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    Molecular targets and anti-cancer potential of escin.
    Cancer Lett 2018 Feb 20. Epub 2018 Feb 20.
    Department of Physiology, Yong Loo Lin School of Medicine, National University of Singapore, 117593, Singapore. Electronic address:
    Escin is a mixture of triterpenoid saponins extracted from the horse chestnut tree, Aesculus hippocastanum. Its potent anti-inflammatory and anti-odematous properties makes it a choice of therapy against chronic venous insufficiency and odema. More recently, escin is being actively investigated for its potential activity against diverse cancers. Read More

    Demographic and clinical features do not affect the outcome of combined endovenous therapy to treat leg swelling.
    Vascular 2018 Jan 1:1708538118760742. Epub 2018 Jan 1.
    Vascular Surgery, Total Vascular Care®, Brooklyn, NY, USA.
    Background There have been well-documented implications of race/ethnicity on the outcome of various vascular diseases, yet there are limited data on risk factors and outcome of lower limb swelling. While many patients improve with endovenous therapy (thermal ablation or iliac vein stenting), some patients' symptoms persist. The goal of this study was to identify clinical factors including race/ethnicity related to persistent leg swelling after treatment with both iliac vein stenting and thermal ablation. Read More

    The hemodynamic effects of pregnancy on the lower extremity venous system.
    J Vasc Surg Venous Lymphat Disord 2018 Mar 21;6(2):246-255. Epub 2017 Sep 21.
    The Vein Center at Greater Baltimore Medical Center, Baltimore, Md. Electronic address:
    Objective: Pregnancy has significant effects on the lower extremity venous system. Increasing venous pressure and blood volume, in combination with reduced flow rates within the deep veins, predisposes pregnant women to both primary and secondary chronic venous insufficiency (CVI). This review article highlights the specific physiologic and hemodynamic changes that occur during pregnancy and examines the nonpharmacologic, pharmacologic, and invasive interventions that are appropriate for both prophylaxis and treatment of CVI and venous thromboembolism (VTE). Read More

    Management of an enormous inferior mesenteric vein aneurysm.
    J Vasc Surg Venous Lymphat Disord 2018 Mar;6(2):241-243
    Department of Surgery, Joondalup Health Campus, Joondalup, Western Australia; Department of Vascular and Endovascular Surgery, Royal Perth Hospital, Perth, Western Australia.
    Venous aneurysms are rare entities, with mesenteric venous aneurysms among the rarest reported. We present a case of a 66-year-old man with abdominal pain secondary to an enormous 7.8-cm inferior mesenteric vein aneurysm. Read More

    Interventional Treatment of Severe Tricuspid Regurgitation: Early Clinical Experience in a Multicenter, Observational, First-in-Man Study.
    Circ Cardiovasc Interv 2018 Feb;11(2):e006061
    From the Charité - Universitätsmedizin Berlin, Germany (A.L., H.D., D.L., B.A., U.L., K.S., M.L., V.F.); Deutsches Zentrum für Herz-Kreislauf-Forschung (DZHK), Berlin, Germany (A.L., H.D., D.L., B.A., U.L., K.S., M.L., A.U., V.F.); Friedrich-Schiller-Universitaet Jena, Germany (H.R.F., T.D., M.F.); Department of Medicine II, Heart Center Bonn, University Hospital Bonn, Germany (A.S.); German Heart Center Berlin (A.U., V.F.); Division of Cardiology, St. Michaels Hospital, Toronto, Canada (N.F.); Albertinen Heart Center, Hamburg, Germany (J.S.); Medizinische Klinik und Poliklinik I, Ludwig-Maximilians-Universität München, Munich, Germany (J.H.); Medical Faculty, Division of Cardiology, Pulmonology and Vascular Medicine, University Düsseldorf, Germany (C.J.); and Berlin Institute of Health, Germany (U.L.).
    Background: Transcatheter caval valve implantation is under evaluation as a treatment option for inoperable patients with severe tricuspid regurgitation (TR). The procedure involves the catheter-based implantation of bioprosthetic valves in the inferior vena cava and superior vena cava to treat symptoms associated with TR. This study is the first to evaluate the feasibility, safety, and efficacy of this interventional concept. Read More

