Pub Date : 2025-12-01DOI: 10.1016/j.jvn.2025.11.002
Rebecca JL Brown PhD, MEd, RN
{"title":"Review of article: Cucato G, Longano PPL, Perren D, Ritti-Dias RM, Saxton JM. Effects of additional exercise therapy after a successful vascular intervention for people with symptomatic peripheral arterial disease. Cochrane Database of Systematic Reviews 2024, Issue 5. Art. No.: CD014736","authors":"Rebecca JL Brown PhD, MEd, RN","doi":"10.1016/j.jvn.2025.11.002","DOIUrl":"10.1016/j.jvn.2025.11.002","url":null,"abstract":"","PeriodicalId":45419,"journal":{"name":"Journal of Vascular Nursing","volume":"43 4","pages":"Pages 253-255"},"PeriodicalIF":1.2,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145712377","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-12-01DOI: 10.1016/j.jvn.2025.08.001
Wagner Jorge Ribeiro Domingues , Emely Kércia Santiago de Souza Brandão , Lenon Corrêa de Souza , Emmina Lima da Cruz de Souza , Paulo Lucas da Silva e Silva , Stephanie Vitória Alves dos Santos , Priscilla Ribeiro dos Santos Campelo , Neivaldo José Nazaré dos Santos , Caroline Ferraz Simões
Background
Chronic venous insufficiency (CVI) affects physical function; however, the impact of disease severity on gait, balance, and handgrip strength in patients with CVI remains unclear.
Objective
To evaluate the impact of the clinical severity of CVI on physical function parameters in patients in less severe stages (CEAP C3–C4) compared to those in more advanced stages of the disease (CEAP C5–C6).
Methods
This cross-sectional study included 96 patients of both sexes with CVI with Etiology-Anatomy-Pathology (CEAP) C3 to C6. Physical function was measured using the six-minute walk test (6MWT), Short Physical Performance Battery (SPPB), Gait speed (usal and fast) and handgrip strength. The Mann-Whitney U test was applied to compare physical function indicators according to the disease severity of CVI (CEAP C3-C4 and CEAP C5-C6).
Results
Patients with CVI CEAP C3-C4 walked 68 meters longer compared to individuals with CVI CEAP C5-C6 (451 m vs 383 m; p = 0.001 respectively) and had a higher total score on the SPPB (11 vs 10 points; p = 0.029). For the other tests there were no statistical differences (P > 0.05).
Conclusion
Therefore, the clinical severity of CVI appears to influence physical function, with patients in less severe stages (CEAP C3-C4) of the disease demonstrating better walking distances and SPPB scores compared with those classified in more advanced stages of the disease (CEAP C5-C6).
{"title":"Impact of disease severity on physical function in patients with chronic venous insufficiency: A cross-sectional study","authors":"Wagner Jorge Ribeiro Domingues , Emely Kércia Santiago de Souza Brandão , Lenon Corrêa de Souza , Emmina Lima da Cruz de Souza , Paulo Lucas da Silva e Silva , Stephanie Vitória Alves dos Santos , Priscilla Ribeiro dos Santos Campelo , Neivaldo José Nazaré dos Santos , Caroline Ferraz Simões","doi":"10.1016/j.jvn.2025.08.001","DOIUrl":"10.1016/j.jvn.2025.08.001","url":null,"abstract":"<div><h3>Background</h3><div>Chronic venous insufficiency (CVI) affects physical function; however, the impact of disease severity on gait, balance, and handgrip strength in patients with CVI remains unclear.</div></div><div><h3>Objective</h3><div>To evaluate the impact of the clinical severity of CVI on physical function parameters in patients in less severe stages (CEAP C3–C4) compared to those in more advanced stages of the disease (CEAP C5–C6).