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

英文中文

Limb volumetry using an iPad-Based three-dimensional scanner for the assessment of edema 使用基于ipad的三维扫描仪进行肢体体积测量以评估水肿。

IF 2.8 2区医学 Q2 PERIPHERAL VASCULAR DISEASE

Journal of vascular surgery. Venous and lymphatic disorders

Pub Date : 2025-10-16 DOI: 10.1016/j.jvsv.2025.102291

Caiyu Gao MD, Furong Liu MD

引用次数: 0

Events of Interest 关注的事件

IF 2.8 2区医学 Q2 PERIPHERAL VASCULAR DISEASE

Journal of vascular surgery. Venous and lymphatic disorders

Pub Date : 2025-10-16 DOI: 10.1016/S2213-333X(25)00168-4

引用次数: 0

Information for Readers 读者资讯

IF 2.8 2区医学 Q2 PERIPHERAL VASCULAR DISEASE

Journal of vascular surgery. Venous and lymphatic disorders

Pub Date : 2025-10-16 DOI: 10.1016/S2213-333X(25)00167-2

引用次数: 0

Preliminary study on the application of contrast-enhanced ultrasound in lymphovenous anastomosis 超声造影在淋巴静脉吻合中的应用初探。

IF 2.8 2区医学 Q2 PERIPHERAL VASCULAR DISEASE

Journal of vascular surgery. Venous and lymphatic disorders

Pub Date : 2025-10-14 DOI: 10.1016/j.jvsv.2025.102344

Jing Wang MMed , Min Lu MD , Mingxing Hu BMed , Liuyi Li BMed , Kui Zhang MMed , Xu Li MMed

Objective

To explore the value of lymphatic contrast-enhanced ultrasound (CEUS) in lymphovenous anastomosis (LVA), with a particular focus on its role in preoperative lymphatic localization.

Methods

On the basis of whether preoperative ultrasound lymphatic contrast imaging was performed, the lymphatic diameter and depth from the skin were measured. Patients were divided into two groups: indocyanine green (ICG, 21 patients) and ICG combined with CEUS (21 patients). The differences between the two groups were compared in terms of total surgery time; number of anastomoses; anastomosis time per lymphatic vessel; and limb volume reduction at 1 week, 1 month, and 3 months postoperatively. A P value of < .05 was considered to indicate statistical significance.

Results

In the ICG + CEUS group, the success rate of ultrasound contrast imaging was 95%. The average lymphatic diameter was 0.6 ± 0.2 mm, and the average depth from the skin was 5.3 ± 2.8 mm. Among these patients, 74% had lymphatic reflux, 55% had reflux into the dermis, and 36% had collateral vessel formation. Compared with the ICG group, the ICG + CEUS group had a significantly shorter total surgery time (320 ± 124 vs 398 ± 93 minutes; P = .005), shorter anastomosis time per lymphatic vessel (14 ± 2 vs 32 ± 15 minutes; P < .001), and more anastomoses (median 19 vs 12; P < .001). There were no significant differences between the two groups in terms of limb volume reduction at 1 week, 1 month, or 3 months postoperatively (P > .05).

Conclusions

CEUS can be a powerful supplement for locating lymphatic vessels before LVA.

目的：探讨淋巴造影增强超声（CEUS）在淋巴静脉吻合（LVA）中的应用价值，重点探讨其在术前淋巴定位中的作用。方法：根据术前是否行超声淋巴造影术，测量淋巴结直径及离皮肤深度。患者分为吲哚菁绿组（ICG， 21例）和ICG联合超声造影组（21例）。比较两组总手术时间的差异；吻合口数；每根淋巴管吻合时间；术后1周、1个月和3个月肢体体积减小。结果：ICG + CEUS组超声造影成功率为95%。平均淋巴管直径0.6±0.2 mm，平均离皮肤深度5.3±2.8 mm。在这些患者中，74%有淋巴反流，55%有反流进入真皮层，36%有侧支血管形成。与ICG组相比，ICG + CEUS组总手术时间明显缩短（320±124 min vs 398±93 min, p = 0.005），每根淋巴管吻合时间明显缩短（14±2 min vs 32±15 min, p < 0.001），吻合次数较多（中位19例vs 12例，P0.05）。结论：超声造影可作为LVA前淋巴管定位的有力补充。

