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Dermatophlebology: Understanding dermal responses to venous disease. 皮肤静脉学:了解皮肤对静脉疾病的反应。
Pub Date : 2024-08-22 DOI: 10.1177/02683555241239721
Ronald Bush

Dermatophlebology refers to the study of dermal alterations that occur with transmitted high venous pressure. These changes may range from telangiectasia, complex dermal vascular conditions, and all changes in Clinical Etiology Anatomical Pathophysiology classes IV-VI. Understanding the underlying pathophysiology is essential to treating the skin manifestations of venous disease.

皮肤血管病学是指研究高静脉压引起的真皮改变。这些变化包括毛细血管扩张、复杂的真皮血管状况以及临床病因解剖病理生理学 IV-VI 级的所有变化。了解潜在的病理生理学对于治疗静脉疾病的皮肤表现至关重要。
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引用次数: 0
Mechanochemical chemically assisted ablation of varicose veins for venous insufficiency: American vein and lymphatic society position statement. 针对静脉功能不全的曲张静脉机械化学辅助消融术:美国静脉与淋巴协会立场声明。
Pub Date : 2024-08-21 DOI: 10.1177/02683555241276554
John Blebea, Eri Fukaya, Keith S Moore, Fedor Lurie

Background: Mechanical occlusion chemically assisted ablation (MOCA) of incompetent saphenous veins has been utilized since its FDA approval in 2008. However, only recently have longer-term three and 5 year clinical follow up data become available. This updated information necessitates a societal update to guide treatment and ensure optimal patient outcomes. Method: The American Vein and Lymphatic Society convened an expert panel to write a Position Statement with explanations and recommendations for the appropriate use of MOCA for patients with venous insufficiency. Result: This Position Statement was produced by the expert panel with recommendations for appropriate use, treatment technique, outcomes review, and potential adverse events. These recommendations were reviewed, edited, and approved by the Guidelines Committee of the Society. Conclusions: MOCA is effective in alleviating symptoms and a safe treatment option for venous insufficiency. It obviates the need for tumescent anesthesia, has less procedural discomfort and lower risk of thermal nerve or skin injury. It may be used in both the below knee distal GSV as well as the SSV. However, it is associated with significantly lower rates of vessel closure and higher recanalization rates compared to both RFA and EVLA and is less cost effective than thermal techniques. It is an available option for those in whom thermal ablation is not suitable.

背景:自 2008 年获得美国食品及药物管理局批准以来,针对无功能隐静脉的机械闭塞化学辅助消融术(MOCA)一直在使用。然而,直到最近才有了三年和五年的长期临床随访数据。有必要对这些最新信息进行社会更新,以指导治疗并确保患者获得最佳疗效。方法:美国静脉和淋巴协会召集了一个专家小组,撰写了一份立场声明,对静脉功能不全患者如何适当使用 MOCA 做出了解释和建议。结果:专家小组撰写了这份立场声明,就适当使用、治疗技术、结果审查和潜在不良事件提出了建议。学会指南委员会对这些建议进行了审查、编辑和批准。结论:MOCA能有效缓解症状,是静脉功能不全的安全治疗方案。它无需进行肿胀麻醉,减少了手术过程中的不适感,降低了热神经或皮肤损伤的风险。它既可用于膝下远端 GSV,也可用于 SSV。不过,与 RFA 和 EVLA 相比,它的血管闭合率明显较低,再通率较高,而且成本效益低于热疗技术。对于那些不适合热消融的患者来说,这是一种可行的选择。
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引用次数: 0
Endovenous thermal ablation mid-term outcomes for the treatment of large diameter incompetent great saphenous veins. 静脉腔内热消融治疗大隐静脉闭塞的中期疗效。
Pub Date : 2024-08-20 DOI: 10.1177/02683555241272971
Christos Karathanos, Konstantinos Spanos, Konstantinos Batzalexis, Athanasios Chaidoulis, Konstantinos Tzimas-Dakis, Georgios Volakakis, George Kouvelos, Miltiadis Matsagas, Athanasios D Giannoukas

Introduction: The aim of this study was to assess the efficacy and safety of endovenous thermal ablation (EVTA) in treating large diameter, ≥12 mm, incompetent great saphenous vein (GSV) in comparison to smaller ones.

Methods: A retrospective comparative study was undertaken including 196 patients (205 limbs) undergoing EVTA. According to maximum GSV diameter patients were divided into two groups (group A <12 mm, group B ≥12 mm). Primary outcome was anatomic success defined as absence of reflux of GSV. Secondary outcomes were complications, postoperative pain using the 10-cm Visual Analog Scale (VAS) and improvement of Venous Clinical Severity Score (VCSS) and Chronic Venous Insufficiency Quality-of-Life Questionnaire (CΙVIQ-20) scores assessed at 7- days, 1 month, 12 months and 24 months postoperatively.

