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

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Emergency covered stent repair of superior vena cava rupture causing acute cardiac tamponade and cardiac arrest during central venous recanalization 急诊覆膜支架修复中心静脉再通过程中引起急性心包填塞和心脏骤停的上腔静脉破裂。
IF 2.8 2区 医学 Q2 PERIPHERAL VASCULAR DISEASE Pub Date : 2025-11-28 DOI: 10.1016/j.jvsv.2025.102358
Hamzeh R. Shahin MD, Tareq Massimi MD
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引用次数: 0
Two-year outcomes of ThermoBlock radiofrequency ablation in chronic saphenous vein insufficiency: A single-center experience with 910 cases ThermoBlock射频消融治疗慢性隐静脉不全的两年疗效:910例单中心研究
IF 2.8 2区 医学 Q2 PERIPHERAL VASCULAR DISEASE Pub Date : 2025-11-21 DOI: 10.1016/j.jvsv.2025.102357
Mehmet Emre Elci MD, Gözde Tekin MD
<div><h3>Background</h3><div>Chronic venous insufficiency is a common vascular disorder that can lead to significant morbidity if left untreated. Endovenous thermal ablation, particularly radiofrequency ablation (RFA), has become a first-line therapy owing to its high efficacy and favorable safety profile. We sought to evaluate the technical success, safety, and clinical outcomes of the ThermoBlock RFA system in patients with reflux grade 4 great saphenous vein (GSV) insufficiency.</div></div><div><h3>Methods</h3><div>This single-center retrospective study included 910 patients (444 males, 466 females; mean age, 45.4 ± 11.5 years) who underwent ThermoBlock RFA between March 2019 and June 2023. Clinical severity was assessed using the Venous Clinical Severity Score, and quality of life (QoL) was measured with the VEINES-QOL/Sym questionnaire. Duplex ultrasound examinations were performed at baseline and at 3, 6, 12, and 24 months. Statistical analyses used paired <em>t</em> tests for continuous variables and Wilcoxon signed-rank tests for ordinal variables, with effect sizes reported.</div></div><div><h3>Results</h3><div>Technical success at 3 months was 97.6%. The Venous Clinical Severity Score improved from 10.9 ± 2.4 to 3.6 ± 0.9 (<em>P</em> < .001; Cohen's d = 3.7), and VEINES-QOL/Sym scores increased from 60.5 ± 7.71 to 84.6 ± 8.52 (<em>P</em> < .001; Cohen's d = 3.0). The mean GSV diameter decreased from 7.33 ± 1.13 mm before the procedure to 5.39 ± 0.60 mm at 3 months and 2.94 ± 0.66 mm at 24 months (<em>P</em> < .001). No mortality or pulmonary embolism occurred; deep vein thrombosis was observed in 0.7% of patients. Minor complications included thrombophlebitis (10.3%), hyperpigmentation (11.9%), ecchymosis (10.9%), and numbness (24.7%).</div></div><div><h3>Conclusions</h3><div>ThermoBlock RFA is a safe and effective treatment for chronic GSV insufficiency, achieving high vein closure rates, substantial symptom relief, and improved QoL with minimal major complications. Its integrated laser guidance system may enhance procedural precision and support durable long-term outcomes.</div></div><div><h3>Clinical Relevance</h3><div>Chronic venous insufficiency is a prevalent condition that significantly impairs QoL and imposes a substantial socioeconomic burden. Endovenous thermal ablation techniques have largely replaced conventional surgery owing to their high efficacy and lower complication rates. The ThermoBlock RFA system integrates precise thermal control with laser-guided catheter positioning, potentially enhancing procedural accuracy and outcomes. In this large, single-center study of 910 patients with advanced saphenous vein insufficiency, ThermoBlock RFA achieved a 97.6% closure rate at 3 months, with marked improvements in Venous Clinical Severity Score and VEINES-QOL/Sym scores, and a low incidence of major complications. These findings support ThermoBlock RFA as a safe, effective, and reproducible first-line option for the t
背景:慢性静脉功能不全(CVI)是一种常见的血管疾病,如果不及时治疗可导致严重的发病率。静脉内热消融,尤其是射频消融(RFA),由于其高疗效和良好的安全性,已成为一线治疗。目的:评估ThermoBlock™RFA系统在4级反流大隐静脉(GSV)功能不全患者中的技术成功、安全性和临床结果。方法:这项单中心回顾性研究纳入了910例患者(男性444例,女性466例,平均年龄45.4±11.5岁),这些患者在2019年3月至2023年6月期间接受了ThermoBlock™RFA。采用静脉临床严重程度评分(VCSS)评估临床严重程度,采用VEINES-QOL/Sym问卷测量生活质量(QoL)。在基线和3、6、12、24个月时进行双超声检查(DUSG)。统计分析对连续变量使用配对t检验,对有序变量使用Wilcoxon符号秩检验,并报告了效应量。结果:3个月技术成功率97.6%。VCSS评分从10.9±2.4分提高到3.6±0.9分(p < 0.001, Cohen’s d = 3.7), VEINES-QOL/Sym评分从60.5±7.71分提高到84.6±8.52分(p < 0.001, Cohen’s d = 3.0)。平均GSV直径从术前的7.33±1.13 mm下降到3个月时的5.39±0.60 mm和24个月时的2.94±0.66 mm (p < 0.001)。无死亡或肺栓塞发生;深静脉血栓形成(DVT)发生率为0.7%。次要并发症包括血栓性静脉炎(10.3%)、色素沉着(11.9%)、瘀斑(10.9%)和麻木(24.7%)。结论:ThermoBlock™RFA是一种安全有效的治疗慢性GSV功能不全的方法,可实现高静脉关闭率,显著缓解症状,改善生活质量,且主要并发症最少。它的集成激光制导系统可以提高程序精度和支持持久的长期结果。