    Suppressed networks of inflammatory mediators characterize chronic venous insufficiency.
    J Vasc Surg Venous Lymphat Disord 2018 Feb 10. Epub 2018 Feb 10.
    Department of Surgery, University of Pittsburgh, Pittsburgh, Pa.
    Objective: Chronic venous insufficiency (CVI) affects 25 million adults in the United States. Little emphasis has been placed on inflammatory changes associated with CVI. We hypothesize that in patients with early to mid-stage benign varicose vein disease, differences in circulating inflammatory mediators will be manifested in blood draining the involved area vs circulating blood in control subjects. Read More

    Glucose tolerance & insulin secretion & sensitivity characteristics in Indian children with cystic fibrosis: A pilot study.
    Indian J Med Res 2017 Oct;146(4):483-488
    Department of Pediatrics, All India Institute of Medical Sciences, New Delhi, India.
    Background & Objectives: Cystic fibrosis (CF) is a life-limiting genetic condition resulting in chronic respiratory infections, pancreatic enzyme insufficiency and associated complications. This pilot study was undertaken to assess the glucose tolerance and insulin secretion and sensitivity among Indian children with CF.

    Methods: Children with CF under regular follow up at the Paediatric Pulmonology Clinic of a tertiary care hospital in New Delhi, India, were enrolled. Read More

    Systematic review and meta-analysis of endovascular and surgical revascularization for patients with chronic lower extremity venous insufficiency and varicose veins.
    Am Heart J 2018 Feb 29;196:131-143. Epub 2017 Sep 29.
    Duke Clinical Research Institute, Durham, NC; Evidence-Based Practice Center, Duke Clinical Research Institute, Durham, NC; Division of Endocrinology, Diabetes, and Metabolism, Department of Medicine, Duke University, Durham, NC.
    Background: Chronic lower extremity venous disease (LECVD) is twice as prevalent as coronary heart disease, and invasive therapies to treat LECVD accounted for an estimated $290 million in Medicare expenditures in 2015. Despite increasing use of these invasive therapies, their comparative effectiveness is unknown.

    Methods: We conducted a systematic review and meta-analysis of treatments for patients (symptomatic and asymptomatic) with lower extremity varicosities and/or lower extremity chronic venous insufficiency/incompetence/reflux. Read More

    Day surgery versus Outpatient setting for endovenous laser ablation treatment. A prospective cohort study.
    Int J Surg 2018 Feb 2;51:180-183. Epub 2018 Feb 2.
    Division of Vascular Surgery (Chief. Prof. P. Rispoli), University of Turin, Department of Surgical Sciences, Azienda Ospedaliera Universitaria Città della Salute e delle Scienza, Molinette Corso Bramante 88, 10126 Torino, Italy.
    Objectives: The traditional surgical approach to the treatment of the superficial venous insufficiency requires at least 12 h of post-operative monitoring and this often means the necessity of an overnight hospitalization. The introduction of new, less invasive techniques (i.e endovenous laser ablation) reduces the hospitalization stay in a Day Surgery setting. Read More

    Surgery for tricuspid regurgitation in a case of anomalous systemic venous return.
    Asian Cardiovasc Thorac Ann 2018 Jan 1:218492318759153. Epub 2018 Jan 1.
    Department of Cardiovascular Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan.
    A 75-year-old woman presented with severe tricuspid regurgitation requiring surgical repair. She had extremely rare anomalies in systemic venous return in spite of situs solitus: persistent left superior vena cava with absent right superior vena cava, infrahepatic inferior vena cava interruption, and hemiazygos continuation to a persistent left superior vena cava. These unusual systemic venous anomalies had significantly enlarged the coronary sinus, and the stretched coronary sinus orifice changed the geometry of the tricuspid annulus and triggered tricuspid regurgitation. Read More

    Predictors of Short-Term Readmission After Pancreaticoduodenectomy.
    J Gastrointest Surg 2018 Feb 5. Epub 2018 Feb 5.
    Department of Surgery, Virginia Commonwealth University, 1200 E. Broad St, PO Box 980011, Richmond, VA, 23298, USA.
    Background: Readmissions are a common complication after pancreaticoduodenectomy and are increasingly being used as a performance metric affecting quality assessment, public reporting, and reimbursement. This study aims to identify general and pancreatectomy-specific factors contributing to 30-day readmission after pancreaticoduodenectomy, and determine the additive value of incorporating pancreatectomy-specific factors into a large national dataset.

