142 results on '"Venous Insufficiency prevention & control"'
Search Results
2. Consistent application of compression: An under-considered variable in the prevention of venous leg ulcers.
- Author
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Shawa HJ, Dahle SE, and Isseroff RR
- Subjects
- Humans, Compression Bandages, Wound Healing, Varicose Ulcer prevention & control, Leg Ulcer, Venous Insufficiency prevention & control
- Abstract
Venous leg ulcers, the most common leg ulcer, occur in patients with chronic venous insufficiency due to venous hypertension. Evidence supports the conservative treatment with lower extremity compression, ideally between 30-40 mm Hg. Pressures in this range provide enough force to partially collapse lower extremity veins without restricting arterial flow in patients without peripheral arterial disease. There are many options for applying such compression, and those who apply these devices have varying levels of training and backgrounds. In this quality improvement project, a single observer utilised a reusable pressure monitor to compare pressures applied using different devices by individuals in wound clinics with diverse training from specialties of dermatology, podiatry, and general surgery. Average compression was higher in the dermatology wound clinic (n = 153) compared to the general surgery clinic (n = 53) (35.7 ± 13.3 and 27.2 ± 8.0 mm Hg, respectively, p < 0.0001), and wraps applied by clinic staff (n = 194) were nearly twice as likely as a self-applied wrap (n = 71) to have pressures greater than 40 mm Hg (relative risk: 2.2, 95% confidence interval: 1.136-4.423, p = 0.02). Pressures were also dependent upon the specific compression device used, with CircAid®s (35.5 mm Hg, SD: 12.0 mm Hg, n = 159) providing higher average pressures than Sigvaris Compreflex (29.5 mm Hg, SD: 7.7 mm Hg, n = 53, p = 0.009) and Sigvaris Coolflex (25.2 mm Hg, SD: 8.0 mm Hg, n = 32, p < 0.0001). These results indicate that the device-provided pressure may be dependent on both the compression device and the background and training of the applicator. We propose that standardisation in the training of compression application and increased use of a point-of-care pressure monitor may improve the consistency of applied compression, thus improving adherence to treatment and outcomes in patients with chronic venous insufficiency., (© 2023 The Wound Healing Society.)
- Published
- 2023
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3. The perplexity of catheter-directed thrombolysis for deep venous thrombosis: the approaches play an important role.
- Author
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Qian C, Chen GP, Lou WS, Wang T, and Li YH
- Subjects
- Duration of Therapy, Female, Humans, Male, Mechanical Thrombolysis instrumentation, Mechanical Thrombolysis methods, Middle Aged, Outcome and Process Assessment, Health Care, Vascular Patency, Catheterization, Peripheral adverse effects, Catheterization, Peripheral instrumentation, Catheterization, Peripheral methods, Femoral Vein pathology, Femoral Vein physiopathology, Iliac Vein pathology, Iliac Vein physiopathology, Thrombolytic Therapy adverse effects, Thrombolytic Therapy instrumentation, Thrombolytic Therapy methods, Venous Insufficiency diagnosis, Venous Insufficiency etiology, Venous Insufficiency prevention & control, Venous Thrombosis diagnosis, Venous Thrombosis physiopathology, Venous Thrombosis therapy
- Abstract
The recent adjunctive catheter-directed thrombolysis (ATTRACT) trial rose a controversy about the treatment effect of catheter-directed thrombolysis (CDT) in deep venous thrombosis (DVT). In fact, most studies including the ATTRACT trial did not perform subgroup analysis of catheterization approaches. Different approaches would confound the conclusions. Therefore, a single-center retrospective analysis was performed to compare the differences between the antegrade (AGA) and retrograde (RGA) approaches. Total 217 DVT patients treated with CDT were enrolled from January 2010 to December 2017, with mean age of 55.3 years (67 received antegrade approach, 150 received retrograde approach). The clot burden reduction by segment was evaluated. The mean access establishment time and thrombolytic time were compared. The patency of the iliofemoral vein at 6 months was evaluated. The rate of PTS, quality of life and venous insufficiency were assessed at 1 year. AGA group showed better thrombolytic effect in popliteal and femoral vein than RGA group. The rate of iliofemoral clot burden reduction in RGA group was mostly at Grade II, while most were at Grade III in AGA group. The retrograde approach showed better thrombolysis effect in iliofemoral DVT than popliteal to iliac DVT. The RGA group reported longer mean access establishment time (5.4 ± 1.8 vs 27.0 ± 7.5 min, p < 0.001) and thrombolytic time (6.9 ± 1.5 days vs 6.8 ± 1.5 days, p = 0.586). At 6 months, RGA group had a lower rate of femoral vein patency (52.0% vs 89.6%, p < 0.001) and a higher rate of venous insufficiency (52.0% vs 29.9%, p < 0.001), compared with AGA group. Although there was no difference in the rate of PTS, the RGA group showed higher Villalta scores in the free and mild PTS. The antegrade approach was preferably recommended over the retrograde approach for CDT treatment.
- Published
- 2021
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4. Rectification of cavernosal fibrosis and veno-occlusive dysfunction by administration of suberoylanilide hydroxamic acid in a rat model of cavernosal nerve injury: Comparison with a PDE5 inhibitor.
- Author
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Cho MC, Lee J, Son H, and Kim SW
- Subjects
- Animals, Disease Models, Animal, Fibrosis etiology, Fibrosis prevention & control, Histone Deacetylases metabolism, Impotence, Vasculogenic prevention & control, Male, Nerve Crush, Penis injuries, Peripheral Nerve Injuries complications, Phosphodiesterase 5 Inhibitors therapeutic use, Rats, Venous Insufficiency etiology, Venous Insufficiency prevention & control, Penis innervation, Peripheral Nerve Injuries drug therapy, Vorinostat therapeutic use
- Abstract
Background: Cavernosal fibrosis, which is induced by cavernosal nerve (CN) injury and progresses with time, is the main cause of cavernosal veno-occlusive dysfunction (CVOD) after radical prostatectomy., Objectives: To determine whether daily oral administration of suberoylanilide hydroxamic acid (SAHA; vorinostat) for 5-weeks from the immediate post-injury period after CN injury would rectify CVOD by suppressing cavernosal fibrosis and normalizing HDAC pathway in a rat model of CN crush injury (CNCI) and to compare the results with those obtained using chronic administration of PDE5-inhibitors (a positive control)., Methods: Fifty-six 12-week-old rats were randomized into the four groups: sham surgery (S), CNCI (I), and CNCI treated with daily administration of 25.0 mg/kg SAHA (V) or 20.0 mg/kg udenafil (P). Group-V and Group-P received the respective treatment for 5-weeks from the following day after CNCI. At 5 weeks after surgery, dynamic infusion cavernosometry (DIC), histological staining, and Western blot analysis were performed., Results: Group-I had a significantly decreased papaverine response, higher maintenance rate or drop rate, lower smooth muscle (SM)/collagen ratio, decreased SM content, and increased protein expression of HDAC2, HDAC3, TGF-β1, and collagen-1, compared with Group-S. The three DIC parameters in Group-V and Group-P significantly improved compared to those in Group-I. Except for the maintenance rate, the improvement in papaverine response and drop rate in Group-V was not significantly different from that in Group-P. Group-V and Group-P showed the rectification of SM/collagen ratio and protein expression of TGF-β1 or collagen-1. SM content was improved in Group-P, but not in Group-V. Group-V showed the normalization of protein expression of both HDAC2 and HDAC3, whereas protein expression of only HDAC2 was partially restored in Group-P., Discussion: Treatment strategies targeting the HDAC pathway might be helpful to alleviate CVOD induced by CN injury., Conclusions: According to our data, chronic administration of SAHA improves post-injury CVOD by suppressing cavernosal fibrosis via rectifying the HDAC/TGF-β1 pathway in nerve-injured rats, comparable to that with PDE5 inhibitors., (© 2020 American Society of Andrology and European Academy of Andrology.)
- Published
- 2021
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5. Compression stocking prevents increased venous retrograde flow time in the lower limbs of pregnant women.
- Author
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Junior OAS, Rollo HA, Saliba O, and Sobreira ML
- Subjects
- Female, Humans, Leg, Pregnancy, Pregnant Women, Saphenous Vein, Stockings, Compression, Varicose Veins therapy, Venous Insufficiency prevention & control
- Abstract
Objectives: To analyze the effect of graduated compression stockings on the venous reflux in the lower limbs of pregnant women., Method: A controlled randomized clinical trial was performed with sixty women: intervention group (n = 30), who used compression stockings, and control group (n = 30). Using duplex-ultrasound, the reflux time and peak reflux velocity in the great saphenous vein and small saphenous vein were analyzed., Results: Great saphenous vein reflux times in the intervention group were 0.13 s at the beginning (initial) and 0.04 s at the end of pregnancy (final) in the right leg and 0.02 s and 0.34 s (p < 0.0001) in the control group. No patient in the intervention group experienced pathological reflux at the end of the pregnancy. There was a significant difference in the reflux time measured from both the great saphenous vein and small saphenous vein and peak reflux velocity between the groups., Conclusion: Compression stockings prevent increased venous reflux in lower limbs of pregnant women.
- Published
- 2020
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6. Examination of the effects of a new compression garment on skin tissue oxygenation in healthy volunteers.
- Author
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Chohan A, Haworth L, Sumner S, Olivier M, Birdsall D, and Whitaker J
- Subjects
- Adolescent, Adult, Female, Germany, Healthy Volunteers, Humans, Male, Middle Aged, Young Adult, Casts, Surgical, Clothing, Compression Bandages, Leg Ulcer therapy, Oxygen physiology, Skin Absorption physiology, Venous Insufficiency prevention & control
- Abstract
Objective: Compression devices have been shown to reduce venous stasis, increase blood flow and skin tissue oxygenation (StO
2 ), promoting healthy tissue. This study aimed to explore the efficacy of a new compression garment in three different positions in healthy adults., Methods: In this quantitative study, potential participants were screened and recruited using the Physical Activity Readiness Questionnaire (PAR-Q, Canada). Participants attended three separate, one-hour sessions to evaluate StO2 in supine-lying, chair-sitting and long-sitting positions. StO2 was recorded for 20 minutes pre-, during and post- a 20-minute intervention using a compression garment, TributeWrap (Lohmann-Rauscher, Germany). A repeated-measures analysis of variance (ANOVA) was followed by post-hoc pairwise comparisons., Results: A total of 28 healthy volunteers took part (aged 24.6 ±8.4years; 13 males, 15 females). A significant difference was seen between the three positions (p<0.001). Chair-sitting had the lowest StO2 pre-intervention, increasing StO2 significantly (32.25%, p<0.001) during wear of the compression garment (24.8% higher than baseline post-intervention). No significant difference was seen between long sitting and supine-lying (p=1.000). In contrast, long-sitting and supine-lying StO2 was higher pre-intervention compared with chair-sitting and only increased post-intervention (11% and 16.8% respectively, p<0.001) compared with baseline., Conclusion: The compression garment significantly increased StO2 levels in both seating positions. Further studies are required to determine if increasing StO2 through short intervention sessions with this device has the potential to improve self-management of tissue health in individuals with reduced mobility, oedema or venous insufficiency.- Published
- 2019
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7. Impact of Venous Outflow Pattern on Flap Compromise in Head and Neck Reconstruction: Review of 309 Radial Forearm Free Flaps.
