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Perforating veins

Sathasivam Sureshkumar, Narayan Vignesh, J Venkatachalam, Chellappa Vijayakumar, Sundaramurthi Sudharsanan
Background The color Doppler, a better investigation to identify the perforators objectively has replaced the clinical examination for the same. However, this has led to a significant number of negative explorations and cosmetic disfigurement. Objective To compare the efficacy of the clinical tests combined with the color Doppler versus color Doppler alone to identify the perforator incompetence during the surgery for primary varicose veins of the lower limb. Methods This was a prospective analytical study, including 61 lower limb varicose vein patients who belonged to the Clinical-Etiology-Anatomy-Pathophysiology (CEAP) class four-six, planned for the surgical treatment for perforator incompetence, excluding those requiring additional vascular or nonvascular procedure, recurrent varicose veins and those who had injection sclerotherapy prior to the surgery...
January 5, 2018: Curēus
Maurizio Pacilli, Catherine J Bradshaw, Simon A Clarke
INTRODUCTION: Medium-term intravenous access in children is normally achieved by means of repeated multiple peripheral intravenous cannula insertions or peripherally inserted central catheters. Long peripheral cannulas might offer an alternative to these devices in children. Our aim was to clarify whether long peripheral cannulas provide reliable medium-term intravenous access avoiding the need for multiple peripheral intravenous cannulations or peripherally inserted central catheter insertion in children undergoing surgery...
March 1, 2018: Journal of Vascular Access
Zhong-Wu Chen, Zheng-Yu Lin, Yi-Ping Chen, Jian Chen, Jin Chen
Objective: The objective of this study is to investigate the clinical efficacy and safety of Habib™ VesOpen, a new intravascular radiofrequency ablation (RFA) catheter in percutaneous puncture of portal vein tumor thrombus (PVTT) in patients with primary hepatocellular carcinoma. Materials and Methods: Collected data of patients with primary hepatocellular carcinoma with portal vein trunk or main branch who were treated by the RFA of portal vein tumor ablation with Habib™ VesOpen, a new intravascular RFA catheter...
January 2018: Journal of Cancer Research and Therapeutics
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...
March 1, 2018: European Journal of Vascular and Endovascular Surgery
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
N D Thimmappa, J V Vasile, C Y Ahn, J L Levine, M R Prince
Autologous breast reconstruction using muscle-sparing free flaps are becoming increasingly popular, although microvascular free flap reconstruction has been utilised for autologous breast reconstructions for >20 years. This innovative microsurgical technique involves meticulous dissection of artery-vein bundle (perforators) responsible for perfusion of the subcutaneous fat and skin of the flap; however, due to unpredictable anatomical variations, preoperative imaging of the donor site to select appropriate perforators has become routine...
February 27, 2018: Clinical Radiology
Assaf A Zeltzer, Randy A De Baerdemaeker, Benoit Hendrickx, Katrin Seidenstücker, Carola Brussaard, Moustapha Hamdi
Abdominal scars are no longer a contra-indication for abdominal perforator flap harvesting. Few research data exists about the regeneration potential of the abdominal wall's perforator system. Therefore, previous abdominoplasty with umbilical transposition is an absolute contra-indication for a DIEaP-flap (deep inferior epigastric artery perforator flap). A 50-year-old patient required a breast reconstruction of the right breast, 10 years after an abdominoplasty with undermining of the superior abdomen and umbilical transposition...
March 1, 2018: Acta Chirurgica Belgica
Toshiaki Aida, Masayuki Shiobara, Kazuo Wakatsuki, Shuka Arai, Kosuke Suda, Kotaro Miyazawa, Tetsutaro Miyoshi, Yoshihisa Takahashi, Shigeru Yoshioka
The patient was a 70-year-old man. He was diagnosed with advanced transverse colon cancer. A computed tomography (CT)revealed liver metastasis and tumor thrombosis of portal vein. We started combination chemotherapy with capecita- bine/oxaliplatin(CapeOX). Perforation of the tumor was observed 5 days after CapeOX therapy was started. Treatment with abscess drainage and ileostmy, infection was controlled and general condition was improved. After 9 courses of CapeOX, we changed chemotherapy regimen to irinotecan/tegafur-gimeracil-oteracilpotassium (IRIS)due to strong side effects...
February 2018: Gan to Kagaku Ryoho. Cancer & Chemotherapy
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
Adrien Daigeler, Cornelius Schubert, Tobias Hirsch, Björn Behr, Marcus Lehnhardt
INTRODUCTION: There are many techniques to identify vessels in perforator surgery, each with specific disadvantages. Handheld Dopplers are easy to use, but inaccurate with respect to the exact localisation of the perforator. Angio-CT is invasive, time consuming, and expensive. In contrast, duplex sonography is a reliable, easy-to-use and availabe alternative for pre-, intra-, and postoperative visualisation of vessels. Power Doppler further increases sensitivity and allows visualisation of vessels smaller than 0...
February 12, 2018: Handchirurgie, Mikrochirurgie, Plastische Chirurgie
Cheng-I Yen, Jui-Yung Yang, Chun-Shin Chang, Jung-Ju Huang, Chih-Wei Wu, Hung-Chang Chen, Shih-Yi Yang, Shu-Yin Chang, Shiow-Shuh Chuang, Yen-Chang Hsiao
BACKGROUND: Nasal reconstruction after burn injury can be challenging due to limited availability of local flaps. We present our experience of free flap reconstruction for full-thickness nasal defect after severe facial burn injury. METHODS: Between August 1998 and September 2015, six patients underwent nasal reconstruction with seven free flaps after burn injury. Among them, flame burn occurred in two patients, chemical burn in two, explosive burn in one, and contact thermal burn in one patient...
