Phlebology最新文献_第8页

Varicose veins as a risk factor for venous thromboembolism in arthroplasty patients: Meta-analysis. 静脉曲张是关节置换术患者静脉血栓栓塞的危险因素:荟萃分析。

IF 1.7 4区医学 Q3 PERIPHERAL VASCULAR DISEASE

Phlebology

Pub Date : 2023-04-01 DOI: 10.1177/02683555221150563

Daniel Westby, Baker M Ghoneim, Fiona Nolan, Mohamed Elsharkawi, Sean Maguire, Stewart R Walsh

Objective: A meta-analysis to determine if patients with varicose veins are at an increased risk of venous thromboembolism (VTE) when undergoing major lower limb arthroplasty.

Methods: Medline, Embase, and Cochrane Library databases were searched using appropriate terms for studies that reported post-operative VTE in patients who had lower limb arthroplasty with any history of varicose veins. Methodological quality of included studies was quantified using the Risk of Bias (ROB) assessment tools. Findings were reported using the meta-analysis of observational studies in epidemiology (MOOSE) checklist.

Results: A total of 129 studies were identified with 11 observational studies being eligible for inclusion. This consisted of 265,194 patients who underwent lower limb arthroplasty, 2188 of which had pre-existing varicose veins. Overall, VTE occurred in 1845 patients, and 122 cases had varicose veins present at time of arthroplasty. Meta-analysis indicates that patients undergoing lower limb arthroplasty with varicose veins are at increased risk of having a VTE, OR 2.37, 95% CI 1.54-3.63, (p < 0.001). One study evaluated if previous varicose veins surgery influenced the risk of VTE in arthroplasty patients, OR 0.96 (95% CI 0.7-1.28), p = 0.429.

Conclusions: Varicose veins and lower limb arthroplasty are known independent risk factors for VTE. There is a paucity of data regarding the risk of VTE in patients undergoing lower limb arthroplasty who have co-existing varicose veins. This meta-analysis shows that patients with varicose veins are at an increased risk of VTE when undergoing major lower limb arthroplasty. Further studies are required in order to determine if such patients should undergo varicose vein surgery before undertaking major lower limb joint replacement.

目的:一项荟萃分析，以确定静脉曲张患者在接受重大下肢关节置换术时是否有静脉血栓栓塞(VTE)的风险增加。方法:对Medline、Embase和Cochrane图书馆数据库进行检索，使用适当的术语检索报道有静脉曲张病史的下肢关节置换术患者术后静脉血栓栓塞的研究。纳入研究的方法学质量采用偏倚风险(ROB)评估工具进行量化。使用流行病学(MOOSE)检查表的观察性研究的荟萃分析报告了研究结果。结果:共纳入129项研究，其中11项观察性研究符合纳入条件。该研究包括265,194例接受下肢关节置换术的患者，其中2188例患有先前存在的静脉曲张。总的来说，1845例患者发生静脉血栓栓塞，其中122例在关节置换术时存在静脉曲张。荟萃分析显示，接受下肢关节置换术合并静脉曲张的患者发生静脉血栓栓塞的风险增加，OR为2.37,95% CI为1.54-3.63，(p < 0.001)。一项研究评估了既往静脉曲张手术是否影响关节置换术患者静脉血栓栓塞的风险，OR为0.96 (95% CI 0.7-1.28)， p = 0.429。结论:静脉曲张和下肢关节置换术是已知的静脉血栓栓塞的独立危险因素。关于同时存在静脉曲张的下肢关节置换术患者发生静脉血栓栓塞风险的数据缺乏。这项荟萃分析显示，静脉曲张患者在接受重大下肢关节置换术时发生静脉血栓栓塞的风险增加。为了确定这些患者在进行下肢大关节置换术之前是否应该进行静脉曲张手术，还需要进一步的研究。

