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Strategies and challenges in treatment of varicose veins and venous insufficiency

World Journal of Clinical Cases 2022年第18期10卷 5946-5956页

作者： Rong-Ding Gao Song-Yi Qian Hai-Hong Wang Yong-Sheng Liu Shi-Yan Ren Department of Laser and Vascular Surgery Aviation General HospitalChina Medical UniversityBeijing 100012China Department of Cardiac Surgery Zhongshan Hospital(Xiamen Brach)Fudan UniversityXiamen 361015Fujian ProvinceChina Department of Peripheral Vascular Disease The Affiliated Hospital of Shanxi University of Chinese MedicineTaiyuan 030024Shanxi ProvinceChina Department of Dermatology Aviation General HospitalChina Medical UniversityBeijing 100012China

Patients with varicose veins can be treated with conservative or surgical approaches based on the clinical conditions and patient *** the recent decade,the recommendations for managing symptomatic varicose veins have changed dramatically due to the rise of minimally invasive endovascular *** literature was systematically searched on Medline without language *** papers on the treatment of varicose veins and venous insufficiency with different procedures were included and *** laser ablation(EVLA)and radiofrequency ablation(RFA)both are same safe and effective in terms of occlusion rate,and time to return to normal *** comparison with RFA or EVLT,Cure conservatrice et Hemodynamique de l’Insufficience Veineuse en Ambulatoire(CHIVA)may cause more bruising and make little or no difference to rates of limb infection,superficial vein thrombosis,nerve injury,or *** terms of recurrence of varicose veins,there is little or no difference between CHIVA and stripping,RFA,or *** saphenous vein recanalization is highest in the ultrasound-guided foam sclerotherapy(FS)group(51%)during 1 year of *** 2013 National Institute for Health and Care Excellence clinical guidelines recommend surgery as a third-line therapeutic option after EVLA or RFA and *** the mechanochemical endovenous ablation(MOCA)is a non-thermal,non-tumescent option and appears to be of similar efficacy to stab avulsion with no potential risk of nerve damage,the overall success rate of MOCA is lower than those of other procedures such as EVLA,RFA,or high ligation and *** is the most cost-effective therapeutic option,with RFA being a close second for the treatment of patients with varicose *** thermal ablation(EVLA or RFA)is recommended as a first-line treatment for varicose veins and has substituted the high ligation of saphenofemoral junctional reflux and stripping of varicose ***

关键词： Varicose veins venous insufficiency High ligation and stripping Endovenous laser ablation Radiofrequency ablation Cure conservatrice et Hemodynamique de l’Insufficience Veineuse en Ambulatoire

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Immune function of erythrocytes in patients with chronic venous insufficiency of the lower extremities

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Chinese Medical Journal 2007年第24期120卷 2224-2228页

作者： ZHANG Lan ZHANG Bai-gen ZHANG Ji-wei ZHANG Hao Department of Vascular Surgery Renji Hospital School of Medicine Shanghai Jiaotong University Shanghai 200127 China

Background The influence of inflammatory processes has been one of the hot topics in discussions of the etiology of chronic venous insufficiency （CVI）. Erythrocytes are very important in controlling inflammatory immunity and innate immune reactions. The purpose of this study was to analyze the correlation between the development of CVI and the change of CD35, Fy6 on erythrocytes, and interleukin-8 （IL-8） levels. Methods A group of 43 patients with CVI were studied in parallel with 8 healthy individuals serving as control subjects. Control subjects were those with normal findings on lower extremity duplex examinations. We used an erythrocyte flow cytometer to examine the expression of both CD35 and Fy6 on red blood cells, and an enzyme-linked immunosorbent assay analysis method to measure plasma IL-8 levels. We also analyzed the change of IL-8 levels under the influence of erythrocytes using a modified method of the hemaimmune reaction. Results Compared with normal control subjects, CD35 expression increased significantly among patients with CVI classified as C4 without lipodermatosclerosis, but tended to decrease and reach the lowest level among patients classified as C5-C6. Fy6 expression increased significantly among patients in the early stages of CVI, but tended to decrease remarkably among patients classified as C5-C6. The inflammatory response intensified at the C5-C6 classification, where high levels of IL-8 coexisted with a low expression of Fy6. The increase in IL-8 in the CVI group was higher than in the control group in association with the complete blood cells, regardless of the presence of erythrocytes, when inactive tumour cells were added, whereas the level of IL-8 in the CVI group was significantly lower than in the control group. Conclusions Abnormalities of erythrocyte innate immunity represents a fundamental derangement in CVI. These inadequate inflammatory responses may lead to local tissue and microvascular damage of the lower extremity.

