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    The Hemodynamic Effects of Aortic Insufficiency in Patients Supported with Continuous-Flow Left Ventricular Assist Devices.
    J Card Fail 2017 Apr 20. Epub 2017 Apr 20.
    Section of Cardiology, University of Chicago, Chicago, IL. Electronic address:
    Background: The impact of aortic insufficiency (AI) on the morbidity and mortality of left ventricular assist device (LVAD) patients remains controversial. This study's aim is to assess the hemodynamics of LVAD patients with at least mild AI, at baseline and in response to device speed changes.

    Methods: Asymptomatic LVAD patients were prospectively enrolled and underwent a hemodynamic and echocardiographic ramp study. Read More

    Failure of the vascular hypothesis of multiple sclerosis in a rat model of chronic cerebrospinal venous insufficiency.
    Folia Neuropathol 2017 ;55(1):49-59
    Chronic cerebrospinal venous insufficiency (CCSVI) is a series of stenotic malformations in the cerebrospinal venous outflow routes, which is postulated to cause multiple sclerosis (MS). The hypotheses assumed that CCSVI leads to iron deposition which triggers inflammation and demyelination in MS. Invasive endovascular treatment of CCSVI was initiated based on the previous theory. Read More

    [Treatment and Secondary Prevention of Venous Thromboembolism - Change in Oral Anticoagulation].
    Dtsch Med Wochenschr 2017 Apr 19. Epub 2017 Apr 19.
    Institut für Pharmakologie und Präventive Medizin, Cloppenburg.
    With the recent approval of the fourth direct non vitamin K dependent oral anticoagulant (NOAC) edoxaban the range of available NOACs for the treatment of venous thromboembolism (VTE) has expanded. Shortly thereafter, two updated guidelines for the prevention and treatment of VTE have been published. In these NOACs are listed as equal anticoagulants to low-molecular weight heparin (LMWH), or fondaparinux (FDX), and VKA for the initial or maintenance treatment of VTE. Read More

    An update on the currently available nonthermal ablative options in the management of superficial venous disease.
    J Vasc Surg Venous Lymphat Disord 2017 May;5(3):422-429
    Department of Surgery, Division of Vascular Surgery, Medical College of Wisconsin, Milwaukee, Wisc. Electronic address:
    Background: Chronic venous insufficiency affects millions of Americans with symptoms spanning a broad range. Saphenous incompetence resulting in chronic reflux is at the root of most disease and is amenable to surgical correction.

    Methods: We conducted a systematic review of the literature on nonthermal ablative techniques using a MEDLINE (Ovid) search from January 2000 to August 2016. Read More

    A novel duplex finding of superficial epigastric vein flow reversal to diagnose iliocaval occlusion.
    J Vasc Surg Venous Lymphat Disord 2017 May;5(3):358-362
    OhioHealth Vascular Institute, OhioHealth Research & Innovation Institute, Columbus, Ohio.
    Objective: Although duplex ultrasound (DUS) imaging is the current gold standard in the diagnosis of femoropopliteal deep venous thrombosis, it is not an optimal diagnostic modality to diagnose iliocaval occlusion. Screening for iliocaval occlusion thus remains a challenge for clinicians because of the lack of a reliable noninvasive technique. This challenge results in most patients undergoing computed tomography venography or magnetic resonance venography or invasive venography and intravascular ultrasound imaging. Read More

    Clinical correlation with failure of endovenous therapy for leg swelling.
    Vascular 2017 Jan 1:1708538116667325. Epub 2017 Jan 1.
    Total Vascular Care, NY, USA.
    Background The development and use of minimally invasive procedures provide improved options for the management of symptoms of chronic venous insufficiency. While many patients with iliac venous occlusive disease and superficial venous insufficiency improve with combined iliac venous stenting and correction of superficial venous reflux, some patients have symptoms which persist. The goal of this study was to identify clinical factors related to persistent symptoms in patients with leg swelling after treatment of both iliac vein stenting and thermal ablation. Read More

    Quantification of early cutaneous manifestations of chronic venous insufficiency by automated analysis of photographic images: Feasibility and technical considerations.
    Phlebology 2017 Jan 1:268355517703840. Epub 2017 Jan 1.
    2 Laboratoires Innothéra, Arcueil, France.
    We postulate that blue telangiectasia and brownish pigmentation at ankle level, early markers of chronic venous insufficiency, can be quantified for longitudinal studies of chronic venous disease in Caucasian people. Objectives and methods To describe a photographic technique specially developed for this purpose. The pictures were acquired using a dedicated photo stand to position the foot in a reproducible way, with a normalized lighting and acquisition protocol. Read More

