Is total abolishment of great saphenous reflux in the invasive treatment of superficial chronic venous insufficiency always necessary?

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Navarro, T P; Nunes, T A; Ribeiro, A L; Castro-Silva, M

2009-02-01

Chronic venous insufficiency ranges from mild telangiectasias to skin ulceration with poor prognosis regarding healing and quality of life. Varicose veins are the most frequent clinical presentation, affecting 75% of such patients and 71% are due to primary reflux of great saphenous vein, which is the most compromised vein in chronic venous insufficiency. However, about 75% of these veins are not dilated. The standard treatment has been stripping of the saphenous vein, because it has 85% of good results at long term. However, saphenous vein is the main arterial substitute and should be spared whenever possible. The development of non-invasive diagnostic methods showed that hemodynamic worsening correlates with clinical severity and that the majority of patients did not have a dilated saphenous vein. Thus, several selective operations proposed to spare the saphenous vein have reported good results. Minimally invasive techniques (eco-guided foam, radiofrequency and laser) have also emerged aiming to obliterate the vein and abolishing reflux and have also reported good results, but they do not spare the vessel. Measurement of saphenous diameter has been shown to correlate with clinical and hemodynamic worsening, thus allowing planning the invasive treatment of chronic venous insufficiency. Dilated diameters (>7.2 mm) correlate with severe disease and poor prognosis, being an indication for total abolishment of saphenous vein reflux. All other presentations must be individualized, sparing saphenous vein whenever possible and and a standardized approach is not indicated for all patients.

The importance of the time of digitalization for the incidence of spasms evoked by ouabain in strips of human saphenous vein.

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Zerkowski, H R; Wagner, J

1982-10-01

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.

Arterial Levels of Oxygen Stimulate Intimal Hyperplasia in Human Saphenous Veins via a ROS-Dependent Mechanism

Science.gov (United States)

Joddar, Binata; Firstenberg, Michael S.; Reen, Rashmeet K.; Varadharaj, Saradhadevi; Khan, Mahmood; Childers, Rachel C.; Zweier, Jay L.; Gooch, Keith J.

2015-01-01

Saphenous veins used as arterial grafts are exposed to arterial levels of oxygen partial pressure (pO2), which are much greater than what they experience in their native environment. The object of this study is to determine the impact of exposing human saphenous veins to arterial pO2. Saphenous veins and left internal mammary arteries from consenting patients undergoing coronary artery bypass grafting were cultured ex vivo for 2 weeks in the presence of arterial or venous pO2 using an established organ culture model. Saphenous veins cultured with arterial pO2 developed intimal hyperplasia as evidenced by 2.8-fold greater intimal area and 5.8-fold increase in cell proliferation compared to those freshly isolated. Saphenous veins cultured at venous pO2 or internal mammary arteries cultured at arterial pO2 did not develop intimal hyperplasia. Intimal hyperplasia was accompanied by two markers of elevated reactive oxygen species (ROS): increased dihydroethidium associated fluorescence (4-fold, ppO2 is suggested by the observation that chronic exposure to tiron, a ROS scavenger, during the two-week culture period, blocked intimal hyperplasia. Electron paramagnetic resonance based oximetry revealed that the pO2 in the wall of the vessel tracked that of the atmosphere with a ~30 mmHg offset, thus the cells in the vessel wall were directly exposed to variations in pO2. Monolayer cultures of smooth muscle cells isolated from saphenous veins exhibited increased proliferation when exposed to arterial pO2 relative to those cultured at venous pO2. This increased proliferation was blocked by tiron. Taken together, these data suggest that exposure of human SV to arterial pO2 stimulates IH via a ROS-dependent pathway. PMID:25799140

Preservação da veia safena magna na cirurgia de varizes dos membros inferiores Varicose vein surgery in lower limbs with preservation of the great saphenous vein

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Hamilton Almeida Rollo

2009-06-01

Full Text Available A veia safena magna autóloga é o melhor substituto arterial nas revascularizações dos membros inferiores, importante na revascularização do miocárdio e pode ser utilizada nas cirurgias do sistema venoso e nos traumas das extremidades. A fleboextração aumenta os riscos de lesões linfáticas e neurológicas. Assim, no tratamento das varizes primárias dos membros inferiores por meio da cirurgia ou de outras técnicas, a preservação da safena é recomendável se ela for normal ou apresentar alterações que ainda permitam sua preservação pela correção da causa desencadeante. Tal correção pode ser feita por técnicas cirúrgicas. Entre elas, a cura hemodinâmica da insuficiência venosa em ambulatório (CHIVA tem mostrado bons resultados. Recentemente, um ensaio clínico randomizado e controlado foi publicado comprovando sua eficácia. Outra técnica bastante utilizada é a da ligadura rasante da junção safenofemoral + crossectomia + ligadura das tributárias de crossa, com a qual se tem obtido resultados contraditórios. Finalmente, as técnicas que corrigem a insuficiência da safena reparando as valvas ostial e pré-ostial (valvoplastia externa são mais fisiológicas. Um ensaio clínico internacional multicêntrico, randomizado e controlado, testando um novo dispositivo, está sendo realizado, com resultados iniciais favoráveis. Este estudo pretende fazer uma revisão sobre as técnicas utilizadas na preservação da safena magna.The autologous great saphenous vein is the most effective bypass choice for lower limb revascularization, playing an important role in myocardial revascularization, and can be used in venous system surgeries and extremity traumas. Stripping increases the risk of lymphatic lesions and nerve damage. Therefore, when surgery or other techniques are used to treat primary varicose veins in the lower limbs, preservation of the saphenous vein is a desirable objective whenever the vein remains healthy or

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

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Stefano Ricci

2014-10-01

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.

Catheter-Directed Thrombolysis via Small Saphenous Veins for Treating Acute Deep Venous Thrombosis.

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Yang, Bin; Xu, Xiao-Dong; Gao, Peng; Yu, Ji-Xiang; Li, Yu; Zhu, Ai-Dong; Meng, Ran-Ran

2016-08-23

BACKGROUND There is little data comparing catheter-directed thrombolysis (CDT) via small saphenous veins vs. systematic thrombolysis on complications and efficacy in acute deep venous thrombosis patients. The aim of our study was to compare the efficacy and safety of CDT via the small saphenous veins with systematic thrombolysis for patients with acute deep venous thrombosis (DVT). MATERIAL AND METHODS Sixty-six patients with acute DVT admitted from June 2012 to December 2013 were divided into 2 groups: 27 patients received systemic thrombolysis (ST group) and 39 patients received CDT via the small saphenous veins (CDT group). The thrombolysis efficiency, limb circumference differences, and complications such as post-thrombotic syndrome (PTS) in the 2 groups were recorded. RESULTS The angiograms demonstrated that all or part of the fresh thrombus was dissolved. There was a significant difference regarding thrombolysis efficiency between the CDT group and ST group (71.26% vs. 48.26%, P=0.001). In both groups the postoperative limb circumference changes were higher compared to the preoperative values. The differences between postoperative limb circumferences on postoperative days 7 and 14 were significantly higher in the CDT group than in the ST group (all Pdeep venous thrombosis.

PX-18 Protects Human Saphenous Vein Endothelial Cells under Arterial Blood Pressure.

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Kupreishvili, Koba; Stooker, Wim; Emmens, Reindert W; Vonk, Alexander B A; Sipkens, Jessica A; van Dijk, Annemieke; Eijsman, Leon; Quax, Paul H; van Hinsbergh, Victor W M; Krijnen, Paul A J; Niessen, Hans W M

2017-07-01

Arterial blood pressure-induced shear stress causes endothelial cell apoptosis and inflammation in vein grafts after coronary artery bypass grafting. As the inflammatory protein type IIA secretory phospholipase A 2 (sPLA 2 -IIA) has been shown to progress atherosclerosis, we hypothesized a role for sPLA 2 -IIA herein. The effects of PX-18, an inhibitor of both sPLA 2 -IIA and apoptosis, on residual endothelium and the presence of sPLA 2 -IIA were studied in human saphenous vein segments (n = 6) perfused at arterial blood pressure with autologous blood for 6 hrs. The presence of PX-18 in the perfusion blood induced a significant 20% reduction in endothelial cell loss compared to veins perfused without PX18, coinciding with significantly reduced sPLA 2 -IIA levels in the media of the vein graft wall. In addition, PX-18 significantly attenuated caspase-3 activation in human umbilical vein endothelial cells subjected to shear stress via mechanical stretch independent of sPLA 2 -IIA. In conclusion, PX-18 protects saphenous vein endothelial cells from arterial blood pressure-induced death, possibly also independent of sPLA 2 -IIA inhibition. Copyright © 2017 Elsevier Inc. All rights reserved.

[A reduction in the invasiveness during surgical revascularization: the harvesting of the great saphenous vein by a video endoscopic technic].

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Terrini, A; Graffigna, A; Martinelli, L

2000-05-01

The authors report their preliminary experience of endoscopic saphenous vein harvesting as part of a program devoted to reducing the invasivity of surgical myocardial revascularization. This method allows us to minimize the cutaneous incisions in the inferior limbs necessary to harvest the saphenous vein, thus reducing the incidence of complications. The study includes 41 patients who underwent endoscopic saphenous vein harvesting from October 1998 to September 1999 and, as a control group, 20 patients with similar characteristics operated on with the traditional technique during the same period. The variables considered were: the time necessary to harvest the saphenous vein, the incidence of complications, and the postoperative mobilization. All the endoscopically harvested grafts were adequate for the scheduled procedure. The only complication occurred in a patient operated on with the traditional technique. The time of harvesting and the day of mobilization were similar in the two groups. The reduction of surgical trauma allowed a fast deambulation recovery and better esthetic results. When complete arterial revascularization is not feasible, the endoscopic harvesting of the required saphenous vein segment allows for a significant reduction in the invasivity of the procedure.

A randomized comparison of the Saphenous Vein Versus Right Internal Thoracic Artery as a Y-Composite Graft (SAVE RITA) trial: early results.

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Hwang, Ho Young; Kim, Jun Sung; Oh, Se Jin; Kim, Ki-Bong

2012-11-01

The Saphenous Vein Versus Right Internal Thoracic Artery as a Y-Composite Graft trial was designed to evaluate the saphenous vein compared with the right internal thoracic artery as a Y-composite graft anastomosed to the side of the left internal thoracic artery. In this early analysis, we compared early angiographic patency rates and clinical outcomes. From September 2008 to October 2011, 224 patients with multivessel coronary artery disease were randomized prospectively to undergo off-pump revascularization using the saphenous vein group (n = 112) or the right internal thoracic artery group (n = 112) as Y-composite grafts. Early postoperative (1.4 ± 1.1 days) angiographic patency and clinical outcomes were compared. There was 1 operative death in the right internal thoracic artery group. No statistically significant differences in postoperative morbidities, including atrial fibrillation and acute renal failure, were observed between the groups. The number of distal anastomoses using the side-arm Y-composite graft (saphenous vein vs right internal thoracic artery) were 2.3 ± 0.8 and 1.9 ± 0.7 in the saphenous vein and right internal thoracic artery groups, respectively (P < .001). A third conduit was used in 44 patients (saphenous vein group vs right internal thoracic artery group, 4/109 vs 40/110; P < .001) to extend the side-arm Y-composite graft for complete revascularization. Early angiography demonstrated an overall patency rate of 99.4% (771 of 776 distal anastomoses). Patency rates of the side-arm Y-composite graft (saphenous vein vs right internal thoracic artery) were 98.8% (245 of 248) and 99.5% (207 of 208) in the saphenous vein and right internal thoracic artery groups, respectively (P = .629). A third conduit was needed to extend the right internal thoracic artery composite graft and reach the target vessels in 36.4% (40/110) of the patients. The saphenous vein composite graft was comparable with the right internal thoracic artery composite graft

Changes of blood levels of LPO, SOD and GSH-Px after endovenous laser treatment of varicose greater saphenous vein

International Nuclear Information System (INIS)

Han Li'na; Gu Ying; Liu Fanguang

2004-01-01

Objective: To investigate the changes of the blood levels of lipid peroxide (LPO), superoxide dismutase (SOD) and glutathione peroxidase (GSH-Px) after treatment of varicose greater saphenous vein with either endovenous laser or conventional surgery (high ligation plus stripping). Methods: Thirty-seven patients with varicose greater saphenous vein were treated with endovenous laser and another 33 patients were treated with conventional surgery. Levels of LPO (serum, with TBA fluorescein), SOD (whole blood, with RIA) and GSH-Px (whole blood, with direct DTNB) were determined in these patients both before and 1, 3, 5, 7, 10, 15 days after treatment. Levels in 30 controls were also measured. Results: The levels of LPO were higher and levels of SOD, GSH-Px lower in the patients than those in the controls. After either form of therapy, the levels LPO rose and levels of SOD, GSH-Px dropped immediately but gradually approached the control values by the 15 th day (slower with SOD and GSH-Px). However, the early increase of LPO levels were less and recovery sooner in the group of patients treated with laser. Conclusion: Changes of levels of LPO, SOD and GSH-Px were closely related to the degree of stress and recovery condition after the treatment

A different management of saphenous vein graft failure related to cardiac tamponade following coronary surgery

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Hamit Serdar Başbuğ

2016-03-01

Full Text Available Cardiac tamponade is a state of constriction of the heart with an excessive fluid or hematoma resulted from various conditions. Postoperative tamponade can occur after coronary bypass surgery. Despite it is uncommon, its results may have a high risk of mortality and morbidity. Acute postoperative cardiac tamponade reveals a vast spectrum of symptoms. Moreover, a compression over the saphenous vein graft is the worst complication that should be managed without delay. We report a rare case of saphenous vein graft failure due to the cardiac tamponade following a coronary surgery and its management with a practical measure.

Comparison of fractional flow reserve of composite Y-grafts with saphenous vein or right internal thoracic arteries.

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Glineur, David; Boodhwani, Munir; Poncelet, Alain; De Kerchove, Laurent; Etienne, Pierre Yves; Noirhomme, Philippe; Deceuninck, Paul; Michel, Xavier; El Khoury, Gebrine; Hanet, Claude

2010-09-01

Composite Y-grafts, using the left internal thoracic artery as the inflow, allow a more efficient use of conduits without the need to touch a diseased ascending aorta. Among other conduits, the saphenous vein graft may be an alternative to the radial artery in elderly patients. We evaluated the hemodynamic characteristics of 17 composite Y-grafts made with the left internal thoracic artery anastomosed to the left anterior descending coronary artery in all cases and with either the free right internal thoracic artery (RITA group, n = 10) or a saphenous vein graft (SVG group, n = 7) implanted proximally to the left internal thoracic artery and distally to the circumflex territory 6 months after the operation. At baseline, the pressure gradient measured with a 0.014-inch pressure wire was minimal between the aorta and the internal thoracic artery stem (2 +/- 1 mm Hg), the internal thoracic artery and left anterior descending (4 +/- 2 mm Hg), the internal thoracic artery and left circumflex (3 +/- 1 mm Hg), and the saphenous vein graft and left circumflex (2 +/- 2 mm Hg). During hyperemia induced by adenosine, the pressure gradient increased significantly to 6 +/- 2 mm Hg in the internal thoracic artery stem, 9 +/- 4 mm Hg in the internal thoracic artery and left anterior descending artery, 9 +/- 3 mm Hg in the internal thoracic artery and left circumflex, and 7 +/- 4 mm Hg in the saphenous vein graft and left circumflex. Fractional flow reserve was 0.94 +/- 0.02 in internal thoracic artery stem, 0.90 +/- 0.04 mm Hg in the internal thoracic artery and left anterior descending, 0.91 +/- 0.03 mm Hg in the internal thoracic artery and left circumflex, and 0.92 +/- 0.06 mm Hg in the saphenous vein graft and left circumflex. No difference between the two types of composite Y-grafts was observed for pressure gradients or fractional flow reserve measured in internal thoracic artery stem or in distal branches. Composite Y-grafts with saphenous vein or right internal thoracic

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

LENUS (Irish Health Repository)

Hynes, Niamh

2006-03-01

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.

Leiomyosarcoma of the great saphenous vein

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Alexandre Campos Moraes Amato

2015-06-01

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.

Greater saphenous vein anomaly and aneurysm with subsequent pulmonary embolism

OpenAIRE

Ma, Truong; Kornbau, Craig

2017-01-01

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...

Short endovenous laser ablation of the great saphenous vein in a modified CHIVA strategy

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Sergio Gianesini

2013-09-01

Full Text Available Mini-invasiveness, ease of use and execution speed represent the reasons for endovenous laser ablation success. Nevertheless, the strategic choice remains the ablation of the saphenous trunk. Hemodynamic correction (CHIVA represents an option, based on a saphenous-sparing therapeutic strategy. We tested the feasibility of a modified CHIVA strategy by means of endovenous lasers (EL shrinkage of segmental great saphenous vein (GSV tracts, in networks characterized by sapheno-femoral incompetence and re-entry perforators focused on the GSV. We report the follow up of the first 2 chronic venous disease [C1,2,3sEpAsPr1,2,3, venous clinical severity score (VCSS 8 and 9 respectively] treated cases. At 1-year follow up both patients were C1,2,3sEpAsPr1,2,3 and the VCSS were 1 and 2 respectively. The non-treated GSV tracts maintained their patency. ELs were herein used within a saphenous-sparing therapeutic plan, thanks to an accurate pre-operative hemodynamic assessment, which allowed the shrinkage of only the first saphenous trunk tract only. Proper technical and hemodynamic considerations are discussed.

Conventional operation and laser therapy in the treatment of varicose veins

Institute of Scientific and Technical Information of China (English)

无

2007-01-01

Objective: To evaluate the effectiveness of endovenous laser therapy and conventional therapy on the varicose of great saphenous vein. Methods: Thirty-two patients received endovenous laser therapy and 32 patients were operated by conventional therapy (high ligation and stripping). The observation results of great saphenous vein(GSV) were recorded by clinical evaluation and duplex ultrasound examination. And the operating time, intraoperative blood loss, time to become moveable, duration of hospitalization and degree of feeling pain were compared between the two groups. Results: Compared with conventional therapy, laser therapy had good curative effect with less complications and no scars and no pains. There were significant differences between the two groups (P＜0.01). Conclusion: Laser therapy for varicose of great saphenous vein is better than the conventional therapy. It deserves to be widely used in clinical treatment.

Interventional treatment of iliac vein compression syndrome

International Nuclear Information System (INIS)

Li Xiaoqiang; Zhou Weiming; Nie Zhonglin; Yu Chaowen

2002-01-01

Objective: To explore the clinical significance of interventional treatment of iliac vein compression syndrome (IVCS). Methods: Percutaneous transluminal angioplasty (PTA) was performed in 40 cases. Thirty-three cases underwent endovascular stent implantation and 27 cases underwent second-stage left saphenous vein ligation and stripping and the valves of left femoral veins narrowing. Thirty-one cases were followed-up postoperatively and the duration was 6-66 months (mean 28 months). Results: The dilation of iliac veins was successful in 36 cases and there were god efficacy in all patients when they discharged from hospital. Followed-up during post-operation, all the limbs ulcers were cured and varicose veins disappeared. The skin pigmentation disappeared in 17 of 19 cases and markedly relieved in 2 cases. Left lower limb swelling disappeared in 15 of 17 cases and relieved in 2 cases. Conclusion: There is good efficacy in the interventional treatment of left iliac vein lesions, but second-stage procedures should be performed in secondary lesions of saphenous veins and valves of femoral veins

[Applied anatomy study and clinical application of great saphenous veno-saphenous neurocutaneous vascular flap].

Science.gov (United States)

Li, Zelong; Ding, Zihai; Wang, Peixin; Xie, Yibo; Zeng, Bo

2006-03-01

To provide the anatomic basis for defect repair of the knee, leg, foot and ankle with great saphenous veno-saphenous neurocutaneous vascular island flaps. The origin, diameter, branches, distribution and anastomoses of the saphenous artery and saphenous neurocutaneous vascular were observed on 20 sides of adult leg specimens and 4 fresh cadaver voluntary legs. Another 4 fresh cadaver voluntary legs were radiographed with a soft X-ray system after the intravenous injection of Vermilion and cross-sections under profound fascial, other hand, micro-anatomic examination was also performed in these 4 fresh cadaver legs. The soft tissue defects in lower extremity, upper extremity, heel or Hucou in hand were repaired with the proximal or distal pedicle flaps or free flaps in 18 patients (12 males and 6 females,aging from 7 to 53 years). The defect was caused by trauma, tumour, ulcer and scar. The locations were Hucou (1 case), upper leg (3 cases), lower extremity and heal (14 cases). Of then, 7 cases were complicated by bone exposure, 3 cases by tendon exposure and 1 case by steel espouse, the defect size were 4 cm x 4 cm to 7 cm x 13 cm. The flap sizes were 4 cm x 6 cm to 8 cm x 15 cm, which pedicle length was 8-11 cm with 2.5-4.0 cm fascia and 1-2 cm skin at width. Genus descending genicular artery began from 9.33 +/- 0.81 cm away from upper the condyles medialis, it branched saphenous artery accompanying saphenous nerve descendent. And saphenous artery reached the surface of the skin 7.21 +/- 0.82 cm away from lower the condyles medialis, and anastomosed with the branches of tibialis posterior artery, like "Y" or "T" pattern. The chain linking system of arteries were found accompanying along the great saphenous vein as saphenous nerve, and then a axis blood vessel was formed. The small artery of only 0.05-0.10 mm in diameter, distributed around the great saphenous vein within 5-8 mm and arranged parallelly along the vein like water wave in soft X-ray film. All proximal

Catheter-directed thrombolysis for acute iliofemoral deep vein thrombosis via the ipsilateral great saphenous vein approach: a comparative clinical study

International Nuclear Information System (INIS)

Su Haobo; Gu Jianping; Lou Wensheng; He Xu; Chen Liang; Chen Guoping; Song Jinhua; Wang Tao

2011-01-01

Objective: To investigate prospectively the feasibility and clinical value of catheterization via the ipsilateral great saphenous vein in catheter-directed thrombolysis (CDT) for acute iliofemoral deep vein thrombosis (IFVT) by a comparative study. Methods: The prospective study included 93 cases of IFVT proved by venography. All patients were divided into three groups randomly. In group A, 31 patients received CDT via the ipsilateral great saphenous vein. In group B, 27 patients received CDT via the ipsilateral popliteal vein. In group C, 35 patients received anterograde thrombolysis via an ipsilateral dorsalis pedis vein. Urokinase was adopted as the thrombolytic agent in all cases. The assessment of the curative effect include therapeutic effective rate, rate of edema reduction and venous patency which were observed according to the clinical symptoms and the follow-up venograms obtained 5 days after thrombolysis. The time and comfort scores of procedures was recorded and compared between group A and B using two independent samples t test. The rate of edema reduction and venous patency were assessed using analysis of variance (LSD method). Therapeutic effective rate and complication rate were assessed using Chi-square test. Results: The total effective rate of the three groups were 90.3% (28/31), 92.6% (25/27) and 68.6% (24/35) respectively. The limbs edema reduction rate were (83.5±21.1)%, (82.4±20.1)%, and (67.0±23.3)% respectively (F= 6.059, P=0.003). The venous patency rate after thrombolysis were (61.2±20.2)%, (55.7±20.5)%, and (44.2±23.6)% respectively. There was no significant difference between group A and B in therapeutic effective rate (χ 2 =0.09, P=0.759), rate of edema reduction (P=0.822) and venous patency (P=0.343) . There was a significant difference statistically in therapeutic effective rate (χ 2 =4.65, P=0.031), rate of edema reduction (P=0.002) and venous patency (P=0.002) between group A and C. Compared with group A and B, the

Preservation for future use of the autologous saphenous vein during femoro-popliteal bypass surgery is inexpedient.

NARCIS (Netherlands)

Dirven, M.; Scharn, D.M.; Blankensteijn, J.D.; Vliet, J.A. van der

2008-01-01

PURPOSE: To investigate the usefulness of greater saphenous vein preservation for future vascular reconstructions during femoro-popliteal bypass surgery. DESIGN: Post-hoc analysis of data acquired in a randomized multi-centre clinical trial comparing two different vascular prostheses

Is catheter-directed foam sclerotherapy more effective than the usual foam sclerotherapy for treatment of the great saphenous vein?

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Camillo, Orsini

2018-01-01

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.

Endovenous laser therapy for occlusion of incompetent saphenous veins using 1940nm

Science.gov (United States)

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

2015-07-01

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

Arterial Blood Pressure Induces Transient C4b-Binding Protein in Human Saphenous Vein Grafts.

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Kupreishvili, Koba; Meischl, Christof; Vonk, Alexander B A; Stooker, Wim; Eijsman, Leon; Blom, Anna M; Quax, Paul H A; van Hinsbergh, Victor W M; Niessen, Hans W M; Krijnen, Paul A J

2017-05-01

Complement is an important mediator in arterial blood pressure-induced vein graft failure. Previously, we noted activation of cell protective mechanisms in human saphenous veins too. Here we have analyzed whether C4b-binding protein (C4bp), an endogenous complement inhibitor, is present in the vein wall. Human saphenous vein segments obtained from patients undergoing coronary artery bypass grafting (n = 55) were perfused in vitro at arterial blood pressure with either autologous blood for 1, 2, 4, or 6 hr or with autologous blood supplemented with reactive oxygen species scavenger N-acetylcysteine. The segments were subsequently analyzed quantitatively for presence of C4bp and complement activation product C3d using immunohistochemistry. Perfusion induced deposition of C3d and C4bp within the media of the vessel wall, which increased reproducibly and significantly over a period of 4 hr up to 3.8% for C3d and 81% for C4bp of the total vessel area. Remarkably after 6 hr of perfusion, the C3d-positive area decreased significantly to 1.3% and the C4bp-positive area to 19% of the total area of the vein. The areas positive for both C4bp and C3d were increased in the presence of N-acetylcysteine. Exposure to arterial blood pressure leads to a transient presence of C4bp in the vein wall. This may be part of a cell-protective mechanism to counteract arterial blood pressure-induced cellular stress and inflammation in grafted veins. Copyright © 2017 Elsevier Inc. All rights reserved.

Saphenous Venous Ablation with Hot Contrast in a Canine Model

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Prasad, Amit; Qian Zhong; Kirsch, David; Eissa, Marna; Narra, Pavan; Lopera, Jorge; Espinoza, Carmen G.; Castaneda, Wifrido

2008-01-01

Purpose. To determine the feasibility, efficacy, and safety of thermal ablation of the saphenous vein with hot contrast medium. Methods. Twelve saphenous veins of 6 dogs were percutaneously ablated with hot contrast medium. In all animals, ablation was performed in the vein of one leg, followed by ablation in the contralateral side 1 month later. An occlusion balloon catheter was placed in the infragenicular segment of the saphenous vein via a jugular access to prevent unwanted thermal effects on the non-target segment of the saphenous vein. After inflation of the balloon, 10 ml of hot contrast medium was injected under fluoroscopic control through a sheath placed in the saphenous vein above the ankle. A second 10 ml injection of hot contrast medium was made after 5 min in each vessel. Venographic follow-up of the ablated veins was performed at 1 month (n = 12) and 2 months (n = 6). Results. Follow-up venograms showed that all ablated venous segments were occluded at 1 month. In 6 veins which were followed up to 2 months, 4 (66%) remained occluded, 1 (16%) was partially patent, and the remaining vein (16%) was completely patent. In these latter 2 cases, an inadequate amount of hot contrast was delivered to the lumen due to a closed balloon catheter downstream which did not allow contrast to displace blood within the vessel. Discussion. Hot contrast medium thermal ablation of the saphenous vein appears feasible, safe, and effective in the canine model, provided an adequate amount of embolization agent is used

Compression Stockings after Endovenous Laser Ablation of the Great Saphenous Vein : A Prospective Randomized Controlled Trial

NARCIS (Netherlands)

Bakker, N. A.; Schieven, L. W.; Bruins, R. M. G.; van den Berg, M.; Hissink, R. J.

2013-01-01

Objectives: To determine if the duration of wearing compression stockings after endovenous laser ablation (EVLA) of the great saphenous vein (GSV) has influence on pain and quality of life. Methods: This was a prospective randomized controlled trial. Between December 2006 and February 2008, 109

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

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Rishi Nayyar

2010-01-01

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.

Effect of Ticagrelor Plus Aspirin, Ticagrelor Alone, or Aspirin Alone on Saphenous Vein Graft Patency 1 Year After Coronary Artery Bypass Grafting: A Randomized Clinical Trial.

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Zhao, Qiang; Zhu, Yunpeng; Xu, Zhiyun; Cheng, Zhaoyun; Mei, Ju; Chen, Xin; Wang, Xiaowei

2018-04-24

The effect of ticagrelor with or without aspirin on saphenous vein graft patency in patients undergoing coronary artery bypass grafting (CABG) is unknown. To compare the effect of ticagrelor + aspirin or ticagrelor alone vs aspirin alone on saphenous vein graft patency 1 year after CABG. Randomized, multicenter, open-label, clinical trial among 6 tertiary hospitals in China. Eligible patients were aged 18 to 80 years with indications for elective CABG. Patients requiring urgent revascularization, concomitant cardiac surgery, dual antiplatelet or vitamin K antagonist therapy post-CABG, and who were at risk of serious bleeding were excluded. From July 2014 until November 2015, 1256 patients were identified and 500 were enrolled. Follow-up was completed in January 2017. Patients were randomized (1:1:1) to start ticagrelor (90 mg twice daily) + aspirin (100 mg once daily) (n = 168), ticagrelor (90 mg twice daily) (n = 166), or aspirin (100 mg once daily) (n = 166) within 24 hours post-CABG. Neither patients nor treating physicians were blinded to allocation. Primary outcome was saphenous vein graft patency 1 year after CABG (FitzGibbon grade A) adjudicated independently by a committee blinded to allocation. Saphenous vein graft patency was assessed by multislice computed tomographic angiography or coronary angiography. Among 500 randomized patients (mean age, 63.6 years; women, 91 [18.2%]), 461 (92.2%) completed the trial. Saphenous vein graft patency rates 1 year post-CABG were 88.7% (432 of 487 vein grafts) with ticagrelor + aspirin; 82.8% (404 of 488 vein grafts) with ticagrelor alone; and 76.5% (371 of 485 vein grafts) with aspirin alone. The difference between ticagrelor + aspirin vs aspirin alone was statistically significant (12.2% [95% CI, 5.2% to 19.2%]; P aspirin alone was not statistically significant (6.3% [95% CI, -1.1% to 13.7%]; P = .10). Five major bleeding episodes occurred during 1 year of follow-up (3 with

Neointima development in externally stented saphenous vein grafts

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Przemysław Węglarz

2016-11-01

Full Text Available Introduction : The main limitation of coronary artery bypass grafting (CABG is rapid neointimal hyperplasia leading to graft failure. Aim : To assess plaque formation in saphenous vein grafts (SVG covered by an external Dacron stent in comparison with the classical technique. Material and methods : In the study group vein grafts covered by external stent mesh made of Dacron were implanted. An intravascular ultrasonography (IVUS study was performed in 35 aorto-coronary SVG covered by an external Dacron stent and in 64 normal SVG during the first year after CABG. In each SVG 25 mm of good quality IVUS image, volumes of lumen, plaque (neointima, outer border of the vein graft (external SVG and adventitia were calculated in three time periods: 0–130 days, 130–260 days and 260–390 days. Results : Between the first and second time period, lumen volume (mm3 was reduced from 10.33 ±4.4, to 6.80 ±2.23 in the second period and 5.69 ±1.26 in the third one. This effect was much less marked in normal grafts. The corresponding lumen volume (mm3 was: 10.90 ±3.9, 9.15 ±2.94 and 8.92 ±2.93 in consecutive time periods. Plaque volume (mm3 did not change in control grafts during the course of the study, but it increased very significantly in stented grafts from 0.86 ±1.24 in the first period to 2.70 ±1.58 in the second and 3.29 ±2.66 in the third one. Conclusions : The experimental technique of implanting SVG covered with an external elastic Dacron stent seems to be inferior to traditional ones. This is probably due to the more complicated process of vein implantation and higher micro-injury occurrence during the surgery.

In situ saphenous vein bypass for limb salvage.

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Sarcina, A; Carlesi, R; Bellosta, R; Agrifoglio, G

1993-02-01

A total of 130 infrapopliteal in situ saphenous vein bypasses were performed in 128 patients between January 1980 and June 1991. The indication for surgery was critical ischaemia with impending limb loss in 121 patients; seven suffered from severe claudication. The distal anastomosis was to the popliteal artery below the knee in 60 cases (46.2%) and in 70 (53.8%) to the tibioperoneal arteries. The results, in terms of secondary patency and limb salvage rates, of the first 68 procedures (1980-1985) and subsequent 62 (1986-June 1991) were compared. In the first period, a secondary patency rate of 42.6% and a limb salvage rate of 67.0% were obtained, compared with 71.3 and 80.8% respectively in the second. These differences are significant for patency (P < 0.005) and limb salvage (P < 0.01). These results show that the in situ technique can give acceptable results but a learning period with a high percentage of early failures is to be expected.

The treatment of malignant ventricular tachycardia by aorto-coronary saphenous vein bypass graft

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Ikram, H.; Jeffery, R. M.; Parkins, R. A.; Makey, A. R.; Emery, E. R. J.; Stone, D. L.

1974-01-01

A 61-year-old man with a previous cardiac infarction had at least fifteen attacks of ventricular tachycardia which finally did not respond to either drug or electrical therapy. Angiography showed a blocked right coronary artery and a non-contractile portion of postero-inferior left ventricular wall. An aorto to right coronary saphenous vein bypass graft was inserted, and although attacks of tachycardia occurred following the operation these were of short duration and reverted spontaneously. He has been free of tachycardia for 5 weeks, with a greatly improved effort tolerance. ImagesFig. 2Fig. 3

Sparing Saphenous Vein During Inguinal Lymphadenectomy in Patients with Vulvar Cancer: A Single Center Experience of 10 Years

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Mustafa Özat

2011-12-01

CONCLUSIONS: The preservation of saphenous vein during inguinal lymphadenectomy reduces the incidence of short-term and long-term complications without affecting the risk of local recurrence. Depending on the experience of the surgeon, the surgical strategy should be individualized and optimized for each patient with vulvar cancer.

Endovenous ablation (radiofrequency and laser and foam sclerotherapy versus conventional surgery for great saphenous vein varices

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Craig Nesbitt

Full Text Available BACKGROUND: Minimally invasive techniques to treat great saphenous varicose veins include ultrasound-guided foam sclerotherapy (USGFS, radiofrequency ablation (RFA and endovenous laser therapy (EVLT. Compared with conventional surgery (high ligation and stripping (HL/S, proposed benefits include fewer complications, quicker return to work, improved quality of life (QoL scores, reduced need for general anaesthesia and equivalent recurrence rates. OBJECTIVE : To review available randomized controlled clinical trials (RCT data comparing USGFS, RFA, EVLT to HL/S for the treatment of great saphenous varicose veins. METHODS : Search methods: The Cochrane Peripheral Vascular Diseases (PVD Group searched their Specialized Register (July 2010 and CENTRAL (The Cochrane Library 2010, Issue 3. In addition the authors performed a search of EMBASE (July 2010. Manufacturers of EVLT, RFA and sclerosant equipment were contacted for trial data. Selection criteria: All RCTs of EVLT, RFA, USGFS and HL/S were considered for inclusion. Primary outcomes were recurrent varicosities, recanalization, neovascularization, technical procedure failure or need for re-intervention, patient quality of life (QoL scores and associated complications. Secondary outcomes were type of anaesthetic, procedure duration, hospital stay and cost. Data collection and analysis: CN, RE, VB, PC, HB and GS independently reviewed, assessed and selected trials which met the inclusion criteria. CN and RE extracted data. The Cochrane Collaboration's tool for assessing risk of bias was used. CN contacted trial authors to clarify details. MAIN RESULTS: Thirteen reports from five studies with a combined total of 450 patients were included. Rates of recanalization were higher following EVLT compared with HL/S, both early (within four months (5/149 versus 0/100; odds ratio (OR 3.83, 95% confidence interval (CI 0.45 to 32.64 and late recanalization (after four months (9/118 versus 1/80; OR 2.97; 95% CI 0

Thrombosed aneurysm of saphenous vein coronary artery bypass grafting

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Queiroz, Rodolfo Mendes; Nastri Filho, Rogerio; Ferez, Marcus Antonio; Costa, Mauro Jose Brandao da; Laguna, Claudio Benedini; Valentin, Marcus Vinicius Nascimento, E-mail: rod_queiroz@hotmail.com [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

2017-06-15

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)

Endovenous laser ablation of the great saphenous vein using a bare fibre versus a tulip fibre: a randomised clinical trial.

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

2012-12-01

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.

Antagonism of lateral saphenous vein serotonin receptors from steers grazing endophyte-free, wild-type, or novel endophyte-infected tall fescue

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Pharmacologic profiling of 5-hydroxytryptamine (5HT) receptors of bovine lateral saphenous vein has shown that cattle grazing endophyte-infected (Neotyphodium coenophialum) tall fescue (Lolium arundinaceum) have altered responses to ergovaline (ERV), 5HT, 5HT2A and 5HT7 agonists. To determine if 5HT...

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

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Stefano Ricci

2017-07-01

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.

Evaluation of the pharmacokinetics of imipenem following regional limb perfusion using the saphenous and the cephalic veins in standing horses.

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

2017-10-01

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.

Comparison between the STENTYS self-apposing bare metal and paclitaxel-eluting coronary stents for the treatment of saphenous vein grafts (ADEPT trial)

NARCIS (Netherlands)

A.J.J. IJsselmuiden (Alexander); C. Simsek (Cihan); Van Driel, A.G. (A. G.); Bouchez, D. (D.); G. Amoroso (Giovanni); P. Vermeersch (Paul); Karjalainen, P.P. (P. P.)

2018-01-01

textabstractAims To describe the safety and performance of STENTYS self-expandable bare metal stents (BMS) versus paclitaxel-eluting stents (PES) in saphenous vein grafts (SVGs). Methods and Results A randomised controlled trial was performed in four hospitals in three European countries between

Analysis of the 5-HT receptor in rabbit saphenous vein exemplifies the problems of using exclusion criteria for receptor classification.

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Martin, G R; MacLennan, S J

1990-08-01

5-Hydroxytryptamine (5-HT) contracts ring preparations of rabbit saphenous vein via direct and indirect components, the latter being compatible with a "tyramine-like" action at sympathetic nerve terminals. Here an attempt was made to establish the identity of the receptor mediating contraction directly, in terms of the currently accepted proposals (Bradley et al. 1986). Results with agonists suggested 5-HT1-like receptor activation: methylsergide behaved as a partial agonist with microcolar affinity and 5-HT effects were mimicked by 5-carboxamidotryptamine (5-CT) and GR43175. The agonist potency order was 5-CT greater than 5-HT greater than methysergide greater than or equal to GR43175, the same as that reported at the 5-HT1-like receptor in dog saphenous vein (Feniuk et al. 1985; Humphrey et al. 1988). Consistent with this, 5-HT effects were resistant to blockade by the selective 5-HT3 receptor antagonist MDL72222 (1.0 mumol/l). In contrast, methiothepin (0.01-0.3 mumol/l), ketanserin (0.3-30.0 mumol/l) and spiperone (0.3-30.0 mumol/l) each produced surmountable antagonism which, although competitive in nature only for methiothepin (pKB = 9.45 +/- 0.09, 17 d.f.), implied 5-HT2 receptor involvement. The possibility that these discrepancies resulted from mixed populations of 5-HT1-like and 5-HT2 receptors can be excluded because; 1). Ketanserin and spiperone blocked the actions of 5-HT and the selective 5-HT1-like receptor agonist GR43175 with equal facility and 2). Responses to all of the agonists studied were similarly antagonised by flesinoxan (pKB approximately 6.4), a simple competitive antagonist at the receptor in rabbit saphenous vein.(ABSTRACT TRUNCATED AT 250 WORDS)

Endovenous Laser Ablation of the Small Saphenous Vein Sparing the Saphenopopliteal Junction

International Nuclear Information System (INIS)

Janne d'Othee, Bertrand; Walker, T. Gregory; Kalva, Sanjeeva P.; Ganguli, Suvranu; Davison, Brian

2010-01-01

To assess outcomes after endovenous laser ablation (EVLA) of the small saphenous vein (SSV). Retrospective review was performed of all consecutive EVLA procedures performed over a 39-month period at three neighboring vein practices for symptomatic, duplex ultrasound-proven incompetence of the SSV. EVLA was performed under ultrasound guidance with an 810- or 980-nm diode laser in continuous mode using the pullback method while sparing the deep, most cephalad segment of the SSV near the saphenopopliteal junction. Follow-up after EVLA included patient symptoms, physical examination, and duplex ultrasound. Pretreatment variables were similar across all three practices. EVLA was performed to treat 67 incompetent SSVs in 63 patients (86% women; mean age and 95% confidence interval, 50 ± 3 years; range, 20-82 years). Average energy delivered was 92 J/cm. Immediate technical success and occlusion of the treated vein at 1-2 weeks was 100%. Imaging follow-up length was 243 ± 65 days (range, 3-893 days). Clinical follow-up (243 ± 66 days) showed symptomatic improvement in 66 (99%) of 67 patients; one patient had recanalization with recurrent reflux by ultrasound (2%). Complications included one case of paresthesias lasting beyond 1 month of follow-up (2%) and three cases of superficial phlebitis (4%), but no deep vein thrombosis, skin burns, or other complications. Although ablation involved only the superficial portion of the SSV and spared its deep segment in the popliteal fossa, SSV occlusion typically extended up to the saphenopopliteal junction or to a gastrocnemial collateral, without popliteal vein involvement. EVLA of the SSV is safe and effective when the saphenopopliteal junction and popliteal fossa are avoided. This approach may help reduce the risk of paresthesias or other complications while maintaining low recanalization rates.

Idiopathic great saphenous phlebosclerosis.

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Ahmadreza Jodati

2013-06-01

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.

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

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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)

2016-06-15

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.

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

International Nuclear Information System (INIS)

Kim, Jun Seok; Park, Sang Woo; Yun, Ik Jin; Hwang, Jae Joon; Lee, Song Am; Chee, Hyun Keun; Hwang, Jin Ho

2016-01-01

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

[Value of preserved saphenous vein graft for the creation of access ports in hemodialyzed patients: report of 309 cases].

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Schneider, Marc; Barrou, Benoît; Cluzel, Philippe; Hamani, Aziz; Bitker, Marc-Olivier; Richard, François

2003-09-01

Biological grafts are rarely used for the creation of vascular access, despite their many advantages. Our group prefers to use distal vascular accesses with interposition of a biological graft when direct access cannot be achieved. The objective of this study was to determine the long-term patency and the complication rate of a series of 309 vascular access procedures using a preserved saphenous (PS) vein homograft. 410 (27%) of the 1,500 vascular access procedures performed by our group required the use of a graft, including 376 PS vein homografts (25%). This retrospective study comprised complete data collection for 309 arteriovenous fistulas (AVF) using preserved saphenous (PS) vein graft in the forearm performed in 267 patients between 1985 and 2000. Primary patency was defined as the interval between creation of the vascular access and the first complication requiring surgical or radiological correction; secondary patency was defined as the interval between creation and loss of the graft, with or without revision of the fistula. Survival rates were calculated according to the Kaplan-Meier method. Inter-group comparison was performed by the Logrank test and analysis of variance was performed by logistic regression. Primary patency rates were 77%, 40% and 27% at 1,2 and 5 years, respectively. Secondary patency rates were 79% and 47% at 1 year and 5 years, respectively. The thrombosis rate was 42%. Two episodes of thrombosis occurred in 25% of grafts and 3 episodes were observed in 10% of cases. Infection rates were 1.9% postoperatively and 5% after dialysis, respectively. An aneurysm occurred on 10% of grafts. The operator's experience (RR = 1.58; p creation of vascular accesses with similar patency rates to those of prosthetic grafts. Vein grafts present a number of advantages, particularly a greater ease of use facilitating distal implantation of the graft and a low infection rate.

Angiographic predictors of 3-year patency of bypass grafts implanted on the right coronary artery system: a prospective randomized comparison of gastroepiploic artery, saphenous vein, and right internal thoracic artery grafts.

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Glineur, David; D'hoore, William; de Kerchove, Laurent; Noirhomme, Philippe; Price, Joel; Hanet, Claude; El Khoury, Gebrine

2011-11-01

Saphenous vein, in situ right gastroepiploic artery, and right internal thoracic artery grafts are routinely used to revascularize the right coronary artery. Little is known about the predictive value of objective preoperative angiographic parameters on midterm graft patency. We prospectively enrolled 210 consecutive patients undergoing coronary revascularization. Revascularization of the right coronary artery was randomly performed with the saphenous vein grafts in 81 patients and the right gastroepiploic artery in 92 patients. During the same study period, 37 patients received right coronary artery revascularization with the right internal thoracic artery used in a Y-composite fashion. All patients underwent a protocol-driven coronary angiogram 3 years after surgery. Preoperative angiographic parameters included minimum lumen diameter percent stenosis measured by quantitative angiography. A graft was considered "not functional" with patency scores of 0 to 2 and "functional" with patency scores of 3 or 4. Angiographic follow-up was 100% complete. A significant difference in the distribution of flow patterns was observed in the 3 groups. In multivariate analysis, the use of a saphenous vein graft was associated with superior graft functionality compared with the other conduits (odds ratio, 6.1; 95% confidence interval, 2.4-15). Graft function was negatively influenced by the minimum lumen diameter (odds ratio, 0.11; confidence interval, 0.05-0.25). In the right gastroepiploic artery and right internal thoracic artery groups, the proportion of functional grafts was higher when the minimum lumen diameter was below a threshold value in the third minimum lumen diameter quartile (0.64-1.30 mm). Preoperative angiography predicts graft patency in the right gastroepiploic artery and right internal thoracic artery, whereas the flow pattern in saphenous vein grafts is significantly less influenced by quantitative angiographic parameters. Copyright © 2011 The American

Varicose vein therapy and nerve lesions.

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Hirsch, Tobias

2017-03-01

Treating varicose veins using endovenous thermal techniques - especially laser and radio frequency ablation - has emerged as an effective alternative to open surgery with stripping and high ligation. Even though these methods are very gentle and patient-friendly, they are nevertheless accompanied by risks and side effects. Compared to open surgical therapy, the risk of damage to peripheral and motor nerves is reduced; however, it still exists as a result of heat exposure and tumescent anaesthesia. Non-thermal methods that can be applied without tumescent anaesthesia have been introduced to the market. They pose a considerably lower risk of nerve lesions while proving to be much more effective. This paper investigates data on postoperative nerve damage and paraesthesia using internet research (PubMed). It analyses the current state of knowledge regarding non-thermal treatment methods and takes into account the latest developments in the use of cyanoacrylate to close insufficient saphenous veins.

Changes of serum IL-1 and sIL-2R levels after intravenous photo-coagulation in patients with varicose greater saphenous vein

International Nuclear Information System (INIS)

Han Li'na; Gu Ying; Liu Fanguang

2004-01-01

Objective: To determine the changes of serum interleukin 2 (IL-2) and soluble interleukin 2 receptor (sIL-2R) levels in patients with varicose greater saphenous vein after intravenous photocoagulation. Methods: Fifty patients with varicose greater saphenous vein were divided into two groups (mild and severe) according to their clinical symptoms. Serum IL-2 and sIL-2R levels were determined with RIA and ELISA respectively in these patients and 30 controls. Results: Serum levels of IL-2 and sIL-2R in patients of the mild group were about the same as those in the controls. In patients of the severe group, levels of IL-2 decreased and levels of sIL-2R increased significantly. After photocoagulation, the IL-2 levels dropped at first but gradually rose; the reverse was true for the sIL-2R levels. The final levels of IL-2 and sIL-2R approached those before treatment in the mild group. In the severe group, the final IL-2 levels were higher and sIL-2R levels lower than those before photocoagulation. Conclusion: Determination of serum IL-2 and sIL-2R levels revealed information about the immune status of the patients and could be applied for judgement of the treatment effect

Association of Angiotensin-Converting Enzyme Genotype, Insertion/Deletion Polymorphism and Saphenous Vein Graft Atherosclerosis in Iranian Patients

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Neda Zeinali

2015-10-01

Full Text Available ABSTRACT OBJECTIVE: The aim of this study was to evaluate possible interactions among Angiotensin-I converting enzyme genotype, insertion/deletion polymorphism and atherosclerosis of vein grafts in Iranian patients, and characterize their clinical and demographic profile. METHODS: In this cross-sectional study, patients who underwent coronary artery bypass graft surgery more than five years ago, were included for angiographic analysis. Atherosclerosis was determined by quantitative angiography and adjusted Gensini score. The gene angiotensin converting enzyme I/D polymorphism was detected by polymerase chain reaction. RESULTS: A total of 102 patients participated in this study. Eighty-four patients were male. The frequency distribution of DD, ID and II polymorphism were 23.6%, 62.7% and 13.7% respectively. There were no differences among genotypic groups in age, sex, number of risk factors, number of vein grafts and months since bypass surgery. According to adjusted Gensini score [0.18±0.12 (II vs. 0.11±0.09 (ID and 0.1±0.09 (DD P=0.021] the II genotype was associated with severity of vein graft atherosclerosis. CONCLUSION: Although there are conflicting results about gene angiotensin converting enzyme I/D polymorphism and the degree of venous bypass graft degeneration, this study suggests an association between ACE genotype II and atherosclerosis of saphenous vein grafts, however, large samples considering clinical, demographic and ethnic profile are necessary to confirm these results.

Classical varicose vein surgery in a diverse ethnic community.

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Murli, N L; Navin, I D

2008-08-01

). Indians had the highest rate of venous ulcers (35.2% of all Indians treated) possibly due to their high BMI and low socioeconomic background. In cases of venous ulcers, gram negative infections (49.8%) were more common than gram positive infections at 18.8%. Operative procedures performed included great saphenous vein high ligation in 96.5% of cases, stripping 93.5% and multiple avulsions in 98.5%, saphenous popliteal junction ligation with multiple avulsions in 13.0% and subfascial ligation in 10.5%. Operative complications included induration (40.0% of cases), bruising in 49.5%, pains in 15.0%, paraesthesia in 3.5%, wound infection in 4.0%, deep venous thrombosis in 3.0% and ulcer recurrence in 7.5%. A total of 96.2% of patients treated expressed satisfaction with varicose vein surgery. Late presentations of chronic venous insufficiency, possibly as a result of poor understanding and inadequate education on diet, weight control, use of stockings and change in lifestyle by patients, employers and general practitioners are probably the cause of high rates of severe chronic venous disease especially venous ulcerations in the local community. However, classical varicose vein surgery is widely applicable across diverse ethnicities with a high rate of success.