</div></div><div><h3>Methods</h3><div>This cross-sectional study included 96 patients of both sexes with CVI with Etiology-Anatomy-Pathology (CEAP) C3 to C6. Physical function was measured using the six-minute walk test (6MWT), Short Physical Performance Battery (SPPB), Gait speed (usal and fast) and handgrip strength. The Mann-Whitney U test was applied to compare physical function indicators according to the disease severity of CVI (CEAP C3-C4 and CEAP C5-C6).</div></div><div><h3>Results</h3><div>Patients with CVI CEAP C3-C4 walked 68 meters longer compared to individuals with CVI CEAP C5-C6 (451 m vs 383 m; p = 0.001 respectively) and had a higher total score on the SPPB (11 vs 10 points; p = 0.029). For the other tests there were no statistical differences (P > 0.05).</div></div><div><h3>Conclusion</h3><div>Therefore, the clinical severity of CVI appears to influence physical function, with patients in less severe stages (CEAP C3-C4) of the disease demonstrating better walking distances and SPPB scores compared with those classified in more advanced stages of the disease (CEAP C5-C6).</div></div>","PeriodicalId":45419,"journal":{"name":"Journal of Vascular Nursing","volume":"43 4","pages":"Pages 186-191"},"PeriodicalIF":1.2,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145712438","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-12-01DOI: 10.1016/j.jvn.2025.08.006
Chedva Levin , Omar Baha , Malak Hater , Adar Klein-Druyan , Mor Saban
Background
Endovascular intervention is often associated with improvements in physical function in patients with peripheral artery disease. Self-efficacy, the belief in one’s ability to successfully carry out specific behaviors, is a well-established determinant of exercise engagement in diverse populations, including those with peripheral artery disease. However, the role of self-efficacy in maintaining basic and instrumental activities of daily living following endovascular intervention is unclear.
Aim
To investigate the relationship between self-efficacy and functioning, walking capacity, and emotional well-being in patients with peripheral artery disease before and after endovascular interventions.
Methods
Twenty-eight individuals with peripheral artery disease presenting with either intermittent claudication or critical limb-threatening ischemia—who underwent endovascular interventions participated in this study. Standardized questionnaires were used to assess self-efficacy, anxiety, and depression. Daily-steps were calculated by a smartwatch. Independence in performing daily living activities was assessed using the modified Barthel Activities of Daily-Living Index and the independence in instrumental activities of daily-living questionnaire. Data was collected before the intervention (T1), at three months (T2), and at six months post-intervention (T3); this design enabled a comprehensive analysis of changes over time.
Results
Initially, higher self-efficacy correlated with better functioning of daily activities (r = 0.437, p < 0.01) and instrumental activities (r = 0.475, p < 0.01). At six months, higher self-efficacy correlated positively with all domains, including increased step count (r = 0.555, p < 0.01). Self-efficacy had a significant negative correlation with reported anxiety (r = -0.574, p < 0.01) and depression levels (r = -0.622, p < 0.01) post-treatment. A positive association was observed between female sex and self-efficacy in those with initially high self-efficacy levels.
Conclusions
Self-efficacy influences outcomes such as functional abilities, physical activity, and mental wellness in patients with peripheral artery disease following endovascular interventions.
