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Sample records for saphenous vein tissue

  1. A RARE VARIATION OF GREAT SAPHENOUS VEIN

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    Nakhate Manisha

    2014-11-01

    Full Text Available The venous system is more complex and variable than arterial system due to its frequent anatomical variations. This paper discusses the anatomy of the great saphenous vein and its variation observed in a male cadaver of around 60 years old.

  2. Primary leiomyosarcoma of saphenous vein presenting as deep venous thrombosis.

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

    2014-12-01

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

  3. Pressure-diameter relationship in the human greater saphenous vein

    NARCIS (Netherlands)

    Stooker, W; Gok, M; Sipkema, P; Niessen, HWM; Baidoshvili, A; Westerhof, N; Jansen, EK; Wildevuur, CRH; Eijsman, L

    2003-01-01

    Background. Compliance of artificial and autologous vascular grafts is related to future patency. We investigated whether differences in compliance exist between saphenous vein grafts derived from the upper or lower leg, which might indicate upper or lower leg saphenous vein preference in coronary a

  4. Small saphenous vein: where does reflux go?

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    Guillermo Gustavo Rossi

    2013-06-01

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

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

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    Muhammed Beşir Öztürk

    2014-01-01

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

  6. Update of endovenous treatment modalities for insufficient saphenous veins-A review of literature

    NARCIS (Netherlands)

    van Eekeren, Ramon R. J. P.; Boersma, Doeke; de Vries, Jean-Paul P. M.; Zeebregts, Clark J.; Reijnen, Michel M. P. J.

    2014-01-01

    Lower-limb venous insufficiency resulting from saphenous vein incompetence is a common disorder, increasing with age. For decades, surgical stripping of the great saphenous vein has been the gold standard in varicose vein treatment. The desire to optimize outcomes of treatment and reduce surgical tr

  7. Update of endovenous treatment modalities for insufficient saphenous veins-A review of literature

    NARCIS (Netherlands)

    van Eekeren, Ramon R. J. P.; Boersma, Doeke; de Vries, Jean-Paul P. M.; Zeebregts, Clark J.; Reijnen, Michel M. P. J.

    Lower-limb venous insufficiency resulting from saphenous vein incompetence is a common disorder, increasing with age. For decades, surgical stripping of the great saphenous vein has been the gold standard in varicose vein treatment. The desire to optimize outcomes of treatment and reduce surgical

  8. Numerical simulation of endovenous laser treatment of the incompetent great saphenous vein with external air cooling.

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

    2013-05-01

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

  9. The in situ saphenous vein bypass graft: radiologic aspects.

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    Schwarz, W; Nozick, J; Richmand, D; Rodgers, B; Simpson, A; Argila, C; Honickman, S

    1986-03-01

    The use of the in situ saphenous vein for bypassing arterial occlusions in the lower extremities appears to have a higher patency rate than other bypass procedures but presents unique technical problems, such as lysing valves and occluding venous tributaries. Forty-four patients undergoing in situ bypasses had preoperative arteriograms. Special attention was paid to the small runoff vessels around the ankle, which are not suitable for reversed bypass procedures but may be adequate for in situ bypasses. Eight patients also had preoperative saphenous venograms, which revealed surgically important abnormalities in six cases. Postoperative arteriograms obtained within 2 weeks in 10 patients and within 2-12 months in 15 patients revealed persistent arteriovenous fistulas in four patients, stenoses in nine, occlusions in five, and progressive disease in the nonbypassed arteries in five patients. Early recognition of these problems led to 11 surgical repairs; nine repairs used the interventional radiologic procedures of balloon angioplasty, transcatheter embolization, and catheter thrombolysis. In this group of 44 patients, five patients died with patent bypasses and three patients required amputation despite functioning bypasses. Only four amputations were attributed to bypass failure. This low figure may be due to the close cooperation of the vascular surgeons and the vascular radiologists in dealing with these complicated cases.

  10. Thrombosed aneurysm of saphenous vein coronary artery bypass grafting.

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    Queiroz, Rodolfo Mendes; Nastri, Rogério; Ferez, Marcus Antônio; Costa, Mauro José Brandão da; Laguna, Claudio Benedini; Valentin, Marcus Vinicius Nascimento

    2017-06-01

    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.

  11. Comparison between mechanical properties of human saphenous vein and umbilical vein

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    Hamedani Borhan

    2012-08-01

    Full Text Available Abstract Background As a main cause of mortality in developed countries, Coronary Artery Disease (CAD is known as silent killer with a considerable cost to be dedicated for its treatment. Coronary Artery Bypass Graft (CABG is a common remedy for CAD for which different blood vessels are used as a detour. There is a lack of knowledge about mechanical properties of human blood vessels used for CABG, and while these properties have a great impact on long-term patency of a CABG. Thus, studying these properties, especially those of human umbilical veins which have not been considered yet, looks utterly necessary. Methods Umbilical vein, as well as human Saphenous vein, are respectively obtained after cesarean and CABG. First, histological tests were performed to investigate different fiber contents of the samples. Having prepared samples carefully, force-displacement results of samples were rendered to real stress–strain measurements and then a fourth-order polynomial was used to prove the non-linear behavior of these two vessels. Results Results were analyzed in two directions, i.e. circumferentially and longitudinally, which then were compared with each other. The comparison between stiffness and elasticity of these veins showed that Saphenous vein’s stiffness is much higher than that of umbilical vein and also, it is less stretchable. Furthermore, for both vessels, longitudinal stiffness was higher than that of circumferential and in stark contrast, stretch ratio in circumferential direction came much higher than longitudinal orientation. Conclusion Blood pressure is very high in the region of aorta, so there should be a stiff blood vessel in this area and previous investigations showed that stiffer vessels would have a better influence on the flow of bypass. To this end, the current study has made an attempt to compare these two blood vessels’ stiffness, finding that Saphenous vein is stiffer than umbilical vein which is somehow as stiff as

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

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    Roberto Delfrate

    2014-06-01

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

  13. Vasorelaxant effect of 17α-ethynylestradiol on human saphenous vein.

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    Jodati, Ahmad Reza; Babaei, Hossein; Azarmi, Yadollah; Fallah, Sahar; Gharebageri, Afsaneh; Fouladi, Danial Fadaei; Safaei, Naser

    2015-03-01

    A protective effect for estrogens against cardiovascular problems has long been known. The aim of this study was to investigate the vasorelaxant effect of 17α-Ethynylestradiol (17α-EE) on human saphenous vein. The veins were suspended horizontally between two triangular stainless steel hooks for the measurement of isometric tension in individual organ baths containing 10ml Krebs solution, at 37°C and gassed with carbogen under 3gr optimum tension. The effect of different concentrations of 17α-EE (2-40 μM) on vascular tone was investigated in veins precontracted with PGF2α. Relaxation was measured after 40min and expressed as the percent decrease of initial contraction. To determine the involvement of potassium channels, endothelium, nitric oxide synthase, guanylylcyclase and prostaglandins in the vasorelaxant effect of estrogen, the veins were incubated with tetraethyl ammonium, N-nitro-L-arginine methyl ester, methylene blue or indomethacin, respectively for 20min prior to experimentation. Responses to 17α-EE were directly compared to those obtained in the same tissues in the absence of the inhibitors. The mean relaxations induced by 17α-EE with concentrations of 2, 5, 10, 20 and 40μM in tissues precontracted with PGF2α were 19.8 ±5.5%, 26.1±10.8%, 32.2±7.4%, 48.6±10.8%and56±7.6%, respectively. The results of the inhibition of potassium channels, nitric oxide synthase, guanylylcyclase, cyclooxygenase and removing endothelium in relaxation induced by 17α-EE on precontracted veins with PGF2α proved no significant differences. This study showed that 17α-EE has significant vasorelaxant effect on human saphenous vein in a concentration-dependent manner. This effect is probably independent of potassium channels, nitric oxide synthase, guanylylcyclase, prostaglandin synthesis and endothelium functions.

  14. Effect of Troglitazone on Expression of Adhesion Molecules and eNOS in Human Saphenous Vein Gaft

    Institute of Scientific and Technical Information of China (English)

    CHEN Shu; HU Zhiwei; ZHANG Kailun; SU Wei; SUN Zongquan

    2007-01-01

    To investigate whether peroxisome proliferators-activated receptor-y (PPARγ) ligand Troglitazone can reduce endothelial injury and activation during storage of harvested saphenous vein grafts. Segments of human saphenous vein graft were collected from 9 patients undergoing coronary bypass surgery and then divided into two equal parts of control and test specimens, were stored in ei-ther heparinized blood (control group) or heparinized blood containing 20 μmol/L troglitazone (test group) for 1 h at room temperature. Tissue distribution and protein expression of VCAM-1, ICAM-1, and endothelial nitric oxide synthase (eNOS) were compared using immunohistochemistry and West-ern blot analysis. Myeloperoxidase (MPO) activity, a marker of neutrophil sequestration in human saphenous vein grafts, was also measured in each group. The expression of ICAM-1 (753±132 versus 7201±934; P<0.01) , VCAM-1 (3731±294 versus 8292±793; P<0.01), and MPO activity (1.52±0.42 U/g, 5.04±1.26 U/g P<0.01) were significantly lower in test group. In contract, eNOS expression (7983±834 versus 3989±1008; P<0.01) was significantly higher in test group. PPARγ ligand troglita- zone might reduce endothelial injury during the storage period of human saphenous vein grafts.

  15. Treatment of recurrent varicose veins of the great saphenous vein by conventional surgery and endovenous laser ablation.

    NARCIS (Netherlands)

    Groenendael, L. van; Vliet, J.A. van der; Flinkenflogel, L.; Roovers, E.A.; Sterkenburg, S.M. van; Reijnen, M.M.P.J.

    2009-01-01

    OBJECTIVE: Varicose vein recurrence of the great saphenous vein (GSV) is a common, costly, and complex problem. The aim of the study was to assess feasibility of endovenous laser ablation (EVLA) in recurrent varicose veins of the GSV and to compare this technique with conventional surgical reinterve

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

    DEFF Research Database (Denmark)

    Flamand, Mette Kehlet; Bækgaard, Niels

    2011-01-01

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

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

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

    1991-01-01

    Intraoperative identification and later development of arteriovenous fistulas were investigated prospectively in 70 in situ saphenous vein bypass procedures. Surveillance was performed by completion arteriography and intra- and postoperative continuous wave Doppler examination. The intraoperative...

  18. An Unusual Course and Termination of Small Saphenous Vein: A Case Report

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    Shetty, Prakashchandra; D’Souza, Melanie Rose

    2016-01-01

    The superficial veins of the lower limb can vary in their course and termination. We report a relatively rare type of variation in the course and termination of small saphenous vein. The small saphenous vein had normal origin and course in the leg. However, instead of terminating into the popliteal vein, it continued up in the posterior compartment of the thigh and terminated into the femoral vein after piercing the fleshy part of the adductor magnus muscle. This course might lead to varicosity of the small saphenous vein due to the compression by the fleshy fibres of adductor magus near its termination. The case may be of interest to general and plastic surgeons and even cardiothoracic surgeons. PMID:27134850

  19. Endovenous mechanochemical ablation of great saphenous vein incompetence using the ClariVein device: a safety study

    NARCIS (Netherlands)

    Eekeren, R. van; Boersma, D.; Elias, S.; Holewijn, S.; Werson, D.A.; Vries, J.P. de; Reijnen, M.M.P.J.

    2011-01-01

    PURPOSE: To evaluate the feasibility and safety of endovenous mechanochemical ablation (MOCA) for the treatment of great saphenous vein (GSV) incompetence. METHODS: The newly developed ClariVein device uses a technique that combines mechanical endothelial damage using a rotating wire with the infusi

  20. Endovenous mechanochemical ablation of great saphenous vein incompetence using the ClariVein device: a safety study

    NARCIS (Netherlands)

    Eekeren, R. van; Boersma, D.; Elias, S.; Holewijn, S.; Werson, D.A.; Vries, J.P. de; Reijnen, M.M.P.J.

    2011-01-01

    PURPOSE: To evaluate the feasibility and safety of endovenous mechanochemical ablation (MOCA) for the treatment of great saphenous vein (GSV) incompetence. METHODS: The newly developed ClariVein device uses a technique that combines mechanical endothelial damage using a rotating wire with the

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

    DEFF Research Database (Denmark)

    Bagi, P; Schroeder, T; Sillesen, H;

    1989-01-01

    Real time ultrasound mapping of the greater saphenous vein (GSV) was performed in 30 consecutive patients admitted for in situ femoro-crural revascularisation. The overall accuracy in predicting the adequacy of the GSV for in situ bypass was 90%. The predictive value of finding the vein usable...

  2. Histological Observations One Year After Mechanochemical Endovenous Ablation of the Great Saphenous Vein

    NARCIS (Netherlands)

    van Eekeren, Ramon R. J. P.; Hillebrands, Jan Luuk; van der Sloot, Kim; de Vries, Jean-Paul P. M.; Zeebregts, Clark J.; Reijnen, Michel M. P. J.

    2014-01-01

    Purpose: To report histological analysis of a great saphenous vein (GSV) 1 year after undergoing mechanochemical endovenous ablation (MOCA) and compare the findings with those of a healthy vein. Case Report: A 59-year-old patient with bilateral GSV incompetence was treated with MOCA using the ClariV

  3. A STUDY OF VARIATIONS IN THE TERMINATION OF SHORT SAPHENOUS VEIN

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    Santhini Arulsevli

    2016-05-01

    Full Text Available BACKGROUND The liability of the superficial venous system of the lower limbs to varicosity has naturally attracted the attention of Clinicians and Surgeons. Variations in the superficial veins of the lower limb are very common. The extent of such variations, their connections are usually described. Out of all the veins of the lower limb, the long saphenous and the small saphenous veins mark the major attraction clinically. Both the veins belong to superficial set of the veins, lie in the superficial fascia and possess valves. The long (great saphenous vein, being the longest vein in the body, begins as a continuation of the medial marginal vein of the foot and ends in the femoral vein distal to the inguinal ligament. It ascends in front of the medial malleolus followed by passing obliquely across the medial surface of the tibia. In the upper part of the leg, it is accompanied by saphenous nerve and finally opens into the femoral vein after passing through the saphenous opening. The short saphenous vein can be the natural choice for coronary arterial bypass surgery, and also can be used in arterial reconstruction. The look for the variation in the termination of short saphenous vein should be taken into account before performing any varicose surgeries. This paper puts in a sincere effort to check the variations of termination of short saphenous vein and thus help the surgeons in betterment of the techniques used for various surgeries. METHODS One hundred specimens were studied in the Department of Anatomy, Vinayaka Mission’s Medical College and Hospital, Karaikal. The skin, superficial fascia and the deep fascia was carefully reflected and the formation of the small saphenous vein was identified. The course was followed and finally the termination was identified and noted. The variations in the termination were identified and a note was made. RESULT In the present study, 68% of the cases had type 2 and 38% of the cases had type 1. The other

  4. Relationship between elevated platelet volume and saphenous vein graft disease.

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

    2010-06-01

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

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

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

    2016-03-01

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

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

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    Venkatesh Kasi

    2012-01-01

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

  7. Groin Swelling in a Four-Year-Old Boy: Primary Great Saphenous Vein Aneurysm.

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

    2015-11-01

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

  8. Pulmonary Embolism following Endovenous Laser Ablation (EVLA of the Great Saphenous Vein

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    Nnamdi Nwaejike

    2008-08-01

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    A 70yr old lady presented to accident and emergency with sudden onset pleuritic chest pain. A pulmonary embolus (PE was diagnosed by CTPA. Ten days earlier she had bilateral EVLA for recurrent long saphenous vein disease. Confounding risk factors for pulmonary embolism included bilateral ligation and stripping of the long saphenous vein a year earlier, malignancy, EVLA and phlebitic tributary varices. EVLA has been shown to be an effective treatment for superficial venous insufficiency with low morbidity and high patient satisfaction. The investigation of confounding risk factors and possible causes should not compromise the initial treatment of PE.

  9. Mycotic aortocoronary saphenous vein graft aneurysm presenting with unstable angina pectoris.

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    Hirsch, Glenn A; Johnston, Peter V; Conte, John V; Achuff, Stephen C

    2004-10-01

    We report the case of a 60-year-old man with a history of coronary bypass surgery 20 years prior who had a fever, chest pain, and a mediastinal mass develop after a complicated postoperative course of abdominal aortic aneurysm resection. A mycotic aneurysm of the saphenous vein graft to his left anterior descending coronary artery was diagnosed based on blood culture results and visualization of the aneurysm before resection. A summary of the saphenous vein graft aneurysm and pseudoaneurysm cause, diagnosis, and management is detailed.

  10. 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.

  11. Continuous Perfusion of Saphenous Vein by Oxygenated Blood during Beating Coronary Surgery

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    Mohammad Hossein Mandegar

    2015-09-01

    Full Text Available Background: The saphenous vein remains the most commonly used conduit for coronary artery bypass surgery (CABG. However, the long-term success of surgical revascularization is largely limited by development of occlusion in vein grafts. Objectives: We sought to reduce graft ischemia by maintaining the blood flow into the harvested vein throughout surgery at lowest costs and without special devices. Patients and Methods: This study was conducted on three hundred patients aged 58.5 ± 8 years undergoing elective first-time off-pump CABG with saphenous veins. Results: In addition to preserving nutritional materials and oxygen, the veins harvested via this novel technique did not go into spasm and were not subjected to high-pressure distension, eventually resulting in minimal damage to the endothelium. Conclusions: This technique confers favorable myocardial function and protection in the presence of left ventricular dysfunction, especially in elderly patients.

  12. Decreased morbidity following long saphenous vein harvesting using a minimally invasive technique: a randomised controlled trial comparing two techniques for long saphenous vein harvest

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    Nkere Udim

    2006-06-01

    Full Text Available Abstract Objectives The objective of this study was to compare the morbidity associated with long saphenous vein harvesting using the traditional open technique (A against a minimally invasive technique using the Mayo vein stripper (B that involves multiple short incisions. Design We conducted a prospective randomized controlled study in 80 patients undergoing first time coronary artery bypass grafting. Pain and healing was assessed on each postoperative day. Rings of long saphenous vein were subjected to organ-bath evaluation of endothelium-dependent and endothelium-independent relaxation. Results Three patients were excluded from the study, leaving 38 patients in Group A and 39 in Group B. With respect to operative procedure, Group A had a greater length of vein harvested than Group B. There was no statistical difference in pain scores and endothelium-dependent or endothelium-independent relaxation between the two groups. However there were significantly more infections in Group A compared with Group B. Conclusion Harvesting vein through multiple incisions using the Mayo vein stripper is quicker, results in fewer infections and has no deleterious effect on endothelial function compared to open technique.

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

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    Lu Xiu-Gui

    2011-06-01

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

  14. Associations between flow in paratibial perforating veins and great saphenous vein patterns of reflux

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    Carlos Alberto Engelhorn

    2015-06-01

    Full Text Available Perforating veins contribute to chronic venous valvular insufficiency (CVVI, subset of CVI of lower extremities (LE. We investigated the role of medial, proximal calf paratibial perforating veins (PTPV. Women with PTPV reflux, diameter ≥3 mm, or tortuosity were selected among 2199 LE mappings. Duplex ultrasonography (US was performed standing. Reflux >0.5 s was abnormal. PTPV conditions were related to great saphenous vein (GSV patterns of reflux. US of 442 LE of 379 women were analyzed, all being Clinical-Etiology-Anatomy-Pathophysiology (CEAP classification C1, C2, and/or having intermittent, conditional swelling. Etiology was primary. Pathophysiology was reflux, not thrombosis or obstruction. Most PTPV drained (n=281, 64% of 442 or 13% of 2199, or were source (n=73, 17%/442, 3%/2199 of GSV reflux; 49 (11%/442, 2%/2199 had reflux not associated with GSV; 39 (9%/442, 2%/2199 did not have reflux. PTPV, when significative for CVVI, primarily drained-GSV reflux. PTPV was linked to reflux in 1 of 5 and was a major source of reflux in 1 of 20 legs. Detailed US of PTPV insured over 80% accuracy in CVVI mapping.

  15. The Dutch experience in percutaneous transluminal angioplasty of narrowed saphenous veins used for aortocoronary arterial bypass

    NARCIS (Netherlands)

    W.H.T. Plokker; H.J. Meester (Hannie); P.W.J.C. Serruys (Patrick)

    1991-01-01

    textabstractOf 19,994 percutaneous transluminal coronary angioplasty procedures performed in The Netherlands between April 1980 and January 1989, the long-term follow-up of 454 patients who underwent angioplasty of greater than or equal to 1 saphenous vein bypass graft was reviewed. In 46% of patien

  16. Disposal of the small saphenous vein trunks during sural neurocutaneous island flap transplantation for repairing soft tissue defects of the foot and ankle%腓肠神经营养皮瓣移植修复足踝软组织缺损中小隐静脉干的处理

    Institute of Scientific and Technical Information of China (English)

    吴文; 章莹; 夏远军; 尹飚

    2008-01-01

    背景:在临床上应用和报道中小隐静脉在皮瓣中所起的作用及血管近端蒂如何处理意见不尽一致.目的:应用腓肠神经营养血管皮瓣逆行转移修复足背、足跟及踝部软组织缺损,观察分析不同方式处理小隐静脉对皮瓣成活的影响.设计、时间及地点:病例对比观察,于1998-03/2007-04在解放军广州军区广州总医院完成.对象:将56例足背、足跟及踝部软组织缺损的患者按手术方式分为2组,结扎小隐静脉近端蒂皮瓣组38例,小隐静脉近端与受区大隐静脉或其属支吻合组18例.方法:应用腓肠神经营养血管皮瓣逆行移植修复时,皮瓣切取面积为3.5 cm×4.0 cm~4.0 cm×4.5 cm的病例35例;皮瓣切取面积为4.0cm×4.5 cm~10.0 cm×12.0 cm的病例21例.主要观察指标:不同切取面积及移植方式的皮瓣成活效果.结果:[1]皮瓣切取面积为(4.0×4.5)cm~(10.0×12.0)cm时,移植后未出现静脉危象:皮瓣切取面积为(3.5×4.0)cm~(4.0×4.5)cm时,结扎小隐静脉近端的患者中5例出现术后静脉危象.[2]在皮瓣切取面积为(3.5×4.0)cm-(4.0×4.5)cm时,移植后小隐静脉近端与受区大隐静脉或其属支吻合皮瓣出现坏死的概率低于结扎小隐静脉近端蒂皮瓣(P=0.017 67).结论:切取皮瓣面积小于(4.0×4.5)cm时,应将小隐静脉近端与受区大隐静脉或其属支吻合.小隐静脉在皮瓣中并非过路浅静脉.对皮瓣有营养作用.%BACKGROUND: Scholars disagree with each other about the small saphenous vein effects on skin flap and how to dispose vascular proximal pedicles.OBJECTIVE: To analyze effects of different methods of the small saphenous vein disposal on flap survival using sural neurocutaneous island flap retrograde metastasis for repairing defects of soft tissue of instep, heelstick and ankle.DESIGN, TIME AND SETTING: The case control observation experiment was performed at the General Hospital of Guangzhou Military Area Command of Chinese PLA

  17. Optical coherence tomography for the assessment of pericardium covered stents for the treatment of degenerated saphenous vein grafts

    NARCIS (Netherlands)

    P. Tyczynski (Pawel); N. Kukreja (Neville); R.J.M. van Geuns (Robert Jan); J.J. Wykrzykowska (Joanna); M.N. Sheppard (Mary); C. di Mario (Carlo)

    2010-01-01

    textabstractAims: Pre- and post-interventional optical coherence tomography (OCT) assessment of degenerated saphenous vein grafts (SVG) treated with implantation of pericardium covered stents. Percutaneous treatment of SVG represents one of the major challenges of current percutaneous coronary

  18. Coronary bilateral ostial enlargement using the saphenous vein in a patient with syphilitic aortitis

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    Ulisses A. Croti

    2000-02-01

    Full Text Available A patient with tertiary syphilis presenting with bilateral coronary ostial lesions and aortic regurgitation underwent surgical reconstruction of the coronary ostia by the anterior approach with autogenous saphenous vein grafting and substitution of the aortic valve with a bovine bioprosthesis. The procedure was easily performed and had good outcomes both early and late. The rarity of the association of a lesion in both coronary ostia with aortic regurgitation in syphilis and the surgical technique employed are discussed.

