Breast cancer-related lymphedema (BCRL) is a chronic complication of breast cancer that requires long-term management. This condition imposes significant disturbance on breast cancer survivors (BCSs) physically, emotionally, and, financially. The purpose of this study was to approach the financial burden of BCRL in Iran.
Methods
This qualitative study was performed based on the standards for reporting qualitative research (SRQR) guidelines. Semi-structured and in-depth interviews were conducted using a voice recorder. Data analysis was performed based on the content analysis method of Graneheim and Lundman. Nine women with BCRL participated in the study.
Results
Three major themes were generated based on the captured data: (1) direct costs related to BCRL management, (2) indirect costs imposed by BCRL at work or home, and, (3) benefits of costs which was a great concern of BCSs that how much these costs eventually make their condition better. High costs of garments, lack of insurance coverage, and, difficulties in accessing lymphedema care were among the frequently mentioned problems by BCSs with BCRL.
Conclusion
The financial burden of BCRL is significant on BCSs in Iran. The establishment of insurance coverage policies, easier access to health services, and, implanting patient-centered measures in evidence-based lymphedema guidelines, could be proper interventions to lower the financial burden of BCRL.
背景：乳腺癌相关淋巴水肿（BCRL）是一种需要长期治疗的乳腺癌慢性并发症。这种情况对乳腺癌幸存者（bcs）的身体、情感和经济造成了严重的困扰。本研究的目的是探讨BCRL在伊朗的经济负担。方法：本定性研究依据定性研究报告标准（SRQR）指南进行。使用录音机进行了半结构化和深度访谈。数据分析采用Graneheim and Lundman的内容分析法。9名患有BCRL的女性参与了这项研究。结果：基于捕获的数据产生了三个主要主题：(1)与BCRL管理相关的直接成本；(2)BCRL在工作或家庭中施加的间接成本；(3)成本效益，这是bcs非常关注的成本效益，这些成本最终使他们的状况更好。服装费用高、缺乏保险覆盖以及难以获得淋巴水肿护理是BCRL的bcs经常提到的问题。结论：BCRL对伊朗bcs的经济负担很大。建立保险覆盖政策，更容易获得卫生服务，以及在基于证据的淋巴水肿指南中植入以患者为中心的措施，可能是减轻BCRL经济负担的适当干预措施。
{"title":"Financial burden of lymphedema among breast cancer survivors in Iran: A qualitative study","authors":"Hossein Yarmohammadi , Masood Soltanipur , Mohammad Shahrabi Farahani , Seyed Ehsan Hosseini , Zahra Sheikhi","doi":"10.1016/j.jdmv.2024.09.001","DOIUrl":"10.1016/j.jdmv.2024.09.001","url":null,"abstract":"<div><h3>Background</h3><div>Breast cancer-related lymphedema (BCRL) is a chronic complication of breast cancer that requires long-term management. This condition imposes significant disturbance on breast cancer survivors (BCSs) physically, emotionally, and, financially. The purpose of this study was to approach the financial burden of BCRL in Iran.</div></div><div><h3>Methods</h3><div>This qualitative study was performed based on the standards for reporting qualitative research (SRQR) guidelines. Semi-structured and in-depth interviews were conducted using a voice recorder. Data analysis was performed based on the content analysis method of Graneheim and Lundman. Nine women with BCRL participated in the study.</div></div><div><h3>Results</h3><div>Three major themes were generated based on the captured data: (1) direct costs related to BCRL management, (2) indirect costs imposed by BCRL at work or home, and, (3) benefits of costs which was a great concern of BCSs that how much these costs eventually make their condition better. High costs of garments, lack of insurance coverage, and, difficulties in accessing lymphedema care were among the frequently mentioned problems by BCSs with BCRL.</div></div><div><h3>Conclusion</h3><div>The financial burden of BCRL is significant on BCSs in Iran. The establishment of insurance coverage policies, easier access to health services, and, implanting patient-centered measures in evidence-based lymphedema guidelines, could be proper interventions to lower the financial burden of BCRL.</div></div>","PeriodicalId":53149,"journal":{"name":"JMV-Journal de Medecine Vasculaire","volume":"49 5","pages":"Pages 203-210"},"PeriodicalIF":0.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142796392","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 : 2024-12-01DOI: 10.1016/j.jdmv.2024.10.001
J.-A. Lebeul, A. Petit, M.-N. De La Lance, J. Potet
Fenestration of the vertebral artery is a rare vascular anatomical variant that can mimic a dissection if discovered during cervical trauma. It is important to diagnose it through computed tomography (CT) angiography or magnetic resonance (MR) angiography in order to best guide the patient's management.