背景：血管干预通常与外周动脉疾病患者身体功能的改善相关。自我效能感，即对自己成功完成特定行为的能力的信念，是各种人群（包括外周动脉疾病患者）参与锻炼的一个公认的决定因素。然而，自我效能感在血管内介入治疗后维持基本和工具性日常生活活动中的作用尚不清楚。目的探讨血管内介入治疗前后外周动脉疾病患者自我效能感与功能、行走能力和情绪幸福感的关系。方法采用血管内介入治疗的28例外周动脉疾病患者，表现为间歇性跛行或严重肢体威胁性缺血。标准化问卷用于评估自我效能、焦虑和抑郁。每日步数由智能手表计算。采用改进的Barthel日常生活活动指数和日常生活问卷工具性活动的独立性来评估进行日常生活活动的独立性。在干预前（T1）、干预后3个月（T2）和干预后6个月（T3）收集数据；这种设计能够全面分析随着时间的变化。结果最初，较高的自我效能感与较好的日常活动功能（r = 0.437, p < 0.01）和工具活动（r = 0.475, p < 0.01）相关。在6个月时，较高的自我效能感与所有领域呈正相关，包括步数增加（r = 0.555, p < 0.01）。自我效能与治疗后报告的焦虑（r = -0.574, p < 0.01）和抑郁水平（r = -0.622, p < 0.01）呈显著负相关。在最初自我效能水平高的人群中，女性性别与自我效能之间存在正相关。结论自我效能感影响外周动脉疾病患者血管内介入治疗后的功能能力、身体活动和心理健康。
{"title":"Self-efficacy and its effect on step count in patients with intermittent claudication after endovascular interventions: A six-month quantitative study","authors":"Chedva Levin , Omar Baha , Malak Hater , Adar Klein-Druyan , Mor Saban","doi":"10.1016/j.jvn.2025.08.006","DOIUrl":"10.1016/j.jvn.2025.08.006","url":null,"abstract":"<div><h3>Background</h3><div>Endovascular intervention is often associated with improvements in physical function in patients with peripheral artery disease. Self-efficacy, the belief in one’s ability to successfully carry out specific behaviors, is a well-established determinant of exercise engagement in diverse populations, including those with peripheral artery disease. However, the role of self-efficacy in maintaining basic and instrumental activities of daily living following endovascular intervention is unclear.</div></div><div><h3>Aim</h3><div>To investigate the relationship between self-efficacy and functioning, walking capacity, and emotional well-being in patients with peripheral artery disease before and after endovascular interventions.</div></div><div><h3>Methods</h3><div>Twenty-eight individuals with peripheral artery disease presenting with either intermittent claudication or critical limb-threatening ischemia—who underwent endovascular interventions participated in this study. Standardized questionnaires were used to assess self-efficacy, anxiety, and depression. Daily-steps were calculated by a smartwatch. Independence in performing daily living activities was assessed using the modified Barthel Activities of Daily-Living Index and the independence in instrumental activities of daily-living questionnaire. Data was collected before the intervention (T1), at three months (T2), and at six months post-intervention (T3); this design enabled a comprehensive analysis of changes over time.</div></div><div><h3>Results</h3><div>Initially, higher self-efficacy correlated with better functioning of daily activities (<em>r</em> = 0.437, <em>p</em> < 0.01) and instrumental activities (<em>r</em> = 0.475, <em>p</em> < 0.01). At six months, higher self-efficacy correlated positively with all domains, including increased step count (<em>r</em> = 0.555, <em>p</em> < 0.01). Self-efficacy had a significant negative correlation with reported anxiety (<em>r</em> = -0.574, <em>p</em> < 0.01) and depression levels (<em>r</em> = -0.622, <em>p</em> < 0.01) post-treatment. A positive association was observed between female sex and self-efficacy in those with initially high self-efficacy levels.</div></div><div><h3>Conclusions</h3><div>Self-efficacy influences outcomes such as functional abilities, physical activity, and mental wellness in patients with peripheral artery disease following endovascular interventions.</div></div>","PeriodicalId":45419,"journal":{"name":"Journal of Vascular Nursing","volume":"43 4","pages":"Pages 216-222"},"PeriodicalIF":1.2,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145712444","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Negative emotional stages are defined as stress, anxiety, and depression. These psychological symptoms can occur among patients with peripheral arterial disease before surgery especially those who present with chronic limb-threatening ischemia (CLTI).
Objective
This study aims to examine predictive factors of negative emotional stages - age, smoking, walking ability, signs and symptoms - of patients with CLTI before surgery.