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引用次数: 1

Authors Reply: Chronic venous disease, platelet and haemostatic abnormalities contribute to the pathogenesis of pigmented purpuric dermatoses. 作者回复:慢性静脉疾病、血小板和止血功能异常与色素紫癜性皮肤病的发病机制有关。

IF 1.7 4区医学 Q3 PERIPHERAL VASCULAR DISEASE

Phlebology

Pub Date : 2023-04-01 DOI: 10.1177/02683555231153019

Parsi K, Connor DE

Dear Editor, We thank you for drawing our attention the letter of Yetkin et al. entitled Pigmented Purpuric Dermatosis-Ecchymosis and Chronic Venous Disease in response to our paper Chronic venous disease, platelet and haemostatic abnormalities contribute to the pathogenesis of pigmented purpuric dermatoses. The authors of the letter have erroneously interpreted ecchymosis and purpura to be synonymous with pigmented purpuric dermatosis (PPD, also known as capillaritis). While ecchymosis is the clinical manifestation of an anatomical bleed, PPD is a distinct dermatological condition with a complex aetiology that is vastly distinct from a simple purpura or ecchymosis. The diagnosis of PPD is confirmed by a biopsy of the affected lesion where histology would typically reveal a perivascular lymphocytic infiltrate and a dermal red cell extravasation. In some sub-categories of PPD, a lichenoid infiltrate, dermal spongiosis or a granulomatous component may be present. PPD is a differential diagnosis for variants of cutaneous T-cell lymphoma (CTCL) and in particular the angiocentric mycosis fungoides (CTCL) that may clinically resemble PPD. It has also been suggested that PPD may be a precursor of CTCL. Various other conditions and in particular cutaneous sarcoidosis may resemble PPD. Hence, a PPD eruption should not be dismissed as simple purpura or pigmentation and appropriate dermatological assessment including a biopsy should be carried out. The novel finding of our study is that patients with PPD would benefit from further assessment of congenital or acquired haemostatic abnormalities that result in thrombocytopenia or affect platelet function. In particular we demonstrated that drugs or supplements such as fish oil may inhibit platelet function contributing to the pathogenesis of PPD. We recommended cessation of any modifiable risk factor when clinically appropriate and treatment of an underlying chronic venous disease when present. Many dermatological conditions may appear clinically similar to non-dermatologists and the confusion is exacerbated when different conditions are titled containing a similar lexicon. Not all conditions containing the term purpura indicate simple bruising as evident from the range of conditions containing the term purpura including PPD, Henoch-Schonlein purpura (IgA vasculitis), thrombotic thrombocytopenic purpura (TTP) and immune-mediated thrombocytopenia (immune thrombocytopenic purpura; ITP). A referral to a dermatologist and appropriate histological confirmation of the clinical diagnosis is recommended when practitioners are dealing with unusual pigmented or purpuric conditions.

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引用次数: 0

Are all patients with sapheno-femoral junction incompetence the same? An ultrasound analysis to potentially predict recurrence after invasive treatments. 所有隐股交界处功能不全的患者都是一样的吗?超声分析预测侵入性治疗后复发的可能性。

IF 1.7 4区医学 Q3 PERIPHERAL VASCULAR DISEASE

Phlebology

Pub Date : 2023-04-01 DOI: 10.1177/02683555231162293

Maurizio Pagano, Daniele Bissacco, Luigi Cacace, Federica Calculli, Renato Casana, Paolo Tondi

The sapheno-femoral junction (SFJ) and the great saphenous vein (GSV) are recognized as one of the main sources of reflux in chronic venous disease. Moreover, reflux time is considered as the main parameter to characterize GSV disease. Despite this, it is well-known in the clinical practice that not all patients with SFJ/GSV reflux are similar, in terms of disease severity and degree. Some other anatomical findings, such as SFJ and GSV diameters, as well as the absence/incompetence of suprasaphenic femoral valve (SFV) might be of interest to better "quantify" the disease severity. The aim of this paper is to describe, through a duplex scan analysis, the relationship between SFJ incompetence, GSV/SFJ diameter and SFV absence/incompetence, to identify if there are patients with "severe" GSV disease and a potential higher recurrence rate after invasive treatments.

