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Venous incompetence

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https://www.readbyqxmd.com/read/29772321/use-of-polidocanol-endovenous-microfoam-to-improve-hemodynamics-and-symptomology-in-patients-with-challenging-clinical-presentations-a-case-series
#1
Paul E Davis, John Phillips, Raghu Kolluri
BACKGROUND: We performed a retrospective review of treatment effects with FDA-approved Polidocanol endovenous microfoam (PEM, Varithena® 1%) on venous symptomology in ten (N=10) C3-C6 patients with chronic venous insufficiency (CVI) and concomitant complex disease/pathology that limited the use of endothermal ablation (ETA). METHODS: Pathology included: risk of bruising or bleeding, severe lipodermatosclerosis (LDS), Hydradenitis Suppurativa, chronic fibrosis of the vein from prior superficial thrombosis, risk for nerve injury and failed prior ETA...
May 14, 2018: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/29725665/venous-pseudoaneurysm-of-the-great-saphenous-vein-stump-as-late-complication-of-flush-saphenofemoral-ligation-and-stripping
#2
Maurizio Domanin, Riccardo Miloro, Silvia Romagnoli, Aldo Basellini
Guidelines now recommend endovenous thermal ablation over open treatment of saphenous incompetence, but flush saphenofemoral ligation and stripping remain relevant when appropriately applied and expertly executed. Complications are rare but could be severe, needing further surgical correction. We report a unique case of a late venous pseudoaneurysm of the great saphenous vein stump after flush saphenofemoral ligation and stripping, successfully treated with surgical sac excision. We highlight the importance of continuous follow-up for patients previously submitted to open venous surgery...
March 2018: Journal of Vascular Surgery Cases and Innovative Techniques
https://www.readbyqxmd.com/read/29688199/-radiofrequency-ablation-in-comprehensive-surgical-treatment-of-patients-with-varicose-veins-of-lower-limbs
#3
M D Dibirov, A I Shimanko, R U Gadzhimuradov, A S Volkov, D S Tiurin, A Kh Magdiev
Analysed herein are the results of using radiofrequency ablation (RFA) in comprehensive surgical treatment of patients presenting with varicose veins of the lower extremities. The study included a series of ninety-eight 28-to-60-year-old patients (with a total of 105 operations performed) suffering from varicose veins of the lower limbs. Of these, there were 10 men (10.3%) and 88 women (89.7%). Venous disease of clinical class C2 according to the CEAP classification was diagnosed in 80 patients, that of class C3 in 17, and that of class C4a in 1 patient...
2018: Angiologii︠a︡ i Sosudistai︠a︡ Khirurgii︠a︡, Angiology and Vascular Surgery
https://www.readbyqxmd.com/read/29682125/two-cases-of-micro-arteriovenous-fistula-in-the-lower-extremity-with-misdiagnosis-of-refractory-cellulitis
#4
Miyako Tanaka, Fukashi Serizawa, Yohei Nagaoka, Takuya Jimbo, Kazuki Kawashima, Takeshi Asakura, Hiroshi Otomo, Kenichi Yokota
We report our experience of two cases of refractory cellulitis caused by peripheral micro-arteriovenous fistulas (AVFs) in the lower extremity. The micro-AVFs were so small that they could not be located accurately; further, the patients' symptoms differed markedly from those previously reported for AVF. AVF is known to cause ischemic symptoms. In contrast, micro-AVF causes congestive symptoms and remains undetected in the majority of patients. Identification of this pathology is crucial to enable effective treatment by the ligation of the incompetent perforator vein that increases venous hypertension, leading to congestive symptoms...
March 25, 2018: Annals of Vascular Diseases
https://www.readbyqxmd.com/read/29678685/success-rate-and-factors-predictive-of-redo-radiofrequency-ablation-of-perforator-veins
#5
Afsha Aurshina, Enrico Ascher, Lauren Mount, Amrit Hingorani, Natalie Marks, Anil Hingorani
OBJECTIVE: Radiofrequency ablation (RFA) is increasingly being employed for treatment of perforator vein insufficiency and venous ulcer healing. Previous studies have shown a closure rate of 60% to 80% in incompetent perforator veins (IPVs) with RFA. The purpose of the study was to determine the utility of a redo RFA for symptomatic recanalized perforators and to predict factors associated with recanalization. METHODS: A retrospective analysis of 642 procedures in 256 patients with venous insufficiency due to IPVs from 2009 to 2015 was conducted...
