Journal of vascular surgery. Venous and lymphatic disorders最新文献

英文中文

Outcomes and Economic Impact of Ultrasound Evaluation to Rule Out Deep Vein Thrombosis in a Multihospital Health System 在多医院卫生系统中超声评估排除深静脉血栓的结果和经济影响

IF 2.8 2区医学 Q2 PERIPHERAL VASCULAR DISEASE

Journal of vascular surgery. Venous and lymphatic disorders

Pub Date : 2026-03-01 Epub Date: 2026-02-28 DOI: 10.1016/j.jvsv.2025.102414

Mateo Coppola BS , Justin Wang BA , James Whitley BS , Ethan Chi BS , Estefania Narvaez BS , Michelle Antony BS , Eric Hager MD

引用次数: 0

Nitinol Venous Stents Do Not Improve Iliac Vein Stenting Accuracy in Comparison to Elgiloy Stents 与髂静脉支架相比，镍钛诺静脉支架不能提高髂静脉支架置入的准确性

IF 2.8 2区医学 Q2 PERIPHERAL VASCULAR DISEASE

Journal of vascular surgery. Venous and lymphatic disorders

Pub Date : 2026-03-01 Epub Date: 2026-02-28 DOI: 10.1016/j.jvsv.2025.102409

Anusha Jacob DO

引用次数: 0

Observation of Bidirectional Lymph Flow Dynamics at the Dermal Backflow Areas in Lymphedema Using Contrast-enhanced Ultrasound 超声造影观察淋巴水肿真皮回流区双向淋巴流动动力学

IF 2.8 2区医学 Q2 PERIPHERAL VASCULAR DISEASE

Journal of vascular surgery. Venous and lymphatic disorders

Pub Date : 2026-03-01 Epub Date: 2026-02-28 DOI: 10.1016/j.jvsv.2025.102412

Takahiro Hirayama MD , Kiyoka Omoto MD, PhD , Shinobu Matsubara MD, PhD , Naoto Yamamoto MD, PhD

引用次数: 0

Risk Activity Index: A Measure of Frailty and Its Impact on Venous Leg Ulcer Healing and Recurrence 风险活动指数：衡量虚弱程度及其对下肢静脉性溃疡愈合和复发的影响

IF 2.8 2区医学 Q2 PERIPHERAL VASCULAR DISEASE

Journal of vascular surgery. Venous and lymphatic disorders

Pub Date : 2026-03-01 Epub Date: 2026-02-28 DOI: 10.1016/j.jvsv.2025.102423

Joseph Hart MD, MHL , Mona Li MD , Mark Davies MD, PhD, MBA

引用次数: 0

Trends in Inferior Vena Cava Filter Placement and Retrieval in the Vascular Quality Initiative Inferior Vena Cava Filter Registry 下腔静脉滤器放置和回收的趋势在血管质量倡议下腔静脉滤器注册

IF 2.8 2区医学 Q2 PERIPHERAL VASCULAR DISEASE

Journal of vascular surgery. Venous and lymphatic disorders

Pub Date : 2026-03-01 Epub Date: 2026-02-28 DOI: 10.1016/j.jvsv.2025.102438

Jonathan Krebs MD , Daniel Neal MS , Khalil Qato MD , Joseph Liechty MD , Howard Shackelford MD , Maureen Sheehan MD , Efthymios Avgerinos MD , Olamide Alabi MD , Benjamin Jacobs MD

引用次数: 0

Analysis of factors influencing the efficacy of ovarian vein embolization for pelvic venous insufficiency and development of a short-term efficacy prediction model with internal validation 卵巢静脉栓塞治疗盆腔静脉功能不全疗效影响因素分析及短期疗效预测模型的建立及内部验证。

IF 2.8 2区医学 Q2 PERIPHERAL VASCULAR DISEASE

Journal of vascular surgery. Venous and lymphatic disorders

Pub Date : 2026-03-01 Epub Date: 2026-01-05 DOI: 10.1016/j.jvsv.2025.102441

Binyu Zheng MS , Yangzheng Xia MS , Ranting Ye MS , Dongmei Liu MD, PhD , Gaorui Liu AMS, FASA, RPhS , Yong Liu MD, PhD