    Comparison of Iodixanol and Iopromide in Patients With Renal Insufficiency and Congestive Heart Failure Undergoing Coronary Angiography by Hemodynamic Monitoring.
    Angiology 2017 Jan 1:3319717701868. Epub 2017 Jan 1.
    1 Department of Cardiology, Chinese People's Liberation Army General Hospital, Beijing, China.
    We investigated the impact of contrast media (CM) with different osmolality on cardiac preload in patients with chronic kidney disease (CKD) and congestive heart failure (CHF). Patients with CKD and CHF were equally randomized to receive either iso-osmolar contrast media (IOCM) iodixanol or low-osmolar contrast media iopromide. We measured cardiac preload indexes by invasive hemodynamic monitoring before and after CM injection. Read More

    Changing Medicare Utilization of Minimally Invasive Procedures for the Treatment of Chronic Venous Insufficiency.
    J Vasc Interv Radiol 2017 Apr 7. Epub 2017 Apr 7.
    Department of Radiology and Imaging Sciences, Emory University School of Medicine, Atlanta, Georgia.
    Purpose: To examine changes in the utilization of procedures related to treatment of chronic venous insufficiency (CVI) in the Medicare population.

    Materials And Methods: Service-specific claims data for phlebectomy, sclerotherapy, and radiofrequency (RF) and laser ablation were identified by using Medicare Physician Supplier Procedure Summary master files from 2005 through 2014. Longitudinal national utilization rates were calculated by using annual Medicare enrollment data from 2005 through 2013. Read More

    Evaluation of inflammatory cell biomarkers in chronic venous insufficiency.
    Phlebology 2017 Jan 1:268355517701806. Epub 2017 Jan 1.
    1 Department of Family Medicine, West Virginia University, Morgantown, WV, USA.
    Objective Inflammation has been implicated as a factor that may contribute to chronic venous insufficiency. The purpose of this study is to compare readily available inflammatory cell biomarkers, with an emphasis on neutrophil count, lymphocyte count, and neutrophil lymphocyte ratio, in patients with chronic venous insufficiency. We hypothesized that circulating leukocyte counts would be higher in the peripheral blood of patients with severe compared to mild chronic venous insufficiency. Read More

    Sensitivity and specificity of clinical findings for the diagnosis of pelvic congestion syndrome in women with chronic pelvic pain.
    Phlebology 2017 Jan 1:268355517702057. Epub 2017 Jan 1.
    2 Grupo de Investigación Salud Comfamiliar, Pereira, Colombia.
    Background Pelvic congestion syndrome is among the causes of pelvic pain. One of the diagnostic tools is pelvic venography using Beard's criteria, which are 91% sensitive and 80% specific for this syndrome. Objective To assess the diagnostic performance of the clinical findings in women diagnosed with pelvic congestion syndrome coming to a Level III institution. Read More

    [Ulcers in obesity-associated chronic venous insufficiency].
    Hautarzt 2017 Mar 29. Epub 2017 Mar 29.
    Klinik für Dermatologie, Venerologie und Allergologie, Venenzentrum der Dermatologischen und Gefäßchirurgischen Kliniken, Ruhr Universität Bochum, Hiltroper Landwehr 11-13, 44805, Bochum, Deutschland.
    Background: Chronic venous insufficiency is a frequently occurring disease consisting of a characteristic symptom complex and ulcerations. Normally, varicose veins with reflux or obstruction can be found. However, these symptoms have also been described in obese people and are considered functional chronic venous insufficiency. Read More

    Proof-of-Concept Evaluation of the SailValve Self-Expanding Deep Venous Valve System in a Porcine Model.
    J Endovasc Ther 2017 Mar 1:1526602817700120. Epub 2017 Mar 1.
    1 Department of Vascular Surgery, University Medical Centre, Utrecht, the Netherlands.
    Purpose: To evaluate the SailValve, a new self-expanding deep venous valve concept based on a single polytetrafluoroethylene cusp floating up and down in the bloodstream like a sail, acting as a flow regulator and allowing minimal reflux to reduce thrombogenicity.