April 17, 2018: Journal of Vascular Surgery. Venous and Lymphatic Disorders
https://www.readbyqxmd.com/read/29674378/the-caval-sphincter-in-cetaceans-and-its-predicted-role-in-controlling-venous-flow-during-a-dive
#6
Margo A Lillie, A Wayne Vogl, Stephen Raverty, Martin Haulena, William A McLellan, Garry B Stenson, Robert E Shadwick
A sphincter on the inferior vena cava can protect the heart of a diving mammal from overload when elevated abdominal pressures increase venous return, yet sphincters are reported incompetent or absent in some cetacean species. We previously hypothesized that abdominal pressures are elevated and pulsatile in fluking cetaceans, and that collagen is deposited on the diaphragm according to pressure levels to resist deformation. Here we tested the hypothesis that cetaceans generating high abdominal pressures need a more robust sphincter than those generating low pressures...
April 19, 2018: Journal of Experimental Biology
https://www.readbyqxmd.com/read/29642798/a-retrospective-study-of-a-new-n-butyl-2-cyanoacrylate-glue-ablation-catheter-incorporated-with-application-guiding-light-for-the-treatment-of-venous-insufficiency-twelve-month-results
#7
Turhan Yavuz, Altay Nihat Acar, Huseyin Aydın, Evren Ekingen
Objective This study aims to present the early results of a retrospective study of the use of novel n-butyl-2-cyanoacrylate (VenaBlock)-based nontumescent endovenous ablation with a guiding light for the treatment of patients with varicose veins. Methods Patients with lower limb venous insufficiency were treated with n-butyl-2-cyanoacrylate (VenaBlock Venous Closure System) between April 2016 and July 2016. The study enrolled adults aged 21-70 years with symptomatic moderate to severe varicosities (C2-C4b) and great saphenous vein reflux lasting longer than 0...
January 1, 2018: Vascular
https://www.readbyqxmd.com/read/29568782/proteinuria-hypoalbuminemia-and-chronic-lymphocytic-leukemia-an-unusual-trio
#8
William Wung, Shubha Ananthakrishnan, Brian A Jonas
Chronic lymphocytic leukemia (CLL) is a chronic, progressive lymphoproliferative disorder characterized by a monoclonal population of functionally incompetent lymphocytes. Renal involvement is rare and poorly described. A 57-year-old male with no prior medical history was diagnosed with CLL and followed with a watch and wait approach. He was referred to our institution several months later due to concern for Richter's transformation to diffuse large B-cell lymphoma. A positron emission tomography/computed tomography scan showed no evidence of diffuse large B-cell lymphoma; however, the patient was noted to have hypoalbuminemia, nephrotic range proteinuria, an acute left renal vein thrombus, and a right pulmonary embolus...
January 2018: Journal of Investigative Medicine High Impact Case Reports
https://www.readbyqxmd.com/read/29514566/altered-velocity-gradient-in-lower-limb-chronic-venous-disease
#9
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
https://www.readbyqxmd.com/read/29503081/comparison-between-duplex-ultrasound-and-multigate-quality-doppler-profile-software-in-the-assessment-of-lower-limb-perforating-vein-direction
#10
Sergio Gianesini, Erica Menegatti, Francesco Sisini, Savino Occhionorelli, Federico Annoni, Byung-Boong Lee, Paolo Zamboni
OBJECTIVES: The aim was to assess more accurately the net flow of the lower limb perforating veins (PVs). MATERIAL AND METHODS: This was an observational prospective study. Two hundred and twenty one limbs with chronic venous disease (C1-6EpAs,pPr) of 193 patients underwent a duplex ultrasound (DUS). All identified PVs were scanned also by means of quality Doppler profile (QDP) multigate analysis in order to determine their net inward and outward flow direction...
May 2018: European Journal of Vascular and Endovascular Surgery
https://www.readbyqxmd.com/read/29502778/open-surgical-reconstruction-for-deep-venous-occlusion-and-valvular-incompetence
#11
REVIEW
Katherin E Leckie, Michael C Dalsing
This article considers the potential options for open deep venous reconstructions based on pathologic complication (obstruction vs insufficiency), anatomic location, presence of disease-free venous architecture, and patient need. Other things being equal, less invasive techniques and disease locations will be attempted as first-line therapy. When other options fail and symptoms persist, open venous surgery by means of bypass for obstructive disease and valve repair or replacement for deep venous insufficiency remains a viable option...
April 2018: Surgical Clinics of North America
https://www.readbyqxmd.com/read/29502767/duplex-ultrasound-for-the-diagnosis-of-acute-and-chronic-venous-diseases
#12
REVIEW
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
https://www.readbyqxmd.com/read/29486654/three-year-follow-up-and-quality-of-life-of-endovenous-radiofrequency-ablation-of-the-great-saphenous-vein-with-the-closurefast%C3%A2-procedure-influence-of-bmi-and-ceap-class
#13
Renato Casana, Valerio Stefano Tolva, Andrea Odero, Chiara Malloggi, Gianfranco Parati
Purpose Endovascular ablation of the great saphenous vein has been proposed as a less invasive alternative to conventional ligation and stripping of varicose veins. Outcomes of patients treated with the radiofrequency ablation ClosureFast™ system over an eight-year period from a single-center were evaluated. Methods Three-year follow-up data included duplex ultrasound scan, complication rate, and questionnaires to assess patients' QOL, level of pain, and days off work. Results A total of 1080 consecutive patients (49...