<div><h3>Objective</h3><div>The study aims to elucidate the factors associated with the short-term efficacy of ovarian vein embolization (OVE) in the treatment of pelvic venous insufficiency (PVI), to construct a predictive model for short-term efficacy of OVE.</div></div><div><h3>Methods</h3><div>Clinical and ultrasound data were retrospectively collected from female patients with PVI and underwent OVE at Beijing Shijitan Hospital between January 2019 and February 2025. This study used the minimal clinically important difference to define symptomatic improvement in the Pelvic Venous Clinical Severity Score. Symptomatic improvement was used as the evaluation criterion, and the related factors affecting the short-term efficacy were analyzed. The receiver operating characteristic curve was also applied to assess the predictive efficacy of the model and calculate the optimal efficiency cut-off value. Internal validation was performed using k-fold cross-validation to assess discrimination, calibration, and clinical utility.</div></div><div><h3>Results</h3><div>The study included a total of 82 patients: 43 patients in the remission group and 39 patients in the nonremission group. No statistically significant differences were found between the two groups with regard to age, body mass index, history of abortion, history of varicose veins of the lower extremities, the number of pregnancies and deliveries. The duration of lower abdominal discomfort in the nonremission group was longer than that in the remission group (<em>t</em> = −1.713; <em>P</em> = .004; independent samples <em>t</em> test). Transabdominal ultrasound showed that the diameter of the left ovarian vein (OV) in the nonremission group was smaller (<em>Z</em> = −2.958; <em>P</em> = .003; Mann-Whitney <em>U</em> test), and the diameter of the left parametrial vein in the nonremission group was smaller (<em>Z</em> = −2.494; <em>P</em> = .013). In addition, the positive rate of internal iliac vein reflux in the nonremission group was higher (χ<sup>2</sup> = 15.649; <em>P</em> < .001; χ<sup>2</sup> test or Fisher's exact test). Binary logistic regression analysis showed that the longer the duration of lower abdominal discomfort (odds ratio [OR], 1.115; 95% confidence interval [CI], 1.001-1.332; <em>P</em> = .049), the smaller the diameter of the left OV (OR, 0.669; 95% CI,0.483-0.928; <em>P</em> = .016) and internal iliac vein reflux (OR, 6.449; 95% CI, 2.238-15.583; <em>P</em> < .001) were independent risk factors for the short-term efficacy of OVE for PVI. The area under the receiver operating characteristic curve (AUC) was 0.807 (95% CI, 0.712-0.902), and the best cut-off value was 0.453. The sensitivity and specificity of predicting the short-term efficacy of OVE were 82.1% and 74.4%, respectively. Internal validation showed acceptable discrimination (area under the receiver operating characteristic curve = 0.779), a Brier score of 0.176 indicating adequate accuracy, reasonable calibra

目的：研究卵巢静脉栓塞（OVE）治疗盆腔静脉功能不全（PVI）短期疗效的影响因素，构建OVE短期疗效预测模型。方法：回顾性收集2019年1月至2025年2月在北京世纪坛医院接受OVE治疗的女性PVI患者的临床和超声资料。本研究使用最小临床重要差异（MCID）来定义盆腔静脉临床严重程度评分（PVCSS）的症状改善。以症状改善为评价标准，分析影响短期疗效的相关因素。采用受试者工作特征（ROC）曲线评估模型的预测效果，并计算最佳效率临界值。采用k-fold交叉验证进行内部验证，以评估鉴别、校准和临床效用。结果：(1)共纳入82例患者，其中缓解组43例，非缓解组39例。两组在年龄、身体质量指数（BMI）、流产史、下肢静脉曲张史、妊娠和分娩次数等方面无统计学差异。(2)非缓解组下腹部不适持续时间长于缓解组（t=-1.713， P=0.004；独立样本t检验）。经腹超声显示，非缓解组左卵巢静脉（OV）直径较小（Z= -2.958， P= 0.003； Mann-Whitney U检验），非缓解组左参数静脉直径较小（Z= -2.494， P= 0.013）。非缓解组髂内静脉反流阳性率较高（χ2 = 15.649, p）结论：(1)下腹部不适持续时间、OV直径和髂内静脉反流是OVE治疗PVI短期疗效的独立预测因子。(2)本研究OVE治疗PVI的短期疗效预测模型具有满意的效度。