  19. 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.

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

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    Alvaro Delgado-Beltran

    2013-01-01

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

  1. Failure of cryopreserved saphenous vein allografts following coronary artery bypass surgery.

    Science.gov (United States)

    Sellke, F W; Stanford, W; Rossi, N P

    1991-01-01

    Internal mammary arteries and saphenous vein grafts are the most satisfactory conduits for coronary artery bypass. However, at times these conduits are not available, due to previous use or poor quality. This paper reports our experience with 6 patients who underwent coronary artery bypass operations using 10 cryopreserved saphenous veins and internal mammary arteries. Postoperative graft patency was assessed with ultra fast computed tomography or cardiac catheterization. At operation, venous graft patency was 100% (10/10), at 1-8 weeks was 60% (6/10), and at 6-30 months was 0% (0/9). Alternately, all seven internal mammary artery grafts were patent at 2 to 18 months following surgery. One patient died 6 months following operation. Poor graft patency may be related to destruction of the cellular components or fibrosis resulting from the cryopreservation process or from immunologic factors. Because of poor patency compared to autologous conduits, we conclude the use of cryopreserved saphenous veins for coronary artery bypass should be severely restricted.

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

    Science.gov (United States)

    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.

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

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    Sarac A

    2014-04-01

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

  4. 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.

  5. Transaortic Intra-Aortic Balloon Pump Catheter Insertion through a Separate Saphenous Vein Graft in Patients with Severe Aortoiliac Disease

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    Faruk Toktas

    2014-01-01

    Full Text Available Background. Intra-aortic balloon pump (IABP is the most widely used mechanical assist device for hemodynamic support in high risk patients undergoing cardiac surgery. The aim of our study was to confirm whether transaortic route is a suitable alternative to allow IABP insertion in patients with severe aortoiliac diseases. Methods. This study included 7 consecutive patients undergoing coronary artery bypass grafting for severe coronary artery disease associated with severe aortoiliac disease. These patients could not be weaned from cardiopulmonary bypass and required the IABP support, which were placed through the ascending aorta. IABP catheter was inserted indirectly through a separate saphenous vein graft anastomosed to the ascending aorta by an end-to-side manner under a partial occluding clamp and advanced to the desired position in the descending thoracic aorta and exteriorly brought into the subcutaneous tissues in the jugulum. Results. The procedure was successfully performed in all the patients. The mean duration of IABP support was 54.0±13.4 hours. There were no in-hospital mortality and complications related to transaortic route. IABP removal did not require repeat sternotomy. At postoperative 6th month, multislice CT examination showed thrombotic occlusion at the remnant of the saphenous vein graft. Conclusions. This technique is a simple, reliable, and reproducible option in patients with severe aortoiliac disease in whom retrograde femoral route is not possible.

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

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    Ferguson Graeme

    2010-05-01

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

  7. Comparing frozen saphenous vein with Gore-tex in vascular access for chronic hemodialysis.

    Science.gov (United States)

    Mousavi, Seyed Reza; Moatamedi, Mohammad Reza Kalantar; Me Akbari, Mohamad

    2011-10-01

    Performing chronic hemodialysis in patients suffering from end-stage renal disease needs a suitable vascular access like arteriovenous fistula in the upper limbs and bridge fistula in the upper or lower limbs, and also use of permanent and temporary catheters. The purpose of this study is to compare frozen saphenous vein versus using synthetic Gore-tex vascular graft for A-V fistula. In the prospective randomized study, 70 patients needing for dialysis access were randomly divided into two groups. We performed the frozen saphenous vein A-V fistula in the test group and the Gore-tex fistula in the control group. An assessment included function criteria (fistula thrill and murmur) and complications (infection and thrombosis) in planned intervals. At the end of the follow-up period, the flow rates of all fistulas were assessed by Doppler sonography. The data were compared. Comparing the function criteria (fistula murmur and thrill) and the flow rate of the test group (frozen saphenous A-V fistula) and the control group (Gore-tex method) showed no significant difference and also no significant difference between two groups in thrombosis. Infection rate of the Gore-tex method was significantly high (p Gore-tex arteriovenous graft in some aspects. © 2011 The Authors; Hemodialysis International © 2011 International Society for Hemodialysis.

  8. Reverse Regulatory Pathway (H2S / PGE2 / MMP in Human Aortic Aneurysm and Saphenous Vein Varicosity.

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    Ingrid Gomez

    Full Text Available Hydrogen sulfide (H2S is a mediator with demonstrated protective effects for the cardiovascular system. On the other hand, prostaglandin (PGE2 is involved in vascular wall remodeling by regulating matrix metalloproteinase (MMP activities. We tested the hypothesis that endogenous H2S may modulate PGE2, MMP-1 activity and endogenous tissue inhibitors of MMPs (TIMP-1/-2. This regulatory pathway could be involved in thinning of abdominal aortic aneurysm (AAA and thickening of saphenous vein (SV varicosities. The expression of the enzyme responsible for H2S synthesis, cystathionine-γ-lyase (CSE and its activity, were significantly higher in varicose vein as compared to SV. On the contrary, the endogenous H2S level and CSE expression were lower in AAA as compared to healthy aorta (HA. Endogenous H2S was responsible for inhibition of PGE2 synthesis mostly in varicose veins and HA. A similar effect was observed with exogenous H2S and consequently decreasing active MMP-1/TIMP ratios in SV and varicose veins. In contrast, in AAA, higher levels of PGE2 and active MMP-1/TIMP ratios were found versus HA. These findings suggest that differences in H2S content in AAA and varicose veins modulate endogenous PGE2 production and consequently the MMP/TIMP ratio. This mechanism may be crucial in vascular wall remodeling observed in different vascular pathologies (aneurysm, varicosities, atherosclerosis and pulmonary hypertension.

  9. Reverse Regulatory Pathway (H2S / PGE2 / MMP) in Human Aortic Aneurysm and Saphenous Vein Varicosity.

    Science.gov (United States)

    Gomez, Ingrid; Ozen, Gulsev; Deschildre, Catherine; Amgoud, Yasmine; Boubaya, Lilia; Gorenne, Isabelle; Benyahia, Chabha; Roger, Thomas; Lesèche, Guy; Galardon, Erwan; Topal, Gokce; Jacob, Marie-Paule; Longrois, Dan; Norel, Xavier

    2016-01-01

    Hydrogen sulfide (H2S) is a mediator with demonstrated protective effects for the cardiovascular system. On the other hand, prostaglandin (PG)E2 is involved in vascular wall remodeling by regulating matrix metalloproteinase (MMP) activities. We tested the hypothesis that endogenous H2S may modulate PGE2, MMP-1 activity and endogenous tissue inhibitors of MMPs (TIMP-1/-2). This regulatory pathway could be involved in thinning of abdominal aortic aneurysm (AAA) and thickening of saphenous vein (SV) varicosities. The expression of the enzyme responsible for H2S synthesis, cystathionine-γ-lyase (CSE) and its activity, were significantly higher in varicose vein as compared to SV. On the contrary, the endogenous H2S level and CSE expression were lower in AAA as compared to healthy aorta (HA). Endogenous H2S was responsible for inhibition of PGE2 synthesis mostly in varicose veins and HA. A similar effect was observed with exogenous H2S and consequently decreasing active MMP-1/TIMP ratios in SV and varicose veins. In contrast, in AAA, higher levels of PGE2 and active MMP-1/TIMP ratios were found versus HA. These findings suggest that differences in H2S content in AAA and varicose veins modulate endogenous PGE2 production and consequently the MMP/TIMP ratio. This mechanism may be crucial in vascular wall remodeling observed in different vascular pathologies (aneurysm, varicosities, atherosclerosis and pulmonary hypertension).

  10. 5-Hydroxytryptamine(1F) receptors do not participate in vasoconstriction: lack of vasoconstriction to LY344864, a selective serotonin(1F) receptor agonist in rabbit saphenous vein.

    Science.gov (United States)

    Cohen, M L; Schenck, K

    1999-09-01

    Recently, several novel approaches to the treatment of migraine have been advanced, including selective 5-hydroxytryptamine (or serotonin) 1B/1D (5-HT(1B/1D)) receptor agonists such as sumatriptan and 5-HT(1F) receptor agonists such as LY344864. Many 5-HT(1B/1D) receptor agonists have been identified based on their ability to produce cerebral vascular contraction, whereas LY344864 was identified as an inhibitor of trigeminal nerve-mediated dural extravasation. In our study, several triptan derivatives were compared with LY344864 for their ability to contract the rabbit saphenous vein, a tissue used in the preclinical identification of sumatriptan-related agonists. Sumatriptan, zolmitriptan, rizatriptan, and naratriptan all contracted the rabbit saphenous vein from baseline tone, whereas LY344864 in concentrations up to 10(-4) M did not contract the rabbit saphenous vein. Furthermore, vascular contractions to sumatriptan were markedly augmented in the presence of prostaglandin F(2alpha) (PGF(2alpha)). However, even in the presence of PGF(2alpha) (3 x 10(-7) M), LY344864 did not contract the rabbit saphenous vein in concentrations well in excess of its 5-HT(1F) receptor affinity (pK(i) = 8.2). Only when concentrations exceeded those likely to activate 5-HT(1B) and 5-HT(1D) receptors (>10(-5) M) did modest contractile responses occur in the presence of PGF(2alpha). Use of these serotonergic agonists revealed a significant correlation between the contractile potency in the rabbit saphenous vein and the affinities of these agonists at 5-HT(1B) and 5-HT(1D) receptors, although contractile agonist potencies were not quantitatively similar to 5-HT(1B) or 5-HT(1D) receptor affinities. In contrast, no significant correlation existed between the contractile potencies of these serotonergic agonists in the rabbit saphenous vein and their affinity at 5-HT(1F) receptors. These data support the contention that activation of 5-HT(1F) receptors will not result in vascular

  11. 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...

  12. Radiofrequency ablation of varicose veins improves venous clinical severity score despite failure of complete closure of the saphenous vein after 1 year

    Directory of Open Access Journals (Sweden)

    Hyeong Yong Jin

    2017-01-01

    Conclusion: In this study, RFA of varicose veins had an initial success rate of 97.7% and a significantly improved patient VCSS at 1 year. Patients with episodic recanalization of the saphenous vein also exhibited an improved VCSS with favorable duplex findings at 1 year.

  13. Conventional surgery and endovenous laser ablation of recurrent varicose veins of the small saphenous vein: a retrospective clinical comparison and assessment of patient satisfaction.

    NARCIS (Netherlands)

    Groenendael, L. van; Flinkenflogel, L.; Vliet, J.A. van der; Roovers, E.A.; Sterkenburg, S.M. van; Reijnen, M.M.P.J.

    2010-01-01

    OBJECTIVES: Recurrences of varicosities of the small saphenous vein (SSV) are common. Surgical reintervention is associated with increased complication rates. The aim of the study was to assess the feasibility of endovenous laser ablation (EVLA) in recurrent varicose veins of the SSV and to compare

  14. [Surgical technique of saphenous vein harvesting using a Cusco vaginal speculum].

    Science.gov (United States)

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

    2014-11-01

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

  15. [Minimally invasive technique for harvesting a saphenous vein via one small incision].

    Science.gov (United States)

    Sato, M; Suenaga, E; Koga, S; Matsuyama, S

    2007-08-01

    We report a minimally invasive technique for harvesting a saphenous vein graft (SVG) via 1 small skin incision. The expected advantages of this technique are better cosmetic results and fewer wound complications than the conventional open technique or the bridging technique. The SVG, 10-15 cm in length, can be harvested by about 3 cm-long single small skin incision. SaphLITE Retractor System (Genzyme Srugical Products, Cambridge), SLS Hematostatic Clip System (Vitalitec International, Plymouth), and curved scissors were necessary instruments for this technique. It is feasible for cases that require a shorter length of SVG.

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

    Science.gov (United States)

    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 E2 (PGE2) and İnterleukine-8 (IL-8) in the supernatant were measured. ATG significantly decreased vascular contractile response to NE. Moreover, it reduced contractions induced by KCl and cumulative addition of CaCl2. The mediators were significantly increased in inflammatory conditions compared to normal conditions, an effect which was inhibited by ATG (10 and 100µM). ATG reduces contractions in SV and decreases the production of proinflammatory-proatherogenic mediators, setting the stage for further evaluating the effect of ATG in cardiovascular diseases. Copyright © 2017 Elsevier B.V. All rights reserved.

  17. Clinical Features of Primary Vein Grafts in Free Tissue Transfers

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    Mitsuru Nemoto

    2015-01-01

    Full Text Available The outcomes of free tissue transfers combined with vein grafts have been inconsistent, and discussions continue regarding their appropriate use. Of the 142 free tissue transfers that we performed from January 2004 to December 2011, we retrospectively analyzed 15 consecutive patients who underwent free tissue transfers in combination with vein grafts. Etiologies included trauma (8 patients, infection (4, and tumor (3. Types of free tissue transfers were fibula (4, anterolateral thigh (3, groin (3, jejunum (3, latissimus dorsi (1, and dorsal pedis (1. Vein grafts were used for the artery (6, vein (2, or both (7. The donor veins were the saphenous vein (12 and the external jugular vein (3. The mean length of the grafted veins was 10.8 cm (range: 4–18 cm. Even though complications of congestion occurred in 2 patients, these flaps survived by reexploration. The flap success rate was 15 of 15 (100% of vein grafted free flaps versus 124 of 127 (97.6% of free flaps not requiring vein grafts. To improve the success rate of free tissue transfers combined with vein grafts, securing healthy recipient vessels, meticulous surgical handling, a reliable vascular anastomosis technique, and strict postoperative monitoring are crucial.

  18. Sequential saphenous vein grafting combined with selective arterialization of middle cardiac vein during off-pump coronary artery bypass surgery

    Institute of Scientific and Technical Information of China (English)

    YU Yang; QI Dan-ni; GU Cheng-xiong

    2010-01-01

    @@ Currently coronary artery bypass grafting (CABG) is the most commonly used procedure for revascularization of coronary heart disease. However it may not be suitable for the patients with diffuse coronary artery diseases. Under this circumstance, retrograde perfusion via cardiac venous system, namely retrograde coronary venous bypass graft (CVBG), may be the proper therapeutic selection.1 The idea of myocardial revascularization by means of grafting the coronary venous system is more than a century old. However, few clinical trials and long-term outcome data have been presented. The use of venous arterialization has not been widely used. We report the use of a sequential saphenous vein graft from the aorta to middle cardiac vein in a patient with diffuse lesions in right coronary artery during off-pump coronary artery bypass surgery (OPCAB).

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

    Directory of Open Access Journals (Sweden)

    Rishi Nayyar

    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.

  20. Giant saphenous vein graft pseudoaneurysm to right posterior descending artery presenting with superior vena cava syndrome

    Institute of Scientific and Technical Information of China (English)

    Andres; Vargas-Estrada; Dianna; Edwards; Mohammad; Bashir; James; Rossen; Firas; Zahr

    2015-01-01

    Saphenous vein grafts(SVG) pseudoaneurysms,especially giant ones,are rare and occur as a late complication of coronary artery bypass grafting. This condition affects both genders and typically occurs within the sixth decade of life. The clinical presentation ranges from an asymptomatic incidental finding on imaging studies to new onset angina,dyspnea,myocardial infarction or symptoms related to compression of neighboring structures. An 82-year-old woman presented with acute onset back pain,dyspnea and was noted to have significantly engorged neck veins. In the emergency department,a chest computed tomographic angiogram with intravenous contrast revealed a ruptured giant bilobed SVG pseudoaneurysm to the right posterior descending artery(RPDA). This imaging modality also demonstrated compression of the superior vena cava(SVC) by the SVG pseudoaneurysm. Coronary angiogram with bypass study was performed to establish the patency of this graft. Endovascular coiling and embolization of the SVG to RPDA was initially considered but disfavored after the coronary angiogram revealed preserved flow from the graft to this arterial branch. After reviewing the angiogram films,a surgical strategy was favored over a percutaneous intervention with a Nitinol self-expanding stent since the latter would have not addressed the superior vena cava compression caused by the giant pseudoaneurysm. Intraoperative transesophageal echocardiogram demonstrated SVCcompression by the giant pseudoaneurysm cranial lobe. Our patient underwent surgical ligation and excision of the giant pseudoaneurysm and the RPDA was regrafted successfully. In summary,saphenous vein grafts pseudoaneurysms can be life-threatening and its therapy should be guided based on the presence of mechanical complications,the patency of the affected vein graft and the involved myocardial territory viability.

  1. Endovenous ablation of incompetent saphenous veins with a new 1,540-nanometer diode laser and ball-tipped fiber.

    Science.gov (United States)

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

    2014-04-01

    Endovenous laser ablation (EVLA) is an efficient method to treat incompetent saphenous veins with high occlusion rates. The major side effects are postoperative pain and bruising. Laser systems with higher wavelengths, associated with new energy delivery devices, have recently shown excellent short-term results, while reducing the previously reported side effects. The aim of this study is to show the first outcome after EVLA of incompetent saphenous veins with a newly developed ball-tipped fiber and a new wavelength 1,540-nm diode laser. Forty-five incompetent saphenous veins in 35 patients (27 women) were treated: 33 great saphenous veins, 6 short saphenous veins, and 6 anterior saphenous veins. The gravity of chronic venous disease was determined according to the clinical-etiology-anatomy-pathophysiology (CEAP) classification, and the severity of symptoms was scored according to the revised Venous Clinical Severity Score. Patient satisfaction was assessed on a 0-3 scale. The average linear endovenous energy density was 63.5 J/cm of vein length. Patients returned to daily activities after a mean of 1.7 days (SD: 2) after treatment. The modified CEAP clinical severity score improved drastically from a preintervention mean of 4.9 (SD: 2.6) to 0.17 (SD: 0.38) at day 30. During the follow-up period (mean: 168 days [range: 90-240 days]), all the veins were occluded. All patients except 1 were satisfied or very satisfied with the method. No severe complications occurred. Two patients (5%) developed mild paresthesia in the treated area, which spontaneously resolved after 3 months. Postoperative ecchymoses are frequent (83%). Sixteen patients (43%) experienced pain, but only 5 patients (14%) described it as quite intense and required analgesic therapy. EVLA of saphenous veins with a 1,540-nm diode laser using a ball-tipped fiber is a safe and efficient therapy option, with a high success rate in the early postoperative period. Copyright © 2014 Elsevier Inc. All rights

  2. 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

  3. Nature and origin of the neointima in whole vessel wall organ culture of the human saphenous vein

    NARCIS (Netherlands)

    Slomp, J.; Gittenberger - Groot, A.C. de; Munsteren, J.C. van; Huysmans, H.A.; Bockel, J.H. van; Hinsbergh, V.W.M. van; Poelmann, R.E.

    1996-01-01

    Intimal proliferation is a characteristic feature of arteriosclerosis. Whole vessel wall organ culture systems have been developed to study the early stages of neointima formation. We have cultured a large number of explants of human saphenous vein specimens for several weeks, and have identified th

  4. Ultrasound-guided foam sclerotherapy of great saphenous vein with 2% polidocanol – one-year follow-up results

    Science.gov (United States)

    Osęka, Marcin; Tworus, Robert; Gałązka, Zbigniew

    2016-01-01

    Introduction Ultrasound-guided foam sclerotherapy (UGFS) of varicose veins is a useful treatment option. It is a relatively safe method in the case of limited, small varicose veins. In theory, a justified concern could be raised that the injection of an active drug into the large superficial venous vessels may potentially cause life-threatening consequences. Aim To assess the safety and efficacy of UGFS using a 2% solution of polidocanol (Aethoxysklerol 2%) in the case of great saphenous vein incompetence. Material and methods Fifty-two patients with great saphenous vein incompetence underwent ultrasound-guided foam sclerotherapy. The efficacy criterion was the elimination of reflux measured ultrasonographically and withdrawal or decrease of complaints: 1 week, and 1, 3, 6 and 12 months after the treatment. Complications of sclerotherapy were reported during follow-up. Results Decrease or withdrawal of complaints of chronic venous insufficiency was reported in 96% of cases (50 patients). Disappearance or decrease of varicose veins was noted in all patients (100%). During examination after 12 months, full success of ultrasound was achieved in 38 (73%) cases, and 11 (21%) patients presented a partial desired effect according to the consensus from Tegernsee. Persistence of reflux longer than 1 s in the treated great saphenous vein was reported in 3 (6%) cases. Serious complications, such as deep vein thrombosis, pulmonary embolism, dyspnea, anaphylaxis, or neurological abnormalities, were not recorded. Conclusions Ultrasound-guided foam sclerotherapy of incompetent great saphenous vein and varicosities with 2% polidocanol was found to be an effective and safe method of treatment during 1 year of observation. However, longer observation is necessary. PMID:27458485

  5. Endovenous laser ablation of great saphenous veins performed using tumescent cold saline solution without local anesthesia.

    Science.gov (United States)

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

    2014-05-01

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

  6. The sural nerve: Sonographic anatomy, variability and relation to the small saphenous vein in the setting of endovenous thermal ablation.

    Science.gov (United States)

    Rodriguez-Acevedo, Omar; Elstner, Kristen; Zea, Aaron; Diaz, Jenny; Martinic, Kui; Ibrahim, Nabeel

    2017-02-01

    Background Neurological complications are well documented in association with both surgical stripping or disconnection and thermal ablation of the small saphenous vein. The sural nerve (medial sural cutaneous nerve) is most vulnerable due to its close relationship to the small saphenous vein. Objective This is a cross-sectional observational study of the sonographic anatomy of 115 Australian patients to determine the course of the sural nerve and its relationship to the small saphenous vein, and to identify its relevance in the thermal ablation of the small saphenous vein. Method Sonographic mapping of the right sural nerve was performed with a Philips L12.5 and Sonosite 10.5 MHz ultrasound machine on 115 patients. The sural nerve was traced proximally from the level of the lateral malleolus to the popliteal fossa in order to measure its distance from the small saphenous vein at four reference points in the lower leg. Results A total of 115 patients were studied (females 82, males 33). The sural nerve was identified in 100% of patients; 64 patients (55.7%) showed usual sural nerve anatomy, while 51 patients (44.3%) demonstrated a range of anatomical variations, including the sural nerve becoming epifascial at a higher point than usual. Conclusion The sural nerve was identifiable on duplex ultrasound in 100% of cases. Classic anatomical relations and the perceived protection of the sural nerve conferred by the deep fascia of the upper calf are unreliable. Preoperative strategies can help to approach and protect the sural nerve in the endovenous ablation setting.