隐静脉-股交界处(SFJ)和大隐静脉(GSV)被认为是慢性静脉疾病反流的主要来源之一。此外，反流时间被认为是表征GSV疾病的主要参数。尽管如此，众所周知，在临床实践中，并非所有SFJ/GSV反流患者在疾病严重程度和程度上都是相似的。其他一些解剖学上的发现，如SFJ和GSV直径，以及隐上股阀(SFV)的缺失或不功能，可能有助于更好地“量化”疾病的严重程度。本文的目的是通过双工扫描分析，描述SFJ功能不全、GSV/SFJ直径和SFV缺失/功能不全之间的关系，以确定是否存在“严重”GSV疾病以及有创治疗后复发率可能较高的患者。

引用次数: 1

Effect of the timing of iliac vein stent implantation on catheter-directed thrombolysis in acute lower extremity deep venous thrombosis patients with severe iliac vein stenosis: a retrospective study. 髂静脉支架置入时机对急性下肢深静脉血栓合并严重髂静脉狭窄患者导管溶栓的影响:回顾性研究。

IF 1.7 4区医学 Q3 PERIPHERAL VASCULAR DISEASE

Phlebology

Pub Date : 2023-04-01 DOI: 10.1177/02683555231157566

Chunjiang Liu, Yue Zhou, Yifeng Sun, Miaojun Xu, Guohua Wang, Liming Tang

Objective: To investigate the effect of the timing of iliac vein stent implantation on catheter-directed thrombolysis (CDT) in acute lower extremity deep venous thrombosis (DVT) patients with severe iliac vein stenosis.

Methods: The clinical data of 66 patients with acute lower extremity DVT complicated with severe iliac vein stenosis from May 2017 to May 2020 were retrospectively analyzed. Patients were divided into two groups by timing of iliac vein stent implantation: group A (iliac vein stent implantation before CDT treatment) for 34 and group B (iliac vein stent implantation after CDT treatment) for 32. The detumescence rate of affected limb, the thrombus clearance rate, the thrombolytic efficiency, the complication rate, the hospitalization cost, the stent patency rate within 1 year, and the scores (venous clinical severity score, Villalta, and chronic venous insufficiency questionnaire (CIVIQ) score) at 1 year postoperatively were compared between the two groups.

Results: The thrombolytic efficiency of group A was higher than that of group B, while the incidence of complications and hospitalization expenses in group A were lower than those in group B. There was no statistical significance in the detumescence rate of affected limb, the thrombus clearance rate, the stent patency rate within 1 year, and the scores (VCSS, Villalta, and CIVIQ score) at 1 year postoperatively between the two groups.

Conclusions: For acute lower extremity DVT patients with severe iliac vein stenosis, iliac vein stent implantation before CDT treatment can improve the thrombolytic efficiency, and reduce the incidence of complications and hospitalization costs.

目的:探讨髂静脉支架植入术时机对急性下肢深静脉血栓形成(DVT)伴严重髂静脉狭窄患者导管溶栓(CDT)的影响。方法:回顾性分析2017年5月~ 2020年5月66例急性下肢深静脉血栓合并严重髂静脉狭窄患者的临床资料。按髂静脉支架植入术时间将患者分为两组:A组(CDT治疗前髂静脉支架植入术)34例，B组(CDT治疗后髂静脉支架植入术)32例。比较两组患者患肢消肿率、1年内血栓清除率、溶栓效率、并发症发生率、住院费用、支架通畅率及术后1年静脉临床严重程度评分、Villalta评分、慢性静脉功能不全问卷(CIVIQ)评分。结果:A组溶栓效率高于B组，A组并发症发生率及住院费用均低于B组。两组术后1年患肢消肿率、血栓清除率、支架通畅率及VCSS、Villalta、CIVIQ评分比较，差异均无统计学意义。结论:对于急性下肢DVT合并严重髂静脉狭窄患者，在行CDT治疗前行髂静脉支架植入术可提高溶栓效率，降低并发症发生率和住院费用。