{"title":"Fenestration of the vertebral artery in a polytrauma patient: A vascular anatomical variant","authors":"J.-A. Lebeul, A. Petit, M.-N. De La Lance, J. Potet","doi":"10.1016/j.jdmv.2024.10.001","DOIUrl":"10.1016/j.jdmv.2024.10.001","url":null,"abstract":"<div><div>Fenestration of the vertebral artery is a rare vascular anatomical variant that can mimic a dissection if discovered during cervical trauma. It is important to diagnose it through computed tomography (CT) angiography or magnetic resonance (MR) angiography in order to best guide the patient's management.</div></div>","PeriodicalId":53149,"journal":{"name":"JMV-Journal de Medecine Vasculaire","volume":"49 5","pages":"Pages 228-229"},"PeriodicalIF":0.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142796388","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 : 2024-12-01DOI: 10.1016/j.jdmv.2024.08.003
Pacôme Constant dit Beaufils , Alderic Lecluse , Benoît Guillon , Godwin Tatah , Guillaume Marc
Complication after carotid artery revascularization is mainly represented by stroke. Reversible cerebral vasoconstriction syndrome triggering by carotid artery revascularization is exceptional but it is an unrecognized aetiology of stroke. It could be associated with brain edema and henceforth, a posterior reversible encephalopathy syndrome can be confused with post-carotid artery revascularization cerebral hyperperfusion syndrome. We reported three cases about reversible cerebral vasoconstriction syndrome following revascularization therapy whose one had also a posterior reversible encephalopathy syndrome. This complication occurred within two weeks after carotid artery revascularization. All took nimodipine and all had a functional improvement at 3-months follow-up. Reversible cerebral vasoconstriction syndrome with posterior reversible encephalopathy syndrome after carotid artery revascularization may mimic cerebral hyperperfusion syndrome. After a comprehensive review, nineteen cases of reversible cerebral vasoconstriction syndrome post-carotid artery revascularization have been reported in the literature mainly after symptoms. It occurs mainly in women around sixty years of age. The onset is expected four days after revascularization.
{"title":"Reversible cerebral vasoconstriction syndrome following carotid artery revascularization: About three case reports and review of literature","authors":"Pacôme Constant dit Beaufils , Alderic Lecluse , Benoît Guillon , Godwin Tatah , Guillaume Marc","doi":"10.1016/j.jdmv.2024.08.003","DOIUrl":"10.1016/j.jdmv.2024.08.003","url":null,"abstract":"<div><div>Complication after carotid artery revascularization is mainly represented by stroke. Reversible cerebral vasoconstriction syndrome triggering by carotid artery revascularization is exceptional but it is an unrecognized aetiology of stroke. It could be associated with brain edema and henceforth, a posterior reversible encephalopathy syndrome can be confused with post-carotid artery revascularization cerebral hyperperfusion syndrome. We reported three cases about reversible cerebral vasoconstriction syndrome following revascularization therapy whose one had also a posterior reversible encephalopathy syndrome. This complication occurred within two weeks after carotid artery revascularization. All took nimodipine and all had a functional improvement at 3-months follow-up. Reversible cerebral vasoconstriction syndrome with posterior reversible encephalopathy syndrome after carotid artery revascularization may mimic cerebral hyperperfusion syndrome. After a comprehensive review, nineteen cases of reversible cerebral vasoconstriction syndrome post-carotid artery revascularization have been reported in the literature mainly after symptoms. It occurs mainly in women around sixty years of age. The onset is expected four days after revascularization.</div></div>","PeriodicalId":53149,"journal":{"name":"JMV-Journal de Medecine Vasculaire","volume":"49 5","pages":"Pages 195-202"},"PeriodicalIF":0.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142796460","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Venous thromboembolism (VTE) rarely occurs during childhood and, with few exceptions, should be considered as a disease of sick children. Current recommendations concerning the duration of anticoagulant treatment for paediatric VTE are essentially based on the results of clinical trials conducted in adults. Yet the underlying medical conditions, incidence, and anatomical locations of the disease, as well as the rates of unprovoked VTE, morbidity, and mortality, differ between adults and children. Unprovoked VTE is uncommon in childhood. Most children experiencing VTE present risk factors, such as the presence of a central venous catheter (CVC), cancer, chemotherapy (in particular with asparaginase or steroids), obesity, severe infection, congenital cardiopathy (notably in conjunction with hepatic venous stasis), serious trauma, an anatomical venous anomaly (such as atresia or agenesia) or a nephrotic syndrome (inducing a deficit in antithrombin or protein S), premature birth, or maternal combined oral contraception. The recent possibility of administering direct oral anticoagulants (DOAC) to children undoubtedly constitutes the greatest change in the treatment of paediatric VTE. The advantages of this therapy include the possibility of its oral administration, even in infants, the absence of any need for laboratory follow-up, and the lack of food interactions. With the approval of the direct factor Xa inhibitor rivaroxaban (by the European Medicines Agency and Health Canada), and the direct thrombin inhibitor dabigatran (by the European Medicines Agency and the US Food and Drug Administration), paediatric anticoagulant therapy is changing. Only rivaroxaban currently has a Marketing Authorisation in France for the treatment of childhood VTE.
