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Masatoshi Jibiki, Tetsuro Miyata, Sachiko Futatsugi, Mitsumasa Iso, Yasutaka Sakanushi
Background and aims: In Japan, stripping under general anesthesia, lumbar anesthesia and tumescent local anesthesia has been used in the treatment of primary varicose veins due to saphenous vein insufficiency. However endovenous laser ablation (EVLA) using a 980 nm diode laser has received National Health Insurance (NHI) coverage in 2011, while EVLA using a 1470 nm diode laser with a radial 2-ring fiber has received coverage in 2014. As a result, the use of EVLA has become widespread in Japan. We herein report on the results of varicose veins treatment at our hospital...
October 1, 2016: Laser Therapy
Fumiaki Kawano, Masaki Tomita, Hiroyuki Tanaka, Hiroyuki Nagahama, Kousei Tashiro, Hironobu Nakao, Hiroaki Kataoka, Kunihide Nakamura
INTRODUCTION: Venous tumor thrombus of thyroid cancer that extend to the great vein is rare, and management criteria for venous thrombus have not been established yet. We report a surgical case of thyroid carcinoma with extensive tumor thrombus in the superior vena cava (SVC) and consider the appropriate treatment strategy for venous thrombus. PRESENTATION OF CASE: A 75-year-old woman consulted our hospital because of thyroid carcinoma with an extensive tumor thrombus...
October 25, 2016: International Journal of Surgery Case Reports
Igor A Zolotukhin, Evgeny I Seliverstov, Elena A Zakharova, Alexander I Kirienko
OBJECTIVE: To establish an effect of isolated phlebectomy in patients with incompetent great saphenous vein (Ambulatory Selective Varices Ablation under Local anesthesia (ASVAL) procedure) on the reflux and diameter of the trunk and to assess recurrence rate of varicose veins at one year. MATERIAL AND METHODS: We conducted a prospective study on patients with primary varicose veins and with C2 or C2,3 or C2,3,4 or C2,4 classes of chronic venous disease and great saphenous vein incompetence...
October 19, 2016: Phlebology
Henghui Yin, Haipeng He, Mian Wang, Zilun Li, Zuojun Hu, Chen Yao, Jinsong Wang, Shenming Wang, Guangqi Chang
BACKGROUND: To evaluate the effect of ultrasound-guided foam sclerotherapy (UGFS) in a single session combined with great saphenous vein (GSV) high ligation for severe lower extremity varicosis classified as C4 to C6, compared with GSV stripping plus multistab avulsion or transilluminated powered phlebectomy (TIPP). METHODS: From January 2012 to December 2014, 177 patients with primary GSV insufficiency, classified as C4 to C6, were randomized into the UGFS group or the control group...
September 23, 2016: Annals of Vascular Surgery
M Venermo, J Saarinen, E Eskelinen, S Vähäaho, E Saarinen, M Railo, I Uurto, J Salenius, A Albäck
BACKGROUND: Endovenous ablation techniques and ultrasound-guided foam sclerotherapy (UGFS) have largely replaced open surgery for treatment of great saphenous varicose veins. This was a randomized trial to compare the effect of surgery, endovenous laser ablation (EVLA) (with phlebectomies) and UGFS on quality of life and the occlusion rate of the great saphenous vein (GSV) 12 months after surgery. METHODS: Patients with symptomatic, uncomplicated varicose veins (CEAP class C2-C4) were examined at baseline, 1 month and 1 year...
October 2016: British Journal of Surgery
S I Savolyuk, V S Gorbovets, V A Khodos
The results of treatment of 58 patients, suffering chronic diseases of the lower extremities veins, were analyzed. In 28 patients a vertical reflux was eliminated using endovascular laser coagulation, in 32 patients--a standard phlebectomy in accordance to Babcock method was performed. The complications rate was compared as well as the term of the patients' stationary treatment. After elimination of endovascular laser coag- ulation the complications rate and severity is significantly lesser, than after a standard phiebectomy...
March 2016: Klinichna Khirurhiia
Ashley Wysong, Brent R Taylor, Michael Graves, Vineet Mishra, Ryan Gilbertson, Hubert T Greenway, Leland Housman
BACKGROUND: Venous ulcers are very common with few curative treatment options. OBJECTIVE: To report the closure rate and clinical characteristics of active venous ulcers in a vein clinic using endovenous laser ablation (EVLA) with a 1,320-nm laser. METHODS AND MATERIALS: A prospective database was kept consisting of patients with an active venous ulcer at the time of consultation in a single-practitioner academic vein clinic from March 2007 to May 2014...