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引用次数: 0

Pigmented purpuric dermatosis-ecchymosis and chronic venous disease. 色素性紫癜性皮肤病-瘀斑和慢性静脉疾病。

IF 1.7 4区医学 Q3 PERIPHERAL VASCULAR DISEASE

Phlebology

Pub Date : 2023-04-01 DOI: 10.1177/02683555231153002

Ertan Yetkin, Hasan Atmaca, Bilal Çuğlan, Kenan Yalta

Dear Editor, We have recently read the article published by Parsi et al. with great enthusiasm and curiosity. They have investigated the etiology of pigmented purpuric dermotoses (PPD) in lower extremity of 67 patients. Briefly the authors have assessed the association of PPD with other concurrent conditions such as bleeding diathesis, NSAID and aspirin use, chronic venous disease (CVD), and fish oil use. Eventually, they have documented that CVD has the highest rate of co-existence (76.2%) with PPD. Moreover, complete resolution of PPDs has been achieved in 95% of the treated patients. Ecchymosis, often used interchangeably with purpura, defines the larger area of discoloration of the skin due to extravasations of blood into the subcutaneous tissue. Although they have similar characteristics in terms of erythrocyte extravasations and sequential discoloration of skin due to hemoglobin catabolism, ecchymosis has been reserved for larger and more extensive area of involvement. Within this context association of CVD with PPD or ecchymosis has already been reported in literature. Ecchymosis has been found to be a sign of varicose vein in a cohort of 494 patients in which arterio occlusive disease, anti-platelet and anticoagulation use, trauma and hematologic diseases have been excluded. Moreover, significant association of muscle cramps with ecchymosis has been documented in patients with peripheral varicose veins. Ruptured superficial veins triggered by muscle contraction and subsequent extravasations of erythrocytes have been supposed to be the underlying mechanism of ecchymosis. Likewise, an independent association of ecchymosis with peripheral varicose vein has been confirmed by using the VEINES-Sym questionnaire. In this regard, Parsi et al. has corroborated that pigmented purpuric lesions or ecchymosis of lower extremities might be a sign of peripheral varicose vein. Therefore, in the absence of known hematologic disease, anti-platelet and/or anticoagulant use, presence of peripheral varicose veins should be preferentially considered in differential diagnosis of PPD or ecchymosis. Moreover, careful individual assessment of patients focusing on the presence of peripheral varicose vein and/or CVD might prevent further unnecessary diagnostic measurements for the etiology of ecchymosis.

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引用次数: 0

Selected phlebological abstracts. 选定的血液学摘要。

IF 1.7 4区医学 Q3 PERIPHERAL VASCULAR DISEASE

Phlebology

Pub Date : 2023-03-01 DOI: 10.1177/02683555231161439

Lowell S Kabnick, Katheen Ozsvath, Jorge H Ulloa

scle-rotherapy

引用次数: 0

Safety and effectiveness of indirect radiofrequency ablation (closure FAST) of incompetent great saphenous veins with Type I aneurysms: Long-term results radiofrequency ablation for saphenous aneurysms. 间接射频消融(FAST)治疗I型动脉瘤无能大隐静脉的安全性和有效性:射频消融治疗隐动脉瘤的长期结果。

IF 1.7 4区医学 Q3 PERIPHERAL VASCULAR DISEASE

Phlebology

Pub Date : 2023-03-01 DOI: 10.1177/02683555221149273

Miloš D Pavlović, Spiro S Schuller, Mark M Head, David Kaiser, Maruša Jerše, Sanja Schuller Petrović

Background: Assess the safety and effectiveness of indirect radiofrequency ablation (RFA, Closure FAST) for the treatment of incompetent great saphenous veins (GSVs) with type 1 aneurysms.

