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Annals of Vascular Surgery Jan 2017The study investigated the association between lower extremity varicose veins in men and varicocele.
BACKGROUND
The study investigated the association between lower extremity varicose veins in men and varicocele.
METHODS
A total of 100 patients who presented to the Department of Vascular Surgery in the First Affiliated Hospital of Anhui Medical University with the diagnosis of lower extremity varicose veins were included in the study group. A total of 100 adults without vascular disease were included as controls. The prevalence of varicocele between the study group and the control group was compared. We compared the prevalence of varicocele and the mean diameter of spermatic veins between the patients with and without reflux in the saphenofemoral junctions. We analyzed the association between the maximum spermatic vein diameter and the maximum diameter of lower extremity varicose veins in patients who had both lower extremity varicose vein and varicocele in the study group. According to their clinic signs, patients with lower extremity varicose veins were divided into C1-C6 by clinic sign grade of Clinical-Etiology-Anatomy-Pathophysiology (CEAP), and we investigated the trend of the incidence of varicocele and the mean diameter of spermatic veins in different grades.
RESULTS
The patients with lower extremity varicose veins had a statistically significant (χ = 20.05, P < 0.01) higher rate of varicocele when compared with controls. We compared the prevalence of varicocele and the mean diameter of spermatic veins between the patients with and without reflux in the saphenofemoral junctions and found no statistically significant differences between them (prevalence of varicocele P > 0.05, diameter P > 0.05). We found a linear correlation between the maximum spermatic vein diameter and the maximum diameter of lower extremity varicose veins in the patients who had both lower extremity varicose veins and varicocele in the study group (coefficient of rank correlation r = 0.4072, P < 0.01). The patients in the study group were classified into 6 grades by CEAP. After the analysis by trend chi-square, we found that the prevalence of varicocele had no statistical trend in different grades (χ = 0.8798, P > 0.05), and the mean diameter of spermatic vein also had no statistical trend in different grades (F = 1.59, P > 0.05).
CONCLUSIONS
In conclusion, we demonstrated that the prevalence of varicocele is higher in patients with varicose veins in lower extremity than the patients without vascular diseases. The reason for the association between varicose vein in lower extremity and varicocele remains uncertain.
Topics: Adult; Case-Control Studies; China; Humans; Lower Extremity; Male; Middle Aged; Predictive Value of Tests; Prevalence; Risk Factors; Spermatic Cord; Ultrasonography, Doppler, Color; Varicocele; Varicose Veins; Veins
PubMed: 27531086
DOI: 10.1016/j.avsg.2016.05.105 -
International Angiology : a Journal of... Dec 2023The study aims to identify the incidence of symptomatic and asymptomatic venous thromboembolism (VTE) after minimally invasive varicose vein surgery and to assess the...
BACKGROUND
The study aims to identify the incidence of symptomatic and asymptomatic venous thromboembolism (VTE) after minimally invasive varicose vein surgery and to assess the predictability of the Caprini risk score (CRS).
METHODS
CAPrini Score In Venous Surgery (NCT03041805) is a registry-based prospective study that enrolls patients undergoing minimally invasive open (high ligation, stripping, miniphlebectomy) and endovascular (thermal and non-thermal ablation) surgery on varicose veins. The main inclusion criteria are CRS assessment before intervention and a duplex ultrasound scan performance within 2-4 weeks after surgery. The primary outcome is a combination of asymptomatic or symptomatic DVT, including EHIT of class 2-4 and PE.
RESULTS
Totally 1878 records with defined outcomes were analyzed. The mean age of patients was 46.9±13.3 years; 66% were female. Endovenous laser ablation was performed in 88%. Varicose tributaries were treated in 40%, perforating veins in 3.9% of cases. CRS ranged from 1 to 12 (mean of 4.0±1.5). Prophylactic anticoagulation was prescribed in 20%. The primary outcome was reported in 63 cases (3.4%; 95% CI, 2.7-4.3%), comprising asymptomatic (N.=29, 1.5%) or symptomatic (N.=10, 0.5%) DVT or EHIT (n=28, 1.6%). No PE was reported. A significant correlation was found between CRS and VTE incidence (P=0.001). Under logistic regression CRS (OR, 1.3; 95% CI, 1.1-1.6) along with treatment of tributaries (OR, 6.3; 95% CI, 3.0-13.0) and perforating veins (OR, 10.7; 95% CI, 3.8-30.2) were associated with VTE in the absence of prophylactic anticoagulation.
CONCLUSIONS
The incidence of VTE after ablation of superficial veins is 3.4%, predominantly due to asymptomatic EHIT and DVT, and significantly correlates with CRS.
