Sample records for saphenous vein harvest

  1. Immunohistochemistry comparing endoscopic vein harvesting vs. open vein harvesting on saphenous vein endothelium. (United States)

    Nezafati, Mohammad Hassan; Nezafati, Pouya; Amoueian, Sakineh; Attaranzadeh, Armin; Rahimi, Hamid Reza


    The present study attempts to compare the immunohistochemistry (IHC) of von Willebrand factor (vWf) , endothelial cadherin, Caveolin and endothelial Nitric Oxide Synthase (eNOS) in VasoView Endoscopic Vein Harvesting (EVH) versus traditional Open Vein Harvesting (OVH) techniques for Coronary Artery Bypass Graft (CABG) Surgery performed in Javad al Aemeh Hospital of Mashhad, Iran in 2013,. Forty-seven patients were scheduled for CABG (30 EVH and 17 OVH) among whom patients with relatively same gender and similar age were selected. Three separate two cm vein samples were harvested from each patient's saphenous vein. Each portion was collected from distal, middle and proximal zones of the saphenous vein. The tissues were deparaffinized, and antigen retrieval was done using EZ-retriever followed by an immunohistochemistry evaluation with vWf, e-cadherin, Caveolin and eNOS. In addition, demographic questioner as of Lipid profile, FBS, BMI, and cardiovascular risk factors were collected. Data analyses, including parametric and nonparametric tests were undertaken using the SPSS 16 software. A P value  0.05). Qualitative report of vWf, e-cadherin, Caveolin and eNOS reveals no significant difference between the EVH and OVH (P > 0.05). This study indicates that VasoView EVH technique causes no endothelial damage in comparison with OVH. This study could be a molecular confirmation for the innocuous of EVH technique.

  2. A systematic review of cost-effectiveness evidence of endoscopic saphenous vein harvesting: is it efficient? (United States)

    García-Altés, A; Peiró, S


    Greater saphenous vein harvest for coronary and lower extremity bypass requires the longest incision of any surgical procedure. Endoscopic vein harvest allows better results in some clinical variables compared to open harvesting techniques. The objective of this study is to present the results of a systematic review of the scientific evidence about the efficiency of endoscopic saphenous vein harvest. We performed a systematic review in the bibliographical databases Pubmed, National Health Service Economic Evaluation Database, and NHS Health Technology Assessment Database. The search strategy was "endoscopic AND harvesting", in the period January 1970-December 2009. We identified only 3 economic evaluation studies, 2 cost analyses with some methodological limitations, and 1 cost-utility analysis. All of them suggest lower hospital costs for endoscopic harvesting. Available evidence does not allow recommendations to be made based on the efficiency of endoscopic saphenous vein harvest, although it suggests lower costs for endoscopic harvesting. More scientific evidence about the long-term efficacy and the effectiveness of this technique is necessary, with studies measuring final outcomes, and carrying out complete and rigorous economic evaluations. Copyright © 2011 European Society for Vascular Surgery. Published by Elsevier Ltd. All rights reserved.

  3. [Surgical technique of saphenous vein harvesting using a Cusco vaginal speculum]. (United States)

    Kikuchi, Keita; Suzuki, Kotaro; Endo, Yoshiki; Matsuyama, Takayoshi; Osaka, Shin-ichi; Kurata, Atsushi


    We used Cusco vaginal speculum in harvesting saphenous vein graft (SVG) as an assist device for making a skin tunnel. After making 2 incisions of 3 to 4 cm, the SVG was dissected in a usual procedure. Then Cusco vaginal speculum was inserted into the skin tunnel between the 2 incisions. The SVG was dissected in a usual fashion under direct vision with the speculum. This procedure requires only small incisions, short learning curve and low cost. The new technique using Cusco vaginal speculum can be a reliable option for harvesting SVG.

  4. The Early and Late Effects of Calcium Dobesilate on Leg Wound Complications After Saphenous Vein Harvesting for Coronary Revascularization

    Directory of Open Access Journals (Sweden)

    Sevinç Bayer Erdoğan


    Full Text Available Introduction: The aim of this study was to determine effects of prophylactic use of calcium dobesilate on complications of saphenectomy after saphenous vein harvest for coronary artery bypass graft.Materials and Methods: A total of consequtive 209 patients who underwent elective coronary artery bypass grafting were divided into two groups. Group 1 included 98 patients who received calcium dobesilate 2 x 500 mg for three months. Group 2 had 111 patients who did not recieve calcium dobesilate. Leg wound complications were analyzed in the postoperative first week, first and third month.Results: The difference of diameter in the first and third month, the incidence of sellulitis in the first week and first month, and superficial wound infections in the first week were significantly lower in the group of patients treated with calcium dobesilate.Conclusion: Our study showed that use of calcium dobesilate 2 x 500 mg during three months can decrease complications of saphenectomy after saphenous vein harvest in coronary artery bypass graft.

  5. Preoperative ultrasound mapping of the saphenous vein

    DEFF Research Database (Denmark)

    Levi, Niels; Schroeder, T


    A prospective series of 92 patients had their greater saphenous vein assessed with duplex ultrasound scanning prior to planned infrainguinal bypass procedures. Sixteen (17%) bypass procedures thrombosed within the first week postoperatively. A naturally occurring optimal vein diameter was discove......A prospective series of 92 patients had their greater saphenous vein assessed with duplex ultrasound scanning prior to planned infrainguinal bypass procedures. Sixteen (17%) bypass procedures thrombosed within the first week postoperatively. A naturally occurring optimal vein diameter...

  6. Preoperative mapping of the saphenous vein

    DEFF Research Database (Denmark)

    Levi-Mazloum, Niels Donald; Sillesen, H; Nielsen, Tina G


    A consecutive series of 92 patients had their greater saphenous vein assessed with duplex ultrasound scanning prior to planned infrainguinal bypass procedures. A naturally occurring optimal vein diameter was discovered. It was significantly correlated with higher postoperative ankle-brachial pres......A consecutive series of 92 patients had their greater saphenous vein assessed with duplex ultrasound scanning prior to planned infrainguinal bypass procedures. A naturally occurring optimal vein diameter was discovered. It was significantly correlated with higher postoperative ankle...

  7. Leiomyosarcoma of the great saphenous vein. (United States)

    El Khoury, M; Mesurolle, B; Trassard, M; Cherel, P; Talma, V; Hagay, C


    Peripheral vascular leiomyosarcomas are rare. A case of leiomyosarcoma of the great saphenous vein diagnosed pre-surgically by MRI and fine-needle aspiration is presented. Characteristics of the tumour and imaging features are discussed.


    African Journals Online (AJOL)

    less rigid erections and are currently re- sponding to oral measures and lCl. Penile numbness occurred in four patients with dorsal plaques, and it was self limiting within six months. We encountered no complaint of penile shortening or impo- tence. Conclusion The saphenous vein presents a reasonable alternative grafting ...

  9. Evaluation of endoscopic vein extraction on structural and functional viability of saphenous vein endothelium


    Hussaini, Bader E; Lu, Xiu-Gui; Wolfe, J Alan; Thatte, Hemant S


    Abstract Objectives Endothelial injury during harvest influences graft patency post CABG. We have previously shown that endoscopic harvest causes structural and functional damage to the saphenous vein (SV) endothelium. However, causes of such injury may depend on the extraction technique. In order to assess this supposition, we evaluated the effect of VirtuoSaph endoscopic SV harvesting technique (VsEVH) on structural and functional viability of SV endothelium using multiphoton imaging, bioch...

  10. Primary leiomyosarcoma of saphenous vein presenting as deep venous thrombosis. (United States)

    Fremed, Daniel I; Faries, Peter L; Schanzer, Harry R; Marin, Michael L; Ting, Windsor


    Only a small number of venous leiomyosarcomas have been previously reported. Of these tumors, those of saphenous origin comprise a minority of cases. A 59-year-old man presented with symptoms of deep vein thrombosis and was eventually diagnosed with primary leiomyosarcoma of great saphenous vein origin. The tumor was treated with primary resection and femoral vein reconstruction with autologous patch. Although extremely rare, saphenous leiomyosarcoma can present as deep vein thrombosis. Vascular tumors should be included in the differential diagnosis of atypical extremity swelling refractory to conventional deep vein thrombosis management. © The Author(s) 2013 Reprints and permissions:

  11. Small saphenous vein: where does reflux go?

    Directory of Open Access Journals (Sweden)

    Guillermo Gustavo Rossi


    Full Text Available BACKGROUND: The anatomy of small saphenous vein (SSV is very variable because of its complex embryological origin. SSV incompetence often causes reflux that goes to the perforating veins, sometimes not respecting the anatomical course. OBJECTIVE: To analyze differences in reflux direction and reentry in the SSV. METHODS: In this prospective, observational study, 60 lower limbs with SSV incompetence of 43 patients were assessed using a color Doppler ultrasound protocol. RESULTS: Reentry variations were grouped into four types and subtypes. Percentage results were: Type A, perforating veins on the medial side = 25/60 cases (41.66%; subtypes: Cockett, Sherman, paratibial and vertex; Type B, lateral malleolus and perforating veins on the lateral side (fibular 17-26 cm = 15/60 cases (25%; subtypes: fibular and malleolus; Type C, two branches = 19/60 cases (31.66%; subtypes: gastrocnemius and Cockett, gastrocnemius and malleolus, and/or fibular, Cockett and malleolus, Cockett-vertex and fibular; Type D, reflux in the superficial system = 1/60 cases (1.66%. CONCLUSION: On most of the lower limbs assessed, reflux did not follow the classical anatomic course. Our findings demonstrated a high degree of variation in reflux/reentry, but no SSV anatomical variations. Reflux seems to, either look for the most accessible anatomical connection for reentry or be originated in the distal area and then reach the SSV.

  12. Leiomyosarcoma of the great saphenous vein

    Directory of Open Access Journals (Sweden)

    Alexandre Campos Moraes Amato


    Full Text Available A 56-year-old male patient presented with a complaint of two painful, hard, palpable nodules in the right lower limb. A Doppler ultrasound scan revealed the presence of nodules, likely to be neoplastic. Computed angiography showed two solid hypervascular nodules in the right great saphenous vein, fed by branches of the posterior tibial artery. Embolization of the nodules using surgical cyanoacrylate was performed, followed by an excisional biopsy. Anatomical pathology and immunohistochemical analysis identified the nodule as a high-grade leiomyosarcoma, characterized by ten mitotic figures per ten high-power fields, necrosis and cell pleomorphism. Immunohistochemical analysis results were positive for caldesmon and desmin labeling. A second surgical procedure was performed to enlarge the free margins.

  13. Microscopic and ultrastructural evaluation of the saphenous vein endothelium for CABG prepared by the no touch technique. (United States)

    Silva, Virgílio Figueiredo; Ishigai, Márcia Marcelino de Souza; Freymüller, Edna; Branco, João Nelson Rodrigues; Gaia, Diego Felipe; Gabriel, Edmo Atique; Romão, Renata Aparecida Leonel; Buffolo, Enio


    Saphenous vein grafts (SV) used in coronary artery bypass grafting have a limited life and vein occlusion may be the final adverse effect. Efforts to develop new techniques to harvest the saphenous vein may improve the viability of the graft. Twenty patients were randomly divided into two groups with the objective of evaluating the vascular endothelium. The No Touch (NT) technique consists in removing the saphenous vein with perivascular tissue. The conventional technique consists in harvesting with "in situ" removal of the perivascular tissue. The standard saphenous vein harvesting procedure used bridged incisions. Characteristics of the vein were considered. Evaluation of the endothelium was achieved by electron microscopy and histologic analysis using hematoxylin eosin staining. The Picrosirius and Masson Trichrome methods were used to analyze subendothelial collagen. Electron microscopy demonstrated that the NT Group had larger non-denudated endothelial areas as well as a smaller number of degraded cells. Histological analysis showed the form and integrity of the saphenous vein layers. A larger amount of collagen fibers were identified in the NT Group. The NT technique better preserves the saphenous vein endothelium suggesting a more viable graft in the long term.

  14. Evaluation of endoscopic vein extraction on structural and functional viability of saphenous vein endothelium. (United States)

    Hussaini, Bader E; Lu, Xiu-Gui; Wolfe, J Alan; Thatte, Hemant S


    Endothelial injury during harvest influences graft patency post CABG. We have previously shown that endoscopic harvest causes structural and functional damage to the saphenous vein (SV) endothelium. However, causes of such injury may depend on the extraction technique. In order to assess this supposition, we evaluated the effect of VirtuoSaph endoscopic SV harvesting technique (VsEVH) on structural and functional viability of SV endothelium using multiphoton imaging, biochemical and immunofluorescence assays. Nineteen patients scheduled for CABG were prospectively identified. Each underwent VsEVH for one portion and "No-touch" open SV harvesting (OSVH) for another portion of the SV. A two cm segment from each portion was immersed in GALA conduit preservation solution and transported overnight to our lab for processing. The segments were labeled with fluorescent markers to quantify cell viability, calcium mobilization and generation of nitric oxide. Morphology, expression, localization and stability of endothelial caveolin, eNOS, von Willebrand factor and cadherin were evaluated using immunofluorescence, Western blot and multiphoton microscopy (MPM). Morphological, biochemical and immunofluorescence parameters of viability, structure and function were well preserved in VsEVH group as in OSVH group. However, tonic eNOS activity, agonist-dependent calcium mobilization and nitric oxide production were partially attenuated in the VsEVH group. This study indicates that VirtuoSaph endoscopic SV harvesting technique preserves the structural and functional viability of SV endothelium, but may differentially attenuate the vasomotor function of the saphenous vein graft.

  15. Urethral Reconstruction Using Everted Saphenous Vein Graft in a Rabbit Model: One-Year Outcomes. (United States)

    Xu, Yujie; Shen, Zhou; Liu, Gang; Liu, Bing; Hua, Xiaoliang; Xiang, Yechen; Dong, Chuanjiang; Li, Bing


    To investigate the efficacy of using everted saphenous vein graft for urethral reconstruction. Thirty-five adult male rabbits were divided into 7 groups randomly: experimental group A, B, C, D, E, stricture control group and normal control group (n = 5). In experimental groups and the stricture control group, a urethral mucosa defect (1.5 × 0.8 cm) was created in each rabbit. In experimental groups, a 2-cm long saphenous vein graft was harvested and incised longitudinally and urethral reconstruction was carried out using the everted saphenous vein patch. Rabbits in experimental group A-E were killed respectively at 1 week, 2 weeks, 1 month, 3 months, and 1 year postoperatively, and the specimens were obtained for histo-pathological examination. Retrograde urethrography was performed to evaluate urethral patency before sacrifice in group D and the stricture control group. In the histo-pathological study, the vein grafts were visible within first week. The vein graft was completely covered by epithelium 1 month postoperatively. Retrograde urethrograms showed the urethral caliber of experimental rabbits were similar to those of normal. While the stricture control group showed a narrow urethral lumen and urothelium defect. For urethral reconstruction, everted saphenous vein graft can be an ideal substitute material because of its longer survival time and rapid epithelization capacity. © 2017 S. Karger AG, Basel.

  16. Evaluation of endoscopic vein extraction on structural and functional viability of saphenous vein endothelium

    Directory of Open Access Journals (Sweden)

    Lu Xiu-Gui


    Full Text Available Abstract Objectives Endothelial injury during harvest influences graft patency post CABG. We have previously shown that endoscopic harvest causes structural and functional damage to the saphenous vein (SV endothelium. However, causes of such injury may depend on the extraction technique. In order to assess this supposition, we evaluated the effect of VirtuoSaph endoscopic SV harvesting technique (VsEVH on structural and functional viability of SV endothelium using multiphoton imaging, biochemical and immunofluorescence assays. Methods Nineteen patients scheduled for CABG were prospectively identified. Each underwent VsEVH for one portion and "No-touch" open SV harvesting (OSVH for another portion of the SV. A two cm segment from each portion was immersed in GALA conduit preservation solution and transported overnight to our lab for processing. The segments were labeled with fluorescent markers to quantify cell viability, calcium mobilization and generation of nitric oxide. Morphology, expression, localization and stability of endothelial caveolin, eNOS, von Willebrand factor and cadherin were evaluated using immunofluorescence, Western blot and multiphoton microscopy (MPM. Results Morphological, biochemical and immunofluorescence parameters of viability, structure and function were well preserved in VsEVH group as in OSVH group. However, tonic eNOS activity, agonist-dependent calcium mobilization and nitric oxide production were partially attenuated in the VsEVH group. Conclusions This study indicates that VirtuoSaph endoscopic SV harvesting technique preserves the structural and functional viability of SV endothelium, but may differentially attenuate the vasomotor function of the saphenous vein graft. Ultramini-Abstract Endoscopic extraction preserved the structure and function, but attenuated the calcium mobilization and nitric oxide generation in human SV endothelium.

  17. Prospective analysis of endoscopic vein harvesting. (United States)

    Patel, A N; Hebeler, R F; Hamman, B L; Hunnicutt, C; Williams, M; Liu, L; Wood, R E


    Utilization of bridging vein harvesting (BVH) of saphenous vein grafts (SVG) for coronary artery bypass grafting (CABG) results in large wounds with great potential for pain and infection. Endoscopic vein harvesting (EVH) may significantly reduce the morbidity associated with SVG harvesting. A prospective database of 200 matched patients receiving EVH and BVH was compared. The patients all underwent CABG done over a period of 4 months (April to August 2000). Patients were excluded if they had prior vein harvesting. The EVH and BVH group included 100 patients each with similar demographics. The patients in the EVH group had significantly fewer wound complications, mean days to ambulation, and total length of stay (P BVH in patients undergoing CABG.

  18. The Short Saphenous Vein: A Viable Alternative Conduit for ...

    African Journals Online (AJOL)

    A wide variety of vascular conduits including the. Internal Mammary Artery (IMA), Radial Artery. (RA) and the Long Saphenous Vein (LSV), are available to the Cardiac Surgeon performing Coronary. Artery Bypass Graft procedures. These have demonstrated various successes over the years in both long-term patency.

  19. Saphenous Vein Sparing Superficial Inguinal Dissection in Lower Extremity Melanoma

    Directory of Open Access Journals (Sweden)

    Muhammed Beşir Öztürk


    Full Text Available Aim. The classic inguinal lymph node dissection is the main step for the regional control of the lower extremity melanoma, but this surgical procedure is associated with significant postoperative morbidity. The permanent lymphedema is the most devastating long-term complication leading to a significant decrease in the patient’s quality of life. In this study we present our experience with modified, saphenous vein sparing, inguinal lymph node dissections for patients with melanoma of the lower extremity. Methods. Twenty one patients (10 women, 11 men who underwent saphenous vein sparing superficial inguinal lymph node dissection for the melanoma of lower extremity were included in this study. The effects of saphenous vein sparing on postoperative complications were evaluated. Results. We have observed the decreased rate of long-term lymphedema in patients undergoing inguinal lymphadenectomy for the lower extremity melanoma. Conclusion. The inguinal lymphadenectomy with saphenous vein preservation in lower extremity melanoma patients seems to be an oncologically safe procedure and it may offer reduced long-term morbidity.

  20. Corporoplasty with Saphenous Vein Graft in the Surgical ...

    African Journals Online (AJOL)

    ObjectivesThe aim of this study is to evaluate the use of the saphenous vein in grafting the tunica albuginea defect after excision/incision of Peyronie's plaque in cases of disabling penile deformity. Patients and MethodsA total of 12 patients with significant penile curvature due to Peyronie's disease interfering with their ...

  1. Greater saphenous vein anomaly and aneurysm with subsequent pulmonary embolism


    Ma, Truong; Kornbau, Craig


    Abstract Venous aneurysms often present as painful masses. They can present either in the deep or superficial venous system. Deep venous system aneurysms have a greater risk of thromboembolism. Though rare, there have been case reports of superficial aneurysms and thrombus causing significant morbidity such as pulmonary embolism. We present a case of an anomalous greater saphenous vein connection with an aneurysm and thrombus resulting in a pulmonary embolism. This is the only reported case o...

  2. The defective protein level of myosin light chain phosphatase (MLCP) in the isolated saphenous vein, as a vascular conduit in coronary artery bypass grafting (CABG), harvested from patients with diabetes mellitus (DM). (United States)

    Matsuo, Yasuko; Kuwabara, Masachika; Tanaka-Totoribe, Naoko; Kanai, Tasuku; Nakamura, Eisaku; Gamoh, Shuji; Suzuki, Akito; Asada, Yujiro; Hisa, Hiroaki; Yamamoto, Ryuichi


    We examined the contractile reactivity to 5-hydroxytryptamine (5-HT) in isolated human saphenous vein (SV), as a vascular conduit in coronary artery bypass grafting (CABG), harvested from patients with diabetes mellitus (DM) and non-DM (NDM). Vascular rings of endothelium-denuded SV were used for functional and biochemical experiments. The vasoconstrictions caused by 5-HT were significantly greater (hyperreactivity) in the DM group than in the NDM group. RhoA/ROCK pathway is activated by various G-protein-coupled receptor agonists and consequently induces phosphorylation of myosin phosphatase target subunit 1 (MYPT1), a subunit of myosin light chain phosphatase (MLCP), which inhibits MLCP activity. In the resting state of the vessels, total tissue protein levels of 5-HT(2A) receptor, 5-HT(1B) receptor, RhoA, ROCK1, and ROCK2 did not differ between NDM and DM groups. However, the total protein level of MYPT1 was significantly lower in the DM group than in the NDM group. Furthermore, the ratio of P(Thr(696))-MYPT1 to total MYPT1 was significantly higher in the DM group than in the NDM group. These results suggest that the hyperreactivity to 5-HT in the SV smooth muscle of patients with DM is due to not only enhanced phosphorylation of MLCP but also defective protein level of MLCP. Thus, we reveal for the first time that the defective protein level of MLCP in the DM group can partially explain the poor patency of SV graft harvested from patients with DM. Copyright © 2011 Elsevier Inc. All rights reserved.

  3. Saphenous vein thrombophlebitis (SVT): a deceptively benign disease. (United States)

    Hanson, J N; Ascher, E; DePippo, P; Lorensen, E; Scheinman, M; Yorkovich, W; Hingorani, A


    The association between deep vein thrombosis (DVT) and the hypercoagulable state is a well-established entity. However, the association between saphenous vein thrombophlebitis and coagulation abnormalities has not been investigated. Although thrombosis of varicose veins typically runs a benign course, phlebitis of the saphenous system may propagate to the deep system or saphenofemoral junction that requires more aggressive therapy. Given the potential similarity in clinical outcome between saphenous vein thrombophlebitis (SVT) and DVT, we have investigated the coagulation profile of patients presenting with isolated SVT. Seventeen consecutive patients who presented to our vascular laboratory with isolated SVT had a coagulation profile performed that included antithrombin III (AT III), protein C (PC), protein S (PS) antigen and activity levels, activated protein C (APC) resistance, factor V DNA mutation, and coagulation factors II and X. All patients had duplex scans performed on both the superficial and deep venous systems. Patients with SVT only were treated with nonsteroidal antiinflammatory drugs (NSAIDs) and warm soaks as outpatients, whereas those patients found to have DVT or a clot at the saphenofemoral junction were fully anticoagulated with heparin and coumadin therapy. All 17 patients had at least one repeat coagulation profile performed up to 5 months after their SVT occurrence to ensure that the results of hypercoagulability were not transient. Ten (59%) of the 17 patients with SVT had abnormal coagulation profiles on initial presentation. All 10 patients who were hypercoagulable had repeat tests and 6 (35%) remained abnormal. Four patients who had abnormal results converted to normal values. Seven patients with normal coagulation profiles on initial presentation had repeat tests and all remained normal. The incidence of the hypercoagulable state in patients with SVT is high. Thirty-five percent of patients with isolated SVT had consistently abnormal

  4. Multi-photon microscopic evaluation of saphenous vein endothelium and its preservation with a new solution, GALA. (United States)

    Thatte, Hemant S; Biswas, Kunda S; Najjar, Samer F; Birjiniuk, Vladimir; Crittenden, Michael D; Michel, Thomas; Khuri, Shukri F


    Injury to endothelium can compromise the patency of bypass grafts harvested during coronary artery bypass graft (CABG) surgery. Maintaining structural and functional viability of endothelium in grafts may lead to improved long-term patency. The information gained from the application of multi-photon microscopy in transmission and epifluorescence mode was used to assess the structural and functional integrity of human saphenous vein segments stored in multiple preservation solutions, and to design a superior storage solution. Multi-photon microscopy was used to image deep within saphenous vein tissue harvested from patients undergoing CABG for analysis of endothelial structure and function. Endothelial cell structural viability, calcium mobilization, and nitric oxide generation were determined using specific fluorescence markers. Within 60 minutes of harvest and storage in standard preservation solutions, calcium mobilization and nitric oxide generation were markedly diminished with more than 90% of endothelial cells no longer viable in the vein. In contrast, veins could be stored for 24 hours without substantial loss in cell viability in a newly formulated heparinized physiologic buffered salt solution containing glutathione, ascorbic acid, and L-arginine (GALA). Standard solutions in clinical use today led to a profound decline in saphenous vein endothelial cell viability, whereas the newly designed physiologic salt solution (GALA) maintained endothelial function and structural viability for up to 24 hours. The improvements seen from using GALA as a vessel storage medium may lead to greater long-term vein graft patency following CABG surgery.

  5. Endovascular vein harvest: systemic carbon dioxide absorption. (United States)

    Maslow, Andrew M; Schwartz, Carl S; Bert, Arthur; Hurlburt, Peter; Gough, Jeffrey; Stearns, Gary; Singh, Arun K


    Endovascular vein harvest (EDVH) requires CO(2) insufflation to expand the subcutaneous space, allowing visualization and dissection of the saphenous vein. The purpose of this study was to assess the extent of CO(2) absorption during EDVH. Prospective observational study. Single tertiary care hospital. Sixty patients (30 EDVH and 30 open-vein harvest) undergoing isolated coronary artery bypass graft surgery. Hemodynamic, procedural, and laboratory data were collected prior to (baseline), during, and at it the conclusion (final) of vein harvesting. Data were also collected during cardiopulmonary bypass (CPB). Data were compared by using t tests, analysis of variance, and correlation statistics when needed. There were significant increases in arterial CO(2) (PaCO(2), 35%) and decreases in pH (1.35%) during EDVH. These were associated with increases in heart rate, mean blood pressure, and cardiac output. Within the EDVH group, greater elevations (>10 mmHg) in PaCO2 were more likely during difficult harvest procedures, and these patients exhibited greater increase in heart rate. Elevated CO(2) persisted during CPB, requiring higher systemic gas flows and greater use of phenylephrine to maintain desired hemodynamics. EDVH was associated with systemic absorption of CO(2). Greater absorption was more likely in difficult procedures and was associated with greater hemodynamic changes requiring medical therapy.

  6. Retrograde mechanochemical ablation of the small saphenous vein for the treatment of a venous ulcer. (United States)

    Moore, Hayley M; Lane, Tristan R A; Franklin, Ian J; Davies, Alun H


    We present the first case of retrograde ablation of the small saphenous vein to treat active venous ulceration. A 73-year-old gentleman with complicated varicose veins of the left leg and a non-healing venous ulcer despite previous successful endovenous treatment to his left great saphenous vein underwent mechanochemical ablation of his small saphenous vein with the ClariVein® system, under local anaesthetic, using a retrograde cannulation technique. Post-operatively the patient had improved symptomatically and the ulcer size had reduced. This report highlights that patients with small saphenous vein incompetence and active ulceration can be treated successfully with retrograde mechanochemical ablation. © The Author(s) 2013 Reprints and permissions:

  7. Multiple ligation of the proximal greater saphenous vein in the CHIVA treatment of primary varicose veins

    Directory of Open Access Journals (Sweden)

    Roberto Delfrate


    Full Text Available Saphenous femoral disconnection is the key point of most surgical techniques in the treatment of primary varicose vein surgery. The aim of this study is to compare and analyze different techniques for conservative saphenousfemoral ligation or disconnection. These techniques can be to perform mini invasive open surgery and are suitable for implementation of the conservative hemodynamic correction of venous insufficiency (CHIVA method. The aim was to present the follow-up by retrospective analysis of three different ligation-disconnection techniques of the proximal great saphenous vein (GSV according to the CHIVA method at the GSV end, i.e. between the very end of the GSV and the first arch tributary, according to the CHIVA method. The first thecnique consisted of a surgical division (crossotomy. The other two consisted of triple superposed ligation with No. 2 non-absorbable braided coated suture without division labeled TSFL (triple saphenous flush ligation and No. 0 polypropylenene ligation TPL (triple polypropylene ligation. The difference between TSFL and TPL was in the thickness and type of material of the thread, though both were non-absorbable. The follow up of 56 TPL procedures, 61 crossotomy procedures, and 82 TSFL procedures was analysed. The follow-up consisted of checking the sapheno-femoral junction occlusion with Duplex color ultra sound. The incidence rates of neovascularization (new vessels in the ligation or surgical disconnection site with saphenous-femoral reflux during the Valsalva maneuver were: 4.9% for the crossotomy group, 6.1% for the TSFL group and 37.5% for the TPL group. The data analysed show satisfactory results with both crossotomy and TSFL. Crossotomy has proven to be an effective technique for performing saphenous-femoral disconnection, but TSFL could also be a reliable, safe and low-cost varicose mini-invasive surgery in outpatients. TPL appeared to be less reliable.

  8. Room for improvement in reoperation for varicosities of the small saphenous vein

    DEFF Research Database (Denmark)

    Flamand, Mette Kehlet; Bækgaard, Niels


    This study was conducted to evaluate the qualitative and quantitative effects of surgery for recurrent varicosities of the small saphenous vein (SSV). To our knowledge, English-language original articles on this subject have not previously been published.......This study was conducted to evaluate the qualitative and quantitative effects of surgery for recurrent varicosities of the small saphenous vein (SSV). To our knowledge, English-language original articles on this subject have not previously been published....

  9. Saphenous vein covered stenting for right coronary artery lesion containing thrombus. (United States)

    Joseph, D; Bashi, V V; Guhathakurtha, S; Harilal, H; Jacob, A; George, T; Suguna, S


    Vein covered stenting to close coronary pseudoaneurysm and perforation and in the setting of acute myocardial infarction have been described. This case report describes saphenous vein covered stenting to exclude a large thrombus in a right coronary artery lesion. Vein covered stenting may be considered as an option when dealing with a thrombus containing lesion.

  10. Thrombosed aneurysm of saphenous vein coronary artery bypass grafting

    Energy Technology Data Exchange (ETDEWEB)

    Queiroz, Rodolfo Mendes; Nastri Filho, Rogerio; Ferez, Marcus Antonio; Costa, Mauro Jose Brandao da; Laguna, Claudio Benedini; Valentin, Marcus Vinicius Nascimento, E-mail: [Documenta - Hospital Sao Francisco, Ribeirao Preto, SP (Brazil). Departamento de Radiologia e Diagnostico por Imagem; Hospital Sao Francisco, Ribeirao Preto, SP (Brazil). Centro de Terapia Intensiva


    We describe the case of a male patient, aged 76 years, referred for cardiac investigation due to retrosternal chest pain and dyspnea. He had a history of acute myocardial infarction and angioplasties in the last 30 years, including a saphenous vein coronary artery bypass grafting (SVCABG). Echocardiogram showed hypoechoic oval formation near the right ventricle, suggesting a pericardial cyst. Computed angiotomography revealed a predominantly fusiform and thrombosed aneurysmal dilation of the SVCABG to the right coronary artery. SVCABG aneurysms are very rare and potentially fatal. They usually appear in the late postoperative period, and patients are often asymptomatic. On radiography, it is frequently presented as enlargement of the mediastinum, with echocardiography, computed tomography and magnetic resonance imaging being very useful for diagnosis. Coronary angiography is the gold standard to detect these cases. Our report illustrates a rare situation arising late from a relatively common surgery. Due to its severity, proper recognition in the routine assessment of patients with a similar history is essential. (author)

  11. Straight configuration saphenous vein transposition to popliteal artery for vascular access. (United States)

    Caco, Gentian; Golemi, Dhurata; Likaj, Eriola


    The saphenous vein is commonly used as a vascular graft in peripheral artery surgery but rarely used for vascular access. The literature on straight configuration saphenous vein transposition to the popliteal artery is scarce. Here we present two cases of straight configuration saphenous vein transposition to the popliteal artery for vascular access, the surgical technique and respective follow-up. Two young men, aged 29 and 36 years, were chosen for lower-limb vascular access for hemodialysis. The first patient was paraplegic since birth. He used his arms to move so upper extremity vascular access was avoided. The second patient presented with an infected upper extremity arteriovenous graft (AVG) and after multiple closed AVFs he had no more available arm veins. Both patients received autologous lower extremity straight configuration saphenous vein transpositions to the popliteal artery under spinal anesthesia in May and October 2012, respectively. Cannulation of the fistula was allowed after one month. There were no early complications. Slight swelling on the leg appeared in one of the patients. Both fistulas were still functional after 36 and 32 months, respectively. The straight configuration saphenous vein transposition to popliteal artery is simple to perform, offers a long and straight segment for cannulation and may be a suitable autologous vascular access in selected patients.

  12. Relationship between elevated platelet volume and saphenous vein graft disease. (United States)

    Tavil, Yusuf; Sen, Nihat; Yazici, Hüseyin Uğur; Hizal, Fatma; Açikgöz, Sadik Kadri; Turfan, Murat; Cengel, Atiye


    Saphenous vein graft (SVG) disease is the major determinant of long term graft viability in patients undergoing coronary artery bypass graft (CABG) surgery. Although, platelets play a major role in this pathogenetic process the nature of this interaction has not been yet been clarified. Mean platelet volume (MPV) reflects platelet production rate and stimulation. This study was designed to investigate MPV in patients with late stage SVG disease. The study population composed of 188 patients who underwent elective coronary angiography more than one year after coronary artery bypass surgery. The study population was divided in to two groups according to SVG patency. The first group consisted of 90 patients (75 men, 15 women; mean age, 63.4 +/- 9.2 years) with patent SVG's (no-stenosis group). The second group consisted of 98 patients (80 men, 18 women; mean age, 62.1 +/- 10.1 years) with SVG stenosis based on the results of coronary angiography (stenosis group). Greater than 50% stenosis within the SVG was accepted as hemodynamically significant. MPV were significantly higher in patients with SVG disease in comparison with the patients without graft disease group (9.3 +/- 1.19 vs. 8.3 +/- 1.10 fl, respectively, p < 0.001). In a multiple regression model, SVG disease was independently associated with MPV (beta=0.837, p=0.05) along with LDL-cholesterol (beta=0.159, p=0.008) and time interval after bypass surgery (beta=-0.092, p=0.05). Platelet volume, and therefore platelet activation, appears to play a causal role in late SVG disease graft disease; hence, MPV may be useful as a post-operative marker of graft success.

  13. An Artificial Cadaveric Leg Blood Flow System for Endoscopic Vein Harvesting Simulation. (United States)

    Karras, Constantine L; DeDonato, Emily A; DiBartola, Kaitlin K; Zhao, Jin-Cheng

    Despite being the most common training model for endoscopic vein harvesting, cadaveric legs are limited by their absence of blood flow, resulting in a faded vascular appearance. Because the saphenous vein and the surrounding tissue seem less distinguishable, dissection of the saphenous vein and bipolar coagulation of its branches becomes increasingly inefficient and difficult. An inexpensive artificial blood flow system was developed to overcome this limitation. A cadaveric leg was thawed to a soft and yielding degree, and the saphenous vein was dissected medial and proximal to the medial malleolus. An artificial blood solution was prepared by dissolving 4% protein powder, red dye, and a contrast agent-for x-ray visualization-in saline. The solution was perfused through the saphenous vein and artery. The open ends of the vessels were temporarily clamped after the perfusion had been completed. Blood flow within the vessels was confirmed via angiography and endoscopic visualization of the leg's vessels. A bleeding effect was observed when the saphenous vein was perforated or when a vascular branch was transected. Conversely, a tight seal indicated successful bipolar coagulation of a branch, providing an objective, quantifiable assessment parameter. The artificial blood flow system helps overcome the limitations of the cadaveric leg, creating a more realistic and inexpensive model for endoscopic vein harvesting simulation training.

  14. Fatores de risco que afetam as complicações da dissecação da veia safena na revascularização cirúrgica do miocárdio The risk factors affecting the complications of saphenous vein graft harvesting in aortocoronary bypass surgery

    Directory of Open Access Journals (Sweden)

    Monir Abbaszadeh


    Full Text Available OBJETIVO: O problema da cicatrização de feridas é comumente observado após procedimentos de revascularização do miocárdio. Nosso objetivo é determinar a prevalência e os indicadores de complicação na dissecação da veia safena após procedimentos de revascularização coronária. MÉTODOS: Após revisão e aprovação pelo comitê de ética da instituição, uma revisão retrospectiva de 4029 procedimentos de revascularização foi realizada com enxerto da veia safena durante um período de seis anos. Treze fatores de risco para aqueles que desenvolveram complicações extensas nas feridas da perna foram analisados e comparados com toda a coorte de pacientes submetidos a procedimentos de revascularização semelhantes durante o mesmo período. RESULTADOS: Complicações nas feridas do membro inferior ocorreram em 68 pacientes (1,7%, 43 deles precisaram de intervenção cirúrgica adicional. Foram realizados 17 desbridamentos de feridas, nove transplantes de pele, uma angioplastia, 11 fasciotomias, três procedimentos vasculares e duas transferências livre de tecidos. Das treze variáveis analisadas pela análise multivariada, sexo feminino, IMC, uso de enxerto de veia torácica interna, doença vascular periférica, o uso de balão intra-aórtico no pós-operatório e hiperlipidemia pré-existente foram identificados como indicadores independentes significativos de complicações extensas nas feridas a perna (pOBJECTIVE: Problem of wound healing is commonly observed after coronary artery bypass graft procedures. Our aim is to determine the prevalence and the predictors of saphenous vein harvesting complication after coronary revascularization procedures. METHODS: After institutional ethical committee review and approval, a retrospective review was undertaken of 4029 bypass procedures with saphenous vein graft performed over a period of six years is conducted. Thirteen risk factors for those who developed major leg wound

  15. Endovenous laser ablation is an effective treatment for great saphenous vein incompetence in teenagers. (United States)

    Terlecki, Piotr; Przywara, Stanislaw; Iłżecki, Marek; Terlecki, Karol; Kawecki, Piotr; Zubilewicz, Tomasz


    The current knowledge of chronic venous disease in teenagers and its treatment is very limited. The aim of the study is to present our experience and the available literature data on the treatment of varicose veins in teenagers with endovenous laser ablation of the great saphenous vein. Five patients, aged 15-17 years, were qualified for surgery, based on typical signs and symptoms of chronic venous disease. Minimally invasive treatment with endovenous laser ablation of the great saphenous vein was applied. The technical success of surgery was achieved in all patients. Over a 2-year follow-up we did not observe any case of recanalisation of the great saphenous vein, recurrence of varicose veins, or serious complications, such as deep vein thrombosis or pulmonary embolism. One patient presented with resolving of post-operative bruising, and two cases of local numbness were transient. Endovenous laser ablation of the great saphenous vein in the treatment of chronic venous disease in teenagers is effective and safe. The method provides excellent cosmetic effects, very short recovery time and high levels of patient satisfaction. © The Author(s) 2015.

  16. Clinical results of a new strategy (modified CHIVA) for surgical treatment of anterior accessory great saphenous varicose veins. (United States)

    Maldonado-Fernández, Nicolás; Linares-Palomino, Jose Patricio; López-Espada, Cristina; Martínez-Gámez, Francisco Javier; Ros-Díe, Eduardo


    Traditionally, anterior accessory great saphenous vein insufficiency was managed by crossectomy and resection of varicose veins. The aim of this paper is to show the safety and efficacy of a new therapeutic strategy for anterior accessory great saphenous varicose veins. This non-randomised prospective study included 65 patients with varicose veins from the anterior accessory great saphenous vein. The novelty of the technique is to avoid the great saphenous vein crossectomy and perform just flebectomy of the visible veins. Venous duplex studies were performed preoperatively, a month and a year postoperatively. The clinical assessment was done by the Fligelstone scale. The baseline CEAP clinical classification was: 58% C2, 26% C3 and 15% C4-6. The new strategy was applied to all cases. 3 haematomas, 7 cases of asymptomatic partial anterior saphenous thrombosis. Reduction of the initial average diameter was from 6.4 mm anterior saphenous to 3.4 mm by one year (p <0.001). At twelve months a forward flow is maintained in 82% of cases. Recurrence of varicose veins was 8%. All patients improved their clinical status based on the Fligelstone scale. Cases with saphenous diameter bigger than 7.5 mm and obesity were identified as predictors of worse clinical and hemodynamic outcome. This modified surgical strategy for anterior saphenous varicose veins results in better clinical outcomes at one year postoperatively. Copyright © 2015 AEC. Publicado por Elsevier España, S.L.U. All rights reserved.

  17. Intercorrências clínicas no membro submetido à exérese de veia safena magna para revascularização do miocárdio Clinical complications of limb undergone harvesting of great saphenous vein for coronary artery bypass grafting using bridge technique

    Directory of Open Access Journals (Sweden)

    Cleusa Ema Quilici Belczak


    Full Text Available OBJETIVO: Avaliar as intercorrências clínicas nos membros submetidos a retirada da veia safena magna por técnica de incisões escalonadas para sua utilização como enxerto venoso na revascularização do miocárdio. MÉTODOS: Selecionou-se aleatoriamente 44 pacientes submetidos a revascularização do miocárdio utilizando a veia safena magna retirada por incisões escalonadas há mais de 3 meses. Critérios de exclusão: retirada da veia safena de ambos os lados; safenectomia prévia do membro contralateral; etiologias de edema de causas sistêmicas, tais como cardíacas, renais, tireoideanas, hepáticas e insuficiência venosa nos membros inferiores (MMII, representada por varizes exuberantes com ou sem alterações tróficas. Foram avaliados as seguintes variáveis: idade, sexo, diabetes, tempo de cirurgia, presença de intercorrências, como edema, parestesias, infecção, linforréia, erisipela e trombose venosa profunda. A avaliação foi clínica e o diagnóstico do diabete foi feito pelos exames do pré-operatório para cirurgia. Para análise estatística foram empregados o teste qui-quadrado, teste exato de Fisher e teste t de Student, considerando erro alfa de 5%. RESULTADOS: O tempo entre avaliação e cirurgia foi de 3 a 187 meses, com média 47,3 + 42,5 meses. Detectou-se 25% de infecção no leito da safena, edema em 52,3% dos casos, parestesia em 29,5%, erisipela em 9,1%, linforréia em 4,5% e trombose venosa profunda em 2,3%. Não houve associação entre diabetes com as intercorrências. CONCLUSÃO: A exérese escalonada da veia safena magna para revascularização do miocárdio não elimina as intercorrências clínicas no leito da safena, como parestesias, infecção e edemaOBJECTIVE: The aim of this study was to assess clinical complications of limbs undergone harvesting of the great saphenous vein for venous coronary artery bypass graft surgery using bridge technique. METHODS: Fourty-four patients who had undergone CABG

  18. Bipolar radiofrequency-induced thermotherapy of great saphenous vein: Our initial experience

    Directory of Open Access Journals (Sweden)

    Venkatesh Kasi


    Full Text Available The incidence of varicose veins in lower limbs is increasing in the Indian subcontinent. With the advent of radiofrequency ablation (RFA, an effective minimally invasive technique is now available to treat varicose veins. RFA can be performed with either unipolar or bipolar probes. We present a simple technique for bipolar radiofrequency-induced thermotherapy of the great saphenous vein. This can be a safe and effective alternative to surgical procedures.

  19. Groin Swelling in a Four-Year-Old Boy: Primary Great Saphenous Vein Aneurysm. (United States)

    Çiçek, Mustafa Cüneyt; Çiçek, Ömer Faruk; Yalçınkaya, Adnan; Taşoğlu, İrfan


    Primary venous aneurysm, especially in pediatric population, is a very rare clinical entity. We report a case of primary great saphenous vein aneurysm in a 4-year-old boy. He was initially suspected of suffering from inguinal hernia because the soft mass was detected at the inguinal region when the patient was in the standing position, but color Doppler ultrasonography demonstrated the swelling to be a great saphenous vein aneurysm. We decided that surgery was the best option because of potential risk for thromboembolism. Copyright © 2015 Elsevier Inc. All rights reserved.

  20. Edema de membro inferior secundário a exérese de veia safena magna para utilização como enxerto na revascularização do miocárdio Lower limb edema after great saphenous vein harvesting to be used as graft in myocardial revascularization

    Directory of Open Access Journals (Sweden)

    Cleusa Ema Quilici Belczak


    Full Text Available CONTEXTO: A revascularização do miocárdio utilizando-se a veia safena magna ainda é procedimento cirúrgico bastante realizado na atualidade. O edema que surge no membro inferior operado causa grande desconforto e necessita ser melhor estudado. OBJETIVOS: Caracterizar o edema de membro inferior secundário a exérese da veia safena magna pela técnica de incisões escalonadas para sua utilização como enxerto venoso na revascularização do miocárdio. MÉTODOS: Foram selecionados aleatoriamente 44 indivíduos submetidos a exérese de veia safena magna para revascularização miocárdica há mais de 3 meses. Excluíram-se fatores que pudessem interferir na formação de edema dos membros inferiores. Foram avaliados por volumetria e perimetria maleolares ambos os membros inferiores. Considerou-se como presença de edema significativo a diferença de volume maior que 50 mL e maior de 2 cm em relação ao membro não-operado. Para a análise estatística foram empregados o teste do qui-quadrado, teste exato de Fisher, teste t de Student e o teste de McNemar. O nível de significância adotado foi de 5% (a = 0,05. RESULTADOS: Encontraram-se diferenças estatisticamente significativas (p BACKGROUND: Myocardial revascularization using the great saphenous vein is still a very common surgical procedure. The edema that occurs in the operated leg causes much discomfort and requires further studies. OBJECTIVES: To describe lower limb edema secondary to great saphenous vein harvesting using the bridge technique for use as venous graft in myocardial revascularization. METHODS: Forty-four individuals previously submitted to great saphenous vein harvesting for myocardial revascularization more than 3 months before were randomly selected. Patients with factors that might interfere with formation of lower limb edema were excluded. Both operated and non-operated legs were evaluated by volumetry and perimetry of the malleolar region. Differences greater than

  1. Evaluation of pain during endovenous laser ablation of the great saphenous vein with ultrasound-guided femoral nerve block. (United States)

    Al Wahbi, Abdullah M


    Endoluminal laser ablation is now considered the method of choice for treating greater saphenous vein insufficiency. General anesthesia and peripheral nerve blocks with sedation have the risk of post-procedural delay in discharge and prolonged immobilization with the risk of deep vein thrombosis. The main pain experienced by patients during the procedure is during the laser ablation and the multiple needle punctures given along and around the great saphenous vein. The aim of our study was to evaluate the safety and efficacy of blocking the femoral nerve only under ultrasound-guidance without sedation, to reduce or prevent pain during injectable tumescent anesthesia in endovenous laser ablation of the greater saphenous vein. Sixty patients in two groups underwent endovenous laser ablation for the greater saphenous vein insufficiency at an outpatient clinic. All patients received tumescent anesthesia. However, one group received a femoral nerve block (FNB) under ultrasound guidance before the procedure. All patients were asked to record the pain or discomfort, using the visual analog score, from the start of the procedure until the end of the great saphenous vein laser ablation. The length of the great saphenous vein and duration of the procedure were also recorded. The results were analyzed using statistical methods. No complications from FNB were observed. The pain associated with application of tumescent anesthesia and laser ablation was more intense in the group without an FNB (P laser ablation during endoluminal laser ablation of the greater saphenous vein.

  2. Midterm Outcome of Mechanochemical Endovenous Ablation for the Treatment of Great Saphenous Vein Insufficiency

    NARCIS (Netherlands)

    Witte, Marianne E.; Holewijn, Suzanne; van Eekeren, Ramon R.; De Vries, Jean-Paul; Zeebregts, Clark J.; Reijnen, Michel M. J. P.


    Purpose: To report the midterm results of mechanochemical ablation (MOCA) for treating great saphenous vein (GSV) insufficiency. Methods: In a 1-year period, 85 consecutive patients (median age 51.4 years; 71 women) undergoing MOCA with polidocanol in 104 limbs were enrolled in a prospective

  3. A New Supermicrosurgery Training Model of Saphenous Artery and Great Saphenous Vein Anastomosis for Development of Advanced Microsurgical Skills. (United States)

    Bas, Can Emre; Cwykiel, Joanna; Siemionow, Maria


    Background This study aimed to confirm the feasibility and reliability of saphenous artery (SA) and great saphenous vein (GSV) anastomosis as a new supermicrosurgery training model and to compare the one-way-up anastomosis with the currently used end-to-end anastomosis technique. Methods Twenty supermicrosurgical anastomoses were performed in 10 Sprague Dawley rats. The external diameters of SA and GSV were measured using Leica LAS EZ software. The right-side SA and GSV anastomoses were performed using the standard end-to-end anastomosis technique. The left-side SA and GSV anastomoses were performed using the one-way-up technique with 11-0 monofilament-interrupted sutures. The duration of the surgery, patency rates, and technical challenges of the two anastomoses methods were compared. Results The mean external diameters of SA and GSV were 0.273 ± 0.03 and 0.291 ± 0.02 mm, respectively, which qualify these vessels for supermicrosurgical training. The vessels were easily accessible and both anastomosis techniques were feasible. The one-way-up technique was proven to be faster as compared with the end-to-end anastomosis technique (artery: 34 ± 2.55 vs. 40.4 ± 2.97 minutes, p = 0.02; and vein: 37 ± 4.85 vs. 44 ± 2.35 minutes, p = 0.05, respectively). Short-term patency rates for arteries and veins were 100% for both techniques. Seven-day anastomosis patency rates for arteries and veins were 80 and 100% for the end-to-end technique and 100 and 80% for the one-way-up technique, respectively. Conclusions We confirmed that saphenous pedicle is suitable for creating a supermicrosurgery training model for practicing the ultrafine motor skills. To the best of our knowledge, this is the first report on supermicrosurgery of SA and GSV in the rat model. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

  4. Brilliant Blue FCF as an Alternative Dye for Saphenous Vein Graft Marking Effect on Conduit Function (United States)

    Voskresensky, Igor V.; Wise, Eric S.; Hocking, Kyle M.; Li, Fan Dong; Osgood, Michael J.; Komalavilas, Padmini; Brophy, Colleen; Cheung-Flynn, Joyce


    IMPORTANCE Surgical skin markers are used off-label to mark human saphenous veins (HSVs) to maintain orientation before implantation as aortocoronary or peripheral arterial bypass grafts. These surgical skin markers impair functional responses of the HSV tissue. OBJECTIVES To investigate the effect of brilliant blue dye 1 (brilliant blue FCF [for food coloring]; hereinafter, FCF) as a nontoxic alternative marking dye and to determine whether FCF has pharmacological properties. DESIGN, SETTING, AND PARTICIPANTS Segments of HSVs were collected in university hospitals from patients undergoing coronary artery bypass grafting procedures immediately after harvest (unmanipulated) or after typical intraoperative surgical graft preparation (after manipulation). Rat inferior venae cavae were used to determine the pharmacological properties and cellular targets of FCF. Endothelial and smooth muscle functional responses were determined in a muscle bath, and intimal thickening in HSVs was determined after 14 days in organ culture. MAIN OUTCOMES AND MEASURES Contractile responses were measured in force and converted to stress. Smooth muscle function was expressed as maximal responses to potassium chloride depolarization contractions. Endothelial function was defined as the percentage of relaxation of maximal agonist-induced contraction. Neointimal thickness was measured by histomorphometric analysis. RESULTS Human saphenous veins stored in the presence of FCF had no loss of endothelial or smooth muscle function. Unmanipulated HSVs preserved in the presence of FCF demonstrated a significant increase in endothelial-dependent relaxation (mean [SEM], 25.2% [6.4%] vs 30.2% [6.7%]; P = .02). Application of FCF to functionally nonviable tissue significantly enhanced the smooth muscle responses (mean [SEM], 0.018 [0.004] × 105N/m2 vs 0.057 [0.016] × 105 N/m2; P = .05). Treatment with FCF reduced intimal thickness in organ culture (mean [SEM], −17.5% [2.1%] for unmanipulated HSVs vs

  5. Adventitial cystic disease of the popliteal artery treated by bypass graft utilizing the short saphenous vein: A case report. (United States)

    Miyake, Katsunori; Sawamura, Naoki; Ikegaya, Yuki; Isogai, Naoko; Kawachi, Jun; Shimoyama, Rai; Fukai, Ryuta; Kashiwagi, Hiroyuki; Ogino, Hidemitsu


    Adventitial cystic disease is relatively rare vascular disease, frequently occurred in the popliteal artery. No definitive treatment has been established yet. A 53-year-old woman presenting intermittent claudication of the right leg was diagnosed as adventitial cystic disease of popliteal artery. Percutaneous balloon dilation yielded an immediate recurrence. The disease was successfully treated by bypass grafting utilizing the short saphenous vein to replace the part of the popliteal artery containing the adventitial cyst. No postoperative complication was found six months after surgery. Comparing to a great saphenous vein, a short saphenous vein as a material of bypass graft has a significant advantage, as only a single surgical field is necessary. We propose that bypass graft surgery employing a short saphenous vein is worth considering as a treatment of adventitial cystic disease at the popliteal artery. Copyright © 2017 The Authors. Published by Elsevier Ltd.. All rights reserved.

  6. Medical management of acute superficial vein thrombosis of the saphenous vein. (United States)

    Scovell, Sherry D; Ergul, Emel A; Conrad, Mark F


    Acute superficial vein thrombosis (SVT) of the axial veins, such as the great saphenous vein (GSV), is a common clinical condition that carries with it significant risk of propagation of thrombus, recurrence, and, most concerning, subsequent venous thromboembolism (VTE). Conservative therapy with nonsteroidal anti-inflammatory medication and heat does not prevent extension of thrombus or protect against recurrent or future VTE in patients with extensive SVT (thrombotic segment of at least 5 cm in length). To prevent future thromboembolic events, anticoagulation has become the treatment of choice for extensive acute SVT in the GSV. In spite of this, the dose and duration of anticoagulation in the treatment of SVT vary widely. This review summarizes the evidence from large prospective, randomized clinical trials on the treatment of SVT with anticoagulation (vs placebo or different doses and durations of anticoagulation) with respect to the outcome measures of thrombus extension, SVT recurrence, and future VTE. A systematic search was performed using the MEDLINE database to identify all prospective, randomized controlled trials of treatment with anticoagulation in patients with SVT in the GSV. Six prospective, randomized trials were identified that met the inclusion criteria and were reviewed in detail. Treatment of acute SVT was most commonly managed in an outpatient setting using either low-molecular-weight heparin (LMWH) in four studies or, alternatively, a factor Xa inhibitor in one large multicenter trial. LMWH was associated with a lower rate of thrombus extension and subsequent recurrence, especially when an intermediate dose (defined as a dose between prophylactic and therapeutic doses) was used for a period of 30 days. The full effect of treatment with LMWH on the risk of subsequent VTE remains unclear, as do the optimal dose and duration of this drug. Prophylactic doses of fondaparinux, a factor Xa inhibitor, were found to be beneficial in reducing the

  7. Crossectomy and Foam Sclerotherapy of the Great Saphenous Vein versus Stripping of Great Saphenous Vein and Varicectomy in the Treatment of the Legs Ulcers

    Directory of Open Access Journals (Sweden)

    Alvaro Delgado-Beltran


    Full Text Available Objective. To show our results in the surgical treatment of legs varicose ulcers, with crossectomy and foam sclerotherapy (CAFE of the great saphenous vein (GSV in group I and stripping of GSV and varicectomy in group II. Methods. 35 patients with active venous leg ulcers were recruited and treated. They were collected in two groups. Group I were treated by crossectomy and foam sclerotherapy of the GSV and group II were treated by stripping of GSV and varicectomy. The healing time of the ulcer and the complications were recorded after the procedure in the follow-up visits. Results. 29 out of the 35 patients completed the follow-up. There were eight cases of incomplete healing of the leg ulcer, 4 in group I (19.04% and 4 in group II (40%, P<0.05. The average rate of healing in group I was 0.38 cm/day and 0.13 in group II, P<0.05. Conclusion. CAFE technique of the great saphenous vein in the treatment of 6 CEAP patients is a procedure that improves the rate of ulcer healing as compared to these two groups. It is a safe and reliable minimally invasive method, with less morbidity.

  8. Reinforced long saphenous vein bypass graft for infrainguinal reconstruction procedures: case series and literature review.

    LENUS (Irish Health Repository)

    Hynes, Niamh


    Poor rehabilitation rates and the high-cost of managing postamputation patients justify an aggressive revascularization policy in critical lower limb ischemia. Endovascular therapy is our first choice for limb salvage in these patients. However there are patients for whom endovascular therapy is not feasible. When bypass is necessary, autologous vein is a superior conduit to synthetic material. However, varicosities usually contraindicate autologous vein bypass because of the risk of aneurysm formation, rupture and increased intimal hyperplasia compared with nonvaricose venous grafts. We report the use of varicosed long saphenous vein (LSV) with external Dacron support in infrainguinal bypass procedures for limb salvage, where endovascular therapy was not feasible. The external Dacron tube was not brought close to the distal anastomotic area itself. With a mean follow-up of 18 months, duplex ultrasonography and computed tomography angiography showed no evidence of stenosis of the reinforced vein segments or aneurysmal degeneration of the residual vein. External reinforcement with Dacron prosthesis allows the use of autogenous greater saphenous veins with varicose dilatation without compromising graft patency and limb salvage.

  9. Numerical simulation of endovenous laser treatment of the incompetent great saphenous vein with external air cooling. (United States)

    Marqa, Mohamad Feras; Mordon, Serge; Hernández-Osma, Esteban; Trelles, Mario; Betrouni, Nacim


    Endovenous laser treatment (ELT) has been proposed as an alternative in the treatment of reflux of the great saphenous vein. Before the procedure, peri-saphenous subcutaneous tumescent saline solution infiltration is usually performed. However, diffusion of this tumescent fluid is rapidly observed and can potentially reduce the efficacy as a heat sink. External skin cooling with cold air was proposed as an alternative solution. The objective of this study is to compare endovenous laser treatment without and with air cooling by realistic numerical simulations. An optical-thermal damage model was formulated and implemented using finite element modeling. The general model simulated light distribution using the diffusion approximation of the transport theory, temperature rise using the bioheat equation, and laser-induced injury using the Arrhenius damage model. Parameters, used in clinical procedures, were considered: power, 15 W; pulse duration, 1 s; fiber pull back, 3-mm increments every second; cold air applied in continuous mode during ELT; and no tumescent anesthesia. Simulations were performed for vein locations at 5, 10, and 15 mm in depth, with and without air cooling. For a vein located at 15 mm in depth, no significant difference was observed with and without cooling. For a vein located at 10 mm in depth, surface temperature increase up to 45 °C is observed without cooling. For a vein located at 5 mm, without cooling, temperature increase leads to irreversible damage of dermis and epidermis. Conversely, with air cooling, surface temperature reaches a maximum of 38 °C in accordance with recordings performed on patients. ELT of the incompetent great saphenous vein with external air cooling system is a promising therapy technique. Use of cold air on the skin continuously flowing in the area of laser shot decreased significantly the heat extent and the thermal damage in the perivenous tissues and the skin.

  10. Long-term results of external valvuloplasty in adult patients with isolated great saphenous vein insufficiency

    Directory of Open Access Journals (Sweden)

    Sarac A


    Full Text Available Atilla Sarac,1 Artan Jahollari,1 Sureyya Talay,1 Sevket Ozkaya,2 Ertugrul Ozal1 1Department of Cardiovascular Medicine, Samsun Medical Park Hospital, Samsun, Turkey; 2Department of Pulmonary Medicine, Faculty of Medicine, Bahcesehir University, Istanbul, Turkey Objective: The aim of this study is to present our 7-year results of external valvuloplasty for isolated great saphenous vein (GSV insufficiency. Methods: External valvuloplasty was applied in 83 patients with isolated GSV insufficiency. Follow-up consisted of venous color duplex scanning performed on the first postoperative day, the first postoperative month, and then annually. Valvular insufficiency, venous reflux, and venous thrombosis formation in the saphenofemoral junction were the main outcomes. Results: A complete clinical and radiological healing was observed in 50 patients (60%. In 13 cases (15.6%, a secondary surgical treatment was performed consisting of vena saphena magna high ligation/stripping and varicose vein excisions, mainly due to severe and progressive vena saphena magna valvular insufficiency and clinical persistence of symptoms. Eight patients (9.6% developed superficial vein thrombosis, and only one patient (1.2% developed deep vein thrombosis. Contact was lost from 32 patients (38.5% for different reasons. Conclusion: External valvuloplasty is an effective surgical technique for selected cases of isolated GSV insufficiency without extensive varicose dilatations. This alternative method can be safely administered as an alternative to high ligation and conventional GSV stripping. Keyword: vein, saphenous, insufficiency, external valv, valvuloplasty, varicosis

  11. Use of arm and lesser saphenous vein compared with prosthetic grafts for infrapopliteal arterial bypass: are they worth the effort? (United States)

    Calligaro, K D; Syrek, J R; Dougherty, M J; Rua, I; Raviola, C A; DeLaurentis, D A


    Arm and lesser saphenous veins (ALSVs) are generally considered to be the best alternative for infrapopliteal arterial bypass grafts when greater saphenous vein is not available. The need for additional incisions and repositioning of the patient, along with occasional use of general anesthesia for arm vein harvesting, led to our perception that the use of ALSVs increased operative time and possibly patient discomfort. Therefore, we compared the outcome of ALSVs with that of prosthetic infrapopliteal arterial bypass procedures performed at our hospital. Between July 1, 1991, and Dec. 31, 1996, we performed 96 infrapopliteal arterial bypass procedures using 45 ALSVs (28 arm vein, 17 lesser saphenous) and 51 polytetrafluoroethylene (PTFE) grafts. Seventy grafts were single-length ALSV or PTFE bypass grafts, and 26 grafts were placed as the distal segment of a sequential or composite bypass graft. Every attempt was made to use ALSV and avoid the use of PTFE, even if a short segment of the vein graft measured less than 4.0 mm in diameter. There were no significant differences between patients with ALSV compared with PTFE grafts in terms of age, sex, indication for surgery, or number of previous revascularization procedures (2.1 vs 1.7), respectively (p > 0.05). However, ALSV grafts had more factors associated with an expected worse outcome: they were more commonly anastomosed to pedal arteries (17% [8 of 45] vs 0%; p = 0.0009), less commonly single-segment grafts (62% [28 of 45] vs 82% [42 of 51]; p = 0.03), had higher average runoff resistance values (2.3 vs 1.5; p = 0.001), and were less frequently treated with lifelong warfarin (65% [29 of 45] vs 95% [48 of 51]; p = 0.0001). The hospital mortality rate was 3.1% (3 of 96; 3 PTFE). All deaths were cardiac-related. Despite the potential factors associated with worse patency rates for ALSVs, 2-year assisted primary patency rates tended to be higher for arm veins (46%) than for lesser saphenous veins (23%) and PTFE grafts

  12. Ultrasound assisted great saphenous vein ligation and division: an office procedure

    Directory of Open Access Journals (Sweden)

    Stefano Ricci


    Full Text Available The aim of this proof of concept study is to describe an ultrasound (US assisted simplified surgical procedure for pre-terminal great saphenous vein (GSV high ligation/division avoiding groin dissection and tributary interruption, in an office setting, in association to varices phlebectomy and saphenous vein foam occlusion treatment. Inclusion criteria: primary GSV reflux due to terminal valve, vein diameter >6 mm. By ultrasonography in standing position, the point GSV passing over the adductor longus muscle (about 3 cm from the junction is identified. This E (easy point, relatively superficial, free from tributaries and other structures, allows an easy grasping and extraction of the GSV vein through a 3 mm stab incision provided an ultrasonography assistance. The vein is divided/ligated about 2 cm distal from the ostium, the distal stump is cannulated and foam is injected on the distal segment from the E-point incision in a retrograde fashion, varices are avulsed by phlebectomy. Twenty procedures in 18 patients (venous clinical severity score: mean 3.15 - GSV diameter: mean 7.34 were performed, all the cases without inconveniences, with a duration not exceeding 10 min in addition to the phlebectomy procedure time. No complications as hemorrhage, infection, nerve lesion, lymphatic leak or thrombosis have been registered. At one month the residual saphenous stump length was in average 2.16 cm with complete closure of GSV in all. Three patients have been controlled at 6 months showing GSV complete closure. The procedure described is a simple office US assisted method for GSV ligationdivision, leaving the 2 last cm of the saphenofemoral junction. It could be associated to most of the procedures in use with limited additional time and resources required.

  13. Real time B-mode mapping of the greater saphenous vein

    DEFF Research Database (Denmark)

    Bagi, P; Schroeder, T; Sillesen, H


    Real time ultrasound mapping of the greater saphenous vein (GSV) was performed in 30 consecutive patients admitted for in situ femoro-crural revascularisation. The overall accuracy in predicting the adequacy of the GSV for in situ bypass was 90%. The predictive value of finding the vein usable...... was 96%, whereas the predictive value of judging the vein inadequate was 50%. The scanning procedure provided morphologic information about the GSVs, including size, tributaries, varicosities, and double segments, which may prevent unnecessary dissection and may further shorten the duration of surgery....... In our opinion the technique is sufficiently accurate to replace phlebography for the routine preoperative assessment of GSV in patients considered for in situ bypass. Veins judged inadequate at scanning, however, should be further evaluated....

  14. Idiopathic great saphenous phlebosclerosis.

    Directory of Open Access Journals (Sweden)

    Ahmadreza Jodati


    Full Text Available Arterial sclerosis has been extensively described but reports on venous sclerosis are very sparse. Phlebosclerosis refers to the thickening and hardening of the venous wall. Despite its morphological similarities with arteriosclerosis and potential morbid consequences, phlebosclerosis has gained only little attention. We report a 72 year old male with paralysis and atrophy of the right leg due to childhood poliomyelitis who was referred for coronary artery bypass surgery. The great saphenous vein, harvested from the left leg, showed a hardened cord-like obliterated vein. Surprisingly, harvested veins from the atrophic limb were normal and successfully used for grafting.

  15. The value of pre-operative ultrasound mapping of the greater saphenous vein prior to 'closed' in situ bypass operations

    NARCIS (Netherlands)

    L.C. van Dijk (Lukas); C.H. Wittens; H. Pieterman; H. van Urk (Hero)


    textabstractObjective: The aim of this study was to test pre-operative ultrasound mapping for the detection of duplications and narrow vein segments of the greater saphenous vein (GSV) used as bypass for occlusive arterial disease surgery. Patients and methods: In 44 patients pre-operative

  16. In situ saphenous vein bypass surgery in diabetic patients

    DEFF Research Database (Denmark)

    Jensen, L P; Schroeder, T V; Lorentzen, J E


    .005). Indication for surgery was gangrene or ulceration in 57% of diabetics, as opposed to 36% in non-diabetic patients (p = 0.0002). A femoro-popliteal bypass was performed in 18% of patients, whereas 82% received an infrapopliteal procedure, of which 42% were to the distal third of the calf or foot. Diabetic......From 1986 through to 1990 a total of 483 consecutive in situ infra-inguinal vein bypass procedures were performed in 444 patients, of whom 112 (25%) were diabetics (57 insulin dependent diabetes mellitus and 55 non-insulin-dependent diabetes mellitus). Based on a prospective vascular data registry...... this material was analysed to determine the influence of diabetes on the outcome. Preoperative risk factors were equally distributed among diabetic and non-diabetic patients, except for smoking habits (diabetics: 48%; non-diabetics: 64%, p = 0.002) and cardiac disease (diabetics: 45%; non-diabetics: 29%, p = 0...