Relevant factors affecting the outcome of ultrasound guided foam sclerotherapy of the great saphenous vein

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Giorgio Falaschi

2013-09-01

Full Text Available Ultrasound guided foam sclerotherapy (UGFS constitutes a valid ablative treatment for superficial vein diseases for the great saphenous vein (GSV, but no standardized protocol for its execution has yet been defined. Different variable factors involved in this procedure influence the final outcome and clinical results. The aim of our study was to analyze the respective influence on efficacy and side effects of three variable factors (foam volume, foam concentration, and contact time between the foam and the endothelium for UGFS procedures for GSV insufficiency in order to select the best protocol for treatment. A retrospective analysis was made of UGFS procedures (190 patients, 201 legs performed for GSV insufficiency in our institute from January 2007 to January 2010. All great saphenous veins included in our study exhibited a trans-ostial reflux and caliber range was 7-11 mm. In all cases, foam was prepared according to the Tessari method, using polidocanol (POL and a gas mixture of CO2 (70% and filtered room air (30%, in a proportion of 1:4. A single injection procedure in the GSV was performed under Doppler ultrasound guidance at mid to lower third of the thigh. Legs were randomly assigned to one of three different treatment protocols: - Group A (71 legs: POL 3%, mean foam volume 4.5 cc, intermittent groin pressure 5 min, supine bed rest 10 min; - Group B (61 legs: POL 2%, mean foam volume 9 cc, intermittent groin pressure 5 min, supine bed rest 10 min; - Group C (69 legs: POL 2%, mean foam volume 9 cc, continuous groin pressure 5 min followed by intermittent groin pressure 5 min, continuous leg compression 5 min, supine bed rest 10 min. Efficacy of treatment and occurrence of side effects were evaluated in each group at two weeks and again at two years after the procedure and the cumulative results compared. Analysis of outcomes did not show any significant difference between the complete obliteration rate (P=0.825 or occurrence of local

Effect of ticlopidine on the long-term patency of saphenous-vein bypass grafts in the legs. Etude de la Ticlopidine après Pontage Fémoro-Poplité and the Association Universitaire de Recherche en Chirurgie.

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Becquemin, J P

1997-12-11

Optimal therapy to prevent late occlusion of arterial bypass grafts in the legs has not been determined. We assessed the effect of ticlopidine, an inhibitor of platelet aggregation, on the long-term patency of saphenous-vein bypass grafts for the treatment of peripheral vascular disease. A total of 243 patients with femoropopliteal or femorotibial saphenous-vein bypass grafts were randomly assigned to receive either ticlopidine (250 mg twice a day) or matching placebo for two years. The primary end point was graft patency at two years, as assessed by physical examination, measurement of the ankle brachial index, and duplex ultrasonography or arteriography. The incidence of death and major ischemic events was also analyzed in the two groups. After two years, 66.4 percent of the patients were alive with a patent graft in the ticlopidine group, as compared with 51.2 percent in the placebo group (95 percent confidence interval for the difference between the two groups, 2.9 to 27.4 percent; P=0.02). The two-year cumulative patency rate was 82 percent in the ticlopidine group and 63 percent in the placebo group (P=0.002). There was no significant difference between groups in overall mortality or major ischemic events. Ticlopidine significantly improved the long-term patency of saphenous-vein bypass grafts in the legs. Since the drug was well tolerated, its use can be recommended after peripheral-vein bypass surgery.

Adolescent External Iliac Artery Trauma: Recurrent Aneurysmal Dilatation of an Iliofemoral Saphenous Vein Graft Treated by Stent-Grafting

International Nuclear Information System (INIS)

Lenton, James; Davies, John; Homer-Vanniasinkam, S.; McPherson, Simon

2008-01-01

An adolescent male sustained a severe penetrating injury to the external iliac artery. Emergency surgical revascularization was with a reversed long saphenous vein interposition graft. The primary graft and the subsequent revision graft both became aneurysmal. The second graft aneurysm was successfully excluded by endovascular stent-grafts with medium-term primary patency. A venous graft was used initially rather than a synthetic graft to reduce the risk of infection and the potential problems from future growth. Aneurysmal dilatation of venous grafts in children and adolescents is a rare but recognized complication. To the best of our knowledge, exclusion of these aneurysms with stent-grafts has not been previously reported in the adolescent population.

Prospectively randomized clinical trial to compare in situ and reversed saphenous vein grafts for femoropopliteal bypass.

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Harris, P L; How, T V; Jones, D R

1987-04-01

Two hundred and fifteen femoropopliteal bypass procedures using autologous saphenous vein grafts were randomly allocated to either the reversed or in situ technique. Eleven veins (5 per cent) were rejected at operation on the basis of their small size, nine in the reversed group and two in the in situ group, and there were two (2 per cent) perioperative deaths in each group, leaving 102 reversed and 98 in situ grafts for further study. The cumulative patency at 3 years of the reversed grafts was 77 per cent and that of the in situ grafts was 68 per cent (n.s.). The patency of all grafts was affected adversely by small veins (P less than 0.005), long grafts (P less than 0.05), low volume of blood flow in the grafts (P less than 0.001) and poor run-off (P less than 0.05). These factors influenced the outcome of the in situ and reversed operations to a similar degree and there was no statistically significant difference between them within any subgroup. The mean compliance of the in situ grafts measured 3 months or more after operation with an ultrasonic echo-tracking system was 0.024 +/- 0.01 per cent/mmHg (+/- s.d.) compared with 0.017 +/- 0.01 per cent/mmHg for the reversed grafts (t = 2.43, P less than 0.02). The incidence of fibrous stricture formation as shown by intravenous digital subtraction angiography was 29 per cent in both the reversed and the in situ grafts. The results of the study to date indicate that reversed and in situ vein grafts are equally effective for femoropopliteal bypass.

Simultaneous evaluation of the pre- and postsynaptic interactions of alpha-2 adrenergic agents in the phenoxybenzamine-treated dog saphenous vein

International Nuclear Information System (INIS)

Buckner, S.; Morse, P.; DeBernardis, J.; Kyncyl, J.

1986-01-01

Functional alpha-2 adrenergic receptors can be demonstrated on both the neuronal and muscular sides of the sympathetic synapse in the superfused, electrically stimulated, 3 H-NE-loaded dog saphenous vein (DSV). Selective alkylation of the alpha-1 subtype in this tissue by phenoxybenzamine produced a preparation which contained functional alpha adrenergic receptors of only the alpha-2 subtype at both locations and provided an experimental model suitable for differentiating alpha-2 selective compounds according to their pre- vs postsynaptic preference. A number of standard alpha-2 selective agonists and antagonists were tested in this model. None of these agents exhibited any significant degree of presynaptic or postsynaptic selectivity

The clinical efficacy evaluation of transcatheter hardening treatment for varicose veins of lower extremity

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Chen Junhui; Ren Yi; He Ping; Xiong Hongli; Wang Li; Zhou Xianbo

2007-01-01

Objective: To explore the clinical efficacy and safety of transcatheter absolute ethanol injection treatment on varicose veins of lower extremity. Methods: twenty-there patients with 25 varicose veins of lower extremity were treated by puncture of great saphenous vein above 1-2 cm of complicated inner ankle, perforating catheter to the point below the 3-4 cm of the conjunction of great saphenous vein and Femoral vein and pressing the conjunction of these two veins. Under the monitor of DSA, inject the absolute ethanol slowly while retrieve the catheter little by little (one limb with varicose veins injected total volume 15-20 mi), in the mean time, using contrast agent to monitor the level of embolism until the formation of total embolism in the all great saphenous veins. Results: All the cases were retrospectively followed up with CDFI examination after 3-12 months of the surgery, No blood flow were seen in the 25 embolismic great saphenous vein. Clinical symptom were alleviated obviously after 2-3 weeks of treatment; varicose veins were collapse after 3 to 7 days. Two cases of leg ulceration were healed after 4 to 6 weeks of operation. 20 limbs were found mild swelling in the 2 day after the surgery. However, all the cases were disappeared after 1 to 2 weeks; 4 treated limbs developed delayed paresthesia in the 3 day after the surgery, and recovered totally in the 2 weeks. No complications of deep vein thrombosis, lung thrombosis etc al, were found after operation. Conclusions: Using transcatheter injection of absolute ethanol to treat varicose veins of lower extremity has the advantage of less invasion, more safety and low appearance of complications. The short term efficacy is solid while the long term effect needs further evaluation. (authors)

Deep venous thrombosis after saphenous endovenous radiofrequency ablation: is it predictable?

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Jacobs, Chad E; Pinzon, Maria Mora; Orozco, Jennifer; Hunt, Peter J B; Rivera, Aksim; McCarthy, Walter J

2014-04-01

Endovenous radiofrequency ablation (RFA) is a safe and effective treatment for varicose veins caused by saphenous reflux. Deep venous thrombosis (DVT) is a known complication of this procedure. The purpose of this study is to describe the frequency of DVT after RFA and the associated predisposing factors. A retrospective analysis was performed using prospectively collected data from December 2008 to December 2011; a total of 277 consecutive office-based RFA procedures were performed at a single institution using the VNUS ClosureFast catheter (VNUS Medical Technologies, San Jose, CA). Duplex ultrasonography scans were completed 2 weeks postprocedure in all patients. Risk factors assessed for the development of DVT included: great versus small saphenous vein (SSV) treated, right versus left side treated, number of radiofrequency cycles used, hypercoagulable state, history of DVT, tobacco use, medications (i.e., oral contraceptives, aspirin, warfarin, and clopidogrel), and vein diameter at the junction of the superficial and deep systems. Seventy-two percent of the patients were women, 56% were treated on the right side, and 86% were performed on the great saphenous vein (GSV). The mean age was 54 ± 14 years (range: 23-88 years). Three percent of patients had a preprocedure diagnosis of hypercoagulable state, and 8% had a history of previous DVT. On postprocedural ultrasound, thrombus protrusion into the deep system without occlusion (endovenous heat-induced thrombosis) was present in 11 patients (4%). DVT, as defined by thrombus protrusion with complete occlusion of the femoral or popliteal vein, was identified in 2 patients (0.7%). Previous DVT was the only factor associated with postprocedural DVT (P = 0.018). Although not statistically significant, there was a trend toward a higher risk of DVT in SSV-treated patients. Factors associated with endovascular heat-induced thrombosis alone were male sex (P = 0.02), SSV treatment (P = 0.05), aspirin use (P = 0.008), and

Venous filling time using air-plethysmography correlates highly with great saphenous vein reflux time using duplex.

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Lattimer, C R; Azzam, M; Kalodiki, E; Geroulakos, G

2014-03-01

Venous filling time (VFT90) is the time taken to reach 90% of the venous volume in the calf. It is recorded by air-plethysmography (APG(®)) and is assumed to measure global venous reflux duration. However, this has never been confirmed by duplex. The aim of the study was to compare VFT on APG to venous reflux time/duration (RT) measured simultaneously with duplex on the same patients. Twenty-six consecutive patients, M:F = 16:10, age (25-78), C1 = 1, C2 = 4, C3 = 8, C4a = 6, C4b = 4, C5 = 2, C6 = 1, underwent simultaneous APG with duplex. The venous filling index (VFI, mL/second), VFT90 (seconds), great saphenous vein (GSV) RT on duplex, averaged thigh GSV diameter and thigh length (length) between the APG sensor air-cuff and duplex transducer were recorded. The VFT100 was calculated by VFT90/0.9. The additional time taken to fill the thigh was achieved using the VFI, length and deep vein diameter (d), to determine the corrected reflux duration: CRD = VFT100 + (length × πd(2)/4 (1/VFI)). Twenty-five patients are presented. One patient with very mild reflux (VFT90 = 55.9 seconds) had an indeterminate endpoint on duplex and was excluded. The median (range) VFI and GSV diameter was 4.9(1.3-15.5) mL/second and 7(4-17) mm, respectively. The VFT90 and VFT100 both correlated with RT on duplex (Spearman, P duplex RT at 24 (16.9) versus 28 (20) seconds respectively, P duplex by performing simultaneous measurements. There was an excellent correlation between the VFT90 versus duplex RT, thereby comparing reverse flow in a single superficial vein against the legs overall venous haemodynamic status. These tests can both be used in the quantification of reflux.

Management of Post-Traumatic Phlegmasia Cerulea Dolens via Right-to-Left Femoral Vein to Femoral Vein Bypass (Palma Procedure).

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Dua, Anahita; Heller, Jennifer; Lee, Cheong

2017-11-01

Phlegmasia cerulea dolens (PCD) is a rare condition resulting from venous occlusion that impairs arterial flow. We report a rare case of post-traumatic PCD after ligation of the iliac vein with successful treatment by right-to-left femoral vein to femoral vein bypass using left great saphenous vein (Palma procedure). The clinical presentation, diagnostic process, and approach to management along with a literature review on the operative management of PCD are presented in this case report.

Endovenous radiofrequency ablation using stent-type electrode for varicose veins: an experimental study in goats

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Won, Je Hwan; Han, Jae Ho; Oh, Chang Kwon [Ajou University Hospital, Suwon (Korea, Republic of); Kwak, Young Lan [Yonsei University College of Medicine, Seoul (Korea, Republic of); Park, Sung Il [Ulsan University GangNeung Asan Hospital, Gangeung (Korea, Republic of)

2004-10-15

The purpose of this study was to investigate the feasibility and the optimal conditions of radiofrequency (RF) ablation by using the stent-type electrode upon the saphenous vein of goats for the endovenous treatment of varicose veins. A self-expandable nitinol stent electrode (6 mm diameter, 2 cm length, cell size; 1.3 x 2 mm) was designed to expose the distal 1 cm segment to allow for contact with the venous wall. The proximal part of the electrode was connected to the RF generator by insulated copper wires located within the stent electrode introducer. Initially, to optimize the power setting, ablation of 6 saphenous veins in 3 goats was performed with power settings of 10, 20 and 30 W. Pull back rate of the electrode was 2 and 4 cm/min for each power level, respectively. The goats were sacrificed 4-6 weeks later and histologic examinations of the saphenous veins were done. For the second part of the experiment, RF ablation of 4 saphenous veins from 2 goats was done by applying the optimal power, based upon the first examination; these procedure was performed with variable pull back rates. Again, the goats were sacrificed 1-6 weeks later and histologic examinations were done. Endovenous ablation of the goat saphenous veins at 20 W caused complete obliteration without complication. There was incomplete occlusion at 10 W, and there were vessel perforation, extravasation, and adjacent tissue injury at 30 W. In second part of the study, the complete circumferential obliteration of the vein was demonstrated at a pull back rate of 1 cm/min and 3 cm/min with the power of 20 W. The stent-type electrode may be useful in endovenous RF ablation for treatment of varicose veins. For stents with a diameter of 6 mm, the optional combination of 20 W of power with a pull back rate of 1-3 cm/min produced the most favorable results. Further study and clinical investigations are warranted.

Endovenous radiofrequency ablation using stent-type electrode for varicose veins: an experimental study in goats

International Nuclear Information System (INIS)

Won, Je Hwan; Han, Jae Ho; Oh, Chang Kwon; Kwak, Young Lan; Park, Sung Il

2004-01-01

The purpose of this study was to investigate the feasibility and the optimal conditions of radiofrequency (RF) ablation by using the stent-type electrode upon the saphenous vein of goats for the endovenous treatment of varicose veins. A self-expandable nitinol stent electrode (6 mm diameter, 2 cm length, cell size; 1.3 x 2 mm) was designed to expose the distal 1 cm segment to allow for contact with the venous wall. The proximal part of the electrode was connected to the RF generator by insulated copper wires located within the stent electrode introducer. Initially, to optimize the power setting, ablation of 6 saphenous veins in 3 goats was performed with power settings of 10, 20 and 30 W. Pull back rate of the electrode was 2 and 4 cm/min for each power level, respectively. The goats were sacrificed 4-6 weeks later and histologic examinations of the saphenous veins were done. For the second part of the experiment, RF ablation of 4 saphenous veins from 2 goats was done by applying the optimal power, based upon the first examination; these procedure was performed with variable pull back rates. Again, the goats were sacrificed 1-6 weeks later and histologic examinations were done. Endovenous ablation of the goat saphenous veins at 20 W caused complete obliteration without complication. There was incomplete occlusion at 10 W, and there were vessel perforation, extravasation, and adjacent tissue injury at 30 W. In second part of the study, the complete circumferential obliteration of the vein was demonstrated at a pull back rate of 1 cm/min and 3 cm/min with the power of 20 W. The stent-type electrode may be useful in endovenous RF ablation for treatment of varicose veins. For stents with a diameter of 6 mm, the optional combination of 20 W of power with a pull back rate of 1-3 cm/min produced the most favorable results. Further study and clinical investigations are warranted

Arctigenin improves vascular tone and decreases inflammation in human saphenous vein.

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

2017-09-05

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 E 2 (PGE 2 ) 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 CaCl 2. 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.

Reduced saphenous vein prostacyclin production in the absence of endothelial detachment

International Nuclear Information System (INIS)

De Caterina, R.; Cruz-Bracho, M.R.; Alonso, D.R.; Subramanian, V.A.; Weksler, B.B.

1988-01-01

High-potassium cardioplegic solutions have been suspected of inducing vascular damage at coronary bypass surgery. In this study the authors compared prostacyclin production and endothelial morphology in saphenous vein segments perfused either with cardioplegic solutions with a potassium concentration of 20, 40 and 80 mEq/1, or with a control buffer (1) at 4 grade centigrades for 30 min; (2) at 37 grade centigrades for 15 min; (3) at 37 grade centigrades for 15 min after the addition of arachidonic acid. Prostacyclin production (6-keto-PGF 1α , pg/ml cm 2 endothelial surface area) in control treated segments was a function of temperature and of substrute availability, being (mean±SEM) 62.4±8.2 in setting (1); 309±34.7 in setting (2); and 1515.4±205.2 in setting (3). Cardioplegic solution containing 20 mEq/1 potassium did not alter prostacyclin production in any of these settings, whereas exposure of tissue to the 40 mEq/1 potassium solution decreased prostacyclin production in setting (21) and (2), and the solution containing 80 mEq/1 potassium decreased prostacyclin production in all three experimental conditions. Absence of endothelial detachment in all experimental settings was documented by immunoperoxidase staining of vascular cross-sections for the specific endothelial marker Factor VIII - related antigen and staining of ''en face'' preparations of endothelial surface with silver nitrate and silver nitrate-hematoxylin. These data indicate that cardioplegic solutions with a potassium concentration equal or greater than 40 mEq/1 can induce morphologically silent endothelial damage manifested by decreased prostacyclin production. The use of these solutions may predispose to possible thrombogenicity after coronary bypass surgery

Endovenous treatment of primary varicose veins: an effective and safe therapeutic alternative to stripping?

International Nuclear Information System (INIS)

Kluner, C.; Fischer, T.; Filimonow, S.; Hamm, B.; Kroencke, T.

2005-01-01

Endovenous laser therapy (EVLT) is a new, minimally invasive therapeutic option for treating primary varicose veins and provides an effective and safe alternative to conventional surgical management (stripping). Short-term and intermediate-term outcome is comparable to surgical stripping in terms of elimination of venous reflux (90% - 98%), resolution of visible varices (85%), and improvement of subjective complaints such as sensations of heaviness and tension (96%). Complications occur in 1% - 3% of cases, which is markedly below the rate of conventional surgical management (up to 30%). The intermediate-term incidence of recurrent varicosis in a vein treated by EVLT depends on the laser fluence applied and is reported to range from 7% - 9% compared to 10% - 20% after surgical intervention. Based on a review of the current literature and our own experience, this survey article presents an overview of the indications and contraindications, the technique and pathophysiology of laser-induced venous occlusion, and the results and possible complications of EVLT. (orig.)

Biomarkers of low-grade inflammation in primary varicose veins of the lower limbs.

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Flore, R; Ponziani, F R; Gerardino, L; Santoliquido, A; Di Giorgio, A; Lupascu, A; Nesci, A; Tondi, P

2015-02-01

To analyze serum biomarkers of CVD in selected patients with primary axial reflux of great saphenous vein in one or both lower limbs. Ninety-six patients affected by uncomplicated varicose veins, were enrolled in the study. A unilateral, primary axial reflux in great saphenous veins was detected in 54 patients (U-CVD group) and a bilateral one in 42 (B-CVD group). Sixty-five age and sex-matched subjects without venous reflux were enrolled as controls. Mean venous pressure of both lower limbs at the distal great saphenous vein (mGSVP) and venous reflux were measured by continuous-wave Doppler ultrasound and echoduplex scanning, respectively. Reactive Oxygen Species (ROS), tissue Plasminogen Activator (t-PA) and its Inhibitor 1 (PAI-1) activities, Hematocrit (HTC), White Blood Cells (WBC), Neutrophyls (NEU), Platelets (PLT), Fibrinogen (FIB) and Blood Viscosity (BV) were assessed in blood samples drawn from the antecubital vein. B-CVD group showed higher fibrinogen values (p < 0.005) and higher mean venous pressure (0 < 0.0001) in comparison to controls, while U-CVD did not. No difference was found between both groups and controls for all the other parameters. Increased fibrinogen levels in patients with bilateral varicose veins may represent an early warning signal, as it could be associated to the long-term progression of chronic venous disease.

Aorto-right atrial fistula secondary to rupture of an occluded old saphenous venous graft to right coronary artery.

Science.gov (United States)

Balestrini, Carlos Sebastian; Saaibi, José Federico; Ortiz, Santiago Navas

2014-09-01

We report a case of an acquired aorta-right atrial fistula, secondary to a ruptured proximal anastomosis of an old saphenous vein graft 12 years after a coronary artery bypass surgery, in a 57 year old patient with multiple cardiovascular risk factors. On admission, he presented with congestive heart failure and on examination a continuous murmur was detected on the right parasternal border. Catheterization showed a fistula from the proximal anastomosis of an occluded right coronary artery saphenous vein graft draining to the right atrium with a large left to right shunt. The fistula was successfully occluded by a percutaneous approach with a Life Tech duct occluder with complete resolution of heart failure. The patient was discharged one week afterwards. After a two-year follow-up, the fistula remained occluded. © 2013 Wiley Periodicals, Inc.

A randomized comparison of the Saphenous Vein Versus Right Internal Thoracic Artery as a Y-Composite Graft (SAVE RITA) trial: One-year angiographic results and mid-term clinical outcomes.

Science.gov (United States)

Kim, Ki-Bong; Hwang, Ho Young; Hahn, Seokyung; Kim, Jun Sung; Oh, Se Jin

2014-09-01

The Saphenous Vein Versus Right Internal Thoracic Artery as a Y-Composite Graft (SAVE RITA) trial was designed to evaluate the noninferiority of the saphenous vein (SV) compared with the right internal thoracic artery ([R]ITA) used as a Y-composite graft. A total of 224 patients who had undergone off-pump revascularization for multivessel coronary artery disease using the SV or RITA as a Y-composite graft based on the in situ left ITA were assigned randomly to the SV Y-composite graft (SV group, n = 112) or free RITA Y-composite graft (RITA group, n = 112). The primary endpoint was the 1-year angiographic patency rate of the second limb conduits (SV or RITA). Postoperative 1-year coronary angiograms were performed in 215 patients (SV group, 108; RITA group, 107). The overall graft patency rate was 97.4% (745 of 765) at 1 year (97.9% in the SV group vs 96.9% in the RITA group, P = .362). The primary endpoint of the study, the 1-year patency rate of the SV composite grafts, was 97.1% (238 of 245) and was noninferior to that of the RITA composite grafts (97.1% [198 of 204]) with a 95% lower confidence limit of -2.6% (P RITA composite grafts in terms of the 1-year angiographic patency rates. Copyright © 2014 The American Association for Thoracic Surgery. Published by Mosby, Inc. All rights reserved.

Ultrasonographic analysis in vitro of parietal thickness of lower limb varicose veins.

Science.gov (United States)

Bruschi, E; Como, G; Zuiani, C; Segatto, E; Rocco, M; Biasi, G; Bazzocchi, M

2006-09-01

The aim of this study was to evaluate the ability of ultrasound (US) to measure the parietal thickness of varicose veins. In a blind in vitro analysis, 28 great saphenous veins, obtained after stripping surgery from 28 patients with chronic venous insufficiency, were examined with a digital US scanner ATL-HDI5000, linear 5-1 to 2-MHz broadband probe, compound imaging technique and analogic-digital zooming. We obtained one to three progressive measurements for each vein wall (total 67 parietal thicknesses). The samples, fixed in formalin, were sent to the pathology laboratory: sections were obtained at the same level of the sonographic planes, and images were obtained by digital camera mounted on an optical microscope. Measurements obtained at histology were considered as the gold standard. K-statistic was applied to compare sonographic and histologic measurements. Considering only the hypoechoic wall portion, 29/29 (100%) diagnoses of hypotrophy (K=0.91), 19/22 (86%) diagnoses of normotrophy (K=0,47) and 12/16 (75%) diagnoses of hypertrophy (K=0.7) were obtained by sonography. In our preliminary experience, the in vitro study of varicose veins allows precise, at least morphological, detection of hypotrophic walls. If these preliminary data are confirmed in vivo, sonography could be used to discriminate patients eligible for conservative treatment instead of surgery.

Persistent below-knee great saphenous vein reflux after above-knee endovenous laser ablation with 1470-nm laser: a prospective study

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Walter Junior Boim de Araujo

2016-01-01

Full Text Available Abstract Background In endovenous laser ablation (EVLA, the great saphenous vein (GSV is usually ablated from the knee to the groin, with no treatment of the below-knee segment regardless of its reflux status. However, persistent below-knee GSV reflux appears to be responsible for residual varicosities and symptoms of venous disease. Objectives To evaluate clinical and duplex ultrasound (DUS outcomes of the below-knee segment of the GSV after above-knee EVLA associated with conventional surgical treatment of varicosities and incompetent perforating veins. Methods Thirty-six patients (59 GSVs were distributed into 2 groups, a control group (26 GSVs with normal below-knee flow on DUS and a test group (33 GSVs with below-knee reflux. Above-knee EVLA was performed with a 1470-nm bare-fiber diode laser and supplemented with phlebectomies of varicose tributaries and insufficient perforating-communicating veins through mini-incisions. Follow-up DUS, clinical evaluation using the venous clinical severity score (VCSS, and evaluation of complications were performed at 3-5 days after the procedure and at 1, 6, and 12 months. Results Mean patient age was 45 years, and 31 patients were women (86.12%. VCSS improved in both groups. Most patients in the test group exhibited normalization of reflux, with normal flow at the beginning of follow-up (88.33% of GSVs at 3-5 days and 70% at 1 month. However, in many of these patients reflux eventually returned (56.67% of GSVs at 6 months and 70% at 1 year. Conclusions These data suggest that reflux in the below-knee segment of the GSV was not influenced by the treatment performed.

(-)-Epicatechin-induced relaxation of isolated human saphenous vein: Roles of K+ and Ca2+ channels.

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Marinko, Marija; Jankovic, Goran; Nenezic, Dragoslav; Milojevic, Predrag; Stojanovic, Ivan; Kanjuh, Vladimir; Novakovic, Aleksandra

2018-02-01

In this study, we aimed to investigate relaxant effect of flavanol (-)-epicatechin on the isolated human saphenous vein (HSV), as a part of its cardioprotective action, and to define the mechanisms underlying this vasorelaxation. (-)-Epicatechin induced a concentration-dependent relaxation of HSV pre-contracted by phenylephrine. Among K + channel blockers, 4-aminopyridine, margatoxin, and iberiotoxin significantly inhibited relaxation of HSV, while glibenclamide considerably reduced effects of the high concentrations of (-)-epicatechin. Additionally, (-)-epicatechin relaxed contraction induced by 80 mM K + , whereas in the presence of nifedipine produced partial relaxation of HSV rings pre-contracted by phenylephrine. In Ca 2+ -free solution, (-)-epicatechin relaxed contraction induced by phenylephrine, but had no effect on contraction induced by caffeine. A sarcoplasmic reticulum Ca 2+ -ATPase inhibitor, thapsigargin, significantly reduced relaxation of HSV produced by (-)-epicatechin. These results demonstrate that (-)-epicatechin produces endothelium-independent relaxation of isolated HSV rings. Vasorelaxation to (-)-epicatechin probably involves activation of 4-aminopyridine- and margatoxin-sensitive K V channels, BK Ca channels, and at least partly, K ATP channels. In addition, not only the inhibition of extracellular Ca 2+ influx, but regulation of the intracellular Ca 2+ release, via inositol-trisphosphate receptors and reuptake into sarcoplasmic reticulum, via stimulation of Ca 2+ -ATPase, as well, most likely participate in (-)-epicatechin-induced relaxation of HSV. Copyright © 2017 John Wiley & Sons, Ltd.

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

African Journals Online (AJOL)

This novel position allowed for two members of the surgical team to operate at the same time, thus ... along the ultrasound-marked vein positions similar to when harvesting the LSV. Once the veins were harvested and ... occlusion compared to LSV grafts utilized in the same procedure,[8] it was brought back to prominence ...

Radiofrequency-induced thermal therapy: results of a European multicentre study of resistive ablation of incompetent truncal varicose veins.

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Braithwaite, B; Hnatek, L; Zierau, U; Camci, M; Akkersdijk, Gjm; Nio, D; Sarlija, M; Ajduk, M; Santoro, P; Roche, E

2013-02-01

To investigate the effectiveness of bipolar radiofrequency-induced thermal therapy (RFITT) in a multicentre non-randomized study. Some 672 incompetent saphenous veins (85% great saphenous varicose vein, 15% short saphenous vein) in 462 patients (56.5% CEAP [clinical, aetiological, anatomical and pathological elements] class 3 or worse) were treated in eight European centres. Patients were assessed between 180 and 360 days postoperatively. Occlusion rates were determined by duplex ultrasound and compared with the power used for treatment, pull back rate and experience of the operating surgeon. Complete occlusion rates of 98.4% were achieved when treatments were performed by an experienced operator (more than 20 cases), when the maximum power setting on the RFITT generator was between 18 and 20 W and the applicator was withdrawn at a rate slower than 1.5 second/cm RFITT is efficacious, well tolerated by patients and has a low incidence of procedure-related post-operative complications.

The Incidence of Giacomini Vein and Its Association with Lower Extremity venous Insufficiency: An Ultrasonographic Study

International Nuclear Information System (INIS)

Park, Soon Chan; Kwon, Se Hwan; Oh, Joo Hyeong; Ryu, Kyung Nam; Ahn, Hyung Joon; Park, Ho Chul

2009-01-01

We wanted to evaluate the incidence of Giacomini vein and its association with lower extremity venous insufficiency by performing US. From September 2006 to July 2007, 173 patients (58 males and 115 females, mean age: 52.7 years, age range: 22-72 years) who had been diagnosed with unilateral/bilateral varicose veins or telangiectasias were evaluated with duplex Doppler ultrasonography. The presence of Giacomini vein, superficial/deep vein reflux, the anatomical sites of the venous reflux and the abnormal perforating veins was investigated in 346 legs. Giacomini veins were found in 33 limbs (9.5%) of 21 patients (12.1%). Bilateral Giacomini veins were found in 12 patients. Of the 33 limbs that had Giacomini veins, 20 limbs had great saphenous vein (GSV) reflux and 4 limbs had small saphenous vein (SSV) reflux. The patients with Giacomini veins were classified into two groups according to the presence of Giacomini vein. There was no significant difference of the GSV reflux (p = 0.155), the SSV reflux (p = 0.760) and the mean velocity of the GSV reflux or the SSV reflux (p = 0.685, p = 0.431, respectively) between the two groups. Our results indicated that Giacomini vein is not associated with either GSV or SSV reflux, and this is contrary to conventional belief

Changes of plasma IL-6 and TNF-α levels during peri-operative period in patients undergoing laser photo-coagulation of greater saphenous varicosities

International Nuclear Information System (INIS)

Wang Taihan; Wang Chunxi

2005-01-01

Objective: To investigate the plasma levels of IL-6 and TNF-α during peri-operative period in patients undergoing laser photocoagulation of greater saphenous varicosities. Methods: Plasma IL-6 and TNF-α levels were determined with RIA before operation and 1, 3, 7, 14 days post-operatively in 110 patients with greater saphenous vein varicosity undergoing different forms of treatment (intravascular laser photo-coagulation 43, photo-coagulation combined with venous valve repair 35, high ligation and segmental stripping 32). Skin trophic disturbances were present in 56 of the 110 patients. Plasma IL-6 and TNF-α levels were also measured in 33 controls. Results: The plasma IL-6 and TNF-α levels in patients with skin trophic disturbances were significantly higher than those in controls (P<0.01), while levels in patients without skin lesions were not much changed. The plasma IL-6 and TNF-α levels were increased at first and dropped later to approaching pre-operative value by d14 in all the 110 patients after operation, however, the amount of increase was least and the normalization was also soonest in the simple photo-coagulation group, the reverse was true for the conventional operation group. Conclusion: Laser photo-coagulation is least stressful among the three types of operation and magnitude of changes of plasma IL-6 and TNF-α levels correctly reflects the intensity of stress. (authors)

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

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

2015-08-01

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 < .001; 95% confidence interval [CI], 0.404-0.758), primary assisted patency (HR, 0.57; P = .004; 95% CI, 0.388-0.831), and secondary patency (HR, 0.56; P = .005; 95% CI, 0.372-0.840) were predicted by GSV compared with AAV, but there was no difference between AAV and prosthetic grafts except for the primary patency, for which prosthetic was protective (HR, 0.38; P < .001; 95% CI, 0.224-0.629). Limb salvage was similar among groups. AAV conduits may not offer a significant

Surgery for acquired cardiovascular disease: antiseptic treatment of contaminated vein grafts.

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

2014-04-01

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.

[Saphenous perforator flap].

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Winkel, R; Tajsic, N; Husum, H; Schlageter, M; Hanebuth, G; Hoffmann, R

2013-04-01

Replacement of full thickness soft tissue defects in the lower leg and ankle, appropriate to the defect and following the course of blood vessels feeding the skin of a distally hinged fasciocutaneous flap most reliably based on the individual anatomy of distal perforators of the posterior tibial artery. Full thickness soft tissue defects, up to 12 cm in length and up to 8 cm in width. Sufficient vascularization of the foot required, in osteomyelitis, and when joints, fractures, implants and tendons are exposed and when a split skin graft, a local flap, a suralis perforator flap or a free flap is not indicated. For patients, in whom a 1-2 h operation is not possible; necessity of angioplasty; decollement or scars around the distal perforators of the posterior tibial artery; local infection or necrosis of soft tissues and/or bone, which cannot be totally excised. Radical debridement; flap dissection without tourniquet; microdissection; design of the flap on the skin: pivot point ~ 10 cm (6-14 cm) proximal of the tip of the medial malleolus; base ~ 5 cm in width, between the course of the saphenous nerve and of the great saphenous vein and the Achilles tendon; adipofascial pedicle up to 15 cm in length sited over the septum between soleus and flexor digitorum muscles, following the course of the saphenous nerve, with a central skin stripe, which expands into a proximal skin island; skin island is outlined similar to the defect, but larger by 1 to 2 cm, surrounded by an adipofascial border: adjustment of the planning as well as of the elevation of these flaps according to the individual position and the caliber of perforators requires in each case the search for a perforator at the estimated pivot point. Delay of transposition, if the division of more than one perforator proximal to the pivot point obviously diminishes circulation. No "tunnelling "of the pedicle; defects of skin due to the elevation of the flap are replaced by split and meshed skin grafts or temporary

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.

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

2017-07-01

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 radiofrequency 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.

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

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Waseem Al Talalwah

2016-03-01

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.

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

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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)

2013-07-01

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.

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

International Nuclear Information System (INIS)

Borges, Marcela Dias; Aguillera, André Haraguti; Brilhante, José Joaquim; Caixeta, Adriano

2013-01-01

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"™ 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"™ 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

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

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Cesar Roberto Busato

2010-09-01

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

Management Strategy for Patients With Chronic Subclavian Vein Thrombosis.

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Keir, Graham; Marshall, M Blair

2017-02-01

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.

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

Science.gov (United States)

Tang, Jianlin; Abbas, Jihad; Hoetzl, Katherine; Allison, David; Osman, Mahamed; Williams, Mallory; Zelenock, Gerald B

2014-12-01

62 year old Caucasian female with pancreatic head mass abutting the superior mesenteric vein (SMV) presented with fine needle aspiration biopsy confirmed diagnosis of ductal adenocarcinoma. CT scan showed near complete obstruction of portal vein and large SMV collateral development. After 3 months of neoadjuvant therapy, her portal vein flow improved significantly, SMV collateral circulation was diminished. Pancreaticoduodenectomy (PD) and superior mesenteric portal vein (SMPV) confluence resection were performed; A saphenous vein interposition graft thrombosed immediately. The splenic vein remnant was distended and adjacent to the stump of the portal vein. Harvesting an internal jugular vein graft required extra time and using a synthetic graft posed a risk of graft thrombosis or infection. As a result, we chose to perform a direct anastomosis of the portal and splenic vein in a desperate situation. The anastomosis decompressed the mesenteric venous system, so we then ligated the SMV. The patient had an uneventful postoperative course, except transient ascites. She redeveloped ascites more than one year later. At that time a PET scan showed bilateral lung and right femur metastatic disease. She expired 15 months after PD. 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.

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

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Rubens Pierry Ferreira Lopes

2010-12-01

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.

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

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João Antonio Corrêa

2007-06-01

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.

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

Science.gov (United States)

Tang, Jianlin; Abbas, Jihad; Hoetzl, Katherine; Allison, David; Osman, Mahamed; Williams, Mallory; Zelenock, Gerald B.

2014-01-01

62 year old Caucasian female with pancreatic head mass abutting the superior mesenteric vein (SMV) presented with fine needle aspiration biopsy confirmed diagnosis of ductal adenocarcinoma. CT scan showed near complete obstruction of portal vein and large SMV collateral development. After 3 months of neoadjuvant therapy, her portal vein flow improved significantly, SMV collateral circulation was diminished. Pancreaticoduodenectomy (PD) and superior mesenteric portal vein (SMPV) confluence resection were performed; A saphenous vein interposition graft thrombosed immediately. The splenic vein remnant was distended and adjacent to the stump of the portal vein. Harvesting an internal jugular vein graft required extra time and using a synthetic graft posed a risk of graft thrombosis or infection. As a result, we chose to perform a direct anastomosis of the portal and splenic vein in a desperate situation. The anastomosis decompressed the mesenteric venous system, so we then ligated the SMV. The patient had an uneventful postoperative course, except transient ascites. She redeveloped ascites more than one year later. At that time a PET scan showed bilateral lung and right femur metastatic disease. She expired 15 months after PD. 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. PMID:25568802

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

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Monir Abbaszadeh

2008-09-01

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

Superficial Vein Thrombophlebitis in a Football Athlete.

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Schleich, Kevin T; Smoot, M Kyle

2016-03-01

A 22-year-old professional football player presented to a preparticipation physical examination with a 2-week history of left leg discomfort extending from the groin to the knee over the previous 2 weeks. He was found to have superficial vein thrombophlebitis (SVT) of the left great saphenous vein extending from the knee to within approximately 1.6 cm of the saphenofemoral junction. There is paucity in the literature regarding the management of SVT, particularly in actively training athletes. This case addresses the considerations of anticoagulation management for SVT as well as the unique challenge of managing anticoagulation therapy in an athlete that is actively training.

Potential advantages of treatment of transplanted saphenous vein aorto-coronary artery bypass grafts with beta irradiation to prevent graft occlusion.

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Smith, R G

1997-01-01

Intimal proliferation or Neointimal hyperplasia (NIH) is a vascular lesion that often arises in arteries after balloon angioplasty or other vessel wall injuries. FIH is a vascular lesion that develops in autologous saphenous vein grafts (SVG) after transplantation into the aorto-coronary circulation or the peripheral vascular circulation. FIH shares elements of smooth muscle migration, proliferation and fibrous tissue deposition in common with nibrointimal proliferation (NIH). Either NIH of a coronary artery or FIH of a SVG obstruct the vascular lumen and result in myocardial dysfunction. Local radiotherapy has been used for several decades to reduce the post-operative recurrence of the fibrovascular proliferations of pterygia and keloids. Similarly, in animal and human experiments, endovascular radiotherapy has been shown to reduce arterial smooth muscle proliferation. Consideration of the similarities of vascular smooth muscle cell proliferation in NIH and FIH leads one to suggest that endovascular beta irradiation can reduce FIH as well as it reduces NIH. The goal of such treatment is to achieve a clinically significant decrease in the morbidity and mortality resulting from SVG occlusions. The potential for large reduction of the consequences of SVG occlusion, the very large number of patients at risk, and the simplicity of the proposed intervention encourages prompt scientific evaluation of this technique.

EVALUATION OF “SEPS” PROCEDURE IN THE MANAGEMENT OF PRIMARY VARICOSE VEINS WITH INCOMPETENT LOWER LIMB PERFORATOR

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Shaik Ahmad

2016-03-01

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

980-nm laser therapy versus varicose vein surgery in racially diverse Penang, Malaysia.

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Lakhwani, Murli N; Dadlani, Navin I; Wong, Yong C

2009-05-01

Chronic venous disorders are conditions of increasing prevalence in the developing world, and venous ulceration is the terminal sequel. Currently there are only limited data on all aspects of this from Southeast Asia. The aim of the present study was to assess differences in the demography and outcome between varicose vein surgery (VVS) and the relatively new endovenous laser therapy (EVT) in patients from Penang, Malaysia. A retrospective study was performed. Patients who presented to the outpatient clinic of the surgical department with saphenofemoral junction and/or saphenopopliteal junction incompetence associated with reflux of the great saphenous vein or small saphenous vein, respectively, underwent either surgery (1999-2004) or laser therapy (2004-2006). A single surgeon at a single institution performed all procedures. A total of 350 limbs were treated from 292 patients. Demographics, symptoms, outcomes and complications that arose in both groups were compared. There were significant improvements in pains, swelling, cramps and heaviness postoperatively (P popular as an elective procedure with its minimally invasive nature, cosmesis, rapid recovery and other advantages. Surgery remains an important and very cost-effective procedure, especially in a developing society such as Penang.

Factors affecting optimal linear endovenous energy density for endovenous laser ablation in incompetent lower limb truncal veins - A review of the clinical evidence.

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Cowpland, Christine A; Cleese, Amy L; Whiteley, Mark S

2017-06-01

Objectives The objective is to identify the factors that affect the optimal linear endovenous energy density (LEED) to ablate incompetent truncal veins. Methods We performed a literature review of clinical studies, which reported truncal vein ablation rates and LEED. A PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analysis) flow diagram documents the search strategy. We analysed 13 clinical papers which fulfilled the criteria to be able to compare results of great saphenous vein occlusion as defined by venous duplex ultrasound, with the LEED used in the treatment. Results Evidence suggests that the optimal LEED for endovenous laser ablation of the great saphenous vein is >80 J/cm and water might have a lower optimal LEED. A LEED 80 J/cm and <95 J/cm based on current evidence for shorter wavelength lasers. There is evidence that longer wavelength lasers may be effective at LEEDs of <85 J/cm.

Reduced recanalization rates of the great saphenous vein after endovenous laser treatment with increased energy dosing: definition of a threshold for the endovenous fluence equivalent.

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Proebstle, Thomas Michael; Moehler, Thomas; Herdemann, Sylvia

2006-10-01

Recent reports indicated a correlation between the amount of energy released during endovenous laser treatment (ELT) of the great saphenous vein (GSV) and the success and durability of the procedure. Our objective was to analyze the influence of increased energy dosing on immediate occlusion and recanalization rates after ELT of the GSV. GSVs were treated with either 15 or 30 W of laser power by using a 940-nm diode laser with continuous fiber pullback and tumescent local anesthesia. Patients were followed up prospectively with duplex ultrasonography at day 1 and at 1, 3, 6, and 12 months. A total of 114 GSVs were treated with 15 W, and 149 GSVs were treated with 30 W. The average endovenous fluence equivalents were 12.8 +/- 5.1 J/cm2 and 35.1 +/- 15.6 J/cm2, respectively. GSV occlusion rates according to the method of Kaplan and Meier for the 15- and 30-W groups were 95.6% and 100%, respectively, at day 1, 90.4% and 100% at 3 months, and 82.7% and 97.0% at 12 months after ELT (log-rank; P = .001). An endovenous fluence equivalent exceeding 20 J/cm2 was associated with durable GSV occlusion after 12 months' follow-up, thus suggesting a schedule for dosing of laser energy with respect to the vein diameter. Higher dosing of laser energy shows a 100% immediate success rate and a significantly reduced recanalization rate during 12 months' follow-up.

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

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Cleusa Ema Quilici Belczak

2009-03-01

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

Effects of selected combinations of tall fescue alkaloids on the vasoconstrictive capacity of fescue-naive bovine lateral saphenous veins.

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Klotz, J L; Kirch, B H; Aiken, G E; Bush, L P; Strickland, J R

2008-04-01

Vasoconstriction is a response associated with consumption of toxic endophyte-infected tall fescue. It is not known if endophyte-produced alkaloids act alone or collectively in mediating the response. Therefore, the objective of this study was to examine the vasoconstrictive potentials of selected ergot alkaloids, individually or in paired combinations, using bovine lateral saphenous veins biopsied from fescue-naïve cattle. Segments (2 to 3 cm) of vein were surgically biopsied from healthy crossbred yearling heifers (n = 22; 330 +/- 8 kg of BW). Veins were trimmed of excess fat and connective tissue, sliced into 2- to 3-mm sections, and suspended in a myograph chamber containing 5 mL of oxygenated Krebs-Henseleit buffer (95% O(2)/5% CO(2); pH = 7.4; 37 degrees C). Increasing doses of ergovaline, lysergic acid, and N-acetylloline individually or in combination were evaluated. Contractile data were normalized as a percentage of the contractile response induced by a reference dose of norepinephrine (1 x 10(- 4) M). Increasing concentrations of lysergic acid did not result in an appreciable contractile response until the addition of 1 x 10(- 4) M lysergic acid. In contrast, the vascular response to increasing concentrations of ergovaline was apparent at 1 x 10(- 8) M and increased to a maximum of 104.2 +/- 6.0% with the addition of 1 x 10(- 4) M ergovaline. The presence of N-acetylloline did not alter the onset or magnitude of vascular response to either lysergic acid or ergovaline. The presence of 1 x 10(- 5) M lysergic acid with increasing concentrations of N-acetylloline and ergovaline generated an increased contractile response during the initial additions compared with the responses of N-acetylloline and ergovaline alone. In the presence of 1 x 10(- 7) M ergovaline, the contractile response increased with increasing concentrations of N-acetylloline and lysergic acid. Neither N-acetylloline nor lysergic acid elicited an intense contractile response individually

Clinical anatomy of the donor zone of venous flaps of forearm

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O. S. Kurochkina

2012-01-01

The variant anatomy of saphenous veins of forearm in the zones of venous flap rising remains unstudied yet, as well as the influence of the valve apparatus of saphenous veins on the arterial perfusion of venous flaps. The paper studies the variant anatomy of saphenous veins of the upper third of the volar surface of forearm. Two versions of saphenous veins are revealed: major (axial) and retiform. It is found experimentally that the valve apparatus of saphenous veins does not influence consid...

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

Endovascular Radiofrequency Ablation for Varicose Veins

Science.gov (United States)

2011-01-01

of 5 years and the disposables (catheter, sheath, guidewire) with a cost of $673 per case. The average case cost for RFA was therefore estimated to be $1,356. One-way sensitivity analysis was also conducted with hospital cost of RFA varied to 60% that of vein stripping surgery (average cost per case = $627.08) to calculate an impact to the province. Historical volumes of vein stripping surgeries in Ontario were used to project surgeries in a linear fashion up to five years into the future. Volumes for RFA and ELT were calculated based on share capture from the surgery market based on discussion with clinical expert opinion and existing private data based on discussion with the manufacturer. RFA is expected to compete with ELT and capture some of the market. If ELT is reimbursed by the public sector then numbers will continue to increase from previous private data and share capture from the conventional surgical treatment market. Therefore, RFA cases will also increase since it will be capturing a share of the ELT market. A budget impact to the province was then calculated by multiplying volumes by the cost of the procedure. RFA is comparable in clinical benefits to vein stripping surgery. It has the extra upfront cost of the generator and cost per case for disposables but does not require an operating theater, anaesthetist or surgical assistant fees. The impact to the province is expected to be 5 M by Year 5 with the introduction of new ELT and RFA image guided endovascular technologies and existing surgery for varicose veins. Conclusion The conclusions on the comparative outcomes between endovascular RFA and surgical ligation and saphenous vein stripping and between endovascular RFA and laser ablation for VV treatment are summarized in the table below (ES Table 1). ES Table 1 Outcome comparisons of RFA vs. surgery and RFA vs ELT for varicose veins Outcome Comparisons RFA vs Surgery RFA vs ELT Post procedural pain, minor complications RFA Surgery RFA ? ELT Patient

Clinical anatomy of the donor zone of venous flaps of forearm

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O. S. Kurochkina

2012-01-01

Full Text Available The variant anatomy of saphenous veins of forearm in the zones of venous flap rising remains unstudied yet, as well as the influence of the valve apparatus of saphenous veins on the arterial perfusion of venous flaps. The paper studies the variant anatomy of saphenous veins of the upper third of the volar surface of forearm. Two versions of saphenous veins are revealed: major (axial and retiform. It is found experimentally that the valve apparatus of saphenous veins does not influence considerably the arterial perfusion of venous flaps of forearm.