Topics: Humans; Female; Adult; Middle Aged; Male; Venous Thromboembolism; Prospective Studies; Varicose Veins; Vascular Surgical Procedures; Risk Factors; Anticoagulants; Saphenous Vein; Treatment Outcome; Retrospective Studies
PubMed: 38078711
DOI: 10.23736/S0392-9590.23.05050-2 -
Dermatologie (Heidelberg, Germany) Mar 2023Endovenous procedures are commonly used for varicose vein treatment. (Review)
Review
BACKGROUND
Endovenous procedures are commonly used for varicose vein treatment.
OBJECTIVES
Types, functionality, and significance of endovenous devices.
METHODS
To describe the different endovenous devices, their mode of action, inherent risks and efficacy according to the literature.
RESULTS
Long-term data confirm that endovenous procedures are equally effective as open surgery. Postoperative pain is minimal and downtime shorter after catheter interventions.
CONCLUSION
Catheter-based endovenous procedures increase the diversity of varicose vein treatment options. They are preferred by patients due to less pain and shorter downtime.
Topics: Humans; Laser Therapy; Catheter Ablation; Saphenous Vein; Varicose Veins; Catheters; Pain, Postoperative
PubMed: 36811641
DOI: 10.1007/s00105-023-05113-w -
Magyar Sebeszet Sep 2018With the development of medicine, technical inventions have been intoduced into the therapy of varicose veins, such as ultrasound examination and laser treatment.
INTRODUCTION
With the development of medicine, technical inventions have been intoduced into the therapy of varicose veins, such as ultrasound examination and laser treatment.
PATIENTS AND METHODS
Over 11 years 1729 laser surgery were performed on varicose veins. Junctions of saphenous veins, saphenous stems and perforator veins were treated with lasers, but reticular and spider veins were treated with other methods. The most important elements of laser surgery are the introduction of the laser fibre into the lumen of the vein and delivering the laser energy. All of this is performed without incisions under ultrasound guidance. Laser crossectomy is an innovation in our technique. This procedure is performed under a combination of local and intravenous anaesthesia.
RESULTS
After 1 year 58% of operated legs (998) were checked (mean 3.3 years) and recurrent varicosity was found in 114 legs (11.4%). Recurrences were found mainly in those cases which would have been excluded from other studies, but in everyday practice they occur in a high percentage, such as being overweight, after delivery and previously operated cases. In selected cases, the recurrence rate is only 6.0%. Complications after laser surgery are less frequent than following classic varicose vein surgery.
CONCLUSIONS
According to international guidelines and this study, endovascular interventions can be recommended instead of classic varicose vein surgery because they are less demanding, and cause fewer complications. Using laser crossectomy, the number of early recurrences decreases. All stem varicosities are suitable for laser surgery.
Topics: Adult; Female; Humans; Laser Therapy; Treatment Outcome; Varicose Veins
PubMed: 30231633
DOI: 10.1556/1046.71.2018.3.4 -
Phlebology Mar 2016In 2013, the new Dutch guideline for "Venous Pathology" was published. The guideline was a revision and update from the guideline "Diagnostics and Treatment of Varicose... (Review)
Review
In 2013, the new Dutch guideline for "Venous Pathology" was published. The guideline was a revision and update from the guideline "Diagnostics and Treatment of Varicose Veins" from 2009 and the guideline "Venous Ulcer" from 2005. A guideline for "Deep Venous Pathology" and one for "Compression Therapy" was added to the overall guideline "Venous Pathology." The chapter about treatment of recurrent varicose veins after initial intervention was recently updated in 2015 and is reviewed here. The Dutch term "recidief varices" or the French "récidive de varices" should be used analogous to the English term "recurrent varicose veins." The DCOP Guideline Development Group Neovarices concluded that "recidief" in Dutch actually suggests recurrence after apparent successful treatment and ignores the natural progression of venous disease in its own right. So the group opted to use the term "neovarices." In the Dutch guideline, neovarices is meant to be an all embracing term for recurrent varicose veins caused by technical or tactical failure, evolvement from residual refluxing veins or natural progression of varicose vein disease at different locations of the treated leg after intervention. This report reviews the most important issues in the treatment of varicose vein recurrence, and discusses conclusions and recommendations of the Dutch Neovarices Guideline Committee.
