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

英文中文

Ablation length, not modality type, determines healing outcomes in venous leg ulcers 消融术长度，而非方式类型，决定下肢静脉性溃疡的愈合结果。

IF 2.8 2区医学 Q2 PERIPHERAL VASCULAR DISEASE

Journal of vascular surgery. Venous and lymphatic disorders

Pub Date : 2025-08-29 DOI: 10.1016/j.jvsv.2025.102308

Misaki M. Kiguchi MD, MBA , Christian Anthony Campat DO , Deeptha Bejugam BS , Juan Carlos Jimenez MD , Ulka Sachdev MD , Niyati Bhatt MD , Alexander Rothstein BM, BA , Julie Bitner PA-C, BA , Leigh Ann O'Banion MD

Objective

Early endovenous intervention of the saphenous system improves healing and recurrence of venous leg ulcers (Clinical-Etiology-Anatomy-Pathophysiology class 6). As ablative methods continue to evolve, it is essential to identify outcome differences between the various techniques. This study aims to compare wound healing rates between primary nonthermal ablation (cyanoacrylate glue [CAG] or commercial polidocanol microfoam ablation [MFA]) and thermal ablation with adjunct MFA.

Methods

In this multicenter retrospective cohort study, patients with healed venous ulcers after nonthermal endovenous treatment were identified from four tertiary referral US institutions. Demographics, comorbidities, procedural, and wound data were collected. Patients whose full-length great saphenous vein was treated with a single nonthermal modality (CAG or MFA) were compared with those treated with radiofrequency ablation plus MFA of the below-knee segment. Multivariate linear regression was performed to identify predictors of wound healing.

Results

We identified 55 patients (27 primary CAG or MFA and 28 radiofrequency ablation plus MFA). The average age was 70 ± 12 years, 56% were male, and 53% had a body mass index of >30 kg/m². Comorbidities were similar between the cohorts. The median ulcer size was 3 cm². The median time to wound healing was 61 days (interquartile range, 30-258 days) with no significant difference between treatment modalities (P = .37), irrespective of ulcer size category. The rate of ulcer recurrence was 16% and did not differ between the cohorts (P = .46). Multivariate linear regression identified proximal access site as the only independent predictor of prolonged wound healing (P = .03).

Conclusions

Treatment of the full-length great saphenous vein with a single nonthermal modality (CAG or MFA) or a thermal modality plus MFA below the knee have comparable times to wound healing. This finding suggests that comprehensive treatment, irrespective of modality, of the entire great saphenous vein to the ankle is the preferred approach for optimal wound healing in Clinical-Etiology-Anatomy-Pathophysiology class 6 patients.

目的：隐静脉系统早期静脉内介入治疗可改善下肢静脉性溃疡的愈合和复发（CEAP-6）。随着烧蚀方法的不断发展，确定各种技术之间的结果差异是至关重要的。本研究旨在比较初级非热[氰基丙烯酸酯胶（CAG）或商业聚多元醇微泡沫消融（MFA）]和热辅助MFA的伤口愈合率。方法：在这项多中心回顾性队列研究中，来自美国四家三级转诊机构的经非热静脉内治疗后静脉溃疡愈合的患者。收集了人口统计学、合并症、手术和伤口数据。将全长大隐静脉（GSV）采用单一非热方式（CAG或MFA）治疗的患者与采用膝下段RFA + MFA治疗的患者进行比较。采用多元线性回归来确定伤口愈合的预测因素。结果：55例确诊患者（27例原发性CAG或MFA， 28例RFA+MFA）。平均年龄70±12岁，男性占56%，体重指数bb0 ~ 30kg/m2占53%。两组患者的合并症相似。溃疡中位数为3cm2。伤口愈合的中位时间为61天（IQR 30-258），治疗方式之间无显著差异（p=0.37），与溃疡大小类别无关（图1）。溃疡复发率为16%，两组间无差异（p=0.46）。多元线性回归发现近端通路是伤口愈合时间延长的唯一独立预测因子（p=0.03）。结论：采用单一非热方式（CAG或MFA）或膝关节以下热加MFA治疗全长GSV的伤口愈合时间相当。这表明，对于CEAP-6患者而言，无论采用何种方式，对踝关节的整个GSV进行综合治疗是最佳伤口愈合的首选方法。

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引用次数: 0

Giant primary great saphenous vein aneurysm 巨大原发性大隐静脉动脉瘤。

IF 2.8 2区医学 Q2 PERIPHERAL VASCULAR DISEASE

Journal of vascular surgery. Venous and lymphatic disorders

Pub Date : 2025-08-29 DOI: 10.1016/j.jvsv.2025.102307

Yan Yang MD , Juan Yang MD , Wen Hao Lu MD

引用次数: 0

Exploring isolated inferior vena cava anomalies beyond the norm 探讨孤立性下腔静脉异常。

IF 2.8 2区医学 Q2 PERIPHERAL VASCULAR DISEASE

Journal of vascular surgery. Venous and lymphatic disorders

Pub Date : 2025-08-29 DOI: 10.1016/j.jvsv.2025.102306

Micaela R. Cuneo MD, Diane F. Hale MD

引用次数: 0

Timing of outpatient stenting is associated with stent size in nonthrombotic iliac vein lesions 门诊支架置入术的时机与非血栓性髂静脉病变的支架大小有关。