Results: 118 patients with GSV diameter <12 mm (group A) and 87 with GSV diameter ≥12 mm (group B) were included. Patients' demographics, CEAP classification and length of ablated vein did not differ between the groups. Preoperative VCSS and VAS pain score were significant greater in group B (6.03 vs 6.94, p = .04 and 5.21 vs 5.77, p = .032, respectively). No differences in adverse events were observed post-operatively among groups. GSV occlusion rate at 1 month was 98.3% (SE 1.3%) in group A and 96.5 % (2.2%) in group B (p = .3), at 12 months 95.7% (SE 2%) and 94.2% (SE 2.8%) (p = .5), and at 24 months 94% (SE 2.4%) and 93.1% (SE 3%) (p = .4) respectively. Both groups experienced significant and similar improvement in their VCSSs and CIVIQ scores postoperatively. In a subgroup analysis among different EVTA and GSV >12 mm, 1470 nm endovenous laser ablation (EVLA) and radiofrequency ablation (RFA) showed comparable results in terms of occlusion rates, complications, VCSS and CIVIQ scores.

Conclusions: Endovenous thermal ablation techniques are efective and safe in the treatment of GSV incompetence regardless the diameter of the GSV. Both 1470 nm EVLA and RFA techniques performed similar outcomes.

简介本研究旨在评估静脉腔内热消融术(EVTA)治疗直径≥12 毫米的大隐静脉(GSV)与小隐静脉(GSV)的疗效和安全性:方法:对接受 EVTA 的 196 名患者(205 条肢体)进行了回顾性比较研究。根据最大 GSV 直径将患者分为两组(A 组 结果:118 名患者的 GSV 直径 p = 0.5;B 组 结果:118 名患者的 GSV 直径 p = 0.5;C 组 结果:118 名患者的 GSV 直径 p = 0.5:118例患者的GSV直径分别为5.21 vs 5.77,P = .04和5.21 vs 5.77,P = .032)。各组术后不良反应无差异。1 个月时,A 组的 GSV 闭塞率为 98.3%(SE 1.3%),B 组为 96.5%(2.2%)(p = .3);12 个月时,A 组为 95.7%(SE 2%),B 组为 94.2%(SE 2.8%)(p = .5);24 个月时,A 组为 94%(SE 2.4%),B 组为 93.1%(SE 3%)(p = .4)。两组患者的 VCSSs 和 CIVIQ 评分在术后均有明显和相似的改善。在不同 EVTA 和 GSV >12 mm 的亚组分析中,1470 nm 静脉腔内激光消融术(EVLA)和射频消融术(RFA)在闭塞率、并发症、VCSS 和 CIVIQ 评分方面显示出相似的结果:无论 GSV 的直径大小,静脉内热消融技术都能有效、安全地治疗 GSV 闭塞。1470纳米EVLA和RFA技术的疗效相似。
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引用次数: 0
The open vein hypothesis - is it the whole story? 开放静脉假说--它是故事的全部吗?
Pub Date : 2024-08-18 DOI: 10.1177/02683555241271914
Benedict Rh Turner, Marwah Salih, Jessica Shea, Adam M Gwozdz, Alun H Davies
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引用次数: 0
Analysis of the efficacy of angiojet percutaneous mechanical thrombectomy combined with catheter-directed thrombolysis versus catheter-directed thrombolysis alone in the treatment of subacute iliofemoral deep venous thrombosis in elderly patients. 在治疗老年患者亚急性髂股深静脉血栓时,分析血管喷射经皮机械血栓切除术联合导管引导溶栓与单纯导管引导溶栓的疗效。
Pub Date : 2024-08-14 DOI: 10.1177/02683555241273064
Luyi Cong, Lihua Huang, Benfang Fan, Xin Hong, Lingyu Ma, Tianan Huang

Purpose: To analysis the clinical efficacy of Angiojet percutaneous mechanical thrombectomy (PMT) combined with Catheter-Directed Thrombolysis (CDT) compared to CDT in treatment of subacute iliofemoral deep venous thrombosis (IFDVT) in elderly patients.

Methods: A retrospective analysis of the clinical data of 117 elderly patients hospitalized for subacute IFDVT was conducted. The patients'basic perioperative data and 2-years follow-up data were compared.

Results: Group A (PMT + CDT) had a more patients reaching Grade III thrombus clearance, and a lower thrombolysis time, dosage of thrombolytic drugs, hospital stay, and bleeding incidence compared to Group B (CDT). There was a statistically significant difference in the occurrence rate of severe PTS within 2 years (p < 0.05).

Conclusion: In treating elderly patients with subacute IFDVT, PMT + CDT effectively reduces the thrombus burden and the dosage of thrombolytic drugs, shortens the hospital stay, and importantly, reduces the occurrence rate of severe PTS within 2 years.