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引用次数: 0

A giant phlebolith in the inferior vena cava discovered incidentally during retrieval of the inferior vena cava filter 在取下腔静脉滤器时偶然发现的下腔静脉巨型静脉石。

IF 2.8 2区医学 Q2 PERIPHERAL VASCULAR DISEASE

Journal of vascular surgery. Venous and lymphatic disorders

Pub Date : 2025-10-10 DOI: 10.1016/j.jvsv.2025.102340

Xuanfeng Zhu MM , Jindi Wei MM , Peng Gao MM , Ruiyuan Yang MSc , Xiquan Zhang MD

引用次数: 0

Meta-analysis of duration of venous thromboembolism risk following hospitalization in surgical and medical patients 外科和内科患者住院后静脉血栓栓塞风险持续时间的meta分析。

IF 2.8 2区医学 Q2 PERIPHERAL VASCULAR DISEASE

Journal of vascular surgery. Venous and lymphatic disorders

Pub Date : 2025-10-10 DOI: 10.1016/j.jvsv.2025.102343

Georges Jreij MD , Caroline Crone BS , Aidan Wiley BA , Aman Kankaria DO , Mary S. Lin MD , Minerva Mayorga-Carlin MPH , Shalini Sahoo MA , John D. Sorkin MD, PhD , Brajesh K. Lal MD

Objective

Hospitalization increases venous thromboembolism (VTE) risk, and over one-half of all VTE events occur after hospital admission. Current decisions on post-hospitalization VTE prophylaxis are not evidence-based. The duration of enhanced risk after hospitalization, in surgical and medical patients, is not well-known. In this meta-analysis, we evaluated the rates of post-hospitalization VTE over time in patients that underwent surgery during their hospitalization and those that did not.

Methods

A literature search was performed through November 2023 using PubMed, EMBASE, and Cochrane. Studies examining the incidence of VTE in hospitalized patients during a specified period following hospitalization were included. Studies were excluded if they focused on nonhospitalized patients, failed to define the follow-up duration, or did not report the incidence of VTE. Screening and data collection was conducted by two reviewers.

Results

From a total of 1504 studies screened, 57 were included. Overall, 9,152,616 patients were included; of these, 1,232,627 were followed for 30 days, 28,522 for 45 days, 2,515,940 for 90 days, and 5,375,527 were followed beyond 90 days. The pooled incidence of VTE during the first 45 days was 0.3% (95% confidence interval [CI], 0.2%- 0.4%) among surgical patients and 4.6% (95% CI, 4.3%-4.9%) among medical patients. The pooled incidence of VTE during the first 90 days was 1.3% (95% CI, 0.7%-2.3%) in surgical patients and 2.9% (95% CI, 2.0%-4.1%) in medical patients. Beyond 90 days (between 180 and 1020 days), the pooled incidence of VTE was 1.0% (95% CI, 0.4%-2.3%) in the surgical cohort, compared with 2.3% (95% CI, 1.6%-3.5%) in the medical cohort.

Conclusions

The post-hospitalization 90-day VTE rate was found to be low for both surgical and medical patients; the risks beyond 90 days was found to be only slightly lower. VTE risk in surgical patients is predominantly short-term and diminishes following recovery from surgery. Conversely, medical patients exhibit a prolonged VTE risk, likely related to persistence of clinical risk factors.