    Methods: Prospective American College of Surgeons-National Surgical Quality Improvement Project (ACS-NSQIP) data were retrospectively analyzed for patients who underwent pancreaticoduodenectomy (PD) between 2011 and 2015. Read More

    Manual lymphatic drainage and quality of life in patients with lymphoedema and mixed oedema: a systematic review of randomised controlled trials.
    Qual Life Res 2018 Feb 5. Epub 2018 Feb 5.
    Department of Non-Communicable Disease Epidemiology, Faculty of Epidemiology and Population Health, London School of Hygiene & Tropical Medicine, London, United Kingdom.
    Purpose: To assess the impact of manual lymphatic drainage (MLD) on the health-related quality of life (HRQoL) of adults with lymphoedema or mixed oedema, through a systematic review of randomised controlled trials (RCTs).

    Methods: MEDLINE, EMBASE, PsycINFO, CENTRAL, the Cochrane Database of Systematic Reviews and were searched to identify RCTs evaluating HRQoL after a MLD intervention compared to non-MLD interventions (PROSPERO 2016:CRD42016042255). Read More

    Re-intervention for occluded iliac vein stents.
    Cardiovasc Diagn Ther 2017 Dec;7(Suppl 3):S258-S266
    Mayo Clinic, Scottsdale, Arizona, USA.
    Iliac vein stenting has become more frequent with improved diagnostic capabilities of intra-vascular ultrasound (IVUS) for recognizing May-Thurner syndrome, chronic venous insufficiency (CVI) and thrombus. In this manuscript, we discuss the reasons for initial stenting, with long-term outcomes and some of the associated pitfalls. The best techniques for re-intervention when iliac stents become occluded will also be discussed. Read More

    Catheter-directed thrombolysis of deep vein thrombosis: literature review and practice considerations.
    Cardiovasc Diagn Ther 2017 Dec;7(Suppl 3):S228-S237
    Division of Interventional Radiology, Mayo Clinic, Phoenix, AZ, USA.
    Deep vein thrombosis (DVT) is a major health problem worldwide. The risk of pulmonary embolism following DVT is well established, but the long-term vascular sequelae of DVT are often underappreciated, costly to manage, and can have extremely detrimental effects on quality of life. Treatment of DVT classically involves oral anticoagulation, which reduces the risk of pulmonary embolism but does not remove the clot. Read More

    Prevalence of vitamin D insufficiency in radiologists: a cross-sectional study.
    Skeletal Radiol 2018 Feb 2. Epub 2018 Feb 2.
    Radiology, Balgrist University Hospital, Forchstrasse 340, 8008, Zurich, Switzerland.
    Objective: To compare the prevalence of vitamin D insufficiency between radiologists and a control group of non-radiologists.

    Materials And Methods: This prospective cross-sectional study was conducted at the Swiss Congress of Radiology in May of 2016. Attendees (radiologists and non-radiologists) were asked to give a venous blood sample to measure vitamin D (25-hydroxyvitamin D) blood serum level. Read More

    [The conspicuous leg].
    Internist (Berl) 2018 Jan 31. Epub 2018 Jan 31.
    Medizinische Klinik 2, Städtisches Klinikum Dresden, Friedrichstr. 41, 01067, Dresden, Deutschland.
    Symptoms of the leg or of both legs, may indicate a need for evaluation and/or treatment, which must be clarified urgently or even as an emergency situation. Among the diseases which must be considered from a vascular viewpoint are critical limb ischemia, suspicion of deep leg vein thrombosis and special forms of venous insufficiency. With respect to infections erysipelas and the syndrome of infected diabetic foot must be considered as well as peripheral and central leg paresis as orthopedic and neurological disorders, respectively. Read More

    Predictors of Post-Thrombotic Ulcer after Acute DVT: The RIETE Registry.
    Thromb Haemost 2018 Feb 29;118(2):320-328. Epub 2018 Jan 29.
    Department of Internal Medicine, Hospital De Badalona Germans Trias I Pujol, Universidad Católica De Murcia, Spain.
    In patients with deep-vein thrombosis (DVT) in the lower limbs, venous ulcer is the most debilitating and end-stage clinical expression of the post-thrombotic syndrome (PTS). To date, risk factors for PTS-related ulcer in DVT patients have not been identified.We used the international observational RIETE registry to assess the evolution of PTS signs and symptoms during a 3-year follow-up period and to identify independent predictors of PTS ulcer at 1 year in patients with acute DVT. Read More

    Plasma concentration of selected biochemical markers of endothelial dysfunction in women with various severity of chronic venous insufficiency (CVI)-A pilot study.
    PLoS One 2018 29;13(1):e0191902. Epub 2018 Jan 29.
    Department of General Chemistry, Chair of Chemistry and Clinical Biochemistry, Poznan University of Medical Sciences, Poznań, Poland.
    Background: Although the endothelial dysfunction is considered to be implicated in the pathogenesis of chronic venous insufficiency (CVI) the endothelial status in patients with venous disorders is still not fully evaluated. Therefore the aim of the study was to measure the concentration of selected markers of endothelial dysfunction: von Willebrand factor (vWf), soluble P-selectin (sP-selectin), soluble thrombomodulin (sTM) and soluble VE-cadherin (sVE-cadherin) in CVI women who constitute the most numerous group of patients suffering from venous disease.