目的:分析Angiojet经皮机械取栓术(PMT)联合导管引导溶栓术(CDT)治疗老年患者亚急性髂股深静脉血栓(IFDVT)的临床疗效:对117名因亚急性髂股深静脉血栓形成住院的老年患者的临床数据进行了回顾性分析。结果:A 组(PMT + CDT)和 B 组(PMT + CDT)的患者在术后 2 年的随访中均获得了良好的治疗效果:结果:与 B 组(CDT)相比,A 组(PMT + CDT)达到 III 级血栓清除率的患者更多,溶栓时间、溶栓药物用量、住院时间和出血发生率更低。2年内严重PTS的发生率差异有统计学意义(P<0.05):结论:在治疗亚急性 IFDVT 老年患者时,PMT + CDT 可有效减少血栓负荷和溶栓药物用量,缩短住院时间,更重要的是,可降低 2 年内严重 PTS 的发生率。
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引用次数: 0
The impact of stent protrusion into the inferior vena cava or jailing of the contralateral iliac vein on the incidence of contralateral deep vein thrombosis following venous stenting. 支架突入下腔静脉或对侧髂静脉狭窄对静脉支架术后对侧深静脉血栓形成发生率的影响。
Pub Date : 2024-08-13 DOI: 10.1177/02683555241273752
Duy Nguyen, Karl Pappas, Shreya Mahadevan, Levan Sulakvelidze, Richard Kennedy, Gaurav Lakhanpal, Sanjiv Lakhanpal, Peter J Pappas

Objective: Iliac vein stenting is the standard of care for patients with pelvic venous disorders secondary to symptomatic iliac vein outflow obstruction. Venous stents are often extended proximally into the inferior vena cava (IVC) which may result in partial or complete coverage of the contralateral iliac vein. The purpose of this investigation is to determine if extension of iliac vein stents into the IVC results in increased risk of contralateral deep venous thrombosis (DVT).

Methods: We retrospectively reviewed prospectively collected data from 409 patients who underwent iliac vein stenting at the Center for Vascular Medicine (CVM) from 2019 to 2020. Stent type, covered territories, initial and follow-up consults, ultrasound and operative reports were reviewed to assess for incidence of post-implantation DVT. Patients were stratified into three groups: Iliac vein stents which protruded into the IVC, stents that completely covered the orifice of the contralateral iliac vein and those with no stent protrusion into the IVC.

Results: Out of 409 patients, the average age was 53.96 ± 13.40 years with 94 males and 315 females. All stents placed were Venovo stents and all iliac vein lesions were non-thrombotic stenoses. The average follow-up period was 14.35 ± 10.09 months. The most common territories stented were the IVC-LCIV-LEIV (n = , 74%) and the IVC-RCIV-REIV (n = , 26%). Stent protrusion and distance into the IVC in millimeters (mm) was the following: Partial protrusion (n = 314, 77%, 27.6 ± 19.1), jailing of the contralateral iliac vein (n = 78, 19%, 45.9 ± 18.6), no protrusion (n = 16, 4%). The overall DVT rate post-implantation was 0.49% (n = 2). No DVTs ipsilateral to the index stent were identified and both DVTs were contralateral DVTs. A hypercoaguable disorder was reported in 6 patients (1.5%). There were no significant differences in prevalence of contralateral DVT between the three groups. (p = .35).

Conclusion: The rate of contralateral DVTs post iliac vein stenting with Nitonol based stents is extremely low. Partial or complete coverage of the contralateral iliac vein via stenting does not result in an increased incidence of contralateral DVT in the short-term. Longer follow up is needed to determine if contralateral DVTs occur after long-term implantation.

