Journal of Vascular Surgery. Venous and Lymphatic Disorders

OBJECTIVE: There is increasing recognition that health systems need to measure and improve the value of patient care by measuring outcomes. Chronic pelvic pain (CPP) secondary to pelvic venous insufficiency can have a significant impact on the quality of life of women affected. Despite growing recognition, Pelvic Venous disorders (PeVD), an important cause of CPP, remain underdiagnosed. Developing a core outcome set (COS) for benchmarking care delivery enhances the standardisation of care...

BACKGROUND: The optimal treatment approach for patients with active venous leg ulcers (VLUs) and post-thrombotic syndrome (PTS) associated with great saphenous vein (GSV) reflux remains unclear. To address this gap, we retrospectively compared the outcomes of patients with post-thrombotic VLU with an intact GSV vs those with a stripped or ablated GSV. METHODS: We retrospectively analyzed data from 48 patients with active VLUs and documented PTS, who were treated at a single center between January 2018 and December 2022...

OBJECTIVE: Interventional treatments for acute iliofemoral deep vein thrombosis (DVT) remain controversial following publication of the ATTRACT study. Interventions have been shown to reduce post-thrombotic syndrome (PTS) severity and improve quality of life in DVT patients but have been accompanied by risk of major bleeding from thrombolytics. We describe thrombus removal using a novel combined basket-rotational thrombectomy device that minimizes the need for thrombolytics or repeat procedures...

OBJECTIVE: This study aimed to characterize radiographic characteristics on computed tomography venography (CTV) and risk factors of inferior vena cava thrombosis (IVCT) in situ following retrievable vena cava filter (VCF) placement. METHODS: Between September 2018 and June 2023, a single-center retrospective cohort study was conducted in patients with or without IVCT in situ following VCF placement. Patient baseline demographics, presentation of lower extremity deep vein thrombosis (LEDVT), thrombus characteristics, concurrent pulmonary embolism, comorbidities and risk factors for LEDVT, and inferior vena cava (IVC) and VCF-related information were collected and analysed...

BACKGROUND: Column interruption duration (CID) is a non-invasive surrogate for venous refill time (VFT), a parameter used in ambulatory venous pressure measurement. CID is more accurate than invasive VFT measurement because it avoids errors involved with indirect access of the deep system through the dorsal foot vein. The aim of this retrospective single center study is to analyze the clinical usefulness of CID in assessment of chronic venous disease (CVD). Methods PATIENTS & SUBJECTS: A total of 1551 limbs (777 patients) were referred with CVD symptoms over a 5-year period (2018-2023); CID, Air plethysmography (APG) and duplex reflux data were analyzed...

BACKGROUND: Recanalization of target veins following treatment of superficial venous incompetence has clinical implications and may be dependent on the type of intervention. The aim of this study was to evaluate patient and procedural factors associated with truncal vein recanalization in a large study cohort using the Vascular Quality Initiative (VQI) Varicose Vein Registry. METHODS: We performed a retrospective review using the VQI Varicose Vein Registry from 2014 to 2018...

OBJECTIVE: To describe the feasibility and short-term outcome of our surgical technique to repair the lymph vessel disruption directly after axillary lymph node dissection (ALND) during breast cancer surgery. This is called immediate lymphatic reconstruction to prevent breast cancer treatment-related lymphedema (BCRL), which frequently occurs after ALND. The surgical technique consisted of lymphaticovenous anastomosis (LVA) or lymphaticolymphatic anastomosis. We named the procedure lymphatic bypass supermicrosurgery (LBS)...

BACKGROUND: In the setting of a known thrombotic event, computed tomography (CT) studies provide reasonable sensitivity for the diagnosis of deep venous thrombosis (DVT). However, the incidence and accuracy of a DVT diagnosis on CT studies not targeted for the detection of DVT is not well described. Additionally, the clinical impact of DVTs incidentally identified on CT is unknown. METHODS: In this single institution retrospective study, we queried all contrasted CT studies of the lower extremities performed over a 10-year period...

OBJECTIVE: Major progress in reperfusion strategies has substantially improved the short-term outcomes of patients with pulmonary embolism (PE), however, up to 50% of patients report persistent dyspnea after acute PE. METHODS: A retrospective study of the pulmonary embolism response team (PERT) registry and included patients with repeat imaging at 3 to 12 months. The primary outcome was to determine the incidence of residual pulmonary vascular obstruction (RPVO) following acute PE...

