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Chronic venous insufficiency

Anna L Hronek, Seth N Clark, Gregg Young, Daniel Kinikini, Jason Wells
Acroangiodermatitis (AAD), also known as pseudo-Kaposi's sarcoma, is an uncommon benign angioproliferative condition most commonly seen in the lower extremities. This condition often presents as discolored patches that progress to painful ulcerations. The list of vascular conditions associated with this diagnosis is vast. Acroangiodermatitis presents similarly to more aggressive conditions such as Kaposi's sarcoma, making histopathologic examination helpful in its diagnosis. We present two cases of AAD in the setting of chronic venous insufficiency...
September 2, 2016: Journal of the American Podiatric Medical Association
Carmen Folguera-Álvarez, Sofia Garrido-Elustondo, José Verdú-Soriano, Diana García-García-Alcalá, Mónica Sánchez-Hernández, Oscar German Torres-de Castro, Maria Luisa Barceló-Fidalgo, Olga Martínez-González, Lidia Ardiaca-Burgués, Carmen Solano-Villarrubia, Pilar Raquel Lebracón-Cortés, Carmen Molins-Santos, Mar Fresno-Flores, Maria Carmen Cánovas-Lago, Luisa Fernanda Benito-Herranz, Maria Teresa García-Sánchez, Olga Castillo-Pla, María Sol Morcillo-San Juan, Maria Begoña Ayuso-de la Torre, Pilar Burgos-Quintana, Ana López-Torres-Escudero, Gema Ballesteros-García, Piedad García-Cabeza, Maria Ángeles de Francisco-Casado, Milagros Rico-Blázquez
BACKGROUND: Chronic venous insufficiency, in its final stage can cause venous ulcers. Venous ulcers have a prevalence of 0.5 % to 0.8 % in the general population, and increases starting at 60 years of age. This condition often causes increased dependency in affected individuals, as well as a perceived reduced quality of life and family overload. Local Treating chronic venous ulcers has 2 components: topically healing the ulcer and controlling the venous insufficiency. There is evidence that compressive therapy favours the healing process of venous ulcers...
2016: BMC Nursing
Kotaro Suehiro, Noriyasu Morikage, Osamu Yamashita, Takasuke Harada, Makoto Samura, Yuriko Takeuchi, Takahiro Mizoguchi, Kimikazu Hamano
Purpose: To clarify the risk factors for venous stasis-related skin lesions in the legs in patients without major abnormalities on duplex ultrasonography (DUS). Methods: Fifty patients (nine males and 41 females, age 27-93 years) with symptoms of C4 or greater according to the Clinical, Etiological, Anatomical, Pathological (CEAP) classification, but having no abnormalities on DUS were reviewed for known risk factors for chronic venous insufficiency (CVI) such as older age (>70 years), obesity (body mass index [BMI] >30 kg/m(2)), short walking distance (<200 m/day), reduced ankle range of motion (<20°), and occupation requiring prolonged standing (>8h per day)...
2016: Annals of Vascular Diseases
Dominik Domanski, Oliwia Zegrocka-Stendel, Anna Perzanowska, Malgorzata Dutkiewicz, Magdalena Kowalewska, Iwona Grabowska, Dorota Maciejko, Anna Fogtman, Michal Dadlez, Katarzyna Koziak
β-escin is a mixture of triterpene saponins isolated from the horse chestnut seeds (Aesculus hippocastanum L.). The anti-edematous, anti-inflammatory and venotonic properties of β-escin have been the most extensively clinically investigated effects of this plant-based drug and randomized controlled trials have proved the efficacy of β-escin for the treatment of chronic venous insufficiency. However, despite the clinical recognition of the drug its pharmacological mechanism of action still remains largely elusive...
2016: PloS One
Manuel Monti, Giovanni Maria Vincentelli, Giuseppe Murdolo, Giuliano Bertazzoni, Francesco Rocco Pugliese, Francesco Borgognoni, Maria Pia Ruggieri, Raffaele Landolfi
INTRODUCTION: Venous thromboembolism (VTE) is the third most common cardiovascular illness after acute coronary syndrome and stroke and and the most common preventable cause of hospital-related death. Several studies have demonstrated a significant reduction of fatal pulmonary embolism attributed to the introduction of thromboprophylactic measures and changes in hospital practices. However, the influence of some demographical variables, especially age, has largely been under appreciated...
September 2016: Recenti Progressi in Medicina
Marie-Tiphaine Falcoz, Nicolas Falvo, Serge Aho-Glélé, Emmanuel Demaistre, Christophe Galland, Sylvain Favelier, Pierre Pottecher, Olivier Chevallier, Bernard Bonnotte, Sylvain Audia, Maxime Samson, Béatrice Terriat, Marco Midulla, Romaric Loffroy
BACKGROUND: Post-thrombotic syndrome (PTS) is a frequent complication of deep vein thrombosis (DVT) despite adequate treatment. Venous angioplasty and stent placement has been progressively used to restore and maintain venous patency in PTS patients. This study reports our single-center experience with the use of endovascular treatment for chronic post-thrombotic symptomatic ilio-femoral venous obstructive lesions. METHODS: A prospective mono-centric observational cohort study of PTS patients with chronic symptomatic ilio-femoral venous obstructive lesions referred for endovascular treatment was conducted from March 2012 to April 2016...
