Pub Date : 2025-10-10DOI: 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。
{"title":"Surgical outcomes of above-knee versus full-length endovenous laser ablation for great saphenous vein varicose veins","authors":"Yafei Zhang MS , Xiao Lin MN , Zihao Wang MS , Wentao Li MD , Yuqin Wang MN , Jing Bian MPH , Yong Liang MD","doi":"10.1016/j.jvsv.2025.102342","DOIUrl":"10.1016/j.jvsv.2025.102342","url":null,"abstract":"<div><h3>Objective</h3><div>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.</div></div><div><h3>Methods</h3><div>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.</div></div><div><h3>Results</h3><div>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; <em>P</em> = .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; <em>P</em> = .002) and 3 days (1.57 ± 0.64 vs 1.77 ± 0.67; <em>P</em> =.01) postoperatively. The AK-GSV treatment group exhibited superior short-term outcomes, with significantly larger reductions in the Venous Clinical Severity Score (VCSS) (<em>P</em> = .009) and the Aberdeen Varicose Vein Questionnaire (AVVQ) score (<em>P</em> = .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%; <em>P</em> = .002), 3 months (2.2% vs 8.4%; <em>P</em> = .021), and 9 months (0.0% vs 4.2%; <em>P</em> = .018). However, this intergroup difference was no longer statistically significant at 6 months (1.5% vs 5.4%; <em>P</em> = .072).</div></div><div><h3>Conclusions</h3><div>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.</div></div>","PeriodicalId":17537,"journal":{"name":"Journal of vascular surgery. Venous and lymphatic disorders","volume":"14 1","pages":"Article 102342"},"PeriodicalIF":2.8,"publicationDate":"2025-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145280650","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}
Pub Date : 2025-10-09DOI: 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
{"title":"Thigh lymphocutaneous fistula in a child","authors":"Qi Di MD , Kai Zheng MD , Qiang-Qiang Nie PhD , San-Lin Li MD , Cheng-Hao Chen MD , Gang Shen MD","doi":"10.1016/j.jvsv.2025.102341","DOIUrl":"10.1016/j.jvsv.2025.102341","url":null,"abstract":"","PeriodicalId":17537,"journal":{"name":"Journal of vascular surgery. Venous and lymphatic disorders","volume":"14 1","pages":"Article 102341"},"PeriodicalIF":2.8,"publicationDate":"2025-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145258238","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}
Pub Date : 2025-10-09DOI: 10.1016/j.jvsv.2025.102339
Zhuoyuan Li MD, MSc , Tan Li MD
{"title":"Spontaneous saccular aneurysm of the external jugular vein with thrombosis","authors":"Zhuoyuan Li MD, MSc , Tan Li MD","doi":"10.1016/j.jvsv.2025.102339","DOIUrl":"10.1016/j.jvsv.2025.102339","url":null,"abstract":"","PeriodicalId":17537,"journal":{"name":"Journal of vascular surgery. Venous and lymphatic disorders","volume":"14 1","pages":"Article 102339"},"PeriodicalIF":2.8,"publicationDate":"2025-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145258193","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}
Pub Date : 2025-10-09DOI: 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.
{"title":"Prevalence of gynecological disorders in women with symptomatic pelvic venous disorders","authors":"Syona Satwah MD, Natalie Ma, Theresa Soto MD, Gaurav Lakhanpal MD, Richard Kennedy PAC, Sanjiv Lakhanpal MD, Peter J. Pappas MD","doi":"10.1016/j.jvsv.2025.102338","DOIUrl":"10.1016/j.jvsv.2025.102338","url":null,"abstract":"<div><h3>Background</h3><div>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.</div></div><div><h3>Methods</h3><div>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.</div></div><div><h3>Results</h3><div>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) (<em>P</em> ≤ .05). For women with a history of endometriosis, pre and post VAS scores were 6.52 ± 3.15 and 2.5 ± 0.6 (<em>P</em> ≤ .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.</div></div><div><h3>Conclusions</h3><div>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.</div></div>","PeriodicalId":17537,"journal":{"name":"Journal of vascular surgery. Venous and lymphatic disorders","volume":"14 1","pages":"Article 102338"},"PeriodicalIF":2.8,"publicationDate":"2025-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145258214","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}
Pub Date : 2025-10-02DOI: 10.1016/j.jvsv.2025.102335
Xu Li MD , Juan Yang MD , Hua Yi Zhang MD
{"title":"Iatrogenic superficial femoral arteriovenous fistula and pseudoaneurysm","authors":"Xu Li MD , Juan Yang MD , Hua Yi Zhang MD","doi":"10.1016/j.jvsv.2025.102335","DOIUrl":"10.1016/j.jvsv.2025.102335","url":null,"abstract":"","PeriodicalId":17537,"journal":{"name":"Journal of vascular surgery. Venous and lymphatic disorders","volume":"14 1","pages":"Article 102335"},"PeriodicalIF":2.8,"publicationDate":"2025-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145228607","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}
Pub Date : 2025-10-01DOI: 10.1016/j.jvsv.2025.102337
Qiong Wu BS , Longxin An BS , Li Xu BS , Wen Zhou BS , Xiaojing Li BS , Longfei Liu BS , Qi Tan MS , Xuecheng Sun MS , Naibo Feng MD
Objective
To evaluate the clinical efficacy of complex decongestive therapy (CDT) combined with needle electrode stimulation (NES) in the management of lymphedema after lymphaticovenular anastomosis (LVA) and to compare its therapeutic outcomes with conventional CDT alone.