Varicose Vein Stripping Under Low-Dose Spinal Anaesthesia

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Nalan Muhammedoğlu

2014-03-01

Full Text Available Aim: Spinal anesthesia is frequently used for procedures involving the lower limbs. Compared with general anesthesia, low-dose spinal anesthesia is a cost-effective method and has advantages such as avoiding hypotension, longer duration of anesthesia and increased length of hospitalization. The aim of this trial was to compare two different low-dose bupivacaine drug regimens. Methods: Sixty unpremedicated patients were randomly allocated into two groups (n=30. There were no differences between the groups in age, weight, the American Society of Anesthesiologists (ASA physical status classification, gender, and duration of surgery. We performed spinal anesthesia at the L3-4 interspace with the patient in the lateral decubitus position. We administered 6.5 mg (group 1 and 8 mg (group 2 0.5% heavy bupivacaine into the subarachnoid space. We positioned the patient laterally to the operation side for 15 minutes, then, turned to supine position. Motor and sensory block was assessed by the Bromage scale and pinprick test. Results: There were significant differences between the two groups in duration of motor block, but no significant differences in hemodynamic response to spinal anesthesia. None of the patients had intraoperative pain. Five patients in group 1 and 2 patients in group 2 had urinary retention. Conclusion: Our observations suggest that 6.5 mg heavy bupivacaine is efficient and suitable for unilateral varicose veins stripping operation. (The Me­di­cal Bul­le­tin of Ha­se­ki 2014; 52: 25-8

Multimodal ultrasonographic assessment of leiomyosarcoma of the femoral vein in a patient misdiagnosed as having deep vein thrombosis

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Zhang, Mei; Yan, Feng; Huang, Bin; Wu, Zhoupeng; Wen, Xiaorong

2017-01-01

Abstract Rationale: Primary leiomyosarcoma (LMS) of the vein is a rare tumor that arises from the smooth muscle cells of the vessel wall and has an extremely poor prognosis. This tumor can occur in vessels such as the inferior vena cava, great saphenous vein, femoral vein, iliac vein, popliteal vein, and renal vein; the inferior vena cava is the most common site. LMS of the femoral vein can result in edema and pain in the lower extremity; therefore, it is not easy to be differentiated from deep vein thrombosis (DVT). Moreover, virtually no studies have described the ultrasonographic features of LMS of the vein in detail. Patient concerns: We present a case of a 55-year-old woman with LMS of the left femoral vein that was misdiagnosed as having deep vein thrombosis (DVT) on initial ultrasonographic examination. The patient began to experience edema and pain in her left leg seven months previously. She was diagnosed as having DVT on initial ultrasonographic examination, but the DVT treatment that she had received for 7 months failed to improve the status of her left lower limb. Diagnoses: She subsequently underwent re-examination by means of a multimodal ultrasonographic imaging approach (regular B-mode imaging, color Doppler imaging, pulsed-wave Doppler imaging, contrast-enhanced ultrasonography), which confirmed a diagnosis of LMS. Interventions: This patient was treated successfully with surgery. Outcomes: This case demonstrates that use of multiple ultrasonographic imaging techniques can be helpful to diagnose LMS accurately. Detection of vasculature in a dilated vein filled with a heterogeneous hypoechoic substance on ultrasonography is a sign of a tumor. Lessons: The pitfall of misdiagnosing this tumor as DVT is a useful reminder. PMID:29145269

Alterations in serotonin receptor-induced contractility of bovine lateral saphenous vein in cattle grazing endophyte-infected tall fescue.

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Klotz, J L; Brown, K R; Xue, Y; Matthews, J C; Boling, J A; Burris, W R; Bush, L P; Strickland, J R

2012-02-01

As part of a 2-yr study documenting the physiologic impact of grazing endophyte-infected tall fescue on growing cattle, 2 experiments were conducted to characterize and evaluate effects of grazing 2 levels of toxic endophyte-infected tall fescue pastures on vascular contractility and serotonin receptors. Experiment 1 examined vasoconstrictive activities of 5-hydroxytryptamine (5HT), α-methylserotonin (ME5HT; a 5HT(2) receptor agonist), d-lysergic acid (LSA), and ergovaline (ERV) on lateral saphenous veins collected from steers immediately removed from a high-endophyte-infected tall fescue pasture (HE) or a low-endophyte-infected mixed-grass (LE) pasture. Using the same pastures, Exp. 2 evaluated effects of grazing 2 levels of toxic endophyte-infected tall fescue on vasoconstrictive activities of (±)-1-(2,5-dimethoxy-4-iodophenyl)-2-aminopropane hydrochloride (DOI), BW 723C86 (BW7), CGS-12066A (CGS), and 5-carboxamidotryptamine hemiethanolate maleate (5CT), agonists for 5HT(2A),( 2B), 5HT(1B), and 5HT(7) receptors, respectively. One-half of the steers in Exp. 2 were slaughtered immediately after removal from pasture, and the other one-half were fed finishing diets for >91 d before slaughter. For Exp. 1, maximal contractile intensities were greater (P 91 d. Experiment 1 demonstrated that grazing of HE pastures for 89 to 105 d induces functional alterations in blood vessels, as evidenced by reduced contractile capacity and altered serotonergic receptor activity. Experiment 2 demonstrated that grazing HE pastures alters vascular responses, which may be mediated through altered serotonin receptor activities, and these alterations may be ameliorated by the removal of ergot alkaloid exposure as demonstrated by the absence of differences in finished steers.

Contractile Response of Bovine Lateral Saphenous Vein to Ergotamine Tartrate Exposed to Different Concentrations of Molecularly Imprinted Polymer

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Manoj B. Kudupoje

2018-01-01

Full Text Available 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 polymers: MIP adsorb ergot alkaloids in vitro, but require evaluation for biological implications. Using ex vivo myography, synthetic polymers were evaluated for effects on the bioactivity of ergotamine tartrate (ETA. Polymers were first evaluated using isotherms. Lateral saphenous veins were collected from 17 steers for four independent studies: dose response of ETA, adsorbent dose response, validation of pre-myograph incubation conditions and MIP/ non-molecularly imprinted polymer (NIP comparison. Norepinephrine normalized percent contractile response to increasing ETA exhibited a sigmoidal dose response (max: 88.47 and log of the effective molar concentration (EC50 (−log [ETA] of 6.66 ± 0.17 M. Although sample preparation time affected contractile response (p < 0.001, pre-myograph incubation temperature (39 vs. 21 °C, 1 h had no effect (p > 0.05. Isothermal adsorption showed a maximum adsorption of 3.27E-008 moles·mg−1 and affinity between 0.51 and 0.57 mg (R2: 0.83–0.92 for both polymers, with no significant difference between polymers (p > 0.05. No significant differences in maximum inhibitory (p = 0.96 and IC50 responses (p = 0.163 between MIP and NIP were noticed. Normalized percent contraction could be predicted from the in vitro adsorption data (R2 = 0.87, p < 0.01, for both polymers. These studies indicate that synthetic polymers are potentially effective adsorbents to mitigate ergot toxicity caused by ergot alkaloids, with little evidence of significant differences between MIP and NIP in aqueous media.

Efficacy of duplex ultrasound surveillance after infrainguinal vein bypass may be enhanced by identification of characteristics predictive of graft stenosis development.

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Tinder, Chelsey N; Chavanpun, Joe P; Bandyk, Dennis F; Armstrong, Paul A; Back, Martin R; Johnson, Brad L; Shames, Murray L

2008-09-01

Controversy regarding the efficacy of duplex ultrasound surveillance after infrainguinal vein bypass led to an analysis of patient and bypass graft characteristics predictive for development of graft stenosis and a decision of secondary intervention. Retrospective analysis of a contemporary, consecutive series of 353 clinically successful infrainguinal vein bypasses performed in 329 patients for critical (n = 284; 80%) or noncritical (n = 69; 20%) limb ischemia enrolled in a surveillance program to identify and repair duplex-detected graft stenosis. Variables correlated with graft stenosis and bypass repair included: procedure indication, conduit type (saphenous vs nonsaphenous vein; reversed vs nonreversed orientation), prior bypass graft failure, postoperative ankle-brachial index (ABI) < 0.85, and interpretation of the first duplex surveillance study as "normal" or "abnormal" based on peak systolic velocity (PSV) and velocity ratio (Vr) criteria. Overall, 126 (36%) of the 353 infrainguinal bypasses had 174 secondary interventions (endovascular, 100; surgery, 74) based on duplex surveillance; resulting in 3-year Kaplan-Meier primary (46%), assisted-primary (80%), and secondary (81%) patency rates. Characteristics predictive of duplex-detected stenosis leading to intervention (PSV: 443 +/- 94 cm/s; Vr: 8.6 +/- 9) were: "abnormal" initial duplex testing indicating moderate (PSV: 180-300 cm/s, Vr: 2-3.5) stenosis (P < .0001), non-single segment saphenous vein conduit (P < .01), warfarin drug therapy (P < .01), and redo bypass grafting (P < .001). Procedure indication, postoperative ABI level, statin drug therapy, and vein conduit orientation were not predictive of graft revision. The natural history of 141 (40%) bypasses with an abnormal first duplex scan differed from "normal" grafts by more frequent (51% vs 24%, P < .001) and earlier (7 months vs 11 months) graft revision for severe stenosis and a lower 3-year assisted primary patency (68% vs 87%; P < .001). In 52

Multimodal ultrasonographic assessment of leiomyosarcoma of the femoral vein in a patient misdiagnosed as having deep vein thrombosis: A case report.

Science.gov (United States)

Zhang, Mei; Yan, Feng; Huang, Bin; Wu, Zhoupeng; Wen, Xiaorong

2017-11-01

Primary leiomyosarcoma (LMS) of the vein is a rare tumor that arises from the smooth muscle cells of the vessel wall and has an extremely poor prognosis. This tumor can occur in vessels such as the inferior vena cava, great saphenous vein, femoral vein, iliac vein, popliteal vein, and renal vein; the inferior vena cava is the most common site. LMS of the femoral vein can result in edema and pain in the lower extremity; therefore, it is not easy to be differentiated from deep vein thrombosis (DVT). Moreover, virtually no studies have described the ultrasonographic features of LMS of the vein in detail. We present a case of a 55-year-old woman with LMS of the left femoral vein that was misdiagnosed as having deep vein thrombosis (DVT) on initial ultrasonographic examination. The patient began to experience edema and pain in her left leg seven months previously. She was diagnosed as having DVT on initial ultrasonographic examination, but the DVT treatment that she had received for 7 months failed to improve the status of her left lower limb. She subsequently underwent re-examination by means of a multimodal ultrasonographic imaging approach (regular B-mode imaging, color Doppler imaging, pulsed-wave Doppler imaging, contrast-enhanced ultrasonography), which confirmed a diagnosis of LMS. This patient was treated successfully with surgery. This case demonstrates that use of multiple ultrasonographic imaging techniques can be helpful to diagnose LMS accurately. Detection of vasculature in a dilated vein filled with a heterogeneous hypoechoic substance on ultrasonography is a sign of a tumor. The pitfall of misdiagnosing this tumor as DVT is a useful reminder.

Evaluation of great saphenous vein occlusion rate and clinical outcome in patients undergoing laser thermal ablation with a 1470-nm bare fiber laser with low linear endovenous energy density

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Walter Junior Boim Araujo

2015-12-01

Full Text Available Abstract Background Water-specific 1470-nm lasers enable vein ablation at lower energy densities and with fewer side effects because they target interstitial water in the vessel wall. Objectives To determine great saphenous vein (GSV occlusion rate after thermal ablation with 1470-nm laser using 7W power and to evaluate clinical outcomes and complications. Method Nineteen patients (31 GSVs underwent thermal ablation. Follow-up duplex scanning, clinical evaluation using the Venous Clinical Severity Score (VCSS, and evaluation of procedure-related complications were performed at 3-5 days after the procedure and at 30 and 180 days. Results Mean patient age was 46 years and 17 of the patients were female (89.47%. Of 31 limbs treated, 2 limbs were clinical class C2, 19 were C3, 9 were C4, and 1 limb was C5 according to the Clinical-Etiology-Anatomy-Pathophysiology (CEAP classification. Mean linear endovenous energy density was 33.53 J/cm. The GSV occlusion rate was 93.5% immediately after treatment, 100% at 3-5 days and 100% at 30 days after treatment and 87.1% 180 days after treatment. There was a significant reduction in VCSS at all time points. Conclusions The data from this study support the possibility that the incidence of complications can be reduced without significantly affecting the clinical outcomes, by using lower energy density. However, this appears to be at the cost of reduced efficacy in terms of GSV occlusion rates.

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

Isolated Subclavian Vein Injury: A Rare and High Mortality Case

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Sahin Iscan

2013-01-01

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.

Endovascular vein harvest: systemic carbon dioxide absorption.

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

2006-06-01

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.

Looking beyond oral mucosa: Initial results of everted saphenous vein graft urethroplasty (eSVGU) in long anterior urethral strictures.

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Akhtar, Arif; Khattar, Nikhil; Goel, Hemant; Rao, Swatantra; Tanwar, Raman; Sood, Rajeev

2017-09-01

To prospectively evaluate the feasibility and initial results of an everted saphenous vein graft (eSVG) as a dorsolateral onlay, in patients with long anterior urethral strictures and/or chronic tobacco users. In all, 20 patients with long anterior urethral strictures (>7 cm) and/or chronic tobacco exposed oral mucosa were included in the study. The harvested SVG was hydro-distended, detubularised, and everted. Substitution urethroplasty using an eSVG was performed using a dorsolateral onlay technique. Symptoms were assessed using the International Prostate Symptom Score (IPSS) and uroflowmetry at 1, 3 and 6 months; and voiding and retrograde urethrograms, and urethroscopy were done at 3 months. Failure was defined as failure to void, need for interventions in form of direct-vision internal urethrotomy or endodilatation. Three patients were excluded because they underwent a staged urethroplasty. In all, 17 patients underwent eSVG substitution urethroplasty. The mean (SD, range) follow-up of our patients was 17.64 (5.23, 10-26) months. The mean (SD, range) length of the strictured segment was 14 (2.5, 10-18) cm and the length of the harvested SVG was 16.3 (2.7, 12-20) cm. The mean (SD) IPSS at 1, 3 and 6 months after catheter removal was 10 (2.8), 10 (3.4) and 10 (1.4) and the quality-of-life score was 1.76 (0.5), 2.05 (1.0) and 2.05 (1.0), respectively. Postoperatively, endodilatation was required in two patients. Complete failure occurred in one patient. An eSVG, as a dorsolateral onlay graft, is a promising and prudent option for long anterior urethral strictures, especially in patients with poor oral hygiene and chronic tobacco use.

Forças mecânicas e veias safenas humanas: implicação na revascularização do miocárdio Mechanical forces and human saphenous veins: coronary artery bypass graft implications

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Rafael Angelo Tineli

2007-03-01

Full Text Available As células endoteliais vasculares estão expostas a uma variedade de forças mecânicas in vivo, resultantes do fluxo sangüíneo pulsátil. Dentre essas forças, destacam-se: forças de cisalhamento, tangenciais à parede do vaso, produzidas pelo atrito com o fluxo sangüíneo viscoso, tensão de complacência da parede vascular e a pressão hidrostática do conteúdo sangüíneo no interior da vasculatura. Diversos autores estudaram as alterações hemodinâmicas, funcionais e morfológicas em veias safenas humanas causadas por esses tipos de forças com resultados conflitantes. A motivação dessa revisão foi analisar dados da literatura e alguns dados experimentais do nosso laboratório. Os aspectos revistos são: 1 Respostas endoteliais e regulação gênica causadas pelo shear stress; 2 Efeitos da pressão hidrostática na morfologia da célula endotelial, expressão gênica da superfície celular endotelial e proliferação das células endoteliais, 3 Efeitos da tração no endotélio de veias safenas humanas.Vascular endothelial cells are exposed to a variety of in vivo mechanical forces, specifically, shear stress for the blood flow, tensile stress from the compliance of the vessel wall and the hydrostatic pressure from containment of blood within inside the vasculature. Many authors studied hemodynamic, functional and morphological human saphenous veins alterations caused by these different forces with conflictant results. This review text was motivated with the specific aim of analyze literature data and some experimental data carried out in our laboratory. The adopted review subjects were: 1 Endothelial responses and gene regulation to shear stress; 2 Effects of the hydrostatic pressure in the endothelial cell morphology, gene expression of the endothelial cellular surface and proliferation of endothelial cells; 3 Effects of the traction on the human saphenous vein endothelium.

Reverse Saphenous Conduit Flap in 19 Dogs and 1 Cat.

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Cavalcanti, Jacqueline V J; Barry, Sabrina L; Lanz, Otto I; Barnes, Katherine; Coutin, Julia V

2018-05-14

The purpose of this retrospective study was to report the outcomes of 19 dogs and 1 cat undergoing reverse saphenous conduit flap between 1999 and 2016. Reverse saphenous conduit flap was used to treat traumatic wounds and wounds resulting from tumor excision in the hind limb; the majority of cases had medial shearing injuries. All animals had complete flap survival. In five animals (20%), minor donor site dehiscence occurred, which did not require surgery. Other postoperative complications included signs of severe venous congestion in one dog. Reverse saphenous conduit flap is a useful technique to repair skin defects of the distal hind limb.

Suitability of Varicose Veins for Endovenous Treatments

International Nuclear Information System (INIS)

Goode, S. D.; Kuhan, G.; Altaf, N.; Simpson, R.; Beech, A.; Richards, T.; MacSweeney, S. T.; Braithwaite, B. D.

2009-01-01

The aim of the study was to assess the suitability of radiofrequency ablation (RFA), endovenous laser ablation (EVLA), and foam sclerotherapy (FS) for patients with symptomatic varicose veins (VVs). The study comprised 403 consecutive patients with symptomatic VVs. Data on 577 legs from 403 consecutive patients with symptomatic VVs were collected for the year 2006. Median patient age was 55 years (interquartile range 45-66), and 62% patients were women. A set of criteria based on duplex ultrasonography was used to select patients for each procedure. Great saphenous vein (GSV) reflux was present in 77% (446 of 577) of legs. Overall, 328 (73%) of the legs were suitable for at least one of the endovenous options. Of the 114 legs with recurrent GSV reflux disease, 83 (73%) were suitable to receive endovenous therapy. Patients with increasing age were less likely to be suitable for endovenous therapy (P = 0.03). Seventy-three percent of patients with VVs caused by GSV incompetence are suitable for endovenous therapy.

In situ saphenous vein bypass surgery in diabetic patients

DEFF Research Database (Denmark)

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

1992-01-01

.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...

Aneurismas múltiplos de pontes aorto-coronárias de veia safena com ruptura fatal Multiple aneurysms of aortocoronary saphenous vein grafts with fatal rupture

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Fábio R. Távora

2007-05-01

Full Text Available Aneurismas de pontes aorto-coronárias de veia safena são eventos raros, usualmente assintomáticos e detectados de forma incidental. Rupturas espontâneas de pontes de safena são raras, havendo poucos dados radiológicos disponíveis na literatura. Relatamos o caso de um senhor de 39 anos internado com hematêmese dez anos depois de ter sido submetido a cirurgia de revascularização miocárdica. Imagens tomográficas mostraram três aneurismas nas pontes de safena, mas o exame não detectou ruptura. O paciente veio a falecer e a necropsia revelou que a causa do óbito havia sido ruptura de aneurisma de pontes de safena. Esse caso ilustra a necessidade de tratamento agressivo de aneurismas sintomáticos de pontes coronarianas.Aortocoronary saphenous vein graft (SVG aneurysms are rare, and are usually asymptomatic and detected incidentally. Spontaneous rupture of SVG is rare and imaging data are few. We report on a 39-year old man who was admitted to the hospital with hematemesis 10 years after aortocoronary bypass surgery. CT images revealed 3 aortocoronary SVG aneurysms, but failed to detect any rupture. His subsequent death due to rupture of SVG aneurysm was documented at autopsy, illustrating the need for aggressive treatment of symptomatic coronary graft aneurysms.

The effects of vasoactive agents on flow through saphenous vein grafts during lower-extremity peripheral vascular surgery.

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

2007-06-01

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.

The Auscultation of a Carbon Dioxide Embolization Event during Endoscopic Vein Harvest

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Erik Strauss

2016-01-01

Full Text Available Endoscopic vein harvest in preparation for coronary artery bypass surgery has become a preferred method of procuring saphenous vein. Several case reports have documented carbon dioxide (CO2 embolization with this procedure as well as CO2 embolization during other laparoscopic surgeries (Markar et al., 2010. Although uncommon, the potential for CO2 entrainment through an open vein or through absorption by vascular structures exists and should be recognized (Lin et al., 2003. We report a case of CO2 embolization during EVH for a 77-year-old patient who underwent CABG that was identified early by the cardiac surgeon through the indirect auscultation of a mill-wheel murmur after the pericardium was opened. This may be the first reported case of a murmur related to air emboli identified without the use of a precordial Doppler probe or a stethoscope. This diagnosis was further supported by TEE before systemic hypotension or cardiovascular collapse occurred.

Adoption of endovenous laser treatment as the primary treatment modality for varicose veins: the Auckland City Hospital experience.

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Fernando, Ruchira S W; Muthu, Carl

2014-08-01

To assess the effectiveness of adopting endovenous laser treatment (EVLT) as the primary treatment modality for varicose veins at Auckland City Hospital (Auckland, New Zealand). The outcomes of 354 consecutive EVLT procedures performed between 2007 and 2013 were reviewed. Data was collected from a prospectively maintained procedural database and by retrospective chart review. Of the 319 patients who had an ultrasound, at 1 month post-procedure there was a saphenous vein occlusion rate of 96%. Side effects were minimal with no cases of DVT or skin burns and one case of self-limiting neuralgia. The procedure was well tolerated with a median pain score of 3. Since the adoption of EVLT there has been a large increase in the number of patients treated for varicose veins (28 in 2007 compared to 176 in 2013). EVLT is a safe and effective treatment for varicose veins and its adoption has allowed a large increase in the number of varicose vein patients treated at Auckland City Hospital.

Prevalência do refluxo na veia safena parva em varizes primárias não complicadas dos membros inferiores pelo eco-Doppler colorido Prevalence of short saphenous vein reflux in primary uncomplicated varicose veins by Doppler ultrasonography

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Fabio Secchi

2006-03-01

Full Text Available OBJETIVO: Determinar a prevalência de refluxo venoso na veia safena parva em membros inferiores com varizes primárias não complicadas pelo eco-Doppler colorido. MÉTODO: No período de 18 meses, 1.953 pacientes foram submetidos ao eco-Doppler colorido de membros inferiores por doença venosa. Destes, 1.631 com varizes primárias não complicadas foram selecionados para esta análise, sendo que 1.383 eram do sexo feminino (84,79% e 248 (15,21% do sexo masculino. A média de idade dos pacientes foi de 42,89 (± 0,48 anos, variando de 13 a 85 anos. Dos 1.631 pacientes, 1.323 foram submetidos a exame bilateral e 308 a exame unilateral, totalizando 2.954 membros inferiores com varizes primárias não complicadas avaliados. Desse total, 1.461 eram membros inferiores direitos e 1.493, esquerdos. Todos os exames foram realizados seguindo o mesmo protocolo. RESULTADO: Dos 2.954 membros inferiores avaliados, 372 (12,59% apresentaram refluxo em veia safena parva. A prevalência nos homens foi de 14,08% e, nas mulheres, de 12,35%. O refluxo da safena parva foi maior no membro inferior esquerdo (13.13% do que no direito (12,05%. A prevalência do refluxo foi significativamente maior nos pacientes acima de 60 anos. CONCLUSÃO: O refluxo da veia safena parva é relativamente comum, e sua pesquisa deve ser sempre realizada em pacientes com varizes primárias de membros inferiores.OBJECTIVE: To determine the prevalence of small saphenous vein reflux (SSVR in patients with uncomplicated varicose veins, using color-flow Doppler ultrasonography. METHOD: Over an 18-month period, a total of 1,953 patients underwent color-flow Doppler ultrasonography for evaluation of venous disease. Out of the total, 1,631 patients with primary uncomplicated varicose veins were selected for this study: 1,383 (84.79% patients were female and 248 (15.21% were male. Mean age was 42.9 (± 0.48 years, ranging from 13 to 85 years. Of the 1,631 patients, 1,323 underwent bilateral

Lower Energy Endovenous Laser Ablation of the Great Saphenous Vein with 980 nm Diode Laser in Continuous Mode

International Nuclear Information System (INIS)

Kim, Hyun S.; Nwankwo, Ikechi J.; Hong, Kelvin; McElgunn, Patrick S.J.

2006-01-01

Purpose. To assess clinical outcomes, complication rates, and unit energy applied using 980 nm diode endovenous laser treatment at 11 watts for symptomatic great saphenous vein (GSV) incompetence and reflux disease. Methods. Thirty-four consecutive ablation therapies with a 980 nm diode endovenous laser at 11 watts were studied. The diagnosis of GSV incompetence with reflux was made by clinical evaluation and duplex Doppler examinations. The treated GSVs had a mean diameter of 1.19 cm (range 0.5-2.2 cm). The patients were followed with clinical evaluation and color flow duplex studies up to 18.5 months (mean 12.19 months ± 4.18). Results. Using 980 nm diode endovenous laser ablation in continuous mode, 100% technical success was noted. The mean length of GSVs treated was 33.82 cm (range 15-45 cm). The mean energy applied during the treatment was 1,155.81 joules (J) ± 239.50 (range 545.40-1620 J) for a mean treatment duration of 90.77 sec ± 21.77. The average laser fiber withdrawal speed was 0.35 cm/sec ± 0.054. The mean energy applied per length of GSV was 35.16 J/cm ± 8.43. Energy fluence, calculated separately for each patient, averaged 9.82 J/cm 2 ± 4.97. At up to 18.5 months follow-up (mean 12.19 months), 0% recanalization was noted; 92% clinical improvement was achieved. There was no major complication. Minor complications included 1 patient with hematoma at the percutaneous venotomy site, 1 patient with thrombophlebitis on superficial tributary varices of the treated GSV, 24% ecchymoses, and 32% self-limiting hypersensitivity/tenderness/'pulling' sensation along the treatment area. One patient developed temporary paresthesia. Four endovenous laser ablation treatments (12%) were followed by adjunctive sclerotherapies for improved cosmetic results. Conclusion. Endovenous laser ablation treatment of GSV using a 980 nm diode laser at 11 watts in continuous mode appears safe and effective. Mean energy applied per treated GSV length of 35.16 J/cm or mean

The spread of injectate during saphenous nerve block at the adductor canal

DEFF Research Database (Denmark)

Andersen, H L; Andersen, S L; Tranum-Jensen, J

2015-01-01

BACKGROUND: The spread of injectate during a saphenous nerve block at the adductor canal has not been clearly described. METHODS: We examined the spread of 15 ml dyed injectate during ultrasound-guided saphenous nerve blocks at the adductor canal in 15 unembalmed cadavers' lower limbs followed...

C1-esterase inhibitor protects against early vein graft remodeling under arterial blood pressure.

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Krijnen, Paul A J; Kupreishvili, Koba; de Vries, Margreet R; Schepers, Abbey; Stooker, Wim; Vonk, Alexander B A; Eijsman, Leon; Van Hinsbergh, Victor W M; Zeerleder, Sacha; Wouters, Diana; van Ham, Marieke; Quax, Paul H A; Niessen, Hans W M

2012-01-01

Arterial pressure induced vein graft injury can result in endothelial loss, accelerated atherosclerosis and vein graft failure. Inflammation, including complement activation, is assumed to play a pivotal role herein. Here, we analyzed the effects of C1-esterase inhibitor (C1inh) on early vein graft remodeling. Human saphenous vein graft segments (n=8) were perfused in vitro with autologous blood either supplemented or not with purified human C1inh at arterial pressure for 6h. The vein segments and perfusion blood were analyzed for cell damage and complement activation. In addition, the effect of purified C1inh on vein graft remodeling was analyzed in vivo in atherosclerotic C57Bl6/ApoE3 Leiden mice, wherein donor caval veins were interpositioned in the common carotid artery. Application of C1inh in the in vitro perfusion model resulted in significantly higher blood levels and significantly more depositions of C1inh in the vein wall. This coincided with a significant reduction in endothelial loss and deposition of C3d and C4d in the vein wall, especially in the circular layer, compared to vein segments perfused without supplemented C1inh. Administration of purified C1inh significantly inhibited vein graft intimal thickening in vivo in atherosclerotic C57Bl6/ApoE3 Leiden mice, wherein donor caval veins were interpositioned in the common carotid artery. C1inh significantly protects against early vein graft remodeling, including loss of endothelium and intimal thickening. These data suggest that it may be worth considering its use in patients undergoing coronary artery bypass grafting. Copyright © 2011 Elsevier Ireland Ltd. All rights reserved.

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

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Herbert Coelho Hortmann

2010-06-01

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

Clinicopathological comparisons of open vein harvesting and endoscopic vein harvesting in coronary artery bypass grafting patients in Mashhad.

Science.gov (United States)

Amouzeshi, Ahmad; Teshnisi, Mohamad Abbassi; Zirak, Nahid; Shamloo, Alireza Sepehri; Hoseinikhah, Hamid; Alizadeh, Behzad; Moeinipour, Aliasghar

2016-01-01

Harvesting of the greater saphenous vein is almost an inevitable part of coronary artery bypass grafting (CABG) operations, and it is done by two main techniques, i.e., conventional or open vein harvesting (OVH) and the minimally-invasive endoscopic vein harvesting (EVH). This study aimed to compare these two techniques in off-pump CABG procedures with respect to clinical and pathological outcomes. This cohort study was conducted on CABG candidates during a one-year period from October 2013 through September 2014 in the Department of Cardiac Surgery at Mashhad University of Medical Sciences. Eighty-seven patients voluntarily underwent EVH, and another 86 patients matched for age, gender, and other cardiovascular risk factors were selected for OVH. They were followed up for six weeks, and the main outcome measures were infections of the wound, pain, duration of hospital stay, and the costs of hospitalization. Paired sample t-test, independent t-test, or their non-parametric equivalents and the chi-squared test were used by SPSS version 17.0 for data analysis. The mean duration of time for vein harvesting was shorter in the EVH group (p < 0.001), and the pain score was lower (p = 0.04). No infections occurred at the site of the wound. The length of hospital stay was not significantly different for the two groups (OVH versus EVH: 8.5 ± 3.3 versus 8.4 ± 3.2 days; p-value: 0.08). Hospitalization costs were significantly higher in the EVH group (OVH versus EVH: 5.8 ± 4.7 versus 7.3 ± 2.0 million Tomman; p-value: 0.008), yet no difference was diagnosed with respect to endothelial damage in the vein grafts harvested by the EVH and OVH techniques. EVH is considered as a minimally invasive and safe vein harvesting technique in our Center, and it can reduce the harvesting time and post-operative pain. In addition, its efficiency was similar to that of OVH.

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

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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

2017-05-01

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 maxLCBI 4 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 maxLCBI 4 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 maxLCBI 4 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 maxLCBI 4mm 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.

Advanced glycation end products impair the functions of saphenous vein but not thoracic artery smooth muscle cells through RAGE/MAPK signalling pathway in diabetes.

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Sun, Yongxin; Kang, Le; Li, Jun; Liu, Huan; Wang, Yulin; Wang, Chunsheng; Zou, Yunzeng

2016-10-01

Saphenous vein (SV) and internal thoracic artery (ITA) are commonly used bypass conduits. However, graft failure occurs in SV rather than in ITA, especially in diabetes (DM). The mechanism for this difference has not been fully understood. Accumulation of advanced glycation end products (AGEs) and activation of AGEs receptor (RAGE) could accelerate smooth muscle cells (SMC) proliferation in DM, we thus asked whether AGEs-RAGE could mediate the differences between SMC from SV (SMCV ) and from ITA (SMCA ). Twenty-five patients with DM and other 25 patients without DM were enclosed in DM and control group, respectively. AGEs (100 μg/ml) were added to cultured SMCA and SMCV obtained at coronary artery bypass graft (CABG) and proliferative rates were determined. Transcript expression, phosphorylation or protein expression levels of MAP kinase family (ERK, p38 and JNK), matrix metalloproteinases (MMP)-2 and MMP-9 were analysed by real-time PCR, Western-blot or immunofluorescence staining, respectively. Compared with paired SMCA , SMCV showed significantly increased proliferation rate, MAP kinase family phosphorylation, and MMP-2/9 expression in both groups, especially in DM group. The responses of SMCV induced by AGEs were significantly larger in DM than in control group, which could be suppressed by inhibition of RAGE and ERK. However, all the cellular events of SMCV were not found in paired SMCA . This study suggests that AGEs-RAGE could induce the proliferation of SMCV but not SMCA via MAP kinase pathway in DM. It is the intrinsic 'inactive' tendency of SMCA that contributes to the different rates of graft disease between SV and ITA after CABG. © 2016 The Authors. Journal of Cellular and Molecular Medicine published by John Wiley & Sons Ltd and Foundation for Cellular and Molecular Medicine.

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

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Fernanda Viaro

2007-06-01

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

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

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Ryan Accord

2011-01-01

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.

The comparative study of conventional and innovative phlebographies in lower extremity

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Chen Guoping; Gu Jianping; He Xu; Lou Wensheng; Chen Liang; Su Haobo; Song Jinghua

2008-01-01

Objective: The clinical values of conventional phlebography via percutaneous dorsal pedal vein access with scalp puncture was compared with innovative phlebography via a percutaneous great saphenous approach with retained catheter in lower extremity for detection of venous diseases. Methods: Conventional and innovative phlebographies in lower extremity were performed in 34 suffering lower extremities of 30 patients, and the efficacy of the two methods was compared in demonstrating the venous diseases in lower extremities. Results: The rates of vascular display of the common iliac vein, the valve of saphenous-femoral vein and the first couple valve of femoral vein were 100%, 100% and 91.18% respectively with innovative phlebography while the rates of vascular display were 32.25%, 73.53% and 64.71% respectively with conventional phlebography. Iliac vein compression syndrome (IVCS), venous valvular disfunction of saphenous-femoral vein and the venous valvular disfunction of the first couple valve of femoral vein were shown in 14, 25 and 21 cases respectively by innovative phlebography, and in 3, 14 and 12 cases respectively by conventional phlebography in patients suffering from varicose veins and chronic swelling of the lower extremities. There was significant difference between the innovative and conventional phlebographies (P < 0.05). Conclusion: The innovative phlebography possesses a higher efficacy in diagnosing IVCS, venous valvular disfunctions of saphenous-femoral vein and the first couple valve of femoral vein compared with conventional method. It would be an alternative method to the conventional one or percutaneous femoral venous approach. (authors)

A new venous conduit utilizing the recipient portal vein branches for segment V in adult partial liver transplantation.

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Moon, I S; Kim, D G; Lee, M D; Hong, S K; Park, S C; Oh, D Y; Ahn, S T; Lee, Y J

2005-03-01

Right anterior-medial lobe congestion due to temporary clamping of segment V and/or VIII is common in the operative theater during adult donor right lobe liver transplantation, the most common procedure in our institute. We have used an autogenous saphenous vein conduit to recipient portal vein tributaries in 15 cases, as a "Y-to-I venoplasty" since January 2004. The recipient portal vein is transected 5 mm proximal to its bifurcation and extended to both sides with partial hepatic dissection. The "Y-to-I venoplasty" is made by suture closure of the portal vein transversely to form a tube. The average length is 7.5 cm with a 1.3 cm width. One end of "Y-to-I venoplasty" conduit is anastomosed to the donor segment V branch on the back table. And the other end is anastomosed directly to the IVC via a new window or the middle hepatic vein stump in recipient. The phase distension of the conduit with respiration is noted in the operative field. A 6/15 (40%) patency rate, was observed by CT angiography at the second postoperative week. All-patient conduits showed good flow on serial examinations at the 60th postoperative day. This new venous graft, made of recipient portal vein is a good conduit for segment V decongestion in adult right lobe partial liver transplantation.

Implante de stent dentro de stent recém-implantado em ponte de veia safena para otimização do resultado angiográfico Stenting a stent in saphenous vein graft to optimize the angiographic result

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Antonio Esteves Fº

1998-03-01

Full Text Available Mulher de 60 anos, com angina progressiva e revascularização do miocárdio, há oito anos, com ponte de veia safena para coronária direita e anastomose de artéria mamaria esquerda para artéria descendente anterior. Submetida a implante de stent Gianturco-Roubin II em terço proximal da ponte de veia safena para artéria coronária direita, com resultado insatisfatório pela persistência de lesão residual, provavelmente, decorrente de prolapso para dentro da luz de material aterosclerótico através dos coils. Foi implantado outro stent (Palmaz-Schatz biliar dentro do stent GRII com sucesso e ótimo resultado angiográfico. Um 2º stent Palmaz-Schatz biliar foi implantado em lesão distal no corpo da ponte, ultrapassando os dois stents, anteriormente implantados, com sucesso. Em algumas situações, implante de stent dentro de outro stent é recurso útil para otimização de resultado angiográfico do implante de um stent.A 60 year-old woman with progressive angina who had been submitted to saphenous bypass-graft to right coronary artery and a left mammary artery graft to anterior descending artery eight years previously, underwent implantation of a Gianturco Roubin II stent in the proximal third of the saphenous vein graft. The result was suboptimal by persistence of a residual stenosis probably due to prolapse of atherosclerotic material through the coil spaces. Another stent (Palmaz-Schatz biliar stent was implanted at the previously stented site with no residual stenosis. Another Palmaz-Schatz biliar stent was successfully implanted in the distal body of the graft to treat another lesion (passing through the previously stents without difficulty. Stenting a stent, in selected situations, is a useful tool to optimize the angiographic result of stent implantation.

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

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Harskamp, Ralf E., E-mail: r.e.harskamp@gmail.com [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)

2016-01-15

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

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

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Yu.O. Syniachenko

2017-02-01

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.

Gd-DTPA-enhanced MR venography for varicose veins of the calf

International Nuclear Information System (INIS)

Kohata, Yoshiko; Naito, Akira; Ito, Katuhide.

1995-01-01

2D time-of-flight MR venography (2D TOF MRV) was performed in 16 patients (25 calves) with varicose veins and 2 volunteers (4 calves), and compared with venography. Sequential SPGR (TR/TE/FA=45 ms/7 ms/60deg) transverse images and/or GRASS (TR/TE/FA=100 ms/13 ms/60deg) transverse images were obtained for MRV. Superior presaturation pulse (S-SAT) was placed in 21 calves, and 0.05 mmol/kg Gd-DTPA was used in all calves. Projection MRVs were generated with maximum intensity projection (MIP) reconstruction. Regarding sequence parameter, S-SAT was useful to eliminate signal from artery that would obscure the signal of deep veins. The detectability of deep veins was improved with the use of S-SAT. In the comparison with venography, MRV could more clearly demonstrate varicose veins more than 5 mm in diameter and their drainage veins than venography. But it could not so clearly demonstrate deep veins as venography. It could not detect fine varicose veins less than 5 mm in diameter and connecting veins with valve insufficiency. In the examination of varicose veins, detection of deep veins, large varicose veins and their main drainage veins is clinically important, because diagnosis of patency of deep veins and dilatation of the drainage veins is necessary to choose the treatment, concluding conservative therapy, stripping and sclerotherapy. However, detection of fine varicose veins and connecting veins are not so important because those veins seldom need treatment. MRV was not so suitable for detection of deep veins, but very useful for detection of varicose veins more than 5 mm in diameter and their main drainage veins. In conclusion, MRV is non-invasive and effective method in varicose veins of calf, and it can take the place of venography with the improvement of deep vein detectability. (author)

[Early results after varicose vein surgery--a multicenter patient inquiry].

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Hermanns, H-J

2008-08-01

Beside varicose vein surgery, endovenous procedures (endovenous laser therapy, VNUS and foam sclerotherapy) are now therapeutic options with the following advantages: low invasiveness, only out-patient operations, quick resumption of general activities. Whether or not classical vein surgery today still fulfills patient demands was analysed by a study group of German vascular surgeons (ANG) as a multicentre patient questioning. The questionnaire was subdivided into eight main complexes with 24 questions about the early results of stripping operations (from start of preparation until suture removal) and the patients answers were analysed. Answers with points (1-6) and free answers were possible. Between 1.1.2005 and 31.3.2005 18 centres for vascular surgery collected 1708 questionnaires from patients after stripping operations. The complex "preparation and information about the operation" was scored with 1.33 to 1.39. The "general organisation" of the vascular centre was scored between 1.22 and 1.30. "Pain after operation" was rated at 1.98 (immediately), 2.26 (first day) and 2.12 (third day after operation). Reasons for other problems after surgery were haematoma (3.09), problems with the compression dressing (1.67), circulatory collapse (1.51), headache (1.33), nausea (1.25). The total score for all centres was 1.47. The early results after varicose vein surgery are good up to very good. The patients' reconvalescence time is short and there is a quick resumption of general activities. The invasiveness of vein surgery seems to be overestimated. Comparative studies to evaluate the new methods are necessary. Benchmarking projects like this study are essential parts of current quality control systems.

Comparing the Rates of Dopamine Hemodynamic Effect Onset after Infusion through Peripheral Veins in Three Regions

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Deokkyu Kim

2017-02-01

Full Text Available Background Dopamine is an inotropic agent that is often selected for continuous infusion. For hemodynamic stability, the rate of infusion is controlled in the range of 5-15 μg/kg/min. This study aimed to compare the time intervals from the administration of dopamine to the onset of its hemodynamic effects when dopamine was administered through three different peripheral veins (the cephalic vein [CV], the great saphenous vein [GSV], and the external jugular vein [EJV]. Methods Patients in group 1, group 2, and group 3 received dopamine infusions in the CV, GSV, and EJV, respectively. A noninvasive continuous cardiac output monitor (NICCOMO™, Medis, Ilmenau, Germany was used to assess cardiac output (CO and systemic vascular resistance (SVR. Six minutes after intubation, baseline heart rate (HR, systolic blood pressure (BP, diastolic BP, mean arterial pressure (MAP, CO, and SVR values were recorded and dopamine infusion was initiated at a dose of 10 μg/kg/min. Hemodynamic changes at 0, 4, 8, 12, and 15 minutes postinfusion were recorded. Results No statistically significant differences were observed among the three groups with respect to the rate of hemodynamic change. In all groups, systolic BP, diastolic BP, MAP, and SVR tended to increase after decreasing for the first 4 minutes; in contrast, HR and CO decreased until 8 minutes, after which they tended to reach a plateau. Conclusions For patients under general anesthesia receiving dopamine at 10 μg/kg/min, there were no clinical differences in the effect of dopamine administered through three different peripheral veins.

Renal vein to renal collecting system fistula: An extreme complication from central venous thrombosis secondary to indwelling catheter

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Aditya Safaya

2018-04-01

Full Text Available Central venous catheters are routinely used for resuscitation, chemotherapy and nutrition but are not without risk. Central lines are the most common extrinsic cause of venous thrombosis in neonates and infants. We present an ex-36 week 1800g infant baby girl recovering after a staged repair of gastroschisis with ileostomy and mucous fistula formation. The patient was receiving parenteral nutrition through an indwelling saphenous vein tunneled catheter, with its tip in the inferior vena cava. The patient developed polyuria, with a characteristic odor of the parenteral nutrition and a urine analysis showed glucose and triglyceride levels consistent with the composition of the parenteral nutrition fluid. A fluoroscopic cysto-urogram and an inferior vena-cavogram showed a catheter-associated inferior vena cava thrombosis leading to backpressure changes, diverting all intravenous contrast into the right renal vein and to renal collecting system, thus elucidating the route of the parenteral nutrition fluid reaching the bladder. Our case represents an extreme case of complicated central venous thrombosis. We emphasize the importance of practicing a high index of suspicion for thrombotic complications in severely ill neonates with central venous access. An early diagnosis and aggressive management may prevent progression of the disease towards an overwhelming complication. Keywords: Central venous catheterization complications, Renal vein-collecting system connection, Renal vein- collecting system fistula

Prevalence of saphenous nerve injury after adductor-canal-blockade in patients receiving total knee arthroplasty

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Henningsen, Maja; Jæger, Pia; Hilsted, K L

2013-01-01

, 76 patients could not discriminate between blunt and sharp stimulation with a needle, 81 patients could not discriminate between cold and warmth, and 82 patients displayed an altered sensation to light brush. CONCLUSION: We found no indications of saphenous nerve injury caused by the adductor...... of the saphenous nerve), as well as the anterior, posterior, lateral and infrapatellar part of the affected and contralateral lower leg. Sensory function was tested with pinprick (sharp and blunt needle), temperature discrimination (cold disinfectant swabs) and light brush. RESULTS: We included 97 patients. None...

Comparison of microbubble presence in the right heart during mechanochemical and radiofrequency ablation for varicose veins.

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Moon, K H; Dharmarajah, B; Bootun, R; Lim, C S; Lane, Tra; Moore, H M; Sritharan, K; Davies, A H

2017-07-01

Objective Mechanochemical ablation is a novel technique for ablation of varicose veins utilising a rotating catheter and liquid sclerosant. Mechanochemical ablation and radiofrequency ablation have no reported neurological side-effect but the rotating mechanism of mechanochemical ablation may produce microbubbles. Air emboli have been implicated as a cause of cerebrovascular events during ultrasound-guided foam sclerotherapy and microbubbles in the heart during ultrasound-guided foam sclerotherapy have been demonstrated. This study investigated the presence of microbubbles in the right heart during varicose vein ablation by mechanochemical abaltion and radiofrequency abaltion. Methods Patients undergoing great saphenous vein ablation by mechanochemical abaltion or radiofrequency ablation were recruited. During the ablative procedure, the presence of microbubbles was assessed using transthoracic echocardiogram. Offline blinded image quantification was performed using International Consensus Criteria grading guidelines. Results From 32 recruited patients, 28 data sets were analysed. Eleven underwent mechanochemical abaltion and 17 underwent radiofrequency abaltion. There were no neurological complications. In total, 39% (11/28) of patients had grade 1 or 2 microbubbles detected. Thirty-six percent (4/11) of mechanochemical abaltion patients and 29% (5/17) of radiofrequency ablation patients had microbubbles with no significant difference between the groups ( p=0.8065). Conclusion A comparable prevalence of microbubbles between mechanochemical abaltion and radiofrequency ablation both of which are lower than that previously reported for ultrasound-guided foam sclerotherapy suggests that mechanochemical abaltion may not confer the same risk of neurological events as ultrasound-guided foam sclerotherapy for treatment of varicose veins.

The short- and long-term outcomes of percutaneous intervention with drug-eluting stent vs bare-metal stent in saphenous vein graft disease: An updated meta-analysis of all randomized clinical trials.

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Kheiri, Babikir; Osman, Mohammed; Abdalla, Ahmed; Ahmed, Sahar; Bachuwa, Ghassan; Hassan, Mustafa

2018-05-11

The use of drug-eluting stents (DES) vs bare-metal stents (BMS) in saphenous vein graft (SVG) lesions remains controversial. We conducted a meta-analysis of all randomized clinical trials comparing the outcomes of DES with BMS in SVG percutaneous coronary interventions. A search of PubMed, Embase, the Cochrane Register of Controlled Trials, and Clinicaltrials.gov was performed for all randomized clinical trials. We evaluated the short- and long-term clinical outcomes of the following: all-cause mortality, major adverse cardiovascular events (MACE), definite/probable stent thrombosis, target lesion revascularization (TLR), and target-vessel revascularization (TVR). From a total of 1582 patients in 6 randomized clinical trials, 797 had DES and 785 had BMS. Patients with DES had lower short-term MACE, TLR, and TVR in comparison with BMS (odds ratio [OR]: 0.56, 95% confidence interval [CI]: 0.35-0.91, P = 0.02; OR: 0.43, 95% CI: 0.19-0.99, P = 0.05; and OR: 0.45, 95% CI: 0.22-0.95, P = 0.04, respectively). However, there were no different outcomes for all-cause mortality (P = 0.63) or stent thrombosis (P = 0.21). With long-term follow-up, there were no significant reductions of MACE (P = 0.20), TLR (P = 0.57), TVR (P = 0.07), all-cause mortality (P = 0.29), and stent thrombosis (P = 0.76). The use of DES in SVG lesions was associated with lower short-term MACE, TLR, and TVR in comparison with BMS. However, there were no significant differences with long-term follow-up. © 2018 Wiley Periodicals, Inc.

Endoluminal laser delivery mode and wavelength effects on varicose veins in an ex vivo model.

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Massaki, Ane B M N; Kiripolsky, Monika G; Detwiler, Susan P; Goldman, Mitchel P

2013-02-01

Endovenous laser ablation (EVLA) has been shown to be effective for the elimination of saphenous veins and associated reflux. Mechanism is known to be heat related, but precise way in which heat causes vein ablation is not completely known. This study aimed to determine the effects of various endovenous laser wavelengths and delivery modes on ex vivo human vein both macroscopically and microscopically. We also evaluated whether protected-tip fibers, consisting of prototype silica fibers with a metal tube over the distal end, reduced vein wall perforations compared with non-protected-tip fibers. An ex vivo EVLA model with human veins harvested during ambulatory phlebectomy procedures was used. Six laser fiber combinations were tested: 810 nm continuous wave (CW) diode laser with a flat tip fiber, 810 CW diode laser with a protected tip fiber, 1,320 nm pulsed Nd:YAG laser, 1,310 nm CW diode laser, 1,470 nm CW diode laser, and 2,100 nm pulsed Ho:YAG laser. Perforation or full thickness necrosis of a portion of the vein wall was observed in 5/11 (45%), 0/11 (0%), 3/22 (14%), 7/11 (64%), 4/6 (67%), and 5/10 (50%) of cross-sections of veins treated with the 810 nm CW diode laser with a flat tip fiber, the 810 CW diode laser with a protected tip fiber, the 1,320 nm pulsed Nd:YAG laser, the 1,310 nm CW diode laser, the 1,470 nm CW diode laser, and the 2,100 nm pulsed Ho:YAG laser, respectively. Our results have shown that the delivery mode, pulsed Nd:YAG versus CW, may be just as important as the wavelength. Therefore, the 1,310 nm CW laser may not be equivalent to the 1,320 nm pulsed laser. In addition, protected 810 nm fibers may be less likely to yield wall perforations than their non-protected counterparts. Copyright © 2012 Wiley Periodicals, Inc.

Varicography in the preoperative evaluation of primary varicose veins

International Nuclear Information System (INIS)

Pinzani, A.; Paoli, G.; Gongolo, A.; Spreafico, G.

1989-01-01

Primary varicose veins in the lower limb are usually well evaluated by the surgeon, who avails himself of tornequet tests and Doppler US. However, the operation is often followed by failure or recurrence, or else it requires ugly skin dissection to eradicate an unforeseeably complicated varicose vein. The authors suggest that, whenever the surgeon considers the information obtained with tests and Doppler US inadequate for planning surgery, varicography be performed to get further morphological (and functional) data about the origin of varicose veins, which is of fundamental importance for an accurate surgical planning (crossectomy, stripping, ligation, sclerosis). Out of 100 varicographies consecutively carried out on patients in whom clinical examination was not conclusive, 62% allowed an already planned surgical approach to be changed. The figure rose to 100% in the case of unusual varicose veins. Such a results allowed the needs of both the surgeon (selectivity, effectiveness, radicality) and the patients (narrow scars, absence of relapse) to be respected. Furthermore, it has been pointed out that some vein segments are often only pathological, and they are to be adequately treated, while others can be undamaged, and they are to be preserved for both their function and an eventual by-pass surgery. Varicography is rapidly performed, without complication, and is well accepted by the patients. It is a fundamental help in the preoperative study of primary varicose veins, especially in case of unusual ones, whenever the surgeon is in the slightest diagnostic - and therefore surgical - doubt

Infra Patellar Branch of Saphenous Nerve Injury during Hamstring Graft Harvest: Vertical versus Oblique Incisions.