IF 2.8 2区医学 Q2 PERIPHERAL VASCULAR DISEASE

Journal of vascular surgery. Venous and lymphatic disorders

Pub Date : 2025-08-23 DOI: 10.1016/j.jvsv.2025.102303

Kurt S. Schultz MD , Paula Pinto Rodriguez MD , Sahar Ali MD , Robert R. Attaran MD , Juan Carlos Perez Lozada MD , Steffen Huber MD , Britt Tonnessen MD , Edouard Aboian MD , Raul J. Guzman MD , Cassius Iyad Ochoa Chaar MD, MPH, MS

Objective

Stent placement is commonly used to treat nonthrombotic iliac vein lesions (NIVLs). On the day of surgery, patients typically fast after midnight and may often present with volume deficits and various degrees of dehydration. This study aims to determine if the time of day stenting is performed predicts the size of the iliac vein stent used to treat NIVLs.

Methods

A retrospective study of patients who underwent outpatient stenting and first-time treatment for NIVLs at a single institution from January 2013 to March 2022 was performed. The exposure variable was the time of day the outpatient stenting was performed, serving as a proxy for fasting duration. Stent timing was dichotomized into an early cohort (procedures before 11 am) and a late cohort (procedures after 11 am). Small stent size was defined as 12 to 16 mm, and large stent size was defined as 18 to 22 mm. A multivariable logistic regression analysis evaluated the independent association between the timing of stenting and iliac vein stent size.

Results

Sixty-four patients met the inclusion criteria, with 53% (n = 34) in the late cohort. The median age of the study population was 53 years (interquartile range, 39-64 years). Patients were 75% female, 30% non-White, and 69% non-Hispanic. Although there were no significant differences in baseline characteristics or iliac vein measurements on intravascular ultrasound examination before stenting between the early and late cohorts, patients in the early cohort were significantly more likely to have a large stent size used compared with the late cohort (70% vs 44%; P = .037). On multivariable logistic regression, each additional hour later in the day that stenting was performed was associated with a 28% higher odds of using a smaller venous stent (P = .036). Older age also independently predicted the implantation of a smaller stent (odds ratio, 0.95; 95% confidence interval, 0.91-0.99; P = .022).

Conclusions

Outpatient stenting performed later in the day was associated with a smaller stent size in patients treated for NIVLs. A 9-hour delay in stent placement was associated with a 2-mm reduction in stent diameter (ie, one stent size smaller). Future studies should investigate the role of a preoperative hydration protocol in optimizing stent sizing for patients with iliac vein lesions.

目的：支架置入术是治疗非血栓性髂静脉病变的常用方法。在手术当天，患者通常在午夜后禁食，可能经常出现体积不足和不同程度的脱水。这项研究的目的是确定一天中进行静脉造影的时间是否可以预测用于治疗非血栓性髂静脉病变的髂静脉支架的大小。方法：回顾性研究2013年1月至2022年3月在同一机构接受门诊静脉造影并首次治疗非血栓性髂静脉病变的患者。暴露变量是门诊静脉造影进行的时间，作为禁食时间的代理。静脉造影时间分为“早队列”（上午11点前）和“晚队列”（上午11点后）。小支架尺寸定义为12-16毫米（mm），大支架尺寸定义为18-22毫米。多变量logistic回归分析评估了静脉造影时间与髂静脉支架大小之间的独立关联。结果：64例患者符合纳入标准，其中53% （n=34）属于晚期队列。研究人群的中位年龄为53岁（IQR， 39-64岁）。患者中75%为女性，30%为非白人，69%为非西班牙裔。尽管在早期和晚期队列中，支架植入前的基线特征或髂静脉血管内超声测量值没有显著差异，但与晚期队列相比，早期队列中的患者更有可能使用大支架尺寸（70%对44%，p=0.037）。在多变量logistic回归中，静脉造影时间每晚1小时，使用较小静脉支架的几率增加28% （p = 0.036）。年龄较大也独立预测了较小支架的植入（OR, 0.95; 95% CI, 0.91-0.99; p = 0.022）。结论：当天晚些时候进行门诊静脉造影与接受非血栓性髂静脉病变治疗的患者支架尺寸较小相关。手术时间的9小时差异与支架尺寸减小2mm相关（即支架尺寸减小1个）。未来的研究应探讨术前水化方案在优化髂静脉病变患者支架尺寸中的作用。

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引用次数: 0

Application of bacterial cellulose film as a wound dressing in varicose vein surgery: A randomized clinical trial 细菌纤维素膜在静脉曲张手术中的应用：一项随机临床试验。