    Materials And Methods: Forty four women with CVI were involved in the study and divided into subgroups based on CEAP classification. Read More

    [Dipyridamole in the treatment and prevention of cerebral venous thrombosis in women using hormonal contraceptives].
    Zh Nevrol Psikhiatr Im S S Korsakova 2017 ;117(12):116-123
    Ulyanovsk State University, Ulyanovsk, Russia.
    The review covers the topic of cerebral venous thrombosis (CVT) in women taking hormonal contraceptives. The paper gives the definition of CVT, the history and analysis of epidemiological data. It was shown that the increased risk of CVT occurs due to the influence of hormonal contraceptives on the system of hemostasis and severity of the risk depends on the preparation formula, the way and duration of its administration. Read More

    The influence of exercise on ulcer healing in patients with chronic venous insufficiency.
    Int Angiol 2018 Jan 25. Epub 2018 Jan 25.
    Surgery & Cancer, Imperial College London, London, UK.
    Background: Venous Leg Ulcer (VLU) affects millions of people, and yet there have been no major advances in its treatment for many decades. Is it the time to change our approach, and try a multidisciplinary one that could bring about a change. The aim of this study is to evaluate whether a regular, home-based exercise could be influential in healing the VLU. Read More

    Rehabilitation of patients with venous diseases of the lower limbs: State of the art.
    Phlebology 2018 Jan 1:268355518754463. Epub 2018 Jan 1.
    5 Morrison Vein Institute, Tempe, AZ, USA.
    Background To date, no document comprehensively focused on the complex issue of the rehabilitation of chronic venous diseases of the lower limbs. Method This article overviews and summarizes current strategies concerning venous rehabilitation of lower limbs. Results Venous rehabilitation is based on four main strategies: (1) lifestyle adaptations and occupational therapies; (2) physical therapies; (3) adapted physical activities; (4) psychological and social support. Read More

    Correlation Between Changes in Extremity Volume and Bioelectrical Impedance in Arm and Leg Lymphedema.
    Lymphat Res Biol 2018 Jan 22. Epub 2018 Jan 22.
    Division of Vascular Surgery, Department of Surgery and Clinical Science, Yamaguchi University Graduate School of Medicine , Yamaguchi, Japan .
    Background: To clarify the differences in the mode of fluid accumulation between arm and leg lymphedema using bioelectrical impedance analysis (BIA).

    Methods And Results: In 22 arms with lymphedema (ALE) and 65 legs with lymphedema (LLE), as well as 54 legs with venous edema (VE) for comparison, BIA was performed twice between April 2015 and March 2017. Then, the changes in BIA-derived parameters were correlated with the changes in extremity volumes. Read More

    Cerebrospinal Fluid Dynamics in Patients with Multiple Sclerosis: The Role of Phase-Contrast MRI in the Differential Diagnosis of Active and Chronic Disease.
    Korean J Radiol 2018 Jan-Feb;19(1):72-78. Epub 2018 Jan 2.
    Department of Anatomy, Karabük University Faculty of Medicine, Karabük 78050, Turkey.
    Objective: Multiple sclerosis (MS) is an inflammatory disease characterized by demyelinating plaques in the white matter. Chronic cerebrospinal venous insufficiency (CCSVI) has been proposed as a new hypothesis for the etiopathogenesis of MS disease. MS-CCSVI includes a significant decrease of cerebrospinal fluid (CSF) flow through the cerebral aqueduct secondary to an impaired venous outflow from the central nervous system. Read More

    Assessment of perfusion of free flaps used in head and neck reconstruction using pulsatility index.
    Indian J Plast Surg 2017 May-Aug;50(2):173-179
    Department of Plastic Surgery, Nil Ratan Sircar Medical College and Hospital, Kolkata, West Bengal, India.
    Objective: To detect venous or arterial obstruction in the pedicle of a free flap we can monitor resistance in the flap bed which is reflected in Pulsatility Index (PI) Therefore if we detect change in the values of the PI in these flaps then we can detect complications in flap due to vascular insufficiency early.

