Patients with peripheral arterial occlusive disease who show an ankle arterial pressure of minimum 60 mmHg can be decongested by use of special padded bandages. Afterwards, medical compression stockings (class 1) with high strength and less elasticity are recommended. Mobile patients seem to benefit from progressive compression therapy with highest pressure above the calf. Read More
This open registry aimed to evaluate the clinical evolution of postpartum varicose veins (VVs), in healthy women after the second pregnancy, how these veins regain shape and competence, and possible treatments. The registry included two groups of women: (1) those who used elastic compression stockings, and (2) who used an oral venotonic agent (Pycnogenol, 100 mg/d). A total of 12 evaluation targets were established. Read More
Sclerotherapy is an important part of the treatment of varicose veins. It may also be performed in patients with contraindications for operative procedures. By adjusting the mode of application (liquid or foam) and the concentration it can be used for the treatment of all vein types. Read More
The authors carried out a study aimed at revealing transitory refluxes along the great saphenous vein (GSV) in patients with intracutaneous varicosity, and at investigating the possibility of removing them by means of preparations of micronized purified flavonoid fraction (MPFF). The study included a total of one hundred and forty-seven 21-to-47-year-old (mean age 31±4.4 years) women presenting with cutaneous varicosity (class C1s). Read More
Background: Orthostatic loading can induce transient venous reflux (TVR). Among patients with telangiectasia and reticular varices, we determined the proportion that developed TVR after a day of orthostatic loading (DOL test), and investigated the remedial effects of micronized purified flavonoid fraction (MPFF).
Methods: All 96 patients enrolled in this study had telangiectasia and reticular varices. Read More
Background: Sclerotherapy has been extensively used in the treatment of valvular insufficiency of superficial veins. Although sclerotherapy seems safe, reports of serious adverse events (AE) have been published. This paper aims to review AE of sclerosing agents. Read More
Chronic venous disease is a common condition with clinical signs and symptoms ranging from spider veins, to varicose veins, to active venous ulceration. Both superficial and deep venous dysfunction may be implicated in the development of this disease. Socio-economic factors are shaping our population, with increasing age and body mass index resulting in significant pressure on healthcare systems worldwide. Read More
Blood supply of the tracheobronchial tree is derived from a dual system involving pulmonary and bronchial circulation. Various primary and secondary abnormalities of central airway vasculature can present with patterns that are distinct during bronchoscopy. These patterns maybe visualized during bronchoscopic evaluation of a patient with hemoptysis or as an incidental finding during an airway examination for other indications. Read More
Aim: To review the literature related to the management of reticular varices and telangiectases of the lower limbs to provide guidance on the treatment of these veins.
Findings: Very few randomised clinical trials are available in this field. A European Guideline has been published on the treatment of reticular varices and telangiectases, which is largely based on the opinion of experts. Read More
The aim of this study was to compare the results of high ligation and stripping of the great saphenous vein (GSV) trunk combined with foam sclerotherapy with conventional surgery for the treatment of superficial venous varicosities of the lower extremity. One hundred and thirty eight patients with primary or secondary superficial venous varicosities of the lower extremity were included. 60 underwent conventional surgery and 78 were treated with high ligation and stripping of the GSV trunk and foam sclerotherapy of GSV branches, spider veins, and reticular veins. Read More
Background: Varicose veins are extremely common disease which is due to elevated superficial venous pressures. We aimed to know that if joint hypermobility causes the venous insufficiency following the prolonged standing.
Materials And Methods: This prospective cohort study conducted on the soldiers of training periods in a military base of Iran Army in Isfahan in 2013. Read More
Background: The prevalence of chronic venous disease is high and occurs more frequently in females. According to the clinical, etiological, anatomical, and pathological classification (CEAP) definition, the reticular veins are included in the C1 class and are mainly associated with aesthetic complaints. Several invasive techniques are used for treatment, including mini phlebectomy, laser ablation, and radiofrequency ablation. Read More
*Department of Dermatology, University of Maryland School of Medicine, Baltimore, Maryland; †Maryland Laser, Skin & Vein Institute, Hunt Valley, Maryland; ‡Department of Dermatology, Dartmouth Medical School, Hanover, New Hampshire; §Department of Dermatology, University of California, San Francisco, California; ‖Department of Dermatology, Weill Cornell Medical College, New York, New York; ¶Department of Dermatology, University of Buffalo, Buffalo, New York; #Department of Dermatology, University of Southern California, Los Angeles, California.