静脉血栓栓塞症（VTE）很少发生在儿童时期，除少数例外情况，应将其视为患病儿童的疾病。目前有关儿童 VTE 抗凝治疗持续时间的建议主要是基于成人临床试验的结果。然而，成人和儿童的基本医疗条件、发病率、疾病的解剖位置以及无诱因 VTE 的发生率、发病率和死亡率均有所不同。无诱因 VTE 在儿童期并不常见。大多数发生 VTE 的儿童都有一些危险因素，如使用中心静脉导管（CVC）、癌症、化疗（尤其是使用天冬酰胺酶或类固醇）、肥胖、严重感染、先天性心脏病（尤其是合并肝静脉淤血）、严重外伤、静脉解剖异常（如闭锁或闭锁不全）或肾病综合征（导致抗凝血酶或蛋白 S 缺乏）、早产或母体联合口服避孕药。最近，儿童可以使用直接口服抗凝剂（DOAC），这无疑是儿科 VTE 治疗的最大变革。这种疗法的优点包括：可以口服，甚至婴儿也可以口服；无需实验室随访；没有食物相互作用。随着直接 Xa 因子抑制剂利伐沙班（由欧洲药品管理局和加拿大卫生部批准）和直接凝血酶抑制剂达比加群（由欧洲药品管理局和美国食品药品管理局批准）的批准，儿科抗凝疗法正在发生变化。目前只有利伐沙班在法国获得了治疗儿童 VTE 的上市许可。
{"title":"Unresolved issues concerning venous thromboembolism. Venous thromboembolism in children. Consensus of the French Society of Vascular Medicine (SFMV)","authors":"Sophie Blaise , Gabrielle Sarlon , Marjolaine Talbot , Guillaume Mahé , Alessandra Bura-Rivière","doi":"10.1016/j.jdmv.2024.11.001","DOIUrl":"10.1016/j.jdmv.2024.11.001","url":null,"abstract":"<div><div>Venous thromboembolism (VTE) rarely occurs during childhood and, with few exceptions, should be considered as a disease of sick children. Current recommendations concerning the duration of anticoagulant treatment for paediatric VTE are essentially based on the results of clinical trials conducted in adults. Yet the underlying medical conditions, incidence, and anatomical locations of the disease, as well as the rates of unprovoked VTE, morbidity, and mortality, differ between adults and children. Unprovoked VTE is uncommon in childhood. Most children experiencing VTE present risk factors, such as the presence of a central venous catheter (CVC), cancer, chemotherapy (in particular with asparaginase or steroids), obesity, severe infection, congenital cardiopathy (notably in conjunction with hepatic venous stasis), serious trauma, an anatomical venous anomaly (such as atresia or agenesia) or a nephrotic syndrome (inducing a deficit in antithrombin or protein S), premature birth, or maternal combined oral contraception. The recent possibility of administering direct oral anticoagulants (DOAC) to children undoubtedly constitutes the greatest change in the treatment of paediatric VTE. The advantages of this therapy include the possibility of its oral administration, even in infants, the absence of any need for laboratory follow-up, and the lack of food interactions. With the approval of the direct factor Xa inhibitor rivaroxaban (by the European Medicines Agency and Health Canada), and the direct thrombin inhibitor dabigatran (by the European Medicines Agency and the US Food and Drug Administration), paediatric anticoagulant therapy is changing. Only rivaroxaban currently has a Marketing Authorisation in France for the treatment of childhood VTE.</div></div>","PeriodicalId":53149,"journal":{"name":"JMV-Journal de Medecine Vasculaire","volume":"49 5","pages":"Pages 211-218"},"PeriodicalIF":0.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142796483","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-12-01DOI: 10.1016/j.jdmv.2024.10.002
C. Doutrelon , C. Matray , C. Klotz , S. Delamarre , M. Razafinimanana , F. De Charry , J.-M. Cournac , C. Jacquier , M. Billhot , M. Aletti
Introduction
Venous thromboembolism (VTE) poses a significant challenge in cancer patients, particularly those with advanced malignancies. The management of recurrent VTE is complicated by the need for effective anticoagulation while addressing the underlying cancer progression.
