenous microfoam (PEM) 1%. Methods Data were pooled from two randomized trials on VV treatment. Wilson-Cleary health outcomes path model was applied to evaluate impact of VVSymQ® symptom score improvement on modified VEINES-QOL/Sym functional and psychological scores. Change scores were evaluated for (i) PEM 1% versus placebo groups and (ii) quartiles of symptom improvement...
January 1, 2017: Phlebology
https://www.readbyqxmd.com/read/28096842/purple-stiff-lesions-resembling-varicose-veins-on-lower-limb-certainly-consider-kaposi-sarcoma
#20
Faruk Cingoz, Gokhan Arslan, Ali Fuat Cicek, Bilgehan Savas Oz
Kaposi's sarcoma (KS) typically presents multiple cutaneous lesions of the lower extremities. Lesions can rarely mimic varicose veins without venous insufficiency, vascular or stasis ulcers. As the initial diagnosis of KS is generally determined clinically, a high index of suspicion and palpation of lesions are necessary for all patients with atypical presentations of varicose-like lesions of lower extremities. Tissue biopsy with histological analysis is essential for all uncertain lesions. This is a case of KS occurring in a 79-year-old man who presented with indurated vascular plaques resembling varicose veins on the right foot...
December 2016: Kardiochirurgia i Torakochirurgia Polska, Polish Journal of Cardio-Thoracic Surgery
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