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引用次数: 0

Results of dedicated venous nitinol stents in treating chronic inferior vena cava occlusions 专用镍钛诺静脉支架治疗慢性下腔静脉阻塞的效果。

IF 2.8 2区医学 Q2 PERIPHERAL VASCULAR DISEASE

Journal of vascular surgery. Venous and lymphatic disorders

Pub Date : 2026-03-01 Epub Date: 2025-12-29 DOI: 10.1016/j.jvsv.2025.102440

Karissa M. Wang MD, Blake E. Murphy MD, Jake F. Hemingway MD

<div><h3>Objective</h3><div>Inferior vena cava (IVC) occlusion resulting from deep vein thrombosis (DVT) or embryologic developmental abnormalities can result in debilitating symptoms, including lower extremity pain, edema, and venous ulceration. This study describes the outcomes associated with endovascular recanalization and stenting of chronic IVC occlusions with dedicated venous nitinol stents.</div></div><div><h3>Methods</h3><div>Patients who underwent endovascular recanalization and nitinol venous stenting at a single institution from 2022 to 2025 were identified. Demographics, comorbidities, CEAP classification, venous reconstruction details, and outcomes, including symptomatic improvement and 30-day complications, were collected. Descriptive analysis was completed. Primary and secondary patency was assessed using Kaplan-Meier analysis.</div></div><div><h3>Results</h3><div>A total of 22 patients with symptomatic IVC occlusions underwent attempted recanalization. The median age at the time of treatment was 41 years (interquartile range [IQR], 37-71 years), and patients were predominantly male (77%). Patient comorbidities included active tobacco use (55%), hypertension (41%), and hypercoagulable disorders (32%). On presentation, 20 patients (91%) had post-thrombotic syndrome, 12 (55%) had CEAP class 4 to 6 chronic venous disease, six (27%) had occluded IVC filters, four (18%) had a prior failed venous intervention, and five (23%) had chronic stent occlusions. The etiology of chronic IVC occlusion included DVT in 13 patients (59%), IVC filter-associated thrombosis in four patients (18%), surgical-related IVC stenosis in two patients (9%), congenital abnormalities in two patients (9%), and IVC clipping in one patient (5%). Cranial extent of stenting was infrarenal in 11 patients (52%) and suprarenal in 10 patients (48%). Common femoral veins were stented in 27 patients (64% of limbs). Sharp recanalization was required in three patients (14%). A total of 21 patients (95%) achieved technical success. All patients were anticoagulated postoperatively, and the median length of stay was 1 day (IQR, 0-2 days). Two patients (9.5%) experienced bleeding-related complications within 30 days. The median follow-up was 259 days (IQR, 78-473 days). Primary patency for the IVC stents was 100% at 12 months. Primary and secondary patency for all components within the venous reconstruction, including IVC and iliofemoral stents, was 84% and 100% at 1 year, respectively. All patients reported symptomatic improvement and venous ulcers healing (if present at index presentation) within 1 year following intervention.</div></div><div><h3>Conclusions</h3><div>Treatment of chronic IVC occlusions using dedicated venous nitinol stents is safe with excellent midterm patency and symptom improvement at 1 year postoperatively. Multi-institutional studies with larger patient populations and standardized outcomes, including quality of life and cost measures, are required to furt