{"title":"Two-year outcomes of ThermoBlock radiofrequency ablation in chronic saphenous vein insufficiency: A single-center experience with 910 cases","authors":"Mehmet Emre Elci MD,&nbsp;Gözde Tekin MD","doi":"10.1016/j.jvsv.2025.102357","DOIUrl":"10.1016/j.jvsv.2025.102357","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Background&lt;/h3&gt;&lt;div&gt;Chronic venous insufficiency is a common vascular disorder that can lead to significant morbidity if left untreated. Endovenous thermal ablation, particularly radiofrequency ablation (RFA), has become a first-line therapy owing to its high efficacy and favorable safety profile. We sought to evaluate the technical success, safety, and clinical outcomes of the ThermoBlock RFA system in patients with reflux grade 4 great saphenous vein (GSV) insufficiency.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Methods&lt;/h3&gt;&lt;div&gt;This single-center retrospective study included 910 patients (444 males, 466 females; mean age, 45.4 ± 11.5 years) who underwent ThermoBlock RFA between March 2019 and June 2023. Clinical severity was assessed using the Venous Clinical Severity Score, and quality of life (QoL) was measured with the VEINES-QOL/Sym questionnaire. Duplex ultrasound examinations were performed at baseline and at 3, 6, 12, and 24 months. Statistical analyses used paired &lt;em&gt;t&lt;/em&gt; tests for continuous variables and Wilcoxon signed-rank tests for ordinal variables, with effect sizes reported.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Results&lt;/h3&gt;&lt;div&gt;Technical success at 3 months was 97.6%. The Venous Clinical Severity Score improved from 10.9 ± 2.4 to 3.6 ± 0.9 (&lt;em&gt;P&lt;/em&gt; &lt; .001; Cohen's d = 3.7), and VEINES-QOL/Sym scores increased from 60.5 ± 7.71 to 84.6 ± 8.52 (&lt;em&gt;P&lt;/em&gt; &lt; .001; Cohen's d = 3.0). The mean GSV diameter decreased from 7.33 ± 1.13 mm before the procedure to 5.39 ± 0.60 mm at 3 months and 2.94 ± 0.66 mm at 24 months (&lt;em&gt;P&lt;/em&gt; &lt; .001). No mortality or pulmonary embolism occurred; deep vein thrombosis was observed in 0.7% of patients. Minor complications included thrombophlebitis (10.3%), hyperpigmentation (11.9%), ecchymosis (10.9%), and numbness (24.7%).&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Conclusions&lt;/h3&gt;&lt;div&gt;ThermoBlock RFA is a safe and effective treatment for chronic GSV insufficiency, achieving high vein closure rates, substantial symptom relief, and improved QoL with minimal major complications. Its integrated laser guidance system may enhance procedural precision and support durable long-term outcomes.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Clinical Relevance&lt;/h3&gt;&lt;div&gt;Chronic venous insufficiency is a prevalent condition that significantly impairs QoL and imposes a substantial socioeconomic burden. Endovenous thermal ablation techniques have largely replaced conventional surgery owing to their high efficacy and lower complication rates. The ThermoBlock RFA system integrates precise thermal control with laser-guided catheter positioning, potentially enhancing procedural accuracy and outcomes. In this large, single-center study of 910 patients with advanced saphenous vein insufficiency, ThermoBlock RFA achieved a 97.6% closure rate at 3 months, with marked improvements in Venous Clinical Severity Score and VEINES-QOL/Sym scores, and a low incidence of major complications. These findings support ThermoBlock RFA as a safe, effective, and reproducible first-line option for the t","PeriodicalId":17537,"journal":{"name":"Journal of vascular surgery. Venous and lymphatic disorders","volume":"14 2","pages":"Article 102357"},"PeriodicalIF":2.8,"publicationDate":"2025-11-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145582389","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
Non-pneumatic compression and its clinical utility in management of lymphedema. A position statement endorsed by the American Venous Forum and the American Venous and Lymphatic Society 非气动压缩及其在淋巴水肿治疗中的临床应用。由美国静脉论坛和美国静脉和淋巴协会认可的立场声明。
IF 2.8 2区 医学 Q2 PERIPHERAL VASCULAR DISEASE Pub Date : 2025-11-19 DOI: 10.1016/j.jvsv.2025.102356
Glenn R. Jacobowitz MD , Ruth Bush MD, JD, MPH , Ronald S. Winokur MD , Joseph D. Raffetto MD