  7. New device for saphenous vein-to-aorta proximal anastomosis without side-clamping

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    Tappainer Ernesto

    2007-05-01

    Full Text Available Abstract Background Side clamping to perform saphenous vein-to-aorta proximal anastomosis is a well known cause of cerebral embolization during coronary bypass surgery. Automatic and manual devices have been introduced to avoid aortic clamping and facilitate proximal anastomosis but the manual ones only allow the traditional hand-sewing running suture. Nevertheless, they are not easy to use and very expensive to buy. Methods We developed a simple object that helps to perform a manual proximal anastomosis without the need to clamp the side of the aorta. This device is a steel bar which blocks the aortic hole and simultaneously it provides a slit to receive the needle. Through the slit comes out a thin, sharp, straight, but also well directed and predictable jet of blood which could be easily controlled during the suture. Results The function of the object is quite different from other devices. Nothing is deployed in the aorta. The object is only placed on the aorta with the small appendage slipped into the hole. The main advantage of the device is that while manipulation of the aorta is avoided no foreign bodies are incorporated in the suture and – most importantly – the aortic intima is not touched at all. The main drawback of the device is the blood jet coming from the slit so that the blood pressure has to be lowered by vasodilators during the anastomosis. Moreover, the suture has to change direction and the needle has to enter the aortic wall first to slip out through the slit. Conclusion The object was named "Slit Device" and is not a routine instrument. It would be only an alternative to other anastomotic devices with the same surgical indications. In the case of ascending aortic disease and saphenous vein grafting, the Slit Device avoids aortic clamping thereby preventing atheroembolism and also avoiding the need for hypothermic circulatory arrest in patients with unclampable aorta.

  8. Safety and Effectiveness of Endovenous Laser Ablation Combined With Ligation for Severe Saphenous Varicose Veins in Japanese Patients.

    Science.gov (United States)

    Izumi, Masafumi; Ikeda, Yuichi; Yamashita, Hiroharu; Asaoka, Yoshinari; Fujishiro, Mitsuhiro; Shin, Masahiro; Abo, Yoshihisa

    2016-01-01

    Endovenous laser ablation (EVLA), which is a relatively new therapeutic option for saphenous varicose veins of the legs, is less invasive than conventional stripping surgery with ligation. In this study, we evaluated the safety and effectiveness of EVLA combined with ligation for severe saphenous varicose veins that were graded as ≥ C4 by the CEAP classification. We treated 119 Japanese patients (141 limbs) between July 2005 and December 2007 utilizing a 1320-nm Nd:YAG laser. The obliteration rate of the treated veins was found to be 100% over the entire follow-up period (2.5 years). Consistent with this finding, all of the patients exhibited improved skin lesions (ie, skin pigmentation and ulceration). No major complications, including deep vein thrombosis (DVT) and nerve injury, were observed. A questionnaire survey with a reasonable response rate (66.4%) demonstrated that subjective symptoms and minor complications that were initially observed after EVLA, such as mild pain, numbness, indurations, and localized hot flashes, were remarkably improved by the end of the follow-up period. Furthermore, high levels of patient satisfaction were noted. Thus, EVLA combined with ligation constituted a safe and effective strategy for treating severe saphenous varicose veins in Japanese patients.

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

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    Davidović Lazar B.

    2004-01-01

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

  10. Mechanochemical endovenous Ablation versus RADiOfrequeNcy Ablation in the treatment of primary great saphenous vein incompetence (MARADONA) : study protocol for a randomized controlled trial

    NARCIS (Netherlands)

    van Eekeren, Ramon R. J. P.; Boersma, Doeke; Holewijn, Suzanne; Vahl, Anco; de Vries, Jean Paul P. M.; Zeebregts, Clark J.; Reijnen, Michel M. P. J.

    2014-01-01

    Background: Radiofrequency ablation (RFA) is associated with an excellent outcome in the treatment of great saphenous vein (GSV) incompetence. The use of thermal energy as a treatment source requires the instillation of tumescence anesthesia. Mechanochemical endovenous ablation (MOCA) combines

  11. Mechanochemical endovenous Ablation versus RADiOfrequeNcy Ablation in the treatment of primary great saphenous vein incompetence (MARADONA) : study protocol for a randomized controlled trial

    NARCIS (Netherlands)

    van Eekeren, Ramon R. J. P.; Boersma, Doeke; Holewijn, Suzanne; Vahl, Anco; de Vries, Jean Paul P. M.; Zeebregts, Clark J.; Reijnen, Michel M. P. J.

    2014-01-01

    Background: Radiofrequency ablation (RFA) is associated with an excellent outcome in the treatment of great saphenous vein (GSV) incompetence. The use of thermal energy as a treatment source requires the instillation of tumescence anesthesia. Mechanochemical endovenous ablation (MOCA) combines mecha

  12. Aberrant Phenotype in Human Endothelial Cells of Diabetic Origin: Implications for Saphenous Vein Graft Failure?

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    Anna C. Roberts

    2015-01-01

    Full Text Available Type 2 diabetes (T2DM confers increased risk of endothelial dysfunction, coronary heart disease, and vulnerability to vein graft failure after bypass grafting, despite glycaemic control. This study explored the concept that endothelial cells (EC cultured from T2DM and nondiabetic (ND patients are phenotypically and functionally distinct. Cultured human saphenous vein- (SV- EC were compared between T2DM and ND patients in parallel. Proliferation, migration, and in vitro angiogenesis assays were performed; western blotting was used to quantify phosphorylation of Akt, ERK, and eNOS. The ability of diabetic stimuli (hyperglycaemia, TNF-α, and palmitate to modulate angiogenic potential of ND-EC was also explored. T2DM-EC displayed reduced migration (~30% and angiogenesis (~40% compared with ND-EC and a modest, nonsignificant trend to reduced proliferation. Significant inhibition of Akt and eNOS, but not ERK phosphorylation, was observed in T2DM cells. Hyperglycaemia did not modify ND-EC function, but TNF-α and palmitate significantly reduced angiogenic capacity (by 27% and 43%, resp., effects mimicked by Akt inhibition. Aberrancies of EC function may help to explain the increased risk of SV graft failure in T2DM patients. This study highlights the importance of other potentially contributing factors in addition to hyperglycaemia that may inflict injury and long-term dysfunction to the homeostatic capacity of the endothelium.

  13. Aberrant phenotype in human endothelial cells of diabetic origin: implications for saphenous vein graft failure?

    Science.gov (United States)

    Roberts, Anna C; Gohil, Jai; Hudson, Laura; Connolly, Kyle; Warburton, Philip; Suman, Rakesh; O'Toole, Peter; O'Regan, David J; Turner, Neil A; Riches, Kirsten; Porter, Karen E

    2015-01-01

    Type 2 diabetes (T2DM) confers increased risk of endothelial dysfunction, coronary heart disease, and vulnerability to vein graft failure after bypass grafting, despite glycaemic control. This study explored the concept that endothelial cells (EC) cultured from T2DM and nondiabetic (ND) patients are phenotypically and functionally distinct. Cultured human saphenous vein- (SV-) EC were compared between T2DM and ND patients in parallel. Proliferation, migration, and in vitro angiogenesis assays were performed; western blotting was used to quantify phosphorylation of Akt, ERK, and eNOS. The ability of diabetic stimuli (hyperglycaemia, TNF-α, and palmitate) to modulate angiogenic potential of ND-EC was also explored. T2DM-EC displayed reduced migration (~30%) and angiogenesis (~40%) compared with ND-EC and a modest, nonsignificant trend to reduced proliferation. Significant inhibition of Akt and eNOS, but not ERK phosphorylation, was observed in T2DM cells. Hyperglycaemia did not modify ND-EC function, but TNF-α and palmitate significantly reduced angiogenic capacity (by 27% and 43%, resp.), effects mimicked by Akt inhibition. Aberrancies of EC function may help to explain the increased risk of SV graft failure in T2DM patients. This study highlights the importance of other potentially contributing factors in addition to hyperglycaemia that may inflict injury and long-term dysfunction to the homeostatic capacity of the endothelium.

  14. 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

  15. Huge saphenous vein graft aneurysm presenting as non-ST elevation myocardial infarction and compressing the heart.

    Science.gov (United States)

    Zencir, Cemil; Akpek, Mahmut; Onay, Sevil; Selvi, Mithat

    2016-09-01

    Coronary artery bypass grafting (CABG) surgery maintains an important role in the treatment of coronary artery disease. The huge saphenous vein graft aneurysm (HSVGA) is rare and occurs as a late complication after CABG. Here, we reported a case of HSVGA presenting as non-ST elevation myocardial infarction. Copyright © 2015 Cardiological Society of India. Published by Elsevier B.V. All rights reserved.

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

    Directory of Open Access Journals (Sweden)

    Kerim Çağlı

    2011-12-01

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

  17. Identification and characterization of (/sup 3/H)-rauwolscine binding to alpha2-adrenoceptors in the canine saphenous vein

    Energy Technology Data Exchange (ETDEWEB)

    Gout, B.

    1988-01-01

    The biochemical exploration of the alpha2-adrenergic receptors was investigated in the canine saphenous vein using the highly selective alpha2-adrenergic antagonist rauwolscine as a tritiated ligand. Following an enzymatic digestive pretreatment, the authors isolated a purified smooth muscle cell membranes fraction from saphenous veins in quantity sufficient to permit them to study the venous alpha2-adrenoreceptor content. The binding of tritiated rauwolscine was rapid, specific, saturable and reversible. The presence of high affinity sites with a density of binding Bmax of 125.2 /+ -/ 43.1 fmol/mg protein was demonstrated on a unique class of non interacting sites. The kinetically derived Kd was 1.28 nM, in good agreement with the value obtained from saturation isotherms. The pharmacological profile of these sites was assessed by the comparison of the potency of alpha-adrenergic agonists and antagonists to inhibit 1 nM (/sup 3/H)-rauwolscine. Their efficacy was respectively: rauwolscine > phentolamine > RX 781094 > clonidine >> prazosin > (-)-phenylephrine > (-)-noradrenaline. The results showed that (/sup 3/H)-rauwolscine bound specifically to sites in their membranal preparation, which had the pharmacological characteristics of the alpha2-adrenoceptors. The correlation between biochemical and pharmacological data revealed the usefulness of binding methods in the further study of adrenergic mechanisms in the canine saphenous vein.

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

    Directory of Open Access Journals (Sweden)

    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

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

    Energy Technology Data Exchange (ETDEWEB)

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

    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.

  20. 带小隐静脉-腓肠神经营养血管的筋膜瓣修复足踝组织缺损%Repairing tissue defects in ankle and foot with lesser saphenous vein-sural neurovascular fascial flap

    Institute of Scientific and Technical Information of China (English)

    李永宁; 邵明

    2011-01-01

    目的 探讨应用带小隐静脉-腓肠神经营养血管的筋膜瓣逆行转移修复足踝部软组织缺损的手术方法和临床效果.方法 2007年3月至2010年12月收治29例足踝部软组织缺损患者,在患肢小腿后外侧选择性切开,向远端游离筋膜瓣至外踝尖上约5 cm并以此为旋转点,逆行转移筋膜瓣覆盖足踝软组织缺损区,术中切取筋膜瓣范围约为5 cm×4 cm~14 cm×12 cm,供区直接缝合,蒂根部及筋膜瓣表面游离植皮修复.结果 随访5个月至3年,术后29例筋膜瓣全部成活,仅2例筋膜瓣远端局部回流障碍,浅表组织坏死,经抗感染治疗后愈合,供区Ⅰ期愈合,所有患者皮瓣外形及功能良好,质地柔软,色泽与受区接近,无局限性臃肿,筋膜瓣受力处无破溃,足部功能恢复良好.结论带小隐静脉-腓肠神经营养的逆行筋膜瓣手术方法简单,抗感染能力强,修复组织缺损效果满意.%Objective To investigate the operative technique and clinical results of repairing soft tissue defects of the ankle and foot with reverse extended repair lesser saphenous vein-sural neurovascular fascial flap. Methods In the crural rearselective incision, free fascia flap was corresponded to the palpable posterior border of the fibula when mapped to the surface. The pivot point was placed at the level of the ankle joint distally, repairing soft tissue defects of the ankle and foot with reverse extended repair nutrition fasciall flap. The flaps were designed with the size of 5 cm x 4 cm-14 cm x 12 cm. Donor sites were directy sutured. The surface of roots and fascia flap were repaired by pedicled skin graft. Results Followingup from 5 months to 2 years all 22 adipofascial flap survived after surgery. Partial inadequate venous return and distal superficial necrosis happened in only 2 cases, which also got secondary healing by anti-infective therapy. The donor sites reached primary healing completely. Appearance and function of the flaps

  1. A kinetic study of the ouabain-induced efflux of norepinephrine from the dog saphenous vein

    Energy Technology Data Exchange (ETDEWEB)

    Monteiro, J.G. (Laboratorio de Farmacologia, Faculdade de Medicina, Porto (Portugal))

    1991-07-01

    Dog saphenous vein strips were incubated with (3H)norepinephrine ((3H)NE), 1.4 microM, after inhibition of the NE-metabolizing enzymes and extraneuronal uptake, and superfused for up to 290 min. From the 70th min onwards the strips were exposed to 10 microM ouabain, some of them being subject to electrical stimulation from the 140th min onwards. Other strips were exposed to either 1, 10 or 100 microM ouabain from the 70th min onwards. The spontaneous efflux of (3H)NE had a long half-time (156 min), and over 90% of the (3H)NE accumulated did not participate in efflux (bound fraction). Ouabain, 10 microM, induced a pronounced increase of the rate of efflux of (3H)NE, which was delayed in its onset and reached a maximum at t = 135 min of superfusion. Increasing the concentration of ouabain decreased both the delay to the beginning of the overflow and the time to maximum efflux and increased the maximum rate of efflux. In Ca(++)-free medium (during the superfusion period), the maximum rate of efflux was lower than in Ca(++)-containing medium, but was attained earlier. The bound fraction amounted to 22% when the efflux was induced by 10 microM ouabain in Ca(++)-containing medium, a value unnaffected by electrical stimulation but reduced markedly by omitting calcium. The results support the view that the efflux of (3H)NE induced by ouabain is delayed and that it is both carrier-mediated and due to exocytosis.

  2. Piglet saphenous vein contains multiple relaxatory prostanoid receptors: evidence for EP4, EP2, DP and IP receptor subtypes

    OpenAIRE

    Wilson, Richard J; Giles, Heather

    2005-01-01

    Prostaglandin E2 produced endothelium-independent relaxation of phenylephrine- and 5-HT-contracted piglet saphenous vein (PSV; pEC50=8.6±0.2; n=6).The prostanoid EP4 receptor antagonist GW627368X (30–300 nM) produced parallel rightward displacement of PGE2 concentration–effect (E/[A]) curves (pKb=9.2±0.2; slope=1). Higher concentrations of GW627368X did not produce further rightward shifts, revealing the presence of non-EP4 prostanoid receptors.In all, 18 other prostanoid receptor agonists re...

  3. Inhibition of noradrenaline release from the sympathetic nerves of the human saphenous vein by presynaptic histamine H3 receptors.

    Science.gov (United States)

    Molderings, G J; Weissenborn, G; Schlicker, E; Likungu, J; Göthert, M

    1992-07-01

    The human saphenous vein was used to examine whether presynaptic histamine receptors can modulate noradrenaline release and, if so, to determine their pharmacological characteristics. Strips of this blood vessel were incubated with [3H]noradrenaline and subsequently superfused with physiological salt solution containing desipramine and corticosterone. Electrically (2 Hz) evoked 3H overflow was inhibited by histamine and the H3 receptor agonist R-(-)-alpha-methylhistamine. Histamine-induced inhibition of electrically evoked tritium overflow was not affected by alpha 2-adrenoceptor blockade by rauwolscine. S-(+)-alpha-methylhistamine (up to 10 mumol/l) as well as the histamine H1 and H2 receptor agonists 2-(2-thiazolyl)ethylamine (up to 3 mumol/l) and dimaprit (up to 30 mumol/l), respectively, were ineffective. The selective histamine H3 receptor antagonist thioperamide abolished the inhibitory effect of histamine. The histamine H2 and H1 receptor antagonists ranitidine and pheniramine, respectively, did not affect the histamine-induced inhibition of evoked tritium overflow. The present results are compatible with the suggestion that the sympathetic nerves of the human saphenous vein are endowed with inhibitory presynaptic histamine receptors of the H3 class.

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

    Energy Technology Data Exchange (ETDEWEB)

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

    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.

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

    Science.gov (United States)

    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...

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

    Directory of Open Access Journals (Sweden)

    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.

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

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    Sanjiv Choudhary

    2016-01-01

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

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

    Science.gov (United States)

    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 < 0.001) and pain (5th day) (1.00 vs. 2.00; p < 0.001) and had a better postoperative quality of life (27 vs. 32; p = 0.023). There was no difference in analgesic intake (p = 0.11) and patient satisfaction rate (p = 0.564). The total occlusion rate at 1 year was 97.02% and there was no significant difference between the two groups (p = 0.309). Using a 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.

  9. A comparative study on the mechanical properties of the healthy and varicose human saphenous vein under uniaxial loading.

    Science.gov (United States)

    Karimi, Alireza; Navidbakhsh, Mahdi; Kudo, Susumu

    2015-01-01

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

  10. Mapping of Autogenous Saphenous Veins as an Imaging Adjunct to Peripheral MR Angiography in Patients with Peripheral Arterial Occlusive Disease and Peripheral Bypass Grafting: Prospective Comparison with Ultrasound and Intraoperative Findings

    OpenAIRE

    Ann-Marie Bintu Munda Jah-Kabba; Guido Matthias Kukuk; Dariusch Reza Hadizadeh; Frank Träber; Arne Koscielny; Mustapha Sundifu Kabba; Frauke Verrel; Hans Heinz Schild; Winfried Albert Willinek

    2014-01-01

    BACKGROUND: Mapping of the great saphenous vein is very important for planning of peripheral and coronary bypass surgery. This study investigated mapping of the great saphenous vein as an adjunct to peripheral MR angiography using a blood pool contrast agent in patients who were referred for evaluation of peripheral arterial occlusive disease and bypass surgery. METHODS: 38 patients with peripheral arterial occlusive disease (21 men; mean age: 71 years, range, 44-88 years) underwent periphera...

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

    Directory of Open Access Journals (Sweden)

    Bartlomiej Perek

    2013-01-01

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

  12. Endovenous laser ablation of great saphenous vein with ultrasound-guided perivenous tumescence:early and midterm results

    Institute of Scientific and Technical Information of China (English)

    CHEN Jia-quan; XIE Hui; DENG Hao-yu; YUAN Kai; ZHANG Ji-wei; ZHANG Hao; ZHANG Lan

    2013-01-01

    Background Endovenous laser ablation (EVLA) is an improved method to treat varicose great saphenous veins (GSV)with a high satisfactory rate.This study aimed to evaluate the efficiency and safety of treatment by EVLA procedures with ultrasound-guided perivenous tumescence.Methods Thirty-one patients (31 limbs) with symptomatic varicose vein primary to chronic venous insufficiency (CVI) treated with EVLA were prospectively studied.The entire procedure was performed under ultrasound-guided tumescent local anesthesia.The patients were evaluated with a 18 month follow-up postoperation using clinical examination and venous duplex ultrasonography.Pain scores and quality of life (QOL) were recorded using visual analog scale (VAS) and the chronic venous insufficiency questionnaire (CIVIQ) at 1 week,1 month,and 12 months after operation.Results All patients tolerated EVLA procedure well.The overall success occlusion rates of GSV were 92%,94%,and 94% at 1,12,and 18 months follow-up,respectively.The score of CIVIQ one week preoperation was 69.14±11.44 while that of CIVIQ one month postoperation was 85.32±4.89.The life quality has significantly improved after the operation of EVLA (t=12.71,P <0.05).The VAS one month after treatment was lower than 1 week before therapy (t=8.048,P <0.05).Major complications such as deep vein thrombosis and skin bums were not found.Most of the complications were minor and improved quickly.Conclusions This refinement type of EVLA procedure is a safe and effective treatment with a high satisfaction rate; it displayed noteworthy features including shortening hospitalization,early ambulant activity,and preferable occlusion rates.

  13. The effects of aging on the intimal region of the human saphenous vein: insights from multimodal microscopy and quantitative image analysis.

    Science.gov (United States)

    Fonseca, Cindy; Taatjes, Douglas J; Callas, Peter; Ittleman, Frank; Bovill, Edwin G

    2012-09-01

    We hypothesized that structural remodeling associated with advancing age occurs in human saphenous veins. To address this hypothesis, we have identified structural remodeling in human saphenous veins by applying histochemistry, fluorescence staining and quantitative image analysis to specifically assess intimal area, intimal cellularity and intimal collagen content and organization. Saphenous veins were collected from patients undergoing coronary artery bypass graft surgery. Area measurements and cellularity were quantified using the image analysis software Stereo Investigator, employing planimetry and counting frames, respectively. Collagen content and organization were quantified in MetaMorph image analysis software based on measurements of color (hue, saturation, and intensity) from polarized light images. Intimal area and cellularity showed no statistically significant increases with age; in contrast, total collagen content showed a significant decrease with advancing age. Furthermore, collagen fiber types also demonstrated a statistically significant alteration with age; increases in age resulted in decreases in larger collagen fibers. No significant changes in small collagen fibers were identified. These results raise the possibility that age-associated structural alterations in total collagen content, specifically collagen fiber size, could be a factor in the etiology of age-associated venous diseases.

  14. Combined subfascial endoscopic perforator surgery and endovenous laser treatment without impact on the great saphenous vein for management of lower-extremity varicose veins

    Institute of Scientific and Technical Information of China (English)

    GAN Shu-jie; QIAN Shui-xian; ZHANG Ci; MAO Jie-qi; LI Ke; TANG Jing-dong

    2013-01-01

    Background Conventional high ligation and stripping of the great saphenous vein (GSV) has a good curative effect but is highly traumatic with a considerable relapse rate.Subfascial endoscopic perforator surgery (SEPS) plus endovenous laser treatment (EVLT) could be applied as individual therapy.This study aimed to evaluate the feasibility of performing combined SEPS and EVLT without impacting GSV in the management of valvular insufficiency of the lower-limb venous perforators.Methods Placement of lower-limb venous perforator insufficiency was marked by ascending phlebography in 83 affected limbs from September 2010 to June 2011.After randomization,SEPS was performed on 41 limbs to address the insufficiency of the venous perforators under the deep fascia,in combination with EVLT to close the superficial varicose veins without impacting the GSV.The remaining 42 limbs were treated using traditional GSV phlebectomy as controls.Results Postoperatively,all varicose veins were resolved,with lightening of the pigmentation and healing of the ulcer.Within a follow-up period of 5-11 months,no symptoms had recurred.Compared with the control group,the operation time,the number of incisions sutured,and the in-hospital time decreased on average by 1.5 hours,4.7,and 6.8 days,respectively (P <0.01 in all cases).Conclusion Combined SEPS and EVLT for treatment of valvular insufficiency of the lower-limb venous perforators offer the advantages of microtrauma and rapid cure.

  15. Pulsatile ex vivo perfusion of human saphenous vein grafts under controlled pressure conditions increases MMP-2 expression

    Directory of Open Access Journals (Sweden)

    Lange Rüdiger

    2011-07-01

    Full Text Available Abstract Background The use of human saphenous vein grafts (HSVGs as a bypass conduit is a standard procedure in the treatment of coronary artery disease while their early occlusion remains a major problem. Methods We have developed an ex vivo perfusion system, which uses standardized and strictly controlled hemodynamic parameters for the pulsatile and non-static perfusion of HSVGs to guarantee a reliable analysis of molecular parameters under different pressure conditions. Cell viability of HSVGs (n = 12 was determined by the metabolic conversion of 3-(4,5-dimethylthiazol-2-yl-2,5-diphenyl-tetrazolium bromide (MTT into a purple formazan dye. Results Under physiological flow rates (10 mmHg HSVGs remained viable for two weeks. Their exposure to arterial conditions (100 mmHg was possible for one week without important reduction in viability. Baseline expression of matrix metalloproteinase-2 (MMP-2 after venous perfusion (2.2 ± 0.5, n = 5 was strongly up-regulated after exposure to arterial conditions for three days (19.8 ± 4.3 or five days (23.9 ± 6.1, p Conclusion Therefore, our system might be helpful to more precisely understand the molecular mechanisms leading to an early failure of HSVGs.