  17. Endovenous laser ablation of great saphenous vein and perforator veins improves venous stasis ulcer healing. (United States)

    Abdul-Haqq, Ryan; Almaroof, Babatunde; Chen, Brian L; Panneton, Jean M; Parent, F Noel


    We sought to compare the outcomes of endovenous laser ablation (EVLA) of the great saphenous vein (GSV) to EVLA of the GSV and calf incompetent perforator veins (IPVs) in management of venous stasis ulcers (VSUs). A retrospective review of patients with active VSUs (clinical, etiology, anatomy, and pathophysiology [CEAP] classification C6) that received EVLA of the GSV or combined EVLA of the GSV and IPV between May 2005 and May 2010 was completed. Primary outcomes measured include ulcer healing and a change in the venous clinical severity score (VCSS). Secondary end points included complications, ulcer recurrence rate, and time to ulcer healing. Ninety-five patients (108 limbs) met inclusion criteria with active VSU (CEAP classification C6) before ablation. The average age was 58 years, with a male predominance (61%). Seventy-eight patients (91 limbs) were treated with EVLA of the GSV alone. Subgroup analysis revealed that 46 of 91 limbs (35 patients) had GSV reflux only (group 1) and 45 of 91 limbs (43 patients) had underlying IPV (group 2). Seventeen patients (17 limbs) underwent combined EVLA of the GSV and IPV (group 3). VSU healing (CEAP classification C5) occurred in 21 of 46 limbs (46%) in group 1, 15 of 45 limbs (33%) in group 2, and 12 of 17 limbs (71%) in group 3. A comparison of ulcer healing between groups 1 and 2 and between groups 1 and 3 revealed no significant difference (Fisher's exact test; P = 0.285 and P = 0.095, respectively). However, there was a significant difference in ulcer healing between groups 2 and 3 (P = 0.011). Group 1 ulcers healed in an average of 14.8 weeks, group 2 ulcers in 11.2 weeks, and group 3 in 13.2 weeks (analysis of variance; P = 0.918). Postoperative complications occurred in 7 limbs (15%) in group 1, 5 limbs (11%) in group 2, and 3 (18%) limbs in group 3. Recurrence of VSU occurred in 2 limbs (4%) in group 1, 5 limbs in group 2 (11%), and in no limbs in group 3 (Fisher's exact test; P = 0.676). Mean follow-up was 16

  18. Evaluation of regional limb perfusion with erythromycin using the saphenous, cephalic, or palmar digital veins in standing horses. (United States)

    Kelmer, G; Martin-Jimenez, T; Saxton, A M; Catasus, C; Elliot, S B; Lakritz, J


    There are no reported studies evaluating the use of erythromycin for regional limb perfusion (RLP) in horses. Our hypothesis was that using the cephalic and saphenous veins for RLP will enable delivery of therapeutic concentrations of erythromycin to the distal limb. Nineteen healthy horses participated in the study. The cephalic, saphenous or palmar digital (PD) vein was used to perfuse the limb with erythromycin. Synovial samples were collected from the metacarpo/metatarso-phalangeal (MCP/MTP) joint and blood samples were collected from the jugular vein. Maximum concentration (C(max)) of erythromycin in the MCP joint using the cephalic vein was 113 mg/L. The Cmax of erythromycin in the MTP joint using the saphenous vein was 38 mg/L. Erythromycin administered using the PD vein was not detectable in the MCP/MTP joint of four of six horses. Concentrations of erythromycin achieved in the synovial fluid of the MCP/MTP joint were between 152 and 452 times the minimal inhibitory concentration (MIC) for Rhodococcus equi (R. equi). In conclusion, the results indicate that when using the saphenous or cephalic veins for RLP, therapeutic concentrations of erythromycin in the MCP/MTP joint can be consistently reached [corrected]. © 2012 John Wiley & Sons Ltd.

  19. Evaluation of regional limb perfusion with chloramphenicol using the saphenous or cephalic vein in standing horses. (United States)

    Kelmer, G; Tatz, A J; Famini, S; Bdolah-Abram, T; Soback, S; Britzi, M


    Regional limb perfusion (RLP) significantly decreases morbidity and mortality associated with distal limb injuries in horses. There is an urgent need for finding additional effective antimicrobial drugs for use in RLP. In this study, we tested the pharmacokinetics (PK) of chloramphenicol in RLP. Eight horses participated in the study, which was approved by the University Animal Care and Use Committee. The cephalic and the saphenous veins were used to perfuse the limbs. Synovial samples were collected from the metacarpo/metatarsophalangeal (MCP/MTP) joint. The Friedman Test was applied for assessing change in PK concentration over time, for all time points. The Wilcoxon Signed Ranks Test was used to test the difference between PK concentration in joint & serum as well as concentration in joint vs. MIC. The comparison of measurements between measurements taken on hind vs. front legs was carried out using the Mann-Whitney Test. A P-value of 5% or less was considered statistically significant. After RLP, the concentration of chloramphenicol in the synovial fluid of the MCP/MTP joint using either the cephalic or the saphenous vein was initially far above the minimal inhibitory concentration (MIC) of most susceptible pathogens and remained above the MIC for approximately 6 h. The results indicate that performing RLP using the cephalic and saphenous veins enables reaching concentrations of chloramphenicol in the MCP/MTP joint that are well above the MIC of most susceptible pathogens. The chloramphenicol concentrations achieved in the synovial fluid of the MCP/MTP joint in the current study were between 1.5 (MTP) and 7 (MCP) times the MIC of MRSA in horses. These results are encouraging since MRSA infections are becoming far more common, causing considerable morbidity. To the best of our knowledge, this is the first study to evaluate the pharmacokinetics of chloramphenicol following RLP in the horse and the results are positive. © 2014 John Wiley & Sons Ltd.

  20. Leiomyosarcoma of inferior vena cava involving bilateral renal veins: Surgical challenges and reconstruction with upfront saphenous vein interposition graft for left renal vein outflow

    Directory of Open Access Journals (Sweden)

    Rishi Nayyar


    Full Text Available Leiomyosarcoma of inferior vena cava (IVC involving bilateral renal veins presents a surgical challenge. Herein, we report the successful management of two such cases using restoration of left renal venous outflow by saphenous vein interposition graft as first step of surgery. Then radical resection of tumor and right kidney was done. IVC was lastly reconstructed using Gore-Tex graft. This report highlights the surgical challenges to ensure radical resection. Furthermore, the importance of restoring left renal outflow in presence of concomitant right nephrectomy is discussed. Both the patients were disease free at six months with no loss of left renal glomerular filtration rate.

  1. Endovenous laser therapy for occlusion of incompetent saphenous veins using 1940nm (United States)

    Sroka, Ronald; Pongratz, Thomas; Esipova, Anna; Dikic, Slobodan; Demhasaj, Sahit; Comsa, Florin; Schmedt, Claus-Georg


    Objective: Several studies indicate that ELT using wavelengths of high water absorption showed advantages compared to conventional ELT. Thulium-Lasers emit nearby the local absorption maximum of water at 1940nm. In this clinical study the effectiveness, safety and the feasibility of 1940nm-ELT is proven. Materials and Method: A single centric, prospective observational study was performed. 1940nm-laserenergy was applied using radial emitting fibres with continuous pullback (1mm/s). Treatment was performed under anesthesia (general, spinal, tumescent) thus simultaneous miniphlebectomy and ligation of perforators could be applied. Patient and technical details were systematically collected. Evaluation included: standardized questionnaire, clinical examination, color-duplex ultrasonography preoperatively, 3d, 4w, 6m postoperatively, statistic. Results: The 1940nm-ELT study include 55 patients (female/men=34/21, mean age 55y, range 23-90y) treating n=72 vessels. The mean maximum diameter of great saphenous veins (GSV, n=59) was 7.5mm (range 3.7-11.3mm) and of small saphenous veins (SSV, n=13) was 5.3mm (3.0-10.0mm). The mean applied longitudinal endovenous energy density (LEED) was 64.3J/cm (40.3-98.2J/cm) in GSVs and 51.0J/cm (37.6-72.7J/cm) in SSVs. Complete occlusion of the vein without sign of reflux was achieved in 100%. The mean length of non-occluded stump at the sapheno-femoral junction was 6.0mm (1.0-20.0mm). Postoperative reduction of the diameter of GSV was 1.6mm (21.3%) and 2.0mm (37.7%) in SSV. One (1.4%) endovenous heat induced thrombus (EHIT) was observed. Further adverse events were: paresthesia 10/72 (13.9%), ecchymosis 1/72 (1.4%), lymphocele 1/72 (1.4%), hyperpigmentation 1/72 (1.4%). The mean postoperative pain intensity was 1.3 and 1.8 single doses of analgesics were administered. Normal physical activity was reached after 3d (1-21d). Conclusion: 1940nm-ELT using radial light application effectively eliminates the reflux in insufficient saphenous

  2. Postoperative neuralgia in the leg after saphenous vein coronary artery bypass graft: a prospective study. (United States)

    Nair, U R; Griffiths, G; Lawson, R A


    The degree of cutaneous sensory deficit in the leg was assessed after removal of the long saphenous vein in 50 consecutive patients undergoing coronary artery bypass vein grafts randomly assigned subcutaneous sutures or a single layer of sutures. Removal of the vein and repair of the leg incision were done by the same team of surgeons. In group 1 (25 patients) the leg incision was repaired with "00" Dexon subcutaneous and "00" prolene subcuticular sutures while in group 2 (25 patients) closure was effected by a single layer of interrupted "00" nylon sutures. All had crepe pressure bandage from the base of the toes to the groin for the first 24 hours followed by TED stockings for six to eight weeks. Sutures were removed on the eighth postoperative day. Cutaneous sensation in the leg and ankle was assessed 48 hours, seven days, and six to eight weeks after surgery, and a final comparison of the cosmetic effects and sensory perception after one year or more was made in 37 patients. There were no major differences between the groups at 48 hours in sensory abnormalities (anaesthesia, hyperaesthesia, and pain) but sensory recovery was significantly better in group 2 at the second and third assessments. There was some reduction in sensory abnormalities at the final review in group 1. No appreciable difference was noted in the quality of the scar between the two groups. We conclude that cutaneous sensation is better preserved by repairing the leg incision in a single layer. Subcutaneous sutures may produce neuropraxia of the long saphenous nerve by direct pressure as healing progresses. PMID:3281308

  3. Saphenous vein graft true aneurysms: Report of nine cases and review of the literature

    Directory of Open Access Journals (Sweden)

    Davidović Lazar B.


    Full Text Available INTRODUCTION The true aneurysm formation of the autogenous saphenous vein graft (ASVG is a very rare complication after bypass surgery [1 -5]. In 1969 Pillet [1] first described a true fusiform aneurysm formation of the ASVG which had been used as a replacement of the iwured superficial femoral artery in 26-year-old male patient. We present nine cases. CASE!. A 71-year-old man with previous history of arterial hypertension and higher serum lipid level, was admitted with an asymptomatic pulsating swelling of the medial portion on the thigh. Five years ago the bellow knee F-P bypass with ASVG due to occlusive disease has been performed. The transfemoral angiography (Figure 1 showed patent graft with fusiform true aneurysm formation at its mid portion. This aneurysm has been replaced with PTFE graft. The pathohistological examination showed an atherosclerotic origin of the aneurysm. This patient died four years after operation due to myocardial infarction with patent graft. CASE 2. A 57-year-old female with previous history of arterial hypertension and higher serum lipid level, had an elective resection and replacement of the superficial femoral artery aneurysm. For the reconstruction an ASVG was used. The saphenous vein showed postflebitic changes. Four years later she was admitted with asymptomatic pulsating mass of the mid portion of the thigh. The control transfemoral angiography showed patent graft with fusiform aneurysm formation of its mid portion. After aneurismal resection, an above knee F-P bypass with 8 mm PTFE graft was performed. A pathohistological examination showed a partially degenerated elastic membrane with fragmentation and disruption, without atherosclerosis (Figure 2. During the follow up period an elective resection of the subclavian artery aneurysm as well as abdominal aortic aneurysm, were performed. CASE3. A subclavian artery aneurysm caused by TOS has been repaired with sapehnous vein graft at 40-year-old female patient

  4. Endovenous laser ablation of great saphenous veins performed using tumescent cold saline solution without local anesthesia. (United States)

    Cavallini, Alvise; Marcer, Daniela; Bernardini, Giovanni; Ferrari Ruffino, Salvatore


    In recent years, laser systems with higher wavelengths, associated with new optical fibers, have shown excellent short-term results in treating saphenous veins and reducing the side effects and, in particular, the postoperative pain. However, if the patients are not anesthetized, they may feel pain even when using low energy with the high-wavelength laser; the only tumescent local anesthesia often does not guarantee a complete pain control during endovenous laser ablation (EVLA). Aim of this study was to demonstrate that the local anesthesia during EVLA of great saphenous veins (GSVs) is not essential for the perioperative comfort of the patient if a mild sedation is made. Forty-nine incompetent GSVs were treated by EVLA with a cold saline tumescent solution (CSTS) without local anesthetic drugs. EVLA was performed with a 1540-nm diode laser and a 600-μc ball-tipped fiber. Intraoperative ultrasonography was then used to guide delivery of CSTS (cold saline solution 0.9% at 5°C) using a motor pump under intravenous sedation. The gravity of chronic venous disease was determined according to the clinical-etiology-anatomy-pathophysiology classification. Patients rated surgery global pain according to 4 types: "extremely," "rather," "slightly," and "not at all" painful. Twenty-five cases (51%) were classified as C3, 20 (41%) as C2, 6 (13%) as C4, and 1 (2%) as C6. Midazolam 2.5 mg + a mean of 0.16 mg of fentanil (minimum: 0.10; maximum: 0.20; standard deviation [SD]: 0.4) + a mean of 178.21 mg of propofol (minimum: 100; maximum: 300; SD: 47.1) were administrated as intravenous sedation. The total average linear endovenous energy density was 57.7 J/cm. Approximately 250 mL (minimum: 100; maximum: 780) of CSTS was administered. No Patient has had pain during the procedure. All patients were discharged 2.5 hrs after surgery. EVLA under sedation using CSTS without diluted anesthetic drugs is a suitable technique in an outpatients clinic, especially useful if the ablation

  5. The effect of arteriovenous fistulas on in situ saphenous vein bypasses

    DEFF Research Database (Denmark)

    Rørdam, Peter; Jensen, Leif Panduro; Schroeder, T


    Doppler examination identified 89% of those branches with sufficient flow to opacify the deep venous system on completion arteriogram. Half of the missed fistulas underwent spontaneous thrombosis, and in only one case did the arteriovenous fistula lead to hemodynamic symptoms demanding surgical closure......Intraoperative identification and later development of arteriovenous fistulas were investigated prospectively in 70 in situ saphenous vein bypass procedures. Surveillance was performed by completion arteriography and intra- and postoperative continuous wave Doppler examination. The intraoperative...... of the fistula. Pursuing a policy of selectively ligating fistulas that only fill the deep venous system on completion arteriography led to an additional nine arteriovenous fistulas. Developed over an average follow-up of six months, four patients presented symptoms of edema and swelling and were relieved upon...

  6. Successful segmental thermal ablation of varicose saphenous veins in a patient with confirmed vascular Ehlers-Danlos syndrome. (United States)

    Frank, Michael; Says, Jerome; Denarié, Nicolas; Sapoval, Marc; Messas, Emmanuel


    We describe here the successful scheduled treatment of varicose veins by radiofrequency segmental thermal ablation in a 43-year-old patient with vascular Ehlers-Danlos syndrome. Her venous disease started at the age of 16 years, 1 year prior to her first major Ehlers-Danlos syndrome-related event which led to the diagnosis of her genetic condition. Surgical stripping was contra-indicated because of Ehlers-Danlos syndrome at the age of 18 years. More than 20 years later, her venous disease had become highly symptomatic despite daily compression and pain medication. Venous reassessment evidenced incompetent right and left great saphenous and left small saphenous veins, with increased diameters of both sapheno-femoral and sapheno-popliteal junctions. Radiofrequency endovenous ablation rather than surgery was considered because of its minimally invasive nature and because of standardized energy delivery.All intended-to-be-treated incompetent saphenous vein segments were occluded successfully, followed by an important improvement of clinical disease severity at day 30, persistent at 1 year post-treatment. Duplex ultrasound confirmed closure and fibrotic retraction of all treated venous segments at 1 year. This report shows that radiofrequency endovenous ablation may be a safe and effective therapy of varicose veins in patients with diagnosed vascular Ehlers-Danlos syndrome. © The Author(s) 2015.

  7. Endoscopic Vein Harvesting for Coronary Bypass Grafting: A Blessing or a Trojan Horse?

    Directory of Open Access Journals (Sweden)

    Ryan Accord


    Full Text Available Conventional open harvest of the great saphenous vein (GSV during CABG results in approximately 7% donor-site complications. Using endoscopic vein harvesting (EVH the full GSV length can be harvested through a 3 cm incision. This nonsystematic review discusses several key issues concerning EVH, based on an extensive Pubmed search. Found studies show that EVH results in reduced number of wound complications, less postoperative pain, earlier postoperative mobilisation, reduced length of hospital stay, and is more cost-effective. Initial studies did not find significant differences in graft histology, patency, or clinical outcome. However, in 2009 convincing evidence of inferior histological graft properties became available. Furthermore, an observational study showed that EVH resulted in significantly more graft stenosis, was associated with higher mortality, more myocard infarction, and more reinterventions. Most recent publications could not confirm these findings, however larger randomised controlled trials focusing on graft quality are being awaited.

  8. High hydrostatic pressure upon the vasa vasorum of the greater saphenous and splenic vein walls: a comparative study. (United States)

    Tao, W; Wei, H; Rui, X; Xiaoji, Z; Haibo, C; Lingyan, J; Meihong, W; Yongbo, X


    Hypoxia and high hydrostatic pressure can induce an increase in the thickness of the tunica media and intima; secondary vasa vasorum (VV) increase to fit the remodeling of the vessel wall. We aimed to investigate the impact of high hydrostatic pressure on VV in the varicose greater saphenous veins (VGSVs) and diseased splenic veins (DSVs). We collected 34 VGSVs and DSVs. Thirty-four normal greater saphenous veins (GSVs) and splenic veins (SVs) were also collected (control group). Samples were cut into slices, and observed under both light and electron microscopy. The mean density and cross-sectional areas of the VV in the adventitia were measured. In both VGSVs and DSVs, VV density increased, in the adventitia and exterior tunica media, offering an intensive linear distribution. However, sporadic distribution of the interior tunica media and intima were seen on light microscopy. The integrated structure of the cell nucleus of endothelial cells in VV, normal morphology and distribution of chromatin, partially hyperchromatic mitochondria matrix, fuzzy or fractured mitochondria cristae, and medullary cristae changes were observed by electron microscopy. Mean density and cross-sectional areas of VV in the adventitia of GSVs and SVs were significantly different. Under high hydrostatic pressure conditions, the number of VV were increased in the wall of VGSVs and DSVs. There was heterogeneity between both types of veins. The splenic vein has a higher number of VV, but the greater saphenous vein has a higher average cross-sectional area. The same ultrastructural changes are seen in the endothelial cells of the VV in both vessels.

  9. Endovenous laser ablation of the great saphenous vein using a bare fibre versus a tulip fibre: a randomised clinical trial. (United States)

    Vuylsteke, M E; Thomis, S; Mahieu, P; Mordon, S; Fourneau, I


    This clinical trial aimed to evaluate the clinical results of the use of a tulip fibre versus the use of a bare fibre for endovenous laser ablation. In a multicentre prospective randomised trial 174 patients were randomised for the treatment of great saphenous vein reflux. A duplex scan was scheduled 1 month, 6 months and 1 year postoperatively. Ecchymosis was measured on the 5th postoperative day. In addition, pain, analgesics requirement, postoperative quality of life (CIVIQ 2) and patient satisfaction rate were noted. Patients treated with a tulip fibre had significantly less postoperative ecchymosis (0.04 vs. 0.21; p tulip fibre for EVLA of the great saphenous vein results, when compared with the use of a bare fibre, in equal occlusion rates at 1 year but causes less postoperative ecchymosis and pain and in a better postoperative quality of life. Copyright © 2012 European Society for Vascular Surgery. Published by Elsevier Ltd. All rights reserved.

  10. Aorta-LITA Bypass Grafting with Saphenous Vein in a Patient Undergoing Coronary Artery Surgery with Subclavian Artery Stenosis

    Directory of Open Access Journals (Sweden)

    Kerim Çağlı


    Full Text Available The internal thoracic artery (ITA is the primary graft for coronary artery bypass grafting and can not be used if there is subclavian artery stenosis (SAS. Aorto-axillary, carotid-subclavian bypass and also angioplasty with stenting or other interventional treatments are acceptable procedures for SAS treatment. Aorta-ITA bypass with saphenous vein can be alternative and simple technique for SAS to save Winslow pathway for patients with peripheral artery disease.

  11. Is catheter-directed foam sclerotherapy more effective than the usual foam sclerotherapy for treatment of the great saphenous vein? (United States)

    Camillo, Orsini


    Objective This retrospective study presents the long-term results of catheter-directed foam sclerotherapy of the great saphenous vein. Method From January 2003 to June 2017, 277 patients with varices and great saphenous vein incompetence were treated with echo-guided foam sclerotherapy. Forty-six patients were treated with long-catheters guided by foam sclerotherapy. Foaming was carried out with sodium-tetra-decyl-sulphate. Results Results were examined in the two groups: A (long-catheters) and B (other procedures). The median overall follow-up was 52.1 months. In the A-group, the complete occlusion rate was 34/46 pts (73.9%) and partial occlusion was 10/46 (21.7%). In the B-group, respectively, 130/231 (56.2%) and 90/231 (38.9%). Comparisons between groups were statistically significant (p = 0.023; p = 0.021). Failures involved, respectively, 2/46 (4.3%) and 11/231 (4.7%) with no statistical significance. The complication rates were similar in the two groups. Conclusions In this long-term experience (median follow-up exceeding four years), foam-guided sclerotherapy of the great saphenous vein with a long-catheter turned out to be more effective than the usual foam-guided sclerotherapy.

  12. A prospective, randomized study of saphenous vein patching versus synthetic patching during carotid endarterectomy. (United States)

    O'Hara, Patrick J; Hertzer, Norman R; Mascha, Edward J; Krajewski, Leonard P; Clair, Daniel G; Ouriel, Kenneth


    The objective of this study was the determination of whether the choice of either autogenous saphenous vein (ASV) or synthetic material for patch angioplasty significantly influences the results after carotid endarterectomy (CEA). With Institutional Review Board approval, 195 patients (145 men and 50 women; mean age, 69 years) who underwent 207 CEAs were prospectively randomized to arteriotomy closure with ASV or synthetic patches from July 1996 to January 2000. One hundred and one patients (52%) were randomized to the ASV cohort, and 94 (48%) were randomized to the synthetic cohort. Aside from a slight gender imbalance (70% versus 79% male in the ASV versus the synthetic group), there were no clinically important differences in baseline demographic variables, risk factors, or surgical indications between the ASV and synthetic groups. With all 207 randomized procedures on an intent-to-treat basis, there were two early (or=60%) carotid stenosis was 4.8% (three of 62) for the ASV group and 6.3% (four of 63) for the synthetic group (P =.99). No significant differences in the stroke, mortality, or restenosis rates were shown between the ASV and the synthetic cohorts. While conceding the power limitations inherent in this study, we conclude that CEA may be safely performed with similar early results with ASV or synthetic patches.

  13. Selective use of embolic protection devices during saphenous vein grafts interventions: a single-center experience. (United States)

    Lavi, Shahar; Ivanov, Joan; Appleby, Clare E; Seidelin, Peter H; Mackie, Karen; Schwartz, Leonard; Dzavík, Vladimír


    To report on outcomes with selective use of embolic protection devices (EPD) during percutaneous coronary intervention (PCI) to saphenous vein grafts (SVG). PCI to SVG is associated with increased risk and the use of EPD is recommended in this setting. Angiographic and clinical outcomes were prospectively obtained from 534 consecutive patients who underwent PCI to SVG with or without EPD at a tertiary cardiac centre. Long-term outcomes were obtained by linkage to a provincial registry. EPD, deployed in 198 of 373 SVGs (53%) suitable for deployment of a distal EPD, were used more often in ectatic (33% vs. 19%, P = 0.003), ulcerated (17% vs. 9%, P = 0.03), thrombotic (26% vs. 10%, P EPD tended to be more likely to have a periprocedural myocardial infarction. During 3 years of follow-up, 49% of the patients had a cardiovascular event. Cumulative mortality was 8.4%, 18.8% and 14.7% in patients unsuitable for distal EPD, suitable but without EPD, and with EPD (p = 0.11). Nonuse of EPD was an independent predictor of MACE at 3 years. (P = 0.02). Selective use of EPD is associated with low in-hospital cardiovascular event rates. Long-term outcomes are manifested by a high rate of events, especially in patients with SVG's suitable for but not receiving EPD. This suggests that routine use of distal EPD may be warranted in unselected patients with suitable SVG anatomy.

  14. Saphenous vein graft thrombus findings by scanning electron microscopy in a patient with acute myocardial infarction

    Energy Technology Data Exchange (ETDEWEB)

    Borges, Marcela Dias; Aguillera, André Haraguti [Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo, SP (Brazil); Brilhante, José Joaquim; Caixeta, Adriano [Hospital Israelita Albert Einstein, São Paulo, SP (Brazil)


    An eighty-year-old male patient with a history of prior (19 years) coronary artery bypass graft surgery was admitted to the hospital with non ST-segment elevation myocardial infarction (NSTEMI). During the hospital stay he was taking acetylsalicylic acid 100mg per day, a loading dose of 600mg clopidogrel, and low molecular weight heparin 1mg/kg twice a day. Twenty-four hours later the patient underwent coronary angiography, which showed a 90% obstruction in the mid portion of the saphenous vein graft to obtuse marginal with signs of degeneration and local thrombus (Figure 1). Thrombus aspiration was performed with a 6-Fr Export{sup ™} catheter (Medtronic, Santa Rosa, CA, USA), which removed small reddish colored fragments. They were fixed in 2,5% glutaraldehyde in a 0.1M sodium cacodilate buffer. The material was processed following the GOTO protocol in which the fragments were washed with osmium tetroxide and titanic acid, after which they were dried in a critical-point device and a golden bath. Scanning electron microscopy and high definition photos (3,000 to 27,221x magnification) were obtained by the FEI Quanta{sup ™} FEG SEM device (FEI Company, Hillsboro, OR, USA). The images showed that the thrombus was rich in activated platelets, with few erythrocytes or inflammatory cells. Many cholesterol crystals were observed (Figures 2 to). The fibrin networks were sparse and thin, which is compatible with a short ischemic time and recent thrombus formation.

  15. Influence of coronary territory on flow profiles of saphenous vein grafts. (United States)

    Amin, Sanaz; Werner, Raphael S; Madsen, Per Lav; Krasopoulos, George; Taggart, David P


    Differing perfusion of the left and right ventricular coronary territory may influence flow-profiles of saphenous vein grafts (SVGs). We compared flow parameters, measured by transit-time flowmetry (TTFM), in left- and right-sided SVGs during coronary artery by-pass grafting (CABG). Routine TTFM measurements were obtained in 167 SVGs to the left territory (55%) and 134 SVGs to the right territory (total of 301 SVGs in 207 patients). The four standard TTFM parameters, [mean graft flow (MGF), pulsatility index (PI), percentage diastolic filling (%DF), and percentage backward flow (%BF)] were compared. Differences in flow parameters were also examined according to surgical technique (on- vs. off-pump). No significant difference between coronary territories was found for MGF, PI and %BF. However, a higher %DF was noted in left-sided SVGs in the overall cohort as well as in the on-pump (both p territory (1.2 ± 2.5 vs. 2.3 ± 3.0, p = 0.023). In a multivariate regression analysis, anastomosing a SVG to the left territory was weakly associated with higher PI (OR = 0.36, p = 0.026) and strongly associated with higher %DF (OR = 5.1, p < 0.001). No significant association was found for MGF, PI, %DF or %BF in either the on-pump nor the off-pump cohorts. Although statistically significant, the established differences in TTFM parameters between left- and right-sided vein grafts were small and unlikely to be of clinical relevance.

  16. Necrotizing fasciitis following saphenofemoral junction ligation with long saphenous vein stripping: a case report

    Directory of Open Access Journals (Sweden)

    Ferguson Graeme


    Full Text Available Abstract Introduction Necrotizing fasciitis is a rare condition with a mortality rate of around 34%. It can be mono- or polymicrobial in origin. Monomicrobial infections are usually due to group A streptococcus and their incidence is on the rise. They normally occur in healthy individuals with a history of trauma, surgery or intravenous drug use. Post-operative necrotizing fasciitis is rare but accounts for 9 to 28% of all necrotizing fasciitis. The incidence of wound infection following saphenofemoral junction ligation and vein stripping is said to be less than 3%, although this complication is probably under-reported. We describe a case of group A streptococcus necrotizing fasciitis following saphenofemoral junction ligation and vein stripping. Case Presentation A 39-year-old woman presented three days following a left sided saphenofemoral junction ligation with long saphenous vein stripping at another institution. She had a three day history of fever, rigors and swelling of the left leg. She was pyrexial and shocked. She had a very tender, swollen left groin and thigh, with a small blister anteriorly and was in acute renal failure. She was prescribed intravenous penicillin and diagnosed with necrotizing fasciitis. She underwent extensive debridement of her left thigh and was commenced on clindamycin and imipenem. Post-operatively, she required ventilatory and inotropic support with continuous veno-venous haemofiltration. An examination 12 hours after surgery showed no requirement for further debridement. A group A streptococcus, sensitive to penicillin, was isolated from the debrided tissue. A vacuum assisted closure device was fitted to the clean thigh wound on day four and split-skin-grafting was performed on day eight. On day 13, a wound inspection revealed that more than 90% of the graft had taken. Antibiotics were stopped on day 20 and she was discharged on day 22. Conclusion Necrotizing fasciitis is a very serious complication for a


    Directory of Open Access Journals (Sweden)

    Andrej Šikovec


    Full Text Available Background. Minimally invasive treatment of varicose veins is becoming more and more important as it represents less burden to the patient and health system. The success of the different methods depends on their capability to eliminate the reflux at the sapheno-femoral junction (SFJ and the incompetent greater saphenous vein (GSV. In achieving these only three methods are successful: ultrasound (US guided catheter sclerosation, radiofrequency or laser endovenous obliteration of GSV.Aims. To demonstrate a novel way to use a laser energy through an endoluminal laser fiber for the minimally invasive treatment of truncal varicosities and the elimination of SFJ reflux.Methods. The patients with US detected reflux in the SFJ and GSV were treated on the outpatient basis under local anaesthesia with laser mediated heat energy in the GSV 2–3 cm from SFJ with the laser of wave length of 980 nm with the power 15 W and the impulse duration of 1 sek. We used 20–40 impulses along the treated segment of GSV. The exact position of the laser fiber was determined by the US. The smaller branch varices were removed by mini phlebectomies. Patients tolerated well the procedure and they were dismissed from the hospital with applied compression stockings (CCL II immediately after the completion of the procedure. The control US was done one week, four weeks and three months later. At one week one out of 16 patients presented with no occlusion of the GSV. At four weeks another patient had recanalisation of GSV but without the reflux. All other patients had the short GSV stump in which the patent epigastric vein was draining while the remaning part of the GSV was obliterated by the thrombus. Except for some skin ecchymosis and mild induration in the but patients did not have any other problems. The unsuccessful treatment in two patients is probably due to insufficient applied energy.Conclusions. Endovenous laser obliteration of GSV is an effective method that can be

  18. Coronary aspirate TNFα reflects saphenous vein bypass graft restenosis risk in diabetic patients

    Directory of Open Access Journals (Sweden)

    Baars Theodor


    Full Text Available Abstract Background Patients with diabetes mellitus (DM have an increased risk for periprocedural complications and adverse cardiac events after percutaneous coronary intervention. We addressed the potential for coronary microvascular obstruction and restenosis in patients with and without DM undergoing stenting for saphenous vein bypass graft (SVG stenosis under protection with a distal occlusion/aspiration device. Methods SVG plaque volume and composition were analyzed using intravascular ultrasound before stent implantation. Percent diameter stenosis was determined from quantitative coronary angiography before, immediately after and 6 months after stent implantation. Coronary aspirate was retrieved during stent implantation and divided into particulate debris and plasma. Total calcium, several vasoconstrictors, and tumor necrosis factor (TNFα in particulate debris and coronary aspirate plasma were determined. Results Patients with and without DM had similar plaque volume, but larger necrotic core and greater particulate debris release in patients with than without DM (20.3±2.7 vs. 12.7±2.6% and 143.9±19.3 vs. 75.1±10.4 mg, Pvs. 5.1±2.4 pmol/mg and 2.2±0.7 vs. 1.1±0.2 pmol/L, Pvs. 6.34±1.11%, PP Conclusion In diabetics, particulate debris and coronary aspirate plasma contained more TNFα, which might reflect the activity of the underlying atherosclerotic process. Trial registration URL:; unique identifier: NCT01430884

  19. Arctigenin improves vascular tone and decreases inflammation in human saphenous vein. (United States)

    Daci, Armond; Neziri, Burim; Krasniqi, Shaip; Cavolli, Raif; Alaj, Rame; Norata, Giuseppe Danilo; Beretta, Giangiacomo


    The goal of this study was to test the effects of bioactive phenylpropanoid dibenzylbutyrolactone lignan arctigenin (ATG) in vascular tone. Human bypass graft vessel, from a saphenous vein (SV), were set up in organ bath system and contracted with potassium chloride (KCl, 40mM). Two concentration-response curves of noradrenaline (NE) (10nM-100μM) separated with an incubation period of 30min without (Control) or with ATG (3-100μM) were established. Inhibitors of nitric oxide, prostaglandins, K+ related channels or calcium influx were used to delineate the molecular mechanisms beyond ATG effects. To investigate anti-inflammatory actions, SV were treated with 10μM or 100μM ATG and incubated for 18h in the absence or presence of both interleukin-1beta (IL-1β) and lipopolysaccharide (LPS) to mimic the physiological or inflamed tissue conditions. Proatherogenic and inflammatory mediators İnterleukine-1 beta (IL-1β), Monocyte Chemoattractant Proteine-1 (MCP-1), Tumor Necrosis Factor- α (TNF-α), İnterleukine-6 (IL-6), Prostaglandin E2 (PGE2) and İnterleukine-8 (IL-8) in the supernatant were measured. ATG significantly decreased vascular contractile response to NE. Moreover, it reduced contractions induced by KCl and cumulative addition of CaCl2. The mediators were significantly increased in inflammatory conditions compared to normal conditions, an effect which was inhibited by ATG (10 and 100µM). ATG reduces contractions in SV and decreases the production of proinflammatory-proatherogenic mediators, setting the stage for further evaluating the effect of ATG in cardiovascular diseases. Copyright © 2017 Elsevier B.V. All rights reserved.

  20. Contemporary approaches to saphenous vein graft interventions: a survey of 275 interventional cardiologists. (United States)

    Mahmood, Arif; Khair, Tarif; Abdel-karim, Abdul-rahman R; Papayannis, Aristotelis; Xu, Hao; Banerjee, Subhash; Brilakis, Emmanouil S


    We sought to examine contemporary practice patterns of saphenous vein graft (SVG) interventions. A link to a 10-item online questionnaire was completed in June 2009 by 275 (7%) of 3,771 US interventional cardiologists surveyed. Sixty-five percent of the respondents use an embolic protection device (EPD) in >75% of SVG interventions. The main reason for not using an EPD was "anatomic difficulties" (55%), followed by device complexity (20%). Filter-based EPDs were the most widely available, well known, and commonly used EPDs, whereas the Guardwire (Medtronic Vascular) was the least commonly used EPD. The main factors underlying EPD selection were lesion location (83%), familiarity with devices (72%), and SVG diameter (64%). Factors that could increase EPD use included availability of simpler to use devices (63%), and more studies demonstrating benefit from EPD use (37%). Compared with interventionalists who used EPDs in most cases (>75%), those who utilized EPDs less frequently were less likely to be familiar with each EPD and had less EPDs available for use. Many interventionalists (84%) administer intragraft vasodilators during SVG interventions, prefer drug-eluting stents (63%) and administer >12 months antiplatelet therapy poststent implantation. During SVG interventions (1) "anatomic difficulties" are the most common reason for not utilizing an EPD; (2) filter-based EPDs are most commonly used; (3) lesion location is the most important factor for EPD selection; (4) availability of simpler to use devices could increase EPD use; and (5) intragraft vasodilators, drug-eluting stents and prolonged antiplatelet therapy are commonly utilized. Copyright © 2011 Wiley-Liss, Inc.

  1. Evaluation of the pharmacokinetics of imipenem following regional limb perfusion using the saphenous and the cephalic veins in standing horses. (United States)

    Kelmer, G; Tatz, A J; Kdoshim, E; Britzi, M; Segev, G


    This prospective experimental study goal was to determine the pharmacokinetics of imipenem after intravenous regional limb perfusion (IV-RLP) in standing horses. Nine horses participated in the study; that was approved by the University Animal Care and Use Committee. One thoracic limb or one pelvic limb of each horse was randomly selected. After the veins were catheterized, an Esmarch bandage tourniquet was applied and the catheter was injected with a solution containing 500mg of imipenem. Synovial fluid samples were collected from the fetlock joint and blood samples were collected from the jugular vein. All samples were analyzed for imipenem concentration using liquid chromatography mass spectrometry. Cmax of imipenem in the fetlock joint using the cephalic and the saphenous vein was 87 and 60μg⁄mL, respectively. The results indicate that by performing IV-RLP using the cephalic/saphenous, one can achieve imipenem concentrations in the fetlock joint that are well above the MIC of most susceptible pathogens including resistant bacteria such as Methicillin Resistant Staphylococcus aureus (MRSA) and Pseudomonas aeruginosa. Thus, with selective; judicious use, RLP with imipenem can markedly increase treatment efficacy of severe distal limb infections in horses. Copyright © 2017 Elsevier Ltd. All rights reserved.

  2. Ruptured common femoral vein pseudoaneurysm from a common femoral arteriovenous fistula presenting as lower extremity steal after radiofrequency ablation of the great saphenous vein. (United States)

    Brumberg, Robert Scott; Davis, Cassie


    Radiofrequency ablation of the superficial venous systems has become one of the mainstays of minimally invasive approaches to varicose veins and chronic venous insufficiency. These procedures have high rates of success with scarce complications. This case report highlights a patient with a common femoral arteriovenous fistula presenting with lower extremity steal after radiofrequency ablation treatment of the great saphenous vein. During operative repair of the arteriovenous fistula, a pseudoaneurysm of the common femoral vein ruptured. We review the current literature and highlight the importance of expanding the scope of complications that can occur from seemingly straightforward minimally invasive venous procedures. Informed consent was obtained for publication of this report. Copyright © 2017 The Authors. Published by Elsevier Inc. All rights reserved.

  3. Efficacy of endovenous ablation of the saphenous veins for prevention and healing of venous ulcers. (United States)

    Marston, William A


    In many countries, endovenous ablation (EVA) has replaced surgical stripping as the preferred method of eliminating saphenous reflux in symptomatic patients. Studies have examined the success of EVA at saphenous closure and improving leg pain and edema. However, less information is available on the ability of these techniques to promote venous leg ulcer healing or to prevent recurrence. The comparison of surgery and compression with compression alone in chronic venous ulceration (ESCHAR) trial identified the role of saphenous stripping in reducing the rate of ulcer recurrence after healing, supporting this procedure for Clinical, Etiologic, Anatomic, and Pathologic (CEAP) clinical class 5 and 6 patients. In patients with venous ulcers, it remains controversial whether EVA procedures provide results similar to those of saphenous stripping in clinically relevant outcomes. This review examines the evidence supporting the use of thermal or nonthermal EVA in patients with healed or active venous ulcers and saphenous insufficiency. Copyright © 2015 Society for Vascular Surgery. Published by Elsevier Inc. All rights reserved.

  4. Patency of Saphenous Vein Grafts Using the PAS-Port System During Coronary Artery Bypass Surgery. (United States)

    Kubota, Hiroshi; Endo, Hidehito; Ishii, Hikaru; Tsuchiya, Hiroshi; Takahashi, Yu; Inaba, Yusuke; Noma, Mio; Yoshimoto, Akihiro; Higuchi, Satoshi; Kohshoh, Hideyasu; Taniai, Seiichi; Ishiguro, Haruhisa; Yoshino, Hideaki; Sudo, Kenichi


    Several proximal anastomosis devices have been developed to shorten the time required for a proximal anastomosis and to avoid aortic cross-/side-clamping during coronary artery bypass grafting. This study retrospectively examined the patency of saphenous vein grafts (SVGs) using the PAS-Port System (Cardia Inc, Redwood City, CA). From 2004 to 2014, 451 patients underwent coronary artery bypass graft operations requiring at least 1 proximal anastomosis using a PAS-Port device. A total of 802 PAS-Port devices were used, and 95.0% (762 of 802) were implanted successfully. Among the successfully implanted anastomoses, 76.8% (585 of 762) were evaluated using coronary angiography or multidimensional computed tomography, or both. The evaluations were performed between postoperative days 4 and 3,182 (mean, 319 ± 624 days). The early (1 to 365 days) and the midterm to long-term (more than 366 days) occlusion rates were examined. A complete postoperative clinical course was recorded for 70.7% of the patients. Overall, 93.8% (549 of 585) of the device-dependent SVGs were patent. The patency rates of device-dependent SVGs that were 1, 2, 3, 4, 5, 6, 7, and 8 years old were 90.1% ± 1.8%, 87.1% ± 2.3%, 86.1% ± 2.5%, 82.9% ± 3.3%, 80.6% ± 3.9%, 77.2% ± 5.0%, 77.2% ± 5.0%, and 70.2% ± 8.1%, respectively. The longest follow-up period was 3,182 days (8.7 years). The occlusion rate for device-dependent SVGs tended to decrease as the number of patients accumulated. The PAS-Port system provided acceptable SVG patency and clinical outcome for the early and midterm to long-term. There may be a learning curve for the use of PAS-Port device that affects the device-dependent SVG patency. Copyright © 2017 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.

  5. Retrograde endovenous laser ablation through saphenopopliteal junctional area for incompetent small saphenous vein; Comparison with antegrade approach

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Jun Seok; Park, Sang Woo; Yun, Ik Jin; Hwang, Jae Joon; Lee, Song Am; Chee, Hyun Keun; Hwang, Jin Ho [Konkuk University Hospital, Konkuk University School of Medicine, Seoul (Korea, Republic of)


    To evaluate the safety and efficacy of retrograde endovenous laser ablation (EVLA) and to compare it with the conventional antegrade EVLA for incompetent small saphenous vein (SSV). Small saphenous vein was cannulated via two approaches under ultrasound-guidance. One method involved puncturing the SSV cranially at mid-calf (the antegrade group). If the antegrade puncture into the SSV failed twice, the other approach for puncture was selected that involved puncturing the SSV toward the ankle (the retrograde group). Patients were evaluated in terms of technical and clinical success, closure rates of the SSV, and complications including pain, bruising, or paresthesia at all follow-up visits. The 1470 nm endovenous laser was used in all limbs. Technical success was seen in all limbs in both groups (100%). Closure rate in both groups showed about 95%, without significant difference (p = 0.685). Similar linear endovenous energy density was supplied during the EVLA in both groups (p = 0.876). Three frequent complications including bruising, pain, and paresthesia did not show statistical significance between groups (p = 0.465, 0.823, 1.000, respectively). Major complications were absent in both groups. The EVLA for the incompetent SSV using a retrograde approach is safe and effective and should be considered the alternative method if the antegrade access fails due to vasospasm or small SSV diameter.

  6. Gender dimorphism in differential peripheral blood leukocyte counts in mice using cardiac, tail, foot, and saphenous vein puncture methods

    Directory of Open Access Journals (Sweden)

    Crockett Elahé T


    Full Text Available Abstract Background In many animal models that investigate the pathology of various diseases, there is a need to monitor leukocyte counts and differentials. However, various researchers use a range of different techniques in male and female laboratory animals to collect such blood variable information. These studies are then compared to one another without consideration of the possibility that different bleeding sites or techniques as well as gender may produce varying results. In light of this, the peripheral blood leukocyte counts and differentials of C57BL/6 male and female mice were determined using four blood-sampling techniques: cardiac, tail, foot, and saphenous vein punctures. Methods Blood smears were prepared and stained with Wright-stain for differential cell analysis. The total number of peripheral blood leukocytes was determined with the aid of a hemocytometer. Applying ANOVA and Student t-test analysis made comparisons between groups. Results The total leukocyte counts obtained using the cardiac puncture method were significantly lower as compared to the other three blood sources; saphenous, tail and foot. There were no significant differences between leukocyte counts of blood samples collected from the tail, saphenous, and foot. Additionally, no significant differences were observed in total leukocyte counts between male and female mice. Differential analysis showed lymphocytes as the predominant cell type present in the peripheral blood of both male and female mice, comprising 75–90% of the total leukocytes. While no significant differences were observed between male and female differential counts of blood collected from saphenous and tail veins, a significant difference in differential counts of blood obtained via cardiac puncture was observed between the male and female groups, suggesting the role of sex hormones. Further, of the four methods, cardiac puncture appeared to be the fastest and more reliable technique, yielding

  7. Long-term outcome following percutaneous coronary intervention with drug-eluting stents compared with bare-metal stents in saphenous vein graft lesions

    DEFF Research Database (Denmark)

    Hougaard, Mikkel; Thayssen, Per; Kaltoft, Anne


    reduced the risk of restenosis in native coronary artery lesions. In saphenous vein grafts (SVG) the outcome after DES compared with BMS is insufficiently described. METHODS: From January 1, 2002 to December 31, 2010 all patients with PCI of SVG lesions were identified among 3.0 million inhabitants. Stent...

  8. 56. Endoscopic vein graft harvest for coronary artery bypass surgery: Single center experience in Saudi Arabia

    Directory of Open Access Journals (Sweden)

    M. Algadheeb


    Full Text Available Open saphenous vein technique is the standard of care in patients undergoing coronary artery surgery (CABG worldwide and in Saudi Arabia. Endoscopic vein harvest (EVH is an innovative technique that have been recommended by the international society of minimally invasive surgery. Our aim in the current study is to review our preliminary data about endoscopic vein harvest. Would endoscopic vein harvest decrease the incidence of leg wound infections? This is a retrospective study of a single tertiary care center of 94 consecutive patients who underwent CABG with EVH. Preoperative associated risk factors were assessed. Postoperative follow up includes leg wound infection and patient satisfaction with EVH by using a telephone and/or a paper questionnaire. We had 94 consecutive patients who underwent CABG with EVH between October 2014 and October 2015, mean age was 56.7 (33–77 years, 91.5% were male, mean euro score II was 2.47%. The most common presentation was NSTEMI (39.4% followed by STEMI (26.6%, unstable angina (11.7% and stable angina (5.3%. Our cohort had the following characteristics: 85.1% were diabetic, 84% were hypertensive, 46.8% had dyslipidemia, 2.1% had CVA, 7.4% had Carotid artery disease, 2.1% had Congestive heart failure, 4.3% had any renal disease and 4.3% had previous PCI. Most of our patients received 3 grafts (44.7% followed by 4 grafts (42.6% of which only one leg was used for EVH (94.1%. Leg wound infection occurred in one patient only and in this case EVH was converted to open technique. A written and/or telephone questionnaire resulted in a high patient-satisfaction with the cosmetic outcome of EVH as well as very low grade of leg wound pain. EVH is a very promising innovative technique in patient undergoing CABG. Our patients were highly satisfied with their leg wound cosmetic outcome. In this single center experience, in Saudi Arabia, EVH is a promising innovative technique for saphenous vein harvest. It is highly

  9. Great saphenous vein dilatation with reflux at the saphenofemoral junction: A rare underlying association of eccrine angiomatous hamartoma

    Directory of Open Access Journals (Sweden)

    Sanjiv Choudhary


    Full Text Available Eccrine angiomatous hamartoma (EAH is an exceedingly rare benign tumor-like lesion prevalent in childhood, which can produce pain and marked sweating. Histological features include proliferation of eccrine sweat glands and angiomatous capillary channels. It may be rarely associated with underlying pathological conditions. A 15-year-old female patient presented with multiple tender reddish papules and nodules coalescing to form plaques of 10 × 8 cm over the anterior aspect of the right lower thigh since birth. It was associated with hypertrichosis, hyperhidrosis, pain, and occasional bleeding on trauma. Histopathological examination of the lesion showed increased proliferation of both eccrine and angiomatous channels. Ultrasonography and Color Doppler of the right thigh showed dilatation of the great saphenous vein (GSV above the right knee, with evidence of grade 3 reflux at saphenofemoral junction. Magnetic resonance imaging revealed large dilated GSV with slow flow and venous malformation in the anterior part of the right knee

  10. A comparative study on the mechanical properties of the healthy and varicose human saphenous vein under uniaxial loading. (United States)

    Karimi, Alireza; Navidbakhsh, Mahdi; Kudo, Susumu


    Saphenous Vein (SV) due to fatness, age, inactiveness, etc. can be afflicted with varicose. The main reason of the varicose vein is believed to be related to the leg muscle pump which is unable to return the blood to the heart in contradiction of the effect of gravity. As a result of the varicose vein, both the structure and mechanical properties of the vein wall would alter. However, so far there is a lack of knowledge on the mechanical properties of the varicose vein. In this study, a comparative study was carried out to measure the elastic and hyperelastic mechanical properties of the healthy and varicose SVs. Healthy and varicose SVs were removed at autopsy and surgery from seven individuals and then axial tensile load was applied to them up to the failure point. In order to investigate the mechanical behaviour of the vein, this study was benefitted from three different stress definitions, such as 2nd Piola-Kichhoff, engineering and true stresses and four different strain definitions, i.e. Almansi-Hamel, Green-St. Venant, engineering and true strains, to determine the linear mechanical properties of the SVs. A Digital Image Correlation (DIC) technique was used to measure the true strain of the vein walls during load bearing. The non-linear mechanical behaviour of the SVs was also computationally evaluated via the Mooney-Rivlin material model. The true/Cauchy stress-strain diagram exhibited the elastic modulus of the varicose SVs as 45.11% lower than that of the healthy ones. Furthermore, by variation of the stress a significant alteration on the maximum stress of the healthy SVs was observed, but then not for the varicose veins. Additionally, the highest stresses of 4.99 and 0.65 MPa were observed for the healthy and varicose SVs, respectively. These results indicate a weakness in the mechanical strength of the SV when it becomes varicose, owing to the degradation of the elastin and collagen content of the SV. The Mooney-Rivlin hyperelastic and the Finite

  11. Long Term Outcomes of MGuard Stent Deployment in Saphenous Vein Grafts and Native Coronary Arteries: A Single Center Experience. (United States)

    Vaknin-Assa, Hana; Assali, Abid; Lev, Eli I; Greenberg, Gabriel; Orvin, Katia; Valzer, Orna; Paul, Gideon; Levi, Amos; Kornowski, Ran


    The MGuard™ stent (InspireMD, Tel Aviv, Israel) is a bare metal mesh-covered stent, developed to prevent no-reflow phenomenon during percutaneous coronary intervention (PCI) of saphenous vein grafts (SVG) and acute myocardial infarction (MI), both associated with significant atherothrombotic lesions. To report on local experience with patients treated with the MGuard stent until follow-up at 1 year. We followed 163 consecutive patients who underwent MGuard stent deployment during the period 2009 to 2014 in a large tertiary cardiac center in central Israel. The MGuard stent was used in 67% of patients who underwent SVG-PCI while 33% were treated for native coronary artery disease, the majority during ST-elevation MI (STEMI). The mean age was 67 years and 83% were males. The clinical presentation was STEMI in 30% and non-STEMI/unstable angina in 60% of patients. Of the total number of patients, 47% had diabetes and 29% had chronic kidney disease. All patients had follow-up at 1 year. Mortality in the native group was 1.9% vs. 10% in the vein graft cohort. ST was 2% in both groups. The major adverse cardiac event (MACE) rates were 11% in the native artery and 29% in the vein graft group, mainly due to respective target lesion revascularization/target vessel revascularization rates of 6% and 7% in the native vessel group and 11% and 15% in the SVG group. In suitable patients undergoing SVG-PCI or native lesion intervention during acute MI, the MGuard stent is a viable treatment strategy. Its potential merits and limitations warrant further evaluation.

  12. Vasorelaxant effects of the potassium channel opener SR 47063 on the isolated human saphenous vein and rat aorta

    Directory of Open Access Journals (Sweden)

    D.N. Criddle


    Full Text Available The vasorelaxant effects of SR 47063 (4-(2-cyanimino-1,2-dihydropyrid-1-yl-2,2-dimethyl-6-nitrochromene, a new K+-channel opener structurally related to levcromakalim, were examined in isolated human saphenous vein (HSV and rat aorta (RA. HSV or RA rings were precontracted with either KCl or noradrenaline and cumulative relaxant concentration-response curves were obtained for SR 47063 (0.1 nM to 1 µM in the presence or absence of 3 µM glibenclamide. SR 47063 potently relaxed HSV and RA precontracted with 20 mM (but not 60 mM KCl or 10 µM noradrenaline in a concentration-dependent manner, showing slightly greater activity in the aorta. The potency of the effect of SR 47063 on HSV and RA was 12- and 58-fold greater, respectively, than that reported for the structurally related K+-channel opener levcromakalim. The vasorelaxant action of SR 47063 in both blood vessels was strongly inhibited by 3 µM glibenclamide, consistent with a mechanism of action involving ATP-dependent K+-channels.

  13. Papaverine Prevents Vasospasm by Regulation of Myosin Light Chain Phosphorylation and Actin Polymerization in Human Saphenous Vein.

    Directory of Open Access Journals (Sweden)

    Kyle M Hocking

    Full Text Available Papaverine is used to prevent vasospasm in human saphenous veins (HSV during vein graft preparation prior to implantation as a bypass conduit. Papaverine is a nonspecific inhibitor of phosphodiesterases, leading to increases in both intracellular cGMP and cAMP. We hypothesized that papaverine reduces force by decreasing intracellular calcium concentrations ([Ca2+]i and myosin light chain phosphorylation, and increasing actin depolymerization via regulation of actin regulatory protein phosphorylation.HSV was equilibrated in a muscle bath, pre-treated with 1 mM papaverine followed by 5 μM norepinephrine, and force along with [Ca2+]i levels were concurrently measured. Filamentous actin (F-actin level was measured by an in vitro actin assay. Tissue was snap frozen to measure myosin light chain and actin regulatory protein phosphorylation. Pre-treatment with papaverine completely inhibited norepinephrine-induced force generation, blocked increases in [Ca2+]i and led to a decrease in the phosphorylation of myosin light chain. Papaverine pre-treatment also led to increased phosphorylation of the heat shock-related protein 20 (HSPB6 and the vasodilator stimulated phosphoprotein (VASP, as well as decreased filamentous actin (F-actin levels suggesting depolymerization of actin.These results suggest that papaverine-induced force inhibition of HSV involves [Ca2+]i-mediated inhibition of myosin light chain phosphorylation and actin regulatory protein phosphorylation-mediated actin depolymerization. Thus, papaverine induces sustained inhibition of contraction of HSV by the modulation of both myosin cross-bridge formation and actin cytoskeletal dynamics and is a pharmacological alternative to high pressure distention to prevent vasospasm.

  14. Effect of Extended-Release Niacin on Saphenous Vein Graft Atherosclerosis: Insights from the Atherosclerosis Lesion Progression Intervention Using Niacin Extended Release in Saphenous Vein Grafts (ALPINE-SVG) Pilot Trial. (United States)

    Kotsia, Anna P; Rangan, Bavana V; Christopoulos, Georgios; Coleman, Ameka; Roesle, Michele; Cipher, Daisha; de Lemos, James A; McGuire, Darren K; Packer, Milton; Banerjee, Subhash; Brilakis, Emmanouil S


    Intermediate saphenous vein graft (SVG) lesions have high rates of progression. The purpose of this study was to examine the impact of extended-release niacin (ER-niacin) vs placebo on intermediate SVG lesions. Patients with intermediate (30%-60% diameter stenosis) SVG lesions were randomized to ER-niacin vs placebo for 12 months. Quantitative coronary angiography (QCA), intravascular ultrasonography (IVUS), and optical coherence tomography (OCT) were performed at baseline and at 12 months. The primary endpoint was change in percent atheroma volume (ΔPAV). Enrollment was planned for 138 patients for 90% power to detect ≥2.5% difference in the primary endpoint of ΔPAV, but stopped early after publication of two negative outcome trials of ER-niacin, with enrolled patients completing the 12-month trial protocol. Thirty-eight patients were randomized to niacin (n = 19) or placebo (n = 19), yielding power of 47% to detect the primary planned treatment effect of 2.5 ± 4.0% difference in ΔPAV. Between baseline and 12-month follow-up, no significant difference was found between study groups in ΔPAV (-1.31 ± 6.05% vs 1.05 ± 17.8%; P=.60). By OCT, the ER-niacin vs placebo group had less plaque rupture within the intermediate SVG lesion (0.0% vs 36.0%; P=.01). Administration of ER-niacin did not significantly impact intermediate SVG disease, with the notable limitation of compromised statistical power due to early termination of enrollment.

  15. Autologous alternative veins may not provide better outcomes than prosthetic conduits for below-knee bypass when great saphenous vein is unavailable. (United States)

    Avgerinos, Efthymios D; Sachdev, Ulka; Naddaf, Abdallah; Doucet, Dannielle R; Mohapatra, Abhisekh; Leers, Steven A; Chaer, Rabih A; Makaroun, Michel S


    There is a need to better define the role of alternative autologous vein (AAV) segments over contemporary prosthetic conduits in patients with critical limb ischemia when great saphenous vein (GSV) is not available for use as the bypass conduit. Consecutive patients who underwent bypass to infrageniculate targets between 2007 and 2011 were categorized in three groups: GSV, AAV, and prosthetic. The primary outcome was graft patency. The secondary outcome was limb salvage. Cox proportional hazards regression was used to adjust for baseline confounding variables. A total of 407 infrainguinal bypasses to below-knee targets were analyzed; 255 patients (63%) received a single-segment GSV, 106 patients (26%) received an AAV, and 46 patients (11%) received a prosthetic conduit. Baseline characteristics were similar among groups, with the exception of popliteal targets and anticoagulation use being more frequent in the prosthetic group. Primary patency at 2 and 5 years was estimated at 47% and 32%, respectively, for the GSV group; 24% and 23% for the AAV group; and 43% and 38% for the prosthetic group. Primary assisted patency at 2 and 5 years was estimated at 71% and 55%, respectively, for the GSV group; 53% and 51% for the AAV group; and 45% and 40% for the prosthetic group. Secondary patency at 2 and 5 years was estimated at 75% and 60%, respectively, for the GSV group; 57% and 55% for the AAV group; and 46% and 41% for the prosthetic group. In Cox analysis, primary patency (hazard ratio [HR], 0.55; P prosthetic grafts except for the primary patency, for which prosthetic was protective (HR, 0.38; P Limb salvage was similar among groups. AAV conduits may not offer a significant patency advantage in midterm follow-up over prosthetic bypasses. Copyright © 2015 Society for Vascular Surgery. Published by Elsevier Inc. All rights reserved.

  16. Outcomes of Saphenous Vein Graft Intervention With and Without Embolic Protection Device: A Comprehensive Review and Meta-Analysis. (United States)

    Paul, Timir K; Bhatheja, Samit; Panchal, Hemang B; Zheng, Shimin; Banerjee, Subhash; Rao, Sunil V; Guzman, Luis; Beohar, Nirat; Zhao, David; Mehran, Roxana; Mukherjee, Debabrata


    Current guidelines give a class I recommendation to use of embolic protection devices (EPD) for saphenous vein graft (SVG) intervention; however, studies have shown conflicting results. The objective of this meta-analysis is to compare all-cause mortality, major adverse cardiovascular events, myocardial infarction (MI), or target vessel revascularization in SVG intervention with and without EPD. Literature was searched through October 2016. Eight studies (n=52 893) comparing SVG intervention performed with EPD (n=11 506) and without EPD (n=41 387) were included. There was no significant difference in all-cause mortality (odds ratio [OR], 0.79; confidence interval [CI], 0.55-1.12; P=0.19), major adverse cardiovascular events (OR, 0.73, CI, 0.51-1.05; P=0.09), target vessel revascularization (OR, 1.0; CI, 0.95-1.05; P=0.94), periprocedural MI (OR, 1.12; CI, 0.65-1.90, P=0.69), and late MI (OR, 0.80; CI, 0.52-1.23; P=0.30) between the 2 groups. Sensitivity analysis excluding CathPCI Registry study showed no difference in periprocedural MI, late MI, and target vessel revascularization; however, it favored EPD use in all-cause mortality and major adverse cardiovascular events. Further sensitivity analysis including only observational studies revealed no difference in all-cause mortality, major adverse cardiovascular events, target vessel revascularization, and late MI. Additional analysis after excluding CathPCI Registry study revealed no difference in outcomes. This study including 52 893 patients suggests no apparent benefit in routine use of EPD during SVG intervention in the contemporary real-world practice. Further randomized clinical trials are needed in current era to evaluate long-term outcomes in routine use of EPD, and meanwhile, current guideline recommendations on EPD use should be revisited. © 2017 American Heart Association, Inc.

  17. Mid-term outcomes for Endoscopic versus Open Vein Harvest: a case control study

    Directory of Open Access Journals (Sweden)

    Chetcuti Karen


    Full Text Available Abstract Background Saphenous vein remains the most common conduit for coronary artery bypass grafting with increasing uptake of minimally invasive harvesting techniques. While Endoscopic Vein Harvest (EVH has been demonstrated to improve early morbidity compared to Open Vein Harvest (OVH, recent literature suggests that this may be at the expense of graft patency at one year and survival at three years. Methods We undertook a retrospective single-centre, single-surgeon, case-control study of EVH (n = 89 and OVH (n = 182. The primary endpoint was death with secondary endpoints including acute coronary syndrome, revascularisation or other major adverse cardiac events. Freedom from angina, wound complications and self-rated health status were also assessed. Where repeat angiography had been performed, this was reviewed. Results Both groups were well matched demographically and for peri-operative characteristics. All cause mortality was 2/89 (2% and 11/182 (6% in the EVH and OVH groups respectively. This was shown by Cox Log-Rank analysis to be non-significant (p = 0.65, even if adjusting for inpatient mortality (p = 0.74. There was no difference in the rates of freedom from angina (p = 1.00, re-admission (p = 0.78 or need for further anti-anginals (p = 1.00. There was a significant reduction in the incidence of leg wound infections and complications in the endoscopic group (EVH: 7%; OVH: 28%; p = 0.0008 and the skew of high patient self-rated health scores in the EVH group (61% compared to 52% in the open group approached statistical significance (p = 0.06. Conclusions While aware of the limitations of this small retrospective study, we are heartened by the preliminary results and consider our data to be justification for continuing to provide patients the opportunity to have minimally invasive conduit harvest in our centre. More robust evidence is still required to elucidate the implications of endoscopic techniques on conduit patency and patient

  18. Avaliação microscópica e ultra-estrutural do endotélio de veia safena preparada pela técnica "no touch" Microscopic and ultrastructural evaluation of the saphenous vein endothelium for CABG prepared by the no touch technique

    Directory of Open Access Journals (Sweden)

    Virgílio Figueiredo Silva


    Full Text Available OBJETIVO: O enxerto de veia safena (VS utilizado em revascularização miocárdica possui uma vida útil, sendo o estágio final a oclusão do vaso. Esforços em adquirir novas técnicas de coleta da VS podem possibilitar uma viabilidade maior do enxerto. MÉTODOS: Vinte pacientes foram randomizados e divididos em dois grupos com o objetivo de avaliação do endotélio vascular. A técnica "no touch" (NT consiste em retirar o segmento de VS com o tecido perivascular. A técnica convencional consiste em retirar a VS, com remoção "in situ" do tecido perivascular e conseqüente vasoespasmo. Houve um padrão de retirada das VS com incisões longitudinais escalonadas. Características da VS foram consideradas. A avaliação do endotélio das VS foi realizada usando microscópio eletrônico (ME pelo método de varredura e de transmissão. Cortes histológicos das VS foram corados em Hematoxilina-Eosina (HE. O colágeno subendotelial foi analisado pelos métodos de Picro-Sirius e Tricrômio de Masson. RESULTADOS: A ME evidenciou que o Grupo NT possui maiores áreas endoteliais não desnudadas, além de um menor número de células degradadas. A coloração em HE nos permitiu verificar a forma e a integridade das camadas das VS. Há um predomínio maior de fibras colágenas coradas no Grupo NT. CONCLUSÕES: A técnica NT permite uma melhor preservação endotelial da VS, sugerindo um enxerto mais viável em longo prazo.OBJECTIVE: Saphenous vein grafts (SV used in coronary artery bypass grafting have a limited life and vein occlusion may be the final adverse effect. Efforts to develop new techniques to harvest the saphenous vein may improve the viability of the graft. METHODS: Twenty patients were randomly divided into two groups with the objective of evaluating the vascular endothelium. The No Touch (NT technique consists in removing the saphenous vein with perivascular tissue. The conventional technique consists in harvesting with "in situ" removal

  19. The impact of distension pressure on acute endothelial cell loss and neointimal proliferation in saphenous vein grafts. (United States)

    Stigler, Robert; Steger, Christina; Schachner, Thomas; Holfeld, Johannes; Edlinger, Michael; Grimm, Michael; Semsroth, Severin


    We aimed to determine the extent of acute endothelial cell loss and neointimal proliferation in the long-term in saphenous vein grafts (SVGs) exposed to defined distension pressures. During routine competence testing of SVGs for coronary artery bypass grafting (CABG), blinded peak pressure measurements were performed in 10 patients. In an experimental set-up, distension pressure-related endothelial damage was studied in the SVGs of 20 patients. In a subgroup (n = 10), each patient's SVG was divided into segments and subjected to four constant pressures (50, 100, 150 and 300 mmHg) for 30 min each. In another subgroup (n = 10), SVGs were exposed to a short phase of high pressure (low pressure followed by 300 mmHg for 5 min). Acute endothelial cell loss was quantified by CD31-immunostaining. After 2 weeks of organ culture, the neointimal proliferation was evaluated using histomorphometry. Pressure-related damage was compared with damage at baseline (0 mmHg). During routine competence testing for CABG, we revealed a median peak pressure of 355 mmHg (range: 240-639 mmHg). In the experimental set-up, significant acute endothelial cell loss occurred at all tested distension pressures: at 50 mmHg, the median endothelial cell loss was 29% (range: 20-51%, P = 0.015), at 100 mmHg 54% (range: 37-69%, P high-pressure exposure 65% (range: 49-82%, P pressure of 50 mmHg was exceeded: at 50 mmHg, median neointimal proliferation was 97 µm (range: 60-380 µm, P = 0.176), at 100 mmHg 168 µm (range: 100-600 µm, P = 0.001), at 150 mmHg 183 µm (range: 160-440 µm, P high-pressure exposure 130 µm (range: 60-410 µm, P = 0.02) in comparison with 90 µm (range: 60-170 µm) at baseline. In vitro exposure of SVGs to low distension pressure ranges causes significant acute endothelial cell loss and crucial long-term damage, namely neointimal proliferation.

  20. The importance of the time of digitalization for the incidence of spasms evoked by ouabain in strips of human saphenous vein. (United States)

    Zerkowski, H R; Wagner, J


    The extent of contracture induced by ouabain on preparations of the greater saphenous vein obtained from patients undergoing elective coronary bypass surgery was investigated. The medical pretreatment of the various donor patients was similar but differed with regard to the duration of preoperative digitalization ranging from several days to months. Whereas the maximal contraction induced by noradrenaline was not influenced by prior digitalization, the contracture evoked by ouabain showed a strong dependency on the duration of preoperative digitalization. In patients without or with only short-term preoperative digitalization the spasm exerted by ouabain amounted to 48.8% and 49.2%, respectively, of the maximal contraction induced by noradrenaline, and decreased to zero in patients with long-term digitalization. From this result it is concluded that, in patients after coronary artery bypass grafting who did not receive cardiac glycosides for long-term treatment, the acute administration of glycosides may be a mechanism responsible for the early occlusion of saphenous vein bypass grafts.