Background

Lymphedema is a chronic, incurable condition caused by impaired lymphatic drainage, leading to progressive swelling and functional impairment. Phlebolymphedema, a subtype linked to chronic venous insufficiency (CVI), accounts for 41.8% of lower extremity lymphedema cases and contributes to an economic burden exceeding $1 billion over 5 years. Despite its high prevalence, lymphedema remains underdiagnosed and undertreated. Current management relies on compression therapy, exercise, and limb elevation, with pneumatic compression devices (PCDs) as adjuncts. However, PCDs present limitations, including user immobilization, poor adherence, and inadequate muscle pump activation, highlighting the need for more effective, patient-centered therapies.

Methods

This paper evaluates the use of a non-pneumatic compression device (NPCD) that integrates static compression, sequential gradient compression (distal to proximal), and muscle pump activation.

Results

In two randomized controlled trials, NPCD demonstrated superior outcomes over advanced PCDs, including greater edema reduction, improved quality of life, and higher adherence rates. Unlike traditional PCDs, NPCD enables active movement during treatment, optimizing lymphatic drainage and venous return.

Conclusions

Given its distinctive multi-modal mechanisms and advantages, NPCD represents a clinically safe and effective, user-friendly alternative to PCDs, aligning with current best practices in vascular and lymphatic medicine. Its inclusion in future lymphedema treatment guidelines should be considered.
淋巴水肿是一种慢性、无法治愈的疾病,由淋巴排水受损引起,导致进行性肿胀和功能损害。淋巴水肿是一种与慢性静脉功能不全(CVI)相关的亚型,占下肢淋巴水肿病例的41.8%,并在五年内造成超过10亿美元的经济负担。尽管淋巴水肿发病率很高,但仍未得到充分诊断和治疗。目前的治疗依赖于压缩治疗、运动和肢体抬高,并辅以气动压缩装置(PCDs)。然而,PCDs存在局限性,包括使用者固定,依从性差,肌肉泵激活不足,强调需要更有效的,以患者为中心的治疗。本文评估了非气动压缩装置(NPCD)的使用,该装置集成了静态压缩、顺序梯度压缩(远端到近端)和肌肉泵激活。在两项随机对照试验中(Rockson et al., 2022和Barfield et al., 2025), NPCD表现出优于晚期pcd的结果,包括更大程度的水肿减少、生活质量的改善和更高的依从率。与传统的pcd不同,NPCD可以在治疗期间进行主动运动,优化淋巴引流和静脉回流。鉴于其独特的多模式机制和优势,NPCD是临床安全、有效、用户友好的PCDs替代品,符合当前血管和淋巴医学的最佳实践。应考虑将其纳入未来的淋巴水肿治疗指南。
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引用次数: 0
Vitis vinifera seed extract reduces venous reflux time in patients with varicose veins: VICTORY randomized controlled trial 葡萄籽提取物减少静脉曲张患者静脉回流时间:VICTORY随机对照试验
IF 2.8 2区 医学 Q2 PERIPHERAL VASCULAR DISEASE Pub Date : 2025-11-15 DOI: 10.1016/j.jvsv.2025.102355
SungA Bae MD, PhD , Hakju Kim MD , Nak-Hoon Son MD, PhD , Minkwan Kim MD, PhD , Sungjoon Park MD , In Hyun Jung MD, PhD

Background

Varicose veins affect 25% to 40% of adults, with higher prevalence in older populations. Although Vitis vinifera seed extract (VVSE) can alleviate symptoms of venous insufficiency, its effects on venous reflux remain uncertain. We hypothesized that oral VVSE supplementation would significantly reduce venous reflux time compared with lifestyle modifications alone in patients with lower extremity varicose veins.

Methods

This prospective, open-label, randomized controlled trial enrolled adults aged 19 to 80 years with varicose veins and venous reflux confirmed by Doppler ultrasound (≥0.5 seconds in superficial veins or ≥1 second in deep veins). Patients were provided oral VVSE (150 mg twice daily) plus therapeutic lifestyle changes or therapeutic lifestyle changes alone (control) over 12 weeks. The mean venous reflux time, changes in specific vein reflux times, proportion achieving improved reflux (≤0.5 seconds for superficial veins, ≤1 second for deep veins), Venous Clinical Severity Score (VCSS), and Chronic Venous Insufficiency Quality of Life Questionnaire (CIVIQ-14) score were compared.

Results

Among 176 participants (88/group), the VVSE group experienced significantly greater reductions in mean venous reflux time. Improvements were observed in both superficial and deep veins, with notable effects in the great saphenous and popliteal veins. The proportion of patients achieving improved venous reflux was significantly higher in the VVSE group. The VVSE group also demonstrated superior symptom improvement, with greater reductions in VCSS and CIVIQ-14 scores.

Conclusions

VVSE significantly reduced venous reflux time across both superficial and deep veins, improving patient-reported symptoms compared with lifestyle modifications alone. The beneficial effects were consistent across diverse patient subgroups and particularly noteworthy in deep venous insufficiency.
背景:25-40%的成年人患有静脉曲张,在老年人群中患病率更高。虽然葡萄籽提取物(VVSE)可以缓解静脉功能不全的症状,但其对静脉反流的影响仍不确定。我们假设,与单纯改变生活方式相比,口服VVSE补充剂可显著减少下肢静脉曲张患者的静脉回流时间。方法:这项前瞻性、开放标签、随机对照试验招募了年龄在19-80岁、经多普勒超声证实的静脉曲张和静脉反流(浅表静脉≥0.5 s或深静脉≥1 s)的成年人。患者口服VVSE (150mg,每日两次)加治疗性生活方式改变(TLC)或单独TLC(对照组)超过12周。比较两组患者平均静脉反流时间、特定静脉反流次数变化、反流改善比例(浅静脉≤0.5s,深静脉≤1s)、静脉临床严重程度评分(VCSS)、慢性静脉功能不全生活质量问卷(CIVIQ-14)评分。结果:在176名参与者(88人/组)中,VVSE组的平均静脉回流时间明显减少。浅静脉和深静脉均有改善,其中大隐静脉和腘静脉效果显著。静脉回流改善的患者比例在VVSE组中明显更高。VVSE组也表现出更好的症状改善,VCSS和civq -14评分下降幅度更大。结论:与单纯改变生活方式相比,VVSE显著减少了浅静脉和深静脉的静脉回流时间,改善了患者报告的症状。在不同的患者亚组中,有益的效果是一致的,特别是在深静脉功能不全中。
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引用次数: 0
Long-term efficacy of inguinal reoperation for recurrent saphenofemoral incompetence 腹股沟再手术治疗复发性隐股功能不全的远期疗效观察。
IF 2.8 2区 医学 Q2 PERIPHERAL VASCULAR DISEASE Pub Date : 2025-11-12 DOI: 10.1016/j.jvsv.2025.102353
Elitsa Valentinova Doncheva , Stefania Aglaia Gerontopoulou MD , Candan Altindas-Jürgensen , Houman Jalaie MD , Knuth Rass MD

Objective

Recurrence originating from the saphenofemoral junction (SFJ) after an open surgical approach to or endovenous ablation of the great saphenous vein frequently occurs. The optimal treatment for a saphenofemoral recurrence remains a subject of debate. Currently, open redo surgery is becoming less common. This study analyzes the long-term effectiveness of saphenofemoral redo surgery following the principles of a modern surgical approach.