August 2016: Dermatologic Surgery: Official Publication for American Society for Dermatologic Surgery [et Al.]
Tom Wallace, Clement Leung, Sandip Nandhra, Nehemiah Samuel, Daniel Carradice, Ian Chetter
OBJECTIVES: To produce a tumescent anaesthesia solution with physiological pH for endovenous thermal ablation and evaluate its influence on peri- and postoperative pain, clinical and quality of life outcomes, and technical success. METHODS: Tumescent anaesthetic solution (0.1% lidocaine with 1:2,000,000 epinephrine) was titrated to physiological pH by buffering with 2 ml incremental aliquots of 8.4% sodium bicarbonate. Patients undergoing great saphenous vein endovenous laser ablation and ambulatory phlebectomy were studied before and after introduction of buffered tumescent anaesthetic...
June 15, 2016: Phlebology
Tristan Lane, Roshan Bootun, Brahman Dharmarajah, Chung S Lim, Mojahid Najem, Sophie Renton, Kaji Sritharan, Alun H Davies
BACKGROUND: Endovenous thermal ablation has revolutionised varicose vein treatment. New non-thermal techniques such as mechanical occlusion chemically assisted endovenous ablation (MOCA) allow treatment of entire trunks with single anaesthetic injections. Previous non-randomised work has shown reduced pain post-operatively with MOCA. This study presents a multi-centre randomised controlled trial assessing the difference in pain during truncal ablation using MOCA and radiofrequency endovenous ablation (RFA) with six months' follow-up...
May 24, 2016: Phlebology
Daniel N Meijles, Lampson M Fan, Maziah M Ghazaly, Brendan Howlin, Martin Krönke, Gavin Brooks, Jian-Mei Li
BACKGROUND: The NADPH oxidase, by generating reactive oxygen species, is involved in the pathophysiology of many cardiovascular diseases and represents a therapeutic target for the development of novel drugs. A single-nucleotide polymorphism, C242T of the p22(phox) subunit of NADPH oxidase, has been reported to be negatively associated with coronary heart disease and may predict disease prevalence. However, the underlying mechanisms remain unknown. METHODS AND RESULTS: With the use of computer molecular modeling, we discovered that C242T single-nucleotide polymorphism causes significant structural changes in the extracellular loop of p22(phox) and reduces its interaction stability with Nox2 subunit...
June 14, 2016: Circulation
Peter H Lin, Jesus M Matos, Aaron Chen, Walter Kim, Mun J Poi, Jenny S Jiang, Carlos F Bechara
INTRODUCTION: Transilluminated powered phlebectomy (TIPP) is a minimally invasive technique of varicose vein removal, which combines irrigated illumination with tumescent anesthesia for ablation of superficial varicosities and endoscopic-powered venous resection. The objective of this study was to analyze treatment outcomes of this treatment modality. METHODS: A retrospective evaluation of prospectively collected data from all patients undergoing TIPP procedure for symptomatic varicose veins during a recent 12-year period was performed...
May 2016: Vascular and Endovascular Surgery
M P Potapov, P P Potapov, E V Staver, L S Mazepina
Analysed herein are the data of 737 patients (a total of 745 lower limbs) suffering from lower-limb varicose veins (LLVV) and subjected to treatment at the Surgical Department consisting of crossectomy, truncal and tributary phlebectomy, dissection of perforant veins exclusively in the basin of the great saphenous vein. Relapses during five-year follow up occurred in 13.8% (102/745) of cases. Based on clinical signs and laboratory findings we studied the effect of the factor of undifferentiated connective tissue dysplasia (UDCTD) on the development of lower-limb varicosity...
2016: Angiologii︠a︡ i Sosudistai︠a︡ Khirurgii︠a︡, Angiology and Vascular Surgery
Javier Barallobre-Barreiro, Rahmi Oklu, Marc Lynch, Marika Fava, Ferheen Baig, Xiaoke Yin, Temo Barwari, David N Potier, Hassan Albadawi, Marjan Jahangiri, Karen E Porter, Michael T Watkins, Sanjay Misra, Julianne Stoughton, Manuel Mayr
AIMS: Extracellular matrix remodelling has been implicated in a number of vascular conditions, including venous hypertension and varicose veins. However, to date, no systematic analysis of matrix remodelling in human veins has been performed. METHODS AND RESULTS: To understand the consequences of venous hypertension, normal and varicose veins were evaluated using proteomics approaches targeting the extracellular matrix. Varicose saphenous veins removed during phlebectomy and normal saphenous veins obtained during coronary artery bypass surgery were collected for proteomics analysis...
