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[PMID]: 24840967
[Au] Autor:Spencer EB; Stratil P; Mizones H
[Ad] Address:RIA Endovascular, Denver, CO. Electronic address: brooke.spencer@riaco.com.
[Ti] Title:Novel treatment techniques for recanalization of femoral-popliteal deep venous occlusion from chronic thrombosis.
[So] Source:Tech Vasc Interv Radiol;17(2):114-20, 2014 Jun.
[Is] ISSN:1557-9808
[Cp] Country of publication:United States
[La] Language:eng
[Ab] Abstract:Patients with postthrombotic syndrome due to previous femoral-popliteal deep venous thrombosis often experience lifestyle-limiting lower-extremity pain and swelling. Conservative treatment options include compression stockings and lymphedema massage, but in many cases these treatments only temporarily and partially improve symptoms. Ultrasound and venography in patients with postthrombotic syndrome often show only partial recanalization of the femoral vein with significant collateral vein formation. These abnormal veins are insufficient for adequate venous drainage from the lower extremity as evidenced by the patient's continued symptoms. Recanalization of the occluded or partially occluded femoral vein using prolonged venoplasty, with or without chemical thrombolysis, combined with optimizing anticoagulation and conservative treatment measures, results in lasting improvement in symptoms for a high percentage of patients.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1405
[Js] Journal subset:IM
[St] Status:In-Data-Review

  2 / 155054 MEDLINE  
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[PMID]: 24840966
[Au] Autor:Williams DM
[Ad] Address:Department of Radiology, University of Michigan, Ann Arbor, MI. Electronic address: davidwms@med.umich.edu.
[Ti] Title:Iliocaval reconstruction in chronic deep vein thrombosis.
[So] Source:Tech Vasc Interv Radiol;17(2):109-13, 2014 Jun.
[Is] ISSN:1557-9808
[Cp] Country of publication:United States
[La] Language:eng
[Ab] Abstract:Chronic occlusion of the iliac veins and the inferior vena cava is a source of significant morbidity to often otherwise healthy patients, but it can be successfully managed with percutaneous recanalization and stenting. In this article, I summarize our current approach to patients with chronic occlusion of the iliac veins: patient selection, timing of intervention, commonly needed equipment, procedure, difficulties encountered, complications, clinical follow-up, and outcomes. An ideal patient is the one who is physically active (or was so before iliocaval occlusion), is at least 6 months past acute iliocaval thrombosis, has a patent common femoral vein and hepatic vein or caval confluence, and has no thrombophilic state. The duration of the occlusion has not affected our technical success of recanalization but may, by predisposing the patient to recurrent deep vein thrombosis, affect long-term patency by degrading the size and number of inflow vessels. Secondary patency rates at 4 years can be as high as 70%-90%. We anticipate that even higher success rates will follow with ongoing evolutions in device design (stents with appropriate diameter, length, radial conformity to conduits of varying diameter, and resistance to compression); better understanding of the biological interaction of the stent, the veins, and the coagulation system; and improved navigation systems to cross longer, occluded segments that are resistant to guidewire passage.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1405
[Js] Journal subset:IM
[St] Status:In-Data-Review

  3 / 155054 MEDLINE  
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[PMID]: 24840965
[Au] Autor:Vedantham S
[Ad] Address:Interventional Radiology Section, Mallinckrodt Institute of Radiology, Washington University School of Medicine, St. Louis, MO. Electronic address: vedanthams@mir.wustl.edu.
[Ti] Title:Treating infrainguinal deep venous thrombosis.
[So] Source:Tech Vasc Interv Radiol;17(2):103-8, 2014 Jun.
[Is] ISSN:1557-9808
[Cp] Country of publication:United States
[La] Language:eng
[Ab] Abstract:Endovascular DVT therapy has historically been directed at patients with the most extensive DVT. As evidence has been developed to support the use of catheter-directed thrombolysis for iliofemoral DVT, interventional radiologists are increasingly being referred patients with DVT that is anatomically less severe. In this article, we outline the key considerations that should be weighed in determining whether or not to provide aggressive therapy to patients with DVT limited to the femoropopliteal veins.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1405
[Js] Journal subset:IM
[St] Status:In-Data-Review