Cases
We present two clinical cases from the gastroenterology department at Percy French military hospital involving patients with progressive malignant digestive diseases. Patient 1, a 62-year-old woman, developed recurrent pulmonary embolism despite appropriate anticoagulation with low molecular weight heparin (LMWH). After treatment adjustments, she ultimately succumbed to tumor progression. Patient 2, a 54-year-old man hospitalized for pulmonary embolism, faced upper gastrointestinal bleeding and delayed anticoagulation initiation. Although he showed initial improvement with immunotherapy and stabilization of thrombotic events, he experienced oncological progression and recurrent VTE, leading to palliative care.
Discussion
These cases illustrate the difficulties of managing recurrent VTE, even with curative anticoagulation and dose escalation. In case of VTE recurrence, it is essential to investigate for cancer progression and ensure patient adherence to treatment. A comprehensive management strategy should involve both the malignancy and the thrombotic complications.
Conclusion
The management of recurrent VTE in cancer patients requires a multidisciplinary approach to evaluate the benefit-risk ratio of anticoagulation adjustments. These clinical cases highlight the necessity for integrated care that addresses both oncological and thrombotic concerns, emphasizing the importance of timely intervention and collaboration among healthcare providers.
{"title":"Management challenges of recurrent venous thromboembolism in advanced digestive cancers: Case studies and therapeutic strategies","authors":"C. Doutrelon , C. Matray , C. Klotz , S. Delamarre , M. Razafinimanana , F. De Charry , J.-M. Cournac , C. Jacquier , M. Billhot , M. Aletti","doi":"10.1016/j.jdmv.2024.10.002","DOIUrl":"10.1016/j.jdmv.2024.10.002","url":null,"abstract":"<div><h3>Introduction</h3><div>Venous thromboembolism (VTE) poses a significant challenge in cancer patients, particularly those with advanced malignancies. The management of recurrent VTE is complicated by the need for effective anticoagulation while addressing the underlying cancer progression.</div></div><div><h3>Cases</h3><div>We present two clinical cases from the gastroenterology department at Percy French military hospital involving patients with progressive malignant digestive diseases. Patient 1, a 62-year-old woman, developed recurrent pulmonary embolism despite appropriate anticoagulation with low molecular weight heparin (LMWH). After treatment adjustments, she ultimately succumbed to tumor progression. Patient 2, a 54-year-old man hospitalized for pulmonary embolism, faced upper gastrointestinal bleeding and delayed anticoagulation initiation. Although he showed initial improvement with immunotherapy and stabilization of thrombotic events, he experienced oncological progression and recurrent VTE, leading to palliative care.</div></div><div><h3>Discussion</h3><div>These cases illustrate the difficulties of managing recurrent VTE, even with curative anticoagulation and dose escalation. In case of VTE recurrence, it is essential to investigate for cancer progression and ensure patient adherence to treatment. A comprehensive management strategy should involve both the malignancy and the thrombotic complications.</div></div><div><h3>Conclusion</h3><div>The management of recurrent VTE in cancer patients requires a multidisciplinary approach to evaluate the benefit-risk ratio of anticoagulation adjustments. These clinical cases highlight the necessity for integrated care that addresses both oncological and thrombotic concerns, emphasizing the importance of timely intervention and collaboration among healthcare providers.</div></div>","PeriodicalId":53149,"journal":{"name":"JMV-Journal de Medecine Vasculaire","volume":"49 5","pages":"Pages 222-227"},"PeriodicalIF":0.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142796393","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 : 2024-09-01DOI: 10.1016/j.jdmv.2024.08.001
Sébastien Miranda , Marjolaine Talbot , Isabelle Gouin-Thibault , Benjamin Espinasse , Guillaume Mahe , SFMV
Obesity is an alarming worldwide public health issue and is defined as a body mass index (BMI) of 30 kg/m2 or more. It is considered as a risk factor for first thrombotic event and is associated with a significant risk of recurrence. Consequently, obese patients are often treated by anticoagulant therapy but data from randomised control trial are scarce. We will review in this narrative review the state of the art of the prescription of anticoagulant for the prevention and treatment of venous thromboembolism (VTE) in obese patients.