关键词： venous insufficiency erythrocytes natural immunity

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Comparison of 1470 nm Radial Fiber Laser Ablation and Radiofrequency Ablation in Endovascular Treatment of venous insufficiency

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World Journal of Cardiovascular Surgery 2016年第9期6卷 117-124页

作者： Havva Nur Alparslan Yümün Özcan Gür Selami Gürkan Department of General Surgery Corlu Devlet Hastanesi Tekirdag Turkey Department of Cardiovascular Surgery Namik Kemal University Tekirdag Turkey

Background: In this study, we aimed to compare the results of endovenous laser ablation (EVLA) and radiofrequency ablation (RFA) in patients with lower extremity venous insufficiency due to great saphenous vein (GSV) reflux on efficiency, patient comfort and postoperative morbidity. Methods: Endovascular approach in treatment of GSV insufficiency was performed in 283 patients between 2011 and 2014 at our clinic. In group 1, EVLA was performed on 149 patients (42 male, 107 female;mean age 46.90 ± 11.43) and in group 2, RFA was performed on 134 patients (41 male, 93 female;mean age 47.02 ± 12.58). The results were compared in terms of local pain, ecchymosis, paresthesia, venous clinic severity score (VCSS), length of GSV that process performed, efficiency and Clinical Etiology Anatomy Pathophysiology (CEAP) classification data. Results: GSV diameter at saphenofemoral junction level was 10.65 ± 3.72 mm and 11.29 ± 3.78 mm in group 1 and 2, respectively. Length of GSV that process performed was 38.97 ± 6.88 cm in group 1 and 41.83 ± 4.82 cm in group 2. Postoperatively burn, pulmonary embolism (PE) and deep venous thrombosis (DVT) were not observed in both groups. Postoperative complications in group 1 were hematoma formation in 2 (1.3%) patients, ecchymosis in 13 (8.7%) patients, edema in 21 (14.1%) patients and paresthesia in 10 (6.7%) patients. Postoperative complications in group 2 were hematoma formation in 1 (0.7%) patient, ecchymosis in 8 (6%) patients, edema in 12 (9%) patients and paresthesia in 6 (4.5%) patients. The efficiency of the process was 96.6% in EVLA group and 98.5% in RFA group. Conclusion: We conclude that both RFA and 1470 nm radial fiber EVLA procedures are effective and reliable techniques in treatment of GSV insufficiency. No significant difference was found between two techniques in terms of efficiency and postoperative morbidity.

关键词： Endovascular Radiofrequency Laser venous insufficiency

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Case Report of a Chronic Wound Due to venous insufficiency Following a Traumatic Arteriovenous Fistula

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Open Journal of Clinical Diagnostics 2021年第2期11卷 47-51页

作者： Jialiang Chen Louis Chebli Department of Vascular Surgery CHU Brugmann Brussels Belgium

Chronic lower limb wounds are common. They can be of arterial or venous origin. In this article, we will present a clinical case of a 30-year-old patient with a chronic injury to the right medial malleolus. In his history, we can note a gunshot wound to the right leg. Ultrasonography and CT angiography helped in the diagnosis of traumatic arteriovenous fistula. The patient underwent a fistula embolization which allowed the wound to heal. The clinical presentation, additional examinations and the latest treatment recommendations will be discussed in this article.

关键词： Arteriovenous Fistula Chronic Wound Trauma venous insufficiency

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Intense venous reflux,quantified by a new software to analyze presurgical ultrasound,is associated with unfavorable outcomes of microsurgical varicocelectomy

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Asian Journal of Andrology 2023年第1期25卷 119-125页

作者： Kai You Bang-Bin Chen Peng Wang Ren-Ge Bu Xue-Wen Xu Department of Pediatrics Shengjing Hospital of China Medical UniversityShenyang 110004China Department of Urology Shengjing Hospital of China Medical UniversityShenyang 110004China Department of Ultrasound Shengjing Hospital of China Medical UniversityShenyang 110004China

The hemodynamic characteristics of venous reflux are associated with infertility in patients with varicocele;however,an effective method for quantifying the structural distribution of the reflux is *** study aimed to predict surgical outcomes using a new software for venous reflux *** was a retrospective cohort study of a consecutive series of 105 patients(age range:22–44 years)between July 2017 and September *** reflux of the varicocele was obtained using the Valsalva maneuver during scrotal Doppler ultrasonography before microsurgical *** this software,the colored reflux signals were segmented,and the gray scale of the color pixels representing the reflux velocity was comprehensively quantified into the mean reflux velocity of the green layer(MRVG)and the reflux velocity standard deviation of the green layer(RVSDG).Spontaneous pregnancy and changes from baseline in the semen parameters were assessed during a 12-month follow-up *** were analyzed using logistic regression *** association of the high MRVG group with impaired progressive motility(odds ratio[OR]=2.868,95%confidence interval[CI]:1.133–7.265)and impaired sperm concentration(OR=2.943,95%CI:1.196–7.239)was found during multivariate *** MRVG(OR=2.680,95%CI:1.086–6.614)and high RVSDG(OR=2.508,95%CI:1.030–6.111)were found to be independent predictors of failure to achieve pregnancy following microsurgical *** summary,intense venous reflux is an independent predictor of impaired progressive motility,sperm concentration,and pregnancy outcomes after microsurgical varicocelectomy.

关键词： male infertility ultrasonography varicocele venous insufficiency

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Treatment of leg veins 2nd ed

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丛书名： Procedures in cosmetic dermatology

2011年

作者： edited by Murad Alam Sirunya Silapunt DVD editors Michael R. Migden Tri H. Nguyen.

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