Methods

Patients who underwent saphenofemoral reoperation in 2015 and 2016 were identified retrospectively and invited to participate in a prospective follow-up examination. Redo surgery was performed under general and additional tumescent local anesthesia as inpatient treatment and included flush religation of the SFJ , stump suture, cauterization of the free endothelium, and removal of neovascularization. The following objectives were analyzed: Duplex ultrasound-detectable recurrent reflux at the SFJ, clinical recurrence according to Recurrent Varices After Surgery classification, disease severity and quality of life using standardized protocols (Revised Venous Clinical Severity Score, Homburg Varicose Vein Severity Score, Chronic Venous Insufficiency Questionnaire), and patient-reported satisfaction.

Results

A total of 84 patients (94 treated legs) were included with a median follow-up of 6.6 years. Five of the 94 legs (5.3%) had a duplex-detected reflux in the groin, with only 1 leg (1.1%) showing grade 2 neovascularization (vessel diameter of ≥4 mm). According to Recurrent Varices After Surgery classification, 2 of the 94 legs (2.1%) revealed clinical recurrence arising from the inguinal region. Disease severity at follow-up was low with a mean Revised Venous Clinical Severity Score(0-30) of 1.8 ± 1.8 and a mean Homburg Varicose Vein Severity Score (0-33) of 3.9 ± 3.4. According to the Clinical, Etiological, Anatomical and Pathological classification, the stage of disease improved significantly (P < .001) in 55% of the treated legs. The procedure was well-accepted by patients: 94.1% indicated they would undergo saphenofemoral reoperation again if medically advised.

Conclusions

This study demonstrates that saphenofemoral redo surgery is very effective when certain technical strategies are implemented to prevent neovascularization. Long-term treatment results may be superior to minimally invasive procedures, indicating the need for comparative studies. Until such studies are available, open redo surgery should continue to be considered as an appropriate treatment option for saphenofemoral recurrence.
目的:大隐静脉切开入路或静脉内消融后,起源于隐股交界处的复发是常见的。隐股骨头复发的最佳治疗方法仍然是一个有争议的话题。目前,开放式重做手术越来越不常见。本研究分析了隐股重做手术的远期疗效,遵循现代手术入路的原则。方法:回顾性分析2015年和2016年行隐股再手术的患者,并邀请其参加前瞻性随访检查。重做手术在全麻和局部肿胀麻醉下进行,作为住院治疗,包括冲洗重新结扎隐股连接处,残端缝合,烧灼游离内皮和去除新生血管。分析以下目标:双工超声检测到隐股交界处的复发性反流,根据术后复发性静脉曲张分类的临床复发,疾病严重程度和使用标准化方案的生活质量(修订静脉临床严重程度评分,Homburg静脉曲张严重程度评分,慢性静脉功能不全问卷),以及患者报告的满意度。结果:共纳入84例患者(94条治疗腿),中位随访6.6年。5/94条腿(5.3%)在腹股沟有双重检测到反流,只有一条腿(1.1%)显示2级新生血管(血管直径≥4mm)。根据术后静脉曲张复发分类,2/94条腿(2.1%)的临床复发起源于腹股沟区。随访时疾病严重程度较低,修订静脉临床严重程度评分(0-30)平均为1.8±1.8,洪堡静脉曲张严重程度评分(0-33)平均为3.9±3.4。根据临床、病因学、解剖和病理生理分类(CEAP), 55%的治疗腿的疾病分期明显改善(p < 0.001)。患者对该手术的接受程度较高:94.1%的患者表示,如果医生建议,他们会再次进行隐股手术。结论:本研究表明,当实施某些技术策略以防止新血管形成时,隐股重做手术是非常有效的。长期治疗结果可能优于微创手术,这表明需要进行比较研究。直到有这样的研究,开放重做手术应该继续被认为是治疗隐股骨头复发的合适选择。
{"title":"Long-term efficacy of inguinal reoperation for recurrent saphenofemoral incompetence","authors":"Elitsa Valentinova Doncheva ,&nbsp;Stefania Aglaia Gerontopoulou MD ,&nbsp;Candan Altindas-Jürgensen ,&nbsp;Houman Jalaie MD ,&nbsp;Knuth Rass MD","doi":"10.1016/j.jvsv.2025.102353","DOIUrl":"10.1016/j.jvsv.2025.102353","url":null,"abstract":"<div><h3>Objective</h3><div>Recurrence originating from the saphenofemoral junction (SFJ) after an open surgical approach to or endovenous ablation of the great saphenous vein frequently occurs. The optimal treatment for a saphenofemoral recurrence remains a subject of debate. Currently, open redo surgery is becoming less common. This study analyzes the long-term effectiveness of saphenofemoral redo surgery following the principles of a modern surgical approach.</div></div><div><h3>Methods</h3><div>Patients who underwent saphenofemoral reoperation in 2015 and 2016 were identified retrospectively and invited to participate in a prospective follow-up examination. Redo surgery was performed under general and additional tumescent local anesthesia as inpatient treatment and included flush religation of the SFJ , stump suture, cauterization of the free endothelium, and removal of neovascularization. The following objectives were analyzed: Duplex ultrasound-detectable recurrent reflux at the SFJ, clinical recurrence according to Recurrent Varices After Surgery classification, disease severity and quality of life using standardized protocols (Revised Venous Clinical Severity Score, Homburg Varicose Vein Severity Score, Chronic Venous Insufficiency Questionnaire), and patient-reported satisfaction.</div></div><div><h3>Results</h3><div>A total of 84 patients (94 treated legs) were included with a median follow-up of 6.6 years. Five of the 94 legs (5.3%) had a duplex-detected reflux in the groin, with only 1 leg (1.1%) showing grade 2 neovascularization (vessel diameter of ≥4 mm). According to Recurrent Varices After Surgery classification, 2 of the 94 legs (2.1%) revealed clinical recurrence arising from the inguinal region. Disease severity at follow-up was low with a mean Revised Venous Clinical Severity Score<sub>(0-30)</sub> of 1.8 ± 1.8 and a mean Homburg Varicose Vein Severity Score <sub>(0-33)</sub> of 3.9 ± 3.4. According to the Clinical, Etiological, Anatomical and Pathological classification, the stage of disease improved significantly (<em>P</em> &lt; .001) in 55% of the treated legs. The procedure was well-accepted by patients: 94.1% indicated they would undergo saphenofemoral reoperation again if medically advised.</div></div><div><h3>Conclusions</h3><div>This study demonstrates that saphenofemoral redo surgery is very effective when certain technical strategies are implemented to prevent neovascularization. Long-term treatment results may be superior to minimally invasive procedures, indicating the need for comparative studies. Until such studies are available, open redo surgery should continue to be considered as an appropriate treatment option for saphenofemoral recurrence.</div></div>","PeriodicalId":17537,"journal":{"name":"Journal of vascular surgery. Venous and lymphatic disorders","volume":"14 1","pages":"Article 102353"},"PeriodicalIF":2.8,"publicationDate":"2025-11-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145523452","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
Factors associated with postoperative care among patients with varicose veins of the lower extremities 下肢静脉曲张患者术后护理的相关因素。
IF 2.8 2区 医学 Q2 PERIPHERAL VASCULAR DISEASE Pub Date : 2025-11-10 DOI: 10.1016/j.jvsv.2025.102354
Jing Li MSN (RN) , Edmund Xie BS , Xiaojin Huang MD , Xi Huang MSN candidate, RN , Danyang Yu PhD , In Hye Park PhD (RN) , Yang Liu RN, PhD , Peijia Zha PhD