{"title":"Unresolved questions on venous thromboembolic disease. Venous thromboembolism (VTE) management in obese patients. Consensus statement of the French Society of Vascular Medicine (SFMV)","authors":"Sébastien Miranda , Marjolaine Talbot , Isabelle Gouin-Thibault , Benjamin Espinasse , Guillaume Mahe , SFMV","doi":"10.1016/j.jdmv.2024.08.001","DOIUrl":"10.1016/j.jdmv.2024.08.001","url":null,"abstract":"<div><p>Obesity is an alarming worldwide public health issue and is defined as a body mass index (BMI) of 30<!--> <!-->kg/m<sup>2</sup> or more. It is considered as a risk factor for first thrombotic event and is associated with a significant risk of recurrence. Consequently, obese patients are often treated by anticoagulant therapy but data from randomised control trial are scarce. We will review in this narrative review the state of the art of the prescription of anticoagulant for the prevention and treatment of venous thromboembolism (VTE) in obese patients.</p></div>","PeriodicalId":53149,"journal":{"name":"JMV-Journal de Medecine Vasculaire","volume":"49 3","pages":"Pages 170-175"},"PeriodicalIF":0.0,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142228946","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}
Venous leg ulcer refers to chronic wounds, generally difficult to heal and often prone to recurrence. The objective of this research was to assess a double layered compression stocking VenoTrain® ulcertec on a population with mostly severe pathologies. This prospective, multicenter, interventional type II study was conducted between September 2018 and January 2022. Out of 124 patients enrolled, 97.6% had a history of previous leg ulceration, 72.6% were already being followed for leg ulcerations, 30.9% were severely overweight and 24.2% diabetic. Overall, a majority of target ulcers were present for 6 months or more, and the ulcer surface area was larger than 8 cm2 in nearly one in every five cases. The primary endpoint was the rate of closed ulcer after a maximum follow-up of 20 weeks. While most of the treated venous leg ulcerations may be regarded as hard-to-heal wounds, closure rate at 20 weeks ranged between 50.0% (two severity criteria) and 69.0% (no severity criteria) according to baseline wound severity criteria. Besides, VenoTrain® ulcertec device was particularly well accepted and tolerated by patients. In 93.2% of visits, patients stated using it every day. When managing venous ulcerations not requiring strongly thick absorbent dressings, VenoTrain® ulcertec device represents an efficient and more suitable alternative to venous compression bandaging.
{"title":"Impact on healing of double-layered compression stocking in the treatment of severe venous leg ulcers: A prospective, multicenter, controlled trial","authors":"Audrey Stansal , Angelique Marchand , Isabelle Lazareth , Ulrique Michon-Pasturel , Alexandra Yannoutsos , Candice Ostrowka , Clémence Berthin , Tiffany Klejtman , Nina Sigg , Clément Jaillette , Florence Perrinet , Raphaël Attal , Soufyane Sebbane , Mathilde Pecourt , Parinaz Ghaffari , Clémence Caucanas , Emmanuelle Sacco , Hélène Beaussier , Pascal Priollet","doi":"10.1016/j.jdmv.2024.07.001","DOIUrl":"10.1016/j.jdmv.2024.07.001","url":null,"abstract":"<div><p>Venous leg ulcer refers to chronic wounds, generally difficult to heal and often prone to recurrence. The objective of this research was to assess a double layered compression stocking VenoTrain® ulcertec on a population with mostly severe pathologies. This prospective, multicenter, interventional type II study was conducted between September 2018 and January 2022. Out of 124 patients enrolled, 97.6% had a history of previous leg ulceration, 72.6% were already being followed for leg ulcerations, 30.9% were severely overweight and 24.2% diabetic. Overall, a majority of target ulcers were present for 6<!--> <!-->months or more, and the ulcer surface area was larger than 8<!--> <!-->cm<sup>2</sup> in nearly one in every five cases. The primary endpoint was the rate of closed ulcer after a maximum follow-up of 20<!--> <!-->weeks. While most of the treated venous leg ulcerations may be regarded as hard-to-heal wounds, closure rate at 20<!--> <!