目的：由深静脉血栓形成（DVT）或胚胎发育异常引起的下腔静脉（IVC）阻塞可导致虚弱症状，包括下肢疼痛、水肿和静脉溃疡。本研究描述了血管内再通和专用静脉镍钛诺支架治疗慢性下腔静脉闭塞的相关结果。方法：对2022年至2025年在同一机构接受血管内再通和镍钛诺静脉支架植入术的患者进行分析。统计资料、合并症、CEAP分类、静脉重建细节和结果，包括症状改善和30天并发症。完成描述性分析。使用Kaplan-Meier分析评估原发性和继发性通畅。结果：共有22例症状性下腔静脉闭塞患者尝试再通。治疗时的中位年龄为41岁（IQR 37,71），患者以男性为主（77%）。患者的合并症包括吸烟（55%）、高血压（41%）和高凝性疾病（32%）。在就诊时，20名患者（91%）患有血栓形成后综合征，12名患者（55%）患有CEAP 4-6级慢性静脉疾病，6名患者（27%）有静脉滤过器闭塞，4名患者（18%）有静脉干预失败，5名患者（23%）有慢性支架闭塞。慢性IVC闭塞的病因包括13例（59%）DVT， 4例（18%）IVC滤过器相关血栓形成，2例（9%）手术相关IVC狭窄，2例（9%）先天性异常，1例（5%）IVC夹闭。11例（52%）患者在肾下，10例（48%）患者在肾上。27例患者（占四肢的64%）行股总静脉支架置入。3例（14%）患者需要快速再通。共有21例患者（95%）获得了技术上的成功。所有患者术后均抗凝，中位住院时间为1天（IQR 0, 2）。2例患者（9.5%）在30天内出现出血相关并发症。中位随访时间为259天（IQR为78,473）。12个月时，下腔静脉支架的初次通畅率为100%。静脉重建中所有组成部分（包括下腔静脉和髂股支架）的一期和二期通畅在1年时分别为84%和100%。所有患者在干预后1年内均报告症状改善和静脉溃疡愈合（如果在指数表现时出现）。结论：使用专用静脉尼替诺支架治疗慢性下腔静脉闭塞是安全的，术后1年症状改善，中期通畅。需要更多患者群体的多机构研究，以及包括生活质量和成本测量在内的标准化结果，以进一步验证研究结果。

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引用次数: 0

Treatment of catheter related thrombosis: A systematic review, meta-analysis, and national survey 导管相关血栓的治疗：一项系统回顾、荟萃分析和全国调查。

IF 2.8 2区医学 Q2 PERIPHERAL VASCULAR DISEASE

Journal of vascular surgery. Venous and lymphatic disorders

Pub Date : 2026-03-01 Epub Date: 2025-11-29 DOI: 10.1016/j.jvsv.2025.102359

Laurens A. Oomen MD, MSc , Janette van Diest BSc , Felice R.M. Lucas BSc , Jitske Rijpkema MD , George L. Burchell MSc , Florianne J.L. van Zanten MD , Kee F. Choi MD , Marcella C.A. Muller MD, PhD , Angelique M.E. de Man MD, MSc, PhD , Alexander P.J. Vlaar MD, PhD, MBA , Jarom Heijmans MD, PhD , Bart J. Biemond MD, PhD , Nick van Es MD, PhD , Jasper M. Smit MD, PhD , Pieter R. Tuinman MD, PhD

Background

Catheter-related thrombosis (CRT) is a known complication of central venous catheters and peripherally inserted central catheters, yet optimal treatment remains uncertain. We conducted a systematic review and national survey to assess current CRT management strategies.

Methods

Following the PRISMA guidelines, we searched three databases through October 2024 for studies on CRT associated with central venous catheters or peripherally inserted central catheters. Meta-analyses and subgroup analyses were performed by anticoagulant type. A national survey among Dutch intensive care and hematology physicians explored current treatment practices.

Results

Of 4123 records screened, 34 observational studies were included, mostly involving patients with cancer. The venous thromboembolism recurrence rate per 100 patient-years was higher in patients with cancer (14.1; 95% confidence interval, 11.4- 17.4; I² = 35.1) vs patients without cancer (2.0; 95% confidence interval, 0.6-6.0; I² = 10.3; P = .0002). Recurrence was comparable between direct oral anticoagulants (DOACs) and low-molecular-weight heparin/vitamin K antagonists (LMWH/VKAs), at 11.0 vs 7.6 (P = .14). Major bleeding occurred in 10.5 vs 13.1 (P = .45), and clinically relevant nonmajor bleeding in 26.2 vs. 22.4 (P = .70), for DOACs vs LMWH/VKAs, respectively. All studies were observational, most at high risk of bias. Survey data showed LMWH was preferred for symptomatic CRT (50%), with treatment lasting 8 days to 6 months. In asymptomatic CRT, anticoagulant type and duration were left to physician discretion in 64% of cases.