Methods
A retrospective analysis was conducted on 50 patients with secondary lymphedema who underwent LVA at the Department of Traumatic Orthopedics, Weifang People's Hospital, between June 2023 and June 2024. All patients met strict inclusion criteria and were randomly assigned to one of two groups: group A (CDT combined with NES; n = 25; 3 males, 22 females) and group B (CDT alone; n = 25; 3 males, 22 females). There was no significant difference in sex distribution between groups (χ2 = 0.00; P > .99), indicating baseline comparability.
Results
No significant main effect of group was observed for limb swelling rate (P = .46; n = 50), indicating comparable overall swelling levels between groups. A significant main effect of time was found across all timepoints (preoperatively and at 2 weeks, 1 month, 3 months, 6 months, and 12 months postoperatively; P < .01; n = 25), suggesting a general decrease in swelling over time. Importantly, a significant group × time interaction was identified (P = .03; n = 25), indicating that the rate of decrease in swelling differed, with group A showing a greater and faster improvement. For quality of life assessed by the Lymphedema Life Impact Scale (LLIS), the between-group difference was not statistically significant (P = .09; n = 25). However, a significant time effect was observed (P < .01), and a significant group × time interaction (P = .02) indicated a more favorable trajectory in group A. No adverse events, including infection, poor wound healing, or cellulitis, were reported during the study.
Conclusions
CDT combined with NES demonstrates superior efficacy in decreasing limb swelling and improving Lymphedema Life Impact Scale scores compared with CDT alone in the postoperative management of lymphedema after LVA. This combination therapy significantly enhances postoperative recovery, suggesting its potential as a more effective approach for lymphedema rehabilitation.
目的：评价综合减充血疗法（CDT）联合针电极刺激治疗淋巴小囊吻合（LVA）后淋巴水肿的临床疗效，并与单纯常规减充血疗法的疗效进行比较。方法：回顾性分析潍坊市人民医院创伤骨科于2023年6月至2024年6月行淋巴静脉吻合术（LVA）的继发性淋巴水肿患者50例。所有患者均符合严格的纳入标准，随机分为两组：A组（CDT联合针电极刺激，n = 25，男3，女22）和B组（CDT单独治疗，n = 25，男3，女22）。各组间性别分布差异无统计学意义（χ2 = 0.00, p < 0.99），具有基线可比性。结果：各组肢体肿胀率无显著主效应（p = 0.46, N = 50），各组整体肿胀水平相当。时间在所有时间点（术前、术后2周、1个月、3个月、6个月和12个月；p < 0.01, N = 25）均有显著的主要影响，表明肿胀随时间的推移普遍减轻。重要的是，发现了显著的组与时间交互作用（p = 0.03, N = 25），表明肿胀减轻的速度不同，a组的改善更大更快。以淋巴水肿生活影响量表（LLIS）评估的生活质量，组间差异无统计学意义（p = 0.09, N = 25）。然而，观察到显著的时间效应（p < 0.01），并且显著的组×时间相互作用（p = 0.02）表明a组的发展轨迹更有利，在研究期间没有报告不良事件，包括感染，伤口愈合不良或蜂窝织炎。结论：CDT联合针电极刺激在减轻肢体肿胀和提高LLIS评分方面优于CDT单独治疗LVA术后淋巴水肿。这种联合治疗显著提高术后恢复，提示其作为淋巴水肿康复的更有效方法的潜力。
{"title":"Complex decongestive therapy combined with needle electrode stimulation facilitates postoperative rehabilitation of lymphedema","authors":"Qiong Wu BS , Longxin An BS , Li Xu BS , Wen Zhou BS , Xiaojing Li BS , Longfei Liu BS , Qi Tan MS , Xuecheng Sun MS , Naibo Feng MD","doi":"10.1016/j.jvsv.2025.102337","DOIUrl":"10.1016/j.jvsv.2025.102337","url":null,"abstract":"<div><h3>Objective</h3><div>To evaluate the clinical efficacy of complex decongestive therapy (CDT) combined with needle electrode stimulation (NES) in the management of lymphedema after lymphaticovenular anastomosis (LVA) and to compare its therapeutic outcomes with conventional CDT alone.</div></div><div><h3>Methods</h3><div>A retrospective analysis was conducted on 50 patients with secondary lymphedema who underwent LVA at the Department of Traumatic Orthopedics, Weifang People's Hospital, between June 2023 and June 2024. All patients met strict inclusion criteria and were randomly assigned to one of two groups: group A (CDT combined with NES; n = 25; 3 males, 22 females) and group B (CDT alone; n = 25; 3 males, 22 females). There was no significant difference in sex distribution between groups (χ<sup>2</sup> = 0.00; <em>P</em> > .99), indicating baseline comparability.