-->weeks ranged between 50.0% (two severity criteria) and 69.0% (no severity criteria) according to baseline wound severity criteria. Besides, VenoTrain® ulcertec device was particularly well accepted and tolerated by patients. In 93.2% of visits, patients stated using it every day. When managing venous ulcerations not requiring strongly thick absorbent dressings, VenoTrain® ulcertec device represents an efficient and more suitable alternative to venous compression bandaging.</p></div>","PeriodicalId":53149,"journal":{"name":"JMV-Journal de Medecine Vasculaire","volume":"49 3","pages":"Pages 123-134"},"PeriodicalIF":0.0,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2542451324001330/pdfft?md5=9480918d81db129f2e57cb1287772827&pid=1-s2.0-S2542451324001330-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141848470","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-09-01DOI: 10.1016/j.jdmv.2024.05.001
O. Lahjouji, A. Akammar, N. El Bouardi, M. Haloua, B. Alami, M. Boubbou, S. Bouchal, N. Chtaou, F. Belahsen, M. Maaroufi, M.Y. Alaoui Lamrani
Most anatomic features of the internal carotid artery (ICA) are described as a straight course to the skull base free of branches. In some cases, the excessive elongation of the internal carotid artery in a confined space results in a curvature showing a “C” or “S” shape, or in an abnormal vascular shape made of a single or double vessel loop. These anatomic variants are called dolichoarteriopathies of the internal carotid artery. The correlation between dolichoarteriopathy of the ICA and stroke is still questionable, however it is believed that it can be associated with cerebral ischemia with a clinical symptomatology that accompanies ischemic stroke. We report a case of a 41-year-old patient, with a history of hypertension, who was admitted for right hemiparesis with Broca's aphasia. The rest of the clinical examination was normal. Radiological investigations confirmed an acute left sylvian ischemic stroke with an abrupt occlusion of the posterior trunk of the left M2 segment on the CT angiogram, an excessive elongation of the ICA on both sides, describing a shape of coils or loops. Etiologic workup for ischemic stroke was negative.
颈内动脉（ICA）的大多数解剖特征被描述为直达颅底，没有分支。在某些情况下，颈内动脉在狭小空间内过度伸长，导致其弯曲呈 "C "形或 "S "形，或形成由单管或双管环形组成的异常血管形状。这些解剖上的变异被称为颈内动脉十二指肠畸形（dolichoarteriopathies of the internal carotid artery）。颈内动脉多支动脉病变与中风之间的相关性仍然值得怀疑，但人们认为它可能与脑缺血有关，并伴有缺血性中风的临床症状。我们报告了一例 41 岁患者的病例，该患者有高血压病史，因右偏瘫伴布罗卡失语入院。其他临床检查均正常。放射学检查证实，患者为急性左侧蝶骨缺血性卒中，CT血管造影显示左侧M2段后干突然闭塞，两侧ICA过度伸长，呈线圈或环状。缺血性中风的病因检查结果为阴性。
{"title":"Bilateral dolichoarteriopathy of internal carotid arteries as cause of bilateral ischemic strokes: Case report","authors":"O. Lahjouji, A. Akammar, N. El Bouardi, M. Haloua, B. Alami, M. Boubbou, S. Bouchal, N. Chtaou, F. Belahsen, M. Maaroufi, M.Y. Alaoui Lamrani","doi":"10.1016/j.jdmv.2024.05.001","DOIUrl":"10.1016/j.jdmv.2024.05.001","url":null,"abstract":"<div><p><span><span><span>Most anatomic features of the internal carotid artery (ICA) are described as a straight course to the </span>skull base<span> free of branches. In some cases, the excessive elongation of the internal carotid artery in a confined space results in a curvature showing a “C” or “S” shape, or in an abnormal vascular shape made of a single or double vessel loop. These anatomic variants are called dolichoarteriopathies of the internal carotid artery. The correlation between dolichoarteriopathy of the ICA and stroke is still questionable, however it is believed that it can be associated with cerebral ischemia<span> with a clinical symptomatology that accompanies ischemic stroke. We report a case of a 41-year-old patient, with a history of hypertension, who was admitted for right </span></span></span>hemiparesis with </span>Broca's aphasia. The rest of the clinical examination was normal. Radiological investigations confirmed an acute left sylvian ischemic stroke with an abrupt occlusion of the posterior trunk of the left M2 segment on the CT angiogram, an excessive elongation of the ICA on both sides, describing a shape of coils or loops. Etiologic workup for ischemic stroke was negative.</p></div>","PeriodicalId":53149,"journal":{"name":"JMV-Journal de Medecine Vasculaire","volume":"49 3","pages":"Pages 186-189"},"PeriodicalIF":0.0,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142228950","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 : 2024-09-01DOI: 10.1016/j.jdmv.2024.08.002