Methods
This is a descriptive study of 90 patients with CLTI before surgery who met the inclusion and exclusion criteria recruited from two tertiary hospitals, in Bangkok, Thailand. The walking impairment questionnaire, Rutherford’s categories, and Depression Anxiety Stress Scales (DASS - 21) were used for collecting data.
Results
Of 90 preoperative CLTI patients, 57.8 % were male, with an average age of 71.90 years (SD = 11.32). The participants had depression and anxiety equal to 24.4 % and stress for 7.8 %. The majority of the participants had depression, anxiety, and stress scores in mild levels, 13.3 % ( = 3.30, SD = 2.69), 17.8 % (= 2.36, SD = 2.14), and 4.4 % (= 3.47, SD = 3.12), respectively. 32.2 % of the participants had a negative emotional stage in one symptom. The multiple linear regression analysis by the backward method found that age can predict depression symptoms with statistically significant (β = -0.282, p < .05). Walking ability can predict anxiety symptoms with statistically significant (β = -0.278, p < .05). Age and walking ability can predict stress symptoms with statistically significant (β = -0.207, p < .05, β = -0.302, p < .05).
Conclusions
This study shows that age and walking ability influence negative emotional states in patients with CLTI before surgery.
消极的情绪阶段被定义为压力、焦虑和抑郁。这些心理症状可发生在手术前患有外周动脉疾病的患者中，特别是那些存在慢性肢体威胁缺血（CLTI）的患者。目的探讨CLTI患者术前负性情绪分期的预测因素——年龄、吸烟、行走能力、体征和症状。方法：本研究是一项描述性研究，从泰国曼谷的两家三级医院招募了90名符合纳入和排除标准的术前CLTI患者。采用步行障碍问卷、卢瑟福分类、抑郁焦虑压力量表（DASS - 21）收集数据。结果90例术前CLTI患者中，男性占57.8%，平均年龄71.90岁（SD = 11.32）。24.4%的人有抑郁和焦虑，7.8%的人有压力。大多数参与者的抑郁、焦虑和压力得分在轻度水平，分别为13.3% （x¯= 3.30,SD = 2.69）、17.8% （x¯= 2.36,SD = 2.14）和4.4% （x¯= 3.47,SD = 3.12）。32.2%的参与者在一种症状中有消极情绪阶段。通过反向多元线性回归分析发现，年龄对抑郁症状的预测有统计学意义（β = -0.282, p < 0.05）。行走能力对焦虑症状的预测具有统计学意义（β = -0.278, p < 0.05）。年龄和行走能力对应激症状的预测有统计学意义（β = -0.207, p < 05; β = -0.302, p < 05）。结论年龄和行走能力对CLTI患者术前负性情绪状态有影响。
{"title":"Factors influencing negative emotional stages in patients with chronic limb-threatening ischemia prior to surgery","authors":"Nutthawadee Sinporn , Kessiri Wongkongkam , Suporn Danaidutsadeekul , Khamin Chinsakchai","doi":"10.1016/j.jvn.2025.08.002","DOIUrl":"10.1016/j.jvn.2025.08.002","url":null,"abstract":"<div><h3>Introduction</h3><div>Negative emotional stages are defined as stress, anxiety, and depression. These psychological symptoms can occur among patients with peripheral arterial disease before surgery especially those who present with chronic limb-threatening ischemia (CLTI).</div></div><div><h3>Objective</h3><div>This study aims to examine predictive factors of negative emotional stages - age, smoking, walking ability, signs and symptoms - of patients with CLTI before surgery.</div></div><div><h3>Methods</h3><div>This is a descriptive study of 90 patients with CLTI before surgery who met the inclusion and exclusion criteria recruited from two tertiary hospitals, in Bangkok, Thailand. The walking impairment questionnaire, Rutherford’s categories, and Depression Anxiety Stress Scales (DASS - 21) were used for collecting data.</div></div><div><h3>Results</h3><div>Of 90 preoperative CLTI patients, 57.8 % were male, with an average age of 71.90 years (SD = 11.32). The participants had depression and anxiety equal to 24.4 % and stress for 7.8 %. The majority of the participants had depression, anxiety, and stress scores in mild levels, 13.3 % (<span><math><mover><mi>x</mi><mo>¯</mo></mover></math></span> = 3.30, SD = 2.69), 17.8 % (<span><math><mover><mi>x</mi><mo>¯</mo></mover></math></span>= 2.36, SD = 2.14), and 4.4 % (<span><math><mover><mi>x</mi><mo>¯</mo></mover></math></span>= 3.47, SD = 3.12), respectively. 