Conclusions

Treatment with LMWH/VKA or DOACs shows similarly low venous thromboembolism recurrence, although rates are higher in patients with cancer. Bleeding was substantial and comparable across therapies. Evidence is limited by observational bias. Survey data show that LMWH predominates for CRT, with variable duration. Well-designed randomized controlled trials are warranted.

导言：导管相关性血栓形成（CRT）是中心静脉导管（CVCs）和外周中心导管（PICCs）的一种已知并发症，但最佳治疗方法仍不确定。我们进行了系统回顾和全国调查，以评估目前的CRT管理策略。方法：根据PRISMA指南，我们检索了截至2024年10月的三个数据库，检索了CRT与CVCs或PICCs相关的研究。按抗凝类型进行meta分析和亚组分析。一项针对荷兰重症监护和血液学医生的全国性调查探讨了目前的治疗方法。结果：在筛选的4123份记录中，包括34项观察性研究，主要涉及癌症患者。癌症患者的静脉血栓栓塞复发率（14.1;95% CI, 11.4- 17.4; I2=35.1）高于非癌症患者（2.0;95% CI, 0.6-6.0; I2=10.3； P=0.0002）。直接口服抗凝剂（DOACs）和低分子肝素/维生素K拮抗剂（LMWH/VKAs）的复发率相当，分别为11.0和7.6 （p = 0.14）。大出血发生率为10.5 vs 13.1 (p = 0.45)，临床相关非大出血（CRNMB）发生率为26.2vs。DOACs与低分子肝素/ vka分别为22.4 （p = 0.70）。所有的研究都是观察性的，大多数有很高的偏倚风险。调查数据显示，有症状的CRT首选低分子肝素（50%），治疗持续8天至6个月。在无症状的CRT中，64%的病例由医生决定抗凝类型和持续时间。结论：低分子肝素/VKA或DOACs治疗的VTE复发率相似，但在癌症患者中更高。各种治疗方法的出血相当严重，且具有可比性。证据受到观察偏倚的限制。调查数据显示，低分子肝素在CRT中占主导地位，但持续时间不同。设计良好的随机对照试验是必要的。

{"title":"Treatment of catheter related thrombosis: A systematic review, meta-analysis, and national survey","authors":"Laurens A. Oomen MD, MSc , Janette van Diest BSc , Felice R.M. Lucas BSc , Jitske Rijpkema MD , George L. Burchell MSc , Florianne J.L. van Zanten MD , Kee F. Choi MD , Marcella C.A. Muller MD, PhD , Angelique M.E. de Man MD, MSc, PhD , Alexander P.J. Vlaar MD, PhD, MBA , Jarom Heijmans MD, PhD , Bart J. Biemond MD, PhD , Nick van Es MD, PhD , Jasper M. Smit MD, PhD , Pieter R. Tuinman MD, PhD","doi":"10.1016/j.jvsv.2025.102359","DOIUrl":"10.1016/j.jvsv.2025.102359","url":null,"abstract":"<div><h3>Background</h3><div>Catheter-related thrombosis (CRT) is a known complication of central venous catheters and peripherally inserted central catheters, yet optimal treatment remains uncertain. We conducted a systematic review and national survey to assess current CRT management strategies.</div></div><div><h3>Methods</h3><div>Following the PRISMA guidelines, we searched three databases through October 2024 for studies on CRT associated with central venous catheters or peripherally inserted central catheters. Meta-analyses and subgroup analyses were performed by anticoagulant type. A national survey among Dutch intensive care and hematology physicians explored current treatment practices.</div></div><div><h3>Results</h3><div>Of 4123 records screened, 34 observational studies were included, mostly involving patients with cancer. The venous thromboembolism recurrence rate per 100 patient-years was higher in patients with cancer (14.1; 95% confidence interval, 11.4- 17.4; I<sup>2</sup> = 35.1) vs patients without cancer (2.0; 95% confidence interval, 0.6-6.0; I<sup>2</sup> = 10.3; <em>P</em> = .0002). Recurrence was comparable between direct oral anticoagulants (DOACs) and low-molecular-weight heparin/vitamin K antagonists (LMWH/VKAs), at 11.0 vs 7.6 (<em>P</em> = .14). Major bleeding occurred in 10.5 vs 13.1 (<em>P</em> = .45), and clinically relevant nonmajor bleeding in 26.2 vs. 22.4 (<em>P</em> = .70), for DOACs vs LMWH/VKAs, respectively. All studies were observational, most at high risk of bias. Survey data showed LMWH was preferred for symptomatic CRT (50%), with treatment lasting 8 days to 6 months. In asymptomatic CRT, anticoagulant type and duration were left to physician discretion in 64% of cases.</div></div><div><h3>Conclusions</h3><div>Treatment with LMWH/VKA or DOACs shows similarly low venous thromboembolism recurrence, although rates are higher in patients with cancer. Bleeding was substantial and comparable across therapies. Evidence is limited by observational bias. Survey data show that LMWH predominates for CRT, with variable duration. Well-designed randomized controlled trials are warranted.</div></div>","PeriodicalId":17537,"journal":{"name":"Journal of vascular surgery. Venous and lymphatic disorders","volume":"14 2","pages":"Article 102359"},"PeriodicalIF":2.8,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145648894","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Erratum. 勘误表。