Methods: This was a retrospective analysis performed in three centers (2007-2021). All patients presenting with saphenous aneurysms close to the junction (within 2 cm) were included. They were treated with RFA. Phlebectomies and/or sclerotherapy were performed during the same treatment session. Duplex ultrasound (DUS) was performed early after the procedure and then, more than a year later.

Results: Eight patients (11 limbs) were included between June 2007 and May 2021 with a median diameter of the GSV aneurysm 21 mm (IQR 17.2-23.4). No severe adverse events occurred apart from one endovenous heat-induced thrombosis (EHIT) class III (9.1%). After more than a year (mean 7.2 ± 4.2, median 8 years), none of the aneurysms was present on DUS and the truncal obliteration rate was 100%.

Conclusion: RFA appears to be a safe and effective treatment for patients presenting with incompetent saphenous veins with the type 1 aneurysm.

背景:评估间接射频消融(RFA, closed FAST)治疗无能大隐静脉(GSVs)合并1型动脉瘤的安全性和有效性。方法:对三个中心(2007-2021年)进行回顾性分析。所有在交界附近(2厘米以内)出现隐动脉瘤的患者均被纳入研究。他们接受RFA治疗。静脉切除术和/或硬化治疗在同一疗程进行。双工超声(DUS)在手术后早期进行，然后在一年多后进行。结果:2007年6月至2021年5月纳入8例(11条肢体)，GSV动脉瘤中位直径为21 mm (IQR为17.2-23.4)。除一例静脉内热致血栓形成(EHIT) III级(9.1%)外，未发生严重不良事件。术后1年多(平均7.2±4.2年，中位8年)，DUS检查无动脉瘤出现，截骨闭塞率100%。结论:RFA是治疗1型动脉瘤患者隐静脉功能不全的一种安全有效的方法。

{"title":"Safety and effectiveness of indirect radiofrequency ablation (closure FAST) of incompetent great saphenous veins with Type I aneurysms: Long-term results radiofrequency ablation for saphenous aneurysms.","authors":"Miloš D Pavlović, Spiro S Schuller, Mark M Head, David Kaiser, Maruša Jerše, Sanja Schuller Petrović","doi":"10.1177/02683555221149273","DOIUrl":"https://doi.org/10.1177/02683555221149273","url":null,"abstract":"Background: Assess the safety and effectiveness of indirect radiofrequency ablation (RFA, Closure FAST) for the treatment of incompetent great saphenous veins (GSVs) with type 1 aneurysms.Methods: This was a retrospective analysis performed in three centers (2007-2021). All patients presenting with saphenous aneurysms close to the junction (within 2 cm) were included. They were treated with RFA. Phlebectomies and/or sclerotherapy were performed during the same treatment session. Duplex ultrasound (DUS) was performed early after the procedure and then, more than a year later.Results: Eight patients (11 limbs) were included between June 2007 and May 2021 with a median diameter of the GSV aneurysm 21 mm (IQR 17.2-23.4). No severe adverse events occurred apart from one endovenous heat-induced thrombosis (EHIT) class III (9.1%). After more than a year (mean 7.2 ± 4.2, median 8 years), none of the aneurysms was present on DUS and the truncal obliteration rate was 100%.Conclusion: RFA appears to be a safe and effective treatment for patients presenting with incompetent saphenous veins with the type 1 aneurysm.","PeriodicalId":20139,"journal":{"name":"Phlebology","volume":"38 2","pages":"129-132"},"PeriodicalIF":1.7,"publicationDate":"2023-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9096711","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"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: 2

Improving thromboprophylaxis in the medical inpatients: The role of the resident in an academic hospital. 改善住院病人血栓预防:学术医院住院医师的作用。