32.2 % of the participants had a negative emotional stage in one symptom. The multiple linear regression analysis by the backward method found that age can predict depression symptoms with statistically significant (<em>β</em> = -0.282, <em>p</em> < .05). Walking ability can predict anxiety symptoms with statistically significant (<em>β</em> = -0.278, <em>p</em> < .05). Age and walking ability can predict stress symptoms with statistically significant (<em>β</em> = -0.207, <em>p</em> < .05, <em>β</em> = -0.302, <em>p</em> < .05).</div></div><div><h3>Conclusions</h3><div>This study shows that age and walking ability influence negative emotional states in patients with CLTI before surgery.</div></div>","PeriodicalId":45419,"journal":{"name":"Journal of Vascular Nursing","volume":"43 4","pages":"Pages 192-197"},"PeriodicalIF":1.2,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145712439","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-12-01DOI: 10.1016/j.jvn.2025.08.003
Evangelos C. Fradelos , Eleni Tsimitrea , Elias Tsagalas , Konstantinos Spanos , Christos Karathanos , George Kouvelos , Athanasios Giannoukas , Anna Mavroforou
Background
Vascular surgery practice presents a variety of ethical dilemmas for vascular surgeons and nurses.
Aim
The present study aimed to explore the ethical dilemmas that healthcare professionals are facing in vascular surgery practice.
Methods
Qualitative study design was employed in this study. Two focus group were conducted using a semi-structured focus group guide, in which ten healthcare professionals participated. Recordings were transcribed, and then analyzed using an inductive content analysis approach.
Results
Analysis identified two primary themes: (1) Balancing patient care and minimizing harm, which included subthemes on patient autonomy and concordance, age and surgical intervention, and end-of-life care with invasive procedures; and (2) Aligning treatment with patient values, which encompassed subthemes on understanding patient preferences and values, and addressing patient concordance, lifestyle modification, and challenges of non- concordant patients. One of the most challenging issues they face daily in clinical practice is balancing patient care with minimal complications.
Conclusions
Vascular healthcare professionals express various concerns during daily vascular surgery practice. The challenges of balancing patient care with minimizing harm along with the patient’s values remain a major issue.
{"title":"Exploring ethical dilemmas in vascular surgery practice. A Qualitative study","authors":"Evangelos C. Fradelos , Eleni Tsimitrea , Elias Tsagalas , Konstantinos Spanos , Christos Karathanos , George Kouvelos , Athanasios Giannoukas , Anna Mavroforou","doi":"10.1016/j.jvn.2025.08.003","DOIUrl":"10.1016/j.jvn.2025.08.003","url":null,"abstract":"<div><h3>Background</h3><div>Vascular surgery practice presents a variety of ethical dilemmas for vascular surgeons and nurses.</div></div><div><h3>Aim</h3><div>The present study aimed to explore the ethical dilemmas that healthcare professionals are facing in vascular surgery practice.</div></div><div><h3>Methods</h3><div>Qualitative study design was employed in this study. Two focus group were conducted using a semi-structured focus group guide, in which ten healthcare professionals participated. Recordings were transcribed, and then analyzed using an inductive content analysis approach.