    Materials And Methods: Seven patients of Free Fibular Flap Reconstruction and ten patients of Free Radial Forearm Flap reconstruction were evaluated over a period of 18 months. In the pre op we recorded PI of Radial and Peroneal artery using colour doppler study. Read More

    Echocolor Doppler morpho-functional study of the jugulo-subclavian confluence in chronic cerebro-spinal venous insufficiency and multiple sclerosis patients.
    Ann Ital Chir 2017 ;88:546-552
    Objectives: The aim of this work is to measure the mean diameter of the confluence jugulo- subclavian, the impact of different types of jugular confluences and the correlation between the types of confluences and the Valsalva maneuver (jugular reflux) in subjects with Chronic Cerebro-Spinal Venous Insufficiency (CCSVI) and Multiple Sclerosis.

    Method: We investigated by Echo-Color-Doppler (ECD) 103 subjects (67 F 36M) of mean age 45 ± 12 years (a minimum of 22 to a maximum of 79 years, with a median of 44 and a modal value 42 years), mean EDSS of 4.7 and average disease duration of 12 years. Read More

    Radiofrequency Thermal Ablation Heat Energy Transfer in anModel.
    Am Surg 2017 Dec;83(12):1373-1380
    Little work has been done to consider the temperature changes and energy transfer that occur in the tissue outside the vein with ultrasound-guided vein ablation therapy. In this experiment, a Ex-Vivo model of the human calf was used to analyze heat transfer and energy degradation in tissue surrounding the vein during endovascular radiofrequency ablation (RFA). A clinical vein ablation protocol was used to determine the tissue temperature distribution in 10 per cent agar gel. Read More

    A Summation Analysis of Compliance and Complications of Compression Hosiery for Patients with Chronic Venous Disease or Post-thrombotic Syndrome.
    Eur J Vasc Endovasc Surg 2018 Jan 9. Epub 2018 Jan 9.
    Faculty of Medicine, University of Cambridge, Cambridge, UK; Academic Section of Vascular Surgery, Imperial College London, London, UK; Department of Vascular Surgery, Addenbrooke's Hospital, Cambridge, Cambridge, UK. Electronic address:
    Objectives: Compression stockings are commonly prescribed for patients with a range of venous disorders, but are difficult to don and uncomfortable to wear. This study aimed to investigate compliance and complications of compression stockings in patients with chronic venous disease (CVD) and post-thrombotic syndrome (PTS).

    Methods: A literature search of the following databases was carried out: MEDLINE (via PubMed), EMBASE (via OvidSP, 1974 to present), and CINAHL (via EBSCOhost). Read More

    A Novel Method of Noninvasive Monitoring of Free Flaps With Near-Infrared Spectroscopy.
    Eplasty 2017 15;17:e37. Epub 2017 Dec 15.
    Department of Plastic Surgery, Kobe University Graduate School of Medicine, Kobe, Japan.
    Thrombosis of a site of anastomosis in microsurgical free tissue transfer can result in tissue necrosis. To salvage potentially failing free flap, various methods of monitoring the viability of tissue have been described. We report a novel method of monitoring free flaps using near-infrared spectroscopy. Read More

    Iliac vein stenosis is an underdiagnosed cause of pelvic venous insufficiency.
    J Vasc Surg Venous Lymphat Disord 2018 Mar 29;6(2):202-211. Epub 2017 Dec 29.
    Center for Vein Restoration, Greenbelt, Md; Center for Vascular Medicine, Greenbelt, Md. Electronic address:
    Background: Reflux in the ovarian veins, with or without an obstructive venous outflow component, is reported to be the primary cause of pelvic venous insufficiency (PVI). The degree to which venous outflow obstruction plays a role in PVI is currently ill-defined.