</div></div><div><h3>Results</h3><div>No significant main effect of group was observed for limb swelling rate (<em>P</em> = .46; n = 50), indicating comparable overall swelling levels between groups. A significant main effect of time was found across all timepoints (preoperatively and at 2 weeks, 1 month, 3 months, 6 months, and 12 months postoperatively; <em>P</em> < .01; n = 25), suggesting a general decrease in swelling over time. Importantly, a significant group × time interaction was identified (<em>P</em> = .03; n = 25), indicating that the rate of decrease in swelling differed, with group A showing a greater and faster improvement. For quality of life assessed by the Lymphedema Life Impact Scale (LLIS), the between-group difference was not statistically significant (<em>P</em> = .09; n = 25). However, a significant time effect was observed (<em>P</em> < .01), and a significant group × time interaction (<em>P</em> = .02) indicated a more favorable trajectory in group A. No adverse events, including infection, poor wound healing, or cellulitis, were reported during the study.</div></div><div><h3>Conclusions</h3><div>CDT combined with NES demonstrates superior efficacy in decreasing limb swelling and improving Lymphedema Life Impact Scale scores compared with CDT alone in the postoperative management of lymphedema after LVA. This combination therapy significantly enhances postoperative recovery, suggesting its potential as a more effective approach for lymphedema rehabilitation.</div></div>","PeriodicalId":17537,"journal":{"name":"Journal of vascular surgery. Venous and lymphatic disorders","volume":"14 1","pages":"Article 102337"},"PeriodicalIF":2.8,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145225721","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}
Pub Date : 2025-09-30DOI: 10.1016/j.jvsv.2025.102320
Cláudia Carvalho Sathler de Melo MD , Felipe Puricelli Faccini MD, MSc
Objective
To evaluate the safety and efficacy of hemodynamic hybrid LASER cryosclerotherapy for the treatment of chronic venous disease in patients with telangiectasias, reticular veins, and varicose veins.
Methods
This retrospective cohort included patients classified as C1 and C2 low treated between February 2022 and November 2024. A total of 41 women were included. All patients underwent clinical evaluation, Doppler ultrasound venous mapping for evidence of deep and superficial reflux and standardized pretreatment and post-treatment photography. Exclusion criteria included previous saphenous treatment, thromboembolic events, and Fitzpatrick skin type VI. We used YAG Laser and cooled 67% to 75% dextrose injection.
Results
A total of 71 treatment sessions were performed. Lesion clearance was categorized as insufficient (<50%), moderate (50%-69%), or complete (70%-100%) based on photographic comparison by the treating physician and patient consensus. Complete clearance was achieved in 83% of patients (34/41). Postinflammatory hyperpigmentation was the most common complication, with no cases of skin necrosis. Two minor thrombotic events were observed. No allergic reactions were reported.
Conclusions
Hemodynamic hybrid LASER cryosclerotherapy appears to be a safe and effective office-based treatment for C1 and C2 low patients, potentially reducing the need for invasive saphenous vein procedures in early-stage chronic venous disease.