Objective

Varicose veins of the lower extremities are a prevalent chronic vascular condition. Effective postoperative self-management is crucial for recovery and preventing complications. However, there is limited understanding of the factors influencing patients’ self-management following surgical intervention. The objectives of this study were to investigate level of postoperative self-management ability and identify sociodemographic, clinical procedural, and health education factors that impact on postoperative self-management among patients with varicose veins of the lower extremities.

Methods

A cross-sectional study was conducted using convenience sampling. A total of 622 patients from the Department of Vascular Surgery at a tertiary hospital in Xiamen completed the telephone survey between January 2022 and December 2022. Data were collected via a structured questionnaire, including sociodemographic, clinical procedural, health education, and self-management scales. Statistical analyses included univariate and bivariate analyses to identify key influencing factors.

Results

The overall score of postoperative self-management ability of patients with varicose veins of the lower extremities was moderately high (mean, 24.27). Sociodemographic, clinical procedural, and health education factors significantly impacted patient postoperative self-management. Sociodemographic characteristics, including gender, age, education level, living arrangement, and monthly income significantly impacted the postoperative self-management. Clinical manifestations-etiology-anatomy-pathophysiology (CEAP) classification, types of surgery, and postoperative time also significantly affected the postoperative self-management. Health education received after surgery and health education methods impacted the postoperative self-management ability of patients with varicose veins in the lower extremities.