Antoine Elias , Mario Maufus , Marie Elias , Marjolaine Talbot , Guillaume Mahe , Marie-Antoinette Sevestre , Gilles Pernod , French Society for Vascular Medicine (SFMV)
An accurate diagnosis of lower limb deep vein thrombosis (DVT) recurrence is mandatory. The diagnosis is difficult and has not been well investigated. Our objective was to define the role of clinical probability assessment, D-dimer assay, venous ultrasound and other imaging methods in the diagnosis of this condition based on a review of published data. Our review did not find any clinical prediction rule (CPR) specific to the diagnosis of DVT recurrence. D-dimer assays have not been sufficiently validated or proved effective either alone or when combined with the assessment of clinical probability or with ultrasound. The only validated ultrasound criteria are a new non-compressible vein segment and a ≥ 2 mm or > 4 mm increase in diameter of the common femoral or popliteal vein under compression in the transverse plane between two examinations. Limitations of these criteria include poor inter-observer agreement, non-availability of previous ultrasound reports and measurements, a high percentage of non-diagnostic ultrasound results, lack of power in diagnostic accuracy and diagnostic management studies, and lack of external validation. The analysis of venous obstruction, thrombus appearance, vein diameter and blood flow based on colour Doppler ultrasound criteria has not yet been validated in studies. Magnetic resonance direct thrombus imaging (MRDTI) is a new promising diagnostic imaging method, but is hardly accessible, costly and needs large scale validation studies. Based on this review, an update of the guidance for clinical practice is proposed for the diagnostic management of patients with clinically suspected lower limb DVT recurrence.
{"title":"Update on the diagnosis of recurrence of lower limb deep vein thrombosis. A Consensus statement of the French Society for Vascular Medicine (SFMV)","authors":"Antoine Elias , Mario Maufus , Marie Elias , Marjolaine Talbot , Guillaume Mahe , Marie-Antoinette Sevestre , Gilles Pernod , French Society for Vascular Medicine (SFMV)","doi":"10.1016/j.jdmv.2024.08.002","DOIUrl":"10.1016/j.jdmv.2024.08.002","url":null,"abstract":"<div><p>An accurate diagnosis of lower limb deep vein thrombosis (DVT) recurrence is mandatory. The diagnosis is difficult and has not been well investigated. Our objective was to define the role of clinical probability assessment, D-dimer assay, venous ultrasound and other imaging methods in the diagnosis of this condition based on a review of published data. Our review did not find any clinical prediction rule (CPR) specific to the diagnosis of DVT recurrence. D-dimer assays have not been sufficiently validated or proved effective either alone or when combined with the assessment of clinical probability or with ultrasound. The only validated ultrasound criteria are a new non-compressible vein segment and a<!--> <!-->≥<!--> <!-->2<!--> <!-->mm or<!--> <!-->><!--> <!-->4<!--> <!-->mm increase in diameter of the common femoral or popliteal vein under compression in the transverse plane between two examinations. Limitations of these criteria include poor inter-observer agreement, non-availability of previous ultrasound reports and measurements, a high percentage of non-diagnostic ultrasound results, lack of power in diagnostic accuracy and diagnostic management studies, and lack of external validation. The analysis of venous obstruction, thrombus appearance, vein diameter and blood flow based on colour Doppler ultrasound criteria has not yet been validated in studies. Magnetic resonance direct thrombus imaging (MRDTI) is a new promising diagnostic imaging method, but is hardly accessible, costly and needs large scale validation studies. Based on this review, an update of the guidance for clinical practice is proposed for the diagnostic management of patients with clinically suspected lower limb DVT recurrence.</p></div>","PeriodicalId":53149,"journal":{"name":"JMV-Journal de Medecine Vasculaire","volume":"49 3","pages":"Pages 176-185"},"PeriodicalIF":0.0,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142228947","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}
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