{"title":"Safety and efficacy for the treatment of C1 and C2 patients with a new method hemodynamic hybrid Nd YAG 1064 LASER and cryosclerotherapy","authors":"Cláudia Carvalho Sathler de Melo MD , Felipe Puricelli Faccini MD, MSc","doi":"10.1016/j.jvsv.2025.102320","DOIUrl":"10.1016/j.jvsv.2025.102320","url":null,"abstract":"<div><h3>Objective</h3><div>To evaluate the safety and efficacy of hemodynamic hybrid LASER cryosclerotherapy for the treatment of chronic venous disease in patients with telangiectasias, reticular veins, and varicose veins.</div></div><div><h3>Methods</h3><div>This retrospective cohort included patients classified as C1 and C2 low treated between February 2022 and November 2024. A total of 41 women were included. All patients underwent clinical evaluation, Doppler ultrasound venous mapping for evidence of deep and superficial reflux and standardized pretreatment and post-treatment photography. Exclusion criteria included previous saphenous treatment, thromboembolic events, and Fitzpatrick skin type VI. We used YAG Laser and cooled 67% to 75% dextrose injection.</div></div><div><h3>Results</h3><div>A total of 71 treatment sessions were performed. Lesion clearance was categorized as insufficient (<50%), moderate (50%-69%), or complete (70%-100%) based on photographic comparison by the treating physician and patient consensus. Complete clearance was achieved in 83% of patients (34/41). Postinflammatory hyperpigmentation was the most common complication, with no cases of skin necrosis. Two minor thrombotic events were observed. No allergic reactions were reported.</div></div><div><h3>Conclusions</h3><div>Hemodynamic hybrid LASER cryosclerotherapy appears to be a safe and effective office-based treatment for C1 and C2 low patients, potentially reducing the need for invasive saphenous vein procedures in early-stage chronic venous disease.</div></div>","PeriodicalId":17537,"journal":{"name":"Journal of vascular surgery. Venous and lymphatic disorders","volume":"14 1","pages":"Article 102320"},"PeriodicalIF":2.8,"publicationDate":"2025-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145213148","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}
Pub Date : 2025-09-26DOI: 10.1016/j.jvsv.2025.102328
Pingping Liu MD , Yilong Guo MD , Ning Ma MD , Sen Chen MD , Yan Cao MD , Zhe Yang MD , Yangqun Li MD
Objective
To evaluate the long-term outcomes and recurrence patterns of surgical treatment for perineal lymphatic malformations (LMs), which are rare but functionally and cosmetically disabling.
Methods
We conducted a retrospective review of 19 patients with perineal LMs who underwent surgical excision between 2000 and 2024. All patients were followed for at least 1 year. Clinical presentation, surgical details, complications, and recurrences were analyzed. Recurrence-free survival was estimated using the Kaplan-Meier method, and risk factors were explored using univariate analysis.
Results
The cohort included 17 males and 2 females. Lesions were primarily located on the penis and scrotum. Symptoms included local swelling, disfigurement, cutaneous masses, lymphostatic elephantiasis, pain, skin discoloration, and functional compromise. No patients underwent surgery at 0 to 1 year of age, six were treated at 1 to 6 years, one at 6 to 12 years, six at 12 to 18 years, and six as adults (>18 years). The median follow-up duration was 12 years (range, 1-24 years). All skin grafts and flaps survived, and patient-reported functional and cosmetic outcomes improved significantly. The complication rate was 26.3%, including wound dehiscence, lymphatic leakage, and hypertrophic scars. Overall patient satisfaction was 84.2%. Primary surgical success (no recurrence after one procedure) was achieved in 63.2% of cases. Seven patients experienced recurrence. The estimated 20-year recurrence-free survival was 42.3%. Lymphostatic elephantiasis was significantly associated with recurrence (P < .05).
Conclusions
Surgical excision of perineal LMs is safe and effective. Most patients achieved lasting symptom relief and cosmetic benefits after one operation. However, recurrence is a long-term concern, highlighting the need for ongoing surveillance.