Science.gov (United States)

Joshi, A; Kayasth, N; Shrestha, S; Kc, B R

2016-09-01

Autologous hamstring grafts are commonly used for anterior cruciate ligament reconstruction. The injury of infrapatellar branch of saphenous nerve is one of the concerns leading to various pattern of sensory loss in the operated leg. An oblique incision to harvest the graft has been reported to be better than the vertical one.The aim of this study was to compare the incidence, recovery of nerve injury and final outcome in patients with hamstring harvest of vertical or oblique incision. A total of 146 patients who underwent hamstring graft harvest for anterior cruciate ligament reconstruction, were included in the study. They were randomized into two (Vertical and Oblique) groups as per the incisions used. The sensory loss along the Infra Patellar Branch of Saphenous Nerve was documented on 3rd day. Recovery of the nerve injury was monitoredat three, six and 12 months follow-ups. At final follow up Tegner Lysholm score and scale was recorded to compare between two groups. The incidence of infrapatellar branch of saphenous nerve injury was 25% in vertical group and 16.36% in oblique group. Recovery of nerve injury started earlier in oblique group compared to vertical group. The mean TegnerLyshom score was not significantly different in both the groups. Oblique incision to harvest hamstring graft has lesser incidence of infrapatellar branch of saphenous nerve injury, recovers earlier and does not have any adverse effect on final outcome compared to the vertical incision.

The clinical efficacy observation of fluoroscopy-guided foam sclerotherapy with lauromacrogol for varicose veins of the lower extremities

International Nuclear Information System (INIS)

Zhu Yongqiang; Xu Jingxuan; Chen Junying; Wu Yan; Zhang Chuanhong; Li Liang

2012-01-01

Objective: To assess the clinical efficacy of foam sclerotherapy with lauromacrogol for varicose veins of the lower extremities. Methods: During the period from February to July 2011, we retrospectively analyzed 20 patients with varicose veins of the lower extremities, who were treated with lauromacrogol foam sclerosing agent injected directly at varicose veins, and in 5 extremities injected at the great saphenous vein (GSV) through a catheter at the same time. Elastic bandages were applied at the site of the injected varicosities after the therapy. The clogging of the varicose veins, the improvement of the clinical symptoms and the adverse reaction were observed. Results: Lauromacrogol foam sclerosing agent was successfully injected under the guidance of fluoroscopy in 20 patients with 28 affected extremities. The average volume of foam sclerosing agent in each affected extremity was 7.8 ml. All patients presented self limiting minor complications, including swelling and pain, which was obviously alleviated by the externally applied Mucopolysaccharide Polysulfate Cream. Two patients presented cough that was relieved after inhaling oxygen. Most of treated varicosities demonstrated pigmentation after the first week, which gradually disappeared after the four-month use of vitamin E capsule. A second foam sclerotherapy was carried out for 3 affected extremities of 3 patients two months after the first therapy. Two cases of leg venous ulcer were healed within a few weeks. All patients could walk immediately with no deep vein thrombosis, pulmonary embolism, anaphylaxis, or transient visual disturbance. Obvious abnormal varicose veins as well as the soreness and fatigue of the lower extremities disappeared in all patients at the 10th-month follow-up. The grading of the disease was significantly improved by the treatment (Z=5.103, P<0.01). Conclusions: The efficacy of lauromacrogol foam sclerosing agent in the treatment of varicose veins of the lower extremities is

In Vitro Vasoactive Effects of Levobupivacaine and Ropivacaine on the Isolated Human Umbilical Artery and Vein

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Alper Kılıçaslan

2011-06-01

Full Text Available Objective: In this in vitro study, we investigated the vasoactive effects of levobupivacaine and ropivacaine on vascular smooth muscle derived from human umbilical arteries and veins.Material and Methods: The strips were mounted in tissue baths at 37°C continuously gassed with 5% CO2 in oxygen for isometric recording of contractile activity on a polygraph. The endothelium of some tissues was mechanically removed to assess the influence of the endothelium on contractility. The strips were precontracted with serotonin (10-6 M 5-HT; n=7. After obtaining the maximal contraction, responses obtained by adding levobupivacaine and ropivacaine (10-9-10-4 M; n=7 cumulatively were recorded. Contractions were expressed as the (% of 5HT maximal response percentage of 5 HT’s maximal response.Results: Both levobupivacaine and ropivacaine induce a concentration-dependent contraction in the smooth muscle cells of umbilical arteries and veins. Maximum contractile response (Emax of levobupivacaine (79.2±2.5, 71.1±2.6 was higher than ropivacaine (68.4±2, 36.2±2.8 on both umbilical arteries and veins. There were no statistically significant differences between contraction responses of endothelium-intact and endothelium-denuded tissues. Conclusion: The results suggest that, in high concentrations, levobupivacaine and ropivacaine may affect umbilical blood flow by contracting the umbilical artery and vein, thus reducing fetal blood flow.

The surgical anatomy of the infrapatellar branch of the saphenous nerve in relation to incisions for anteromedial knee surgery.

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Kerver, A L A; Leliveld, M S; den Hartog, D; Verhofstad, M H J; Kleinrensink, G J

2013-12-04

Iatrogenic injury to the infrapatellar branch of the saphenous nerve is a common complication of surgical approaches to the anteromedial side of the knee. A detailed description of the relative anatomic course of the nerve is important to define clinical guidelines and minimize iatrogenic damage during anterior knee surgery. In twenty embalmed knees, the infrapatellar branch of the saphenous nerve was dissected. With use of a computer-assisted surgical anatomy mapping tool, safe and risk zones, as well as the location-dependent direction of the nerve, were calculated. The location of the infrapatellar branch of the saphenous nerve is highly variable, and no definite safe zone could be identified. The infrapatellar branch runs in neither a purely horizontal nor a vertical course. The course of the branch is location-dependent. Medially, it runs a nearly vertical course; medial to the patellar tendon, it has a -45° distal-lateral course; and on the patella and patellar tendon, it runs a close to horizontal-lateral course. Three low risk zones for iatrogenic nerve injury were identified: one is on the medial side of the knee, at the level of the tibial tuberosity, where a -45° oblique incision is least prone to damage the nerves, and two zones are located medial to the patellar apex (cranial and caudal), where close to horizontal incisions are least prone to damage the nerves. The infrapatellar branch of the saphenous nerve is at risk for iatrogenic damage in anteromedial knee surgery, especially when longitudinal incisions are made. There are three low risk zones for a safer anterior approach to the knee. The direction of the infrapatellar branch of the saphenous nerve is location-dependent. To minimize iatrogenic damage to the nerve, the direction of incisions should be parallel to the direction of the nerve when technically possible. These findings suggest that iatrogenic damage of the infrapatellar branch of the saphenous nerve can be minimized in anteromedial

Ultrastructural investigations for reducing endothelial cell damage of vein grafts during CABG-operation and practical consequences.

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Hickethier, T; Dämmrich, J; Silber, R E; Finster, S; Elert, O

1999-02-01

In the present study the influence of different storage solutions on endothelial integrity or damage was investigated with direct methods particularly with transmission electron microscopy (TEM), scanning electron microscopy (SEM) and immunohistochemistry. Saphenous vein segments of 10 cm in length were taken surgically from 6 male CABG-patients (aged 60-70) under standardized conditions. Each vein segment was cut into rings, which were incubated at room temperature for 45 minutes in different storage solutions, particularly in 0.9% sodium chloride solution and in buffered solution (M 199) with 5% human serum albumin respectively. Then, the vein segments were fixed in 3.5% glutaraldehyde and prepared for scanning and transmission electron microscopy to evaluate the endothelial damage. In addition, immunohistochemical staining (CD34, PECAM and Factor VIII) was performed. When using 0.9% sodium chloride solution, the SEM-examination revealed that 55% of the cell population was destroyed. In comparison to these findings only 26% of the endothelial cell population was damaged when the venous segment was stored in buffered solution with 5% albumin (p<0.01). In immunohistochemistry (CD34, PECAM, Factor VIII) these findings were supported. This study demonstrates the importance of storage solutions in regard to endothelial integrity. For best preservation of endothelium it is necessary to modify conventional storage methods. So, storage in buffered solution with albumin has shown much better endothelial cell preservation compared with physiological saline which might reduce the obliteration rate of CABG in future.

Cirurgia de varizes: história e evolução Varicose vein surgery: history and evolution

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Charles Angotti Furtado de Medeiros

2006-12-01

Full Text Available Como a safenectomia é uma cirurgia bem estabelecida, a utilização de um método pouco invasivo para obter os mesmos efeitos indica que os benefícios esperados a curto e médio prazo devem prevalecer sobre os riscos previstos. Entretanto, em se tratando de uma doença muito prevalente na população mundial, há grande preocupação por parte dos órgãos de saúde governamentais e das sociedades científicas correlacionadas sobre esse assunto, de tal forma que os argumentos sobre novas modalidades de tratamento devem estar bem fundamentados, inclusive para aceitação pelo público em geral.Com o intuito de se avaliar efetivamente novos dispositivos, devem ser conduzidos estudos em pacientes e com grupos controles que sejam bem delineados. É preciso submeter qualquer projeto de pesquisa sobre o assunto à apreciação do comitê de ética na instituição em que o trabalho será conduzido para aprovação prévia.Since great saphenous vein stripping is a well established surgery, the use of a minimally invasive method to obtain the same effects indicates that short and medium-term benefits should prevail over expected risks. However, because it is a very common disease in the world population, there is great concern about this subject by government health institutions and correlated scientific societies. Therefore, the arguments about new treatment modalities must be well based, including to gain acceptance by the general public.To effectively evaluate new devices, there must be well designed clinical studies with groups and controls. All projects about this matter must be submitted to the appreciation of an ethics committee at the institution where the research will be carried out for previous approval.

Analytical prediction of the heat transfer from a blood vessel near the skin surface when cooled by a symmetrical cooling strip

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Chato, J. C.; Shitzer, A.

1971-01-01

An analytical method was developed to estimate the amount of heat extracted from an artery running close to the skin surface which is cooled in a symmetrical fashion by a cooling strip. The results indicate that the optimum width of a cooling strip is approximately three times the depth to the centerline of the artery. The heat extracted from an artery with such a strip is about 0.9 w/m-C which is too small to affect significantly the temperature of the blood flow through a main blood vessel, such as the carotid artery. The method is applicable to veins as well.

Secondary venous aneurysm following intravenous drug abuse: A case report

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Marković Miroslav

2016-01-01

Full Text Available Introduction. Venous aneurysm (VA is a rare condition that can be presented in both superficial and deep venous system. Secondary VAs as well as pseudoaneurysms are usually caused by external spontaneous or iatrogenic trauma. They are often misdiagnosed and inadequately treated. Complications include thrombosis, phlebitis, eventual pulmonary embolism and rupture. Case report. We presented a case of secondary VA of the great saphenous vein developed in a young addict following chronic intravenous drug application in the groin region. Aneurysm required urgent surgical treatment due to bleeding complication as it was previously misdiagnosed for hematoma (or abscess and punctuated by a general surgeon. Complete resection of VA with successful preservation of continuity of the great saphenous vein was performed. Postoperative course was uneventful. Regular venous flow through the great saphenous vein was confirmed on control ultrasound examination. Conclusion. VAs are uncommon, among them secondary VA being extremely rare. In cases with a significant diameter or threatening complications surgical treatment is recommended. [Projekat Ministarstva nauke Republike Srbije, br. ON175008 i br. III41007

Clinical presentation of women with pelvic source varicose veins in the perineum as a first step in the development of a disease-specific patient assessment tool.

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Gibson, Kathleen; Minjarez, Renee; Ferris, Brian; Neradilek, Moni; Wise, Matthew; Stoughton, Julianne; Meissner, Mark

2017-07-01

Pelvic venous incompetence can cause symptomatic varicose veins in the perineum, buttock, and thigh. Presentation, symptom severity, and response to treatment of pelvic source varicose veins are not well defined. Currently available tools to measure the severity of lower extremity venous disease and its effects on quality of life may be inadequate to assess disease severity in these patients. The purpose of this study was to evaluate the histories, demographics, and clinical presentations of women with pelvic source varicose veins and to compare these data to a population of women with nonpelvic source varicose veins. A total of 72 female patients with symptomatic pelvic source varicose veins were prospectively followed up. Age, weight, height, parity, and birth weights of offspring were recorded. Both pelvic source varicose veins and saphenous incompetence were identified by duplex ultrasound. Patients were queried as to their primary symptoms, activities that made their symptoms worse, and time when their symptoms were most prominent. Severity of disease was objectively evaluated using the revised Venous Clinical Severity Score (rVCSS) and 10-point numeric pain rating scale (NPRS). Compared with women without a pelvic source of varicose veins (N = 1163), patients with pelvic source varicose veins were younger (mean, 44.6 ± 8.6 vs 52.6 ± 12.9 years; P source varicose veins are a unique subset of patients. They are younger and thinner than those with nonpelvic source varicose veins, have larger infants than the general U.S. population, and have an inverse correlation between age and pain. As the majority of premenopausal patients have increased symptoms during menses, this may be due to hormonal influence. As it is poorly associated with patient-reported discomfort, the rVCSS is a poor tool for evaluating pelvic source varicose veins. A disease-specific tool for the evaluation of pelvic source varicose veins is critically needed, and this study is a first

Sarpogrelate hydrochloride reduced intimal hyperplasia in experimental rabbit vein graft.

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Kodama, Akio; Komori, Kimihiro; Hattori, Keisuke; Yamanouchi, Dai; Kajikuri, Junko; Itoh, Takeo

2009-05-01

The selective 5-HT(2A) receptor antagonist sarpogrelate has been clinically used for treatment in atherosclerotic diseases. However, it remains unknown whether administration of sarpogrelate inhibits intimal hyperplasia seen in autologous vein grafts. Therefore, we sought to clarify this question using an experimental rabbit vein graft model. Male rabbits were divided into two groups: a control group and a sarpogrelate-treated group. The jugular vein was interposed in the carotid artery in reversed fashion for 4 weeks and intimal hyperplasia of the grafted vein was measured (n = 8, in each group). Acetylcholine (ACh)-induced endothelium-dependent relaxation was tested by precontraction with prostaglandin F(2alpha) (PGF(2alpha), 5 muM) (n = 5, in each). endothelial nitric oxide synthase (eNOS) protein expression and superoxide production of these veins were also assessed. The suppression of intimal hyperplasia was significantly greater in the sarpogrelate-treated group than in the control group. ACh induced an endothelium-dependent relaxation in the sarpogrelate-treated group (but not in the control group). In endothelium-intact strips from the sarpogrelate-treated group, the nitric oxide (NO) synthase inhibitor nitroarginine enhanced the PGF(2alpha)-induced contraction and blocked the ACh-induced relaxation. Immunoreactive eNOS protein expression was similar between the two groups but superoxide production (estimated from ethidium fluorescence) in endothelial cells was significantly smaller in the sarpogrelate-treated group. The present results indicate that in vivo blockade of 5-HT(2A) receptors leads to an inhibition of intimal hyperplasia in rabbit vein graft. It is suggested that an increased function of endothelium-derived NO through a reduction in endothelial superoxide production may be a possible underlying mechanism for this. These novel findings support the clinical usefulness of sarpogrelate for preventing intimal hyperplasia in vein graft after bypass

Antiplatelet drug selection in PCI to vein grafts in patients with acute coronary syndrome and adverse clinical outcomes

DEFF Research Database (Denmark)

Sirker, Alex; Kwok, Chun Shing; Kontopantelis, Evangelos

2018-01-01

OBJECTIVE: This study aims to evaluate outcomes associated with different P2Y12 agents in Saphenous Vein graft (SVG) percutaneous coronary intervention (PCI). BACKGROUND: SVG PCI is associated with greater risks of ischemic complications, compared with native coronary PCI. Outcomes associated...... with the use of potent P2Y12 blocking drugs, Prasugrel and Ticagrelor, in SVG PCI are unknown. METHODS: Patients included in the study underwent SVG PCI in the United Kingdom between 2007 and 2014 for acute coronary syndrome and were grouped by P2Y12 antiplatelet use. In-hospital major adverse cardiac events....... CONCLUSIONS: Our real world national study provides no clear evidence to indicate that use of potent P2Y12 blockers in SVG PCI is associated with improved clinical outcomes....

Strip interpolation in silicon and germanium strip detectors

International Nuclear Information System (INIS)

Wulf, E. A.; Phlips, B. F.; Johnson, W. N.; Kurfess, J. D.; Lister, C. J.; Kondev, F.; Physics; Naval Research Lab.

2004-01-01

The position resolution of double-sided strip detectors is limited by the strip pitch and a reduction in strip pitch necessitates more electronics. Improved position resolution would improve the imaging capabilities of Compton telescopes and PET detectors. Digitizing the preamplifier waveform yields more information than can be extracted with regular shaping electronics. In addition to the energy, depth of interaction, and which strip was hit, the digitized preamplifier signals can locate the interaction position to less than the strip pitch of the detector by looking at induced signals in neighboring strips. This allows the position of the interaction to be interpolated in three dimensions and improve the imaging capabilities of the system. In a 2 mm thick silicon strip detector with a strip pitch of 0.891 mm, strip interpolation located the interaction of 356 keV gamma rays to 0.3 mm FWHM. In a 2 cm thick germanium detector with a strip pitch of 5 mm, strip interpolation of 356 keV gamma rays yielded a position resolution of 1.5 mm FWHM

Morphologic changes in the vein after different numbers of radiofrequency ablation cycles.

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Shaidakov, Evgeny V; Grigoryan, Arsen G; Korzhevskii, Dmitriy E; Ilyukhin, Evgeny A; Rosukhovski, Dmitriy A; Bulatov, Vasiliy L; Tsarev, Oleg I

2015-10-01

It has not yet been clarified whether it is possible to decrease the percentage of recurrences after radiofrequency (RF) ablation by way of increasing the number of RF ablation cycles. The aim of this study was to assess the morphologic changes in excised vein fragments after different durations of RF ablation exposure. In the first part of the study, we performed a morphologic analysis of eight cases of great saphenous vein (GSV) recanalization 6 months after RF ablation. The second part was performed on a suprafascial segment of the GSV with a length of >22 cm and a minimum diameter of 5 mm in 10 patients, who had given their consent to intraoperative excision of suprafascial GSV segments after RF ablation treatment through four 1-cm-long diametrical cuts. Prior ultrasound analysis had shown an average 6.9-mm diameter of the suprafascial segments. The segment was divided into three 7-cm-long subsegments and one control segment. The first, second, and third segments were treated with three, two, and one RF ablation cycles (ClosureFast; Covidien, Mansfield, Mass), respectively; the control segment was not exposed to RF ablation at all. Morphologic study of 160 sections of the vein (five sections of each segment and 10 control specimens) was carried out. The specimens were dyed with hematoxylin and orcein. The ensuing analysis was performed by an experienced expert with the blind study method (the specimens were numbered without any hint as to the quantity of RF ablation cycles performed on them). The intergroup comparison of the depth of venous wall damage was based on comparison of the coefficient of alteration, which is calculated as the relation of damage depth to thickness of the vein. After one RF ablation cycle, the depth of blurring of the structural elements only on some portions reached the middle of the muscle layer of the wall (coefficient of alteration, α = 26%). After two cycles, blurring of the structural elements on some portions extended to the

Sclerotherapy of Varicose Veins and Spider Veins

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... Index A-Z Sclerotherapy of Varicose Veins and Spider Veins Sclerotherapy uses injections from a very fine, ... Sclerotherapy? What is Sclerotherapy of Varicose Veins and Spider Veins? Sclerotherapy is a minimally invasive treatment used ...

One-year results of the use of endovenous radiofrequency ablation utilising an optimised radiofrequency-induced thermotherapy protocol for the treatment of truncal superficial venous reflux.

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Badham, George E; Dos Santos, Scott J; Lloyd, Lucinda Ba; Holdstock, Judy M; Whiteley, Mark S

2018-06-01

Background In previous in vitro and ex vivo studies, we have shown increased thermal spread can be achieved with radiofrequency-induced thermotherapy when using a low power and slower, discontinuous pullback. We aimed to determine the clinical success rate of radiofrequency-induced thermotherapy using this optimised protocol for the treatment of superficial venous reflux in truncal veins. Methods Sixty-three patients were treated with radiofrequency-induced thermotherapy using the optimised protocol and were followed up after one year (mean 16.3 months). Thirty-five patients returned for audit, giving a response rate of 56%. Duplex ultrasonography was employed to check for truncal reflux and compared to initial scans. Results In the 35 patients studied, there were 48 legs, with 64 truncal veins treated by radiofrequency-induced thermotherapy (34 great saphenous, 15 small saphenous and 15 anterior accessory saphenous veins). One year post-treatment, complete closure of all previously refluxing truncal veins was demonstrated on ultrasound, giving a success rate of 100%. Conclusions Using a previously reported optimised, low power/slow pullback radiofrequency-induced thermotherapy protocol, we have shown it is possible to achieve a 100% ablation at one year. This compares favourably with results reported at one year post-procedure using the high power/fast pullback protocols that are currently recommended for this device.

Distal anastomotic vein adjunct usage in infrainguinal prosthetic bypasses.

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

2013-04-01

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

Subsartorial Entrapment of the Saphenous Nerve of a Competitive.

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Dumitru, D; Windsor, R E

1989-01-01

In brief: A 40-year-old bodybuilder had a six- week history of progressively worsening pain of the medial part of her right knee that did not respond to rest and a nonsteroidal anti-inflammatory drug (NSAID). Somatosensory evoked potential readings suggested that both branches of the right saphenous nerve were entrapped. Management consisting of two intramuscular injections of bupivacaine, administrations of two different NSAIDs, and application of knee wraps around the subsartorial region resolved the patient's symptoms within five weeks. She then resumed an intensive lower-extremity exercise regimen without discomfort, in preparation for a bodybuilding competition.

Brachial artery repair using the basilic vein as a reliable conduit in a 3-year-old child

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Hyunyoung G. Kim

2017-04-01

Full Text Available A supracondylar fracture of the humerus is the most common upper extremity fracture in children with concurrent neurovascular complications. However, bypass grafting in the management of a pediatric open elbow dislocation with an arterial injury has rarely been reported in the literature. Hence, an adequate conduit for a vessel graft interposition remains questionable when a primary anastomosis is limited in an arterial reconstruction. The purpose of this study is to present a brachial artery reconstruction in a 3-year-old patient with an open supracondylar fracture of the humerus. In the clinical and surgical examination of the patient, an open wound in the left antecubital fossa presented with accompanying brachial artery injury. To repair the artery, a reverse end-to-end anastomosis was conducted using basilic vein graft from the ipsilateral arm under general anesthesia. The patient had palpable radial pulses in the postoperative clinical examination and was discharged without complications. The great saphenous vein (GSV has proven to be the most common and the best conduit for arterial reconstruction of the upper extremity in the adult patients. However, the GSV graft is known to have the propensity for becoming aneurysmal in pediatric patients. Some studies have demonstrated the basilic vein as a suitable conduit in pediatric patients, in that it has durable patency, fewer branches, size compatibility for anastomosis, and proximity to the brachial artery. Our case confirms the safety of using this autogenous vein from within the zone of injury for arterial reconstruction, after a supracondylar humeral fracture. The management of pediatric elbow fractures accompanying vascular injuries can be technically demanding due to relatively small, delicate structures and concurrent neurovascular network. Nonetheless, a vascular injury should be treated with high level of suspicion and immediate intervention to avoid any limb ischemia or loss. In

A retrospective study of a new n-butyl-2-cyanoacrylate glue ablation catheter incorporated with application guiding light for the treatment of venous insufficiency: Twelve-month results.

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Yavuz, Turhan; Acar, Altay Nihat; Aydın, Huseyin; Ekingen, Evren

2018-01-01

Objective This study aims to present the early results of a retrospective study of the use of novel n-butyl-2-cyanoacrylate (VenaBlock)-based nontumescent endovenous ablation with a guiding light for the treatment of patients with varicose veins. Methods Patients with lower limb venous insufficiency were treated with n-butyl-2-cyanoacrylate (VenaBlock Venous Closure System) between April 2016 and July 2016. The study enrolled adults aged 21-70 years with symptomatic moderate to severe varicosities (C2-C4b) and great saphenous vein reflux lasting longer than 0.5 s with great saphenous vein diameter between 5.5 and 15 mm assessed in the standing position. No compression stockings were used after the procedure. Duplex ultrasound imaging and clinical follow-up were performed on the third day, first month, sixth month, and 12th month. Clinical, etiological, anatomical, pathophysiological classification; venous clinical severity score; and completed Aberdeen varicose vein questionnaire were recorded. Results Five hundred thirty-eight patients with great saphenous vein incompetency underwent n-butyl-2-cyanoacrylate ablation. The mean ablation length was 25.69 ± 4.8 cm, and the average amount of n-butyl-2-cyanoacrylate delivered was 0.87 ± 0.15 ml. The mean procedure time was 11.7 ± 4.9 min. Procedural success was 100%, and complete occlusion was observed after treatment and at the third-day follow-up. We observed ecchymosis in five patients (1.00%) at the entry site at the third-day follow-up. Phlebitis was encountered with six (1.20%) patients. No skin pigmentation, hematoma, paresthesia, deep vein thrombosis, or pulmonary embolism was observed. Kaplan-Meier analysis yielded an occlusion rate of 99.4% at the 12-month follow-up. All patients had significant improvement in venous clinical severity score and Aberdeen varicose vein questionnaire scores postoperatively ( p <0.0001). Venous clinical severity score scores decreased from 5.43 ± 0.87 to

Pelvic Vein Embolisation in the Management of Varicose Veins

International Nuclear Information System (INIS)

Ratnam, Lakshmi A.; Marsh, Petra; Holdstock, Judy M.; Harrison, Charmaine S.; Hussain, Fuad F.; Whiteley, Mark S.; Lopez, Anthony

2008-01-01

Pelvic vein incompetence is common in patients with atypical varicose veins, contributing to their recurrence after surgery. Therefore, refluxing pelvic veins should be identified and treated. We present our experience with pelvic vein embolisation in patients presenting with varicose veins. Patients presenting with varicose veins with a duplex-proven contribution from perivulval veins undergo transvaginal duplex sonography (TVUS) to identify refluxing pelvic veins. Those with positive scans undergo embolisation before surgical treatment of their lower limb varicose veins. A total of 218 women (mean age of 46.3 years) were treated. Parity was documented in the first 60 patients, of whom 47 (78.3%) were multiparous, 11 (18.3%) had had one previous pregnancy, and 2 (3.3%) were nulliparous. The left ovarian vein was embolised in 78%, the right internal iliac in 64.7%, the left internal iliac in 56.4%, and the right ovarian vein in 42.2% of patients. At follow-up TVUS, mild reflux only was seen in 16, marked persistent reflux in 6, and new reflux in 3 patients. These 9 women underwent successful repeat embolisation. Two patients experienced pulmonary embolisation of the coils, of whom 1 was asymptomatic and 1 was successfully retrieved; 1 patient had a misplaced coil protruding into the common femoral vein; and 1 patient had perineal thrombophlebitis. The results of our study showed that pelvic venous embolisation by way of a transjugular approach is a safe and effective technique in the treatment of pelvic vein reflux.

Journal of Special Operations Medicine. Volume 9, Edition 2, Spring 2009

Science.gov (United States)

2009-01-01

patient. The most accessible veins for intra- venous catheterization include the cephalic vein on the thoracic limb (Figure 10), the saphenous vein on...threatening hypotension by restoring central blood vol- ume through enhancement of venous blood flow back to the heart with each inspiratory effort. HOW...examination of the latest advancements in medicine and the history of unconventional warfare medicine. Content: Content of this publication is not

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

Science.gov (United States)

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

2013-11-01

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.

A comparative study on the uniaxial mechanical properties of the umbilical vein and umbilical artery using different stress-strain definitions.

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Karimi, Alireza; Navidbakhsh, Mahdi

2014-12-01

The umbilical cord is part of the fetus and generally includes one umbilical vein (UV) and two umbilical arteries (UAs). As the saphenous vein and UV are the most commonly used veins for the coronary artery disease treatment as a coronary artery bypass graft (CABG), understating the mechanical properties of UV has a key asset in its performance for CABG. However, there is not only a lack of knowledge on the mechanical properties of UV and UA but there is no agreement as to which stress-strain definition should be implemented to measure their mechanical properties. In this study, the UV and UA samples were removed after caesarean from eight individuals and subjected to a series of tensile testing. Three stress definitions (second Piola-Kichhoff stress, engineering stress, and true stress) and four strain definitions (Almansi-Hamel strain, Green-St. Venant strain, engineering strain, and true strain) were employed to determine the linear mechanical properties of UVs and UAs. The nonlinear mechanical behavior of UV/UA was computationally investigated using hyperelastic material models, such as Ogden and Mooney-Rivlin. The results showed that the effect of varying the stress definition on the maximum stress measurements of the UV/UA is significant but not when calculating the elastic modulus. In the true stress-strain diagram, the maximum strain of UV was 92 % higher, while the elastic modulus and maximum stress were 162 and 42 % lower than that of UA. The Mooney-Rivlin material model was designated to represent the nonlinear mechanical behavior of the UV and UA under uniaxial loading.

Superior Lower Extremity Vein Graft Bypass Patency among Married Patients with Peripheral Artery Disease.

Science.gov (United States)

Lagergren, Emily; Kempe, Kelly; Craven, Timothy E; Kornegay, Susan T; Hurie, Justin B; Garg, Nitin; Velazquez-Ramirez, Gabriela; Edwards, Matthew S; Corriere, Matthew A

2017-10-01

Outcome disparities associated with lower extremity bypass (LEB) for peripheral artery disease (PAD) have been identified but are poorly understood. Marital status may affect outcomes through factors related to health risk behaviors, adherence, and access to care but has not been characterized as a predictor of surgical outcomes and is often omitted from administrative data sets. We evaluated associations between marital status and vein graft patency following LEB using multivariable models adjusting for established risk factors. Consecutive patients undergoing autogenous LEB for PAD were identified and analyzed. Survival analysis and Cox proportional hazards models were used to evaluate patency stratified by marital status (married versus single, divorced, or widow[er]) adjusting for demographic, comorbidity, and anatomic factors in multivariable models. Seventy-three participants who underwent 79 autogenous vein LEB had complete data and were analyzed. Forty-three patients (58.9%) were married, and 30 (41.1%) were unmarried. Compared with unmarried patients, married patients were older at the time of their bypass procedure (67.3 ± 10.8 years vs. 62.2 ± 10.6 years; P = 0.05). Married patients also had a lower prevalence of female gender (11.6% vs. 33.3%; P = 0.02). Diabetes, hypertension, hyperlipidemia, and smoking were common among both married and unmarried patients. Minimum great saphenous vein conduit diameters were larger in married versus unmarried patients (2.82 ± 0.57 mm vs. 2.52 ± 0.65 mm; P = 0.04). Twenty-four-month primary patency was 66% for married versus 38% for unmarried patients. In a multivariable proportional hazards model adjusting for proximal and distal graft inflow/outflow, medications, gender, age, race, smoking, diabetes, and minimum vein graft diameter, married status was associated with superior primary patency (hazard ratio [HR] = 0.33; 95% confidence limits [0.11, 0.99]; P = 0.05); other predictive covariates

Foot skin depots of 18F-fluorodeoxyglucose do not enable PET/CT lymphography of the lower extremity lymphatic system in man

DEFF Research Database (Denmark)

Jensen, Mads Radmer; Simonsen, Lene; Lonsdale, Markus

2013-01-01

consecutive PET scans of the same region.Blood activity increased faster and to a greater extent in the great saphenous veins compared to the medial cubital vein. PET/CT images showed activity in the superficial and deep veins of the lower extremities. No lymphatic collectors or nodes were visualized....... CONCLUSION: Neither subcutaneous nor intradermal injection of 18F-FDG allows imaging of the lower extremity lymphatic system in man....

Fill and aspirate foam sclerotherapy (FAFS): a new approach for sclerotherapy of large superficial varicosities concomitant to endovenous laser ablation of truncal vein

International Nuclear Information System (INIS)

Atasoy, M.M.

2015-01-01

Aim: To define and assess the short-term clinical feasibility of fill and aspirate foam sclerotherapy (FAFS) for treating large superficial varicose veins concomitant to endovenous laser ablation (EVLA). Materials and methods: Twenty-seven patients who refused to have phlebectomies with great saphenous vein reflux and large superficial varicosities were included in the study. Both EVLA and FAFS were performed concomitantly. FAFS is a technique in which all or most of the bubbles and blood–foam mixture are removed from the targeted large varicose veins immediately after the foam has caused sufficient damage to the endothelial cells. Patients were reviewed 1 month and 6 months after the treatment. Improvement in the clinical, aetiological, anatomical, and pathological classification (CEAP), and clinical severity was graded using the revised venous clinical severity score (rVCSS) and cosmetic results were investigated at the 6 month visit. Results: Ablation of GSV was performed in 27 limbs in 27 patients (19 males, 70.3%; mean age 44 years; range 21–69 years). All patients had a technically successful FAFS treatment. The CEAP classification score, the rVCSS values, and the cosmetic results showed prominent improvement 6 months after the treatment. There were no significant complications, such as stroke, skin burns, necrosis, paresthesia, deep-vein thrombosis, or allergic reaction. None of the patients experienced neurological events. Conclusion: FAFS is a promising safe and effective technique for treating large superficial varicosities concomitant to EVLA of the truncal veins with excellent clinical results. Randomized prospective studies with larger series are required to compare the FAFS with ambulatory phlebectomy and standard foam sclerotherapy. - Highlights: • Fill and aspirate foam sclerotherapy (FAFS) is a easy and feasible alternative to the ambulatory phlebectomy for the treatment of large superficial varicose veins. • By using FAFS, foam can be

Portal Vein Thrombosis

Directory of Open Access Journals (Sweden)

Hakan Demirci

2016-01-01

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.

The effects of fenoldopam on coronary conduit blood flow after coronary artery bypass graft surgery.

LENUS (Irish Health Repository)

Halpenny, M

2012-02-03

OBJECTIVE: To quantify the effects of fenoldopam, 0.1 microg\\/kg\\/min, on left internal mammary artery (LIMA) and saphenous vein blood flow after coronary anastomosis. DESIGN: Prospective, randomized, double-blind, placebo-controlled trial. SETTING: University teaching hospital, single institution. PARTICIPANTS: Thirty-one American Society of Anesthesiologists III patients undergoing elective coronary revascularization. INTERVENTIONS: A perivascular ultrasonic flow probe (Linton Instrumentation, Norfolk, UK) was placed around the LIMA and saphenous vein graft after coronary anastomosis. MEASUREMENTS AND MAIN RESULTS: Immediately before and at 5-minute intervals for 15 minutes after starting the infusion, blood flow was measured in the LIMA and one saphenous vein graft using a transit time ultrasonic flow probe. Heart rate, blood pressure, and central venous pressure were documented at these time points. Administration of fenoldopam, 0.1 microg\\/kg\\/min, did not alter heart rate or blood pressure. A small, nonsignificant increase in LIMA blood flow occurred during the 15-minute study period (30 +\\/- 12 to 35 +\\/- 10 mL\\/min) in patients who received fenoldopam. No significant changes occurred in the placebo group. CONCLUSIONS: The findings indicate that fenoldopam, 0.1 microg\\/kg\\/min, did not influence coronary conduit blood flow to a clinically significant extent. The small increase in LIMA blood flow may be of greater importance in high-risk patients or in the prevention of coronary arterial spasm.

Collateral veins in left renal vein stenosis demonstrated via CT

Energy Technology Data Exchange (ETDEWEB)

Lien, H.H.; Lund, G.; Talle, K.

1983-02-01

Twelve patients with left renal vein stenosis from tumor compression were studied with CT. All had distended collateral veins in the perirenal space which either formed a radiating or a cobweb pattern or appeared as marked longitudinal veins. Inferior phrenic vein branches were seen in seven patients and were considerably enlarged in two. Other major veins possibly taking part in collateral circulation could not be recognized due to obliteration of fat planes. The renal fascia was thickened in eleven patients, probably due to edema. A close study of the perirenal space with CT may give valuable information about collateral development.

Collateral veins in left renal vein stenosis demonstrated via CT

International Nuclear Information System (INIS)

Lien, H.H.; Lund, G.; Talle, K.

1983-01-01

Twelve patients with left renal vein stenosis from tumor compression were studied with CT. All had distended collateral veins in the perirenal space which either formed a radiating or a cobweb pattern or appeared as marked longitudinal veins. Inferior phrenic vein branches were seen in seven patients and were considerably enlarged in two. Other major veins possibly taking part in collateral circulation could not be recognized due to obliteration of fat planes. The renal fascia was thickened in eleven patients, probably due to edema. A close study of the perirenal space with CT may give valuable information about collateral development. (orig.)

Cumulative inhibitory effect of low-dose aspirin on vascular prostacyclin and platelet thromboxane production in patients with atherosclerosis.

Science.gov (United States)

Weksler, B B; Tack-Goldman, K; Subramanian, V A; Gay, W A

1985-02-01

The relationship between the antithrombotic and antiplatelet effects of aspirin is complex, since aspirin influences other systems that protect against thrombosis as well as inhibiting platelet function. We investigated possible cumulative effects of low-dose aspirin on vascular production of prostacyclin in patients with documented atherosclerotic cardiovascular disease. Candidates for coronary artery vein graft bypass ingested 20 mg of aspirin daily during the week before surgery, and platelet aggregation, platelet formation of thromboxane A2 (TXA2), aortic and saphenous vein production of prostacyclin (PGI2), and hemostatic status were measured at the time of the bypass surgery. Low-dose aspirin markedly inhibited platelet aggregation responses and reduced TXA2 generation by greater than 90%, effects similar to those observed with much higher doses of aspirin. Both aortic and saphenous vein production of PGI2 were inhibited by 50% compared with PGI2 produced by vascular tissues of control subjects who received no aspirin preoperatively (51 +/- 10 pg 6-keto-PGF1 alpha/mg aortic wet weight [mean +/- SEM] in aspirin-treated subjects vs 130 +/- 16 pg/mg in control subjects, and 71 +/- 8 pg/mg saphenous vein wet weight vs 131 +/- 17 pg/mg). Blood loss at surgery was not significantly increased by preoperative low-dose aspirin as measured by chest tube drainage (754 +/- 229 ml in aspirin-treated subjects vs 645 +/- 271 ml in control subjects), hematocrit nadir (31.2 +/- 1.9% vs 31.8 +/- 1.7%), or transfusions (2.2 +/- 1.3 units of red blood cells vs 2.2 +/- 1.7 units).(ABSTRACT TRUNCATED AT 250 WORDS)

Model for prediction of strip temperature in hot strip steel mill

International Nuclear Information System (INIS)

Panjkovic, Vladimir

2007-01-01

Proper functioning of set-up models in a hot strip steel mill requires reliable prediction of strip temperature. Temperature prediction is particularly important for accurate calculation of rolling force because of strong dependence of yield stress and strip microstructure on temperature. A comprehensive model was developed to replace an obsolete model in the Western Port hot strip mill of BlueScope Steel. The new model predicts the strip temperature evolution from the roughing mill exit to the finishing mill exit. It takes into account the radiative and convective heat losses, forced flow boiling and film boiling of water at strip surface, deformation heat in the roll gap, frictional sliding heat, heat of scale formation and the heat transfer between strip and work rolls through an oxide layer. The significance of phase transformation was also investigated. Model was tested with plant measurements and benchmarked against other models in the literature, and its performance was very good

Model for prediction of strip temperature in hot strip steel mill

Energy Technology Data Exchange (ETDEWEB)

Panjkovic, Vladimir [BlueScope Steel, TEOB, 1 Bayview Road, Hastings Vic. 3915 (Australia)]. E-mail: Vladimir.Panjkovic@BlueScopeSteel.com

2007-10-15

Proper functioning of set-up models in a hot strip steel mill requires reliable prediction of strip temperature. Temperature prediction is particularly important for accurate calculation of rolling force because of strong dependence of yield stress and strip microstructure on temperature. A comprehensive model was developed to replace an obsolete model in the Western Port hot strip mill of BlueScope Steel. The new model predicts the strip temperature evolution from the roughing mill exit to the finishing mill exit. It takes into account the radiative and convective heat losses, forced flow boiling and film boiling of water at strip surface, deformation heat in the roll gap, frictional sliding heat, heat of scale formation and the heat transfer between strip and work rolls through an oxide layer. The significance of phase transformation was also investigated. Model was tested with plant measurements and benchmarked against other models in the literature, and its performance was very good.

Endovenous Laser Ablation and Concomitant Foam Sclerotherapy: Experience in 504 Patients

International Nuclear Information System (INIS)

Yilmaz, Saim; Ceken, Kagan; Alparslan, Ahmet; Durmaz, Sedat; Sindel, Timur

2012-01-01

Purpose: To investigate the value of endovenous laser ablation (ELA) and concomitant ultrasound-guided foam sclerotherapy (USGFS) in patients with chronic venous insufficiency. Methods: During a 6-year period, concomitant USGFS of the varicose veins were performed in 504 out of 610 patients who underwent ELA for truncal or perforating vein insufficiency. In these 504 patients (944 legs; bilateral in 440 patients), the incompetent veins were greater saphenous vein in 615 legs, small saphenous vein in 118 veins, perforating veins in 42 legs, and a combination of these in 169 legs. In all patients, after ELA of the incompetent veins, USGFS was performed for the remaining varicosities with 1–3% polidocanol foam. Patients were followed up clinically and with color Doppler ultrasound at 1, 6, and 12 months. Results: ELA was technically successful in all cases, although another venous puncture was necessary in 29 legs. Concomitant USGFS was also technically successful in all cases, but one to three additional sclerotherapy sessions were performed in 203 legs with persistent varicosities. During the follow-up, recanalization of the laser-ablated refluxing veins occurred in 16 legs (1.7%) and was treated with repeat ELA or USGFS. Major complications occurred in 1.4% of the treated legs and included skin necrosis and calf vein thrombosis. Conclusion: ELA and concomitant foam sclerotherapy is feasible and effective. The procedures are associated with a low complication rate and can be performed in both legs in the same session. Concomitant use of laser and foam may potentially decrease the recanalization rate of laser-ablated vessels.

Focus on Varicose Veins

Science.gov (United States)

... because the valves of the veins no longer work. Under the pressure of gravity these veins can continue to expand and, in ... and to determine whether the vein valves are work- ing properly or have ... painless. How are varicose veins treated? Varicose veins are always ...

Popliteal Arterial Aneurysms

African Journals Online (AJOL)

plication was acute arterial occlusion caused by thrombo- embolism. The reasons for ... Total. 43. 55. TABLE 11. CONCOMITANT DISEASE IN 38 PATIENTS .... Dacron prosthesis in 4. .... genous saphenous vein and the type of anastomosis.

Morbidity of Inguinofemoral Lymphadenectomy in Vulval Cancer

Directory of Open Access Journals (Sweden)

A. A. Soliman

2012-01-01

Results. Within a total of 64 inguinofemoral lymphadenectomies, 24% of the inguinal wounds were affected with cellulitis, 13% developed a seroma, 10% suffered wound breakdown, 5% showed lower limb edema within a month of the operation, and 21.4% showed lower limb edema during the long-term followup. No significant correlation could be found between saphenous vein ligation and the development of any of the local complications. The 3-year survival rate in our cohort was 89.3%. Conclusions. Local complications after inguino-femoral lymphadenectomy are still very high, with no single pre-, intra-, or postoperative factor that could be incriminated. Saphenous vein sparing provided no significant difference in decreasing the rate of local complications. More trials should be done to study the sentinel lymph node detection technique.

Three-dimensional contrast-enhanced magnetic resonance angiography (3-D CE-MRA) in the evaluation of hemodialysis access complications, and the condition of central veins in patients who are candidates for hemodialysis access.

Science.gov (United States)

Paksoy, Yahya; Gormus, Niyazi; Tercan, Mehmet Akif

2004-01-01

Arteriovenous (AV) fistulas are crucial in patients requiring long-term hemodialysis (HD). Dysfunctions of these fistulas are the most common causes of recurrent hospitalizations. This study aimed to evaluate the feasibility, safety and usefulness of contrast-enhanced magnetic resonance angiography (CE-MRA) in the evaluation of HD fistulas complications, and the condition of the central veins before HD access. This study comprised 30 consecutive patients (15 females, 15 males; age range 25-66 yrs, mean +/- SD 51.2 +/- 9.9 yrs). Of 30 patients, 26 had native AV fistulas and the remaining four patients, who had a history of previous subclavian vein catheterization, were candidates for HD fistulas. Nine patients had a radiocephalic fistula, 15 had a brachiobasilic fistula, one had a saphenous vein graft, and one had brachiobasilic vein transposition. To observe the fistula complications in these cases, three-dimensional (3-D) CE-MRA using gadolinium was performed. The results were considered normal in three patients (10%), who were candidates for AV fistula construction; one patient had central vein occlusion due to previous catheterization. Thirteen patients (43.3%) had venous stenosis or occlusion; three of them (10%) had low CE arteries distal to fistula region, leading to ischemic complications, and six (20%) had stenosis at the fistula region. Seven patients (23.3%) had venous pseudoaneurysms, whereas two of them had both pseudoaneurysms and fistula region stenosis, and one had both venous stenosis and pseudoaneurysm. There were no adverse or allergic-like reactions or heat and taste sensations observed in our series. 3-D CE-MRA is a useful, safe and a practical imaging modality in complicated fistula diagnosis with fewer complications and side-effects in comparison to fistulography.

The use of expanded microporous polytetrafluoroethylene for limb salvage: a preliminary report.

Science.gov (United States)

Campbell, C D; Brooks, D H; Webster, M W; Bahnson, H T

1976-05-01

Initial laboratory and clinical evaluations of a new prosthetic material, expanded microporous polytetrafluoroethylene (PTFE), for small vessel replacement is promising and encourages further clinical trial. Frequently the autogenous saphenous vein is not available for bypass procedures, and alternative arterial substitutes have not proved reliable for replacement of small vessels. In this study, 15 patients with impending loss of limb and no available saphenous vein underwent revascularization of the lower extremity with expanded microporous PTFE grafts. Thirteen of 15 patients now demonstrate viable extremities with a resulting over-all early patency and limb salvage rate of 87 percent for this series. Follow-up ranges from one to 8 months. Seven patients had diabetes mellitus and eight had atherosclerotic heart disease. Nine grafts crossed the knee joint. In all patients arterial runoff was poor. Six patients had previous femoropopliteal bypasses, five with autogenous veins and one with Dacron velour. Two patients had multiple previous operations that failed, first with autogenous vein and later with fabric grafts. The current limb salvage and patency rate of 87 percent in high-risk patients suggests that expanded PTFE may be the prosthesis of choice when an autogenous vein is not available and possibly an equally good substitute when the venous autograft is available.

Spider Vein Removal

Science.gov (United States)

Spider veins: How are they removed? I have spider veins on my legs. What options are available ... M.D. Several options are available to remove spider veins — thin red lines or weblike networks of ...

What Are Varicose Veins?

Science.gov (United States)

... Leer en español What Is Varicose (VAR-i-kos) veins are swollen, twisted veins that you can ... TA-ze-uhs), spider veins, varicoceles (VAR-i-ko-seals), and other vein problems. Telangiectasias Telangiectasias are ...

Varicose vein - noninvasive treatment

Science.gov (United States)

... spider veins. These are small varicose veins. Salt water (saline) or a chemical solution is injected into the varicose vein. The vein will harden and then disappear. Laser treatment can be used on the surface of the skin. Small bursts ...

Prolonged knee pain relief by saphenous block (new technique

Directory of Open Access Journals (Sweden)

Rajeev Harshe

2013-01-01

Full Text Available Pain in the knee joint can be from a variety of reasons. It can be either from the joint itself, it can be myofascial or it can be neuropathy, radicular pain. The myofascial component can be in different forms, namely, collateral ligament pain, bursitis, tendinitis, and so on. This responds well to local injections of steroids. Pain from the joint can be because of osteoarthritis (OA, rheumatoid arthritis or any other variety of arthritis. Among these osteoarthritis is the most common and naturally occurring pain. There are several modalities used for managing pain in the knee joint. They include medicines and physiotherapy, intra-articular steroid injection, intra-articular Hyalgan, Synvisc injection, prolotherapy, genicular nerve block, ablation, intra-articular pulsed radio frequency (PRF ablation, acupuncture, injection of platelet-rich plasma in the joint, total knee replacement, high tibial osteotomy, arthroscopy and lavage, and so on. All these modalities have their pros and cons. Literature and experience state that the pain relief provided may last for a few months with these modalities except in surgical interventions in advanced OA. The saphenous nerve is termination of femoral nerve and it is essentially sensory nerve. It supplies the medial compartment and some part of the anterior compartment of the knee joint. This nerve has been blocked near the knee joint by way of infiltration by surgeons and anesthetists, for relief of pain after knee surgery, with varying pain relief of postoperative pain. When we block the saphenous in the mid thigh in the sartorial canal, the fluid tends to block the medial branch of the anterior femoral cutaneous nerve also. It is hypothesized that this may give complete medial and anterior knee pain relief and as most of the knee OA patients have medial and anterior knee pain, this may prove useful. Use of ultrasonography helps to locate the nerve better, ensuring perfection. An effort has been made to

Fluoroscopy-guided endovenous sclerotherapy using a microcatheter prior to endovenous laser ablation: Comparison between liquid and foam sclerotherapy for varicose tributaries

Energy Technology Data Exchange (ETDEWEB)

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

2014-08-15

To compare the efficacy and adverse effects of endovenous foam sclerotherapy (EFS) and liquid sclerotherapy (ELS) using a microcatheter for the treatment of varicose tributaries. From December 2007 to January 2009, patients with venous reflux in the saphenous vein were enrolled. The foam or liquid sclerosant was injected through a microcatheter just before endovenous laser ablation (EVLA). Patients were evaluated for the technical success, clinical success, and procedure-related complications during the procedure and follow-up visits. A total of 94 limbs were included: 48 limbs (great saphenous vein [GSV], 35; small saphenous vein [SSV], 13) were managed using EFS and EVLA (foam group; FG), and 46 limbs (GSV, 37; SSV, 9) were treated by ELS and EVLA (liquid group; LG). Varicose tributaries demonstrated complete sclerosis in 92.7% with FG and in 71.8% with LG (p = 0.014). Bruising (78.7% in FG vs. 73.2% in LG, p > 0.05), pain or tenderness (75.6% in FG vs. 51.2% in LG, p = 0.0237) were noted. Hyperpigmentation (51.2% in FG vs. 46.2% in LG, p > 0.05) was found. Endovenous foam sclerotherapy using a microcatheter is more effective than ELS for eliminating remnant varicose tributaries prior to EVLA. However, EFS is more commonly associated with local complications such as pain or tenderness than ELS. Furthermore, both techniques seem to prolong the duration of hyperpigmentation along with higher costs.

Difluorothromboxane A2 and stereoisomers: Stable derivatives of thromboxane A2 with differential effects on platelets and blood vessels

International Nuclear Information System (INIS)

Morinelli, T.A.; Okwu, A.K.; Mais, D.E.; Halushka, P.V.; John, V.; Chen, Chienkuang; Fried, J.