    Methods: Both iliac veins of 5 pigs were implanted with SailValve devices; the first animal was an acute pilot experiment to show the feasibility of accurately positioning the SailValve via a femoral access. The other 4 animals were followed for 2 weeks (n=2) or 4 weeks (n=2) under a chronic implantation protocol. Read More

    Hesperetin-loaded lipid-core nanocapsules in polyamide: a new textile formulation for topical drug delivery.
    Int J Nanomedicine 2017 15;12:2069-2079. Epub 2017 Mar 15.
    Department of Pharmacy, Federal University of Sergipe, São Cristóvão, Sergipe, Brazil.
    Chronic venous insufficiency is characterized by chronic reflux disorder of blood from the peripheral to the central vein, with subsequent venous hypertension and resulting changes in the skin. Traditionally, nonsurgical treatments relied on the use of compression therapy, and more recently a variety of flavonoids have been shown to have positive effects. There have also been developments of more effective drug delivery systems using various textiles and nanotechnology to provide new therapeutic options. Read More

    Acute lung injury complicating acute kidney injury: A model of endogenous αKlotho deficiency and distant organ dysfunction.
    Bone 2017 Mar 24. Epub 2017 Mar 24.
    Charles and Jane Pak Center of Mineral Metabolism and Clinical Research, University of Texas Southwestern Medical Center, Dallas, TX 75390-9034, United States of America.
    The lung interfaces with atmospheric oxygen via a large surface area and is perfused by the entire venous return bearing waste products collected from the whole body. It is logical that the lung is endowed with generous anti-oxidative capacity derived both locally and from the circulation. The single-pass pleiotropic alpha-Klotho (αKlotho) protein was discovered when its genetic disruption led to premature multi-organ degeneration and early death. Read More

    Application of the L-Dex Score for the Assessment of Bilateral Leg Edema.
    Lymphat Res Biol 2017 Mar 27. Epub 2017 Mar 27.
    Division of Vascular Surgery, Department of Surgery and Clinical Science, Yamaguchi University Graduate School of Medicine , Ube, Yamaguchi, Japan .
    Background: We evaluated a modified L-Dex score by using the right arm as a reference (LDSrarm), to determine whether it could be used for the assessment of leg edema in place of the usual L-Dex score calculated by using the contralateral normal leg as a reference (LDScont).

    Methods: Bioimpedance analysis was performed in the legs and right arms of 38 patients with unilateral leg edema and in 42 healthy volunteers by using a standard equipotential electrode arrangement.

    Results: The impedance ratio in the right arms of patients (2. Read More

    Risk Factors Related to Lower Limb Edema, Compression, and Physical Activity During Pregnancy. A Retrospective Study.
    Lymphat Res Biol 2017 Mar 27. Epub 2017 Mar 27.
    3 Department of Sports Medicine and Human Nutrition, Faculty of Physical Education and Sport, University of Physical Education Krakow , Krakow, Poland .
    Objective: The aim of the article was to assess risk factors and to analyze methods applied in the prevention and treatment of lower limb edema in pregnant women with a particular focus on compression therapy and exercise.

    Materials And Methods: Fifty-four women during the early 24-hour period following delivery were assigned to two groups-either to a group with swellings of lower limbs during pregnancy, located mostly in the region of feet and lower legs (Group A, n = 42), or to a group without edema (Group B, n = 12). Two subgroups, namely A1 and A2, were additionally distinguished in Group A. Read More

    The answer is blowing in the wind: an uncommon cause for severe ARDS accompanied by circulatory insufficiency requiring extracorporeal membrane oxygenation.
    BMJ Case Rep 2017 Mar 24;2017. Epub 2017 Mar 24.
    Department of Nephrology, Stadtisches Klinikum Braunschweig GmbH, Braunschweig, Germany.
    We report a rare complication in an immunosuppressed patient with IgA nephropathy who suffered from severe acute respiratory distress syndrome, severe capillary leakage and shock after placement of a double lumen central venous catheter. He could be successfully treated by extracorporeal membrane oxygenation (ECMO) and therapeutic plasma exchange. This report highlights the severity of late-onset complications of catheter placements and shows the potential of ECMO treatment for the management of acute illnesses with bridge to recovery. Read More

    Intracardiac Venous Stent Migration: Emergency Department Presentation of a Catastrophic Complication.
    J Emerg Med 2017 Mar 20. Epub 2017 Mar 20.
    Department of Emergency Medicine, Icahn School of Medicine at Mount Sinai Beth Israel, New York, New York.
    Background: Venous stents are commonly placed to ensure patency in patients with chronic peripheral venous insufficiency. Although serious complications are uncommon, peripheral venous stent placement can have some potentially life-threatening complications. One of the most feared, and certainly the most dramatic, complication is stent migration. Read More

    Is there an effect of race/ethnicity on early complications of iliac vein stenting?
    Vascular 2017 Jan 1:1708538117699335. Epub 2017 Jan 1.
    Total Vascular Care®, Brooklyn, NY, USA.
    Background There have been well-documented implications of race/ethnicity on the outcome of various vascular diseases. Little literature has examined the effect of race/ethnicity on venous disease. Iliac vein stenting is an emerging technology in treating chronic venous insufficiency. Read More

