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VASA. Zeitschrift Fur Gefasskrankheiten Nov 2023Insufficiency of the small saphenous vein causes 15% of varicose veins in the lower extremities. Endovenous ablation for the treatment of small saphenous vein varices... (Review)
Review
Insufficiency of the small saphenous vein causes 15% of varicose veins in the lower extremities. Endovenous ablation for the treatment of small saphenous vein varices has become a trend, and an increasing number of studies have reported the effects of different types of endovenous ablation in patients with small saphenous varicose veins. The purpose of this systematic review is to summarize the results of existing studies on endovenous ablation for the treatment of small saphenous varicose veins, compare its role and efficacy, and provide insights into the future development of endovenous ablation for treating small saphenous varicose veins. A systematic review of literature published from January 1, 2002 to January 1, 2022 was conducted from PubMed, Embase, and China Academic Journals full-text databases. The pre-determined inclusion criteria were clinical literature of endovenous ablation for treating small saphenous varicose veins. Keywords included "ablation", "small saphenous vein", "lesser saphenous vein", "short saphenous vein", "xiaoyinjingmai" and "xiaorong". Of the 506 articles screened, 33 articles were included in this review: 19 articles were related to endovenous laser ablation, five were related to mechanochemical ablation, seven were related to radiofrequency ablation, and two were related to both endovenous laser ablation and radiofrequency ablation. The anatomical success rate of endovenous laser ablation, radiofrequency ablation, and mechanochemical ablation were 94.3%, 96.0%, and 88.1%, respectively, and the heterogeneities were all moderate. Most of the current studies are of a low-quality level of research. Hence, long-term follow-up studies and large-scale randomized controlled trials are required to obtain high-quality evidence. Although the gold standard for the treatment of small saphenous vein insufficiency remains unclear, endovenous ablation is still the recommended method.
Topics: Humans; Saphenous Vein; Varicose Veins; Sclerotherapy; Laser Therapy; China; Treatment Outcome; Venous Insufficiency
PubMed: 37779391
DOI: 10.1024/0301-1526/a001091 -
Frontiers in Psychiatry 2023Varicose veins commonly occur on the legs and cause discomfort, pain, and aesthetic issues. Varicose vein surgery has an significant impact on sleep disorders such as...
BACKGROUND
Varicose veins commonly occur on the legs and cause discomfort, pain, and aesthetic issues. Varicose vein surgery has an significant impact on sleep disorders such as Restless Leg Syndrome (RLS), daytime sleepiness (DS), and sleep quality (SQ). We intended to determine if preoperative and postoperative sleep quality, excessive daytime sleepiness, and RLS severity impacted in those who had varicose vein surgery.
MATERIALS AND METHODS
The research included 160 patients who presented to the Cardiovascular Surgery outpatient clinic with symptoms of leg pain and cramping and were diagnosed with venous insufficiency. The Restless Legs Syndrome Study Group Rating Scale (RLSS), Epworth Sleepiness Scale (ESS), and Pittsburgh Sleep Quality Index (PSQI) tests were performed on patients. The patients' scores on the scales were compared preoperatively and postoperatively.
RESULTS
The mean age of the 160 patients was calculated to be 48.7 ± 10.6 years. There were 109 female (68.1%) and 51 male (31.9%). The mean ferritin level of the patients was calculated as 61.4 mL/ng (4.3-421 mL/ng). After varicose vein surgery 63% reported improved sleep quality. Individuals with increased DS had lower postoperative RLSS scores and higher SQ. There was a decrease in postoperative RLSS scores and an increase in postoperative SQ in patients with normal DS ( < 0.001). Postoperative RLSS and DS scores were lower in patients with good SQ ( < 0.001).
CONCLUSION
Patients had a lower RLSS score, a lower DS score, and a higher SQ after varicose vein surgery. Surgical treatment is critical to improving the quality of life and sleep comfort of patients with varicose veins and sleep disorders.
PubMed: 37692314
DOI: 10.3389/fpsyt.2023.1254936 -
VASA. Zeitschrift Fur Gefasskrankheiten Jun 2024The risk of developing deep vein thrombosis (DVT) after endovenous ablation of varicose veins varies in the literature. Little is known about the characteristics of...