  4 / 155054 MEDLINE  
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[PMID]: 24840963
[Au] Autor:Koo S; Fan CM
[Ad] Address:Angiography and Interventional Radiology, Brigham and Women's Hospital, Boston, MA.
[Ti] Title:Pelvic congestion syndrome and pelvic varicosities.
[So] Source:Tech Vasc Interv Radiol;17(2):90-5, 2014 Jun.
[Is] ISSN:1557-9808
[Cp] Country of publication:United States
[La] Language:eng
[Ab] Abstract:Pelvic venous insufficiency (PVI), defined as retrograde flow in the gonadal and internal iliac veins, is the underlying cause of pelvic congestion syndrome (PCS), a common cause of disabling chronic pelvic pain in women of child-bearing age. PCS is a chronic pain syndrome characterized by positional pelvic pain that is worse in the upright position and is associated with pelvic and vulvar varicosities as well as symptoms of dyspareunia and postcoital pain. Through collaterals to the lower extremity venous system, PVI may also contribute to varicose vein formation and recurrence in the lower extremities. Endovascular embolization of the ovarian and internal iliac veins has become the treatment of choice for PVI and PCS. This article reviews the pelvic retroperitoneal venous anatomy, pathophysiology of PCS, treatment options and techniques, and clinical outcomes of embolotherapy for PCS.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1405
[Js] Journal subset:IM
[St] Status:In-Data-Review

  5 / 155054 MEDLINE  
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[PMID]: 24840962
[Au] Autor:Winokur RS; Khilnani NM
[Ad] Address:Division of Interventional Radiology, Department of Radiology, Weill Cornell Vascular, New York-Presbyterian Hospital/Weill Cornell Medical College, New York, NY.
[Ti] Title:Superficial veins: treatment options and techniques for saphenous veins, perforators, and tributary veins.
[So] Source:Tech Vasc Interv Radiol;17(2):82-9, 2014 Jun.
[Is] ISSN:1557-9808
[Cp] Country of publication:United States
[La] Language:eng
[Ab] Abstract:Superficial venous insufficiency is a common cause of lower-extremity symptoms of pain and swelling. A thorough understanding of the superficial venous anatomy, as well as gaining knowledge of treatment approaches, can direct one's approach to providing an appropriate treatment for desired and durable outcomes. This article reviews the details of anatomy and treatment of the saphenous veins, perforator veins, and tributary veins.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1405
[Js] Journal subset:IM
[St] Status:In-Data-Review

  6 / 155054 MEDLINE  
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[PMID]: 24840961
[Au] Autor:Hunter DW; Mortazavi S
[Ad] Address:Department of Radiology, University of Minnesota Medical Center, Minneapolis, MN. Electronic address: Hunte001@umn.edu.
[Ti] Title:Imaging venous disease: pearls and pitfalls.
[So] Source:Tech Vasc Interv Radiol;17(2):74-81, 2014 Jun.
[Is] ISSN:1557-9808
[Cp] Country of publication:United States
[La] Language:eng
[Ab] Abstract:In this day of rapidly advancing quantitative and molecular imaging techniques, imaging of veins and venous pathology still primarily relies on qualitative interpretation of ultrasound and venographic images. This article is primarily dedicated to understanding the nuances of the qualitative use of these two, by now, "old-fashioned" modalities. As such, the article is an attempt to help the imaging practitioner, in their daily practice, to avoid some of the interpretive mishaps that can befall the unwary. There are special strengths of the 3-dimensional imaging techniques of magnetic resonance imaging and computed tomography venography that will be briefly mentioned and discussed as to when and where they should be added to the venous imaging armamentarium.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1405
[Js] Journal subset:IM
[St] Status:In-Data-Review