    Magnetic Resonance Imaging of Internal Jugular Veins in Multiple Sclerosis: Interobserver Agreement and Comparison with Doppler Ultrasound Examination.
    Ann Vasc Surg 2017 Mar 11. Epub 2017 Mar 11.
    Department of Vascular Surgery, Helsinki University Hospital, University of Helsinki, Helsinki, Finland; Department of Surgery, Faculty of Medicine, University of Helsinki, Helsinki, Finland.
    Background: Doppler ultrasound (US) has been widely used to evaluate the cervical venous system of multiple sclerosis patients according to the hypothesis of chronic cerebrospinal venous insufficiency with contradictory results. Venous anatomy and pathology can be examined with less operator-dependent magnetic resonance imaging (MRI). Our aim is to assess the interobserver agreement in measuring internal jugular vein (IJV) cross-sectional area (CSA) in MR images and to explore the agreement between US and MRI in the detection of calibers of ≤0. Read More

    The Morphofunctional Changes in the Wall of Varicose Veins.
    Ann Vasc Surg 2017 Mar 11. Epub 2017 Mar 11.
    Department of Morphology, Institute of Anatomy and Anthropology, Riga Stradins University, Riga, Latvia.
    Background: Varicose vein (VV) disease is a frequently occurring pathology of the lower extremities. Although the pathogenesis of varicosity development is not clearly defined, the final common pathway leading to chronic venous insufficiency is the development of venous hypertension, which is associated with severe changes in the venous wall. The aim of this study was to clarify the histological and immunohistochemical changes in great saphenous veins (GSVs) in chronic venous insufficiency. Read More

    Acquired perforating dermatosis: clinicopathological study of 31 cases, emphasizing pathogenesis and treatment.
    J Eur Acad Dermatol Venereol 2017 Mar 16. Epub 2017 Mar 16.
    Unit of Dermatology, Hospital San Jorge, Huesca, Spain.
    Background: Acquired perforating dermatosis (APD) is a rare group of skin disorders of unknown aetiology and pathogenesis and is associated with several systemic diseases.

    Objective: We review the clinicopathological features, associated systemic diseases and treatment response in a series of APD patients.

    Methods: We conducted a retrospective observational study of all patients histologically diagnosed with APD in Hospital San Jorge (Huesca, Spain) between 2002 and 2014. Read More

    Deep Venous Thrombosis and Pulmonary Embolism: Current Therapy.
    Am Fam Physician 2017 Mar;95(5):295-302
    University of Iowa Carver College of Medicine, Iowa City, IA, USA.
    Pulmonary embolism and deep venous thrombosis are the two most important manifestations of venous thromboembolism (VTE), which is the third most common life-threatening cardiovascular disease in the United States. Anticoagulation is the mainstay of VTE treatment. Most patients with deep venous thrombosis or low-risk pulmonary embolism can be treated in the outpatient setting with low-molecular-weight heparin and a vitamin K antagonist (warfarin) or direct-acting oral anticoagulants. Read More

    Approach to Lower Extremity Edema.
    Curr Treat Options Cardiovasc Med 2017 Mar;19(3):16
    Section of Vascular Medicine, Cleveland Clinic, Cleveland, OH, USA.
    Opinion Statement: Lower extremity edema is extremely common among patients seen across multiple specialties. The differential diagnosis is broad and ranges from simple dependent edema to more complex conditions such as chronic venous disease and lymphedema. Several key features from the history and physical exam can assist with the diagnosis. Read More

    Ultrasound Elastography for Determination of the Age of Venous Thrombi. Evaluation of Thrombus Evolution in Patients After Sclerotherapy.
    Pol J Radiol 2017 13;82:88-91. Epub 2017 Feb 13.
    Department of Radiology, Gruca Orthopedic and Trauma Teaching Hospital, Center of Postgraduate Medical Education, Otwock, Poland.
    Background: Venous thrombosis is a multicausal disease involving intravenous clot formation. It may occur spontaneously or after provoking events, such as traumatic injuries to the pelvis, upper and lower extermities, immobilization, intravascular procedures, including venous catheterization or injection. Color Doppler ultrasonography is a rapid and non-invasive technique for evaluation of venous disease. Read More

    Fetal growth restriction: current knowledge.
    Arch Gynecol Obstet 2017 May 11;295(5):1061-1077. Epub 2017 Mar 11.
    Department of Obstetrics, Paulista School of Medicine, Federal University of São Paulo (EPM-UNIFESP), Rua Belchior de Azevedo, 156 apto. 111 Torre Vitoria, São Paulo-SP, CEP 05089-030, Brazil.
    Background: Fetal growth restriction (FGR) is a condition that affects 5-10% of pregnancies and is the second most common cause of perinatal mortality. This review presents the most recent knowledge on FGR and focuses on the etiology, classification, prediction, diagnosis, and management of the condition, as well as on its neurological complications.