- Author
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Kim YC, Kim MJ, Kim HB, Kim SC, and Choi JW
- Subjects
- Adolescent, Adult, Aged, Aged, 80 and over, Female, Forearm surgery, Humans, Male, Middle Aged, Plastic Surgery Procedures, Regional Blood Flow, Venous Insufficiency etiology, Venous Insufficiency prevention & control, Young Adult, Anastomosis, Surgical methods, Free Tissue Flaps blood supply, Head and Neck Neoplasms surgery
- Abstract
There is ongoing controversy regarding the most appropriate venous drainage pattern for anastomosing the radial forearm free flap in head and neck reconstruction. Although the various perforator flaps have been used in our practice, the authors evaluated the impact of venous outflow pattern on the incidence of only the radial forearm free flap compromise for minimizing the bias. The authors retrospectively reviewed 309 radial forearm free flaps used for head and neck reconstruction following cancer ablation (January 2005 to December 2015), and evaluated the association between the incidence of venous insufficiency and the choice of venous system in the flap and at the recipient site, the number of venous anastomoses, and the combination of flap and recipient venous systems. No significant association was found between the incidence of venous insufficiency and the risk factors evaluated. Compared with single or dual anastomosis involving only the vena comitantes, dual anastomosis involving distinct venous systems was associated with lower incidence of venous insufficiency (P = 0.039). The dual anastomosis of separate venous system was correlated with lower incidence of venous insufficiency compared with the single or dual anastomosis of vena comitantes only (P = 0.039).
- Published
- 2019
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8. Effects of preventive use of compression stockings for elderly with chronic venous insufficiency and swollen legs: a systematic review and meta-analysis.
- Author
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Dahm KT, Myrhaug HT, Strømme H, Fure B, and Brurberg KG
- Subjects
- Aged, Edema physiopathology, Edema prevention & control, Humans, Patient Compliance, Treatment Outcome, Venous Insufficiency physiopathology, Venous Insufficiency prevention & control, Edema therapy, Lower Extremity physiopathology, Stockings, Compression, Venous Insufficiency therapy
- Abstract
Background: Many home-dwelling elderly use medical compression stockings to prevent venous insufficiency, deep venous thrombosis, painful legs and leg ulcers. Assisting users with applying and removing compression stockings demands resources from the home based health services, but the effects are uncertain. This systematic review aims to summarize the effects of preventive use of medical compression stockings for patients with chronic venous insufficiency and swollen legs., Methods: We conducted a search in six databases (Epistemonikos, Cochrane Database of Systematic Reviews, MEDLINE, Embase, CENTRAL and CINAHL) in March 2018. Randomized controlled trials evaluating the preventive effects of European standard compression stockings class 3 or 2 for elderly with chronic venous insufficiency and swollen legs were included. Primary outcomes were thrombosis, leg ulcers and mobility. Secondary outcomes were other health related outcomes, e.g. pain, compliance. We assessed risk of bias in the included studies and used the Grading of Recommendations Assessment, Development and Evaluation (GRADE) tool for evaluating the overall quality of evidence., Results: Five randomized controlled trials met the inclusion criteria. Comparing compression stockings class 2 to class 1, meta-analysis showed a reduction in leg ulcer recurrence at 12 months (RR 0.52; 95% CI 0.30 to 0.88). The quality of evidence was assessed as moderate by GRADE. One study (100 participants) did not detect a difference between compression stockings class 3 versus class 2 on ulcer recurrence after six months (RR 0.64; 95% CI 0.20 to 2.03). In another study, patients wearing class 3 compression stockings had lower recurrence risk compared with patients without stockings (RR 0.46; 95% CI 0.27 to 0.76) at six months and (RR 0.43; 95% CI 0.27 to 0.69) at 12 months. We found no difference between class 2 and class 1 stockings on subjective symptoms of chronic venous insufficiency or outcomes of vein thrombosis or mobility., Conclusion: Compression stockings class 2 probably reduce the risk of leg ulcer recurrence compared to compression stockings class 1. It is uncertain whether the use of stockings with higher compression grades is associated with a further risk reduction. More randomized controlled trials on vein thrombosis and mobility are needed.
- Published
- 2019
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9. The increasing of pedicled propeller perforator flap survival by an extra vein anastomosis.
- Author
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Yildiz K, Ozeren M, Kelahmetoglu O, and Guneren E
- Subjects
- Anastomosis, Surgical, Graft Survival, Humans, Male, Middle Aged, Soft Tissue Injuries complications, Leg Ulcer surgery, Perforator Flap blood supply, Perforator Flap surgery, Soft Tissue Injuries surgery, Veins surgery, Venous Insufficiency prevention & control
- Published
- 2017
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10. [Prophylaxis of Recurrent Venous Leg Ulcer].
- Author
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Kroeger K, Storck M, Kujath P, Rabe E, and Dissemond J
- Subjects
- Patient Compliance, Patient Education as Topic, Self Care, Stockings, Compression, Varicose Veins complications, Varicose Veins etiology, Varicose Veins physiopathology, Varicose Veins prevention & control, Venous Insufficiency complications, Venous Insufficiency etiology, Venous Insufficiency physiopathology, Venous Insufficiency prevention & control, Wound Healing physiology, Secondary Prevention, Varicose Ulcer prevention & control
- Abstract
Venous leg ulcer (VLU) counts among the most common chronic wounds in Europe. Treatment is lengthy, cumbersome and costly, and there is a high rate of recurrence. This review shows the measures that should be offered to every patient with healed VLU to permanently prevent recurrence. To prevent VLU in case of varicose veins, the progression of chronic venous insufficiency (CVI) has to be stopped. There is convincing evidence that the effective treatment of varicose veins reduces the recurrence rate in patients with VLU. In patients with post-thrombotic syndrome (PTS), further thrombosis should be prevented through targeted prophylaxis of new thromboembolic events. The benefit of endovascular revascularization on the VLU recurrence rate in patients with post-thrombotic damage in the pelvic veins has not been proven in clinical studies. On the other hand, it has been clearly demonstrated in several studies that compression therapy is the basic procedure for the prevention of recurrent VLU in patients with varicose veins or PTS, regardless of whether other measures have been implemented or not. Good adherence in patients with compression therapy is more important than choosing the highest possible compression class. Future efforts for patients with VLU must aim to provide therapists with tools and treatment strategies to guide their patients and to increase patients' acceptance and understanding of the importance of self-management, in particular regarding compression therapy for the prevention of recurrent VLU., Competing Interests: Interessenkonflikt: Nein, (Georg Thieme Verlag KG Stuttgart · New York.)
- Published
- 2017
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11. The efficiency of O-(beta-hydroxyethyl)-rutosides in reducing the incidence of superficial venous insufficiency in patients with calf muscle pump dysfunction.
- Author
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Yildiz CE, Conkbayir C, Huseynov E, Sayin OA, Tok O, Kaynak G, Cebi D, Ugurlucan M, Kantarci F, and Inan M
- Subjects
- Adult, Female, Follow-Up Studies, Humans, Hydroxyethylrutoside administration & dosage, Incidence, Male, Prospective Studies, Saphenous Vein diagnostic imaging, Saphenous Vein physiopathology, Fracture Fixation adverse effects, Hydroxyethylrutoside analogs & derivatives, Leg Injuries diagnostic imaging, Leg Injuries physiopathology, Leg Injuries surgery, Postoperative Complications diagnostic imaging, Postoperative Complications physiopathology, Postoperative Complications prevention & control, Ultrasonography, Doppler, Color, Venous Insufficiency diagnostic imaging, Venous Insufficiency etiology, Venous Insufficiency physiopathology, Venous Insufficiency prevention & control
- Abstract
Objective We aimed to evaluate the efficiency of O-(beta-Hydroxyethyl)-rutosides (Oxerutin) in reducing the incidence of venous system disease among patients with calf muscle pump dysfunction secondary to immobilization due to lower-limb fractures. Methods A total of 60 patients with lower-limb fractures and immobilized in plaster casts were included in this study randomized into control (n = 30; mean: 30.37 ± 6.03 years; 73.3% males; no treatment) and experiment (n = 30; mean: 31.67 ± 4.76 years; 66.6% males; Oxerutin, 500 mg po q12hr) treatment groups. Doppler ultrasound was performed to evaluate the effect of oxerutin on the alterations in the venous circulation. Results Patients in the control group were determined to be more commonly affected from the below-knee immobilization in terms of venous dysfunction in the great saphenous vein in the below-knee region when compared with the patients in the oxerutin treatment group (46.7 vs. 13.3%, respectively; p = 0.011). Incidence of reflux in the small saphenous vein was more common in the control group during the healing period when compared with the experiment group (40.0 vs. 10.0%, respectively; p = 0.017). None of the patients developed venous thrombosis. Conclusions In conclusion, the impairment of the lower extremity muscle pump should be considered as an important risk factor for venous disease, and should be evaluated. O-(beta-Hydroxyethyl)-rutosides during 6-8 week cast immobilization for a lower limb fracture may be an effective prophylactic regimen in reducing the incidence of reflux in the below-knee superficial veins.
- Published
- 2017
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12. Comparison of Single and Double Venous Anastomoses in Head and Neck Oncologic Reconstruction Using Free Flaps: A Meta-Analysis.