  1. Dynamic ultrasound-guided short-axis needle tip navigation technique vs. landmark technique for difficult saphenous vein access in children: a randomised study. (United States)

    Hanada, S; Van Winkle, M T; Subramani, S; Ueda, K


    Dynamic ultrasound-guided short-axis needle tip navigation is a novel technique for vascular access. After venipuncture, the needle and catheter are further advanced within the vessel lumen under real-time ultrasound guidance with constant visualisation of the needle tip in the short-axis view. This can minimise the risk of transfixing the cannulated vessel. We compared two techniques for non-visible saphenous vein cannulation under general anaesthesia in children weighing ≥ 3 kg and less than four years of age: dynamic ultrasound-guided short-axis needle tip navigation technique (ultrasound group) vs. landmark technique. Venous cannulation was performed by three experienced anaesthetists. The primary outcome measure was first-attempt success rate. Success rate within 10 min was a secondary outcome. A total of 102 patients were randomly allocated to either the ultrasound group or the landmark group. First-attempt success rate was 90% in the ultrasound group compared with 51% in the landmark group, pdynamic ultrasound-guided short-axis needle tip navigation technique improved non-visible saphenous vein cannulation in children compared with the landmark technique. © 2017 The Association of Anaesthetists of Great Britain and Ireland.

  2. Comparison of 12-w versus 14-w endovenous laser ablation in the treatment of great saphenous varicose veins: 5-year outcomes from a randomized controlled trial. (United States)

    Samuel, Nehemiah; Wallace, Tom; Carradice, Daniel; Mazari, Fayyaz A K; Chetter, Ian C


    Endovenous laser ablation (EVLA) has been demonstrated to be an effective treatment for lower limb varicose veins in the short and midterm results. This study reports the 5-year outcomes of EVLA technique at different power settings. Patients with primary symptomatic, unilateral varicose veins secondary to saphenofemoral junction (SFJ) incompetence and great saphenous vein (GSV) reflux were recruited and randomized to either 12W (intermittent laser withdrawal) or 14W (continuous laser withdrawal). They were assessed at baseline, 1, 6, 12, 52, 104 weeks, and 5 years. Outcome measures included: Venous Clinical Severity Score (VCSS), pain scores, time taken to return to normal functions, complications, recurrence, quality of life (QoL), and duplex ultrasound findings. 76 consecutive patients, M: F 30:46, median age 54(IQR: 37.3-59) years were randomized. Intragroup analysis: Significant improvement was seen in both groups in VCSS, pain scores, Aberdeen varicose vein questionnaire (AVVQ) scores, Shortform-36 (SF-36) and Euroqol (EQ-5D) domains over the follow-up period (P 0.05). Late outcomes following EVLA were superior for the 14W continuous power settings achieving better long term venous occlusion and lowered recurrence rates without increasing post-operative morbidity. Hence 14W continuous setting should be the energy delivery mode of choice.

  3. Procedural and clinical outcomes after use of the glycoprotein IIb/IIIa inhibitor abciximab for saphenous vein graft interventions

    Energy Technology Data Exchange (ETDEWEB)

    Harskamp, Ralf E., E-mail: [Academic Medical Center–University of Amsterdam, Amsterdam (Netherlands); VU University Medical Center, Amsterdam (Netherlands); Duke Clinical Research Institute, Durham, NC (United States); Hoedemaker, Niels [Academic Medical Center–University of Amsterdam, Amsterdam (Netherlands); Newby, L. Kristin [Duke Clinical Research Institute, Durham, NC (United States); Woudstra, Pier; Grundeken, Maik J.; Beijk, Marcel A.; Piek, Jan J.; Tijssen, Jan G. [Academic Medical Center–University of Amsterdam, Amsterdam (Netherlands); Mehta, Rajendra H. [Duke Clinical Research Institute, Durham, NC (United States); Winter, Robbert J. de [Academic Medical Center–University of Amsterdam, Amsterdam (Netherlands)


    Background: Percutaneous coronary intervention (PCI) of saphenous vein grafts (SVG) poses a high-risk for distal coronary thromboembolic events. Glycoprotein IIb/IIIa inhibitors are frequently used in hope of reducing the impact of this, although the safety and efficacy of these drugs to improve outcomes in this setting are understudied. Methods: Patients were included if they had prior coronary artery bypass surgery and subsequently underwent PCI of ≥ 1 SVG graft at a Dutch academic center between 1997 and 2008. These patients were matched 1:1 based on peri-procedural use of abciximab using a propensity-score matching algorithm based on 17 variables. Conditional logistic regression and Cox regression stratified on matched pairs were performed to evaluate the association between abciximab use and MACCE (the composite measure of mortality, myocardial infarction, stroke and repeat revascularization) at 30 days and up to 1 year. Results: The composite of 30-day MACCE occurred in 18 patients (15.3%) in the abciximab group and 16 patients (13.6%) in the propensity matched control group (OR: 1.13, 95% CI: 0.57–2.21, p = 0.73). At 1-year follow-up, MACCE rates were also similar (32.5% vs. 33.9%, HR: 0.97, 95% CI: 0.59–1.59). Major bleeding (BARC types 3a–c) was higher in the abciximab group (11.9% vs. 4.2%, OR: 2.80, 95% CI: 1.01–7.77). Ischemic outcomes did not differ among patients with acute coronary syndromes. Conclusion: The use of intravenous abciximab was not associated with improved clinical outcomes up to 1-year among patients undergoing SVG PCI, but was related to more bleeding. - Highlights: • PCI of SVG poses a high-risk for distal coronary thromboembolic events. • Glycoprotein IIb/IIIa inhibitors are frequently used in an attempt to reduce this risk. • We evaluated the safety and efficacy of abciximab (a glycoprotein IIb/IIIa inhibitor) using a propensity-score matched analysis of 236 patients at a large academic medical center. • Thirty

  4. A Comparison of 1,470-nm Endovenous Laser Ablation and Radiofrequency Ablation in the Treatment of Great Saphenous Veins 10 mm or More in Size. (United States)

    Mese, Bulent; Bozoglan, Orhan; Eroglu, Erdinc; Erdem, Kemalettin; Acipayam, Mehmet; Ekerbicer, Hasan Cetin; Yasim, Alptekin


    To compare 1,470-nm endovenous laser ablation (EVLA) and radiofrequency ablation (RFA) in the treatment of patients with great saphenous vein diameters of 10 mm or more. One hundred twenty consecutive patients presenting to the cardiovascular surgery department with a great saphenous vein diameter exceeding 10 mm at the saphenofemoral junction between January and December 2013 were included in the study. The first randomly selected 60 patients (group 1) received 1,470-nm EVLA and the other 60 patients (group 2) received RFA. Patients were assessed on the second day, the first week, and the first, third, and sixth months. Major and minor complications were recorded. Minor complications in EVLA and RFA were hyperemia at 20% and 30% (P = 0.50), ecchymosis at 16.7% and 48.3% (P = 0.02), and edema at 40.0% and 65.5% (P < 0.08), respectively. No major complication was observed in any patient. Recanalization developed during monitoring in 3 patients in the RFA group, a rate of 5%. No recanalization was observed in the EVLA group. Success rates in the EVLA and RFA groups were 100% and 95%, respectively. Mean time to return to daily activity was 0.7 days in the EVLA group and 1.4 days in the RFA group (P < 0.006), whereas mean time to return to work was 1.8 days in the EVLA group and 2.2 days in the RFA group (P < 0.07). There was no statistically significant difference between the groups in terms of pain during the procedure or postoperatively. Less pain was reported in the EVLA during both (P < 0.02). EVLA using a 1,470-nm radial fiber is superior to RFA in the treatment of saphenous veins larger than 10 mm in diameter. Copyright © 2015 Elsevier Inc. All rights reserved.

  5. The effects of vasoactive agents on flow through saphenous vein grafts during lower-extremity peripheral vascular surgery. (United States)

    Maslow, Andrew D; Bert, Arthur; Slaiby, Jeffrey; Carney, William; Marcaccio, Edward


    The purpose of this study was to assess the effects of hemodynamic alterations on vein graft flow during peripheral vascular surgery. It was hypothesized that vasopressors can be administered without compromising flow through the vein grafts. Tertiary care center, university medical center. Randomized placebo-controlled double-blinded study. The effects of phenylephrine, epinephrine, milrinone, intravenous fluid, and placebo on newly constructed peripheral vein grafts were assessed in 60 patients (12 patients in each of 5 groups). Systemic and central hemodynamics were measured by using intra-arterial and pulmonary artery catheters. Vein graft flow was measured by using a transultrasonic flow probe (Transultrasonic Inc, Ithaca, NY). Phenylephrine increased systemic mean blood pressure (mBP) (68.2-94.0 mmHg, p < 0.01), systemic vascular resistance (SVR) (1,091-1,696 dynes x sec x cm(-5), p < 0.001), and vein graft flow (39.5-58.9 mL/min, p < 0.01), whereas cardiac output remained unchanged. Epinephrine resulted in increased cardiac output (4.4-6.9 L/min, p < 0.01) and mBP (72.7-89.1 mmHg, p < 0.01), whereas vein graft flow was reduced in 6 of 12 patients. Intravenous fluid administration resulted in a relatively smaller increase in graft flow (37.6-46.0 mL/min, p < 0.05), an increase in cardiac output, and an insignificant decrease in SVR. Other treatments had either little or no effect on vein graft flow. The study hypothesis was partly supported. Although both phenylephrine and epinephrine increased blood pressure, only the former increased vein graft flow in all patients. In conjunction with increases in graft flow after fluid administration, these data suggest that factors affecting vein graft flow are not just simply related to systemic hemodynamics.

  6. Preexisting High Expression of Matrix Metalloproteinase-2 in Tunica Media of Saphenous Vein Conduits Is Associated with Unfavorable Long-Term Outcomes after Coronary Artery Bypass Grafting

    Directory of Open Access Journals (Sweden)

    Bartlomiej Perek


    Full Text Available Introduction. Migration of the smooth muscle cells (SMCs to the tunica media in the saphenous vein (SV transplants is facilitated by matrix metalloproteinases (MMPs. The aim of this study was to identify any associations between expression of MMP-2 or endogenous tissue inhibitors (TIMP-2 and TIMP-3 in the SV segments and late failure of the SV grafts. Methods. Two hundred consecutive patients with a mean age of 63.1 ± 8.9 years who underwent primary isolated venous CABG were examined. Patients were retrospectively split into two subgroups, with the SV graft disease (SVGD (+; or without it (SVGD (−; . In the SV segments, immunohistochemical analysis of the expression of the MMP-2, TIMP-2, and -3 was performed. Results. In the SVGD (+ patients, tissue expression of MMP-2 was stronger, whereas that of both TIMPs was weaker than in the SVGD (− patients. In majority of the SV segments obtained from the SVGD (− individuals, a balance in MMP and TIMP expressions was found, whereas an upregulation of MMP-2 expression was usually noted in the SVGD (+ subjects. Conclusion. The strong expression of MMP-2 accompanied by reduced immunostaining of both TIMPs is associated with the development of the SV graft disease and unfavorable CABG outcomes.

  7. Renal Vein Reconstruction for Harvesting Injury in Kidney Transplantation

    Directory of Open Access Journals (Sweden)

    Birkan Bozkurt


    Full Text Available Kidney transplantation is the best treatment choice in the end-stage renal disease. In the renal transplantation, renal vein damage or shortness which occurs during cadaveric or living donor nephrectomy causes technical difficulties for surgeons. The lack of the donors already especially cadaveric, the acquirement of the graft, gets very much importance. In this report, it is aimed to share the clinical experiment by which it seen, how anastomosis can become appropriate by using the renal vein which is damaged in the way that anastomosis cannot be done anyway by using cadaveric vena cava graft. The renal vein brought to length for anostomosis which is repaired by using cadaveric vena cava graft, is anastomosed successfully by becoming an end-to-side of the external iliac vein of the recipient. Vascular anastomoses are applied easily in technique. The time of the warm ischemia was under 2 hours and the kidney was functional in the post-operative period. Renal vein trombosis was not observed. The renal vein damage occured during cadaveric or living donor nephrectomy, can be repaired by some methods. In the kidneys in which vein requirement is done, the success rates are rather high although acute tubular necrosis and delayed function can be seen more.

  8. Saphenous vein graft near-infrared spectroscopy imaging insights from the lipid core plaque association with clinical events near-infrared spectroscopy (ORACLE-NIRS) registry. (United States)

    Danek, Barbara A; Karatasakis, Aris; Alame, Aya J; Nguyen-Trong, Phuong-Khanh J; Karacsonyi, Judit; Rangan, Bavana; Roesle, Michele; Atwell, Amy; Resendes, Erica; Martinez-Parachini, Jose Roberto; Iwnetu, Rahel; Kalsaria, Pratik; Siddiqui, Furqan; Muller, James E; Banerjee, Subhash; Brilakis, Emmanouil


    We sought to examine near-infrared spectroscopy (NIRS) imaging findings of aortocoronary saphenous vein grafts (SVGs). SVGs are prone to develop atherosclerosis similar to native coronary arteries. They have received little study using NIRS. We examined the clinical characteristics and imaging findings from 43 patients who underwent NIRS imaging of 45 SVGs at our institution between 2009 and 2016. The mean patient age was 67 ± 7 years and 98% were men, with high prevalence of diabetes mellitus (56%), hypertension (95%), and dyslipidemia (95%). Mean SVG age was 7 ± 7 years, mean SVG lipid core burden index (LCBI) was 53 ± 60 and mean maxLCBI4 mm was 194 ± 234. Twelve SVGs (27%) had lipid core plaques (2 yellow blocks on the block chemogram), with a higher prevalence in SVGs older than 5 years (46% vs. 5%, P = 0.002). Older SVG age was associated with higher LCBI (r = 0.480, P < 0.001) and higher maxLCBI4 mm (r = 0.567, P < 0.001). On univariate analysis, greater annual total cholesterol exposure was associated with higher SVG LCBI (r = 0.30, P = 0.042) and annual LDL-cholesterol and triglyceride exposure were associated with higher SVG maxLCBI4 mm (LDL-C: r = 0.41, P = 0.020; triglycerides: r = 0.36, P = 0.043). On multivariate analysis, the only independent predictor of SVG LCBI and maxLCBI4mm was SVG age. SVG percutaneous coronary intervention was performed in 63% of the patients. An embolic protection device was used in 96% of SVG PCIs. Periprocedural myocardial infarction occurred in one patient. Older SVG age and greater lipid exposure are associated with higher SVG lipid burden. © 2016 Wiley Periodicals, Inc. © 2016 Wiley Periodicals, Inc.

  9. A DUPLICATED GREAT SAPHENOUS VEIN AND CLINICAL SIGNIFICANCE FOR VARICOSITY. Duplicación de la vena safena magna y significado clínico de las várices

    Directory of Open Access Journals (Sweden)

    Waseem Al Talalwah


    Full Text Available En varios estudios se ha relacionado la vena safena magna doble con dilataciones varicosas. Durante una clase de disección de pre-grado de la extremidad inferior se encontró una doble vena safena magna unilateral en el miembro inferior izquierdo de un cadáver masculino. La incidencia de esta variación fue del 1,3% de todos los especímenes muestra. En este trabajo se reporta la variabilidad del drenaje venoso de las extremidades inferiores para mejorar la conciencia para los radiólogos vasculares y proporcionar además una opción adicional en la cirugía de bypass de la arteria coronaria para evitar las várices iatrogénicas. A double great saphenous vein has been associated with varicosity in a number of studies. During routine undergraduate dissection of the lower limb a unilateral double great saphenous was found in the left lower limb of a male cadaver. The incidence of this variation was 1.3% of all specimens. This paper reports the variability of lower limb venous drainage to increase the awareness for vascular radiologists and provide further an additional option in coronary artery bypass surgery to avoid iatrogenic varicosity.

  10. A randomized prospective long-term (>1 year) clinical trial comparing the efficacy and safety of radiofrequency ablation to 980 nm laser ablation of the great saphenous vein. (United States)

    Sydnor, Malcolm; Mavropoulos, John; Slobodnik, Natalia; Wolfe, Luke; Strife, Brian; Komorowski, Daniel


    Purpose To compare the short- and long-term (>1 year) efficacy and safety of radiofrequency ablation (ClosureFAST™) versus endovenous laser ablation (980 nm diode laser) for the treatment of superficial venous insufficiency of the great saphenous vein. Materials and methods Two hundred patients with superficial venous insufficiency of the great saphenous vein were randomized to receive either radiofrequency ablation or endovenous laser ablation (and simultaneous adjunctive therapies for surface varicosities when appropriate). Post-treatment sonographic and clinical assessment was conducted at one week, six weeks, and six months for closure, complications, and patient satisfaction. Clinical assessment of each patient was conducted at one year and then at yearly intervals for patient satisfaction. Results Post-procedure pain ( p ablation group. Improvements in venous clinical severity score were noted through six months in both groups (endovenous laser ablation 6.6 to 1; radiofrequency ablation 6.2 to 1) with no significant difference in venous clinical severity score ( p = 0.4066) or measured adverse effects; 89 endovenous laser ablation and 87 radiofrequency patients were interviewed at least 12 months out with a mean long-term follow-up of 44 and 42 months ( p = 0.1096), respectively. There were four treatment failures in each group, and every case was correctable with further treatment. Overall, there were no significant differences with regard to patient satisfaction between radiofrequency ablation and endovenous laser ablation ( p = 0.3009). There were no cases of deep venous thrombosis in either group at any time during this study. Conclusions Radiofrequency ablation and endovenous laser ablation are highly effective and safe from both anatomic and clinical standpoints over a multi-year period and neither modality achieved superiority over the other.

  11. Utilização da safena magna in situ para arterialização do arco venoso do pé The great saphenous vein in situ for the arterialization of the venous arch of the foot

    Directory of Open Access Journals (Sweden)

    Cesar Roberto Busato


    Full Text Available CONTEXTO: O tratamento da isquemia crítica de membros inferiores sem leito arterial distal pode ser realizado por meio da inversão do fluxo no arco venoso do pé. OBJETIVO: O objetivo deste trabalho foi apresentar a técnica e os resultados obtidos com a arterialização do arco venoso do pé, mantendo a safena magna in situ. MÉTODOS: Dezoito pacientes, dos quais 11 com aterosclerose (AO, 6 com tromboangeíte obliterante (TO e 1 com trombose de aneurisma de artéria poplítea (TA foram submetidos ao método. A safena magna in situ foi anastomosada à melhor artéria doadora. O fluxo arterial derivado para o sistema venoso progride por meio da veia cujas válvulas são destruídas. As colaterais da veia safena magna são ligadas desde a anastomose até o maléolo medial, a partir do qual são preservadas. RESULTADOS: Dos pacientes, 10 (55,6% mantiveram suas extremidades, 5 com AO e 5 com TO; 7 (38,9% foram amputados, 5 com AO, 1 com TO e 1 com Ta; houve 1 óbito (5,5%. CONCLUSÃO: A inversão do fluxo arterial no sistema venoso do pé deve ser considerada para salvamento de extremidade com isquemia crítica sem leito arterial distal.BACKGROUND: Critical lower limb ischemia in the absence of a distal arterial bed can be treated by arterialization of the venous arch of the foot. OBJETIVE: The objective of this paper was to present the technique and the results of the arterialization of the venous arch of the foot with the in situ great saphenous vein. METHODS: Eighteen patients, 11 with atherosclerosis (AO, 6 with thromboangiitis obliterans (TO and 1 with popliteal artery aneurysm thrombosis were submitted to venous arch arterialization. The in situ great saphenous vein was anastomosed to the best donor artery. Arterial flow derived from the venous system progresses through the vein whose valves were destroyed. The collateral vessels of the great saphenous vein are linked from the anastomosis to the medial malleolus and preserved from this point

  12. Embolia atrial de trombo flutuante da veia safena magna após escleroterapia com microespuma ecoguiada Atrial embolism of floating thrombus of the great saphenous vein after microfoam ultrasound-guided sclerotherapy

    Directory of Open Access Journals (Sweden)

    Rubens Pierry Ferreira Lopes


    Full Text Available A escleroterapia com microespuma vem sendo utilizada amplamente no tratamento da doença venosa varicosa. No entanto, a despeito da sua pouca invasividade e segurança, complicações potencialmente graves e letais já foram descritas, como o acidente vascular cerebral e parada cardiorrespiratória. Descrevemos um caso de embolia atrial tardia de trombo flutuante da junção safeno-femoral de veia safena magna varicosa, após escleroterapia com microespuma de polidocanol guiada por ultrassom, e o tratamento dessa complicação.Microfoam sclerotherapy has been widely used in the treatment of varicose vein disease. However, despite its low invasiveness and safety, potentially serious and lethal complications have been described, such as stroke and cardiorespiratory arrest. We describe a case of delayed atrial embolism of floating thrombus in the saphenofemoral junction of a great saphenous varicose vein after microfoam ultrasound-guided sclerotherapy, as well as the treatment of this complication.

  13. Early Outcomes of Endoscopic Vein Harvesting during the Initial Learning Period

    Directory of Open Access Journals (Sweden)

    Do Yeon Kim


    Full Text Available Background: The endoscopic vein harvesting (EVH method has been used in coronary artery bypass surgery in many countries. We started using the EVH method recently, and investigated the results during the early learning period. Methods: Between March 2012 and June 2014, 75 patients (31 patients in the EVH method group, and 44 patients in the open method group who underwent isolated first-time coronary artery bypass grafting using vein grafts were retrospectively analyzed with respect to the early outcomes including graft patency and risk factors for leg wound complications. For assessing the patency of vein graft, we performed coronary computed tomography angiography during the immediate postoperative period and 6 months later. Results: Mean harvesting time of endoscopic method was about 15 minutes. Patency rate during the immediate operative period and the 6-month patency rate were similar between the two groups (postoperative period: EVH 100% vs. open method 94.4%, p=0.493; at 6 months: EVH 93.3% vs. open method 90.9%, p=0.791. Leg wound complications occurred more frequently in the open method group (EVH 3.2% vs. open method 13.6%, p=0.127. According to the analysis, age was an independent risk factor for leg wound complications. Conclusion: EVH is a feasible method even for beginners and can be performed satisfactorily during their learning period.

  14. Long-term outcomes with drug-eluting stents versus bare metal stents in the treatment of saphenous vein graft disease (results from the REgistro Regionale AngiopLastiche Emilia-Romagna registry). (United States)

    Vignali, Luigi; Saia, Francesco; Manari, Antonio; Santarelli, Andrea; Rubboli, Andrea; Varani, Elisabetta; Piovaccari, Giancarlo; Menozzi, Alberto; Percoco, Gianfranco; Benassi, Alberto; Rusticali, Guido; Marzaroli, Paolo; Guastaroba, Paolo; Grilli, Roberto; Maresta, Aleardo; Marzocchi, Antonio


    Percutaneous revascularization of saphenous vein grafts (SVGs) remains a challenging task. Drug-eluting stents (DESs) have been shown to decrease the incidence of restenosis in de novo native coronary artery lesions. However, their clinical value in SVGs remains to be established. We compared long-term clinical outcomes of percutaneous coronary intervention with DESs and bare metal stents (BMSs) for de novo lesions in SVGs. In a large prospective, multicenter registry, 360 patients underwent stenting of a de novo lesion in SVGs using BMSs (288 patients) or DESs (72 patients). Incidence of major adverse cardiac events (MACEs), including all-cause mortality, reinfarction, and target vessel revascularization, was recorded at a 12-month follow-up. Compared with the DES group, patients receiving BMSs were more likely to be men, to have chronic renal insufficiency or higher Charlson scores, but less likely to have undergone previous percutaneous coronary intervention. Incidence of MACEs at 12-month follow-up was similar in the 2 groups (17.8% in DES group vs 20.3% in BMS group, respectively, p = 0.460). Cox regression analysis identified age, chronic renal failure, cardiogenic shock at presentation, and ostial location of stenosis as independent predictors of long-term MACEs. In conclusion, our data suggest that rates of 12-month MACEs associated with the use of DESs and BMSs are similar in patients undergoing treatment of de novo lesions in SVGs.

  15. Effect of Extended-Release Niacin on Carotid Intima Media Thickness, Reactive Hyperemia, and Endothelial Progenitor Cell Mobilization: Insights From the Atherosclerosis Lesion Progression Intervention Using Niacin Extended Release in Saphenous Vein Grafts (ALPINE-SVG) Pilot Trial. (United States)

    Guerra, Andres; Rangan, Bavana V; Coleman, Ameka; Xu, Hao; Kotsia, Anna; Christopoulos, Georgios; Sosa, Alan; Chao, Howard; Han, Henry; Abdurrahim, Guthbudeen; Roesle, Michele; de Lemos, James A; McGuire, Darren K; Packer, Milton; Banerjee, Subhash; Brilakis, Emmanouil S


    Thirty-eight patients with intermediate (30%-60% diameter stenosis) saphenous vein graft lesions were randomized to extended-release niacin (ER-niacin) or placebo for 12 months. We sought to evaluate the impact of ER-niacin on carotid intima media thickness (CIMT), endothelial function, and endothelial progenitor cell (EPC) mobilization. Carotid B-mode ultrasound was used to image the common and internal carotid arteries, at baseline and at 12 months after enrollment. Reactive hyperemia peripheral arterial tonometry, as assessed with EndoPAT 2000 (Itamar Medical, Inc) and EPC mobilization assessed with flow cytometry, were measured at enrollment, and at 1 and 12 months. The baseline clinical characteristics were similar in the two study groups. High-density lipoprotein cholesterol levels tended to increase more in the ER-niacin group (5.9 ± 8.7 mg/dL vs 1.4 ± 7.1 mg/dL; P=.14). Between baseline and 12 months, right common carotid artery (0.96 ± 0.44 mm vs 0.70 ± 0.24 mm; P=.04), and left common carotid artery (0.80 ± 0.30 mm vs 0.70 ± 0.20 mm; P=.08) CIMT tended to decrease in the ER-niacin group, compared with no change in the placebo group. The change in logarithmic reactive hyperemia index between 1 month and 12 months was similar in patients receiving ER-niacin vs placebo (0.003 ± 0.12 vs -0.058 ± 0.12; P=.39), whereas EPC mobilization increased in the ER-niacin group and decreased in the placebo group (8.65 ± 28.41 vs -5.87 ± 30.23 EPC colony forming units/mL of peripheral blood; P=.02). ER-niacin did not have a significant impact on CIMT or endothelial function, but increased EPC mobilization.

  16. Saphenous ablation: what are the choices, laser or RF energy. (United States)

    Morrison, Nick


    Endovenous ablation has been reported to be safe and effective in eliminating the proximal portion of the great saphenous vein from the venous circulation, with faster recovery and better cosmetic results than surgical stripping. However, the definition of a successful outcome in the literature has not been uniform. As in a successful stripping procedure, complete elimination of at least the proximal portion of the great saphenous vein should also be the standard for these endovenous ablation procedures. Our experience with over 1,400 endovenous ablation procedures, of which 1,150 were radiofrequency and over 250 were laser procedures, has allowed evaluation and comparison of these two techniques. And while we have not seen as high success rates as in published reports (especially with laser ablation), we have still concluded that both radiofrequency and laser techniques to destroy the saphenous vein are safe and effective. Patient acceptance is overwhelmingly better than stripping. Physicians performing these techniques should embrace a commitment to addressing all sites of venous insufficiency in a patient, not just the proximal great saphenous vein. Without this level of commitment, one will be left with poor results and a dissatisfied patient.

  17. Saphenous vein graft bypass in the treatment of giant cavernous sinus aneurysms: report of two cases Anastomose intra-extracraniana com enxerto de veia safena no tratamento de aneurismas gigantes do seio cavernoso: relato de dois casos

    Directory of Open Access Journals (Sweden)



    Full Text Available Two cases of giant intracavernous aneurysms treated by high flow bypass with saphenous vein graft between the external carotid artery (ECA and branches of the middle cerebral artery (MCA are presented. Very often these aneurysms are unclippable because they are fusiform or have a large neck. Occlusion of the internal carotid artery (ICA is the treatment of choice in many cases. This procedure has however a high risk of brain infarction. Revascularization of the brain by extra-intracranial anastomosis between the superficial temporal artery (STA and branches of the MCA is frequently performed. This procedure provides however a low flow bypass and brain infarction may occur. We report two cases of giant cavernous sinus aneurysms treated by high flow bypass and endovascular balloon occlusion of the ICA. Immediate high flow revascularization of MCA branches was achieved and the patients showed no ischemic events. Follow-up of 8 and 14 months after operation shows patency of the venous graft and no neurological deficits. Angiographic control examination showed complete aneurysm occlusion in both cases.Aneurismas gigantes da porção intracavernosa da artéria carótida interna frequentemente são inoperáveis por serem fusiformes ou apresentarem colo muito largo. Ligadura da artéria carótida interna é muitas vezes o tratamento de escolha para esses pacientes. Esse procedimento apresenta no entanto alta incidência de complicações isquêmicas agudas e tardias. Dois casos de aneurismas gigantes da porção intracavernosa são apresentados. Esses aneurismas foram tratados com cirurgia de "bypass"com enxerto de veia safena magna entre a artéria carótida externa e ramo M2 da artéria cerebral média e oclusão endovascular da artéria carótida interna. Revascularização com enxerto de alto fluxo sanguineo ocorreu nos dois pacientes não se observando nenhuma alteração isquêmica no período pós-operatório. O seguimento desses pacientes ap

  18. Should complete stripping operation to the ankle be avoided in the treatment of primary varicose veins due to greater saphenous vein insufficiency? Deve-se evitar a flebo-extração completa até o tornozelo no tratamento das varizes primárias por insuficiência da veia safena magna?

    Directory of Open Access Journals (Sweden)

    Hakan Uncu


    Full Text Available PURPOSE: The most preferred method for the treatment of primary varicose veins due to greater saphenous vein (GSV insufficiency is saphenofemoral high ligation and thigh stripping of the GSV, and ambulatory phlebectomy. Stripping is usually ended at the knee level to prevent nerve injury in the calf. However, different surgical modalities may be used depending on the surgeon's choice and experience. METHODS: We present the results of complete stripping of the GSV to the ankle and ambulatory phlebectomies performed by a single surgeon. Ninety-six patients (102 limbs who underwent standardized surgical procedure were participated in this study. Median follow-up time was 3.4 years. RESULTS: All complaints due to varicose veins were resolved in all extremities. Some temporary complications observed were resolved fully during follow-up. Permanent paresthesia which was the most important complication was found only in two patients (2%. No recurrence was observed. CONCLUSION: The risk of saphenous nerve injury in the calf should not to be considered a reason to avoid complete stripping of the GSV to the ankle. If it is applied carefully and with appropriate technique, complete stripping still seems to be a good treatment option.OBJETIVO: O método de escolha para o tratamento das varizes primárias devido a insuficiência da veia safena magna (VSM é a ligagura safenofemoral e a fleboextração em coxa e a flebectomia ambulatorial. A fleboextração é geralmente feita ao nível do joelho para prevenir a lesão neurológica no tornozelo. Diferentes modalidades operatórias, no entanto, podem ser utilizadas dependendo da escolha e da experiência do cirurgião. MÉTODOS: Apresentamos os resultados da fleboextração completa da VSM até o tornozelo e flebectomias ambulatoriais realizadas por um único cirurgião. Noventa e seis pacientes (102 membros que foram submetidos a procedimento cirúrgico padrão participaram deste estudo. A mediana do tempo de

  19. Primary varicose veins: Frequency, clinical significance and surgical treatment

    Directory of Open Access Journals (Sweden)

    Vasić Dragan M.


    Full Text Available INTRODUCTION According to the definition of the World Health Organization, varicose veins represent abnormally enlarged superficial veins having baggy or cylindrical shape. The most frequent cause of primary varicose veins is the insufficiency of long saphenous vein (LSV, but especially the basin of its connection with femoral vein and perforating veins. OBJECTIVE The objectives of these investigations were: the determination of insufficiency incidence of SSV in cases of LSV insufficiency; the establishment of association of insufficiency of perforating veins of the basin of LSV and SSV; the study of the results of surgical treatment of insufficiency and varicosity of both short and long saphenous veins. METHODS In this study, 100 patients (66 women and 34 men, average age 52.1 years, with clinical symptoms showing the insufficiency and varicosity of long saphenous vein with no change of deep vein system were examined. Ultrasonographic examinations were made using Color Doppler probes - 7.5 and 3.75 MHz (Toshiba Corevison SSA 350 A; the development of incompetence of long saphenous vein (LSV and short saphenous vein (SSV at the level of the junction as well as other incompetent valves were examined. The reflux was defined as a retrograde flow of the duration longer than 0.5 seconds. RESULTS The insufficiency of short saphenous vein was determined by ultrasonographic examination in 34%, while the insufficiency of perforating veins in 80% of patients. 40% of patients were operated (33.3% of females, and 52.9% of males. The most frequent indications for surgical treatment of superficial veins insufficiency were: strong varicosities, clear symptoms and signs, superficial thrombophlebitis and conditions after superficial thrombophlebitis. Surgical treatment was applied in 16% of patients due to recurrence in the basin of long saphenous vein, and in 6% of cases because of the recurrence in the basin of short saphenous vein. Data analysis failed to

  20. Comparação da perviedade entre artéria radial e veia safena em pacientes em pós-operatório de cirurgia de revascularização miocárdica com retorno dos sintomas Comparison of patency between radial artery and saphenous vein in a coronary artery bypass grafting post operative with return of the symptoms

    Directory of Open Access Journals (Sweden)

    Herbert Coelho Hortmann


    Full Text Available OBJETIVO: Comparar a perviedade da artéria radial e veia safena em pacientes com retorno dos sintomas após cirurgia de revascularização do miocárdio (CRVM. MÉTODOS: Estudo retrospectivo. No período de janeiro de 1998 a dezembro de 2005, foram realizadas 469 CRVMs com o uso da artéria radial dentre os enxertos, no Hospital Vera Cruz, em Belo Horizonte/MG. Destes, 94 pacientes apresentaram alterações isquêmicas no pós-operatório recente ou tardio e foram reestudados com cineangiocoronariografia. Os enxertos foram divididos em três grupos: artéria torácica interna (ATI, artéria radial (AR e veia safena (VS, e foram estratificados segundo a gravidade das lesões: sem lesão grave (OBJECTIVE: To compare the radial artery and saphenous vein's patency in patients with recurrence of symptoms in a coronary artery bypass grafting (CABG. METHODS: Retrospective study. From January 1998 to December 2005, 469 CABGs were performed using the radial artery as a graft, in Vera Cruz Hospital in Belo Horizonte/ MG. Among the patients who underwent those surgeries, 94 presented ischemic changes in early or late postoperative period, which led them to be re-evaluated by coronary angiography. The grafts were divided in three groups: internal thoracic artery (ITA, radial artery (RA and saphenous vein (SV, and they were stratified according to the severity of injury: uninjured or patent (< 70%, severe obstruction (70 to 99% and occlusion. RESULTS: For the 94 patients in the study, 86 grafts of ITA, 94 of RA and 111 of SV were used. For the 86 ITA grafts, 73 (84.88% were found patent. For the 94 RA grafts, 55 (58.51% were found patent, and for the 111 SV grafts, 73 (65.76% were uninjured. A statistically significant difference (P= 0.001 was found between RA and SV grafts, with a higher patency found for VS graft. For the RA grafts, women presented a worse result concerning the RA patency (65.7% and 40.7%, with P = 0.006. Concerning coronary

  1. Achieving and Sustaining Zero: Preventing Surgical Site Infections After Isolated Coronary Artery Bypass With Saphenous Vein Harvest Site Through Implementation of a Staff-Driven Quality Improvement Process. (United States)

    Kles, Candis Lee; Murrah, C Patrick; Smith, Kerry; Baugus-Wellmeier, Elizabeth; Hurry, Terri; Morris, Cullen D


    Surgical site infections (SSI) increase morbidity and mortality, hospital costs, length of stay, readmissions, and risk of litigation and may impact a facility's reputation. Through implementation of a Six Sigma, interdisciplinary team process and the Contextual Model for change engaged all stakeholders. A total of 44 perioperative processes were evaluated, with 15 processes ultimately altered. Revisions involved identifying inconsistent implementation of procedures and standardizing processes, as well as utilizing new suture techniques and products including disposable electrocardiogram leads and pacing wires, antibiotic-coated sutures, and silver-impregnated midsternal dressings. In isolated coronary artery bypass grafting with donor-site procedures, an incidence of 3.74 per 100 procedures was reduced to 0.7 and ultimately to 0. No patients who underwent coronary artery bypass grafting developed a deep sternal wound infection in over 30 months and 590 procedures, resulting in an estimated cost savings of more than $600 000, from May 2012 through December 2014. A significant reduction in deep sternal wound infections was achieved by working at all levels of the organization through a multidisciplinary approach to create sustained change. Using real-time observations for current practices, areas for improvement were identified. By engaging frontline staff in the process, ownership of the outcomes and adherence to practice change were promoted. The result was a dramatic, rapid, and sustainable improvement in the prevention of deep sternal wound infection.

  2. Cephalic veins in coronary artery bypass surgery

    DEFF Research Database (Denmark)

    Licht, P; Jakobsen, Erik; Lerbjerg, G


    Various alternative conduits for aortocoronary bypass grafting have been suggested when the saphenous vein quality is inadequate. During a 10-year period we have used the cephalic vein in 39 patients. Eighteen entered an angiographic follow-up study. A total of 31 arm vein grafts were used with 43...... bypass operations....

  3. Alterações estruturais e moleculares (cDNA precoces em veias safenas humanas cultivadas sob regime pressórico arterial Precocious structural and molecular (cDNA changes in the human saphenous veins cultivated under arterial hemodynamic conditions

    Directory of Open Access Journals (Sweden)

    Luís Alberto O. Dallan


    Interleucina 1ß. A expressão do Oncogene 3 estava elevada em 11 (68,7% das veias cultivadas sob regime arterial, enquanto observou-se aumento da expressão da Interleucina 1ß em nove (56,2% desses segmentos venosos (pOBJECTIVE: The saphenous vein (SV used in coronary artery bypass grafting is submitted to elevated and continuous shear stress. Occlusion of the grafts can occur in response to the new hemodynamic conditions. The aim of this study is to compare the precocious structural and molecular (cDNA changes in saphenous veins grafts submitted to low pressure hemodynamic conditions versus systemic hemodynamic conditions. METHOD: Forty sections of SV were cultivated "ex-vivo" under venous hemodynamic conditions (VHC (without pressure, flow: 5 mL/min and under arterial hemodynamic conditions (AHC (pressure: 80 mmHg, flow: 50 mL/min. The following variables were analyzed: cellular viability (MTT assay cellular density (hoeschst 33258 staining and apoptosis (TUNEL assay, before and 1, 2 and 4 days after the procedure. "cDNA microarray" analysis of the SV sections was used to determine the precociously changed molecular targets in the veins cultivated under arterial conditions. The identification of these targets was achieved using a RNA homogenized pool of these vein sections, interacting on slides with 16,000 pre-determined human genes (Agilent Technologies slide. The genes with changed expressions were verified by real time PCR in the veins of 16 patients. RESULTS: There was a gradual reduction in the cellular density and in the tissue viability in the saphenous veins cultivated under AHC, whereas no alterations were observed in the saphenous veins cultivated under VHC of up to 4 days. In the AHC group there were signs of a cellular apoptotic process (positive - TUNEL from the first day after cultivation. In the VHC group these alterations were not observed. Although the cellular density was the same in the veins submitted to arterial conditions, after 24 hours of

  4. Comparação entre o laser endovenoso e a fleboextração total da veia safena interna: resultados em médio prazo Comparison of endovenous laser therapy vs. conventional stripping of the great saphenous vein: midterm results

    Directory of Open Access Journals (Sweden)

    Charles Angotti Furtado de Medeiros


    Full Text Available OBJETIVO: Comparar a fotocoagulação endovenosa com laser diodo e a fleboextração total da veia safena interna. MÉTODOS: Trata-se de um estudo prospectivo, controlado e cego de 20 pacientes com varizes sintomáticas e insuficiência bilateral da veia safena interna que foram operados entre março de 2002 e fevereiro de 2004. Para cada caso, foram realizadas aleatoriamente (sorteio as duas técnicas, sendo uma em cada lado. A avaliação pós-operatória consistiu na aplicação de questionários, exame físico e fotografia digital em todos os pacientes desde o 7º dia de pós-operatório. Também foi realizado controle ultra-sonográfico no 30º dia de pós-operatório e pletismografia a ar no 60º dia após a cirurgia. Este projeto foi aprovado pela comissão de ética, e os pacientes foram incluídos ao assinarem o consentimento pós-informação. Os dados foram submetidos a análise estatística com os programas SPSS e SAS. RESULTADOS: A técnica que utilizou o laser endovenoso apresentou dor semelhante, mas menos edema e menos hematoma durante o pós-operatório. O índice de melhora estética e de satisfação com a cirurgia foi de 100% para as duas técnicas, mas a maioria dos pacientes respondeu que o membro operado com o laser foi o mais beneficiado. Houve melhora do tempo de enchimento venoso nos dois grupos, mas sem diferença significativa entre eles. Durante o seguimento (média de 26 meses, houve um caso de parestesia leve e transitória do lado convencional e somente uma recanalização do lado laser. CONCLUSÃO: A fotocoagulação endovenosa para o tratamento da veia safena interna em pacientes com varizes de membros inferiores é segura e apresenta resultados comparáveis aos da fleboextração convencional.OBJECTIVE: To compare endovenous diode laser photocoagulation and conventional stripping of the great saphenous vein. METHODS: A controlled and blind prospective study of 20 patients with symptomatic varicose veins and

  5. Surgery for acquired cardiovascular disease: antiseptic treatment of contaminated vein grafts. (United States)

    Schmidt, F P; Peivandi, A A; Kohnen, W; Jansen, B


    Saphenous vein grafts harvested for use as bypass conduits can be contaminated intraoperatively, e.g. by being inadvertently dropped to the floor of the operating room (OR). This study was performed to investigate microorganisms most likely contaminating vein grafts and to assess the possible efficacy of measures to treat potentially contaminated vein grafts antiseptically for further use. In a first step we determined the microbiological flora of the OR using surface cultures and cultures from intentionally dropped vein grafts. Several antiseptic agents (PVP-iodine 10%, octenidinhydrochloride 0.1%, polyhexanide 1%) were evaluated for their in vitro efficacy to disinfect artificially contaminated vein segments. The most promising antiseptic regimen was tested on veins contaminated in a real OR setting. Finally, we tested for possible alterations in mechanical properties of the veins caused by antiseptic treatment. Coagulase-negative staphylococci where the predominant bacteria recovered from the OR with 59.9%. Antiseptic treatment with a combination of octenidine and PVP-iodine resulted in a higher rate of negative cultures than any single agent. Treatment of 50 saphenous vein grafts contaminated in the OR with the combination regimen resulted in only 3 positive cultural results within 7 days. Mechanical tear-stress testing comparing antiseptically treated vein grafts with controls showed no difference in their resistance to tear stress. Antiseptic treatment of contaminated vein grafts was shown to be effective in a high percentage of cases without altering mechanical properties of grafts and may be an option for the surgeon in case of a contamination.

  6. Pharmacological assessment of adrenergic receptors in human varicose veins. (United States)

    Miller, V M; Rud, K S; Gloviczki, P


    Experiments were to characterize pharmacologically adrenergic receptors in human varicose veins to the natural transmitter norepinephrine and to an extract of Ruscus. Greater saphenous veins and varicose tributaries from patients undergoing elective surgery for primary varicose disease and portions of greater saphenous veins from patients undergoing peripheral arterial reconstruction (control) were suspended for the measurement of isometric force in organ chambers. Concentration response curves were obtained to norepinephrine or the extract of Ruscus aculeatus in the absence and presence of selective antagonists of alpha, and alpha2 adrenergic receptors. Norepinephrine and Ruscus extract caused concentration-dependent contractions in all veins. Contractions to norepinephrine were greater in control veins than in varicose tributaries. Contractions to the extract were greater in varicose tributaries than in greater saphenous veins from varicose patients. Contractions to norepinephrine were reduced similarly by alpha and alpha2-adrenergic agonists in control and varicose veins but to a greater extent by alpha2-blockade in greater saphenous veins from varicose patients. Contractions to Ruscus extract were not reduced by alpha-adrenergic blockade in control veins but were reduced by alpha2-adrenergic blockade in varicose veins. These results suggest a differential distribution of alpha adrenergic receptors on greater saphenous veins from non-varicose patients compared to those with primary varicose disease. Venotropic agents from plant extract probably exert effects by way of multiple receptor and non-receptor mediated events.

  7. Disfunção endotelial causada pela pressão aguda de distensão em veias safenas humanas utilizadas para revascularização do miocárdio Endothelium dysfunction caused by acute pressure distension of human saphenous vein used for myocardial revascularization

    Directory of Open Access Journals (Sweden)

    Fernanda Viaro


    Full Text Available OBJETIVO: Estudar as alterações morfofuncionais induzidas por pressão de distensão, em veias safenas humanas utilizadas para revascularização do miocárdio. MÉTODO: Foram estudadas veias safenas de 20 pacientes, distribuídas em quatro grupos experimentais: controle, 100, 200 e 300 mmHg, submetidos a distensões pressóricas com solução de Krebs por 15 segundos. A metodologia utilizada incluiu: 1 Imunohistoquímica do CD34; 2 Estudo in vitro da reatividade vascular em câmaras de órgãos. RESULTADOS: Os principais achados experimentais foram: 1 A partir da pressurização com 200 mmHg, observou-se uma tendência à diminuição da expressão do CD34, tornando-se estatisticamente significante com 300 mmHg; 2 Não houve comprometimento da contratilidade e dos relaxamentos estudados in vitro. CONCLUSÕES: Embora o estudo in vitro não tenha demonstrado comprometimento da reatividade vascular das veias estudadas, o estudo imunohistoquímico do CD34 mostrou que existe disfunção endotelial com pressurizações de 300 mmHg.OBJECTIVE: To study morphofunctional alterations induced by brief pressure increases in human saphenous veins utilized in coronary artery bypass grafting. METHOD: Saphenous veins of 20 patients undergoing coronary artery bypass grafting, were distributed into four experimental groups, control, 100 mmHg, 200 mmHg and 300 mmHg, and submitted to pressure distention over 15 seconds using Krebs solution. The evaluation included CD34 immunohistochemistry and an In vitro vascular reactivity study in organ chambers. RESULTS: The main experimental findings were 1 From pressures of 200 mmHg there was a tendency to reduce the CD34 expression which became statistically significant at 300 mmHg; 2 There was no impairment of the contraction and relaxation as evidenced by in vitro vascular reactivity tests. CONCLUSION: Although vascular reactivity impairment was not demonstrated in vitro, the CD34 expression, measured by

  8. Distally Based Saphenous Nerve-Greater Saphenous Venofasciocutaneous Flap for Reconstruction of Soft Tissue Defects in Distal Lower Leg. (United States)

    Cheng, Zhaohui; Wu, Weigang; Hu, Pengfei; Wang, Min


    To this day, the reconstruction of soft tissue defects in the distal lower leg is still a challenge for reconstructive surgeons. At present, free flap, musculocutaneous flap, anterior and posterior tibial artery flap, cross-leg flap, and distally based neurocutaneous flap are the main surgical alternatives. However, these methods are not always satisfactory. This article describes our experience with the distally based saphenous nerve-greater saphenous venofasciocutaneous flap method to reconstruct soft tissue defects in the distal lower leg. A total of 27 patients (17 men and 10 women) underwent reconstructive surgery in our department from October 2009 to July 2012. Their mean age was 44.8 years (range, 16-62 years). The mean follow-up period was 18 months (range, 12-30 months). The only etiology was acute traumatic injury. Defects were located in the distal tibia around the ankle joint and the foot. The fasciocutaneous pedicle was 3 to 4 cm wide and the anatomical structures consisted of the superficial and deep fascia, the saphenous nerve, the greater saphenous vein, and their accompanying vessels together with an islet of subcutaneous cellular tissue and skin. The pivot point was approximately 5 cm proximal to the tip of medial malleolus. The size of skin islands ranged from 7 × 5 to 14 × 10 cm. All flaps survived without any partial necrosis and no arterial crisis occurred postoperatively in any case. Severe venous congestion occurred only in 1 case; however, the flap got better gradually and survived eventually after limb raise and interrupted bloodletting. All donor sites were 1-stage closed with split-skin grafting. The reverse saphenous neurocutaneous island flap is a reliable and efficient method to reconstruct soft tissue defects in the distal lower leg. Both this flap and the classic sural flap provide valuable alternative coverage of such defects.

  9. Graft pathology at the time of harvest: impact on long-term survival

    Directory of Open Access Journals (Sweden)

    Shi-Min Yuan


    Full Text Available Objective: This study aims to present the graft pathology at the time of harvest and its impact on long-term survival. Methods: The remnants of the bypass grafts from 66 consecutive patients with coronary artery disease receiving a coronary artery bypass grafting were investigated pathologically, and pertinent predictive risk factors and survival were analyzed. Results: Medial degenerative changes with or without intimal proliferation were present in 36.8%, 37.8% and 35.6% of left internal mammary artery (IMA, radial artery and saphenous vein grafts. There were 2 (3.0% hospital deaths and 9 (14.1% late deaths. Multinomial logistic regression revealed left IMA pathological changes, dyslipidemia, history of percutaneous transluminal coronary angioplasty/stent deployment and Y-graft were significant predictive risk factors negatively influencing the patients’ long-term survival. Kaplan-Meier survival analysis revealed that the long-term survival of patients with left IMA pathological changes were significantly reduced compared with those without (74.1% vs. 91.4%, P=0.002; whereas no differences were noted in long-term survivals between patients with and without pathological changes of the radial arterial or saphenous vein grafts. Conclusion: Pathological changes may be seen in the bypass graft at the time of harvest. The subtle ultrastructural modifications and the expressions of vascular tone regulators might be responsible for late graft patency. The pathological changes of the left IMA at the time of harvest rather than those of the radial artery or saphenous vein graft affect significantly longterm survival. Non-traumatic maneuver of left IMA harvest, well-controlled dyslipidemia and avoidance of using composite grafts can be helpful in maintaining the architecture of the grafts.

  10. Day surgery is effective and safe for patients with great saphenous ...

    African Journals Online (AJOL)


    Nov 2, 2015 ... deep vein thrombosis (DVT), saphenous nerve injury (SNI), wound infection, and recurrence in DS and IS groups was. 0.9% versus 0.8%; 2% versus 3%; 3.3% versus 3.8%; and 1.3% versus 1.1%, respectively. Moreover, there was no significant difference in incidence of DVT, SNI, wound infection, and ...

  11. Efficacy of varicose vein surgery with preservation of the great safenous vein

    Directory of Open Access Journals (Sweden)

    Bernardo Cunha Senra Barros

    Full Text Available OBJECTIVE: To evaluate the efficacy of surgical treatment of varicose veins with preservation of the great saphenous vein. METHODS: We conducted a prospective study of 15 female patients between 25 and 55 years of age with clinical, etiologic, anatomic and pathophysiologic (CEAP classification 2, 3 and 4. The patients underwent surgical treatment of primary varicose veins with great saphenous vein (GSV preservation. Doppler ultrasonography exams were carried out in the first and third months postoperatively. The form of clinical severity of venous disease, Venous Clinical Severity Score (VCSS was completed before and after surgery. We excluded patients with history of deep vein thrombosis, smoking or postoperatively use of elastic stockings or phlebotonics. RESULTS: All patients had improved VCSS (p <0.001 and reduction in the diameter of the great saphenous vein (p <0.001. There was a relationship between VCSS and the GSV caliber, as well as with preoperative CEAP. There was improvement in CEAP class in nine patients when compared with the preoperative period (p <0.001. CONCLUSION: The varicose vein surgery with preservation of the great saphenous vein had beneficial effects to the GSV itself, with decreasing caliber, and to the symptoms when the vein had maximum caliber of 7.5 mm, correlating directly with the CEAP. The decrease in GSV caliber, even without complete abolition of reflux, leads to clinical improvement by decreasing the reflux volume.

  12. ClariVein® - Early results from a large single-centre series of mechanochemical endovenous ablation for varicose veins. (United States)

    Tang, T Y; Kam, J W; Gaunt, M E


    Objectives This study assessed the effectiveness and patient experience of the ClariVein® endovenous occlusion catheter for varicose veins from a large single-centre series in the UK. Methods A total of 300 patients (371 legs) underwent ClariVein® treatment for their varicose veins; 184 for great saphenous vein (GSV) incompetence, 62 bilateral GSV, 23 short saphenous vein (SSV), 6 bilateral SSV and 25 combined unilateral great saphenous vein and SSV. Patients were reviewed at an interval of two months post procedure and underwent Duplex ultrasound assessment. Postoperative complications were recorded along with patient satisfaction. Results All 393 procedures were completed successfully under local anaesthetic. Complete occlusion of the treated vein was initially achieved in all the patients, but at eight weeks' follow-up, there was only partial obliteration in 13/393 (3.3%) veins. These were all successfully treated with ultrasound-guided foam sclerotherapy. Procedures were well tolerated with a mean pain score of 0.8 (0-10). No significant complications were reported. Conclusions ClariVein® can be used to ablate long and short saphenous varicose veins on a walk-in-walk-out basis. Bilateral procedures can be successfully performed, and these are well tolerated as can multiple veins in the same leg. Early results are promising but further evaluation and longer term follow-up are required.

  13. Evaluation of Saphenous Venipuncture and Modified Tail-clip Blood Collection in Mice (United States)

    Abatan, Omorodola I; Welch, Kathleen B; Nemzek, Jean A


    The purpose of this study was to evaluate the effects of 2 methods of blood collection in unanesthetized mice. The saphenous venipuncture method was compared with a modified tail-clip technique that requires minimal restraint. Mice were evaluated through behavioral observation and plasma corticosterone levels. The results showed that the 2 methods produced similar corticosterone responses and that the tail-clip method produced fewer behavioral reactions. In addition, the effects of saphenous venipuncture method appeared to be dependent on the handler's technical expertise. When a series of 4 blood collections were performed over 1 wk, the 2 methods yielded similar corticosterone levels that did not increase over time. Some of the behavioral signs appeared to increase over the series of blood collections obtained by the saphenous venipuncture method. Serial complete blood counts showed that the tail vessels yielded higher total white blood cell, neutrophil, and lymphocyte counts than did the saphenous vein. Neither method appeared to cause stress-associated changes in the leukogram after serial blood collection. Overall, the effects of modified tail-clip method were similar to those of the saphenous venipuncture method in unanesthetized mice. PMID:18459706

  14. Day surgery is effective and safe for patients with great saphenous ...

    African Journals Online (AJOL)

    During follow‑up after surgery, incidence of deep vein thrombosis (DVT), saphenous nerve injury (SNI), wound infection, and recurrence in DS and IS groups was 0.9% versus 0.8%; 2% versus 3%; 3.3% versus 3.8%; and 1.3% versus 1.1%, respectively. Moreover, there was no significant difference in incidence of DVT, SNI, ...

  15. Great saphenous vein stripping using nasogastric tube | Ademola ...

    African Journals Online (AJOL)

    Nigerian Journal of Plastic Surgery. Journal Home · ABOUT THIS JOURNAL · Advanced Search · Current Issue · Archives · Journal Home > Vol 8, No 1 (2012) >. Log in or Register to get access to full text downloads.

  16. Association between incision technique for hamstring tendon harvest in anterior cruciate ligament reconstruction and the risk of injury to the infra-patellar branch of the saphenous nerve: a meta-analysis. (United States)

    Grassi, Alberto; Perdisa, Francesco; Samuelsson, Kristian; Svantesson, Eleonor; Romagnoli, Matteo; Raggi, Federico; Gaziano, Teide; Mosca, Massimiliano; Ayeni, Olufemi; Zaffagnini, Stefano


    To determine how the incision technique for hamstring tendon (HT) harvest in anterior cruciate ligament (ACL) reconstruction affects the risk of injury to the IPBSN and clinical outcome. A systematic literature search of the MEDLINE/Pubmed, Cochrane Central Register of Controlled Trials (CENTRAL) and EBSCOhost electronic databases and for unpublished studies was performed to identify comparative studies investigating injury to the IPBSN after HT ACL reconstruction by comparing at least two different incision techniques. Data were extracted for the number of patients with evidence of any neurologic deficit corresponding to injury to the IPBSN, area of sensory deficit, the Lysholm score and patient satisfaction. The mean difference (MD) in study outcome between incision groups was assessed. The relative risk (RR) and the number needed to treat (NNT) were calculated. The Chi-square and Higgins' I 2 tests were applied to test heterogeneity. Data were pooled using a Mantel-Haenszel random-effects model if the statistical heterogeneity was > 50% and a fixed-effects model if the statistical heterogeneity was < 50%. The risk of bias was evaluated according to the Cochrane Database questionnaire and the quality of evidence was graded according to the Grading of Recommendations Assessment, Development and Evaluation (GRADE) guidelines. A total of eight studies (three randomized controlled trials (RCTs) and five comparative studies) were included, of which six compared vertical and oblique incisions, one horizontal and vertical incisions, and one compared all three techniques. HT harvest was performed through a vertical incision in 329 patients, through an oblique incision in 195 patients and through a horizontal incision in 151 patients. Considering the meta-analysis of the RCTs, the performance of a vertical incision significantly increased the risk of causing IPBSN deficiency compared with both oblique and horizontal incision [RR 1.65 (CI 1

  17. [Vascularization of the wall of the superficial veins. Anatomic study of the vasa vasorum]. (United States)

    Lefebvre, D; Lescalie, F


    The blood vessel wall is almost always nourished by two ways; from the blood stream itself and through the outer part of the wall by vasa vasorum. The aim of this study was to demonstrate that this kind of nutrition is also available for the venous wall and to define the distribution pattern in superficial venous walls. 50 long saphenous veins and 20 short saphenous veins latex or barium injections, dissections with magnifying glasses and microradiographies. Topographical evaluation of the origin of vasa vasorum. The results showed that vasa vasorum originated from perforating arteries coming from several levels and getting a lot of anastomosis. We showed that the main sources for the long saphenous vein are the external pudendal artery and descending artery of the knee and for the short saphenous vein, the short saphenous vein artery. In thrombosis and varicose veins, the vasa were strongly altered. This study outlines the fact that superficial veins are supplied by arterial and venous vasa vasorum, and the role of vasa vasorum must be considered when questioning the pathogenesis of varicose and post thrombotic disease.

  18. Lymphoscintigraphic changes after harvesting of the saphenous vein for coronary artery bypass graft Alterações linfocintilográficas após retirada da veia safena para ponte da artéria coronária

    Directory of Open Access Journals (Sweden)

    Cleusa Ema Quilici Belczak


    Full Text Available Bridged incisions do not eliminate lesions to the lymphatic vessels and so the identification of risk factors associated to lymphatic lesions is important.Incisões-ponte não eliminam a lesão de vasos linfáticos e assim a identificação de fatores de risco associados às lesões linfática é importante.

  19. Factors Associated with Recurrence of Varicose Veins after Thermal Ablation: Results of The Recurrent Veins after Thermal Ablation Study

    Directory of Open Access Journals (Sweden)

    R. G. Bush


    Full Text Available Background. The goal of this retrospective cohort study (REVATA was to determine the site, source, and contributory factors of varicose vein recurrence after radiofrequency (RF and laser ablation. Methods. Seven centers enrolled patients into the study over a 1-year period. All patients underwent previous thermal ablation of the great saphenous vein (GSV, small saphenous vein (SSV, or anterior accessory great saphenous vein (AAGSV. From a specific designed study tool, the etiology of recurrence was identified. Results. 2,380 patients were evaluated during this time frame. A total of 164 patients had varicose vein recurrence at a median of 3 years. GSV ablation was the initial treatment in 159 patients (RF: 33, laser: 126, 52 of these patients had either SSV or AAGSV ablation concurrently. Total or partial GSV recanalization occurred in 47 patients. New AAGSV reflux occurred in 40 patients, and new SSV reflux occurred in 24 patients. Perforator pathology was present in 64% of patients. Conclusion. Recurrence of varicose veins occurred at a median of 3 years after procedure. The four most important factors associated with recurrent veins included perforating veins, recanalized GSV, new AAGSV reflux, and new SSV reflux in decreasing frequency. Patients who underwent RF treatment had a statistically higher rate of recanalization than those treated with laser.

  20. Antioxidative mechanism in the course of varicose veins. (United States)

    Horecka, Anna; Biernacka, Jadwiga; Hordyjewska, Anna; Dąbrowski, Wojciech; Terlecki, Piotr; Zubilewicz, Tomasz; Musik, Irena; Kurzepa, Jacek


    Objective Our objective was to evaluate the state of oxidative stress in the great saphenous varicose vein wall and blood of varicose vein patients taken from the antecubital vein. Methods The superoxide dismutase, reduced glutathione (GSH) and total antioxidant status were measured with commercially available colorimetric kits in erythrocytes, plasma and varicose vein wall of 65 patients (second degree of clinical state classification, etiology, anatomy and pathophysiology) aged 22-70 (49 women, 16 men) in comparison to normal great saphenous vein walls collected from 10 patients who underwent coronary artery bypass graft and blood collected from 20 healthy individuals. Results A statistically significant decrease (p < 0.001) in superoxide dismutase activity in erythrocytes and the increase (p < 0.05) in superoxide dismutase activity in varicose vein has been observed. There have been no significant changes in the concentration of GSH in plasma and in varicose vein. The decreased concentration of total antioxidant status in plasma (p < 0.001) and in varicose vein wall (p < 0.05) in comparison to the control has been noticed. Conclusion The varicose vein patients are affected by oxidative stress. Our results indicate impaired antioxidant defense mechanism in the blood of varicose vein patients. In contrast to the blood, an increased process of antioxidant defense in the varicose vein wall was noticed.

  1. Conservative hemodynamic surgery for varicose veins. (United States)

    Criado, Enrique; Luján, Salvador; Izquierdo, Luis; Puras, Enrique; Gutierrez, Miguel; Fontcuberta, Juan


    Conservative hemodynamic surgery for varicose veins is a minimally invasive, nonablative technique that preserves the saphenous vein and helps avoid excision of varicosities. It represents a physiologic approach to the surgical treatment of varicose veins based on knowledge of the underlying venous pathophysiology gained through detailed duplex scanning. A change in venous hemodynamics is attained through fragmentation of the blood column by interruption of the refluxing saphenous trunks, closure of the origin of the refluxing varicose branches, and preservation of the communicating veins that drain the incompetent varicose veins into the deep venous system. After surgery, varicose veins regress through a reduction in hydrostatic pressure and efficient emptying of the superficial system by the musculo-venous pump. Obvious advantages of this technique are that it is done in an ambulatory setting, minimizes the risk of surgical complications, and permits a rapid return to full activity. The long-term hemodynamic improvement and recurrence rate of this technique remain to be established. Copyright 2002 by W.B. Saunders Company

  2. Comparative study of traditional long incision vein harvesting and multiple incisions with small skin bridges in patients with coronary artery bypass grafting at King Abdullah University Hospital - Jordan Estudo comparativo entre a exérese da veia safena tradicional por incisão contínua e incisões múltiplas com pequenos "patchs" de pele em pacientes submetidos à revascularização do miocárdio no Hospital Universitário King Abdullah - Jordânia

    Directory of Open Access Journals (Sweden)

    Emad Mohamed Hijazi


    Full Text Available OBJECTIVE: Saphenous vein harvesting can be associated with wound complications, incision pain, infection, and poor cosmetic outcome. The objective of our study is to determine the difference in wound complication and infection rates between two saphenous vein harvesting techniques, long incision versus multiple short interrupted incisions (tunneling for coronary artery bypass grafting at the King Abdullah University Hospital - Jordan. METHODS: Retrospectively we analyzed data from 1,050 consecutive elective coronary artery bypass procedures performed from May 5, 2003, to December 31, 2007, in our institution. Saphenectomy using traditional Long incision vein harvesting (Group 1 performed in six hundred and fifty patients (n=650, while saphenectomy using multiple incisions with small skin bridges - tunneling (Group 2 performed in four hundred patients (n=400. Saphenectomy performed by the cardiac surgery assistant or main cardiac surgeon. Inflammation, dehiscence, cellulites, lymphangitis, drainage, necrosis, or abscess necessitating dressing, antibiotics or debridement before complete healing without eschar were defined as wound complications. There was no statistical difference in preoperative risk factors in both groups. Test results were considered significant when POBJETIVO: A exérese da veia safena pode estar associada a complicações da ferida, dor da incisão, infecção e resultado cosmético ruim. O objetivo deste estudo é determinar a diferença de complicações da ferida e as taxas de infecção entre as duas técnicas de exérese de veia safena, incisão longa versus múltiplas incisões curtas separadas (tunneling para a revascularização do miocárdio no Hospital Universitário King Abdullah, Jordânia. MÉTODOS: Analisamos, retrospectivamente, os dados de 1.050 procedimentos eletivos consecutivos de revascularização do miocárdio realizados no período de 5 de maio de 2003 a 31 de dezembro de 2007, em nossa institui

  3. Anatomical and clinical factors favoring the performance of saphenous ablation and microphlebectomy or sclerotherapy as a single-stage procedure. (United States)

    Kokkosis, A A; Schanzer, H


    To identify the anatomical and clinical parameters that predict lack of regression of superficial varicosities after ablation of the great saphenous vein. Symptomatic patients treated with endovenous ablation from August 2006 to July 2013, by a single surgeon, were included. Recorded parameters included age, sex, size, and extent of varicosities (class I-IV) (patient standing), and diameter and length (patient supine) of treated great saphenous vein. Varicose vein classification was defined as: class I ≤6 mm and localized to thigh or leg, class II ≤6 mm and present in the thigh and leg (extensive), class III >6 mm and localized to the thigh or leg, and class IV >6 mm and extensive. "Excellent" results were defined as complete resolution of varicosities, "good" results as incomplete resolution, and "poor" results as no improvement. A total of 267 patients and 302 consecutive limbs were included in the study. There were 175 females (65.5%), and the mean age was 54 years old (22-92). The CEAP classification was as follows: C2 (81.5%), C3 (6.3%), C4 (7.9%), C5 (2.0%), and C6 (2.3%). Great saphenous vein diameters was significantly larger in patients with C3-C6 (proximal 0.84 ± 0.25 versus 0.65 ± 0.21, p = class III-IV varicose veins (proximal 0.85 ± 0.25 versus 0.75 ± 0.27, p = 0.012, distal 0.62 ± 0.62 versus 0.50 ± 0.17, p Class III-IV limbs had a "good/poor" result 69.8% of the time, as compared to 51.9% of the limbs class I-II varicose veins (p = 0.002). Advanced chronic venous disease (C3-C6) patients have larger diameter great saphenous veins, reflecting the progressive nature of the disease. Patients with more severe varicosities regardless of CEAP class were more likely to require a secondary procedure. The severity of the varicosities may not correlate with the degree of venous disease, but it is an indication of which patients should undergo secondary procedures, possibly with a one-stage approach.

  4. Efficacy of varicose vein surgery with preservation of the great safenous vein. (United States)

    Barros, Bernardo Cunha Senra; Araujo, Antonio Luiz de; Magalhães, Carlos Eduardo Virgini; Barros, Raimundo Luiz Senra; Fiorelli, Stenio Karlos Alvim; Gatts, Raphaella Ferreira


    To evaluate the efficacy of surgical treatment of varicose veins with preservation of the great saphenous vein. We conducted a prospective study of 15 female patients between 25 and 55 years of age with clinical, etiologic, anatomic and pathophysiologic (CEAP) classification 2, 3 and 4. The patients underwent surgical treatment of primary varicose veins with great saphenous vein (GSV) preservation. Doppler ultrasonography exams were carried out in the first and third months postoperatively. The form of clinical severity of venous disease, Venous Clinical Severity Score (VCSS) was completed before and after surgery. We excluded patients with history of deep vein thrombosis, smoking or postoperatively use of elastic stockings or phlebotonics. All patients had improved VCSS (p caliber, as well as with preoperative CEAP. There was improvement in CEAP class in nine patients when compared with the preoperative period (p caliber, and to the symptoms when the vein had maximum caliber of 7.5 mm, correlating directly with the CEAP. The decrease in GSV caliber, even without complete abolition of reflux, leads to clinical improvement by decreasing the reflux volume.