IF 1.7 4区医学 Q3 PERIPHERAL VASCULAR DISEASE

Phlebology

Pub Date : 2023-03-01 DOI: 10.1177/02683555221147472

Francisco J Torres-Quintanilla, José R Azpiri-López, Maria E Romero-Ibarguengoitia, Tadeo H Ponce-Sierra, Eunice P Martínez-Gallegos

Introduction: Venous thromboembolism (VTE) is one of the main causes of preventable in-hospital death. It is recommended for hospitals to have an appropriate thromboprophylaxis (TP) protocol to avoid VTE complications.

Objective: To determine the effect of the resident physician feedback to the staff physician in TP appropriateness after the Caprini RAM score implementation.

Methods: Caprini RAM was implemented by the residents in medical patients. Patients were divided in low, moderate, high, and highest-risk groups, with TP recommendation accordingly. In cases with inadequate TP, the resident provided feedback to the staff physician for adjustment. Change to appropriate TP was assessed retrospectively.

Results: A total of 265 records were included. Before intervention, 193 (72.8%) patients had appropriate TP and post-intervention, 207 (78.1%) patients received adequate TP (p < .001).

Conclusions: Feedback from the internal medicine resident to staff physician improves appropriate TP in medical inpatients as a quality of care strategy.

静脉血栓栓塞(VTE)是可预防的院内死亡的主要原因之一。建议医院有适当的血栓预防(TP)方案，以避免静脉血栓栓塞并发症。目的:探讨capryini RAM评分实施后住院医师反馈给主治医师对TP适宜性的影响。方法:由住院医师对住院病人实施capryini RAM。将患者分为低、中、高、高危组，并据此推荐TP。在TP不足的情况下，住院医师向主治医师提供反馈以进行调整。对适当TP的改变进行回顾性评估。结果:共纳入265条记录。干预前有193例(72.8%)患者TP适宜，干预后有207例(78.1%)患者TP适宜(p < 0.001)。结论:内科住院医师对主治医师的反馈可提高住院患者的TP作为一种护理质量策略。

{"title":"Improving thromboprophylaxis in the medical inpatients: The role of the resident in an academic hospital.","authors":"Francisco J Torres-Quintanilla, José R Azpiri-López, Maria E Romero-Ibarguengoitia, Tadeo H Ponce-Sierra, Eunice P Martínez-Gallegos","doi":"10.1177/02683555221147472","DOIUrl":"https://doi.org/10.1177/02683555221147472","url":null,"abstract":"Introduction: Venous thromboembolism (VTE) is one of the main causes of preventable in-hospital death. It is recommended for hospitals to have an appropriate thromboprophylaxis (TP) protocol to avoid VTE complications.Objective: To determine the effect of the resident physician feedback to the staff physician in TP appropriateness after the Caprini RAM score implementation.Methods: Caprini RAM was implemented by the residents in medical patients. Patients were divided in low, moderate, high, and highest-risk groups, with TP recommendation accordingly. In cases with inadequate TP, the resident provided feedback to the staff physician for adjustment. Change to appropriate TP was assessed retrospectively.Results: A total of 265 records were included. Before intervention, 193 (72.8%) patients had appropriate TP and post-intervention, 207 (78.1%) patients received adequate TP (p < .001).Conclusions: Feedback from the internal medicine resident to staff physician improves appropriate TP in medical inpatients as a quality of care strategy.","PeriodicalId":20139,"journal":{"name":"Phlebology","volume":"38 2","pages":"91-95"},"PeriodicalIF":1.7,"publicationDate":"2023-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10844920","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"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: 1

Outcomes of cyanoacrylate closure of the truncal varicose vein insufficiency: A comparison between young and elderly patients. 氰基丙烯酸酯治疗短段静脉曲张不全的疗效:青年和老年患者的比较。

IF 1.7 4区医学 Q3 PERIPHERAL VASCULAR DISEASE

Phlebology

Pub Date : 2023-03-01 DOI: 10.1177/02683555221150147

Görkem Yiğit

Objectives: Cyanoacrylate closure (CAC) procedure has become an alternative treatment method that has become increasingly popular in the treatment of chronic venous insufficiency (CVI) in recent years. The present study was designed to assess the feasibility, tolerance, results, and efficacy of CAC for truncal varicosities in elderly population.