1989-01-01

The present study reports on the selective effects on human platelets and canine saphenous veins of four stable difluorinated analogues and thromboxane A 2 (TXA 2 ), in which the characteristic 2,6-dioxa[3.1.1]bicycloheptane structure of TXA 2 has been retained. The four compounds differ in their stereochemistry of the 5,6 double bond and/or the 15-hydroxyl group. Only 10,10-difluoro-TXA 2 (compound I) with the natural stereochemistry of TXA 2 was an agonist in both platelets and canine saphenous veins. (15R)-10,10-Difluoro-TXA 2 (compound II), (5E)-10,10-difluoro-TXA 2 (compound III), and (5E,15R)-10,10-difluoro-TXA 2 (compound IV) were antagonists of platelet aggregation stimulated by compound I. However, compounds II, III, and IV stimulated contraction of canine saphenous veins. All four compounds could displace the TXA 2 /prostaglandin H 2 antagonist 9,11-dimethylmethano-11,12-methano-16-(3- 125 I-4-hydroxyphenyl)-13,14-dihydro-13-aza-15αβ-ω-tetranor-TXA 2 from its platelet receptor. These results support the existence of two subtypes of TXA 2 /prostaglandin H 2 receptors and emphasize the importance of the stereochemical requirements of these TXA 2 analogues for interaction with these receptors. These stable fluorinated TXA 2 analogues should prove useful tools for the further characterization of these and other TXA 2 /prostaglandin H 2 receptors

Improving the Outcome of Vein Grafts: Should Vascular Surgeons Turn Veins into Arteries?

OpenAIRE

Isaji, Toshihiko; Hashimoto, Takuya; Yamamoto, Kota; Santana, Jeans M.; Yatsula, Bogdan; Hu, Haidi; Bai, Hualong; Jianming, Guo; Kudze, Tambudzai; Nishibe, Toshiya; Dardik, Alan

2017-01-01

Autogenous vein grafts remain the gold standard conduit for arterial bypass, particularly for the treatment of critical limb ischemia. Vein graft adaptation to the arterial environment, i.e., adequate dilation and wall thickening, contributes to the superior performance of vein grafts. However, abnormal venous wall remodeling with excessive neointimal hyperplasia commonly causes vein graft failure. Since the PREVENT trials failed to improve vein graft outcomes, new strategies focus on the ada...

Fluoroscopically-guided foam sclerotherapy with sodium morrhuate for the treatment of lower extremity varices

International Nuclear Information System (INIS)

Wang Haiting; Jiang Zhongpu; Zhou Yi

2011-01-01

Objective: To evaluate fluoroscopically-guided foam sclerotherapy with injection of domestic sodium morrhuate in treating lower extremity varices. Methods: A total of 30 cases (39 diseased lower limbs) with lower extremity varices were enrolled in this study. Under fluoroscopic guidance foam sclerotherapy with injection of domestic sodium morrhuate was carried out in all patients. The obstructed condition of the great saphenous vein was observed during the following three months. Results: The technical success was achieved in all 39 patients. The mean dose of foam sclerosant used for each diseased limb was 5.9 ml (3.4-8.2 ml). Disappearance of blood flow reflux in lower extremity vein immediately after the treatment was seen in 35 patients (90%). Three months after the therapy, vascular sonography showed that the great saphenous vein was obstructed, and no serious complications occurred. Conclusion: For the treatment of lower extremity varices, fluoroscopically-guided foam sclerotherapy with injection of domestic sodium morrhuate is safe and effective with satisfactory results. This technique is a newly-developed micro-invasive therapy for lower extremity varices. (authors)

Influence of gallamine, pancuronium, d-tubocurarine and succinylcholine on adrenergic neurotransmission

NARCIS (Netherlands)

Vercruysse, P.; Bossuyt, P.; Verbeuren, T. J.; Vanhoutte, P. M.; Hanegreefs, G.

1979-01-01

The influence of gallamine, pancuronium, d-tubocurarine and succinylcholine on adrenergic neurotransmission was studied in the isolated saphenous vein of the dog. Pancuronium increased the response of vascular smooth muscle to adrenergic nerve stimulation and to exogenous norepinephrine; gallamine,

Accessory hepatic vein: MR imaging

International Nuclear Information System (INIS)

Lee, Chang Hee; Rho, Tack Soo; Cha, Sang Hoon; Park, Cheol Min; Cha, In Ho

1995-01-01

To evaluate the MR appearance of the accessory hepatic veins. The study included 87 consecutive patients for whom abdominal MR images were obtained. The subjects who had liver lesion or hepatic vascular abnormalities were excluded. Couinaud classified accessory hepatic veins into inferior and middle right hepatic veins. Our major interests were evaluation of the incidence, morphology, and location of the accessory hepatic vein. Inferior right hepatic vein was demonstrated in 43 out of 87 patients (49%). The morphology was linear in 35 patients (80.5%), and V-shaped in 8 patients (19.5%). In 40 patients (93%), the inferior right hepatic vein was located in the posteroinferior aspect of the right lobe. Middle right hepatic vein was demonstrated in 7 out of 87 patients (8%). All were single linear in morphology, combined with the inferior right hepatic vein, and located between the right hepatic vein and inferior right hepatic vein. The accessory hepatic vein was demonstrated in 49% among the Korean adult population, and was located in posteroinferior portion of the liver, in 93%

Quantitative comparison of 3 enamel-stripping devices in vitro: how precisely can we strip teeth?

Science.gov (United States)

Johner, Alexander Marc; Pandis, Nikolaos; Dudic, Alexander; Kiliaridis, Stavros

2013-04-01

In this in-vitro study, we aimed to investigate the predictability of the expected amount of stripping using 3 common stripping devices on premolars. One hundred eighty extracted premolars were mounted and aligned in silicone. Tooth mobility was tested with Periotest (Medizintechnik Gulden, Modautal, Germany) (8.3 ± 2.8 units). The selected methods for interproximal enamel reduction were hand-pulled strips (Horico, Hapf Ringleb & Company, Berlin, Germany), oscillating segmental disks (O-drive-OD 30; KaVo Dental, Biberach, Germany), and motor-driven abrasive strips (Orthofile; SDC Switzerland, Lugano-Grancia, Switzerland). With each device, the operator intended to strip 0.1, 0.2, 0.3, or 0.4 mm on the mesial side of 15 teeth. The teeth were scanned before and after stripping with a 3-dimensional laser scanner. Superposition and measurement of stripped enamel on the most mesial point of the tooth were conducted with Viewbox software (dHal Software, Kifissia, Greece). The Wilcoxon signed rank test and the Kruskal-Wallis test were applied; statistical significance was set at alpha ≤ 0.05. Large variations between the intended and the actual amounts of stripped enamel, and between stripping procedures, were observed. Significant differences were found at 0.1 mm of intended stripping (P ≤ 0.05) for the hand-pulled method and at 0.4 mm of intended stripping (P ≤ 0.001 to P = 0.05) for all methods. For all scenarios of enamel reduction, the actual amount of stripping was less than the predetermined and expected amount of stripping. The Kruskal-Wallis analysis showed no significant differences between the 3 methods. There were variations in the stripped amounts of enamel, and the stripping technique did not appear to be a significant predictor of the actual amount of enamel reduction. In most cases, actual stripping was less than the intended amount of enamel reduction. Copyright © 2013 American Association of Orthodontists. Published by Mosby, Inc. All rights

Biomolecular Materials. Materials Research Society Symposium Proceedings Held in Boston, Massachusetts on December 1-3, 1992. Volume 292

Science.gov (United States)

1992-12-03

histological examination demonstrated a dense fibrovascular scar. For the test animals two compositions of bioelastic materials were used, X2 0 -poly... hyperplasia of saphenous vein bypass grafts, graft atherosclerosis, progression of underlying coronary artery disease 6 5 -, prosthetic valve failure

Closure of the cribriform fascia: an efficient anatomical barrier against postoperative neovascularisation at the saphenofemoral junction? A prospective study

NARCIS (Netherlands)

de Maeseneer, M. G.; Philipsen, T. E.; Vandenbroeck, C. P.; Lauwers, P. R.; Hendriks, J. M.; de Hert, S. G.; van Schil, P. E.

2007-01-01

BACKGROUND: Neovascularisation at the sapheno-femoral junction (SFJ) ligation site in the groin may occur within one year after great saphenous vein (GSV) surgery. Several anatomical and prosthetic barrier techniques have been proposed to prevent this evolution. OBJECTIVE: A prospective study

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

2018-01-01

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 in p...

Stripping Voltammetry

Science.gov (United States)

Lovrić, Milivoj

Electrochemical stripping means the oxidative or reductive removal of atoms, ions, or compounds from an electrode surface (or from the electrode body, as in the case of liquid mercury electrodes with dissolved metals) [1-5]. In general, these atoms, ions, or compounds have been preliminarily immobilized on the surface of an inert electrode (or within it) as the result of a preconcentration step, while the products of the electrochemical stripping will dissolve in the electrolytic solution. Often the product of the electrochemical stripping is identical to the analyte before the preconcentration. However, there are exemptions to these rules. Electroanalytical stripping methods comprise two steps: first, the accumulation of a dissolved analyte onto, or in, the working electrode, and, second, the subsequent stripping of the accumulated substance by a voltammetric [3, 5], potentiometric [6, 7], or coulometric [8] technique. In stripping voltammetry, the condition is that there are two independent linear relationships: the first one between the activity of accumulated substance and the concentration of analyte in the sample, and the second between the maximum stripping current and the accumulated substance activity. Hence, a cumulative linear relationship between the maximum response and the analyte concentration exists. However, the electrode capacity for the analyte accumulation is limited and the condition of linearity is satisfied only well below the electrode saturation. For this reason, stripping voltammetry is used mainly in trace analysis. The limit of detection depends on the factor of proportionality between the activity of the accumulated substance and the bulk concentration of the analyte. This factor is a constant in the case of a chemical accumulation, but for electrochemical accumulation it depends on the electrode potential. The factor of proportionality between the maximum stripping current and the analyte concentration is rarely known exactly. In fact

Varicose Veins - Multiple Languages

Science.gov (United States)

... Concerns and Discomforts of Pregnancy: Varicose Veins - English MP3 Concerns and Discomforts of Pregnancy: Varicose Veins - 简体中文 (Chinese, Simplified (Mandarin dialect)) MP3 Concerns and Discomforts of Pregnancy: Varicose Veins - English ...

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: pbeddy@eircom.net; 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)

2006-05-15

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.

Near-infrared spectroscopy during peripheral vascular surgery

DEFF Research Database (Denmark)

Eiberg, J P; Schroeder, T V; Vogt, K C

1997-01-01

Near-infrared spectroscopy was performed perioperatively on the dorsum of the foot in 14 patients who underwent infrainguinal bypass surgery using a prosthesis or the greater saphenous vein. Dual-wavelength continuous light spectroscopy was used to assess changes in tissue saturation before, duri...

CT findings of portal vein aneurysm

International Nuclear Information System (INIS)

Yang, Dal Mo; Chang, Mi Son; Yoon, Myung Hwan; Kim, Hak Soo; Kim, Hyung Sik; Chung, Hyo Sun; Chung, Jin Woo

1999-01-01

To describe the CT findings of portal vein aneurysm in eight patients. All patients included in this study (two men and six women) underwent CT examinations between October 1996 and June1998. Of these eight, three were suffering from hepatic disease and portal hypertension. We determined the location, shape, size, and characteristics of the lesions, and the presence or absence of portal vein anomaly. Seven patients had intrahepatic portal vein aneurysm (at the umbilical portion of the left portal vein in five patients, between the transverse and umbilical portion of the left portal vein in one, and at the bifurcation of the anterior and posterior branch of the right portal vein in one), while extrahepatic portal vein aneurysm, at the confluence of the superior mesenteric and splenic vein was found in only one. Lesions were cyst-shaped in seven cases and saccular in one, and showed well-circumscribed, markedly enhanced mass, which communicated with the portal vein and/or gives off major branches. Portal vein anomaly, in which the right anterior segmental portal vein originated from the umbilical portion of the left portal vein, was seen in three patients. In all three, intrahepatic portal vein aneurysm was present at the umbilical portion of the left portal vein, and in one, the umbilical protion of the left portal vein was located to the right of the Cantlic line. CT examination can help reveal portal vein aneurysm by detecting a well-circumscribed, markedly enhanced mass which communicates with the portal vein and/or gives off major branches

Forkhead box C2 promoter variant c.-512C>T is associated with increased susceptibility to chronic venous diseases.

Directory of Open Access Journals (Sweden)

Sumi Surendran

Full Text Available Chronic venous disease (CVD is one of the most prevalent yet underrated disorders worldwide. High heritability estimates of CVD indicate prominent genetic components in its etiology and pathology. Mutations in human forkhead box C2 (FoxC2 gene are strongly associated with valve failure in saphenous and deep veins of lower extremities. We explored the association of genetic variants of FoxC2 as well as FoxC2 mRNA and protein expression levels with CVD of lower limbs. We systematically sequenced the single coding exon, 5' and 3' flanking regions of FoxC2 gene in 754 study subjects which includes 382 patients with CVD and 372 healthy subjects. Four novel and three reported polymorphisms were identified in our cohort. Three variants in 5' flanking region and one in 3' flanking region of FoxC2 gene were significantly associated with CVD risk. FoxC2 mRNA in vein tissues from 22 patients was 4±1.42 fold increased compared to saphenous veins from 20 normal subjects (pT (rs34221221: C>T variant which is located in the FoxC2 putative promoter region was further analyzed. Functional analysis of c.-512C>T revealed increased mRNA and protein expression in patients with homozygous TT genotype compared to heterozygous CT and wild CC genotypes. Luciferase assay indicated higher transcriptional activity of mutant compared to wild genotype of this variant. These findings suggested that c.-512C>T variant of FoxC2 was strongly associated with susceptibility to CVD and also that this variant resulted in FoxC2 overexpression. To obtain a mechanistic insight into the role of upregulated FoxC2 in varicosities, we overexpressed FoxC2 in venous endothelial cells and observed elevated expression of arterial markers Dll4 and Hey2 and downregulation of venous marker COUP-TFII. Our study indicates altered FoxC2-Notch signaling in saphenous vein wall remodeling in patients with varicose veins.

Cardiac CT angiography after coronary artery surgery in children using 64-slice CT scan

International Nuclear Information System (INIS)

Marini, Davide; Agnoletti, Gabriella; Brunelle, Francis; Sidi, Daniel; Bonnet, Damien; Ou, Phalla

2009-01-01

Objective: The purpose of this study was to compare the diagnostic accuracy of 64-slice CT with that of invasive angiography in the detection of graft and/or coronary angioplasty stenosis in children who had undergone coronary artery surgery. Population and methods: Fifteen consecutive children (8 male and 7 female; age 9.2 ± 6.1 years) underwent 64-slice CT because of chest pain or ECG changes mean 4.8 ± 3.7 years after surgical coronary artery surgery; 10 patients had coronary angioplasty using a patch from the saphenous vein, four had mammary artery bypass, and one had saphenous vein bypass. Six main segments of the coronary arteries and all the bypass graft considered as a single segment were analyzed and compared with invasive angiography used as the reference standard. Results: CT correctly identified the four children with coronary angioplasty and mammary graft lesions that were confirmed by conventional angiography: one patient had a significant stenosis (>50% stenosis) at the mammary bypass graft anastomosis site; three other had non-significant stenosis (<50% stenosis) including a mild lesion of the saphenous vein patch in two patients and a mild lesion at the anastomosis site of the mammary bypass in one. All segments identified as normal by CT in the other 11 children were also found to be normal by conventional angiography. Conclusion: In centers expert in this technique, 64-slice CT scanning is a promising, rapid, and useful diagnostic technique for evaluating both coronary angioplasty and bypass graft lesions in children who had undergone coronary artery surgery.

Generalised left ventricular dysfunction after traumatic right coronary ...

African Journals Online (AJOL)

A patient with traumatic right coronary artery to right atrial fistula, which was repaired by direct closure and aortocoronary saphenous vein bypass grafting, is described. Cardiac catheterisation and selective cine angiocardiography were performed pre- and postoperatively, and left ventricular (LV) function was studied in ...

Development of Bioelastic Material for Aspects of Wound Repair.

Science.gov (United States)

1992-01-01

injury site and at eight weeks histological examination demonstrated a dense fibrovascular scar. For the test animals two compositions of bioelastic...reoperation5 O,6 5 : "intimal hyperplasia of saphenous vein bypass grafts, graft atherosclerosis, progression of underlying coronary artery disease 6 5

Testbeam evaluation of silicon strip modules for ATLAS Phase - II Strip Tracker Upgrade

CERN Document Server

Blue, Andrew; The ATLAS collaboration; Ai, Xiaocong; Allport, Phillip; Arling, Jan-Hendrik; Atkin, Ryan Justin; Bruni, Lucrezia Stella; Carli, Ina; Casse, Gianluigi; Chen, Liejian; Chisholm, Andrew; Cormier, Kyle James Read; Cunningham, William Reilly; Dervan, Paul; Diez Cornell, Sergio; Dolezal, Zdenek; Dopke, Jens; Dreyer, Etienne; Dreyling-Eschweiler, Jan Linus Roderik; Escobar, Carlos; Fabiani, Veronica; Fadeyev, Vitaliy; Fernandez Tejero, Javier; Fleta Corral, Maria Celeste; Gallop, Bruce; Garcia-Argos, Carlos; Greenall, Ashley; Gregor, Ingrid-Maria; Greig, Graham George; Guescini, Francesco; Hara, Kazuhiko; Hauser, Marc Manuel; Huang, Yanping; Hunter, Robert Francis Holub; Keller, John; Klein, Christoph; Kodys, Peter; Koffas, Thomas; Kotek, Zdenek; Kroll, Jiri; Kuehn, Susanne; Lee, Steven Juhyung; Liu, Yi; Lohwasser, Kristin; Meszarosova, Lucia; Mikestikova, Marcela; Mi\\~nano Moya, Mercedes; Mori, Riccardo; Moser, Brian; Nikolopoulos, Konstantinos; Peschke, Richard; Pezzullo, Giuseppe; Phillips, Peter William; Poley, Anne-luise; Queitsch-Maitland, Michaela; Ravotti, Federico; Rodriguez Rodriguez, Daniel

2018-01-01

The planned HL-LHC (High Luminosity LHC) is being designed to maximise the physics potential of the LHC with 10 years of operation at instantaneous luminosities of \\mbox{$7.5\\times10^{34}\\;\\mathrm{cm}^{-2}\\mathrm{s}^{-1}$}. A consequence of this increased luminosity is the expected radiation damage requiring the tracking detectors to withstand hadron equivalences to over $1x10^{15}$ 1 MeV neutron equivalent per $cm^{2}$ in the ATLAS Strips system. The silicon strip tracker exploits the concept of modularity. Fast readout electronics, deploying 130nm CMOS front-end electronics are glued on top of a silicon sensor to make a module. The radiation hard n-in-p micro-strip sensors used have been developed by the ATLAS ITk Strip Sensor collaboration and produced by Hamamatsu Photonics. A series of tests were performed at the DESY-II test beam facility to investigate the detailed performance of a strip module with both 2.5cm and 5cm length strips before irradiation. The DURANTA telescope was used to obtain a pointing...

Vein grafting in fingertip replantations.

Science.gov (United States)

Yan, Hede; Jackson, William D; Songcharoen, Somjade; Akdemir, Ovunc; Li, Zhijie; Chen, Xinglong; Jiang, Liangfu; Gao, Weiyang

2009-01-01

In this retrospective study, the survival rates of fingertip replantation with and without vein grafting were evaluated along with their postoperative functional and cosmetic results. One hundred twenty-one-fingertip amputations were performed in 103 patients between September 2002 and July 2007. Thirty-four amputated fingertips were replanted without vein grafting, while 87 amputated fingertips were replanted with vein grafting for arterial and/or venous repairs. The overall survival rates of the replantations with and without vein grafting were 90% (78/87) and 85% (29/34), respectively. The survival rates were 88% (36/41) with venous repair, 93% (25/27) with arterial repair, and 89% (17/19) with both. Nineteen patients without vein grafting and 48 patients with vein grafting had a follow-up period of more than one year. Good cosmetic and functional outcomes were observed in both groups of patients. The results show that vein grafting is a reliable technique in fingertip replantations, showing no significant difference (P > 0.05) in survival between those with and without vein grafting. Furthermore, no significant difference (P > 0.05) in survival was found between cases with vein grafts for arterial and/or venous repairs. In fingertip replantations with vein grafting, favorable functional and esthetic results can be achieved without sacrificing replantation survival. (c) 2009 Wiley-Liss, Inc.

Vein matching using artificial neural network in vein authentication systems

Science.gov (United States)

Noori Hoshyar, Azadeh; Sulaiman, Riza

2011-10-01

Personal identification technology as security systems is developing rapidly. Traditional authentication modes like key; password; card are not safe enough because they could be stolen or easily forgotten. Biometric as developed technology has been applied to a wide range of systems. According to different researchers, vein biometric is a good candidate among other biometric traits such as fingerprint, hand geometry, voice, DNA and etc for authentication systems. Vein authentication systems can be designed by different methodologies. All the methodologies consist of matching stage which is too important for final verification of the system. Neural Network is an effective methodology for matching and recognizing individuals in authentication systems. Therefore, this paper explains and implements the Neural Network methodology for finger vein authentication system. Neural Network is trained in Matlab to match the vein features of authentication system. The Network simulation shows the quality of matching as 95% which is a good performance for authentication system matching.

Delayed presentation of a traumatic brachial artery pseudoaneurysm.

LENUS (Irish Health Repository)

Forde, James C

2009-09-01

Delayed presentation of a brachial artery pseudoaneurysm following penetrating trauma is infrequently reported. We report the case of a 23-year-old male who presented three months following a penetrating trauma to his antecubital fossa with a sudden exacerbation of swelling and tenderness of his elbow. Doppler ultrasound and computed tomography arteriography confirmed the presence of a large pseudoaneurysm. Surgical reconstruction was performed using the long saphenous vein as an interposition vein graft, restoring normal arterial circulation.

~~v~:r~r:~

African Journals Online (AJOL)

1974-09-07

Sep 7, 1974 ... A patient with traumatic right coronary artery to right atrial fistula, which was repaired by direct closure and aorto- coronary saphenous vein bypass grafting, is described. Cardiac catheterisation and selective cine angiocardio- graphy were performed pre- and postoperatively, and left ventricular (LV) function ...

Tall Fescue Alkaloids Bind Serotonin Receptors in Cattle

Science.gov (United States)

The serotonin (5HT) receptor 5HT2A is involved in the tall fescue alkaloid-induced vascular contraction in the bovine periphery. This was determined by evaluating the contractile responses of lateral saphenous veins biopsied from cattle grazing different tall fescue/endophyte combinations. The contr...

Pharmacologic assessment of bovine ruminal and mesenteric vascular serotonin receptor populations

Science.gov (United States)

Prior work using a contractility bioassay determined that the serotonin (5-HT) receptor subtype 5-HT2A is present in bovine lateral saphenous veins and plays a role in ergot alkaloid-induced vascular contraction in steers grazing endophyte-infected (Epichloë coenophiala) tall fescue (Lolium arundina...

Arterial injuries in civilian practice in Lagos, Nigeria | Thomas ...

African Journals Online (AJOL)

Nigerian Journal of Clinical Practice ... Method: Data was collated from case notes of patients, operation register in theatre and admission and discharge books from the surgical wards and the data bank of consultants ... Eight patients had prosthetic graft interposition while 2 patients had reversed saphenous vein grafts.

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 ... used to bypass the blocked arteries in the heart. The venous graft is sewn to the aorta ...

ARTERIAL REVASCULARIZATION WITH THE RIGHT GASTROEPIPLOIC ARTERY AND INTERNAL MAMMARY ARTERIES IN 300 PATIENTS

NARCIS (Netherlands)

GRANDJEAN, JG; BOONSTRA, PW; DENHEYER, P; EBELS, T; KIRKLIN, JW

From September 1989 to September 1992, the right gastroepiploic artery in combination with one or both internal mammary arteries was used as a graft in 300 patients who underwent coronary artery bypass grafting. The gastroepiploic artery was the primary choice in preference to the saphenous vein.

Anatomy Comic Strips

Science.gov (United States)

Park, Jin Seo; Kim, Dae Hyun; Chung, Min Suk

2011-01-01

Comics are powerful visual messages that convey immediate visceral meaning in ways that conventional texts often cannot. This article's authors created comic strips to teach anatomy more interestingly and effectively. Four-frame comic strips were conceptualized from a set of anatomy-related humorous stories gathered from the authors' collective…

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

2012-06-01

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.

Polidocanol versus hypertonic glucose for sclerotherapy treatment of reticular veins of the lower limbs: study protocol for a randomized controlled trial.

Science.gov (United States)

Bertanha, Matheus; Sobreira, Marcone Lima; Pinheiro Lúcio Filho, Carlos Eduardo; de Oliveira Mariúba, Jamil Victor; Farres Pimenta, Rafael Elias; Jaldin, Rodrigo Gibin; Moroz, Andrei; Moura, Regina; Rollo, Hamilton Almeida; Yoshida, Winston Bonetti

2014-12-19

The prevalence of chronic venous disease is high and occurs more frequently in females. According to the clinical, etiological, anatomical, and pathological classification (CEAP) definition, the reticular veins are included in the C1 class and are mainly associated with aesthetic complaints. Several invasive techniques are used for treatment, including mini phlebectomy, laser ablation, and radiofrequency ablation. However, a wide range of sclerosing agents may serve as minimally invasive alternatives, promoting chemical sclerosis of the vein wall. Although this technique is routinely performed around the world, there is no consensus on the most efficacious and safe chemical agent to be used. Inclusion criteria are women between 18 and 69 years old with at least 10 cm long reticular veins in the lower limbs, on the outer side of the leg/thigh. Patients with CEAP 2 to 6, or with allergies, pregnancy, performing breastfeeding, or with any dermatologic or clinical problems will be excluded. Patients with venous ultrasound mapping showing involvement of saphenous trunks and/or a deep venous system will also be excluded. Patients will be randomized into two groups, one receiving 75% pure glucose and the other group receiving 0.2% polidocanol diluted in 70% glucose. Just one limb and one session per patient will be performed. The sclerosing agent volume will not exceed 5 mL. Clinical follow-up will include visits on days 7 and 60, always with photographic documentation. This project aims to enroll 96 patients and subject them to a double-blind treatment after the randomization process. The design is intended to evaluate efficacy through a primary end point and safety through a secondary end point. Forty-eight patients have currently been enrolled. Preliminary results for these patients showed that 25 received treatment, 2 were excluded, and 22 returned after 7 days and showed no greater adverse events. To date, establishing efficacy criteria has not been possible, and no

Surgical Access to Jejunal Veins for Local Thrombolysis and Stent Placement in Portal Vein Thrombosis

International Nuclear Information System (INIS)

Schellhammer, Frank; Esch, Jan Schulte am; Hammerschlag, Sascha; Knoefel, Wolfram Trudo; Fuerst, Guenter

2008-01-01

Portal vein thrombosis is an infrequent entity, which may cause high morbidity and mortality. We report a case of portal vein thrombosis due to benign stenosis following partial pancreatoduodenectomy with segmental replacement of the portal vein by a Gore-tex graft. Using a surgical access to jenunal veins, local thrombolysis, mechanical fragmentation of thrombus, and stent placement were successfully performed.

Evaluation of peripheral neuropathy of lower limbs in patients with type 2 diabetes mellitus by high-frequency ultrasonography

Directory of Open Access Journals (Sweden)

Jia-bei HE

2014-04-01

Full Text Available Objective To observe the abnormalities of femoral and saphenous nerves in patients of type 2 diabetes mellitus (T2DM with or without diabetic periphery neuropathy (DPN by high-frequency ultrasonography.  Methods Eighty-one T2DM patients were enrolled and divided into 2 groups: group B (T2DM without DPN, N = 40, group C (T2DM with DPN, N = 41. Forty-two healthy subjects were enrolled as control group (group A. LOGIQ-E9 color Doppler ultrasound instrument was used. Between inguinal ligment and inguinal fold, the femoral nerve was slightly hyperechoic with reticular structure near by the femoral artery on transverse section. In the inner thigh, the saphenous nerve was slightly hyperechoic with reticular structure along with adductor canal on transverse section. The internal echo and succession of the two nerves in 3 groups were observed. The width, thickness and cross-sectional areas of the two nerves were measured and compared.  Results In group A, the internal echo of the two nerves appeared as slightly hyperechoic with reticular structure on transverse section, and strips of hypoechogenicity and parallel structure of slightly hyperechogenicity on longitudinal section. Compared with group A, the internal echo of group B was decreased slightly, and the reticular structure was slightly obscure and strips of echo on longitudinal section were less clear; while the internal echo of group C was decreased obviously, the reticular structure was not clear and strips of echo on longitudinal section were obscure. Compared with group A, both the width (P = 0.000, for all, thickness (P = 0.023, 0.036 and cross-sectional area (P = 0.000, for all of femoral nerve and the width (P = 0.010, 0.014, thickness (P = 0.001, for all and cross-sectional area (P = 0.002, 0.004 of saphenous nerve in group B and C were increased. Besides, compared with group B, thickness (P = 0.048, 0.012 and cross-sectional area (P = 0.031, 0.034 of femoral and saphenous nerves in

Science Comic Strips

Science.gov (United States)

Kim, Dae Hyun; Jang, Hae Gwon; Shin, Dong Sun; Kim, Sun-Ja; Yoo, Chang Young; Chung, Min Suk

2012-01-01

Science comic strips entitled Dr. Scifun were planned to promote science jobs and studies among professionals (scientists, graduate and undergraduate students) and children. To this end, the authors collected intriguing science stories as the basis of scenarios, and drew four-cut comic strips, first on paper and subsequently as computer files.…

Blood-conservation techniques for coronary-artery bypass surgery at a private hospital.

Science.gov (United States)

Davies, M J; Picken, J; Buxton, B F; Fuller, J A

1988-11-21

The utilization of homologous blood and blood products was recorded in 100 consecutive patients who underwent primary coronary-artery bypass surgery. Nine patients underwent saphenous-vein grafts only, 55 patients underwent a single internal-mammary-artery graft that was supplemented by vein grafts and 36 patients underwent bilateral internal-mammary-artery grafts and vein grafts. All patients underwent normovolaemic haemodilution, and autologous blood was collected before bypass surgery. Residual blood was collected from the cardiopulmonary bypass machine and was washed and concentrated in a cell processor, and blood also was scavenged postoperatively from the mediastinal drainage tubes as methods to conserve blood. The mean (+/- SD) utilization of homologous blood was 1.3 +/- 1.5 units with 0.2 +/- 0.7 units of fresh-frozen plasma being used, and 0.8 +/- 2.1 units of platelets being used. The utilization of homologous blood was not different among the three different methods of coronary-artery bypass surgery, but patients who underwent bilateral internal-mammary-artery grafts suffered a greater postoperative loss of blood than did those patients who underwent saphenous-vein grafts or single internal-mammary-artery grafts. A comparison of patients who were taking aspirin or a non-steroidal anti-inflammatory drug preoperatively with those patients who were not showed no difference in the utilization of homologous blood but a statistically-significant difference was found in the loss of blood postoperatively.

The economics of vein disease.

Science.gov (United States)

Sales, Clifford M; Podnos, Joan; Levison, Jonathan

2007-09-01

The management of cosmetic vein problems requires a very different approach than that for the majority of most other vascular disorders that occur in a vascular surgery practice. This article focuses on the business aspects of a cosmetic vein practice, with particular attention to the uniqueness of these issues. Managing patient expectations is critical to the success of a cosmetic vein practice. Maneuvering within the insurance can be difficult and frustrating for both the patient and the practice. Practices should use cost accounting principles to evaluate the success of their vein work. Vein surgery--especially if performed within the office--can undergo an accurate break-even analysis to determine its profitability.

The Strip Module

DEFF Research Database (Denmark)

Pedersen, Tommy

1996-01-01

When the behaviour of a ship in waves is to be predicted it is convenient to have a tool which includes different approaches to the problem.The aim of this project is to develop such a tool named the strip theory module. The strip theory module will consist of submodules dependent on the I...

Nuclear reactor spring strip grid spacer

International Nuclear Information System (INIS)

Patterson, J.F.; Flora, B.S.

1978-01-01

A bimetallic grid spacer is described comprising a grid structure of zircaloy formed by intersecting striplike members which define fuel element openings for receiving fuel elements and spring strips made of Inconel positioned within the grid structure for cooperating with the fuel elements to maintain them in their desired position. A plurality of these spring strips extend longitudinally between sides of the grid structure, being locked in position by the grid retaining strips. The fuel rods, which are disposed in the fuel openings formed in the grid structure, are positioned by means of the springs associated with the spring strips and a plurality of dimples which extend from the zircaloy grid structure into the openings. In one embodiment the strips are disposed in a plurality of arrays with those spring strip arrays situated in opposing diagonal quadrants of the grid structure extending in the same direction and adjacent spring strip arrays in each half of the spacer extending in relatively perpendicular directions. Other variations of the spring strip arrangements for a particular fuel design are disclosed herein

Deep Vein Thrombosis

African Journals Online (AJOL)

OWNER

Deep Vein Thrombosis: Risk Factors and Prevention in Surgical Patients. Deep Vein ... preventable morbidity and mortality in hospitalized surgical patients. ... the elderly.3,4 It is very rare before the age ... depends on the risk level; therefore an .... but also in the post-operative period. ... is continuing uncertainty regarding.

Noise analysis due to strip resistance in the ATLAS SCT silicon strip module

International Nuclear Information System (INIS)

Kipnis, I.

1996-08-01

The module is made out of four 6 cm x 6 cm single sided Si microstrip detectors. Two detectors are butt glued to form a 12 cm long mechanical unit and strips of the two detectors are electrically connected to form 12 cm long strips. The butt gluing is followed by a back to back attachment. The module in this note is the Rφ module where the electronics is oriented parallel to the strip direction and bonded directly to the strips. This module concept provides the maximum signal-to-noise ratio, particularly when the front-end electronics is placed near the middle rather than at the end. From the noise analysis, it is concluded that the worst-case ΔENC (far-end injection) between end- and center-tapped modules will be 120 to 210 el. rms (9 to 15%) for a non-irradiated detector and 75 to 130 el. rms (5 to 9%) for an irradiated detector, for a metal strip resistance of 10 to 20 Ω/cm

Area specific stripping factors for AGS. A method for extracting stripping factors from survey data

Energy Technology Data Exchange (ETDEWEB)

Aage, H.K.; Korsbech, U. [Technical Univ. of Denmark (Denmark)

2006-04-15

In order to use Airborne Gamma-ray Spectrometry (AGS) for contamination mapping, for source search etc. one must to be able to eliminate the contribution to the spectra from natural radioactivity. This in general is done by a stripping technique. The parameters for performing a stripping have until recently been measured by recording gamma spectra at special calibration sites (pads). This may be cumbersome and the parameters may not be correct when used at low gamma energies for environmental spectra. During 2000-2001 DTU tested with success a new technique for Carborne Gamma-ray Spectrometry (CGS) where the spectra from the surveyed area (or from a similar area) were used for calculating the stripping parameters. It was possible to calculate usable stripping ratios for a number of low energy windows - and weak source signals not detectable by other means were discovered with the ASS technique. In this report it is shown that the ASS technique also works for AGS data, and it has been used for recent Danish AGS tests with point sources. (Check of calibration of AGS parameters.) By using the ASS technique with the Boden data (Barents Rescue) an exercise source was detected that has not been detected by any of the teams during the exercise. The ASS technique therefore seems to be better for search for radiation anomalies than any other method known presently. The experiences also tell that although the stripping can be performed correctly at any altitude there is a variation of the stripping parameters with altitude that has not yet been quite understood. However, even with the oddly variations the stripping worked as expected. It was also observed that one might calculate a single common set of usable stripping factors for all altitudes from the entire data set i.e. some average a, b and c values. When those stripping factors were used the stripping technique still worked well. (au)

Arabidopsis thaliana Ei-5: Minor Vein Architecture Adjustment Compensates for Low Vein Density in Support of Photosynthesis.

Science.gov (United States)

Stewart, Jared J; Polutchko, Stephanie K; Demmig-Adams, Barbara; Adams, William W

2018-01-01

An Arabidopsis thaliana accession with naturally low vein density, Eifel-5 (Ei-5), was compared to Columbia-0 (Col-0) with respect to rosette growth, foliar vein architecture, photosynthesis, and transpiration. In addition to having to a lower vein density, Ei-5 grew more slowly, with significantly lower rates of rosette expansion, but had similar capacities for photosynthetic oxygen evolution on a leaf area basis compared to Col-0. The individual foliar minor veins were larger in Ei-5, with a greater number of vascular cells per vein, compared to Col-0. This compensation for low vein density resulted in similar values for the product of vein density × phloem cell number per minor vein in Ei-5 and Col-0, which suggests a similar capacity for foliar sugar export to support similar photosynthetic capacities per unit leaf area. In contrast, the product of vein density × xylem cell number per minor vein was significantly greater in Ei-5 compared to Col-0, and was associated not only with a higher ratio of water-transporting tracheary elements versus sugar-transporting sieve elements but also significantly higher foliar transpiration rates per leaf area in Ei-5. In contrast, previous studies in other systems had reported higher ratios of tracheary to sieve elements and higher transpiration rate to be associated with higher - rather than lower - vein densities. The Ei-5 accession thus further underscores the plasticity of the foliar vasculature by illustrating an example where a higher ratio of tracheary to sieve elements is associated with a lower vein density. Establishment of the Ei-5 accession, with a low vein density but an apparent overcapacity for water flux through the foliar xylem network, may have been facilitated by a higher level of precipitation in its habitat of origin compared to that of the Col-0 accession.

Strip casting apparatus and method

Science.gov (United States)

Williams, R.S.; Baker, D.F.

1988-09-20

Strip casting apparatus including a molten-metal-holding container and a nozzle to deposit molten metal onto a moving chill drum to directly cast continuous metallic strip. The nozzle body includes a slot bounded between a back and a front lip. The slot width exceeds about 20 times the gap distance between the nozzle and the chill drum surface. Preferably, the slot width exceeds 0.5 inch. This method of strip casting minimizes pressure drop, insuring better metal-to-chill-drum contact which promotes heat transfer and results in a better quality metallic strip. 6 figs.

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

Science.gov (United States)

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

2016-07-01

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

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

2014-12-01

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.

Vein visualization: patient characteristic factors and efficacy of a new infrared vein finder technology.

Science.gov (United States)

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

2013-06-01

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.

Palliative treatment of TIPS to portal vein tumor thrombosis complicated with portal vein hypertension

International Nuclear Information System (INIS)

Jiang Zaibo; Shan Hong; Guan Shouhai; Zhu Kangshun; Huang Mingsheng; Li Zhengran; Guo Tiansheng; Liu Lang

2002-01-01

Objective: To evaluate the palliative therapeutic effects of transjugular intrahepatic portosystemic shunt (TIPS) in portal vein tumor thrombosis (PVTT) complicated with portal vein hypertension, and to discuss the technical skills. Methods: There were 14 cases of end-stage hepatocellular carcinoma complicated with PVTT and portal vein hypertension, the average age was 53.6 yr. There were 8 cases with complete occlusion of main portal vein, 6 eases with incomplete thrombosis, and 5 cases combined with portal vein cavernous transformation. One case had simple hemorrhage, 3 eases had intractable ascites, and 10 cases had hemorrhage accompanied by intractable ascites. Results: The procedure of TIPS was successful in 10 cases, the successful rate was about 71%. The mean portal vein pressure was reduced from 37.2 mm Hg to 18.2 mm Hg, with an average reduction of 19.0 mm Hg. After the procedure of TIPS, the ascites decreased, hemorrhage stopped and the clinical symptoms disappeared. The average survival period was 132.3 days. The procedure were failing in 4 cases. Conclusion: TIPS was an effective palliative therapeutic methods to control the hemorrhage and ascites aroused by hepatic carcinoma complicated with PVTT

The Honeycomb Strip Chamber

International Nuclear Information System (INIS)

Graaf, Harry van der; Buskens, Joop; Rewiersma, Paul; Koenig, Adriaan; Wijnen, Thei

1991-06-01

The Honeycomb Strip Chamber (HSC) is a new position sensitive detector. It consists of a stack of folded foils, forming a rigid honeycomb structure. In the centre of each hexagonal cell a wire is strung. Conducting strips on the foils, perpendicular to the wires, pick up the induced avalanche charge. Test results of a prototype show that processing the signals form three adjacent strips nearest to the track gives a spatial resolution better than 64 μm for perpendicular incident tracks. The chamber performance is only slightly affected by a magnetic field. (author). 25 refs.; 21 figs

Concerns and Discomforts of Pregnancy - Varicose Veins

Science.gov (United States)

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

Corrosion cast study of the canine hepatic veins.

Science.gov (United States)

Uršič, M; Vrecl, M; Fazarinc, G

2014-11-01

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.

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

Directory of Open Access Journals (Sweden)

Young Ho Park

2012-10-01

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

Normal hepatic vein patterns on ultrasound

International Nuclear Information System (INIS)

Kim, Hae Jin; Chae, Yoo Soon; Park, Hea Yeoung; Park, Bok Hwan; Kim, Yang Sook

1987-01-01

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.

Selective chemical stripping

Science.gov (United States)

Malavallon, Olivier

1995-04-01

At the end of the 80's, some of the large European airlines expressed a wish for paint systems with improved strippability on their aircraft, allowing the possibility to strip down to the primer without altering it, using 'mild' chemical strippers based on methylene chloride. These improvements were initially intended to reduce costs and stripping cycle times while facilitating rapid repainting, and this without the need to change the conventionally used industrial facilities. The level of in-service performance of these paint systems was to be the same as the previous ones. Requirements related to hygiene safety and the environment were added to these initial requirements. To meet customers' expectations, Aerospatiale, within the Airbus Industry GIE, formed a work group. This group was given the task of specifying, following up the elaboration and qualifying the paint systems allowing requirements to be met, in relation with the paint suppliers and the airlines. The analysis made in this report showed the interest of transferring as far upstream as possible (to paint conception level) most of the technical constraints related to stripping. Thus, the concept retained for the paint system, allowing selective chemical stripping, is a 3-coat system with characteristics as near as possible to the previously used paints.

Charge collection in silicon strip detectors

International Nuclear Information System (INIS)

Kraner, H.W.; Beuttenmuller, R.; Ludlam, T.; Hanson, A.L.; Jones, K.W.; Radeka, V.; Heijne, E.H.M.

1982-11-01

The use of position sensitive silicon detectors as very high resolution tracking devices in high energy physics experiments has been a subject of intense development over the past few years. Typical applications call for the detection of minimum ionizing particles with position measurement accuracy of 10 μm in each detector plane. The most straightforward detector geometry is that in which one of the collecting electrodes is subdivided into closely spaced strips, giving a high degree of segmentation in one coordinate. Each strip may be read out as a separate detection element, or, alternatively, resistive and/or capacitive coupling between adjacent strips may be exploited to interpolate the position via charge division measrurements. With readout techniques that couple several strips, the numer of readout channels can, in principle, be reduced by large factors without sacrificing the intrinsic position accuracy. The testing of individual strip properties and charge division between strips has been carried out with minimum ionizing particles or beams for the most part except in one case which used alphs particless scans. This paper describes the use of a highly collimated MeV proton beam for studies of the position sensing properties of representative one dimensional strip detectors

The umbilical and paraumbilical veins of man.

Science.gov (United States)

Martin, B F; Tudor, R G

1980-03-01

During its transit through the umbilicus structural changes occur in the thick wall of the extra-abdominal segment of the umbilical vein whereby the components of the intra-abdominal segment acquire an essentially longitudinal direction and become arranged in fibro-elastic and fibro-muscular zones. The vein lumen becomes largely obliterated by asymmetrical proliferation of loose subendothelial conective tissue. The latter forms a new inner zone within which a small segment of the lumen persists in an eccentric position. This residual lumen transmits blood to the portal system from paraumbilical and systemic sources, and is retained in the upper part of the vein, even in old age. A similar process of lumen closure is observed in the ductus venosus. In early childhood the lower third of the vein undergoes breakdown, with fatty infiltration, resulting in its complete division into vascular fibro-elastic strands, and in old age some breakdown occurs in the outermost part of the wall of the upper two thirds. The paraumbilical veins are thick-walled and of similar structure to the umbilical vein. Together they constitute an accessory portal system which is confined between the layers of the falciform ligament and is in communication with the veins of the ventral abdominal wall. The constituents form an ascending series, namely, Burow's veins, the umbilical vein, and Sappey's inferior and superior veins. The main channel of Sappey's inferior veins may be the remnant of the right umbilical vein since it communicates with the right rectus sheath and often communicates directly with the portal system within the right lobe of the liver. The results are of significance in relation to clinical usage of the umbilical vein.

Idiopathic Bilateral External Jugular Vein Thrombosis.

Science.gov (United States)

Hindi, Zakaria; Fadhel, Ehab

2015-08-20

Vein thrombosis is mainly determined by 3 factors, which constitute a triad called Virchow's triad: hypercoagulability, stasis, and endothelial injury. Venous thrombosis commonly occurs in the lower extremities since most of the blood resides there and flows against gravity. The veins of the lower extremities are dependent on intact valves and fully functional leg muscles. However, in case of valvular incompetency or muscular weakness, thrombosis and blood stasis will occur as a result. In contrast, the veins of the neck, specially the jugulars, have distensible walls which allow flexibility during respiration. In addition, the blood directly flows downward towards the heart. Nevertheless, many case reports mentioned the thrombosis of internal jugular veins and external jugular veins with identified risk factors. Jugular vein thrombosis has previously been associated in the literature with a variety of medical conditions, including malignancy. This report is of a case of idiopathic bilateral external jugular vein thrombosis in a 21 year-old male construction worker of Southeast Asian origin with no previous medical history who presented with bilateral facial puffiness of gradual onset over 1 month. Doppler ultrasound and computed tomography were used in the diagnosis. Further work-up showed no evidence of infection or neoplasia. The patient was eventually discharged on warfarin. The patient was assessed after 6 months and his symptoms had resolved completely. Bilateral idiopathic external jugular veins thrombosis is extremely rare and can be an indicator of early malignancy or hidden infection. While previous reports in the literature have associated jugular vein thrombosis with malignancy, the present case shows that external jugular vein thrombosis can also be found in persons without malignancy.

Parallel superconducting strip-line detectors: reset behaviour in the single-strip switch regime

International Nuclear Information System (INIS)

Casaburi, A; Heath, R M; Tanner, M G; Hadfield, R H; Cristiano, R; Ejrnaes, M; Nappi, C

2014-01-01

Superconducting strip-line detectors (SSLDs) are an important emerging technology for the detection of single molecules in time-of-flight mass spectrometry (TOF-MS). We present an experimental investigation of a SSLD laid out in a parallel configuration, designed to address selected single strip-lines operating in the single-strip switch regime. Fast laser pulses were tightly focused onto the device, allowing controllable nucleation of a resistive region at a specific location and study of the subsequent device response dynamics. We observed that in this regime, although the strip-line returns to the superconducting state after triggering, no effective recovery of the bias current occurs, in qualitative agreement with a phenomenological circuit simulation that we performed. Moreover, from theoretical considerations and by looking at the experimental pulse amplitude distribution histogram, we have the first confirmation of the fact that the phenomenological London model governs the current redistribution in these large area devices also after detection events. (paper)

Blood sampling from adrenal gland vein

International Nuclear Information System (INIS)

Sun Yong; Ni Caifang

2009-01-01

Adrenal gland vein sampling is an interventional method to get the blood samples from the adrenal gland vein. The blood is obtained via a catheter which is selectively inserted in the adrenal gland vein. This technique is mainly used to be diagnostic for primary hyperaldosteronism. A full knowledge of the anatomy and variations of the adrenal gland vein, serious preoperative preparation and skilled catheterization manipulation are necessary for obtaining sufficient blood sample and for reducing the occurrence of complications. Providing the physicians with definite diagnostic evidence and being technically feasible, adrenal gland vein sampling should become one of the routine examinations for clarifying the cause of primary hyperaldosteronism. (authors)

Isolated inferior mesenteric portal hypertension with giant inferior mesenteric vein and anomalous inferior mesenteric vein insertion

Directory of Open Access Journals (Sweden)

G Raghavendra Prasad

2013-01-01

Full Text Available Extrahepatic portal hypertension is not an uncommon disease in childhood, but isolated inferior mesenteric portal varices and lower gastrointestinal (GI bleed have not been reported till date. A 4-year-old girl presented with lower GI bleed. Surgical exploration revealed extrahepatic portal vein obstruction with giant inferior mesenteric vein and colonic varices. Inferior mesenteric vein was joining the superior mesenteric vein. The child was treated successfully with inferior mesenteric - inferior vena caval anastomosis. The child was relieved of GI bleed during the follow-up.

Duplex sonography of the near-surface leg veins

International Nuclear Information System (INIS)

Mendoza, E.

2007-01-01

The book contains the following contributions: The ultrasonograph, selection of the ultrasonic transducer, anatomy of the near-surface vein system, physiology of the near-surface vein system, varicose status classification, systematics of the duplex sonography of near-surface leg veins, provocational maneuver for the duplex sonographic varicose diagnostics, exploration of vena saphena parva, perforans veins, side branches, phlebitis, sonography for varicose therapy, postsurgical sonography, deep leg veins, examination of near-surface leg veins for the pathology of the deep vein system, differential diagnostic clarification of leg oedema from the phlebologic-lymphological view, diagnostic side features along the near-surface leg veins

Self-taught axillary vein access without venography for pacemaker implantation: prospective randomized comparison with the cephalic vein access.

Science.gov (United States)

Squara, Fabien; Tomi, Julien; Scarlatti, Didier; Theodore, Guillaume; Moceri, Pamela; Ferrari, Emile

2017-12-01

Axillary vein access for pacemaker implantation is uncommon in many centres because of the lack of training in this technique. We assessed whether the introduction of the axillary vein technique was safe and efficient as compared with cephalic vein access, in a centre where no operators had any previous experience in axillary vein puncture. Patients undergoing pacemaker implantation were randomized to axillary or cephalic vein access. All three operators had no experience nor training in axillary vein puncture, and self-learned the technique by reading a published review. Axillary vein puncture was fluoroscopy-guided without contrast venography. Cephalic access was performed by dissection of delto-pectoral groove. Venous access success, venous access duration (from skin incision to guidewire or lead in superior vena cava), procedure duration, X-ray exposure, and peri-procedural (1 month) complications were recorded. results We randomized 74 consecutive patients to axillary (n = 37) or cephalic vein access (n = 37). Axillary vein was successfully accessed in 30/37 (81.1%) patients vs. 28/37 (75.7%) of cephalic veins (P = 0.57). Venous access time was shorter in axillary group than in cephalic group [5.7 (4.4-8.3) vs. 12.2 (10.5-14.8) min, P < 0.001], as well as procedure duration [34.8 (30.6-38.4) vs. 42.0 (39.1-46.6) min, P = 0.043]. X-ray exposure and peri-procedural overall complications were comparable in both groups. Axillary puncture was safe and faster than cephalic access even for the five first procedures performed by each operator. Self-taught axillary vein puncture for pacemaker implantation seems immediately safe and faster than cephalic vein access, when performed by electrophysiologists trained to pacemaker implantation but not to axillary vein puncture. Published on behalf of the European Society of Cardiology. All rights reserved. © The Author 2017. For Permissions, please email: journals.permissions@oup.com.