August 2016: Quantitative Imaging in Medicine and Surgery
Benedikt Weber, Jürg Hafner, Torsten Willenberg, Simon P Hoerstrup
Chronic insufficiency of lower extremity venous valves represents a frequent structural disorder of the vascular system being responsible for a substantial global disease load. While in the field of superficial valve insufficiency surgical as well as endoluminal interventions represent good therapeutic options with high rates of complete remission of symptoms, only limited options exist in the field of deep venous reflux today. Bioengineered, autologous cell-based, endothelialized valve constructs may open up new therapeutic options in these patients, potentially offering novel treatment options in cases with severe insufficiency of deep venous segments in the future...
October 12, 2016: Expert Review of Medical Devices
Matheus Bertanha, Paula Angeleli Bueno de Camargo, Regina Moura, Winston Bonetti Yoshida, Rafael Elias Farres Pimenta, Jamil Victor de Oliveira Mariúba, Giovana Piteri Alcantara, Dênia Reis de Paula, Marcone Lima Sobreira
BACKGROUND: Telangiectasias are defined as small venules abnormally dilated, located in the intradermal portion of the skin, of reddish or bluish tinge, their diameter not exceeding 1 mm; they are classified by the American Venous Forum as mild venous disease CEAP C1. Conventional treatment consists of chemical sclerotherapy, considered a minimally invasive technique with rapid clinical recovery. A wide variety of sclerosing solutions can be used for this purpose. METHODS/DESIGN: This project intends to include 96 patients that will be randomized to a triple-blind study...
September 2016: Medicine (Baltimore)
Marco Apperti, Ermenegildo Furino, Antonio Sellitti, Gennaro Quarto
AIM: To explain the mode of using and the obtained results during EVLA procedures and sclerotherapies with support of Visioven®, a laser transillumination instrument. MATERIALS AND METHODS: 205 patients suffering from Chronic Venous Insufficiency - CEAP-C stage 1-2 enrolled (103 females and 102 males) and divided into two groups. A Group: patients candidate for sclerotherapy; B Group: patients to be subjected to endovascular laser ablation (EVLA). In both groups patients were divided into two sub-groups on the basis of the use of Visioven® or not during the procedure...
2016: Annali Italiani di Chirurgia
Jean-Philippe Galanaud, Manuel Monreal, Susan R Kahn
The post-thrombotic syndrome (PTS), which refers to chronic clinical manifestations of venous insufficiency after a deep vein thrombosis (DVT), is a frequent occurrence. Because treatment options for PTS are limited, its management mainly relies on the prevention of its occurrence after DVT. Among identified predictors of PTS, extensive proximal location of DVT directly modifies the treatment of DVT because of the possibility of performance of complementary endovascular techniques. The association between poor international normalized ratio control and subsequent PTS should encourage physicians to perform frequent and regular international normalized ratio monitoring of patients receiving vitamin K antagonists...
October 2016: Journal of Vascular Surgery. Venous and Lymphatic Disorders
Paolo Zamboni, Erica Menegatti, Corrado Cittanti, Francesco Sisini, Sergio Gianesini, Fabrizio Salvi, Francesco Mascoli
OBJECTIVE: Increased ventricle volume and brain hypoperfusion are linked to neurodegeneration. We hypothesized that in patients with restricted jugular flow, surgical restoration may reduce brain ventricle volume, because it should improve the pressure gradient, hence promoting cerebrospinal fluid reabsorption into the venous system. METHODS: The effects of restoring the jugular flow were assessed by means of a validated echocardiography with color Doppler (ECD) protocol of flow quantification, magnetic resonance venography, and single-photon emission computed tomography combined with computed tomography (SPECT-CT)...
October 2016: Journal of Vascular Surgery. Venous and Lymphatic Disorders
A V Pokrovskiĭ, I M Ignat'ev, M Iu Volodiukhin, E G Gradusov
The present study was aimed at assessing initial results of hybrid operations in obstructive lesions of the iliac-femoral veins in patients with post-thrombotic disease (PTD). Hybrid operations [open endovenectomy from the common femoral vein (CFV) with creation of an arteriovenous fistula + stenting of iliac veins] were performed carried out in a total of eleven patients with PTD. Of these, there were 7 men and 4 women aged from 34 to 52 years (mean age - 42.8±7 years). All patients had severe-degree chronic venous insufficiency (CVI)...
2016: Angiologii︠a︡ i Sosudistai︠a︡ Khirurgii︠a︡, Angiology and Vascular Surgery
James X Chen, Deepak Sudheendra, S William Stavropoulos, Gregory J Nadolski
The treatment for iliofemoral deep venous thrombosis (DVT) is challenging, as the use of anticoagulation alone can be insufficient for restoring venous patency and thus lead to prolongation of acute symptoms and an increased risk of chronic complications, including venous insufficiency and postthrombotic syndrome (PTS). In these cases, earlier and more complete thrombus removal can ameliorate acute symptoms and reduce long-term sequelae. Endovascular therapies involving the use of pharmacologic, mechanical, and combined pharmacomechanical modalities have been developed to achieve these goals...