  5. Evaluation of apoptosis in varicose vein disease complicated by superficial vein thrombosis. (United States)

    Filis, Konstantinos; Kavantzas, Nikolaos; Dalainas, Ilias; Galyfos, George; Karanikola, Evridiki; Toutouzas, Konstantinos; Tsioufis, Constantinos; Sigala, Fragiska


    The factors contributing to superficial vein thrombosis (SVT) in patients with varicose vein disease are unclear. Differences in vein wall apoptotic activity could be associated with the pathogenesis of SVT. The aim of the study is to address the role of the programmed cell death in the vein wall by comparing varicose veins with history of SVT to uncomplicated varicose veins. Vein segments from the proximal part of the great saphenous vein (GSV), the distal part of the vein and from a varicose tributary, from 16 patients with varicose vein disease and one episode of SVT, were evaluated for the immunohistochemical expression of pro-apoptotic (Bax, p53, Caspase 3, BCL-6, BCL-xs), anti-apoptotic (BCL-xl and BCL-2) and proliferation (Ki-67) markers. The results of this study were compared to the results from the evaluation of 19 patients suffering from uncomplicated varicose vein disease and 10 healthy GSVs as controls. Overall, there was increased apoptosis in the distal part of GSV compared to the proximal part documented by increased expression of Bax (p SVT showed significant differences among the three different anatomic locations. In the proximal GSV, only BCL-xs was higher in patients with SVT (p = 0.029). In the tributaries, Bax, BCL-xl and Ki-67 were higher in patients with SVT (p SVT shows increased pro-apoptotic activity compared to uncomplicated disease and normal veins. Whether increased vein wall cell apoptosis is a causative factor for SVT in varicose veins disease or a repairing mechanism of the thrombosis itself needs further research.

  6. Interposition vein graft for giant coronary aneurysm repair (United States)

    Firstenberg, M. S.; Azoury, F.; Lytle, B. W.; Thomas, J. D.


    Coronary aneurysms in adults are rare. Surgical treatment is often concomitant to treating obstructing coronary lesions. However, the ideal treatment strategy is poorly defined. We present a case of successful treatment of a large coronary artery aneurysm with a reverse saphenous interposition vein graft. This modality offers important benefits over other current surgical and percutaneous techniques and should be considered as an option for patients requiring treatment for coronary aneurysms.

  7. [Measurement of oxygen tension in normal and varicose vein walls]. (United States)

    Taccoen, A; Lebard, C; Borie, H; Poullain, J C; Zuccarelli, F; Gerentes, I; Stern, S; Guichard, M


    Oxygen tension (PO2) was investigated in vivo in the long saphenous vein from 21 varicose patients (31 veins) during venous surgery and 7 patients with normal venous network undergoing popliteo-femoral by-pass. Measurement was achieved using computerized polarographic system Kimoc 6650 (Eppendorf, Hamburg) providing a microdriven stepwise progression of a needle probe. Oxygen tension profile was similar in both groups of patients. A slow PO2 decrease was observed from adventitia up to the union of the middle and inner thirds of the media where values were at the lowest then followed by a marked increased in the intima and the saphenous lumen. Oxygenation of the two external thirds of the venous wall was provided by vasa vasorum. The average minimum values in the media was significantly reduced in varicose veins compared to no-varicose veins (7,9 mmHg versus 13,4 mmHg; p vein nutrition and suggest a primary or secondary deficiency in oxygen supply in varicose veins.

  8. Cyclic nucleotides and production of prostanoids in human varicose veins. (United States)

    Nemcova, S; Gloviczki, P; Rud, K S; Miller, V M


    Experiments were designed to determine the production of prostacyclin and thromboxane and the activation of cyclic nucleotides in human varicose and nonvaricose veins and to determine whether these second messenger pathways were differentially activated by the venotropic extract of Ruscus aculeatus. The experiments were designed to characterize the activity of cyclic nucleotides and the production of prostaglandins in human varicose and nonvaricose veins. Segments of the greater saphenous veins and the adjacent tributaries were obtained from patients who underwent vein stripping and excision of primary varicose veins. The saphenous veins from the patients who underwent peripheral arterial bypass grafting were used as controls. The segments of veins were incubated in Krebs-Ringer bicarbonate solution in the presence of venotropic extract of Ruscus aculeatus (10(-3) g/mL) or in water-miscible organic solvent (dimethyl sulfoxide, 10(-3) g/mL), for 1, 5, and 10 minutes at 37 degrees C. The nonspecific phosphodiesterase inhibitor (3-isobutyl-1-methylxanthine, 10(-4) g/mL) was used to block cyclic nucleotide degradation in some samples. Tissue and media samples were collected. Tissue concentrations of both cyclic adenosine monophosphate and cyclic guanosine monophosphate (cAMP and cGMP, respectively) and media concentrations of 6-ketoprostaglandin-F(1)(alpha) (the stable metabolite of prostacyclin) and thromboxane B(2) (the stable metabolite of thromboxane A(2)) were measured by means of radioimmunoassay. Cyclooxygenase 2 was measured with Western blot analysis. The varicose veins showed greater levels of cAMP but not of cGMP at all time points as compared with the control veins. Prostanoid production was not significantly altered in the varicose veins. Stimulation with Ruscus aculeatus increased the cAMP concentration in the varicose veins but did not affect the cGMP levels. The ratio between 6-ketoprostaglandin-F(1)(alpha) and thromboxane B(2) was two-fold greater in

  9. Management Strategy for Patients With Chronic Subclavian Vein Thrombosis. (United States)

    Keir, Graham; Marshall, M Blair


    We performed a systematic review to determine best practice for the management of patients with chronic or subacute subclavian vein thrombosis. This condition is best managed with surgical excision of the first rib followed by long-term anticoagulation. Interventional techniques aimed at restoring patency are ineffective beyond 2 weeks postthrombosis. Additional therapeutic options should be made based on the severity of symptoms as well as vein status. Patients with milder symptoms are given decompression surgery followed by anticoagulation whereas patients with more severe symptoms are considered for either a jugular vein transposition or saphenous patch based on the vein characteristics. Copyright © 2017 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.

  10. Implementation of Endovenous Laser Ablation for Varicose Veins in a Large Community Hospital : The First 400 Procedures

    NARCIS (Netherlands)

    van den Bremer, J.; Joosten, P. Ph. A. Hedeman; Hamming, J. F.; Moll, F. L.

    Endovenous Laser ablation (ELA) has become a standard treatment of the incompetent great saphenous vein (GSV). Our prospective audit examines the implementation of this new method in a large community hospital with special attention to obstacles, technical results, pain scores, failures and our

  11. Prevention of vein graft intimal hyperplasia with photochemical tissue passivation. (United States)

    Salinas, Harry M; Khan, Saiqa I; McCormack, Michael C; Fernandes, Justin R; Gfrerer, Lisa; Watkins, Michael T; Redmond, Robert W; Austen, William G


    Saphenous vein is the conduit of choice for bypass grafting. Saphenous vein grafts have poor long-term patency rates because of intimal hyperplasia (IH) and subsequent accelerated atherosclerosis. One of the primary triggers of IH is endothelial injury resulting from excessive dilation of the vein after exposure to arterial pressures. Photochemical tissue passivation (PTP) is a technology that cross-links adventitial collagen by a light-activated process, which limits dilation by improving vessel compliance. The objective of this study was to investigate whether PTP limits the development of IH in a rodent venous interposition graft model. PTP is accomplished by coating venous adventitia with a photosensitizing dye and exposing it to light. To assess the degree of collagen cross-linking after PTP treatment, a biodegradation assay was performed. Venous interposition grafts were placed in the femoral artery of Sprague-Dawley rats. Rats were euthanized after 4 weeks, and intimal thickness was measured histologically. Vein dilation at the time of the initial procedure was also measured. Time to digestion was 63 ± 7 minutes for controls, 101 ± 2.4 minutes for rose bengal (RB), and 300 ± 0 minutes for PTP (P collagen cross-linking, decreased vessel compliance, and significant reduction in IH. Copyright © 2015 Society for Vascular Surgery. Published by Elsevier Inc. All rights reserved.

  12. Varicose vein - noninvasive treatment (United States)

    Sclerotherapy; Laser therapy - varicose veins; Radiofrequency vein ablation; Endovenous thermal ablation; Ambulatory phlebectomy; Transilluminated power phlebotomy; Endovenous laser ablation; Varicose vein ...

  13. Endovenous ablation of incompetent perforating veins is effective treatment for recalcitrant venous ulcers. (United States)

    Lawrence, Peter F; Alktaifi, Ali; Rigberg, David; DeRubertis, Brian; Gelabert, Hugh; Jimenez, Juan Carlos


    Endovenous closure of incompetent saphenous veins has been reported to facilitate venous ulcer healing; however, there is little information about the effectiveness of perforator ablation (PA) in healing recalcitrant venous ulcers. We report our experience with PA with venous ulcers unresponsive to prolonged compression therapy. Patients with nonhealing venous ulcers of >3 months' duration underwent duplex ultrasound to assess their lower extremity venous system for incompetence of superficial, perforating, and deep veins. Patients who had either no saphenous incompetence or persistent ulcers after saphenous ablation underwent PA of incompetent perforating veins >3 mm that demonstrated reflux; initial treatment was performed on the perforator vein adjacent to the ulcer with additional incompetent veins treated if ulcer healing failed. Seventy-five ulcers with 86 associated incompetent perforating veins were treated with PA in 45 patients with CEAP 6 recalcitrant venous ulcers. Treated incompetent perforator veins were located in the medial ankle (61%), calf (37%), and lateral ankle (2%). Initial success of PA, assessed by postprocedure duplex ultrasound, was 58%; repeat ablation was 90% successful and 71% had eventual successful perforator closure. No complications (skin necrosis, infection, or nerve injury) occurred. Failure of ulcer healing with successful perforator closure occurred in 10% and was due to intercurrent illness, patient noncompliance, and patient death due to unrelated causes. Of patients who healed their ulcers, the healing occurred at a mean of 138 days; an average PA of 1.5 incompetent veins per ulcer was required for healing. Ninety percent of ulcers healed when at least one perforator was closed; no ulcer healed without at least one perforator being closed. This experience demonstrates both the feasibility and effectiveness of PA for a selected group of patients with venous ulcers who fail conventional therapy with compression. Copyright

  14. Extracellular matrix remodelling in response to venous hypertension: proteomics of human varicose veins. (United States)

    Barallobre-Barreiro, Javier; Oklu, Rahmi; Lynch, Marc; Fava, Marika; Baig, Ferheen; Yin, Xiaoke; Barwari, Temo; Potier, David N; Albadawi, Hassan; Jahangiri, Marjan; Porter, Karen E; Watkins, Michael T; Misra, Sanjay; Stoughton, Julianne; Mayr, Manuel


    Extracellular matrix remodelling has been implicated in a number of vascular conditions, including venous hypertension and varicose veins. However, to date, no systematic analysis of matrix remodelling in human veins has been performed. To understand the consequences of venous hypertension, normal and varicose veins were evaluated using proteomics approaches targeting the extracellular matrix. Varicose saphenous veins removed during phlebectomy and normal saphenous veins obtained during coronary artery bypass surgery were collected for proteomics analysis. Extracellular matrix proteins were enriched from venous tissues. The proteomics analysis revealed the presence of >150 extracellular matrix proteins, of which 48 had not been previously detected in venous tissue. Extracellular matrix remodelling in varicose veins was characterized by a loss of aggrecan and several small leucine-rich proteoglycans and a compensatory increase in collagen I and laminins. Gene expression analysis of the same tissues suggested that the remodelling process associated with venous hypertension predominantly occurs at the protein rather than the transcript level. The loss of aggrecan in varicose veins was paralleled by a reduced expression of aggrecanases. Chymase and tryptase β1 were among the up-regulated proteases. The effect of these serine proteases on the venous extracellular matrix was further explored by incubating normal saphenous veins with recombinant enzymes. Proteomics analysis revealed extensive extracellular matrix degradation after digestion with tryptase β1. In comparison, chymase was less potent and degraded predominantly basement membrane-associated proteins. The present proteomics study provides unprecedented insights into the expression and degradation of structural and regulatory components of the vascular extracellular matrix in varicosis. © The Author 2016. Published by Oxford University Press on behalf of the European Society of Cardiology.

  15. Endovascular radiofrequency ablation. Effect on the vein diameter using the ClosureFast(®) catheter. (United States)

    Bauzá Moreno, Hernán; Dotta, Mariana; Katsini, Roxana; Marquez Fosser, Carolina; Rochet, Sofía; Pared, Carlos; Martinez, Hugo


    Endovascular radiofrequency with first generation catheters was not successful due to its technical difficulty and restrictions in veins with diameters larger than 12mm. However, using the new catheter there is not enough scientific evidence to affirm that the diameter represents a technical limitation. The aim of this study was to evaluate and compare pre and post-operative venous trunks diameter, aiming at the reduction of size after 6 months with last generation catheters. Retrospective observational and descriptive study on a cohort of patients with insufficiency of the great saphenous vein, small saphenous vein and anterior accessory vein operated on with last generation radiofrequency catheters. The diameters were evaluated in the pre and post-operative period with ultrasound. Between 2007 and 2014 a total of 365 ablations were performed in veins with an average diameter of 9±3.1mm showing a reduction of it after 6 months with a mean value of 5.2±0.8mm (P<.0001). Total occlusion was also observed in 100% of cases and complications such as deep vein thrombosis in 0.5% and heat-induced thrombosis in 1.1%. A significant reduction in venous diameter after endovascular treatment with the new ClosureFast(®) catheters was checked, even in veins with diameters greater than 12mm. Copyright © 2016 AEC. Publicado por Elsevier España, S.L.U. All rights reserved.

  16. Evidence for varicose vein surgery in venous leg ulceration. (United States)

    Kheirelseid, Elrasheid A H; Bashar, Khalid; Aherne, Thomas; Babiker, Thamir; Naughton, Peter; Moneley, Daragh; Walsh, Stewart R; Leahy, Austin L


    Venous leg ulcers affect 1-3% of adults with a significant economic impact, utilizing 1% of annual healthcare budgets in some western European countries. To determine the effects of intervention for incompetent superficial veins on ulcer healing and recurrence in patients with active or healed venous ulcers. In October 2014, we searched Medline, CINAHL, EMBASE, Scopus, the Cochrane library and Web of Science without date or language restriction for relevant randomized or observational studies. Bibliographies of included studies were also searched for additional studies. Observational studies or randomized controlled trials comparing intervention for varicose veins with compression therapy alone for venous leg ulcers were eligible. In addition, studies compared open to endovenous therapy for varicose veins in patients with leg ulcers and those compared treating saphenous and perforating veins to treating saphenous veins only were also included. Studies had to report at least one ulcer-related outcome (healing rate, recurrence or time to healing). Details of potentially eligible studies were extracted and summarized using a data extraction table. Data extraction and quality assessment were performed independently by two review authors, and any disagreements resolved by consensus or by arbitration of a third author. Intervention for superficial venous reflux improved ulcer healing (risk ratio = 1.11 [1.00, 1.22], 95% CI, p = 0.04) and reduced recurrence (risk ratio = 0.48 [0.32, 0.67], 95% CI, p venous leg ulcer is at beast weak. A well-structured RCT is required to investigate the role of endovenous ablation of incompetent superficial veins in improving venous leg ulcer outcomes. Copyright © 2016 Royal College of Surgeons of Edinburgh (Scottish charity number SC005317) and Royal College of Surgeons in Ireland. Published by Elsevier Ltd. All rights reserved.

  17. Successful Coronary Stent Retrieval from the Saphenous Vein Graft to Right Coronary Artery

    Directory of Open Access Journals (Sweden)

    Mustafa Aydin


    Full Text Available Stent dislodgement and migration is a rare but serious complication of stent usage. For extraction of unexpanded stents different techniques have been described previously. We describe a case which used small baloon catheter for retrieval of a stent from the SVG-RCA.

  18. miRNA-21 is dysregulated in response to vein grafting in multiple models and genetic ablation in mice attenuates neointima formation

    NARCIS (Netherlands)

    McDonald, Robert A; White, Katie M; Wu, Junxi; Cooley, Brian C; Robertson, Keith E; Halliday, Crawford A; McClure, John D; Francis, Sheila; Lu, Ruifaug; Kennedy, Simon; George, Sarah J; Wan, Song; van Rooij, Eva; Baker, Andrew H

    AIMS: The long-term failure of autologous saphenous vein bypass grafts due to neointimal thickening is a major clinical burden. Identifying novel strategies to prevent neointimal thickening is important. Thus, this study aimed to identify microRNAs (miRNAs) that are dysregulated during neointimal

  19. Classical varicose vein surgery in a diverse ethnic community. (United States)

    Murli, N L; Navin, I D


    Chronic venous disorders range from telangiactasia or spider veins to varicose veins, venous swellings, skin changes and venous ulcerations. The aim of this study is to assess outcome of varicose vein surgery in the ethnically diverse population of Penang, Malaysia. This study is a retrospective analysis of patients seen from 1999 to 2004. All patients who presented to the outpatient clinic of our surgical department with saphenofemoral junction (SFJ) and/or saphenopopliteal junction (SPJ) reflux associated with incompetence of the great saphenous vein (GSV) or small saphenous vein (SSV) respectively underwent classical varicose varicose vein surgery. A single surgeon at a single institution performed the surgeries. Data from pre-operative, post-operative and follow-up procedures were recorded in case report forms. A total of 202 cases were treated. Of these, 200 were qualified by the inclusion criteria and follow-ups, with 23 who were treated bilaterally. Of those treated, Chinese comprised 47.5%, Indians 27.0%, Malays 12.5% and foreigners 13.0% (largely Indonesian Chinese, British and Americans). The average age was 52.1 years. Indians had the highest average BMI of 29.2, compared to the Chinese who had the lowest of 24.6. Based on occupation, housewives (43.0%), blue collar workers (19.0%), salespersons (12.0%) and factory workers (9.5%) were among those afflicted with varicose veins. While local Chinese predominated in the business groups (salespersons and food-related workers), the Indians and Malays in this study were mainly factory workers and/or blue collar workers. Symptomatology in descending order of severity included pain in 80.0% of cases, swelling in 65.5%, heaviness in 53.5%, cramps in 53.0%, lipodermatosclerosis in 39.0%, superficial thrombophlebitis in 33.5%, venous ulceration in 32.0%, eczema 22.0% and cellulitis in 12.5% of patients. Post surgery pains dropped to 9.9%, cramps 6.4%, heaviness 5.5% and swelling 5.3% (p<0.0001 in all groups

  20. Phenazines and natural products; Novel synthesis of saphenic acid

    DEFF Research Database (Denmark)

    Petersen, Lars; Jensen, Knud Jørgen; Nielsen, John


    The natural product saphenic acid (6-(1-hydroxyethyl)1-phenazinecarboxylic acid) was synthesized from readily accessible starting materials. The desired product was obtained in an overall yield of 22% for four steps with the key steps being formation of a diphenylamine, followed by cyclization un...... under alkaline and reducing conditions. Assignments of H-1 NMR spectra were achieved by homo- and heteronuclear 1D and 2D correlations. Double pulsed field gradient spin-echo one-dimensional NOESY proved especially valuable for assignment of aromatic protons....

  1. Phenazines and natural products; novel synthesis of saphenic acid

    DEFF Research Database (Denmark)

    Petersen, Lars; Jensen, Knud J.; Nielsen, John


    The natural product saphenic acid (6-(1-hydroxyethyl)1- phenazinecarboxylic acid) was synthesized from readily accessible starting materials. The desired product was obtained in an overall yield of 22% for four steps with the key steps being formation of a diphenylamine, followed by cyclization u...... under alkaline and reducing conditions. Assignments of 1H NMR spectra were achieved by homo- and heteronuclear 1D and 2D correlations. Double pulsed field gradient spin-echo one-dimensional NOESY proved especially valuable for assignment of aromatic protons....

  2. Development of endothelium-denuded human umbilical veins as living scaffolds for tissue-engineered small-calibre vascular grafts. (United States)

    Hoenicka, Markus; Schrammel, Siegfried; Bursa, Jiri; Huber, Georgine; Bronger, Holger; Schmid, Christof; Birnbaum, Dietrich E


    Tissue-engineered small-calibre vessel grafts may help to alleviate the lack of graft material for coronary and peripheral bypass grafting in an increasing number of patients. This study explored the use of endothelium-denuded human umbilical veins (HUVs) as scaffolds for vascular tissue engineering in a perfusion bioreactor. Vessel diameter (1.2 ± 0.4 mm), wall thickness (0.38 ± 0.09 mm), uniaxial ultimate failure stress (8029 ± 1714 kPa) and burst pressure (48.4 ± 20.2 kPa, range 28.4-83.9 kPa) were determined in native samples. The effects of endothelium removal from HUVs by enzymatic digestion, hypotonic lysis and dehydration were assessed. Dehydration did not significantly affect contractile function, tetrazolium dye reduction, mechanical strength and vessel structure, whereas the other methods failed in at least one of these parameters. Denudation by dehydration retained laminin, fibronectin, collagen and elastic fibres. Denuded HUVs were seeded in a perfusion bioreactor with either allogeneic HUVs endothelial cells or with saphenous vein endothelial cells harvested from patients with coronary artery disease. Seeding in a perfusion bioreactor resulted in a confluent monolayer of endothelial cells from both sources, as judged by histology and scanning electron microscopy. Seeded cells contained von Willebrand factor and CD31. In conclusion, denuded HUVs should be considered an alternative to decellularized blood vessels, as the process keeps the smooth muscle layer intact and functional, retains proteins relevant for biomechanic properties and for cell attachment and provides a suitable scaffold for seeding an autologous and flow-resistant endothelium. Copyright © 2012 John Wiley & Sons, Ltd.

  3. The sapheno femoral junction involvement in the treatment of varicose veins disease

    Directory of Open Access Journals (Sweden)

    Stefano Ricci


    Full Text Available Sapheno femoral junction (SFJ incompetence has been considered the most important cause of chronic venous insufficiency in a high percent of cases since the beginning of history varicose veins treatment. As a consequence SFJ dissection, ligation and section has been practiced all along the last century, generally associated to great saphenous vein stripping, with the porpoise of stopping the effect of hydrostatic pressure considered the origin of varicose veins. Recurrence prevalence at the site of SFJ, even in correctly performed dissection suggests that this attitude may not be the ideal one. Moreover, with the introduction of catheter-based systems of endovenous heating of the great saphenous vein with radiofrequency or endovenous laser ablation, it was shown that venous ablation could be achieved without high ligation of the SFJ. Also foam sclerotherapy demonstrated good results, even if less effective, always leaving the SFJ untouched. Following this trend several methods have been suggested that spare the SFJ, so that this site have lost its strategical importance. In this review history of the SFJ involvement in the varicose vein strategy is analyzed with particular attention to the new generation methods, technology assisted, launched on the market.

  4. [Ultrasound imaging of bridge vessel transplant used to reconstruct the tributary of middle hepatic vein in living donor liver transplantation]. (United States)

    Lu, Qiang; Luo, Yan; Yuan, Chao-xin; Yan, Lü-nan; Wu, Hong; Zhang, Zhong-wei


    To discuss the application of color Doppler ultrasound in the imaging of bridge vein transplant used to reconstruct the tributary of the middle hepatic vein in adult living donor liver transplantation (LDLT). From December 2005 to July 2006, 25 patients underwent the adult living donor liver transplantation with right lobe grafts without middle hepatic vein. Tributaries of middle hepatic vein larger than 5 mm were reconstructed with great saphenous vein. Types and numbers of reconstructed tributaries of middle hepatic vein were listed below: single V5 (n=8), double V5 (n=2), the V5 and V8 (n=9), V8 (n=6). The successive investigation of the vein grafts was performed by color Doppler ultrasound in the period of from postoperative 7 days to 8 months. All vein transplants were detected by color Doppler ultrasound. Among them, 34 vein transplants of 24 cases undergoing adult LDLT appeared patent, but one case was suspected to have reconstructed finally the bypass vessels for blood circle regardless of the grafted bridge vein probably occurring the thrombosis. Color Doppler ultrasound can precisely detect and appear the postoperative bridge vessel grafted, and also measure the blood flow velocity in grafted vein used to reconstruct the tributaries of the middle hepatic vein in LDLT.

  5. Sclerotherapy and foam sclerotherapy for varicose veins. (United States)

    Coleridge Smith, P


    To review published evidence concerning treatment of varicose veins using ultrasound-guided foam sclerotherapy (UGFS) to assess the safety and efficacy of this treatment. Medical literature databases including MedLine, Embase and DH-DATA were searched for recent literature concerning UGFS. Papers describing the early results and later outcome have been assessed and their main findings were included in this summary. Few randomized studies have been published in this field and much of the available data come from clinical series reported by individual clinicians. It is clear that foam sclerotherapy is far more effective than liquid sclerotherapy and that ultrasound imaging allows the treatment to be delivered accurately to affected veins. There is evidence that 3% polidocanol foam is no more effective than 1% polidocanol foam. The optimum ratio of gas to liquid is 4:1, although a range of ratios is reported in the published work. There is a wide variation in the volume used as well as the method by which it is injected. The use of carbon dioxide foam reduces the systemic complications, particularly visual disturbance, as compared with air foams. Very few serious adverse events have been reported in the literature despite the widespread use of this method. Rates of recanalization of saphenous trunks following UGFS are similar to those observed after endovenous laser and endovenous RF ablation of veins, as well as the residual incompetence after surgical treatment. UGFS is a safe and effective method of treating varicose veins. The relative advantages or disadvantages of this treatment in the longer term have yet to be published.

  6. Minimally invasive posterior approach in the popliteal fossa for semitendinosus and gracilis tendon harvesting: an anatomic study. (United States)

    Roussignol, X; Bertiaux, S; Rahali, S; Potage, D; Duparc, F; Dujardin, F


    Harvesting the semitendinosus (ST) and gracilis (GR) tendons at the anteromedial side of the knee may be hampered by a conjoint tendon insertion on the tibial metaphysis and an accessory bundle between the ST and the medial gastrocnemius. Locating and sparing the terminal branches of the saphenous nerve are difficult on an anteromedial approach. The principal objective of the present anatomic study was to assess the feasibility of ST and GR harvesting from a minimally invasive posterior approach in the popliteal fossa. The secondary objective was to analyze the risk of saphenous nerve branch lesion during harvesting. Ten cadaver knees, free of scarring, were used. The whole body was positioned supine. The tendons were located in the popliteal fossa with the knee in 30° flexion. A mini-incision was performed in the fossa. The ST and GR tendons were located, and retrograde followed by anterograde stripping was performed. Tendon lengths and diameters were measured. The knees were then dissected to check for saphenous nerve branch lesions (anterior, infrapatellar and posterior branches). The GR and ST tendons were respectively located at 14.4 and 24 mm from the medial edge of the knee. In 90% of cases, there was an accessory ST bundle toward the medial gastrocnemius muscle, 26 mm below the posterior edge. Tendons could be harvested without deviation of the stripper. Knee dissection did not find any saphenous nerve branches, these being protected by the sartorius fascia. Posterior ST and GR tendon harvesting in the popliteal fossa is reliable and reproducible. It allows easy sectioning of the accessory ST bundle, without deviation during retrograde stripping. Unlike anterior harvesting, which leads to a rate of saphenous branch lesion of 50-78%, posterior harvesting protects the nerve branches by keeping away from the sartorius. Level 4. Copyright © 2015 Elsevier Masson SAS. All rights reserved.

  7. Isolated Subclavian Vein Injury: A Rare and High Mortality Case

    Directory of Open Access Journals (Sweden)

    Sahin Iscan


    Full Text Available Isolated subclavian vein injuries are rarely seen without concomitant arterial injury, bone fracture, damage to brachial plexus, and thoracal traumas. Our case was brought to the emergency service 6 hours after he had been shot at the shoulder with a firearm. After detection of extravasation from the left axillary and subclavian vein on arteriographic and venographic examinations, he was operated on. An autogenous saphenous vein graft was interposed between subclavian and axillary veins. Cardiac arrest developed twice because of hypovolemia, which was resolved with medical therapy. Subclavian vein injuries have a more mortal course when compared with the injuries to the subclavian arteries. Its most important reason is excessive blood loss and air embolism because of delayed arrival to hospital. As is the case in all vascular injuries, angiography is the most important diagnostic examination. If the general health state of the patient permits, arteriography and venography should be performed in patients potentially exposed to vascular injuries. In patients with extreme blood loss and deteriorated health state, direct surgical exploration of the injury site, containment of the bleeding, and venous repair are life-saving approaches.

  8. Reflux in foot veins is associated with venous toe and forefoot ulceration. (United States)

    van Bemmelen, Paul S; Spivack, Daniel; Kelly, Patrick


    To determine the prevalence of foot vein incompetence in a group of patients with chronic venous insufficiency and to assess the association of this, with venous ulceration located on the forefoot. A total of 20 consecutive patients (21 limbs) with active or healed venous ulceration was prospectively studied with duplex ultrasound of the superficial and plantar foot veins. In these, four extremities had venous ulceration involving the forefoot. Specifically, the superficial venous arch near the metatarsal heads, the foot portion of the great and small saphenous veins, the anterior arch veins on the foot dorsum, and the plantar veins were interrogated with a 12-MHz probe. Reflux was found in 32% of pedal vein segments in CEAP C5, C6 legs, with ulceration involving only the gaiter area (mean number of incompetent foot segments, 1.6 ± 1.2). Pedal reflux was present in 65% of foot vein segments when forefoot ulceration was present (mean number of incompetent foot segments, 3.3 ± 1.3). Student t-test for the difference in the mean number of incompetent foot vein segments was significant (P Venous ulceration can affect the forefoot and toe areas and is associated with reflux in the pedal vein segments. Copyright © 2011 Society for Vascular Surgery. Published by Mosby, Inc. All rights reserved.

  9. Portal Vein Thrombosis

    Directory of Open Access Journals (Sweden)

    Hakan Demirci


    Full Text Available Portal vein thrombosis is an important cause of presinusoidal portal hypertension. Portal vein thrombosis commonly occurs in patient with cirrhosis, malignancy and prothrombotic states. Patients with acute portal vein thrombosis have immediate onset. Patients with chronic portal vein thrombosis have developed portal hypertension and cavernous portal transformation. Portal vein thrombosis is diagnosed with doppler ultrasound, computed tomography and magnetic resonance imaging. Therapy with low molecular weight heparin achieves recanalization in more than half of acute cases.

  10. Endovenous Laser Ablation of Perforating Veins: Feasibility, Safety, and Occlusion Rate Using a 1,470-nm Laser and Bare-Tip Fiber. (United States)

    Chehab, Monzer; Dixit, Purushottam; Antypas, Elias; Juncaj, Mare; Wong, Oliver; Bischoff, Michael


    To describe technical feasibility and safety of perforating vein ablation with the use of a 1,470-nm laser and bare-tip fiber in the management of chronic venous insufficiency (CVI). A total of 171 perforating veins were ablated in 101 limbs of 87 patients (mean age, 54.4 y; 79% female). Outcomes included sonographic occlusion of ablated perforator, subjective changes of insufficiency symptoms, incidence of procedure-related side effects (pain, hyperpigmentation), and complications (burn, infection, deep vein thrombosis, paresthesia). Correlation between perforator closure and patient symptoms was assessed by Pearson χ(2) test. Factors influencing failure of perforator closure were analyzed by analysis of variance. Forty-nine perforating veins had previous great saphenous vein (GSV) interruption, 25 had previous small saphenous vein (SSV) interruption, 88 had previous GSV and SSV interruption, and 9 had competent saphenous systems. Ninety-one ablations were combined with microphlebectomy, 55 were combined with sclerotherapy, and 25 were performed alone. At 1 and 3 months' follow-up, 94% and 98% of ablated perforators were sonographically occluded, and 82% and 96% of patients noted complete symptom resolution, respectively. Complications included 5 cases of new-onset paresthesia and 1 case of nonocclusive deep vein thrombosis. Ablation failed in 10 perforators, and treatment failure showed significant correlations with higher clinical, etiology, anatomy, and physiology score (P = .002) and history of GSV/SSV interruption (P = .042). Three-month closure of perforating veins is achievable by using a 1,470-nm laser and bare-tip fiber and can be safely performed alone or in combination with microphlebectomy or sclerotherapy at all stages of CVI severity. Copyright © 2015 SIR. Published by Elsevier Inc. All rights reserved.

  11. Focus on Varicose Veins (United States)

    ... plethysmography. These diagnostic tests are non-invasive and painless. How are varicose veins treated? Varicose veins are ... and mid-term results. • RF treatment involves controlled delivery of radio- frequency (RF) energy directly to a ...

  12. Portal Vein Thrombosis

    Directory of Open Access Journals (Sweden)

    Ronny Cohen


    Full Text Available Portal vein thrombosis (PVT is the blockage or narrowing of the portal vein by a thrombus. It is relatively rare and has been linked with the presence of an underlying liver disease or prothrombotic disorders. We present a case of a young male who presented with vague abdominal symptoms for approximately one week. Imaging revealed the presence of multiple nonocclusive thrombi involving the right portal vein, the splenic vein, and the left renal vein, as well as complete occlusion of the left portal vein and the superior mesenteric vein. We discuss pathogenesis, clinical presentation, and management of both acute and chronic thrombosis. The presence of PVT should be considered as a clue for prothrombotic disorders, liver disease, and other local and general factors that must be carefully investigated. It is hoped that this case report will help increase awareness of the complexity associated with portal vein thrombosis among the medical community.

  13. What Are Varicose Veins? (United States)

    ... often they develop in people who have certain genetic disorders, viral infections, or other conditions, such as ... all people who have varicose veins have a family history of them. Older ... or blue veins in a web or tree branch pattern. Often, these veins appear on the ...

  14. Effect of temperature on the responsiveness of cutaneous veins to the extract of Ruscus aculeatus. (United States)

    Rubanyi, G; Marcelon, G; Vanhoutte, P M


    In canine cutaneous veins cooling augments and warming depresses the responses to sympathetic nerve stimulation. In these veins the extract of Ruscus aculeatus (Ruscus) causes contractions due to alpha-adrenergic activation. To determine the effects of temperature on the response to Ruscus, rings of canine saphenous veins were studied at 24 degrees, 37 degrees and 41 degrees C. At 37 degrees C, Ruscus caused an increase in isometric tension which was depressed by prazosin and rauwolscine. Cooling inhibited the response to Ruscus, while warming augmented it. Rauwolscine potentiated, and prazosin reversed the effect of cooling on contractions evoked by Ruscus. Prazosin reduced, and rauwolscine augmented the effect of warming. These experiments demonstrate that temperature affects the venoconstriction induced by Ruscus in an opposite fashion as that to sympathetic nerve activation, presumably because the alpha 1-adrenergic component of the response to Ruscus predominates.

  15. In vitro effect of calcium dobesilate on oxidative/inflammatory stress in human varicose veins. (United States)

    Alda, O; Valero, M S; Pereboom, D; Serrano, P; Azcona, J M; Garay, R P


    To determine whether calcium dobesilate can act in chronic venous insufficiency by similar antioxidant, anti-inflammatory mechanisms as in diabetic retinopathy. Calcium dobesilate was tested in vitro for its protective action against oxidative/inflammatory stress in human varicose veins. Varicose greater saphenous veins were obtained from 14 patients (11 men, 3 women) aged 53-65 years. Oxidative stress was induced exogenously in the vein segments, with the phenazine methosulphate (PMS)/NADH couple. Total antioxidant status (TAS) and malondialdehyde (MDA) contents were used as markers of oxidative stress. Calcium dobesilate significantly prevented oxidative disturbances in the micromolar range. PMS/NADH-dependent TAS decrease was fully prevented with IC(50) = 11.4 ± 2.3 µmol/L (n = 6 veins), whereas MDA increase was fully prevented with IC(50) = (102 ± -3) µmol/L (n = 6 veins). Calcium dobesilate acted quali- and quantitatively like rutin, the reference compound. Comparison with pharmacokinetic data suggests that calcium dobesilate can act at therapeutic concentrations. Calcium dobesilate protected human varicose veins against oxidative stress in vitro at levels that correspond to therapeutic concentrations. Further studies are required to investigate whether a similar action is found in varicose veins from patients orally treated with calcium dobesilate.

  16. Deep Vein Thrombosis

    African Journals Online (AJOL)


    CONCLUSION: Deep Venous Thrombosis is a common disease with fatal and serious long term burdensome complications. ... WAJM 2009; 28(2): 77–82. Keywords: Deep Vein Thrombosis, Venous Thrombosis,. Phlebothrombosis. ... phlebitic syndrome, ulcers and varicose veins. In surgical patients with malignant disease ...

  17. Comparison of infracondylar versus subsartorial approach to saphenous nerve block: A randomized controlled study

    Directory of Open Access Journals (Sweden)

    L Sahin


    Conclusion: Both of the different anatomical approaches have equally high success rates. Although the DSB was found to be significantly longer in the subsartorial approach, this is clinically unimportant, and the medial infracondylar approach is still a viable alternative technique during saphenous nerve blockage.

  18. Vein Problems Related to Varicose Veins (United States)

    ... Examples of these factors include family history, older age, gender, pregnancy, overweight or obesity , lack of movement, and leg trauma. Varicose veins are treated with lifestyle changes and medical procedures. The goals of treatment are to relieve symptoms, prevent complications, and improve ...

  19. Remodeling leads to distinctly more intimal hyperplasia in coronary than in infrainguinal vein grafts. (United States)

    Zilla, Peter; Moodley, Loven; Scherman, Jacques; Krynauw, Hugo; Kortsmit, Jeroen; Human, Paul; Wolf, Michael F; Franz, Thomas


    Flow patterns and shear forces in native coronary arteries are more protective against neointimal hyperplasia than those in femoral arteries. Yet, the caliber mismatch with their target arteries makes coronary artery bypass grafts more likely to encounter intimal hyperplasia than their infrainguinal counterparts due to the resultant slow flow velocity and decreased wall stress. To allow a site-specific, flow-related comparison of remodeling behavior, saphenous vein bypass grafts were simultaneously implanted in femoral and coronary positions. Saphenous vein grafts were concomitantly implanted as coronary and femoral bypass grafts using a senescent nonhuman primate model. Duplex ultrasound-based blood flow velocity profiles and vein graft and target artery dimensions were correlated with dimensional and histomorphologic graft remodeling in large, senescent Chacma baboons (n = 8; 28.1 ± 4.9 kg) during a 24-week period. At implantation, the cross-sectional quotient (Q(c)) between target arteries and vein grafts was 0.62 ± 0.10 for femoral grafts vs 0.17 ± 0.06 for coronary grafts, resulting in a dimensional graft-to-artery mismatch 3.6 times higher (P maximum flow velocity (P = .0048), 48.1% ± 23.6% lower maximal cycling wall shear stress (P = .012), and 62.2% ± 21.2% lower mean velocity (P = .007) in coronary grafts. After 24 weeks, the luminal diameter of all coronary grafts had contracted by 63%, from an inner diameter of 4.49 ± 0.60 to 1.68 ± 0.63 mm (P < .0001; subintimal diameter: -41.5%; P = .002), whereas 57% of the femoral interposition grafts had dilated by 31%, from 4.21 ± 0.25 to 5.53 ± 1.30 mm (P = .020). Neointimal tissue was 2.3 times thicker in coronary than in femoral grafts (561 ± 73 vs 240 ± 149 μm; P = .001). Overall, the luminal area of coronary grafts was an average of 4.1 times smaller than that of femoral grafts. Although coronary and infrainguinal bypass surgery uses saphenous veins as conduits, they undergo significantly different

  20. Alterations in serotonin receptor-induced contractility of bovine lateral saphenous vein in cattle grazing endophyte-infected tall fescue (United States)

    As part of a large 2-year study documenting the physiologic impact of grazing endophyte-infected tall fescue on growing cattle, 2 experiments were conducted to characterize and evaluate the effects of grazing 2 levels of toxic endophyte-infected tall fescue pastures on vascular contractility and ser...

  1. Application of radiofrequency ablation procedure on a morbidly obese patient with a venous ulcer and large saphenous vein. (United States)

    Yener, Ali Ümit; Yener, Özlem; Gedik, Hikmet Selçuk; Korkmaz, Kemal; Özkan, Turgut; Lafçi, Ayşe; Çağli, Kerim


    Venous ulcers that occur due to chronic venous insufficiency are seen on the upper medial malleol of the ankle. Treatment of venous ulcers is protracted and generally the success rate is low. Co-morbid factors play an important role in the success of treatment of venous ulcers. In this case report, we demonstrate successful venous ulcer treatment in a morbidly obese patient with co-morbid conditions.

  2. Contractile response of bovine lateral saphenous vein to ergotamine tartrate exposed to different concentrations of molecularly imprinted polymers (United States)

    Ergot alkaloids, in their active isomeric form, affect animal health and performance and adsorbents are used to mitigate toxicities by reducing bioavailability. Adsorbents with high specificity (molecularly imprinted: MIP and non-imprinted: NIP polymers) adsorb ergot alkaloids in vitro, but require ...

  3. Congenital preduodenal portal vein

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Sang Jin; Hwang, Mi Soo; Huh, Young Soo; Park, Bok Hwan [College of Medicine, Youngnam University, Gyeongsan (Korea, Republic of)


    Congenital preduodenal portal vein, first reported by Knight in 1921, is an extremely rare congenital anomaly in which the portal vein passes anteriorly to the duodenum rather than posteriorly in its normal location. It is of surgical significance because it may cause difficulties in operations involving the gall bladder, biliary duct, or duodenum. Recently, we experienced 2 cases of preduodenal portal vein. One was found during surgical exploration for the diagnosis and correction of malrotation of the bowels and the other in a 3 day-old male newborn associated with dextrocardia, situs inversus, and duodenal obstruction by diaphragm. We report these 2 cases with a review of the literature.

  4. An unusual case of symptomatic deep vein thrombosis and pulmonary embolism after arthroscopic meniscus surgery. (United States)

    Fang, Chao-Hua; Liu, Hua; Zhang, Jun-Hui; Yan, Shi-Gui


    Although thrombosis complication is rare after arthroscopic meniscus surgery, deep vein thrombosis and pulmonary embolism can be fatal. The associated risk factors and whether anticoagulant prevention after arthroscopic knee surgery is necessary have not reach consensus. Here we present a case of deep vein thrombosis and pulmonary embolism after a common arthroscopic meniscectomy. The patient had no risk factors except ipsilateral leg varicose veins. She present swell at knee and calf from postoperative 3 weeks, and developed dyspnea, palpitation, and nausea on 33th day, pulmonary embolism was confirmed with CT angiography at emergency department. After thrombolysis and anticoagulation therapy were administered, the patient improved well and discharged. And the intravenous ultrasound confirmed thrombosis of popliteal vein and small saphenous vein. Who don't have common risk factors for venous thromboembolism. Despite the low incidence of thromboembolic complications after simple arthroscopy surgery, its life-threatening and devastating property make clinicians rethink the necessity of thromboprophylaxis and importance of preoperative relative risk factors screening.

  5. What Are Varicose Veins? (United States)

    ... these factors include family history, older age, gender, pregnancy, overweight or obesity , lack of movement, and leg trauma. Varicose veins are treated with lifestyle changes and medical procedures. The goals of treatment ...

  6. Preventing Deep Vein Thrombosis (United States)

    ... methods that contain estrogen or hormone therapy for menopause symptoms Certain illnesses, including heart failure, inflammatory bowel disease, and some kidney disorders Obesity Smoking Varicose veins Having a tube in a ...

  7. Popliteal vein aneurysm. (United States)

    Falkowski, A; Poncyljusz, W; Zawierucha, D; Kuczmik, W


    The incidence of a popliteal vein aneurysm is extremely low. Two cases of this rare venous anomaly are described. The epidemiology, morphology, and diagnostic methods are discussed and the potentially dangerous complications and treatment methods are presented.

  8. Emergency autologous vein graft reconstruction after using a vascular closure device Reconstrução de emergência de enxerto autólogo de veia após uso de dispositivo de fechamento vascular

    Directory of Open Access Journals (Sweden)

    Giel G Koning


    Full Text Available An emergency operation for access related acute critical limb ischemia with signs of infection is described. Inguinal femoral reconstruction was performed with a bifurcated graft constructed from the ipsilateral saphenous vein.Uma operação de emergência relacionada à isquemia aguda com sinais de infecção é descrita. Reconstrução femoral inguinal foi realizada com um enxerto bifurcado feito a partir da veia safena ipsilateral.

  9. Medline Plus

    Full Text Available Heart bypass surgery begins with an incision made in the chest, with the breastbone cut exposing the heart. Next, a portion of the saphenous vein is harvested from the inside of the leg. Pieces of this ...

  10. Clinical course and effective treatment of varicose vein of lower limb in diabetic patients

    Directory of Open Access Journals (Sweden)

    Yu.O. Syniachenko


    Full Text Available Background. Type 2 diabetes mellitus (DM2 is a risk factor for arteriosclerosis of the lower extremities, and the relationship with the state of the feet venous vascular territory remains insufficiently studied, the effectiveness of surgical treatment of patients with varicose veins is not defined. Objective: to analyze the clinical course of foot varicose veins and the effectiveness of medical measures on the background of DM2. Materials and methods. The study included 302 patients (227 men and 75 women aged 29–72 years old, 16 % of which had previous phlebothrombosis and the prevalece of II, III, IV, V and VI class of venous insufficiency was 10, 14, 37 16 and 23 %, respectively. 263 patients underwent endovenous laser coagulation, and 39 — the traditional phlebectomy and ligation of perforating veins. Results. Among the examined patients with varicose veins of lower extremities DM2 was diagnosed in 9 % of cases, more often in males and elderly patients on the background of atherosclerosis of the foot vessels (iliac, femoral, tibial, popliteal artery, which was accompanied by more frequent involvement of the great saphenous vein in the process and its gate extension, the prevalence of severe grades of venous insufficiency, significantly worse the results of surgical treatment of varicose veins and greater frequency of complications, despite more frequent using of rivaroxaban and low molecular weight heparins, and the effectiveness of endovenous laser ablation after four weeks of its implementation is inferior to that in the group without DM2, while glycemic index inversely correlated with the surface tension of the venous blood, which has prognostic significance in the context of future medical interventions. Conclusions. The presence of DM2 is a risk factor for more severe feet varicose veins, is a negative predictive factor in the effectiveness of surgical treatment of the disease and the complications number.

  11. Energy harvester

    NARCIS (Netherlands)

    Herder, J.L.; Tolou, N.


    Energy harvester comprising a mass (2) that is subjectable to environmental forces for bringing it into the status of a moving mass, and means (5) linked to the mass (2) for converting and storing of energy embodied in the moving mass, which means (5) are arranged for subsequent release of said

  12. Effect of polidocanol foam administration into rat peripheral veins on pulmonary parenchyma. (United States)

    de Moraes Silva, Melissa A; Ferreira, Rimarcs G; de Jesus-Silva, Seleno G; Cardoso, Rodolfo S; Miranda, Fausto


    Background Sclerotherapy has been gaining increased acceptance and popularity as an effective therapy for the treatment of varicose veins. This attention has fed growing interest into the safety and potential complications of this procedure. There is no evidence of pulmonary complications from foam sclerotherapy in humans; however, animal studies have shown possible damage. The aim of this study is to show the changes in rat pulmonary parenchyma after the injection of 1% polidocanol Tessari foam into the peripheral vein using histological analysis of the inflammatory and fibrosis processes. Methods Twenty-four Wistar rats were divided into the following four groups: 24 h polidocanol, seven-day polidocanol, 28-day polidocanol, and control group. After the foam was injected into the lateral saphenous vein, the lungs of the rats were removed for histological analysis. Results Alveolar edema was observed in only the 24 h group (P < 0.005). Vessel thickening was observed in the seven-and 28-day groups (P < 0.001). Interstitial fibrosis was found in only the 28-day group (P = 0.006). There was no evidence of venous or arterial thrombosis in either group. Conclusion Polidocanol Tessari foam injection into rat peripheral veins causes alveolar edema, vessel thickening, and interstitial fibrosis.

  13. Portal Vein Thrombosis (United States)

    Chawla, Yogesh K.; Bodh, Vijay


    Portal vein thrombosis is an important cause of portal hypertension. PVT occurs in association with cirrhosis or as a result of malignant invasion by hepatocellular carcinoma or even in the absence of associated liver disease. With the current research into its genesis, majority now have an underlying prothrombotic state detectable. Endothelial activation and stagnant portal blood flow also contribute to formation of the thrombus. Acute non-cirrhotic PVT, chronic PVT (EHPVO), and portal vein thrombosis in cirrhosis are the three main variants of portal vein thrombosis with varying etiological factors and variability in presentation and management. Procoagulant state should be actively investigated. Anticoagulation is the mainstay of therapy for acute non-cirrhotic PVT, with supporting evidence for its use in cirrhotic population as well. Chronic PVT (EHPVO) on the other hand requires the management of portal hypertension as such and with role for anticoagulation in the setting of underlying prothrombotic state, however data is awaited in those with no underlying prothrombotic states. TIPS and liver transplant may be feasible even in the setting of PVT however proper selection of candidates and type of surgery is warranted. Thrombolysis and thrombectomy have some role. TARE is a new modality for management of HCC with portal vein invasion. PMID:25941431

  14. [Deep vein thrombosis prophylaxis. (United States)

    Sandoval-Chagoya, Gloria Alejandra; Laniado-Laborín, Rafael


    Background: despite the proven effectiveness of preventive therapy for deep vein thrombosis, a significant proportion of patients at risk for thromboembolism do not receive prophylaxis during hospitalization. Our objective was to determine the adherence to thrombosis prophylaxis guidelines in a general hospital as a quality control strategy. Methods: a random audit of clinical charts was conducted at the Tijuana General Hospital, Baja California, Mexico, to determine the degree of adherence to deep vein thrombosis prophylaxis guidelines. The instrument used was the Caprini's checklist for thrombosis risk assessment in adult patients. Results: the sample included 300 patient charts; 182 (60.7 %) were surgical patients and 118 were medical patients. Forty six patients (15.3 %) received deep vein thrombosis pharmacologic prophylaxis; 27.1 % of medical patients received deep vein thrombosis prophylaxis versus 8.3 % of surgical patients (p < 0.0001). Conclusions: our results show that adherence to DVT prophylaxis at our hospital is extremely low. Only 15.3 % of our patients at risk received treatment, and even patients with very high risk received treatment in less than 25 % of the cases. We have implemented strategies to increase compliance with clinical guidelines.

  15. Cucumber vein yellowing virus (United States)

    Cucurbits are an important crop of temperate, subtropical and tropical regions of the world. Cucumber vein yellowing virus (CVYV) is a major viral pathogen of cucurbits. This chapter provides an overview of the biology of CVYV and the disease it causes....

  16. Squash vein yellowing virus (United States)

    Cucurbits are an important crop of temperate, subtropical and tropical regions of the world. Squash vein yellowing virus (SqVYV) is a major viral pathogen of cucurbits. This chapter provides an overview of the biology of SqVYV and the disease it causes....

  17. What Causes Varicose Veins? (United States)

    ... Examples of these factors include family history, older age, gender, pregnancy, overweight or obesity , lack of movement, and leg trauma. Varicose veins are treated with lifestyle changes and medical procedures. The goals of treatment are to relieve symptoms, prevent complications, and improve ...

  18. Deep Vein Thrombosis

    Centers for Disease Control (CDC) Podcasts


    This podcast discusses the risk for deep vein thrombosis in long-distance travelers and ways to minimize that risk.  Created: 4/5/2012 by National Center for Emerging and Zoonotic Infectious Diseases (NCEZID).   Date Released: 4/5/2012.

  19. Portal Vein Thrombosis: Recent Advance. (United States)

    Qi, Xingshun


    Portal vein thrombosis is a life-threatening vascular disorder of the liver. In this chapter, I will review the recent advance regarding the epidemiology, etiology, management, and prognosis of portal vein thrombosis.

  20. Concerns and Discomforts of Pregnancy - Varicose Veins (United States)

    Concerns and Discomforts of Pregnancy - Varicose Veins Varicose veins are enlarged veins you may see on your legs. They can itch, ... Healthy Roads Media project www. healthyroadsmedia. org English - Concerns and Discomforts of Pregnancy (Varicose Veins) Last reviewed 2012

  1. Cutaneous saphenous nerve graft for the treatment of sciatic neurotmesis in a dog


    Granger, Nicolas; Moissonnier, Pierre; Fanchon, Laurent; Hidalgo, Antoine; Gnirs, Kirsten; Blot, Stephane


    Case Description—A 2-year-old Griffon Vendéen was examined because of a 1-month history of right hind limb lameness after a traumatic injury. Clinical Findings—Neurologic examination revealed monoplegia and anesthesia of the right hind limb distal to the stifle (femorotibial) joint except for the area supplied by the cutaneous saphenous nerve. Results of electromyographic testing were consistent with a severe lesion of the tibial and peroneal nerves at the level of the stifle joint. Treatment...

  2. Harvesting technique ESO

    Energy Technology Data Exchange (ETDEWEB)

    Saell, H.O.


    The report presents an extensive survey of the development of harvesters for energy forest plantations. The international cooperation on short rotation cultivation and harvesting is discussed. Various designs of harvesters, loaders and chippers are described.

  3. Leiomyosarcoma of the renal vein

    Directory of Open Access Journals (Sweden)

    Lemos Gustavo C.


    Full Text Available Leiomyosarcoma of the renal vein is a rare tumor of complex diagnosis. We presented a case of renal vein leiomyosarcoma detected in a routine study. The primary treatment was complete surgical removal of the mass. In cases where surgical removal is not possible the prognosis is poor, with high rates of local recurrence and distant spread.

  4. [The experimental study on inside-out vein graft for repairing inferior alveolar nerve defect in the rabbit]. (United States)

    Chen, P; Li, H; Zhang, G


    This study describes a modification of the vein graft technique inside-out vein graft, creates an autogenous vein conduct with the collagen-rich and Schwann cells exposed to regenerating axons. To compare regeneration of inferior alveolar nerves through two conduits: inside-out vein graft and the standard vein graft. 18 adult white rabbits were selected and vena facialises of both sides were harvested. Turned the right vena facialis into inside-out vein and used to bridge an 8 mm defect created in the right inferior alveolar nerve. An 8 mm defect of the left inferior alveolar nerve was bridged by the standard vein graft. After rabbits sacrificed at 8, 14 and 20 weeks, the regenerating nerve cables were harvested from the conduits and performed histologic study. At 20 weeks, performed also electrophysiologic studies and statistical analysis of conductive velocities and histological results. Regenerating nerves connected with proximal and distal nerve stumps on both sides postoperation 8 weeks, a number of regenerating nerve fibers and thickness of axon were gradually increasing. At 20 weeks regenerating nerve on the inside-out vein graft side showed superior function results--faster conduction velocities (P nerve regeneration by an environment with collagen-rich and Schwann cells. The inside-out vein graft is an original way to repair inferior alveolar nerve.

  5. Persistência da veia ciática Persistent sciatic vein

    Directory of Open Access Journals (Sweden)

    Bárbara Borges Cardoso


    and expansion. Consequently, anomalies may occur during this process. When there is persistence of the sciatic vein, it may communicate with the small saphenous vein or with the popliteal vein during its route, being anastomosed to the superior perforating vein and to the medial circumflex femoral vein. OBJECTIVE: To report a case of bilateral persistent sciatic vein on the lower limbs in comparison to the literature. METHODS: Thirty-two lower limbs from 16 corpses preserved in formaldehyde were dissected at the Laboratory of Anatomy of the discipline of Topographic Anatomy of the Medical School of Universidade Santo Amaro (Unisa, during 2006 and 2007, and the sciatic vein was observed in 2 lower limbs of one single corpse. RESULTS: On the left lower limb of a corpse that presented bilateral anomaly, the vein had 37 cm, emerging on the popliteal vein, accompanying the sciatic nerve, perforating the long adductor muscle and leading into the deep femoral vein. On the right lower limb, it measured 36 cm, emerged receiving the veins of the anterior tibial compartment, accompanied the sciatic nerve, perforated the long adductor muscle and led into the internal iliac vein. CONCLUSION: The anatomical variations of the lower limb venous system are the most common ones. The persistent sciatic vein may cause chronic venous failure in the lower limbs and, in this manner, must be investigated aiming at a better clinical or surgical management.

  6. Dynamics of uranium vein mineralization

    Energy Technology Data Exchange (ETDEWEB)

    Petrosyan, R.V. (Ministerstvo Geologii SSR, Moscow)


    The formation of uraniun vein deposits and the essence of consanguinity of the mineralization and wall metasomatites are considered. The formation of uranium mineralization is analysed from the positions of Korzhinsky D. S. : the formation of metasomatite aureole and associated vein ores take place as a result of the development of one solution flow while the formation of mineral vein associations occurs on the background of continuous filtration of the solution during metasomato is due to a repeated (pulse) half-opening of fractures and their filling with a part of filtrating solution. The analysis of the available information on the example of two different uranium manifestations permits to reveal certain relations both in the character of wall rock alterations and between the metasomatosis and the formation of ore minerals in veins. The conclusion is made that spatial-time correlations of vein formations with wall metasomatites attest that the pulse formation of ores in veinlets occurs on the background and in interrelation with a consecutive precipitation of components in the aureole volume. The analysis of element migration dynamics in wall aureole carried out from the positions of the Korzhinsky hypothesis of the advance wave of acid components that takes into account the interaction of continuous and pulse mechanisms of solution movement permits to avoid contradictions when interpreting the processes of wall rock alterations and vein ore-forming, and permits to make a common scheme of vein ore-genesis.

  7. Distal anastomotic vein adjunct usage in infrainguinal prosthetic bypasses. (United States)

    McPhee, James T; Goodney, Philip P; Schanzer, Andres; Shaykevich, Shimon; Belkin, Michael; Menard, Matthew T


    Single-segment saphenous vein remains the optimal conduit for infrainguinal revascularization. In its absence, prosthetic conduit may be used. Existing data regarding the significance of anastomotic distal vein adjunct (DVA) usage with prosthetic grafts are based on small series. This is a retrospective cohort analysis derived from the regional Vascular Study Group of New England as well as the Brigham and Women's hospital database. A total of 1018 infrainguinal prosthetic bypass grafts were captured in the dataset from 73 surgeons at 15 participating institutions. Propensity scoring and 3:1 matching was performed to create similar exposure groups for analysis. Outcome measures of interest included: primary patency, freedom from major adverse limb events (MALEs), and amputation free survival at 1 year as a function of vein patch utilization. Time to event data were compared with the log-rank test; multivariable Cox proportional hazard models were used to evaluate the adjusted association between vein cuff usage and the primary end points. DVA was defined as a vein patch, cuff, or boot in any configuration. Of the 1018 bypass operations, 94 (9.2%) had a DVA whereas 924 (90.8%) did not (no DVA). After propensity score matching, 88 DVAs (25%) and 264 no DVAs (75%) were analyzed. On univariate analysis of the matched cohort, the DVA and no DVA groups were similar in terms of mean age (70.0 vs 69.0; P = .55), male sex (58.0% vs 58.3%; P > .99), and preoperative characteristics such as living at home (93.2% vs 94.3%; P = .79) and independent ambulatory status (72.7% vs 75.7%; P = .64). The DVA and no DVA groups had similar rates of major comorbidities such as hypertension chronic obstructive pulmonary disease, diabetes mellitus, coronary artery disease, and dialysis dependence (P > .05 for all). Likewise, they had similar rates of distal origin grafts (13.6% vs 12.5%; P = .85), critical limb ischemia indications (P = .53), and prior arterial bypass (58% vs 47%; P = .08

  8. Varicose Vein Treatment (Endovenous Ablation of Varicose Veins) (United States)

    ... surgery. Most of the veins treated are effectively invisible even to ultrasound 12 months after the procedure. ... understanding of the possible charges you will incur. Web page review process: This Web page is reviewed ...

  9. Saphenofemoral junction ligation and disconnection for varicose veins-a longitudinal study of cosmesis and function. (United States)

    Barandiaran, Jesus V; Hall, Thomas C; Lim, Michael; El-Barghouti, N; Perry, Eugene P


    Saphenofemoral junction ligation and disconnection (SFJLD) can be performed without exceeding the safe limits of local anesthetic if stripping of the long saphenous vein is not routine. We studied the early cosmetic and functional outcome of this procedure to identify the optimum time gap from SFJLD to multiple stab avulsions for varicose veins (VV). A series of patients with primary VV underwent SFJLD under local anesthetic as day case procedures. The volume of VV was quantified with a cartograph wheel, whereas the extent and severity of VV was assessed with four validated questionnaires: (a) Clinical Etiology Anatomy Pathology Score, (b) Venous Clinical Severity Score, (c) Aberdeen Varicose Vein Severity Score, and (d) Short Form 36. Patients were assessed preoperatively, and at 1, 3, and 6 months postoperatively. The analysis of variance for repeated measures test was used; a p value men; mean age: 54 years; 95% CI: 29-79). In all, 91% (n = 44) of patients had cosmetic and symptomatic improvement. The volume of VV reduced significantly over the three postoperative time points when compared with preoperatively (112 [95% CI: 88-136] vs. 75 [95% CI: 55-97] vs. 65 [95% CI: 43-87] vs. 58 [95% CI: 31-86], p = 0.001). Using the Clinical Etiology Anatomy Pathology, Venous Clinical Severity Score, and Aberdeen Varicose Vein Severity Score questionnaires, severity of VV improved postoperatively when compared withpreoperatively (p = 0.001 respectively). Improvements in quality of life were also noted postoperatively with the Short Form 36 questionnaire (p = 0.032). At maximum follow-up of 3 years, 13% (n = 6) had recurrent VV. SFJLD confers cosmetic and symptomatic improvement at 1 month. Improvement is sustained on early follow-up, thereby allowing multiple stab avulsions to be performed as a staged procedure within 6 months. The rates of recurrent VV are acceptable on short-term follow-up. Copyright © 2011 Annals of Vascular Surgery Inc. Published by Elsevier Inc. All

  10. First report of Squash vein yellowing virus in watermelon in Guatemala (United States)

    In this study, we report the first detection of Squash vein yellowing virus (SqVYV)-induced watermelon vine decline in Central America. Symptoms including wilt and collapse of plants at harvest, and non-marketable fruits with internal rind necrosis were observed. This report provides an overview o...

  11. Erectile function restoration after repair of resected cavernous nerves by adipose-derived stem cells combined with autologous vein graft in rats. (United States)

    Ying, Chengcheng; Hu, Wanli; Cheng, Bei; Yang, Mei; Zheng, Xinmin; Wang, Xinghuan


    Cavernous nerve (CN) injury is the main cause of erectile dysfunction (ED) following radical prostatectomy. The recovery of erectile function following this procedure remains challenging. Here, we investigated the ability of adipose-derived stem cells (ADSCs) combined with autologous vein graft to improve erectile function in a rat model of bilateral long CN resection. Sprague-Dawley rats (n = 36) were randomized into four groups. Group A underwent sham operation. In Groups B, C, and D, an 8-mm segment of CN was excised bilaterally. In Group B and C, a 10-mm segment of autologous saphenous vein was interposed bilaterally at the site of injury, and the two nerve stumps were inserted into the vein lumen. 50 μL ADSCs were injected into each vein in Group B, and 50 μL of phosphate-buffered saline was injected in Group C. Group D underwent no repair. Erectile function assessed after 3 months by measuring intracavernosal pressure demonstrated significant recovery in erectile function in Group B with minimal recovery in Group C or D. Immunohistochemical staining showed that the nNOS-positive area was significantly larger in Group B than in Group D. ADSCs combined with autologous vein graft treatment had beneficial effects on the smooth muscle/collagen ratio in the corpus cavernosum. This procedure, therefore, provided a means of regenerating CN tissue and restoring autonomic erectile function after long bilateral CN resection (0.8 cm) in rats.

  12. A Vein Map Biometric System

    Directory of Open Access Journals (Sweden)

    Felix Fuentes


    Full Text Available There is increasing demand world-wide, from government agencies and the private sector for cutting-edge biometric security technology that is difficult to breach but userfriendly at the same time. Some of the older tools, such as fingerprint, retina and iris scanning, and facial recognition software have all been found to have flaws and often viewed negatively because of many cultural and hygienic issues associated with them. Comparatively, mapping veins as a human barcode, a new technology, has many advantages over older technologies. Specifically, reproducing a three-dimensional model of a human vein system is impossible to replicate. Vein map technology is distinctive because of its state-of-the-art sensors are only able to recognize vein patterns if hemoglobin is actively flowing through the person

  13. Portal Vein Thrombosis in non cirrhotic patients

    NARCIS (Netherlands)

    M.C.W. Spaander (Manon)


    textabstractExtrahepatic portal vein thrombosis (EPVT) is the most common cause of portal hypertension in non- cirrhotic patients. EPVT has been defined as an obstruction of the extrahepatic portal vein with or without involvement of the intrahepatic portal veins. Although the portal vein accounts

  14. Retro-aortic, left inferior renal capsular vein

    Directory of Open Access Journals (Sweden)

    Umberto G Rossi


    Full Text Available In our case report, abdominal multi-detector computed tomography was used for the pre-operative anatomy evaluation in a living kidney donor. The early phase of the test revealed normal kidneys in the donor. The vascular phase detected a venous variant on the left side: An inferior renal capsular vein, which had a loop and a retro-aortic course. This preoperative knowledge was crucial for the laparoscopic nephrectomy as a surgical procedure for harvesting kidney from the living donor.

  15. Gypsum veins in Triassic Moenkopi mudrocks of southern Utah: Analogs to calcium sulfate veins on Mars (United States)

    Young, B. W.; Chan, M. A.


    Well-exposed gypsum veins in the Triassic Moenkopi formation in southern Utah, USA, are similar to veins at Endeavour and Gale Craters on Mars. Both Moenkopi and Mars veins are hydrated calcium sulfate, have fibrous textures, and crosscut other diagenetic features. Moenkopi veins are stratigraphically localized with strontium and sulfur isotope ratios similar to primary Moenkopi sulfate beds and are thus interpreted to be sourced from within the unit. Endeavour veins seem to be distributed by lithology and may have a local source. Gale veins cut across multiple lithologies and appear to be sourced from another stratigraphic interval. Evaluation of vein network geometries indicates that horizontal Moenkopi veins are longer and thicker than vertical veins. Moenkopi veins are also generally oriented with the modern stress field, so are interpreted to have formed in the latest stages of exhumation. Endeavour veins appear to be generally vertical and oriented parallel to the margins of Cape York and are interpreted to have formed in response to topographic collapse of the crater rim. Gale horizontal veins appear to be slightly more continuous than vertical veins and may have formed during exhumation. Abrupt changes in orientation, complex crosscutting relationships, and fibrous (antitaxial) texture in Moenkopi and Mars veins suggest emplacement via hydraulic fracture at low temperatures. Moenkopi and Mars veins are interpreted as late-stage diagenetic features that have experienced little alteration since emplacement. Moenkopi veins are useful terrestrial analogs for Mars veins because vein geometry, texture, and chemistry record information about crustal deformation and vein emplacement.

  16. Commercialization of vein contrast enhancement (United States)

    Lovhoiden, Gunnar; Deshmukh, Harshal; Vrancken, Carlos; Zhang, Yong; Zeman, Herbert D.; Weinberg, Devin


    An ongoing clinical study of an experimental infrared (IR) device, the Vein Contrast Enhancer (VCE) that visualizes surface veins for medical access, indicates that a commercial device with the performance of the existing VCE would have significant clinical utility for even a very skilled phlebotomist. A proof-of-principle prototype VCE device has now been designed and constructed that captures IR images of surface veins with a commercial CCD camera, transfers the images to a PC for real-time software image processing to enhance the vein contrast, and projects the enhanced images back onto the skin with a modified commercial LCD projector. The camera and projector are mounted on precision slides allowing for precise mechanical alignment of the two optical axes and for measuring the effects of axes misalignment. Precision alignment of the captured and projected images over the entire field-of-view is accomplished electronically by software adjustments of the translation, scaling, and rotation of the enhanced images before they are projected back onto the skin. This proof-of-principle prototype will be clinically tested and the experience gained will lead to the development of a commercial device, OnTarget!, that is compact, easy to use, and will visualize accessible veins in almost all subjects needing venipuncture.