- Author
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Chaput B, Vergez S, Somda S, Mojallal A, Riot S, Vairel B, Meresse T, Garrido I, Grolleau JL, and de Bonnecaze G
- Subjects
- Anastomosis, Surgical, Humans, Microsurgery, Postoperative Complications prevention & control, Treatment Outcome, Venous Insufficiency prevention & control, Venous Thrombosis prevention & control, Free Tissue Flaps, Head and Neck Neoplasms surgery, Plastic Surgery Procedures, Vascular Surgical Procedures
- Abstract
Background: Venous insufficiency is the main cause of failure and surgical revision in free flap surgery. Achieving a double venous anastomosis is frequently proposed to improve flap drainage. However, this procedure remains controversial. The authors evaluated, through a meta-analysis, the benefit of double venous anastomoses in the venous thrombosis, surgical revision, and failure rates of free flaps in head and neck oncologic reconstruction., Methods: A systematic literature review was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses criteria in the MEDLINE, PubMed Central, Cochrane Library, and EMBASE databases. Statistical heterogeneity evaluation and then fixed effects and random effects models were used., Results: Sixteen articles were included involving 3684 flaps. The overall success rate was 96.15 percent. The authors reported a failure rate of 1.51 percent in the group with two anastomoses versus 5.03 percent in the group with single anastomoses (OR, 0.64; 95 percent CI, 0.277 to 1.522; p = 0.320). The authors found a venous thrombosis rate of 2.74 percent in the group with two anastomoses versus 4.54 percent in the group with single anastomoses (OR, 0.535; 95 percent CI, 0.334 to 0.858; p = 0.009). There were also more surgical revisions in the single venous anastomoses group, 11.87 percent versus 6.04 percent (OR, 0.474; 95 percent CI, 0.349 to 0.643; p < 0.001)., Conclusions: This meta-analysis supports that performing a double venous anastomosis confers protective effects in venous thrombosis and surgical revision, thus reducing free flap failure. The authors recommend the achievement of double venous anastomosis whenever it is feasible in head and neck oncologic reconstruction., Clinical Question/level of Evidence: Therapeutic, IV.
- Published
- 2016
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13. [Thrombectomy and plication of veins as a method of preventing pulmonary artery thromboembolism at a multidisciplinary surgical hospital].
- Author
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Galkin SV, Pashin NV, Dedyukhin IG, Aleksandrov AG, and Lebedeva MV
- Subjects
- Adult, Aged, Female, Humans, Iliac Vein pathology, Iliac Vein surgery, Lower Extremity blood supply, Male, Middle Aged, Pregnancy, Retrospective Studies, Russia, Thrombectomy methods, Tomography, X-Ray Computed, Ultrasonography, Doppler, Duplex methods, Vena Cava, Inferior pathology, Vena Cava, Inferior surgery, Postoperative Complications prevention & control, Pulmonary Embolism diagnosis, Pulmonary Embolism etiology, Pulmonary Embolism prevention & control, Venous Insufficiency etiology, Venous Insufficiency prevention & control, Venous Thrombosis complications, Venous Thrombosis diagnosis, Venous Thrombosis surgery
- Abstract
The authors assessed efficacy and safety of the operation of plication of deep veins of lower extremities, pelvic veins, and the inferior vena cava as a method of preventing fatal pulmonary artery thromboembolism. A total of 48 patients were operated on. Of these, 23 patients belonged to traumatological-and-orthopaedical cohort, 3 to general surgical cohort, 4 to gynaecological, and 18 to vascular cohort (isolated deep vein thrombosis). The length of the floating head of the thrombus varied from 2 to 10 cm. The presence of a floating thrombus in traumatological, surgical and gynaecological patients, regardless of the length of the floating part was an absolute indication for thrombectomy and venous plication. Vascular patients were operated on in accordance with the National Guidelines (with the length of the thrombus floating portion of not less than 4 cm). In all cases, surgical management envisaged direct and indirect thrombectomy. Plication was always performed above the level of venotomy. It was shown that thrombectomy combined with plication of major veins is a reliable and safe method of prophylaxis, being in some cases the only possible method of preventing fatal pulmonary artery thromboembolism. The operation of plication makes it possible not to cancel a scheduled surgical intervention in patients with a detected floating thrombus of major veins. The operation of thrombectomy and plication above the level of the floating head of the thrombus may be considered an operation of choice in the conditions where there is no possibility to use endovascular methods of treatment (implantation of a cava filter, endovascular catheter thrombectomy), as well as in pregnant women. Restoration of the venous lumen occurs at safe terms spontaneously, not requiring repeat surgical intervention. Simultaneous plication of the vein does not complicate the course of the postoperative period of the main surgical intervention. Thrombectomy and plication do not lead to the development of severe chronic venous insufficiency.
- Published
- 2016
14. Slow femoral venous flow and venous thromboembolism following inguinal hernioplasty in patients without or with low molecular weight heparin prophylaxis.
- Author
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Lozano FS, Sánchez-Fernández J, González-Porras JR, García-Alovio J, Santos JA, Mateos R, and Alberca I
- Subjects
- Adult, Aged, Anticoagulants therapeutic use, Blood Flow Velocity, Female, Heparin, Low-Molecular-Weight therapeutic use, Humans, Male, Middle Aged, Surgical Mesh adverse effects, Venous Insufficiency etiology, Venous Insufficiency prevention & control, Venous Thromboembolism etiology, Venous Thromboembolism prevention & control, Young Adult, Femoral Vein surgery, Hernia, Inguinal surgery, Herniorrhaphy adverse effects
- Abstract
Background: Prosthetic material (mesh) is commonly used to repair inguinal hernias. Its implantation close to the common femoral vein (CFV) can induce slow flow and favor the appearance of venous thromboembolism (VTE) events., Aim: To investigate the speed of flow, diameter and area of the CFV after inguinal hernioplasty., Methods: Two hundred and fifty patients receiving open hernioplasty with a non-resorbable mesh for the repair of a unilateral, primary, simple inguinal hernia were prospectively investigated. Patients were stratified, by consensus, into a low or a moderate risk of VTE group. The moderate-risk group (n = 163) received low molecular weight heparin. On day 10 post-operation a blinded Echo-Doppler was carried out, and repeated 7 days later in patients with a venous flow of <15 cm/s. The speed of flow (cm/s), diameter (cm), and area (cm(2)) of the ipsilateral and contralateral CFV of the groin operated upon were measured., Results: No event symptomatic of VTE was documented. One case of asymptomatic deep vein thrombosis (1/163, 0.6%) was found in the moderate-risk group. In 29 patients (2 and 27 in the low- and moderate-risk groups, respectively; p < 0.001) a maximum blood flow velocity of <15 cm/s was found in the ipsilateral CFV; these flows were close to normal in the second measurement. Taking the entire sample into account, the maximum venous blood flow found in the ipsilateral CFV of the operated groin was less than that measured in the contralateral CFV (20.88 vs. 24.01 cm/s; p < 0.001); this difference was significant in both VTE risk groups. The diameter and area of the CFV were both greater in the ipsilateral than the contralateral CFV (p < 0.01); this finding proved to be significant only in hernias of the left groin (p < 0.001)., Conclusions: In the immediate postoperative period, inguinal hernioplasty with mesh induces a temporarily slow venous flow in the ipsilateral CFV. However, this does not lead to an increase in the incidence of VTE.
- Published
- 2015
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15. Pharmacological treatment and prevention of chronic venous ulcers: a review.
- Author
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Cerbone AM, Tufano A, Coppola A, Cimino E, Di Minno MN, and Di Minno G
- Subjects
- Anticoagulants administration & dosage, Anticoagulants therapeutic use, Chronic Disease, Humans, Postthrombotic Syndrome etiology, Postthrombotic Syndrome prevention & control, Quality of Life, Recurrence, Stockings, Compression, Varicose Ulcer etiology, Varicose Ulcer prevention & control, Venous Insufficiency etiology, Venous Insufficiency prevention & control, Venous Thrombosis complications, Venous Thrombosis prevention & control, Postthrombotic Syndrome therapy, Varicose Ulcer therapy, Venous Insufficiency therapy
- Abstract
Chronic venous insufficiency and chronic venous ulcers represent an important medical problem, because of the high incidence and prevalence in the general population, and need to be considered as a lifelong degenerative condition, with socioeconomic consequences. Ulceration is a severe complication of the post-thrombotic syndrome, often precipitated by minor trauma. The rate of post-thrombotic syndrome varies between 20% and 100% of patients with deep vein thrombosis, mostly occurring within two years of an initial thrombotic event. This syndrome is difficult to treat, causes significant disability and reduces the quality of life. To date, there are no effective therapies of chronic venous ulcers and no definite strategies for identifying patients at risk for the development of ulceration. The role of adequate compression with elastic stockings is well recognized. Several systemic drugs have been tested for a possible effect on chronic venous ulcer healing, but none has been widely accepted as standard therapy in this setting. It has been suggested that extended oral anticoagulation should be investigated as a possible preventative measure. Waiting for the results in this field, an adequate management of anticoagulation in terms of anticoagulant intensity and duration should be recommended for the prevention of recurrent deep vein thrombosis, post-thrombotic syndrome and chronic venous ulcers.
- Published
- 2015
16. Hemodynamic and biologic determinates of arteriovenous fistula outcomes in renal failure patients.
- Author
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Hammes M
- Subjects
- Arteriovenous Shunt, Surgical methods, Computer Simulation, Humans, Renal Circulation, Renal Dialysis methods, Treatment Outcome, Venous Insufficiency etiology, Venous Insufficiency prevention & control, Arteriovenous Shunt, Surgical adverse effects, Kidney Failure, Chronic physiopathology, Kidney Failure, Chronic therapy, Models, Biological, Renal Dialysis adverse effects, Venous Insufficiency physiopathology
- Abstract
The outcome of patients with end-stage renal disease on hemodialysis depends on a functioning vascular access. Although a variety of access options are available, the arteriovenous fistula remains the best vascular access. Unfortunately the success rate of mature fistula use remains poor. The creation of an arteriovenous fistula is followed by altered hemodynamic and biological changes that may result in neointimal hyperplasia and eventual venous stenosis. This review provides an overview of these changes and the needed research to provide a long lasting vascular access and hence improve outcomes for patients with end-stage renal disease.
- Published
- 2015
- Full Text
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17. Protective effects of activated protein C (APC) on free groin flaps after secondary venous stasis in the rat model.