  16. Systematic comparison of the effectiveness of radial artery and saphenous vein or right internal thoracic artery coronary bypass grafts in non-left anterior descending coronary arteries

    Institute of Scientific and Technical Information of China (English)

    Xiang HU; Qiang ZHAO

    2011-01-01

    Coronary artery bypass grafting surgery is increasingly being carried out on patients with multi-vessel coronary artery disease, but the best grafting candidate for non-left antetior descending coronary arteries is unclear.This research sought to systematically compare the efficacies and safeties of coronary bypass with radial artery and other available grafts. A systematic literature retrieval was performed for all clinical trials comparing the outcomes of coronary artery bypass surgery with radial artery and other grafts in PubMed, EMBASE, and the Cochrane Library.Seven eligible clinical studies, comparing radial artery and great saphenous vein grafts, were found between 1966 and 2010: one prospective non-randomized and six prospective randomized trials. The pooling analysis obtained a relative risk of 0.507 (P<0.05) of graft occlusion in radial arteries compared with great saphenous veins. There was a significantly lower infection rate in arms (i.e., harvest sites for radial arteries) relative to legs (harvest sites for veins), with a pooled relative risk of 0.140 (P<0.05). From the reports on mortality after follow-up ranging from one year to six years,there was no significant difference in mortality between the two graft types (P=0.927). In addition, four cohort controlled trials for radial and right internal thoracic artery grafts were included. The radial graft was associated with less cardiac related events relative to the right intemal thoracic artery graft (P=0.014), but with comparable mortality and comparable rates of repeat percutaneous transluminal coronary angioplasty. Subjects with radial arteries seemed to have a lower occlusion rate and a lower graft harvest site infection rate than those with great saphenous veins. Moreover there were fewer cardiac related events with radial arteries relative to the right internal thoracic artery grafts. More studies are needed to confirm these findings concerning the favorable outcomes of coronary artery

  17. Radiofrequency ablation of the great saphenous vein with the ClosureFAST™ procedure: mid-term experience on 400 patients from a single centre.

    Science.gov (United States)

    Tolva, Valerio S; Cireni, Lea V; Bianchi, Paolo G; Lombardo, Almarosa; Keller, Guido C; Casana, Renato M

    2013-07-01

    Endovascular obliteration of the great saphenous vein (GSV) has been proposed as an alternative to conventional extirpative treatment of varicose veins. This report reviewed the initial experience with the ClosureFAST™ procedure in 407 legs over a one-year period. Occlusion of the GSV was seen on 98 % of completion scans and in all patients within 1 week of the procedure. Persistent occlusion was documented in all cases. One had paresthesias and one had skin pigmentation. Three patients had transient superficial thrombophlebitis in a treated segment of a superficial collateral of the GSV. One patient was found to have extension of an asymptomatic, nonocclusive thrombus into the common femoral vein 1 week after the procedure. Radiofrequency ablation of the GSV appears to be a safe alternative to conventional stripping and ligation. Randomised clinical trials and longer follow-up periods are required to establish the overall superiority of the procedure in comparison to conventional stripping.

  18. Percutaneous laser-assisted thermal coronary angioplasty in native coronary arteries and saphenous vein grafts: initial results and angiographic follow-up.

    Science.gov (United States)

    Linnemeier, T J; Rothbaum, D A; Cumberland, D C; Landin, R J; Hodes, Z I; Ball, M W

    1990-01-01

    Percutaneous laser-assisted thermal coronary angioplasty was attempted in 29 vessels (27 patients): 10 left anterior descending, 2 left circumflex and 17 mid-shaft (non-anastomotic) saphenous vein grafts. Argon or YAG laser thermal energy was applied via a 1.3, 1.6 or 1.9 mm metal capped probe followed by conventional balloon angioplasty in 27 vessels and sole thermal laser therapy in two vessels. The laser probe successfully crossed 83% (24/29) of vessels and subsequent balloon dilatation increased the success rate to 93% (25/27). Perforation occurred in a vein graft resulting in one in-hospital death post repeat emergency coronary artery bypass graft surgery. Angiographic follow-up was obtained in 85% (24/28) of vessels. Angiographic restenosis ( greater than 50% reduction in lumen diameter) occurred in 27% (3/11) of native coronary arteries and 62% (8/13) of saphenous vein grafts. Therefore, despite high initial success rates, the application of laser thermal energy with small laser probes relative to vessel size, followed by conventional balloon angioplasty, does not appear to alter restenosis. Further evaluation of coronary laser systems should be continued only with catheters that are capable of creating channels closer to the size of the vessel treated.

  19. [Hyaluronic acid (hyaluronan) levels in pathological human saphenous veins. Effects of procyanidol oligomers].

    Science.gov (United States)

    Drubaix, I; Maraval, M; Robert, L; Robert, A M

    1997-01-01

    We investigated the hyaluronan content in the pathologic human venous wall using an ELSA assay with hyaluronectin according to the method of Delpech et al. The mean hyaluronan content in the 74 fragments from 12 venous walls studied was 596 +/- 528 ng/mg dry weight. These 12 venous walls could be separated in 3 distinct groups according to their hyaluronan content, low (277 +/- 141 ng/mg dry weight), moderate (552 +/- 361 ng/m dry weight) or high (1299 +/- 568 ng/mg dry weight). The differences between these groups are significant (p < 0.001). The presence of a veino-lymphatic oedema was generally associated with a high hyaluronan level (in 65% of cases). The 3H-glucosamine incorporation in cultured venous wall explants showed a 35% increase (p < 0.002) in varicosis as compared with the non or less modified segments of the vein and a 29% (p < 0.001) increase in presence of a veino-lymphatic oedema. The addition of 1 mg/ml of PCO (Procyanidolic Oligomers) to the culture media induced near to 20% decrease of the 3H-glucosamine incorporation and a 34% decrease of the hyaluronan content. Our results confirm the role of local overproduction of hyaluronan in the establishment of oedema and the potential effect of PCO to counteract it.

  20. Curative Effect Observation on Modified Great Saphenous Varicose Vein High Ligation Joint Peeling Treatment of Primary Great Saphenous Varicose Veins%用改良后的大隐静脉曲张高位结扎联合剥脱术治疗原发性大隐静脉曲张的疗效研究

    Institute of Scientific and Technical Information of China (English)

    宋进军

    2015-01-01

    Objective: To evaluate the modified great saphenous varicose vein high ligation joint peeling technique in the efficacy of treatment of primary great saphenous varicose veins. Method: The data of 30 cases of primary great saphenous varicose veins seen between May.2011 to May.2014 has been collected to divide into two groups with 15 cases in each group. The treatment group was treated with modified great saphenous varicose vein high ligation joint peeling technique, while control group was treated with traditional method. To review and analysis the data, and observe the treatment result. Results: The overall response rate of treatment group was significantly decreased compared to control group (p<0.05). Conclusion: Compared to the traditional method, the modified great saphenous varicose vein high ligation joint peeling technique plays more important role to improve the cure rate of patients, and it is worth to popularize and apply in the clinical treatment.%目的:探讨用改良后的大隐静脉曲张高位结扎联合剥脱术治疗原发性大隐静脉曲张的临床效果。方法:对2011年5月~2014年5月期间我院收治的30例原发性大隐静脉曲张患者的临床资料进行回顾性研究。将这30例患者随机分为对照组和观察组,每组各有15例患者。为观察组患者使用改良后的大隐静脉曲张高位结扎联合剥脱术进行治疗,为对照组患者使用传统的大隐静脉曲张高位结扎联合剥脱术进行治疗。然后,比较两组患者的治疗效果。结果:观察组患者治疗的总有效率明显高于对照组患者,二者相比差异具有显著性(P<0.05)。结论:用改良后的大隐静脉曲张高位结扎联合剥脱术治疗原发性大隐静脉曲张的疗效显著。此疗法值得在临床上推广使用。

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

    Science.gov (United States)

    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.

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

    Science.gov (United States)

    Klotz, J L; Aiken, G E; Johnson, J M; Brown, K R; Bush, L P; Strickland, J R

    2013-09-01

    Pharmacologic profiling of serotonin (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, 5HT, 5HT2A, and 5HT7 agonists. To determine if 5HT receptor activity of tall fescue alkaloids is affected by grazing endophyte-free (EF), wild-type [Kentucky-31 (KY31)], novel endophyte AR542-infected (MAXQ), or novel endophyte AR584-infected (AR584) tall fescue, contractile responses of lateral saphenous veins biopsied from cattle grazing these different fescue-endophyte combinations were evaluated in presence or absence of antagonists for 5HT2A (ketanserin) or 5HT7 (SB-269970) receptors. Biopsies were conducted over 2 yr on 35 mixed-breed steers (361.5 ± 6.3 kg) grazing EF (n = 12), KY31 (n = 12), MAXQ (n = 6), or AR584 (n = 5) pasture treatments (3 ha) between 84 and 98 d (Yr 1) or 108 to 124 d (Yr 2). Segments (2 to 3 cm) of vein were surgically biopsied, sliced into 2- to 3-mm cross-sections, and suspended in a myograph chamber containing 5 mL of oxygenated Krebs-Henseleit buffer (95% O2/5% CO2; pH = 7.4; 37°C). Veins were exposed to increasing concentrations of 5HT, ergovaline, and ergovaline + 1 × 10(-5) M ketanserin or + 1 × 10(-6) M SB-269970 in Yr 1. In Yr 2, ergotamine and ergocornine were evaluated in presence or absence of 1 × 10(-5) M ketanserin. Contractile response data were normalized to a reference addition of 1 × 10(-4) M norepinephrine. In Yr 1, contractile response to 5HT and ergovaline were least (P endophyte-fescue combinations.

  3. Rapid elongation of arteries and veins in rats with a tissue expander.

    Science.gov (United States)

    Stark, G B; Hong, C; Futrell, J W

    1987-10-01

    The saphenous arteries and veins of 40 rats were elongated with 20-cc tissue expanders underlying the leg adductor muscles. The mean rate of successful elongation of the vessels was 84 +/- 47 percent SD, with a maximum gain of 140 percent. The fastest mean elongation velocity reached 45 percent per day. Thrombosis occurred only with stretching velocities of more than 10 percent per day, which seemed to be a safe margin. Distribution of the volume into many intervals was safer than infrequent high-volume injections. Histology showed no reduction in vessel wall diameter or loss intimal integrity. Subendothelial cellular proliferation was an indicator of this rapid regeneration. Microvascular anastomoses performed in elongated arteries and veins had the same patency rate (90 percent) as in controls.

  4. Comparison of Different Surgical Treatment for Varicosis of Great Saphenous Vein%大隐静脉曲张不同手术治疗方法比较

    Institute of Scientific and Technical Information of China (English)

    彭利武; 周恩湘; 唐华; 文星均

    2011-01-01

    目的:探讨大隐静脉高位结扎加腔内激光治疗大隐静脉曲张的临床意义.方法:150例大隐静脉曲张患者分为A、B两组,其中A组70例,采用大隐静脉高位结扎加剥脱术治疗,B组80例,采用高位结扎加腔内激光治疗,比较两组在手术过程、术后疼痛、术后恢复及并发症发生率等方面的差别.结果:B组患者切口个数、手术时间、术中出血量、止痛药使用百分比和平均住院时间均少于A组(P0.05).结论:大隐静脉高住结扎加腔内激光术的临床疗效优于传统的高位结扎加剥脱术,且患者损伤小、恢复快、疼痛轻,值得临床推广.%Objective: To study the clinical significance of high ligation and intracavitary laser in the treatment of varicosis of great saphenous vein.Methods: In the A group, 70 cases with varicosis of great saphenous vein were treated by high ligation and stripping procedure, and 80 cases in B group by high ligation and intracavitary laser.To compare the curative effect of A and B group, the surgical procedure, postoperative pain, postoperative recovery and complication incidence were evaluated and analyzed.Results: The operation incision, surgery duration, amount of intraoperative bleeding, percentage of patients taking painkillers, duration of hospitalisation in group B were all significantly lower than those in group A (P<0.01 or 0.05), but there was no difference in NRE scores, time for first ambulation and complication incidence between the two groups (P>0.05).Conclusion: The high ligation and intracavitary laser procedure for varicosis of great saphenous vein has proved to be more effective than traditional method for low patient injury, rapid recovery and light pain, deserving to be widely used in clinical therapy.

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

    Energy Technology Data Exchange (ETDEWEB)

    Harskamp, Ralf E., E-mail: 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

  6. Impending rupture of saphenous vein graft aneurysm with floating fractured bare metal stent treated by coil embolization and covered stent implantation.

    Science.gov (United States)

    Kodama, Atsuko; Kurita, Tairo; Kato, Osamu; Suzuki, Takahiko

    2016-11-01

    Aneurysmal degeneration of a saphenous vein graft (SVG) is a rare, but potentially fatal complication of coronary artery bypass graft (CABG) surgery. In this case report, a patient that had undergone prior CABG surgery and bare metal stent (BMS) implantation at the site of a stenotic SVG lesion presented at our hospital with chest pain, and an SVG aneurysm was detected at the previous BMS implantation site. In addition, the implanted BMS was fractured and floating in the SVG aneurysm. The SVG aneurysm was successfully occluded by percutaneous intervention, using a combination of distal covered stent deployment at the site of the anastomosis between the native coronary artery and the SVG and proximal coil embolization of the aneurysm.

  7. 血管内激光光凝治疗大隐静脉曲张的超微结构观察%Ultrastructure of the varicose great saphenous vein after the treatment with intravascular laser occlusion

    Institute of Scientific and Technical Information of China (English)

    陈筱春; 文质君

    2005-01-01

    Chinese PLA from January to April 2004. The inclusive criteria: There must be obvious vein tangles beneath the undystrophic skin at ankle without apparent thrombus inside the vein. The patients involved should be voluntary to take part in the study. Finally 9 patients were enrolled in this study.INTERVENTION: The great saphenous vein was intravenously occluded with laser of 810 nm and the working power was 12 W and the exposure time was 1 s. The occluded vein sample was taken out 3 hours after the occlusion.MAINOUTCOME MEASURES: The ultrastrncture of the occluded vein was observed histopathologically. Normal vein and prereatment varicose vein served as control.RESULTS: The normal vein wall can be divided into 3 layers: the internal layer was composed of the simple endothelial cells; the median layer was composed of the smooth muscle cells, elastic fibers and collagenous fibers; the external layer was composed of the loose connective tissues. However, the internal layer of the varicose vein was incomplete, and the endothelial cells were loosely connected. The smooth muscle cells became hyperplasic, hypertrophic or atrophic. The elastic fibers decreased in number in contrast to the increase of collagenous fibers. After laser occlusion, in the vein lumen there was a large number of blood cells. The platelets became flattened with pseudopods and adhered to collagenous fibers. The endothelial cells and smooth muscle cells near the lumen were damaged and the cytoplasma leaked and fused with extracellular matrix. Broken collagenous and elastic fibers could be seen near the lumen and some were observed in the lumen. There was no structure change in the external layer and adjacent elastic fibers and collagenous fibers.CONCLUSION: Laser occlusion damaged the internal layer and part of median layer of the varicose vein, caused aggregation of the blood cells in the lumen and promoted the adhesion of platelets to vein walls.

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

    Directory of Open Access Journals (Sweden)

    Virgílio Figueiredo Silva

    2008-09-01

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

  9. Idiopathic great saphenous phlebosclerosis.

    Directory of Open Access Journals (Sweden)

    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.

  10. 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

    Directory of Open Access Journals (Sweden)

    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

  11. Mapping of autogenous saphenous veins as an imaging adjunct to peripheral MR angiography in patients with peripheral arterial occlusive disease and peripheral bypass grafting: prospective comparison with ultrasound and intraoperative findings.

    Directory of Open Access Journals (Sweden)

    Ann-Marie Bintu Munda Jah-Kabba

    Full Text Available BACKGROUND: Mapping of the great saphenous vein is very important for planning of peripheral and coronary bypass surgery. This study investigated mapping of the great saphenous vein as an adjunct to peripheral MR angiography using a blood pool contrast agent in patients who were referred for evaluation of peripheral arterial occlusive disease and bypass surgery. METHODS: 38 patients with peripheral arterial occlusive disease (21 men; mean age: 71 years, range, 44-88 years underwent peripheral MR angiography using the blood pool contrast agent Gadofosveset trisodium. Apart from primary arterial assessment images were evaluated in order to determine great saphenous vein diameters at three levels: below the saphenofemoral junction, mid thigh and 10 cm above the knee joint (usability: diameter range: >3 and 3.5 and <10 mm at a neighboring level. Duplex ultrasound was performed by an independent examiner providing diameter measurements at the same levels. Additionally, vessel usability was determined intraoperatively by the vascular surgeon during subsequent bypass surgery. RESULTS: Mean venous diameters for MR angiography/duplex ultrasound were 5.4±2.6/5.5±2.8 mm (level 1, 4.7±2.7/4.6±2.9 mm (level 2 and 4.4±2.2/4.5±2.3 mm (level 3, respectively, without significant differences between the modalities (P = 0.207/0.806/0.518. Subsequent surgery was performed in 27/38 patients. A suitable saphenous vein was diagnosed in 25 and non-usability was diagnosed in 2 of the 27 patients based on MR angiography/duplex ultrasound, respectively. Usability was confirmed by intraoperative assessment in all of the 24 patients that received a venous bypass graft in subsequent bypass surgery. In 1 case, in which the great saphenous vein was assessed as useable by both MR angiography and duplex ultrasound, it was not used during subsequent bypass surgery due to the patients clinical condition and comorbidities. CONCLUSION: Simultaneous mapping of the great

  12. Perivenous application of fibrin glue reduces early injury to the human saphenous vein graft wall in an ex vivo model

    NARCIS (Netherlands)

    Stooker, W; Niessen, HWM; Wildevuur, WR; van Hinsbergh, VWM; Fritz, J; Jansen, EK; Wildevuur, CRH; Eijsman, L

    2002-01-01

    Objectives: From animal and clinical studies it is known that prevention of 'overdistention' of vein grafts by using extravascular support ameliorates the arterialization process in vein grafts with subsequent more favorable patency. The most ideal support is a biodegradable, porous, elastic graft (

  13. 聚桂醇注射联合手术治疗下肢大隐静脉曲张的疗效观察%Effect observation of foam sclerotherapy of lauromacrogol combined with surgery for great saphenous varicose veins

    Institute of Scientific and Technical Information of China (English)

    卢惟钦; 蒋劲松; 杨光唯; 来集富; 卢凯平

    2012-01-01

    目的:探讨泡沫硬化剂聚桂醇联合手术治疗下肢大隐静脉曲张的安全性及有效性.方法:选择本院2010年10月至2011年5月间86例单侧下肢大隐静脉曲张的患者,随机分为A、B两组,每组43例.A组行大隐静脉高位结扎、主干剥脱,小腿曲张静脉内注射聚桂醇泡沫硬化剂.B组行传统大隐静脉曲张手术.结果:86例患者均成功施行治疗.A组手术时间小于B组(P<0.01).A组住院时间也小于B组(P<0.01).术后随访半年,A组3例(6.9%)患肢出现局限的静脉曲张,B组2例(4.7%),复发率无明显差异(P>0.05).结论:聚桂醇注射联合手术治疗下肢静脉曲张安全、有效,较传统手术缩短了手术时间与患者住院时间.%AIM: To evaluate the efficacy and safety of foam sclerotherapy of lauromacrogol combined with surgery for great saphenous varicose veins. METHODS: 86 patients with great saphenous varicose veins were randomized into 2 groups of A and B. Group A was treated by sa-pheno-femoral junction ligation and stripping of great saphenous veins. Verosis veins below the knee underwent foam sclerotherapy. Group B was treated by standard stripping of great saphenous veins. RESULTS: All treatments were completed as intended. The time of completing treatment and hospitalization were shorter in group A than those in group B(P<0. 01). Allpatients were followed up 6 months with satisfactory outcomes except 3 patients in group A and 2 patients in group B with recurrence of varicose veins. CONCLUSION: Foam sclerotherapy of lauromacrogol combined with surgery for great saphenous varicose veins is safe and effective. Compared with traditional stripping operation, it has a shorter treatment and hospitalization time.

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

    Science.gov (United States)

    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.

  15. Probabilidade de refluxo nas veias safenas de mulheres com diferentes graus de insuficiência venosa crônica Reflux probability in saphenous veins of women with different degrees of chronic venous insufficiency

    Directory of Open Access Journals (Sweden)

    Maria Fernanda Cassou

    2007-09-01

    Full Text Available CONTEXTO: A presença de refluxo nas junções safeno-femoral e safeno-poplítea é um dado importante para programação da cirurgia de varizes. Estudos mostraram que, na maioria dos pacientes com insuficiência venosa crônica, as junções estão competentes, e o refluxo está presente ao longo do trajeto das veias safenas. OBJETIVOS: Identificar probabilidade de diferentes padrões de refluxo nas veias safenas de mulheres com vários graus de insuficiência venosa crônica e avaliar se o comprometimento das junções das safenas está associado com gravidade da insuficiência venosa. MÉTODOS: Um total de 1.184 membros inferiores de 672 mulheres foram estudados pela ultra-sonografia vascular com Doppler colorido e avaliados pela classificação clínica, etiológica, anatômica e patológica (CEAP. As extremidades foram agrupadas de acordo com a gravidade da insuficiência venosa em graus leve (CEAP C1-C2, moderado (CEAP C3 e grave (CEAP C4-C6. Para avaliar a classificação clínica CEAP na predição do padrão de refluxo, utilizou-se o Teorema de Bayers. Para avaliar associação entre classificação clínica CEAP e padrões de refluxo com ou sem comprometimento das junções das safenas, utilizou-se o teste qui-quadrado (p BACKGROUND: Presence of reflux in saphenofemoral and saphenopopliteal junctions represents important data for indication of varicose vein surgery. Studies demonstrated that in most patients with chronic venous insufficiency junctions are competent and reflux is present in segments in the course of saphenous veins. OBJECTIVES: To identify the probability of different reflux patterns in the saphenous veins of women with various degrees of chronic venous insufficiency and to evaluate whether junction impairment is associated with severity of venous insufficiency. METHODS: A total of 1,184 lower limbs of 672 women were evaluated by color-flow Doppler ultrasonography and classified according to clinical, etiologic

  16. Clinical Features of Primary Vein Grafts in Free Tissue Transfers

    OpenAIRE

    Mitsuru Nemoto; Kenichi Kumazawa; Eiju Uchinuma; Natsuko Kounoike; Akira Takeda

    2015-01-01

    The outcomes of free tissue transfers combined with vein grafts have been inconsistent, and discussions continue regarding their appropriate use. Of the 142 free tissue transfers that we performed from January 2004 to December 2011, we retrospectively analyzed 15 consecutive patients who underwent free tissue transfers in combination with vein grafts. Etiologies included trauma (8 patients), infection (4), and tumor (3). Types of free tissue transfers were fibula (4), anterolateral thigh (3),...

  17. [Foot defect with vascular and neural injury due to freshwater stingray sting: reconstruction with a lesser saphenous vein adipo-fascial flap].

    Science.gov (United States)

    Moutran, M; Mojallal, A; Chekaroua, K; Martin, E; Braye, F

    2009-04-01

    The emergency care to stingrays envenomation permits, in the majority of cases, to limit the damage caused. In the case of delayed medical care, we can meet deep and extensive lesions that need to be thoroughly explored in order to better address their reconstruction. We report the case of a patient injured by freshwater stingray. He presented a necrotic defect of 6 cm in diameter under the right medial malleolus with bone exposure and neurovascular injury. We opted for a therapeutic strategy in two steps. The first step consisted in a large debridement of the necrotic defect, under appropriate antibiotics and negative pressure therapy. Three weeks later, we covered the defect with a distally based lesser saphenous vein veno-fascia-subcutaneous flap, covered with a split-thickness graft. The coverage of the defect was satisfactory. The infection was controlled with antibiotics, which we prolonged for one month. The patient presented, initially, hypoesthesia of the upper lateral foot in relation with a neurapraxis of the sural nerve. The symptoms resolved at two months. The foot edema due to venous stasis also resolved at two months. The donor site healed without complications. The ability to wear normal shoes was preserved. The patient resumed his daily activities promptly.