    Methods: We retrospectively reviewed the charts of 227 women with PVI who presented to the Center for Vascular Medicine from January 2012 to September 2015. Read More

    Systematic review and meta-analysis of randomized controlled trials evaluating long-term outcomes of endovenous management of lower extremity varicose veins.
    J Vasc Surg Venous Lymphat Disord 2018 Mar 29;6(2):256-270. Epub 2017 Dec 29.
    Department of Vascular Surgery, Mater Misericordiae University Hospital, Dublin, Ireland.
    Background: Early studies have demonstrated that endovenous therapy for varicose veins is associated with a faster recovery and lower complication rates compared with conventional therapy. More than one million procedures have been performed worldwide. The objective of this study was to determine long-term efficacy of currently available endovenous therapy methods for varicose veins compared with conventional surgery (saphenofemoral ligation and stripping of great saphenous vein [GSV] with or without multiple avulsions) in management of GSV-related varicose veins. Read More

    A pilot study of venous duplex ultrasound parameters in healthy children.
    J Vasc Surg Venous Lymphat Disord 2017 Dec 29. Epub 2017 Dec 29.
    Department of Surgery, University of Michigan Cardiovascular Center, Ann Arbor, Mich. Electronic address:
    Objective: The spectrum of chronic venous disease (CVD) in adults is well documented, whereas there is a paucity of data published commenting on pediatric CVD. We previously identified that there is often venous reflux present in cases of pediatric lower extremity edema despite an alternative confirmed diagnosis. To further assess the clinical significance of this venous reflux, this study aimed to elicit venous parameters in healthy pediatric controls. Read More

    The initial report on 1-year outcomes of the feasibility study of the VENITI VICI VENOUS STENT in symptomatic iliofemoral venous obstruction.
    J Vasc Surg Venous Lymphat Disord 2018 Mar 28;6(2):192-200. Epub 2017 Dec 28.
    SP Vascular Center, Limassol, Cyprus.
    Objective: The objective of this study was to assess the safety and efficacy of a dedicated venous stent (the VICI VENOUS STENT; VENITI, Fremont, Calif) for treatment of symptomatic iliofemoral venous outflow obstruction.

    Methods: Thirty patients (24 female; median age, 43 years) were enrolled in the feasibility phase of an international, multicenter investigational device exemption trial from June 2014 to February 2015. All patients exhibited unilateral venous disease with ≥50% stenosis in the iliofemoral veins. Read More

    Diagnosis of Budd-Chiari syndrome.
    Abdom Radiol (NY) 2017 Dec 28. Epub 2017 Dec 28.
    Department of Radiology, Hôpital Beaujon, HUPNVS, 100, Bd du Général Leclerc, Clichy, France.
    Budd-Chiari syndrome (BCS) is defined by clinical and laboratory signs associated with partial or complete impairment of hepatic venous drainage in the absence of right heart failure or constrictive pericarditis. Primary BCS is the most frequent type and is a complication of hypercoagulable states, in particular myeloproliferative neoplasms. Secondary BCS involves tumor invasion or extrinsic compression. Read More

    Customizing elastic pressure bandages for reuse to a predetermined, sub-bandage pressure: A randomized controlled trial.
    Phlebology 2017 Jan 1:268355517746434. Epub 2017 Jan 1.
    Division of Vascular Surgery, Department of Surgery, Faculty of Medicine, Siriraj Hospital, Mahidol University, Bangkok, Thailand.
    Objective A randomized clinical trial was performed to compare the effectiveness of unmarked bandages and customized bandages with visual markers in reproducing the desired sub-bandage pressure during self-bandaging by patients. Method Ninety patients were randomly allocated to two groups ("customized bandages" and "unmarked bandages") and asked to perform self-bandaging three times. The achievement of a pressure between 35 and 45 mmHg in at least two of the three attempts was defined as adequate quality. Read More

    Association of Venous Leg Ulcers With Ankle Range of Motion in People Attending Chiropractic Mobile Clinics in the Dominican Republic.
    J Chiropr Med 2017 Dec 11;16(4):263-270. Epub 2017 Oct 11.
    Private Practice, Santo Domingo, Dominican Republic.
    Objective: The goal of the study was to determine if there was an association between chronic venous disorders (CVDs), particularly venous leg ulcers, and ankle range of motion (ROM) in the Dominican Republic.

    Methods: Chronic venous disorders were classified using the clinical manifestations portion (C) of the CEAP (clinical manifestations, etiology, anatomy, pathophysiology) method. The legs of participants attending mobile chiropractic clinics in rural, low-income areas in the Dominican Republic were assessed for clinical signs of CVD and venous ulcers. Read More

    Troxerutin, a mixture of O-hydroxyethyl derivatives of the natural flavonoid rutin: Chemical stability and analytical aspects.
    J Pharm Biomed Anal 2018 Feb 9;150:248-257. Epub 2017 Dec 9.
    Laboratory of Pharmaceutical Analysis, Department of Pharmaceutical Sciences, Università del Piemonte Orientale, Largo Donegani 2, 28100 Novara, Italy. Electronic address:
    Troxerutin (TRX) is a mixture of semisynthetic hydroxyethylrutosides (Hers) arising from hydroxyethylation of rutin, a natural occurring flavonoid. TRX is commonly used for its anti-oxidant and anti-inflammatory properties in chronic venous insufficiency and other vascular disorders. In recent studies, the protective effects of TRX in Alzheimer's disease, colon carcinogenesis and hepatocellular carcinoma are emerged. Read More