- Author
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Wallmichrath J, Knab R, Baumeister RG, Holzbach T, Giunta RE, and Frick A
- Subjects
- Animals, Disease Models, Animal, Groin surgery, Male, Microscopy, Video, Neck surgery, Rats, Rats, Sprague-Dawley, Reperfusion Injury prevention & control, Tissue Survival drug effects, Venous Insufficiency prevention & control, Anticoagulants pharmacology, Capillaries drug effects, Free Tissue Flaps blood supply, Protein C pharmacology, Reperfusion Injury drug therapy, Venous Insufficiency drug therapy
- Abstract
Background: The goal of this study was to determine whether the focused delivery of APC by rinsing of free adipocutaneous groin flaps shows protective effects on flap survival following a fatal secondary venous stasis in a rat model., Methods: 36 Sprague Dawley rats were randomized to three groups and free microvascular groin flaps were transplanted to the neck in each animal. 20 hours postoperatively the flap pedicle was re-explored and the distal stump of the flap artery was catheterised. Animals in group I (n = 12) remained untreated, whereas animals of group II were treated with 1 ml of Ringer's solution. Those in group III received 1 ml of APC (2 mg/kg). Afterwards the flap vein was clamped for 35 minutes. The skin of the flaps and the native contralateral groin was examined by intravital video microscopy using FITC-Dextran and CFDA-SE-labelled thrombocytes., Results: APC-pretreatment significantly increased the functional capillary density (FCD) of the flaps. Flap viability was 8% in group I (n = 1/12), 9% in group II (n = 1/11) and 60% in group III (n = 6/10), respectively. No partial flap loss was detected., Conclusions: The focused delivery of APC resulted in significantly improved flap salvage.
- Published
- 2015
- Full Text
- View/download PDF
18. [Perforating veins insufficiency in patients with varicose disease].
- Author
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Sukhovatykh BS and Sukhovatykh MB
- Subjects
- Adult, Aged, Female, Hemodynamics, Humans, Ligation adverse effects, Ligation methods, Male, Middle Aged, Outcome Assessment, Health Care, Ultrasonography, Varicose Ulcer etiology, Varicose Ulcer prevention & control, Lower Extremity blood supply, Postoperative Complications diagnosis, Postoperative Complications physiopathology, Postoperative Complications prevention & control, Sclerotherapy methods, Varicose Veins complications, Varicose Veins diagnosis, Varicose Veins physiopathology, Varicose Veins surgery, Vascular Surgical Procedures adverse effects, Vascular Surgical Procedures methods, Venous Insufficiency diagnosis, Venous Insufficiency etiology, Venous Insufficiency physiopathology, Venous Insufficiency prevention & control, Venous Valves diagnostic imaging, Venous Valves physiopathology, Venous Valves surgery
- Abstract
Material and Methods: It was analyzed the results of complex survey and treatment of 181 patients with varicose disease CEAP degrees C3-C6. Ultrasonic scanning was applied to define localization, severity and extension of blood reflux in venous system., Results: Superficial reflux was revealed in all patients, perforating--in 59.7%, deep--in 22.8% of cases. We concluded that high-intensive total-subtotal blood reflux in superficial veins was main hemodynamic factor resulted perforating insufficiency in 42% of patients, high-intensive deep reflux--in 17.7% of cases additionally. In patients with subcompensated course of disease superficial reflux removal and large perforating veins (diameter 4.5±0.5 mm) ligation are advisable. Small perforating veins insufficiency (diameter 3.5±0.5 mm) is eliminated independently after superficial reflux removal. Two-staged treatment should be used in patients with decompensated course of disease and trophic disorders ofshin. Perforating veins sclerotherapy under ultrasonic control is advisable secondarily after superficial reflux removal.
- Published
- 2015
- Full Text
- View/download PDF
19. An old controversy revisited-one versus two venous anastomoses in microvascular head and neck reconstruction using anterolateral thigh flap.
- Author
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Chen WF, Kung YP, Kang YC, Lawrence WT, and Tsao CK
- Subjects
- Adult, Anastomosis, Surgical, Female, Humans, Male, Middle Aged, Postoperative Complications prevention & control, Retrospective Studies, Treatment Outcome, Venous Insufficiency prevention & control, Free Tissue Flaps, Plastic Surgery Procedures methods
- Abstract
Background: The necessity of a second venous anastomosis in free tissue transfer is controversial. We review a single surgeon's 8-year experience of head and neck reconstruction using free anterolateral flap reconstruction to assess the need for a second venous anastomosis., Patients and Method: Three hundred and fifteen cases were included in the study after selecting only for anterolateral thigh flap, head, and neck reconstruction, and those that used superior thyroid artery as recipient. The selection criteria were designed to create as homogeneous a group as possible to decrease confounding factors., Results: The group with single anastomosis required more frequent take-backs than the group with dual anastomoses (19% vs 10.8%, P = 0.055). The trend persisted when only take-backs for venous insufficiencies were compared (8.2% vs 2.5%, P = 0.039). When flaps with single anastomosis developed venous congestion, they were more likely to require operative salvage for venous insufficiency than those with dual anastomoses (35.5% vs. 6.3%, P = 0.037). No difference was found in postoperative complications and flap survival., Conclusion: Our data suggest that flaps with single venous anastomosis are more likely to require take-back for flap salvage than those with dual anastomoses., (© 2013 Wiley Periodicals, Inc.)
- Published
- 2014
- Full Text
- View/download PDF
20. [Role of enterosorbents in treatment of complicated varicose disease].
- Author
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Biliaieva OO, Korzhyk NP, Myronov OM, Balins'ka MI, and Iemets' VV
- Subjects
- Administration, Oral, Administration, Topical, Adult, Aged, Aged, 80 and over, Anti-Bacterial Agents administration & dosage, Anti-Bacterial Agents therapeutic use, Drug Therapy, Combination, Female, Heme administration & dosage, Heme therapeutic use, Humans, Injections, Intravenous, Lidocaine administration & dosage, Lidocaine therapeutic use, Male, Microcirculation drug effects, Middle Aged, Ofloxacin administration & dosage, Ofloxacin therapeutic use, Ointments, Secondary Prevention, Silicones administration & dosage, Treatment Outcome, Varicose Ulcer complications, Varicose Ulcer drug therapy, Varicose Ulcer physiopathology, Varicose Ulcer surgery, Varicose Veins complications, Varicose Veins physiopathology, Varicose Veins surgery, Venous Insufficiency etiology, Venous Insufficiency physiopathology, Venous Insufficiency prevention & control, Venous Insufficiency surgery, Heme analogs & derivatives, Silicones therapeutic use, Sorption Detoxification methods, Varicose Veins drug therapy
- Abstract
Results of treatment of 43 patients, suffering varicose disease, complicated by trophic disorders, were analyzed. To the patients a complex was prescribed, including sorpents, angioprotectors, locally - ointments. There were operated 14 patients.
- Published
- 2014
21. Neo-valvuloplasty for lymphatic supermicrosurgery.
- Author
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Yamamoto T and Koshima I
- Subjects
- Anastomosis, Surgical, Humans, Venous Insufficiency prevention & control, Lymphatic Vessels surgery, Lymphedema surgery, Microsurgery methods, Veins surgery
- Published
- 2014
- Full Text
- View/download PDF
22. Orthostatics and chronic venous insufficiency in Croatian doctors of dental medicine.
- Author
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Basić R, Rosić D, Ledinsky I, and Lovricević I
- Subjects
- Adult, Case-Control Studies, Croatia, Dentists, Edema diagnosis, Edema epidemiology, Edema prevention & control, Humans, Hyperpigmentation diagnosis, Hyperpigmentation epidemiology, Hyperpigmentation prevention & control, Occupational Diseases diagnosis, Occupational Diseases prevention & control, Posture, Prevalence, Risk Factors, Surveys and Questionnaires, Venous Insufficiency diagnosis, Venous Insufficiency prevention & control, Occupational Diseases epidemiology, Venous Insufficiency epidemiology
- Abstract
The purpose of the study was to point to occupational exposure of dental medicine doctors in Croatia and to the effect of static performance on developing venous disease. The study included 120 subjects, 60 of them doctors of dental medicine and 60 from other professions. The study was focused on finding a way to upgrade preventive measures against developing chronic venous insufficiency and the quality of life of dental medicine doctors. Study subjects underwent verbal testing (questionnaire), clinical examination and ultrasonography (color Doppler).
- Published
- 2014
23. Advantages of using volar vein repair in finger replantations.
- Author
-
Mersa B, Kabakas F, Pürisa H, Özçelik IB, Yeşiloğlu N, Sezer I, and Tunçer S
- Subjects
- Graft Survival, Humans, Replantation adverse effects, Retrospective Studies, Venous Insufficiency etiology, Amputation, Traumatic surgery, Finger Injuries surgery, Fingers blood supply, Replantation methods, Veins surgery, Venous Insufficiency prevention & control
- Abstract
Providing adequate venous outflow is essential in finger replantation surgeries. For a successful result, the quality and quantity of venous repairs should be adequate to drain arterial inflow. The digital dorsal venous plexus is a reliable source of material for venous repairs. Classically, volar digital veins have been used only when no other alternative was available. However, repairing volar veins to augment venous outflow has a number of technical advantages and gives a greater chance of survival. Increasing the repaired vein:artery ratio also increases the success of replantation. The volar skin, covering the volar vein, is less likely to be avulsed during injury and is also less likely to turn necrotic, than dorsal skin, after the replantation surgery. Primary repair of dorsal veins can be difficult due to tightness ensuing from arthrodesis of the underlying joint in flexion. In multiple finger replantations, repairing the volar veins after arterial repair and continuing to do so for each finger in the same way without changing the position of the hand and surgeon save time. In amputations with tissue loss, the size discrepancy is less for volar veins than for dorsal veins. We present the results of 366 finger replantations after volar vein repairs., (Copyright © 2013 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Ltd. All rights reserved.)
- Published
- 2014
- Full Text
- View/download PDF
24. [Restoration of valvular function of deep veins in lower-limb varicose disease].
- Author
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Pokrovskiĭ AV, Gradusov EG, Ignat'ev IM, and Akhmetzianov RV
- Subjects
- Adolescent, Adult, Aged, Female, Humans, Lower Extremity blood supply, Male, Middle Aged, Phlebography methods, Retrospective Studies, Severity of Illness Index, Treatment Outcome, Ultrasonography, Doppler, Duplex methods, Vascular Patency, Angioplasty adverse effects, Angioplasty methods, Postoperative Complications diagnosis, Postoperative Complications physiopathology, Postoperative Complications prevention & control, Varicose Veins diagnosis, Varicose Veins etiology, Varicose Veins physiopathology, Varicose Veins surgery, Venous Insufficiency diagnosis, Venous Insufficiency etiology, Venous Insufficiency physiopathology, Venous Insufficiency prevention & control, Venous Valves pathology, Venous Valves physiopathology, Venous Valves surgery
- Abstract
The present work was based on analysing the results of a complex examination and surgical treatment of 16-to-78-year-old patients presenting with varicose disease during the period from 2006 to 2010. A total of 1,095 limbs were examined and operated on in 1,070 patients. Of these, 298 (29.6 %) were men, and 709 (70.4 %) women. The distribution of the patients according to the CEAP clinical classification was as follows: C1 - 3 patients, C2 - 215, C3 - 566, C4 - 203, C5 - 29, and C6 - 79 subjects. All patients underwent ultrasonic duplex scanning, with retrograde phlebography performed in 21 cases. 51.2% of patients were diagnosed as having pathological deep venous reflux. In the group of patients with valvular insufficiency of deep veins, a total of 93 operations aimed at correcting deep reflux were performed, including 12 interventions for congenital avalvulation of veins. The indications for restorative operations on the valvular apparatus of deep veins were determined in severe forms of chronic venous insufficiency combined with axial reflux along deep veins in cases of inefficiency of conventional methods of surgical and conservative treatment. The long-term outcomes of surgery were assessed after 18-48 months. The results were evaluated by means of clinical and instrumental methods of examination: the disease severity scale, patients quality of life questionnaire, ultrasonographic and roentgen contrast methods of examination, and legometry. The operations aimed at restoring the valvular function of the femoral veins turned out to be effective methods of correcting venous reflux and made it possible to restore the valvular function in 84% of cases. In the remote postoperative period valvular competence was observed in 74.6% of patients. Carrying out such operations significantly improve the course of the disease due to decreasing the malleolar volume (p<0.001), manifestations of symptoms of chronic venous insufficiency (p<0.001), and improving quality of life (p<0.001).