Topics: Humans; Netherlands; Practice Guidelines as Topic; Recurrence; Varicose Veins
PubMed: 26916778
DOI: 10.1177/0268355516631683 -
Phlebology Dec 2021The Venablock Venous Closure System (Invamed, Ankara, Turkey) is a novel cyanoacrylate-based non-thermal non-tumescent embolization device to block refluxing truncal... (Clinical Trial)
Clinical Trial
BACKGROUND
The Venablock Venous Closure System (Invamed, Ankara, Turkey) is a novel cyanoacrylate-based non-thermal non-tumescent embolization device to block refluxing truncal veins for chronic venous insufficiency and varicose veins. The aim was to prospectively evaluate the safety and 6 months efficacy of Venablock for the treatment of primary great saphenous vein (GSV) and small saphenous vein (SSV) incompetency in a multi-ethnic cohort from Singapore.
METHODS
This was a single arm, single investigator prospective study of 29 patients (39 limbs, 39 truncal veins) recruited over a 5-month period (August 2019 to February 2020), who were treated with the Venablock device at a tertiary vascular unit in Singapore. Patients with symptomatic varicose veins (C2-6) and had truncal reflux > 0.5 second on venous Duplex ultrasound were included. Follow-up occurred at 2 weeks, 3 and 6 months with dedicated quality of life questionnaires and a targeted Duplex ultrasound performed to check for continued venous occlusion.
RESULT
Mean age was 61.4 (±11.0) years and mean BMI was 26.2 (±5.7) kg/m. 11/29 (37.9%) were males. Most common CEAP class treated was 2 (12/29, 41.3%). Mean diameter of treated GSV was 5.7 (±2.0) mm, 4.8 (±1.7) mm and 4.2 (±1.3) mm for the proximal, mid and distal above knee segments respectively. Mean time from access puncture to sheath removal was 23.4 (±10.0) mins. Vein occlusion at 2 weeks, 3 and 6 months was 39/39 (100%), 39/39 (100%) and 36/37 (97.2%) respectively. 5/29 (17.2%) developed puncture site infections, of which 3/29 (7.7%) required formal surgical drainage. 3/29 (7.7%) developed phlebitis. At 6 months, revised Venous Clinical Severity Score improved from 5.2 (±3.5) to 2.1 (±2.9; p < .001); EuroQol-5 Dimension score, from 7.4 (±2.1) to 5.7 (±1.4; p < .001); Aberdeen Varicose Vein Questionnaire score, from 18.1 (±15.5) to 7.9 (±8.9; p = .007); and Chronic Venous Insufficiency Questionnaire, from 18.6 (±16.2) to 4.5 (±6.3; p < .001).
CONCLUSION
Venablock is a safe and efficacious option of treating truncal venous insufficiency in a multi-ethnic Asian cohort from Singapore in the short term. There is a significant improvement in QoL. Longer follow-up is required to assess the durability of this technique, in particular the higher puncture site infection rates observed compared to other glue-based therapies.
Topics: Humans; Male; Middle Aged; Prospective Studies; Quality of Life; Registries; Saphenous Vein; Singapore; Treatment Outcome; Varicose Veins; Venous Insufficiency
PubMed: 34152882
DOI: 10.1177/02683555211025181 -
International Journal of Molecular... Jan 2024One of the early symptoms of chronic venous disease (CVD) is varicose veins (VV) of the lower limbs. There are many etiological environmental factors influencing the... (Review)
Review
One of the early symptoms of chronic venous disease (CVD) is varicose veins (VV) of the lower limbs. There are many etiological environmental factors influencing the development of chronic venous insufficiency (CVI), although genetic factors and family history of the disease play a key role. All these factors induce changes in the hemodynamic in the venous system of the lower limbs leading to blood stasis, hypoxia, inflammation, oxidative stress, proteolytic activity of matrix metalloproteinases (MMPs), changes in microcirculation and, consequently, the remodeling of the venous wall. The aim of this review is to present current knowledge on CVD, including the pathophysiology and mechanisms related to vein wall remodeling. Particular emphasis has been placed on describing the role of inflammation and oxidative stress and the involvement of extracellular hemoglobin as pathogenetic factors of VV. Additionally, active substances used in the treatment of VV were discussed.
Topics: Humans; Varicose Veins; Veins; Venous Insufficiency; Lower Extremity; Chronic Disease; Inflammation
PubMed: 38338837
DOI: 10.3390/ijms25031560 -
African Health Sciences Sep 2023This research was devoted to estimate the outcome of preventive nursing intervention on venous thromboembolism (VTE) after varicose vein surgery in lower extremities.
OBJECTIVE
This research was devoted to estimate the outcome of preventive nursing intervention on venous thromboembolism (VTE) after varicose vein surgery in lower extremities.