    [An update on the treatment of venous insufficiency in pregnancy].
    Semergen 2017 Dec 14. Epub 2017 Dec 14.
    Servicio de Obstetricia y Ginecología, Complexo Hospitalario Universitario de Ourense, Ourense, España. Electronic address:
    Chronic venous insufficiency is a long-term pathological condition resulting from anatomical or functional alterations of the venous system. This leads to the appearance of symptoms and physical signs that affect a large part of the population and particularly pregnant women, due to the physiology of pregnancy. The few published studies on the use of pharmacological treatments of venous insufficiency in this group of the population, often makes the management of this condition difficult in routine clinical practice. Read More

    Clinical correlation of success and acute thrombotic complications of lower extremity endovenous thermal ablation.
    J Vasc Surg Venous Lymphat Disord 2018 Jan 16;6(1):25-30. Epub 2017 Aug 16.
    Department of Vascular Surgery, Total Vascular Care, Brooklyn, NY; Department of Vascular Surgery, NYU Lutheran Medical Center, Brooklyn, NY.
    Objective: Endovenous thermal ablation has become the primary modality of treatment for patients with venous insufficiency. Previous literature has provided reviews of radiofrequency ablation (RFA) or endovenous laser ablation (EVLA) that mostly focus on the great saphenous vein (GSV) and small saphenous vein (SSV). Data with an extended review including the anterior accessory saphenous vein (ASV) and perforator veins (PVs) have been limited. Read More

    Invasive treatment of superficial veins of the lower extremities.
    Duodecim 2017;133(11):1069-75
    Modern invasive treatment of superficial venous insufficiency of the lower extremities is largely based on the use of intravenous procedures under ultrasound guidance. The first-line treatment is thermoablation, in which the insufficient superficial vein, typically vena saphena magna or parva, is constricted by using laser or radio frequency energy under ultrasound guidance. The procedure is nearly always successful under local anesthesia and can be performed as an outpatient operation. Read More

    Troxerutin Protects Against Myocardial Ischemia/Reperfusion Injury Via Pi3k/Akt Pathway in Rats.
    Cell Physiol Biochem 2017 8;44(5):1939-1948. Epub 2017 Dec 8.
    Department of Cardiovascular Surgery, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China.
    Background/aims: Troxerutin, also known as vitamin P4, has been commonly used in the treatment of chronic venous insufficiency (CVI) disease. However, its effect on in vivo myocardial ischemia/reperfusion (I/R) injury, a model that closely mimics acute myocardial infarction in humans, is still unknown.

    Methods: The myocardial I/R injury rat model was created with troxerutin preconditioning. Read More

    Prospective, double-blind, randomized controlled trial comparing electrocoagulation and radiofrequency in the treatment of patients with great saphenous vein insufficiency and lower limb varicose veins.
    J Vasc Surg Venous Lymphat Disord 2018 Mar 9;6(2):212-219. Epub 2017 Dec 9.
    Department of Radiology, Arizona Heart Hospital, Phoenix, Ariz.
    Objective: Thermoablation has been replacing conventional surgery in the surgical treatment of great saphenous vein (GSV) reflux in patients with lower limb varicose veins; however, thermoablation is expensive. Intravenous electrocoagulation (EC) may, selectively and safely, cause necrosis of the GSV wall, but the clinical results have never been studied. The objective of this study was to compare EC and radiofrequency ablation (RFA) in the treatment of GSV insufficiency, considering efficacy, complications, and effect on quality of life. Read More

    Pelvic vein incompetence: clinical perspectives.
    Vasc Health Risk Manag 2017 27;13:439-447. Epub 2017 Nov 27.
    Academic Surgery Unit, University of Manchester.
    Chronic pelvic pain (CPP) affects 24% of premenopausal women, accounts for 20%-30% of UK gynecology outpatient appointments, and has an annual pan-European economic cost of €3.8 billion. Despite extensive investigation, often including laparoscopy, up to 55% of women do not receive a diagnosis and endure persistent symptoms. Read More