  17. Post-harvest physiology (United States)

    Weather and management constraints, as well as the intended use of the harvested forage, all influence the forage harvest system selected by the producer. Generally, maximum retention of dry matter from harvested forage crops is achieved at moistures intermediate between the standing fresh crop and ...

  18. Harvesting wood for energy. (United States)

    Rodger A. Arola; Edwin W. Miyata


    Illustrates the potential of harvesting wood for industrial energy, based on the results of five harvesting studies. Presents information on harvesting operations, equipment costs, and productivity. Discusses mechanized thinning of hardwoods, clearcutting of low-value stands and recovery of hardwood tops and limbs. Also includes basic information on the physical and...

  19. Reverse saphenous conduit flap in small animals: Clinical applications and outcomes

    Directory of Open Access Journals (Sweden)

    Ross C. Elliott


    Full Text Available Due to the lack of skin elasticity defects of the distal hind limb can be a challenge to close. This article assesses a well-described, but completely under-used technique for closure of wounds on the distal tarsus. The technique was used with good success in six cases presenting to the Bryanston Veterinary Hospital with a wide range of underlying pathology ranging from trauma to neoplastic disease of the tarsus. All six cases were treated with a reverse saphenous conduit flap and two of them underwent radiation therapy with no adverse side effects. All cases showed excellent results with a very low degree of flap necrosis that never exceeded 15% of the total flap area. This skin flap provides an excellent treatment method that is reliable in closure of defects of the distal tarsus with few adverse effects. To the author’s knowledge there has been only one previously published report on the clinical use of this type of skin flap,even though the flap is well described in most texts.

  20. Ultrasound-guided saphenous nerve block is an effective technique for perioperative analgesia in ambulatory arthroscopic surgery of the internal knee compartment. (United States)

    Bonet, A; Koo, M; Sabaté, A; Otero, I; Bocos, J; Pi, A


    Arthroscopic knee surgery is a minimally invasive technique with moderate pain during the first 24h. Our main objective was to evaluate the efficacy of ultrasound guided saphenous nerve block as a method of pain control intraoperatively and postoperatively for this surgery. A prospective and observational study. All patients received general anesthesia with laryngeal mask in the saphenous group, nerve block was performed with 10 ml ropivacaine 0.475%. Location of the surgery (external compartment group/internal compartment group), morphine consumption, VAS for pain at 5, 30, 60 and 120 min and 24 h after surgery, need for rescue medication, onset of nausea and vomiting, length of stay in PACU, delayed discharge and satisfaction were evaluated. The study included 73 patients. Of these, 46 received saphenous nerve block and 27 didn't receive it. Consumption of intraoperative, postoperative and total morphine was significantly lower in the saphenous group as well as VAS at 24h. In the subgroup of internal compartment surgery differences in VAS 24 h, morphine consume and lenght of stay in PACU were mantained. The ultrasound-guided block of saphenous nerve, particularly in the internal compartment arthroscopic knee surgery, decreases analgesic requirements, obtaining more effective pain control in the first 24 h postoperatively and without any known side effects. Copyright © 2014 Sociedad Española de Anestesiología, Reanimación y Terapéutica del Dolor. Publicado por Elsevier España, S.L.U. All rights reserved.

  1. Electromagnetic energy harvester for harvesting acoustic energy

    Indian Academy of Sciences (India)

    AEH) for extracting acoustical energy. The developed AEH comprises Helmholtz resonator (HR), a wound coil bonded to a flexible membrane and a permanent magnet placed in a magnet holder. The harvester's performance is analyzed ...

  2. Anomalous branching pattern of the portal vein: right posterior portal vein originating from the left portal vein. (United States)

    Yasaka, Koichiro; Akai, Hiroyuki; Kiryu, Shigeru


    To introduce a rare variant branching pattern of the portal vein with clinical relevance. A 55-year-old man was examined by contrast-enhanced computed tomography to investigate the cause of fever and mildly elevated hepatic enzyme levels. Based on computed tomography, liver abscesses were identified which may have caused the fever and elevated hepatic enzyme levels. And a variation in the branching pattern of the portal vein was also detected in this patient, which has not been reported previously; the right posterior portal vein originated from the end of the horizontal part of the left portal vein. Identification of this rare branching pattern of the portal vein prior to hepatectomy, liver transplantation, and portal vein embolization is considered important to prevent complications. A rare variant in which the right posterior portal vein originated from the left portal vein was identified. Recognition of this variant may be important prior to surgical or interventional radiological strategies.

  3. Extrahepatic Portal Vein Obstruction and Portal Vein Thrombosis in Special Situations: Need for a New Classification (United States)

    Wani, Zeeshan A.; Bhat, Riyaz A.; Bhadoria, Ajeet S.; Maiwall, Rakhi


    Extrahepatic portal vein obstruction is a vascular disorder of liver, which results in obstruction and cavernomatous transformation of portal vein with or without the involvement of intrahepatic portal vein, splenic vein, or superior mesenteric vein. Portal vein obstruction due to chronic liver disease, neoplasm, or postsurgery is a separate entity and is not the same as extrahepatic portal vein obstruction. Patients with extrahepatic portal vein obstruction are generally young and belong mostly to Asian countries. It is therefore very important to define portal vein thrombosis as acute or chronic from management point of view. Portal vein thrombosis in certain situations such as liver transplant and postsurgical/liver transplant period is an evolving area and needs extensive research. There is a need for a new classification, which includes all areas of the entity. In the current review, the most recent literature of extrahepatic portal vein obstruction is reviewed and summarized. PMID:26021771

  4. How Are Varicose Veins Diagnosed? (United States)

    ... Examples of these factors include family history, older age, gender, pregnancy, overweight or obesity , lack of movement, and leg trauma. Varicose veins are treated with lifestyle changes and medical procedures. The goals of treatment are to relieve symptoms, prevent complications, and improve ...

  5. How Are Varicose Veins Treated? (United States)

    ... Examples of these factors include family history, older age, gender, pregnancy, overweight or obesity , lack of movement, and leg trauma. Varicose veins are treated with lifestyle changes and medical procedures. The goals of treatment are to relieve symptoms, prevent complications, and improve ...


    Directory of Open Access Journals (Sweden)

    Shaik Ahmad


    Full Text Available BACKGROUND Varicose veins affect at least 1 out of 5 in the world and the cost of health care for the society is significant. In a developing country like India, study encompassing the clinical evaluation and management of lower limb varicose veins on the conventional lines seems a necessity to improve the quality care with the available resources. OBJECTIVES To study the relation between site of incompetence and complications, pattern of complications, surgical management and its outcome for lower limb varicose veins. METHODS A total 26 number of patients with primary varicose veins admitted, investigated, operated and followed up. Final outcome evaluated. All the information was taken down in the proforma, designed for the study. RESULTS In the study, it was noted that the varicose veins affect younger, adult, and middle age population. (20 to 60 years. Majority of the patients were male (84.60%. Perforator incompetence only = 42.3% (n=11. Perforator incompetence + saphenofemoral/saphenopopliteal incompetence seen in 57.7%. Long saphenous vein involvement was seen in 90.5% of the patients and both LSV and SSV involvement in 9.5%. A greater portion of the patients had combined valvular incompetence (69.56%. The mean ulcer healing time in our study was 2.8 weeks following surgery (90%. Residual incompetent perforators are seen in 7.6% (n=2. New incompetent perforators seen in 7.6% (n=2. Postoperative wound infection of the incision of SPJ ligation was seen in 3.8% (n=1 of the patients, but not the SEPS wound infection and the total complication rate was 3.85%. The mean postoperative stay for patients undergoing SEPS procedure alone was 3.6 days. The mean postoperative stay for patients who underwent perforator ligation with concomitant stripping procedure was 5 days. INTERPRETATION AND CONCLUSION Majority of the patients present with complications of varicose vein with combined valvular incompetence and surgical treatment with stripping of path

  7. Complicações no tratamento com laser endovascular em varizes de membros inferiores Complications evidenced in the endovascular laser treatment for varicose veins

    Directory of Open Access Journals (Sweden)

    Jorge Enrique Soracco


    Full Text Available OBJETIVO: O objetivo do presente estudo é relatar as complicações no tratamento de varizes em membros inferiores com laser endovascular. MÉTODOS: Foram levantadas, no período de junho de 1999 a dezembro de 2002, algumas complicações, como queimadura de pele, neurite do nervo safeno, hiperpigmentação e fibrose no local da safena em 250 pacientes submetidos a tratamento endovascular com laser em varizes de membros inferiores. O diagnóstico das complicações foi clínico e baseado nos sinais e sintomas. Avaliou-se 196 pacientes do sexo feminino e 54 do sexo masculino, com idades variando entre 25 e 79 anos, no Hospital Militar de Buenos Aires. Foram tratados com laser de diodo de alta potência de 810 nm de longitude de onda mediante um sistema de fibras óticas semi-rígidas de quartzo de 400 e 600 µm e ponta de contato plana em modo cirúrgico contínuo. Para análise estatística, foram calculadas as percentagens. RESULTADOS: Lesões tipo queimadura foram observadas em 3,2%, hiperpigmentação em 9,6%, fibrose no local da safena por mais de 6 meses em 5,6% e neurite do nervo safeno em 4,8%. CONCLUSÃO: Conclui-se que o tratamento com laser endovascular de varizes de membros inferiores não é desprovido de intercorrências e que os fatores que levaram a essas complicações devem ser identificados e reavaliados.OBJECTIVE: The aim of the present study is to report the complications seen in the endovascular laser treatment of varicose veins of the lower limbs. METHODS: From June 1999 to December 2002, 250 patients submitted to the endovascular treatment of varicose veins of the lower limbs using lasers and suffering from complications, such as skin burns, saphenous neuritis, hyperpigmentation and fibrosis along the course of the saphenous vein, were assessed. The diagnosis of the complications was made clinically based on the signs and symptoms evidenced. Of the 250 patients, aged 25-79 years, treated in the Hospital Militar de Buenos

  8. Derivação com veias de membro superior após trombólise de aneurisma de artéria poplítea: alternativa para salvamento de membro Arm vein bypass after popliteal artery aneurysm thrombolysis: an alternative for limb salvage

    Directory of Open Access Journals (Sweden)

    João Antonio Corrêa


    Full Text Available Os autores relatam um caso de aneurisma de artéria poplítea trombosado em que se realizou fibrinólise com sucesso na fase aguda. Foram utilizadas veias de braço para realização do enxerto e exclusão do aneurisma, pois o paciente havia sido previamente submetido à safenectomia bilateral e revascularização do miocárdio com as veias do outro braço. Apesar das dificuldades, o salvamento do membro foi alcançado.The authors report a case of a thrombosed popliteal artery aneurysm successfully treated by fibrinolysis in its acute stage. Arm veins were used to perform a bypass and aneurysm exclusion, since the patient had previously been submitted to bilateral saphenous vein stripping and myocardial revascularization using the veins of the other arm. Despite the difficulties, limb salvage was achieved.

  9. Recurrence of superficial vein thrombosis in patients with varicose veins. (United States)

    Karathanos, Christos; Spanos, Konstantinos; Saleptsis, Vassileios; Tsezou, Aspasia; Kyriakou, Despina; Giannoukas, Athanasios D


    To investigate which factors other than history of superficial vein thrombosis (SVT) are associated with recurrent spontaneous SVT episodes in patients with varicose veins (VVs). Patients with a history of spontaneous SVT and VVs were followed up for a mean period of 55 months. Demographics, comorbidities, and thrombophilia screening test were analyzed. Patients were grouped according to the clinical-etiology-anatomy-pathophysiology classification. A multiple logistic regression analysis with the forward likelihood ratio method was undertaken. Thirteen patients out of 97 had a recurrence SVT episode during the follow-up period. All those patients were identified to have a thrombophilia defect. Protein C and S, antithrombin, and plasminogen deficiencies were more frequently present in patients without recurrence. Gene mutations were present in 38% in the nonrecurrence group and 77% in the recurrence group. After logistic regression analysis, patients with dislipidemia and mutation in prothrombin G20210A (FII) had an increased risk for recurrence by 5.4-fold and 4.6-fold, respectively. No deep vein thrombosis or pulmonary embolism occurred. Dislipidemia and gene mutations of F II are associated with SVT recurrence in patients with VVs. A selection of patients may benefit from anticoagulation in the short term and from VVs intervention in the long term. © The Author(s) 2015.

  10. Use of a Dacron shape-memory intravascular coil to achieve slow, progressive occlusion of the jugular vein in dogs. (United States)

    Nanfelt, Michelle R; Marolf, Angela J; Powers, Barbara E; Monnet, Eric


    To investigate the ability of shape memory Dacron polymer vascular coils to induce the complete, gradual occlusion of the canine jugular vein. Observational pilot study. Nine purpose-bred dogs. Eighteen coils were deployed in nine dogs using fluoroscopic-guided percutaneous transvenous coil implantation. Individual coil formulations varied around a Dacron polymer base. Jugular vein diameter, percent vessel occlusion, and thrombus echogenicity were monitored at weekly intervals using ultrasonography. Affected jugular veins were harvested at 6 weeks post-implantation and histopathological analysis was performed to assess adventitial fibrosis, intimal layer thickening, and inflammation. Ten coils migrated from the jugular veins to the pulmonary vasculature within 0-2 weeks following implantation. Three jugular veins achieved at least 90% occlusion at six weeks. Histopathology of these jugular veins revealed marked perivascular thickening and fibrovascular proliferation, increased infiltration of macrophages, neutrophils and lymphocytes, and abundant fibroplasia. Complete, gradual occlusion of a jugular vein was achieved in three dogs. Significant vessel wall reaction and inflammation can induce gradual vessel occlusion when a Dacron coil remains implanted within the jugular vein. Dacron polymer coils could be a feasible treatment option for the gradual occlusion of congenital portosystemic shunts in dogs using minimally invasive, percutaneous transvenous implantation. © Copyright 2011 by The American College of Veterinary Surgeons.

  11. Unusual termination of the right testicular vein | Woldeyes | Anatomy ...

    African Journals Online (AJOL)

    The testicular veins are formed by the veins emerging from the testis and epididymis forming the pampiniform venous plexus. The right testicular vein drains into inferior vena cava and the left testicular vein to the left renal vein. Testicular veins display a great variability with regard to their number, course and sites of ...

  12. Endovascular radiofrequency ablation for varicose veins: an evidence-based analysis. (United States)


    United States (FDA clearance). In Ontario, RFA is not an insured service and is currently being introduced in private clinics. Literature Search The MAS evidence-based review was performed to support public financing decisions. The literature search was performed on March 9th, 2010 using standard bibliographic databases for studies published up until March, 2010. English language full-reports and human studies Original reports with defined study methodologyReports including standardized measurements on outcome events such as technical success, safety, effectiveness, durability, quality of life or patient satisfaction Reports involving RFA for varicose veins (great or small saphenous veins)Randomized controlled trials (RCTs), systematic reviews and meta-analysesCohort and controlled clinical studies involving ≥ 1 month ultrasound imaging follow-up Non systematic reviews, letters, comments and editorials Reports not involving outcome events such as safety, effectiveness, durability, or patient satisfaction following an intervention with RFAReports not involving interventions with RFA for varicose veinsPilot studies or studies with small samples (< 50 subjects) THE MAS EVIDENCE SEARCH ON THE SAFETY AND EFFECTIVENESS OF ENDOVASCULAR RFA ABLATION OF VV IDENTIFIED THE FOLLOWING EVIDENCE: three HTAs, nine systematic reviews, eight randomized controlled trials (five comparing RFA to surgery and three comparing RFA to ELT), five controlled clinical trials and fourteen cohort case series (four were multicenter registry studies). The majority (12⁄14) of the cohort studies (3,664) evaluating RFA for VV involved treatment with first generation RFA catheters and the great saphenous vein (GSV) was the target vessel in all studies. Major adverse events were uncommonly reported and the overall pooled major adverse event rate extracted from the cohort studies was 2.9% (105⁄3,664). Imaging defined treatment effectiveness of vein closure rates were variable ranging from 68% to 96% at

  13. 1974 Washington timber harvest. (United States)

    J.D. Jr. Lloyd


    The 1974 timber harvest of 6.88 billion board feet declined 933 million board feet (11.9 percent) below the record 1973 harvest. Decreases occurred in almost all owner groups. In western Washington the decline was 856 million board feet (13.0 percent). In eastern Washington the decline was 76 million board feet (6.3 percent).

  14. Effects of calcium dobesilate and diosmin-hesperidin on apoptosis of venous wall in primary varicose veins. (United States)

    Iriz, E; Vural, C; Ereren, E; Poyraz, A; Erer, D; Oktar, L; Gokgoz, L; Halit, V; Soncul, H


    Evaluation of the therapeutic effects of calcium dobesilate and diosmin-hesperidin through regulation of apoptosis. 56 Patients were divided into four groups; Group 1 consisted of patients (n = 18) with the recent diagnosis of primary varicose disorder who have never used medications, Group 2 consisted of patients (n = 14) who have used diosmin-hesperidin for at least six weeks prior to the operation, Group 3 consisted of patients (n = 14) who have used calcium dobesilate for at least six weeks prior to the operation and finally Group 4 (Control group) consisted of normal saphenous vein biopsies (n = 10). All biopsies were stained with Hematoxylin and Eosin. Tissue samples from 56 patients were immunohistochemically stained with antibodies of anti-bcl-2, anti-bax and anti-p53. Apoptosis was evaluated by TUNEL method. There were no statistically significant differences among the groups in respect to gender distribution and smoking status. Immunohistochemical evaluation of apoptosis related proteins revealed a statistically significant difference between Group 4 and the other groups with respect to the apoptag staining on venous wall (p = 0.026). There were significant differences in the presence of bcl-2 protein expression between groups 4 and Group 1 (p = 0.0002) and between Group 1 and Group 3 (p = 0.023). Our study highlights the significance of apoptosis in varicose disorders and suggests that calcium dobesilate, which is used in the treatment of varicose veins, could be of benefit by regulating apoptosis.

  15. Comparing low volume saphenous-obturator block with placebo and femoral-obturator block for anterior cruciate ligament reconstruction: a randomized controlled trial

    DEFF Research Database (Denmark)

    Lenz, Katja; Jensen, Kenneth; Tanggaard, Katrine


    BACKGROUND: Anterior cruciate ligament reconstruction (ACL-RC) is often associated with moderate to severe postoperative pain even with a multimodal analgesic regimen. We aimed to compare the analgesic efficacy of low volume saphenous-obturator block with placebo and femoral- obturator block...

  16. Three Year Follow-Up of a Vein Patch Repair for a Coronary Artery Saccular Aneurysm of the Left Main Bifurcation. (United States)

    Kawase, Yasuhiro; Ishii, Yosuke; Yoshio, Takahide; Nishina, Dai; Bessho, Ryuzo; Nitta, Takashi


    This report describes a case of surgical treatment for a coronary artery saccular aneurysm of the left main bifurcation. A coronary artery saccular aneurysm (7 mm × 10 mm) and three vessel disease, including the left main trunk, were diagnosed by coronary angiography. A surgical resection and saphenous vein patch repair of the left main coronary artery aneurysm was performed concomitantly with coronary artery bypass grafting. The pathological findings of the aneurysm clarified that the aneurysm wall was atrophic and extremely thin because of a collapsed trilaminar arterial structure due to atherosclerosis. A coronary computed tomographic scan revealed no aneurysmal formation in the patent left main trunk and patent grafts 3 years after surgery.

  17. Oxidative Stress in Hypertensive Patients Induces an Increased Contractility in Vein Grafts Independent of Endothelial Function

    Directory of Open Access Journals (Sweden)

    Claudio Joo Turoni


    Full Text Available Objective. To evaluate the impact of oxidative stress on vascular reactivity to vasoconstrictors and on nitric oxide (NO bioavailability in saphenous vein (SV graft with endothelial dysfunction from hypertensive patients (HT. Methods. Endothelial function, vascular reactivity, oxidative state, nitrites and NO release were studied in isolated SV rings from HT and normotensive patients (NT. Only rings with endothelial dysfunction were used. Results. HT rings presented a hyperreactivity to vasoconstrictors that was reverted by diphenylene iodonium (DPI. In NT, no effect of DPI was obtained, but Nω-nitro-L-arginine methyl ester (L-NAME increased the contractile response. NO was present in SV rings without endothelial function. Nitrites were higher in NT than in HT (1066.1 ± 86.3 pmol/mg; n=11 versus 487.8 ± 51.6; n=23; P<0.01 and inhibited by nNOS inhibitor. L-arginine reversed this effect. Antioxidant agents increased nitrites and NO contents only in HT. The anti-nNOS-stained area by immunohistochemistry was higher in NT than HT. HT showed an elevation of oxidative state. Conclusions. Extraendothelial NO counter-regulates contractility in SV. However, this action could be altered in hypertensive situations by an increased oxidative stress or a decreased ability of nNOS to produce NO. Further studies should be performed to evaluate the implication of these results in graft patency rates.

  18. Rabbit model provides new insights in liver regeneration after transection with portal vein ligation. (United States)

    Liao, Mingheng; Zhang, Tao; Wang, Haichuan; Liu, Ying; Lu, Minxun; Huang, Jiwei; Zeng, Yong


    The rabbit model of associating liver partition and portal vein ligation for staged hepatectomy (ALPPS) has not been reported before. New Zealand white rabbits were allocated to two protocols. Protocol 1 involved either liver parenchymal transection (LPT, n = 5) or portal vein ligation (PVL, n = 5). Protocol 2 involved the ligation of different portal vein branches combined with liver partition, including the LPT + 20% PVL group (n = 5; the caudate portal vein was ligated), the LPT + 50% PVL group (n = 5; the left portal vein was ligated), and the LPT + 70% PVL group (n = 10; both veins were ligated). Computed tomography liver volumetry was performed immediately after operation. Blood samples were harvested before surgery and at days 1, 3, 7, or 14 after surgery for liver function evaluation. Most rabbits were humanely euthanized on day 7. The livers were harvested, divided into lobes, and weighed; biopsies of each lobe and immunohistochemical staining were performed. In this article, we present a new rabbit model to simulate ALPPS procedure, with a description of the regional anatomical features, surgical routes, and key techniques. The growth rate of remnant right lobe volume increased with proportionally PVL combined with LPT. Specifically, right lobe volume growth rate of the LPT + 50% PVL group overwhelmed 70% PVL alone. There were putative underlying mechanisms other than portal inflow redistribution in triggering residual liver regeneration after ALPPS procedure. This rabbit model is feasible for further mechanism research of this special clinical phenomenon. Copyright © 2016 Elsevier Inc. All rights reserved.

  19. Bundling harvester; Nippukorjausharvesteri

    Energy Technology Data Exchange (ETDEWEB)

    Koponen, K. [Eko-Log Oy, Kuopio (Finland)


    The staring point of the project was to design and construct, by taking the silvicultural point of view into account, a harvesting and processing system especially for energy-wood, containing manually driven bundling harvester, automatizing of the harvester, and automatized loading. The equipment forms an ideal method for entrepreneur`s-line harvesting. The target is to apply the system also for owner`s-line harvesting. The profitability of the system promotes the utilization of the system in both cases. The objectives of the project were: to construct a test equipment and prototypes for all the project stages, to carry out terrain and strain tests in order to examine the usability and durability, as well as the capacity of the machine, to test the applicability of the Eko-Log system in simultaneous harvesting of energy and pulp woods, and to start the marketing and manufacturing of the products. The basic problems of the construction of the bundling harvester have been solved using terrain-tests. The prototype machine has been shown to be operable. Loading of the bundles to form sufficiently economically transportable loads has been studied, and simultaneously, the branch-biomass has been tried to be utilized without loosing the profitability of transportation. The results have been promising, and will promote the profitable utilization of wood-energy

  20. Normal hepatic vein patterns on ultrasound

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Hae Jin; Chae, Yoo Soon; Park, Hea Yeoung; Park, Bok Hwan; Kim, Yang Sook [Maryknoll Hospital, Busan (Korea, Republic of)


    Understanding of the anatomy of the hepatic vein is important in manipulation for transplantation of the liver, hepatectomy and the treatment of hepatic trauma with avulsion of the hepatic vein. Demonstrated of the inferior right hepatic vein (IRHV) is also important; in some cases of hepatocellular carcinoma, thrombus can be seen in the IRHV; in primary Budd-Chiari syndrome, the IRHV is main draining vein; during hepatectomy, the postero-inferior segment of the right lobe and draining IRHV can be preserved. For some 10 months ultrasound examination was done in a total of 124 patients with normal liver function with special emphasis on the hepatic vein, their branches, and the IRHV, and analysed in terms of branching pattern and relative size of the hepatic vein and the detection rate of the IRHV.

  1. Influence of harvester type and harvesting time on quality of harvested chamomile


    Pajić Miloš B.; Pajić Vesna S.; Ivanović Sanjin M.; Oljača Mićo V.; Gligorević Kosta B.; Radojičić Dušan R.; Dražić Milan S.; Zlatanović Ivan J.


    This paper is the result of studying effects of mechanical chamomile harvesting on yield and quality of harvested chamomile. Chamomile (Chamomilla recutita (L) Rausch.) was harvested at three time intervals (T1 - 240 days, T2 - 250 days and T3 - 260 days after sowing) by three conceptually different harvesters. The results achieved indicate that the harvester type significantly influences quality of harvested chamomile, whereas it is not influenced by chamo...

  2. Topical application of sodium hyaluronate for preventing perivascular adhesion of the vein grafts in rabbits: An experimental study

    Directory of Open Access Journals (Sweden)

    Ming-ke GUO


    Full Text Available Objective To explore the effect of topical application of sodium hyaluronate on preventing perivascular adhesion of the vein grafts in rabbits. Methods Thirty-six male New Zealand white rabbits, aged 5 months, were randomly and equally divided into 2 groups: groups A and B. Arterial defect model was established by cutting about 1cm artery from the middle part of the dissected left common carotid artery. A section about 3cm was cut from the right external jugular vein, and the harvested vein was inverted and anastomosed end-to-end to the artery defect. After the anastomosis, the adventitia and two anastomoses of the grafted veins in group A were coated locally with 0.2ml sodium hyaluronate. The grafted veins were obtained 1, 2 and 4 weeks after the operation, with the perivascular adhesion of the vein grafts being examined macroscopically before the resection. HE staining and Masson staining were preformed for histological changes of grafted vein wall and the perivascular adhesion of the vein grafts. At 2, 4 weeks postoperation, the perivascular adhesions of the vein grafts were graded by the grading criteria of adhesion in macroscopic evaluation and histological evaluation. Results At 1, 2 and 4 weeks postoperatively, the macroscopic and histological observation found that the perivascular adhesions in group A were looser than those in group B. The macroscopic grade and histological grade were lower in group A than in group B, there was a significant difference between the two groups at 2 and 4 weeks postoperation (P<0.05. Conclusion Topical application of sodium hyaluronate can reduce the perivascular adhesion and is an ideal treatment strategy for preventing perivascular adhesion of vein grafts. DOI: 10.11855/j.issn.0577-7402.2017.08.14

  3. Hand collection - hand harvest (United States)

    US Fish and Wildlife Service, Department of the Interior — This is a summary of activities related to the collection and harvest of seeds on Neal Smith National Wildlife Refuge between 1992 and 2009. Information about hand...

  4. Catheter-based infrared light scanner as a tool to assess conduit quality in coronary artery bypass surgery. (United States)

    Burris, Nicholas; Schwartz, Kimberly; Tang, Cha-Min; Jafri, M Samir; Schmitt, Joseph; Kwon, Michael H; Toshinaga, Ozeki; Gu, Junyan; Brown, Jamie; Brown, Emile; Pierson, Richard; Poston, Robert


    Endothelial disruption within saphenous vein and radial artery grafts increases thrombosis risk. However, no clinically applicable method for imaging the intima currently exists. We used a novel infrared imaging technology, optical coherence tomography (OCT; LightLab Imaging, Inc, Westford, Mass), to visualize the intima within harvested conduits. Conduits were procured endoscopically (37 saphenous vein grafts and 8 radial artery grafts) or with the open technique (9 radial artery grafts) from 50 patients. Surplus segments were analyzed by means of OCT for evidence of preexisting pathology or traumatic injury. Focal plaques in radial artery grafts and the intimal hyperplasia area in saphenous vein grafts were quantified as having an intimal/medial thickness ratio of greater than 0.5. Biopsy specimens were obtained for histologic confirmation and to analyze matrix metalloproteinase 2 levels (saphenous vein grafts) and prostacyclin/nitric oxide metabolites (radial artery grafts). Interobserver kappa coefficients and a Bland-Altman analysis were used to determine the reproducibility and accuracy of OCT interpretations. Radial artery imaging revealed plaque in 76%. Endoscopically harvested vessels showed intraluminal clot (38%) and intimal tears ranging from severe (6%) to mild (88%). In saphenous vein grafts intimal thickening was detected in 86% and intraluminal clotting in 68%. The intimal/medial thickness ratio determined by means of OCT correlated directly with matrix metalloproteinase 2 levels (R = 0.6804) in saphenous vein grafts and inversely with metabolites of prostacyclin (R = -0.55) and nitric oxide (R = -0.58) in radial artery grafts. OCT imaging was reproducible (interobserver kappa coefficients of >0.81 for the characterization of plaque types) and showed a strong correlation with histology (R = 0.8, P < .001). OCT imaging provides an accurate, real-time, and reproducible means for assessing saphenous vein graft and radial artery graft bypass conduits

  5. Shock Veins as Recorders of Shock Pressures in Chondrites: Pressure Histories from Thin vs. Thick Veins (United States)

    Xie, Z.; Sharp, T.; Decarli, P.


    High-pressure minerals are generally found within or adjacent to shock-induced melt veins and melt pockets in highly shocked chondrites. The minerals that crystallize in the melt veins and pockets and the distribution of these minerals provide a record of crystallization and quench histories that can be used to constrain shock pressure and pulse duration. Most previous investigations have focused on relatively thick veins (>100 μ m in width) because they tend to contain high-pressure minerals that are observable using petrography or scanning electron microscopy. However, the mineralogy of thin shock veins can provide additional constraints on the pressure history of shocked meteorites. Because shock veins cool predominantly by conduction to the surrounding matrix, rather than by adiabatic decompression, the timing of shock-vein crystallization depends strongly on vein thickness and position within the veins. Therefore, the thinnest melt veins, which solidify within tens of nanoseconds after melting, provide a brief crystallization history at the time of formation whereas thicker veins provide a longer history that may reflect crystallization during decompression. If thin veins form during compression or early in the shock pulse, they will likely record the equilibrium shock pressure or the peak pressure. The goal of this study is to characterize the mineralogy of thin melt veins and to compare the results to those of thicker veins in the same samples. We have investigated three L chondrites that contain a wide range of melt vein sizes. These include Tenham (several μ m to 600 μ m in width), Roy (10 μ m to 150 μ m in width) and Umbarger (35 μ m to 300 μ m in width). Thick veins in these samples have been previously investigated using FESEM and TEM, resulting in crystallization pressures of approximately 25, 20 and 18 GPa for Tenham, Roy and Umbarger, respectively. Thin veins from these samples were investigated using TEM. Three thin veins in Tenham show three

  6. Internal Jugular Vein Cannulation; Anatomical Surface Markings ...

    African Journals Online (AJOL)

    We report the case of a female patient scheduled for skin grafting of chronic Burulli ulcers who had a history of difficult peripheral vein cannulation. She had undergone numerous central venous cannulations and unsuccessful peripheral vein cut-downs in the past. On two separate occasions she had central venous ...

  7. Generating and analyzing synthetic finger vein images

    NARCIS (Netherlands)

    Hillerström, Fieke; Kumar, Ajay; Veldhuis, Raymond N.J.


    Abstract: The finger-vein biometric offers higher degree of security, personal privacy and strong anti-spoofing capabilities than most other biometric modalities employed today. Emerging privacy concerns with the database acquisition and lack of availability of large scale finger-vein database have

  8. Deep vein thrombosis and pulmonary embolism

    NARCIS (Netherlands)

    Di Nisio, Marcello; van Es, Nick; Büller, Harry R.


    Deep vein thrombosis and pulmonary embolism, collectively referred to as venous thromboembolism, constitute a major global burden of disease. The diagnostic work-up of suspected deep vein thrombosis or pulmonary embolism includes the sequential application of a clinical decision rule and D-dimer

  9. Tratamento de varizes com laser endovenoso: estudo prospectivo com seguimento de 39 meses Treatment of varicose veins with endovenous laser: a prospective 39-month follow-up study

    Directory of Open Access Journals (Sweden)

    Luiz Marcelo Aiello Viarengo


    (39 months, 253 outpatients (417 limbs were treated with 810 and 980 nm diode laser energy delivered percutaneously using optical fiber introduced by puncture under ultrasound guidance. Tumescent anesthesia (50-150 ml of 0.2% lidocaine was delivered perivenously. Power and duration of the pulse were determined by vein diameter. Duplex control was performed at 7 days, 1 month, 3 months, 6 months, 1 year and yearly thereafter to assess treatment efficacy and adverse effects. RESULTS: Primary great saphenous vein occlusion was obtained in 405 of 417 members (97.1%. Twelve recurrent cases (2.9% were successfully treated. Mean follow-up time was 18 months. During this period, global recurrence rate of varicose veins was 7.4%; 6.3% (26 limbs related to tributary and collateral veins of the saphenofemoral junction, and 1.2% (five limbs with great saphenous vein recanalization. All recurrences occurred between 3 and 12 months. Ecchymosis was the most common adverse effect (60.6%. Other complications were: moderate pain during the procedure (16.1%; hematoma (5.5%, superficial phlebitis of varicose tributaries (3.4%, hyperpigmentation (2.9%, transient paresthesia (3.4%. There were no cases of great saphenous vein thrombophlebitis, deep vein thrombosis or pulmonary emboli. CONCLUSION: Varicose vein treatment with endovenous laser technique was successful in occluding great saphenous vein and its branches, with self-limited adverse effects and recurrence rate lower than 8% in the follow-up period.

  10. Energy harvesting for microsystems

    Energy Technology Data Exchange (ETDEWEB)

    Ruichao Xu


    The purpose of this project is to design and fabricate piezoelectric energy harvesters based on integration of Pb(ZrxTi1-x)O3 (PZT) thick film technology and silicon microtechnology. The fabrication processes are carried out in close collaboration with Meggitt Sensing Systems (MSS) who has the unique expertise to screen print piezoelectric thick film layers, thus all screen printing steps are done by MSS while the silicon micromachining is carried out at Danchip facility at DTU. The presented energy harvesters are all based on using piezoelectric thick film operating in the 31-mode to generate power when strained. Three archetypes of the numerous fabricated energy harvesters will be presented in detail, they represent three major milestones in this project. The first energy harvester archetype has an unimorph cantilever beam, which consists of a 20 {mu}m silicon layer and 10-30 {mu}m screen printed PZT layer, anchored on a silicon frame at one end and attached to a silicon proof mass at the other. Electrodes will cover both side of the PZT layer, so the harvested energy can be collected electrically. The second archetype has a bimorph cantilever beam, which consists of two 15-35 {mu}m PZT layers, anchored on a silicon frame at the one end and attached to a silicon proof mass at the other. Electrodes are deposited below, between and above the two PZT layers. The root mean square (RMS) power output measured on this type of harvesters is as high as 37.1{mu}W at 1 g. The third archetype is similar to the first one, the screen printed PZT layer is replaced by a lead free piezoelectric material, (KxNa1-x)NbO3 (KNN). Some of the major challenges encountered during the development processes are bad adhesion, fragile structures and short circuiting through the PZT layer. All of which have being fully or partially solved in this project. The final energy harvesters are designed to be used in an energy harvester powered wireless sensing system. (Author)

  11. Doppler ultrasound evaluation of pattern of venous incompetance and relation with skin changes in varicose vein patients

    Directory of Open Access Journals (Sweden)

    HP Pant


    Full Text Available BACKGROUND Varicosity of lower limb is a common problem in agricultural country like Nepal. Doppler ultrasound is a standard investigation modality for confirmation of diagnosis, evaluation of severity and venous mapping to plan treatment. We aim to find out the epidemiology, common pattern of incompetance, severity assessment by doppler and association of the important doppler variables with skin changes. METHODOLOGY Doppler venous study was done in 56 patients from june 2013 to july 2014. Patients with deep vein thrombosis and peripheral arterial disease were excluded. Altogether 56 patients, 96 limbs were studied. Data was entered in preformed proforma. Doppler study was conducted by senior radiologist with linear probes. Data was entered in SPSS software version 16 and statistical significance was calculated using chi square test. RESULTS Bilateral limb involvement was seen in 40 patients and unilateral in 16 patuents only. Skin related changes were seen in 58 limbs. Saphenofemoral junction incompetance was seen in 79(82.2% limbs and was most common pattern of incompetance. Overall, superficial veins were involved in 88(91.7% limbs and deep in 30(31.2% limbs. Prolonged duration of varicosity (>9 year (p=0.000, bilateral limb involvement(p=0.024, reflux in deep venous system(p=0.002, larger Greater Saphenous Vein (GSV size(p=0.003, prolonged duration of reflux(p=0.000 and perforator incompetence (p=0.002 were associated with skin changes. GSV diameter more than 7 mm was associated with reflux significantly (P=0.002. CONCLUSION Superficial vein incompetance is common pattern compared to deep venous system. Sapheno Femoral Junction (SFJ incompetance is the commonest pattern. Larger caliber of vein, prolonged duration of reflux, reflux in deep venous system and perforator insufficiency are significantly associated with skin changes.DOI: Journal of College of Medical Sciences-Nepal, 2014, Vol-10, No-3

  12. [Portal vein embolization: Present and future]. (United States)

    Piron, Lauranne; Deshayes, Emmanuel; Escal, Laure; Souche, Regis; Herrero, Astrid; Pierredon-Foulongne, Marie-Ange; Assenat, Eric; le Lam, Ngo; Quenet, François; Guiu, Boris


    Portal vein embolization consists of occluding a part of the portal venous system in order to achieve the hypertrophy of the non-embolized liver segments. This technique is used during the preoperative period of major liver resection when the future remnant liver (FRL) volume is insufficient, exposing to postoperative liver failure, main cause of death after major hepatectomy. Portal vein embolization indication depends on the FRL, commonly assessed by its volume. Nowadays, FRL function evaluation seems more relevant and can be measured by 99mTc labelled mebrofenin scintigraphy. Portal vein embolization procedure is mostly performed with percutaneous trans-hepatic access by using ultrasonography guidance and consists of embolic agent injection, such as cyanoacrylate, in the targeted portal vein branches with fluoroscopic guidance. It is a safe and well-tolerated technique, with extremely low morbi-mortality. Portal vein embolization leads to sufficient FRL hypertrophy in about 80% of patients, allowing them to undergo surgery from which they were initially rejected. The two main reasons of non-resection are tumor progression (≈15% of cases) and FRL insufficient hypertrophy (≈5% of cases). When portal vein embolization is not enough to obtain adequate FRL regeneration, hepatic vein embolization may potentiate its effect (liver venous deprivation technique). Copyright © 2017 Société Française du Cancer. Published by Elsevier Masson SAS. All rights reserved.

  13. Portal vein gas in emergency surgery

    Directory of Open Access Journals (Sweden)

    Mahmood Hind


    Full Text Available Abstract Background Portal vein gas is an ominous radiological sign, which indicates a serious gastrointestinal problem in the majority of patients. Many causes have been identified and the most important was bowel ischemia and mesenteric vascular accident. The presentation of patients is varied and the diagnosis of the underlying problem depends mainly on the radiological findings and clinical signs. The aim of this article is to show the clinical importance of portal vein gas and its management in emergency surgery. Methods A computerised search was made of the Medline for publications discussing portal vein gas through March 2008. Sixty articles were identified and selected for this review because of their relevance. These articles cover a period from 1975–2008. Results Two hundreds and seventy-five patients with gas in the portal venous system were reported. The commonest cause for portal vein gas was bowel ischemia and mesenteric vascular pathology (61.44%. This was followed by inflammation of the gastrointestinal tract (16.26%, obstruction and dilatation (9.03%, sepsis (6.6%, iatrogenic injury and trauma (3.01% and cancer (1.8%. Idiopathic portal vein gas was also reported (1.8%. Conclusion Portal vein gas is a diagnostic sign, which indicates a serious intra-abdominal pathology requiring emergency surgery in the majority of patients. Portal vein gas due to simple and benign cause can be treated conservatively. Correlation between clinical and diagnostic findings is important to set the management plan.

  14. Radiological features of azygous vein aneurysm. (United States)

    Choudhary, Arabinda Kumar; Moore, Michael


    Mediastinal masses are most commonly associated with malignancy. Azygous vein aneurysm is a very rare differential diagnosis of mediastinal mass. We report here three cases of azygous vein aneurysm including children and adult patients. In the pediatric patient it was further complicated by thrombosis and secondary pulmonary embolism. We describe the radiological features on CXR, MRI, CT, PET-CT, US and angiogram and their differential diagnosis. Imaging findings of continuity with azygous vein, layering of contrast medium on enhanced CT and dynamic MRA showing filling of the mass at the same time as the azygous vein without prior enhancement will be strongly suggestive of azygous vein aneurysm with transtracheal ultrasound being the definitive test in these patients. It is important to keep a vascular origin mass in the differential diagnosis of mediastinal masses. Also, in young healthy patients with pulmonary embolism, a vascular etiology such as azygous vein aneurysm should be carefully evaluated. This article will help the clinicians to learn about the imaging features of azygous vein aneurysm on different imaging modalities.

  15. Valsalva and gravitational variability of the internal jugular vein and common femoral vein: Ultrasound assessment

    Energy Technology Data Exchange (ETDEWEB)

    Beddy, P. [Department of Radiology, The Adelaide and Meath Hospital, Tallaght, Dublin 24 (Ireland)]. E-mail:; Geoghegan, T. [Department of Radiology, The Adelaide and Meath Hospital, Tallaght, Dublin 24 (Ireland); Ramesh, N. [Department of Radiology, The Adelaide and Meath Hospital, Tallaght, Dublin 24 (Ireland); Buckley, O. [Department of Radiology, The Adelaide and Meath Hospital, Tallaght, Dublin 24 (Ireland); O' Brien, J. [Department of Radiology, The Adelaide and Meath Hospital, Tallaght, Dublin 24 (Ireland); Colville, J. [Department of Radiology, The Adelaide and Meath Hospital, Tallaght, Dublin 24 (Ireland); Torreggiani, W.C. [Department of Radiology, The Adelaide and Meath Hospital, Tallaght, Dublin 24 (Ireland)


    Purpose: Central venous cannulation via the common femoral vein is an important starting point for many interventions. The purpose of this study was to determine the optimum conditions for cannulation of the femoral vein and to compare these with the relative changes in the internal jugular vein. Methods: High-resolution 2D ultrasound was utilised to determine variability of the calibre of the femoral and internal jugular veins in 10 healthy subjects. Venous diameter was assessed during the Valsalva manoeuvre and in different degrees of the Trendelenburg position. Results: The Valsalva manoeuvre significantly increased the size of the femoral and internal jugular veins. There was a relatively greater increase in femoral vein diameter when compared with the internal jugular vein of 40 and 29%, respectively. Changes in body inclination (Trendelenburg position) did not significantly alter the luminal diameter of the femoral vein. However, it significantly increased internal jugular vein diameter. Conclusions: Femoral vein cannulation is augmented by the Valsalva manoeuvre but not significantly altered by the gravitational position of the subject.

  16. Combine Harvester Simulator

    DEFF Research Database (Denmark)

    Vilmann, Ole; Sørlie, James Arnold


    A simulator for training pilots in the operation of a modern high-tech combine harvester is presented. The new simulator application is based on DMI´s well-known DMS maritime simulator architecture. Two major challenges have been encountered in the development of the simulator: 1) interfacing the...

  17. 1975 Washington timber harvest. (United States)

    J.D. Jr. Lloyd


    In 1975, the Washington timber harvest declined for the 2d year to 6.2 billion board feet, 10 percent below 1974, and the lowest level in 8 years. The decrease, which occurred on almost all ownerships, amounted to 561 million board feet in western Washington and 130 million board feet in eastern Washington.

  18. Microwave liver ablation: influence of hepatic vein size on heat-sink effect in a porcine model. (United States)

    Yu, Nam C; Raman, Steven S; Kim, Young Jun; Lassman, Charles; Chang, Xinlian; Lu, David S K


    To determine influence of hepatic vein size on perfusion-mediated attenuation in adjacent microwave thermal ablation. With approval of the institutional animal research committee, seven Yorkshire pigs underwent percutaneous (n = 2) or open (n = 5) microwave liver ablation under general anesthesia. In each, multiple ultrasound-guided, nonoverlapping thermal lesions were created within 1 cm of hepatic veins in a 5-10-minute ablation at 45 W. After euthanasia, the liver was harvested and sectioned at 0.5-cm intervals and the degree of perivascular coagulation attenuation was graded on histopathologic analysis. Correlation between venous size (small, 6 mm) and attenuation grade was performed with use of the Spearman rank test. In 63 of 103 sections (61%)--29 of 37 (78%) small, 27 of 48 (56%) medium, and seven of 18 (39%) large veins--the thermal injury extended to the vein wall around the entire circumference of the coagulation front without distortion of the ablation margin. In 40 of 103 sections (38.9%), varying degrees of concave distortion of perivenous ablation margins were noted, with significant correlation between vein size and heat-sink extent (P heat-sink effect was significantly dependent on hepatic vein size, the majority of pathologic sections exhibited no or minimal effect. Further study is required to assess clinical implications.

  19. Distally based saphenous neurocutaneous perforator flap combined with vac therapy for soft tissue reconstruction and hardware salvage in the lower extremities. (United States)

    Wen, Gen; Wang, Chun-Yang; Chai, Yi-Min; Cheng, Liang; Chen, Ming; Yi-Min, L V


    The complex wound with the exposed hardware and infection is one of the common complications after the internal fixation of the tibia fracture. The salvage of hardware and reconstruction of soft tissue defect remain challenging. In this report, we presented our experience on the use of the distally based saphenous neurocutaneous perforator flap combined with vacuum-assisted closure (VAC) therapy for the coverage of the soft tissue defect and the exposed hardware in the lower extremity with fracture. Between January 2008 and July 2010, seven patients underwent the VAC therapy followed by transferring a reversed saphenous neurocutaneous perforator flap for reconstruction of the wound with exposed hardware around the distal tibia. The sizes of the flaps ranged from 6 × 3 cm to 15 × 6 cm. Six flaps survived completely. Partial necrosis occurred in one patient. There were no other complications of repair and donor sites. Bone healing was achieved in all patients. In conclusion, the reversed saphenous neurocutaneous perfortor flaps combined with the VAC therapy might be one of the options to cover the complex wound with exposed hardware in the lower extremities. © 2013 Wiley Periodicals, Inc.

  20. Designing A General Deep Web Harvester by Harvestability Factor

    NARCIS (Netherlands)

    Khelghati, Mohammadreza; Hiemstra, Djoerd; van Keulen, Maurice


    To make deep web data accessible, harvesters have a crucial role. Targeting different domains and websites enhances the need of a general-purpose harvester which can be applied to different settings and situations. To develop such a harvester, a large number of issues should be addressed. To have

  1. Una nueva experiencia clínica: Colgajo safeno interno diferido A new clinical experience: the delayed reverse saphenous flap

    Directory of Open Access Journals (Sweden)

    G.A. Wolff I


    Full Text Available Los defectos de tejidos blandos de la pierna y el pie cuasados por traumatismos, tumores o infecciones, requieren frecuentemente procedimientos de cobertura mediante el empleo de colgajos. El colgajo safeno interno ha demostrado ser una excelente opción por su versatilidad y su poca morbilidad en el área donante. El diferimiento es un procedimiento útil para reducir las complicaciones vasculares de los colgajos, en pacientes con factores de riesgo añadidos. Su fisiología ha sido estudiada detalladamente, pero aún persisten interrogantes en torno a su uso y al periodo de diferimiento. Presentamos nuestra experiencia clínica con el uso de colgajos diferidos en 2 casos de reconstrucción de pie y tobillo secundarios a traumatismos, en los que se presentó sufrimiento vascular agudo al realizar el colgajo safeno interno reverso. El período de diferimiento varió entre los 7 y los 10 días. Los resultados postoperatorios fueron satisfactorios. Se presentó solo un complicación consistente en necrosis de los bordes de uno de los colgajos (menor del 1%. En conclusión, creemos que el diferimiento de los colgajos regionales es una herramienta útil para reducir la tasa de complicaciones vasculares en los mismos. Nuestra experiencia con el colgajo safeno interno diferido, reportada por primera vez según nuestro conocimiento, confirma la utilidad del procedimiento en este tipo de colgajo, demostrando que aún en condiciones de riesgo vascular esta modificación del colgajo se presenta como una opción alternativa para la reconstrucción exitosa de este tipo de defectos.Complex soft tissue defects of the distal third of the leg and foot represent a challenge in the reconstructive. The internal saphenous flap is a frequently used option for lower leg reconstruction because its versatility and minimal donor site morbidity. The commonly known delay procedure is an alternative. The concept of delay was clearly explained years ago, but still there is

  2. Wearable Biomechanical Energy Harvesting Technologies

    Directory of Open Access Journals (Sweden)

    Young-Man Choi


    Full Text Available Energy harvesting has been attracting attention as a technology that is capable of replacing or supplementing a battery with the development of various mobile electronics. In environments where stable electrical supply is not possible, energy harvesting technology can guarantee an increased leisure and safety for human beings. Harvesting with several watts of power is essential for directly driving or efficiently charging mobile electronic devices such as laptops or cell phones. In this study, we reviewed energy harvesting technologies that harvest biomechanical energy from human motion such as foot strike, joint motion, and upper limb motion. They are classified based on the typical principle of kinetic energy harvesting: piezoelectric, triboelectric, and electromagnetic energy harvesting. We focused on the wearing position of high-power wearable biomechanical energy harvesters (WBEHs generating watt-level power. In addition, the features and future trends of the watt-level WBEHs are discussed.

  3. Hepatic vein obstruction (Budd-Chiari) (United States)

    ... MedlinePlus Site Map FAQs Customer Support Health Topics Drugs & Supplements Videos & Tools Español You Are Here: Home → Medical Encyclopedia → Hepatic vein obstruction (Budd-Chiari) URL of this page: // ...

  4. Primary leiomyosarcoma of the innominate vein. (United States)

    Illuminati, Giulio; Miraldi, Fabio; Mazzesi, Giuseppe; D'urso, Antonio; Ceccanei, Gianluca; Bezzi, Marcello


    Primary venous leiomyosarcoma is rare. We report the case of a primary leiomyosarcoma of the left innominate vein, with neoplastic thrombus extending into the left jugular and subclavian veins. The tumor was curatively resected en bloc with anterior mediastinal and laterocervical lymphatics, through a median sternotomy prolonged into left cervicotomy. Primary venous sarcomas may be associated with prolonged survival in individual cases, with curative resection recommended as the standard treatment, in the absence of distant spread.

  5. CT in thrombosed dilated posterior epidural vein

    Energy Technology Data Exchange (ETDEWEB)

    Bammatter, S.; Schnyder, P.; Preux, J. de


    The authors report a case of thrombosis of the distal end of an enlarged right posterior epidural vein. The patient had a markedly narrow lumbar canal due to L5 spondylolisthesis. The dilated vein and the thrombosis were displayed by computed tomography but remained unrecognized until surgery. Pathogenesis of this condition is discussed. A review of the English, French and German literature revealed no prior radiological reports of a similar condition.

  6. Retrotracheal aberrant left brachiocephalic vein: CT findings

    Energy Technology Data Exchange (ETDEWEB)

    Yigit, Adalet E.; Haliloglu, Mithat; Karcaaltincaba, Musturay; Ariyurek, Macit O. [Hacettepe University Faculty of Medicine, Department of Radiology, Ankara (Turkey)


    We present a child with double aberrant left brachiocephalic vein (ALBCV) that was an incidental finding on CT. The anterior and thin branch was above the aortic arch and behind the truncus brachiocephalicus and drained into the superior vena cava (SVC). The posterior and thick branch of the ALBCV coursed posterior to the trachea and oesophagus and joined with the azygos vein before draining into the SVC. To our knowledge, retrotracheal ALBCV has not been previously described. (orig.)

  7. Harvest Regulations and Implementation Uncertainty in Small Game Harvest Management

    Directory of Open Access Journals (Sweden)

    Pål F. Moa


    Full Text Available A main challenge in harvest management is to set policies that maximize the probability that management goals are met. While the management cycle includes multiple sources of uncertainty, only some of these has received considerable attention. Currently, there is a large gap in our knowledge about implemention of harvest regulations, and to which extent indirect control methods such as harvest regulations are actually able to regulate harvest in accordance with intended management objectives. In this perspective article, we first summarize and discuss hunting regulations currently used in management of grouse species (Tetraonidae in Europe and North America. Management models suggested for grouse are most often based on proportional harvest or threshold harvest principles. These models are all built on theoretical principles for sustainable harvesting, and provide in the end an estimate on a total allowable catch. However, implementation uncertainty is rarely examined in empirical or theoretical harvest studies, and few general findings have been reported. Nevertheless, circumstantial evidence suggest that many of the most popular regulations are acting depensatory so that harvest bag sizes is more limited in years (or areas where game density is high, contrary to general recommendations. A better understanding of the implementation uncertainty related to harvest regulations is crucial in order to establish sustainable management systems. We suggest that scenario tools like Management System Evaluation (MSE should be more frequently used to examine robustness of currently applied harvest regulations to such implementation uncertainty until more empirical evidence is available.

  8. Veins improve fracture toughness of insect wings.

    Directory of Open Access Journals (Sweden)

    Jan-Henning Dirks

    Full Text Available During the lifetime of a flying insect, its wings are subjected to mechanical forces and deformations for millions of cycles. Defects in the micrometre thin membranes or veins may reduce the insect's flight performance. How do insects prevent crack related material failure in their wings and what role does the characteristic vein pattern play? Fracture toughness is a parameter, which characterises a material's resistance to crack propagation. Our results show that, compared to other body parts, the hind wing membrane of the migratory locust S. gregaria itself is not exceptionally tough (1.04±0.25 MPa√m. However, the cross veins increase the wing's toughness by 50% by acting as barriers to crack propagation. Using fracture mechanics, we show that the morphological spacing of most wing veins matches the critical crack length of the material (1132 µm. This finding directly demonstrates how the biomechanical properties and the morphology of locust wings are functionally correlated in locusts, providing a mechanically 'optimal' solution with high toughness and low weight. The vein pattern found in insect wings thus might inspire the design of more durable and lightweight artificial 'venous' wings for micro-air-vehicles. Using the vein spacing as indicator, our approach might also provide a basis to estimate the wing properties of endangered or extinct insect species.

  9. Cirurgia de varizes em regime de mutirão A task force for varicose vein surgery

    Directory of Open Access Journals (Sweden)

    Carlos Eduardo Virgini-Magalhães


    estágios moderados da doença, especialmente nas classes C2 e C3 da CEAP, e que requerem cirurgias de médio e grande porte para o tratamento de suas patologias.BACKGROUND: Varicose vein surgery of the lower limbs is one of the most frequent procedures carried out in the Brazilian public health system (Sistema Único de Saúde, especially during task forces focused on elective surgeries. However, detailed information on the results of such initiatives are absent in the literature, particularly with regard to the population that benefits from the task forces. OBJECTIVES: To present and discuss the profile of patients operated on during a task force for varicose vein surgery carried out in a public health institution. METHODS: The patients were selected from a database organized by the Brazilian Health Ministry for the program of elective surgeries, and they had no previous link with the hospital institution. A protocol for objective evaluation with the clinical data and demographic profile of the patients was applied. The patients were staged according to CEAP classification. RESULTS: From September 2005 to January 2006, 100 patients (106 procedures underwent surgery, females being predominant (85% of the cases. Mean age was 35±9.8 years. Predominant schooling level among patients was primary school (53%. C2 (49.5% and C3 (39% were the most frequent CEAP classes in the clinical evaluation of lower limbs. A total of 106 surgeries was performed (100 patients. The preferred anesthetic technique was block anesthesia (93% of the procedures. Six patients were submitted to two different procedures due to great volume of lower limb varicose veins; 33 patients were submitted to internal saphenous vein stripping (four cases of segmental saphenous vein stripping; and eight patients were submitted to bilateral total saphenous vein stripping. CONCLUSION: Profile of the population that benefited from the task force for varicose vein surgeries was: young symptomatic female patients

  10. An update in varicose vein pathology after ten years of endovenous laser therapy (EVLT) with a 980 nm diode laser: clinical experience of a single center. (United States)

    Scarpelli, Pietro; Maggipinto, Annamaria; Leopardi, Marco; Di Marco, Evelina; Disabato, Angelo; Boschetti, Michelangelo; Sbenaglia, Giorgio; Spartera, Carlo; Ventura, Marco


    To show our experience in the surgical treatment of superficial vein insufficiency of the lower limbs. Since 2002 we have performed 659 procedures of endovascular laser therapy (EVLT) (group A) in the treatment of chronic venous insufficiency of the great saphenous vein using a 980 nm diode laser. A closely matched group of 100 patients (50 Group A, 50 Group B) with homogeneous clinical findings (CEAP classification) was controlled with a mean follow-up of 18 months in our more recent experience (3 years). Most patients operated on in this period were lost to follow-up. The Final results showed that EVLT can be used only in a specific selected group of cases based on anatomy and hemodynamics and while 980 nm EVLT could not be selected as the best treatment for this pathology, it could be placed side by side with conventional therapy. In our one year's more recent experience, we observed an increased number of patients treated with conventional therapy. The development of new laser tools (new wavelengths and continuous radial laser) and the improvement of clinical follow up may lead us to a more correct application of EVLT in the absence of randomized trials because of widespread clinical findings and poor pathological follow-up of this approach to superficial venous insufficiency.

  11. Piezoelectric Energy Harvesting Solutions (United States)

    Caliò, Renato; Rongala, Udaya Bhaskar; Camboni, Domenico; Milazzo, Mario; Stefanini, Cesare; de Petris, Gianluca; Oddo, Calogero Maria


    This paper reviews the state of the art in piezoelectric energy harvesting. It presents the basics of piezoelectricity and discusses materials choice. The work places emphasis on material operating modes and device configurations, from resonant to non-resonant devices and also to rotational solutions. The reviewed literature is compared based on power density and bandwidth. Lastly, the question of power conversion is addressed by reviewing various circuit solutions. PMID:24618725

  12. Piezoelectric Energy Harvesting Solutions

    Directory of Open Access Journals (Sweden)

    Renato Caliò


    Full Text Available This paper reviews the state of the art in piezoelectric energy harvesting. It presents the basics of piezoelectricity and discusses materials choice. The work places emphasis on material operating modes and device configurations, from resonant to non-resonant devices and also to rotational solutions. The reviewed literature is compared based on power density and bandwidth. Lastly, the question of power conversion is addressed by reviewing various circuit solutions.

  13. Piezoelectric energy harvesting solutions. (United States)

    Caliò, Renato; Rongala, Udaya Bhaskar; Camboni, Domenico; Milazzo, Mario; Stefanini, Cesare; de Petris, Gianluca; Oddo, Calogero Maria


    This paper reviews the state of the art in piezoelectric energy harvesting. It presents the basics of piezoelectricity and discusses materials choice. The work places emphasis on material operating modes and device configurations, from resonant to non-resonant devices and also to rotational solutions. The reviewed literature is compared based on power density and bandwidth. Lastly, the question of power conversion is addressed by reviewing various circuit solutions.

  14. Advances in energy harvesting methods

    CERN Document Server

    Elvin, Niell


    Advances in Energy Harvesting Methods presents a state-of-the-art understanding of diverse aspects of energy harvesting with a focus on: broadband energy conversion, new concepts in electronic circuits, and novel materials. This book covers recent advances in energy harvesting using different transduction mechanisms; these include methods of performance enhancement using nonlinear effects, non-harmonic forms of excitation and non-resonant energy harvesting, fluidic energy harvesting, and advances in both low-power electronics as well as  material science. The contributors include a brief liter

  15. Diagnosis and treatment of superficial vein thrombosis. (United States)

    Bauersachs, R M


    Superficial vein thrombosis (SVT) is a common disease, characterized by an inflammatory-thrombotic process in a superficial vein. Typical clinical findings are pain and a warm, tender, reddish cord along the vein. Until recently, no reliable epidemiological data were available. The incidence is estimated to be higher than that of deep-vein thrombosis (DVT) (1/1000). SVT shares many risk factors with DVT, but affects twice as many women than men and frequently occurs in varicose veins. Clinically, SVT extension is commonly underestimated, and patients may have asymptomatic DVT. Therefore, ultrasound assessment and exclusion of DVT is essential. Risk factors for concomitant DVT are recent hospitalization, immobilization, autoimmune disorders, age > 75 years, prior VTE, cancer and SVT in non-varicose veins. Even though most patients with isolated SVT (without concomitant DVT or PE) are commonly treated with anticoagulation for a median of 15 days, about 8% experience symptomatic thromboembolic complications within three months. Risk factors for occurrence of complications are male gender, history of VTE, cancer, SVT in a non-varicose vein or SVT involving the sapheno-femoral junction (SFJ). As evidence supporting treatment of isolated SVT was sparse and of poor quality, the large, randomized, double-blind, placebo-controlled CALISTO trial was initiated assessing the effect of fondaparinux on symptomatic outcomes in isolated SVT. This study showed that, compared with placebo, 2.5 mg fondaparinux given for 45 days reduced the risk of symptomatic thromboembolic complications by 85% without increasing bleeding. Based on CALISTO and other observational studies, evidence-based recommendations can be made for the majority of SVT patients. Further studies can now be performed in higher risk patients to address unresolved issues.

  16. Corrosion cast study of the canine hepatic veins. (United States)

    Uršič, M; Vrecl, M; Fazarinc, G


    This study presents a detailed description of the distribution, diameters and drainage patterns of hepatic veins on the basis of the corrosion cast analysis in 18 dogs. We classified the hepatic veins in three main groups: the right hepatic veins of the caudate process and right lateral liver lobe, the middle hepatic veins of the right medial and quadrate lobes and the left hepatic veins of both left liver lobes and the papillary process. The corrosion cast study showed that the number of the veins in the Nomina Anatomica Veterinaria and most anatomical textbooks is underestimated. The number of various-sized hepatic veins of the right liver division ranged from 3 to 5 and included 1 to 4 veins from the caudate process and 2 to 4 veins from the right lateral liver lobe. Generally, in all corrosion casts, one middle-sized vein from the right part of the right medial lobe, which emptied separately in the caudal vena cava, was established. The other vein was a large-sized vein from the remainder of the central division, which frequently joined the common left hepatic vein from the left liver lobes. The common left hepatic vein was the largest of all the aforementioned hepatic veins.

  17. Iliac Vein Interrogation Augments Venous Ulcer Healing in Patients Who Have Failed Standard Compression Therapy along with Pathological Venous Closure. (United States)

    Mousa, Albeir Y; Broce, Mike; Yacoub, Michael; AbuRahma, Ali F


    Treatment of venous ulcers is demanding for patients, as well as clinicians, and the investigation of underlying venous hypertension is the cornerstone of therapy. We propose that occult iliac vein stenosis should be ruled out by iliac vein interrogation (IVI) in patients with advanced venous stasis. We conducted a systematic retrospective analysis of a consecutive series of patients who presented with CEAP (clinical, etiological, anatomical, and pathophysiological) 6 venous disease. All patients had great saphenous vein ablation, compressive treatment, wound care (including Unna boot compression), and perforator closure using ablation therapy. Iliac vein stenosis was defined as ≥50% stenosis in cross-sectional surface area on intravascular ultrasound. Primary outcomes include time of venous ulcer healing and/or measurable change in the Venous Clinical Severity Score. Twenty-two patients with CEAP 6 venous disease met the inclusion criteria (active ulcers >1.5 cm in diameter). The average age and body mass index were 62.2 ± 9.2 years and 41.7 ± 16.7, respectively. The majority were female (72.7%) with common comorbidities, such as hyperlipidemia (54.5%), hypertension (36.4%), and diabetes mellitus (27.3%). Twenty-nine ulcers with an average diameter of 3.4 ± 1.9 cm and a depth of 2.2 ± 0.5 mm were treated. The majority of the ulcers occurred on the left limb (n = 17, 58.6%). Average perforator venous reflux was 3.6 ± 0.8 sec, while common femoral reflux was 1.8 ± 1.6. The majority (n = 19, 64.5%) of the perforator veins were located at the base of the ulcer, while the remainder (n = 10, 34.5%) were within 2 cm from the base. Of the 13 patients who underwent IVI, 8 patients (61.5%) had stenosis >50% that was corrected with iliac vein angioplasty and stenting (IVAS). There was a strong trend toward shorter healing time in the IVI group (7.9 ± 9.5 weeks) than for patients in the no iliac vein interrogation (NIVI) group (20.2 ± 15

  18. Differential fat harvesting

    Directory of Open Access Journals (Sweden)

    Sebastian Torres Farr


    Full Text Available Aim: Volume replacement with fillers is regularly performed with the use of diverse volumetric materials to correct different structures around the face, depending on the volume enhancement required and the thickness of the soft tissue envelope. Differential fat harvesting and posterior grafting is performed to place the correct fat parcel size for each target area, expanding the potential applications of fat. Methods: Sixty patients consecutively recruited on a first come basis undergone a facial fat grafting procedure, in private practice setting between March 2012 and October 2013. Fat grafting quantity and quality was predicted for each case. Differential harvesting was performed, with 2 fat parcels size. Processing was performed through washing. Fat infiltration was carried out through small cannulas or needles depending on the treated area. Outcomes were analysed both by the physicians and the patients at 7 days, 1 month, 3 months and 6 months through a perceived satisfaction questionnaire. Parameters considered were downtime or discomfort, skin benefits, volume restoration, reabsorption rate estimated and overall improvement. Results: Full facial differential fat grafting procedure lasted an average of 1.5-2.5 h. Average downtime was 3-4 days. Follow-up was performed to a minimum of 6 months. Both patient and physician overall satisfaction rates were mostly excellent. Adverse events like lumps or irregularities were not encountered. Conclusion: Differential fat harvesting and posterior grafting is a valid alternative, to expand the repertoire of fat use, allow a more homogeneous effect, reduce the potential complications, speed up the process, improve graft survival, and to enhance overall aesthetic outcome.

  19. Micro energy harvesting

    CERN Document Server

    Briand, Danick; Roundy, Shad


    With its inclusion of the fundamentals, systems and applications, this reference provides readers with the basics of micro energy conversion along with expert knowledge on system electronics and real-life microdevices. The authors address different aspects of energy harvesting at the micro scale with a focus on miniaturized and microfabricated devices. Along the way they provide an overview of the field by compiling knowledge on the design, materials development, device realization and aspects of system integration, covering emerging technologies, as well as applications in power management, e

  20. Nanostructured piezoelectric energy harvesters

    CERN Document Server

    Briscoe, Joe


    This book covers a range of devices that use piezoelectricity to convert mechanical deformation into electrical energy and relates their output capabilities to a range of potential applications. Starting with a description of the fundamental principles and properties of piezo- and ferroelectric materials, where applications of bulk materials are well established, the book shows how nanostructures of these materials are being developed for energy harvesting applications. The authors show how a nanostructured device can be produced, and put in context some of the approaches that are being invest

  1. Energy harvesting for microsystems

    DEFF Research Database (Denmark)

    Xu, Ruichao

    to the first one, the screen printed PZT layer is replaced by a lead free piezoelectric material, (KxNa1-x)NbO3 (KNN). Some of the major challenges encountered during the development processes are bad adhesion, fragile structures and short circuiting through the PZT layer. All which have being fully......The purpose of this project is to design and fabricate piezoelectric energy harvesters based on integration of Pb(ZrxTi1-x)O3 (PZT) thick film technology and silicon microtechnology. The fabrication processes are carried out in close collaboration with Meggitt Sensing Systems (MSS) who has...