Methods: In this retrospective single-center observational cohort study, CAC procedure was performed in 160 patients (184 limbs) with truncal varicose vein insufficiency. The patients were divided into two groups: elderly group, and younger group. The primary outcome of this study was to assess the feasibility, tolerance, and safety of the CAC procedure for truncal varicosities in elderly population over 70 years. The Venous Clinical Severity Score (VCSS), visual analogue scale of pain (VASP) and occlusion rate of the treated target veins of the patients were evaluated and compared among groups. The secondary outcomes were to evaluate and compare technical success, mortality, major adverse events, and other postoperative complications between the groups.

Results: All operations were carried out under local anesthesia. There were no technical failures or device-related complications. Anatomic success rate was 100% after procedures. The occlusion rate for the elderly group at 2 weeks, 6 months, and 12 months was 100%, 92.3%, and 92.3%, respectively, while the occlusion rate for the younger group was 100%, 97%, and 94.7%, respectively. There was no significant difference in occlusion rates between two groups (p > .05) (Log Rank = 0,231). Improvement in the VCSSs was statistically significant between baseline and 12 months after procedure in both groups (p < .001). Improvement in the VASPs was statistically significant between baseline and 2 weeks after procedure in both groups (p < .001). There were no symptoms or signs of sural nerve injury, hematoma, or phlebitis in either group.

Conclusions: Although it has some potential risks, it is conceivable that the CAC procedure may be applied in selected fit elderly patients for the treatment of CVI. Age appeared to have no effect on the early and mid-term prognosis of the CAC procedure performed in the study cohort.

目的:近年来，氰基丙烯酸酯闭合术(CAC)已成为治疗慢性静脉功能不全(CVI)的一种替代治疗方法。本研究旨在评估CAC治疗老年人椎体静脉曲张的可行性、耐受性、结果和疗效。方法:在回顾性单中心观察队列研究中，对160例(184条肢体)下肢静脉曲张不全患者行CAC手术。患者分为两组:老年组和小年组。本研究的主要结果是评估CAC手术治疗70岁以上老年人椎体静脉曲张的可行性、耐受性和安全性。比较两组患者静脉临床严重程度评分(VCSS)、疼痛视觉模拟评分(VASP)及治疗靶静脉闭塞率。次要结果是评估和比较两组之间的技术成功率、死亡率、主要不良事件和其他术后并发症。结果:所有手术均在局麻下进行。没有出现技术故障或设备相关并发症。手术后解剖成功率为100%。老年组2周、6个月、12个月的闭塞率分别为100%、92.3%、92.3%，青年组闭塞率分别为100%、97%、94.7%。两组间闭塞率差异无统计学意义(p > 0.05) (Log Rank = 0,231)。两组患者VCSSs的改善在基线和术后12个月间均有统计学意义(p < 0.001)。两组患者vasp的改善在基线和术后2周之间具有统计学意义(p < 0.001)。两组患者均无腓肠神经损伤、血肿或静脉炎的症状或体征。结论:尽管存在一定的潜在风险，但可以想象CAC手术可用于选择适合的老年患者治疗CVI。在研究队列中，年龄似乎对CAC手术的早期和中期预后没有影响。

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引用次数: 2

Multi-factor analysis of failure for modified single-session Angiojet rheolytic thrombectomy in treatment of acute iliofemoral venous thrombosis from iliac vein compression syndrome. 改良单期血管射流溶栓术治疗髂静脉压迫综合征急性髂股静脉血栓失败的多因素分析。