{"title":"Surgical treatment of perineal lymphatic malformations: A single-center retrospective study of 24 years","authors":"Pingping Liu MD , Yilong Guo MD , Ning Ma MD , Sen Chen MD , Yan Cao MD , Zhe Yang MD , Yangqun Li MD","doi":"10.1016/j.jvsv.2025.102328","DOIUrl":"10.1016/j.jvsv.2025.102328","url":null,"abstract":"<div><h3>Objective</h3><div>To evaluate the long-term outcomes and recurrence patterns of surgical treatment for perineal lymphatic malformations (LMs), which are rare but functionally and cosmetically disabling.</div></div><div><h3>Methods</h3><div>We conducted a retrospective review of 19 patients with perineal LMs who underwent surgical excision between 2000 and 2024. All patients were followed for at least 1 year. Clinical presentation, surgical details, complications, and recurrences were analyzed. Recurrence-free survival was estimated using the Kaplan-Meier method, and risk factors were explored using univariate analysis.</div></div><div><h3>Results</h3><div>The cohort included 17 males and 2 females. Lesions were primarily located on the penis and scrotum. Symptoms included local swelling, disfigurement, cutaneous masses, lymphostatic elephantiasis, pain, skin discoloration, and functional compromise. No patients underwent surgery at 0 to 1 year of age, six were treated at 1 to 6 years, one at 6 to 12 years, six at 12 to 18 years, and six as adults (>18 years). The median follow-up duration was 12 years (range, 1-24 years). All skin grafts and flaps survived, and patient-reported functional and cosmetic outcomes improved significantly. The complication rate was 26.3%, including wound dehiscence, lymphatic leakage, and hypertrophic scars. Overall patient satisfaction was 84.2%. Primary surgical success (no recurrence after one procedure) was achieved in 63.2% of cases. Seven patients experienced recurrence. The estimated 20-year recurrence-free survival was 42.3%. Lymphostatic elephantiasis was significantly associated with recurrence (<em>P</em> < .05).</div></div><div><h3>Conclusions</h3><div>Surgical excision of perineal LMs is safe and effective. Most patients achieved lasting symptom relief and cosmetic benefits after one operation. However, recurrence is a long-term concern, highlighting the need for ongoing surveillance.</div></div>","PeriodicalId":17537,"journal":{"name":"Journal of vascular surgery. Venous and lymphatic disorders","volume":"14 1","pages":"Article 102328"},"PeriodicalIF":2.8,"publicationDate":"2025-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145186316","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}
Pub Date : 2025-09-24DOI: 10.1016/j.jvsv.2025.102327
Daniel J. Lehane MD, Joshua T. Geiger MD, Baqir J. Kedwai MD, Grayson S. Pitcher MD, Michael C. Stoner MD, Jennifer L. Ellis MD, Karina A. Newhall MD, MS
<div><h3>Objective</h3><div>Endovenous thermal ablation (EVTA) of superficial lower extremity veins performed with laser or radiofrequency ablation has high rates of technical success. However, it is understudied how improvement in patient-reported outcomes after EVTA is related to the preoperative clinical class in the Clinical, Etiological, Anatomical, and Pathophysiological (CEAP) classification. This study investigated whether patients with a higher CEAP clinical class have lower odds of perceived symptomatic improvement than patients with lower preprocedural clinical class.</div></div><div><h3>Methods</h3><div>A retrospective cohort analysis of Vascular Quality Initiative (VQI) Varicose Vein Registry data from 2014 to 2021 was conducted. Patients >18 years of age who underwent EVTA alone and followed up within 3 months were included, and those with a clinical CEAP class of C0 or C1, nontruncal ablation, missing baseline CEAP score, or weight and height outside VQI data standards were excluded. Patient-reported limb appearance, work impact, and a composite score of heaviness, achiness, swelling, throbbing and itching (HASTI) were analyzed on a per-limb basis. Factors associated with improvement in patient-reported outcomes were tested with multivariable mixed effects logistic regression. The models adjusted for CEAP class, demographics, and anatomical variables as fixed effects and were clustered by VQI center. Demographic and comorbidity data were compared across CEAP classes with Chi-squared, Kruskal-Wallis, or analysis of variance testing as appropriate.