- Published
- 2014
25. Effects of verapamil, nifedipine, and daflon on the viability of reverse-flow island flaps in rats.
- Author
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Kilinc H, Aslan SS, Bilen BT, Eren AT, Karadag N, and Karabulut AB
- Subjects
- Animals, Cell Survival drug effects, Epigastric Arteries pathology, Epigastric Arteries surgery, Microsurgery, Rats, Rats, Sprague-Dawley, Surgical Flaps adverse effects, Veins pathology, Veins surgery, Venous Insufficiency etiology, Venous Insufficiency pathology, Venous Insufficiency prevention & control, Diosmin pharmacology, Nifedipine pharmacology, Surgical Flaps blood supply, Surgical Flaps pathology, Vasodilator Agents pharmacology, Verapamil pharmacology
- Abstract
Reverse-flow flaps are preferable in reconstructive surgery due to their several advantages. However, they may have venous insufficiency and poor blood flow. In this study, effects of various pharmacological agents on the viability of reverse-flow flaps were investigated. Forty Sprague-Dawley rats were used. Superficial epigastric artery- and superficial epigastric vein-based reverse-flow island flaps were preferred. The rats were divided into 4 groups. Group 1 was considered as the control group. Group 2 was given verapamil 0.3 mg/kg per day, group 3 nifedipine 0.5 mg/kg per day, and group 4 Daflon 80 mg/kg per day for 7 days. On day 7, viable flap areas were measured, angiography was performed, serum nitric oxide levels were evaluated, and histopathological examination was done.The mean flap viability rate was 67.59% (±13.12259) in group 1, 77.38% (±4.12506) in group 2, 74.57% (±3.44780) in group 3, and 85.39% (±4.36125) in group 4 (P = 0.001). The mean nitric oxide level was 31.66 μmol/dL (±2.42212) in group 1, 51.00 μmol/dL (±2.96648) in group 2, 34.00 μmol/dL (±2.96648) in group 3, and 47.66 μmol/dL (±2.80476) in group 4 (P = 0.001). On angiography, there were vessel dilations and convolutions in group 2; capillaries became noticeable, and anastomotic vessels extended toward the more distal part of the flaps in group 4. Histological examinations showed severe inflammation in group 3 and minimal inflammation and venous vasodilatation in group 2.Verapamil and Daflon in therapeutic doses significantly increased the viability of reverse-flow island flaps. However, nifedipine did not make a significant contribution to the flap viability. The results of this study will contribute to the literature about the hemodynamics of reverse-flow island flaps and guide further studies on the issue.
- Published
- 2013
- Full Text
- View/download PDF
26. Non-pharmacological interventions for preventing venous insufficiency in a standing worker population.
- Author
-
Robertson L, Yeoh SE, and Kolbach DN
- Subjects
- Chronic Disease, Cross-Over Studies, Female, Humans, Prospective Studies, Air Travel, Occupational Diseases prevention & control, Posture, Stockings, Compression, Venous Insufficiency prevention & control
- Abstract
Background: Chronic venous insufficiency (CVI) is a common problem, affecting up to 50% of the population in industrialised countries. It is a chronic condition which, if untreated, can progress to serious complications that in turn can interfere with working ability. Standing at work is a known risk factor for CVI, yet the true effect of non-pharmacological preventive strategies remains unknown. This is an update of a review first published in 2012., Objectives: To assess the efficacy of non-pharmacological strategies and devices to prevent CVI in a standing worker population., Search Methods: For this update the Cochrane Peripheral Vascular Diseases Group Trials Search Co-ordinator searched the Specialised Register (last searched September 2013) and CENTRAL (2013, Issue 8). We also handsearched reference lists of relevant studies., Selection Criteria: Randomised and non-randomised controlled trials that recruited standing workers to evaluate non-pharmacological devices or strategies used to prevent CVI were eligible for inclusion. Trials had to report an objective measure of clinical features of CVI or complaints associated with this condition in order to be included., Data Collection and Analysis: Selection of the trials, quality assessment and data abstraction were completed independently by two review authors. We resolved disagreements by discussion. Only one trial was eligible for inclusion in the review so we did not perform meta-analyses., Main Results: The primary outcomes of this review were clinical features of CVI and its associated symptoms. No new included studies were identified for this update. One prospective cross-over trial was included in this review. It measured the effect of no compression followed by two phases with different gradients of compression stockings on symptoms in 19 female flight attendants who were required to stand, almost continuously, for long periods of time. The included study provided some evidence that compression stockings improved symptoms of leg fatigue in standing workers. However, the strength of the evidence in this review is weak as it is based on only one very small trial which was at high risk of bias. The included study did not address any of the secondary outcomes including quality of life or economic impact of the interventions. Nor did the study report the length of time that the population were required to stand at work. Furthermore, no trials were found which measured the effectiveness of other non-pharmacological interventions or strategies aimed at preventing CVI in standing workers., Authors' Conclusions: Due to the extremely limited number of trials, there is insufficient evidence to draw any conclusions about the effectiveness of non-pharmacological interventions for preventing CVI in standing workers. Further large-scale studies examining all possible non-pharmacological interventions and outcomes are required.
- Published
- 2013
- Full Text
- View/download PDF
27. [Ambulatory sclerosurgical treatment of varicose disease of the lower extremities].
- Author
-
Khodos VA
- Subjects
- Adult, Aged, Female, Humans, Male, Middle Aged, Sclerosing Solutions therapeutic use, Severity of Illness Index, Treatment Outcome, Varicose Veins diagnosis, Varicose Veins epidemiology, Varicose Veins therapy, Venous Insufficiency epidemiology, Venous Insufficiency prevention & control, Young Adult, Ambulatory Care methods, Sclerotherapy methods, Varicose Veins surgery
- Abstract
The results of ambulatory sclerosurgical treatment of 258 patients, suffering varicose disease of the lower extremities (VDLE), were analyzed. The complications revealed are not severe and do not worsen the treatment results in whole. Application of intraoperative microfoam scleroobliteration of the stem veins have had guaranteed their complete occlusion in 97.5% of the patients. Sclerosurgical treatment have promoted a trustworthy (P < 0.0001) reduction of rate of chronic venous insufficiency (CHVI) class C2-C5 (in accordance with CEAP classification), and estimation of the CHVI severity classes C0, C1 witnesses the efficacy of this method of the VDLE treatment.
- Published
- 2013
28. Late complications of electrotherapy - a clinical analysis of indications for transvenous removal of endocardial leads: a single centre experience.
- Author
-
Polewczyk A, Kutarski A, Tomaszewski A, Polewczyk M, and Janion M
- Subjects
- Aged, Electrodes, Implanted adverse effects, Equipment Failure Analysis, Female, Heart Injuries prevention & control, Humans, Male, Middle Aged, Prosthesis-Related Infections prevention & control, Retrospective Studies, Treatment Outcome, Venous Insufficiency prevention & control, Defibrillators, Implantable adverse effects, Device Removal methods, Equipment Failure, Heart Injuries etiology, Pacemaker, Artificial adverse effects, Prosthesis-Related Infections etiology, Venous Insufficiency etiology
- Abstract
Background: Despite advances in electrotherapy, late complications constitute an increasing clinical and therapeutic problem. Transvenous lead extraction (TLE) is becoming a safe and effective approach to the treatment of such complications., Aim: To assess indications for TLE and to evaluate safety and efficacy of TLE procedures., Methods: A retrospective clinical analysis of 100 patients with complications of electrotherapy admitted to a tertiary care centre in 2008-2011., Results: In 2008-2011, the number of electrotherapy complications increased markedly. The most frequent reason for TLE was lead dysfunction (62% of patients, including 31% with an implanted cardioverter-defibrillator [ICD] and 31% with a pacemaker [PM]). The most common type of lead dysfunction was conductor damage (38% of patients, including 23% with ICD, 15% with PM), followed by late myocardial perforation (14% of patients, including 7% with ICD, 7% with PM), abnormal course of the lead (7% of patients, including 1% with ICD, 6% with PM), and lead insulation failure (3% of patients). Other reasons for TLE were infectious complications (24% of patients, including 15% with PM pocket infection), venous insufficiency (17% of patients, including 10% in whom an indwelling lead was a direct obstacle to switching the pacing mode), and the need to switch the pacing mode (4% of patients). Procedural efficacy was 96% (lead fragments were left in place in 4% of patients). No significant clinical complications were observed in any of the patients in the periprocedural period., Conclusions: Clinical manifestations of electrotherapy complications in the study group varied and included a relatively small number of infectious complications (24%) and a relatively large number of late myocardial perforations (14%). Efficacy and safety of the procedures were very high.
- Published
- 2013
- Full Text
- View/download PDF
29. [Risk factors for the development of venous insufficiency of the lower limbs during pregnancy--part 1].