Background: The American Society for Dermatologic Surgery (ASDS) periodically develops consensus documents for its members concerning various aspects of dermatologic surgery. Unwanted and painful leg veins are a very widespread problem. Many advances in sclerotherapy of varicose and telangiectatic leg veins have occurred since the previous consensus documents. Read More
We herein present a case of a 59-year-old man who had undergone pylorus preserving pancreaticoduodenectomy with regional lymph node dissection prior to episodes of melena. Series of conventional endoscopic investigations failed to identify the bleeding source. Enhanced computed tomography scan revealed complete obstruction of the main portal vein with numerous collateral veins running towards the hepatic hilus. Read More
The recognition of lower extremity venous disease as a significant cause of morbidity and lower quality of life, afflicting up to 25 % of Western populations, has led to rapid and drastic improvements in treatment options as well as an increasing awareness of the disease. Superficial venous disease, a frequent medical problem encountered in clinical practices, is now a common reason for referral to providers offering a spectrum of interventions. Venous guidelines have been set forth by the American Venous Forum and Society for Vascular Surgery covering simple spider veins to chronic venous ulcerations. Read More
Physicists and medical doctors "speak" different languages. Endovenous laser ablation (EVLA) is a good example in which technology is essential to guide the doctor to the final result: optimal treatment. However, for the doctor, it is by far insufficient just to turn on the knobs of the laser. Read More
The University Hospital of Zurich has provided an email-based medical consultation service for the general public since 1999. We examined the enquiries in a 13-year period to identify those related to vascular surgery (based on 22 ICD-10 codes specific for vascular surgery). There were 40,062 questions, of which 643 (2%) were selected by ICD-10 codes. Read More
The technique of foam sclerotherapy directed at the distal most vessels, draining the ulcer bed was first described in 2010, with excellent penetration into the underlying venous network possible with this technique. Thirty-five patients have now been treated with this technique as the initial treatment at Midwest Vein Laser, USA. There have been no complications with this technique and rapid healing occurred within 4-8 weeks after the initial treatment in 90% of the patients, and all ulcers were healed at 4 months. Read More
Objective: To assess the efficacy and safety of a new method of clearing varicose veins in the long term. It consists of applying the long-pulsed Nd:YAG laser following the injection of polidocanol microfoam, in two consecutive sessions, treating both legs in full in each session.
Method: Randomized, Polidocanol-controlled, blind evaluation clinical trial comparing the results between 79 legs treated with Polidocanol and 517 treated with Polidocanol + Laser. Read More
Superficial venous disease is a common clinical problem. The concerning disease states of the superficial venous system are venous reflux, varicose veins, and superficial venous thrombosis. Superficial venous reflux can be a significant contributor to chronic venous stasis wounds of the lower extremity, the treatment of which can be costly both in terms of overall health care expenditure and lost working days for affected patients. Read More
The objective of the study was to review the literature reporting visual disturbance (VD)following sclerotherapy for varicose veins. Underlying mechanisms will be discussed. A literature search of the databases Medline and Google Scholar was performed. Read More
Aim: The authors propose a new classification of telangiectasias: conditions involving demonstrated reflux are classified as type A telangiectasias; clustered, spider telangiectasias not related to reflux and with vein diameters of >0.2 mm are classified as type B, while isolated telangiectatic veins of ≤0.2 mm diameter are classed as type C. Read More
Venous insufficiency can be defined as a fixed venous outflow disturbance of the limbs. It is caused by the malfunction of the venous system, that may or may not be associated with venous valvular insufficiency and may involve the superficial or deep venous system of the lower limbs, or both. The CEAP scale includes clinical, etiologic, anatomic and pathophysiologic aspects and has been used in the assessment of venous insufficiency Clinical classification comprises of 7 groups. Read More
Chronic venous disease, reviewed herein, is manifested by a spectrum of signs and symptoms, including cosmetic spider veins, asymptomatic varicosities, large painful varicose veins, edema, hyperpigmentation and lipodermatosclerosis of skin, and ulceration. However, there is no definitive stepwise progression from spider veins to ulcers and, in fact, severe skin complications of varicose veins, even when extensive, are not guaranteed. Treatment options range from conservative (eg, medications, compression stockings, lifestyle changes) to minimally invasive (eg, sclerotherapy or endoluminal ablation), invasive (surgical techniques), and hybrid (combination of ≥1 therapies). Read More
In 1983, selective photothermolysis dramatically transformed vascular surgery, reducing the adverse effects and increasing its efficacy. As a result, laser surgery is now considered the gold standard treatment for many congenital and acquired skin vascular disorders. In this paper, the authors analyze the main laser sources for vascular surgery, the general parameters regarding laser-tissue interactions that can influence the treatment (such as hemodynamic features, anatomical areas, vessel depth, and diameters), and other aspects important for a good laser practice. Read More
According to the guidelines and the manufacturer's information, pregnancy is a contraindication for sclerotherapy with Polidocanol. However, in some cases sclerotherapy has been conducted in a period when the pregnancy is not known by the patient. When pregnancy is diagnosed, patients and gynecologists often ask the phlebologist if there is an indication for the interruption of pregnancy. Read More
Background: Some leg telangiectasias may be refractory to treatment, including sclerotherapy and lasers.
Objective: To describe the innovative Sclerotherapy in Tumescent Anesthesia of Reticular veins and Telangiectasias (START) approach to achieving good results in such patients, which also proves effective in treating reticular veins.