    Methods: The Pubmed, SCOPUS, and Embase databases were searched using the term "fetal growth restriction". Read More

    Pharmaco Penile Duplex Ultrasonography in the Evaluation of Erectile Dysfunction.
    J Clin Diagn Res 2017 Jan 1;11(1):TC07-TC10. Epub 2017 Jan 1.
    Ex Resident, Department of Radiology, Nizam's Institute of Medical Sciences , Hyderabad, Telangana, India .
    Introduction: The National Institute of Health defined 'erectile dysfunction' as the persistent inability to achieve and/or to maintain an erection for a satisfactory sexual performance. In last few years, the concept of erectile dysfunction has evolved from that of a disorder referred to as 'impotence' which used to be considered predominantly psychogenic to that of 'Erectile Dysfunction' (ED), a well understood physiologic result of multiple risk factors, both psychological and organic. The most common cause of organic erectile dysfunction is vasculogenic causes. Read More

    Patient-Reported Benefits of Extracranial Venous Therapy: British Columbia CCSVI Registry.
    Can J Neurol Sci 2017 Mar 8:1-9. Epub 2017 Mar 8.
    4Department of Medicine (Neurology),University of British Columbia,Vancouver,British Columbia,Canada.
    Objective Chronic cerebrospinal venous insufficiency (CCSVI) has been hypothesized to be a risk factor for multiple sclerosis (MS). Venoplasty has been proposed as a treatment for CCSVI. The aim of our study was to gain a better understanding of the "real-world" safety and longitudinal effectiveness of venoplasty Methods: British Columbia residents who self-reported having had venoplasty and consented to participate in the study were interviewed and followed for up to 24 months post-therapy using standardized structured questionnaires Results: Participants reported procedure-related complications (11. Read More

    Anticoagulation manager: development of a clinical decision support mobile application for management of anticoagulants.
    Conf Proc IEEE Eng Med Biol Soc 2016 Aug;2016:2582-2585
    Patients with certain clotting disorders or conditions have a greater risk of developing arterial or venous clots and downstream embolisms, strokes, and arterial insufficiency. These patients need prescription anticoagulant drugs to reduce the possibility of clot formation. However, historically, the clinical decision making workflow in determining the correct type and dosage of anticoagulant(s) is part science and part art. Read More

    The safety and efficacy of full- versus reduced-dose betrixaban in the Acute Medically Ill VTE (Venous Thromboembolism) Prevention With Extended-Duration Betrixaban (APEX) trial.
    Am Heart J 2017 Mar 18;185:93-100. Epub 2016 Dec 18.
    Guy's and St Thomas' Hospitals, London, UK.
    Background: The APEX trial assessed the safety and efficacy of extended-duration thromboprophylaxis using betrixaban versus standard dosing of enoxaparin among hospitalized, acutely ill medical patients. The 80-mg betrixaban dose was halved to 40 mg among subjects with severe renal insufficiency and those receiving a concomitant strong P-glycoprotein inhibitor.

    Methods: This analysis assessed the pharmacokinetics, efficacy, and safety of full- (80 mg) and reduced-dose (40 mg) betrixaban relative to enoxaparin in the APEX trial. Read More

    Medical Treatment for Postthrombotic Syndrome.
    Semin Intervent Radiol 2017 Mar;34(1):61-67
    Department of Vascular Medicine, Cardiovascular Section, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma.
    Deep vein thrombosis (DVT) is a prevalent disease. About 20 to 30% of patients with DVT will develop postthrombotic syndrome (PTS) within months after the initial diagnosis of DVT. There is no gold standard for diagnosis of PTS, but clinical signs include pitting edema, hyperpigmentation, phlebectatic crown, venous eczema, and varicose veins. Read More