February 10, 2018: Microsurgery
Vedran Premuzic, Lea Katalinic, Marijan Pasalic, Hrvoje Jurin
Cardiac tamponade caused by perforation of the cardiac wall is a rare complication related to central venous catheter (CVC) placement. A 71-year-old female with a previous history of moderate aortic stenosis and kidney transplantation was admitted to hospital due to global heart failure and worsening of allograft function. Intensified hemodialysis was commenced through a CVC placed in the right subclavian vein. Chest radiography revealed catheter tip in the right atrium and no signs of pneumothorax. Thorough diagnostics outruled immediate life-threatening conditions, such as myocardial infarction and pulmonary embolism...
January 2018: Saudi Journal of Anaesthesia
Rashid Alobaidi, Natalie Anton, Dominic Cave, Elham Khodayari Moez, Ari R Joffe
AIM: To determine potentially modifiable predictors of early outcomes after liver transplantation in children of age < 3 years. METHODS: This study was a retrospective chart review including all consecutive children of age less than 3-years-old having had a liver transplant done at the Western Canadian referral center from June 2005 to June 2015. Pre-specified potential predictor variables and primary and secondary outcomes were recorded using standard definitions and a case report form...
January 27, 2018: World Journal of Hepatology
Daniele Bissacco, Enza L Castronovo, Silvia Romagnoli, Maurizio Domanin
BACKGROUND: To evaluate clinical pictures, symptoms and etiology of Recurrent Varices After Surgery (REVAS) through a clinical and color-Doppler-ultrasound scan (CDUS) analysis. METHODS: During a three-year period, data about 9043 consecutive outpatients were collected. Among these, 160 patients (1.8%) were affected by REVAS. Data about risk factors, types of primary vein surgery, symptomatology, clinical and CDUS characteristics were analyzed using the Clinical, Etiology, Anatomy and Pathophysiology (CEAP), Stonebridge and Perrin classifications in order to evaluate clinical and anatomical varices patterns...
January 29, 2018: International Angiology: a Journal of the International Union of Angiology
W Reith, A Haußmann
Virchow-Robin spaces are perivascular fluid-filled cavities that surround perforating arteries and veins in the brain parenchyma. As a rule in healthy people they are approximately 5 mm in diameter. Typical localizations are brainstem ganglia, mesencephalon and the white matter of the brain. Morphological imaging characteristics of Virchow-Robin spaces are round or tubular, smoothly bordered areas which are hyperintense in T2-weighted sequences. Virchow-Robin spaces represent a physiological structure in normal brain parenchyma...
January 26, 2018: Der Radiologe
Jakob Nedomansky, Stefanie Nickl, Christine Radtke, Werner Haslik, Klaus F Schroegendorfer
BACKGROUND: Abdominal seroma formation after deep inferior epigastric perforator (DIEP) flap breast reconstruction is a common donor-site complication. Additional dissection of one or both of the superficial inferior epigastric veins (SIEVs) in DIEP flap breast reconstruction allows an additional anastomosis for venous superdrainage if venous congestion occurs. However, generally, SIEV dissection involves greater invasiveness into the inguinal region, which can traumatize lymphatic tissue and lead to lymph accumulation...
February 2018: Plastic and Reconstructive Surgery
Goutham Talari, Preetham Talari, Saurabh Parasramka, Aibek E Mirrakhimov
Peripherally inserted central catheter (PICC) migration into azygos vein (AV) is a rare complication. It is recognised only when catheter malfunction occurs or when patients develop associated complications. PICC migration into AV has been reported to be associated with various complications such as catheter malfunction, perforation, haemorrhage, thrombosis, infection and stenosis of AV. Pleural effusion and trachea-azygos fistulas have also been reported. We present a patient with recurrent migration of PICC into AV after an initial corrective repositioning during the same hospital stay...
January 23, 2018: BMJ Case Reports
Edoardo Picetti, Michela Generali, Francesca Mensi, Giampaolo Neri, Roberta Damia, Giuseppe Lippi, Gianfranco Cervellin
A 55 years old man self-presented to our Emergency Department (ED) reporting an attempted suicide by cutting the left forearm veins and ingesting approximately 200 mL of an herbicide (Myrtos®, containing 36% of glyphosate as isopropylamine salt). Laboratory tests showed metabolic acidosis. Hydration with normal saline and alkalinization with sodium bicarbonate was started according to suggestion of the poison control center, since an antidote was unavailable. Cardiorespiratory condition gradually worsened, so that non-invasive positive pressure ventilation (NIPPV) was applied and infusion of fluids was established...
January 16, 2018: Acta Bio-medica: Atenei Parmensis
Yosuke Yamada, Ken Sugimoto, Yashiro Yoshizawa, Yoshifumi Arai, Yoshiro Otsuki, Tomio Arai, Yasuyuki Kobayashi, Yoshihiko Sato, Yoshisuke Hosoda
BACKGROUND: Mesenteric inflammatory veno-occlusive disease (MIVOD) is difficult to diagnose because of its rarity, nonspecific clinical findings, and frequent confusion with other diseases including inflammatory bowel disease. This report presents a very rare case of MIVOD that occurred during the course of ulcerative colitis (UC). CASE PRESENTATION: A 32-year-old man, who had been diagnosed with UC at the age of 29 and was in remission maintained by oral administration of 5-aminosalicylic acid (5-ASA), showed exacerbation of diarrhea and was admitted to the hospital...
January 11, 2018: BMC Gastroenterology
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