- Author
-
Ropacka-Lesiak M, Kasperczak J, and Breborowicz GH
- Subjects
- Adult, Female, Health Status, Humans, Leg blood supply, Life Style, Pregnancy, Pregnancy Complications, Cardiovascular prevention & control, Quality of Life, Venous Insufficiency prevention & control, Venous Thrombosis prevention & control, Young Adult, Pregnancy Complications, Cardiovascular epidemiology, Severity of Illness Index, Venous Insufficiency epidemiology, Venous Thrombosis epidemiology, Weight Gain, Women's Health
- Abstract
The venous system alters its function in pregnancy--the changes are both functional and structural. It becomes particularly vulnerable to the development of venous thrombosis and related complications. These adverse factors acting on the veins in pregnancy include: an increase in circulating blood volume, expansion of the uterus, weight gain, reduced physical activity hormonal changes. The changes in the plasma have a significant impact on the venous system. In pregnancy an increased level of fibrinogen and coagulation factors VII, VIII, IX and X, and von Willenbrand factor can be observed. Smooth muscle relaxation and relaxation of collagen fibers are caused by progesterone and estrogen, and it may result in the development of varicose veins, venous thrombosis and venous insufficiency The relationships between the hormones and the muscle pump efficiency has not been proven as yet. Estrogens cause an increase in the synthesis of coagulation proteins and it may result in the high risk of venous thrombosis and its consequences. Progesterone inhibits smooth muscle contraction, while estrogens cause relaxation and loosening of the bonds between the collagen fibers. The increase in the level of progesterone is of particular importance. It has a relaxing effect on the muscle, resulting in disorders of the vein shrinkage, affecting the increase of their capacity and valvular insufficiency, and valvular edges are not in contact with each other due to the vasodilatation. Estrogens have a similar effect, and additionally it may also cause an impairment in the collagen fibers connection and synthesis. This can result in the formation of telanglectasia without venous hypertension. Estrogens may also affect the synthesis of prostaglandins and nitric oxide. Estradiol inhibits vascular smooth muscle cell proliferation and stimulates cell migration and secretion of matrix proteins, as well as regeneration of the damaged vessels. Estrogen inhibits the production of cytokines, adhesion molecules, and reduce platelet response, i.e. the aggregation and adhesion in the presence of monocytes. Estradiol increases the production, activity and bioavailability of nitric oxide, a molecule with a strong vasodilating effect. Additionally adverse affects may appear due to short intervals between pregnancies, genetics, presence of venous thrombosis or venous insufficiency in the superficial and deep system in anamnesis. Caesarean section is also a risk factor for venous thrombosis. Family factors are associated with inheritance of the formation of varicose changes and venous insufficiency in both ways, dominant and recessive, and also sex-related. Among other factors affecting the development of venous insufficiency during pregnancy the following can be distinguished: type of work (standing, sitting, in forced positions and vibration), interval between pregnancies (determining the possibility of regeneration of physiological regeneration of the system). In case of women who were pregnant more than once, the risk of developing varicose veins and other venous insufficiency is doubled.
- Published
- 2012
30. Sporty compression socks: to wear or not to wear?
- Author
-
Powers JG and Phillips TJ
- Subjects
- Adult, Equipment Design, Female, Foot, Humans, Male, Materials Testing, Surface Properties, Protective Clothing standards, Running, Stockings, Compression standards, Venous Insufficiency prevention & control
- Published
- 2012
- Full Text
- View/download PDF
31. What is the medical rationale for the treatment of varicose veins?
- Author
-
Meissner MH
- Subjects
- Chronic Disease, Humans, Varicose Ulcer complications, Venous Insufficiency etiology, Venous Thrombosis etiology, Quality of Life, Varicose Ulcer therapy, Venous Insufficiency prevention & control, Venous Thrombosis therapy
- Abstract
Varicose veins occur in up to one-third of Western populations and are associated with clinical manifestations ranging from asymptomatic, isolated varicose veins (C2 disease) to venous ulceration. While the development of less invasive treatment options, such as endovenous ablation and sclerotherapy, have been well accepted by patients they have led to increased utilization of scarce health-care resources. While few would argue with the treatment of acute complications such as superficial venous thrombosis and variceal haemorrhage, the role of interventional treatment in the management of lifestyle limiting symptoms and the prevention of disease progression may be debatable. Good-quality evidence does suggest that surgical management of varicose veins is associated with improved quality of life at costs below the thresholds of many Western health-care systems. However, the progression of isolated C2 disease to advanced chronic venous insufficiency occurs infrequently and the role of treatment to prevent such progression remains undefined at present.
- Published
- 2012
- Full Text
- View/download PDF
32. [Prevention of chronic venous disease: which advice for our patients?].
- Author
-
Glauser F, Codreanu A, Tribout B, Mazzolai L, and Depairon M
- Subjects
- Humans, Risk Factors, Primary Prevention methods, Venous Insufficiency prevention & control
- Abstract
Chronic venous disease (CVD) is a major public health problem due to its high prevalence and socioeconomic costs. In absence of adequate care, it can lead to chronic venous insufficiency (CVI). Disturbed venous-flow patterns lead to venous hypertension. Therefore, prevention of CVD involves venous hypertension reduction. In primary prevention, it is essential to inform the patient about necessary lifestyle changes. In case of CVD, it is essential to propose treatment (compression, venoactive drugs, and interventional treatments) to avoid CVI appearance and eventually offer the best therapy solutions for CVI complications.
- Published
- 2012
33. Non-pharmacological interventions for preventing venous insufficiency in a standing worker population.
- Author
-
Robertson L, Yeoh SE, and Kolbach DN
- Subjects
- Chronic Disease, Cross-Over Studies, Female, Humans, Prospective Studies, Aerospace Medicine, Occupational Diseases prevention & control, Posture, Stockings, Compression, Venous Insufficiency prevention & control
- Abstract
Background: Chronic venous insufficiency (CVI) is a common problem, affecting up to 50% of the population in industrialised countries. It is a chronic condition which, if untreated, can progress to serious complications that in turn can interfere with working ability. Standing at work is a known risk factor for CVI, yet the true effect of non-pharmacological preventive strategies remains unknown., Objectives: To undertake a systematic review of randomised or controlled clinical trials to assess the efficacy of non-pharmacological strategies and devices to prevent CVI in a standing worker population., Search Methods: The Cochrane Peripheral Vascular Diseases (PVD) Group searched their Specialised Register (last searched April 2011) and CENTRAL (Issue 2, 2011). No date or language restrictions were applied. We also handsearched reference lists of relevant studies., Selection Criteria: Randomised and non-randomised controlled trials that recruited standing workers to evaluate non-pharmacological devices or strategies used to prevent CVI were eligible for inclusion. Trials had to report an objective measure of clinical features of CVI or complaints associated with this condition in order to be included., Data Collection and Analysis: Selection of the trials, quality assessment and data abstraction were completed independently by two review authors. We resolved disagreements by discussion. Only one trial was eligible for inclusion in the review so we did not perform meta-analyses., Main Results: The primary outcomes of this review were clinical features of CVI and its associated symptoms. One prospective cross-over trial was included in this review. It measured the effect of no compression followed by two phases with different gradients of compression stockings on symptoms in 19 female flight attendants who were required to stand, almost continuously, for long periods of time. The included study provided some evidence that compression stockings improved symptoms of leg fatigue in standing workers. However, the strength of the evidence in this review is weak as it is based on only one very small trial which was at high risk of bias. The included study did not address any of the secondary outcomes including quality of life or economic impact of the interventions. Nor did the study report the length of time that the population were required to stand at work. Furthermore, no trials were found which measured the effectiveness of other non-pharmacological interventions or strategies aimed at preventing CVI in standing workers., Authors' Conclusions: Due to the extremely limited number of trials, there is insufficient evidence to draw any conclusions about the effectiveness of non-pharmacological interventions for preventing CVI in standing workers. Further large-scale studies examining all possible non-pharmacological interventions and outcomes are required.
- Published
- 2012
- Full Text
- View/download PDF
34. [Trends in systemic inflammatory factors and aminoterminal brain natriuretic propeptide in the treatment of chronic heart failure].
- Author
-
Egorova EN, Kuz'mina MI, Mazur VV, Kalinkin MN, and Mazur ES
- Subjects
- C-Reactive Protein analysis, Chronic Disease, Cytokines blood, Female, Heart Failure drug therapy, Heart Failure immunology, Heart Failure physiopathology, Humans, Male, Middle Aged, Severity of Illness Index, Systemic Inflammatory Response Syndrome drug therapy, Systemic Inflammatory Response Syndrome immunology, Systemic Inflammatory Response Syndrome physiopathology, Treatment Outcome, Venous Insufficiency immunology, Venous Insufficiency physiopathology, Venous Insufficiency prevention & control, Coronary Circulation drug effects, Heart Failure blood, Natriuretic Peptide, Brain blood, Peptide Fragments blood, Systemic Inflammatory Response Syndrome blood, Venous Insufficiency blood
- Abstract
Aim: To study trends in systemic inflammatory factors and aminoterminal brain natriuretic propeptide (NT-proBNP) in the blood of patients with stage IIA and IIB chronic heart failure (CHF) during therapy aimed at reducing venous congestion., Material and Methods: The study enrolled 52 patients with postinfarction cardiosclerosis (PICS). Clinical, echocardiographic and laboratory studies were conducted. The levels of TNF-alpha, IL-6, IL-10 and C-reactive protein (CRP) were measured by enzyme immunoassay. The concentration of endotoxin (ET) was estimated by the end-point chromogenic LAL test, that of NT-proBNP--by immunochromotographic assay., Results: In the patients with CHF, clinical signs of pulmonary venous congestion are associated with a statistically significant increase in the blood levels of TNF-alpha and CRP, those of systemic venous congestion are related to a further rise in TNF-alpha levels and elevation of blood concentrations of NT-proBNP, ET and IL-10. Treatment-related reduction in pulmonary venous congection is associated with a decrease in the levels of TNF-alpha, CRP and IL-6; that in systemic venous congestion--with lower concentrations of NT-proBNP, TNF-alpha and ET., Conclusion: Specific changes in the levels of systemic inflammatory factors and NT-proBNP were found in patients with CHF in the presence of pulmonary and systemic venous congestion. Treatment aimed at elimination of the latter leads to reduction in the levels of systemic inflammatory factors and NT-proBNP.