</div></div><div><h3>Results</h3><div>Analysis identified two primary themes: (1) Balancing patient care and minimizing harm, which included subthemes on patient autonomy and concordance, age and surgical intervention, and end-of-life care with invasive procedures; and (2) Aligning treatment with patient values, which encompassed subthemes on understanding patient preferences and values, and addressing patient concordance, lifestyle modification, and challenges of non- concordant patients. One of the most challenging issues they face daily in clinical practice is balancing patient care with minimal complications.</div></div><div><h3>Conclusions</h3><div>Vascular healthcare professionals express various concerns during daily vascular surgery practice. The challenges of balancing patient care with minimizing harm along with the patient’s values remain a major issue.</div></div>","PeriodicalId":45419,"journal":{"name":"Journal of Vascular Nursing","volume":"43 4","pages":"Pages 198-202"},"PeriodicalIF":1.2,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145712440","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-12-01DOI: 10.1016/j.jvn.2025.07.005
Sankar S. Sailesh MPH
{"title":"Letter to the editor: Health literacy in stroke disease: A systematic review","authors":"Sankar S. Sailesh MPH","doi":"10.1016/j.jvn.2025.07.005","DOIUrl":"10.1016/j.jvn.2025.07.005","url":null,"abstract":"","PeriodicalId":45419,"journal":{"name":"Journal of Vascular Nursing","volume":"43 4","pages":"Page 250"},"PeriodicalIF":1.2,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145712375","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-12-01DOI: 10.1016/j.jvn.2025.08.007
Jennifer J. DeVries , Holly A. Myers , Jasmine Buffington , Alexis Brant
Introduction
Chronic abdominal pain can be diagnostically challenging, especially when vascular causes like Budd-Chiari Syndrome (BCS) are overlooked. BCS, often linked to prothrombotic conditions such as protein S deficiency, may be further complicated by anatomical anomalies like May-Thurner Syndrome (MTS), leading to significant hepatic congestion and morbidity. This case highlights the need to consider vascular etiologies in patients with hypercoagulable risk factors to ensure timely diagnosis and intervention.
Case Study
A 21-year-old Caucasian female with a complex history including type 1 diabetes mellitus (DM1), protein S deficiency, and prior pulmonary embolism presented with progressive right upper quadrant abdominal pain, early satiety, bloating, and edema. Imaging and venography revealed BCS due to hepatic venous congestion, as well as MTS with chronic thrombus in the left iliac vein and inferior vena cava. She underwent successful iliac vein stenting, which initially improved her symptoms, but later experienced recurrent pain linked to biliary dyskinesia. Gallbladder ultrasound and hepatobiliary iminodiacetic acid (HIDA) scan revealed wall thickening, sludge, and reduced ejection fraction, leading to laparoscopic cholecystectomy. Her symptoms significantly improved postoperatively, highlighting the role of overlapping vascular and hepatobiliary pathologies in chronic abdominal pain.
Conclusion
This case highlights the importance of evaluating vascular causes in young patients with chronic abdominal symptoms, especially when thrombophilia is present. Early identification and coordinated management of BCS, MTS, and associated complications can prevent serious hepatic consequences. A multidisciplinary, vascular-focused approach was essential in achieving a positive outcome in this diagnostically complex presentation.