METHODS
A total of 516 subjects with varicose veins of lower extremities (from January 2020 to January 2022) treated in our hospital were separated into observation subgroup (n = 258) and control subgroup (n = 258) at random. The conventional nursing intervention was applied in the control subgroup, preventive nursing intervention, prophylactic anticoagulation and the use of Caprini score was applied in the observation subgroup. The levels of blood indexes [hemoglobin (Hb), platelet (PLT) and D-dimer (D-D)] were compared between the two subgroups before operation and 7 days postoperative, the occurrence of subcutaneous congestion, lower limb swelling and pain, VTE and nursing satisfaction of the subject 4 (four) weeks after discharge.
RESULTS
After intervention, the levels of PLT and D-D in the observation subgroup were notably lower than those in the control subgroup. Four weeks after discharge, the incidence of subcutaneous congestion, lower limb swelling and pain, there had no notable difference in two subgroups Versus the control subgroup, VTE in the observation subgroup was notably lower and nursing satisfaction was higher.
CONCLUSION
Preventive nursing intervention can reduce the level of PLT and D-D, restrain in the incidence of VTE and improve the nursing satisfaction of subjects with varicose veins of lower extremities after varicose vein surgery of lower limb.
Topics: Humans; Venous Thromboembolism; Risk Assessment; Risk Factors; Anticoagulants; Varicose Veins; Pain; Retrospective Studies
PubMed: 38357111
DOI: 10.4314/ahs.v23i3.72 -
Dermatologic Surgery : Official... Jun 2023Recurrent varicose veins with neovascularization are a common clinical problem. Although endovenous laser ablation (EVLA) has become the standard treatment modality to...
BACKGROUND
Recurrent varicose veins with neovascularization are a common clinical problem. Although endovenous laser ablation (EVLA) has become the standard treatment modality to treat truncal veins, additional sclerotherapy is required to treat newly formed tortuous veins. A novel laser fiber with an injection channel (nLF) allows for such simultaneous proximal sclerotherapy and offers a potentially more effective treatment option.
OBJECTIVE
The aim of this study was to present our experience using the nLF for combined EVLA and sclerotherapy treatment of symptomatic recurrent varicose veins.
MATERIALS AND METHODS
A retrospective single-center cohort study analyzed the outcomes of all patients with symptomatic recurrent varicose veins, treated with an nLF between September 2020 and August 2022.
RESULTS
In total, 28 combined EVLA/sclerotherapy procedures performed with the nLF in 26 patients were analyzed. In all cases, neovascularizations were treated by sclerotherapy through the nLF catheter, followed by laser ablation of the remaining truncal veins. All follow-up ultrasound examinations showed persistent complete occlusion of the treated truncal veins and neovascularizations. No clinically relevant complications were observed.
CONCLUSION
Combining proximal foam sclerotherapy and distal EVLA using an nLF for the treatment of symptomatic recurrent varicose veins is safe and effective.
Topics: Humans; Sclerotherapy; Cohort Studies; Retrospective Studies; Saphenous Vein; Varicose Veins; Laser Therapy; Treatment Outcome; Catheter Ablation
PubMed: 36989122
DOI: 10.1097/DSS.0000000000003765 -
Phlebology Sep 2023To evaluate the postoperative hemodynamic changes in varicose vein surgery related with SSV reflux using APG.
PURPOSE
To evaluate the postoperative hemodynamic changes in varicose vein surgery related with SSV reflux using APG.
METHODS
Totals of 181 limbs and 178 patients who underwent high ligation and stripping (HLS) (87 limbs), radiofrequency ablation (RFA) (43 limbs), or endovenous laser ablation (EVLA) (51 limbs) for SSV reflux from 1995 to 2022 were enrolled. We measured venous volume (VV), venous filling index (VFI), ejection fraction (EF), and residual volume fraction (RVF) preoperatively and at postoperative one and 6 months.
RESULTS
Comparing preoperative results to those at postoperative 1 month, the reduction rates of VV, VFI, and RVF were 27, 53, and 31%, while EF increased by 18% ( < 0.001). Comparing preoperative and postoperative 6 month, the reduction rates of VV, VFI, and RVF were 27, 45, and 35%, while EF increased by 27% ( < 0.001).
CONCLUSIONS
There were hemodynamic improvement in the lower leg after varicose vein surgery including HLS, RFA, and EVLA.
Topics: Humans; Varicose Veins; Saphenous Vein; Treatment Outcome; Vascular Surgical Procedures; Hemodynamics; Laser Therapy; Venous Insufficiency
PubMed: 37478564
DOI: 10.1177/02683555231186508