目的：住院增加静脉血栓栓塞的风险，超过一半的静脉血栓栓塞事件发生在住院后。目前关于住院后静脉血栓栓塞预防的决定是没有证据的。在外科和内科患者中，住院后风险增加的持续时间尚不清楚。在这项荟萃分析中，我们评估了住院期间接受手术和未接受手术的患者的住院后静脉血栓栓塞率。方法：通过PubMed、EMBASE和Cochrane检索到2023年11月的文献。研究纳入了住院患者在住院后特定时期内静脉血栓栓塞发生率的研究。如果研究集中于非住院患者，未能确定随访时间，或未报告静脉血栓栓塞的发生率，则排除研究。筛选和数据收集由两名审稿人进行。结果：在总共1504项研究中，57项被纳入。总体而言，纳入了9,152,616例患者；其中，30天随访12232627人，45天随访28522人，90天随访2515940人，90天以上随访5375527人。手术患者前45天静脉血栓栓塞总发生率为0.3%(95%可信区间[CI]: 0.2; 0.4)，内科患者为4.6%（95%可信区间：4.3-4.9）。手术患者前90天内静脉血栓栓塞的总发生率为1.3% (95% CI: 0.7-2.3)，内科患者为2.9% （95% CI: 2.0-4.1）。超过90天（180 - 1020天），手术组静脉血栓栓塞总发生率为1.0% (95% CI: 0.4-2.3)，而医学组为2.3% （95% CI: 1.6-3.5）。结论：外科和内科患者住院后90天静脉血栓栓塞发生率均较低；超过90天的风险仅略低。手术患者的静脉血栓栓塞风险主要是短期的，并随着手术恢复而降低。相反，内科患者的静脉血栓栓塞风险延长，可能与临床风险因素的持续存在有关。

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引用次数: 0

Surgical outcomes of above-knee versus full-length endovenous laser ablation for great saphenous vein varicose veins 膝上与全静脉内激光消融治疗大隐静脉曲张的疗效比较。

IF 2.8 2区医学 Q2 PERIPHERAL VASCULAR DISEASE

Journal of vascular surgery. Venous and lymphatic disorders

Pub Date : 2025-10-10 DOI: 10.1016/j.jvsv.2025.102342

Yafei Zhang MS , Xiao Lin MN , Zihao Wang MS , Wentao Li MD , Yuqin Wang MN , Jing Bian MPH , Yong Liang MD

Objective

This study compares the surgical outcomes between endovenous laser ablation of the above-knee great saphenous vein (AK-GSV) and full-length great saphenous vein (FL-GSV) for the treatment of lower limb varicose veins.

Methods

This retrospective study analyzed clinical data from consecutive patients with lower extremity varicose veins treated at a tertiary vascular surgery center between November 2023 and December 2024. Participants were categorized into two groups based on surgical approach: the AK-GSV laser treatment group (n = 134) and the FL-GSV laser closure treatment group (n = 166). The study compared operative time, postoperative pain intensity, improvement in general symptoms, and incidence of saphenous nerve injury between the two groups.

Results

AK-GSV laser treatment was associated with shorter surgical duration (60.52 ± 8.26 minutes) compared with the FL- GSV laser treatment (64.01 ± 8.71 minutes; P = .000). Additionally, AK-GSV treatment was associated with milder early postoperative pain, as reflected by lower Visual Analogue Scale (VAS) scores at 1 day (2.82 ± 0.96 vs 3.14 ± 0.83; P = .002) and 3 days (1.57 ± 0.64 vs 1.77 ± 0.67; P =.01) postoperatively. The AK-GSV treatment group exhibited superior short-term outcomes, with significantly larger reductions in the Venous Clinical Severity Score (VCSS) (P = .009) and the Aberdeen Varicose Vein Questionnaire (AVVQ) score (P = .045) during the early postoperative period (within the first 1 month postoperatively) compared with the FL-GSV group. Compared with the FL-GSV treatment group, the AK-GSV group had a significantly lower incidence of saphenous nerve injury at 1 month (4.5% vs 15.7%; P = .002), 3 months (2.2% vs 8.4%; P = .021), and 9 months (0.0% vs 4.2%; P = .018). However, this intergroup difference was no longer statistically significant at 6 months (1.5% vs 5.4%; P = .072).

Conclusions

AK-GSV endovenous laser ablation is a safe and effective minimally invasive treatment approach. Compared with FL-GSV ablation, this technique demonstrates comparable efficacy in improving venous stasis symptoms while offering significant advantages, including reduced operative time, decreased postoperative pain, accelerated recovery, and lower risks of neurological complications.