Optimizing the Stripping Procedure for LHCb

CERN Document Server

Richardson, Rachel

2017-01-01

The LHCb experiment faces a major challenge from the large amounts of data received while the LHC is running. The ability to sort this information in a useful manner is important for working groups to perform physics analyses. Both hardware and software triggers are used to decrease the data rate and then the stripping process is used to sort the data into streams and further into stripping lines. This project studies the hundreds of stripping lines to look for overlaps between them in order to make the stripping process more efficient.

Using Comic Strips in Language Classes

Science.gov (United States)

Csabay, Noémi

2006-01-01

The author believes that using comic strips in language-learning classes has three main benefits. First, comic strips motivate younger learners. Second, they provide a context and logically connected sentences to help language learning. Third, their visual information is helpful for comprehension. The author argues that comic strips can be used in…

Effect of preoperative antiplatelet drugs on vascular prostacyclin synthesis.

Science.gov (United States)

Karwande, S V; Weksler, B B; Gay, W A; Subramanian, V A

1987-03-01

Patients undergoing aortocoronary bypass using autogenous saphenous veins were randomly divided into three comparable groups. Group 1 (n = 10) acted as a control, Group 2 (n = 14) received 80 mg of aspirin at midnight before the operation, and Group 3 (n = 12) received 80 mg of aspirin and 75 mg of dipyridamole at midnight and an additional 75-mg dose of dipyridamole at 6 AM. The purpose was to determine which regimen would maximally inhibit platelet function without depressing vascular prostacyclin synthesis. Serum thromboxane A2, saphenous vein wall and aortic wall prostacyclin, platelet aggregation, and bleeding time were measured in all patients. None was restarted on a regimen of aspirin or dipyridamole postoperatively. Aspirin alone and in combination with dipyridamole significantly inhibited thromboxane A2 and platelet aggregation in all treated patients but spared venous prostacyclin synthesis. Aortic prostacyclin synthesis was partially inhibited in both treated groups. Chest tube drainage was comparable in all three groups. These results indicate that the combination of aspirin and dipyridamole offers no measurable advantage over aspirin alone in the perioperative period.

Test-beam evaluation of heavily irradiated silicon strip modules for ATLAS Phase-II Strip Tracker Upgrade

CERN Document Server

Blue, Andrew; The ATLAS collaboration

2018-01-01

The planned HL-LHC (High Luminosity LHC) is being designed to maximise the physics potential of the LHC with 10 years of operation at instantaneous luminosities of 7.5x1034cm−2s−1. A consequence of this increased luminosity is the expected radiation damage requiring the tracking detectors to withstand hadron equivalences to over 1x1015 1 MeV neutron equivalent per cm2 in the ATLAS Strips system. The silicon strip tracker exploits the concept of modularity. Fast readout electronics, deploying 130nm CMOS front-end electronics are glued on top of a silicon sensor to make a module. The radiation hard n-in-p micro-strip sensors used have been developed by the ATLAS ITk Strip Sensor collaboration and produced by Hamamatsu Photonics. A series of tests were performed at the DESY-II and CERN SPS test beam facilities to investigate the detailed performance of a strip module with both 2.5cm and 5cm length strips before and after irradiation with 8x1014neqcm−2 protons and a total ionising dose of 37.2MRad. The DURA...

Pavement Stripping in Saudi Arabia: Prediction and Prevention

Directory of Open Access Journals (Sweden)

H.I. Al-Abdul Wahhab

2004-12-01

Full Text Available Pavement weathering or stripping is a major distress in highway networks in arid regions. Using the Saudi Arabian road network as a case study area, seventeen road test sections were selected, out of which eight were stripped and nine were non-stripped. Aggregates from quarries used to build these sections were also collected and subjected to detailed physical and chemical tests to evaluate the ability of these tests to distinguish between stripped and non-stripped sections. The modified Lottman test was used to distinguish between compacted mixes. In addition, the Swedish Rolling Bottle test, was also found to be effective in being able to distinguish between different asphalt-aggregates for stripping potential. Eleven anti-stripping liquid additives, lime and cement, in addition to two polymers, were evaluated for their ability to reduce/eliminate stripping potential of stripping-prone aggregates. It was found that EE-2 Polymer, Portland cement, and their combination were effective with all aggregate sources.

Portal vein thrombosis.

Science.gov (United States)

Chawla, Yogesh K; Bodh, Vijay

2015-03-01

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.

Impact of Laser Fiber Design on Outcome of Endovenous Ablation of Lower-Extremity Varicose Veins: Results from a Single Practice

International Nuclear Information System (INIS)

Prince, Ethan A.; Soares, Gregory M.; Silva, MaryLou; Taner, Anil; Ahn, SunHo; Dubel, Gregory J.; Jay, Bryan S.

2011-01-01

The design of laser fibers used for endovenous laser ablation (EVLA) in the management of lower-extremity varicose vein disease may affect treatment success. The purpose of this investigation is to report our experience using the gold-tip NeverTouch VenaCure laser fiber (AngioDynamics, Queensbury, NY) and to compare that to our experience with standard bare-tip fibers. A retrospective chart review of 363 consecutive EVLA treatments using the gold-tip laser fiber was performed. Demographic data including patient age, sex, history of previous varicose vein stripping, vein identity, laterality, treatment length, total applied energy in joules (J), use of adjuvant sclerotherapy and ambulatory phlebectomy, treatment-related complications, and treatment failure, which was defined as recanalization of any portion of the treated vein during follow-up as assessed by duplex ultrasound examination―were entered into a spreadsheet. These data were compared with a control group of 471 EVLA treatments performed with a standard bare-tip laser fiber. Data were analyzed using independent-samples Student’s t test, chi-square test, and multivariate analysis. Demographic data were similar between the two groups. Treatments with the gold-tip fiber had a failure rate of 11.1%, whereas treatment with a bare-tip fiber had a failure rate of 2.3% during a similar follow-up period. This difference was highly statistically significant (p < 0.0001). Multivariate analysis showed fiber type as the most significant factor associated with treatment failure. We conclude that laser fiber design has a significant effect on treatment success in the performance of EVLA.

Case report: Varicosity of the communicating vein between the left renal vein and the left ascending lumbar vein mimicking a renal artery aneurysm: Report of an unusual site of varicose veins and a novel hypothesis to explain its association with abdominal pain

Directory of Open Access Journals (Sweden)

Sandeep G Jakhere

2011-01-01

Full Text Available A communicating vein between the left renal vein and the left ascending lumbar vein has only rarely been reported in the imaging literature. There are very few reports of varicosity of this communicating vein. Nonetheless, awareness about this communicating vein is of utmost importance for surgeons performing aortoiliac surgeries and nephrectomies as it may pose technical difficulties during surgery or cause life-threatening retroperitoneal hemorrhage. Varicosity of this venous channel may be mistaken for paraaortic lymphadenopathy, adrenal pseudo-mass, or renal artery aneurysm. We report a case of a patient with varicosity of this communicating vein, which mimicked a left renal artery aneurysm. A novel hypothesis is also proposed to explain the relationship with abdominal pain.

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

Directory of Open Access Journals (Sweden)

Ross C. Elliott

2014-08-01

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.

The angiographic demonstration of hepatic vein obstruction

International Nuclear Information System (INIS)

Zu Maoheng; Xu Hao; Li Guojun; Gu Yuming; Wei Ning; Wang Cheng; Xu Wei

2004-01-01

Objective: To evaluate the angiographic feature of hepatic vein obstruction. Methods Forty-five patients (male 23, female 22, age 9-54 years) suffered from hepatic vein obstruction. The inferior vena cavography and the hepatic venography were performed in all cases. Results: IVC was free in 37 patients with hepatic vein obstruction, both IVC and HV were obstructed in 8 patients. The local or long stenosis of IVC was found in 31 inferior vena cavography. The diameter of IVC was normal in 12 patients. The sign of membranous dome was found in hepatic vein orifice in 5 cases and in accessory hepatic vein orifice in 4 cases. Intrahepatic venous collaterals were found in 45 cases. Conclusion: Hepatic vein obstruction can be reproached primarily in inferior vena cavography, the membranous dome is a direct sign of membranous obstruction of HV and AHV in inferior vena cavography. The selected hepatic venography can provide reliable evidence to diagnose hepatic vein obstruction

Large strip RPCs for the LEPS2 TOF system

Energy Technology Data Exchange (ETDEWEB)

Tomida, N., E-mail: natsuki@scphys.kyoto-u.ac.jp [Department of Physics, Kyoto University, Kyoto 606-8502 (Japan); Niiyama, M. [Department of Physics, Kyoto University, Kyoto 606-8502 (Japan); Ohnishi, H. [RIKEN (The Institute of Physical and Chemical Research), Wako, Saitama 351-0198 (Japan); Tran, N. [Research Center for Nuclear Physics (RCNP), Osaka University, Ibaraki, Osaka 567-0047 (Japan); Hsieh, C.-Y.; Chu, M.-L.; Chang, W.-C. [Institute of Physics, Academia Sinica, Nankang, Taipei 11529, Taiwan (China); Chen, J.-Y. [National Synchrotron Radiation Research Center (NSRRC), Hsinchu 30076, Taiwan (China)

2014-12-01

High time-resolution resistive plate chambers (RPCs) with large-size readout strips are developed for the time-of-flight (TOF) detector system of the LEPS2 experiment at SPring-8. The experimental requirement is a 50-ps time resolution for a strip size larger than 100 cm{sup 2}/channel. We are able to achieve 50-ps time resolutions with 2.5×100 cm{sup 2} strips by directly connecting the amplifiers to strips. With the same time resolution, the number of front-end electronics (FEE) is also reduced by signal addition. - Highlights: • Find a way to achieve a good time resolution with a large strip RPC. • 2.5 cm narrow strips have better resolutions than 5.0 cm ones. • The 0.5 mm narrow strip interval shows flat time resolutions between strips. • FEEs directly connected to strips make the signal reflection at the strip edge small. • A time resolution of 50 ps was achieved with 2.5 cm×100 cm strips.

A Vein Map Biometric System

Directory of Open Access Journals (Sweden)

Felix Fuentes

2013-08-01

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

Deep vein thrombosis of the leg

Energy Technology Data Exchange (ETDEWEB)

Lee, Eun Hee; Rhee, Kwang Woo; Jeon, Suk Chul; Joo, Kyung Bin; Lee, Seung Ro; Seo, Heung Suk; Hahm, Chang Kok [College of Medicine, Hanyang University, Seoul (Korea, Republic of)

1987-04-15

Ascending contrast venography is the definitive standard method for the diagnosis of deep vein thrombosis (DVT) of the lower extremities. Authors analysed 22 cases of DVT clinically and radiographically. 1.The patients ranged in age from 15 to 70 yrs and the most prevalent age group was 7th decade (31%). There was an equal distribution of males and females. 2.In 11 cases of 22 cases, variable etiologic factors were recognized, such as abdominal surgery, chronic bedridden state, local trauma on the leg, pregnancy, postpartum, Behcet's syndrome, iliac artery aneurysm, and chronic medication of estrogen. 3.Nineteen cases out of 22 cases showed primary venographic signs of DVT, such as well-defined filling defect in opacified veins and narrowed, irregularly filled venous lumen. In only 3 cases, the diagnosis of DVT was base upon the segmental nonvisualization of deep veins with good opacification of proximal and distal veins and presence of collaterals. 4.Extent of thrombosis: 3 cases were confined to calf vein, 4 cases extended to femoral vein, and 15 cases had involvement above iliac vein. 5.In 17 cases involving relatively long segment of deep veins, propagation pattern of thrombus was evaluated by its radiologic morphology according to the age of thrombus: 9 cases suggested central or antegrade propagation pattern and 8 cases, peripheral or retrograde pattern. 6.None of 22 cases showed clinical evidence of pulmonary embolism. The cause of the rarity of pulmonary embolism in Korean in presumed to be related to the difference in major involving site and propagation pattern of DVT in the leg.

Deep vein thrombosis of the leg

International Nuclear Information System (INIS)

Lee, Eun Hee; Rhee, Kwang Woo; Jeon, Suk Chul; Joo, Kyung Bin; Lee, Seung Ro; Seo, Heung Suk; Hahm, Chang Kok

1987-01-01

Ascending contrast venography is the definitive standard method for the diagnosis of deep vein thrombosis (DVT) of the lower extremities. Authors analysed 22 cases of DVT clinically and radiographically. 1.The patients ranged in age from 15 to 70 yrs and the most prevalent age group was 7th decade (31%). There was an equal distribution of males and females. 2.In 11 cases of 22 cases, variable etiologic factors were recognized, such as abdominal surgery, chronic bedridden state, local trauma on the leg, pregnancy, postpartum, Behcet's syndrome, iliac artery aneurysm, and chronic medication of estrogen. 3.Nineteen cases out of 22 cases showed primary venographic signs of DVT, such as well-defined filling defect in opacified veins and narrowed, irregularly filled venous lumen. In only 3 cases, the diagnosis of DVT was base upon the segmental nonvisualization of deep veins with good opacification of proximal and distal veins and presence of collaterals. 4.Extent of thrombosis: 3 cases were confined to calf vein, 4 cases extended to femoral vein, and 15 cases had involvement above iliac vein. 5.In 17 cases involving relatively long segment of deep veins, propagation pattern of thrombus was evaluated by its radiologic morphology according to the age of thrombus: 9 cases suggested central or antegrade propagation pattern and 8 cases, peripheral or retrograde pattern. 6.None of 22 cases showed clinical evidence of pulmonary embolism. The cause of the rarity of pulmonary embolism in Korean in presumed to be related to the difference in major involving site and propagation pattern of DVT in the leg

Bilateral meandering pulmonary veins

Energy Technology Data Exchange (ETDEWEB)

Thupili, Chakradhar R.; Udayasankar, Unni [Pediatric Imaging, Imaging Institute Cleveland Clinic, Cleveland, OH (United States); Renapurkar, Rahul [Imaging Institute Cleveland Clinic, Thoracic Imaging, L10, Cleveland, OH (United States)

2015-06-15

Meandering pulmonary veins is a rare clinical entity that can be mistaken for more complex congenital syndromes such as hypogenetic lung syndrome. We report imaging findings in a rare incidentally detected case of bilateral meandering pulmonary veins. We briefly discuss the role of imaging in diagnosing this condition, with particular emphasis on contrast-enhanced CT. (orig.)

Mechanical behaviour of a creased thin strip

Directory of Open Access Journals (Sweden)

J. Liu

2018-02-01

Full Text Available In this study the mechanical behaviour of a creased thin strip under opposite-sense bending was investigated. It was found that a simple crease, which led to the increase of the second moment of area, could significantly alter the overall mechanical behaviour of a thin strip, for example the peak moment could be increased by 100 times. The crease was treated as a cylindrical segment of a small radius. Parametric studies demonstrated that the geometry of the strip could strongly influence its flexural behaviour. We showed that the uniform thickness and the radius of the creased segment had the greatest and the least influence on the mechanical behaviour, respectively. We further revealed that material properties could dramatically affect the overall mechanical behaviour of the creased strip by gradually changing the material from being linear elastic to elastic-perfect plastic. After the formation of the fold, the moment of the two ends of the strip differed considerably when the elasto-plastic materials were used, especially for materials with smaller tangent modulus in the plastic range. The deformation patterns of the thin strips from the finite element simulations were verified by physical models made of thin metal strips. The findings from this study provide useful information for designing origami structures for engineering applications using creased thin strips.

The veining phenomenon in unalloyed plutonium

International Nuclear Information System (INIS)

White, J.S.

1976-01-01

An investigation has been made of the veining phenomenon in unalloyed plutonium. The surface markings, or veins, which are sometimes seen on α-phase plutonium samples, arise as a result of the β→α transformation. As far as is known, this veining is unrivalled in its scale and form as compared with the solid state surface transformation effects shown by any other metal. The phenomenon has been explained by the application of the Le Chatelier principle to the phase change. In this instance, the large (10%) volume contraction associated with the β→α reaction and the anisotropy of the nonoclinic α-phase structure, account for the fact that the veins are so prominent in plutonium. On the basis of the proposed model, the veins can only form at temperatures where the transformation mechanism is non-martensitic. (Auth.)

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 ...

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

2015-12-01

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.

Comparative limnology of strip-mine lakes

Energy Technology Data Exchange (ETDEWEB)

Parsons, J D

1964-01-01

Lakes were classified according to chemical properties. The concentration of the ferric iron oxides was responsible for a reddish-black turbidity which, in turn, played a major role in the thermal stratification of red strip-mine lakes. Owing to the lack of measurable turbidity and as a result of selective absorption of visible solar radiation, other strip-mine lakes appeared blue in color. The annual heat budget and the summer heat budget are essentially equivalent under saline conditions. Regardless of the physical and chemical conditions of the strip-mine lakes, heat income was a function of the circulating water mass. The progressive oxidation and precipitation of the iron oxides is the key to the classification of strip-mine lakes.

Investigation of adverse events associated with an off-label use of arterial stents and CE-marked iliac vein stents in the iliac vein: insights into developing a better iliac vein stent.

Science.gov (United States)

Shida, Takuya; Umezu, Mitsuo; Iwasaki, Kiyotaka

2018-06-01

We analyzed the adverse events associated with an off-label use of arterial stents and CE-marked iliac vein stents for the treatment of iliac venous thromboembolism and investigated their relationships with the anatomical features of the iliac vein, to gain insights into the development of a better iliac vein stent. Reports of adverse events following the use of stents in the iliac vein were retrieved from the Manufacturer and User Facility Device Experience (MAUDE) database that contain suspected device-associated complications reported to the Food and Drug Administration. Data from 2006 to 2016 were investigated. The literature analysis was also conducted using PubMed, Cochrane Library, EMBASE, and Web of Science focusing on English articles published up to 4 October 2016. The analysis of 88 adverse events from the MAUDE database and 182 articles from the literature revealed that a higher number of adverse events had been reported following the use of arterial stents in the iliac vein compared to CE-marked iliac vein stents. While stent migration and shortening were reported only for the arterial stents, stent fracture and compression occurred regardless of the stent type, even though a vein does not pulsate. A study of the anatomical features of the iliac vein implies that bending, compression, and kink loads are applied to the iliac vein stents in vivo. For designing, developing, and pre-clinical testing of stents intended for use in the iliac vein, the above mechanical load environments induced by the anatomical features should be considered.

The CT appearance of the superior intercostal veins

International Nuclear Information System (INIS)

Lund, G.

1982-01-01

The CT appearance of the superior intercostal veins is described. The veins are more frequently seen on the right side. The right superior intercostal vein should not be misinterpreted as a paraspinal mass when it is large or bulges into the contour of the right lung. A case of stenosis of the left brachiocephalic vein is shown, where the left superior intercostal vein serves as a collateral. (orig.)

Balloon-occluded retrograde transvenous obliteration of gastric varix draining via the left inferior phrenic vein into the left hepatic vein

International Nuclear Information System (INIS)

Ibukuro, Kenji; Mori, Koichi; Tsukiyama, Toshitaka; Inoue, Yoshihiro; Iwamoto, Yukako; Tagawa, Kazumi

1999-01-01

We encountered a patient with gastric varix draining not via the usual left suprarenal vein but via the left inferior phrenic vein joining the left hepatic vein. Transfemoral balloon-occluded retrograde transvenous obliteration (BRTO) of the varix was performed under balloon occlusion of the left inferior phrenic vein via the left hepatic vein and retrograde injection of the sclerosing agent (5% of ethanolamine oleate) into the gastric varix. Disappearance of the gastric varix was confirmed on endoscopic examination 2 months later.

Varicose Veins: Role of Mechanotransduction of Venous Hypertension

Science.gov (United States)

Atta, Hussein M.

2012-01-01

Varicose veins affect approximately one-third of the adult population and result in significant psychological, physical, and financial burden. Nevertheless, the molecular pathogenesis of varicose vein formation remains unidentified. Venous hypertension exerted on veins of the lower extremity is considered the principal factor in varicose vein formation. The role of mechanotransduction of the high venous pressure in the pathogenesis of varicose vein formation has not been adequately investigated despite a good progress in understanding the mechanomolecular mechanisms involved in transduction of high blood pressure in the arterial wall. Understanding the nature of the mechanical forces, the mechanosensors and mechanotransducers in the vein wall, and the downstream signaling pathways will provide new molecular targets for the prevention and treatment of varicose veins. This paper summarized the current understanding of mechano-molecular pathways involved in transduction of hemodynamic forces induced by blood pressure and tries to relate this information to setting of venous hypertension in varicose veins. PMID:22489273

[Deep vein thrombosis prophylaxis.

Science.gov (United States)

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

2013-01-01

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.

Anomalous adrenal vein anatomy complicating the evaluation of primary hyperaldosteronism

Directory of Open Access Journals (Sweden)

Kaitlin M. Ford, BS

2018-02-01

Full Text Available Adrenal vein development in utero occurs concurrently with the development of the inferior vena cava, the renal veins, and the gonadal veins. The embryologic formation of these veins involves communication of various venous systems. Although the left adrenal-renal vein complex is most commonly described as a shared emptying of the left adrenal vein and the left inferior phrenic vein into the left renal vein, there have been reports of numerous anatomic variations of this complex. In this report, we present a case of a rare variant of the left adrenal vein, in which the left adrenal vein empties into the left gonadal vein, which takes an atypical course superolateral to the left kidney.

On dynamics of uranium vein mineralization

International Nuclear Information System (INIS)

Petrosyan, R.V.

1981-01-01

The formation of urnaium 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 contineous 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 [ru

A Morphological Insight of the Femoral Vein

Directory of Open Access Journals (Sweden)

Ferreira AH

2015-10-01

Full Text Available A total of 13 cadavers (12 men and 1 women of different age group were used for the study with the purpose to determine the prevalence of femoral vein duplication. Lower limb regions (26 sides were carefully dissected as per the standard dissection procedure. Femoral vein (unitruncular was found in 96.15% of specimen. Bitruncular configurations (total bifidity was found in a male cadaver of 75 years of age (3.85%. In the right lower limb, 6.5 cms below the inguinal ligament the femoral vein - lateral ramus received the lateral circumflex femoral vein, and the medial circumflex femoral vein, and the lateral and medial ramii formed a common venous trunk. Knowledge of the truncular venous variations is important to recognize and avoid potential errors in diagnosis of deep venous thrombosis of the femoral vein, in the case of an occluded duplicated trunk.

Nodular granulomatous phlebitis: a phlebitic tuberculid.

Science.gov (United States)

McHugh, Angela; Siller, Gregory; Williamson, Richard; Faulkner, Catherine

2008-11-01

A 22-year-old woman presented with recurrent non-ulcerating skin nodules overlying the great saphenous vein on the anteromedial lower legs. Histology showed a granulomatous phlebitis, and polymerase chain reaction performed on lesional skin detected DNA specific for Mycobacterium tuberculosis. The lesions resolved with anti-tuberculous therapy. This case may be a further example of nodular granulomatous phlebitis, a phlebitic tuberculid.

Cavernous transformation of the portal vein

International Nuclear Information System (INIS)

Lehotska, V.; Dostalova, K.; Durkovsky, A.; Samal, V.

1995-01-01

In this contribution, the authors give an account of a rare case of a cavernous transformation of the portal vein that may have originated secondarily in a proliferative hematogenous disease with a polyglobulia and thrombosis in the periferal blood count as well as development of portal hypertension of a prehepatal type. The state of hyper-coagulation in a myeloproliferative disease may have lead to a chronic thrombosis of the portal vein with a subsequent malformation of the portal vein in terms of a cavernous transformation of the portal vein. The case is an interesting one because of the discrepancy between the gravity of the thrombotic complication and slightness of the symptoms in the clinical picture. The authors point out the importance of ultrasonography and computed tomography examination following the intravenous application of a water solution of a contrast medium in a morphologic diagnosing of a rare complication of a chronic thrombotic clot of the portal vein - the cavernous transformation. (authors)

Varicose Vein Treatment (Endovenous Ablation of Varicose Veins)

Science.gov (United States)

... associated veins. top of page What are the benefits vs. risks? Benefits No surgical incision is needed—only a small ... risk of infection. The chance of infection requiring antibiotic treatment appears to be less than one in ...

Superconducting nano-strip particle detectors

International Nuclear Information System (INIS)

Cristiano, R; Ejrnaes, M; Casaburi, A; Zen, N; Ohkubo, M

2015-01-01

We review progress in the development and applications of superconducting nano-strip particle detectors. Particle detectors based on superconducting nano-strips stem from the parent devices developed for single photon detection (SSPD) and share with them ultra-fast response times (sub-nanosecond) and the ability to operate at a relatively high temperature (2–5 K) compared with other cryogenic detectors. SSPDs have been used in the detection of electrons, neutral and charged ions, and biological macromolecules; nevertheless, the development of superconducting nano-strip particle detectors has mainly been driven by their use in time-of-flight mass spectrometers (TOF-MSs) where the goal of 100% efficiency at large mass values can be achieved. Special emphasis will be given to this case, reporting on the great progress which has been achieved and which permits us to overcome the limitations of existing mass spectrometers represented by low detection efficiency at large masses and charge/mass ambiguity. Furthermore, such progress could represent a breakthrough in the field. In this review article we will introduce the device concept and detection principle, stressing the peculiarities of the nano-strip particle detector as well as its similarities with photon detectors. The development of parallel strip configuration is introduced and extensively discussed, since it has contributed to the significant progress of TOF-MS applications. (paper)

Preduodenal portal vein: its surgical significance.

Science.gov (United States)

Makey, D A; Bowen, J C

1978-11-01

Preduodenal portal vein is a rare anatomical variant which may be one of many anomalies in the neonate with duodenal "atresia." Preduodenal portal vein also may be an occasional finding in an adult undergoing biliary, gastric, or pancreatic surgery. Awareness and recognition of the anomaly are essential for the avoidance of injury during such operations. We report here a symptomless patient whose preduodenal portal vein was discovered at cholecystectomy.

Duplication of the Portal Vein: A Case Report

Energy Technology Data Exchange (ETDEWEB)

Kim, Sang Won; Shin, Hyeong Cheol; Jou, Sung Shick; Han, Jong Kyu; Kim, Il Young [Soonchunhyang University Cheonan Hospital, Cheonan (Korea, Republic of)

2009-12-15

The duplication of the portal vein is an uncommon congenital anomaly. To date, only four cases have been reported in the medical literature. This anomaly can cause portal hypertension in pediatric patients. In addition, duplication of the portal vein has various patterns of connection with a splenic vein or mesenteric veins, and it can lie anterior or posterior to the duodenum. We report the MDCT findings of an adult patient with duplication of the portal vein that was found incidentally

Absent right superior caval vein in situs solitus

DEFF Research Database (Denmark)

Lytzen, Rebekka; Sundberg, Karin; Vejlstrup, Niels

2015-01-01

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...... no postnatal complications. All children were found to have healthy hearts at follow-up. CONCLUSIONS: In all cases, the findings proved to be a benign condition with no clinical manifestations or complications. Although isolated absent right superior caval vein does not seem to affect the outcome, associated...

Depletive stripping chronopotentiometry : a major step forward in electrochemical stripping techniques for metal ion speciation analysis

NARCIS (Netherlands)

Town, R.M.; Leeuwen, van H.P.

2004-01-01

A comparative evaluation of the utility of the various modes of stripping chronopotentiometry (SCP) for trace metal speciation analysis is presented in the broad context of stripping voltammetric techniques. The remarkable fundamental advantages of depletive SCP at scanned deposition potential

Finger vein extraction using gradient normalization and principal curvature

Science.gov (United States)

Choi, Joon Hwan; Song, Wonseok; Kim, Taejeong; Lee, Seung-Rae; Kim, Hee Chan

2009-02-01

Finger vein authentication is a personal identification technology using finger vein images acquired by infrared imaging. It is one of the newest technologies in biometrics. Its main advantage over other biometrics is the low risk of forgery or theft, due to the fact that finger veins are not normally visible to others. Extracting finger vein patterns from infrared images is the most difficult part in finger vein authentication. Uneven illumination, varying tissues and bones, and changes in the physical conditions and the blood flow make the thickness and brightness of the same vein different in each acquisition. Accordingly, extracting finger veins at their accurate positions regardless of their thickness and brightness is necessary for accurate personal identification. For this purpose, we propose a new finger vein extraction method which is composed of gradient normalization, principal curvature calculation, and binarization. As local brightness variation has little effect on the curvature and as gradient normalization makes the curvature fairly uniform at vein pixels, our method effectively extracts finger vein patterns regardless of the vein thickness or brightness. In our experiment, the proposed method showed notable improvement as compared with the existing methods.

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

Directory of Open Access Journals (Sweden)

Young-Kyun Kim

2016-07-01

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.

Ductility of reinforced concrete columns confined with stapled strips

International Nuclear Information System (INIS)

Tahir, M.F.; Khan, Q.U.Z.; Shabbir, F.; Sharif, M.B.; Ijaz, N.

2015-01-01

Response of three 150x150x450mm short reinforced concrete (RC) columns confined with different types of confining steel was investigated. Standard stirrups, strips and stapled strips, each having same cross-sectional area, were employed as confining steel around four comer column bars. Experimental work was aimed at probing into the affect of stapled strip confinement on post elastic behavior and ductility level under cyclic axial load. Ductility ratios, strength enhancement factor and core concrete strengths were compared to study the affect of confinement. Results indicate that strength enhancement in RC columns due to strip and stapled strip confinement was not remarkable as compared to stirrup confined column. It was found that as compared to stirrup confined column, stapled strip confinement enhanced the ductility of RC column by 183% and observed axial capacity of stapled strip confined columns was 41 % higher than the strip confined columns. (author)

Potential profile in a conducting polymer strip

DEFF Research Database (Denmark)

Bay, Lasse; West, Keld; Vlachopoulos, Nikolaos

2002-01-01

Many conjugated polymers show an appreciable difference in volume between their oxidized and reduced forms. This property can be utilized in soft electrochemically driven actuators, "artificial muscles". Several geometries have been proposed for the conversion of the volume expansion into useful...... mechanical work. In a particularly simple geometry, the length change of polymer strips is exploited. The polymer strips are connected to the driving circuit at the end of the strip that is attached to the support of the device. The other end of the strip is connected to the load. The advantage of this set...

Study on lifetime of C stripping foils

International Nuclear Information System (INIS)

Zhang Hongbin; Lu Ziwei; Zhao Yongtao; Li Zhankui; Xu Hushan; Xiao Guoqing; Wang Yuyu; Zhang Ling; Li Longcai; Fang Yan

2007-01-01

The carbon stripping foils can be prepared with the AC and DC arc discharge methods, or even sandwiched with AC-DC alternative layers. The lifetime of the carbon stripping foils of 19 μg/cm 2 prepared with different methods and/or structures was measured. The factors affecting the bombarding lifetime of the carbon stripping foils, especially the method of the foil preparation and the structure of the carbon stripping foils, were discussed. It is observed that the foils prepared with the DC arc discharge method have a longer bombarding lifetime than those prepared with the AC arc discharge method. (authors)

Augmented reality based real-time subcutaneous vein imaging system.

Science.gov (United States)

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

2016-07-01

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.

A randomised controlled trial of ultrasound-guided blockade of the saphenous nerve and the posterior branch of the obturator nerve for postoperative analgesia after day-case knee arthroscopy

DEFF Research Database (Denmark)

Westergaard, B; Jensen, K; Lenz, K

2014-01-01

The purpose of this study was to investigate the effects of blockade of the saphenous nerve and the posterior branch of the obturator nerve in addition to a standard analgesic regimen for patients discharged the same day after knee arthroscopy. The primary outcome was knee pain on flexion during...

Personal authentication through dorsal hand vein patterns

Science.gov (United States)

Hsu, Chih-Bin; Hao, Shu-Sheng; Lee, Jen-Chun

2011-08-01

Biometric identification is an emerging technology that can solve security problems in our networked society. A reliable and robust personal verification approach using dorsal hand vein patterns is proposed in this paper. The characteristic of the approach needs less computational and memory requirements and has a higher recognition accuracy. In our work, the near-infrared charge-coupled device (CCD) camera is adopted as an input device for capturing dorsal hand vein images, it has the advantages of the low-cost and noncontact imaging. In the proposed approach, two finger-peaks are automatically selected as the datum points to define the region of interest (ROI) in the dorsal hand vein images. The modified two-directional two-dimensional principal component analysis, which performs an alternate two-dimensional PCA (2DPCA) in the column direction of images in the 2DPCA subspace, is proposed to exploit the correlation of vein features inside the ROI between images. The major advantage of the proposed method is that it requires fewer coefficients for efficient dorsal hand vein image representation and recognition. The experimental results on our large dorsal hand vein database show that the presented schema achieves promising performance (false reject rate: 0.97% and false acceptance rate: 0.05%) and is feasible for dorsal hand vein recognition.

Thrombosis of right ovarian vein

International Nuclear Information System (INIS)

Forner, J.; Talens, A.; Flores, M.; Mendez, M.

2001-01-01

Ovarian vein thrombosis is a rare postpartum complication (0.1%). It can be fatal, since it can lead to sepsis, pulmonary thromboembolisms and inferior vena cava or renal vein thrombosis. Computed tomography and magnetic resonance imaging are the techniques of choice for its diagnosis, while the value of ultrasound is limited due to its low sensitivity and specificity. We report the case of a woman who, during puerperium, developed thrombosis of right ovarian vein that presented clinical, ultrasonographic and computed tomographic features of appendicitis. We describe the radiological sings and stress the fact that this diagnosis should be suspected in puerperal women. (Author) 9 refs

Ultrasonic examination of JBK-75 strip material

International Nuclear Information System (INIS)

Cook, K.V.; Cunningham, R.A. Jr.; Lewis, J.C.; McClung, R.W.

1982-12-01

An ultrasonic inspection system was assembled to inspect the JBK-75 stainless steel sheath material (for the Large Coil Project) for the Westinghouse-Airco superconducting magnet program. The mechanical system provided for handling the 180-kg (400-lb) coils of strip material [1.6 mm thick by 78 mm wide by 90 to 120 m long (0.064 by 3.07 in. by 300 to 400 ft)], feeding the strip through the ultrasonic inspection and cleaning stations, and respooling the coils. We inspected 54 coils of strip for both longitudinal and laminar flaws. Simulated flaws were used to calibrate both inspections. Saw-cut notches [0.28 mm deep (0.011 in., about 17% of the strip thickness)] were used to calibrate the longitudinal flaw inspections; 1.59-mm-diam (0.063-in.) flat-bottom holes drilled halfway through a calibration strip were used to calibrate the laminar flaw tests

Hardness of approximation for strip packing

DEFF Research Database (Denmark)

Adamaszek, Anna Maria; Kociumaka, Tomasz; Pilipczuk, Marcin

2017-01-01

Strip packing is a classical packing problem, where the goal is to pack a set of rectangular objects into a strip of a given width, while minimizing the total height of the packing. The problem has multiple applications, for example, in scheduling and stock-cutting, and has been studied extensively......)-approximation by two independent research groups [FSTTCS 2016,WALCOM 2017]. This raises a questionwhether strip packing with polynomially bounded input data admits a quasi-polynomial time approximation scheme, as is the case for related twodimensional packing problems like maximum independent set of rectangles or two...

Assessment and management of patients with varicose veins.

Science.gov (United States)

Allen, Louise

Varicose veins are enlarged superficial veins found in the legs. This article explores the anatomy and physiology of the venous system to assist nurses to assess, manage and treat patients with varicose veins.

Deep vein thrombosis: a clinical review

Directory of Open Access Journals (Sweden)

Kesieme EB

2011-04-01

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

Transfusion and blood donation in comic strips.

Science.gov (United States)

Lefrère, Jean-Jacques; Danic, Bruno

2013-07-01

The representation of blood transfusion and donation of blood in the comic strip has never been studied. The comic strip, which is a relatively recent art, emerged in the 19th century before becoming a mass medium during the 20th century. We have sought, by calling on collectors and using the resources of Internet, comic strips devoted, wholly or in part, to the themes of transfusion and blood donation. We present some of them here in chronologic order, indicating the title, country of origin, year of publication, and names of authors. The theme of the superhero using transfusion to transmit his virtues or his powers is repeated throughout the 20th century in North American comic strips. More recently, comic strips have been conceived from the outset with a promotional aim. They perpetuate positive images and are directed toward a young readership, wielding humor to reduce the fear of venipuncture. Few comic strips denounce the abuse of the commercialization of products derived from the human body. The image of transfusion and blood donation given by the comic strips is not to be underestimated because their readership is primarily children, some of whom will become blood donors. Furthermore, if some readers are transfused during their lives, the impact of a memory more or less conscious of these childhood readings may resurface, both in hopes and in fears. Copyright © 2013 Elsevier Inc. All rights reserved.

Dual Balloon-Occluded Retrograde Transvenous Obliteration of Gastric Varix Draining into the Left Adrenal Vein and Left Inferior Phrenic Vein

International Nuclear Information System (INIS)

Nishida, Norifumi; Ninoi, Teruhisa; Kitayama, Toshiaki; Yamamoto, Akira; Sakai, Yukimasa; Sato, Kimihiko; Hamuro, Masao; Nakamura, Kenji; Inoue, Yuichi; Yamada, Ryusaku

2004-01-01

A 66-year-old woman with a gastric varix, draining into a dilated left adrenal vein and a left inferior phrenic vein, was treated with dual balloon-occluded retrograde transvenous obliteration (B-RTO). Under balloon occlusion of the left adrenal vein and the left inferior phrenic vein, retrograde injection of a sclerosant (5% ethanolamine oleate) into the gastric varix was performed. Two weeks later, disappearance of flow in the gastric varix was confirmed on endoscopic ultrasound examination

Recurrence of superficial vein thrombosis in patients with varicose veins.

Science.gov (United States)

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

2016-08-01

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.

Leiomyosarcoma of the renal vein

Directory of Open Access Journals (Sweden)

Lemos Gustavo C.

2003-01-01

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.

Development of floating strip micromegas detectors

Energy Technology Data Exchange (ETDEWEB)

Bortfeldt, Jonathan

2014-04-28

Micromegas are high-rate capable, high-resolution micro-pattern gaseous detectors. Square meter sized resistive strip Micromegas are foreseen as replacement of the currently used precision tracking detectors in the Small Wheel, which is part of the forward region of the ATLAS muon spectrometer. The replacement is necessary to ensure tracking and triggering performance of the muon spectrometer after the luminosity increase of the Large Hadron Collider beyond its design value of 10{sup 34} cm{sup -2}s{sup -1} around 2020. In this thesis a novel discharge tolerant floating strip Micromegas detector is presented and described. By individually powering copper anode strips, the effects of a discharge are confined to a small region of the detector. This reduces the impact of discharges on the efficiency by three orders of magnitude, compared to a standard Micromegas. The physics of the detector is studied and discussed in detail. Several detectors are developed: A 6.4 x 6.4 cm{sup 2} floating strip Micromegas with exchangeable SMD capacitors and resistors allows for an optimization of the floating strip principle. The discharge behavior is investigated on this device in depth. The microscopic structure of discharges is quantitatively explained by a detailed detector simulation. A 48 x 50 cm{sup 2} floating strip Micromegas is studied in high energy pion beams. Its homogeneity with respect to pulse height, efficiency and spatial resolution is investigated. The good performance in high-rate background environments is demonstrated in cosmic muon tracking measurements with a 6.4 x 6.4 cm{sup 2} floating strip Micromegas under lateral irradiation with 550 kHz 20 MeV proton beams. A floating strip Micromegas doublet with low material budget is developed for ion tracking without limitations from multiple scattering in imaging applications during medical ion therapy. Highly efficient tracking of 20 MeV protons at particle rates of 550 kHz is possible. The reconstruction of the

Development of floating strip micromegas detectors

International Nuclear Information System (INIS)

Bortfeldt, Jonathan

2014-01-01

Micromegas are high-rate capable, high-resolution micro-pattern gaseous detectors. Square meter sized resistive strip Micromegas are foreseen as replacement of the currently used precision tracking detectors in the Small Wheel, which is part of the forward region of the ATLAS muon spectrometer. The replacement is necessary to ensure tracking and triggering performance of the muon spectrometer after the luminosity increase of the Large Hadron Collider beyond its design value of 10 34 cm -2 s -1 around 2020. In this thesis a novel discharge tolerant floating strip Micromegas detector is presented and described. By individually powering copper anode strips, the effects of a discharge are confined to a small region of the detector. This reduces the impact of discharges on the efficiency by three orders of magnitude, compared to a standard Micromegas. The physics of the detector is studied and discussed in detail. Several detectors are developed: A 6.4 x 6.4 cm 2 floating strip Micromegas with exchangeable SMD capacitors and resistors allows for an optimization of the floating strip principle. The discharge behavior is investigated on this device in depth. The microscopic structure of discharges is quantitatively explained by a detailed detector simulation. A 48 x 50 cm 2 floating strip Micromegas is studied in high energy pion beams. Its homogeneity with respect to pulse height, efficiency and spatial resolution is investigated. The good performance in high-rate background environments is demonstrated in cosmic muon tracking measurements with a 6.4 x 6.4 cm 2 floating strip Micromegas under lateral irradiation with 550 kHz 20 MeV proton beams. A floating strip Micromegas doublet with low material budget is developed for ion tracking without limitations from multiple scattering in imaging applications during medical ion therapy. Highly efficient tracking of 20 MeV protons at particle rates of 550 kHz is possible. The reconstruction of the track inclination in a single

7 CFR 29.6128 - Straight Stripped (X Group).

Science.gov (United States)

2010-01-01

... 7 Agriculture 2 2010-01-01 2010-01-01 false Straight Stripped (X Group). 29.6128 Section 29.6128... REGULATIONS TOBACCO INSPECTION Standards Grades § 29.6128 Straight Stripped (X Group). This group consists of..., and tolerances X1 Fine Quality Straight Stripped. Heavy, ripe, firm, semielastic, normal strength and...

Apparatus for measuring profile thickness of strip material

International Nuclear Information System (INIS)

Hold, A.C.

1982-01-01

Apparatus for measuring the thickness profile of steel strip comprises a radiation source reciprocally movable in a stepwise fashion (by a belt) across the strip width on one side thereof and a single elongated detector on the other side of the strip aligned with the scanning source. This detector may be a fluorescent scintillator detector or an ionisation chamber. Means are provided for sensing the degree of excitation in the detector in synchronism with the scanning source whereby to provide an output representative of the thickness profile of the strip. (author)

Biotransformation of glyceryl trinitrate (GTN) in isolated bovine pulmonary artery (BPA) and bovine pulmonary vein (BPV)

International Nuclear Information System (INIS)

Anon.

1986-01-01

A proposed mechanism of GTN-induced vasodilation requires biotransformation of GTN to glyceryl dinitrate (GDN). They have previously shown that GTN is metabolized to GDN during relaxation of isolated rabbit aorta. The authors have extended this study to include BPA and BPV and to determine if their sensitivity to GTN correlates with their ability to metabolize GTN. Strips of BPA and BPV were contracted submaximally with KCl and then incubated with 0.5 μM 14 C-GTN for 2 min. GTN-induced relaxation of these vessels was monitored and tissue GTN and metabolite concentrations were measured. Data are presented which support the above hypothesis that GTN biotransformation and relaxation occur together in vascular smooth muscle; however, there appear to be factors other than extent of GTN biotransformation that account for the difference in sensitivity to GTN of the artery and vein

Stability of barotropic vortex strip on a rotating sphere.

Science.gov (United States)

Sohn, Sung-Ik; Sakajo, Takashi; Kim, Sun-Chul

2018-02-01

We study the stability of a barotropic vortex strip on a rotating sphere, as a simple model of jet streams. The flow is approximated by a piecewise-continuous vorticity distribution by zonal bands of uniform vorticity. The linear stability analysis shows that the vortex strip becomes stable as the strip widens or the rotation speed increases. When the vorticity constants in the upper and the lower regions of the vortex strip have the same positive value, the inner flow region of the vortex strip becomes the most unstable. However, when the upper and the lower vorticity constants in the polar regions have different signs, a complex pattern of instability is found, depending on the wavenumber of perturbations, and interestingly, a boundary far away from the vortex strip can be unstable. We also compute the nonlinear evolution of the vortex strip on the rotating sphere and compare with the linear stability analysis. When the width of the vortex strip is small, we observe a good agreement in the growth rate of perturbation at an early time, and the eigenvector corresponding to the unstable eigenvalue coincides with the most unstable part of the flow. We demonstrate that a large structure of rolling-up vortex cores appears in the vortex strip after a long-time evolution. Furthermore, the geophysical relevance of the model to jet streams of Jupiter, Saturn and Earth is examined.

Stability of barotropic vortex strip on a rotating sphere

Science.gov (United States)

Sohn, Sung-Ik; Sakajo, Takashi; Kim, Sun-Chul

2018-02-01

We study the stability of a barotropic vortex strip on a rotating sphere, as a simple model of jet streams. The flow is approximated by a piecewise-continuous vorticity distribution by zonal bands of uniform vorticity. The linear stability analysis shows that the vortex strip becomes stable as the strip widens or the rotation speed increases. When the vorticity constants in the upper and the lower regions of the vortex strip have the same positive value, the inner flow region of the vortex strip becomes the most unstable. However, when the upper and the lower vorticity constants in the polar regions have different signs, a complex pattern of instability is found, depending on the wavenumber of perturbations, and interestingly, a boundary far away from the vortex strip can be unstable. We also compute the nonlinear evolution of the vortex strip on the rotating sphere and compare with the linear stability analysis. When the width of the vortex strip is small, we observe a good agreement in the growth rate of perturbation at an early time, and the eigenvector corresponding to the unstable eigenvalue coincides with the most unstable part of the flow. We demonstrate that a large structure of rolling-up vortex cores appears in the vortex strip after a long-time evolution. Furthermore, the geophysical relevance of the model to jet streams of Jupiter, Saturn and Earth is examined.

Gonadal vein tumor thrombosis due to renal cell carcinoma

Directory of Open Access Journals (Sweden)

Hamidreza Haghighatkhah

2015-01-01

Full Text Available Renal cell carcinoma (RCC had a tendency to extend into the renal vein and inferior vena cava, while extension into the gonadal vein has been rarely reported. Gonadal vein tumor thrombosis appears as an enhancing filling defect within the dilated gonadal vein anterior to the psoas muscle and shows an enhancement pattern identical to that of the original tumor. The possibility of gonadal vein thrombosis should be kept in mind when looking at an imaging study of patients with RCC

Identifikasi Pepper vein yellows virus yang Berasosiasi dengan Penyakit Yellow Vein Banding pada Tanaman Mentimun di Bali

Directory of Open Access Journals (Sweden)

I Dewa Nyoman Nyana

2016-11-01

Full Text Available Yellowing vein banding disease has been reported infecting cucurbit plants in Bali since 2014. Similar vein banding symptom on chilli pepper was observed previously, and early diagnosis indicated infection of Polerovirus. The objective of this research was to confirm the presence of Polerovirus infection on cucumber plant showing yellow vein banding symptom in Bali. Reverse transcription polymerase chain reaction – based detection method was conducted using specific primer pairs PeVYV-CP-F-BamH1/ PeVYV-CP-R-Pst1followed by sequencing and nucleotide sequence analysis.  Specific DNA fragments of ± 650 bp was successfully amplified from field samples.  Nucleotide sequence analysis showed that the sequence has the highest similarity > 95% with Pepper vein yellow virus (PeVYV infecting chili pepper from Indonesia (Bali, and Rembang, Japan, and Greece.

Endovascular management for significant iatrogenic portal vein bleeding.

Science.gov (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

2017-11-01

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.

Increase in specific density of levobupivacaine and fentanyl solution ensures lower incidence of inadequate block.

Science.gov (United States)

Djeno, Ivana Tudorić; Duzel, Viktor; Ajduk, Marko; Oremus, Zrinka Safarić; Zupcić, Miroslav; Dusper, Silva; Jukić, Dubravko; Husedzinović, Ino

2012-06-01

The clinical presentation of a subarachnoid block (SAB) is dependent upon the intrathecal spread of local anesthetic (LA). Intrathecal distribution depends on the chemical and physical characteristics of LA, puncture site, technique used, patient anatomical characteristics and hydrodynamic properties of cerebrospinal fluid. We tried to determine whether a combined glucose/LA solution can render a clinically significant difference in sensory block distribution and motor block intensity.This was a controlled, randomized and double blinded study. The surgical procedures were stripping of the great or small saphenous vein and extirpation of remaining varicose veins. The study included 110 patients distributed into two groups: Hyperbaric (7.5 mg levobupivacaine (1.5 ml 0.5% Chirocaine) + 50 microg Fentanyl (0.5 ml Fentanil) and 1 ml 10% glucose (Pliva)) vs. Hypobaric (7.5 mg levobupivacaine (1.5 ml 0.5% Chirocaine) + 50 microg Fentanyl (0.5 ml Fentanil) and 1 ml 0.9% NaCl (Pliva, Zagreb)) adding to a total volume of 3.5 ml per solution. Spinal puncture was at L3-L4 level. Spinal block distribution was assessed in five minute intervals and intensity of motor block was assessed according to the modified Bromage scale. Pain was assessed with the Visual Analogue Scale. A statistically significant difference in sensory block distribution, motor block intensity and recovery time was established between hyperbaric and hypobaric solutions. By increasing the specific density of anesthetic solution, a higher sensory block, with lesser variability, a diminished influence of Body Mass Index, decreased motor block intensity and faster recovery time may be achieved.

Assessing outcomes, costs, and benefits of emerging technology for minimally invasive saphenous vein in situ distal arterial bypasses.

Science.gov (United States)

Piano, G; Schwartz, L B; Foster, L; Bassiouny, H S; McKinsey, J F; Rosenthal, D; Gewertz, B L

1998-06-01

), secondary patency at 1 year (79%+/-10% vs 88%+/-8%, respectively), limb salvage at 1 year (85%+/-10% vs 94%+/-6%, respectively), or patient survival at 1 year (89%+/-8% vs 61%+/-13%, respectively). Patients undergoing the MIAB procedure avoided lengthy vein exposure incisions without sacrificing short-term results. There was a trend toward decreased hospital stay and cost, which may be further realized as the clinical experience broadens. Although longer follow-up and larger cohorts will always be required to define durability, immediate access to outcomes and costs on small numbers of patients facilitates the early assessment of emerging technology.

Conventional tomographic hilar anatomy emphasizing the pulmonary veins

International Nuclear Information System (INIS)

Genereux, G.P.