目的:髂静脉支架植入术是治疗继发于症状性髂静脉流出道阻塞的盆腔静脉疾病患者的标准疗法。静脉支架通常会向近端延伸至下腔静脉(IVC),这可能会导致部分或完全覆盖对侧髂静脉。本研究旨在确定髂静脉支架延伸至 IVC 是否会增加对侧深静脉血栓形成(DVT)的风险:我们回顾性审查了2019年至2020年期间在血管医学中心(CVM)接受髂静脉支架植入术的409名患者的前瞻性数据。回顾了支架类型、覆盖区域、初次和随访咨询、超声和手术报告,以评估植入后深静脉血栓的发生率。患者被分为三组:髂静脉支架突入内静脉、支架完全覆盖对侧髂静脉口以及支架未突入内静脉:在 409 名患者中,平均年龄为 53.96±13.40 岁,其中男性 94 人,女性 315 人。所有植入的支架均为 Venovo 支架,所有髂静脉病变均为非血栓性狭窄。平均随访时间为(14.35 ± 10.09)个月。最常见的支架区域是IVC-LCIV-LEIV(n = ,74%)和IVC-RCIV-REIV(n = ,26%)。支架突出和进入 IVC 的距离(毫米)如下:部分突出(n = 314,77%,27.6 ± 19.1),对侧髂静脉阻塞(n = 78,19%,45.9 ± 18.6),无突出(n = 16,4%)。植入后深静脉血栓的总发生率为 0.49%(n = 2)。没有发现同侧的深静脉血栓,两个深静脉血栓都是对侧深静脉血栓。有 6 名患者(1.5%)报告出现高凝状态。三组患者的对侧深静脉血栓发生率无明显差异。(P=0.35):结论:使用 Nitonol 支架进行髂静脉支架置入术后,对侧深静脉血栓的发生率极低。通过支架部分或完全覆盖对侧髂静脉在短期内不会导致对侧深静脉血栓发生率增加。要确定长期植入后是否会发生对侧深静脉血栓,还需要更长时间的随访。
{"title":"The impact of stent protrusion into the inferior vena cava or jailing of the contralateral iliac vein on the incidence of contralateral deep vein thrombosis following venous stenting.","authors":"Duy Nguyen, Karl Pappas, Shreya Mahadevan, Levan Sulakvelidze, Richard Kennedy, Gaurav Lakhanpal, Sanjiv Lakhanpal, Peter J Pappas","doi":"10.1177/02683555241273752","DOIUrl":"https://doi.org/10.1177/02683555241273752","url":null,"abstract":"<p><strong>Objective: </strong>Iliac vein stenting is the standard of care for patients with pelvic venous disorders secondary to symptomatic iliac vein outflow obstruction. Venous stents are often extended proximally into the inferior vena cava (IVC) which may result in partial or complete coverage of the contralateral iliac vein. The purpose of this investigation is to determine if extension of iliac vein stents into the IVC results in increased risk of contralateral deep venous thrombosis (DVT).</p><p><strong>Methods: </strong>We retrospectively reviewed prospectively collected data from 409 patients who underwent iliac vein stenting at the Center for Vascular Medicine (CVM) from 2019 to 2020. Stent type, covered territories, initial and follow-up consults, ultrasound and operative reports were reviewed to assess for incidence of post-implantation DVT. Patients were stratified into three groups: Iliac vein stents which protruded into the IVC, stents that completely covered the orifice of the contralateral iliac vein and those with no stent protrusion into the IVC.</p><p><strong>Results: </strong>Out of 409 patients, the average age was 53.96 ± 13.40 years with 94 males and 315 females. All stents placed were Venovo stents and all iliac vein lesions were non-thrombotic stenoses. The average follow-up period was 14.35 ± 10.09 months. The most common territories stented were the IVC-LCIV-LEIV (<i>n</i> = , 74%) and the IVC-RCIV-REIV (<i>n</i> = , 26%). Stent protrusion and distance into the IVC in millimeters (mm) was the following: Partial protrusion (<i>n</i> = 314, 77%, 27.6 ± 19.1), jailing of the contralateral iliac vein (<i>n</i> = 78, 19%, 45.9 ± 18.6), no protrusion (<i>n</i> = 16, 4%). The overall DVT rate post-implantation was 0.49% (<i>n</i> = 2). No DVTs ipsilateral to the index stent were identified and both DVTs were contralateral DVTs. A hypercoaguable disorder was reported in 6 patients (1.5%). There were no significant differences in prevalence of contralateral DVT between the three groups. (<i>p</i> = .35).</p><p><strong>Conclusion: </strong>The rate of contralateral DVTs post iliac vein stenting with Nitonol based stents is extremely low. Partial or complete coverage of the contralateral iliac vein via stenting does not result in an increased incidence of contralateral DVT in the short-term. Longer follow up is needed to determine if contralateral DVTs occur after long-term implantation.</p>","PeriodicalId":94350,"journal":{"name":"Phlebology","volume":" ","pages":"2683555241273752"},"PeriodicalIF":0.0,"publicationDate":"2024-08-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141977616","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}
引用次数: 0
Comparison of one-year outcomes and quality of life between radiofrequency ablation and microwave ablation in the treatment of lower extremity varicose veins: A retrospective cohort study. 射频消融与微波消融治疗下肢静脉曲张的一年疗效和生活质量比较:回顾性队列研究。
Pub Date : 2024-08-10 DOI: 10.1177/02683555241273229
Junyu Zhang, Yao Lin, Lifeng Zhang, Caijuan Geng, Wei Huang, Qifan Yang, Wei Zeng, Chunshui He

Objective: This study compared the outcomes of radiofrequency ablation (RFA) and microwave ablation (EMA) for treating lower limb varicose veins.

Methods: Patients who underwent RFA (n = 240) or EMA (n = 209) at our institute from December 2020 to August 2022 were included in this retrospective investigation. Follow-up outcomes included active vein occlusion rate, Venous Clinical Severity Score (VCSS), the Aberdeen Varicose Vein Questionnaire (AVVQ), and Chronic Insufficiency Venous Quality of Life questionnaire-14 (CIVIQ-14)score.

Results: There was no significant difference in the active vein occlusion rate between the two groups after the operation (p > .05). Compared to pre-surgery scores, both groups showed substantial improvement in VCSS, AVVQ, and CIVIQ-14 scores(p < .05), there was no significant difference in these scores in either group (p > .05).

Conclusion: Intravenous radiofrequency and microwave ablation effectively improve the quality of life for patients with lower limb varicose veins, with low post-operative complication and recurrence rates.