INTRODUCTION: Pelvic venous reflux may be responsible for pelvic venous disorders and/or lower limb (LL) varicose veins. Ultrasound investigation with Doppler allows a complete study of the entire infra-diaphragmatic venous reservoir. OBJECTIVES: To guide and standardize the investigation of the pelvic origin of venous reflux in female patients with LL varicose veins. METHOD: In this case-control study, we applied a comprehensive ultrasound investigation protocol, which involved four steps: 1...

No abstract text is available yet for this article.

OBJECTIVES: Chronic venous disease (CVD) and static foot disorders (SFD) are prevalent conditions that commonly cause lower extremity pain. These conditions share common factors such as age and weight in their etiology. This study aimed to investigate the impact of SFD on the treatment response of patients undergoing conservative treatment for CVD without wounds. MATERIALS AND METHODS: A retrospective evaluation was conducted on 328 patients (60 males, 268 females) with CVD...

BACKGROUND: Thrombolytic therapy is effective method in the high-risk acute pulmonary embolism treatment (PE). Reduced-dose thrombolysis (RDT) plus oral anticoagulation therapy is effective and safe method in the moderate and severe PE treatment. It is leading to good early and intermediate-term outcomes. In the RE-COVER and RE-COVER II studies, dabigatran shown similar effectiveness as warfarin in the acute PE treatment. HYPOTHESIS: Dabigatran leads to fewer hemorrhagic complications and is not inferior in efficacy to warfarin in the PE prevention after mechanical fragmentation and reduced-dose thrombolysis (CDT+RDT) in patients with high and intermediate-high PE risk...

No abstract text is available yet for this article.

OBJECTIVE: Lymphedema is a common complication of cancer treatment such as lymphadenectomy and radiation therapy. It is a debilitating condition with pathologic tissue changes that hinder effective curative treatment and jeopardize patients' quality of life. Various attempts to prevent the development of lymphedema have been made with improvements in the incidence of the pathology. However, it is still prevalent among cancer survivors. In this paper, we review both molecular therapeutics and immediate surgical lymphatic reconstruction as treatment strategies after lymphadenectomy...

BACKGROUND AND OBJECTIVE: Endovenous radiofrequency ablation (RFA) and laser ablation (LA) have been commonly used for treating lower extremity varicose veins (LEVV). Their therapeutic effects have been widely recognized compared with conventional surgery. However, there have been some controversies regarding the choice between RFA and LA. The objective of our study was to conduct a systematic review and meta-analysis comparing the early and long-term outcomes of RFA and LA. METHODS: A comprehensive search was performed in the PubMed, Embase, and Cochrane databases to identify relevant literature on endovenous thermal ablation (ETA) for primary LEVV up until June 2023...

BACKGROUND: The overall goal of this report is to provide a high-level, practical approach to managing venous outflow obstruction (VOO). METHODS: A group of vascular surgeons from Australian and New Zealand with specific interest, training, and experience in the management of VOO were surveyed to assess current local practice. The results were analysed, and areas of disagreement identified. Following this, the group performed a literature review of consensus guidelines published by leading international organizations focused on the management of chronic venous disease, namely the Society for Vascular Surgery, American Venous Forum, European Society for Vascular Surgery, American Vein and Lymphatic Society, Cardiovascular and Interventional Radiology Society of Europe, and American Heart Association...

OBJECTIVE: Intraluminal anomalies within the left common iliac vein, characteristic of iliac vein compression syndrome, are thought to result from compression by and pulsation of the overlying right common iliac artery. This cadaver study was designed to expand on the existing literature by surveying and photographing these spurs in addition to exploring whether certain factors, inherent to the cadaver, are associated with spur presence. METHODS: Dissection to expose the aorta, inferior vena cava, and common iliac arteries and veins was performed in 51 cadavers...

OBJECTIVE: The aim of this study is to assess race and sex disparities in utilization and outcomes of various interventions in acute PE patients. METHODS: 129,445 patients with acute PE were included from the National Inpatient Sample (NIS) from January 2016 - December 2019. Rates of inferior vena cava (IVC) filter placement, catheter directed thrombolysis (CDT), CDT with ultrasound (CDT-US), systemic thrombolysis, surgical embolectomy, percutaneous thrombectomy, extracorporeal membrane oxygenation (ECMO), and mechanical ventilation were compared between race and sex subgroups, along with length of hospital stay, major bleeding events, mortality, and other adverse events...

No abstract text is available yet for this article.