  18. Endovenous laser treatment for saphenous varicose vein surgery%腔内激光治疗大隐静脉曲张的手术配合

    Institute of Scientific and Technical Information of China (English)

    王文君

    2011-01-01

    目的 总结腔内激光治疗大隐静脉曲张术手术室护士的配合要点,不断提高手术医生和手术患者的满意率.方法 回顾性分析62例患者的术前准备、术中配合过程,对术中的注意事项进行分析.结果62例患者手术顺利,术后随访1~12个月,无复发.结论手术室护士娴熟的手术配合,是手术成功的重要保障.%Objective To summarize the cooperative highlights of operating room nurses in endovenous laser treatment for saphenous varicose vein surgery, thus enhancing the satisfaction of both surgeons and patients. Methods Retrospective analysis of 62 cases has been done in terms of preoperative preparation and intraoperative cooperation. Some important issues concerning operation have been analyzed as well. Results All patients had smooth surgeries and follow-up visits were paid ranging from one to 12 months after surgery. There were no recurrences. Conclusion The operating room nurses' adept surgery coordination is important in a successful operation.

  19. Experience of great saphenous varicose vein high ligation main stripping operation combined with foam hardening agent in the treatment of varicose vein of lower limb%大隐静脉曲张高位结扎主干剥除术联合泡沫硬化剂治疗下肢静脉曲张的体会

    Institute of Scientific and Technical Information of China (English)

    徐庆; 肖启明; 路鹏

    2016-01-01

    Objective:To explore the curative effect of great saphenous varicose vein high ligation main stripping operation combined with foam hardening agent in the treatment of varicose vein of lower limb.Methods:36 patients with varicose vein of lower limb were selected.They were given great saphenous varicose vein high ligation main stripping operation combined with foam hardening agent.The curative effects were observed.Results:1 case was postoperative limb numbness and pain,1 case had hematoma formation after great saphenous main stripping operation.No wound infection and deep vein thrombosis were found,and no recurrence was found.Conclusion:Great saphenous varicose vein high ligation main stripping operation combined with foam hardening agent in the treatment of varicose vein of lower limb has a better treatment effect.%目的:探讨大隐静脉曲张高位结扎主干剥除术联合泡沫硬化剂治疗下肢静脉曲张疗效。方法:收治下肢静脉曲张患者36例,给予大隐静脉高位结扎主干剥除术联合泡沫硬化剂治疗,观察疗效。结果:术后患肢麻木疼痛1例,大隐静脉主干剥除后血肿形成1例,无伤口感染及深静脉血栓形成,未发现复发病例。结论:大隐静脉曲张高位结扎主干剥除术联合泡沫硬化剂治疗下肢静脉曲张具有较好的疗效。

  20. Ultrasound guided foam sclerotherapy of recurrent varices of the great and small saphenous vein: 5-year follow up

    Directory of Open Access Journals (Sweden)

    Patrizia Pavei

    2014-11-01

    Full Text Available Ultrasound guided foam sclerotherapy (UGFS proved to be effective in recurrent varices. In this observational study from 2006 and 2012 we treated 142 neovascularization, 155 inguinal recurrence and 28 popliteal recurrent varices. For neovascularization 0.3-0.5% polidocanol (POL sclerosant foam (SF was injected for vein having diameter <3 mm and 0.5-1% POL or sodium tetradecylsulphate (STS SF for higher vein diameters. The patients with residual sapheno-femoral or sapheno-popliteal junctions were treated with 1% STS SF for diameter up to 5 mm, while for larger veins 3% STS was used. From 1 to 3 sessions were necessary in both groups with 4 to 10 ml injected per session. In the group of neovascularization the 3-5years follow up revealed good results in 90.8% of the cases. In the group of popliteal recurrences the 3-5 years follow up showed 60.7% of good results, while in the group of inguinal recurrences we observed 80% of good results at 3-5 years. We did not have major complication. As minor complications we had 0.2% of gastrocnemial vein thrombosis, 0.1% of minor neurological problems, 2.8% of superficial vein thrombosis, 3.9% of pigmentation and light to mild post-treatment pain in 16.5% of the cases. In conclusion our data show that UGFS is a well tolerate technique, preferred by previously operated patients, safe and easily repeatable with good medium-term results both in case of neovascularization and of recurrence from residual femoral or popliteal stump.

  1. Comparative Study on Secondary Branches of Saphenous Vein High Lligation Combined with Electrocoagulation and Traditional Operation for Varicose Veins%次高位大隐静脉结扎联合属支电凝术与传统静脉曲张手术的对比研究

    Institute of Scientific and Technical Information of China (English)

    段学军

    2014-01-01

    Objective To investigate the time of great saphenous vein ligation combined with self-made high superiority trocar electrocoagulation of great saphenous veins.Methods Single lower limb varicosis of great saphenous vein in 81 casesdivided into modified group (28) and conventional group (53), respectively, to accept the traditional operation is of great saphenous vein high ligation and stripping of great saphenous vein and high ligation combined with self-madetrocar electrocoagulation, curative ef ect observation. Results The operationtime, bleeding volume, improved group number of the incision, incision lengthis less than the traditional group; quality of life score after operation (CIVIQ) is higher than that of the traditional group; <0.05. Conclusion High saphenous vein ligation combined with self-made trocar electrocoagulation is strippedsaphenous vein trunk, and a thorough treatment of the branches vein, simple and easy operation, smal trauma recovery, more beautiful, reflected thedevelopment direction of minimal y invasive surgery.%目的:探讨次高位大隐静脉结扎联合自制套管针电凝术治疗大隐静脉曲张的优越性。方法将单下肢大隐静脉曲张患者81例分成改良组(28例)和传统组(53例),分别接受传统手术即大隐静脉高位结扎剥脱术和次高位大隐静脉结扎联合自制简易套管针电凝术,观察疗效。结果改良组的手术时间、出血量、切口数量、切口总长度均小于传统组;术后生活质量评分(CIVIQ)高于传统组,<0.05。结论次高位大隐静脉结扎联合自制简易套管针电凝术即剥除了大隐静脉主干,同时彻底治疗了属支静脉,简便易操作,创伤小恢复快,更加美观,体现了外科的微创发展方向。

  2. 内窥镜采集大隐静脉术后下肢切口护理效果的探讨%Discussion Effect of Nursing Lower Limb Incision in Endoscopic Saphenous Vein after Operation

    Institute of Scientific and Technical Information of China (English)

    郭玉宏

    2015-01-01

    目的:探讨冠状动脉旁路移植术(CABG)中应用Medos内窥镜采集大隐静脉后下肢切口的护理效果。方法:回顾性分析300例采用Medos内窥镜采集大隐静脉行不停跳CABG患者的临床资料。观察并记录术后下肢切口的愈合情况,结痂时间,血肿、感觉麻木、伤口水泡、伤口渗液、伤口裂开等发生例数。结果:单侧下肢取大隐静脉233例,双侧下肢取大隐静脉67例,大隐静脉平均采集时间(22.50±8.40)min,大隐静脉平均采集长度(42.40±16.30)cm,下肢切口平均长度(3.90±2.51)cm,下肢切口愈合不良43例。平均结痂时间(7.04±2.14)d,下肢血肿22例、伤口水泡31例,伤口渗液12例,感觉麻木55例、伤口感染2例、伤口裂开2例,气体栓塞0例,下肢深静脉血栓形成0例。下肢切口愈合不良患者经过有效的医疗干预及护理措施均愈合。结论:正规有效的护理措施可明显改善CABG患者内窥镜取大隐静脉下肢切口的愈合情况,降低伤口并发症,促进下肢功能恢复。%Objective: To investigate the coronary artery bypass grafting (CABG) in the application of Medos endoscope nursing effect of leg wound saphenous vein after.Methods:Retrospective analysis of 300 cases clinical data using endoscope mirror saphenous vein for off-pump patients with CABG Medos. Observe and record the healing, postoperative leg incision scabs time, hematoma, feeling numb, wound blisters, wound exudate, wound dehiscence occurred cases.Results:The unilateral lower limb from the saphenous vein in 233 cases, bilateral lower extremity saphenous vein harvesting great saphenous vein in 67 cases, the average acquisition time (22.50±8.40) min, the average length of saphenous vein collection (42.40±16.30) cm, the average length of leg wound (3.90±2.51) cm, poor wound healing in 43 cases of lower extremity. The average time to crusting (7.04±2.14) d, lower extremity hematoma

  3. Treatment of varicose veins of the small saphenous vein by completely minimally phlebectomy.%完全点式剥脱治疗小隐静脉瓣膜功能不全疗效观察

    Institute of Scientific and Technical Information of China (English)

    亓明; 白云清

    2012-01-01

    目的 探讨完全点式剥脱术治疗下肢小隐静脉的手术方法及疗效.方法 对2004年10月至2011年4月间,应用该手术方法治疗的40例患者(47条下肢)下肢小隐静脉曲张的临床资料进行回顾性研究.观察其手术时间、术后住院时间、并发症、手术效果及对切口外观满意度等.结果 本组肢体行小隐静脉完全点式剥脱,手术时间平均45 min;手术后平均1.5 d出院.所有患者术后下肢静脉曲张消失,临床症状缓解.腓肠神经损伤(外侧足背皮肤麻木感)1例(2.5%).无严重并发症发生.全部患者获得随访,平均随访24(1~48)个月,无明确的下肢静脉曲张复发;1例腓肠神经损伤的患者在术后2个月恢复.无下肢深静脉血栓等严重的并发症发生,疗效满意.结论 小隐静脉完全点式剥脱术治疗下肢静脉曲张的手术方法是外科方法中简单、微创、有效的治疗方法.%Objective To evaluate the completely minimally phlebectomy in the treatment of varicose vein. Methods From Oct. 2004 to Oct. 2010,40 patients ( 47 limbs ) with small saphenous vein varices received completely minimally phlebectomy,and the clinical data were analyzed retrospectively. Results Satisfied surgical results with varicose veins reflux disappeared were obtained in all cases. The average operative time and the average hospitalization after operation were 45 minutes and 1.5 days, respectively. Sural nerve damage occurred in 1 (2.5% ) case. Moreover, 580 patients were followed up with a mean time of 24 ( 1 -48 ) months, no remained varicose veins, and cases with sural nerve damage recovered in 2 -3 months postoperatively. JNo serious complications such as deep venous thrombosis occurred and the satisfied cosmetic effects and cost - effect ratio achieved. Conclusion Treatment of varicose veins of small saphenous vein by completely minimally phlebectomy has the benefit of mini - invasion, fast recovery, and good curative effect.

  4. The distally based lateral sural neuro-lesser saphenous veno-fasciocutaneous flap: anatomical basis and clinical applications.

    Science.gov (United States)

    Wang, Chen; Xiong, Zhuyou; Xu, Jing; Zhang, Li; Huang, He; Li, Guangzao

    2014-09-01

    Soft tissue management around the lower third of the leg and foot presents a considerable challenge to the plastic surgeon. The aim of this research was to investigate the anatomical relationships of artery, nerve, vein and other adjacent structures in the posterolateral region of the calf, and our experience with using a distally based island flap pedicled with the lateral sural nerve and the lesser saphenous vein for soft tissue reconstruction of lower third of leg, foot, and ankle defects in 15 patients. Five fresh cadavers (ten lower limbs) were infused with colored red latex. The origin of the nutrient vessel of the lesser saphenous vein and the lateral sural nerve was identified. Based on the anatomical studies, an island flap supplied by the vascular axis of the lesser saphenous vein and the lateral sural nerve was designed for clinical reparative applications in 15 cases. The nutrient vessel of the lesser saphenous vein and the lateral sural nerve originates from the superficial sural artery, musculocutaneous perforators of the posterior tibial artery, and septocutaneous perforators of the peroneal artery in different segment of the calf. Meanwhile, these vessels have many sub-branches nourishing subcutaneous tissue and skin, form a favorable vascular chain around the nerve and the vein, and also communicate with vascular plexus of superficial and deep fascia. Among 15 flaps, 13 showed complete survival (86.66 %), while marginal flap necrosis occurred in one patient (6.67 %) and distal wound dehiscence in another (6.67 %). Their appearance and function were satisfactory, with feeling maintained in the heel and lateral side of the foot. The distally based flap pedicled with the lateral sural nerve and lesser saphenous vein was a reliable source for repairing soft tissue defects in the lower leg and foot due to its advantages of infection control, high survival rate, and sufficient blood supply without the need to sacrifice a major blood vessel.

  5. Pathological alterations of the first venous valve in great saphenous varicose vein%曲张病变大隐静脉第一对瓣膜的病理改变

    Institute of Scientific and Technical Information of China (English)

    王鑫; 乔彤

    2011-01-01

    Objective To investigate the pathological alterations of the first valve in great saphenous varicose vein. Methods The pathological chnges in the first valve of 24 great saphenous varicose veins(group A) and 3 normal great saphenous veins were observed with HE and Sirius red staining. CD31 and α-SMA were detected using immunohistochemistry as well Results Compared to group C, valves of group A appeared to be twisted and lengthened with hyperplasia of collagen fiberand,different expressions of CD31 in endothelium cells on two sides and highly expressed α-SMA (P<0.05). Conclusion Significant alterations in morphology, structure,endothelium in the first valve of great saphenous varicose vein are seen, which may play an important role in the pathogenesis of primary varicose veins.%目的 探讨曲张病变大隐静脉第一对瓣膜的病理改变.方法 大隐静脉曲张(A)组24例,正常对照(C)组3例,分别采用HE、SiriusRed染色及CD31、α-SMA免疫组织化学法检测大隐静脉第一对静脉瓣在曲张病变中的病理改变.结果 与C组比较,A组静脉瓣膜延伸变长、扭曲变形,伴胶原纤维增生,瓣膜两侧内皮细胞表达CD31不一致(P<0.05),并异常高表达α-SMA(P<0.05).结论 曲张大隐静脉中瓣膜的形态、结构、内皮均发生了明显病理改变,提示静脉瓣膜的这些改变在下肢静脉曲张的发病机制中起重要作用.

  6. [Lower limb varicose veins as a manifestation of undifferentiated connective tissue dysplasia].

    Science.gov (United States)

    Potapov, M P; Potapov, P P; Staver, E V; Mazepina, L S

    2016-01-01

    Analysed herein are the data of 737 patients (a total of 745 lower limbs) suffering from lower-limb varicose veins (LLVV) and subjected to treatment at the Surgical Department consisting of crossectomy, truncal and tributary phlebectomy, dissection of perforant veins exclusively in the basin of the great saphenous vein. Relapses during five-year follow up occurred in 13.8% (102/745) of cases. Based on clinical signs and laboratory findings we studied the effect of the factor of undifferentiated connective tissue dysplasia (UDCTD) on the development of lower-limb varicosity. We carried out comparative analysis in the groups with relapsing LLVV (n=43), without relapses (n=39) and control group comprising volunteers not suffering from LLVV (n=37). The median of blood serum total oxiprolin concentration in LLVV patients both with and without relapses was elevated and amounted to 18.4 (IR 14.9-19.65) and 14.3 (IR 13.1-16.5) versus 8.35 (5.75-9.75) μmol/l, respectively. The mode of the clinical parameter of UDCTD degree in accordance with the rating scale of Smolnova T.Yu. (2003) in the group of patients with LLVV relapses turned out to be higher (Mo=19) than in the group of patients without relapses (Mo=10, p=0.003). The lowest score was in the control group. In patients having immediate relatives with LLVV the level of blood serum total oxiprolin and clinical scores of LLVV turned out to be statistically significantly higher. Hence, based on the obtained during the study clinical and laboratory findings it may be supposed that undifferentiated connective tissue dysplasia plays an important part in the development of both lower limb varicosity and relapses thereof.

  7. Mapping the methylation status of the miR-145 promoter in saphenous vein smooth muscle cells from individuals with type 2 diabetes.

    Science.gov (United States)

    Riches, Kirsten; Huntriss, John; Keeble, Claire; Wood, Ian C; O'Regan, David J; Turner, Neil A; Porter, Karen E

    2017-03-01

    Type 2 diabetes mellitus prevalence is growing globally, and the leading cause of mortality in these patients is cardiovascular disease. Epigenetic mechanisms such as microRNAs (miRs) and DNA methylation may contribute to complications of type 2 diabetes mellitus. We discovered an aberrant type 2 diabetes mellitus-smooth muscle cell phenotype driven by persistent up-regulation of miR-145. This study aimed to determine whether elevated expression was due to changes in methylation at the miR-145 promoter. Smooth muscle cells were cultured from saphenous veins of 22 non-diabetic and 22 type 2 diabetes mellitus donors. DNA was extracted, bisulphite treated and pyrosequencing used to interrogate methylation at 11 CpG sites within the miR-145 promoter. Inter-patient variation was high irrespective of type 2 diabetes mellitus. Differential methylation trends were apparent between non-diabetic and type 2 diabetes mellitus-smooth muscle cells at most sites but were not statistically significant. Methylation at CpGs -112 and -106 was consistently lower than all other sites explored in non-diabetic and type 2 diabetes mellitus-smooth muscle cells. Finally, miR-145 expression per se was not correlated with methylation levels observed at any site. The persistent up-regulation of miR-145 observed in type 2 diabetes mellitus-smooth muscle cells is not related to methylation at the miR-145 promoter. Crucially, miR-145 methylation is highly variable between patients, serving as a cautionary note for future studies of this region in primary human cell types.

  8. Relationship between Serum Albumin Level and Monocyte-to-High-Density Lipoprotein Cholesterol Ratio with Saphenous Vein Graft Disease in Coronary Bypass.

    Science.gov (United States)

    Akboga, Mehmet Kadri; Yayla, Cagri; Balci, Kevser Gulcihan; Ozeke, Ozcan; Maden, Orhan; Kisacik, Halil; Temizhan, Ahmet; Aydogdu, Sinan

    2017-06-01

    Background Previous studies proposed that inflammation, oxidative stress, and impaired endothelial dysfunction have a crucial role in occurrence of saphenous vein graft (SVG) disease (SVGD). The aim of this study was to assess the relationship between monocyte-to-high-density lipoprotein cholesterol (HDL-C) ratio (MHR) and serum albumin (SA) level as readily available inflammatory and oxidative stress markers with the presence of SVGD in patients with a coronary bypass. Methods In this retrospective cross-sectional study, a total of 257 patients (n = 112 SVGD [+] [mean age was 65.3 ± 8.4 years, 75.0% males] and n = 145 SVGD [-] [mean age was 66.5 ± 10.1 years, 74.5% males]) were enrolled. At least one SVG with ≥ 50% stenosis was defined as SVGD. Independent predictors of SVGD were determined by logistic regression analysis. Results White blood cell, neutrophil, monocyte, the age of SVG, and MHR were significantly higher, whereas SA level was significantly lower in patients with SVGD. In regression analysis, neutrophil, age of SVG, SA (odds ratio [OR]: 0.232 [0.156-0.370], p MHR (OR: 1.122 [1.072-1.174], p MHR (r = 0.238, p MHR has a 71.4% sensitivity and 60.0% specificity for prediction of SVGD. Conclusion Consequently, to the best of our knowledge, this is the first study showing a significant and independent association between SA and MHR with SVGD. Georg Thieme Verlag KG Stuttgart · New York.

  9. Feasibility, safety, and preliminary efficacy of a novel ePTFE-covered self-expanding stent in saphenous vein graft lesions: the Symbiot II trial.

    Science.gov (United States)

    Laarman, Gerrit J; Kiemeneij, Ferdinand; Mueller, Ralf; Guagliumi, Giuglio; Cobaugh, Michael; Serruys, Patrick W

    2005-03-01

    Compared with percutaneous interventions in native coronary arteries, revascularization of saphenous vein graft (SVG) lesions is associated with increased rates of immediate and long-term major adverse cardiac events (MACE). The Symbiot II trial was a multicenter prospective study designed to evaluate the feasibility and safety of a novel self-expanding polytetrafluoroethylene (ePTFE)-covered stent in the treatment of de novo and restenotic SVG lesions. The primary endpoint was MACE through 30 days postprocedure. Successful Symbiot stent deployment was achieved in 75 of 77 patients (97.4%) with SVG lesions < or = 35 mm in length (visual assessment). The procedural success rate (defined as < 30% residual stenosis at the target site and no clinical complications) was 83%, and all study device procedures provided grade 3 TIMI flow postprocedure. Within the first 30 days postprocedure, four patients (5.2%) experienced MACE (defined as death, Q-wave or non-Q-wave myocardial infarction, and clinically driven target vessel revascularization), of whom three patients (3.9%) experienced periprocedural non-Q-wave myocardial infarction. No subacute stent thrombosis was observed over the 6-month follow-up period. No relevant luminal loss at the target site (mean, 0.3 +/- 0.9 mm) was observed in the 58 patients (77.3% of enrolled patients) who underwent quantitative coronary angiography at 6 months. The incidences of binary in-stent restenosis, in-segment restenosis, and target vessel failure (defined as acute and late-term MACE through 6 months postprocedure) were low (7.0%, 8.6%, and 14.3%, respectively). The Symbiot self-expanding ePTFE membrane-covered stent was associated with a high procedural success rate (97.4%), low incidences of MACE at 30 days (5.2%) and 6 months (14.3%), suggesting that it is safe and effective in the treatment of SVG disease.

  10. The Efficacy of Low Molecular Weight Heparin in Prevention Deep of Vein Thrombosis after the Operation of Great Saphenous Varicose Vein%低分子肝素在预防大隐静脉曲张术后患肢深静脉血栓形成中的作用

    Institute of Scientific and Technical Information of China (English)

    董春锋; 王苏杭

    2012-01-01

    目的 探讨低分子肝素在预防大隐静脉曲张术后患肢深静脉血栓形成中的作用.方法 分析200例大隐静脉曲张术后应用低分子肝素抗凝患者(观察组)及200例术后未应用低分子肝素抗凝患者(对照组)下肢深静脉血栓形成发生情况及术后患肢皮下血肿的发生情况.结果 两组患者术后患肢深静脉血栓形成的发生率比较差异有统计学意义(P0.05).结论 大隐静脉曲张术后应用低分子肝素抗凝治疗,可显著降低下肢深静脉血栓形成的发生,同时不增加患肢术后出血的风险.%Objective To investigate the efficacy of low molecular weight heparin in prevention deep vein thrombosis( DVT )after the operation of great saphenous varicose vein. Methods The DVT incidence of 200 case of great saphenous varicose vein who were given low molecular weight heparin after operation( observation group )and 200 case of great saphenous varicose vein who were not given low molecular weight heparin after operation( control group )were analyzed, and the incidence of subcutaneous hematoma of the two groups were observed. Results There was significant difference between the two groups in DVT incidence ( P 0.05 ). Conclusion The therapy of the low molecular weight heparin after the operation of great saphenous varicose vein can reduce the incidence of DVT,without increasing the incidence of subcutaneous hematoma.