目的:比较射频消融术(RFA)和微波消融术(EMA)治疗下肢静脉曲张的效果:本研究比较了射频消融术(RFA)和微波消融术(EMA)治疗下肢静脉曲张的效果:2020年12月至2022年8月期间在我院接受射频消融术(RFA)(n = 240)或微波消融术(EMA)(n = 209)的患者被纳入此次回顾性调查。随访结果包括活动性静脉闭塞率、静脉临床严重程度评分(VCSS)、阿伯丁静脉曲张问卷(AVVQ)和慢性静脉功能不全生活质量问卷-14(CIVIQ-14)评分:结果:术后两组患者的活动静脉闭塞率无明显差异(P > .05)。与术前评分相比,两组患者的 VCSS、AVVQ 和 CIVIQ-14 评分均有显著改善(P < .05),但两组患者的这些评分均无明显差异(P > .05):结论:静脉射频和微波消融术能有效改善下肢静脉曲张患者的生活质量,术后并发症和复发率较低。
{"title":"Comparison of one-year outcomes and quality of life between radiofrequency ablation and microwave ablation in the treatment of lower extremity varicose veins: A retrospective cohort study.","authors":"Junyu Zhang, Yao Lin, Lifeng Zhang, Caijuan Geng, Wei Huang, Qifan Yang, Wei Zeng, Chunshui He","doi":"10.1177/02683555241273229","DOIUrl":"https://doi.org/10.1177/02683555241273229","url":null,"abstract":"<p><strong>Objective: </strong>This study compared the outcomes of radiofrequency ablation (RFA) and microwave ablation (EMA) for treating lower limb varicose veins.</p><p><strong>Methods: </strong>Patients who underwent RFA (<i>n</i> = 240) or EMA (<i>n</i> = 209) at our institute from December 2020 to August 2022 were included in this retrospective investigation. Follow-up outcomes included active vein occlusion rate, Venous Clinical Severity Score (VCSS), the Aberdeen Varicose Vein Questionnaire (AVVQ), and Chronic Insufficiency Venous Quality of Life questionnaire-14 (CIVIQ-14)score.</p><p><strong>Results: </strong>There was no significant difference in the active vein occlusion rate between the two groups after the operation (<i>p</i> > .05). Compared to pre-surgery scores, both groups showed substantial improvement in VCSS, AVVQ, and CIVIQ-14 scores(<i>p</i> < .05), there was no significant difference in these scores in either group (<i>p</i> > .05).</p><p><strong>Conclusion: </strong>Intravenous radiofrequency and microwave ablation effectively improve the quality of life for patients with lower limb varicose veins, with low post-operative complication and recurrence rates.</p>","PeriodicalId":94350,"journal":{"name":"Phlebology","volume":" ","pages":"2683555241273229"},"PeriodicalIF":0.0,"publicationDate":"2024-08-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141915009","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}
引用次数: 0
Nonpelvic comorbid symptoms of 45 patients with pain of pelvic venous origin, before and after treatment. 45 名骨盆静脉源性疼痛患者治疗前后的非骨盆合并症状。
Pub Date : 2024-08-10 DOI: 10.1177/02683555241273109
Steven J Smith, B Holly Smith, Michael J Sichlau, Brenda Chen, Dacre Knight, Peter C Rowe

Objective: To report the prevalence and severity of nonpelvic symptoms for patients with venous-origin chronic pelvic pain (VO-CPP) and to describe outcomes after pelvic vein stenting and embolization.

Methods: We retrospectively reviewed outcomes of 45 women with VO-CPP who underwent treatment with iliac vein stenting and/or embolization. Patients completed symptom-severity questionnaires before and after treatment that assessed for pelvic pain, and multiple other symptoms, including brain fog, anxiety, depression, musculoskeletal pain, fatigue, migraines and more.

Results: Patient age ranged from 18 to 65 years. The prevalence of common symptoms was as follows: migraines, 69%; brain fog, 76%; anxiety attacks, 58%; excess sweating, 64%; hip pain, 73%; diarrhea, 62%; constipation, 76%; and abdominal bloating, 82%. After treatment, most symptom scores improved by more than 50%; exceptions were excessive sweating (41% improvement) and bloating (47% improvement). Prevalence of individual symptoms that bundle into POTS ranged from 29% to 76%, where symptom improvement ranged from 23% to 59% after treatment. Overlapping individual symptoms characteristic of fibromyalgia and myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) were present in 64% to 82% of patients and all improved by 49% to 63% after treatment.

Conclusions: Pelvic venous flow abnormality is linked causally to a spectrum of interrelated symptoms, of which many can be bundled into named syndromes of unknown cause. With catheter- based treatment of pelvic venous pooling, nonpelvic symptom and syndrome scores improved.