June 1, 2016: Cardiovascular Research
Nicos Labropoulos, Matthew Comito, Patrizia De Zolt, Dimitrios Kontothanassis
OBJECTIVE: Perforator vein aneurysms (PVAs) of the lower extremity have not been defined or reported. This study reports the clinical presentation of patients, the PVA characteristics, and the clinical outcome of their management. METHODS: Patients with signs and symptoms of chronic venous disease who had a PVA were included. Diagnosis of a PVA was made with duplex ultrasound. Normal perforator veins have a diameter of <3 mm. A PVA was defined as a diameter dilation of >9 mm, and it was always found below the deep fascia...
July 2015: Journal of Vascular Surgery. Venous and Lymphatic Disorders
William P Shutze, Katherine Kane, Tammy Fisher, Yahya Doud, Grace Lassiter, Richard Leuking, Elizabeth Nguyen, William P Shutze
OBJECTIVE: We hypothesized that the incidence of endothermal heat-induced thrombosis (EHIT) depends on the laser wavelength used in endovenous laser ablation (EVLA) of the saphenous veins. METHODS: We identified patients undergoing EVLA in our office from 2005 to 2014 with an 810-nm (hemoglobin-specific) or 1470-nm (water-specific) laser. We reviewed the records for age, sex, body mass index, Clinical, Etiologic, Anatomic, and Pathophysiologic (CEAP) class, vein diameter, vein(s) treated, adjunctive phlebectomy, energy delivered, laser pullback times, and EHIT (closure level ≥3) development...
January 2016: Journal of Vascular Surgery. Venous and Lymphatic Disorders
Caitlin W Hicks, Ying Wei Lum, Jennifer A Heller
Herpes simplex virus infection following surgery is an unusual postoperative phenomenon. Many mechanisms have been suggested, with the most likely explanation related to latent virus reactivation due to a proinflammatory response in the setting of local trauma. Here, we present a case of herpes simplex virus reactivation in an immunocompetent female following a conventional right lower extremity stab phlebectomy. Salient clinical and physical examination findings are described, and management strategies for herpes simplex virus reactivation are outlined...
February 27, 2016: Phlebology
V I Palamarchuk, S I Odnorog, M M Gvozdyak, A M Vilgash
The experience of surgical treatment of 50 patients for varicose disease of lower extremities, complicated by trophic ulcers, in the presence of diabetes mellitus type II were analysed. During surgery in patients of the 1st group performed a combined phlebectomy, group 2--scleroobliteration and echoscleroobliteration. Using fleboscleroobliteration method helped reduce the frequency of early postoperative complications in (6.5 +/- 1.3) times.
June 2015: Klinichna Khirurhiia
Luca Spinedi, Daniel Staub, Heiko Uthoff
Stroke is a very rare but potential fatal complication of endovenous thermal treatment in patients with a right-to-left shunt. To our best knowledge, there are only two reports in the literature of stroke after endovenous thermal ablation of varicose veins, one after endovenous laser ablation and one after radiofrequency ablation and phlebectomy, both treated conservatively. This report describes a successful lysis in a patient with an ischemic stroke associated with bilateral endovenous heat-induced thrombosis class I after endovenous laser ablation of both great saphenous vein and extensive miniphlebectomy in a patient with an unknown patent foramen ovale...
May 2016: Phlebology
Andrea T Obi, Bradley N Reames, Trent J Rook, Sandford O Mouch, Arya Zarinsefat, Cathy Stabler, John E Rectenwald, Dawn M Coleman, Thomas W Wakefield
BACKGROUND: Patients with painful varicose veins and venous insufficiency can be treated by eliminating axial reflux only or by eliminating axial reflux plus phlebectomy with transilluminated powered phlebectomy. This study was undertaken with the aim of determining and improving signs and symptoms of venous disease (measured by venous clinical severity score) and complications (by routine surveillance ultrasound and long-term post-operative follow up) for each treatment strategy. METHODS: We performed a retrospective evaluation of prospectively collected data from 979 limbs undergoing procedures for significant varicose veins and venous insufficiency from March 2008 until June 2014 performed at a single tertiary referral hospital...
October 2016: Phlebology
Briony F Hudson, Jade Davidson, Mark S Whiteley
BACKGROUND: Elevated patient anxiety during surgery is linked to a range of suboptimal treatment outcomes. Reflexology has been reported to be effective in reducing pre and post-operative anxiety and post-operative pain. OBJECTIVES: To explore whether the addition of hand reflexology to treatment as usual during minimally invasive varicose vein surgery under local anaesthetic impacted upon patient reported anxiety and pain during surgery, and patient satisfaction with treatment...
December 2015: International Journal of Nursing Studies
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