1983-01-01

The pulmonary hili are a frequent site of interpretive uncertainty because of thir complex anatomy. The right hilar shadow relates primarily to the ascending and descending pulmonary arteries and the right superior pulmonary vein, whereas the left hilar density accrues from the left pulmonary artery, left descending pulmonary artery, and left superior pulmonary vein. The right and left superoir pulmonary veins are intimately associated with and inseparable from the arteries. Knowledge of the course of these veins facilitates their identification on conventional tomograms. The right and left inferior pulmonary veins lie behind the lower hili and contribute only a small increment to the normal hilar density; the horizontal course of these vessels readily distinguishes them from the vertically oriented lower lobe arteries. Prominence of both the right and left superior and inferior veins may cause hilar pseudotumors. Conventional tomograms are most helpful in understanding plain radiographs. A multiview approach in anteroposterior, 55 0 posterior oblique, and lateral projections is recommended for a complete assessment. Computed tomography in transaxial sections adds further understanding of spatial relations in the hili, including the contributions of the pulmonary veins

Evaluation of the portal veins, hepatic veins and bile ducts using fat-suppressed segmented True FISP

International Nuclear Information System (INIS)

Ueda, Takashi; Uchikoshi, Masato; Imaoka, Izumi; Iwaya, Kazuo; Matsuo, Michimasa; Wada, Akihiko

2005-01-01

True FISP (fast imaging with steady-state free precession) is a fast imaging technique that provides high SNR (signal to noise ratio) and excellent delineation of parenchymal organs. The contrast of True FISP depends on the mixture of T 2 /T 1 . Vessels with slow flow are usually displayed as high signal intensity on True FISP images. The purpose of this study was to optimize fat-suppressed (FS) segmented True FISP imaging for portal veins, hepatic veins, and bile ducts. FS segmented True FISP images were applied to the phantoms of liver parenchyma, saline, and oil with various flip angles (every 10 degrees from 5-65 degrees) and k-space segmentations (3, 15, 25, 51, 75, 99). Five healthy volunteers were also examined to get optimized flip angle and k-space segmentation. The largest flip angle, 65 degrees, showed the best contrast between the liver parenchyma phantom, saline, and oil. The largest segmentations, 99, provided the best contrast between a liver parenchyma phantom and saline. However, the signal of the oil phantom exceeded that of the liver parenchyma phantom with 99 segmentations. As a result, the flip angle of 65 degrees and 75 segments is recommended to get the best contrast between the liver parenchyma phantom and saline, while suppressing the signal of oil. The volunteer studies also support the phantom studies and showed excellent anatomical delineation of portal veins, hepatic veins, and bile ducts when using these parameters. We conclude that True FISP is potentially suitable for the imaging of portal veins, hepatic veins, and bile ducts. The flip angle of 65 degrees with 75 segments is recommended to optimize FS segmented True FISP images. (author)

Factors affecting hydrocarbon removal by air stripping

International Nuclear Information System (INIS)

McFarland, W.E.

1992-01-01

This paper includes an overview of the theory of air stripping design considerations and the factors affecting stripper performance. Effects of temperature, contaminant characteristics, stripping tower geometry and air/water ratios on removal performance are discussed. The discussion includes treatment of groundwater contaminated with petroleum hydrocarbons and chlorinated solvents such as TCE and PCE. Control of VOC emissions from air strippers has become a major concern in recent years, due to more stringent restrictions on air quality in many areas. This paper includes an overview of available technology to control air emissions (including activated carbon adsorption, catalytic oxidation and steam stripping) and the effects of air emission control on overall efficiency of the treatment process. The paper includes an overview of the relative performance of various packing materials for air strippers and explains the relative advantages and disadvantages of comparative packing materials. Field conditions affecting selection of packing materials are also discussed. Practical guidelines for the design of air stripping systems are presented, as well as actual case studies of full-scale air stripping projects

Generating and analyzing synthetic finger vein images

OpenAIRE

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

2014-01-01

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 posed challenges in exploring this technology for large scale applications. This paper details the first such attempt to synthesize finger-vein images and presents analysis of synthesized images fo...

Magnetic stripping studies for SPL

CERN Document Server

Posocco, P; CERN. Geneva. BE Department

2010-01-01

Magnetic stripping of H- can seriously enhance the beam losses along the SPL machine. These losses depend on the beam energy, on the beam transverse distribution and on the intensity of the magnetic field. For radioprotection issues the losses must be limited to 1 W/m. In this paper we will concentrate on the stripping phenomena inside the quadrupole magnets with the aim of defining the quadrupole range for the design phase of SPL.

micro strip gas chamber

CERN Multimedia

1998-01-01

About 16 000 Micro Strip Gas Chambers like this one will be used in the CMS tracking detector. They will measure the tracks of charged particles to a hundredth of a millimetre precision in the region near the collision point where the density of particles is very high. Each chamber is filled with a gas mixture of argon and dimethyl ether. Charged particles passing through ionise the gas, knocking out electrons which are collected on the aluminium strips visible under the microscope. Such detectors are being used in radiography. They give higher resolution imaging and reduce the required dose of radiation.

Umbilical vein draining into the inferior vena cava via the internal iliac vein, bypassing the liver

International Nuclear Information System (INIS)

Currarino, G.; Stannard, M.W.; Texas Univ., Dallas, TX; Kolni, H.

1991-01-01

This is the third report of an anomalous umbilical vein draining ectopically in a left pelvic vein, probably the left internal iliac, and through the inferior vena cava into the right atrium. The anomaly was encountered in a newborn infant with nonimmune hydrops fetalis, hypertrophic cardiomyopathy, multiorgan failure and possibly Noonan Syndrome. (orig.)

Umbilical vein draining into the inferior vena cava via the internal iliac vein, bypassing the liver

Energy Technology Data Exchange (ETDEWEB)

Currarino, G.; Stannard, M.W. (Children' s Medical Center, Dallas, TX (United States). Dept. of Radiology Texas Univ., Dallas, TX (United States). Southwestern Medical Center); Kolni, H. (Methodist Hospital, Dallas, TX (United States). Dept. of Pediatrics)

1991-05-01

This is the third report of an anomalous umbilical vein draining ectopically in a left pelvic vein, probably the left internal iliac, and through the inferior vena cava into the right atrium. The anomaly was encountered in a newborn infant with nonimmune hydrops fetalis, hypertrophic cardiomyopathy, multiorgan failure and possibly Noonan Syndrome. (orig.).

Microstructural research on hot strips of low carbon steel produced by a compact strip production line under different thermal histories

International Nuclear Information System (INIS)

Yu Hao; Chen Qixiang; Kang Yonglin; Sun Yi

2005-01-01

Coupons with the same composition and thickness (4.0 mm nominal gauge) obtained from hot strips of low carbon steel underwent a series of investigations to analyze the microstructural characteristics and mechanisms responsible for their differences in mechanical properties. Two different industrial technologies were adopted, although the strips used in this research were produced on the same Compact Strip Production (CSP) line. One of the strips was produced with a routine γ→α CSP thermal history, but the other with a γ→α→γ* conventional thermal history. The only difference between them was that one technology had a α→γ* thermal history. Different specimens of both types of strips were prepared for metallographic observation, tensile tests, electron back-scattered diffraction tests and positron annihilation technique tests. Experimental results showed that the differences in mechanical properties could be ascribed to dissimilarities not only in the grain size and textural components but also in dislocation density

High Pressure Water Stripping Using Multi-Orifice Nozzles

Science.gov (United States)

Hoppe, David

1999-01-01

The use of multi-orifice rotary nozzles greatly increases the speed and stripping effectiveness of high pressure water blasting systems, but also greatly increases the complexity of selecting and optimizing the operating parameters. The rotational speed of the nozzle must be coupled with its transverse velocity as it passes across the surface of the substrate being stripped. The radial and angular positions of each orifice must be included in the analysis of the nozzle configuration. Orifices at the outer edge of the nozzle head move at a faster rate than the orifices located near the center. The energy transmitted to the surface from the impact force of the water stream from an outer orifice is therefore spread over a larger area than energy from an inner orifice. Utilizing a larger diameter orifice in the outer radial positions increases the total energy transmitted from the outer orifice to compensate for the wider distribution of energy. The total flow rate from the combination of all orifices must be monitored and should be kept below the pump capacity while choosing orifice to insert in each position. The energy distribution from the orifice pattern is further complicated since the rotary path of all the orifices in the nozzle head pass through the center section. All orifices contribute to the stripping in the center of the path while only the outer most orifice contributes to the stripping at the edge of the nozzle. Additional orifices contribute to the stripping from the outer edge toward the center section. With all these parameters to configure and each parameter change affecting the others, a computer model was developed to track and coordinate these parameters. The computer simulation graphically indicates the cumulative affect from each parameter selected. The result from the proper choices in parameters is a well designed, highly efficient stripping system. A poorly chosen set of parameters will cause the nozzle to strip aggressively in some areas

Patterning of leaf vein networks by convergent auxin transport pathways.

Science.gov (United States)

Sawchuk, Megan G; Edgar, Alexander; Scarpella, Enrico

2013-01-01

The formation of leaf vein patterns has fascinated biologists for centuries. Transport of the plant signal auxin has long been implicated in vein patterning, but molecular details have remained unclear. Varied evidence suggests a central role for the plasma-membrane (PM)-localized PIN-FORMED1 (PIN1) intercellular auxin transporter of Arabidopsis thaliana in auxin-transport-dependent vein patterning. However, in contrast to the severe vein-pattern defects induced by auxin transport inhibitors, pin1 mutant leaves have only mild vein-pattern defects. These defects have been interpreted as evidence of redundancy between PIN1 and the other four PM-localized PIN proteins in vein patterning, redundancy that underlies many developmental processes. By contrast, we show here that vein patterning in the Arabidopsis leaf is controlled by two distinct and convergent auxin-transport pathways: intercellular auxin transport mediated by PM-localized PIN1 and intracellular auxin transport mediated by the evolutionarily older, endoplasmic-reticulum-localized PIN6, PIN8, and PIN5. PIN6 and PIN8 are expressed, as PIN1 and PIN5, at sites of vein formation. pin6 synthetically enhances pin1 vein-pattern defects, and pin8 quantitatively enhances pin1pin6 vein-pattern defects. Function of PIN6 is necessary, redundantly with that of PIN8, and sufficient to control auxin response levels, PIN1 expression, and vein network formation; and the vein pattern defects induced by ectopic PIN6 expression are mimicked by ectopic PIN8 expression. Finally, vein patterning functions of PIN6 and PIN8 are antagonized by PIN5 function. Our data define a new level of control of vein patterning, one with repercussions on other patterning processes in the plant, and suggest a mechanism to select cell files specialized for vascular function that predates evolution of PM-localized PIN proteins.

Patterning of leaf vein networks by convergent auxin transport pathways.

Directory of Open Access Journals (Sweden)

Megan G Sawchuk

Full Text Available The formation of leaf vein patterns has fascinated biologists for centuries. Transport of the plant signal auxin has long been implicated in vein patterning, but molecular details have remained unclear. Varied evidence suggests a central role for the plasma-membrane (PM-localized PIN-FORMED1 (PIN1 intercellular auxin transporter of Arabidopsis thaliana in auxin-transport-dependent vein patterning. However, in contrast to the severe vein-pattern defects induced by auxin transport inhibitors, pin1 mutant leaves have only mild vein-pattern defects. These defects have been interpreted as evidence of redundancy between PIN1 and the other four PM-localized PIN proteins in vein patterning, redundancy that underlies many developmental processes. By contrast, we show here that vein patterning in the Arabidopsis leaf is controlled by two distinct and convergent auxin-transport pathways: intercellular auxin transport mediated by PM-localized PIN1 and intracellular auxin transport mediated by the evolutionarily older, endoplasmic-reticulum-localized PIN6, PIN8, and PIN5. PIN6 and PIN8 are expressed, as PIN1 and PIN5, at sites of vein formation. pin6 synthetically enhances pin1 vein-pattern defects, and pin8 quantitatively enhances pin1pin6 vein-pattern defects. Function of PIN6 is necessary, redundantly with that of PIN8, and sufficient to control auxin response levels, PIN1 expression, and vein network formation; and the vein pattern defects induced by ectopic PIN6 expression are mimicked by ectopic PIN8 expression. Finally, vein patterning functions of PIN6 and PIN8 are antagonized by PIN5 function. Our data define a new level of control of vein patterning, one with repercussions on other patterning processes in the plant, and suggest a mechanism to select cell files specialized for vascular function that predates evolution of PM-localized PIN proteins.

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)

2016-10-15

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.)

Recanalization after acute deep vein thrombosis

Directory of Open Access Journals (Sweden)

Gustavo Mucoucah Sampaio Brandao

2013-12-01

Full Text Available The process of recanalization of the veins of the lower limbs after an episode of acute deep venous thrombosis is part of the natural evolution of the remodeling of the venous thrombus in patients on anticoagulation with heparin and vitamin K inhibitors. This remodeling involves the complex process of adhesion of thrombus to the wall of the vein, the inflammatory response of the vessel wall leading to organization and subsequent contraction of the thrombus, neovascularization and spontaneous lysis of areas within the thrombus. The occurrence of spontaneous arterial flow in recanalized thrombosed veins has been described as secondary to neovascularization and is characterized by the development of flow patterns characteristic of arteriovenous fistulae that can be identified by color duplex scanning. In this review, we discuss some controversial aspects of the natural history of deep vein thrombosis to provide a better understanding of its course and its impact on venous disease.

Renal vein doppler sonography in rabbits with acute ureteral obstruction: usefulness of impedance index of renal vein

International Nuclear Information System (INIS)

Sohn, Kyung Myung; Chung, Su Kyo; Lee, Sung Yong

2004-01-01

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

Percutaneous transhepatic portal vein stenting in a patient with benign non-transplant postoperative portal vein stenosis: A case report

OpenAIRE

Madhusudhan, KS; Agrawal, Nikhil; Srivastava, Deep N; Pal, Sujoy; Gupta, Arun K

2013-01-01

Extrahepatic portal vein stenosis is caused by a variety of benign and malignant diseases and results in development of symptoms due to portal hypertension. Benign post-surgical adhesions causing portal vein stenosis in non-transplant population is an uncommon etiology of portal hypertension. Endovascular treatment of such patients with angioplasty and stenting is uncommonly reported in literature. We report a case of portal hypertension caused by benign postoperative portal vein fibrosis, su...

Animal Model of Acute Deep Vein Thrombosis

International Nuclear Information System (INIS)

Roy, Sumit; Laerum, Frode; Brosstad, Frank; Kvernebo, Knut; Sakariassen, Kjell S.

1998-01-01

Purpose: To develop an animal model of acute deep vein thrombosis (DVT). Methods: In part I of the study nine juvenile domestic pigs were used. Each external iliac vein was transluminally occluded with a balloon catheter. Thrombin was infused through a microcatheter in one leg according to one of the following protocols: (1) intraarterial (IA): 1250 U at 25 U/min in the common femoral artery (n= 3); (2) intravenous (IV): 5000 U in the popliteal vein at 500 U/min (n= 3), or at 100 U/min (n= 3). Saline was administered in the opposite leg. After the animals were killed, the mass of thrombus in the iliofemoral veins was measured. The pudendoepiploic (PEV), profunda femoris (PF), and popliteal veins (PV) were examined. Thrombosis in the tributaries of the superficial femoral vein (SFVt) was graded according to a three-point scale (0, +, ++). In part II of the study IV administration was further investigated in nine pigs using the following three regimens with 1000 U at 25 U/min serving as the control: (1) 1000 U at 100 U/min, (2) 250 U at 25 U/min, (3) 250 U at 6.25 U/min. Results: All animals survived. In part I median thrombus mass in the test limbs was 1.40 g as compared with 0.25 g in the controls (p= 0.01). PEV, PFV and PV were thrombosed in all limbs infused with thrombin. IV infusion was more effective in inducing thrombosis in both the parent veins (mass 1.32-1.78 g) and SVFt (++ in 4 of 6 legs), as compared with IA infusion (mass 0.0-1.16 g; SFVt ++ in 1 of 3 legs). In part II thrombus mass in axial veins ranged from 1.23 to 2.86 g, and showed no relationship with the dose of thrombin or the rate of infusion. Tributary thrombosis was less extensive with 250 U at 25 U/min than with the other regimens. Conclusion: Slow distal intravenous thrombin infusion in the hind legs of pigs combined with proximal venous occlusion induces thrombosis in the leg veins that closely resembles clinical DVT in distribution

Properties isotropy of magnesium alloy strip workpieces

Directory of Open Access Journals (Sweden)

Р. Кавалла

2016-12-01

Full Text Available The paper discusses the issue of obtaining high quality cast workpieces of magnesium alloys produced by strip roll-casting. Producing strips of magnesium alloys by combining the processes of casting and rolling when liquid melt is fed continuously to fast rolls is quite promising and economic. In the process of sheet stamping considerable losses of metal occur on festoons formed due to anisotropy of properties of foil workpiece, as defined by the macro- and microstructure and modes of rolling and annealing. The principal causes of anisotropic mechanical properties of metal strips produced by the combined casting and rolling technique are the character of distribution of intermetallic compounds in the strip, orientation of phases of metal defects and the residual tensions. One of the tasks in increasing the output of fit products during stamping operations consists in minimizing the amount of defects. To lower the level of anisotropy in mechanical properties various ways of treating the melt during casting are suggested. Designing the technology of producing strips of magnesium alloys opens a possibility of using them in automobile industry to manufacture light-weight body elements instead of those made of steel.

Re-implant of the right coronary artery: a surgical technique for the treatment of ostial lesions

Directory of Open Access Journals (Sweden)

Bongiovani Hércules Lisboa

2002-01-01

Full Text Available Previously described surgical treatment for ostial coronary artery stenosis relied on either venous or arterial bypasses or ostial patch angioplasty. These surgical procedures are performed with bovine pericardium, saphenous vein or internal thoracic artery. We describe a technique of right coronary artery re-implantation into the aorta. The procedure was performed in four patients with right coronary artery ostial stenosis along with other left coronary artery lesions.

Evaluation of silicon micro strip detectors with large read-out pitch

International Nuclear Information System (INIS)

Senyo, K.; Yamamura, K.; Tsuboyama, T.; Avrillon, S.; Asano, Y.; Bozek, A.; Natkaniec, Z.; Palka, H.; Rozanska, M.; Rybicki, K.

1996-01-01

For the development of the silicon micro-strip detector with the pitch of the readout strips as large as 250 μm on the ohmic side, we made samples with different structures. Charge collection was evaluated to optimize the width of implant strips, aluminum read-out strips, and/or the read-out scheme among strips. (orig.)

A Case Study of Deep Vein Thrombosis of the Right Internal Jugular Vein in a Healthy 21-Year-Old Male

Directory of Open Access Journals (Sweden)

Javier Corral

2016-01-01

Full Text Available We are reporting a case of a healthy 21-year-old male, with no significant past medical history, who was found to have an incidental nonocclusive deep vein thrombosis in the right internal jugular vein detected on a head MRI previously ordered for work-up of headaches. A follow-up upper extremity venous Doppler ultrasound confirmed the presence of a partially occlusive deep vein thrombosis in the right jugular vein. The case presented is unique for the reason that the patient is young and has no prior risk factor, personal or familial, for venous thrombosis except for associated polycythemia on clinical presentation.

Micro-strip sensors based on CVD diamond

Energy Technology Data Exchange (ETDEWEB)

Adam, W.; Berdermann, E.; Bergonzo, P.; Bertuccio, G.; Bogani, F.; Borchi, E.; Brambilla, A.; Bruzzi, M.; Colledani, C.; Conway, J.; D' Angelo, P.; Dabrowski, W.; Delpierre, P.; Deneuville, A.; Dulinski, W.; Eijk, B. van; Fallou, A.; Fizzotti, F.; Foulon, F.; Friedl, M.; Gan, K.K.; Gheeraert, E.; Hallewell, G.; Han, S.; Hartjes, F.; Hrubec, J.; Husson, D.; Kagan, H.; Kania, D.; Kaplon, J.; Kass, R.; Koeth, T.; Krammer, M.; Logiudice, A.; Lu, R.; Mac Lynne, L.; Manfredotti, C.; Meier, D. E-mail: dirk.meier@cern.ch; Mishina, M.; Moroni, L.; Oh, A.; Pan, L.S.; Pernicka, M.; Peitz, A.; Perera, L.; Pirollo, S.; Procario, M.; Riester, J.L.; Roe, S.; Rousseau, L.; Rudge, A.; Russ, J.; Sala, S.; Sampietro, M.; Schnetzer, S.; Sciortino, S.; Stelzer, H.; Stone, R.; Suter, B.; Tapper, R.J.; Tesarek, R.; Trischuk, W.; Tromson, D.; Vittone, E.; Walsh, A.M.; Wedenig, R.; Weilhammer, P.; Wetstein, M.; White, C.; Zeuner, W.; Zoeller, M

2000-10-11

In this article we present the performance of recent chemical vapour deposition (CVD) diamond micro-strip sensors in beam tests. In addition, we present the first comparison of a CVD diamond micro-strip sensor before and after proton irradiation.

Micro-strip sensors based on CVD Diamond

CERN Document Server

Adam, W; Bergonzo, P; Bertuccio, G; Bogani, F; Borchi, E; Brambilla, A; Bruzzi, Mara; Colledani, C; Conway, J; D'Angelo, P; Dabrowski, W; Delpierre, P A; Deneuville, A; Dulinski, W; van Eijk, B; Fallou, A; Fizzotti, F; Foulon, F; Friedl, M; Gan, K K; Gheeraert, E; Hallewell, G D; Han, S; Hartjes, F G; Hrubec, Josef; Husson, D; Kagan, H; Kania, D R; Kaplon, J; Kass, R; Koeth, T W; Krammer, Manfred; Lo Giudice, A; Lü, R; MacLynne, L; Manfredotti, C; Meier, D; Mishina, M; Moroni, L; Oh, A; Pan, L S; Pernicka, Manfred; Peitz, A; Perera, L P; Pirollo, S; Procario, M; Riester, J L; Roe, S; Rousseau, L; Rudge, A; Russ, J; Sala, S; Sampietro, M; Schnetzer, S R; Sciortino, S; Stelzer, H; Stone, R; Suter, B; Tapper, R J; Tesarek, R J; Trischuk, W; Tromson, D; Vittone, E; Walsh, A M; Wedenig, R; Weilhammer, Peter; Wetstein, M; White, C; Zeuner, W; Zoeller, M M

2000-01-01

In this article we present the performance of recent chemical vapour deposition (CVD) diamond micro-strip sensors in beam tests. In addition we present the first comparison of a CVD diamond micro-strip sensor before and after proton irradiation.

Micro-strip sensors based on CVD diamond

International Nuclear Information System (INIS)

Adam, W.; Berdermann, E.; Bergonzo, P.; Bertuccio, G.; Bogani, F.; Borchi, E.; Brambilla, A.; Bruzzi, M.; Colledani, C.; Conway, J.; D'Angelo, P.; Dabrowski, W.; Delpierre, P.; Deneuville, A.; Dulinski, W.; Eijk, B. van; Fallou, A.; Fizzotti, F.; Foulon, F.; Friedl, M.; Gan, K.K.; Gheeraert, E.; Hallewell, G.; Han, S.; Hartjes, F.; Hrubec, J.; Husson, D.; Kagan, H.; Kania, D.; Kaplon, J.; Kass, R.; Koeth, T.; Krammer, M.; Logiudice, A.; Lu, R.; Mac Lynne, L.; Manfredotti, C.; Meier, D.; Mishina, M.; Moroni, L.; Oh, A.; Pan, L.S.; Pernicka, M.; Peitz, A.; Perera, L.; Pirollo, S.; Procario, M.; Riester, J.L.; Roe, S.; Rousseau, L.; Rudge, A.; Russ, J.; Sala, S.; Sampietro, M.; Schnetzer, S.; Sciortino, S.; Stelzer, H.; Stone, R.; Suter, B.; Tapper, R.J.; Tesarek, R.; Trischuk, W.; Tromson, D.; Vittone, E.; Walsh, A.M.; Wedenig, R.; Weilhammer, P.; Wetstein, M.; White, C.; Zeuner, W.; Zoeller, M.

2000-01-01

In this article we present the performance of recent chemical vapour deposition (CVD) diamond micro-strip sensors in beam tests. In addition, we present the first comparison of a CVD diamond micro-strip sensor before and after proton irradiation

Micro-strip sensors based on CVD diamond

Science.gov (United States)

Adam, W.; Berdermann, E.; Bergonzo, P.; Bertuccio, G.; Bogani, F.; Borchi, E.; Brambilla, A.; Bruzzi, M.; Colledani, C.; Conway, J.; D'Angelo, P.; Dabrowski, W.; Delpierre, P.; Deneuville, A.; Dulinski, W.; van Eijk, B.; Fallou, A.; Fizzotti, F.; Foulon, F.; Friedl, M.; Gan, K. K.; Gheeraert, E.; Hallewell, G.; Han, S.; Hartjes, F.; Hrubec, J.; Husson, D.; Kagan, H.; Kania, D.; Kaplon, J.; Kass, R.; Koeth, T.; Krammer, M.; Logiudice, A.; Lu, R.; mac Lynne, L.; Manfredotti, C.; Meier, D.; Mishina, M.; Moroni, L.; Oh, A.; Pan, L. S.; Pernicka, M.; Peitz, A.; Perera, L.; Pirollo, S.; Procario, M.; Riester, J. L.; Roe, S.; Rousseau, L.; Rudge, A.; Russ, J.; Sala, S.; Sampietro, M.; Schnetzer, S.; Sciortino, S.; Stelzer, H.; Stone, R.; Suter, B.; Tapper, R. J.; Tesarek, R.; Trischuk, W.; Tromson, D.; Vittone, E.; Walsh, A. M.; Wedenig, R.; Weilhammer, P.; Wetstein, M.; White, C.; Zeuner, W.; Zoeller, M.; RD42 Collaboration

2000-10-01

In this article we present the performance of recent chemical vapour deposition (CVD) diamond micro-strip sensors in beam tests. In addition, we present the first comparison of a CVD diamond micro-strip sensor before and after proton irradiation.

Membrane air stripping utilizing a plate and frame configuration

International Nuclear Information System (INIS)

Boswell, S.T.

1991-01-01

Membrane air stripping has recently been proposed as a possible method to remove volatile organic chemicals (VOCs) and radon from drinking water supplies. Current and anticipated regulatory requirements, driven by health consequences, make the removal of these contaminants mandatory. This work examines the use of plate and frame membrane air stripping for the removal of VOCs and radon from a water supply. The theoretical basis of membrane air stripping and a literature review are included. The advantages of membrane air stripping versus other methods of removal, as well as the advantages of a plate and frame configuration versus a hollow fiber configuration for membrane air stripping are discussed. Multiple regression/correlation techniques are used to model mass transfer coefficients and fluid resistances. An economic evaluation is performed using the developed models. The costs of comparable membrane and packed tower air stripping systems are 4.86 cents per thousand gallons versus 4.36 cents per thousand gallons, respectively. This work indicates that plate and frame membrane air stripping may, in fact, prove to be an economical alternative to packed tower aeration and carbon adsorption for the removal of VOCs and radon

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.

Transvenous liver biopsy via the femoral vein

International Nuclear Information System (INIS)

Khosa, F.; McNulty, J.G.; Hickey, N.; O'Brien, P.; Tobin, A.; Noonan, N.; Ryan, B.; Keeling, P.W.N.; Kelleher, D.P.; McDonald, G.S.A.

2003-01-01

AIM: To study the safety, effectiveness and diagnostic value of transvenous forceps biopsy of the liver in 54 patients with coagulopathy, gross ascites or morbid obesity and suspected liver disease in whom percutaneous liver biopsy was contraindicated. MATERIAL AND METHODS: Forceps biopsy of the liver via the femoral vein was attempted in 54 adult patients with advanced liver disease of unknown aetiology who had coagulation disorders (41 cases), gross ascites (11 cases) or morbid obesity (two cases). In each patient two to six biopsies (average four) were taken using a radial jaw forceps inserted via the right or left femoral vein. RESULTS: The procedure was successful in 53 cases. Hepatic vein catheterization failed in one patient. Adequate liver tissue for diagnosis was obtained in 84% of cases. One patient developed delayed haemorrhage at 12 h from a capsular leak that was undetected during the biopsy procedure. This patient required blood transfusions and laparotomy to control bleeding. There were no deaths in the 53 patients studied. Transient minor chest and shoulder pain was encountered during sheath insertion into a hepatic vein in 23 patients. Three patients developed a femoral vein haematoma, which resolved with conservative treatment. CONCLUSION: Transvenous liver biopsy via the femoral vein is another safe, effective, simple alternative technique of biopsy when the percutaneous route is contraindicated

Advection endash diffusion past a strip. II. Oblique incidence

International Nuclear Information System (INIS)

Knessl, C.; Keller, J.B.

1997-01-01

Advection and diffusion of particles past an impenetrable strip is considered when the strip is oblique to the advection or drift velocity. The particle concentration p(x,y) is determined asymptotically for large values of vL/D, where v is the drift velocity, D is the diffusion coefficient, and 2L is the width of the strip. The results complement those of Part I, which treated a strip normal to the drift velocity. copyright 1997 American Institute of Physics

Stripping of uranium from Dehpa/kerosene solvents by different aqueous media

International Nuclear Information System (INIS)

Khorfan, S.; Stas, J.; Kassem, M.

1998-01-01

Stripping uranium from Dehpa/kerosene solvent is a crucial step in the recovery of uranium. Stripping was studied using different stripping media mainly ammonium carbonate, phosphoric acid, sulfuric acid, hydrochloric acid and nitric acid. Stripping was measured at different operating conditions such as aqueous concentrations, temperatures, and Dehpa/kerosene concentrations. The results obtained showed that stripping by acid media increases with the acid concentration and follows the order: HF > H 3 PO 4 > H 2 SO 4 > HCl > HNO 3 . To achieve higher stripping by phosphoric acid it was found necessary to increase the temperature to 50 deg C, the acid concentration to 5 mol/l and to reduce the uranium to U 4+ . Stripping by basic media was found to increase with increasing concentration of the stripping media and to follow the order: Na 2 CO 3 > (NH 4 ) 2 CO 3 > NH 4 HCO 3 . Stripping by ammonium carbonate was found to increase with temperature and carbonate concentration. The stripping was optimized at 0.5 mol/l carbonate concentration and at a temperature of 50 deg C. Stripping was decreased by increasing concentration of Dehpa in kerosene and was depressed more by adding the synergant Topo to the Dehpa solvent especially at 1/4 mol/mol ratio. (author)

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)

1986-10-15

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.

Computed tomographic evaluation of the portal vein in the hepatomas

International Nuclear Information System (INIS)

Lee, Kee Hyung; Lee, Seung Chul; Bae, Man Gil; Seo, Heung Suk; Kim, Soon Yong; Lee, Min Ho; Kee, Choon Suhk; Park, Kyung Nam

1986-01-01

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.

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

OpenAIRE

Park, Young Ho; Park, Kang Ryoung

2012-01-01

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 diffic...

A Modified Technique of Basilic Vein Transposition for Haemodialysis

International Nuclear Information System (INIS)

Chaudhary, F. A.; Parvez, Z.

2014-01-01

Objective: To modify the technique of basilic vein transposition for vascular accesss for haemodialysis aiming at better maturation rate, longer survival of fistula and lesser complications. Study Design: Case series. Place and Duration of Study: Shaikh Zayed Hospital and Omer Hospital, Lahore, from February 2008 to July 2011. Methodology: Patients referred for basilic vein transposition for haemodialysis vascular access were prospectively enrolled. The surgical technique included small tracking incisions, an extra 3 - 4 cm of vein length harvesting to avoid tension in the vein in its new course, an oval arteriotomy and a smooth curved pathway, away from vein harvesting incision to avoid entrapment of vein in the scar. Maturation rate, fistula survival and other complications were noted. Results: There was no immediate failure in 51 patients. The complications during follow-up period were infection and thrombosis, bleeding and non-development of basilic vein in 2 patients each; and false aneurysm formation in one. Four patients died during follow-up period. The maturation time was 4.9 A +- 1.1 weeks. The early patency rate was 92.2%, same at 6 months and 90.7% at 12 months. Conclusion: Arteriovenous fistula constructed with modified technique of basilic vein transposition is an acceptable and valid option of vascular access for haemodialysis. (author)

Stage- vs. Channel-strip Metaphor

DEFF Research Database (Denmark)

Gelineck, Steven; Korsgaard, Dannie Michael; Büchert, Morten

2015-01-01

This study compares the stage metaphor and the channel strip metaphor in terms of performance. Traditionally, music mixing consoles employ a channels strip control metaphor for adjusting parameters such as volume and panning of each track. An alternative control metaphor, the so-called stage meta...... is surprisingly similar and thus we are not able to detect any significant difference in performance between the two interfaces. Qualitative data however, suggests that the stage metaphor is largely favoured for its intuitive interaction - confirming earlier studies....

Study of inter-strip gap effects and efficiency for full energy detection of double sided silicon strip detectors

International Nuclear Information System (INIS)

Fisichella, M.; Forneris, J.; Grassi, L.

2015-01-01

We performed a characterization of Double Sided Silicon Strip Detectors (DSSSD) with the aim to carry out a systematic study of the inter-strip effects on the energy measurement of charged particles. The dependence of the DSSSD response on ion, energy and applied bias has been investigated. (author)

Percutaneous transhepatic portal vein stenting in a patient with benign non-transplant postoperative portal vein stenosis: A case report

Directory of Open Access Journals (Sweden)

KS Madhusudhan

2013-01-01

Full Text Available Extrahepatic portal vein stenosis is caused by a variety of benign and malignant diseases and results in development of symptoms due to portal hypertension. Benign post-surgical adhesions causing portal vein stenosis in non-transplant population is an uncommon etiology of portal hypertension. Endovascular treatment of such patients with angioplasty and stenting is uncommonly reported in literature. We report a case of portal hypertension caused by benign postoperative portal vein fibrosis, successfully treated by self-expandable metallic stent.

Stripping of uranium from Dehpa/Kerosene solvents by different aqueous media

International Nuclear Information System (INIS)

Khorfan, S.; Stas, J.; Kassem, M.

2000-01-01

Stripping uranium from Dehpa/kerosene solvent is a crucial step in the recovery of uranium. Stripping was studied using different stripping media mainly ammonium carbonate, phosphoric acid, sulfuric acid, hydrochloric acid and nitric acid. Stripping was measured at different operating conditions such as aqueous concentrations, temperatures, and Dehpa/kerosene concentrations. The results obtained showed that stripping by acid media increases with the acid concentration and follows the order: HF > H sub 3 Po sub 4 > H sub 2 S O sub 4 > HCl > HNO sub 3. To achieve higher stripping by phosphoric acid it was found necessary to increase the temperature to 50 deg C, the acid concentration to 5 mol/l and to reduce the uranium to U sup 4 sup +. Stripping by basic media was found to increase with increasing concentration of the stripping media and to follow the order: Na sub 2 CO sub 3 > (NH sub 4) sub 2 CO sub 3 > NH sub 4 HCO sub 3. Stripping by ammonium carbonate was found to increase with temperature and carbonate concentration. The stripping was optimized at 0.5 mol/l carbonate concentration and at a temperature of 50 deg C. Stripping was decreased by increasing concentration of Dehpa in kerosene and was depressed more by adding the synergant TOPO to the Dehpa solvent especially at 1/4 mol/mol ratio. (author)

Strip defect recognition in electrical tests of silicon microstrip sensors

Energy Technology Data Exchange (ETDEWEB)

Valentan, Manfred, E-mail: valentan@mpp.mpg.de

2017-02-11

This contribution describes the measurement procedure and data analysis of AC-coupled double-sided silicon microstrip sensors with polysilicon resistor biasing. The most thorough test of a strip sensor is an electrical measurement of all strips of the sensor; the measured observables include e.g. the strip's current and the coupling capacitance. These measurements are performed to find defective strips, e.g. broken capacitors (pinholes) or implant shorts between two adjacent strips. When a strip has a defect, its observables will show a deviation from the “typical value”. To recognize and quantify certain defects, it is necessary to determine these typical values, i.e. the values the observables would have without the defect. As a novel approach, local least-median-of-squares linear fits are applied to determine these “would-be” values of the observables. A least-median-of-squares fit is robust against outliers, i.e. it ignores the observable values of defective strips. Knowing the typical values allows to recognize, distinguish and quantify a whole range of strip defects. This contribution explains how the various defects appear in the data and in which order the defects can be recognized. The method has been used to find strip defects on 30 double-sided trapezoidal microstrip sensors for the Belle II Silicon Vertex Detector, which have been measured at the Institute of High Energy Physics, Vienna (Austria).

Applied anatomic study of testicular veins in adult cadavers and in human fetuses

Directory of Open Access Journals (Sweden)

Luciano A. Favorito

2007-04-01

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.

Strip type radiation detector and method of making same

International Nuclear Information System (INIS)

Jantsch, O.; Feigt, I.; Willig, W.R.

1976-01-01

An improved strip detector and a method for making such a detector in which a high resistivity N conduction semiconductor body has electrode strips formed thereon by diffusion is described. The strips are formed so as to be covered by an oxide layer at the surface point of the PN junction and in which the opposite side of the semiconductor body then has a substantial amount of material etched away to form a thin semiconductor upon which strip electrodes which are perpendicular to the electrodes on the first side are then placed

Supracardiac total anomalous pulmonary venous connection with a descending vertical vein.

Science.gov (United States)

Shah, Sejal; Singh, Mukesh; John, Colin; Maheshwari, Sunita

2009-10-01

The commonly used Darling classification for total anomalous pulmonary venous connection (TAPVC) consists of supracardiac, cardiac, infracardiac, and mixed types (Craig et al., Lab Invest 6:44-64, 1967). In supracardiac TAPVC, the common pulmonary vein drains superiorly into the left innominate vein, the superior vena cava, or the azygos vein by way of an ascending vertical vein. We describe a case of supracardiac TAPVC draining into the azygos vein atypically by way of a descending vertical vein.

Induced chorioretinal venous anastomosis in experimental retinal branch vein occlusion.

OpenAIRE

McAllister, I L; Yu, D Y; Vijayasekaran, S; Barry, C; Constable, I

1992-01-01

Iatrogenic retinal vein to choroidal vein anastomoses were created using laser photocoagulation in six of seven dog eyes in which a partial branch retinal vein occlusion had previously been created photochemically. A similar attempt to create an anastomosis was made in six control eyes in which no branch vein occlusion was present. In the eyes in which a branch retinal vein had been created, a venous chorioretinal anastomosis appeared to be present by 3 to 6 weeks. In three control eyes simil...

Stripping voltammetry in environmental and food analysis.

Science.gov (United States)

Brainina, K Z; Malakhova, N A; Stojko, N Y

2000-10-01

The review covers over 230 papers published mostly in the last 5 years. The goal of the review is to attract the attention of researchers and users to stripping voltammetry in particular, its application in environmental monitoring and analysis of foodstuffs. The sensors employed are impregnated graphite, carbon paste, thick film carbon/graphite and thin film metallic electrodes modified in-situ or beforehand. Hanging mercury drop electrodes and mercury coated glassy carbon electrodes are also mentioned. Strip and long-lived sensors for portable instruments and flow through systems are discussed as devices for future development and application of stripping voltammetry.

Radiation Retinopathy Associated with Central Retinal Vein Occlusion

Institute of Scientific and Technical Information of China (English)

Yan; Liu; FengWen

2007-01-01

Purpose: To report a case of radiation retinopathy associated with central retinal vein occlusion.Methods: The clinical features and fundus fluorescein angiography of this case were analyzed.Results: The patient had been treated with radiotherapy for her nasopharyngeal carcinoma, and presented with sudden visual loss in the left eye. The funduscopic examination and fluorescein angiography showed the features of radiation retinopathy in both eyes, and central retinal vein occlusion in the left eye.Conclusions: Radiation retinopathy can be associated with central retinal vein occlusion in the same eye, and it seems that the endothelial cell loss caused by radiation retinopathy may lead to retinal vein occlusion.

Disastrous Portal Vein Embolization Turned into a Successful Intervention

Energy Technology Data Exchange (ETDEWEB)

Dobrocky, Tomas, E-mail: tomas.dobrocky@insel.ch [University of Bern, Department of Interventional, Pediatric and Diagnostic Radiology, Inselspital, University Hospital (Switzerland); Kettenbach, Joachim, E-mail: joachim.kettenbach@stpoelten.lknoe.at [Universitätsklinikum St. Pölten-Lilienfeld, Institute of Medical Radiology, Diagnostic, Intervention (Austria); Lopez-Benitez, Ruben, E-mail: Ruben.lopez@insel.ch; Kara, Levent, E-mail: levent.kara@insel.ch [University of Bern, Department of Interventional, Pediatric and Diagnostic Radiology, Inselspital, University Hospital (Switzerland)

2015-10-15

Portal vein embolization (PVE) may be performed before hemihepatectomy to increase the volume of future liver remnant (FLR) and to reduce the risk of postoperative liver insufficiency. We report the case of a 71-year-old patient with hilar cholangiocarcinoma undergoing PVE with access from the right portal vein using a mixture of n-butyl-2-cyanoacrylate and ethiodized oil. During the procedure, nontarget embolization of the left portal vein occurred. An aspiration maneuver of the polymerized plug failed; however, the embolus obstructing portal venous flow in the FLR was successfully relocated into the right portal vein while carefully bypassing the plug with a balloon catheter, inflating the balloon, and pulling the plug into the main right portal vein.

Non-contact finger vein acquisition system using NIR laser

Science.gov (United States)

Kim, Jiman; Kong, Hyoun-Joong; Park, Sangyun; Noh, SeungWoo; Lee, Seung-Rae; Kim, Taejeong; Kim, Hee Chan

2009-02-01

Authentication using finger vein pattern has substantial advantage than other biometrics. Because human vein patterns are hidden inside the skin and tissue, it is hard to forge vein structure. But conventional system using NIR LED array has two drawbacks. First, direct contact with LED array raise sanitary problem. Second, because of discreteness of LEDs, non-uniform illumination exists. We propose non-contact finger vein acquisition system using NIR laser and Laser line generator lens. Laser line generator lens makes evenly distributed line laser from focused laser light. Line laser is aimed on the finger longitudinally. NIR camera was used for image acquisition. 200 index finger vein images from 20 candidates are collected. Same finger vein pattern extraction algorithm was used to evaluate two sets of images. Acquired images from proposed non-contact system do not show any non-uniform illumination in contrary with conventional system. Also results of matching are comparable to conventional system. We developed Non-contact finger vein acquisition system. It can prevent potential cross contamination of skin diseases. Also the system can produce uniformly illuminated images unlike conventional system. With the benefit of non-contact, proposed system shows almost equivalent performance compared with conventional system.

Management of reticular veins and telangiectases.

Science.gov (United States)

Smith, Philip Coleridge

2015-11-01

To review the literature related to the management of reticular varices and telangiectases of the lower limbs to provide guidance on the treatment of these veins. Very few randomised clinical trials are available in this field. A European Guideline has been published on the treatment of reticular varices and telangiectases, which is largely based on the opinion of experts. Older accounts written by individual phlebologists contain extensive advice from their own practice, which is valuable in identifying effective methods of sclerotherapy. All accounts indicate that a history should be taken combined with a clinical and ultrasound examination to establish the full extent of the venous disease. Sclerotherapy is commenced by injecting the larger veins first of all, usually the reticular varices. Later in the same session or in subsequent sessions, telangiectases can be treated by direct injection. Following treatment, the application of class 2 compression stockings for a period of up to three weeks is beneficial but not used universally by all phlebologists. Further sessions can follow at intervals of 2-8 weeks in which small residual veins are treated. Resistant veins can be managed by ultrasound-guided injection of underlying perforating veins and varices. Other treatments including RF diathermy and laser ablation of telangiectases have very limited efficacy in this condition. Sclerotherapy, when used with the correct technique, is the most effective method for the management of reticular varices and telangiectases. © The Author(s) 2015.

A review of the anatomy and clinical significance of adrenal veins.

Science.gov (United States)

Cesmebasi, Alper; Du Plessis, Maira; Iannatuono, Mark; Shah, Sameer; Tubbs, R Shane; Loukas, Marios

2014-11-01

The adrenal veins may present with a multitude of anatomical variants, which surgeons must be aware of when performing adrenalectomies. The adrenal veins originate during the formation of the prerenal inferior vena cava (IVC) and are remnants of the caudal portion of the subcardinal veins, cranial to the subcardinal sinus in the embryo. The many communications between the posterior cardinal, supracardinal, and subcardinal veins of the primordial venous system provide an explanation for the variable anatomy. Most commonly, one central vein drains each adrenal gland. The long left adrenal vein joins the inferior phrenic vein and drains into the left renal vein, while the short right adrenal vein drains immediately into the IVC. Multiple variations exist bilaterally and may pose the risk of surgical complications. Due to the potential for collaterals and accessory adrenal vessels, great caution must be taken during an adrenalectomy. Adrenal venous sampling, the gold standard in diagnosing primary hyperaldosteronism, also requires the clinician to have a thorough knowledge of the adrenal vein anatomy to avoid iatrogenic injury. The adrenal vein acts as an important conduit in portosystemic shunts, thus the nature of the anatomy and hypercoagulable states pose the risk of thrombosis. © 2014 Wiley Periodicals, Inc.

Kinetics of vein graft hyperplasia

International Nuclear Information System (INIS)

Zwolak, R.M.; Adams, M.C.; Clowes, A.W.

1986-01-01

Human aortocoronary vein grafts fail due to accelerated occlusive disease. The possibility that this is related to cellular hyperplasia was investigated in a rabbit model where kinetics of vein graft thickening, endothelial (EC) repair, and smooth muscle cell (SMC) proliferation were measured from 2 days to 24 weeks after implanting jugular vein segments in the carotid artery. Immediately after graft placement focal EC denudation was observed. These defects were repaired within 1 week and did not recur. By 4 weeks intimal area had increased 30 fold from 0.028 +/- 0.004 to 0.705 +/- 0.021 mm 2 , and a 24 weeks was 0.93 +/- 0.21 mm 2 . This response did not produce a reduction in graft lumen area. EC and SMC thymidine-labeling index were measured by en face and cross-section autoradiography after injection of 3 H-thymidine and perfusion fixation. Despite rapid EC surface repair EC labeling index remained elevated and only returned to normal levels at 12 weeks; SMC labeling was 10 fold greater than baseline even at 24 weeks (0.22% vs 0.02%). SMC mass demonstrated morphometrically increased between 2 and 12 weeks. Intimal thickening in vein grafts is due to SMC proliferation and develops after the EC layer has been restored. In contrast, intimal SMC proliferate in damaged arteries when the EC layer is absent and cease when the EC layer is regenerated

Interventional treatment for the occlusive hepatic veins in Budd-Chiari syndrome

International Nuclear Information System (INIS)

Zhang Xitong; Xu Ke; Feng Bo; Su Hongying; Li Hong; Zu Maoheng; Cui Jingguo; Yang Xueliang; Zhao Jinxu; Chen Kai

2003-01-01

Objective: To evaluate the interventional methods for occlusive hepatic veins in Budd-Chiari syndrome and its mid and long-term effects. Methods: Forty-two patients (male 17 cases and female 25 cases) aged from 18 to 57 years old (mean 34.5 years) were studied. The liver functions were Child A in 23 cases, Child B in 6 cases, and Child C in 13 cases, respectively. A total of 92 hepatic veins were occluded. Among them, 29 left hepatic veins, 24 middle hepatic veins, 36 right hepatic veins, and 3 accessory hepatic veins were occluded. Thirty-four patients were accompanied with the stenotic or occlusive inferior vena cave (IVC) . The interventional methods included: (1) recanalization of occlusive hepatic veins (by transjugular, transfemoral, and percutaneous transhepatic route, or the combination of above three methods); (2) percutaneous transluminal angioplasty; (3) self-expanding stent implantation. The occlusive IVC in 32 patients also accepted PTA and/or stent implantation. Results: The successful recanalization was carried out in forty hepatic veins in 40 patients. PTA of occlusive veins was followed by stent implantation in 8 patients. The pressure of hepatic veins dropped from 34.5 cm H 2 O (25.0-48.0 cm H 2 O) to 22.0 cm H 2 O (12.0-35.0 cm H 2 O) after intervention (T=11.50, P < 0.01). The symptoms and pathological signs improved obviously in 32 cases and improved partly in 8 cases. During the follow-up period from 1 month to 54 months (mean 27.5 months), one cases died of liver function failure at one month after intervention. The re-intervention of occlusive veins in two cases were performed and the better results were acquired again. Five cases didn't accept re-intervention. Neither recurrence of symptoms nor re-occlusion of hepatic veins was found in the other 32 patients. Conclusion: (1) Multiple and synthetical interventional methods for the occlusive hepatic veins in Budd-Chiari syndrome can be utilized. (2) The intervention of hepatic vein is mini

Duplex sonography of the near-surface leg veins; Duplexsonographie der oberflaechlichen Beinvenen

Energy Technology Data Exchange (ETDEWEB)

Mendoza, E.

2007-07-01

The book contains the following contributions: The ultrasonograph, selection of the ultrasonic transducer, anatomy of the near-surface vein system, physiology of the near-surface vein system, varicose status classification, systematics of the duplex sonography of near-surface leg veins, provocational maneuver for the duplex sonographic varicose diagnostics, exploration of vena saphena parva, perforans veins, side branches, phlebitis, sonography for varicose therapy, postsurgical sonography, deep leg veins, examination of near-surface leg veins for the pathology of the deep vein system, differential diagnostic clarification of leg oedema from the phlebologic-lymphological view, diagnostic side features along the near-surface leg veins.

Generating and analyzing synthetic finger vein images

NARCIS (Netherlands)

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

2014-01-01

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

Collisional stripping of planetary crusts

Science.gov (United States)

Carter, Philip J.; Leinhardt, Zoë M.; Elliott, Tim; Stewart, Sarah T.; Walter, Michael J.

2018-02-01

Geochemical studies of planetary accretion and evolution have invoked various degrees of collisional erosion to explain differences in bulk composition between planets and chondrites. Here we undertake a full, dynamical evaluation of 'crustal stripping' during accretion and its key geochemical consequences. Crusts are expected to contain a significant fraction of planetary budgets of incompatible elements, which include the major heat producing nuclides. We present smoothed particle hydrodynamics simulations of collisions between differentiated rocky planetesimals and planetary embryos. We find that the crust is preferentially lost relative to the mantle during impacts, and we have developed a scaling law based on these simulations that approximates the mass of crust that remains in the largest remnant. Using this scaling law and a recent set of N-body simulations of terrestrial planet formation, we have estimated the maximum effect of crustal stripping on incompatible element abundances during the accretion of planetary embryos. We find that on average approximately one third of the initial crust is stripped from embryos as they accrete, which leads to a reduction of ∼20% in the budgets of the heat producing elements if the stripped crust does not reaccrete. Erosion of crusts can lead to non-chondritic ratios of incompatible elements, but the magnitude of this effect depends sensitively on the details of the crust-forming melting process on the planetesimals. The Lu/Hf system is fractionated for a wide range of crustal formation scenarios. Using eucrites (the products of planetesimal silicate melting, thought to represent the crust of Vesta) as a guide to the Lu/Hf of planetesimal crust partially lost during accretion, we predict the Earth could evolve to a superchondritic 176Hf/177Hf (3-5 parts per ten thousand) at present day. Such values are in keeping with compositional estimates of the bulk Earth. Stripping of planetary crusts during accretion can lead to

Complications of umbilical vein catherisation. Case Report

International Nuclear Information System (INIS)

Bothur-Nowacka, J.; Czech-Kowalska, J.; Gruszfeld, D.; Nowakowska-Rysz, M.; Dobrzanska, A.; Kosciesza, A.; Polnik, D.