- Published
- 2011
35. Summary of evidence of effectiveness of primary chronic venous disease treatment.
- Author
-
Marston W
- Subjects
- Cardiovascular Agents therapeutic use, Chronic Disease, Compression Bandages, Evidence-Based Medicine, Humans, Sclerotherapy, Treatment Outcome, Varicose Ulcer physiopathology, Varicose Ulcer prevention & control, Vascular Surgical Procedures, Venous Insufficiency physiopathology, Venous Insufficiency prevention & control, Wound Healing, Varicose Ulcer therapy, Venous Insufficiency therapy
- Published
- 2010
- Full Text
- View/download PDF
36. Avenues to prevent venous insufficiency.
- Author
-
Wakefield T and Henke P
- Subjects
- Anticoagulants therapeutic use, Equipment Design, Humans, Postthrombotic Syndrome etiology, Risk Assessment, Risk Factors, Stockings, Compression, Thrombectomy instrumentation, Thrombolytic Therapy, Treatment Outcome, Venous Insufficiency etiology, Venous Thromboembolism complications, Venous Thromboembolism diagnosis, Venous Thrombosis complications, Venous Thrombosis diagnosis, Postthrombotic Syndrome prevention & control, Venous Insufficiency prevention & control, Venous Thromboembolism therapy, Venous Thrombosis therapy
- Published
- 2010
37. Prevention of venous stasis in the lower limb by transcutaneous electrical nerve stimulation.
- Author
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Izumi M, Ikeuchi M, Mitani T, Taniguchi S, and Tani T
- Subjects
- Adult, Blood Flow Velocity, Blood Volume, Humans, Intermittent Pneumatic Compression Devices, Middle Aged, Musculoskeletal Manipulations, Popliteal Vein diagnostic imaging, Regional Blood Flow, Treatment Outcome, Ultrasonography, Doppler, Duplex, Ultrasonography, Doppler, Pulsed, Venous Insufficiency diagnostic imaging, Venous Insufficiency physiopathology, Venous Thromboembolism diagnostic imaging, Venous Thromboembolism physiopathology, Young Adult, Hemodynamics, Lower Extremity blood supply, Peroneal Nerve, Popliteal Vein physiopathology, Transcutaneous Electric Nerve Stimulation, Venous Insufficiency prevention & control, Venous Thromboembolism prevention & control
- Abstract
Objectives: This study aims to investigate the effects of thromboprophylactic transcutaneous electrical nerve stimulation (TpTENS) of the peroneal nerve on venous blood flow in the limbs of volunteers. TpTENS might be considered for use in preventing venous stasis during surgical treatment., Methods: In 10 volunteers, peak venous velocity (PV) and flow volume (FV) in the popliteal vein were measured using duplex ultrasonography during calf-muscle stimulation. The effects of TpTENS of the peroneal nerve were compared with those of other mechanical methods, including electrical muscle stimulation, intermittent pneumatic compression, active ankle motion and calf squeeze, used to prevent venous stasis and achieve thromboprophylaxis., Results: TpTENS had similar effects on popliteal vein blood flow in comparison with other established methods of thromboprophylaxis. The PV increased its basal flow by 3.9 times (p < 0.01) and FV by 2.7 times (p < 0.01), respectively, compared with baseline values., Conclusions: TpTENS is as effective as other electrical and mechanical methods of calf-muscle pump activation in achieving acceleration of venous flow in the lower limb., (Copyright (c) 2009 European Society for Vascular Surgery. Published by Elsevier Ltd. All rights reserved.)
- Published
- 2010
- Full Text
- View/download PDF
38. A single center comparison of one versus two venous anastomoses in 564 consecutive DIEP flaps: investigating the effect on venous congestion and flap survival.
- Author
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Enajat M, Rozen WM, Whitaker IS, Smit JM, and Acosta R
- Subjects
- Anastomosis, Surgical, Humans, Mammaplasty, Retrospective Studies, Tissue Survival, Vascular Surgical Procedures, Surgical Flaps blood supply, Veins surgery, Venous Insufficiency prevention & control
- Abstract
Background: Venous complications have been reported as the more frequently encountered vascular complications seen in the transfer of deep inferior epigastric artery (DIEA) perforator (DIEP) flaps, with a variety of techniques described for augmenting the venous drainage of these flaps to minimize venous congestion. The benefits of such techniques have not been shown to be of clinical benefit on a large scale due to the small number of cases in published series., Methods: A retrospective study of 564 consecutive DIEP flaps at a single institution was undertaken, comparing the prospective use of one venous anastomosis (273 cases) to two anastomoses (291 cases). The secondary donor vein comprised a second DIEA venae commitante in 7.9% of cases and a superficial inferior epigastric vein (SIEV) in 92.1%. Clinical outcomes were assessed, in particular rates of venous congestion., Results: The use of two venous anastomoses resulted in a significant reduction in the number of cases of venous congestion to zero (0 vs. 7, P = 0.006). All other outcomes were similar between groups. Notably, the use of a secondary vein did not result in any significant increase in operative time (385 minutes vs. 383 minutes, P = 0.57)., Conclusions: The use of a secondary vein in the drainage of a DIEP flap can significantly reduce the incidence of venous congestion, with no detriment to complication rates. Consideration of incorporating both the superficial and deep venous systems is an approach that may further improve the venous drainage of the flap.
- Published
- 2010
- Full Text
- View/download PDF
39. [Functional venous insufficiency: diagnosis and treatment (literature review) (Part I)].
- Author
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lliukhin EA and Zolotukhin IA
- Subjects
- Adult, Bandages, Cohort Studies, Female, Humans, Male, Multicenter Studies as Topic, Oxidative Stress, Phlebitis, Pregnancy, Randomized Controlled Trials as Topic, Risk Factors, Sex Factors, Stockings, Compression, Surveys and Questionnaires, Time Factors, Quality of Life, Venous Insufficiency diagnosis, Venous Insufficiency epidemiology, Venous Insufficiency etiology, Venous Insufficiency prevention & control, Venous Insufficiency therapy
- Abstract
Unlabelled: Reviewed herein are the available literature data concerning functional venous insufficiency (phlebopathies). Part I analyses the data on terminology, epidemiology, effect on quality of life, aetiology and pathogenesis, risk factors, as well as possible methods of diagnosis of this pathological condition., Method: search in the MEDLINE database by means of the PubMed system.
- Published
- 2010
40. Endothelial function impairment in chronic venous insufficiency: effect of some cardiovascular protectant agents.
- Author
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Carrasco OF, Ranero A, Hong E, and Vidrio H
- Subjects
- Adult, Aged, Chronic Disease, Endothelium, Vascular drug effects, Female, Follow-Up Studies, Humans, Male, Middle Aged, Prognosis, Retrospective Studies, Saphenous Vein diagnostic imaging, Saphenous Vein drug effects, Ultrasonography, Doppler, Duplex, Vasodilation drug effects, Venous Insufficiency diagnostic imaging, Venous Insufficiency prevention & control, Cardiovascular Agents therapeutic use, Endothelium, Vascular physiopathology, Saphenous Vein physiopathology, Vasodilation physiology, Venous Insufficiency physiopathology
- Abstract
In segments of human varicose veins, endothelial function was assessed by measuring relaxation induced by acetylcholine in noradrenaline-precontracted preparations. In addition, concentration-response curves to acetylcholine were obtained before and after incubation with the arterial endothelium protectant agents captopril, losartan, troglitazone, pravastatin, or simvastatin. The antivaricose agent escin was also tested. Mean acetylcholine-induced relaxation of varicose venous rings was about 13%, approximately one third of that reported for control saphenous veins. Concentration-response curves to acetylcholine were ''u'' shaped, the result of endothelium-mediated relaxation at low concentrations, superseded by subsequent smooth muscle contractile responses. Relaxation was enhanced by the endothelium-protecting agents and by escin, troglitazone being the least, and simvastatin the most effective. It was concluded that endothelial dysfunction is present in varicose veins, that this anomaly can be reverted by cardiovascular protecting agents, and that it can play a role in the pathogenesis and treatment of chronic venous insufficiency.
- Published
- 2009
- Full Text
- View/download PDF
41. Chronic oedema in patients with CVI and ulceration of the lower limb.
- Author
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Williams A
- Subjects
- Chronic Disease, Community Health Nursing methods, Edema diagnosis, Edema etiology, Evidence-Based Practice, Humans, Leg Ulcer diagnosis, Leg Ulcer etiology, Skin Care methods, Skin Care nursing, Stockings, Compression, Venous Insufficiency complications, Venous Insufficiency diagnosis, Edema prevention & control, Leg Ulcer prevention & control, Venous Insufficiency prevention & control
- Published
- 2009
- Full Text
- View/download PDF
42. Leech therapy.
- Author
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Yantis MA, O'Toole KN, and Ring P
- Subjects
- Animals, Attitude to Health, Contraindications, Hirudo medicinalis, Humans, Infection Control methods, Leeching psychology, Medical Waste Disposal methods, Nurse's Role, Nursing Assessment, Patient Education as Topic, Patient Selection, Risk Factors, Skin Care methods, Skin Care nursing, Venous Insufficiency etiology, Venous Insufficiency prevention & control, Leeching methods, Leeching nursing
- Abstract
Leech therapy is experiencing a resurgence in health care today, primarily in plastic and reconstructive surgery as a treatment for venous congestion, which can threaten surgical outcomes. Most nurses have had no formal training in administering the therapy or in maintaining Hirudo medicinalis, the species of freshwater worm used therapeutically. Yet nurses may be expected to participate in this therapy in a variety of clinical settings and can use these guidelines for the safe and effective use of the leech in treatment.
- Published
- 2009
- Full Text
- View/download PDF
43. Thrombus resolution and vein wall injury: dependence on chemokines and leukocytes.
- Author
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Henke PK and Wakefield T
- Subjects
- Cell Transdifferentiation, Chronic Disease, Humans, Inflammation complications, Inflammation pathology, Inflammation therapy, Intercellular Signaling Peptides and Proteins metabolism, Male, Matrix Metalloproteinases metabolism, Postthrombotic Syndrome pathology, Postthrombotic Syndrome prevention & control, Stem Cells immunology, Thrombosis complications, Thrombosis pathology, Thrombosis therapy, Veins pathology, Venous Insufficiency pathology, Venous Insufficiency prevention & control, Chemokines metabolism, Inflammation immunology, Leukocytes immunology, Postthrombotic Syndrome immunology, Thrombosis immunology, Veins immunology, Venous Insufficiency immunology
- Abstract
Chronic venous insufficiency resulting in post-thrombotic syndrome occurs commonly after acute deep vein thrombosis, and is a prevalent cause of vascular disease morbidity in the community. Therefore, a better understanding of the pathophysiologic mechanisms that promote the development of chronic venous insufficiency could lead to novel approaches to interrupt the natural history and prevent post-thrombotic syndrome. In this paper, we will review the evidence that venous thrombus resolution is an inflammatory process that is dependent on chemokines and leukocytes.