The risk of developing deep vein thrombosis (DVT) after endovenous ablation of varicose veins varies in the literature. Little is known about the characteristics of this complication and associated factors. This study aimed: 1) to study the occurrence of DVT after ultrasound-guided foam sclerotherapy (UGFS) alone or combined with endovenous laser ablation (EVLA) for lower-limb varicose veins; 2) to identify factors associated with DVT. The study included all outpatients aged 18 years or older who underwent UGFS and EVLA or UGFS alone at the University Hospital of Zurich between 2011 and 2015. Data were extracted from the hospital electronic medical record. Patients were surveyed about their level of pain after the procedure and their level of satisfaction with the procedure. Duplex ultrasound was used to assess the deep venous system 7-10 days and 6-8 months after the procedure. Regression analysis was used to examine the association of patient and procedure characteristics with the development of DVT. A total of 334 patients (561 procedures performed in 393 different sessions) were included: 73% of the patients underwent combined UGFS and EVLA and 27% underwent UGFS alone. DVT occurred in 24 (7.2%) patients, of whom 88% underwent combined procedures and 17% underwent interventions involving both the great and small saphenous veins on the same session. DVT occurred in 8.2% of patients receiving thromboprophylaxis and in 9.5% of patients not receiving thromboprophylaxis. DVT occurred in 5.2% of women and 11.9% of men. No factors associated with a diagnosis of DVT after intervention were identified. Pain and satisfaction levels did not differ between patients with and without DVT. This study adds to the knowledge of the risk of DVT following UGFS alone or combined with EVLA. Further studies are needed to revise thromboprophylaxis.
PubMed: 38867589
DOI: 10.1024/0301-1526/a001130 -
International Wound Journal Nov 2023Chronic venous disease (CVD) occurs because of structural or functional disturbances to the venous system of the lower limbs. Signs and symptoms include leg pain,... (Review)
Review
Chronic venous disease (CVD) occurs because of structural or functional disturbances to the venous system of the lower limbs. Signs and symptoms include leg pain, swelling, varicose veins, and skin changes, with venous ulceration ultimately occurring in severe disease. To assess the prevalence of CVD among health care workers, a scoping review of existing publications exploring the prevalence of CVD among health care workers was conducted in July 2022. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines were used. A total of 15 papers met the inclusion criteria and these formed the basis of the review. Among health care workers, the mean prevalence of CVD was 58.5% and the mean prevalence for varicose veins was 22.1%. There is an increased prevalence of CVD in health care workers when compared with the general population. Therefore, there is a need for early diagnosis and the use of preventative measures to protect health care workers from CVD and varicose vein development.
Topics: Humans; Venous Insufficiency; Prevalence; Varicose Veins; Varicose Ulcer; Chronic Disease; Health Personnel
PubMed: 37139850
DOI: 10.1111/iwj.14222 -
Archives of Medical Sciences.... 2024Chronic venous disease (CVD) constitutes a frequently underdiagnosed pathological condition that progressively diminishes patients' quality of life and imposes an...
INTRODUCTION
Chronic venous disease (CVD) constitutes a frequently underdiagnosed pathological condition that progressively diminishes patients' quality of life and imposes an escalating strain on healthcare resources. This study aims to comprehensively investigate the epidemiological landscape of varicose vein disease, examining age group distributions, gender patterns, residence influences, marital status correlations, weight considerations, educational impacts, and various aspects related to varicose veins.
MATERIAL AND METHODS
This was a single-centre retrospective analysis, in Albania from May 2018 to September 2023. Data were collected retrospectively through hospital records. Data collection involved administering a structured questionnaire to study participants, categorically organised into three sections. The first section focused on collecting demographic information, the second section involved self-perception of identifying risk factors associated with varicose veins, and the final section included inquiries about the history of variceal surgery.
RESULTS
The CEAP classification distribution in our cohort revealed a predominant presence of C2 (varicose veins) in 53.3% of patients, followed by C3 (oedema) at 29.2%, and C4 (changes in skin and subcutaneous tissue secondary to CVD) at 10.5%, whereas C5 (healed venous ulcer) and C6 (active venous ulcer) were less frequent. Based on the body mass index (BMI) scale, data from patients indicated that 9.7% were in the category of underweight, 54.8% had a normal BMI, and 35.5% were categorised as overweight.
CONCLUSIONS
The study's thorough exploration of patient perspectives, risk factors, and treatment choices contributes to a holistic understanding of varicose vein management, emphasising the importance of personalised approaches that account for demographic variations and individual beliefs.
PubMed: 38846060
DOI: 10.5114/amsad/183653 -
Annals of Vascular Diseases Sep 2023: Due to the potential of thrombus blockage and aneurysm rupture, saphenous veins with varicose veins are not advised for use as bypass grafts. However, if no other...
: Due to the potential of thrombus blockage and aneurysm rupture, saphenous veins with varicose veins are not advised for use as bypass grafts. However, if no other autologous vein is accessible for use as a conduit in lower-limb bypass; varicose vein transplants may be employed. Few reports have studied the clinical results of lower-limb bypass using varicose vein grafts. We therefore investigated whether or not acceptable patency rates of varicose vein graft for lower-limb bypass could be achieved. : We performed lower-limb bypass using varicose vein graft on nine limbs from June 2017 to May 2020 and conducted a retrospective analysis of prospectively collected data. : Early graft failure following bypass surgery using a varicose vein transplant was not detected, and major complications, such as acute graft occlusion or aneurysm dilatation, were not noted throughout the follow-up period. The primary and secondary patency of varicose vein graft was 70.0% and 100% at 3 years, respectively. : The incidence of major problems of the varicose vein transplants does not seem to be higher than with conventional saphenous vein grafts. If there are no other appropriate autologous veins, a varicose vein graft may be useful as a conduit for bypass surgery.