{"title":"Chronic abdominal pain: Budd-Chiari syndrome with converging pathologies","authors":"Jennifer J. DeVries , Holly A. Myers , Jasmine Buffington , Alexis Brant","doi":"10.1016/j.jvn.2025.08.007","DOIUrl":"10.1016/j.jvn.2025.08.007","url":null,"abstract":"<div><h3>Introduction</h3><div>Chronic abdominal pain can be diagnostically challenging, especially when vascular causes like Budd-Chiari Syndrome (BCS) are overlooked. BCS, often linked to prothrombotic conditions such as protein S deficiency, may be further complicated by anatomical anomalies like May-Thurner Syndrome (MTS), leading to significant hepatic congestion and morbidity. This case highlights the need to consider vascular etiologies in patients with hypercoagulable risk factors to ensure timely diagnosis and intervention.</div></div><div><h3>Case Study</h3><div>A 21-year-old Caucasian female with a complex history including type 1 diabetes mellitus (DM1), protein S deficiency, and prior pulmonary embolism presented with progressive right upper quadrant abdominal pain, early satiety, bloating, and edema. Imaging and venography revealed BCS due to hepatic venous congestion, as well as MTS with chronic thrombus in the left iliac vein and inferior vena cava. She underwent successful iliac vein stenting, which initially improved her symptoms, but later experienced recurrent pain linked to biliary dyskinesia. Gallbladder ultrasound and hepatobiliary iminodiacetic acid (HIDA) scan revealed wall thickening, sludge, and reduced ejection fraction, leading to laparoscopic cholecystectomy. Her symptoms significantly improved postoperatively, highlighting the role of overlapping vascular and hepatobiliary pathologies in chronic abdominal pain.</div></div><div><h3>Conclusion</h3><div>This case highlights the importance of evaluating vascular causes in young patients with chronic abdominal symptoms, especially when thrombophilia is present. Early identification and coordinated management of BCS, MTS, and associated complications can prevent serious hepatic consequences. A multidisciplinary, vascular-focused approach was essential in achieving a positive outcome in this diagnostically complex presentation.</div></div>","PeriodicalId":45419,"journal":{"name":"Journal of Vascular Nursing","volume":"43 4","pages":"Pages 246-249"},"PeriodicalIF":1.2,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145712374","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-12-01DOI: 10.1016/j.jvn.2025.07.007
Dr. Brijesh Sathian PhD, Javed Iqba RN, MHA, Syed Muhammad Ali MBBS, FCPS
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Pub Date : 2025-12-01DOI: 10.1016/S1062-0303(25)00116-5
{"title":"Information for readers","authors":"","doi":"10.1016/S1062-0303(25)00116-5","DOIUrl":"10.1016/S1062-0303(25)00116-5","url":null,"abstract":"","PeriodicalId":45419,"journal":{"name":"Journal of Vascular Nursing","volume":"43 4","pages":"Page A3"},"PeriodicalIF":1.2,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145712380","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-12-01DOI: 10.1016/j.jvn.2025.07.004
Jane Todhunter , Helen Greenhow , Leon Jonker
Background
In a subset of patients with leg ulcer, reduced compression is indicated to aid wound healing whilst not compromising circulation. It is not clear if there are differences in efficacy between different two-layer compression bandages.
Methods
A single-centre, prospective, non-blinded, randomised, controlled trial was conducted in a Hospital’s vascular department in England to determine 'wound healed’ status at week 12 of treatment. Two ‘Lite' compression bandaged were compared, each providing ∼25 mmHg of pressure. Eligible patients could have leg ulcer of venous or mixed venous-arterial nature, with or without contributing co-morbidities.
Results
In total, 78 patients were randomised. With Andoflex TLC Calamine Lite (also marketed under brand name Coflex, OVIK Health) 18 out of 34 (53%) wounds healed and for Coban2 Lite (3 M) this figure was 15 out of 33 (45%; p-value 0.63, Fisher exact test). A secondary outcome semi-quantitative measure of wound size, PUSH score, did not show a statistical difference between the two bandages either: median score of 0 (inter-quartile range 7) for Andoflex TLC Calamine Lite and 1.5 (inter-quartile range 8) for Coban2 Lite respectively (p-value 0.60, Mann-Whitney U test). Associated leg ulcer symptoms did not differ significantly either.
Conclusions
Andoflex TLC Calamine Lite and Coban2 Lite are non-inferior to each other to up to 20% difference in ‘wound healed’ status at twelve weeks of compression bandage treatment. Any preference in utilisation of one over the other can therefore be dictated by clinician and patient preference. Future research may focus on a comparison of two-layer compression in patients who can tolerate full compression, and/or of two-layer versus hosiery or four-layer devices.
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