Conclusions

Postoperative self-management was moderately high among patients with varicose veins of the lower extremities, but gaps in knowledge about complications and adherence to recommended practices were noted. Targeted, evidence-based health education tailored to individual patient characteristics can significantly improve self-management outcomes. This study underscores the importance of personalized interventions in enhancing patient-centered care and optimizing long-term recovery outcomes.
背景:下肢静脉曲张是一种常见的慢性血管疾病。有效的术后自我管理对于恢复和预防并发症至关重要。然而,对手术干预后影响患者自我管理的因素了解有限。目的:本研究的目的是调查下肢静脉曲张患者术后自我管理能力水平,并确定影响患者术后自我管理的社会人口学、临床程序和健康教育因素。方法:采用方便抽样法进行横断面研究。在2022年1月至2022年12月期间,厦门某三级医院血管外科共有622名患者完成了电话调查。数据通过结构化问卷收集,包括社会人口学、临床程序、健康教育和自我管理量表。结果:下肢静脉曲张患者术后自我管理能力总分为中高(Mean=24.27)。社会人口学、临床程序和健康教育因素显著影响患者术后自我管理。性别、年龄、受教育程度、居住安排、月收入等社会人口特征对术后自我管理有显著影响。临床表现-病因-解剖-病理生理(CEAP)分类、手术类型和术后时间也显著影响术后自我管理。术后健康教育和健康教育方法对下肢静脉曲张患者术后自我管理能力有影响。讨论:下肢静脉曲张患者术后自我管理程度中等,但注意到对并发症的了解和对推荐做法的依从性存在差距。有针对性的、基于证据的健康教育可以根据患者的个体特征显著改善自我管理的结果。这项研究强调了个性化干预在加强以患者为中心的护理和优化长期康复结果中的重要性。
{"title":"Factors associated with postoperative care among patients with varicose veins of the lower extremities","authors":"Jing Li MSN (RN) ,&nbsp;Edmund Xie BS ,&nbsp;Xiaojin Huang MD ,&nbsp;Xi Huang MSN candidate, RN ,&nbsp;Danyang Yu PhD ,&nbsp;In Hye Park PhD (RN) ,&nbsp;Yang Liu RN, PhD ,&nbsp;Peijia Zha PhD","doi":"10.1016/j.jvsv.2025.102354","DOIUrl":"10.1016/j.jvsv.2025.102354","url":null,"abstract":"<div><h3>Objective</h3><div>Varicose veins of the lower extremities are a prevalent chronic vascular condition. Effective postoperative self-management is crucial for recovery and preventing complications. However, there is limited understanding of the factors influencing patients’ self-management following surgical intervention. The objectives of this study were to investigate level of postoperative self-management ability and identify sociodemographic, clinical procedural, and health education factors that impact on postoperative self-management among patients with varicose veins of the lower extremities.</div></div><div><h3>Methods</h3><div>A cross-sectional study was conducted using convenience sampling. A total of 622 patients from the Department of Vascular Surgery at a tertiary hospital in Xiamen completed the telephone survey between January 2022 and December 2022. Data were collected via a structured questionnaire, including sociodemographic, clinical procedural, health education, and self-management scales. Statistical analyses included univariate and bivariate analyses to identify key influencing factors.</div></div><div><h3>Results</h3><div>The overall score of postoperative self-management ability of patients with varicose veins of the lower extremities was moderately high (mean, 24.27). Sociodemographic, clinical procedural, and health education factors significantly impacted patient postoperative self-management. Sociodemographic characteristics, including gender, age, education level, living arrangement, and monthly income significantly impacted the postoperative self-management. Clinical manifestations-etiology-anatomy-pathophysiology (CEAP) classification, types of surgery, and postoperative time also significantly affected the postoperative self-management. Health education received after surgery and health education methods impacted the postoperative self-management ability of patients with varicose veins in the lower extremities.</div></div><div><h3>Conclusions</h3><div>Postoperative self-management was moderately high among patients with varicose veins of the lower extremities, but gaps in knowledge about complications and adherence to recommended practices were noted. Targeted, evidence-based health education tailored to individual patient characteristics can significantly improve self-management outcomes. This study underscores the importance of personalized interventions in enhancing patient-centered care and optimizing long-term recovery outcomes.</div></div>","PeriodicalId":17537,"journal":{"name":"Journal of vascular surgery. Venous and lymphatic disorders","volume":"14 1","pages":"Article 102354"},"PeriodicalIF":2.8,"publicationDate":"2025-11-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145505237","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
Comparison of bleomycin polidocanol foam versus absolute ethanol for sclerotherapy of venous malformations 博来霉素聚多醇泡沫与无水乙醇硬化治疗静脉畸形的比较。
IF 2.8 2区 医学 Q2 PERIPHERAL VASCULAR DISEASE Pub Date : 2025-11-06 DOI: 10.1016/j.jvsv.2025.102352
Jiayi Lai MD, Zian Xu MD, Hui Chen MD, PhD, Li Hu MD, PhD, Xiaoxi Lin MD, PhD, Xi Yang MD

Objective

The purpose of this study was to compare the efficacy and safety between two sclerosants for venous malformations (VMs), bleomycin polidocanol foam (BPF) and absolute ethanol (AE), and provide more clinical evidence for the application of BPF for VMs.

Methods

We conducted a retrospective study of 104 patients with VMs who had been treated with BPF and AE sclerotherapy. Patients were followed-up after treatment to assess clinical efficacy and complications. Clinical efficacy was independently evaluated by three experts based on pre- and post-treatment photos and magnetic resonance images. Complications were categorized according to the Society of Interventional Radiology Adverse Event Classification System.

Results

A total of 104 patients with VM were enrolled in this study, of which 53 (51%) received BPF sclerotherapy, and 51 (49%) received AE sclerotherapy. Most of the patients had head and neck VMs (n = 64; 62%), and the most common symptom was disfigurement. The number of sessions in the BPF group was significantly lower than in the AE group (1.5 vs 2.2; P < .05). The median treatment efficacy score was 3.0 for the BPF group and 2.7 for the AE group, with no significant difference between two groups. The median follow-up was 45 months for the BPF group and 33 months for the AE group, with no significant difference between two groups. Complications occurred in 11 patients in the BPF group and in 15 patients in the AE group, but there was no significant difference between the two groups. Mild adverse events occurred in 10 of 53 patients (19%) in the BPF group and 10 of 51 (20%) in the AE group. Moderate adverse events occurred in one patient (2%) in the BPF group and three patients (6%) in the AE group. Two patients (4%) in the AE group had nerve injury, evaluated as severe adverse events, whereas no patients in the BPF group did.