目的报告静脉源性慢性盆腔痛(VO-CPP)患者非盆腔症状的发生率和严重程度,并描述盆腔静脉支架植入术和栓塞术后的疗效:我们对 45 名接受髂静脉支架植入术和/或栓塞术治疗的 VO-CPP 女性患者的疗效进行了回顾性研究。患者在治疗前后填写了症状严重性问卷,评估盆腔疼痛和其他多种症状,包括脑雾、焦虑、抑郁、肌肉骨骼疼痛、疲劳、偏头痛等:患者年龄从 18 岁到 65 岁不等。常见症状的发生率如下:偏头痛,69%;脑雾,76%;焦虑发作,58%;多汗,64%;臀部疼痛,73%;腹泻,62%;便秘,76%;腹胀,82%。治疗后,大多数症状的评分都提高了 50%以上,但多汗(提高 41%)和腹胀(提高 47%)除外。与 POTS 相结合的个别症状发生率为 29% 至 76%,治疗后症状改善率为 23% 至 59%。64%至82%的患者存在纤维肌痛和肌痛性脑脊髓炎/慢性疲劳综合征(ME/CFS)的重叠症状,治疗后症状改善率为49%至63%:结论:盆腔静脉血流异常与一系列相互关联的症状存在因果关系,其中许多症状可归纳为原因不明的综合征。通过导管治疗骨盆静脉积水,非骨盆症状和综合征评分均有所改善。
{"title":"Nonpelvic comorbid symptoms of 45 patients with pain of pelvic venous origin, before and after treatment.","authors":"Steven J Smith, B Holly Smith, Michael J Sichlau, Brenda Chen, Dacre Knight, Peter C Rowe","doi":"10.1177/02683555241273109","DOIUrl":"https://doi.org/10.1177/02683555241273109","url":null,"abstract":"<p><strong>Objective: </strong>To report the prevalence and severity of nonpelvic symptoms for patients with venous-origin chronic pelvic pain (VO-CPP) and to describe outcomes after pelvic vein stenting and embolization.</p><p><strong>Methods: </strong>We retrospectively reviewed outcomes of 45 women with VO-CPP who underwent treatment with iliac vein stenting and/or embolization. Patients completed symptom-severity questionnaires before and after treatment that assessed for pelvic pain, and multiple other symptoms, including brain fog, anxiety, depression, musculoskeletal pain, fatigue, migraines and more.</p><p><strong>Results: </strong>Patient age ranged from 18 to 65 years. The prevalence of common symptoms was as follows: migraines, 69%; brain fog, 76%; anxiety attacks, 58%; excess sweating, 64%; hip pain, 73%; diarrhea, 62%; constipation, 76%; and abdominal bloating, 82%. After treatment, most symptom scores improved by more than 50%; exceptions were excessive sweating (41% improvement) and bloating (47% improvement). Prevalence of individual symptoms that bundle into POTS ranged from 29% to 76%, where symptom improvement ranged from 23% to 59% after treatment. Overlapping individual symptoms characteristic of fibromyalgia and myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) were present in 64% to 82% of patients and all improved by 49% to 63% after treatment.</p><p><strong>Conclusions: </strong>Pelvic venous flow abnormality is linked causally to a spectrum of interrelated symptoms, of which many can be bundled into named syndromes of unknown cause. With catheter- based treatment of pelvic venous pooling, nonpelvic symptom and syndrome scores improved.</p>","PeriodicalId":94350,"journal":{"name":"Phlebology","volume":" ","pages":"2683555241273109"},"PeriodicalIF":0.0,"publicationDate":"2024-08-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141915010","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}
引用次数: 0
Physical activity levels in patients with chronic venous insufficiency. 慢性静脉功能不全患者的体育锻炼水平。
Pub Date : 2024-08-09 DOI: 10.1177/02683555241273153
Wagner Jorge Ribeiro Domingues, Antonio Henrique Germano-Soares, Gabriel Grizzo Cucato, Lenon Corrêa de Souza, Emely Kércia Santiago de Souza Brandão, Emmina Lima da Cruz de Souza, Thiago Renan da Silva E Silva, Guilherme Peixoto Tinoco Arêas, Cleinaldo Costa, Priscilla Ribeiro Dos Santos Campelo, Neivaldo José Nazaré Dos Santos, Gustavo Oliveira da Silva, Caroline Ferraz Simões

Background: Increasing the levels of physical activity (PA) is widely recommended for people with chronic venous insufficiency (CVI). However, studies investigating the patterns of PA and adherence to PA guidelines using objective measures are lacking.

Objective: The primary aim was to examine the patterns of PA and adherence to PA guidelines among patients with CVI. A secondary aim was to identify whether adherence to PA recommendations differed according to patients' sociodemographic and clinical characteristics.

Methods: This cross-sectional study included 96 patients with CVI with Clinical-Etiology-Anatomy-Pathology (CEAP) C3 to C6 (69.1% women 59 ± 11 years; 51.5% C5-C6 on CEAP classification). Objective time spent in PA was measured by a triaxial accelerometer. To examine adherence to PA guidelines, patients were grouped as meeting (or) the recommendations if they had at least 150 min/week of moderate to vigorous PA. Sociodemographic and clinic characteristics were obtained by self-report. Binary logistic regression was employed to examine whether sociodemographic and clinical characteristics were associated with adherence to PA guidelines. T-tests were employed to compare PA levels at different intensities according to patients' age.