2011-01-01

Umbilical vein catheterization is a relatively easy procedure performed routinely on the neonate intensive care units. It provides a fast central vein access, but some complications have been described in the literature. Case Reports: We presented a case report of a premature infant (34 hbd) with extravasation of the parenteral nutrition and drugs to the liver after umbilical vein catheterization. Fever and increasing biochemical markers of infection were observed. USG revealed a heterogenic, well-limited space of 4 cm in diameter, located in the right lobe of the liver. CT excluded liver abscess. Considering neoplastic process or incorrect location of the catheter of the central vein, we performed liver biopsy. Results: Cytological and biochemical analysis of the aspirated fluid revealed extravasation of parenteral nutrition to the liver.Our case confirms the necessity of controlling a proper location of the central catheter right after its insertion and during hospitalization. (authors)

[Treatment of nontumoral portal vein thrombosis in cirrhosis].

Science.gov (United States)

Bañares, Rafael; Catalina, María-Vega

2014-07-01

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.

Effects of electrocautery to provoke endovascular thermal injury Efeitos do eletrocautério para provocar lesão térmica endovascular

Directory of Open Access Journals (Sweden)

Fabio Henrique Rossi

2011-10-01

Full Text Available PURPOSE: To investigate the effects of a new electrocautery device to provoke endovascular venous thermal injury. METHODS: An experimental endovascular electrocautery was placed inside eight ex-vivo bovine saphenous veins models. Each one was divided in eight segments and progressive intensities of electric energy liberated. The macroscopic and microscopic effects were analyzed. RESULTS: Forty bovine saphenous veins segments were studied. The higher the electric energy applied the greater the nuclear picnosis and more intense the cytoplasmatic shrinkage and electrocoagulation effects. CONCLUSION: The experimental endovascular electrocautery device demonstrated to be both capable of inducing the destruction of the intimal layers of the studied vein model and provoke endovascular thermal injury.OBJETIVO: Investigar os efeitos de um modelo experimental de eletrocautério em provocar lesão venosa térmica endovascular. MÉTODOS: O eletrocautério endovascular foi colocado dentro de oito modelos experimentais de veia safena bovina. Cada uma foi dividida em oito segmentos e intensidades progressivas de energia elétrica liberada. Os efeitos macroscópicos e microscópicos foram analisados. RESULTADOS: Foram estudados quarenta segmentos de veia safena bovina. Quanto maior a energia elétrica aplicada pelo eletrocauterizador endovascular maiores foram as alteraçoes de picnose nuclear e mais intensa a retração citoplasmática observada. CONCLUSÃO: O eletrocautério endovascular experimental demonstrou ser capaz de induzir a destruição da camada íntima e provocar lesão térmica endovascular.

New Concept of Cultivation Using Limited Strip-Tillage with Strip Shallow Irrigation

Directory of Open Access Journals (Sweden)

Yazid Ismi Intara

2014-04-01

Full Text Available Normal 0 false false false IN X-NONE X-NONE Dry land is one of land resources which potentially used for food crop cultivation, especially in the areas which have light to medium technical obstacles. The development of technology to improve soil quality in marginal lands to be productive lands is still widely open for agricultural development in Indonesia. Rooting medium quality can be improved by changing soil tillage method and observing the proper crop irrigation technology. It can be the solution for crop cultivation in clay loam soil. This study aimed to obtain water movement model in a minimally-tilled clay soil with strip shallow irrigation. The concept is limited soil-tillage with strip shallow irrigation method, water supply technique, and crop water requirement. Method used in this study includes developing water movement model (software development in a minimally-tilled clay soil with subsurface irrigation. In the final stages, research also conducted water movement analysis testing apparatus in the laboratory, field validation of the subsurface irrigation performance, and cultivation technique testing to chili pepper growth (Capsicum annuumL.. The development of water movement simulation on a limited strip-tillage with subsurface irrigation uses the concept to quantify the amount of water in the soil. The analysis of movement pattern was demonstrated on contour patterns. It showed that the wetting process can reach depth zone – 5 cm to the rooting zone. It was an important discovery on the development of minimum stripe tillage soil with subsurface irrigation. Specifically, it can be concluded that: the result of fitting by eyes to diffusivity graphic and water content obtained the required parameter values for soil physical properties. It was then simulated on horizontal water movement model on a minimum strip-tillage with strip shallow irrigation /* Style Definitions */ table.MsoNormalTable {mso-style-name:"Table Normal"; mso

Catheter Displacement into Inferior Epigastric Vein Causing Local Phlebitis and Cellulitis

Directory of Open Access Journals (Sweden)

Noriko Hattori

2012-01-01

Full Text Available Catheter insertion for intravenous hyperalimentation is a commonly and widely used clinical technique. When compared with the incidence of complications associated with insertions into the internal jugular vein or the subclavian vein, complications associated with insertions into the femoral vein are less frequent. In this paper, we describe a very rare complication of femoral vein catheter insertion—namely, catheter displacement into the inferior epigastric vein.

Renal Vein Reconstruction for Harvesting Injury in Kidney Transplantation

Directory of Open Access Journals (Sweden)

Birkan Bozkurt

2014-03-01

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.

Strip specimen tests for pipeline materials and girth welds

Energy Technology Data Exchange (ETDEWEB)

Mohr, William C. [Edison Welding Institute (EWI), Columbus, Ohio (United States)

2009-07-01

Strip specimen testing of pipeline materials has been widely applied as a method of getting data relevant to the performance of pipelines under axial direction loading. Comparisons of strip specimen against smaller standard tests (round tensile bar, fracture toughness specimens, polished round bars) and against full-scale or large-scale testing will be explored. Data from early-generation pipe welds from the 1920's to the 1940's to the most recent materials for offshore reeled pipe will be used for examples. Strip samples can provide full thickness information to take account of varying material properties or imperfection distribution through the thickness. Strip samples can also accommodate measurement of effects of the original surface finish or weld surface shape. Strip samples have more design flexibility than standard tests, but must be designed to limit stress concentrations and effects of local bending. (author)

Fatigue of graphite/epoxy buffer strip panels with center cracks

Science.gov (United States)

Bigelow, C. A.

1985-01-01

The effects of fatigue loading on the behavior of graphite/epoxy panels with either S-Glass or Kevlar-49 buffer strips is studied. Buffer strip panels are fatigued and tested in tension to measure their residual strength with crack-like damage. Panels are made with 45/0/-45/90 sub 2s layup with either S-Glass or Kevlar-49 buffer strip material. The buffer strips are parallel to the loading direction and made by replacing narrow strips of the 0-degree graphite plies with strips of either 0-degree S-Glass/epoxy or Kevlar-49/epoxy on a one-for-one basis. The panels are subjected to a fatigue loading spectrum MINITWIST, the shortened version of the standardized load program for the wing lower surface of a transport aircraft. Two levels of maximum strain are used in the spectrum with three durations of the fatigue spectrum. One group of panels is preloaded prior to the application of the fatigue cycling. The preload consists of statistically loading the spectrum in tension until the crack-tip damage zone reaches the ajacent buffer strips. After fatigue loading, all specimens are statistically loaded in tension to failure to determine their residual strengths.

Congestive index of portal vein

International Nuclear Information System (INIS)

Kim, Won Ho; Kim, H. K.; Lee, S. C.; Han, S. H.; Han, K. H.; Chung, J. B.; Choi, H. J.

1989-01-01

In patients with portal hypertension, the blood flow volume is maintained despite decreased blood flow velocity due to enlargement of the vascular cross sectional area. Thus, the 'congestion index' of the portal vein, which is the ratio between the cross sectional area (cm2) and the blood flow velocity (cm/sec) determined by a Doppler ultrasonography, may be a sensitive index by which to assess portal hypertension. We performed Doppler ultrasonography on 24 normal subjects, 14 patients with biopsy proved chronic active hepatitis and 55 patients with liver cirrhosis in order to assess the diagnostic value of the congestion index. The cross sectional area of the portal vein was significantly enlarged and the mean blood flow velocity was significantly reduced in patients with liver cirrhosis compared with controls. However, the blood flow volume was no difference. The congestion index of the portal vein was significantly increased in patients with liver cirrhosis (0.113+0.035) compared with patients with chronic active hepatitis(0.078+0.029) (p<0.001) and controls (0.053+0.016) (p<0.001). The sensitivity, specificity and predictability of the congestion index for detection of patients with the cirrhosis of the liver were 76.4%, 100% and 100% respectively, when the normal range was set at mean+2SD. The results suggest that the congestion index of the portal vein may pla a significant role in diagnosis of portal hypertensive patients

Photosensitive Strip RETHGEM

CERN Document Server

Peskov, Vladimir; Nappi, E.; Oliveira, R.; Paic, G.; Pietropaolo, F.; Picchi, P.

2008-01-01

An innovative photosensitive gaseous detector, consisting of a GEM like amplification structure with double layered electrodes (instead of commonly used metallic ones) coated with a CsI reflective photocathode, is described. In one of our latest designs, the inner electrode consists of a metallic grid and the outer one is made of resistive strips; the latter are manufactured by a screen printing technology on the top of the metallic strips grid The inner metallic grid is used for 2D position measurements whereas the resistive layer provides an efficient spark protected operation at high gains - close to the breakdown limit. Detectors with active areas of 10cm x10cm and 10cm x20cm were tested under various conditions including the operation in photosensitive gas mixtures containing ethylferrocene or TMAE vapors. The new technique could have many applications requiring robust and reliable large area detectors for UV visualization, as for example, in Cherenkov imaging devices.

Phenotypic heterogeneity in the endothelium of the human vortex vein system.

Science.gov (United States)

Yu, Paula K; Tan, Priscilla E Z; Cringle, Stephen J; McAllister, Ian L; Yu, Dao-Yi

2013-10-01

The vortex vein system is the drainage pathway for the choroidal circulation and serves an important function in the effective drainage of the exceptionally high blood flow from the choroidal circulation. As there are only 4-6 vortex veins, a large volume of blood must be drained from many choroidal veins into each individual vortex vein. The vortex vein system must also cope with passing through tissues of different rigidity and significant pressure gradient as it transverses from the intrao-cular to the extra-ocular compartments. However, little is known about how the vortex vein system works under such complex situations in both physiological and pathological condition. Endothelial cells play a vital role in other vascular systems, but they have not been studied in detail in the vortex vein system. The purpose of this study is to characterise the intracellular structures and morphology in both the intra-and extra-ocular regions of the human vortex vein system. We hypothesise the presence of endothelial phenotypic heterogeneity through the vortex vein system. The inferior temporal vortex vein system from human donor eyes were obtained and studied histologically using confocal microscopy. The f-actin cytoskeleton and nuclei were labelled using Alexa Fluor conjugated Phalloidin and YO-PRO-1. Eight regions of the vortex vein system were examined with the venous endothelium studied in detail with quantitative data obtained for endothelial cell and nuclei size and shape. Significant endothelial phenotypic heterogeneity was found throughout the vortex vein system with the most obvious differences observed between the ampulla and its downstream regions. Variation in the distribution pattern of smooth muscle cells, in particular the absence of smooth muscle cells around the ampulla, was noted. Our results suggest the presence of significantly different haemodynamic forces in different regions of the vortex vein system and indicate that the vortex vein system may play

Nanoscale Test Strips for Multiplexed Blood Analysis

Science.gov (United States)

Chan, Eugene

2015-01-01

A critical component of the DNA Medicine Institute's Reusable Handheld Electrolyte and Lab Technology for Humans (rHEALTH) sensor are nanoscale test strips, or nanostrips, that enable multiplexed blood analysis. Nanostrips are conceptually similar to the standard urinalysis test strip, but the strips are shrunk down a billionfold to the microscale. Each nanostrip can have several sensor pads that fluoresce in response to different targets in a sample. The strips carry identification tags that permit differentiation of a specific panel from hundreds of other nanostrip panels during a single measurement session. In Phase I of the project, the company fabricated, tested, and demonstrated functional parathyroid hormone and vitamin D nanostrips for bone metabolism, and thrombin aptamer and immunoglobulin G antibody nanostrips. In Phase II, numerous nanostrips were developed to address key space flight-based medical needs: assessment of bone metabolism, immune response, cardiac status, liver metabolism, and lipid profiles. This unique approach holds genuine promise for space-based portable biodiagnostics and for point-of-care (POC) health monitoring and diagnostics here on Earth.

Finger Vein Recognition Based on Personalized Weight Maps

Science.gov (United States)

Yang, Gongping; Xiao, Rongyang; Yin, Yilong; Yang, Lu

2013-01-01

Finger vein recognition is a promising biometric recognition technology, which verifies identities via the vein patterns in the fingers. Binary pattern based methods were thoroughly studied in order to cope with the difficulties of extracting the blood vessel network. However, current binary pattern based finger vein matching methods treat every bit of feature codes derived from different image of various individuals as equally important and assign the same weight value to them. In this paper, we propose a finger vein recognition method based on personalized weight maps (PWMs). The different bits have different weight values according to their stabilities in a certain number of training samples from an individual. Firstly we present the concept of PWM, and then propose the finger vein recognition framework, which mainly consists of preprocessing, feature extraction, and matching. Finally, we design extensive experiments to evaluate the effectiveness of our proposal. Experimental results show that PWM achieves not only better performance, but also high robustness and reliability. In addition, PWM can be used as a general framework for binary pattern based recognition. PMID:24025556

Finger Vein Recognition Based on Personalized Weight Maps

Directory of Open Access Journals (Sweden)

Lu Yang

2013-09-01

Full Text Available Finger vein recognition is a promising biometric recognition technology, which verifies identities via the vein patterns in the fingers. Binary pattern based methods were thoroughly studied in order to cope with the difficulties of extracting the blood vessel network. However, current binary pattern based finger vein matching methods treat every bit of feature codes derived from different image of various individuals as equally important and assign the same weight value to them. In this paper, we propose a finger vein recognition method based on personalized weight maps (PWMs. The different bits have different weight values according to their stabilities in a certain number of training samples from an individual. Firstly we present the concept of PWM, and then propose the finger vein recognition framework, which mainly consists of preprocessing, feature extraction, and matching. Finally, we design extensive experiments to evaluate the effectiveness of our proposal. Experimental results show that PWM achieves not only better performance, but also high robustness and reliability. In addition, PWM can be used as a general framework for binary pattern based recognition.

Data acquisition software for the CMS strip tracker

International Nuclear Information System (INIS)

Bainbridge, R; Cripps, N; Fulcher, J; Radicci, V; Wingham, M; Baulieu, G; Bel, S; Delaere, C; Drouhin, F; Gill, K; Mirabito, L; Cole, J; Jesus, A C A; Giassi, A; Giordano, D; Gross, L; Hahn, K; Mersi, S; Nikolic, M; Tkaczyk, S

2008-01-01

The CMS silicon strip tracker, providing a sensitive area of approximately 200 m 2 and comprising 10 million readout channels, has recently been completed at the tracker integration facility at CERN. The strip tracker community is currently working to develop and integrate the online and offline software frameworks, known as XDAQ and CMSSW respectively, for the purposes of data acquisition and detector commissioning and monitoring. Recent developments have seen the integration of many new services and tools within the online data acquisition system, such as event building, online distributed analysis, an online monitoring framework, and data storage management. We review the various software components that comprise the strip tracker data acquisition system, the software architectures used for stand-alone and global data-taking modes. Our experiences in commissioning and operating one of the largest ever silicon micro-strip tracking systems are also reviewed

Deep Vein Thrombosis

Centers for Disease Control (CDC) Podcasts

2012-04-05

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.

Characterization of a porcine model of chronic superficial varicose veins.

Science.gov (United States)

Jones, Gregory T; Grant, Mark W; Thomson, Ian A; Hill, B Geraldine; van Rij, André M

2009-06-01

Previous animal models of venous disease, while inducing venous hypertension and valvular insufficiency, do not produce superficial varicose veins. In this study, we aimed to develop and characterize a pig-based model of superficial varicose veins. Right femoral arteriovenous fistulae (AVF) were surgically fashioned in young adult pigs. Animals were examined at postoperative times up to 15 weeks to determine the development of varicose veins and measurement of both blood pressure and flow velocities within the superficial thigh veins. Histology and vascular corrosion casts were used to characterize the resulting structural venous alterations. Porcine pathophysiological features were compared with those of human primary superficial varicose veins. Gross superficial varicosities developed over the ipsilateral medial thigh region after an initial lag period of 1-2 weeks. Veins demonstrated retrograde filling with valvular incompetence, and a moderate, non-pulsatile, venous hypertension, which was altered by changes in posture and Valsalva. Venous blood flow velocities were elevated to 15-30 cm/s in varicose veins. Structurally, pig varicose veins were enlarged, tortuous, had valvular degeneration, and regions of focal medial atrophy with or without overlying intimal thickening. The superficial varicose veins, which developed within this model, have a pathophysiology that is consistent with that observed in humans. The porcine femoral AVF model is proposed as a suitable experimental model to evaluate the pathobiology of superficial venous disease. It may also be suitable for the evaluation of treatment interventions including drug therapy.

[Portal perfusion with right gastroepiploic vein flow in liver transplant].

Science.gov (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.

A study of images of Projective Angles of pulmonary veins

Energy Technology Data Exchange (ETDEWEB)

Wang Jue [Beijing Anzhen Hospital, Beijing (China); Zhaoqi, Zhang [Beijing Anzhen Hospital, Beijing (China)], E-mail: zhaoqi5000@vip.sohu.com; Yu Wei; Miao Cuilian; Yan Zixu; Zhao Yike [Beijing Anzhen Hospital, Beijing (China)

2009-09-15

Aims: In images of magnetic resonance and computed tomography (CT) there are visible angles between pulmonary veins and the coronary, transversal or sagittal section of body. In this study these angles are measured and defined as Projective Angles of pulmonary veins. Several possible influential factors and characters of distribution are studied and analyzed for a better understanding of this imaging anatomic character of pulmonary veins. And it could be the anatomic base of adjusting correctly the angle of the central X-ray of the angiography of pulmonary veins undergoing the catheter ablation of atrial fibrillation (AF). Method: Images of contrast enhanced magnetic resonance angiography (CEMRA) and contrast enhanced computer tomography (CECT) of the left atrium and pulmonary veins of 137 health objects and patients with atrial fibrillation (AF) are processed with the technique of post-processing, and Projective Angles to the coronary and transversal sections are measured and analyzed statistically. Result: Project Angles of pulmonary veins are one of real and steady imaging anatomic characteristics of pulmonary veins. The statistical distribution of variables is relatively concentrated, with a fairly good representation of average value. It is possible to improve the angle of the central X-ray according to the average value in the selective angiography of pulmonary veins undergoing the catheter ablation of AF.

Adrenal vein catheterization. Anatomic considerations

Energy Technology Data Exchange (ETDEWEB)

El-Sherief, M.A. (Akademiska Sjukhuset, Uppsala (Sweden))

1982-01-01

Twenty post-mortem specimens and 93 phlebographies (56 right side, 37 left side) from 44 patients were investigated with respect to the adrenal venous anatomy. At autopsy, the venous orifices displayed in the area of adrenal drainage were injected bilaterally to identify the adrenal vein(s), the surrounding channels and the presence of interconnections. The findings were correlated with those at clinical phlebography, and the different sources of error were elicited. These were mainly found on the right side. Some guidelines are suggested in the hope that these will contribute to eliminate misconceptions.

The development of drift-strip detectors based on CdZnTe

DEFF Research Database (Denmark)

Gostilo, V.; Budtz-Jørgensen, Carl; Kuvvetli, Irfan

2002-01-01

The design and technological development of a CdZnTe drift strip detector is described. The device is based on a monocrystal of dimensions 10 x 10 x 3 mm(3) and has a pitch of 200 mum and a strip width of 100 mum. The strip length is 9.5 mm. The distribution of the leakage currents of the strips...

Treatment of hepatic encephalopathy by retrograde transcaval coil embolization of an ileal vein-to-right gonadal vein portosystemic shunt

International Nuclear Information System (INIS)

Nishie, Akihiro; Yoshimitsu, Kengo; Honda, Hiroshi; Kaneko, Kuniyuki; Kuroiwa, Toshiro; Fukuya, Tatsuro; Irie, Hiroyuki; Ninomiya, Toshiharu; Yoshimitsu, Takahiro; Hirakata, Hideki; Okuda, Seiya; Masuda, Kouji

1997-01-01

A 43-year-old non-cirrhotic woman suffered from encephalopathy caused by an extrahepatic portosystemic shunt between the ileal vein and inferior vena cava via the right gonadal vein. Percutaneous transcatheter embolization with stainless steel coils was performed by the retrograde systemic venous approach. Encephalopathy improved dramatically

Vein-type uranium deposits

International Nuclear Information System (INIS)

Rich, R.A.; Holland, H.D.; Petersen, U.

1975-01-01

A critical review is presented of published data bearing on the mineralogy, paragenesis, geochemistry, and origin of veiw-type uranium deposits. Its aim is to serve as a starting point for new research and as a basis for the development of new exploration strategies. During the formation of both vein and sandstone types of deposits uranium seems to have been dissolved by and transported in rather oxidized solutions, and deposited where these solutions encountered reducing agents such as carbon, sulfides, ferrous minerals and hydrocarbons. Granitic rocks abnormally enriched in uranium have apparently been the most common source for uranium in vein-type deposits. Oxidizing solutions have been derived either from the surface or from depth. Surface solutions saturated with atmospheric oxygen have frequently passed through red bed or clean sandstone conduits on their way to and from uranium source rocks. Deep solutions of non-surface origin have apparently become sufficiently oxidizing by passage through and equilibration with red beds. The common association of clean sandstones or red beds with uranium-rich granites in the vicinity of vein-type uranium deposits is probably not fortuitous, and areas where these rock types are found together are considered particularly favorable targets for uranium exploration

Interposition vein cuffs.

Science.gov (United States)

Harris, P; Da Silva, T; How, T

1996-01-01

A vein cuff interposed at the distal anastomosis between a prosthetic vascular graft and a recipient infrageniculate artery improves the chances of continued patency of the graft, at least in the short and medium term. The mode of effect appears to be suppression or modification of anastomotic myointimal hyperplasia (MIH). In the event of graft failure the recipient artery and run-off vessels remain free from MIH and their patency is preserved thereby improving the prospects for further vascular reconstruction and limb salvage. The mechanisms by which interposition vein cuffs might modulate MIH are reviewed. Experimental evidence is described to show that the geometry of a cuffed anastomosis promotes a characteristic haemodynamic flow structure with a stable vortex. It is suggested that this vortex exerts greater shear stress upon the wall of the artery than the normal laminar flow observed in conventional anastomoses. High shear stress is known to inhibit MIH.

Eddy current distribution and lift force for finite MAGLEV strips

Energy Technology Data Exchange (ETDEWEB)

Atherton, D L; Eastham, A R; Fombrun, C; Chong, M

1974-07-01

The transverse distribution of induced eddy currents across a flat conducing strip of finite width, due to a rectangular dc magnet moving above it, was modelled experimentally, and was compared with that calculated for an infinite sheet. The electrodynamic suspension was simulated by means of a stationary ac-excited copper magnet suspended above an aluminum strip, and the induced surface current density was measured by a voltage pickup probe connected to a lock-in amplifier. The effect of reducing strip width is examined and shown to produce high current densities close to the edges. These results are related to the variation of lift force with strip width, determined by impedance modelling. A slight enhancement of lift is evident for intermediate strip widths.

Opening the medial tibiofemoral compartment by pie-crusting the superficial medial collateral ligament at its tibial insertion: a cadaver study.

Science.gov (United States)

Roussignol, X; Gauthe, R; Rahali, S; Mandereau, C; Courage, O; Duparc, F

2015-09-01

Arthroscopic treatment of tears in the middle and posterior parts of the medial meniscus can be difficult when the medial tibiofemoral compartment is tight. Passage of the instruments may damage the cartilage. The primary objective of this cadaver study was to perform an arthroscopic evaluation of medial tibiofemoral compartment opening after pie-crusting release (PCR) of the superficial medial collateral ligament (sMCL) at its distal insertion on the tibia. The secondary objective was to describe the anatomic relationships at the site of PCR (saphenous nerve, medial saphenous vein). We studied 10 cadaver knees with no history of invasive procedures. The femur was held in a vise with the knee flexed at 45°, and the medial aspect of the knee was dissected. PCR of the sMCL was performed under arthroscopic vision, in the anteroposterior direction, at the distal tibial insertion of the sMCL, along the lower edge of the tibial insertion of the semi-tendinosus tendon. Continuous 300-N valgus stress was applied to the ankle. Opening of the medial tibiofemoral compartment was measured arthroscopically using graduated palpation hooks after sequential PCR of the sMCL. The compartment opened by 1mm after release of the anterior third, 2.3mm after release of the anterior two-thirds, and 3.9mm after subtotal release. A femoral fracture occurred in 1 case, after completion of all measurements. Both the saphenous nerve and the medial saphenous vein were located at a distance from the PCR site in all 10 knees. PCR of the sMCL is chiefly described as a ligament-balancing method during total knee arthroplasty. This procedure is usually performed at the joint line, where it opens the compartment by 4-6mm at the most, with some degree of unpredictability. PCR of the sMCL at its distal tibial insertion provides gradual opening of the compartment, to a maximum value similar to that obtained with PCR at the joint space. The lower edge of the semi-tendinosus tendon is a valuable landmark

Deuteron stripping reactions using dirac phenomenology

Science.gov (United States)

Hawk, E. A.; McNeil, J. A.

2001-04-01

In this work deuteron stripping reactions are studied using the distorted wave born approximation employing dirac phenomenological potentials. In 1982 Shepard and Rost performed zero-range dirac phenomenological stripping calculations and found a dramatic reduction in the predicted cross sections when compared with similar nonrelativistic calculations. We extend the earlier work by including full finite range effects as well as the deuteron's internal D-state. Results will be compared with traditional nonrelativistic approaches and experimental data at low energy.

LYCORIS - A Large Area Strip Telescope

CERN Document Server

Krämer, U; Stanitzki, M; Wu, M

2018-01-01

The LYCORIS Large Area Silicon Strip Telescope for the DESY II Test Beam Facility is presented. The DESY II Test Beam Facility provides elec- tron and positron beams for beam tests of up to 6 GeV. A new telescope with a large 10 × 20 cm2 coverage area based on a 25 μm pitch strip sensor is to be installed within the PCMAG 1 T solenoid. The current state of the system is presented.

Combined effect of bulk and surface damage on strip insulation properties of proton irradiated n$^{+}$-p silicon strip sensors

CERN Document Server

Dalal, R; Ranjan, K; Moll, M; Elliott-Peisert, A

2014-01-01

Silicon sensors in next generation hadron colliders willface a tremendously harsh radiation environment. Requirement tostudy rarest reaction channels with statistical constraints hasresulted in a huge increment in radiation flux, resulting in bothsurface damage and bulk damage. For sensors which are used in acharged hadron environment, both of these degrading processes takeplace simultaneously. Recently it has been observed in protonirradiated n$^{+}$-p Si strip sensors that n$^{+}$ strips had a goodinter-strip insulation with low values of p-spray and p-stop dopingdensities which is contrary to the expected behaviour from thecurrent understanding of radiation damage. In this work a simulationmodel has been devised incorporating radiation damage to understandand provide a possible explanation to the observed behaviour ofirradiated sensors.

Internal jugular vein: Peripheral vein adrenocorticotropic hormone ratio in patients with adrenocorticotropic hormone-dependent Cushing′s syndrome: Ratio calculated from one adrenocorticotropic hormone sample each from right and left internal jugular vein during corticotrophin releasing hormone stimulation test

Directory of Open Access Journals (Sweden)

Sachin Chittawar

2013-01-01

Full Text Available Background: Demonstration of central: Peripheral adrenocorticotropic hormone (ACTH gradient is important for diagnosis of Cushing′s disease. Aim: The aim was to assess the utility of internal jugular vein (IJV: Peripheral vein ACTH ratio for diagnosis of Cushing′s disease. Materials and Methods: Patients with ACTH-dependent Cushing′s syndrome (CS patients were the subjects for this study. One blood sample each was collected from right and left IJV following intravenous hCRH at 3 and 5 min, respectively. A simultaneous peripheral vein sample was also collected with each IJV sample for calculation of IJV: Peripheral vein ACTH ratio. IJV sample collection was done under ultrasound guidance. ACTH was assayed using electrochemiluminescence immunoassay (ECLIA. Results: Thirty-two patients participated in this study. The IJV: Peripheral vein ACTH ratio ranged from 1.07 to 6.99 ( n = 32. It was more than 1.6 in 23 patients. Cushing′s disease could be confirmed in 20 of the 23 cases with IJV: Peripheral vein ratio more than 1.6. Four patients with Cushing′s disease and 2 patients with ectopic ACTH syndrome had IJV: Peripheral vein ACTH ratio less than 1.6. Six cases with unknown ACTH source were excluded for calculation of sensitivity and specificity of the test. Conclusion: IJV: Peripheral vein ACTH ratio calculated from a single sample from each IJV obtained after hCRH had 83% sensitivity and 100% specificity for diagnosis of CD.

Convolutional Neural Network-Based Finger-Vein Recognition Using NIR Image Sensors.

Science.gov (United States)

Hong, Hyung Gil; Lee, Min Beom; Park, Kang Ryoung

2017-06-06

Conventional finger-vein recognition systems perform recognition based on the finger-vein lines extracted from the input images or image enhancement, and texture feature extraction from the finger-vein images. In these cases, however, the inaccurate detection of finger-vein lines lowers the recognition accuracy. In the case of texture feature extraction, the developer must experimentally decide on a form of the optimal filter for extraction considering the characteristics of the image database. To address this problem, this research proposes a finger-vein recognition method that is robust to various database types and environmental changes based on the convolutional neural network (CNN). In the experiments using the two finger-vein databases constructed in this research and the SDUMLA-HMT finger-vein database, which is an open database, the method proposed in this research showed a better performance compared to the conventional methods.

The vein collar

DEFF Research Database (Denmark)

Lundgren, F; Schroeder, Torben Veith

2012-01-01

Randomized studies evaluating the effect of a vein collar at the distal anastomosis of PTFE-grafts show conflicting results. The study of the Joint Vascular Research Group (JVRG) of UK found improved primary patency while the Scandinavian Miller Collar Study (SCAMICOS) found neither any effect...

Mesenteric vein thrombosis after percitaneous transhepatic portal vein catheterisation for the localisation of an insulinoma

International Nuclear Information System (INIS)

Luska, G.; Langer, H.E.; Le Blanc, S.; Medizinische Hochschule Hannover

1984-01-01

The authors report on a fatal mesenteric vein thrombosis following an uncomplicated percutaneous transhepatic portal vein catheterisation for the localisation of an insulinoma. Several hours after the procedure the patient developed an acute abdomen. An emergency laparotomy revealed a haemorrhagic infarct of the ileum. The resected specimen showed an acute phlebitis with fresh thrombus. The cause of the phlebothrombosis was thought to be intimal damage from high osmolar contrast medium. There was no evidence of damage due to the catheder, either on the phlebogram or pathologically. (orig.) [de

Incidental retroaortic left innominate vein in adult patient

Directory of Open Access Journals (Sweden)

Alexandre Semionov, MD, PhD

2017-09-01

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.

TrapEase inferior vena cava filter placement: use of the subclavian vein.

Science.gov (United States)

Stone, Patrick A; Aburahma, Ali F; Hass, Stephen M; Hofeldt, Matthew J; Zimmerman, William B; Deel, John T; Deluca, John A

2004-01-01

The purpose of this paper was to evaluate the safety and technical success of TrapEase inferior vena cava filter placement via the subclavian vein. As of yet, no reports in the literature have specifically investigated the use of the subclavian vein as a route for deploying TrapEase vena cava filters. Retrospective chart review was conducted of 135 patients with attempted TrapEase inferior vena cava filter placement over a 2-year period. In a majority of cases, the choice of subclavian vein approach was based primarily on surgeon preference. Other circumstances for subclavian vein deployment included cervical immobilization secondary to trauma, desire for concomitant placement of a subclavian long-term central venous access catheter, and patient body habitus limiting exposure to the internal jugular vein. One hundred and thirty-five filters were placed over this 2-year period. The internal jugular vein approach was used in 56 patients, the femoral vein approach in 39 patients, and the subclavian vein approach in 40 patients. Thirty-nine of the 40 TrapEase filter placements using the subclavian vein were successful. Twenty-six were deployed through the right subclavian vein and 14 through the left subclavian vein. The single failed subclavian deployment was due to the inability to pass the guidewire adequately into the inferior vena cava after successful cannulation of the right subclavian vein. The average deployment time for subclavian vein placement was 26 minutes when TrapEase filter placement was the only procedure performed. No insertional complications were encountered, specifically no pneumothoraces confirmed by chest radiography or fluoroscopy. The subclavian vein provides an alternative site of access for the TrapEase inferior vena cava filter. This route is comparable to other alternative methods evaluated both in average deployment time and complication occurrence. Furthermore, the subclavian vein route is valuable in patients with limited central access

Intravitreal triamcinolone acetonide injections in the treatment of retinal vein occlusions.

Science.gov (United States)

Roth, Daniel B; Cukras, Catherine; Radhakrishnan, Ravi; Feuer, William J; Yarian, David L; Green, Stuart N; Wheatley, Harold M; Prenner, Jonathan

2008-01-01

To report the visual acuity response after intravitreal triamcinolone injection in patients with macular edema due to retinal vein occlusions. Retrospective nonrandomized interventional series of 172 consecutive patients with macular edema due to retinal vein occlusions who were treated with intravitreal triamcinolone acetonide injection. Patients underwent Snellen visual acuity testing and ophthalmoscopic examination at baseline and 1, 3, 6, and 12 months after intravitreal triamcinolone acetonide injection. All subtypes of retinal vein occlusions showed significant improvements in mean visual acuity 1 month after injection. This improvement in visual acuity was maintained over the 12-month period for all but the central retinal vein occlusion group. Seventy-one (41.3%) of the 172 patients received more than one intravitreal triamcinolone injection for unresolved or recurrent macular edema. This study demonstrates a benefit associated with intravitreal triamcinolone acetonide injection for retinal vein occlusions that was maintained by patients with branch retinal vein occlusions and hemiretinal vein occlusions over a 12-month period. Visual acuity improvement was not maintained in patients with central retinal vein occlusions with this course of treatment.

Robust finger vein ROI localization based on flexible segmentation.

Science.gov (United States)

Lu, Yu; Xie, Shan Juan; Yoon, Sook; Yang, Jucheng; Park, Dong Sun

2013-10-24

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.

Robust Finger Vein ROI Localization Based on Flexible Segmentation

Directory of Open Access Journals (Sweden)

Dong Sun Park

2013-10-01

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.

Robust Finger Vein ROI Localization Based on Flexible Segmentation

Science.gov (United States)

Lu, Yu; Xie, Shan Juan; Yoon, Sook; Yang, Jucheng; Park, Dong Sun

2013-01-01

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. PMID:24284769

Induction heating in in-line strip production process

International Nuclear Information System (INIS)

Costa, P.; Santinelli, M.

1995-05-01

ISP (In-line Strip Production), a continuous process for steel strip production, has recently been set in an italian innovative plant, where ecological impact and power requirements are lighter than usual. This report describes the studies performed by ENEA (Italian Agency for New Technologies, Energy and the Environment), while a prototype reheating facility was arranged by Acciaieria ISP in Cremona (Italy). The authors, after a study of the prototype electromagnetic field, calculate the heating rate, with the thermal network method. Then they detect, with a 1-D-FEM, the heat diffusion through the strip cross section. Afterward, since the heat distribution depends on the eddy current density one, which is given by the magnetic field distribution, the authors, with a 3-D-FEM, carry out a coupled, electromagnetic and thermal, analysis in time domain. The strip temperature map is established by the balance between skin depth heating and surface cooling: a thermal analysis, performed with a moving 2-D-FEM, take into account the effects of the different heating and cooling situations, originated by the strip moving at a speed of 6m/min through four consecutive reheating facilities. The temperatures of a strip sample heated by the prototype have been monitored, acquired by a computer and related with the simulation results. The little difference between experiment and simulation assessed the qualitative and quantitative validity of this analysis, that has come out to be a tool, useful to evaluate the effects of possible improvements to the ISP process

Analysis of 'Coma strip' galaxy redshift catalog

International Nuclear Information System (INIS)

Klypin, A.A.; Karachentsev, I.D.; Lebedev, V.S.

1990-01-01

We present results of the analysis of a galaxy redshift catalog made at the 6-m telescope by Karachentsev and Kopylov (1990. Mon. Not. R. astr. Soc., 243, 390). The catalog covers a long narrow strip on the sky (10 arcmin by 63 0 ) and lists 283 galaxies up to limiting blue magnitude m B = 17.6. The strip goes through the core of Coma cluster and this is called the 'Coma strip' catalog. The catalog is almost two times deeper than the CfA redshift survey and creates the possibility of studying the galaxy distribution on scales of 100-250 Mpc. Due to the small number of galaxies in the catalog, we were able to estimate only very general and stable parameters of the distribution. (author)

31 CFR 356.31 - How does the STRIPS program work?

Science.gov (United States)

2010-07-01

... 31 Money and Finance: Treasury 2 2010-07-01 2010-07-01 false How does the STRIPS program work? 356.31 Section 356.31 Money and Finance: Treasury Regulations Relating to Money and Finance (Continued...) Miscellaneous Provisions § 356.31 How does the STRIPS program work? (a) General. Notes or bonds may be “stripped...

Using Comic Strips as a Book Report Alternative

Science.gov (United States)

Reading Teacher, 2012

2012-01-01

Comic strips are great to share with parents, younger students, and peers. This article presents an activity where students use a six-paneled comic strip to summarize a story. This activity allows for multiple interpretations and enhances comprehension by drawing attention to story elements.

Contact-free palm-vein recognition based on local invariant features.

Directory of Open Access Journals (Sweden)

Wenxiong Kang

Full Text Available Contact-free palm-vein recognition is one of the most challenging and promising areas in hand biometrics. In view of the existing problems in contact-free palm-vein imaging, including projection transformation, uneven illumination and difficulty in extracting exact ROIs, this paper presents a novel recognition approach for contact-free palm-vein recognition that performs feature extraction and matching on all vein textures distributed over the palm surface, including finger veins and palm veins, to minimize the loss of feature information. First, a hierarchical enhancement algorithm, which combines a DOG filter and histogram equalization, is adopted to alleviate uneven illumination and to highlight vein textures. Second, RootSIFT, a more stable local invariant feature extraction method in comparison to SIFT, is adopted to overcome the projection transformation in contact-free mode. Subsequently, a novel hierarchical mismatching removal algorithm based on neighborhood searching and LBP histograms is adopted to improve the accuracy of feature matching. Finally, we rigorously evaluated the proposed approach using two different databases and obtained 0.996% and 3.112% Equal Error Rates (EERs, respectively, which demonstrate the effectiveness of the proposed approach.

Contact-free palm-vein recognition based on local invariant features.

Science.gov (United States)

Kang, Wenxiong; Liu, Yang; Wu, Qiuxia; Yue, Xishun

2014-01-01

Contact-free palm-vein recognition is one of the most challenging and promising areas in hand biometrics. In view of the existing problems in contact-free palm-vein imaging, including projection transformation, uneven illumination and difficulty in extracting exact ROIs, this paper presents a novel recognition approach for contact-free palm-vein recognition that performs feature extraction and matching on all vein textures distributed over the palm surface, including finger veins and palm veins, to minimize the loss of feature information. First, a hierarchical enhancement algorithm, which combines a DOG filter and histogram equalization, is adopted to alleviate uneven illumination and to highlight vein textures. Second, RootSIFT, a more stable local invariant feature extraction method in comparison to SIFT, is adopted to overcome the projection transformation in contact-free mode. Subsequently, a novel hierarchical mismatching removal algorithm based on neighborhood searching and LBP histograms is adopted to improve the accuracy of feature matching. Finally, we rigorously evaluated the proposed approach using two different databases and obtained 0.996% and 3.112% Equal Error Rates (EERs), respectively, which demonstrate the effectiveness of the proposed approach.

Budd-Chiari and inferior caval vein syndromes due to membranous obstruction of the liver veins. Successful treatment with angioplasty and transcaval TIPS

DEFF Research Database (Denmark)

Holland-Fischer, Peter

2004-01-01

The case is presented of a 25-year-old Caucasian patient with Budd-Chiari syndrome due to membranous obstruction of the liver veins and inferior caval vein syndrome as a result of secondary hyperplasia of the caudate lobe of the liver, obstructing the caval vein. Diagnosis was established...... that angioplasty and TIPS are safe and efficient procedures to reduce liver engorgement and complications of portal hypertension in selected patients with Budd-Chiari syndrome....

Retinal vein occlusion: pathophysiology and treatment options

OpenAIRE

Karia, Niral

2010-01-01

Niral KariaDepartment of Ophthalmology, Southend Hospital, Prittlewell Chase, Westcliff on Sea, Essex, United KingdomAbstract: This paper reviews the current thinking about retinal vein occlusion. It gives an overview of its pathophysiology and discusses the evidence behind the various established and emerging treatment paradigms.Keywords: central, hemispheric, branch, retinal vein occlusion, visual loss

Percutaneous closure of patent ductus arteriosus in interrupted inferior caval vein through femoral vein approach

Directory of Open Access Journals (Sweden)

Endale Tefera

2014-01-01

Full Text Available Percutaneous closure of the patent arterial duct in patients with interrupted inferior caval vein poses a technical challenge. A 12-year-old girl with a patent ductus arteriosus (PDA and interrupted inferior caval vein is described in this report. The diagnosis of interrupted inferior caval vein and azygos continuation was made in the catheterization laboratory. A catheter was advanced and snared in the descending aorta. An exchange wire was advanced through the catheter and snared in the descending aorta. Then, an Amplatzer TorqVue 2 delivery sheath was advanced over the wire from the venous side and again snared in the descending aorta. An Amplatzer duct occluder (ADO size 8/6 was advanced through the sheath while still holding the sheath with a snare. The device was opened. The sheath was then unsnared once the aortic disc was completely out. The sheath and the device were pulled back into the duct and the device was successfully implanted. The device was then released and it attained a stable position. An aortic angiogram was performed which showed complete occlusion.

Percutaneous closure of patent ductus arteriosus in interrupted inferior caval vein through femoral vein approach

International Nuclear Information System (INIS)

Tefera, Endale; Bermudez-Cañete, Ramon

2014-01-01

Percutaneous closure of the patent arterial duct in patients with interrupted inferior caval vein poses a technical challenge. A 12-year-old girl with a patent ductus arteriosus (PDA) and interrupted inferior caval vein is described in this report. The diagnosis of interrupted inferior caval vein and azygos continuation was made in the catheterization laboratory. A catheter was advanced and snared in the descending aorta. An exchange wire was advanced through the catheter and snared in the descending aorta. Then, an Amplatzer TorqVue 2 delivery sheath was advanced over the wire from the venous side and again snared in the descending aorta. An Amplatzer duct occluder (ADO) size 8/6 was advanced through the sheath while still holding the sheath with a snare. The device was opened. The sheath was then unsnared once the aortic disc was completely out. The sheath and the device were pulled back into the duct and the device was successfully implanted. The device was then released and it attained a stable position. An aortic angiogram was performed which showed complete occlusion

[Intraosseous veins of the maxilla in the newborn].

Science.gov (United States)

Bogdanov, R A

1975-12-01

The intraosseous veins of the maxilla in newborns grow larger with enlargement of the bone and become disposed in three mutually perpendicular planes. The venous plexus of the alveolar process is large. V. v. vallares are thin and interlace forming a network. The veins of interdental septum are well pronounced. The thick venous network of the periosteum and the mucous membrane of the nasal surface of the palatine process includes the vessels transversal and longitudinal to the nasal septum. The venous loops of the incisor part are of triangular, pentagonal and polygonal shape. The veins of the palatine process are connected with 3-4 large vessels falling into the vessels of the tear duct. The transversal and oblique veins of the oral surface of the palatine process are connected with large vessels disposed in parallel to the medial structure of the hard palate. The venous network of the incisor part of the bone is restricted by densified small arc-shaped plexuses. Two-three largest veins lie sagittally and, connected by arc-shaped anastomoses, are tributaries of the vessels of the palate bone, soft palate and pharynx.

Magnetic ring for stripping enhancement

International Nuclear Information System (INIS)

Selph, F.

1992-10-01

A ring designed to recycle ions through a stripping medium offers the possibility for increasing output of the desired charge state by up to 4x. This could be a very important component of a Radioactive Nuclear Beam Facility. In order for such a ring to work effectively it must satisfy certain design conditions. These include achromaticity at the stripper, a dispersed region for an extraction magnet, and a number of first and higher order optics constraints which are necessary to insure that the beam emittance is not degraded unduly by the ring. An example is given of a candidate design of a stripping ring

5-Carboxamide tryptamine, a compound with high affinity for 5-hydroxytryptamine1 binding sites, dilates arterioles and constricts arteriovenous anastomoses.

OpenAIRE

Saxena, P. R.; Verdouw, P. D.

1985-01-01

The effects of 5-carboxamide tryptamine, which activates non-5-hydroxytryptamine2-'atypical' receptors for 5-hydroxytryptamine (5-HT) in the dog saphenous vein, was studied on the complete distribution of cardiac output and common carotid blood flow in anaesthetized pigs. The drug was infused for 10 min at the rate of 0.025, 0.1 and 0.4 micrograms kg-1 min-1 either intravenously (cardiac output distribution) or intra-arterially (carotid distribution). 5-Carboxamide tryptamine decreased arteri...

Anatomical variation of thyroid veins on contrast-enhanced multi-detector row computed tomography

Energy Technology Data Exchange (ETDEWEB)

Tomita, Hayato, E-mail: m04149@yahoo.co.jp [Department of Radiology, St. Marianna University School of Medicine, Yokohama City Seibu Hospital, 1197-1 Yasashicho, Asahi-ku, Yokohama, Kanagawa 241-0811 (Japan); Yamada, Takayuki; Murakami, Kenji; Hashimoto, Kazuki; Tazawa, Yoko; Kumano, Reiko [Department of Radiology, St. Marianna University School of Medicine, Yokohama City Seibu Hospital, 1197-1 Yasashicho, Asahi-ku, Yokohama, Kanagawa 241-0811 (Japan); Nakajima, Yasuo [Department of Radiology, St. Marianna University School of Medicine, 2-16-1 Sugao, Miyamae-ku, Kawasaki, Kanagawa 216-8511 (Japan)

2015-05-15

Highlights: • This is the first study to demonstrate the anatomy of thyroid veins on contrasted-enhanced MDCT. • Identifying the thyroid vein on MDCT prior to selective venous sampling of parathyroid hormone provides clinical information to interventional radiologist. • Detecting especially the inferior thyroid veins with individual variability in numbers, locations, and lengths may have an effect on SVS for HPT and decrease the difficulty and time of the procedure. - Abstract: Objective: The objective of this study was to clarify the anatomical variation of thyroid veins into the systemic vein using contrast-enhanced multi-detector row computed tomography (MDCT). Design and methods: : The subjects were 80 patients (34 males and 46 females; mean age, 50.1 years; age range, 15–92 years) with neck diseases who underwent MDCT. The number and location of inflow points of the thyroid veins into the systemic vein, and the length from the junction of bilateral brachiocephalic veins to the orifice of inferior thyroid vein were investigated by reviewing the axial and coronal images. Results: All superior thyroid veins were detected. Right and left middle thyroid veins were identified in 39 and 29 patients, respectively. Right inferior thyroid veins, left inferior thyroid veins, and common trunks were detected in 43, 46, and 39 patients, respectively; in five patients, two left thyroid veins were identified. All left inferior thyroid veins and 34 common trunks flowed into the innominate vein, while right ones had some variations in inflow sites. Mean lengths were 3.01 ± 1.30 cm (range, 0.5–6.19) and 2.04 ± 0.91 cm (0.5–4.4) in the left inferior thyroid vein and common trunk, and 1.96 ± 1.05 cm (0.81–4.8) and 1.65 ± 0.69 cm (0.63–2.94) in the right one flowing into the right internal jugular vein and the innominate vein, respectively. Conclusions: The numbers and orifices of thyroid veins were identified at high rates on contrast-enhanced MDCT. This

Do repeated rumble strip hits improve driver alertness?

NARCIS (Netherlands)

Watling, C.N.; Akerstedt, T.; Kecklund, L.G.; Anund, A.

2016-01-01

Driving while sleepy is associated with increased crash risk. Rumble strips are designed to alert a sleepy or inattentive driver when they deviate outside their driving lane. The current study sought to examine the effects of repeated rumble strip hits on levels of physiological and subjective

Evaluation of anatomy comic strips for further production and applications

Science.gov (United States)

Shin, Dong Sun; Kim, Dae Hyun; Park, Jin Seo; Jang, Hae Gwon

2013-01-01

The corresponding author of the study has been sketching comic strips to explain anatomy in a humorous manner. All the anatomy comic strips, including those in Korean (650 episodes) and English (451 episodes), can be viewed on the homepage (http://anatomy.co.kr). Such comic strips were created with the aim of assisting medical students. However, their impact was unknown, and therefore, we surveyed the students' responses. We noted that anatomy grades were better in the students who read the comic strips. The comics helped the trainees chat with individuals with and without a medical background. The authors also considered comments on the problems with the comic strips and attempted to find solutions. The episodes are being currently used and further produced for educational purposes. To support this effort, the readers' valuable opinions will be continuously collected and assessed. PMID:24179697

Evaluation of anatomy comic strips for further production and applications.

Science.gov (United States)

Shin, Dong Sun; Kim, Dae Hyun; Park, Jin Seo; Jang, Hae Gwon; Chung, Min Suk

2013-09-01

The corresponding author of the study has been sketching comic strips to explain anatomy in a humorous manner. All the anatomy comic strips, including those in Korean (650 episodes) and English (451 episodes), can be viewed on the homepage (http://anatomy.co.kr). Such comic strips were created with the aim of assisting medical students. However, their impact was unknown, and therefore, we surveyed the students' responses. We noted that anatomy grades were better in the students who read the comic strips. The comics helped the trainees chat with individuals with and without a medical background. The authors also considered comments on the problems with the comic strips and attempted to find solutions. The episodes are being currently used and further produced for educational purposes. To support this effort, the readers' valuable opinions will be continuously collected and assessed.