</div></div><div><h3>Results</h3><div>There were 6364 patients who met inclusion the criteria, and we analyzed 7607 limbs within the study period. Patient demographics and comorbid venous pathologies were not evenly distributed among the CEAP classes. Patients with C6 disease (odds ratio [OR], 0.63; 95% confidence interval [CI], 0.45-0.88; <em>P</em> = .01) and patients with a history of phlebitis (OR, 0.76; 95% CI, 0.59-0.99; <em>P</em> = .04) had lower odds of improvement in HASTI score. For patient-reported appearance, C3 (OR, 0.79; 95% CI, 0.66-0.94; <em>P</em> = .01) and C6 (OR, 0.50; 95% CI, 0.38-0.67; <em>P</em> < .01) disease were associated with lower odds of improvement. Obesity (OR, 0.87; 95% CI, 0.76-0.99; <em>P</em> = .04), preoperative anticoagulation (OR, 0.77; 95% CI, 0.62-0.97; <em>P</em> = .03), and prior vein treatment (OR, 0.81; 95% CI, 0.71-0.93; <em>P</em> < .01) were also negatively associated with appearance, whereas age ≥65 years was positively associated (OR, 1.17; 95% CI, 1.01-1.35; <em>P</em> = .04). Clinical class showed no association with an improvement in impact on work. Female sex was positively associated with an improved impact on work (OR, 1.17; 95% CI, 1.02-1.36; <em>P</em> = .03).</div></div><div><h3>Conclusions</h3><div>Higher CEAP clinical class was associated with odds of improvement in HASTI and appearance but not associated with improvemen
{"title":"Higher clinical class Clinical, Etiological, Anatomical, and Pathophysiological score is associated with lower odds of improvement in patient-reported outcomes after endovenous thermal ablation of truncal veins","authors":"Daniel J. Lehane MD, Joshua T. Geiger MD, Baqir J. Kedwai MD, Grayson S. Pitcher MD, Michael C. Stoner MD, Jennifer L. Ellis MD, Karina A. Newhall MD, MS","doi":"10.1016/j.jvsv.2025.102327","DOIUrl":"10.1016/j.jvsv.2025.102327","url":null,"abstract":"<div><h3>Objective</h3><div>Endovenous thermal ablation (EVTA) of superficial lower extremity veins performed with laser or radiofrequency ablation has high rates of technical success. However, it is understudied how improvement in patient-reported outcomes after EVTA is related to the preoperative clinical class in the Clinical, Etiological, Anatomical, and Pathophysiological (CEAP) classification. This study investigated whether patients with a higher CEAP clinical class have lower odds of perceived symptomatic improvement than patients with lower preprocedural clinical class.</div></div><div><h3>Methods</h3><div>A retrospective cohort analysis of Vascular Quality Initiative (VQI) Varicose Vein Registry data from 2014 to 2021 was conducted. Patients >18 years of age who underwent EVTA alone and followed up within 3 months were included, and those with a clinical CEAP class of C0 or C1, nontruncal ablation, missing baseline CEAP score, or weight and height outside VQI data standards were excluded. Patient-reported limb appearance, work impact, and a composite score of heaviness, achiness, swelling, throbbing and itching (HASTI) were analyzed on a per-limb basis. Factors associated with improvement in patient-reported outcomes were tested with multivariable mixed effects logistic regression. The models adjusted for CEAP class, demographics, and anatomical variables as fixed effects and were clustered by VQI center. Demographic and comorbidity data were compared across CEAP classes with Chi-squared, Kruskal-Wallis, or analysis of variance testing as appropriate.</div></div><div><h3>Results</h3><div>There were 6364 patients who met inclusion the criteria, and we analyzed 7607 limbs within the study period. Patient demographics and comorbid venous pathologies were not evenly distributed among the CEAP classes. Patients with C6 disease (odds ratio [OR], 0.63; 95% confidence interval [CI], 0.45-0.88; <em>P</em> = .01) and patients with a history of phlebitis (OR, 0.76; 95% CI, 0.59-0.99; <em>P</em> = .04) had lower odds of improvement in HASTI score. For patient-reported appearance, C3 (OR, 0.79; 95% CI, 0.66-0.94; <em>P</em> = .01) and C6 (OR, 0.50; 95% CI, 0.38-0.67; <em>P</em> < .01) disease were associated with lower odds of improvement. Obesity (OR, 0.87; 95% CI, 0.76-0.99; <em>P</em> = .04), preoperative anticoagulation (OR, 0.77; 95% CI, 0.62-0.97; <em>P</em> = .03), and prior vein treatment (OR, 0.81; 95% CI, 0.71-0.93; <em>P</em> < .01) were also negatively associated with appearance, whereas age ≥65 years was positively associated (OR, 1.17; 95% CI, 1.01-1.35; <em>P</em> = .04). Clinical class showed no association with an improvement in impact on work. Female sex was positively associated with an improved impact on work (OR, 1.17; 95% CI, 1.02-1.36; <em>P</em> = .03).</div></div><div><h3>Conclusions</h3><div>Higher CEAP clinical class was associated with odds of improvement in HASTI and appearance but not associated with improvemen","PeriodicalId":17537,"journal":{"name":"Journal of vascular surgery. Venous and lymphatic disorders","volume":"14 1","pages":"Article 102327"},"PeriodicalIF":2.8,"publicationDate":"2025-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145176220","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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