Conclusions

BPF has comparable treatment efficacy to AE in sclerotherapy for VMs. BPF showed a trend toward a lower rate of severe adverse events, although this difference was not statistically significant in our cohort. It could be an optimal sclerosant to treat VMs.
目的:比较博来霉素聚多醇泡沫(BPF)和无水乙醇(AE)两种硬化剂治疗静脉畸形(vm)的疗效和安全性,为BPF在vm中的应用提供更多临床依据。方法:我们对104例接受BPF和AE硬化治疗的vm患者进行了回顾性研究。治疗后随访患者,评估临床疗效及并发症。临床疗效由三位专家根据治疗前后照片和磁共振图像独立评估。并发症按照介入放射学会(SIR)不良事件分类系统进行分类。结果:104例VM患者入组,其中53例(51%)接受BPF硬化治疗,51例(49%)接受AE硬化治疗。大多数患者有头颈部vm (n=64, 62%),最常见的症状是毁容。BPF组的治疗次数明显低于AE组(1.5 vs 2.2)。结论:BPF在vm硬化治疗中的疗效与无水乙醇相当。BPF显示出严重不良事件发生率较低的趋势,尽管这种差异在我们的队列中没有统计学意义。它可能是治疗vm的最佳硬化剂。
{"title":"Comparison of bleomycin polidocanol foam versus absolute ethanol for sclerotherapy of venous malformations","authors":"Jiayi Lai MD,&nbsp;Zian Xu MD,&nbsp;Hui Chen MD, PhD,&nbsp;Li Hu MD, PhD,&nbsp;Xiaoxi Lin MD, PhD,&nbsp;Xi Yang MD","doi":"10.1016/j.jvsv.2025.102352","DOIUrl":"10.1016/j.jvsv.2025.102352","url":null,"abstract":"<div><h3>Objective</h3><div>The purpose of this study was to compare the efficacy and safety between two sclerosants for venous malformations (VMs), bleomycin polidocanol foam (BPF) and absolute ethanol (AE), and provide more clinical evidence for the application of BPF for VMs.</div></div><div><h3>Methods</h3><div>We conducted a retrospective study of 104 patients with VMs who had been treated with BPF and AE sclerotherapy. Patients were followed-up after treatment to assess clinical efficacy and complications. Clinical efficacy was independently evaluated by three experts based on pre- and post-treatment photos and magnetic resonance images. Complications were categorized according to the Society of Interventional Radiology Adverse Event Classification System.</div></div><div><h3>Results</h3><div>A total of 104 patients with VM were enrolled in this study, of which 53 (51%) received BPF sclerotherapy, and 51 (49%) received AE sclerotherapy. Most of the patients had head and neck VMs (n = 64; 62%), and the most common symptom was disfigurement. The number of sessions in the BPF group was significantly lower than in the AE group (1.5 vs 2.2; <em>P</em> &lt; .05). The median treatment efficacy score was 3.0 for the BPF group and 2.7 for the AE group, with no significant difference between two groups. The median follow-up was 45 months for the BPF group and 33 months for the AE group, with no significant difference between two groups. Complications occurred in 11 patients in the BPF group and in 15 patients in the AE group, but there was no significant difference between the two groups. Mild adverse events occurred in 10 of 53 patients (19%) in the BPF group and 10 of 51 (20%) in the AE group. Moderate adverse events occurred in one patient (2%) in the BPF group and three patients (6%) in the AE group. Two patients (4%) in the AE group had nerve injury, evaluated as severe adverse events, whereas no patients in the BPF group did.</div></div><div><h3>Conclusions</h3><div>BPF has comparable treatment efficacy to AE in sclerotherapy for VMs. BPF showed a trend toward a lower rate of severe adverse events, although this difference was not statistically significant in our cohort. It could be an optimal sclerosant to treat VMs.</div></div>","PeriodicalId":17537,"journal":{"name":"Journal of vascular surgery. Venous and lymphatic disorders","volume":"14 2","pages":"Article 102352"},"PeriodicalIF":2.8,"publicationDate":"2025-11-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145476913","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
Left renal vein thrombosis with nutcracker syndrome. 胡桃夹子综合征左肾静脉血栓形成。
IF 2.8 2区 医学 Q2 PERIPHERAL VASCULAR DISEASE Pub Date : 2025-11-01 Epub Date: 2025-07-16 DOI: 10.1016/j.jvsv.2025.102288
Xin Wei Zhou, Dong Zhe Chai, Hua Yi Zhang
{"title":"Left renal vein thrombosis with nutcracker syndrome.","authors":"Xin Wei Zhou, Dong Zhe Chai, Hua Yi Zhang","doi":"10.1016/j.jvsv.2025.102288","DOIUrl":"10.1016/j.jvsv.2025.102288","url":null,"abstract":"","PeriodicalId":17537,"journal":{"name":"Journal of vascular surgery. Venous and lymphatic disorders","volume":" ","pages":"102288"},"PeriodicalIF":2.8,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12356302/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144667868","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Clinical outcomes of venous tumor thrombectomy in renal cell carcinoma. 肾细胞癌静脉肿瘤血栓切除术的临床疗效。
IF 2.8 2区 医学 Q2 PERIPHERAL VASCULAR DISEASE Pub Date : 2025-11-01 Epub Date: 2025-07-17 DOI: 10.1016/j.jvsv.2025.102290
Sang Ah Lee, Hyeyeon Jang, Youngjin Han, Yong-Pil Cho, Jun Gyo Gwon

Objective: Renal cell carcinoma (RCC) has a unique feature in which tumor thrombus extends through the vein into the inferior vena cava. RCC with venous tumor thrombus is classified based on the level of thrombus. Standard treatment involves a combination of radical nephrectomy and tumor thrombectomy, despite the technical challenges associated with this approach. We aimed to evaluate the clinical outcomes based on the tumor thrombus level.

Methods: We conducted a retrospective analysis of patients who underwent tumor resection and thrombectomy for RCC with venous tumor thrombus at a single center between January 2001 and December 2022. Tumor thrombus levels were classified into four levels (I-IV) according to the Mayo Clinic grading system, and patients were grouped based on the hepatic vein level: levels 0, I, and II were categorized as group 1, while levels III and IV were categorized as group 2. Survival outcomes were compared between the two groups using Kaplan-Meier survival analysis.

Results: A total of 287 patients with RCC with venous tumor thrombus who underwent tumor resection and thrombectomy were identified. The distribution of patients according to the tumor thrombus level was as follows: 84 patients had level 0 thrombus, 71 had level I, 85 had level II, 19 had level III, and 28 had level IV. This results in 240 patients in group 1 (levels 0, I, and II) and 47 patients in group 2 (levels III and IV). The 5-year survival rates were 46.7% for group 1 and 53.2% for group 2. Kaplan-Meier survival analysis showed no significant difference in 5-year overall survival between the two groups (P = .75). However, patients in group 2 had a significantly longer postoperative hospital stay (21.43 ± 23.09 days) compared with those in group 1 (10.63 ± 6.31 days; P = .004).