    Cellulitis: current insights into pathophysiology and clinical management.
    Neth J Med 2017 Nov;75(9):366-378
    Department of Medicine, Academic Medical Center, Amsterdam, the Netherlands.
    Cellulitis is a bacterial skin and soft tissue infection which occurs when the physical skin barrier, the immune system and/or the circulatory system are impaired. Diabetes, obesity and old age are associated with defects in all of these areas and as a result are major predisposing factors for cellulitis. In this review, we summarise current insights into the pathophysiology of cellulitis and place the Dutch guidelines on the clinical management of cellulitis of the lower extremities in perspective. Read More

    Individualised versus standard duration of elastic compression therapy for prevention of post-thrombotic syndrome (IDEAL DVT): a multicentre, randomised, single-blind, allocation-concealed, non-inferiority trial.
    Lancet Haematol 2018 Jan 5;5(1):e25-e33. Epub 2017 Dec 5.
    Department of Vascular Medicine, Heart and Vascular Center, Maastricht University Medical Center, Maastricht, Netherlands; Laboratory of Clinical Thrombosis and Hemostasis, Cardio Vascular Research Institute, Maastricht University, Maastricht, Netherlands.
    Background: Therapy with elastic compression stockings has been the cornerstone for prevention of post-thrombotic syndrome for decades in patients after acute deep venous thrombosis. It is uncertain who benefits most from therapy, and what the optimum duration of therapy should be. We therefore aimed to assess the safety and efficacy of individualised duration of compression therapy versus the standard duration of 24 months following an initial treatment period of 6 months. Read More

    Oxidative Stress And Prolidase Enzyme Activity In The Pathogenesis Of Primary Varicose Veins.
    Vascular 2017 Jan 1:1708538117741764. Epub 2017 Jan 1.
    3 State Hospital Cardiovascular Surgery Clinic, Tokat, TURKEY.
    Objectives Vascular endothelial dysfunction leads to the emerging of free oxygen radicals, deficiency of antioxidant system, forming of oxidative stress, inflammatory processes and release of proinflammatory cytokines. These things play big role in the development of primary varicose veins. Prolidase has been reported as an indicator of oxidative stress in diabetes, diabetic neuropathy, non-ulcerous dyspepsia, osteoporosis, polycystic over syndrome and many other diseases. Read More

    Pharmacomechanical Catheter-Directed Thrombolysis for Deep-Vein Thrombosis.
    N Engl J Med 2017 12;377(23):2240-2252
    From the Washington University School of Medicine, St. Louis (S.V., L.L., J.R.D., P.N., M.C.D., N.S., M.B.); Brigham and Women's Hospital, Harvard Medical School (S.Z.G.), and Massachusetts General Hospital, Harvard Medical School (M.R.J.) - all in Boston; McMaster University, Hamilton, ON (J.A.J., M.F., C.-S.G., C.K.), and McGill University, Jewish General Hospital, Montreal (S.R.K.) - all in Canada; the University of Missouri, St. Luke's Mid America Heart Institute, Kansas City (D.J.C., E.M.); St. Joseph's Vascular Institute, Orange (M.K.R.), and University of California, Los Angeles, Los Angeles (S.K.) - both in California; University of Michigan, Ann Arbor (A.J.C.); Cleveland Clinic Heart and Vascular Institute, Cleveland (H.L.G.); Rhode Island Hospital, Brown University, Providence (T.P.M.); Central DuPage Hospital, Winfield, IL (J.S.); University of North Carolina, Chapel Hill (S.M.); Reading Hospital, Reading, PA (D.S.); Henry Ford Hospital, Detroit (J.L.); Holy Name Hospital, Teaneck, NJ (J.R.); Christiana Care Hospital, Newark, DE (M.G.); St. Elizabeth's Regional Medical Center, Lincoln, NE (R.R., E.V.); and Pepin Heart Center, Tampa, FL (V.M.).
    Background: The post-thrombotic syndrome frequently develops in patients with proximal deep-vein thrombosis despite treatment with anticoagulant therapy. Pharmacomechanical catheter-directed thrombolysis (hereafter "pharmacomechanical thrombolysis") rapidly removes thrombus and is hypothesized to reduce the risk of the post-thrombotic syndrome.

    Methods: We randomly assigned 692 patients with acute proximal deep-vein thrombosis to receive either anticoagulation alone (control group) or anticoagulation plus pharmacomechanical thrombolysis (catheter-mediated or device-mediated intrathrombus delivery of recombinant tissue plasminogen activator and thrombus aspiration or maceration, with or without stenting). Read More

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