Method: Because compression enhances the rate of success of sclerotherapy of C1 veins (telangiectasias and reticular), Ringer solution (with or without lidocaine-epinephrine) was injected subcutaneously before, during, or immediately after sclerotherapy of therapy-refractory C1 veins. Read More
Objective: The purpose of this study was to correlate the clinical findings in the Edinburgh Vein Study with the results of duplex scanning of the deep and superficial venous systems.
Methods: An age-stratified random sample of 1566 people (699 men and 867 women) aged 16-64 were selected from computerized age-sex registers of participating practices (twelve general practices with catchment areas geographically and socioeconomically distributed throughout Edinburgh). Screening included clinical examination, photography and duplex ultrasonography of the superficial veins and the deep veins down to popliteal level. Read More
Background: Chromated glycerin (CG) is an effective, although painful, sclerosing agent for telangiectasias and reticular leg veins treatment.
Objective: To determine pain level and relative efficacy of pure or one-third lidocaine-epinephrine 1% mixed chromated glycerin in a prospective randomized double-blind trial.
Method: Patients presenting with telangiectasias and reticular leg veins on the lateral aspect of the thigh (C(1A) or (S) E(P) A(S) P(N1) ) were randomized to receive pure CG or CG mixed with one-third lidocaine-epinephrine 1% (CGX) treatment. Read More
With the recent US Food and Drug Administration (FDA) approval of polidocanol in the United States, there has been a resurgence of interest in sclerotherapy. Despite the popularity of laser therapy, sclerotherapy remains the gold standard for treating spider and reticular veins. Although this traditional method of treatment has been around for more than 100 years, better sclerosing agents and newer techniques have made sclerotherapy safer and more efficacious than ever before. Read More
Objective: To prospectively study quality-of-life (QoL) benefits comparing compression stockings to sclerotherapy in subjects with symptomatic reticular veins and telangiectasia.
Methods: Fifty-eight consecutive female patients with normal saphenous and deep venous systems and venous dysfunction score (VDS) ≥ 4 were randomized to either sclerotherapy (N = 29) or thigh high 20-30 mmHg compression stockings (N = 29). Following a trial of compression, subjects in the compression arm were eligible to crossover to the sclerotherapy arm. Read More
Similar to other antiaging procedures like Botox, skin rejuvenation, and facial plastic surgery, spider vein therapy is seen as a way to reverse the signs of aging. This article will introduce the clinician to this issue and describe treatment, which may be accomplished with the same lasers used for laser hair reduction. Read More
Background: AIMS Short- and mid-term side effects of sclerotherapy, in particular with polidocanol (lauromacrogol 400), have been previously described in our registry of 12,173 sessions. The objective of this follow-up registry was to evaluate the long-term incidence of adverse events with polidocanol.
Methods: The physicians involved in the initial French registry were contacted and asked to partake in the follow-up survey. Read More
With the development of novel sclerosing solutions, there has been an increase of choice in which sclerosant to utilize for a particular varicosity. It is not only important for the practitioner to define which sclerosant may be effective in a given clinical scenario, but also identify the minimal sclerosant concentration (MSC) that will produce effective results. This article will overview the salient points of choosing the appropriate sclerosant as well as review which MSC to choose based on patient profile, physician experience, FDA recommendations, and vessel diameter to maximize clinical outcomes while decreasing adverse effects. Read More
Lasers have affected health care in many ways. Clinical applications have been found in a number of medical and surgical specialities. In particular, applications of laser technology in phlebology has made it essential for vein physicians to obtain a fundamental knowledge of laser physics, laser operation and also to be well versed in laser safety procedures. Read More
Objectives: A systematic review to compare efficacy and safety of foam (F) sclerotherapy versus liquid (L) sclerotherapy for primary varicose veins of the lower limbs.
Methods: Systematic searches of electronic databases were conducted in April 2009 to identify relevant published studies. Database searches were augmented with abstracts from conference proceedings and electronic and hand searching of journals not consistently indexed in the major databases. Read More
Objective: To find the related syndrome factors of gouty arthritis with blood stasis syndrome by mathematical methods of set pair analysis and connection number so as to guide the diagnosis.
Methods: Seventy gouty arthritis patients diagnosed with blood stasis syndrome were analyzed according to priority by the method of connection number. Syndrome factors of gouty arthritis with blood stasis syndrome were selected according to the numerical values of dialectics connection value (DCV). Read More
To the Center of angiology and microsurgery have been submitted 75 patients seeking for the cosmetic result of their treatment improvement, to whom operative interventions for the lower extremities varicosities were performed previously. The sclerosing procedures for the dilated venous tributaries, reticular veins and teleangiectasiae was conducted, complete elimination of a "heavy feet" syndrome was noted together with reduction of the symptoms severity. The phlebosclerosing method permits to achieve good clinical, aesthetic results, to improve the quality of life and social activity of the patients. Read More