IF 2.8 2区医学 Q2 PERIPHERAL VASCULAR DISEASE

Journal of vascular surgery. Venous and lymphatic disorders

Pub Date : 2026-02-28 DOI: 10.1016/j.jvsv.2026.102458

引用次数: 0

Comparison of polidocanol endovenous microfoam (Varithena) to physician-compounded foam in sclerotherapy treatment of truncal varicosities: A systematic review and network meta-analysis. 聚多醇静脉内微泡沫（Varithena®）与医师复合泡沫在硬化治疗椎体静脉曲张中的比较：系统综述和网络荟萃分析。

IF 2.8 2区医学 Q2 PERIPHERAL VASCULAR DISEASE

Journal of vascular surgery. Venous and lymphatic disorders

Pub Date : 2026-02-26 DOI: 10.1016/j.jvsv.2026.102460

Runzhi Chen, Chien Lin Soh, Marwah Salih, Matthew Tan, Benedict Turner, Sarah Onida, Alun H Davies

Background: Commercial premixed foam sclerosants such as Varithena, a polidocanol endovenous microfoam, have been developed and marketed as better alternatives to physician-compounded foams (PCFs). The aim of this study was to evaluate the efficacy of Varithena compared with PCFs in foam sclerotherapy for the treatment of truncal varicose veins.

Methods: A systematic review was performed according to PRISMA and Meta-Analysis guidelines with a registered protocol (PROSPERO: CRD42024494805) using Medline and EMBASE databases from inception to June 17, 2025, by two reviewers. Randomized controlled trials that reported on occlusion rates after truncal varicose vein treatment with foam sclerotherapy were included. A network meta-analysis was performed.

Results: Six randomized controlled trials with a total of 1726 patients were identified. Complete occlusion was defined as elimination of saphenofemoral junction reflux or occlusion of the saphenous vein on duplex imaging. The median follow-up was 39 weeks (range, 12-52 weeks). No significant difference was observed between Varithena and PCF with respect to occlusion rates at follow-up (risk ratio [RR], 1.12; 95% confidence interval [CI], 0.93-1.35; I² =71%). Moreover, similar rates of adverse events were observed between the Varithena and PCF groups (RR, 2.89; 95% CI, 0.64-12.97; I² = 0%). Compared with foam sclerotherapy with Varithena, surgical removal and endovenous laser ablation showed a significantly higher occlusion rate at follow-up (RR, 1.31; 95% CI, 1.18-1.47; I² =71% and RR, 1.32; 95% CI, 1.18-1.49; I² =71%, respectively).

Conclusions: In patients with saphenous varices, there was no indication that Varithena was superior to or associated with fewer complications than PCFs Further trials are required to define the role of Varithena in the treatment of varicose veins, especially within the context of less expensive alternatives.