  11. 大隐静脉高位结扎联合剥脱术治疗原发性大隐静脉曲张的疗效观察%Curative Effect Observation on Great Saphenous Vein High Ligation Joint Peeling Treatment of Primary Great Saphenous Varicose Veins

    Institute of Scientific and Technical Information of China (English)

    王晓

    2014-01-01

    目的:评价改良后的大隐静脉曲张高位结扎联合剥脱术在治疗原发性大隐静脉曲张中的疗效。方法:选取2010年9月到2012年10月于我院收治的50例原发性大隐静脉曲张患者,按照患者入院编号,随机分为常规组和改良组,每组25例,比较两组患者药物治疗的疗效以及住院时间、手术时间、出血量等各项指标。结果:常规组患者的总治愈率为80%,手术时间为(54.5±6.3)h,住院时间为(7.2±1.2)d,手术过程中出血量为(133.4±4.4)ml;改良组患者的总治愈率为96%,手术时间为(54.5±6.3)h,住院时间为(6.1±0.9)d,手术过程中出血量为(25.6±1.3)ml;改良组患者治疗效果、手术时间、手术出血量以及住院时间均比常规组要好,组间比较均存在明显差异(P<0.05)。结论:采用改良方法能明显提高患者治愈率,缩短手术以及治疗时间,减少治疗过程中的出血量,降低手术风险。%Objective:To evaluate the modified great saphenous varicose vein high ligation joint peeling technique in the efficacy of the treatment of primary great saphenous varicose veins. Methods:To choose in September 2010 to October 2012 in our hospital of 50 patients of primary great saphenous varicose veins, according to the patients admitted to hospital number, were randomly divided into normal group and improvement group, 25 cases in each group, compare the curative effect of two groups of patients with medication and hospitalization time, operation time, blood loss and other indicators. Results:The routine group of patients with total cure rate was 80%, operation time for (54.5±6.3)h, length of hospital stay for (7.2±1.2)d, blood loss during surgery for (133.4±4.4)ml;Improved group of patients with total cure rate was 96%, operation time for (54.5±6.3)h, length of hospital stay for (6.1±0.9)d, blood loss during surgery for (25.6±1.3)ml;Group of patients improved treatment effect, operation time, surgical blood loss

  12. The experience of blood drive belt used in the operation of varicose great saphenous vein%驱血带在大隐静脉曲张手术中的应用体会

    Institute of Scientific and Technical Information of China (English)

    姚建国

    2015-01-01

    Objective:To summarize the advantages of using blood drive belt in the operation of varicose great saphenous vein. Methods:68 patients with varicose great saphenous vein were selected from August 2008 to August 2014.All of those patients were unilateral great saphenous varicose veins.They were randomly divided into two groups.The first groups of 34 cases took operation after drive blood using blood drive belt,and the second groups of 34 cases took operation directly without using blood drive belt. Results:The operation time of the first group was averaged 43 min,the bleeding volume was averaged 30 mL.While in the second group,the operation time was averaged 62 min,and the bleeding volume was averaged 90 mL.Conclusion:Using of blood drive belt in the operation of varicose great saphenous vein can significantly shorten the operation time,and significantly reduced bleeding, meanwhile,the method of operation is simple,so it is worthy of popularization.%目的:总结在大隐静脉曲张手术中应用驱血带的优点。方法:2008年8月-2014年8月收治大隐静脉曲张患者68例,均为单侧大隐静脉曲张,将患者随机平均分成两组,第1组34例采用驱血带驱血后进行手术,第2组34例不采用驱血带驱血,直接进行手术。结果:第1组平均手术时间43 min,平均出血量30 mL。第2组平均手术时间62 min,平均出血量90 mL。结论:在大隐静脉曲张手术中使用驱血带,不仅手术时间明显缩短,出血量明显减少,而且操作方法简单,值得在各级医院推广使用。

  13. Estenose do enxerto de veia safena magna reversa em revascularização arterial infrainguinal Stenosis of reverse great saphenous vein graft in infrainguinal arterial revascularization

    Directory of Open Access Journals (Sweden)

    Francesco Evangelista Botelho

    2011-04-01

    infrainguinal bypasses stenosis using reverse great saphenous vein graft. METHODS: From March of 2008 to March of 2009, 56 infrainguinal bypasses were performed with reverse great saphenous vein graft in 56 patients. On the 30th post-operative day, 32 out of 56 patients were submitted to vascular ultrasonography. The prevalence of significant graft stenosis was determined. In addition, the diagnosis of stenosis was related to the clinical and surgical characteristics of the patients. The variables analyzed at the moment of diagnosis were the localization of the graft stenosis, the risk factors associated with stenosis and the association of vascular ultrasonography findings with ankle brachial pressure index (ABI. RESULTS: The overall prevalence of significant graft stenosis was 48.4%. Out of the total number of observed stenosis, 19.4% were considered severe, and 29% mild or moderate. There was no significant association between the presence of significant stenosis and the following variables: gender, diabetes, hypertension, smoking, hipercholesterolemia, graft diameter, site of the distal anastomosis, and graft composition. There was a weak agreement between ABI and vascular ultrasonography in detecting stenosis in general (K = 0.30; CL95% 0.232 - 0.473; p = 0.018. However, there was a substantial agreement in detecting severe stenosis (K = 0.75; CL95% 0.655 - 0.811; p = 0.0001. CONCLUSION: There was a high prevalence of stenosis on the 30th post-operative day, mostly localized in the proximal half of the vein graft. There was no significant association of stenosis with clinical and surgical factors analyzed. ABI and vascular ultrasonography had weak agreement with the diagnosis of stenosis in general and an important agreement for the diagnosis of severe stenosis.

  14. Effects of aggressive statin therapy on patients with coronary saphenous vein bypass grafts: a systematic review and meta-analysis of randomized, controlled trials.

    Science.gov (United States)

    Kang, Sheng; Liu, Yong; Liu, Xue-bo

    2013-08-01

    The aim of this study was to investigate the effectiveness and safety of aggressive statin versus moderate statin therapy on patients with saphenous vein grafts (SVGs) in randomized, controlled trials (RCTs). We searched MEDLINE (1980-June 2012), the Cochrane Controlled Trials Register, EMBASE, Science Citation Index, and PubMed (to June 2012), and found 10 relevant RCTs, including 7 substudy analyses from a Post-CABG trial, and 1 pooled analysis of the PROVE-IT TIMI 22 trial (Pravastatin or Atorvastatin Evaluation and Infection Therapy-Thrombolysis in Myocardial Infarction 22 Investigators) and A to Z trial. Early intensive vs a delayed conservative simvastatin strategy in patients with acute coronary syndromes; phase Z of the A to Z trial. A total of 6645 of participants, ages ranging from 21 to 75 years old, were treated with coronary artery bypass graft (CABG) and were followed for 2 to 5 years. Eight studies showed that aggressive statin therapy had lower LDL-C levels and a decrease of 39% in graft atherosclerotic progression, 12% in new occlusions, and 19% in new lesions more than moderate statin therapy. Three reports indicated that aggressive statin therapy lowered the risk of repeated myocardial infarction more than moderate statin therapy for coronary revascularization (95% CI, 0.66-0.95; risk ratio [RR] = 0.80; and 95% CI, 0.66-0.85; RR = 0.75) and lowered the risk of cardiac death as well (95% CI, 0.64-1.08; RR = 0.83). Aggressive statin therapy had safety similar to that of moderate statin therapy except for a slight increase in myopathic events and aminotransferase levels. Seventy percent to 90% of patients took statin treatment as prescribed in long-term. Compared with moderate statin therapy, long-term aggressive statin lowered the LDL-C level significantly, further decreased the atherosclerotic progression of SVG, reduced the risks of repeated myocardial infarction and coronary revascularization after CABG, and revealed similar patient compliance

  15. Relationship between the diameter of great saphenous vein and body mass index Relação entre o diâmetro da veia safena magna e o índice de massa corporal

    Directory of Open Access Journals (Sweden)

    Amélia C. Seidel

    2005-09-01

    Full Text Available OBJECTIVE: This study has been designed to correlate the diameter of the greater saphenous vein in different levels of the lower limbs with the body mass index of each individual to determine a possible relation between them. METHODS: Fifty-two lower limbs in 26 volunteers (six males and 20 females without a chronic venous disease record, aged 21-68 were evaluated. Prior to color-flow duplex scanning the body mass index was defined. The deep and superficial venous systems and perforator veins were assessed as described in the literature. The diameter of the greater saphenous vein was measured with ultrasound longitudinal imaging in seven different levels. For the statistical analysis, Student t test for paired data and Spearman test were used. RESULTS: The difference observed in saphenous venous in the second and third levels when compared to the lower right and left limbs was not considered significant and a single group was formed to correlate with body mass index. The correlation was considered statistically irrelevant. CONCLUSION: By correlating the diameters of the greater saphenous vein with the body mass index of each individual it was noted that the relation between them is not significant, therefore it can be assumed that tall thin individuals can have greater saphenous vein with similar diameter as short fat individuals.OBJETIVO: Este estudo teve o objetivo de comparar o diâmetro da veia safena magna em diferentes níveis dos membros inferiores e o índice de massa corporal dos sujeitos para determinar uma possível relação entre esses fatores. MÉTODOS: Cinqüenta e dois membros inferiores de 26 voluntários (seis homens e 20 mulheres sem registro de doença venosa crônica, com idades entre 21 e 68 anos, foram avaliados. O índice de massa corporal foi definido antes do eco-Doppler colorido. Os sistemas venosos superficial e profundo e as veias perfurantes foram avaliados de acordo com a literatura. O diâmetro da veia safena

  16. Study on the Effect of Small-incision Saphenous Vein Stripping Operation Combined With Foam Sclerotherapy Injection in Treatment of Varicose Veins of Lower Extremity%小切口大隐静脉剥脱术联合泡沫硬化剂注射治疗下肢浅静脉曲张的效果研究

    Institute of Scientific and Technical Information of China (English)

    张海龙; 李谊佳; 陈昊泽

    2016-01-01

    Objective Effect of smal-incision saphenous vein stripping operation combined with foam sclerotherapy injection in treatment of varicose veins of lower extremity is to be studied.Methods Chose 52 patients with varicose veins of lower extremity who were treated in hospital from January to December 2015 and separated them into control group(small-incision saphenous vein stripping operation)and study group(small-incision saphenous vein stripping operation combined with foam sclerotherapy injection treatment)by drawing lottery and then compared treatment effects between two groups.Results Patients’every physical index was much better,treatment efficacy was higher and infection rate was much lower in study group than counterparts in control group,there was a differential between these two groups,and such a differential had statistic value(P<0.05). ConclusionSmal-incision saphenous vein stripping operation combined with foam sclerotherapy injection is quiet effective in treatment of varicose veins of lower extremity.%目的:研究小切口大隐静脉剥脱术联合泡沫硬化剂注射治疗下肢浅静脉曲张的疗效。方法研究年度2015年1~12月,研究对象为下肢浅静脉曲张患者52例,给予抽签分组。对照组(小切口大隐静脉剥脱术)和研究组(小切口大隐静脉剥脱术联合泡沫硬化剂注射),对比两组疗效。结果两组中研究组各项指标优,治疗有效率高,感染率低,差异有统计学意义(P<0.05)。结论下肢浅静脉曲张采用小切口大隐静脉剥脱术联合泡沫硬化剂注射治疗,疗效确切。

  17. 大隐静脉高位结扎剥落加局部电凝术对下肢静脉曲张的治疗效果探讨%To Explore the Curative Effect of High Ligation of Great Saphenous Vein Stripping and Bureau of Electrocoagulation on Varicose Veins of Lower Extremity

    Institute of Scientific and Technical Information of China (English)

    潘清文; 叶永生; 陈哲

    2014-01-01

    目的:探讨分析大隐静脉高位结扎剥落加局部电凝术对下肢静脉曲张的临床治疗效果。方法选取在我院接受治疗的59例下肢静脉曲张患者为研究对象,将其随机分成观察组和对照组,观察组30例,对照组29例,观察组实施大隐静脉高位结扎剥落加局电凝术治疗,对照组实施传统大隐静脉高位结扎加分段抽剥手术治疗,分析两组患者的治疗效果。结果观察组总有效率为75.86%,对照组总有效率为93.33%,观察组效果尤为明…显,P <0.05。结论对下肢静脉曲张患者实施大隐静脉高位结扎剥落加局部电凝术治疗具有显著的临床效果。%Objective To investigate the clinical analysis of curative effect of high ligation of great saphenous vein stripping plus local electrocoagulation for varicose veins of lower extremity. Methods 59 patients with varicose vein of lower extremity patients were treated in our hospital as the research object, and were randomly divided into the observation group and control group, 30 cases in observation group, 29 cases in the control group, the observation group to implement the high ligation of great saphenous vein stripping and bureau of electric coagulation treatment, the control group received traditional great saphenous vein high ligation sectional stripping operation treatment, of the two groups of patients with treatment effect. Results the total effective rate of observation group was 75.86%, the control group the total effective rate was 93.33%, the observation group effect is particularly obvious, P<0.05. Conclusion The clinical effect was significant with in patients with lower extremity varicose vein high ligation of great saphenous vein stripping and implementation of local electric coagulation treatment, worthy of clinical application.

  18. Arterialization and anomalous vein wall remodeling in varicose veins is associated with upregulated FoxC2-Dll4 pathway.

    Science.gov (United States)

    Surendran, Sumi; S Ramegowda, Kalpana; Suresh, Aarcha; Binil Raj, S S; Lakkappa, Ravi Kumar B; Kamalapurkar, Giridhar; Radhakrishnan, N; C Kartha, Chandrasekharan

    2016-04-01

    Varicose veins of lower extremities are a heritable common disorder. Mechanisms underlying its pathogenesis are still vague. Structural failures such as valve weakness and wall dilatation in saphenous vein result in venous retrograde flow in lower extremities of body. Reflux of blood leads to distal high venous pressure resulting in distended veins. In an earlier study, we observed a positive association between c.-512C>T FoxC2 gene polymorphism and upregulated FoxC2 expression in varicose vein specimens. FoxC2 overexpression in vitro in venous endothelial cells resulted in the elevated mRNA expression of arterial endothelial markers such as Delta-like ligand 4 (Dll4) and Hairy/enhancer-of-split related with YRPW motif protein 2 (Hey2). We hypothesized that an altered FoxC2-Dll4 signaling underlies saphenous vein wall remodeling in patients with varicose veins. Saphenous veins specimens were collected from 22 patients with varicose veins and 20 control subjects who underwent coronary artery bypass grafting. Tissues were processed for paraffin embedding and sections were immunostained for Dll4, Hey2, EphrinB2, α-SMA, Vimentin, and CD31 antigens and examined under microscope. These observations were confirmed by quantitative real-time PCR and western blot analysis. An examination of varicose vein tissue specimens by immunohistochemistry indicated an elevated expression of Notch pathway components, such as Dll4, Hey2, and EphrinB2, and smooth muscle markers, which was further confirmed by gene and protein expression analyses. We conclude that the molecular alterations in Dll4-Hey2 signaling are associated with smooth muscle cell hypertrophy and hyperplasia in varicose veins. Our observations substantiate a significant role for altered FoxC2-Dll4 signaling in structural alterations of saphenous veins in patients with varicose veins.

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

    Directory of Open Access Journals (Sweden)

    Monir Abbaszadeh

    2008-09-01

    complications were analyzed and compared with the entire cohort of patients, undergoing similar bypass procedures during the same period. RESULTS: Lower extremity wound complications occurred in 68 patients (1.7%, 43 of them required additional surgical interventions. There were 17 wound debridements, nine skin grafts, one angioplasty, 11 fasciotomies, three vascular procedures, and two free tissue transfers. Of 13 variables evaluated by multivariate analysis, female gender, BMI, use of internal thoracic artery graft, peripheral vascular disease, the use of postoperative intraaortic balloon pump and preexisting hyperlipidemia were identified as significant independent predictors of major leg wound complications (p<0.05. CONCLUSIONS: The causes of major leg wound complications after saphenous vein harvest for coronary artery bypass graft procedures are multifactorial. To minimize these complications, we recommend vascular evaluations before saphenous vein harvest, attention to proper surgical technique, and careful harvest site section.

  20. 大隐静脉曲张手术所致严重血管损伤的治疗%The management of severe vascular injuries caused by stripping of great saphenous vein varicosis

    Institute of Scientific and Technical Information of China (English)

    程志华; 王宏飞; 陈光; 赵文光; 王嘉桔

    2010-01-01

    目的 总结大隐静脉曲张手术导致严重血管损伤并发症的治疗经验.方法 回顾性分析2004年12月至2009年4月收治的4例(5条肢体)大隐静脉曲张手术发生严重血管损伤患者的临床资料.对1条股总动脉末端至胫后动脉上段动脉被剥脱的肢体应用人工血管行动脉重建术,术后肢体坏疽行膝上截肢术;对3条股浅动脉被剥脱10~15 cm的肢体取自体大隐静脉行动脉重建术,术后5 d对1条坏死肢体行膝上截肢术.1条股浅静脉被切除2 cm的肢体取自体大隐静脉行股浅静脉重建术.结果 4例患者中,围手术期无死亡病例,4条动脉损伤肢体中2条肢体(50%)行膝上截肢术;2条肢体(50%)得到保伞,随访12~46个月,平均29个月,血管通畅良好.1例股浅静脉损伤患者恢复良好.结论 提高对医源性血管损伤的认识,术中规范操作,辨明解剖,可以减少和预防严重血管并发症的发生;一旦有血管损伤应早期而有效的处理.%Objective To summarize our experience on the treatment for severe vascular injuries in the operation of great saphenous varicose vein. Methods The clinical data of 4 cases (5 lower limbs) from December 2004 to April 2009 of severe vascular injuries were retrospectively analyzed. For the lower limbs in which from the end of femoral artery to the upper part of posterior tibial artery were stripped, reconstruction operation using blood vessel prothesis was performed, above knee amputation was performed because of limb gangrene. For three limbs in which 10 cm to 15 cm superficial femoral artery were stripped, reconstruction operation using autologous saphenous vein were performed, above knee amputation was performed for one limb 5 days after the operation. For the limb in which 2 cm superficial femoral vein were cut, reconstruction operation using autologous saphenous vein were performed. Results No cases died perioperatively,for four limbs of injuried artery, ampution were performed

  1. Clinical Efficacy of the Lower Leg Section Reserved thigh Saphenous Vein Stripping Segment Surgical for Elderly Patients with Varicose Veins of Lower Extremity%老年人下肢静脉曲张患者保留小腿段大隐静脉大腿段剥脱术的临床效果

    Institute of Scientific and Technical Information of China (English)

    王兵

    2016-01-01

    目的:观察老年人下肢静脉曲张应用保留小腿段大隐静脉大腿段剥脱术的效果。方法选取2014年3月~2015年3月本院接收的86例下肢静脉曲张患者,随机分作研究组与传统组,每组43例,分别行大隐静脉大腿段剥脱术联合小腿曲张静脉剥脱术、传统大隐静脉高位结扎及全段剥脱术治疗,比较两组手术效果。结果研究组患者平均术中失血量、术程、住院时间分别为(30.52±4.23)ml、(45.40±5.65) min、(4.25±0.36)d;传统组分别为(75.23±5.12)ml、(65.55±6.24) min、(12.36±0.42)d,研究组平均术中失血量、术程、住院时间均较传统组少,差异具统计学意义(P<0.01);研究组并发症发生率与术后1年复发率分别为6.98%与0,传统组分别为23.26%与13.95%,研究组并发症发生率更低,差异具统计学意义(P<0.05)。结论老年下肢静脉曲张应用保留小腿段大隐静脉大腿段剥脱术治疗效果理想,值得应用。%Objective To discuss the clinical efficacy of the lower leg section reserved thigh saphenous vein stripping segment surgical for elderly patients with varicose veins of lower extremity.Methods Selected 86 cases with varicose veins from Mar 2013 to Mar 2014 were randomly divided into study group and the conventional group, each of 43 cases. Study group was treated with the great saphenous vein stripping surgery combined with calf thigh section stripping of varicose veins, and conventional group was treated with the traditional great saphenous vein high ligation and stripping of intact. Clinical efifcacy of two groups was compared.Results Study patients mean intraoperative blood loss, surgery process, duration of hospitalization was (30.52 ± 4.23)ml, (45.40 ± 5.65)min, (4.25 ± 0.36) d; conventional group were (75.23 ± 5.12)ml, (65.55 ± 6.24)min, (12.36 ± 0.42)d, and study group mean intraoperative blood loss, surgery process, length of stay

  2. Analysis of the Clinical Effect of Punctate Stripping in the Treatment of Great Saphenous Varicose Veins%分析点状抽剥在大隐静脉曲张治疗中的临床效果

    Institute of Scientific and Technical Information of China (English)

    祖连平

    2015-01-01

    Objective To explore the clinical effect of punctate stripping in the treatment of great saphenous varicose veins. Methods 50 cases with great saphenous varicose veins admitted in Department of Varicose Veins of our hospital from March 2013 to March 2015 were selected as the subjects and randomly divided into two groups with 25 cases in each. Pa-tients in the control group were treated by cutting and stripping surgery, while those in the observation group were treated by punctate stripping surgery. And the treatment effect of two groups was compared. Results The operation time of the ob-servation group was (43.0±7.8) min, and that of the control group was (60.0±13) min; the amount of intraoperative blood transfusion of the observation group was (53.1±15.1)mL, and that of the control group was (135.0±33.8) mL; the length of hospital stay of the observation group was (7.1±2.1)d, and that of the control group was (9.5±2.5)d, the differences between the two groups were statistically significant (P<0.05). Conclusion Punctate stripping for great saphenous varicose veins can effectively improve the treatment effect, so it is worthy of promotion and application.%目的:探讨在大隐静脉曲张中使用下段点状抽剥治疗的临床效果。方法整群选取该院2013年3月—2015年3月静脉曲张专科中大隐静脉曲张50例患者为研究对象,随机分为2组,每组25例。对照组应用切开剥除技术,观察组应用点状抽剥技术,对比两组的治疗效果。结果观察观察组手术时间为(43.0±7.8) min,对照组手术时间为(60.0±13)min;对照组术中输血量为(135.0±33.8) ml,观察组术中输血量为(53.1±15.1) ml;对照组住院时间为(9.5±2.5) d,观察组住院时间为(7.1±2.1) d,差异有统计学意义(P<0.05)。结论应用点状抽剥技术能有效提高病症治疗量,值得在临床进行推广使用。

  3. 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

  4. 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.

  5. 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.