  2. The anatomy of the cardiac veins in mice (United States)

    Ciszek, Bogdan; Skubiszewska, Daria; Ratajska, Anna


    Although the cardiac coronary system in mice has been the studied in detail by many research laboratories, knowledge of the cardiac veins remains poor. This is because of the difficulty in marking the venous system with a technique that would allow visualization of these large vessels with thin walls. Here we present the visualization of the coronary venous system by perfusion of latex dye through the right caudal vein. Latex injected intravenously does not penetrate into the capillary system. Murine cardiac veins consist of several principal branches (with large diameters), the distal parts of which are located in the subepicardium. We have described the major branches of the left atrial veins, the vein of the left ventricle, the caudal veins, the vein of the right ventricle and the conal veins forming the conal venous circle or the prepulmonary conal venous arch running around the conus of the right ventricle. The venous system of the heart drains the blood to the coronary sinus (the left cranial caval vein) to the right atrium or to the right cranial caval vein. Systemic veins such as the left cranial caval, the right cranial caval and the caudal vein open to the right atrium. Knowledge of cardiac vein location may help to elucidate abnormal vein patterns in certain genetic malformations. PMID:17553104

  3. Superficial vein thrombosis with hemorrhagic cerebral infarction

    Directory of Open Access Journals (Sweden)

    Yu-wei CONG


    Full Text Available Background Cerebral superficial vein thrombosis was rare and often misdiagnosed or missed for its various etiological factors, and complicated and nonspecific clinical manifestations. This paper reported one case of superficial vein thrombosis in right fronto-parietal lobe with hemorrhagic infarction. The anatomy of superficial vein, pathophysiological points, diagnosis and treatment of superficial vein thrombosis were reviewed to help to reduce missed diagnosis or misdiagnosis. Methods and Results A 18-year-old male patient had suffered from progressive headache for 4 years and weakness of left limbs for 2 d. Head MRI showed circular space-occupying lesion in right fronto-parietal lobe. Magnetic resonance venography (MRV examination showed the front two-thirds of the superior sagittal sinus was not clear. The lesions were removed and decompressive craniectomy was conducted, showing the brain tissue was pale, partly yellow or dark red, and superficial venous engorgement. Histological observation showed pial superficial vein thrombosis and subpial encephalomalacia, and multifocal hemorrhage of cerebral cortex and local parenchymal hemorrhage. A large number of "grid cells" and vascular "cuff" phenomenan were visible in surrounding tissue, and the parenchymal blood vessel proliferation was obvious. Left hand activity of the patient was obviously limited after the operation. Conclusions Clinical diagnosis of superficial vein thrombosis with hemorrhagic infarction is difficult, and brain imaging and serological examination can provide certain help. Much attention should be paid to the multidisciplinary diagnosis and treatment to reduce misdiagnosis or missed diagnosis, and gather clinical experience. DOI: 10.3969/j.issn.1672-6731.2016.01.007

  4. Multifunctional Piezoelectric Energy Harvesting Concepts


    Anton, Steven Robert


    Energy harvesting technology has the ability to create autonomous, self-powered electronic systems that do not rely on battery power for their operation. The term energy harvesting describes the process of converting ambient energy surrounding a system into useful electrical energy through the use of a specific material or transducer. A widely studied form of energy harvesting involves the conversion of mechanical vibration energy into electrical energy using piezoelectric materials, which ...

  5. Spontaneous activity in C-fibres after partial damage to the saphenous nerve in mice: Effects of retigabine. (United States)

    Bernal, L; Lopez-Garcia, J A; Roza, C


    Spontaneous pain is the most devastating positive symptom in neuropathic pain patients. Recent data show a direct relationship between spontaneous discharges in C-fibres and spontaneous pain in neuropathic patients. Unfortunately, to date there is a lack of experimental animal models for drug testing. We recorded afferent fibres from a new experimental model in vitro. The preparation contains a neuroma formed in a peripheral branch of the saphenous nerve together with the undamaged branches, which maintain intact terminals in a skin flap. Fibres with stable rates of ectopic spontaneous discharges were found among axotomized (5 A- and 18 C-fibres, mean discharge 0.48 ± 0.08 Hz) and 'putative intact' fibres (12 C-fibres, mean discharge 0.28 ± 0.08 Hz). A proportion (~9%) of axotomized fibres had mechanical receptive fields in the skin far beyond the site of injury. Collision experiments demonstrated that action potentials evoked from neuroma and skin travelled by the same fibre, indicating functional cross-talk between neuromatose and putative intact fibres. Retigabine, the specific Kv7 channel opener, depressed spontaneous discharges by 70% in 15/18 units tested. In contrast, responses to mechanical stimulation of the skin were unaltered by retigabine. Partial damage to a peripheral nerve may increase the incidence of spontaneous activity in C-fibres. Retigabine reduced spontaneous activity but not stimulus-evoked activity, suggesting an important role for ion channels in the control of spontaneous pain and demonstrating the utility of the model for the testing of compounds in clinically relevant variables. WHAT DOES THIS STUDY ADD?: Our in vitro experimental model of peripheral neuropathy allows for pharmacological characterization of spontaneously active fibres. Using this model, we show that retigabine inhibits aberrant spontaneous discharges without altering physiological responses in primary afferents. © 2016 European Pain Federation - EFIC®

  6. Importance of anatomically locating the infrapatellar branch of the saphenous nerve in reconstructing the anterior cruciate ligament using flexor tendons,

    Directory of Open Access Journals (Sweden)

    Julio Cesar Gali


    Full Text Available Objective:To describe the path of the infrapatellar branch of the saphenous nerve (IBSN using the medial joint line, anterior tibial tuberosity (ATT, tibial collateral ligament and a horizontal line parallel to the medial joint line that passes over the ATT, as reference points, in order to help surgeons to diminish the likelihood of injuring this nerve branch during reconstruction of the anterior cruciate ligament (ACL using flexor tendons.Methods:Ten frozen knees that originated from amputations were examined. Through anatomical dissection performed with the specimens flexed, we sought to find the IBSN, from its most medial and proximal portion to its most lateral and distal portion. Following this, the anatomical specimens were photographed and, using the ImageJ software, we determined the distance from the IBSN to the medial joint line and to a lower horizontal line going through the ATT and parallel to the first line. We also measured the angle of the direction of the path of the nerve branch in relation to this lower line.Results:The mean angle of the path of the nerve branch in relation to the lower horizontal line was 17.50 ±6.17°. The mean distance from the IBSN to the medial joint line was 2.61 ± 0.59 cm and from the IBSN to the lower horizontal line, 1.44 ±0.51 cm.Conclusion:The IBSN was found in all the knees studied. In three knees, we found a second branch proximal to the first one. The direction of its path was always from proximal and medial to distal and lateral. The IBSN was always proximal and medial to the ATT and distal to the medial joint line. The medial angle between its direction and a horizontal line going through the ATT was 17.50 ± 6.17°.

  7. Deep vein thrombosis: a clinical review

    Directory of Open Access Journals (Sweden)

    Kesieme EB


    Full Text Available Emeka Kesieme1, Chinenye Kesieme2, Nze Jebbin3, Eshiobo Irekpita1, Andrew Dongo11Department of Surgery, Irrua Specialist Teaching Hospital, Irrua, Nigeria; 2Department of Paediatrics, Irrua Specialist Teaching Hospital, Irrua, Nigeria; 3Department of Surgery, University of Port Harcourt Teaching Hospital, Port-Harcourt, NigeriaBackground: Deep vein thrombosis (DVT is the formation of blood clots (thrombi in the deep veins. It commonly affects the deep leg veins (such as the calf veins, femoral vein, or popliteal vein or the deep veins of the pelvis. It is a potentially dangerous condition that can lead to preventable morbidity and mortality.Aim: To present an update on the causes and management of DVT.Methods: A review of publications obtained from Medline search, medical libraries, and Google.Results: DVT affects 0.1% of persons per year. It is predominantly a disease of the elderly and has a slight male preponderance. The approach to making a diagnosis currently involves an algorithm combining pretest probability, D-dimer testing, and compression ultrasonography. This will guide further investigations if necessary. Prophylaxis is both mechanical and pharmacological. The goals of treatment are to prevent extension of thrombi, pulmonary embolism, recurrence of thrombi, and the development of complications such as pulmonary hypertension and post-thrombotic syndrome.Conclusion: DVT is a potentially dangerous condition with a myriad of risk factors. Prophylaxis is very important and can be mechanical and pharmacological. The mainstay of treatment is anticoagulant therapy. Low-molecular-weight heparin, unfractionated heparin, and vitamin K antagonists have been the treatment of choice. Currently anticoagulants specifically targeting components of the common pathway have been recommended for prophylaxis. These include fondaparinux, a selective indirect factor Xa inhibitor and the new oral selective direct thrombin inhibitors (dabigatran and selective

  8. Thermoelectrics and its energy harvesting

    National Research Council Canada - National Science Library

    Rowe, David Michael


    .... It details the latest techniques for the preparation of thermoelectric materials employed in energy harvesting, together with advances in the thermoelectric characterisation of nanoscale material...

  9. Image Quality Enhancement Using the Direction and Thickness of Vein Lines for Finger-Vein Recognition

    Directory of Open Access Journals (Sweden)

    Young Ho Park


    Full Text Available On the basis of the increased emphasis placed on the protection of privacy, biometric recognition systems using physical or behavioural characteristics such as fingerprints, facial characteristics, iris and finger-vein patterns or the voice have been introduced in applications including door access control, personal certification, Internet banking and ATM machines. Among these, finger-vein recognition is advantageous in that it involves the use of inexpensive and small devices that are difficult to counterfeit. In general, finger-vein recognition systems capture images by using near infrared (NIR illumination in conjunction with a camera. However, such systems can face operational difficulties, since the scattering of light from the skin can make capturing a clear image difficult. To solve this problem, we proposed new image quality enhancement method that measures the direction and thickness of vein lines. This effort represents novel research in four respects. First, since vein lines are detected in input images based on eight directional profiles of a grey image instead of binarized images, the detection error owing to the non-uniform illumination of the finger area can be reduced. Second, our method adaptively determines a Gabor filter for the optimal direction and width on the basis of the estimated direction and thickness of a detected vein line. Third, by applying this optimized Gabor filter, a clear vein image can be obtained. Finally, the further processing of the morphological operation is applied in the Gabor filtered image and the resulting image is combined with the original one, through which finger-vein image of a higher quality is obtained. Experimental results from application of our proposed image enhancement method show that the equal error rate (EER of finger-vein recognition decreases to approximately 0.4% in the case of a local binary pattern-based recognition and to approximately 0.3% in the case of a wavelet transform

  10. Clinical Significance of the Soleal Vein and Related Drainage Veins, in Calf Vein Thrombosis in Autopsy Cases with Massive Pulmonary Thromboembolism (United States)

    Kageyama, Norimasa


    Objective: To clarify the histopathological characteristics of deep vein thrombosis (DVT) resulting in lethal pulmonary thromboembolism (PE). Subjects and Methods: We investigated 100 autopsy cases of PE from limb DVT. The distribution and chronology of DVT in each deep venous segment were examined. Venous segments were classified into three groups: iliofemoral vein, popliteal vein and calf vein (CV). The CV was subdivided into two subgroups, drainage veins of the soleal vein (SV) and non drainage veins of SV. Results: Eighty-nine patients had bilateral limb DVTs. CV was involved in all limbs with DVT with isolated calf DVTs were seen in 47% of patients. Fresh and organized thrombi were detected in 84% of patients. SV showed the highest incidence of DVTs in eight venous segments. The incidence of DVT gradually decreased according to the drainage route of the central SV. Proximal tips of fresh thrombi were mainly located in the popliteal vein and tibioperoneal trunk, occurring in these locations in 63% of limbs. Conclusions: SV is considered to be the primary site of DVT; the DVT then propagated to proximal veins through the drainage veins. Lethal thromboemboli would occur at proximal veins as a result of proximal propagation from calf DVTs. PMID:27087868

  11. Portal-to-right portal vein bypass for extrahepatic portal vein obstruction. (United States)

    Long, Li; Jinshan, Zhang; Zhen, Chen; Qi, Li; Ning, Dong; Mei, Diao; Wei, Cheng


    Rex shunt (mesenteric-to-left portal vein bypass) is considered a more physiologically rational treatment for EHPVO than other portosystemic systemic shunts in children. However, about 13.6% of children with EHPVO do not have usable left portal veins and up to 28.1%. Rex operations in children are not successful. Hence, a Rex shunt in these children was impossible. This study reports a novel approach by portal-to-right portal vein bypass for treatment of children with failed Rex shunts. Eight children (age 6.1years, range 3.5-8.9years) who underwent Rex shunts developed recurrent gastrointestinal bleeding and hypersplenism 13months (11-30months) postoperatively. After ultrasound confirmation of blocked shunt, they underwent exploration. Three patients were found to have right portal vein agenesis. Five patients (62.5%) were found to have the patent right portal vein, with the diameter of 3-6mm. Four patients underwent bypass between the main portal vein in the hepatoduodenal ligament and the right portal vein by interposing an inferior mesenteric vein autograft, whereas the remaining patient underwent a bypass using ileal mesenteric vein autograft. The operations took 2.3h (1.9-3.5h). The estimated blood loss was 50ml (30-80ml), with no complication. The portal venous pressure dropped from 34.6cmH2O (28-45 cmH2O) before the bypass to 19.6cmH2O (14-24cmH2O) after the bypass. The 5 patients were followed up for 10.2months (4-17months) and the post-operative ultrasound and CT angiography confirmed the patency of all the grafts and disappearance of the portal venous cavernova in all five patients. The portal-to-right portal vein bypass technique is feasible and safe for treatment of children with EHPVO who have had failed Rex shunts. Our preliminary result indicates that this technique extends the success of Rex shunt from left portal vein to right portal vein and open a new indication of physiological shunt for some of the children who not only have had failed Rex

  12. Myeloid-related protein-14 regulates deep vein thrombosis (United States)

    Wang, Yunmei; Gao, Huiyun; Kessinger, Chase W.; Schmaier, Alvin; Jaffer, Farouc A.; Simon, Daniel I.


    Using transcriptional profiling of platelets from patients presenting with acute myocardial infarction, we identified myeloid-related protein-14 (MRP-14, also known as S100A9) as an acute myocardial infarction gene and reported that platelet MRP-14 binding to platelet CD36 regulates arterial thrombosis. However, whether MRP-14 plays a role in venous thrombosis is unknown. We subjected WT and Mrp-14–deficient (Mrp-14-/-) mice to experimental models of deep vein thrombosis (DVT) by stasis ligation or partial flow restriction (stenosis) of the inferior vena cava. Thrombus weight in response to stasis ligation or stenosis was reduced significantly in Mrp-14-/- mice compared with WT mice. The adoptive transfer of WT neutrophils or platelets, or the infusion of recombinant MRP-8/14, into Mrp-14-/- mice rescued the venous thrombosis defect in Mrp-14-/- mice, indicating that neutrophil- and platelet-derived MRP-14 directly regulate venous thrombogenesis. Stimulation of neutrophils with MRP-14 induced neutrophil extracellular trap (NET) formation, and NETs were reduced in venous thrombi harvested from Mrp-14-/- mice and in Mrp-14-/- neutrophils stimulated with ionomycin. Given prior evidence that MRP-14 also regulates arterial thrombosis, but not hemostasis (i.e., reduced bleeding risk), MRP-14 appears to be a particularly attractive molecular target for treating thrombotic cardiovascular diseases, including myocardial infarction, stroke, and venous thromboembolism. PMID:28570273

  13. An unusual case: right proximal ureteral compression by the ovarian vein and distal ureteral compression by the external iliac vein

    Directory of Open Access Journals (Sweden)

    Halil Ibrahim Serin


    Full Text Available A 32-years old woman presented to the emergency room of Bozok University Research Hospital with right renal colic. Multidetector computed tomography (MDCT showed compression of the proximal ureter by the right ovarian vein and compression of the right distal ureter by the right external iliac vein. To the best of our knowledge, right proximal ureteral compression by the ovarian vein together with distal ureteral compression by the external iliac vein have not been reported in the literature. Ovarian vein and external iliac vein compression should be considered in patients presenting to the emergency room with renal colic or low back pain and a dilated collecting system.

  14. Energy harvesting water vehicle

    KAUST Repository

    Singh, Devendra


    An efficient energy harvesting (EEH) water vehicle is disclosed. The base of the EEH water vehicle is fabricated with rolling cylindrical drums that can rotate freely in the same direction of the water medium. The drums reduce the drag at the vehicle-water interface. This reduction in drag corresponds to an increase in speed and/or greater fuel efficiency. The mechanical energy of the rolling cylindrical drums is also transformed into electrical energy using an electricity producing device, such as a dynamo or an alternator. Thus, the efficiency of the vehicle is enhanced in two parallel modes: from the reduction in drag at the vehicle-water interface, and from capturing power from the rotational motion of the drums.

  15. Portal vein aneurysm and portal biliopathy. (United States)

    Kurtcehajic, Admir; Vele, Esved; Hujdurovic, Ahmed


    Highlight Kurtcehajic and colleagues present a rare case of congenital portal vein aneurysm (PVA) with biliopathy. Symptoms associated with PVA occur in less than 10% of cases. Imaging modalities showed the PVA partially compressing the common and right hepatic ducts. Conservative treatment markedly lowered bilirubin levels and relieved the abdominal pain. © 2016 Japanese Society of Hepato-Biliary-Pancreatic Surgery.

  16. Portal vein thrombosis complicating appendicitis | Ayantunde | West ...

    African Journals Online (AJOL)

    Appendicitis is still the most common acute surgical abdomen all over the world and its complications may be grave. We report an adult case of acute appendicitis complicated by Portal Vein Thrombosis (PVT) and ascending portomesenteric phlebitis treated successfully with antibiotics and anticoagulation with no residual ...

  17. vein thrombosis in elective hip replacement

    African Journals Online (AJOL)

    With the decision tree and these costs, the cost of the various modalities of prophylaxis was then detennined. Results. The probability, detennined by the forum, of developing a deep-vein thrombosis (DYD when no prophylaxis is used was 0.5, with a mortality rate of 2.1 %. The cost of this decision was R875. No prophylaxis ...

  18. Combined central retinalartery and vein occlusion complicating ...

    African Journals Online (AJOL)

    Orbital Cellulitis is a dreaded ophthalmologic disease. Itmay destroy vision and the eye andmay even become life threatening. Often visual loss is the result of exposure and subsequent destruction of ocular tissue commonly the cornea and the uvea. We report a case of combined central retinal artery and vein occlusion ...

  19. Preduodenal portal vein: A potential laparoscopic cholecystectomy ...

    African Journals Online (AJOL)

    Variations of biliary anatomy are well described. Those of most relevance to the operative surgeon are the variations of the extrahepatic ducts and their relationships to the right hepatic artery and its branches. We describe another even rarer congenital anomaly of a preduodenal portal vein. Its embryological derivation and ...

  20. Retinal Vein Occlusion in Benin City, Nigeria

    African Journals Online (AJOL)

    neovascularization). A diagnosis of CRVO was made in the presence of generalized, scattered hemorrhages consisting of dot, blot, or flame shaped hemorrhages located in the superficial or deep layers of the retina, retinal edema, venous dilatation, and areas of occluded veins. BRVO or HRVO was characterized by retinal ...

  1. Portal vein thrombosis in patients with cirrhosis

    DEFF Research Database (Denmark)

    von Köckritz, Leona; De Gottardi, Andrea; Trebicka, Jonel


    Portal vein thrombosis (PVT) is frequent in patients with liver cirrhosis and possible severe complications such as mesenteric ischemia are rare, but can be life-threatening. However, different aspects of clinical relevance, diagnosis and management of PVT are still areas of uncertainty...

  2. Who Is at Risk for Varicose Veins? (United States)

    ... Examples of these factors include family history, older age, gender, pregnancy, overweight or obesity , lack of movement, and leg trauma. Varicose veins are treated with lifestyle changes and medical procedures. The goals of treatment are to relieve symptoms, prevent complications, and improve ...

  3. How Can Varicose Veins Be Prevented? (United States)

    ... Examples of these factors include family history, older age, gender, pregnancy, overweight or obesity , lack of movement, and leg trauma. Varicose veins are treated with lifestyle changes and medical procedures. The goals of treatment are to relieve symptoms, prevent complications, and improve ...

  4. Percutaneous portal vein access and transhepatic tract hemostasis. (United States)

    Saad, Wael E A; Madoff, David C


    Percutaneous portal vein interventions require minimally invasive access to the portal venous system. Common approaches to the portal vein include transjugular hepatic vein to portal vein access and direct transhepatic portal vein access. A major concern of the transhepatic route is the risk of postprocedural bleeding, which is increased when patients are anticoagulated or receiving pharmaceutical thrombolytic therapy. Thus percutaneous portal vein access and subsequent closure are important technical parts of percutaneous portal vein procedures. At present, various techniques have been used for either portal access or subsequent transhepatic tract closure and hemostasis. Regardless of the method used, meticulous technique is required to achieve the overall safety and effectiveness of portal venous procedures. This article reviews the various techniques of percutaneous transhepatic portal vein access and the various closure and hemostatic methods used to reduce the risk of postprocedural bleeding.

  5. Incidental retroaortic left innominate vein in adult patient

    Directory of Open Access Journals (Sweden)

    Alexandre Semionov, MD, PhD


    Full Text Available Retro-aortic left innominate vein is a rare vascular abnormality, usually associated with congenital heart disease. Here we report a case of isolated retro-aortic left innominate vein in an adult female.

  6. Deep Vein Thrombosis (DVT) / Pulmonary Embolism (PE) - Blood Clot Forming in a Vein (United States)

    ... Facebook Tweet Share Compartir Deep Vein Thrombosis and Pulmonary Embolism (DVT/PE) are often underdiagnosed and serious, but ... bloodstream to the lungs, causing a blockage called pulmonary embolism (PE). If the clot is small, and with ...

  7. Radio Frequency Energy Harvesting Sources

    Directory of Open Access Journals (Sweden)



    Full Text Available This radio frequency (RF energy harvesting is an emerging technology and research area that promises to produce energy to run low-power wireless devices. The great interest that has recently been paid to RF harvesting is predominantly driven by the great progress in both wireless communication systems and broadcasting technologies that have availed a lot of freely propagating ambient RF energy. The principle aim of an RF energy harvesting system is to convert the received ambient RF energy into usable DC power. This paper presents a state of the art concise review of RF energy harvesting sources for low power applications, and also discusses open research questions and future research directions on ambient RF energy harvesting.

  8. Evaluation of left renal vein entrapment using multidetector computed tomography

    Energy Technology Data Exchange (ETDEWEB)

    Poyraz, Ahmet K.; Onur, Mehmet R. [Dept. of Radiology, Firat Univ. School of Medicine, Elazig (Turkey)], e-mail:; Firdolas, Fatih [Dept. of Urology, Firat Univ. School of Medicine, Elazig (Turkey); Kocakoc, Ercan [Dept. of Radiology, Bezmialem Vakif Univ., School of Medicine, Istanbul (Turkey)


    Background: Nutcracker syndrome, also called left renal vein entrapment syndrome, is a cause of non-glomerular hematuria with difficulties in diagnosis. Multidetector computed tomography (MDCT) is a powerful tool to prevent unnecessary diagnostic procedures. Purpose: To retrospectively determine the prevalence of nutcracker phenomenon and nutcracker syndrome seen in MDCT in consecutive patients. Material and Methods: The institutional review board approved the study and waived the requirement for informed consent. Abdominal contrast-enhanced MDCT scans were reviewed from 1000 consecutive patients. MDCT scan assessment included renal vein diameter measurements and evaluation for the presence of anterior or posterior left renal vein entrapment. Electronic medical records and urine analysis reports of patients with left renal vein entrapment were reviewed. Student's t test was used to assess differences in renal vein diameter in patients with left renal vein entrapment. Results: Left renal vein entrapment was observed in 10.9% (109), retroaortic left renal vein in 6.5% (65), entrapment of left renal vein between superior mesenteric artery and aorta in 4.1% (41), and circumaortic left renal vein in 0.3% (3) of patients. Mean diameters of right (8.8 {+-} 1.9 mm) and unentrapped left (8.9 {+-} 1.8 mm) renal veins were not significantly different (P = 0.1). The mean diameter of anterior entrapped left renal veins (10.3 {+-} 2 mm) was significantly greater (P = 0.04) than contralateral renal veins (8.6 {+-} 2.1 mm) in their widest portion. In 8.8% of patients with the left renal vein entrapment, urine analysis showed isomorphic hematuria or proteinuria with no other known cause. Varicocele and pelvic congestion were seen in 5.5% of patients with the left renal vein entrapment. Conclusion: Left renal vein entrapment is not a rare entity and renal nutcracker phenomenon might be underdiagnosed.

  9. Vein visualization: patient characteristic factors and efficacy of a new infrared vein finder technology. (United States)

    Chiao, F B; Resta-Flarer, F; Lesser, J; Ng, J; Ganz, A; Pino-Luey, D; Bennett, H; Perkins, C; Witek, B


    We investigated the patient characteristic factors that correlate with identification of i.v. cannulation sites with normal eyesight. We evaluated a new infrared vein finding (VF) technology device in identifying i.v. cannulation sites. Each subject underwent two observations: one using the conventional method (CM) of normal, unassisted eyesight and the other with the infrared VF device, VueTek's Veinsite™ (VF). A power analysis for moderate effect size (β=0.95) required 54 samples for within-subject differences. Patient characteristic profiles were obtained from 384 subjects (768 observations). Our sample population exhibited an overall average of 5.8 [95% confidence interval (CI) 5.4-6.2] veins using CM. As a whole, CM vein visualization were less effective among obese [4.5 (95% CI 3.8-5.3)], African-American [4.6 (95% CI 3.6-5.5 veins)], and Asian [5.1 (95% CI 4.1-6.0)] subjects. Next, the VF technology identified an average of 9.1 (95% CI 8.6-9.5) possible cannulation sites compared with CM [average of 5.8 (95% CI 5.4-6.2)]. Seventy-six obese subjects had an average of 4.5 (95% CI 3.8-5.3) and 8.2 (95% CI 7.4-9.1) veins viewable by CM and VF, respectively. In dark skin subjects, 9.1 (95% CI 8.3-9.9) veins were visible by VF compared with 5.4 (95% CI 4.8-6.0) with CM. African-American or Asian ethnicity, and obesity were associated with decreased vein visibility. The visibility of veins eligible for cannulation increased for all subgroups using a new infrared device.

  10. Adventitial cystic disease of the common femoral vein presenting as deep vein thrombosis

    Directory of Open Access Journals (Sweden)

    Young-Kyun Kim


    Full Text Available Adventitial cystic disease of the common femoral vein is a rare condition. We herein report the case of a 50-year-old woman who presented with painless swelling in her left lower leg that resembled deep vein thrombosis. She underwent femoral exploration and excision of the cystic wall. The presentation, investigation, treatment, and pathology of this condition are discussed with a literature review.

  11. Portal vein thrombosis after reconstruction in 270 consecutive patients with portal vein resections in hepatopancreatobiliary (HPB) surgery. (United States)

    Miyazaki, Masaru; Shimizu, Hiroaki; Ohtuka, Masayuki; Kato, Atsushi; Yoshitomi, Hiroyuki; Furukawa, Katsunori; Takayashiki, Tsukasa; Kuboki, Satoshi; Takano, Shigetsugu; Suzuki, Daisuke; Higashihara, Taku


    This study was aimed to evaluate the occurrence of portal vein thrombosis after portal vein reconstruction. The portal veins were repaired with venorrhaphy, end-to-end, patch graft, and segmental graft in consecutive 270 patients undergoing hepato-pancreto-biliary (HPB) surgery. Portal vein thrombosis was encountered in 20 of 163 of end-to-end, 2 of 56 of venorrhaphy, and 2 of 5 of patch graft groups, as compared with 0 of 46 of segmental graft group (p Portal vein thrombosis occurred more frequently after hepatectomy than after pancreatectomy (p portal vein blood flow was more sufficiently achieved in the early re-operation within 3 days after surgery than in the late re-operation over 5 days after surgery (p portal vein reconstruction. The revision surgery for portal vein thrombosis should be performed within 3 days after surgery. Copyright © 2016 Elsevier Inc. All rights reserved.

  12. A bountiful spring harvest

    CERN Multimedia


    Although we recently put the clocks forward and spring has officially begun, the view from my window looks more autumnal – befitting of the season of mists and mellow fruitfulness, rather than that of sowing seeds for the future. Which, in a way is appropriate. With the LHC paused, we are reaping a kind of harvest in the form of recognition for our efforts.   Two weeks ago, I was in Edinburgh, on behalf of everyone at CERN, to collect the Edinburgh medal, which we shared with Peter Higgs. I particularly like the citation for this honour: “The Edinburgh Medal is awarded each year to men and women of science and technology whose professional achievements are judged to have made a significant contribution to the understanding and well-being of humanity.” I like this, because it underlines a fact that needs to be shouted louder – that fundamental science does more than build the sum of human knowledge, it is also the foundation of human well-being. A few d...

  13. Internal vein texture and vein evolution of the epithermal Shila-Paula district, southern Peru (United States)

    Chauvet, Alain; Bailly, Laurent; André, Anne-Sylvie; Monié, Patrick; Cassard, Daniel; Tajada, Fernando Llosa; Vargas, Juan Rosas; Tuduri, Johann


    The epithermal Shila-Paula Au-Ag district is characterized by numerous veins hosted in Tertiary volcanic rocks of the Western Cordillera (southern Peru). Field studies of the ore bodies reveal a systematic association of a main E-W vein with secondary N55-60°W veins—two directions that are also reflected by the orientation of fluid-inclusion planes in quartz crystals of the host rock. In areas where this pattern is not recognized, such as the Apacheta sector, vein emplacement seems to have been guided by regional N40°E and N40°W fractures. Two main vein-filling stages are identified. stage 1 is a quartz-adularia-pyrite-galena-sphalerite-chalcopyrite-electrum-Mn silicate-carbonate assemblage that fills the main E-W veins. stage 2, which contains most of the precious-metal mineralization, is divided into pre-bonanza and bonanza substages. The pre-bonanza substage consists of a quartz-adularia-carbonate assemblage that is observed within the secondary N45-60°W veins, in veinlets that cut the stage 1 assemblage, and in final open-space fillings. The two latter structures are finally filled by the bonanza substage characterized by a Fe-poor sphalerite-chalcopyrite-pyrite-galena-tennantite-tetrahedrite-polybasite-pearceite-electrum assemblage. The ore in the main veins is systematically brecciated, whereas the ore in the secondary veins and geodes is characteristic of open-space crystallization. Microthermometric measurements on sphalerite from both stages and on quartz and calcite from stage 2 indicate a salinity range of 0 to 15.5 wt% NaCl equivalent and homogenization temperatures bracketed between 200 and 330°C. Secondary CO2-, N2- and H2S-bearing fluid inclusions are also identified. The age of vein emplacement, based on 40Ar/39Ar ages obtained on adularia of different veins, is estimated at around 11 Ma, with some overlap between adularia of stage 1 (11.4±0.4 Ma) and of stage 2 (10.8±0.3 Ma). A three-phase tectonic model has been constructed to explain the

  14. Development of a chamomile harvester

    Directory of Open Access Journals (Sweden)

    Detlef Ehlert


    Full Text Available The cultivation of chamomile results in increased biodiversity in farms and in additional income sources. To make the harvest of chamomile flowers more efficient, a three-year research project was funded. The aim was the development and investigation of a research prototype characterized by a high picking quality, low losses, productivity of 1 hectare per hour, and low costs. In the final phase of the project a selfpropelled harvester was tested, which provided the base for the future commercial manufacturing of the new harvester in small series.

  15. Biometric Authentication Using Infrared Imaging of Hand Vein Patterns (United States)

    Bhattacharyya, Debnath; Shrotri, A.; Rethrekar, S. C.; Patil, M. H.; Alisherov, Farkhod A.; Kim, Tai-Hoon

    Hand vein patterns are unique and universal. Vein pattern is used as biometric feature in recent years. But, it is not very much popular biometric system as compared to other systems like fingerprint, iris etc, because of the higher cost. For conventional algorithm, it is necessary to use high quality images, which demand high-priced collection devices. There are two approaches for vein authentication, these are hand dorsa and hand ventral. Currently we are working on hand dorsa vein patterns. Here we are putting forward the new approach for low cost hand dorsa vein pattern acquisition using low cost device and proposing a algorithm to extract features from these low quality images.

  16. Thermal stimulation of intra-abdominal veins in conscious rabbits. (United States)

    Cranston, W I; Hellon, R F; Townsend, Y


    1. Infusions of hot and cold Hartmann's solution were given into the hepatic portal vein and inferior vena cava of conscious rabbits. Similar infusions were given into an ear vein as controls. The time integral of the displacement of brain temperature was measured. 2. There was no evidence for the presence of warm sensors in the inferior vena cava, portal vein, liver or hepatic vein, and no evidence for a concentration of cold sensors in the inferior vena cava. 3. There may be cold-sensitive elements in the portal vein or the tissue perfused by blood passing through it. PMID:650560

  17. Ligation of superior mesenteric vein and portal to splenic vein anastomosis after superior mesenteric-portal vein confluence resection during pancreaticoduodenectomy – Case report

    Directory of Open Access Journals (Sweden)

    Jianlin Tang


    Conclusion: The lessons we learned are (1 Before SMPV confluence resection, internal jugular vein graft should be ready for reconstruction. (2 Synthetic graft is an alternative for internal jugular vein graft. (3 Direct portal vein to SMV anastomosis can be achieved by mobilizing liver. (4 It is possible that venous collaterals secondary to SMV tumor obstruction may have allowed this patient's post-operative survival.

  18. Deep dorsal vein arterialisation in vascular impotence. (United States)

    Wespes, E; Corbusier, A; Delcour, C; Vandenbosch, G; Struyven, J; Schulman, C C


    A series of 12 patients with vasculogenic impotence (4 arterial lesions; 8 arterial and venous lesions) underwent deep dorsal vein arterialisation after pre-operative assessment by a multidisciplinary approach. Cumulative graft patency was 58% (7 of 12 patients) up to 21 months but only 4 patients developed almost normal erections. Digital angiography, with and without the intracavernous injection of papaverine, was performed during follow-up to determine the vascular physiological status. At flaccidity, the corpora cavernosa were never opacified in the absence of a venocorporeal shunt. The penile glans was always visualised. Opacification of the deep dorsal vein and the circumflex system decreased with penile rigidity, resulting from their compression between Buck's fascia and the tunica albuginea. Intracavernous pressure recorded before and after the surgical procedure showed a marked increase when a caverno-venous shunt was performed. Hypervascularisation of the glans occurred in 2 cases. The relevance of this new surgical technique and its functional mechanism are discussed.

  19. Double suicide genes selectively kill human umbilical vein endothelial cells

    Directory of Open Access Journals (Sweden)

    Liu Lunxu


    Full Text Available Abstract Background To construct a recombinant adenovirus containing CDglyTK double suicide genes and evaluate the killing effect of the double suicide genes driven by kinase domain insert containing receptor (KDR promoter on human umbilical vein endothelial cells. Methods Human KDR promoter, Escherichia coli (E. coli cytosine deaminase (CD gene and the herpes simplex virus-thymidine kinase (TK gene were cloned using polymerase chain reaction (PCR. Plasmid pKDR-CDglyTK was constructed with the KDR promoter and CDglyTK genes. A recombinant adenoviral plasmid AdKDR-CDglyTK was then constructed and transfected into 293 packaging cells to grow and harvest adenoviruses. KDR-expressing human umbilical vein endothelial cells (ECV304 and KDR-negative liver cancer cell line (HepG2 were infected with the recombinant adenoviruses at different multiplicity of infection (MOI. The infection rate was measured by green fluorescent protein (GFP expression. The infected cells were cultured in culture media containing different concentrations of prodrugs ganciclovir (GCV and/or 5-fluorocytosine (5-FC. The killing effects were measured using two different methods, i.e. annexin V-FITC staining and terminal transferase-mediated dUTP nick end-labeling (TUNEL staining. Results Recombinant adenoviruses AdKDR-CDglyTK were successfully constructed and they infected ECV304 and HepG2 cells efficiently. The infection rate was dependent on MOI of recombinant adenoviruses. ECV304 cells infected with AdKDR-CDglyTK were highly sensitive to GCV and 5-FC. The cell survival rate was dependent on both the concentration of the prodrugs and the MOI of recombinant adenoviruses. In contrast, there were no killing effects in the HepG2 cells. The combination of two prodrugs was much more effective in killing ECV304 cells than GCV or 5-FC alone. The growth of transgenic ECV304 cells was suppressed in the presence of prodrugs. Conclusion AdKDR-CDglyTK/double prodrog system may be a useful

  20. Augmented reality based real-time subcutaneous vein imaging system. (United States)

    Ai, Danni; Yang, Jian; Fan, Jingfan; Zhao, Yitian; Song, Xianzheng; Shen, Jianbing; Shao, Ling; Wang, Yongtian


    A novel 3D reconstruction and fast imaging system for subcutaneous veins by augmented reality is presented. The study was performed to reduce the failure rate and time required in intravenous injection by providing augmented vein structures that back-project superimposed veins on the skin surface of the hand. Images of the subcutaneous vein are captured by two industrial cameras with extra reflective near-infrared lights. The veins are then segmented by a multiple-feature clustering method. Vein structures captured by the two cameras are matched and reconstructed based on the epipolar constraint and homographic property. The skin surface is reconstructed by active structured light with spatial encoding values and fusion displayed with the reconstructed vein. The vein and skin surface are both reconstructed in the 3D space. Results show that the structures can be precisely back-projected to the back of the hand for further augmented display and visualization. The overall system performance is evaluated in terms of vein segmentation, accuracy of vein matching, feature points distance error, duration times, accuracy of skin reconstruction, and augmented display. All experiments are validated with sets of real vein data. The imaging and augmented system produces good imaging and augmented reality results with high speed.

  1. Varicose veins of the pelvis men

    Directory of Open Access Journals (Sweden)

    O. B. Zhukov


    Full Text Available Syndrome of pelvic venous congestion in men and of prostate particularly in contrast to women disease is poorly known. Classification of varicose pelvic veins in men does not exist. In this paper we analyzed their own data on the diagnosis and treatment of venous congestion in the pelvic and prostate in patients with varicocele. Classification of prostate varicose are also offered by us.

  2. Deep Vein Thrombosis after Coronary Angiography

    Directory of Open Access Journals (Sweden)

    Vivek Singh Guleria


    Full Text Available Deep vein thrombosis (DVT is a rare but potentially serious complication of coronary angiography (CAG, incidence being just 0.05%. Only a few clinical cases of DVT after diagnostic transfemoral catheterization have been reported. Here, we describe the case of a 54-year-old woman who developed significant DVT after CAG without venous thromboembolism (VTE and, which was treated with anticoagulants.

  3. Atypical ultrasonographic presentation of ovarian vein thrombosis. (United States)

    Graupera, B; Pascual, M A; Garcia, P; Di Paola, R; Ubeda, B; Tresserra, F


    Ovarian vein trombosis (OVT) is a pathologic entity classically considered as a postpartum complication and only rarely associated with other diseases. Due to its vague symptoms, it is usually underdiagnosed. However its consequences can be fatal. We report a case of an incidental finding of ovarian thrombosis in an asymptomatic 45-year-old woman who underwent surgery due to the ultrasonographic finding of a para-ovarian cyst.

  4. Ultrasonic Vein Detector Implementation for Medical Applications


    Taheri, Seyedd Arash


    Nowadays, taking blood samples from a human forearm and using Cephalic, Basilic, and Median Cubital veins to perform various injections can be considered as one of the most routine medical procedures for diagnostic purposes. Most human patients don’t need to waste a lot of time in clinics waiting for the nurses and/or doctors to locate an applicable venipuncture site. However, minority of individuals who suffer from obesity, cancer, and other similar medical complications have to go to excruc...

  5. Deep vein thrombosis: diagnosis, treatment, and prevention

    Energy Technology Data Exchange (ETDEWEB)

    Stewart, W.P.; Youngswick, F.D.

    Deep vein thrombosis (DVT) is a dangerous complication that may present after elective foot surgery. Because of the frequency with which DVT occurs in the elderly patient, as well as in the podiatric surgical population, the podiatrist should be acquainted with this entity. A review of the diagnosis, treatment, prevention, and the role of podiatry in the management of DVT is discussed in this paper.

  6. Absent right superior caval vein in situs solitus

    DEFF Research Database (Denmark)

    Lytzen, Rebekka; Sundberg, Karin; Vejlstrup, Niels


    Introduction In up to 0.07% of the general population, the right anterior cardinal vein obliterates and the left remains open, creating an absent right superior caval vein and a persistent left superior caval vein. Absent right superior caval vein is associated with additional congenital heart...... disease in about half the patients. We wished to study the consequences of absent right superior caval vein as an incidental finding on prenatal ultrasonic malformation screening. Material and methods This is a retrospective case series study of all foetuses diagnosed with absent right superior caval vein...... at the national referral hospital, Rigshospitalet, Denmark, from 2009 to 2012. RESULTS: In total, five cases of absent right superior caval vein were reviewed. No significant associated cardiac, extra-cardiac, or genetic anomalies were found. Postnatal echocardiographies confirmed the diagnosis and there were...

  7. Deep vein thrombosis and pulmonary embolism. (United States)

    Di Nisio, Marcello; van Es, Nick; Büller, Harry R


    Deep vein thrombosis and pulmonary embolism, collectively referred to as venous thromboembolism, constitute a major global burden of disease. The diagnostic work-up of suspected deep vein thrombosis or pulmonary embolism includes the sequential application of a clinical decision rule and D-dimer testing. Imaging and anticoagulation can be safely withheld in patients who are unlikely to have venous thromboembolism and have a normal D-dimer. All other patients should undergo ultrasonography in case of suspected deep vein thrombosis and CT in case of suspected pulmonary embolism. Direct oral anticoagulants are first-line treatment options for venous thromboembolism because they are associated with a lower risk of bleeding than vitamin K antagonists and are easier to use. Use of thrombolysis should be limited to pulmonary embolism associated with haemodynamic instability. Anticoagulant treatment should be continued for at least 3 months to prevent early recurrences. When venous thromboembolism is unprovoked or secondary to persistent risk factors, extended treatment beyond this period should be considered when the risk of recurrence outweighs the risk of major bleeding. Copyright © 2016 Elsevier Ltd. All rights reserved.

  8. Laser photocoagulation for retinal vein occlusion

    Directory of Open Access Journals (Sweden)

    K. A. Mirzabekova


    Full Text Available Retinal vein occlusion (RVO is one of the leading causes of permanent vision loss. In adults, central retinal vein occlusion (CRVO occurs in 1.8% while branch retinal vein occlusion (BRVO occurs in 0.2%. Treatment strategy and disease prognosis are determined by RVO type (ischemic/non-ischemic. Despite numerous studies and many current CRVO and BRVO treatment approaches, the management of these patients is still being debated. Intravitreal injections of steroids (triamcinolone acetate, dexamethasone and vascular endothelial growth factor (VEGF inhibitors (bevacizumab, ranibizumab were shown to be fairly effective. However, it is unclear whether anti-VEGF agents are reasonable in ischemic RVOs. Laser photocoagulation remains the only effective treatment of optic nerve head and/or retinal neovascularization. Laser photocoagulation is also indicated for the treatment of macular edema. Both threshold and sub-threshold photocoagulation may be performed. Photocoagulation performed with argon (514 nm, krypton (647 nm, or diode (810 nm laser for macular edema provides similar results (no significant differences. The treatment may be complex and include medication therapy and/or surgery. Medication therapy includes anti-aggregant agents and antioxidants, i.e., emoxypine which may be used in acute RVO as well as in post-thrombotic retinopathy. 

  9. Laser photocoagulation for retinal vein occlusion

    Directory of Open Access Journals (Sweden)

    K. A. Mirzabekova


    Full Text Available Retinal vein occlusion (RVO is one of the leading causes of permanent vision loss. In adults, central retinal vein occlusion (CRVO occurs in 1.8% while branch retinal vein occlusion (BRVO occurs in 0.2%. Treatment strategy and disease prognosis are determined by RVO type (ischemic/non-ischemic. Despite numerous studies and many current CRVO and BRVO treatment approaches, the management of these patients is still being debated. Intravitreal injections of steroids (triamcinolone acetate, dexamethasone and vascular endothelial growth factor (VEGF inhibitors (bevacizumab, ranibizumab were shown to be fairly effective. However, it is unclear whether anti-VEGF agents are reasonable in ischemic RVOs. Laser photocoagulation remains the only effective treatment of optic nerve head and/or retinal neovascularization. Laser photocoagulation is also indicated for the treatment of macular edema. Both threshold and sub-threshold photocoagulation may be performed. Photocoagulation performed with argon (514 nm, krypton (647 nm, or diode (810 nm laser for macular edema provides similar results (no significant differences. The treatment may be complex and include medication therapy and/or surgery. Medication therapy includes anti-aggregant agents and antioxidants, i.e., emoxypine which may be used in acute RVO as well as in post-thrombotic retinopathy. 

  10. Magnetic Nanocomposite Cilia Energy Harvester

    KAUST Repository

    Khan, Mohammed Asadullah


    An energy harvester capable of converting low frequency vibrations into electrical energy is presented. The operating principle, fabrication process and output characteristics at different frequencies are discussed. The harvester is realized by fabricating an array of polydimethylsiloxane (PDMS) - iron nanowire nanocomposite cilia on a planar coil array. Each coil element consists of 14 turns and occupies an area of 600 μm x 600μm. The cilia are arranged in a 12x5 array and each cilium is 250 μm wide and 2 mm long. The magnetic characteristics of the fabricated cilia indicate that the nanowires are well aligned inside of the nanocomposite, increasing the efficiency of energy harvesting. The energy harvester occupies an area of 66.96 mm2 and produces an output r.m.s voltage of 206.47μV, when excited by a 40 Hz vibration of 1 mm amplitude.

  11. Energy harvesting on highway bridges. (United States)


    A concept for harvesting energy from the traffic-induced loadings on a highway bridge using piezoelectric : materials to generate electricity was explored through the prototype stage. A total of sixteen lead-zirconate : titanate (PZT) Type 5A piezoel...

  12. Rooftop level rainwater harvesting system

    National Research Council Canada - National Science Library

    Hayssam Traboulsi; Marwa Traboulsi


    ... and economic growth. Although rainwater harvesting is considered to be a safe and reliable alternative source for domestic water, the inconvenience or impracticalities related to the cost and space needed...

  13. Compatability Determination for Timber Harvesting (United States)

    US Fish and Wildlife Service, Department of the Interior — This is a compliance document which pertains to allowing commercial and non-commercial timber harvesting to conserve, restore and rehabilitate forest ecosystems at...

  14. The vertebral venous plexuses: the internal veins are muscular and external veins have valves. (United States)

    Stringer, Mark D; Restieaux, Matthew; Fisher, Amanda L; Crosado, Brynley


    The internal and external vertebral venous plexuses (VVP) extend the length of the vertebral column. Authoritative sources state that these veins are devoid of valves, permitting bidirectional blood flow and facilitating the hematogenous spread of malignant tumors that have venous connections with these plexuses. The aim of this investigation was to identify morphologic features that might influence blood flow in the VVP. The VVP of 12 adult cadavers (seven female, mean age 79.5 years) were examined by macro- and micro-dissection and representative veins removed for histology and immunohistochemistry (smooth muscle antibody staining). A total of 26, mostly bicuspid, valves were identified in 19 of 56 veins (34%) from the external VVP, all orientated to promote blood flow towards the internal VVP. The internal VVP was characterized by four main longitudinal channels with transverse interconnections; the maximum caliber of the longitudinal anterior internal VVP veins was significantly greater than their posterior counterparts (P < 0.001). The luminal architecture of the internal VVP veins was striking, consisting of numerous bridging trabeculae (cords, thin membranes and thick bridges) predominantly within the longitudinal venous channels. Trabeculae were composed of collagen and smooth muscle and also contained numerous small arteries and nerve fibers. A similar internal venous trabecular meshwork is known to exist within the dural venous sinuses of the skull. It may serve to prevent venous overdistension or collapse, to regulate the direction and velocity of venous blood flow, or is possibly involved in thermoregulation or other homeostatic processes. © 2011 Wiley Periodicals, Inc.

  15. Absence of Middle Hepatic Vein Combined with Retro-Aortic Left Renal Vein: a Very Rare Case Report

    Directory of Open Access Journals (Sweden)

    Sezer Akçer


    Full Text Available The hepatic and renal veins drain into the inferior vena cava. The upper group of hepatic veins consists of three veins which extend to the posterior face of the liver to join the inferior cava. The left renal vein passes anterior to the aorta just below the origin of the superior mesenteric artery. We detected a variation in the hepatic and renal veins in a multislice CT angiogram of a nine-year-old male patient in the Radiology Department of Afyon Kocatepe University Medical School. The upper group hepatic veins normally drains into the inferior vena cava as three separate trunks, namely the right, left and middle. In our case, we found that only the right and left hepatic veins existed and the middle hepatic vein was absent. Furthermore, the left renal vein, which normally passes anterior to the abdominal aorta, was retro-aortic. Left renal vein variations are of great importance in planning retroperitoneal surgery and vascular interventions. Knowledge of a patient’s hepatic vein and renovascular anatomy and determining their variations and anomalies are of critical importance to abdominal operations, transplantations and preoperative evaluation of endovascular interventions.

  16. Multiple variations in the azygos venous system: a preaortic interazygos vein and the absence of hemiazygos vein. (United States)

    Ozdemir, B; Aldur, M M; Celik, H H


    Multiple variations of the azygos venous system were detected during routine dissection. The hemiazygos vein was underdeveloped. On the left side of the thorax, posterior intercostal veins between the 8th and 11th intercostal spaces and the subcostal vein drained into the azygos vein independently. In addition, the posterior 4th, 5th, 6th and 7th intercostal veins united and formed two superior and inferior trunks. The superior common trunk, at the level of the T4 vertebra, crossed the vertebral column obliquely, lying anterior to the aorta and posterior to the esophagus, opening into the azygos vein at the level of the T4 vertebra. The other structures in this part were normal. There were different courses of the azygos vein system. This variation is important in mediastinal surgery and also in the interpretation of radiographs.


    Veronese, Chiara; Staurenghi, Giovanni; Pellegrini, Marco; Maiolo, Chiara; Primavera, Laura; Morara, Mariachiara; Armstrong, Grayson W; Ciardella, Antonio P


    The aim of this study is to describe the clinical presentation of vortex vein varices with multimodal imaging. The authors carried out a retrospective case series of eight patients (7 female, 1 male) with an average age of 60.2 years (min 8, max 84, median 68.5) presenting with vortex vein varices. All patients were evaluated at the Sant'Orsola-Malpighi Hospital, University of Bologna, Bologna, Italy and at Luigi Sacco Hospital, University of Milan, Milan, Italy. Patients underwent complete ophthalmologic examinations, including best corrected visual acuity, intraocular pressure, anterior segment, and fundus examination. Imaging studies, including fundus color photography, near-infrared reflectance imaging, fundus autofluorescence, fluorescein angiography, indocyanine green angiography, and spectral-domain enhanced depth imaging optical coherence tomography were also performed. Ultra-widefield fluorescein angiography and ultra-widefield indocyanine angiography using the Heidelberg Retina Angiograph and the Staurenghi 230 SLO Retina Lens were used to demonstrate the disappearance of all retinal lesions when pressure was applied to the globe. All eight cases initially presented to the emergency room. One patient presented secondary to trauma, two patients presented for suspected hemangioma, whereas the other five were referred to the authors' hospitals for suspected retinal lesions. On examination, retinal abnormalities were identified in all 8 patients, with 7 (87.5%) oculus dexter and 1 (12.5%) oculus sinister, and with 1 (12.5%) inferotemporally, 3 (37.5%) superonasally, 3 (37.5%) inferonasally, and 1 (12.5%) inferiorly. Fundus color photography showed an elevated lesion in seven patients and a nonelevated red lesion in one patient. In all patients, near-infrared reflectance imaging showed a hyporeflective lesion in the periphery of the retina. Fundus autofluorescence identified round hypofluorescent rings surrounding weakly hyperfluorescent lesions in all

  18. Modelling of strategic grass harvest management

    NARCIS (Netherlands)

    Thiessen, M.; Mourik, van S.; Evert, van F.K.


    Grass harvest plays a crucial role in milk production. Farmers face the problem of timing the harvest with respect to quality (crude protein content) and quantity (dry matter yield). Literature suggests that harvesting more frequently and thereby keeping the grass short (light harvesting) will

  19. Anatomic Variation of Facial Vein in Carotid-Cavernous Fistula and Trans-Facial Vein Embolization. (United States)

    Luo, Chao-Bao; Chang, Feng-Chi; Teng, Michael Mu-Huo; Ting, Ta-Wei


    Trans-facial vein (FV) embolization via the internal jugular vein is an alternative approach to embolization of carotid cavernous fistulas (CCFs). The purpose of this study is to report the anatomic variation of FVs and our experience of trans-FV embolization of CCFs. Over 6 years, 26 patients (12 men and 14 women; age range 27-72 years old) with CCFs underwent trans-FV embolization because of anterior drainage of fistulas. We retrospectively analyzed angioarchitecture of the CCFs focusing on the anatomic variations of FVs and angiographic and clinical outcomes after embolization. FVs drained to the internal jugular vein in 10 (38%) cases; FVs unexpectedly emptied into the external jugular vein in 16 (62%) cases. All FVs entered into the internal jugular vein at the level of the hyoid bone. In cases with fistulas to the FV and EJV, the termination of FVs was variable including superior (n = 5), inferior (n = 1), or at the level of the hyoid bone (n = 10). Successful microcatheterization via different insertions of FVs to jugular veins was achieved in all cases. One patient had a small residual fistula, and 2 patients had fistula recurrence. Temporary impairment of cranial nerve III or VI occurred in 4 patients. The mean clinical follow-up time was 18 months. Trans-FV embolization is an effective and safe method to manage CCFs with anterior drainage. However, anatomic variations of the FV exist, and a careful work-up of fistula venous drainage before trans-FV embolization is essential to reduce erroneous attempts, procedure time, and periprocedural risk. Copyright © 2015 Elsevier Inc. All rights reserved.

  20. Automated detection of periventricular veins on 7 T brain MRI (United States)

    Kuijf, Hugo J.; Bouvy, Willem H.; Zwanenburg, Jaco J. M.; Viergever, Max A.; Biessels, Geert Jan; Vincken, Koen L.


    Cerebral small vessel disease is common in elderly persons and a leading cause of cognitive decline, dementia, and acute stroke. With the introduction of ultra-high field strength 7.0T MRI, it is possible to visualize small vessels in the brain. In this work, a proof-of-principle study is conducted to assess the feasibility of automatically detecting periventricular veins. Periventricular veins are organized in a fan-pattern and drain venous blood from the brain towards the caudate vein of Schlesinger, which is situated along the lateral ventricles. Just outside this vein, a region-of- interest (ROI) through which all periventricular veins must cross is defined. Within this ROI, a combination of the vesselness filter, tubular tracking, and hysteresis thresholding is applied to locate periventricular veins. All detected locations were evaluated by an expert human observer. The results showed a positive predictive value of 88% and a sensitivity of 95% for detecting periventricular veins. The proposed method shows good results in detecting periventricular veins in the brain on 7.0T MR images. Compared to previous works, that only use a 1D or 2D ROI and limited image processing, our work presents a more comprehensive definition of the ROI, advanced image processing techniques to detect periventricular veins, and a quantitative analysis of the performance. The results of this proof-of-principle study are promising and will be used to assess periventricular veins on 7.0T brain MRI.

  1. Quantification of deep medullary veins at 7 T brain MRI

    Energy Technology Data Exchange (ETDEWEB)

    Kuijf, Hugo J.; Viergever, Max A.; Vincken, Koen L. [University Medical Center Utrecht, Image Sciences Institute, Utrecht (Netherlands); Bouvy, Willem H.; Razoux Schultz, Tom B.; Biessels, Geert Jan [University Medical Center Utrecht, Department of Neurology, Brain Center Rudolf Magnus, Utrecht (Netherlands); Zwanenburg, Jaco J.M. [University Medical Center Utrecht, Image Sciences Institute, Utrecht (Netherlands); University Medical Center Utrecht, Department of Radiology, Utrecht (Netherlands)


    Deep medullary veins support the venous drainage of the brain and may display abnormalities in the context of different cerebrovascular diseases. We present and evaluate a method to automatically detect and quantify deep medullary veins at 7 T. Five participants were scanned twice, to assess the robustness and reproducibility of manual and automated vein detection. Additionally, the method was evaluated on 24 participants to demonstrate its application. Deep medullary veins were assessed within an automatically created region-of-interest around the lateral ventricles, defined such that all veins must intersect it. A combination of vesselness, tubular tracking, and hysteresis thresholding located individual veins, which were quantified by counting and computing (3-D) density maps. Visual assessment was time-consuming (2 h/scan), with an intra-/inter-observer agreement on absolute vein count of ICC = 0.76 and 0.60, respectively. The automated vein detection showed excellent inter-scan reproducibility before (ICC = 0.79) and after (ICC = 0.88) visually censoring false positives. It had a positive predictive value of 71.6 %. Imaging at 7 T allows visualization and quantification of deep medullary veins. The presented method offers fast and reliable automated assessment of deep medullary veins. (orig.)

  2. Computed tomographic evaluation of the portal vein in the hepatomas

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Kee Hyung; Lee, Seung Chul; Bae, Man Gil; Seo, Heung Suk; Kim, Soon Yong; Lee, Min Ho; Kee, Choon Suhk; Park, Kyung Nam [Hanyang University College of Medicine, Seoul (Korea, Republic of)


    Computed tomography and pornographic findings of 63 patients with hepatoma, undergone hepatic angiography and superior mesenteric pornography for evaluation of tumor and thrombosis of portal vein and determination of indication of transcatheter arterial embolization for palliative treatment of hepatoma from April, 85 to June, 86 in Hanyang university hospital, were reviewed. The results were as follows: 1. In 36 cases, portal vein thrombosis was detected during photography. Nineteen of 37 cases which revealed localized hepatoma in the right lobe of the liver showed portal vein thrombosis; 9 of 11 cases of the left lobe; 8 of 14 cases which were involved in entire liver revealed thrombosis. One case localized in the caudate lobe showed no evidence of invasion to portal vein. 2. Twenty-four of 34 cases with diffuse infiltrative hepatoma revealed portal vein thrombosis and the incidence of portal vein thrombosis in this type were higher than in the cases of the nodular type. 3. The portal vein thrombosis appeared as filling defects of low density in the lumen of the portal veins in CT and they did not reveal contrast enhancement. 4. CT revealed well the evidence of obstructions in the cases of portal vein thrombosis and the findings were well-corresponded to the findings of the superior mesenteric photography. 5. Five of the cases of the portal vein thrombosis were missed in the CT and the causes were considered as due to partial volume effect of enhanced portal vein with partial occlusion or arterioportal shunts. 6. Six of 13 cases with occlusion of main portal vein showed cavernous transformation and they were noted as multiple small enhanced vascularities around the porta hepatis in the CT. According to the results, we conclude that CT is a useful modality to detect the changes of the portal veins in the patients of the hepatoma.

  3. Pressure-Temperature History of Shock-Induced Melt Veins (United States)

    Decarli, P. S.; Sharp, T. G.; Xie, Z.; Aramovich, C.


    Shock-induced melt veins that occur in chondrites commonly contain metastable high-pressure phases such as (Mg,Fe)SiO3-perovskite, akimotoite, ringwoodite, and majorite, that crystallized from the melt at high pressure. The metastable high-pressure minerals invert rapidly to stable low-pressure phases if they remain at high temperatures after the pressure is released. Although shock compression mechanisms permit rapid heating of the vein volume, adiabatic cooling on decompression is negligible because of the relative incompressibility of the material in the vein. The presence of metastable mantle minerals in a vein thus implies that the vein was quenched via thermal conduction to adjacent cooler material at high pressure. The quenching time of the vein can be determined from ordinary heat flow calculations (Langenhorst and Poirier, 2000), given knowledge of the vein dimensions and the temperatures at the time of vein formation in both the vein and the surrounding material. We have calculated a synthetic Hugoniot for the Tenham L6 chondrite to estimate bulk post-shock and shock temperatures as a function of shock pressure. Assuming a superliquidus temperature of 2500°C for the melt vein, we use a simple thermal model to investigate then thermal histories of melt veins during shock. The variation in crystallization assemblages within melt veins can be explained in terms of variable cooling rates. Survival of (Mg,Fe)SiO3-perovskite in Tenham (Tomioka and Fugino, 1997) requires that melt veins cooled to below 565°C before pressure release, which further constrains shock pressure, duration of the pressure pulse and cooling histories.

  4. Acute Thrombosis of Left Portal Vein during Right Portal Vein Embolization Extended to Segment 4. (United States)

    Shaw, Colette M; Madoff, David C


    Portal vein thrombosis (PVT) is an uncommon, but potentially devastating complication of portal vein embolization (PVE). Its occurrence relates to both local and systemic risk factors. In the setting of PVE, precipitating factors include injury to the vessel wall and reduced portal flow. Contributory factors include portal hypertension, hypercoagulopathy, inflammatory processes, malignancy, pregnancy, oral contraceptive use, and asplenia. The goal of therapy is to prevent thrombus progression and lyse existing clot. Hepatectomy is impossible if adequate recanalization has not occurred and/or overt portal hypertension develops. The mechanisms for thrombus development, its diagnosis, management, and prognosis are discussed.

  5. Portal vein and mesenteric vein gas: CT features; Aeroportie ety aeromesenterie: donnees TDM

    Energy Technology Data Exchange (ETDEWEB)

    Schmutz, G.; Fournier, L.; Le Pennec, V.; Provost, N.; Hue, S.; Phi, I.N. [Centre Hospitalier Universitaire, 14 - Caen (France)


    Portal vein and mesenteric vein gas are unusual conditions with a complex and nuclear pathogenesis. Mesenteric ischemia frequently causes such pathological conditions but a variety of other causes are known: inflammatory bowel disease, bowel distension, traumatic and iatrogenic injury, intra-abdominal sepsis, and idiopathic conditions. This pathologic entity is favored by intestinal wall alterations, bowel distension and sepsis. The prognosis is frequently fatal, especially when associated with extended bowel necrosis although in the majority of the cases, outcome is favorable without surgery. (author)

  6. Genealogy and fine mapping of obscuravenosa, a gene affecting the distribution of chloroplasts in leaf veins, and evidence of selection during breeding of tomatoes (Lycopersicon esculentum; Solanaceae). (United States)

    Jones, Carl M; Rick, Charles M; Adams, Dawn; Jernstedt, Judy; Chetelat, Roger T


    In the processes of plant domestication and variety development, some traits are under direct selection, while others may be introduced by indirect selection or linkage. In the cultivated tomato (Lycopersicon esculentum = Solanum lycopersicum), and all other Solanaceae examined, chloroplasts are normally absent from subepidermal and mesophyll cells surrounding the leaf veins, and thus, veins appear clear upon subillumination. The tomato mutant obscuravenosa (obv), in contrast, contains chloroplasts in cells around the vein, and thus, veins appear as dark as the surrounding leaf tissue. Among tomato cultivars, the obv allele is common in processing varieties bred for mechanical harvest, but is otherwise rare. We traced the source of obv in processing tomatoes to the cultivar Earliana, released in the 1920s. The obv locus was mapped to chromosome 5, bin 5G, using introgression lines containing single chromosome segments from the wild species L. pennellii. This region also contains a quantitative trait locus (QTL) for plant height, pht5.4, which cosegregated with SP5G, a paralog of self-pruning (sp), the gene that controls the switch between determinate and indeterminate growth in tomato. The pht5.4 QTL was partially dominant and associated with a reduced percentage of red fruit at harvest. Our data suggest that the prevalence of obv in nearly all processing varieties may have resulted from its tight linkage to a QTL conferring a more compact, and horticulturally desirable, plant habit.

  7. heteroHarvest: Harvesting Information from Heterogeneous Sources

    DEFF Research Database (Denmark)

    Qureshi, Pir Abdul Rasool; Memon, Nasrullah; Wiil, Uffe Kock


    The abundance of information regarding any topic makes the Internet a very good resource. Even though searching the Internet is very easy, what remains difficult is to automate the process of information extraction from the available online information due to the lack of structure and the diversity...... in the sharing methods. Most of the times, information is stored in different proprietary formats, complying with different standards and protocols which makes tasks like data mining and information harvesting very difficult. In this paper, an information harvesting tool (heteroHarvest) is presented...... with objectives to address these problems by filtering the useful information and then normalizing the information in a singular non hypertext format. Finally we describe the results of experimental evaluation. The results are found promising with an overall error rate equal to 6.5% across heterogeneous formats....

  8. Vibro-impacting power harvester (United States)

    Moss, Scott; Powlesland, Ian; Galea, Stephen; Carman, Gregory


    The certification of retro-fitted structural health monitoring (SHM) systems for use on aircraft raises a number of challenges. One critical issue is determining the optimal means of supplying power to these systems, given that access to the existing aircraft power-system is often problematic. Previously, the DSTO has shown that a structural-strain based energy harvesting approach can be used to power a device for SHM of aircraft structure. Acceleration-based power harvesting from airframes can be more demanding than a strain based approach because the vibration spectrum of an aircraft structure can vary dynamically with flight conditions. A vibration spectrum with varying frequency may severely limit the power harvested by a single-degree-of-freedom resonance-based device, and hence a frequency agile or (relatively) broadband device is often required to maximize the energy harvested. This paper reports on an investigation into the use of a vibro-impact approach to construct an acceleration-based power harvester that can operate in the frequency range 29-41 Hz.

  9. Vestibular tributaries to the vein of the vestibular aqueduct

    DEFF Research Database (Denmark)

    Hansen, Jesper Marsner; Qvortrup, Klaus; Friis, Morten


    CONCLUSION: The vein of the vestibular aqueduct drains blood from areas extensively lined by vestibular dark cells (VDCs). A possible involvement in the pathogenesis of an impaired endolymphatic homeostasis can be envisioned at the level of the dark cells area. OBJECTIVES: The aim of this study...... was to investigate the vascular relationship between the vein of the vestibular aqueduct and the vestibular apparatus, with focus on the VDCs. METHODS: Sixteen male Wistar rats were divided into groups of 6 and 10. In the first group, 2 µm thick sections including the vein of the vestibular aqueduct, utricle...... relation to the VDCs in the utricle and the crista ampullaris of the lateral semicircular canal in the vestibular apparatus. One major vein emanated from these networks, which emptied into the vein of the vestibular aqueduct. Veins draining the saccule and the common crus of the superior and posterior...

  10. Central Retinal Vein Occlusion Revealing Coelic Disease

    Directory of Open Access Journals (Sweden)



    Full Text Available Introduction: Thrombosis has been widely reported in coeliac disease (CD but central retinal vein occlusion (CRVO is rarely described. Case presentation: A 27-year-old woman presented with acute visual loss and was diagnosed with CRVO. Her protein S and protein C levels were low and CD was diagnosed on the basis of endoscopic, immunological and histological results. A gluten-free diet resulted in favourable evolution. Conclusion: CD should be considered in young patients with thrombosis, especially if in an unusual location. Treatment is based on a gluten-free diet.