    Left-Sided Varicocele as a Rare Presentation of May-Thurner Syndrome.
    Ann Vasc Surg 2017 Feb 28. Epub 2017 Feb 28.
    Division of Vascular and Endovascular Surgery, New York-Presbyterian Hospital, Weill Cornell Medicine, New York, NY. Electronic address:
    Background: May-Thurner syndrome (MTS), the clinical sequelae of left iliac vein compression between the right iliac artery and the spine, is an accepted cause of lower extremity edema and venous thromboembolism. It is more prevalent in younger women and typically presents with left lower extremity symptoms. Atypical presentations such as right-sided symptoms, chronic pelvic pain, and even fatal venous rupture have been reported. Read More

    A failure of preoperative duplex imaging to diagnose a lower extremity venous aneurysm in a patient with severe chronic venous insufficiency.
    SAGE Open Med Case Rep 2017 8;5:2050313X17692937. Epub 2017 Feb 8.
    Division of Vascular Surgery, USF Health Morsani College of Medicine, Tampa, FL, USA.
    Objective: We present a case of recurrent bilateral lower extremity venous stasis ulcers in association with a superficial venous aneurysm at the right saphenofemoral junction that was misdiagnosed on preoperative duplex scanning.

    Methods: A 53-year-old female presented to our clinic with 6-year history of bilateral lower extremity venous stasis ulcers. Her past medical history was significant for refractory venous stasis ulcers of the bilateral lower extremities present for 6 years and morbid obesity. Read More

    Reverse sural flap for ankle and heel soft tissues reconstruction.
    J Med Life 2017 Jan-Mar;10(1):94-98
    Bucharest Clinical Emergency Hospital, Bucharest, Romania; "Carol Davila" University of Medicine and Pharmacy, Bucharest, Romania.
    Introduction: The potential of the medial calf integument, as donor site for a free flap based on musculocutaneous branches of the medial sural artery, was first identified by Taylor and Daniel, following cadaver investigation. In 1981, Pontén described the fasciocutaneous sural flap as a reconstructive option for soft tissue loss of the lower extremity, particularly around the knee. Two years later, Donski and Fogdestram presented the distally based fasciocutaneous flap from the sural region followed by Montegut and Allen who considered the sural artery perforator flap as a viable alternative for the gastrocnemius myocutaneous flap. Read More

    May-Thurner syndrome: an often overlooked cause for refractory venous leg ulcers.
    Int Wound J 2017 Mar 1. Epub 2017 Mar 1.
    Department of Dermatology, Venerology and Allergology, University Hospital of Essen, Essen, Germany.
    We report a 53-year-old female patient presenting with a refractory venous leg ulcer and unremarkable findings in the conventional ultrasonography of the leg veins. Further comprehensive diagnostics demonstrated an underlying May-Thurner syndrome. After resolution of the primary mechanical obstruction, rapid wound healing in the following 3 weeks was documented. Read More

    Initial single center experience: radiofrequency ablation assisted vertebroplasty and osteoplasty using a bipolar device in the palliation of bone metastases.
    Ann Palliat Med 2017 Jan 16. Epub 2017 Jan 16.
    Department of Medical Imaging, Sunnybrook Health Sciences Centre, Toronto, Canada.
    Background: To assess the safety and clinical outcomes of bipolar radiofrequency ablation (RFA) assisted vertebroplasty (VP) and osteoplasty (OP) in pathological and insufficiency fractures. The insufficiency fractures were in patients who sustained demineralization secondary to cancer treatment.

    Methods: Patients referred for symptomatic malignant or insufficiency fractures for VP or OP from January 2011 to May 2015 were retrospectively reviewed. Read More

    Rac1 Pharmacological Inhibition Rescues Human Endothelial Dysfunction.
    J Am Heart Assoc 2017 Feb 28;6(3). Epub 2017 Feb 28.
    IRCCS Neuromed, Pozzilli (IS), Italy.
    Background: Endothelial dysfunction contributes significantly to the development of vascular diseases. However, a therapy able to reduce this derangement still needs to be identified. We evaluated the effects of pharmacological inhibition of Rac1, a small GTPase protein promoting oxidative stress, in human endothelial dysfunction. Read More

    Effect of Fibrinogen Concentrate on Intraoperative Blood Loss Among Patients With Intraoperative Bleeding During High-Risk Cardiac Surgery: A Randomized Clinical Trial.
    JAMA 2017 02;317(7):738-747
    Department of Cardiothoracic Anesthesia and Intensive Care, Isala Zwolle, the Netherlands.
    Importance: Fibrinogen concentrate might partly restore coagulation defects and reduce intraoperative bleeding.