- Published
- 2009
- Full Text
- View/download PDF
44. Dealing with the venous congestion of free flaps: venous catheterization.
- Author
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Gürsoy K, Kankaya Y, Uysal A, and Koçer U
- Subjects
- Adult, Anastomosis, Surgical adverse effects, Anastomosis, Surgical methods, Axillary Vein surgery, Carcinoma, Squamous Cell surgery, Catheterization, Central Venous instrumentation, Facial Neoplasms surgery, Female, Follow-Up Studies, Forearm blood supply, Humans, Jugular Veins surgery, Neck Dissection, Neoplasm Recurrence, Local surgery, Regional Blood Flow physiology, Skin Neoplasms surgery, Venous Insufficiency prevention & control, Venous Thrombosis etiology, Venous Thrombosis therapy, Catheterization, Central Venous methods, Hyperemia therapy, Plastic Surgery Procedures methods, Surgical Flaps blood supply
- Abstract
For head and neck reconstruction after tumor ablation surgery, free flaps are mostly the chosen treatment modality for most of the centers. Coping with venous insufficiency and increasing venous outflow of the flap during this process increases the success rate. To increase venous outflow, triple-lumen central venous catheter is inserted to one of the donor veins of the flap that has venous insufficiency and one intact vein anastomosis.
- Published
- 2008
- Full Text
- View/download PDF
45. [In focus: the optimal venous therapy].
- Author
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Hess C
- Subjects
- Angioplasty, Laser methods, Catheter Ablation methods, Catheterization methods, Chronic Disease, Female, Humans, Male, Sclerotherapy methods, Varicose Ulcer complications, Varicose Veins complications, Varicose Veins surgery, Varicose Veins therapy, Venous Insufficiency etiology, Venous Insufficiency prevention & control, Venous Insufficiency therapy
- Published
- 2008
- Full Text
- View/download PDF
46. [Surgical treatment of pelvic vein thrombosis--contra].
- Author
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Dellas C and Konstantinides S
- Subjects
- Chronic Disease, Collateral Circulation physiology, Humans, Postthrombotic Syndrome prevention & control, Secondary Prevention, Veins surgery, Venous Insufficiency prevention & control, Venous Thromboembolism prevention & control, Venous Thrombosis complications, Venous Thrombosis surgery, Anticoagulants therapeutic use, Intermittent Pneumatic Compression Devices, Pelvis blood supply, Stockings, Compression, Thrombolytic Therapy, Venous Thrombosis therapy
- Published
- 2008
- Full Text
- View/download PDF
47. Management of petrosal veins during microvascular decompression for trigeminal neuralgia.
- Author
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Zhong J, Li ST, Xu SQ, Wan L, and Wang X
- Subjects
- Adult, Aged, Aged, 80 and over, Brain Edema etiology, Brain Edema physiopathology, Brain Edema prevention & control, Cerebral Infarction etiology, Cerebral Infarction physiopathology, Cerebral Infarction prevention & control, Cerebral Veins pathology, Cerebral Veins physiopathology, Cranial Fossa, Middle anatomy & histology, Cranial Fossa, Middle surgery, Cranial Sinuses anatomy & histology, Decompression, Surgical adverse effects, Female, Humans, Male, Microcirculation pathology, Microcirculation physiopathology, Middle Aged, Monitoring, Intraoperative methods, Neurosurgical Procedures adverse effects, Postoperative Complications etiology, Postoperative Complications physiopathology, Postoperative Complications prevention & control, Postoperative Hemorrhage etiology, Postoperative Hemorrhage physiopathology, Postoperative Hemorrhage prevention & control, Retrospective Studies, Tissue Adhesions pathology, Tissue Adhesions physiopathology, Tissue Adhesions surgery, Treatment Outcome, Trigeminal Nerve blood supply, Trigeminal Nerve physiopathology, Trigeminal Nerve surgery, Trigeminal Neuralgia physiopathology, Venous Insufficiency etiology, Venous Insufficiency physiopathology, Venous Insufficiency prevention & control, Cerebral Veins surgery, Decompression, Surgical methods, Microcirculation surgery, Neurosurgical Procedures methods, Trigeminal Neuralgia surgery
- Abstract
Objective: Venous compression might be the main cause of incomplete decompression and symptom recurrence after microvascular decompression (MVD) in patients with trigeminal neuralgia. Although it can be killed in most cases, cutting the vein sometimes has the potential risk arising from venous congestion. To maneuver the vein safely, we introduced a temporary occlusion test of the vein., Methods: Among 407 consecutive MVD cases, 48 (11.8%) offending and 157 block veins were encountered. The vein was cut directly in 147 (71.7%). Owing to the potential risk following killing of the vein, 58 (28.3%) patients underwent venous occlusion test with neurophysiologic monitoring during the operation. The temporal occlusion should be ceased immediately as soon as any changes in brainstem auditory evoked potential (BAEP) or trigeminal evoked potential (TEP) wave figuration turn up; otherwise, it would last for 15 minutes., Results: The occlusion test was negative in 53 (91.4%), while positive in five patients (8.6%). According to the results, we cut the vein in test-negative patients, which made the operation easy and offered a satisfactory decompression. Among the five positive cases, the vein was finally saved in two and cut in three cases. Yet, all the three patients developed a severe ipsilateral cerebellar edema and brainstem shift after the vein was sacrificed. Despite those patients were reoperated on immediately for posterior fossa decompression, they remained equilibrium disorder with numbness in ipsilateral face and mind hemiparesis in contralateral extremities post-operatively. The residual two patients had an incomplete pain relief., Conclusion: This venous occlusion test could help the surgeon in making a right decision before manipulation of the petrosal veins during MVD.
- Published
- 2008
- Full Text
- View/download PDF
48. Early Palma procedure after iliac vein injury in abdominal penetrating trauma.
- Author
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Alcocer F, Aguilar J, Agraz S, and Jordan WD Jr
- Subjects
- Abdominal Injuries diagnostic imaging, Abdominal Injuries physiopathology, Adult, Anastomosis, Surgical, Anticoagulants therapeutic use, Femoral Vein surgery, Humans, Iliac Vein diagnostic imaging, Iliac Vein injuries, Iliac Vein physiopathology, Ligation, Male, Middle Aged, Retrospective Studies, Saphenous Vein surgery, Time Factors, Treatment Outcome, Ultrasonography, Doppler, Duplex, Vascular Patency, Venous Insufficiency etiology, Venous Insufficiency prevention & control, Venous Thrombosis etiology, Venous Thrombosis prevention & control, Wounds, Gunshot diagnostic imaging, Wounds, Gunshot physiopathology, Abdominal Injuries surgery, Iliac Vein surgery, Vascular Surgical Procedures adverse effects, Wounds, Gunshot surgery
- Abstract
Ligation for penetrating abdominal vein trauma may have better outcome than a vascular reconstruction in an unstable patient. However, symptoms of chronic venous insufficiency may appear over time. We describe our surgical experience with 4 patients who underwent iliac vein ligation followed by venous bypass with a modified Palma derivation between 48 and 240 hours after sustaining penetrating abdominal trauma with concomitant iliac vein injury. Patients were assessed for venous symptoms and conduit patency with continuous wave Doppler and duplex scanning. One graft occluded acutely and the remaining three remain patent with functioning valves. In order to preserve venous outflow after severe iliac vein injury, we think that venous ligation as a part of damage control surgery followed by a modified Palma operation may prevent chronic symptoms of venous outflow obstruction without compromising an already injured patient.
- Published
- 2008
- Full Text
- View/download PDF
49. Lower extremity venous disorders: implications for nursing practice.
- Author
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Kelechi T and Bonham PA
- Subjects
- Humans, Lower Extremity diagnostic imaging, Nursing Assessment methods, Nursing Methodology Research, Risk Factors, Ultrasonography, Doppler nursing, Varicose Ulcer diagnostic imaging, Varicose Ulcer prevention & control, Venous Insufficiency diagnostic imaging, Venous Insufficiency prevention & control, Venous Thrombosis nursing, Lower Extremity blood supply, Nurse's Role, Quality of Life, Varicose Ulcer nursing, Venous Insufficiency nursing
- Abstract
Lower extremity chronic venous disorders are significant and common causes of vascular morbidity and mortality worldwide. Venous ulcer relapse rates are as high as 72% and account for approximately 80% to 90% of all lower extremity ulcers. Venous disorders, much like arterial disease, are often progressive and chronic in nature, resulting in enormous economic and human costs in terms of treatment, pain, and suffering. Individuals with skin changes are at high risk of recurrent leg ulcers, which negatively affect the quality of life for both the individual and the family. Prevention efforts should target anatomical vein dysfunction, edema, and skin changes to prevent leg ulcers. This article presents an overview of both clinical and laboratory assessments of lower extremity chronic venous disorders, including descriptions of the risks and pathogenesis for differential diagnosis and implications for nursing.
- Published
- 2008
- Full Text
- View/download PDF
50. [The effect of oral contraceptives on the orthostatic diameter of lower limb major veins and its correction].
- Author
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Tsukanov IuT, Tsukanov AIu, and Bazhenov VN
- Subjects
- Adolescent, Adult, Endothelium, Vascular diagnostic imaging, Endothelium, Vascular drug effects, Female, Femoral Vein diagnostic imaging, Femoral Vein drug effects, Humans, Saphenous Vein diagnostic imaging, Saphenous Vein drug effects, Ultrasonography, Doppler, Duplex, Venous Insufficiency diagnostic imaging, Venous Thrombosis diagnostic imaging, Young Adult, Contraceptives, Oral, Hormonal adverse effects, Diosmin pharmacology, Diosmin therapeutic use, Dizziness, Venous Insufficiency chemically induced, Venous Insufficiency prevention & control, Venous Thrombosis chemically induced, Venous Thrombosis prevention & control
- Abstract
Unlabelled: The study assessed the effect of combined oral contraceptives (COCs) on the lower limb major vein diameter during orthostasis and the possibility of its medical correction in 214 women aged 17-42 with chronic venous insufficiency (CVI), including 37 women with CEAP class C0, 76 - with class C1 and 101 - with class C2. Venous diameter was measured by duplex scanning; its increment between evening and morning measurements was calculated in 3 groups. In the first group (n=68) venous diameter was measured before COC indication and after 2 months of COC use. In this group the second assessment revealed significant increase in venous diameter among women with CVI classes C1 and C1. The second group (n=69) received COCs for at least 6 months; then COC was withdrawn and Flebodia 600 was indicated. In this group venous scanning was fulfilled during COC use and after 2 months of its withdrawal and Flebodia 600 indication. Statistically significant decrease of orthostatic venous diameter was demonstrated for all scanned veins, evidencing diosmine-induced enhanced venous tone. The third group (n=77) did not interrupted COC intake and received Flebodia 600 concurrently. In this group venous measurements were fulfilled before and after 2 months of Flebodia 600 intake. Significant, though not ubiquitous decrease of venous diameter was registered in this group., Conclusion: Phlebopathic effect of COCs was demonstrated in women with CVI, CEAP classes 0-1-2, as well as safety and efficiency of Flebodia 600. The results prove the feasibility of Flebodia 600 indication for this population in case of COC intake.
- Published
- 2008
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