  11. Portal vein thrombosis in patients with cirrhosis (United States)

    von Köckritz, Leona; De Gottardi, Andrea; Praktiknjo, Michael


    Abstract Portal vein thrombosis (PVT) is frequent in patients with liver cirrhosis and possible severe complications such as mesenteric ischemia are rare, but can be life-threatening. However, different aspects of clinical relevance, diagnosis and management of PVT are still areas of uncertainty and investigation in international guidelines. In this article, we elaborate on PVT classification, geographical differences in clinical presentation and standards of diagnosis, and briefly on the current pathophysiological understanding and risk factors. This review considers and highlights the pitfalls of the various treatment approaches and prophylactic treatments. Finally, we review the controversial issue of clinical impact of PVT on prognosis, especially considering liver transplantation and future perspectives. PMID:28533912

  12. Unilateral pulmonary vein atresia: A case report

    Energy Technology Data Exchange (ETDEWEB)

    Yoon, So Hwa; Kim, Ki Jun [Dept. of Radiology, Incheon St. Mary' s Hospital, The Catholic University of Korea College of Medicine, Incheon (Korea, Republic of)


    Unilateral pulmonary vein atresia is a rare congenital anomaly. Its symptoms begin to manifest in childhood and a broad spectrum of clinical severity has been described, ranging from asymptomatic, recurrent pulmonary infection, severe hemoptysis, to death. Only a few adult cases with this condition, with no or mild symptoms, have been reported. Pulmonary angiography has been typically used for definite diagnosis. However, pulmonary angiography may be replaced with the current developing multidetector CT. This report presents an adult case with mild symptoms, diagnosed by multidetector CT.

  13. Pediatric aneurysms and vein of Galen malformations (United States)

    Rao, V. R. K.; Mathuriya, S. N.


    Pediatric aneurysms are different from adult aneurysms – they are more rare, are giant and in the posterior circulation more frequently than in adults and may be associated with congenital disorders. Infectious and traumatic aneursyms are also seen more frequently. Vein of Galen malformations are even rarer entities. They may be of choroidal or mural type. Based on the degree of AV shunting they may present with failure to thrive, with hydrocephalus or in severe cases with heart failure. The only possible treatment is by endovascular techniques – both transarterial and transvenous routes are employed. Rarely transtorcular approach is needed. These cases should be managed by an experienced neurointerventionist. PMID:22069420

  14. Treatment of superficial vein thrombosis to prevent deep vein thrombosis and pulmonary embolism: a systematic review

    NARCIS (Netherlands)

    Wichers, Iris M.; Di Nisio, Marcello; Büller, Harry R.; Middeldorp, Saskia


    The aim of this systematic review was to summarize the evidence from randomized controlled trials (RCT) concerning the efficacy and safety of medical or surgical treatments of superficial vein thrombosis (SVT) for the prevention of deep venous thrombosis (DVT) and pulmonary embolism (PE). A

  15. Marginal vein is not a varicose vein; it is a venous malformation

    Directory of Open Access Journals (Sweden)

    Byung-Boong Lee


    Full Text Available Marginal vein (MV is one form of venous malformation (VM; MV is not a varicose vein. MV is the outcome of defective development during the later stage of embryogenesis while the vein trunk is formed. It is an embryonic vein tissue remnant remaining on birth following the failure of normal involutional process. MV is the most common VM involved to Klippel-Trenaunay syndrome (KTS; together with the lymphatic malformation, MV is one of two clinically most important congenital vascular malformation components among KTS. MV causes chronic venous insufficiency (CVI due to a unique condition of avalvulosis (lack of venous valve development it accompanies with. Besides, it accompanies a high risk of venous thromboembolism (VTE due to its structural defect with a lack of smooth muscle cell to form the media properly as a truncular VM infrequently causing fatal pulmonary embolism. Therefore, the MV is indicated for the surgical excision whenever feasible not only for the prevention of VTE and CVI but also for abnormal long bone growth known as vascular bone syndrome as well as lymphatic complication precipitated by MV.

  16. Vein mechanism simulation study for deep vein thrombosis early diagnosis using cfd (United States)

    Ibrahim, Nabilah; Aziz, Nur Shazilah Abd; Manap, Abreeza Noorlina Abd


    Using a Computational Fluid Dynamics (CFD) technique, this work focus on the analysis of pressure, velocity, and vorticity of blood flow along the popliteal vein. Since the study of early stage of Deep Vein Thrombosis (DVT) becomes essential to prevent the pulmonary embolism (PE), those three parameters are analysed to assess the effect of different opening between two valves of a normal popliteal vein. When only one valve is simulated, the result of pressure shows that the highest and lowest velocities are 15.45 cm/s and 0.73 cm/s, respectively. From the visualization of observed data, however, the different size of orifice between the first and second valves influencing the velocity and vorticity of the blood flow. The rotational motion of blood particle at the same region increases the probability of blood accumulating which is associated with the development of thrombus. Thus, a series of experiment has been conducted by changing the size of valve orifice for the first and second valves along the vein distribution. The result of the CFD simulation shows a significant variation in blood flow in terms of velocity and vorticity.

  17. Computer Vision for Timber Harvesting

    DEFF Research Database (Denmark)

    Dahl, Anders Lindbjerg

    The goal of this thesis is to investigate computer vision methods for timber harvesting operations. The background for developing computer vision for timber harvesting is to document origin of timber and to collect qualitative and quantitative parameters concerning the timber for efficient harvest...... segments. The purpose of image segmentation is to make the basis for more advanced computer vision methods like object recognition and classification. Our second method concerns image classification and we present a method where we classify small timber samples to tree species based on Active Appearance...... to the development of the logTracker system the described methods have a general applicability making them useful for many other computer vision problems....

  18. [Portal perfusion with right gastroepiploic vein flow in liver transplant]. (United States)

    Mendoza-Sánchez, Federico; Javier-Haro, Francisco; Mendoza-Medina, Diego Federico; González-Ojeda, Alejandro; Cortés-Lares, José Antonio; Fuentes-Orozco, Clotilde

    Liver transplantation in patients with liver cirrhosis, portal vein thrombosis, and cavernous transformation of the portal vein, is a complex procedure with high possibility of liver graft dysfunction. It is performed in 2-19% of all liver transplants, and has a significantly high mortality rate in the post-operative period. Other procedures to maintain portal perfusion have been described, however there are no reports of liver graft perfusion using right gastroepiploic vein. A 20 year-old female diagnosed with cryptogenic cirrhosis, with a Child-Pugh score of 7 points (class "B"), and MELD score of 14 points, with thrombosis and cavernous transformation of the portal vein, severe portal hypertension, splenomegaly, a history of upper gastrointestinal bleeding due to oesophageal varices, and left renal agenesis. The preoperative evaluation for liver transplantation was completed, and the right gastroepiploic vein of 1-cm diameter was observed draining to the infrahepatic inferior vena cava and right suprarenal vein. An orthotopic liver transplantation was performed from a non-living donor (deceased on January 30, 2005) using the Piggy-Back technique. Portal vein perfusion was maintained using the right gastroepiploic vein, and the outcome was satisfactory. The patient was discharged 13 days after surgery. Liver transplantation was performed satisfactorily, obtaining an acceptable outcome. In this case, the portal perfusion had adequate blood flow through the right gastroepiploic vein. Copyright © 2015 Academia Mexicana de Cirugía A.C. Publicado por Masson Doyma México S.A. All rights reserved.

  19. Portal Vein Thrombosis After Splenic and Pancreatic Surgery. (United States)

    Ruiz-Tovar, Jaime; Priego, Pablo


    The portal vein is formed by the confluence of the splenic and superior mesenteric veins, which drain the spleen and small intestine respectively. Occlusion of the portal vein by thrombus typically occurs in patients with cirrhosis and/or prothrombotic disorders. However, portal vein thrombosis (PVT) can also happen after determined surgeries. Moreover, PVT can have serious consequences depending on the location and extent of the thrombosis, including hepatic ischemia, intestinal ischemia, portal hypertension… In this chapter, we will review the incidence, management and prophylaxis of PVT after splenectomy, pancreas transplantation, pancreatic surgery and in the setting of acute and chronic pancreatitis.

  20. A rare case of branch retinal vein occlusion following Sirsasana

    National Research Council Canada - National Science Library

    Balamurugan, Anugraha; Srikanth, Krishnagopal


    .... It is also known to cause causes raised intraocular pressure, decompression retinopathy, glaucomatous visual field defects, central retinal vein occlusion, progression of glaucoma, optic neuropathy...

  1. Can deep vein thrombosis be predicted after varicose vein operation in women in rural areas? (United States)

    Warot, Marcin; Synowiec, Tomasz; Wencel-Warot, Agnieszka; Daroszewski, Przemysław; Bojar, Iwona; Micker, Maciej; Chęciński, Paweł


    Chronic venous disease is a group of symptoms caused by functional and structural defects of the venous vessels. One of the most common aspects of this disease is the occurrence of varicose veins. There are many ways of prevention and treatment of varicose veins, but in Poland the leading one is still surgery. As in every medical procedure there is the possibility of some complications. One of them is deep vein thrombosis (DVT). The diagnosis of DVT can be difficult, especially when access to a specialist is limited, such as in case of rural patients. The aim of the study. The aim of the study was estimation of the influence of LMWH primary prophylaxis on the formation of postoperative DVT, as well as sensitivity and specificity of clinical examination and D-dimer value in diagnosis of postoperative DVT in women. The study was conducted in a group of 93 women operated on in the Department of General, Vascular Surgery and Angiology at the Karol Marcinkowski University of Medical Sciences in Poznań, Poland. The patients had undergone a varicose vein operation and were randomly divided into two groups: A - 48 women receiving LMWH during two days of the perioperative period, B - 45 women receiving LMWH during seven days of the perioperative period. There was no significant difference in the postoperative DVT complications in both groups. The value of D-dimer > 0.987 mcg/ml and swelling > 1.5 cm of shin (in comparison to the preoperative period) plays a significant role in diagnosis of DVT. The extended primary prophylaxis with LMWH does not affect the amount or quality of thrombotic complications after varicose vein operation. If the DVT occurs, the evaluation of the D - dimer and careful clinical examination can be a useful method for its diagnosis.

  2. Can deep vein thrombosis be predicted after varicose vein operation in women in rural areas?

    Directory of Open Access Journals (Sweden)

    Marcin Warot


    Full Text Available [b]Introduction[/b]. Chronic venous disease is a group of symptoms caused by functional and structural defects of the venous vessels. One of the most common aspects of this disease is the occurrence of varicose veins. There are many ways of prevention and treatment of varicose veins, but in Poland the leading one is still surgery. As in every medical procedure there is the possibility of some complications. One of them is deep vein thrombosis (DVT. The diagnosis of DVT can be difficult, especially when access to a specialist is limited, such as in case of rural patients. [b]The aim of the study.[/b] The aim of the study was estimation of the influence of LMWH primary prophylaxis on the formation of postoperative DVT, as well as sensitivity and specificity of clinical examination and D-dimer value in diagnosis of postoperative DVT in women. [b]Materials and methods[/b]. The study was conducted in a group of 93 women operated on in the Department of General, Vascular Surgery and Angiology at the Karol Marcinkowski University of Medical Sciences in Poznań, Poland. The patients had undergone a varicose vein operation and were randomly divided into two groups: A – 48 women receiving LMWH during two days of the perioperative period, B – 45 women receiving LMWH during seven days of the perioperative period. [b]Results[/b]. There was no significant difference in the postoperative DVT complications in both groups. The value of D-dimer > 0.987 mcg/ml and swelling > 1.5 cm of shin (in comparison to the preoperative period plays a significant role in diagnosis of DVT. [b]Conclusions[/b]. The extended primary prophylaxis with LMWH does not affect the amount or quality of thrombotic complications after varicose vein operation. If the DVT occurs, the evaluation of the D – dimer and careful clinical examination can be a useful method for its diagnosis.

  3. A DUPLICATED GREAT SAPHENOUS VEIN AND CLINICAL SIGNIFICANCE FOR VARICOSITY. Duplicación de la vena safena magna y significado clínico de las várices


    Waseem Al Talalwah; Roger Soames


    En varios estudios se ha relacionado la vena safena magna doble con dilataciones varicosas. Durante una clase de disección de pre-grado de la extremidad inferior se encontró una doble vena safena magna unilateral en el miembro inferior izquierdo de un cadáver masculino. La incidencia de esta variación fue del 1,3% de todos los especímenes muestra. En este trabajo se reporta la variabilidad del drenaje venoso de las extremidades inferiores para mejorar la conciencia para los radiólogos vascula...

  4. Harvest of table olives by mechanical harvesting equipment

    Directory of Open Access Journals (Sweden)

    Filippo Gambella


    Full Text Available In this work, we have evaluated the performance, of an electric comb equipped with five undulated fingers used for mechanized the harvesting of table olives. The first aim of the work was to test three different types of coating materials used for covering the fingers: Silicon (S, Vulcanized rubber (VR and Natural rubber (NR. The diameter of the coating materials tested were 7mm (D1, 14 mm (D2, 19 mm (D3 in order to evaluate the damage of different working conditions on the intact olives. During harvesting, silicon at 7mm and 14mm resulted in the largest percentage of undamaged the fruit (67% and 65%, natural rubber 63% and vulcanized rubber at the 54%. The second aim was to evaluate the combination, in terms of the best performance, of the machines used for mechanized harvesting of table olives. Several factors have been examined: undulating fingers variation thickness, different rotational speeds and different coating materials used to reduce the impact damage on olives. From the tests on olive tree we have determined that while plastic materials (S and (NR appear to have a positive role in harvest quality, the vibration transmitted to the operator’s hand is great from 6.48 m/s2 for S to 6.31 m/ s2 for NR and 2.92 m/s2 for VR, respect to the materials used.

  5. Losses in industrial tomato harvesting according to harvester setting

    Directory of Open Access Journals (Sweden)

    João Paulo Barreto Cunha


    Full Text Available Losses in the mechanical harvesting of industrial tomatoes, depending on the levels reached, may considerably reduce the yield of the planted areas. This study aimed to evaluate the effect of settings of the rotary separation system on losses observed during the mechanized harvesting process. The statistical design was completely randomized, in a factorial scheme with four replications, where each plot consisted of the combination of three rotation levels (6 rpm, 24 rpm and 18 rpm with three vibration frequencies (0.83 Hz, 2.50 Hz and 4.17 Hz from the separation system. The recorded losses were divided into branch losses, fruit losses on the soil and total losses. Sequential and control charts for individual values and variable ranges composed by the upper and lower limits of control and average were used as a tool of statistical process control. The results showed that the total losses incurred are outside the control limits and acceptable standards for industrial tomato crops. The use of higher levels of rotation and vibration in the harvester separation system provided a higher harvest efficiency.

  6. Deep inferior epigastric artery perforator flap harvest after full abdominoplasty. (United States)

    Zeltzer, Assaf A; De Baerdemaeker, Randy A; Hendrickx, Benoit; Seidenstücker, Katrin; Brussaard, Carola; Hamdi, Moustapha


    Abdominal scars are no longer a contra-indication for abdominal perforator flap harvesting. Few research data exists about the regeneration potential of the abdominal wall's perforator system. Therefore, previous abdominoplasty with umbilical transposition is an absolute contra-indication for a DIEaP-flap (deep inferior epigastric artery perforator flap). A 50-year-old patient required a breast reconstruction of the right breast, 10 years after an abdominoplasty with undermining of the superior abdomen and umbilical transposition. The patient was scheduled for a free lumbar artery perforator (LaP) flap. The preoperative computed tomography-angiography mapping showed nice lumbar perforators and to our surprise a good-sized DIEa perforator in the peri-umbilical region. The DIEa perforator on the right hemi-abdomen, consisting of two veins and one artery, was pulsatile and found suitable in size. A classical flap harvest and transfer was further performed. This case report is the first in which a dominant perforator is found in the area of undermining after a full abdominoplasty with umbilical repositioning. Further investigations regarding the nature and timing of re-permeation or regeneration of perforators after abdominoplasty are to be done. Nevertheless, we are convinced that with appropriate perforator mapping and a suitable plan B, previous abdominoplasty is no longer an absolute but a relative contra-indication for performing DIEaP-flap.

  7. Neonatal vitelline vein aneurysm with thrombosis: prompt treatment should be needed (United States)

    Kim, Soo-Hong; Yu, Hyeong Won; Jo, Heui Seung


    Vitelline veins are a pair of embryonic structures. The veins develop the portal vein system. Serious problems occur if the vitelline vein does not regress and becomes an aneurysm. Thrombus formation in the vitelline vein aneurysm could lead to portal vein thrombosis and portal hypertension unless promptly and correctly treated. Though vitelline vein aneurysm is an extremely rare anomaly, it rapidly progresses to portal vein thrombosis that requires prompt diagnosis and treatment. We reported a case of neonatal vitelline vein aneurysm and thrombosis that was cured by prompt operation. PMID:26665130

  8. Doppler-guided cannulation of internal jugular vein, subclavian vein and innominate (brachiocephalic) vein--a case-control comparison in patients with reduced and normal intracranial compliance. (United States)

    Schummer, Wolfram; Schummer, Claudia; Niesen, Wolf-Dirk; Gerstenberg, Hendrik


    A case-control comparison of Doppler guidance on the success rate of central venous cannulation in patients with normal or reduced intracranial compliance. A single operator performed central venous access procedures with continuous wave Doppler guidance. It was used on patients on a ventilator. The position of patients with reduced intracranial compliance (RIC) was not changed for the procedure. Patients with normal intracranial compliance (NIC) were put in the Trendelenburg position. We prospectively evaluated 249 Doppler-guided central venous access procedures performed over a 12-month period at our 10-bed neuro-intensive care unit at a university hospital. The group with RIC included 26 males and 35 females (n=61) aged 16-79 years. In this group 155 Doppler-guided cannulation procedures (62%) were performed. The group with NIC (n=52) comprised 29 males and 23 females aged 34-76 years; 94 Doppler-guided cannulation procedures (38%) were carried out. The veins cannulated in RIC and NIC, respectively, were: right innominate vein: 24/18, left innominate vein 26/12, right subclavian vein 12/7, left subclavian vein 25/14, and right internal jugular vein 33/18 and left internal jugular vein 35/24. The absence of one left internal jugular vein was identified in the NIC group. The success rate of first needle pass in patients with RIC was 92% and in patients with NIC 89%. This study showed that Doppler guidance allows the cannulation of central veins in patients with RIC placed in head-up position. Cannulation can be ensured and first-pass needle placement maximised.

  9. Further evidence of Mirafiori lettuce big-vein virus but not of Lettuce big-vein associated virus with big-vein disease in lettuce. (United States)

    Sasaya, Takahide; Fujii, Hiroya; Ishikawa, Koichi; Koganezawa, Hiroki


    Mirafiori lettuce big-vein virus (MLBVV) and Lettuce big-vein associated virus (LBVaV) are found in association with big-vein disease of lettuce. Discrimination between the two viruses is critical for elucidating the etiology of big-vein disease. Using specific antibodies to MLBVV and LBVaV for western blotting and exploiting differences between MLBVV and LBVaV in host reaction of cucumber and temperature dependence in lettuce, we separated the two viruses by transfering each virus from doubly infected lettuce plants to cucumber or lettuce plants. A virus-free fungal isolate was allowed to acquire the two viruses individually or together. To confirm the separation, zoospores from MLBVV-, LBVaV-, and dually infected lettuce plants were used for serial inoculations of lettuce seedlings 12 successive times. Lettuce seedlings were infected at each transfer either with MLBVV alone, LBVaV alone, or both viruses together, depending on the virus carried by the vector. Lettuce seedlings infected with MLBVV alone developed the big-vein symptoms, while those infected with LBVaV alone developed no symptoms. In field surveys, MLBVV was consistently detected in lettuce plants from big-vein-affected fields, whereas LBVaV was detected in lettuce plants not only from big-vein-affected fields but also from big-vein-free fields. LBVaV occurred widely at high rates in winter-spring lettuce-growing regions irrespective of the presence of MLBVV and, hence, of the presence of the big-vein disease.

  10. Wideband Piezomagnetoelastic Vibration Energy Harvesting

    DEFF Research Database (Denmark)

    Lei, Anders; Thomsen, Erik Vilain


    This work presents a small-scale wideband piezomagnetoelastic vibration energy harvester (VEH) aimed for operation at frequencies of a few hundred Hz. The VEH consists of a tape-casted PZT cantilever with thin sheets of iron foil attached on each side of the free tip. The wideband operation...

  11. Photodynamics of Light Harvesting Systems

    NARCIS (Netherlands)

    Ruijter, Ward Piet Frans de


    Light harvesting (LH) lies at the basis of photosynthesis, the process in which energy from the sun is stored by a photochemical reaction. The photophysics of light absorption and energy transfer is the key to a detailed understanding of the first steps in this process. This thesis describes the

  12. Post-harvest loss reduction

    NARCIS (Netherlands)

    Gogh, van Bart; Boerrigter, Henry; Noordam, Maryvon; Ruben, Ruerd; Timmermans, Toine


    This paper was written by experts from Wageningen University & Research (WUR), representing their combined expertise on food chains, post-harvest technology, sustainability, food security, economics, and food safety. The paper was drafted at the request of the Dutch Ministry of Economic Affairs in

  13. Triboelectric effect in energy harvesting (United States)

    Logothetis, I.; Vassiliadis, S.; Siores, E.


    With the development of wearable technology, much research has been undertaken in the field of flexible and stretchable electronics for use in interactive attire. The challenging problem wearable technology faces is the ability to provide energy whilst keeping the endproduct comfortable, light, ergonomic and nonintrusive. Energy harvesting, or energy scavenging as it is also known, is the process by which ambient energy is captured and converted into electric energy. The triboelectric effect converts mechanical energy into electrical energy based on the coupling effect of triboelectrification and electrostatic induction and is utilized as the basis for triboelectric generators (TEG). TEG’s are promising for energy harvesting due their high output power and efficiency in conjunction with simple and economical production. Due to the wide availability of materials and ease of integration, in order to produce the triboelectric effect such functional materials are effective for wearable energy harvesting systems. Flexible TEG’s can be built and embedded into attire, although a thorough understanding of the underlying principle of how TEG’s operate needs to be comprehended for the development and in incorporation in smart technical textiles. This paper presents results associated with TEG’S and discusses their suitability for energy harvesting in textiles structures.

  14. Preventing intimal thickening of vein grafts in vein artery bypass using STAT-3 siRNA

    Directory of Open Access Journals (Sweden)

    Sun Jiangbin


    Full Text Available Abstract Background Proliferation and migration of vascular smooth muscle cells (VSMCs play a key role in neointimal formation which leads to restenosis of vein graft in venous bypass. STAT-3 is a transcription factor associated with cell proliferation. We hypothesized that silencing of STAT-3 by siRNA will inhibit proliferation of VSMCs and attenuate intimal thickening. Methods Rat VSMCs were isolated and cultured in vitro by applying tissue piece inoculation methods. VSMCs were transfected with STAT 3 siRNA using lipofectamine 2000. In vitro proliferation of VSMC was quantified by the MTT assay, while in vivo assessment was performed in a venous transplantation model. In vivo delivery of STAT-3 siRNA plasmid or scramble plasmid was performed by admixing with liposomes 2000 and transfected into the vein graft by bioprotein gel applied onto the adventitia. Rat jugular vein-carotid artery bypass was performed. On day 3 and7 after grafting, the vein grafts were extracted, and analyzed morphologically by haematoxylin eosin (H&E, and assessed by immunohistochemistry for expression of Ki-67 and proliferating cell nuclear antigen (PCNA. Western-blot and reverse transcriptase polymerase chain reaction (RT-PCR were used to detect the protein and mRNA expression in vivo and in vitro. Cell apoptosis in vein grafts was detected by TUNEL assay. Results MTT assay shows that the proliferation of VSMCs in the STAT-3 siRNA treated group was inhibited. On day 7 after operation, a reduced number of Ki-67 and PCNA positive cells were observed in the neointima of the vein graft in the STAT-3 siRNA treated group as compared to the scramble control. The PCNA index in the control group (31.3 ± 4.7 was higher than that in the STAT-3 siRNA treated group (23.3 ± 2.8 (P Conclusions The STAT-3 siRNA can inhibit the proliferation of VSMCs in vivo and in vitro and attenuate neointimal formation.

  15. Energy Harvesting from Mechanical Shocks Using a Sensitive Vibration Energy Harvester

    Directory of Open Access Journals (Sweden)

    Zdenek Hadas


    Full Text Available This paper deals with a unique principle of energy harvesting technologies. An energy harvesting device generates electric energy from its surroundings using some kind of energy conversion method. Therefore, the considered energy harvesting device does not consume any fuel or substance. The presented energy harvesting system is used forenergy harvesting of electrical energy from mechanical shocks. The presented energy harvesting system uses a very sensitive vibration energy harvester, which was developed for an aeronautic application at Brno University of Technology. This energy harvesting system is a complex mechatronic device, which consists of a precise mechanical part, an electromagnetic converter, power electronics (power management and a load (e.g., wireless sensor. The very sensitive vibration energy harvester is capable of usingthe mechanical energy of mechanical shocks and it can harvest useful energy. This energy harvesting system is used with a wireless temperature sensor and measured results are presented in this paper.

  16. Can We Sustainably Harvest Ivory? (United States)

    Lusseau, David; Lee, Phyllis C


    Despite the 1989 ivory trade ban, elephants continue to be killed to harvest their tusks for ivory. Since 2008, this poaching has increased to unprecedented levels driven by consumer demand for ivory products. CITES is now considering the development of a legal ivory trade [1, 2]. The proposal relies on three assumptions: (1) harvest regulation will cease all illegal activities, (2) defined sustainable quotas can be enforced, and (3) we can define meaningful sustainable quotas that come close to the current demand. We know that regulation of harvest does not stop illegal takes. Despite whaling regulation after World War II, illegal whaling continued for decades [3]. The introduction of wolf culls in the US actually increased poaching activities [4], and one-off ivory sales in 1999 and 2008 did nothing to halt elephant poaching. Governance issues over the ivory supply chains, including stockpiling, make enforcing quotas challenging, if not impossible [5, 6]. We have not yet adequately assessed what could be a sustainable ivory yield. To do so, we develop a compartmental model composed of a two-sex age-structured demographic model and an ivory production and harvest model. We applied several offtake and quota strategies to define how much ivory could be sustainably harvested. We found that the sustainability space is very small. Only 100 to 150 kg of ivory could be removed from a reference population of 1,360 elephants, levels well below the current demand. Our study shows that lifting the ivory ban will not address the current poaching challenge. We should instead focus on reducing consumer demand. Copyright © 2016 Elsevier Ltd. All rights reserved.

  17. Energy-Harvesting Performances of Two Tandem Piezoelectric Energy Harvesters with Cylinders in Water

    Directory of Open Access Journals (Sweden)

    Xiaobiao Shan


    Full Text Available This paper presents a new energy-harvesting system with two identical piezoelectric energy harvesters in a tandem configuration. Each harvester consists of a piezoelectric beam and a circular cylinder. Experiments are performed to investigate the energy-harvesting performances of this system in water. It can be found that their energy-harvesting performances are all different from that of the single harvester (without an upstream or downstream harvester. The experimental results show that the water speed and the spacing ratio have significant effects on the energy-harvesting performances of the two tandem harvesters. The output power of the upstream harvester first increases, and then decreases with the water speed increasing. The maximum output power of 167.8 μW is achieved at the water speed of 0.306 m/s and the spacing ratio (L/D of 2.5. Increasing the water speed results in an increase in the energy performance of the downstream harvester. Compared with the single harvester, the performance of the downstream harvester is weakened in the low water speed range, but enhanced in the higher water speed range. Further, the output power of 533 μW is obtained by the downstream harvester at the water speed of 0.412 m/s and the spacing ratio of 1.7, which is 29 times more than that of the single harvester. The results indicate the superiority of the two tandem harvesters in energy-harvesting performance.

  18. Supraclavicular versus Infraclavicular Subclavian Vein Catheterization in Infants


    Wen-Hsien Lu; Mei-Ling Yao; Kai-Sheng Hsieh; Pao-Chin Chiu; Ying-Yao Chen; Chu-Chuan Lin; Ta-Cheng Huang; Chu-Chin Chen


    Central venous catheterization is an important procedure for infant patients for a number of different purposes, including nutritional support, surgical operation, hemodynamic monitoring, and multiple lines for critical care medications. Subclavian vein catheterization (SVC) is one of the central vein catheterization techniques. SVC can be performed from 4 different locations: right supraclavicular (RSC), left supraclavicular (LSC), right infraclavicular (RIC), and left infraclavicular (LIC)....

  19. Ovarian vein thrombosis | Jenayah | Pan African Medical Journal

    African Journals Online (AJOL)

    Ovarian vein thrombosis (OVT) is a rare cause of abdominal pain that may mimic a surgical abdomen. It is most often diagnosed during the postpartum period. In this report, we present four cases of postoperative ovarian vein thrombosis .The complications of OVT can be significant, and the diagnosis relies on a careful ...

  20. Portal Vein Stenting for Portal Biliopathy with Jaundice. (United States)

    Hyun, Dongho; Park, Kwang Bo; Lim, Seong Joo; Hwang, Jin Ho; Sinn, Dong Hyun


    Portal biliopathy refers to obstruction of the bile duct by dilated peri- or para-ductal collateral channels following the main portal vein occlusion from various causes. Surgical shunt operation or endoscopic treatment has been reported. Herein, we report a case of portal biliopathy that was successfully treated by interventional portal vein recanalization.

  1. Endovascular management for significant iatrogenic portal vein bleeding. (United States)

    Kim, Jong Woo; Shin, Ji Hoon; Park, Jonathan K; Yoon, Hyun-Ki; Ko, Gi-Young; Gwon, Dong Il; Kim, Jin Hyoung; Sung, Kyu-Bo


    Background Despite conservative treatment, hemorrhage from an intrahepatic branch of the portal vein can cause hemodynamic instability requiring urgent intervention. Purpose To retrospectively report the outcomes of hemodynamically significant portal vein bleeding after endovascular management. Material and Methods During a period of 15 years, four patients (2 men, 2 women; median age, 70.5 years) underwent angiography and embolization for iatrogenic portal vein bleeding. Causes of hemorrhage, angiographic findings, endovascular treatment, and complications were reported. Results Portal vein bleeding occurred after percutaneous liver biopsy (n = 2), percutaneous radiofrequency ablation (n = 1), and percutaneous cholecystostomy (n = 1). The median time interval between angiography and percutaneous procedure was 5 h (range, 4-240 h). Common hepatic angiograms including indirect mesenteric portograms showed active portal vein bleeding into the peritoneal cavity with (n = 1) or without (n = 2) an arterioportal (AP) fistula, and portal vein pseudoaneurysm alone with an AP fistula (n = 1). Successful transcatheter arterial embolization (n = 2) or percutaneous transhepatic portal vein embolization (n = 2) was performed. Embolic materials were n-butyl cyanoacrylate alone (n = 2) or in combination with gelatin sponge particles and coils (n = 2). There were no major treatment-related complications or patient mortality within 30 days. Conclusion Patients with symptomatic or life-threatening portal vein bleeding following liver-penetrating procedures can successfully be managed with embolization.

  2. Portal Vein Stenting for Portal Biliopathy with Jaundice

    Energy Technology Data Exchange (ETDEWEB)

    Hyun, Dongho, E-mail:; Park, Kwang Bo, E-mail: [Sungkyunkwan University School of Medicine, Department of Radiology, Samsung Medical Center (Korea, Republic of); Lim, Seong Joo [Konyang University, Department of Radiology, College of Medicine, Konyang University Hospital (Korea, Republic of); Hwang, Jin Ho [Hallym University Sacred Heart Hospital, Department of Radiology (Korea, Republic of); Sinn, Dong Hyun [Sungkyunkwan University School of Medicine, Department of Medicine, Samsung Medical Center (Korea, Republic of)


    Portal biliopathy refers to obstruction of the bile duct by dilated peri- or para-ductal collateral channels following the main portal vein occlusion from various causes. Surgical shunt operation or endoscopic treatment has been reported. Herein, we report a case of portal biliopathy that was successfully treated by interventional portal vein recanalization.

  3. unilateral idiopathic dilated episcleral vein with secondary open ...

    African Journals Online (AJOL)


    intraocular pressure (IOP) is a function of: production of aqueous humour, resistance to aqueous outflow at the anterior chamber angles, and episcleral venous pressure. When the episcleral veins are dilated, the pressure in these veins becomes elevated. Prolonged elevation of episcleral venous pressure often causes ...

  4. Foam treatment for varicose veins; efficacy and safety | Kotb ...

    African Journals Online (AJOL)

    Introduction: Lower extremity varicose vein is a common disease. Sclerotherapy can be used to treat truncal varices of the superficial venous system. This involves injecting a sclerosant intraluminally in order to cause fibrosis and eventual obliteration of the vein. Objective: To demonstrate the efficacy and safety of foam ...

  5. Foam treatment for varicose veins; efficacy and safety

    African Journals Online (AJOL)

    Mamdouh Mohamed Kotb


    Apr 8, 2013 ... Abstract Introduction: Lower extremity varicose vein is a common disease. Sclerotherapy can be used to treat truncal varices of the superficial venous system. This involves injecting a sclerosant intraluminally in order to cause fibrosis and eventual obliteration of the vein. Objective: To demonstrate the ...

  6. HIV Associated Deep Vein Thrombosis: Case Reports from Jos ...

    African Journals Online (AJOL)

    Deep vein thrombosis (DVT) has been reported to be 2-10 times commoner in HIV infected patients than in the general population. We report two cases of extensive unilateral deep vein thrombosis involving the lower limb in HIV infected patients on highly active antiretroviral therapy (HAART). Doppler ultrasound in the two ...

  7. Early Diagnosis of Posttraumatic Deep Vein Thrombosis - A Review ...

    African Journals Online (AJOL)

    OBJECTIVE: The importance of early diagnosis and treatment of deep vein thrombosis in patients with fractures of long bones. INTRODUCTION: Associated injury to deep-veins in limb fractures presents a serious pathology. It results not only to localized venous occlusion but also to death from pulmonary embolism.

  8. Upper extremity deep vein thrombosis after elbow trauma: a case ...

    African Journals Online (AJOL)

    Treatment by low molecular weight heparin (LMWH) then by vitamin K antagonists was conducted and evaluation by Doppler ultrasonography realized 18 months after trauma showed recanalization of basilica and humeral veins and thrombosis of axillary and subclavian veins. Management of occupational activity was ...

  9. A Tight Spot After Pulmonary Vein Catheter Ablation

    NARCIS (Netherlands)

    Amir, Rabia; Yeh, Lu; Montealegre-Gallegos, Mario; Saraf, Rabya; Matyal, Robina; Mahmood, Feroze


    A 52-YEAR-OLD woman with a history of embolic stroke due to paroxysmal atrial fibrillation was referred to the authors’ institution for epicardial surgical pulmonary vein isolation with left atrial appendage resection. The patient had 2 previous failed pulmonary vein catheter ablations. Dense

  10. Geology and geochemistry of giant quartz veins from the ...

    Indian Academy of Sciences (India)

    They show imprints of strong brittle to ductile–brittle deformation, and in places are associated with base metal and gold incidences, and pyrophyllite-diaspore mineralization. The geochemistry of giant quartz veins were studied. Apart from presenting new data on the geology and geochemistry of these veins, an attempt has ...

  11. Renal Vein Leiomyoma: A Rare Entity with Review of Literature

    Directory of Open Access Journals (Sweden)

    Santosh Kumar


    Full Text Available Tumors of vascular origin are unusual. These tumors are predominantly malignant and commonly arise from the inferior vena cava. Benign smooth muscle tumors arising from renal vein are very rare. We present a case of leiomyoma of renal vein in a post-menopausal woman that clinically resembled a retroperitoneal paraganglioma.

  12. The fifth pulmonary vein | Kinfemichael | Anatomy Journal of Africa

    African Journals Online (AJOL)

    A cadaver in Myungsung Medical College (MMC) had a 3rd pulmonary vein originating from the middle lobe of the right lung. Such anatomical variations are very rare. People with this variation have a total of five pulmonary veins entering left atrium. It has clinical implications especially for thoracic surgeons and radiologists ...

  13. Doppler spectral characteristics of infrainguinal vein bypasses

    DEFF Research Database (Denmark)

    Nielsen, Tina G; von Jessen, F; Sillesen, H


    of arteriovenous fistulas the initially antegrade diastolic velocity was replaced by a retrograde flow within 3 months, whereas a forward flow in diastole was sustained in grafts with patent fistulas. Abnormal Duplex findings in 31 patients led to angiography and revision in 13 cases. Four revised grafts failed......, while nine remained patent at follow-up 1-12 months later. Ten (56%) of 18 non-revised bypasses with abnormal Duplex findings failed within 9 months compared to 1 (1%) of 76 bypasses with a normal velocity profile (p ... valuable information concerning haemodynamics of infrainguinal vein bypasses and identifies grafts at risk of thrombosis. Inclusion of low resistance index (detection of stenoses appears to improve the sensitivity of Duplex scanning....

  14. Nyala and Bushbuck II: A Harvesting Model. (United States)

    Fay, Temple H.; Greeff, Johanna C.


    Adds a cropping or harvesting term to the animal overpopulation model developed in Part I of this article. Investigates various harvesting strategies that might suggest a solution to the overpopulation problem without actually culling any animals. (ASK)

  15. Heat Harvesting by Artificial Muscles Project (United States)

    National Aeronautics and Space Administration — NASA emphasizes the need to implement energy harvesting in its future mission activities. By harvesting energy from the ambient surroundings, there is less...

  16. Climate drives vein anatomy in Proteaceae. (United States)

    Jordan, Gregory J; Brodribb, Timothy J; Blackman, Christopher J; Weston, Peter H


    The mechanisms by which plants tolerate water deficit are only just becoming clear. One key factor in drought tolerance is the ability to maintain the capacity to conduct water through the leaves in conditions of water stress. Recent work has shown that a simple feature of the leaf xylem cells, the cube of the thickness of cell walls divided by the lumen width (t/b)(3), is strongly correlated with this ability. Using ecologically, phylogenetically, and anatomically diverse members of Proteaceae, we tested the relationships between (t/b)(3) and climate, leaf mass per unit area, leaf area, and vein density. To test relationships at high phylogenetic levels (mostly genus), we used phylogenetic and nonphylogenetic single and multiple regressions based on data from 50 species. We also used 14 within-genus species pairs to test for relationships at lower phylogenetic levels. All analyses revealed that climate, especially mean annual precipitation, was the best predictor of (t/b)(3). The variation in (t/b)(3) was driven by variation in both lumen diameter and wall thickness, implying active control of these dimensions. Total vein density was weakly related to (t/b)(3) but unrelated to either leaf area or climate. We conclude that xylem reinforcement is a fundamental adaptation for water stress tolerance and, among evergreen woody plants, drives a strong association between rainfall and xylem anatomy. The strong association between (t/b)(3) and climate cannot be explained by autocorrelation with other aspects of leaf form and anatomy that vary along precipitation gradients.

  17. Mineral vein dynamics modelling (FRACS II)

    Energy Technology Data Exchange (ETDEWEB)

    Urai, J.; Virgo, S.; Arndt, M. [RWTH Aachen (Germany); and others


    The Mineral Vein Dynamics Modeling group ''FRACS'' started out as a team of 7 research groups in its first phase and continued with a team of 5 research groups at the Universities of Aachen, Tuebingen, Karlsruhe, Mainz and Glasgow during its second phase ''FRACS 11''. The aim of the group was to develop an advanced understanding of the interplay between fracturing, fluid flow and fracture healing with a special emphasis on the comparison of field data and numerical models. Field areas comprised the Oman mountains in Oman (which where already studied in detail in the first phase), a siliciclastic sequence in the Internal Ligurian Units in Italy (closed to Sestri Levante) and cores of Zechstein carbonates from a Lean Gas reservoir in Northern Germany. Numerical models of fracturing, sealing and interaction with fluid that were developed in phase I where expanded in phase 11. They were used to model small scale fracture healing by crystal growth and the resulting influence on flow, medium scale fracture healing and its influence on successive fracturing and healing, as well as large scale dynamic fluid flow through opening and closing fractures and channels as a function of fluid overpressure. The numerical models were compared with structures in the field and we were able to identify first proxies for mechanical vein-hostrock properties and fluid overpressures versus tectonic stresses. Finally we propose a new classification of stylolites based on numerical models and observations in the Zechstein cores and continued to develop a new stress inversion tool to use stylolites to estimate depth of their formation.

  18. Asymptomatic portal vein aneurysms: To treat, or not to treat? (United States)

    Hirji, Sameer A; Robertson, Faith C; Casillas, Sergio; McPhee, James T; Gupta, Naren; Martin, Michelle C; Raffetto, Joseph D


    Background Portal vein aneurysms are rare dilations in the portal venous system, for which the etiology and pathophysiological consequences are poorly understood. Method We reviewed the existing literature as well as present a unique anecdotal case of a patient presenting with a very large portal vein aneurysm that was successfully managed conservatively and non-operatively without anticoagulation, with close follow-up and routine surveillance. Result The rising prevalence of abdominal imaging in clinical practice has increased rates of portal vein aneurysm detection. While asymptomatic aneurysms less than 3 cm can be clinically observed, surgical intervention may be necessary in large asymptomatic aneurysms (>3 cm) with or without thrombus, or small aneurysms with evidence of evolving mural thrombus formation on imaging. Conclusion Portal vein aneurysms present a diagnostic challenge for any surgeon, and the goal for surgical therapy is based on repairing the portal vein aneurysm, and if portal hypertension is present decompressing via surgically constructed shunts.

  19. Three superficial veins coursing over the clavicles: a case report. (United States)

    Anastasopoulos, Nikolaos; Paraskevas, George; Apostolidis, Stylianos; Natsis, Konstantinos


    We report a unique bilateral combination of multiple variations in the superficial venous system of the neck of a 77-year-old male cadaver. On the right side of the neck, the external jugular vein (EJV) crossed superficial to the lateral third of the clavicle constituting a common trunk with the cephalic vein (CV) that drained into the subclavian vein (SCV). On the left side the EJV descended distally, passed over the anterior surface of the medial third of the clavicle and drained into the SCV. The posterior external jugular vein (PEJV) crossed superficial to the lateral third of the clavicle and terminated into the CV, providing an additional communicating branch to the EJV. Knowledge of both normal and abnormal anatomy of the veins of the neck plays an important role for anesthesiologists or cardiologists doing catheterization, orthopedic surgeons treating clavicle fractures and general surgeons performing head and neck surgery, to avoid inadvertent injury to these vascular structures.

  20. Thrombolysis for acute upper extremity deep vein thrombosis

    DEFF Research Database (Denmark)

    Feinberg, Joshua; Nielsen, Emil Eik; Jakobsen, Janus C


    BACKGROUND: About 5% to 10% of all deep vein thromboses occur in the upper extremities. Serious complications of upper extremity deep vein thrombosis, such as post-thrombotic syndrome and pulmonary embolism, may in theory be avoided using thrombolysis. No systematic review has assessed the effects...... of thrombolysis for the treatment of individuals with acute upper extremity deep vein thrombosis. OBJECTIVES: To assess the beneficial and harmful effects of thrombolysis for the treatment of individuals with acute upper extremity deep vein thrombosis. SEARCH METHODS: The Cochrane Vascular Information Specialist...... of thrombolytics added to anticoagulation, thrombolysis versus anticoagulation, or thrombolysis versus any other type of medical intervention for the treatment of acute upper extremity deep vein thrombosis. DATA COLLECTION AND ANALYSIS: Two review authors independently screened all records to identify those...

  1. Persistent right umbilical vein: sonographic detection and subsequent neonatal outcome. (United States)

    Hill, L M; Mills, A; Peterson, C; Boyles, D


    To review our experience with antenatal detection and subsequent neonatal outcome of fetuses with a persistent right umbilical vein. In a prospective observational study, 33 cases of persistent right umbilical vein were detected during 15,237 obstetric ultrasound examinations performed after 15 weeks' gestation. Persistent right umbilical vein was detected at a rate of one per 476 obstetric ultrasound examinations. Six of 33 (18.2%) fetuses with a persistent right umbilical vein had additional important congenital malformations. Careful second- and third-trimester ultrasound examinations can detect a persistent right umbilical vein. When this particular anomaly is detected, a thorough fetal anatomic survey, including echocardiography, should be performed to rule out more serious congenital malformations.

  2. Catheter entrapment in a pulmonary vein: a unique complication of pulmonary vein isolation. (United States)

    Monney, Pierre; Pascale, Patrizio; Fromer, Martin; Pruvot, Etienne


    Ablation strategies for the treatment of atrial fibrillation (AF) are associated with several potential complications. During electro-anatomic mapping of the left atrium (LA) before ablation, the ablation catheter was entrapped in the right inferior pulmonary vein (RIPV). After multiple unsuccessful gentle tractions, stronger maneuvers with rotation of the catheter slowly allowed its retrieval. Examination of the catheter showed a thin, translucent membrane covering its tip, suggesting complete stripping of a vein branch. Occlusion of the superior branch of the RIPV was confirmed by LA angiogram. During the following days, no pericardial effusion was noted, but the patient complained of light chest pain and mild hemoptysis, spontaneously resolving within 48 h. This case shows that catheter entrapment and mechanical disruption of a PV branch can be a rare potential complication of AF ablation. In this case, the outcome was spontaneously favorable and symptoms only included transient mild hemoptysis.

  3. Energy harvesting devices for harvesting energy from terahertz electromagnetic radiation (United States)

    Novack, Steven D.; Kotter, Dale K.; Pinhero, Patrick J.


    Methods, devices and systems for harvesting energy from electromagnetic radiation are provided including harvesting energy from electromagnetic radiation. In one embodiment, a device includes a substrate and one or more resonance elements disposed in or on the substrate. The resonance elements are configured to have a resonant frequency, for example, in at least one of the infrared, near-infrared and visible light spectra. A layer of conductive material may be disposed over a portion of the substrate to form a ground plane. An optical resonance gap or stand-off layer may be formed between the resonance elements and the ground plane. The optical resonance gap extends a distance between the resonance elements and the layer of conductive material approximately one-quarter wavelength of a wavelength of the at least one resonance element's resonant frequency. At least one energy transfer element may be associated with the at least one resonance element.

  4. Harvesting Maturity, Handling, Storage of Okra Pods


    TAMURA, Junsuke; MINAMIDE, Takahisa


    The growth pattern of okra pod after flowering was studied in detail. The changes of chemical components and physical properties of okra pod for a period between flowering and harvesting maturity was investigated to determine the optimum harvesting maturity. Storage and handling problems for harvested okra pods were discussed. It was found that the harvesting maturity of okra pod was 4 to 6 days after flowering. The optimum storage temperature of okra pod determined experimentally was at 12℃.

  5. Waste energy harvesting mechanical and thermal energies

    CERN Document Server

    Ling Bing, Kong; Hng, Huey Hoon; Boey, Freddy; Zhang, Tianshu


    Waste Energy Harvesting overviews the latest progress in waste energy harvesting technologies, with specific focusing on waste thermal mechanical energies. Thermal energy harvesting technologies include thermoelectric effect, storage through phase change materials and pyroelectric effect. Waste mechanical energy harvesting technologies include piezoelectric (ferroelectric) effect with ferroelectric materials and nanogenerators. The book aims to strengthen the syllabus in energy, materials and physics and is well suitable for students and professionals in the fields.

  6. Portal Vein Recanalization and Transjugular Intrahepatic Portosystemic Shunt Creation for Chronic Portal Vein Thrombosis: Technical Considerations. (United States)

    Thornburg, Bartley; Desai, Kush; Hickey, Ryan; Kulik, Laura; Ganger, Daniel; Baker, Talia; Abecassis, Michael; Lewandowski, Robert J; Salem, Riad


    Portal vein thrombosis (PVT) is common in cirrhotic patients and presents a challenge at the time of transplant. Owing to the increased posttransplant morbidity and mortality associated with complete PVT, the presence of PVT is a relative contraindication to liver transplantation at many centers. Our group began performing portal vein (PV) recanalization and transjugular intrahepatic portostystemic shunt placement (PVR-TIPS) several years ago to optimize the transplant candidacy of patients with PVT. The procedure has evolved to include transsplenic access to assist with recanalization, which is now our preferred method due to its technical success without significant added morbidity. Here, we describe in detail our approach to PVR-TIPS with a focus on the transsplenic method. The procedure was attempted in 61 patients and was technically successful in 60 patients (98%). After transitioning to transsplenic access to assist with recanalization, the technical success rate has improved to 100%. The recanalized portal vein and TIPS have maintained patency during follow-up, or to the time of transplant, in 55 patients (92%) with a mean follow-up of 16.7 months. In total, 23 patients (38%) have undergone transplant, all of whom received a physiologic anastomosis (end-to-end anastomosis in 22 of 23 patients, 96%). PVR-TIPS placement should be considered as an option for patients with chronic PVT in need of transplantation. Transsplenic access makes the procedure technically straightforward and should be considered as the primary method for recanalization. Copyright © 2016 Elsevier Inc. All rights reserved.

  7. NMR and mushrooms : imaging post harvest senescence

    NARCIS (Netherlands)

    Donker, H.C.W.


    The objective of the study described in this thesis was to explore the potentials of NMR for the study of water relations in harvested mushrooms ( Agaricus bisporus ). Since harvested mushrooms tend to continue their growth after harvest, their morphogenesis is heavily

  8. Total anomalous connection of pulmonary veins to the portal vein. Value of multislice angiotomography. Report on three cases

    Directory of Open Access Journals (Sweden)

    Sara Alejandra Solórzano-Morales


    15 and 26% if all its varieties. Multislice angiotomography allows us to view the blood vessels and adjacent organs under consideration and obtain high-definition anatomic information. In the patients in this study, total anomalous connection of pulmonary veins to the portal vein was viewed with three-dimensional volumetric tomographic reconstructions and their correlation with ultrasonography studies.

  9. Leaf hydraulic conductance varies with vein anatomy across Arabidopsis thaliana wild-type and leaf vein mutants. (United States)

    Caringella, Marissa A; Bongers, Franca J; Sack, Lawren


    Leaf venation is diverse across plant species and has practical applications from paleobotany to modern agriculture. However, the impact of vein traits on plant performance has not yet been tested in a model system such as Arabidopsis thaliana. Previous studies analysed cotyledons of A. thaliana vein mutants and identified visible differences in their vein systems from the wild type (WT). We measured leaf hydraulic conductance (Kleaf ), vein traits, and xylem and mesophyll anatomy for A. thaliana WT (Col-0) and four vein mutants (dot3-111 and dot3-134, and cvp1-3 and cvp2-1). Mutant true leaves did not possess the qualitative venation anomalies previously shown in the cotyledons, but varied quantitatively in vein traits and leaf anatomy across genotypes. The WT had significantly higher mean Kleaf . Across all genotypes, there was a strong correlation of Kleaf with traits related to hydraulic conductance across the bundle sheath, as influenced by the number and radial diameter of bundle sheath cells and vein length per area. These findings support the hypothesis that vein traits influence Kleaf , indicating the usefulness of this mutant system for testing theory that was primarily established comparatively across species, and supports a strong role for the bundle sheath in influencing Kleaf . © 2015 John Wiley & Sons Ltd.

  10. Evaluation of modern cotton harvest systems on irrigated cotton: harvester performance (United States)

    Picker and stripper harvest systems were evaluated on production-scale irrigated cotton on the High Plains of Texas over three harvest seasons. Observations on harvester performance, including time-in-motion, harvest loss, seed cotton composition, and turnout, were conducted at seven locations with...

  11. Toward a semi-mechanical harvesting platform system for harvesting blueberries with fresh-market quality (United States)

    Major concerns related to harvesting blueberries for fresh market with over-the-row (OTR) harvesters are that the quality of the fruit harvested with OTR machines is generally low and ground loss is excessive. Machine-harvested blueberries have more internal bruise and usually soften rapidly in col...

  12. Fruit harvesting robots in Japan. (United States)

    Kondo, N; Monta, M; Fujiura, T


    We have developed harvesting robots for tomato, petty-tomato, cucumber and grape in Japan. These robots mainly consist of manipulators, end-effectors, visual sensors and traveling devices. These mechanisms of the robot components were developed based on the physical properties of the work objects. The robots must work automatically by themselves in greenhouses or fields, since we are considering for one operator to tend several robots in the production system. The system is modeled after Japanese agriculture which is commonly seen to produce many kinds of crops in greenhouses and in many small fields intensively. Bioproduction in space is somewhat similar to the agricultural system in Japan, because few operators have to work in a small space. Employing robots for bioproduction in space is considered desirable in near future. The following is a description of the harvesting robots.

  13. Forage Harvest and Transport Costs

    Energy Technology Data Exchange (ETDEWEB)

    Butler, J.; Downing, M.; Turhollow, A.


    An engineering-economic approach is used to calculate harvest, in-field transport, and over-the-road transport costs for hay as bales and modules, silage, and crop residues as bales and modules. Costs included are equipment depreciation interest; fuel, lube, and oil; repairs; insurance, housing, and taxes; and labor. Field preparation, pest control, fertilizer, land, and overhead are excluded from the costs calculated Equipment is constrained by power available, throughput or carrying capacity, and field speed.

  14. Review of magnetostrictive vibration energy harvesters (United States)

    Deng, Zhangxian; Dapino, Marcelo J.


    The field of energy harvesting has grown concurrently with the rapid development of portable and wireless electronics in which reliable and long-lasting power sources are required. Electrochemical batteries have a limited lifespan and require periodic recharging. In contrast, vibration energy harvesters can supply uninterrupted power by scavenging useful electrical energy from ambient structural vibrations. This article reviews the current state of vibration energy harvesters based on magnetostrictive materials, especially Terfenol-D and Galfenol. Existing magnetostrictive harvester designs are compared in terms of various performance metrics. Advanced techniques that can reduce device size and improve performance are presented. Models for magnetostrictive devices are summarized to guide future harvester designs.

  15. Palm Vein Verification Using Multiple Features and Locality Preserving Projections

    Directory of Open Access Journals (Sweden)

    Ali Mohsin Al-juboori


    Full Text Available Biometrics is defined as identifying people by their physiological characteristic, such as iris pattern, fingerprint, and face, or by some aspects of their behavior, such as voice, signature, and gesture. Considerable attention has been drawn on these issues during the last several decades. And many biometric systems for commercial applications have been successfully developed. Recently, the vein pattern biometric becomes increasingly attractive for its uniqueness, stability, and noninvasiveness. A vein pattern is the physical distribution structure of the blood vessels underneath a person’s skin. The palm vein pattern is very ganglion and it shows a huge number of vessels. The attitude of the palm vein vessels stays in the same location for the whole life and its pattern is definitely unique. In our work, the matching filter method is proposed for the palm vein image enhancement. New palm vein features extraction methods, global feature extracted based on wavelet coefficients and locality preserving projections (WLPP, and local feature based on local binary pattern variance and locality preserving projections (LBPV_LPP have been proposed. Finally, the nearest neighbour matching method has been proposed that verified the test palm vein images. The experimental result shows that the EER to the proposed method is 0.1378%.

  16. Preliminary Study for Designing a Novel Vein-Visualizing Device (United States)

    Kim, Donghoon; Kim, Yujin; Yoon, Siyeop; Lee, Deukhee


    Venipuncture is an important health diagnosis process. Although venipuncture is one of the most commonly performed procedures in medical environments, locating the veins of infants, obese, anemic, or colored patients is still an arduous task even for skilled practitioners. To solve this problem, several devices using infrared light have recently become commercially available. However, such devices for venipuncture share a common drawback, especially when visualizing deep veins or veins of a thick part of the body like the cubital fossa. This paper proposes a new vein-visualizing device applying a new penetration method using near-infrared (NIR) light. The light module is attached directly on to the declared area of the skin. Then, NIR beam is rayed from two sides of the light module to the vein with a specific angle. This gives a penetration effect. In addition, through an image processing procedure, the vein structure is enhanced to show it more accurately. Through a phantom study, the most effective penetration angle of the NIR module is decided. Additionally, the feasibility of the device is verified through experiments in vivo. The prototype allows us to visualize the vein patterns of thicker body parts, such as arms. PMID:28178227

  17. Morphopatological and histochemical highlights in normal and varicose vein wall

    Directory of Open Access Journals (Sweden)

    Alina Condor


    Full Text Available The nutrition of the venous wall appears to be an important factor in the vascularfibrillar trophicity and in the dynamic of the extracellular matrix formation for the normal veins and, for the chronic venous ulcers of legs, on period of healing. Sequential biopsies were taken at various levels of venous wall of external and internal saphena in 16 cases presenting a chronic condition of legs venous system (35-58 years old patients, both sexes. 8 vein fragments with normal macroscopic appearance were also taken, in necropsy. These samples were analyzed using regular morphological methods and some histochemical reactions to reveal the glycogen, glycoproteins, and glycosaminoglycans substrates. There were been used the Gomori silver impregnation and orcein to expose some specific substrates like reticulin or elastin. Other staining methods, like Gomori trichrome, were used to differentiate the specific structures of the vein wall, were used to differentiate the specific structures of the vein wall. A rich vascularization of normal and dilated vein wall could be remarked.Angiogenesis in vein wall and vasa vasorum changes as well as alcianophilic of vascular intima seem to be reactive and protective factors, depending on the applied therapeutic modalities. The veins are weak structures whose integrity depends on the thickness of the media and the support of neighboring structures.

  18. Applied anatomic study of testicular veins in adult cadavers and in human fetuses

    Directory of Open Access Journals (Sweden)

    Luciano A. Favorito


    Full Text Available OBJECTIVES: Analyze the anatomic variations of the testicular veins in human cadavers and fetuses. MATERIALS AND METHODS: One hundred male adult cadavers and 24 fetuses were studied. Four anatomic aspects were considered: 1 Number of testicular veins, 2 The local of vein termination, 3 Type and number of collaterals present and 4 Testicular vein termination angle. RESULTS: Cadavers - Right side - One testicular vein occurred in 85% and 2 veins in 5% of the cases. There were communicating veins with the colon in 21% of the cases. Left side - One testicular vein occurred in 82%, two veins in 15%, three veins in 2% and four veins in 1% of the cases. There were communicating veins with the colon in 31% of the cases. Fetuses - Right side -One testicular vein occurred in all cases. This vein drained to the vena cava in 83.3% of the cases, to the junction of the vena cava with the renal vein in 12.5% and to the renal vein in 4.2%. There were communicating veins with the colon in 25% of the cases. Left side - One testicular vein occurred in 66.6% of the cases, and 2 veins in occurred 33.3%. Communicating veins with the colon were found in 41.6% of the cases. CONCLUSION: The testicular vein presents numeric variations and also variations in its local of termination. In approximately 30% of the cases, there are collaterals that communicate the testicular vein with retroperitoneal veins. These anatomic findings can help understanding the origin of varicocele and its recurrence after surgical interventions.

  19. [Prevalence and risk factors of varicose veins in adults]. (United States)

    Ahumada, Miguel; Vioque, Jesús


    We intended to estimate the prevalence of varicose veins in the mature population of the Valencia Community and to analyze its relationship with socio-demographic variables, self-reported health status, body mass index and the presence of hemorrhoids, tobacco smoking, alcohol consumption and physical activity. Information on self-reported varicose veins was collected from 1,778 adults older than 14 years (819 men and 959 women) who participated in the Health and Nutrition Survey of the Valencia Community (Spain). We estimated the prevalence of varicose veins by age groups and sex. To explore the association between varicose veins and variables, we estimated adjusted odds ratios (OR) with 95% confidence intervals (CI 95%) by multiple logistic regression. The overall prevalence of varicose veins was 16.4%, with a much higher prevalence in women that in men (26.7% versus 5.5%) and with older age. Gender and age were the 2 strongest predictors of varicose veins in multivariate analysis. Women had seven times more risk than men (OR = 7.01; CI 95%, 4.52-10.87) and those older than 35 years almost tripled the risk with respect to those aged 15-24 years. A body mass index of 30 kg/m2, a poor self-reported health status and hemorrhoids were significantly associated with the presence of varicose veins. Employers showed higher risk than workers. A moderate alcohol consumption (varicose veins. Although being a woman and having an advanced age were the strongest predictors of varicose veins, other factors such as a high BMI, poor health status, hemorrhoids and some professional categories may be also important factors in their presentation. A moderate alcohol consumption seems to have a protective effect.

  20. Deep vein thrombosis as a paraneoplastic syndrome

    Directory of Open Access Journals (Sweden)

    Klačar Marija


    Full Text Available Introduction: Several conditions represent the risk factor for deep vein thrombosis (DVT but sometimes it occurs with no apparent reason. DVT usually involve lower extremities. It can be a component of paraneoplastic syndrome, and occasionally it is the first manifestation of malignancy. Case report: Fifty-five years old male reported to his general practitioner with history of painless right leg swelling of three weeks duration. He denied leg trauma or any other hardship. The patient had a long history of hypertension and took his medications irregularly. Family history was positive for cardiovascular diseases but negative for metabolic diseases or malignancies. He was a smoker and physically active. Physical examination revealed right calf swelling without skin discoloration, distention of superficial veins or trophic changes. Pulses of magistral arteries of the leg were symmetrical, Homans' sign was positive on the right leg. The rest of the physical examination was normal, except for the blood pressure. He was referred to vascular surgeon with the clinical diagnosis of femoro- popliteal phlebothrombosis of the right leg. Vascular surgeon performed the Color duplex scan of the lower extremities which confirmed the diagnosis. The patient was treated with low-molecular-weight heparin. The swelling significantly subsided after two weeks of therapy, but then patient fell and fractured left ramus of ischial bone. X-ray examination of pelvis revealed both fracture line and osteoblastic deposits in pelvis and the fracture was pronounced pathological. In order to localize the primary tumor, subsequent tests included chest X-ray, abdominal and pelvic ultrasound and digitorectal examination of prostate were performed. The results of all of the above mentioned examinations were within normal ranges, including routine blood tests. Skeletal scintigraphy revealed multiple secondary deposits in pelvic bones, vertebral column and ribs. Tumor markers' values

  1. Harvesting systems and costs for short rotation poplar (United States)

    B. Rummer; D. Mitchell


    The objective of this review is to compare the cost of coppice and longer rotation poplar harvesting technology. Harvesting technology for short rotation poplar has evolved over the years to address both coppice harvest and single-stem harvest systems. Two potential approaches for coppice harvesting are modified forage harvesters and modified mulcher-balers. Both of...

  2. Pylephlebitis of a variant mesenteric vein complicating sigmoid diverticulitis. (United States)

    Falkowski, Anna L; Cathomas, Gieri; Zerz, Andreas; Rasch, Helmut; Tarr, Philip E


    Pylephlebitis--suppurative thrombophlebitis of the portal and/or mesenteric veins--is a rare complication of abdominal infections, especially diverticulitis. It can lead to severe complications such as hepatic abscess, sepsis, peritonitis, bowel ischemia, etc., which increase the mortality rate. Here we present a case of suppurative thrombophlebitis of the inferior mesenteric vein, as a complication of sigmoid diverticulitis. The epidemiology, clinical and radiological features as well as treatment strategies are discussed. We also review the anatomy of the mesenteric vein given its anatomic variation in the present case and how this anatomic knowledge might influence the operative approach should surgery be necessary.

  3. MDCT of inferior mesenteric vein: normal anatomy and pathology

    Energy Technology Data Exchange (ETDEWEB)

    Akpinar, E.; Turkbey, B. [Department of Radiology, Hacettepe University School of Medicine, Ankara (Turkey); Karcaaltincaba, M. [Department of Radiology, Hacettepe University School of Medicine, Ankara (Turkey)], E-mail:; Karaosmanoglu, D.; Akata, D. [Department of Radiology, Hacettepe University School of Medicine, Ankara (Turkey)


    Multidetector computed tomography (MDCT) is a useful technique for imaging the inferior mesenteric vein. The aim of the present review was to discuss the normal anatomy and the pathologies of the inferior mesenteric vein, including partial or total thrombosis secondary to inflammation (pyophlebitis) and malignancy, occlusion, dilatation and reversed flow, which are rarely encountered. Optimal reconstruction techniques are also discussed. The pathologies of the inferior mesenteric vein can be clearly demonstrated using MDCT using curved-planar reformatted multiplanar reconstruction (MPR) and minimum intensity projection (MIP) images.

  4. Bilateral retinal vein occlusion and rubeosis irides: lessons to learn.

    Directory of Open Access Journals (Sweden)

    Umi Kalthum Md Noh


    Full Text Available Uncontrolled hypertension is well- known to give rise to systemic complications involving multiple central organs. Artherosclerosis leads to damage of the retinal vessels wall, contributing to venous stasis, thrombosis and finally, occlusion. Retinal vein occlusions compromise vision through development of ischaemic maculopathy, macular oedema, and rubeotic glaucoma. Laser photocoagulation remains the definitive treatment for ischaemic vein occlusion with secondary neovascularization. Timely treatment with anti- vascular endothelial growth factor prevents development of rubeotic glaucoma. We hereby report an unusual case of bilateral retinal vein occlusion complicated by rubeosis irides, which was successfully managed to improve vision and prevent rubeotic glaucoma.

  5. Rabbit tibial periosteum and saphenous arteriovenous vascular bundle as an in vivo bioreactor to construct vascularized tissue-engineered bone: a feasibility study. (United States)

    Han, Dong; Guan, Xiaoyi; Wang, Jian; Wei, Jiao; Li, Qingfeng


    The aim of this project was to construct vascularized tissue-engineered living bone with an autologous vascular network by means of a rabbit bioreactor in vivo. The key components of the in vivo bioreactor for bone formation were the vascularized tibial periosteum and the saphenous vascular bundle. Beta-tricalcium phosphate (β-TCP) scaffolds were implanted into the in vivo bioreactor (vascular pedicle implantation and vascularized periosteum encapsulation). At 4 weeks postsurgery, new bone formation was mainly "cartilage-bone inducing" in the inner periosteum, and was primarily seen in the outer aspects of the scaffold with some amount in the middle part as well. Microvascular infusion showed that direct revascularization of β-TCP was obtained by means of vascular implantation. Triple staining results showed a large amount of blue collagen fibers. Vascular endothelial growth factor immunohistochemical staining displayed endothelial cells of new blood vessels in bone tissue. The bioreactor established in this study can be used to prepare tissue-engineered bone with a vascular network. © 2013 Wiley Periodicals, Inc. and International Center for Artificial Organs and Transplantation.

  6. Early-onset severe neuromatous pain of the infrapatellar branch of the saphenous nerve after total knee arthroplasty

    Directory of Open Access Journals (Sweden)

    Kanto Nagai


    Full Text Available While performing total knee arthroplasty (TKA using a standard midline skin incision, the transection of the infrapatellar branch of the saphenous nerve (ISN or its terminal branches is relatively common. This usually causes an area of numbness in the distribution of the ISN, but rarely results in painful neuroma. Usually, the progress of neuromatous pain is relatively slow and the degree of the pain is not so severe, but in our present case the progress of neuromatous pain was rapid and severe, and therefore, the patient could not be discharged from our hospital after TKA. To our knowledge, there has been no previous report demonstrating early-onset neuromatous knee pain after TKA in the English literature. We present a rare case in which early-onset severe neuromatous pain was encountered after TKA and partial denervation of the ISN was effective. Neuromatous knee pain can occur shortly after TKA, and, in these cases, surgeons should consider partial denervation for patients who have intractable neuromatous pain before functional loss occurs.

  7. Formation of the external jugular vein in the brown brocket deer (Mazama gouazoubira

    Directory of Open Access Journals (Sweden)

    Gregório Corrêa Guimarães


    Full Text Available The brown brocket deer (Mazama gouazoubira is a brown-greyish short-haired wild ruminant living in Central and South Americas. This paper aimed at describing the formation of the external jugular vein in a male specimen which died due to run-over. The facial and cervical regions were dissected so as to allow the visualization of the external jugular vein and its tributaries. This vein was formed by the union of the maxillary and linguofacial veins. The first originated from the superficial and transverse facial temporal veins, and it received along its length the angular vein of the eye, as well as the dorsal and lateral veins of the nose and upper lip. The second was formed after the anastomosis of the lingual and facial veins. The facial vein was originated by the union of the lower lip and deep facial veins, in the middle third of the face, rostral to the masseter muscle. This vascular arrangement differs from that usually observed in domestic ruminants, in which the transverse facial vein is underdeveloped and the facial vein receives the angular vein of the eye, the dorsal and lateral veins of the nose, besides the upper lip vein. The external jugular vein in the brown brocket deer presented the same tributaries than domestic ruminants, however, with a different vessel arrangement of the facial and facial transverse veins.