    Objective: To determine whether fibrinogen concentrate infusion dosed to achieve a plasma fibrinogen level of 2.5 g/L in high-risk cardiac surgery patients with intraoperative bleeding reduces intraoperative blood loss. Read More

    Endophlebectomy of the common femoral vein and arteriovenous fistula creation as adjuncts to venous stenting for post-thrombotic syndrome.
    Br J Surg 2017 May 21;104(6):718-725. Epub 2017 Feb 21.
    Department of Surgery, Maastricht University Medical Centre, Maastricht, The Netherlands.
    Background: Good results have been reported for angioplasty and stenting of post-thrombotic lesions of the iliac and proximal femoral veins. If lesions at the origin of the superficial femoral and profunda veins are stented, the intraluminal synechiae can be pushed against the orifices of inflow vessels, potentially decreasing stent inflow. Surgical disobliteration of the common femoral vein (endophlebectomy) has been suggested to mitigate this problem. Read More

    Study on Mucin in Normal-Appearing Leg Skin.
    Am J Dermatopathol 2017 Mar;39(3):163-170
    Consultant Histopathologist, Department of Cellular Pathology, Hospital El Bierzo, Ponferrada, Spain.
    Dermal deposits of mucin in the legs have been described associated with venous insufficiency. However, some degree of stasis dermatitis is generally common in aged individuals. Therefore, some amount of mucin is expected a priori in the reticular dermis of aged patients, even in the absence of clinical lesions. Read More

    Clinical and epidemiological assessment of patients hospitalized for primary and recurrent erysipelas
    Przegl Epidemiol 2016 ;70(4):575-584
    Medical University of Bialystok, Poland; Department of Dermatology and Venereology
    Introduction: Erysipelas is a bacterial infection, caused by group A β-hemolytic streptococci (Streptococcus pyogenes), rarely other bacteria. It is characterized by sudden onset and rapid course, with the presence of systemic symptoms.

    Objective: A retrospective analysis of patients hospitalized for primary and recurrent erysipelas with particular consideration of clinical profile of patients, causes, complications and risk factors of the recurrence. Read More

    Internal iliac venous aneurysm associated with pelvic venous insufficiency.
    J Vasc Surg Venous Lymphat Disord 2017 Mar 25;5(2):257-260. Epub 2016 Jul 25.
    Division of Vascular Surgery, University of Michigan, Ann Arbor, Mich. Electronic address:
    Aneurysmal disease of the internal iliac vein is rare, with no standard indication for or accepted modality of treatment. Here we report an instance of unilateral, primary left internal iliac venous aneurysm and associated pelvic venous insufficiency. Following extensive workup for alternative causes, the aneurysm and left gonadal vein were coil embolized with good effect. Read More

    The value of near-infrared spectroscopy for the assessment of calf muscle function in venous patients.
    J Vasc Surg Venous Lymphat Disord 2017 Mar 28;5(2):244-253. Epub 2016 Feb 28.
    Department of Vascular Surgery, University of Athens Medical School, "Attikon" University Hospital, Athens, Greece.
    Objective: Near-infrared spectroscopy (NIRS) is a noninvasive technique with the potential to determine the degree of tissue oxygenation. The aim of the current study was to investigate the use of NIRS as a reliable method of detecting calf muscle pump dysfunction in groups of patients with venous disease.

    Methods: Patients with superficial venous insufficiency (SVI) or history of deep venous thrombosis (DVT) were classified according to the comprehensive classification system for chronic venous disorders (clinical class, etiology, anatomy, and pathophysiology) and compared with controls (GROUP variable). Read More

    Relationship between patient-reported symptoms, limitations in daily activities, and psychological impact in varicose veins.
    J Vasc Surg Venous Lymphat Disord 2017 Mar;5(2):224-237
    BTG International Inc, West Conshohocken, Pa.
    Objective: The objective of this study was to evaluate the relationship between patient-reported symptoms, functional limitations, and psychological impact of varicose veins (VVs) vs pathophysiologic mechanism, incorporating demographic and behavioral factors.

    Methods: We conducted a pooled analysis from two clinical studies (Efficacy and Safety Study of Polidocanol Injectable Foam for the Treatment of Saphenofemoral Junction Incompetence [VANISH-1] and Polidocanol Endovenous Microfoam Versus Vehicle for the Treatment of Saphenofemoral Junction Incompetence [VANISH-2]) in patients with VVs (superficial venous reflux only). Health outcomes were classified on the basis of the Wilson-Cleary conceptual framework continuum linking clinical and anatomic factors (Clinical, Etiology, Anatomy, and Pathophysiology [CEAP] clinical class and great saphenous vein [GSV] diameter, respectively) to patient-reported outcomes: Varicose Vein Symptoms Questionnaire (VVSymQ) score; modified Venous Insufficiency Epidemiologic and Economic Study on Quality of Life/Symptoms (m-VEINES-QOL/Sym) limitations in daily activities (functional limitations hereafter) score; and m-VEINES-QOL/Sym psychological impact score. Read More