September 2016: Radiographics: a Review Publication of the Radiological Society of North America, Inc
Cora Scheerer, Helene Tsoupis, Cornelia Erfurt-Berge
HISTORY AND CLINICAL FINDINGS: We report on a 83-year-old female patient which suffered from a chronic ulcer of the right leg for several years. She has been treated with standard wound dressings under the diagnosis of an ulcer due to chronic venous insufficiency. INVESTIGATIONS AND DIAGNOSIS: A first biopsy showed a lower leg dermatitis and dermatosclerosis due to the chronic venous insufficiency. Not till a second biopsy was taken in the course of the disease, a sqamous cell carcinoma could be diagnosed...
September 2016: Deutsche Medizinische Wochenschrift
Jan Shepherd
Venous leg ulceration (VLU) is a chronic condition associated with chronic venous insufficiency (CVI), where the most frequent complication is recurrence of ulceration after healing. Traditionally, graduated compression therapy has been shown to increase healing rates and also to reduce recurrence of VLU. Graduated compression occurs because the circumference of the limb is narrower at the ankle, thereby producing a higher pressure than at the calf, which is wider, creating a lower pressure. This phenomenon is explained by the principle known as Laplace's Law...
September 2016: British Journal of Community Nursing
Irene M Lang, Peter Dorfmüller, Anton Vonk Noordegraaf
Chronic thromboembolic pulmonary hypertension (CTEPH) is a late sequel of venous thromboembolism that cannot be completely reproduced in animal models. The prevalence of CTEPH in humans is estimated at roughly 17-20 per million; however, partly because up to 50% of patients with CTEPH never experience symptomatic pulmonary embolism, precise numbers on the incidence and prevalence are not known. Because CTEPH is diagnosed at a median age of 63 years in patients who often have other concomitant cardiovascular disease or lung disease, assessment of pathophysiology in patients can be challenging, We do know that CTEPH is a dual vascular disorder...
July 2016: Annals of the American Thoracic Society
Kentaro Nakai
Selective estrogen receptor modulators(SERMs)have beneficial effects on the improvement of bone mineral density of the spine and hip, and decrease the vertebral fracture in postmenopausal women. Similar to patients with advanced chronic kidney disease, including dialysis patients, however, SERMs cannot decrease the risk of hip fracture, which is extremely high in Japanese dialysis patients. One of the most important disadvantages of SERMs is an increase in the risk of venous thromboembolic events and fatal stroke in high-risk groups of the Framingham Stroke Risk Score...
September 2016: Clinical Calcium
Lisa J Gould, Garima Dosi, Kara Couch, Gary W Gibbons, Raelina S Howell, Harold Brem, Marjana Tomic-Canic
BACKGROUND: Venous leg ulcers (VLUs) represent the most common ulcers of the lower extremity. VLUs are notorious for delayed and prolonged healing with high rates of recurrence. Most patients with VLUs also have significant comorbidities that interfere with primary wound healing. Thus, caring for patients with VLUs requires an interdisciplinary approach that addresses the abnormal venous anatomy and the downstream effects that lead to inflammation, ulceration, and a hostile wound microenvironment...
September 2016: Plastic and Reconstructive Surgery
H Jalaie, K Schleimer, M E Barbati, A Gombert, J Grommes, M A F de Wolf, R de Graaf, C H A Wittens
BACKGROUND: Postthrombotic syndrome (PTS) is the development of symptoms and signs of chronic venous insufficiency following deep vein thrombosis (DVT) and has a significant negative effect on the quality of life. The current understanding is that the clinical manifestation of PTS is related more to venous obstruction than it is to venous reflux. The use of interventional techniques for the treatment of venous obstruction and/or venous occlusion has rapidly increased in recent years. OBJECTIVE: This article summarizes the current concept of endovenous and hybrid interventions and presents the optimized treatment of choice in patients with chronic symptomatic venous obstruction...
2016: Gefässchirurgie: Zeitschrift Für Vaskuläre und Endovaskuläre Chirurgie
Afsha Aurshina, Enrico Ascher, Anil Hingorani, Sergio X Salles-Cunha, Natalie Marks, Eleanor Iadgarova
BACKGROUND: Accreditation in peripheral venous testing can be obtained based upon femoropopliteal duplex ultrasound evaluation, and many laboratories limit their examination to this segment only. This simplified protocol detects acute femoropopliteal deep venous thrombosis (DVT) but misses calf vein DVT, superficial venous thrombosis, chronic DVT, venous reflux, and other non-venous findings potentially responsible of the patients' presenting conditions. A protocol limited to the femoropopliteal segment results in additional unnecessary testing and can create patient dissatisfaction...
August 12, 2016: Annals of Vascular Surgery
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