  6. 大隐静脉抽剥对下肢深静脉瓣膜功能的影响%Effect of deep venous valve function after the stripping of saphenous vein

    Institute of Scientific and Technical Information of China (English)

    曾昕明; 王鹏程; 赵军

    2010-01-01

    目的 研究大隐静脉激抽剥术治疗下肢慢性静脉功能不全对改善深静脉瓣膜功能的作用.方法 收集45例(50条肢体)住院治疗的下肢下肢慢性静脉功能不全的患者,行大隐静脉高位结扎剥脱术.所有患者术前均经过双功能彩色多普勒超声检查记录深静脉血流动力学指标,手术后3个月对患者进行随访,比较手术前后深静脉瓣膜功能是否有改善及改善的程度.结果 除6例共7条患肢术后3个月未见明显降低级别外,其余患肢所有患肢术后均出现深静脉功能级别下降1级或1级以上;术前深静脉功能记分为139,术后3个月降到93,差异有显著性(P<0.01).血流动力学指数(股浅静脉第一对瓣膜返流时间与返流最大流速)术后均显著改善(P<0.05).结论 大隐静脉激抽剥术治疗下肢慢性静脉功能不全的有效术式,并且确实可以在一定程度上改善深静脉瓣膜功能.%Objective To evaluate the effect on deep venous valve function after proximal saphenous vein ligation and ablation of varicose veins in treatment of chronic venous insufficiency (CVI) of lower limbs.Methods Forty five(50 limbs)cases with CVI were enrolled to accept surgical management of vein systems.Each patient was detected with Color Doppler Ultra sonography, whose deep venous hemodynamics index was measured and recorded pre-operation and three month after operation. Results Except 6 ( 7 limbs) cases without degradation of deep venous valve function class post operation, the others cases are all decrease one or more. The scoring of deep venous valve function post operation are significantly decrease from 139 (pre-operation)to 93 (P<0. 01 ). The index of deep venous hemodynamics( back flow time and peak flow rate of back flow)has prominent improvement after operation(P< 0 05). Conclusion It is effective way of proximal saphenous vein ligation and ablation of varicose veins in treatment of CVI and it is confirmed that it can

  7. Aberrant expression of Tiel gene in venous valves in great saphenous varicose vein%Tiel基因在曲张大隐静脉瓣膜的异常表达

    Institute of Scientific and Technical Information of China (English)

    王鑫; 乔彤; 刘长建

    2012-01-01

    Objective To investigate the aberrant expression of Tiel gene in venous valves in great saphenous varicose vein,and its role in pathogenesis of varicose vein of lower extremity.Methods Varicose veins group ( 15 samples) and normal control group ( 11 samples) were set up.By using immunohistochemistry staining,the expression of CD31 and Tiel in the first valves in great saphenous veins was detected.Western blotting was used to check the expression of Tiel protein in venous valves.Results In normal control group valves,there was no difference between proximal and distal sides endothelium in expressing CD31 (P > 0.05 ).The proximal side endothelium expressed Tie1 stronger than distal side at the basal part (P < 0.05 ),but this difference was not found at valve cusp (P > 0.05 ).In varicose veins group,besides morphological changes of valves,the proximal side endothelia expressed CD31 weaker than diatal side endothelia ( P < 0.05 ),and expressed Tiel much weaker than diatal side endothelia ( P <0.01 ).The expression of Tiel protein was undetectable in venous valves.Conclusion The decreased expression of Tiel in proximal side of venous valves may play a role in the pathogenesis of primary lower extremity varicose veins.%目的 观察下肢静脉曲张疾病中,Tiel基因在曲张大隐静脉第1对瓣膜中的异常表达,探讨其与下肢静脉曲张发病机制之间的关系.方法 大隐静脉曲张组15例,正常对照组11例;用免疫组织化学法检测大隐静脉第一对瓣膜CD31及Tiel的表达,并用Western blot检测瓣膜中Tiel蛋白的表达.结果 正常对照组中瓣膜两侧内皮细胞表达CD31差异无统计学意义(P>0.05),在瓣膜根部近心侧内皮细胞表达Tiel强于远心侧(P<0.05),但在瓣膜尖部差异无统计学意义(P>0.05);静脉曲张组中瓣膜除了形态发生变化外,瓣膜近心侧内皮细胞CD31的表达稍弱于远心侧(P<0.05),而Tiel的表达显著弱于远心侧(P<0.01);Western blot

  8. Nova técnica cirúrgica de preparo da veia safena para revascularização do miocárdio sem manipulação direta - no-touch Novel no-touch technique of harvesting the saphenous vein for coronary artery bypass grafting

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    Fabio de Rueda

    2008-06-01

    technique consists of harvesting the vein with a pedicle of surrounding tissue, which protects the vein from spasms, obviating the need for distension. METHODS: A prospective, randomized study with 156 patients who underwent artery bypass grafting was performed comparing three saphenous vein harvesting techniques: conventional, intermediate, and no-touch. A morphological study of the endothelium was carried out using scanning microscopy. An angiographic assessment of the vein graft patency was performed at a mean follow-up time of 18 months. Also, an immunohistochemical assessment was carried out to identify the endothelial enzyme nitric oxide synthase (eNOS in the vein wall RESULTS: The preservation of the endothelial cell integrity was greater in the no-touch technique than in the other procedures. At angiographic follow-up, the patency for the no-touch group was 95.4%, 88.9% for the grafts of the conventional technique group, and 86.2% for the grafts performed in the intermediate technique group. The immunohistochemical assessment revealed eNOS in all three layers of the vein wall in the no-touch group and reduction of this enzyme in the conventional group. CONCLUSION: The endothelial integrity and eNOS activity were better preserved when using the no-touch technique for vein graft harvesting. The mechanical protection provided by the cushion of surrounding tissue in the no-touch group, the vasorelaxation and thromboresistant activities of nitric oxide may be responsible for the reduction of vasospasms and improved patency rate.

  9. [ENDOVENOUS LASER TREATMENT FOR VARICOSE VEINS].

    Science.gov (United States)

    Tezuka, Masahiro; Kanaoka, Yuji; Ohki, Takao

    2015-05-01

    Varicose veins are a common condition attecting approximately 10 million patients in Japan. The main cause of varicose veins is reflux of the saphenous vein, and conventional treatment for several decades was stripping the affected saphenous vein and phlebectomy. Endovenous laser treatment (EVLT) is a less-invasive treatment method in which the saphenous vein is ablated with a laser under local anesthesia. EVLT has been approved by the Japanese Ministry of Health, Labor and Welfare since 2011, and we have performed EVLT on 5,160 legs with saphenous insufficiency with no severe complications including deep vein thrombosis except for one case of arteriovenous fistula. EVLT appears to be a safe, effective treatment option for varicose veins with saphenous insufficiency.

  10. Association between the Hypomethylation of Osteopontin and Integrin β3 Promoters and Vascular Smooth Muscle Cell Phenotype Switching in Great Saphenous Varicose Veins

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    Han Jiang

    2014-10-01

    Full Text Available Lower extremity varicose veins are a common condition in vascular surgery and proliferation of vascular smooth muscle cells (VSMCs in the intima is a significant pathological feature of varicosity. However, the pathogenesis of varicose veins is not fully understood. Osteopontin (OPN could promote the migration and adhesion of VSMCs through the cell surface receptor integrin β3 and the cooperation of OPN and integrin β3 is involved in many vascular diseases. However, the role of OPN and integrin β3 in varicosity remains unclear. In the current study, we found that the methylation levels in the promoter regions of OPN and integrin β3 genes in the VSMCs of varicose veins are reduced and the protein expression of OPN and integrin β3 are increased, compared with normal veins. Furthermore, it was observed that VSMCs in the neointima of varicose veins were transformed into the synthetic phenotype. Collectively, hypomethylation of the promoter regions for OPN and integrin β3 genes may increase the expression of these genes in varicosity, which is closely related to VSMC phenotype switching. Hypomethylation of the promoter regions for OPN and integrin β3 genes may be a key factor in the pathogenesis of varicosity.

  11. Association between the hypomethylation of osteopontin and integrin β3 promoters and vascular smooth muscle cell phenotype switching in great saphenous varicose veins.

    Science.gov (United States)

    Jiang, Han; Lun, Yu; Wu, Xiaoyu; Xia, Qian; Zhang, Xiaoyu; Xin, Shijie; Zhang, Jian

    2014-10-17

    Lower extremity varicose veins are a common condition in vascular surgery and proliferation of vascular smooth muscle cells (VSMCs) in the intima is a significant pathological feature of varicosity. However, the pathogenesis of varicose veins is not fully understood. Osteopontin (OPN) could promote the migration and adhesion of VSMCs through the cell surface receptor integrin β3 and the cooperation of OPN and integrin β3 is involved in many vascular diseases. However, the role of OPN and integrin β3 in varicosity remains unclear. In the current study, we found that the methylation levels in the promoter regions of OPN and integrin β3 genes in the VSMCs of varicose veins are reduced and the protein expression of OPN and integrin β3 are increased, compared with normal veins. Furthermore, it was observed that VSMCs in the neointima of varicose veins were transformed into the synthetic phenotype. Collectively, hypomethylation of the promoter regions for OPN and integrin β3 genes may increase the expression of these genes in varicosity, which is closely related to VSMC phenotype switching. Hypomethylation of the promoter regions for OPN and integrin β3 genes may be a key factor in the pathogenesis of varicosity.

  12. Experimental study of surrounding the tendon end with great saphenous vein to prevent the adhesion of extensor tendon%大隐静脉包裹肌腱断端防止伸肌腱粘连的实验研究

    Institute of Scientific and Technical Information of China (English)

    张申申; 王磊; 郭卫中

    2015-01-01

    Objective To observe the effect of surrounding the tendon end with great saphenous vein to prevent the adhesion of extensor tendon. Methods 30 normal domestic chicken were divided into 3 groups at random. Group A: Tendon end of natural healing. Group B: end was surrand the great saphenous vein. Group C: end was reverse packaged by the great saphenous vein (vascular intima turn to outside, blood vessels, outer membrane with the tendon broken contact). After 6 weeks chickens were killed, anatomical extensor tendon was examined by, to measure the indicators. Results Tendon anastomosis in group B, edema degree, mobility in the adhesion area is better than the other two groups, collagen fibers and fibroblasts, collagen fiber orientation is consistent, the vertical axis is arranged along the tendons, have small capillaries angiogenesis. Conclusion With chicken as experimental models, the use of autogenous great saphenous vein as package, can better play a role of great saphenous vein barrier.%目的:观察大隐静脉替代腱周组织预防伸肌腱粘连的临床疗效。方法正常本地鸡30只随机分三组。A组:肌腱断端自然愈合;B组:断端采用大隐静脉包裹;C组:断端采用大隐静脉反向包裹(血管内膜翻转向外,血管外膜与肌腱断端接触)。术后6周将鸡处死,解剖伸肌腱,对各项指标观察测定。结果B组肌腱吻合口处的活动度、水肿度、粘连面积优于其他两组;胶原纤维及纤维母细胞连接、胶原纤维排列方向大部分一致,沿肌腱纵轴排列,有小毛细血管生成。结论以鸡建立实验模型,使用自体大隐静脉正向包裹肌腱断端,可以较好地发挥大隐静脉屏障作用,减轻肌腱粘连。

  13. Coil embolization of arteriovenous fistulae on in situ saphenous vein bypasses: success rate and complications; Erfolgs- und Komplikationsrate der Coil-Embolisation arteriovenoeser Fisteln nach Vena-saphena-magna-in-situ-Bypassanlage

    Energy Technology Data Exchange (ETDEWEB)

    Krueger, K. [Koeln Univ. (Germany). Inst. und Poliklinik fuer Radiologische Diagnostik; Vivantes Humboldt-Klinikum, Berlin (Germany). Inst. fuer Radiologie und Interventionelle Therapie; Wagner, D.; Strohe, D.; Uedelhoven, J.; Lackner, K. [Koeln Univ. (Germany). Inst. und Poliklinik fuer Radiologische Diagnostik; Gawenda, M.; Brunkwall, J. [Vivantes Humboldt-Klinikum, Berlin (Germany). Inst. fuer Radiologie und Interventionelle Therapie

    2007-06-15

    Purpose: To determine the success and complication rate of coil embolization of arteriovenous fistulae on in situ saphenous vein bypasses. Materials and Method: 82 AV-fistulae on 30 bypasses (28 patients, 20 men, age 62.5 {+-} 8.3 years) were treated using coils. The success rate, complications, duration, amount of contrast material and radiation exposure were measured. Color-coded duplex sonography was performed 1 - 2 days and up to 6 - 18 months after embolization. Results: The success rate was 68.3 %. The reasons for persistent fistula perfusion were: 96 % fistula not accessible, 4 % reperfusion during thrombolysis. 7 complications were observed in 6 bypasses: failure of placement and retrieving of coil (n = 4), thrombembolic complications with thrombolysis (n = 3). The duration of intervention was 118.3 {+-} 46.6 min, the contrast material need was 277.03 {+-} 94.0 ml, and the radiation exposure was 10 966 {+-} 11 295 cGy/cm{sup 2}. Additional balloon dilatation was performed in 30 % of the bypasses. All bypasses were open 1 - 2 days after intervention. During follow-up, 11 persistent fistulae were detected. (orig.)

  14. 大隐静脉高位结扎合并腔内电凝闭合术治疗下肢浅静脉曲张疗效分析%Clinical effect of high ligation of the great saphenous vein combined with endovenous electrocoagulation in the treatment of varicose veins in the lower extremities

    Institute of Scientific and Technical Information of China (English)

    陆峻逵; 刘芳君

    2012-01-01

    Objective To explore the clinical effect of high ligation of the great saphenous vein combined with endovenous electrocoagulation for treating varicose veins in the lower extremities. Methods 210 patients with varicose veins in the lower extremity were randomly divided into the study group and the control group. Patients in the control group received endovenous electrocoagulation, while those in the study group were treated with high ligation of the great saphenous vein combined with endovenous electrocoagulation. Results The cure rate in the study group was 98.9%, significantly higher than 85.9% in the control group (P<0.05). 147 cases in the study group were found with complications, significantly lower than 219 cases in the control group (P<0.05). The relapse of varicose veins and ulcer occurred in one leg and 2 legs in the study group, respectively, significantly less than 9 legs and 13 legs in the control group. The incidence of postoperative pain is significantly higher in the study group than the control group (P<0.05). Conclusion For patients with varicose veins in the lower extremities, the combination of high ligation of the great saphenous vein and endovenous electrocoagulation can effectively improve the clinical efficacy and the prognosis.%目的 探讨大隐静脉高位结扎合并腔内电凝闭合术对下肢浅静脉曲张治疗的疗效.方法 将我院收治的210例(共350条肢体)下肢浅静脉曲张患者随机分为实验组和对照组,对照组患者采用腔内电凝闭合术进行治疗,实验组患者采用大隐静脉高位结扎合并腔内电凝闭合术进行治疗.结果 实验组临床治愈率为98.9%,高于对照组的85.9%(P<0.05);实验组患者出现并发症147例次,低于对照组的219例次(P<0.05);实验组静脉曲张复发以及溃疡复发的患肢分别为1肢和2肢,而对照组分别为9肢和13肢(P<0.05);实验组患者术后疼痛的发生机会明显大于对照组(P<0.05).结论 对患者

  15. The use of primary stenting or balloon percutaneous transluminal coronary angioplasty for the treatment of acutely occluded saphenous vein grafts. Results from the Brazilian National Registry - CENIC

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    Luiz Alberto Mattos

    2001-06-01

    Full Text Available OBJECTIVE: We conducted a comparative analysis of the in-hospital outcomes of patients who underwent primary percutaneous transluminal angioplasty (PTCA or stent implantation because of an acute myocardial infarction (AMI related to an acute vein graft occlusion. METHODS: Since 1991 the Brazilian Society of Hemodynamic and Interventional Cardiology has maintained a large database (CENIC. From these, we selected all consecutive patients, who underwent primary PTCA or stenting in the first 24 hours of AMI, with the target vessel being an occluded vein graft. Immediate results and major coronary events occurring up until hospital discharge were analyzed. RESULTS: During this period, 5,932 patients underwent primary PTCA or stenting; 158 (3% of the procedures were performed because of an acute vein graft occlusion. Stenting was performed in 74 (47% patients. Patients treated with stents had a higher success rate and lower mean residual stenosis compared with those who underwent primary balloon PTCA. The incidence of reinfarction and death were similar for stenting and balloon PTCA. CONCLUSION: Primary percutaneous treatment of AMI related to acute vein graft occlusion is still an uncommon practice. Primary stenting improved luminal diameter and offered higher rates of success; however, this strategy did not reduce the in-hospital reinfarction and death rate, compared with that occurring with PTCA treatment.

  16. 单纯性下肢静脉曲张中医辨证分型与大隐静脉超声观察指标的相关性研究∗%The correlation between Chinese medicine syndrome types of simplex varicose veins in lower extremity and great saphenous vein ultrasound indexes

    Institute of Scientific and Technical Information of China (English)

    王朝歆; 赵晖; 曹建春; 刘艳; 杨玲

    2015-01-01

    目的:探讨单纯性下肢静脉曲张中医辨证分型与大隐静脉超声观察指标之间的相关性。方法将132例单纯性下肢静脉曲张患者分为脉络湿邪阻滞证组、脉络湿邪瘀阻证组、脉络湿毒瘀热证组,分别对3组患者进行超声检查,比较3组大隐静脉近心段管径、返流峰值速度、返流时间。结果3组大隐静脉近心段管径比较差异有统计学意义( P<0.001),3组中每2组管径比较差异均有统计学意义(P<0.05),大隐静脉近心段管径从粗到细的顺序为:脉络湿毒瘀热证组、脉络湿邪瘀阻证组、脉络湿邪阻滞证组。3组返流峰值速度比较差异有统计学意义( P<0.001),3组中每2组返流峰值速度比较差异均有统计学意义(P<0.05),大隐静脉近心段的返流峰值速度从高到低的顺序为:脉络湿毒瘀热证组、脉络湿邪瘀阻证组、脉络湿邪阻滞证组。3组返流时间比较差异有统计学意义( P<0.001),3组中每2组返流时间比较差异均有统计学意义( P<0.05),大隐静脉近心段的返流时间从长到短的顺序为:脉络湿毒瘀热证组、脉络湿邪瘀阻证组、脉络湿邪阻滞证组。结论大隐静脉超声观察指标与单纯性下肢静脉曲张的中医证型具有一定的相关性,可为单纯性下肢静脉曲张辨证分型提供客观依据。%Objective To explore the correlation between Chinese medicine syndrome differentiation types of simplex varicose veins in lower extremity and great saphenous vein ultrasound indexes. Methods 132 patients suffering simplex varicose veins of lower extremity were divided into 3 groups:dampness blocking channels syndrome, dampness and blood stasis blocking channels syndrome, dampness and stagnant heat syndrome. Great saphenous vein in recent period of pipe diameter, peak reflux velocity ( PRV ) and reflux time ( RT) were compared among the three groups. Results There was significant difference of great saphenous vein

  17. 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

    Directory of Open Access Journals (Sweden)

    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.

  18. Application of minimally invasive stripping of great saphenous vein operation combined with foam sclerotherapy treated on patients with varicose veins of lower extremity%小切口大隐静脉剥脱术联合泡沫硬化剂注射在下肢浅静脉曲张患者中的应用

    Institute of Scientific and Technical Information of China (English)

    邹翰林

    2015-01-01

    Objective:To investigate the clinical effect of minimally invasive stripping of great saphenous vein operation combined with foam sclerotherapy treated on patients with varicose veins of lower extremity.Methods:60 patients with varicose veins of lower extremity were selected from August 2007 to 2013 September.They were divided into the observation group and the control group. Patients in the control group were treated with minimally invasive stripping of great saphenous vein operation,furthermore,the observation group were injected foam sclerotherapy based on the operation,then we compared the clinical efficacy between two groups.Results:The clinical results showed that patients in the observation group improved better than the control group,and the difference in improvement rate was statistically significant(P<0.05);when compared with the control group,the operation time and hospitalization time was shorter in the observation group,and the bleeding volume was lower,the differences were statistically significant(P<0.05);the infection rate of the observation group was lower than that of the control group(P<0.05).Conclusion:Application of minimally invasive stripping of great saphenous vein operation combined with foam sclerotherapy treated on patients with varicose veins of lower extremity has significant clinical effect.It can improve the clinical cure rate,and speed up the rehabilitation progress,so it is worth to be promote.%目的:探讨小切口大隐静脉剥脱术联合泡沫硬化剂注射在下肢静脉曲张患者中的临床应用效果。方法:2007年8月-2013年9月收治下肢静脉曲张患者60例,分成两组(观察组、对照组),对照组给予小切口大隐静脉剥脱术,观察组在该基础上注射泡沫硬化剂,比较两组患者临床疗效。结果:观察组临床好转率优于对照组,差异有统计学意义(P<0.05);观察组手术时间、出血量、住院时间等指标优于对照组

  19. 超声引导下注射泡沫硬化剂治疗大隐静脉曲张%Follow-up of varicose veins with incompetent great saphenous veintreated with ultrasound guided foam sclerotherapy

    Institute of Scientific and Technical Information of China (English)

    温朝阳; 刘小平; 王月香; 程志刚; 唐杰; 郭伟; 宋奕

    2009-01-01

    Objective To assess the clinical outcome of varicose veins with incompetent great saphenous vein(GSV) treated with ultrasound guided foam sclerotherapy. Methods Forty limbs with moderate to severe symptomatic varicose veins with incompetent GSV in 38 patients were injected with foam sclerosing agent (Fibro-Vein) under ultrasound guidance. There were 36 patients with unilateral varicose veins and 2 with bilateral varicose veins. No of them suffered from deep vein incompetence or perforating vein incompetence. Second injection was performed one month after the initial injection in 7 limbs. Thirty-eight of 40 limbs were followed up with clinical examination and duplex ultrasound scan 30-47 months (mean 40 months) after the treatment. Results Among 38 limbs with follow-up mild debilitation was found in two limbs(5. 3%). There were no other symptoms or complications. Duplex ultrasound demonstrated four type of results: type I, sclerosed GSV trunk with no detectable venous flow in 32 of 38 limbs (84. 2%) ;type II,patent GSV trunk in 3 limbs (7. 9%) ,two of them had mild reflux in the GSV trunk;type III,sclerosed GSV trunk and mild reflux in the GSV tributaries, 1/38(2. 6%) ; type IV,sclerosed proximal GSV trunk,patent distal GSV communicated with a superficial vein and mild reflux in the veins, 2/38 (5. 3% ). Conclusions Clinical examination and duplex ultrasound scan demonstrated excellent results of varicose veins with incompetent GSV treated with ultrasound guided foam sclerotherapy 40 months after the treatment. Sclerotherapy is less invasive treatment option for varicose veins with incompetent GSV with satisfactory clinical and cosmetic outcome.%目的 探讨超声引导下注射泡沫硬化剂治疗大隐静脉曲张的临床疗效.方法 无深静脉及穿静脉功能不全的中、重度大隐静脉曲张40条患肢(38例患者,2例为双侧下肢大隐静脉曲张),在超声引导下注射泡沫硬化剂Fibro-Vein对隐股交界处下方10 cm处及其以远的

  20. Decreased PGE₂ content reduces MMP-1 activity and consequently increases collagen density in human varicose vein.

    Directory of Open Access Journals (Sweden)

    Ingrid Gomez

    Full Text Available Varicose veins are elongated and dilated saphenous veins. Despite the high prevalence of this disease, its pathogenesis remains unclear.In this study, we investigated the control of matrix metalloproteinases (MMPs expression by prostaglandin (PGE₂ during the vascular wall remodeling of human varicose veins.Varicose (small (SDv and large diameter (LDv and healthy saphenous veins (SV were obtained after surgery. Microsomal and cytosolic PGE-synthases (mPGES and cPGES protein and mRNA responsible for PGE₂ metabolism were analyzed in all veins. cPGES protein was absent while its mRNA was weakly expressed. mPGES-2 expression was similar in the different saphenous veins. mPGES-1 mRNA and protein were detected in healthy veins and a significant decrease was found in LDv. Additionally, 15-hydroxyprostaglandin dehydrogenase (15-PGDH, responsible for PGE₂ degradation, was over-expressed in varicose veins. These variations in mPGES-1 and 15-PGDH density account for the decreased PGE₂ level observed in varicose veins. Furthermore, a significant decrease in PGE₂ receptor (EP4 levels was also found in SDv and LDv. Active MMP-1 and total MMP-2 concentrations were significantly decreased in varicose veins while the tissue inhibitors of metalloproteinases (TIMP -1 and -2, were significantly increased, probably explaining the increased collagen content found in LDv. Finally, the MMP/TIMP ratio is restored by exogenous PGE₂ in varicose veins and reduced in presence of an EP4 receptor antagonist in healthy veins.In conclusion, PGE₂ could be responsible for the vascular wall thickening in human varicose veins. This mechanism could be protective, strengthening the vascular wall in order to counteract venous stasis.

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

    African Journals Online (AJOL)

    2015-11-02

    Nov 2, 2015 ... surgery (IS) were collected from hospital main clinical database. Baseline characteristics ... and safe for patients with great saphenous vein varices who meet American ..... Financial support and sponsorship. Nil. Conflicts of ...