    Ablation of the great saphenous vein with nontumescent n-butyl cyanoacrylate versus endovenous laser therapy.
    J Vasc Surg Venous Lymphat Disord 2017 Mar 12;5(2):210-215. Epub 2017 Jan 12.
    Department of Cardiovascular Surgery, Cerrahpaşa Medical Faculty, Istanbul University, Istanbul, Turkey.
    Objective: The endovenous application of n-butyl cyanoacrylate (NBCA) is a new nontumescent ablation technique for the treatment of venous insufficiency. The aim of this study was to retrospectively compare an NBCA-based ablation method with endovenous laser ablation (EVLA) for the management of incompetent great saphenous veins.

    Methods: Between May 2013 and August 2014, there were 339 patients with incompetent varicose veins who were treated with either the endovenous application of NBCA (VariClose Vein Sealing System [VVSS]; Biolas, Ankara, Turkey) or EVLA. Read More

    Radiofrequency ablation with concomitant stab phlebectomy increases risk of endovenous heat-induced thrombosis.
    J Vasc Surg Venous Lymphat Disord 2017 Mar;5(2):200-209
    Department of Surgery, Johns Hopkins Vein Center, Johns Hopkins Medical Centers, Baltimore, Md. Electronic address:
    Objective: Endovenous heat-induced thrombosis (EHIT) is a well-documented phenomenon that follows endovenous ablation, but the treatment, surveillance, and risk factors for EHIT have yet to be comprehensively elucidated. We sought to identify characteristics that may put patients at higher risk for development of EHIT after radiofrequency ablation (RFA) for the treatment of symptomatic superficial venous insufficiency.

    Methods: A retrospective review was performed of all consecutive patients undergoing treatment with RFA to the great saphenous vein by a single surgeon from July 2013 through October 2015. Read More

    Recommendations for the medical management of chronic venous disease: The role of Micronized Purified Flavanoid Fraction (MPFF).
    Phlebology 2017 Apr;32(1_suppl):3-19
    6 Extrapolate LLC, USA.
    Scope A systematic review of the clinical literature concerning medical management of chronic venous disease with the venoactive therapy Micronized Purified Flavonoid Fraction was conducted in addition to an investigation of the hemodynamics and mechanism of chronic venous disease. Methods The systematic review of the literature focused on the use of Micronized Purified Flavonoid Fraction (diosmin) which has recently become available in the US, in the management of chronic venous disease. The primary goal was to assess the level of evidence of the role of Micronized Purified Flavonoid Fraction in the healing of ulcers, and secondarily on the improvement of the symptoms of chronic venous disease such as edema. Read More

    The current spectrum of contact sensitization in patients with chronic leg ulcers or stasis dermatitis - new data from the Information Network of Departments of Dermatology (IVDK).
    Contact Dermatitis 2017 Feb 14. Epub 2017 Feb 14.
    Department of Dermatology, University Hospital Erlangen, 91054, Erlangen, Germany.
    Background: Patients with lower leg dermatitis, chronic venous insufficiency or chronic leg ulcers have a high prevalence of contact sensitization.

    Objectives: To identify the current spectrum of contact allergens in these patients.

    Patients And Methods: Data of the Information Network of Departments of Dermatology on 5264 patients with the above diagnoses from the years 2003 to 2014 (study group) were compared with data on 4881 corresponding patients from 1994 to 2003 (historical control group) and with a current control group without these diagnoses (n = 55 510). Read More

    Italian intersociety consensus on DOAC use in internal medicine.
    Intern Emerg Med 2017 Apr 13;12(3):387-406. Epub 2017 Feb 13.
    Department of Internal Medicine and Medical Specialties, "La Sapienza" University of Rome, Rome, Italy.
    The direct oral anticoagulants (DOACs) are drugs used in clinical practice since 2009 for the prevention of stroke or systemic embolism in non-valvular atrial fibrillation, and for the treatment and secondary prevention of venous thromboembolism. The four DOACs, including the three factor Xa inhibitors (rivaroxaban, apixaban and edoxaban) and one direct thrombin inhibitor (dabigatran) provide oral anticoagulation therapy alternatives to Vitamin K antagonists (VKAs). Despite their clear advantages, the DOACs require on the part of the internist a thorough knowledge of their pharmacokinetic and pharmacodynamic characteristics to ensure their correct use, laboratory monitoring and the appropriate management of adverse events. Read More

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