Results: Patients spent an average of 311.4 ± 91.5 min/week, 42.1 ± 28.0 min/week, and 19.8 ± 17.8 min/week in low-light PA, high-light PA, and moderate-to-vigorous PA, respectively. The proportion of patients meeting PA recommendations was 36.2%, and older patients had lower odds (OR = 0.94; 95%CI: 0.89 to 0.99). Additional analysis reinforced that by showing lower time in high-light PA (51.2 ± 30.0 min/day vs. 31.9 ± 21.8 min/day; p = .001) and moderate-to-vigorous PA (24.3 ± 15.8 min/day vs. 14.8 ± 18.8 min/day; p = .012) among older patients than their peers younger.

Conclusion: Our findings showed that 36,2% of CVI patients met PA recommendations, with lower odds found among older patients. Public health interventions to enhance PA engagement among CVI patients should prioritize those who are older.

背景:人们普遍建议慢性静脉功能不全(CVI)患者增加体育锻炼(PA)。然而,目前尚缺乏使用客观测量方法对患者的体力活动模式和遵守体力活动指南的情况进行调查的研究:主要目的是研究 CVI 患者的 PA 模式和对 PA 指南的遵守情况。次要目的是确定根据患者的社会人口学和临床特征,对 PA 建议的遵守情况是否有所不同:这项横断面研究纳入了 96 名临床-病因-解剖-病理(CEAP)为 C3 至 C6 的 CVI 患者(69.1% 为女性,59 ± 11 岁;51.5% 为 CEAP 分类中的 C5-C6)。客观锻炼时间由三轴加速度计测量。为了检查患者是否遵守了体育锻炼指南,如果患者每周至少有 150 分钟的中度至剧烈体育锻炼,则将其归类为符合(或)建议。社会人口学和临床特征通过自我报告获得。采用二元逻辑回归法检验社会人口学和临床特征是否与坚持锻炼指南相关。根据患者的年龄,采用 T 检验比较不同强度的 PA 水平:结果:患者在低强度 PA、高强度 PA 和中强度 PA 方面的平均花费分别为 311.4 ± 91.5 分钟/周、42.1 ± 28.0 分钟/周和 19.8 ± 17.8 分钟/周。符合 PA 建议的患者比例为 36.2%,老年患者的几率较低(OR = 0.94;95%CI:0.89 至 0.99)。其他分析表明,老年患者的高光 PA(51.2 ± 30.0 分钟/天 vs. 31.9 ± 21.8 分钟/天;p = .001)和中强度 PA(24.3 ± 15.8 分钟/天 vs. 14.8 ± 18.8 分钟/天;p = .012)时间低于年轻患者:我们的研究结果表明,36.2% 的 CVI 患者符合 PA 建议,而老年患者符合 PA 建议的几率较低。为提高 CVI 患者的 PA 参与度而采取的公共卫生干预措施应优先考虑年龄较大的患者。
{"title":"Physical activity levels in patients with chronic venous insufficiency.","authors":"Wagner Jorge Ribeiro Domingues, Antonio Henrique Germano-Soares, Gabriel Grizzo Cucato, Lenon Corrêa de Souza, Emely Kércia Santiago de Souza Brandão, Emmina Lima da Cruz de Souza, Thiago Renan da Silva E Silva, Guilherme Peixoto Tinoco Arêas, Cleinaldo Costa, Priscilla Ribeiro Dos Santos Campelo, Neivaldo José Nazaré Dos Santos, Gustavo Oliveira da Silva, Caroline Ferraz Simões","doi":"10.1177/02683555241273153","DOIUrl":"https://doi.org/10.1177/02683555241273153","url":null,"abstract":"<p><strong>Background: </strong>Increasing the levels of physical activity (PA) is widely recommended for people with chronic venous insufficiency (CVI). However, studies investigating the patterns of PA and adherence to PA guidelines using objective measures are lacking.</p><p><strong>Objective: </strong>The primary aim was to examine the patterns of PA and adherence to PA guidelines among patients with CVI. A secondary aim was to identify whether adherence to PA recommendations differed according to patients' sociodemographic and clinical characteristics.</p><p><strong>Methods: </strong>This cross-sectional study included 96 patients with CVI with Clinical-Etiology-Anatomy-Pathology (CEAP) C3 to C6 (69.1% women 59 ± 11 years; 51.5% C5-C6 on CEAP classification). Objective time spent in PA was measured by a triaxial accelerometer. To examine adherence to PA guidelines, patients were grouped as meeting (or) the recommendations if they had at least 150 min/week of moderate to vigorous PA. Sociodemographic and clinic characteristics were obtained by self-report. Binary logistic regression was employed to examine whether sociodemographic and clinical characteristics were associated with adherence to PA guidelines. T-tests were employed to compare PA levels at different intensities according to patients' age.</p><p><strong>Results: </strong>Patients spent an average of 311.4 ± 91.5 min/week, 42.1 ± 28.0 min/week, and 19.8 ± 17.8 min/week in low-light PA, high-light PA, and moderate-to-vigorous PA, respectively. The proportion of patients meeting PA recommendations was 36.2%, and older patients had lower odds (OR = 0.94; 95%CI: 0.89 to 0.99). Additional analysis reinforced that by showing lower time in high-light PA (51.2 ± 30.0 min/day vs. 31.9 ± 21.8 min/day; <i>p</i> = .001) and moderate-to-vigorous PA (24.3 ± 15.8 min/day vs. 14.8 ± 18.8 min/day; <i>p</i> = .012) among older patients than their peers younger.</p><p><strong>Conclusion: </strong>Our findings showed that 36,2% of CVI patients met PA recommendations, with lower odds found among older patients. Public health interventions to enhance PA engagement among CVI patients should prioritize those who are older.</p>","PeriodicalId":94350,"journal":{"name":"Phlebology","volume":" ","pages":"2683555241273153"},"PeriodicalIF":0.0,"publicationDate":"2024-08-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141915011","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}
引用次数: 0
Mid-term results of cyanoacrylate closure for the treatment of incompetent great and small saphenous veins: Findings from a Japanese prospective consecutive multi-center registry: Mid-term results of cyanoacrylate closure. 氰基丙烯酸酯闭合术治疗大隐静脉和小隐静脉闭合不全的中期效果:日本前瞻性连续多中心登记的结果:氰基丙烯酸酯闭合术的中期效果。
Pub Date : 2024-08-08 DOI: 10.1177/02683555241273013
Takahiro Imai, Makoto Mo, Masayuki Hirokawa, Nobuhisa Kurihara, Shintaro Shokoku, Satoru Sugiyama, Nozomu Shirasugi, Hitoshi Kusagawa, Yuji Hoshino, Takashi Yamamoto, Eiichi Hyodo, Keichi Furubayashi, Tomohiro Ogawa