  7 / 155054 MEDLINE  
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[PMID]: 24840960
[Au] Autor:Black CM
[Ti] Title:Anatomy and physiology of the lower-extremity deep and superficial veins.
[So] Source:Tech Vasc Interv Radiol;17(2):68-73, 2014 Jun.
[Is] ISSN:1557-9808
[Cp] Country of publication:United States
[La] Language:eng
[Ab] Abstract:A thorough understanding of venous anatomy and physiology is foundational to the diagnosis and management of venous disease. Compared with the arterial system, there is significantly greater developmental variation in the venous system. The veins of the lower extremity include the superficial and deep veins, which are defined by their respective relationships to the muscular fascia. Perforating veins traverse the muscular fascia to connect superficial and deep veins. Communicating veins connect veins within the same venous compartment, either deep to deep or superficial to superficial. The deep veins of the lower extremities primarily drain muscles and are encompassed by muscular fascia. The veins located between the skin and the muscular fascia are considered superficial veins. Superficial veins drain the cutaneous microcirculation. The pelvic venous system is a complex transitional outflow pathway between the lower extremities, the pelvic structures, and the inferior vena cava. The terminology used to describe lower-extremity, pelvic, and abdominal vasculature conforms to published international standards.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1405
[Js] Journal subset:IM
[St] Status:In-Data-Review

  8 / 155054 MEDLINE  
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[PMID]: 24694720
[Au] Autor:Menevse GT; TeomanTellioglu A; Altuntas N; Cömert A; Tekdemir I
[Ad] Address:Antalya Research and Education Hospital, Department of Plastic and Reconstructive Surgery, Antalya, Turkey. Electronic address: gulsumt@yahoo.com....
[Ti] Title:Polidocanol injection for chemical delay and its effect on the survival of rat dorsal skin flaps.
[So] Source:J Plast Reconstr Aesthet Surg;67(6):851-6, 2014 Jun.
[Is] ISSN:1878-0539
[Cp] Country of publication:Netherlands
[La] Language:eng
[Ab] Abstract:BACKGROUND AND AIM: Surgical delay is an invasive method requiring a two-stage surgical procedure. Hence, methods that may serve as an alternative to surgical delay have become the focus of interest of research studies. From a conceptual view, any technique that interrupts the blood flow along the edges of a proposed flap will render the flap ischemic and induce a delay phenomenon. Polidocanol (Aethoxysklerol(®)-Kreussler) was initially used as a local anesthetic. Nowadays, it has been used as a sclerosing agent to treat telangiectasias and varicose veins. The aim of this experimental study was to investigate the effects of polidocanol injected around the periphery of a random flap as a sclerosing agent on flap delay and survival in a random flap model. METHODS: A preliminary histopathologic study was performed on two rats to evaluate the sclerosing effect and distribution of polidocanol injection. After the preliminary study, the main study was carried out with three groups: group 1: dorsal flap (n = 10); group 2: dorsal flap + surgical delay (n = 10), group 3: dorsal flap + chemical delay (n = 10). RESULTS: Tissue samples obtained from the flap and injection area revealed destruction of intradermal vessels. The area affected with sclerosis was limited to 0.1 cm beyond the injection site. Mean viable flap areas were 52.1 ± 4.38% (44.0-58.2) in group 1, 64.8 ± 8.92% (57.2-89.2) in group 2, and 71.8 ± 5.18% (64.0-84.0) in group 3. A statistically highly significant difference was found between the surgical delay and chemical delay groups versus the group without delay (p < 0.001 and p < 0.001, respectively). The difference between the mean viable flap areas was not statistically significant in the surgical and chemical delay groups (p = 0.056). CONCLUSION: In conclusion, this study has shown that polidocanol injection around the dorsal flap in the rat is a safe and easy method for nonsurgical delay. The results have shown a flap survival benefit that is superior to controls and equivalent to surgical delay. The clinical application of polidocanol, already in clinical practice for occlusal of telangiectasias, for surgical delay appears feasible.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1405
[Js] Journal subset:IM
[St] Status:In-Data-Review