目的：比较静脉内激光消融膝上大隐静脉（AK-GSV）与全长大隐静脉（FL-GSV）治疗下肢静脉曲张的手术效果。方法：回顾性分析2023年11月至2024年12月在某三级血管外科中心连续治疗的下肢静脉曲张患者的临床资料。根据手术入路将参与者分为两组：膝上GSV激光治疗组（AK-GSV, n = 134）和全长GSV激光闭合治疗组（FL-GSV, n = 166）。比较两组手术时间、术后疼痛强度、一般症状改善情况及隐神经损伤发生率。结果：AK-GSV激光治疗手术时间（60.52±8.26 min）短于FL- GSV激光治疗（64.01±8.71 min， P= 0.000）。此外，AK-GSV治疗与术后早期疼痛较轻相关，这反映在术后1天（2.82±0.96 vs 3.14±0.83,P = 0.002）和3天（1.57±0.64 vs 1.77±0.67,P = 0.01）的视觉模拟评分较低。与FL-GSV组相比，AK-GSV治疗组表现出较好的短期预后，术后早期（术后1个月内）静脉临床严重程度评分（VCSS）（P = 0.009）和阿伯丁静脉曲张问卷评分（AVVQ）（P = 0.045）的降低幅度明显大于FL-GSV组。与FL-GSV治疗组相比，AK-GSV组在1个月（4.5% vs 15.7%, P = 0.002）、3个月（2.2% vs 8.4%, P = 0.021）和9个月（0.0% vs 4.2%, P = 0.018）时的隐神经损伤发生率均显著降低。然而，在6个月时，组间差异不再具有统计学意义（1.5% vs 5.4%, P = 0.072）。结论：AK-GSV静脉内激光消融（EVLA）是一种安全有效的微创治疗方法。与FL-GSV消融相比，该技术在改善静脉淤滞症状方面具有相当的疗效，同时具有显著的优势，包括缩短手术时间、减少术后疼痛、加速恢复和降低神经系统并发症的风险。

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引用次数: 0

Thigh lymphocutaneous fistula in a child 儿童大腿淋巴皮瘘。

IF 2.8 2区医学 Q2 PERIPHERAL VASCULAR DISEASE

Journal of vascular surgery. Venous and lymphatic disorders

Pub Date : 2025-10-09 DOI: 10.1016/j.jvsv.2025.102341

Qi Di MD , Kai Zheng MD , Qiang-Qiang Nie PhD , San-Lin Li MD , Cheng-Hao Chen MD , Gang Shen MD

引用次数: 0

Spontaneous saccular aneurysm of the external jugular vein with thrombosis 颈外静脉自发性囊性动脉瘤伴血栓形成。

IF 2.8 2区医学 Q2 PERIPHERAL VASCULAR DISEASE

Journal of vascular surgery. Venous and lymphatic disorders

Pub Date : 2025-10-09 DOI: 10.1016/j.jvsv.2025.102339

Zhuoyuan Li MD, MSc , Tan Li MD

引用次数: 0

Prevalence of gynecological disorders in women with symptomatic pelvic venous disorders 有症状的盆腔静脉疾病妇女的妇科疾病患病率。

IF 2.8 2区医学 Q2 PERIPHERAL VASCULAR DISEASE

Journal of vascular surgery. Venous and lymphatic disorders

Pub Date : 2025-10-09 DOI: 10.1016/j.jvsv.2025.102338

Syona Satwah MD, Natalie Ma, Theresa Soto MD, Gaurav Lakhanpal MD, Richard Kennedy PAC, Sanjiv Lakhanpal MD, Peter J. Pappas MD

Background

The diagnosis of symptomatic pelvic venous insufficiency (PVI) in women is complicated when concomitant gynecological disorders are present. The purpose of this investigation was to determine the prevalence of concomitant gynecological disorders in women with a pelvic venous disorder secondary to PVI and to assess the effectiveness of therapeutic interventions in women with a history of these disorders.

Methods

We retrospectively reviewed the results of 2544 women treated for symptomatic PVI from January 2017 to March 2024. Women were divided in three groups: pelvic pain alone, leg pain alone or combined pelvic and leg pain (mixed). Patient demographics, prevalence of concomitant gynecological disorders, presenting symptoms, Clinical, Etiology, Anatomy, Pathophysiology class, rVCSS, pre and post visual analog pain scores (VAS), stent type, and vein territory covered were assessed.