Conclusions: Tumor thrombus level is not a significant prognostic factor in RCC. Aggressive surgical removal should be considered, even for thrombus extending beyond the hepatic vein, given the acceptable prognosis.

目的:肾细胞癌(RCC)有一个独特的特点,即肿瘤血栓通过静脉延伸到下腔静脉(IVC)。有静脉肿瘤血栓的肾小细胞癌根据血栓的程度进行分类。标准治疗包括根治性肾切除术和肿瘤血栓切除术的结合,尽管这种方法存在技术挑战。我们的目的是评估基于肿瘤血栓水平的临床结果。方法:我们回顾性分析了2001年1月至2022年12月在单一中心接受肿瘤切除和静脉肿瘤血栓切除术的RCC患者。根据Mayo Clinic分级系统将肿瘤血栓水平分为4级(I-IV级),并根据肝静脉水平对患者进行分组,0、I、II级为1组,III、IV级为2组。采用Kaplan-Meier生存分析比较两组患者的生存结果。结果:共发现287例合并静脉肿瘤血栓的RCC患者行肿瘤切除和取栓术。按肿瘤血栓水平分布:0级血栓84例,I级血栓71例,II级血栓85例,III级血栓19例,IV级血栓28例。1组(0、I、II级)240例,2组(III、IV级)47例。1组5年生存率为46.7%,2组5年生存率为53.2%。Kaplan-Meier生存分析显示两组5年总生存率无显著差异(p=0.75)。然而,2组患者术后住院时间(21.43±23.09天)明显长于1组(10.63±6.31天);p = 0.004)。结论:肿瘤血栓水平不是肾癌预后的重要因素。考虑到可接受的预后,即使血栓延伸到肝静脉以外,也应考虑积极手术切除。
{"title":"Clinical outcomes of venous tumor thrombectomy in renal cell carcinoma.","authors":"Sang Ah Lee, Hyeyeon Jang, Youngjin Han, Yong-Pil Cho, Jun Gyo Gwon","doi":"10.1016/j.jvsv.2025.102290","DOIUrl":"10.1016/j.jvsv.2025.102290","url":null,"abstract":"<p><strong>Objective: </strong>Renal cell carcinoma (RCC) has a unique feature in which tumor thrombus extends through the vein into the inferior vena cava. RCC with venous tumor thrombus is classified based on the level of thrombus. Standard treatment involves a combination of radical nephrectomy and tumor thrombectomy, despite the technical challenges associated with this approach. We aimed to evaluate the clinical outcomes based on the tumor thrombus level.</p><p><strong>Methods: </strong>We conducted a retrospective analysis of patients who underwent tumor resection and thrombectomy for RCC with venous tumor thrombus at a single center between January 2001 and December 2022. Tumor thrombus levels were classified into four levels (I-IV) according to the Mayo Clinic grading system, and patients were grouped based on the hepatic vein level: levels 0, I, and II were categorized as group 1, while levels III and IV were categorized as group 2. Survival outcomes were compared between the two groups using Kaplan-Meier survival analysis.</p><p><strong>Results: </strong>A total of 287 patients with RCC with venous tumor thrombus who underwent tumor resection and thrombectomy were identified. The distribution of patients according to the tumor thrombus level was as follows: 84 patients had level 0 thrombus, 71 had level I, 85 had level II, 19 had level III, and 28 had level IV. This results in 240 patients in group 1 (levels 0, I, and II) and 47 patients in group 2 (levels III and IV). The 5-year survival rates were 46.7% for group 1 and 53.2% for group 2. Kaplan-Meier survival analysis showed no significant difference in 5-year overall survival between the two groups (P = .75). However, patients in group 2 had a significantly longer postoperative hospital stay (21.43 ± 23.09 days) compared with those in group 1 (10.63 ± 6.31 days; P = .004).</p><p><strong>Conclusions: </strong>Tumor thrombus level is not a significant prognostic factor in RCC. Aggressive surgical removal should be considered, even for thrombus extending beyond the hepatic vein, given the acceptable prognosis.</p>","PeriodicalId":17537,"journal":{"name":"Journal of vascular surgery. Venous and lymphatic disorders","volume":" ","pages":"102290"},"PeriodicalIF":2.8,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12356288/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144667867","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Multidisciplinary management of intravenous leiomyomatosis with intracardiac extension 静脉平滑肌瘤合并心内扩张的多学科治疗。
IF 2.8 2区 医学 Q2 PERIPHERAL VASCULAR DISEASE Pub Date : 2025-10-30 DOI: 10.1016/j.jvsv.2025.102350
Chengyi Hui MD , Min Qiu MD , Jiemei Hu MD , Shanyang He MD , Gang Zhao MD , Hujun Cui MD
{"title":"Multidisciplinary management of intravenous leiomyomatosis with intracardiac extension","authors":"Chengyi Hui MD ,&nbsp;Min Qiu MD ,&nbsp;Jiemei Hu MD ,&nbsp;Shanyang He MD ,&nbsp;Gang Zhao MD ,&nbsp;Hujun Cui MD","doi":"10.1016/j.jvsv.2025.102350","DOIUrl":"10.1016/j.jvsv.2025.102350","url":null,"abstract":"","PeriodicalId":17537,"journal":{"name":"Journal of vascular surgery. Venous and lymphatic disorders","volume":"14 1","pages":"Article 102350"},"PeriodicalIF":2.8,"publicationDate":"2025-10-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145422171","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
期刊
Journal of vascular surgery. Venous and lymphatic disorders
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