  8. Portal vein stent placement for the treatment of postoperative portal vein stenosis: long-term success and factor associated with stent failure. (United States)

    Kato, Atsushi; Shimizu, Hiroaki; Ohtsuka, Masayuki; Yoshitomi, Hideyuki; Furukawa, Katsunori; Miyazaki, Masaru


    Portal vein stenosis develops due to different causes including postoperative inflammation and oncological processes. However, limited effective therapy is available for portal vein stenosis. The objectives of this study were to evaluate the efficacy of a portal vein stent for portal vein stenosis after hepatobiliary pancreatic surgery and to determine the factors associated with stent patency. From December 2003 to December 2015, portal vein stents were implanted in 29 patients who had portal vein stenosis after hepatobiliary pancreatic surgery. We conducted a retrospective analysis to evaluate the efficacy and safety of portal vein stent placement. Twelve clinical variables were analyzed for their role in stent patency. The symptoms before portal vein stent placements included nine patients with hepatic encephalopathy, six patients with gastrointestinal bleeding, four patients with ascites, and four patients with hyperbilirubinemia. Portal vein thrombosis due to postoperative portal stenosis was found in four patients. Portal vein stent were successfully implanted without any major complications. Of the 21 patients with symptoms, 17 showed improvement, and stent patency was maintained in 22 (76%) patients. The presence of a collateral vein is the only variable related to the development of an occlusion after portal stenting. Portal vein stent were implanted safely and had good long-term patency. This procedure is useful to relieve portal hypertension-related symptoms and to improve the quality of life. Our data strongly suggest that embolization to block blood flow in a collateral vein during portal vein stent placement will improve the patency of the stent.

  9. The Aristotelian account of "heart and veins". (United States)

    Shoja, Mohammadali M; Tubbs, R Shane; Loukas, Marios; Ardalan, Mohammad R


    The exploration of the cardiovascular (CV) system has a history of at least five millennia. The model of the heart and veins represented by Aristotle (384-322 B.C.) is one of the earliest and accurate descriptions of the CV system. With his own specific metaphysical approach, Aristotle discussed why there might be a vascular tree composed of two vessels and also why these vessels must extend throughout the entire body. Herein, the authors present a history of the original account of the CV system based on the studies and teachings of Aristotle who made detailed observations and experimented upon animals and human corpses to explore the anatomy of the heart and vessels and thus provided the basis for modern CV medicine. The Aristotelian CV model consisted of two related but slightly dissimilar passages based on experimentation and tradition, which could be perceived as the morphology and metaphysical accounts of physiology, respectively. Restricted by his own methodology of dissecting dead animals, Aristotle was the first to describe the anatomy of the heart and blood vessels. A thorough reading of his Historia Animalium showed that he was able to morphologically delineate the right atrium in addition to three distinct heart cavities corresponding to the left atrium and right and left ventricles. The authors conclude that when interpreting Aristotelian doctrine, the methodology and terminology should be taken into account in order to prevent potential misconceptions. It is the early work of such scientists as Aristotle on which we base our current understanding of the CV system.

  10. Nitroprusside modulates pulmonary vein arrhythmogenic activity

    Directory of Open Access Journals (Sweden)

    Chen Yao-Chang


    Full Text Available Abstract Background Pulmonary veins (PVs are the most important sources of ectopic beats with the initiation of paroxysmal atrial fibrillation, or the foci of ectopic atrial tachycardia and focal atrial fibrillation. Elimination of nitric oxide (NO enhances cardiac triggered activity, and NO can decrease PV arrhythmogensis through mechano-electrical feedback. However, it is not clear whether NO may have direct electrophysiological effects on PV cardiomyocytes. This study is aimed to study the effects of nitroprusside (NO donor, on the ionic currents and arrhythmogenic activity of single cardiomyocytes from the PVs. Methods Single PV cardiomyocytes were isolated from the canine PVs. The action potential and ionic currents were investigated in isolated single canine PV cardiomyocytes before and after sodium nitroprusside (80 μM, using the whole-cell patch clamp technique. Results Nitroprusside decreased PV cardiomyocytes spontaneous beating rates from 1.7 ± 0.3 Hz to 0.5 ± 0.4 Hz in 9 cells (P Conclusion Nitroprusside regulates the electrical activity of PV cardiomyocytes, which suggests that NO may play a role in PV arrhythmogenesis.

  11. Deep Vein Thrombosis in Intensive Care. (United States)

    Boddi, Maria; Peris, Adriano


    Venous thromboembolism (VTE) which includes deep vein thrombosis (DVT) and pulmonary embolism (PE) is a severe complication in critically ill patients generally affected by multiorgan disfunction associated with immobilization also prolonged.Nowadays, VTE prophylaxis is included in the requirements of hospital accreditation and evaluation of the maintenance of standards of quality of care. ICU patients are characterized by a dynamic day-to-day variation both of thromboembolic that bleeding risk and DVT incidence in presence of thromboprophylaxis ranges between 5 and 15 %.Patient-centered methods for the assessment of both thrombotic and bleeding risk are recommended because pre-existent factors to ICU admission, diagnosis, emerging syndromes, invasive procedures and pharmacological treatments daily induce important changes in clinical condition.General consensus currently establishes use of heparin in pharmacological prophylaxis at the time of admission to the ICU and the temporary suspension of heparin in patients with active bleeding or severe (pneumatic compression was reported but no general consensus was reached about its use at the best. Much work has to be done but ICU remain the last frontier for VTE prophylaxis.

  12. Deep Vein Thrombosis Prophylaxis in Trauma Patients

    Directory of Open Access Journals (Sweden)

    Serdar Toker


    Full Text Available Deep vein thrombosis (DVT and pulmonary embolism (PE are known collectively as venous thromboembolism (VTE. Venous thromboembolic events are common and potentially life-threatening complications following trauma with an incidence of\t5 to 63%. DVT prophylaxis is essential in the management of trauma patients. Currently, the optimal VTE prophylaxis strategy for trauma patients is unknown. Traditionally, pelvic and lower extremity fractures, head injury, and prolonged immobilization have been considered risk factors for VTE; however it is unclear which combination of risk factors defines a high-risk group. Modalities available for trauma patient thromboprophylaxis are classified into pharmacologic anticoagulation, mechanical prophylaxis, and inferior vena cava (IVC filters. The available pharmacologic agents include low-dose heparin (LDH, low molecular weight heparin (LMWH, and factor Xa inhibitors. Mechanical prophylaxis methods include graduated compression stockings (GCSs, pneumatic compression devices (PCDs, and A-V foot pumps. IVCs are traditionally used in high risk patients in whom pharmacological prophylaxis is contraindicated. Both EAST and ACCP guidelines recommend primary use of LMWHs in trauma patients; however there are still controversies regarding the definitive VTE prophylaxis in trauma patients. Large randomized prospective clinical studies would be required to provide level I evidence to define the optimal VTE prophylaxis in trauma patients.

  13. Power Harvesting Capabilities of SHM Ultrasonic Sensors

    Directory of Open Access Journals (Sweden)

    Christophe Delebarre


    Full Text Available The aim of this work is to show that classical Structural Health Monitoring ultrasonic sensors may provide some power harvesting capabilities from a wide variety of vibration sources. In other words, the authors developed an integrated piezoelectric energy harvesting sensor capable of operating a dual mode, that is, carrying out vibration power harvesting and Structural Health Monitoring. First, vibrations signals of an A380 aircraft recorded during different phases of flight are presented to show the need of a wideband piezoelectric energy harvester. Then, the voltage response of a piezoelectric power harvester bonded onto an aluminium cantilever plate and excited by an electromechanical shaker is measured. A finite element model of the energy harvester system is also presented. This model provides the voltage response of the harvester due to a mechanical excitation of the host structure and allows a better understanding of the energy harvesting process. In many cases, a good agreement with the experimental results is obtained. A power measurement also showed the ability of piezoelectric SHM sensors to harvest power over an extended frequency range present in spectra collected in aircrafts. This result could lead to numerous applications even though this kind of power harvester sensor has been initially designed to operate onboard aircrafts.

  14. Applying New Technologies to Transform Blueberry Harvesting

    Directory of Open Access Journals (Sweden)

    Fumiomi Takeda


    Full Text Available The growth of the blueberry industry in the past three decades has been remarkably robust. However, a labor shortage for hand harvesting, increasingly higher labor costs, and low harvest efficiencies are becoming bottlenecks for sustainable development of the fresh market blueberry production. In this study, we evaluated semi-mechanical harvesting systems consisting of a harvest-aid platform with soft fruit catching surfaces that collected the fruit detached by portable, hand-held, pneumatic shakers. The softer fruit catching surfaces were not glued to the hard sub-surfaces of the harvest-aid platform, but suspended over them. Also, the ergonomic aspect of operating powered harvesting equipment was determined. The pneumatic shakers removed 3.5 to 15 times more fruit (g/min than by hand. Soft fruit catching surfaces reduced impact force and bruise damage. Fruit firmness was higher in fruit harvested by hand compared to that by pneumatic shakers in some cultivars. The bruise area was less than 8% in fruit harvested by hand and with semi-mechanical harvesting system. The percentage of blue, packable fruit harvested by pneumatic shakers comprised as much as 90% of the total, but less than that of hand-harvested fruit. The ergonomic analysis by electromyography showed that muscle strain in the back, shoulders, and forearms was low in workers operating the light-weight, pneumatic shakers that were tethered to the platform with a tool balancer. The new harvesting method can reduce the labor requirement to about 100 hour/hectare/year and help to mitigate the rising labor cost and shortage of workers for harvesting fresh-market quality blueberries.

  15. Ovarian vein thrombosis – a rare but important complication of ...

    African Journals Online (AJOL)

    This case study highlights the clinical importance of ovarian vein thrombosis in the context of pelvic surgery for benign gynaecological conditions and the role of imaging, particularly computed tomography with reformatting, in confirming the diagnosis.

  16. Plantar vein thrombosis: a rare cause of plantar foot pain

    Energy Technology Data Exchange (ETDEWEB)

    Siegal, Daniel S.; Wu, Jim S.; Brennan, Darren D.; Hochman, Mary G. [Beth Israel Deaconess Medical Center, Department of Radiology, Boston, MA (United States); Challies, Tracy [Beth Israel Deaconess Medical Center, Department of Pathology, Boston, MA (United States)


    Plantar vein thrombosis is a rare condition, with only a handful of cases reported in the literature. The cause is unknown; however, the disease has been attributed to prior surgery, trauma, and paraneoplastic conditions. We present a case of a 32-year-old female runner with plantar vein thrombosis diagnosed on contrast-enhanced MRI and confirmed on ultrasound. The symptoms resolved with conservative treatment and evaluation revealed the presence of a prothrombin gene mutation and use of oral contraceptive pills. To our knowledge, this is the first case of plantar vein thrombosis diagnosed initially by MRI. Moreover, this case suggests that plantar vein thrombosis should be considered in patients with hypercoagulable states and plantar foot pain. (orig.)

  17. Travelers' Health: Deep Vein Thrombosis and Pulmonary Embolism (United States)

    ... Books, Journals, Articles & Websites Resources for the Travel Industry Yellow Book Contents Chapter 2 (19) Deep Vein ... recommended. For long-distance travelers, the use of aspirin or anticoagulants to prevent VTE is not recommended. ...

  18. Prevalence of Deep Vein Thrombosis and Associated Factors in ...

    African Journals Online (AJOL)


    ABSTRACT. Background: Deep vein thrombosis (DVT) and pulmonary embolism (PE) collectively referred to as venous thromboembolism (VTE) are associated with significant morbidity and mortality worldwide. DVT is common in hospitalized patients with acute medical illness. Routine use of thromboprophylaxis has.

  19. Two cases of jugular vein thrombosis in severely burned patients

    Directory of Open Access Journals (Sweden)

    Cen H


    Full Text Available Hanghui Cen, Xiaojie HeDepartment of Burn, The Second Affiliated Hospital, Zhejiang University Medical College, Hangzhou, People’s Republic of ChinaAbstract: Here we present two cases of jugular vein thrombosis in burn patients, with diagnosis, risk factor analysis, and treatment approaches. Severely burned patients have high risk of deep vein thrombosis occurrence due to multiple surgeries. The deep vein catheter should be carefully performed. Once deep vein thrombosis is detected, a wide ultrasonography helps to find other thrombosis sites. During the acute phase, low molecular weight heparin can be used. Upon long-term anti-thrombosis treatment, combined use of herbal medicine during rehabilitation is helpful.Keywords: burn, heparin, combined treatment

  20. Blood pooling in extrathoracic veins after glossopharyngeal insufflation

    DEFF Research Database (Denmark)

    Mijacika, Tanja; Frestad, Daria; Kyhl, Kasper


    divers in a sub-study. Results: After GPI, pulmonary volume increased by 0.8 ± 0.6 L above total lung capacity. The diameter of the superior caval (by 36 ± 17%) and intrathoracic part of the inferior caval vein decreased (by 21 ± 16%), while the diameters of the internal jugular (by 53 ± 34%), hepatic......Purpose: Trained breath-hold divers hyperinflate their lungs by glossopharyngeal insufflation (GPI) to prolong submersion time and withstand lung collapse at depths. Pulmonary hyperinflation leads to profound hemodynamic changes. Methods: Thirteen divers performed preparatory breath-holds followed...... (by 28 ± 40%), abdominal part of the inferior caval (by 28 ± 28%), and femoral veins (by 65 ± 50%) all increased (P volume of the internal jugular, the hepatic, the abdominal part of the inferior caval vein, and the combined common iliac and femoral veins increased by 145 ± 115, 80 ± 88...

  1. Central Retinal Vein Occlusion AssociatedWith Sildenafil (Viagra

    Directory of Open Access Journals (Sweden)

    H C Obiudu


    Conclusion - Central retinal vein occlusion is a possible adverse effect of sildenafil use. Physicians should be vigilant while prescribing thismedication and avoid its use in patients with elevated intraocular pressure

  2. Primary leiomyosarcoma of the jugular vein in a dog

    Directory of Open Access Journals (Sweden)

    Alessio Pierini


    Full Text Available A four-year-old, male, Labrador retriever was referred for removal of a spindle cell sarcoma involving the right jugular vein. A post-contrast CT scan showed a seven-centimeter subcutaneous mass originated from the right external jugular vein, which was partially obstructed and showing contrast stasis, suggested a primary intravascular tumor of the jugular vein. The mass was resected, and histological evaluation was consistent with grade II intravenous spindle cell sarcoma of the jugular vein. Immunohistochemical positivity for vimentin, desmin, and αSMA antibody and negativity for S-100 protein confirmed venous leiomyosarcoma. The dog received five doses of intravenous doxorubicin, and there was no recurrence of the tumor 30 months post treatment. In dogs, primary intravascular sarcomas are rare and primary venous leiomyosarcoma has not been described. A venous tumor may be considered as a differential diagnosis in dogs with ventral neck swelling.

  3. Sciatica caused by a dilated epidural vein: MR findings

    Energy Technology Data Exchange (ETDEWEB)

    Demaerel, P.; Petre, C.; Wilms, G. [Dept. of Radiology, Catholic University of Leuven (Belgium); Plets, C. [Dept. of Neurosurgery, Catholic University of Leuven (Belgium)


    We report the MR imaging findings in a 41-year-old woman presenting with sudden low back pain and sciatica. At surgery a dilated epidural vein was found compressing the nerve root. The MR findings may suggest the diagnosis. Magnetic resonance imaging of a dilated epidural vein or varix causing sciatica has not been reported until now. (orig.) (orig.) With 1 fig., 4 refs.

  4. Vein graphite deposits: geological settings, origin, and economic significance


    Luque del Villar, Francisco Javier; Huizenga, Jan-Marten; Crespo Feo, Elena; Wada, Hideki; Ortega Menor, Lorena; Barrenechea, Edurne


    Graphite deposits result from the metamorphism of sedimentary rocks rich in carbonaceous matter or from precipitation from carbon-bearing fluids (or melts). The latter process forms vein deposits which are structurally controlled and usually occur in granulites or igneous rocks. The origin of carbon, the mechanisms of transport, and the factors controlling graphite deposition are discussed in relation to their geological settings. Carbon in granulite-hosted graphite veins derives from sublith...

  5. Neurogenic contraction and relaxation of human penile deep dorsal vein


    Segarra, Gloria; Medina, Pascual; Domenech, Cristina; Martínez León, Juan B; Vila, José M.; Aldasoro, Martin; Lluch, Salvador


    The aim of the present study was to characterize neurogenic and pharmacological responses of human penile deep dorsal vein and to determine whether the responses are mediated by nitric oxide from neural or endothelial origin.Ring segments of human penile deep dorsal vein were obtained from 22 multiorgan donors during procurement of organs for transplantation. The rings were suspended in organ bath chambers for isometric recording of tension. We then studied the contractile and relaxant respon...

  6. Leiomyosarcoma of the pulmonary veins extending into the left atrium. (United States)

    Hong, S P; Choi, J Y; Son, J Y; Lee, Y S; Lee, J B; Kim, K S


    Primary tumors of the great vessels are very rare. Primary leiomyosarcomas of the pulmonary vein are extremely rare and little is known about their clinical manifestation and treatment. We report the case of a 34-year-old patient with primary leiomyosarcoma of the pulmonary vein extending into the left atrium. A review of the clinical manifestation and treatment of 24 cases including our own is provided.

  7. Engorgement of vortex vein and polypoidal choroidal vasculopathy. (United States)

    Chung, Song Ee; Kang, Se Woong; Kim, Jae Hui; Kim, Yun Taek; Park, Do Young


    The purpose of this study was to identify a correlation between engorgement of the vortex vein and the development of polypoidal choroidal vasculopathy (PCV). Engorgement of the vortex vein was evaluated by masked observers using a montage of indocyanine green angiography images. Sixty-three eyes with PCV, 27 uninvolved fellow eyes with PCV, and 30 eyes of age-matched control subjects were included. The incidence and distribution pattern of engorgement were evaluated. Thirty-three eyes (52.4%) of PCV evidenced engorgement of the vortex vein, whereas such engorgement was detected in only 7 of the 30 eyes (30.4%) of the control subjects (P = 0.016). Among 27 fellow eyes with PCV, it was detected in 11 (40.7%) (P = 0.706 vs. control eyes). In all groups, it was most frequently detected at the inferior temporal quadrant. In eyes with PCV, mean (±standard deviation) choroidal thickness of the eyes evidencing vortex vein engorgement was 338.1 ± 131.3 μm and the thickness of those not evidencing vortex vein engorgement was 275.1 ± 107.7 μm. When the choroidal thickness increased to 10 μm in the eyes with PCV, the odds of detecting the engorgement was multiplied by a factor of 1.05 (P = 0.042). The incidence of the engorgement of vortex vein was correlated with the presence of choroidal vascular hyperpermeability (P = 0.009). This study demonstrates that engorgement of the vortex vein was observed more frequently in the eyes with PCV. Such a finding was associated with choroidal thickening and choroidal vascular hyperpermeability. These indicate that the engorgement of the vortex vein might be involved in the pathogenic mechanisms of PCV.

  8. Branch retinal vein occlusion associated with quetiapine fumarate

    Directory of Open Access Journals (Sweden)

    Siang Lim


    Full Text Available Abstract Background To report a case of branch retinal vein occlusion in a young adult with bipolar mood disorder treated with quetiapine fumarate. Case Presentation A 29 years old gentleman who was taking quetiapine fumarate for 3 years for bipolar mood disorder, presented with sudden vision loss. He was found to have a superior temporal branch retinal vein occlusion associated with hypercholesterolemia. Conclusion Atypical antipsychotic drugs have metabolic side effects which require regular monitoring and prompt treatment.

  9. Morphopatological and histochemical highlights in normal and varicose vein wall


    Alina Condor; Caius Solovan; Liliana Vasile


    The nutrition of the venous wall appears to be an important factor in the vascularfibrillar trophicity and in the dynamic of the extracellular matrix formation for the normal veins and, for the chronic venous ulcers of legs, on period of healing. Sequential biopsies were taken at various levels of venous wall of external and internal saphena in 16 cases presenting a chronic condition of legs venous system (35-58 years old patients, both sexes). 8 vein fragments with normal macroscopic appeara...

  10. Associations of Antiphospholipid Antibodies With Splanchnic Vein Thrombosis


    Qi, Xingshun; De Stefano, Valerio; Su, Chunping; Bai, Ming; GUO Xiaozhong; Fan, Daiming


    Abstract Splanchnic vein thrombosis (SVT) refers to Budd–Chiari syndrome (BCS) and portal vein system thrombosis (PVST). Current practice guidelines have recommended the routine screening for antiphospholipid antibodies (APAs) in patients with SVT. A systematic review and meta-analysis of observational studies was performed to explore the association between APAs and SVT. The PubMed, EMBASE, and ScienceDirect databases were searched for all relevant papers, in which the prevalence of positive...

  11. Ultrasonography of the lower extremity veins: Anatomy and basic approach

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Dong Kyu; Ahn, Kyung Sik; Kang, Chang Ho; Cho, Sung Bum [Dept. of Radiology, Korea University Anam Hospital, Korea University College of Medicine, Seoul (Korea, Republic of)


    Ultrasonography is an imaging modality widely used to evaluate venous diseases of the lower extremities. It is important to understand the normal venous anatomy of the lower extremities, which has deep, superficial, and perforating venous components, in order to determine the pathophysiology of venous disease. This review provides a basic description of the anatomy of the lower extremity veins and useful techniques for approaching each vein via ultrasonography.

  12. [Treatment of nontumoral portal vein thrombosis in cirrhosis]. (United States)

    Bañares, Rafael; Catalina, María-Vega


    Portal vein thrombosis in cirrhosis is a relatively common complication associated with the presence of an accompanying prothrombotic phenotype of advanced cirrhosis. The consequences of portal vein thrombosis are relevant because it can be associated with impaired hepatic function, might contraindicate hepatic transplantation and could increase morbidity in the surgical procedure. There is controversy concerning the most effective treatment of portal vein thrombosis, which is based on information that is seldom robust and whose primary objective is to achieve a return to vessel patency. Various studies have suggested that starting anticoagulation therapy early is associated with portal vein repatency more frequently than without treatment and has a low rate of complications. There are no proven data on the type of anticoagulant (low-molecular-weight heparins or dicoumarin agents) and the treatment duration. The implementation of TIPS is technically feasible in thrombosis without cavernous transformation and is associated with portal vein recanalization in a significant proportion of cases. Thrombolytic therapy does not appear to present an adequate balance between efficacy and safety; its use is therefore not supported for this indication. The proper definition of treatment for portal vein thrombosis requires properly designed studies to delimit the efficacy and safety of the various alternatives. Copyright © 2014 Elsevier España, S.L. All rights reserved.

  13. Robust Finger Vein ROI Localization Based on Flexible Segmentation

    Directory of Open Access Journals (Sweden)

    Dong Sun Park


    Full Text Available Finger veins have been proved to be an effective biometric for personal identification in the recent years. However, finger vein images are easily affected by influences such as image translation, orientation, scale, scattering, finger structure, complicated background, uneven illumination, and collection posture. All these factors may contribute to inaccurate region of interest (ROI definition, and so degrade the performance of finger vein identification system. To improve this problem, in this paper, we propose a finger vein ROI localization method that has high effectiveness and robustness against the above factors. The proposed method consists of a set of steps to localize ROIs accurately, namely segmentation, orientation correction, and ROI detection. Accurate finger region segmentation and correct calculated orientation can support each other to produce higher accuracy in localizing ROIs. Extensive experiments have been performed on the finger vein image database, MMCBNU_6000, to verify the robustness of the proposed method. The proposed method shows the segmentation accuracy of 100%. Furthermore, the average processing time of the proposed method is 22 ms for an acquired image, which satisfies the criterion of a real-time finger vein identification system.

  14. Giant Intrahepatic Portal Vein Aneurysm: Leave it or Treat it? (United States)

    Shrivastava, Amit; Rampal, Jagdeesh S; Nageshwar Reddy, D


    Portal vein aneurysm (PVA) is a rare vascular dilatation of the portal vein. It is a rare vascular anomaly representing less than 3% of all visceral aneurysms and is not well understood. Usually, PVA are incidental findings, are asymptomatic, and clinical symptoms are proportionally related to size. Patients present with nonspecific epigastric pain or gastrointestinal bleeding with underlying portal hypertension. PVA may be associated with various complications such as biliary tract compression, portal vein thrombosis/rupture, duodenal compression, gastrointestinal bleeding, and inferior vena cava obstruction. Differential diagnoses of portal vein aneurysms are solid, cystic, and hypervascular abdominal masses, and it is important that the radiologists be aware of their multi-modality appearance; hence, the aim of this article was to provide an overview of the available literature to better simplify various aspects of this rare entity and diagnostic appearance on different modality with available treatment options. In our case, a 55-year-old male patient came to the gastroenterology OPD for further management of pancreatitis with portal hypertension and biliary obstruction with plastic stents in CBD and PD for the same. In this article, we have reported a case of largest intrahepatic portal vein aneurysm and its management by endovascular technique. As per our knowledge, this is the largest intrahepatic portal vein aneurysm and first case where the endovascular technique was used for the treatment of the same.

  15. Hemorrhoids and varicose veins: a review of treatment options. (United States)

    MacKay, D


    Hemorrhoids and varicose veins are common conditions seen by general practitioners. Both conditions have several treatment modalities for the physician to choose from. Varicose veins are treated with mechanical compression stockings. There are several over-the-counter topical agents available for hemorrhoids. Conservative therapies for both conditions include diet, lifestyle changes, and hydrotherapy which require a high degree of patient compliance to be effective. When conservative hemorrhoid therapy is ineffective, many physicians may choose other non-surgical modalities: injection sclerotherapy, cryotherapy, manual dilation of the anus, infrared photocoagulation, bipolar diathermy, direct current electrocoagulation, or rubber band ligation. Injection sclerotherapy is the non-surgical treatment for primary varicose veins. Non-surgical modalities require physicians to be specially trained, own specialized equipment, and assume associated risks. If a non-surgical approach fails, the patient is often referred to a surgeon. The costly and uncomfortable nature of treatment options often lead a patient to postpone evaluation until aggressive intervention is necessary. Oral dietary supplementation is an attractive addition to the traditional treatment of hemorrhoids and varicose veins. The loss of vascular integrity is associated with the pathogenesis of both hemorrhoids and varicose veins. Several botanical extracts have been shown to improve microcirculation, capillary flow, and vascular tone, and to strengthen the connective tissue of the perivascular amorphous substrate. Oral supplementation with Aesculus hippocastanum, Ruscus aculeatus, Centella asiatica, Hamamelis virginiana, and bioflavonoids may prevent time-consuming, painful, and expensive complications of varicose veins and hemorrhoids.

  16. Factors associated with the development of superficial vein thrombosis in patients with varicose veins. (United States)

    Karathanos, Christos; Exarchou, Maria; Tsezou, Aspasia; Kyriakou, Despina; Wittens, Cees; Giannoukas, Athanasios


    Superficial vein thrombosis (SVT) is a common and controversial clinical entity. Recent studies have demonstrated that SVT should be seen as a venous thromboembolism (VTE). The objective of this study was to investigate the prevalence of thrombophilia defects and to estimate the role of age, sex and body mass index (BMI) in patients with varicose veins (VVs) and SVT. A total of 230 patients with VVs, 128 with, and 102 without SVT underwent thrombophilia testing included factor V Leiden, prothrombin G20210A, methylenetetrahydrofolate reductase and plasminogen activator inhibitor- 1 mutations, protein C, protein S (PS), anti-thrombin III and plasminogen deficiencies and levels of A2 antiplasmin, activate protein C resistance and lupus anticoagulant. According to Clinical-Etiology-Anatomy-Pathophysiology (CEAP) classification patients were categorized in two subgroups: moderate disease (C2,3) and severe disease (C4,5,6). Age and body mass index were also assessed. The prevalence of thrombophilia defects was significantly higher in patients with moderate disease and SVT (p=0.002). In the C2,3 group, SVT was associated with PS deficiency (p=0.018), obesity (pSVT development among patients with VVs having moderate disease (C2,3). Copyright © 2013 Elsevier Ltd. All rights reserved.

  17. The inferior emissary vein: a reliable landmark for right adrenal vein sampling. (United States)

    Kohi, Maureen P; Agarwal, Vishal K; Naeger, David M; Taylor, Andrew G; Kolli, K Pallav; Fidelman, Nicholas; LaBerge, Jeanne M; Kerlan, Robert K


    Right adrenal vein (RAV) catheterization can be a very challenging step in adrenal venous sampling (AVS). Visualization of the inferior emissary vein (IEV) may be an indication of successful RAV catheterization. To compare the rate of successful RAV sampling in the presence of the IEV. Retrospective review of all consecutive patients with PA who underwent AVS between April 2009 and April 2012 was performed. A total of 30 patients were identified. Procedural images, cortisol, and aldosterone values obtained from sampling of the RAV and inferior vena cava (IVC) were reviewed. Cortisol measurements obtained from RAV samples were divided by measurements from the infra-renal IVC blood samples in order to calculate the selectivity index (SI). An SI >3 was considered indicative of technically successful RAV sampling. RAV sampling was considered technically successful in 29 out of 30 cases (97%). In cases of successful RAV sampling (29 patients), the IEV was identified in 25 patients (86%). The IEV was visualized in isolation in 16 patients (64%), and in conjunction with visualization of the RAV or right adrenal gland stain in nine patients (36%). The IEV was not visualized in the one case of unsuccessful RAV sampling. Visualizing the IEV had a sensitivity of 86.2% for successful RAV sampling. The IEV may serve as a reliable landmark for the RAV during RAV sampling. © The Foundation Acta Radiologica 2014 Reprints and permissions:

  18. Flow Energy Piezoelectric Bimorph Nozzle Harvester (United States)

    Sherrit, Stewart (Inventor); Walkemeyer, Phillip E. (Inventor); Hall, Jeffrey L. (Inventor); Lee, Hyeong Jae (Inventor); Colonius, Tim (Inventor); Tosi, Phillipe (Inventor); Kim, Namhyo (Inventor); Sun, Kai (Inventor); Corbett, Thomas Gary (Inventor); Arrazola, Alvaro Jose (Inventor)


    A flow energy harvesting device having a harvester pipe includes a flow inlet that receives flow from a primary pipe, a flow outlet that returns the flow into the primary pipe, and a flow diverter within the harvester pipe having an inlet section coupled to the flow inlet, a flow constriction section coupled to the inlet section and positioned at a midpoint of the harvester pipe and having a spline shape with a substantially reduced flow opening size at a constriction point along the spline shape, and an outlet section coupled to the constriction section. The harvester pipe may further include a piezoelectric structure extending from the inlet section through the constriction section and point such that the fluid flow past the constriction point results in oscillatory pressure amplitude inducing vibrations in the piezoelectric structure sufficient to cause a direct piezoelectric effect and to generate electrical power for harvesting.

  19. Transsplenic portal vein reconstruction–transjugular intrahepatic portosystemic shunt in a patient with portal and splenic vein thrombosis

    Directory of Open Access Journals (Sweden)

    Jason T. Salsamendi, MD


    Full Text Available Portal vein thrombosis (PVT is a potential complication of cirrhosis and can worsen outcomes after liver transplant (LT. Portal vein reconstruction–transjugular intrahepatic portosystemic shunt (PVR-TIPS can restore flow through the portal vein (PV and facilitate LT by avoiding complex vascular conduits. We present a case of transsplenic PVR-TIPS in the setting of complete PVT and splenic vein (SV thrombosis. The patient had a 3-year history of PVT complicated by abdominal pain, ascites, and paraesophageal varices. A SV tributary provided access to the main SV and was punctured percutaneously under ultrasound scan guidance. PV access, PV and SV venoplasty, and TIPS placement were successfully performed without complex techniques. The patient underwent LT with successful end-to-end anastomosis of the PVs. Our case suggests transsplenic PVR-TIPS to be a safe and effective alternative to conventional PVR-TIPS in patients with PVT and SV thrombosis.

  20. Aneurysm of the superior mesenteric vein: imaging findings; Anevrisme de la veine mesenterique superieure: apport de l'imagerie

    Energy Technology Data Exchange (ETDEWEB)

    Billaud, Y.; Meyer, X.; Ehre, P.; Weber, G. [Hopital d' Instruction des Armees Desgenettes, Service de Radiologie, 69 - Lyon (France); Pilleul, F.; Henry, L.; Valette, P.J. [Hopital Universitaire Edouard Herriot, Service de Radiologie Digestive, 69 - Lyon (France)


    The authors report two uncommon cases of incidental superior mesenteric vein aneurysm in two asymptomatic women. Patients underwent ultrasonography, CT and MR angiography. The etiology, clinical features and treatment are discussed along with a review of to the literature. (authors)

  1. Rooftop level rainwater harvesting system (United States)

    Traboulsi, Hayssam; Traboulsi, Marwa


    Unfortunately, in Lebanon and other countries in the Middle East region, water becomes scarcer than ever before, and over the last decades the demand on domestic water has increased due to population and economic growth. Although rainwater harvesting is considered to be a safe and reliable alternative source for domestic water, the inconvenience or impracticalities related to the cost and space needed for the construction of ground or underground storage tanks makes this practice not widely common in rural areas and rarely implemented in urban cities. This paper introduces a new technique to rainwater harvesting which can be easily used in both rural and urban areas: it collects and stores rainwater directly in tanks already installed on building roofs and not necessarily in special ground or underground ones. If widely adopted in Lebanon, this technique could help in: (1) collecting around 23 MCM (70 % of the current deficit in the domestic water supply) of rainwater and thus increasing the available water per m2 of building by 0.4 m3 per year, (2) saving around 7 % of the amount of electric energy usually needed to pump water from an aquifer well and ground or underground tank, and (3) considerably reducing the rate of surface runoff of rainwater at the coastal zones where rainwater is not captured at all and goes directly to the sea.

  2. Energy harvesting through piezoelectricity - technology foresight

    DEFF Research Database (Denmark)

    Laumann, Felix; Sørensen, Mette Møller; Hansen, Tina Mølholm


    scientific articles. In contrast to this, is found a low level of ability to convert the technology from academia to commercialization. A decision making model is proposed including a requirement for better understanding of niches, niche definitions and configuration of energy harvesting design......Energy harvesting is important in designing low power intelligent networks, such as Internet-of-Things. Energy harvesting can ensure wireless and lossless energy supply to energy dependent technological solutions with independence of infrastructure. Electrical energy created through...

  3. Microelectronic circuit design for energy harvesting systems

    CERN Document Server

    Di Paolo Emilio, Maurizio


    This book describes the design of microelectronic circuits for energy harvesting, broadband energy conversion, new methods and technologies for energy conversion. The author also discusses the design of power management circuits and the implementation of voltage regulators. Coverage includes advanced methods in low and high power electronics, as well as principles of micro-scale design based on piezoelectric, electromagnetic and thermoelectric technologies with control and conditioning circuit design. Provides a single-source reference to energy harvesting and its applications; Serves as a practical guide to microelectronics design for energy harvesting, with application to mobile power supplies; Enables readers to develop energy harvesting systems for wearable/mobile electronics.

  4. Energy-Harvesting Wireless Sensor Networks

    DEFF Research Database (Denmark)

    Fafoutis, Xenofon; Vuckovic, Dusan; Di Mauro, Alessio


    Energy Harvesting comprises a promising solution to one of the key problems faced by battery-powered Wireless Sensor Networks, namely the limited nature of the energy supply (finite battery capacity). By harvesting energy from the surrounding environment, the sensors can have a continuous lifetime...... Sensor Networks with energy harvesting capability....... without any needs for battery recharge or replacement. However, energy harvesting introduces a change to the fundamental principles based on which WSNs are designed and realized. In this poster we sketch some of the key research challenges as well as our ongoing work in designing and realizing Wireless...

  5. Pyroelectric Quantum Well Energy Harvesters Project (United States)

    National Aeronautics and Space Administration — We propose the investigation of pyroelectric energy harvesters with enhanced efficiencies through quantum wells induced by a multilayer design.  Pyroelectric...

  6. Incidence, location, and cause of recovery of electrical connections between the pulmonary veins and the left atrium after pulmonary vein isolation

    National Research Council Canada - National Science Library

    Yamada, Takumi; Murakami, Yoshimasa; Okada, Taro; Okamoto, Mitsuhiro; Shimizu, Takeshi; Toyama, Junji; Yoshida, Yukihiko; Tsuboi, Naoya; Ito, Teruo; Muto, Masahiro; Kondo, Takahisa; Inden, Yasuya; Hirai, Makoto; Murohara, Toyoaki


    ...) between the left atrium and the pulmonary veins (PVs) after the segmental ostial PV isolation (PVI). Pulmonary vein mapping and successful PVI were performed using a computerized three-dimensional mapping system...

  7. Structural and mechanical characterisation of bridging veins: A review. (United States)

    Famaey, Nele; Ying Cui, Zhao; Umuhire Musigazi, Grace; Ivens, Jan; Depreitere, Bart; Verbeken, Erik; Vander Sloten, Jos


    Bridging veins drain the venous blood from the cerebral cortex into the superior sagittal sinus (SSS) and doing so they bridge the subdural space. Despite their importance in head impact biomechanics, little is known about their properties with respect to histology, morphology and mechanical behaviour. Knowledge of these characteristics is essential for creating a biofidelic finite element model to study the biomechanics of head impact, ultimately leading to the improved design of protective devices by setting up tolerance criteria. This paper presents a comprehensive review of the state-of-the-art knowledge on bridging veins. Tolerance criteria to prevent head injury through impact have been set by a number of research groups, either directly through impact experiments or by means of finite element (FE) simulations. Current state-of-the-art FE head models still lack a biofidelic representation of the bridging veins. To achieve this, a thorough insight into their nature and behaviour is required. Therefore, an overview of the general morphology and histology is provided here, showing the clearly heterogeneous nature of the bridging vein complex, with its three different layers and distinct morphological and histological changes at the region of outflow into the superior sagittal sinus. Apart from a complex morphology, bridging veins also exhibit complex mechanical behaviour, being nonlinear, viscoelastic and prone to damage. Existing material models capable of capturing these properties, as well as methods for experimental characterisation, are discussed. Future work required in bridging vein research is firstly to achieve consensus on aspects regarding morphology and histology, especially in the outflow cuff segment. Secondly, the advised material models need to be populated with realistic parameters through biaxial mechanical experiments adapted to the dimensions of the bridging vein samples. Finally, updating the existing finite element head models with these

  8. Harvesting energy from airflow with a michromachined piezoelectric harvester inside a Helmholtz resonator

    NARCIS (Netherlands)

    Matova, S.P.; Elfrink, R.; Vullers, R.J.M.; Schaijk, R. van


    In this paper we report an airflow energy harvester that combines a piezoelectric energy harvester with a Helmholtz resonator. The resonator converts airflow energy to air oscillations which in turn are converted into electrical energy by a piezoelectric harvester. Two Helmholtz resonators with

  9. Harvesting microalgae grown on wastewater. (United States)

    Udom, Innocent; Zaribaf, Behnaz H; Halfhide, Trina; Gillie, Benjamin; Dalrymple, Omatoyo; Zhang, Qiong; Ergas, Sarina J


    The costs and life cycle impacts of microalgae harvesting for biofuel production were investigated. Algae were grown in semi-continuous culture in pilot-scale photobioreactors under natural light with anaerobic digester centrate as the feed source. Algae suspensions were collected and the optimal coagulant dosages for metal salts (alum, ferric chloride), cationic polymer (Zetag 8819), anionic polymer (E-38) and natural coagulants (Moringa Oleifera and Opuntia ficus-indica cactus) were determined using jar tests. The relative dewaterability of the algae cake was estimated by centrifugation. Alum, ferric chloride and cationic polymer could all achieve >91% algae recovery at optimal dosages. Life cycle assessment (LCA) and cost analysis results revealed that cationic polymer had the lowest cost but the highest environmental impacts, while ferric chloride had the highest cost and lowest environmental impacts. Based on the LCA results, belt presses are the recommended algae dewatering technology prior to oil extraction. Copyright © 2013 Elsevier Ltd. All rights reserved.

  10. Light Harvesting for Organic Photovoltaics (United States)


    The field of organic photovoltaics has developed rapidly over the last 2 decades, and small solar cells with power conversion efficiencies of 13% have been demonstrated. Light absorbed in the organic layers forms tightly bound excitons that are split into free electrons and holes using heterojunctions of electron donor and acceptor materials, which are then extracted at electrodes to give useful electrical power. This review gives a concise description of the fundamental processes in photovoltaic devices, with the main emphasis on the characterization of energy transfer and its role in dictating device architecture, including multilayer planar heterojunctions, and on the factors that impact free carrier generation from dissociated excitons. We briefly discuss harvesting of triplet excitons, which now attracts substantial interest when used in conjunction with singlet fission. Finally, we introduce the techniques used by researchers for characterization and engineering of bulk heterojunctions to realize large photocurrents, and examine the formed morphology in three prototypical blends. PMID:27951633

  11. Mystery of Retinal Vein Occlusion: Vasoactivity of the Vein and Possible Involvement of Endothelin-1

    Directory of Open Access Journals (Sweden)

    Teruyo Kida


    Full Text Available Retinal vein occlusion (RVO is a common vascular disease of retina; however, the pathomechanism leading to RVO is not yet clear. In general, increasing age, hypertension, arteriosclerosis, diabetes mellitus, dyslipidemia, cardiovascular disorder, and cerebral stroke are systemic risk factors of RVO. However, RVO often occur in the unilateral eye and sometimes develop in young subjects who have no arteriosclerosis. In addition, RVO show different variations on the degrees of severity; some RVO are resolved without any treatment and others develop vision-threatening complications such as macular edema, combined retinal artery occlusion, vitreous hemorrhage, and glaucoma. Clinical conditions leading to RVO are still open to question. In this review, we discuss how to treat RVO in practice by presenting some RVO cases. We also deliver possible pathomechanisms of RVO through our clinical experience and animal experiments.

  12. Biogenesis of light harvesting proteins. (United States)

    Dall'Osto, Luca; Bressan, Mauro; Bassi, Roberto


    The LHC family includes nuclear-encoded, integral thylakoid membrane proteins, most of which coordinate chlorophyll and xanthophyll chromophores. By assembling with the core complexes of both photosystems, LHCs form a flexible peripheral moiety for enhancing light-harvesting cross-section, regulating its efficiency and providing protection against photo-oxidative stress. Upon its first appearance, LHC proteins underwent evolutionary diversification into a large protein family with a complex genetic redundancy. Such differentiation appears as a crucial event in the adaptation of photosynthetic organisms to changing environmental conditions and land colonization. The structure of photosystems, including nuclear- and chloroplast-encoded subunits, presented the cell with a number of challenges for the control of the light harvesting function. Indeed, LHC-encoding messages are translated in the cytosol, and pre-proteins imported into the chloroplast, processed to their mature size and targeted to the thylakoids where are assembled with chromophores. Thus, a tight coordination between nuclear and plastid gene expression, in response to environmental stimuli, is required to adjust LHC composition during photoacclimation. In recent years, remarkable progress has been achieved in elucidating structure, function and regulatory pathways involving LHCs; however, a number of molecular details still await elucidation. In this review, we will provide an overview on the current knowledge on LHC biogenesis, ranging from organization of pigment-protein complexes to the modulation of gene expression, import and targeting to the photosynthetic membranes, and regulation of LHC assembly and turnover. Genes controlling these events are potential candidate for biotechnological applications aimed at optimizing light use efficiency of photosynthetic organisms. This article is part of a Special Issue entitled: Chloroplast biogenesis. Copyright © 2015 Elsevier B.V. All rights reserved.

  13. Harvesting Costs For Mechanized Thinning Systems In Slash Pine Plantations (United States)

    James E. Granskog


    Harvesting costs of four tree harvester systems are estimated for row thinning slash pine plantations. Systems incorporating a full-tree type harvester had lower harvesting costs per cord than shortwood and tree-length harvester systems in 15-year-old plantations.

  14. Automated harvesting of flowers and cuttings

    NARCIS (Netherlands)

    Rosier, J.C.; Snel, R.; Goedvolk, E.J.


    The harvesting of flowers and cuttings can be considered as a skilled task. It takes weeks of training for the pickers to harvest quality cutting at the required production rate of one per second. The skill of the pickers is the ability to execute a number of functions within a short time. The

  15. Towards Complete Coverage in Focused Web Harvesting

    NARCIS (Netherlands)

    Khelghati, Mohammadreza; Hiemstra, Djoerd; van Keulen, Maurice


    With the goal of harvesting all information about a given entity, in this paper, we try to harvest all matching documents for a given query submitted on a search engine. The objective is to retrieve all information about for instance "Michael Jackson", "Islamic State", or "FC Barcelona" from indexed

  16. An ergonomics approach to citrus harvest mechanization. (United States)

    Costa, Simone Emmanuelle Alves; Camarotto, João Alberto


    Due to the increase of production costs in manual harvesting, strategies must be developed in order to overcome these effects, such as the attempts in implementing agricultural machines in harvest activities, whether being totally or partially mechanized. This study brings a qualitative and quantitative comparison on the impacts in work conditions and productivity in Brazilian orchards caused by the use of semi-mechanized harvesting systems, such as multiplatforms. The results come from the application of Ergonomic Work Analysis method, which focuses in the activity, quantifying and analyzing times and frequencies of the harvesting cycle, as well as the amount of movements. To achieve this, footage, interviews and a stopwatch were used in the observation 12 pickers' work cycles, six for each method of harvesting. The data interpretation pointed to improvement in working conditions with a reduction in the amount of movements performed by the picker, and increase of up to 60% in productivity with the use of semi-mechanized harvesting. Thus, the found results indicate the viability of this harvesting method. However, other variables must be observed in future studies in order to complete the guidelines for a healthy progress in the area of citrus harvesting in Brazil.

  17. Harvesting Feminist Knowledge for Public Policy : Rebuilding ...

    International Development Research Centre (IDRC) Digital Library (Canada)

    Harvesting Feminist Knowledge for Public Policy : Rebuilding Progress. Couverture du livre Harvesting Feminist Knowledge for Public Policy : Rebuilding Progress. Directeur(s) : Devaki Jain et Diane Elson. Maison(s) d'édition : Sage, CRDI. 3 novembre 2011. ISBN : 9788132107415. 394 pages. e-ISBN : 9781552505458.

  18. Power harvesting in a helicopter lag damper

    NARCIS (Netherlands)

    de Jong, Pieter; Loendersloot, Richard; de Boer, Andries; van der Hoogt, Peter; Boller, C; Janocha, H


    In this paper a new power harvesting application is developed and simulated. Power harvesting is chosen within the European Clean Sky project as a solution to powering in-blade health monitoring systems as opposed to installing an elaborate electrical infrastructure to draw power from and transmit

  19. Harvesting of microalgae by bio-flocculation

    NARCIS (Netherlands)

    Salim, S.; Bosma, R.; Vermuë, M.H.; Wijffels, R.H.


    The high-energy input for harvesting biomass makes current commercial microalgal biodiesel production economically unfeasible. A novel harvesting method is presented as a cost and energy efficient alternative: the bio-flocculation by using one flocculating microalga to concentrate the

  20. Applying new technologies to transform blueberry harvesting (United States)

    The growth of the blueberry industry in the past three decades has been remarkable. However, labor shortage for hand harvesting, increasingly high labor costs, and low harvest efficiencies are becoming bottlenecks for sustainable development of the fresh market blueberry production. In this study ...

  1. Electrodynamic energy harvester for electrical transformer's ...

    Indian Academy of Sciences (India)

    COMSOL Multiphysics software is used to optimize the design of the harvester. The split-cylindrical design of the developed EDEH permitted the harvester to be wrapped around the output power cable of the electrical transformer without shutting-off the power or disconnecting the power cable. From the electrical transformer ...

  2. Harvesting, storing, and shipping [Chapter 13 (United States)

    Thomas D. Landis; Tara Luna


    Plants are ready for harvest and delivery to clients after they have reached target specifications (see Chapter 2, The Target Plant Concept) and have been properly hardened (see Chapter 12, Hardening). Originally, nursery stock was grown in soil in fields; nursery managers would "lift" those seedlings out of the ground to harvest them. That traditional...


    Fişuş, Andreea Dana; Pop, Doina Suzana; Rusu, Monica Blanka; Vultur, Florina; Horvath, Karin Ursula


    Retinal vein occlusion (RVO) is the second most common retinal vein disease with significant visual loss via thrombus or compression of vein wall. Thrombophilia is the predisposition to vascular thrombosis with the existence of genetic defect that leads to blood hypercoagulability. This report describes the case of a 55 year old male patient, with an active life who presented himself at the emergency room with acute visual lose, insidious and progressive visual field constriction, without any known history of neurological or vascular diseases. The examinations revealed unilateral optic nerve head edema, the fluorescein angiography was specific for nonischemic central retinal vein occlusion CRVO complicated with macular edema. Blood examinations has emphasized the presence of the heterozygous mutation A1298C in the methylenetetrahydrofolate reductase gene (MTHFR), the only one presented from the thrombophilia screen panel and a slightly elevated cholesterol level. During the follow-up period, the patient received anti-VEGF treatment (Bevacizumab, 3x 0.1 ml intravitreal injections) with improved visual acuity and amendment of macular edema. The complex etiology calls for interdisciplinary approach to determine better the cause of this ophthalmological disease. Although studies have found a correlation between some thrombophilia mutations and retinal vein occlusion, more studies that contain a larger number of patients are necessary in order to determine the final role of these gene variants.

  4. Palm vein recognition based on directional empirical mode decomposition (United States)

    Lee, Jen-Chun; Chang, Chien-Ping; Chen, Wei-Kuei


    Directional empirical mode decomposition (DEMD) has recently been proposed to make empirical mode decomposition suitable for the processing of texture analysis. Using DEMD, samples are decomposed into a series of images, referred to as two-dimensional intrinsic mode functions (2-D IMFs), from finer to large scale. A DEMD-based 2 linear discriminant analysis (LDA) for palm vein recognition is proposed. The proposed method progresses through three steps: (i) a set of 2-D IMF features of various scale and orientation are extracted using DEMD, (ii) the 2LDA method is then applied to reduce the dimensionality of the feature space in both the row and column directions, and (iii) the nearest neighbor classifier is used for classification. We also propose two strategies for using the set of 2-D IMF features: ensemble DEMD vein representation (EDVR) and multichannel DEMD vein representation (MDVR). In experiments using palm vein databases, the proposed MDVR-based 2LDA method achieved recognition accuracy of 99.73%, thereby demonstrating its feasibility for palm vein recognition.

  5. [Treatment of venous trophic ulcers, using echoscleroobliteration of perforant veins]. (United States)

    Rusyn, V I; Korsak, V V; Boldizhar, P O; Borsenko, M I; Mytrovka, B A


    In 36 patients, suffering trophic ulcers on a chronic venous insufficiency background in a decompensated stage (C6 in accordance to CEAP), echoscleroobliteration of perforant veins, using a "foam-form" method in accordance to Tessari, was performed. In 29 patients postrombophlebitic syndrome in incomplete recanalization stage was diagnosed, in 7 recurrence of varicose disease of the lower extremities. In all the patients during echoscleroobliteration there was possible to obliterate the insufficient perforant veins, in 3 patients two perforant veins were obliterated in each of them. In a one week a pathological blood flow along perforant veins, in accordance to data of ultrasound duplex scanning, was absent. This effect lasted during 6 mo in 29 (80.6%) patients. In 25 (69.4%) patients a trophic ulcers healing was achieved in 1 - 3 mo. In a one year in 30 (83.3%) patients a stable obliteration was noted, in 3 (8.3%) - partial recanalization, in 3 (8.3%) - complete recanalization of perforant veins.

  6. Coronary magnetic resonance vein imaging: imaging contrast, sequence, and timing. (United States)

    Nezafat, Reza; Han, Yuchi; Peters, Dana C; Herzka, Daniel A; Wylie, John V; Goddu, Beth; Kissinger, Kraig K; Yeon, Susan B; Zimetbaum, Peter J; Manning, Warren J


    Recently, there has been increased interest in imaging the coronary vein anatomy to guide interventional cardiovascular procedures such as cardiac resynchronization therapy (CRT), a device therapy for congestive heart failure (CHF). With CRT the lateral wall of the left ventricle is electrically paced using a transvenous coronary sinus lead or surgically placed epicardial lead. Proper transvenous lead placement is facilitated by the knowledge of the coronary vein anatomy. Cardiovascular MR (CMR) has the potential to image the coronary veins. In this study we propose and test CMR techniques and protocols for imaging the coronary venous anatomy. Three aspects of design of imaging sequence were studied: magnetization preparation schemes (T(2) preparation and magnetization transfer), imaging sequences (gradient-echo (GRE) and steady-state free precession (SSFP)), and imaging time during the cardiac cycle. Numerical and in vivo studies both in healthy and CHF subjects were performed to optimize and demonstrate the utility of CMR for coronary vein imaging. Magnetization transfer was superior to T(2) preparation for contrast enhancement. Both GRE and SSFP were viable imaging sequences, although GRE provided more robust results with better contrast. Imaging during the end-systolic quiescent period was preferable as it coincided with the maximum size of the coronary veins. (c) 2007 Wiley-Liss, Inc.

  7. Triboelectric Nanogenerators for Blue Energy Harvesting. (United States)

    Khan, Usman; Kim, Sang-Woo


    Blue energy in the form of ocean waves offers an enormous energy resource. However, it has yet to be fully exploited in order to make it available for the use of mankind. Blue energy harvesting is a challenging task as the kinetic energy from ocean waves is irregular in amplitude and is at low frequencies. Though electromagnetic generators (EMGs) are well-known for harvesting mechanical kinetic energies, they have a crucial limitation for blue energy conversion. Indeed, the output voltage of EMGs can be impractically low at the low frequencies of ocean waves. In contrast, triboelectric nanogenerators (TENGs) are highly suitable for blue energy harvesting as they can effectively harvest mechanical energies from low frequencies (energy harvesting. In this Perspective, we describe some of the recent progress and also address concerns related to durable packaging of TENGs in consideration of harsh marine environments and power management for an efficient power transfer and distribution for commercial applications.

  8. Piezoelectric energy harvesting from broadband random vibrations (United States)

    Adhikari, S.; Friswell, M. I.; Inman, D. J.


    Energy harvesting for the purpose of powering low power electronic sensor systems has received explosive attention in the last few years. Most works using deterministic approaches focusing on using the piezoelectric effect to harvest ambient vibration energy have concentrated on cantilever beams at resonance using harmonic excitation. Here, using a stochastic approach, we focus on using a stack configuration and harvesting broadband vibration energy, a more practically available ambient source. It is assumed that the ambient base excitation is stationary Gaussian white noise, which has a constant power-spectral density across the frequency range considered. The mean power acquired from a piezoelectric vibration-based energy harvester subjected to random base excitation is derived using the theory of random vibrations. Two cases, namely the harvesting circuit with and without an inductor, have been considered. Exact closed-form expressions involving non-dimensional parameters of the electromechanical system have been given and illustrated using numerical examples.

  9. Experimental measurement of energy harvesting with backpack (United States)

    Pavelkova, Radka; Vala, David; Suranek, Pavel; Mahdal, Miroslav


    This article deals with the energy harvesting systems, especially the energy harvesting backpack, which appears as a convenient means for energy harvesting for mobile sensors power. Before starting the experiment, it was necessary to verify whether this energy will be sufficient to get acquainted with the human kinematics and analyze problematics itself. For this purpose there was used motion capture technology from Xsens. Measured data on the position of a particle moving man and back when walking, these data were then used for experimental realization of energy harvesting backpack and as input data to the simulation in Simulink, which brought us a comparison between theoretical assumptions and practical implementation. When measuring characteristics of energy harvesting system we have a problem with measurements on backpack solved when redoing of the hydraulic cylinder as a source of a suitable movement corresponding to the amplitude and frequency of human walk.

  10. Energy harvesting through piezoelectricity - technology foresight

    DEFF Research Database (Denmark)

    Laumann, Felix; Sørensen, Mette Møller; Hansen, Tina Mølholm


    Energy harvesting is important in designing low power intelligent networks, such as Internet-of-Things. Energy harvesting can ensure wireless and lossless energy supply to energy dependent technological solutions with independence of infrastructure. Electrical energy created through piezoelectric......Energy harvesting is important in designing low power intelligent networks, such as Internet-of-Things. Energy harvesting can ensure wireless and lossless energy supply to energy dependent technological solutions with independence of infrastructure. Electrical energy created through...... scientific articles. In contrast to this, is found a low level of ability to convert the technology from academia to commercialization. A decision making model is proposed including a requirement for better understanding of niches, niche definitions and configuration of energy harvesting design...

  11. Investigation of RF Signal Energy Harvesting

    Directory of Open Access Journals (Sweden)

    Soudeh Heydari Nasab


    Full Text Available The potential utilization of RF signals for DC power is experimentally investigated. The aim of the work is to investigate the levels of power that can be harvested from the air and processed to achieve levels of energy that are sufficient to charge up low-power electronic circuits. The work presented shows field measurements from two selected regions: an urbanized hence signal congested area and a less populated one. An RF harvesting system has been specifically designed, built, and shown to successfully pick up enough energy to power up circuits. The work concludes that while RF harvesting was successful under certain conditions, however, it required the support of other energy harvesting techniques to replace a battery. Efficiency considerations have, hence, placed emphasis on comparing the developed harvester to other systems.

  12. Venous duplex and pathologic differences in thrombus characteristics between de novo deep vein thrombi and endovenous heat-induced thrombi. (United States)

    Santin, Brian J; Lohr, Joanne M; Panke, Thomas W; Neville, Patrick M; Felinski, Melissa M; Kuhn, Brian A; Recht, Matthew H; Muck, Patrick E


    Superficial venous reflux disease has been treated with endovenous ablation techniques for more than 15 years. Thrombi discovered in the postoperative period are referred to as endovenous heat-induced thrombi (EHIT). In spite of the few studies of the ultrasound differentiation between EHIT and deep vein thrombi (DVT), there remains a paucity of literature regarding the evaluation of ultrasound examination and pathologic differentiation. Six Yorkshire cross swine underwent femoral vein thrombosis by suture ligation or endovenous radiofrequency ablation. At 1 week after the procedure, each femoral vein was imaged by color Duplex ultrasound and sent for histologic interpretation for differentiation between EHIT and DVT. Five blinded vascular surgery faculty, two vascular surgery fellows, and three vascular surgery residents reviewed the ultrasound images. Thrombi associated with radiofrequency ablation demonstrated a greater degree of hypercellular response, fibroblastic reaction, and edema (3.42 vs 2.92; 3.75 vs 2.42; 2.83 vs 1.33). Specimens harvested from the iatrogenic-induced DVT swine demonstrated a more prolific response to trichrome staining (3.42 vs 2.67). Evidence of revascularization was found in all of the EHIT specimens but in 33% of DVT specimens. On the basis of histologic findings, the pathologist predicted correct modality 92% of the time. Subgroup analysis comparing paired specimens from each swine failed to demonstrate any marked pathologic differences. Recorded ultrasound images from EHIT and DVT samples were reviewed by fellows, residents, and vascular surgery staff to determine whether clot was stationary or free-floating (n = 111; 93%), evidence of retracted or adherent vein (n = 105; 88%), and absence of color flow (n = 102; 85%). The degree of occlusion (partial vs total) and degree of distention of a visualized vein were least likely to be agreed on by reviewers (n = 95; 79% each, respectively). In subgroup (DVT vs EHIT) analyses, the

  13. Assessment of the attenuation of an intra-abdominal vein by use of a silicone-polyacrylic acid gradual venous occlusion device in dogs and cats. (United States)

    Wallace, Mandy L; Ellison, Gary W; Giglio, Robson F; Batich, Christopher D; Berry, Clifford R; Case, J Brad; Kim, Stanley E


    OBJECTIVE To evaluate the closure rate and completeness of closure for a silicone-polyacrylic acid gradual venous occlusion device placed around an intra-abdominal vein to simulate gradual occlusion of an extrahepatic portosystemic shunt. ANIMALS 3 purpose-bred cats and 2 purpose-bred dogs. PROCEDURES The device was surgically placed around an external (cats) or internal (dogs) iliac vein. Computed tomographic angiography was performed at the time of surgery and 2, 4, and 6 weeks after surgery. Ultrasonographic examinations of blood flow through the vein within the device were performed at the time of surgery and at weekly intervals thereafter. Dogs were euthanized 6 weeks after surgery, and the external iliac veins were harvested for histologic examination. RESULTS The prototype gradual venous occlusion device was successfully placed in all animals, and all animals recovered without complications following the placement procedure. The vessel was completely occluded in 2 cats by 6 weeks after surgery, as determined on the basis of results of CT and ultrasonography; there was incomplete occlusion with a luminal diameter of 1.5 mm in the other cat by 6 weeks after surgery. The vessel was completely occluded in both dogs by 6 weeks after surgery. Histologic examination of the external iliac veins obtained from the dogs revealed minimal inflammation of the vessel wall and no thrombus formation. CONCLUSIONS AND CLINICAL RELEVANCE The prototype device induced gradual attenuation of an intra-abdominal vessel over a 6-week period. This device may provide another option for gradual occlusion of extrahepatic portosystemic shunts.

  14. Post-harvest quality of fresh-marketed tomatoes as a function of harvest periods

    Directory of Open Access Journals (Sweden)

    Ferreira Marcos David


    Full Text Available Losses on tomato business chain start at harvest, a two-months period. At the beginning of the harvest, fruits concentrate at the basal part of the plant, then in the middle, and finally at the top, and undergo changes in diameter and maturity indexes as harvest progresses. The aim of this work was to evaluate the impact of handling at three different periods: (I 15 days, (II 30 days, and (III 45 days after the beginning of harvest. Tomatoes were ordinarily grown and harvested in to bamboo baskets, and transferred to plastics boxes. Fruits were classified according to ripening stage and diameter, and evaluated for mechanical damage and external defects caused by harvesting procedures. The time required for the harvest operation was measured; damage to fruits (% and weight loss (%, caused either in the field and/or during the harvesting process, were taken into consideration and related to the final quality of fruit after storage for 21 days. The same methodology was used all through the production and harvest cycle. The highest % fruit damage occurred during period II, a longer harvest time than the other two periods. Fruits not submitted to handling showed lower weight loss than handled fruits. Fruits harvested in period II and stored for 21 days showed higher losses due to mechanical injury.

  15. [Molecular identification of geminivirus inducing vein yellowing in Abelmoschus manihot]. (United States)

    Tang, Mei-qiong; Qin, Liu-yan


    The virus isolate H was identified by molecular biology,it was collected from Abelmoschus manihot plant showing leaf curl,yellow vein symptoms in Guangxi Botanical Garden of Medicinal Plant. The virus isolate H was observed in electron micrograph, and conformed detected by PCR using universal primer pair for the genus Geminivirus. The results indicated that all sequences homologous to the specific fragment belonged to the genus Begomovirus of the family Geminiviridae. There was the highest similarity shared 95% homology at nucleotide between the specific fragment and DNA-A of Emilia yellow vein virus isolates. These findings suggested that there was geminiviridea in Abelmoschus manihot, and the disease probably caused by Emilia yellow vein virus.

  16. Visualization of the superior opthalmic vein on carotid angiography

    Energy Technology Data Exchange (ETDEWEB)

    Servo, A.


    Visualization of the superior ophthalmic vein (SOV) on carotid angiography was investigated based on a prospective sample of 452 carotid angiograms performed during one year. The SOV with normal blood flow direction, from facial veins into the cavernous sinus (CS), was seen on 26% and with reversed flow direction in 7% of the angiograms. A hypothesis was suggested that the anatomical variations of the moddle cerebral (MCV) and uncal veins (UV) affected the visualization. When both the MCV and UV drained into the CS, the SOV was seen in 11% of 179 angiograms. If the MCV and UV bypassed the CS, the SOV was seen on 51% of 118 angiograms. The difference is significant. Intubation of the patient increased the visualization of the SOV with normal flow direction but did not affect the visualization of the SOV with reversed flow. No SOV with normal blood flow direction was seen on selective internal carotid angiography.

  17. Breast cancer metastatic to the kidney with renal vein involvement. (United States)

    Nasu, Hatsuko; Miura, Katsutoshi; Baba, Megumi; Nagata, Masao; Yoshida, Masayuki; Ogura, Hiroyuki; Takehara, Yasuo; Sakahara, Harumi


    The common sites of breast cancer metastases include bones, lung, brain, and liver. Renal metastasis from the breast is rare. We report a case of breast cancer metastatic to the kidney with extension into the renal vein. A 40-year-old woman had undergone left mastectomy for breast cancer at the age of 38. A gastric tumor, which was later proved to be metastasis from breast cancer, was detected by endoscopy. Computed tomography performed for further examination of the gastric tumor revealed a large left renal tumor with extension into the left renal vein. It mimicked a primary renal tumor. Percutaneous biopsy of the renal tumor confirmed metastasis from breast cancer. Surgical intervention of the stomach and the kidney was avoided, and she was treated with systemic chemotherapy. Breast cancer metastatic to the kidney may present a solitary renal mass with extension into the renal vein, which mimics a primary renal tumor.

  18. Shock veins in the Sahara 02500 ordinary chondrite (United States)

    Owocki, Krzysztof; Muszyński, Andrzej


    A specimen of the Sahara 02500 ordinary chondrite contains shock-produced veins consisting of recrystallised fine-grained pyroxenes that include small droplets of Ni-rich metal. Non-melted olivines and pyroxenes show planar deformations filled by shock-melted and -polluted metal and troilite. Shock-melted feldspathic glass is present close to the shock veins. Geothermometric estimations indicate that the meteorite locally experienced moderate shock metamorphism with a minimum local peak temperature above 1400°C, resulting in partial melting of Ca-poor pyroxene and full melting of feldspars, metal and sulphides. The mineral assemblage in the shock veins suggests a pressure during melt recrystallisation below 10 GPa.

  19. Aneurysm of the Vein of Galen Diagnosed with MRI

    Directory of Open Access Journals (Sweden)

    Themistoklis Dagklis


    Full Text Available We describe the case of a neonate with aneurysm of vein of Galen that was diagnosed prenatally in the 33rd gestational week by MRI. A 27-year-old woman, gravida 2, para 2, was admitted to our department at 33 weeks of gestation with suspected fetal hydrocephaly. Ultrasound examination after admission demonstrated an anechoic, supratentorial, and median mass with regular borders, raising the possible diagnosis of an aneurysm of the vein of Galen. MRI confirmed the presence of an aneurysm of the vein of Galen. An elective caesarean section was performed at 33 weeks of gestation. The newborn was admitted to the Neonatal Intensive Care Unit. Despite the full respiratory and medical support given, the sustainment of cardiac failure resulted in neonatal death just one day following its admission.

  20. Renal vein doppler sonography in rabbits with acute ureteral obstruction: usefulness of impedance index of renal vein

    Energy Technology Data Exchange (ETDEWEB)

    Sohn, Kyung Myung; Chung, Su Kyo; Lee, Sung Yong [College of Medicine, The Catholic Univ. of Korea, Seoul (Korea, Republic of)


    To evaluate the usefulness of the impedance index of the renal vein for the diagnosis of acute obstructive uropathy in rabbits. Ligation of the left ureter was done in 12 rabbits. Doppler sonography of the interlobar veins in both kidneys was checked before and 30 minutes, 1, 3, 6, 9 and 24 hours after ureteral ligation. The venous impedance index [(peak flow signal-least flow signal)/peak flow signal] was compared between the obstructed and non-obstructed kidneys for all periods. The change in the impedance index after ureteral ligation was also compared between the obstructed and non-obstructed kidneys. A decrease in the impedance index of the intrarenal vein was observed starting from 30 mins atter ureteral ligation, and the index remained low up to 24 hours after ureteral ligation. The obstructed kidneys had a significantly lower impedance index than the contralateral kidneys for all six of the postligation measurements (p< 0.05). There were significant differences in the change of impedance index after ureteral ligation between the obstructed and non-obstructed kidneys (p< 0.05). The impedance index of the intrarenal vein was significantly decreased in the obstructed kidneys. The measurement of the impedance index of the intrarenal vein using Doppler sonography could provide a useful method of diagnosing obstructive uropathy.