Results

Of the 2544 women, 70 presented with pelvic pain alone, 1012 with leg pain alone, and 1454 with mixed symptoms. The average age of the cohort was 52.0 ± 13.8 years. Racial distribution was 49% White, 16% African American, 11% Hispanic, 1% Asian, and 23% unknown. The most common gynecological disorders reported were hysterectomy (31%), uterine fibroids (4%), endometriosis (4.4%), ovarian cysts (2.8%), and polycystic ovarian syndrome (1.5%). The average follow-up time was 2.32 ± 2.4 years. Pre and post intervention VAS scores were pelvic (7.61 ± 3.72/1.93 ± 3.2), leg (6.18 ± 2.95/2.42 ± 3.2), and mixed (5.72 ± 3.72/2.4 ± 3.1) (P ≤ .05). For women with a history of endometriosis, pre and post VAS scores were 6.52 ± 3.15 and 2.5 ± 0.6 (P ≤ .05). There was no difference in pre and post VAS scores in women with a history of endometriosis compared with the other presenting symptom groups. A total of 1738 stents were placed: 27 pelvic, 564 leg, and 935 mixed. The most common stent diameters and lengths were 14 and 16 mm and 140 and 160 mm. The left common and external iliac veins were the most common vein territories covered. There were 768 reinterventions for a 25.6% reintervention rate at 25 ± 24 months.

Conclusions

The prevalence of concomitant gynecological disorders in women with symptomatic PVI is very low and calls into question whether or not gynecological assessments for etiologies other than PVI are necessary. Even in women with a history of endometriosis, endovascular interventions are very successful at ameliorating pelvic and/or leg symptoms. A history of concomitant gynecological disorders should not prevent the performance of endovascular therapies in women with symptomatic PVI.

导言：女性盆腔静脉功能不全（PVI）的诊断是复杂的，当同时存在妇科疾病。本研究的目的是确定继发于PVI的PeVD女性伴发妇科疾病的患病率，并评估有这些疾病史的女性的治疗干预措施的有效性。方法：我们回顾性分析了2017年1月至2024年3月期间治疗症状性PVI的2544名女性的结果。女性被分成三组。单独骨盆疼痛、单独腿部疼痛或骨盆和腿部合并疼痛（混合性）。评估患者人口统计学特征、伴发妇科疾病的患病率、出现症状、CEAP、rVCSS、视觉模拟疼痛评分（VAS）前后、支架类型和静脉覆盖范围。结果：在2544名女性中，70名仅表现为盆腔疼痛，1012名仅表现为腿部疼痛，1454名表现为混合症状。队列的平均年龄为52±13.8岁。种族分布如下：白人49%，非裔美国人16%，西班牙裔11%，亚裔1%，未知23%。最常见的妇科疾病是子宫切除术（31%）、子宫肌瘤（4%）、子宫内膜异位症（4.4%）、卵巢囊肿（2.8%）和多囊卵巢（1.5%）。平均随访时间为2.32±2.4年。干预前后视觉模拟疼痛（VAS）评分分别为：盆腔（7.61±3.72/1.93±3.2）、腿部（6.18±2.95/2.42±3.2）、混合（5.72±3.72/2.4±3.1）（p≤0.05）。有子宫内膜异位症病史的女性VAS评分分别为：6.52±3.15和2.5±0.6 （p≤0.05）。有子宫内膜异位症病史的女性与其他症状组相比，VAS评分前后无差异。总共放置了1738个支架：骨盆（n=27），腿部（n=564）和混合（n=935）。最常见的支架直径和长度分别为14和16毫米（mm）以及140和160毫米。左髂总静脉和髂外静脉是最常见的静脉区域。在25±24个月，再干预768例，再干预率为25.6%。结论：在有症状的PVI女性中，伴随妇科疾病的患病率非常低，这引起了对PVI以外的病因是否有必要进行妇科评估的疑问。即使在有子宫内膜异位症病史的女性中，血管内介入治疗在改善盆腔和/或腿部症状方面也非常成功。伴有妇科疾病的病史不应妨碍有症状性PVI的妇女进行血管内治疗。

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