背景：商业预混合泡沫硬化剂，如VarithenaTM，一种聚多元醇静脉内微泡沫，已经被开发和销售，作为医生复合泡沫（PCFs）的更好替代品。本研究的目的是评估varthenatm与PCFs在泡沫硬化治疗截尾静脉曲张中的疗效。方法：根据系统评价和荟萃分析指南的首选报告项目，采用注册方案（PROSPERO: CRD42024494805），使用Medline和EMBASE数据库，由两名审评者从开始到2025年6月17日进行系统评价。随机对照试验报告了用泡沫硬化疗法治疗短段静脉曲张后闭塞率。进行网络meta分析。结果：6项随机对照试验共纳入1726例患者。完全闭塞被定义为消除隐股交界处反流或隐静脉阻塞在双工成像。中位随访时间为39周（12-52周）。随访时，VarithenaTM与PCF的闭塞率无显著差异（RR 1.12, 95% CI 0.93-1.35, I2=71%）。此外，VarithenaTM组和PCF组不良事件发生率相似（RR 2.89, 95% CI 0.64-12.97, I2=0%）。与VarithenaTM泡沫硬化治疗相比，手术切除和静脉内激光消融在随访时的闭塞率明显更高（RR分别为1.31,95% CI 1.18-1.47, I2=71%， RR为1.32,95% CI 1.18-1.49, I2=71%）。结论：在隐静脉曲张患者中，没有迹象表明VarithenaTM优于PCFs或与PCFs相关的并发症更少，需要进一步的试验来确定VarithenaTM在治疗静脉曲张中的作用，特别是在更便宜的替代方案的背景下。

{"title":"Comparison of polidocanol endovenous microfoam (Varithena) to physician-compounded foam in sclerotherapy treatment of truncal varicosities: A systematic review and network meta-analysis.","authors":"Runzhi Chen, Chien Lin Soh, Marwah Salih, Matthew Tan, Benedict Turner, Sarah Onida, Alun H Davies","doi":"10.1016/j.jvsv.2026.102460","DOIUrl":"10.1016/j.jvsv.2026.102460","url":null,"abstract":"<p><strong>Background: </strong>Commercial premixed foam sclerosants such as Varithena, a polidocanol endovenous microfoam, have been developed and marketed as better alternatives to physician-compounded foams (PCFs). The aim of this study was to evaluate the efficacy of Varithena compared with PCFs in foam sclerotherapy for the treatment of truncal varicose veins.</p><p><strong>Methods: </strong>A systematic review was performed according to PRISMA and Meta-Analysis guidelines with a registered protocol (PROSPERO: CRD42024494805) using Medline and EMBASE databases from inception to June 17, 2025, by two reviewers. Randomized controlled trials that reported on occlusion rates after truncal varicose vein treatment with foam sclerotherapy were included. A network meta-analysis was performed.</p><p><strong>Results: </strong>Six randomized controlled trials with a total of 1726 patients were identified. Complete occlusion was defined as elimination of saphenofemoral junction reflux or occlusion of the saphenous vein on duplex imaging. The median follow-up was 39 weeks (range, 12-52 weeks). No significant difference was observed between Varithena and PCF with respect to occlusion rates at follow-up (risk ratio [RR], 1.12; 95% confidence interval [CI], 0.93-1.35; I<sup>2</sup> =71%). Moreover, similar rates of adverse events were observed between the Varithena and PCF groups (RR, 2.89; 95% CI, 0.64-12.97; I<sup>2</sup> = 0%). Compared with foam sclerotherapy with Varithena, surgical removal and endovenous laser ablation showed a significantly higher occlusion rate at follow-up (RR, 1.31; 95% CI, 1.18-1.47; I<sup>2</sup> =71% and RR, 1.32; 95% CI, 1.18-1.49; I<sup>2</sup> =71%, respectively).</p><p><strong>Conclusions: </strong>In patients with saphenous varices, there was no indication that Varithena was superior to or associated with fewer complications than PCFs Further trials are required to define the role of Varithena in the treatment of varicose veins, especially within the context of less expensive alternatives.</p>","PeriodicalId":17537,"journal":{"name":"Journal of vascular surgery. Venous and lymphatic disorders","volume":" ","pages":"102460"},"PeriodicalIF":2.8,"publicationDate":"2026-02-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147321672","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

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