IF 2.8 2区医学 Q2 PERIPHERAL VASCULAR DISEASE

Journal of vascular surgery. Venous and lymphatic disorders

Pub Date : 2025-08-20 DOI: 10.1016/j.jvsv.2025.102302

Allan Lemos Maia PhD , Esdras Marques Lins PhD , Fernanda Appolonio Rocha PhD , Layla Carvalho Mahnke PhD , Flávia Cristina Morone Pinto PhD , Tiago de Oliveira Pereira MD , Mariana Vieira Neves MD , Sarah Brandão Palácio PhD , Katharine Valéria Saraiva Hodel MSc , Josiane Dantas Viana Barbosa PhD , Simone Oliveira Penello PhD , Jaiurte Gomes Martins da Silva PhD , José Lamartine de Andrade Aguiar PhD

Background

Chronic venous insufficiency is common all over the world. It is often related to lower limb varicose veins. Surgical treatment is necessary in most cases but the management of the operative wounds remains a challenge. Nowadays, there is no consensus on which is the ideal dressing for covering operative wounds, but features such as low cost, hypoallergenicity, and good adherence are expected. In this study, a material that meets all these features, the bacterial cellulose film (BCF), was evaluated in patients who underwent varicose vein surgery.

Methods

A randomized, prospective clinical trial was carried out at the Angiology and Vascular Surgery Department of the Hospital das Clínicas/EBSERH - UFPE, from May 2023 to September 2024. The study included 55 patients who underwent varicose vein surgery, divided in two groups: an experimental group, which used a BCF to cover microincisions, and a control group. which used microporous tape. Between postoperative days 4 and 6, patients were assessed for pain, itching, and wound appearance using the Southampton Wound Assessment Scale. The groups were homogeneous in all demographic data, presence of comorbidities, and Clinical-Etiology-Anatomy-Pathophysiology Clinical classification.

Results

Pain on removal was more common in the control group with a mean scale score of 3.46 ± 3.26 compared with 0.63 ± 1.38 (P < .001).

Conclusions

There was no statistical difference between the groups in itching and wound healing. BCF showed healing results comparable with microporous tape, with the advantage of generating less pain on removal.

背景：慢性静脉功能不全在世界各地都很常见。它常与下肢静脉曲张有关。手术治疗在大多数情况下是必要的，但手术伤口的处理仍然是一个挑战。目前，对于何种敷料是治疗OW的理想敷料尚未达成共识，但期望其具有低成本、低致敏性和良好粘附性等特点。目的：在这项研究中，一种满足所有这些特征的材料，细菌纤维素膜，在接受静脉曲张手术的患者中进行了评估。方法：随机前瞻性临床试验于2023年5月至2024年9月在医院血管外科Clínicas / EBSERH - UFPE进行。该研究包括55名接受静脉曲张手术的患者，分为两组：实验组使用细菌纤维素膜覆盖微切口，对照组使用微孔胶带。术后第4天至第6天，采用南安普敦伤口评估量表评估患者的疼痛、瘙痒和伤口外观。这些组在所有人口统计数据、合并症的存在和CEAP临床分类上都是相同的。结果：对照组拔牙时疼痛更频繁，平均评分为3.46 (+/- 3.26)，p组为0.63（+/- 1.38）。结论：两组患者在瘙痒和创面愈合方面无统计学差异。细菌纤维素膜显示出与微孔胶带相容的愈合效果，并且具有去除时产生较少疼痛的优点。

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引用次数: 0

Precision therapy demands precision delivery in the evolution of treatment for low-flow vascular malformations 在低流量血管畸形治疗的发展过程中，精确治疗要求精确交付

IF 2.8 2区医学 Q2 PERIPHERAL VASCULAR DISEASE

Journal of vascular surgery. Venous and lymphatic disorders

Pub Date : 2025-08-14 DOI: 10.1016/j.jvsv.2025.102262

Naiem Nassiri MD, FSVS, RPVI

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 : 2025-08-14 DOI: 10.1016/S2213-333X(25)00131-3

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 : 2025-08-14 DOI: 10.1016/S2213-333X(25)00132-5

引用次数: 0

Is iPad-based three-dimensional scanning the future for evaluating lower extremity volume or edema in clinic? 基于ipad的三维扫描在临床评估下肢容积或水肿方面的前景如何？

IF 2.8 2区医学 Q2 PERIPHERAL VASCULAR DISEASE

Journal of vascular surgery. Venous and lymphatic disorders

Pub Date : 2025-08-14 DOI: 10.1016/j.jvsv.2025.102276

Christine L. Shokrzadeh MD, Jose I. Ortiz De Elguea-Lizarraga MD

引用次数: 0

What's race got to do with it? Unraveling disparities in venous thromboembolism 这跟种族有什么关系？揭示静脉血栓栓塞的差异

IF 2.8 2区医学 Q2 PERIPHERAL VASCULAR DISEASE

Journal of vascular surgery. Venous and lymphatic disorders

Pub Date : 2025-08-14 DOI: 10.1016/j.jvsv.2025.102271

Sheila N. Blumberg MD, MS

引用次数: 0

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Journal of vascular surgery. Venous and lymphatic disorders

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