  9 / 155054 MEDLINE  
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[PMID]: 24634303
[Au] Autor:Li X; Fan LH; Liu JJ; Xu DC
[Ad] Address:Department of Vascular Surgery, Qingpu Branch of Zhongshan Hospital, Fudan University, Shanghai, China....
[Ti] Title:Autogenous radiocephalic hemodialysis access in patients with small caliber cephalic veins after expansion with a Fogarty catheter.
[So] Source:Genet Mol Res;13(2):3520-6, 2014.
[Is] ISSN:1676-5680
[Cp] Country of publication:Brazil
[La] Language:eng
[Ab] Abstract:Autogenous arteriovenous fistula (AVF) is the first choice for hemodialysis access in renal failure with uremia. However, AVF cannot be performed in some patients due to small and narrow veins in the forearm. In this study, a Fogarty catheter was used to establish autogenous radiocephalic hemodialysis access in patients with small caliber cephalic veins, and the patency rate and complications of this method were observed. Sixty-seven patients with uremia were divided into a treatment group (40 cases, caliber of cephalic veins <2.5 mm) and a control group (27 cases, caliber of cephalic veins ≥2.5 mm). According to ultrasound results, the treatment group received AVF after expansion with a Fogarty catheter, and the control group received traditional AVF. The fistula patency rate and complications were observed during follow-up. All patients were followed up for an average period of 18 months (range = 3-36 months). AVF was successfully used in 58 patients for hemodialysis, with primary access failure in 9 cases (5 cases in the treatment group and 4 cases in the control group) due to early thrombosis. The primary and secondary patency rates 12 months after surgery in the treatment group were 64 and 72%, respectively, and those in the control group were 60 and 76%, respectively. Patients with small caliber cephalic veins can be treated with radiocephalic fistula after the caliber of cephalic veins is expanded to more than 2.5 mm with a Fogarty catheter. The long-term patency rate awaits observation in a longer follow-up period.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1405
[Js] Journal subset:IM
[St] Status:In-Data-Review
[do] DOI:10.4238/2014.February.25.3

  10 / 155054 MEDLINE  
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[PMID]: 24841688
[Au] Autor:Leuzzi S; Armenio A; Leone L; De Santis V; Di Turi A; Annoscia P; Bufano L; Pascone M
[Ti] Title:Repair of peripheral nerve with vein wrapping*.
[So] Source:G Chir;35(3-4):101-6, 2014 Mar-Apr.
[Is] ISSN:0391-9005
[Cp] Country of publication:Italy
[La] Language:eng
[Ab] Abstract:Objective. The post-traumatic neuro-anastomosis must be protected from the surrounding environment. This barrier must be biologically inert, biodegradable, not compressing but protecting the nerve. Formation of painful neuroma is one of the major issues with neuroanastomosis; currently there is no consensus on post-repair neuroma prevention. Aim of this study is to evaluate the efficacy of neuroanastomosis performed with venous sheath to reduce painful neuromas formation, improve the electrical conductivity of the repaired nerve, and reduce the discrepancies of the sectioned nerve stumps. Patients and methods. From a trauma population of 320 patients treated in a single centre between January 2008 and December 2011, twenty-six patients were identified as having an injury to at least one of the peripheral nerves of the arm and enrolled in the study. Patients were divided into two groups. In the group A (16 patients) the end-to-end nerve suture was wrapped in a vein sheath and compared with the group B (10 patients) in which a simple end-to-end neurorrhaphy was performed. The venous segment used to cover the nerve micro-suture was harvested from the superficial veins of the forearm. The parameters analyzed were: functional recovery of motor nerves, sensitivity and pain. Results. Average follow-up was 14 months (range: 12-24 months). The group A showed a more rapid motor and sensory recovery and a reduction of the painful symptoms compared to the control group (B). Conclusions. The Authors demonstrated that, in their experience, the venous sheath provides a valid solution to avoid the dispersion of the nerve fibres, to prevent adherent scars and painful neuromas formation. Moreover it can compensate the different size of two nerve stumps, allowing, thereby, a more rapid functional and sensitive recovery without expensive devices.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1405
[Js] Journal subset:IM
[St] Status:In-Data-Review


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