PubMed: 37779647
DOI: 10.3400/avd.oa.22-00122 -
Cureus Oct 2023Heparin, a mixture of sulfated polymorphic polysaccharides (glycosaminoglycan) chains of variable lengths and weights and a natural anticoagulant, is widely used in... (Review)
Review
Heparin, a mixture of sulfated polymorphic polysaccharides (glycosaminoglycan) chains of variable lengths and weights and a natural anticoagulant, is widely used in medical practice to prevent intravascular blood coagulation. Heparin has demonstrated antithrombotic and anti-inflammatory activity, and it is mostly administered systemically (intravenously or subcutaneously) for primary or secondary prevention of venous thromboembolism after surgical interventions, or immobilized patients, or on short-term antithrombotic therapy of patients with atrial fibrillation who must undergo treatment. However, since systemic administration of heparin could be, in certain cases, linked to an increased risk of bleeding, topical heparin is widely used for the prevention and treatment of local symptoms of peripheral vascular disorders, such as venous insufficiency, varicose veins, or superficial thrombophlebitis. This review summarizes the main safety and efficacy characteristics of the topical formulation of Heparin in Gel form (1000 International Units of Heparin/g Gel) currently in use, which has demonstrated an excellent efficacy and tolerability profile in reducing signs and symptoms of peripheral vascular disease, e.g., varicose syndromes and their complications, phlebothrombosis, thrombophlebitis, superficial periphlebitis, varicose ulcers, for post-operative varicophlebitis, sequelae of saphenectomy, for traumas and contusions, local edemas and infiltrates, subcutaneous hematoma and for traumatic affections of musculotendinous and capsuloligamentous apparatuses.
PubMed: 38022089
DOI: 10.7759/cureus.47418 -
Annals of Vascular Surgery May 2024The primary aim of this study was to assess the feasibility of introducing a digital health education tool (dHET) for varicose vein surgery.
BACKGROUND
The primary aim of this study was to assess the feasibility of introducing a digital health education tool (dHET) for varicose vein surgery.
METHODS
This randomized, feasibility study allocated 40 patients, into dHET (n = 20) or standard consent (SC) (n = 20) groups. Primary outcomes were related to feasibility. Secondary outcomes were knowledge recall, anxiety, and satisfaction.
RESULTS
Recruitment and retention rates were 100% and 97.5%, respectively. Acceptability was also rated high, confirming feasibility. There was also no evidence of a difference between groups for early knowledge recall (14 [12-17] vs. 14 [11-16]; P = 0.72) or delayed (at 2 weeks) knowledge recall (15 [13-16] vs. 15 [13-16]; P = 0.89). The dHET module took significantly longer to complete compared to SC (13 min [12-18] vs. 9 min [8-12]; P < 0.01). However, the control group asked significantly more questions about the intended procedure (P = 0.03). There was no evidence of a difference between groups for patient anxiety or satisfaction.
CONCLUSIONS
This trial shows that the addition of a dHET is feasible and noninferior to SC. Digital consent provides a unique opportunity to promote patient education and autonomy for better shared decision making. It also offers better documentation of the consent process.
PubMed: 38810723
DOI: 10.1016/j.avsg.2024.02.030 -
Asian Journal of Surgery Jul 2023
Topics: Humans; Infant, Newborn; Klippel-Trenaunay-Weber Syndrome
PubMed: 36828683
DOI: 10.1016/j.asjsur.2023.02.047 -
International Wound Journal Feb 2024This study aimed to investigate the causal relationship between inflammatory cytokines and the risk of varicose veins. The data were sourced from genome-wide association...
This study aimed to investigate the causal relationship between inflammatory cytokines and the risk of varicose veins. The data were sourced from genome-wide association studies (GWAS) of European individuals. Multiple Mendelian randomization (MR) methods were used to evaluate the association between inflammatory cytokines and varicose veins. The study found significant associations between elevated levels of certain inflammatory biomarkers (e.g., CASP-8, Vascular endothelial growth factor A levels (VEGF_A)) and an increased risk of varicose veins, while others (e.g., 4EBP1, MMP-10) showed a protective effect. The MR-Egger Intercept and heterogeneity tests indicated no significant pleiotropy or heterogeneity. This comprehensive MR analysis identifies several cytokines as potential contributors to the pathogenesis of varicose veins, offering insights into novel therapeutic targets. Our findings underscore the importance of inflammation in varicose veins and suggest that targeting specific cytokines could be a promising strategy for the treatment and prevention of varicose veins.
Topics: Humans; Genome-Wide Association Study; Mendelian Randomization Analysis; Vascular Endothelial Growth Factor A; Varicose Veins; Cytokines
PubMed: 38353374
DOI: 10.1111/iwj.14714