January 1, 2018: Vascular
https://www.readbyqxmd.com/read/29452957/a-systematic-review-of-the-efficacy-and-limitations-of-venous-intervention-in-stasis-ulceration
#14
REVIEW
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...
May 2018: Journal of Vascular Surgery. Venous and Lymphatic Disorders
https://www.readbyqxmd.com/read/29448895/the-outcome-of-anticoagulation-on-endovenous-laser-therapy-for-superficial-venous-incompetence
#15
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...
May 2018: Vascular and Endovascular Surgery
https://www.readbyqxmd.com/read/29421005/systematic-review-and-meta-analysis-of-endovascular-and-surgical-revascularization-for-patients-with-chronic-lower-extremity-venous-insufficiency-and-varicose-veins
#16
Sreekanth Vemulapalli, Kishan Parikh, Remy Coeytaux, Victor Hasselblad, Amanda McBroom, Abigail Johnston, Giselle Raitz, Matthew J Crowley, Kathryn R Lallinger, W Schuyler Jones, Gillian D Sanders
BACKGROUND: Chronic lower extremity venous disease (LECVD) is twice as prevalent as coronary heart disease, and invasive therapies to treat LECVD accounted for an estimated $290 million in Medicare expenditures in 2015. Despite increasing use of these invasive therapies, their comparative effectiveness is unknown. METHODS: We conducted a systematic review and meta-analysis of treatments for patients (symptomatic and asymptomatic) with lower extremity varicosities and/or lower extremity chronic venous insufficiency/incompetence/reflux...
February 2018: American Heart Journal
https://www.readbyqxmd.com/read/29376624/investigation-of-non-saphenous-veins-in-c0s-patients
#17
Marzia Lugli, Oscar Maleti, M Letizia Iabichella, Michel Perrin
BACKGROUND: C0S patients have symptoms of chronic venous disorders (CVDs), though an anatomical or pathophysiological explanation is lacking. C0 and C1 classified lower limbs can present with valve incompetence from the second to sixth generation of tributaries of saphenous veins despite the absence of a detectable saphenous truncal reflux. We hypothesized that C0S venous symptoms could stem from the second to sixth generation of saphenous tributaries and small veins that are not connected to the saphenous system...
April 2018: International Angiology: a Journal of the International Union of Angiology
https://www.readbyqxmd.com/read/29336850/microvenous-reflux-in-the-skin-of-limbs-with-superficial-venous-incompetence
#18
Darshna Govind, Kate N Thomas, Brigid G Hill, Andre M van Rij
This study investigated whether microvenous reflux can be detected in limbs with chronic venous disease using superb microvascular imaging (SMI) and colour Doppler imaging. Participants with venous disease (limbs, n = 26) and without venous disease (limbs, n = 10) were studied. The skin in the medial gaiter region was imaged using both SMI and colour Doppler to identify reflux in the small vessels in response to distal augmentation. The diameters and depths of responsive vessels were measured. In limbs with venous disease, reflux in response to provocation was visualised with SMI in a greater number of vessels (12/26 versus 4/26) and smaller vessels than with colour Doppler...
April 2018: Ultrasound in Medicine & Biology
https://www.readbyqxmd.com/read/29326812/endovascular-laser-treatment-of-incompetent-saphenous-veins-using-the-1470-nm-diode-laser-and-radial-fiber
#19
Georgios Vourliotakis, Georgios Sahsamanis, Paschalis Evagelidis, Christina Aivatidi
Objectives: To assess the technical success, complications, and patients' quality of life (QoL) after treatment of chronic venous disease (CVD) using the 1470 nm radial fiber laser. Methods: A total of 170 patients with chronic venous disease, classified as C2 to C4 according to CEAP classification, were treated for incompetent greater (GSV) and small (SSV) saphenous veins, using the 1470 nm radial fiber laser and application of tumescent anesthesia. Additional phlebectomies were performed through stab microincisions, while 11 patients further underwent sclerotherapy intraoperatively...
January 2018: Annals of Medicine and Surgery
https://www.readbyqxmd.com/read/29276603/varicose-vein-appearance-caused-by-perforating-vein-incompetence-detected-after-intense-cycling
#20
Charlotte E Davies, Angie M White, Mark S Whiteley
The role of incompetent perforating veins in the aetiology of varicose veins is not well understood. Anecdotally, competitive cyclists appeared to be more prone to varicose veins than the general population. We present a case of a 63-year-old amateur competitive cyclist who acutely developed a painful varicosity of her left calf while straining during a hill climb in 106-mile cycle race. Duplex ultrasonography has shown an underlying incompetent perforating vein, feeding the varicosity directly through the underlying muscle...
2017: SAGE open medical case reports
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