IF 1.7 4区医学 Q3 PERIPHERAL VASCULAR DISEASE

Phlebology

Pub Date : 2023-03-01 DOI: 10.1177/02683555221149587

Tianan Huang, Wenbin Ding, Yonghai Jin, Jie Jin, Xiaowen Deng, Li Liang, Zhuo Chen, Xin Hong

Purpose: To explore the risk factors of failure for modified single-session Angiojet rheolytic thrombectomy combined with directed iliac vein stenting, directed filter retrieval in the treatment of iliac vein compression with iliofemoral vein thrombosis.

Methods: During September 2017 to September 2021, 278 patients with DVT were retrospectively analyzed and 203 were eligible for inclusion. All patients were tried to take modified single-session Angiojet rheolytic thrombectomy combined with directed iliac vein stenting, directed filter retrieval treatment. The perioperative factors were analyzed between groups: group 1-modified single-session therapy succeed, and group 2-modified single-session therapy failed. The high risk factors of failure group were evaluated by logistic regression analysis.

Results: 48 patients failed in modified single-session therapy, up to 23.64%. Single factor analysis indicated that there were five independent risk factors related with the failure (p < 0.05), including course of disease longer than 7 days, lumbar degeneration-related iliac vein compression syndrome (dIVCS), antegrade vein access, balloon-assisted cracking thrombus, and suction time. Logistic regression analysis indicated that course of disease longer than 7 days (OR = 19.642.95%CI:6.776∼56.933), dIVCS (OR = 11.586.95%CI:4.016∼33.427) were high risk factors for modified single-session therapy failed, antegrade vein access (OR = 0.171.95%CI:0.047∼0.614) and balloon-assisted cracking thrombus (OR = 0.157.95%CI:0.045∼0.542) were protective factors for therapy failure (p < 0.05).

Conclusions: Long course of disease and dIVCS are the high risk factors for failure of modified single-session Angiojet rheolytic thrombectomy combined with directed iliac vein stenting, directed filter retrieval in the treatment of iliac vein compression syndrome (IVCS). But, antegrade vein access and balloon-assisted cracking thrombus intraoperatively may improve the success rate of modified single-session treatment.

目的:探讨改良单期血管射流溶栓取栓联合定向髂静脉支架置入、定向滤过器取栓治疗髂静脉压迫合并髂股静脉血栓形成失败的危险因素。方法:2017年9月至2021年9月，回顾性分析278例DVT患者，其中203例符合纳入条件。所有患者均尝试改良的单期血管射流溶栓术联合定向髂静脉支架置入术、定向滤过器取出治疗。分析两组围手术期因素:1组改良单疗程治疗成功，2组改良单疗程治疗失败。采用logistic回归分析评价失败组的高危因素。结果:改良单疗程治疗失败48例，失败率达23.64%。单因素分析显示与失败相关的独立危险因素有病程大于7天、腰椎退变相关髂静脉压迫综合征(dIVCS)、静脉顺行、球囊辅助破裂血栓、抽吸时间5个(p < 0.05)。Logistic回归分析表明，病程超过7天(OR = 19.642.95%CI:6.776 ~ 56.933)、dIVCS (OR = 11.586.95%CI:4.016 ~ 33.427)是改良单次治疗失败的高危因素，顺行静脉通路(OR = 0.171.95%CI:0.047 ~ 0.614)和球囊辅助破裂血栓(OR = 0.157.95%CI:0.045 ~ 0.542)是治疗失败的保护因素(p < 0.05)。结论:改良单期血管射流溶栓联合定向髂静脉支架置入术、定向滤过器置入术治疗髂静脉压迫综合征(IVCS)失败的高危因素是病程长和dIVCS。但是，顺行静脉通路和术中球囊辅助破栓可以提高改良单次治疗的成功率。

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引用次数: 0