Objectives: We evaluated the efficacy and safety of cyanoacrylate closure (CAC) for endovascular treatment of varicose veins with cyanoacrylate adhesive (VenaSeal® closure system) in Japan.

Methods: A multicenter prospective consecutive registry study was conducted at 12 centers in Japan on 125 patients with primary varicose veins who underwent CAC. The patients were evaluated on target vein occlusion, postoperative complications, Visual Analogue Scale (VAS) for pain, revised Venous Clinical Severity Score (rVCSS), Aberdeen Varicose Vein Questionnaire (AVVQ), and EuroQol 5 dimensions 5-level (EQ-5D-5L) for 1-year after the surgery.

Results: The closure rate was 92.6% at 1 year postoperatively, and 95.0% and 90.2% for GSV and SSV respectively with little difference (p = .491). The mean VAS in the immediate postoperative period was 18.9 ± 23.4. Postoperative complications were observed in 20 patients (16%). Hypersensitivity-type phlebitis occurred in 7 patients (5.6%). Infection of the treated vein resulted in resection of GSV. The rVCSS and AVVQ improved significantly after 90 days and 1 year postoperatively (p < .001), while the EQ-5D-5L have not changed.

Conclusion: Cyanoacrylate Closure was considered generally a safe and minimally invasive treatment with good mid-term outcomes including SSV. However further study is required for some CAC specific complications.

目的:我们对日本使用氰基丙烯酸酯粘合剂(VenaSeal®闭合系统)进行血管内治疗静脉曲张的氰基丙烯酸酯闭合术(CAC)的有效性和安全性进行了评估:在日本的 12 个中心对 125 名接受 CAC 的原发性静脉曲张患者进行了多中心前瞻性连续登记研究。术后 1 年,对患者的靶静脉闭塞情况、术后并发症、疼痛视觉模拟量表(VAS)、修订静脉临床严重程度评分(rVCSS)、阿伯丁静脉曲张问卷(AVVQ)和欧洲质量标准 5 维 5 级(EQ-5D-5L)进行了评估:术后1年的闭合率为92.6%,GSV和SSV的闭合率分别为95.0%和90.2%,差异不大(p = .491)。术后即刻的平均 VAS 为 18.9 ± 23.4。有 20 名患者(16%)出现术后并发症。7名患者(5.6%)出现了过敏性静脉炎。治疗静脉的感染导致了 GSV 的切除。术后 90 天和 1 年后,rVCSS 和 AVVQ 显著改善(p < .001),而 EQ-5D-5L 没有变化:总的来说,氰基丙烯酸酯闭合术是一种安全的微创治疗方法,具有良好的中期疗效,包括 SSV。不过,还需要对一些 CAC 特定并发症进行进一步研究。
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Phlebology
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