  2. Preparation of the saphenous vein for coronary artery bypass grafting: a new technique "no touch" that maintains the vein wall integral and provides high immediate patency Preparo da veia safena na cirurgia de revascularização miocárdica: uma nova técnica -"no touch"- que mantém a parede da veia íntegra e proporciona uma alta perviabilidade imediata

    Directory of Open Access Journals (Sweden)

    Domingos S. R. Souza

    2003-12-01

    Full Text Available BACKGROUND: The technique of harvesting the saphenous vein (SV for coronary artery bypass grafting (CABG influences the fate of vein grafts. A new "no touch" (NT technique of SV preparation was developed where the vein is harvested with a pedicle of surrounding tissue, which protects the vein from spasms therefore obviating the need for distension. METHOD: A prospective randomized study in 156 patients who underwent CABG was performed comparing three SV harvesting techniques. The techniques were conventional (c (adventitial stripping of the vein, manual distention and storing in saline solution; Intermediate (I (after adventitial stripping, the vein was left in situ, covered with a papaverine-soaked compress, and stored in heparinized blood; and "no touch" (SV dissected with its surrounding tissue was left in situ, covered with a saline-soaked compress and stored in heparinized blood. A morphological study of the endothelium was preformed using scanning electronic microscopy and an angiographic assessment of the vein graft patency was performed at 18 months mean follow-up time. Also an immunohistochemistry assessment was performed to identify the enzyme, nitric oxide synthase (NOS in the vein wall. RESULTS: The preservation of the endothelial cell integrity was greater with the "no touch" technique than with the other procedures. At angiographic follow up, the patency for NT was 95.4%, 88.9% for grafts in group C and 86.2% for grafts in group I. The immunohistochemistry assessment revealed NOS in all three layers of the vein wall that was prepared by the "no touch" technique. However, a great reduction of this enzyme in veins treated by the conventional technique was observed. CONCLUSION: The endothelial integrity and NOS activity were better preserved when using the "no touch" technique for vein graft harvesting. The vasorelaxation and thrombo-resistant activities of nitric oxide (NO may be responsible for the reduced of vasospasms and improved

  3. 经皮浅静脉连续环形缝扎术治疗大隐静脉曲张在基层医院的应用%Application of percutaneous continuous circumsuture for superficial varicose veins in treatment of great saphenous vein varicosity in the community hospital

    Institute of Scientific and Technical Information of China (English)

    伍忠礼; 梁发亮; 黄力若

    2016-01-01

    目的:评价经皮下连续环形缝扎术治疗下肢大隐静脉曲张的在基层医院的应用经验。方法回顾分析2009年6月~2013年6月我院治疗86例大隐静脉曲张患者的临床资料,选择行传统大隐静脉高位结扎加剥脱术为传统组(43例),另43例行经皮下连续环形缝扎术为 PCCS组,比较两组患者的临床效果。结果两组患者术后近期下肢浅静脉曲张均消失,比较两组患者的手术时间、切口数量、出血量、并发症和住院时间,差异有统计学意义;而术后发生疼痛天数、足肿以及下肢深静脉血栓两组比较无明显统计学差异。PCCS 组43例平均随访34月,曲张静脉复发1例;传统组平均随访38月,无曲张静脉复发。结论经皮下连续环形缝扎术治疗下肢大隐静脉曲张的操作简单、效果确切,且具有微创、外观美容的效果,适于基层医院。%Objective To summarize up experience and clinical efficacy of percutaneous continuous circumsuture (PCCS) for treatment of great saphenous vein varicosity in the community hospital. Methods A retrospective analysis was conducted on the clinical data of 86 cases of varicosis of great saphenous vein from June 2009 to June 2013. The patients were assigned to tradition group (n=43) and PCCS group (n=43). Patients in tradition group were performed by traditional high ligation and exfoliation procedure. The clinical data of the two groups were compared. Results Superficial varicose veins of lower extremities disappeared in both groups after treatment. There were statistical differences between two groups in operation duration, incision number, blood loss complications and postoperative hospital stay time (all P values were less than 0.05). There was no statistical difference in days of postoperative pain, forced foot and deep veins thrombosis between two groups. Varicose vein recurrence happened on one patient in PCCS group after the average of 34-month

  4. Early Small-incision High-ligation and Stripping for Great Saphenous Varicose Vein Complicated with Acute Superficial Thrombophlebitis%早期小切口大隐静脉高位结扎剥脱术治疗伴急性血栓性浅静脉炎的大隐静脉曲张

    Institute of Scientific and Technical Information of China (English)

    袁链; 尹立伟; 张小明

    2013-01-01

    目的 探讨早期小切口大隐静脉高位结扎剥脱术治疗伴急性血栓性浅静脉炎的大隐静脉曲张的疗效. 方法 同顾性分析我院2008年10月~2011年5月32例大隐静脉曲张并发急性血栓性浅静脉炎的临床资料.发病2周内行小切口大隐静脉高位结扎剥脱术. 结果 全部患者术后局部红肿疼痛于3天内消退,切口全部甲级愈合,住院时间10~ 16 d,平均12.6 d 全部患者随访5~32个月,平均13.6月,其中11例>12个月,未见复发. 结论 早期小切口大隐静脉高位结扎剥脱术治疗伴急性血栓性浅静脉炎的大隐静脉曲张是安全的,术后疗效满意.%Objective To explore the efficacy of high ligation and stripping of the varicose veins through a small incision in early slage for patients with great saphenous varicose vein complicated with acute superficial thrombophlebitis. Methods The clinical data of 32 patients with great saphenous varicose vein complicated with acute superficial thrombophlebitis, who received operation in our hospital from October 2008 to May 2011 , were analyzed retrospectively. All of the patients underwent high ligation and stripping of the varicose veins through a small incision in two weeks since the onset of acute superficial thrombophlebitis. Results All the patients recovered well with grade A wound healing. Local swelling and pain disappeared in 3 days in all the cases. The mean hospital stay was 12. 6 days ( ranged from 10 to 16 days). All the patients were followed up for 5 to 32 months with a mean of 13. 6 months ( > 12 months in 11 cases). No patient had recurrence. Conclusions High ligation and stripping of the varicose veins through a small incision in an early stage is safe and effective for the treatment of great saphenous varicose vein complicated with acute superficial thrombophlebitis. We recommend it to be used in more hospitals.

  5. Updated cannulation technique for tissue plasminogen activator injection into peripapillary retinal vein for central retinal vein occlusion.

    Science.gov (United States)

    van Overdam, Koen A; Missotten, Tom; Spielberg, Leigh H

    2015-12-01

    To update the surgical technique in which a vitrectomy is performed and a retinal branch vein is cannulated and infused with recombinant tissue plasminogen activator (RTPA) to treat central retinal vein occlusion (CRVO) in patients who present with very low visual acuity (VA). Twelve consecutive patients (12 eyes) with CRVO and low VA (logMAR >1.00) at presentation were treated using this method. Cannulation of a peripapillary retinal vein and stable injection of RTPA was successfully performed without surgery-related complications in all 12 eyes. At 12 months after surgery, 8 of the 12 patients (67%) experienced at least one line of improvement in best corrected visual acuity; 6 of the 12 (50%) improved ≥5 lines and 2 (17%) improved ≥8 lines. After additional grid laser and/or subconjunctival or intravitreal corticosteroids, the mean decrease in central foveal thickness was 260 μm, and the mean total macular volume decreased from 12.10 mm(3) to 9.24 mm(3) . Four patients received panretinal photocoagulation to treat either iris neovascularization (n = 2) or neovascularization of the retina and/or disc (n = 2). Administration of RTPA via a peripapillary vein using this updated technique provides an alternative or additional treatment option for patients with very low VA after CRVO. © 2015 Acta Ophthalmologica Scandinavica Foundation. Published by John Wiley & Sons Ltd.

  6. Management Effect of Clinical Pharmacist on Antibiotics Use during Perioperative Period of Great Saphe-nous Varicose Veins Surgery%临床药师参与大隐静脉曲张手术围术期抗菌药物管理的效果评价

    Institute of Scientific and Technical Information of China (English)

    朱亚兰; 包云光; 郭佳奕; 吕世文; 仝淑花; 徐媛青

    2016-01-01

    目的::评价临床药师参与大隐静脉曲张手术围术期预防应用抗菌药物管理的效果。方法:选取2010年6~9月(干预前)、2011年6~9月(干预后)和2014年6~9月(巩固期)出院的大隐静脉单纯剥脱术、大隐静脉高位结扎加剥脱术及大隐静脉高位结扎加静脉内激光治疗的所有病例,针对预防应用抗菌药物的合理性进行评价。结果:临床药师参与管理后,大隐静脉曲张手术围术期预防应用抗菌药物在用药指征、药物品种选择、用法用量、给药途径、溶媒及溶媒量、给药时机、用药疗程、联合用药方面改善明显;抗菌药物使用率、平均住院日、抗菌药物比例、药品比例及输液率均明显降低,并得以巩固。结论:临床药师对大隐静脉曲张手术围术期预防应用抗菌药物的干预,提高了抗菌药物合理使用率,对降低患者费用,规范医院管理有一定意义。%Objective:To evaluate the management effect of clinical pharmacist on antibiotics use during perioperative period of great saphenous varicose veins surgery. Methods:The medical records of all the patients undergoing simple great saphenous vein strip-ping, great saphenous vein high ligation plus simple stripping and saphenous vein ligation plus endovenous laser treatment between June and September in 2010 ( before the intervention) , 2011 ( after the intervention) and 2014 ( consolidation period) were selected, and the rationality of prophylactic use of antibiotics during perioperative period was evaluated. Results: After the management of clinical pharmacists, the preventive application of antibiotics during perioperative period was markedly improved in the indication, medicine va-riety choice,application and dosage, administration route, solvent and solvent dose, administration time, course of treatment and drug combination when compared with that before the intervention. Antibiotics use ratio, average

  7. Pulmonary embolism after greater saphenous vein ligation and stripping%大隐静脉曲张术后并发肺栓塞11例的治疗

    Institute of Scientific and Technical Information of China (English)

    王晓天; 胡何节; 方征东; 孙小杰; 葛新宝; 刘振明

    2015-01-01

    目的 探讨大隐静脉曲张高位结扎剥脱术后患者并发肺栓塞(pulmonary embolism,PE)的临床特点及预防措施.方法 回顾分析安徽省立医院血管外科2008年1月至2013年6月收治及会诊的大隐静脉曲张术后合并PE的11例患者临床特点、诊疗及预后等资料.结果 该组11例PE患者有6例患者经过心肺复苏、抗凝溶栓等治疗无效死亡,死亡率54.5%.5例患者经过早期的抗凝、溶栓等治疗后康复,在溶栓过程中,2例患者因彩超发现股静脉内漂浮血栓选择下腔静脉滤器植入术.对5例患者经过8 ~ 25个月随访,均无呼吸困难、胸闷、胸痛等症状.患者发病时临床表现以呼吸困难最为常见(90.9%),有胸痛症状3例(27.3%),出现晕厥2例(18.2%),猝死2例(18.2%),均无典型的呼吸困难、胸痛、咯血三联征.结论 PE的早期诊断及早期治疗可能降低大隐静脉曲张高位结扎剥脱术后PE患者的死亡率.%Objective To analyze characteristics and prophylaxis of pulmonary embolism (PE) after greater saphenous vein ligation and stripping.Methods We retrospectively analyzed the clinical characteristics and treatment of 11 inpatients with postoperative PE in Anhui Provincial Hospital and other hospitals from January 2008 to June 2013.Results In this group 6 patients died after failed cardiopulmonary resuscitation (CPR) and other treatments,the mortality was 54.5%.5 patients recovered after anticoagulation,thrombolysis and other treatments.During the process of thrombolysis,floating thrombus was found within the femoral vein in 2 patients and inferior vena cava filter was implanted.After 8-25 months follow-up,all 5 patients were free of difficulty of breathing,chest tightness,chest pain and other symptoms.Among many clinical manifestations,dyspnea (90.9%) was the most common,other clinical manifestations included chest pain (27.3%),syncope (18.2%),sudden death (18.2%).There was no typical triad of dyspnea

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

    Directory of Open Access Journals (Sweden)

    Vasić Dragan M.

    2004-01-01

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

  9. Adipose tissue metabolism in humans determined by vein catheterization and microdialysis techniques

    DEFF Research Database (Denmark)

    Simonsen, L; Bülow, J; Madsen, J

    1994-01-01

    glucose load. In addition a technique using microdialysis for measurement of tissue oxygen and carbon dioxide tensions is described. Microdialysis and vein catheterization were performed in the same region on the abdomen, and the subcutaneous adipose tissue blood flow was measured by the local 133Xe...

  10. Adipose tissue metabolism in humans determined by vein catheterization and microdialysis techniques

    DEFF Research Database (Denmark)

    Simonsen, L; Bülow, J; Madsen, J

    1994-01-01

    A technique for catheterization of a vein draining abdominal subcutaneous tissue and a microdialysis technique that allows measurements of intercellular water concentrations in adipose tissue in humans have recently been described. In the present study, we compare the two techniques during an ora...... assumptions on which calculations of venous concentrations from microdialysis data are based. Advantages and disadvantages of the two techniques are discussed....

  11. Preliminary study on temperature feedback manipulator in endovenous laser ablation for great saphenous vari-cose vein%大隐静脉曲张激光闭合术应用温度反馈式机械臂的初步研究

    Institute of Scientific and Technical Information of China (English)

    茅届齐; 秦钧; 张威浩; 戴雪明

    2016-01-01

    目的:初步探讨温度反馈式机械臂在大隐静脉腔内激光闭合术(endovenous laser ablation,EVLA)中的应用。方法:2012年7月至12月收治的80例大隐静脉曲张病人分成两组:机械臂组(26例)和常规组(54例),分别实施机械臂控制的EVLA和常规EVLA,对两组的并发症发生率、主干再通率、复发率进行比较。结果:机械臂组在皮肤灼伤、患肢麻木并发症方面低于常规组(0比14.8%和15.4%比25.9%,P<0.01);术后2年大隐静脉主干再通率,机械臂组也低于常规组(3.8%比13.0%,P<0.01)。结论:机械臂控制大隐静脉EVLA具有一定的可行性。%Objective To study preliminarily on endovenous laser ablation (EVLA) for great saphenous varicose veins using mechanical arm with temperature feedback. Methods Eighty cases with great saphenous varicose vein from July to Dec 2012 were included in this study and divided into two groups with 26 cases in mechanical arm group and 54 cases in control group. The cases in mechanical arm group underwent EVLA with mechanical arm while those in control group EVLA only. The morbidity, recanalization and recurrence of varicose vein were compared between two groups. Results The skin burn and paralysis were found lower in mechanical arm group than in control group (0 vs 14.8%and 15.4%vs 25.9%, P<0.01). The recanalization two years later was lower in mechanical arm group than in control group (3.8% vs 13.0%, P<0.01). Conclusions Mechanical arm might be useful in the procedure of EVLA for great saphenous varicose veins.

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

    Directory of Open Access Journals (Sweden)

    Hakan Uncu

    2009-10-01

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

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

    Directory of Open Access Journals (Sweden)

    Herbert Coelho Hortmann

    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

  14. 三种微创手术方法治疗大隐静脉曲张的临床对比分析%Clinical Comparative Analysis of Three Methods of Minimally Invasive Surgery in the Treatment of Great Saphenous Varicose Veins

    Institute of Scientific and Technical Information of China (English)

    吕兴东

    2016-01-01

    目的:深入探讨在大隐静脉曲张的治疗中,三种微创手术方法的临床效果。方法选取我院2014年10月~2015年7月收治的60例大隐静脉曲张患者为研究对象,随机分为三组:比较三组患者的治疗效果。结果经资料整合,三组患者中血管腔内激光闭合组患者住院时间最短,透光旋切治疗组患者术后愈合时间最短,差异均有统计学意义(P<0.05)。结论研究所选取的三种方法在大隐静脉曲张治疗中都具有一定的效果,在临床实践中应结合患者的实际情况具体选择。%Objective To explore the clinical effect of three methods of minimally invasive surgery in the treatment of great saphenous varicose veins. MethodsSelected 60 patients with great saphenous varicose veins as the research object in our hospital between October 2014 to July 2015, were randomly divided into three groups,the therapeutic effect of three groups were compared.ResultsThrough data integration,three groups of patients with intracavitary laser shortest closed group of patients in the hospital was pervious to light rotary cutting treatment group patients about postoperative healing time,and the difference was statistically significant(P<0.05).ConclusionThree kinds of methods in great saphenous varicose veins therapy has a certain effect,in clinical practice should be combined with the actual situation of patients with specific options.

  15. In vivo suppression of vein graft disease by nonviral, electroporation-mediated, gene transfer of tissue inhibitor of metalloproteinase-1 linked to the amino terminal fragment of urokinase (TIMP-1.ATF), a cell-surface directed matrix metalloproteinase inhibitor.

    Science.gov (United States)

    Eefting, Daniel; de Vries, Margreet R; Grimbergen, Jos M; Karper, Jacco C; van Bockel, J Hajo; Quax, Paul H A

    2010-02-01

    Smooth muscle cell (SMC) migration and proliferation are important in the development of intimal hyperplasia, the major cause of vein graft failure. Proteases of the plasminogen activator (PA) system and of the matrix metalloproteinase (MMP) system are pivotal in extracellular matrix degradation and, by that, SMC migration. Previously, we demonstrated that inhibition of both protease systems simultaneously with viral gene delivery of the hybrid protein TIMP-1.ATF, consisting of the tissue inhibitor of metalloproteinase-1 (TIMP-1) and the receptor-binding amino terminal fragment (ATF) of urokinase, reduces SMC migration and neointima formation in an in vitro restenosis model using human saphenous vein cultures more efficiently than both protease systems separately. Because use of viral gene delivery is difficult in clinical application, this study used nonviral delivery of TIMP-1.ATF plasmid to reduce vein graft disease in a murine bypass model. Nonviral gene transfer by electroporation was used to avert major disadvantages of viral gene delivery, such as immune responses and short-term expression. Plasmids encoding ATF, TIMP-1, TIMP-1.ATF, or luciferase, as a control, were injected and electroporated in both calf muscles of hypercholesterolemic apolipoprotein E3-Leiden (APOE*3Leiden) mice (n = 8). One day after electroporation, a venous interposition of a donor mouse was placed into the carotid artery of a recipient mouse. In this model, vein graft thickening develops with features of accelerated atherosclerosis. Vein grafts were harvested 4 weeks after electroporation and surgery, and histologic analysis of the vessel wall was performed. Electroporation-mediated overexpression of the plasmid vectors resulted in a prolonged expression of the transgenes and resulted in a significant reduction of vein graft thickening (ATF: 36% +/- 9%, TIMP-1: 49% +/- 5%, TIMP-1.ATF: 58% +/- 5%; P ATF-treated mice. Intramuscular electroporation of TIMP-1.ATF inhibits vein graft

  16. Catheter-directed thrombolysis for acute iliofemorai deep vein thrombosis via the ipsilateral great saphenous vein approach: a comparative clinical study%经患侧大隐静脉入路置管溶栓治疗急性髂股静脉血栓的临床对比研究

    Institute of Scientific and Technical Information of China (English)

    苏浩波; 顾建平; 楼文胜; 何旭; 陈亮; 陈国平; 宋进华; 汪涛

    2011-01-01

    目的 研究经患侧大隐静脉穿刺入路置管溶栓治疗急性髂股静脉血栓的可行性及临床应用价值.方法 93例经造影明确诊断的急性髂股静脉血栓患者,按照简单随机化方法分为3组,A组经患侧大隐静脉入路置管溶栓(31例),B组经患侧腘静脉入路置管溶栓(27例),C组经足背静脉顺性溶栓(35例).根据临床症状和溶栓后第5天造影复查结果评估疗效.对3组治疗前后消肿率、静脉通畅度采用方差分析(LSD法)进行组间比较;置管组穿刺时间、舒适度评分采用成组t检验分析;3组疗效及并发症发生情况采用x2检验分析.结果 治疗有效率A组90.3% (28/31)、B组92.6% (25/27)、C组68.6% (24/35),A组与B组相比差异无统计学意义(x2=0.09,P=0.759),A组与C组相比差异有统计学意义(x2 =4.65,P=0.031);消肿率A组(83.5±21.1)%、B组(82.4±20.1)%、C组(67.0±23.3)%,3组之间差异有统计学意义(F=6.059,P=0.003),A组与B组相比,差异无统计学意义(P =0.822)、A组与C组相比,差异有统计学意义(P=0.002);静脉通畅度A组(61.2±20.2)%、B组(55.7±20.5)%、C组(44.2±23.6)%,3组之间差异有统计学意义(F=5.342,P=0.006),A组与B组相比差异无统计学意义(P =0.343),A组与C组相比差异有统计学意义(P=0.002).穿刺时间A组为(8.3±3.1) min,较B组的(16.3±3.5) min少(t=9.379,P<0.05);治疗期间患者舒适度评分A组为(2.2±1.2)分、B组为(5.0±1.4)分,差异有统计学意义(t =8.129,P<0.05);置管相关的并发症A组(3例)少于B组(11例),差异有统计学意义(x2=7.60,P<0.05).结论 经患侧大隐静脉入路置管溶栓治疗急性IFVT是可行、有效的方法,具有操作简便、并发症少的优点.%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

  17. Morphological and phenotypic markers of connective tissue dysplasia patients with varicose veins lower limb

    Directory of Open Access Journals (Sweden)

    E. A. Zaharyan

    2013-02-01

    Full Text Available The features of structure of the vein and integuments are found in the patients with undifferentiated СТD at histological and immunohistochemical study in comparison with the group with a minimum number of stigma: an hypotrophy of smooth-muscle fibers of the veins of the lower extremities; areas of a hypertrophy of the endothelial and subendothelial layers of the vein; deformation and sclerosis of the wall of vein; intensifying of an expression of collagen I type or reduction of III type; dystrophia of epidermis of the skin; deformation of collagen in derma on a background of a hypertrophy of areas of a stratum granulosum; disturbance of a vascular permeability; a perivascular lymphocytic infiltration in derma. It is confirmed, that detailed phenotypical features of severe connective-tissue dysplasia on frequency of occurrence and peculiarities coincide with morphological and immunohistochemical stigma of connective tissue dysplasia, describing severity of the disease, a resistance to therapy of trophic ulcers, frequency of relapses of disease of veins. It can have prognostic value and determine the intensity of therapy and as a whole therapeutic approach.

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

    Directory of Open Access Journals (Sweden)

    Cleusa Ema Quilici Belczak

    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

  19. 大隐静脉曲张膝位结扎分段剥脱术与传统手术的效果比较%Effect comparison of parallel knee ligation segmentation stripping with traditional operation of the great saphenous varicose vein

    Institute of Scientific and Technical Information of China (English)

    杨毅; 何效东

    2011-01-01

    Objective To compare the effect of parallel knee ligation segmentation stripping with traditional high ligation segmentation stripping on treating the great saphenous varicose vein below knee and explore the surgical methods of the great saphenous varicose vein. Methods From January 2004 to January 2009, our hospital had treated the great saphenous varicose vein below knee 146 cases, 162 affected limbs. In a random contrast principle, they were divided into two groups, used parallel knee ligation segmentation stripping and traditional high ligation segmentation stripping respectively. We compared the three areas of the single limb operation time, the single limb surgery blood loss and the single limb postoperative recurrence rate in 2 years. Results The average single limb operation time and the average single limb surgery blood loss what compared parallel knee ligation segmentation stripping with traditional high hgation segmentation stripping have statistical significant difference (P < 0.01 ). The single limb postoperative recurrence rate in 2 years which compared parallel knee hgation segmentation stripping with traditional high ligation segmentation stripping hasn't statistical significant difference (P > 0.05 ). Conclusion It is feasible that use parallel knee ligation segmentation stripping to treat the great saphenous varicose vein below knee. The clinical effect is certain.%目的 比较大隐静脉曲张发生在膝以下者行膝位结扎分段剥脱术与传统高位结扎分段剥脱术的临床效果.方法 选择我院2004年1月-2009年1月收治的大隐静脉曲张发生在膝以下病人146例,162肢体.按照随机对照原则分成两组,分别行膝位结扎分段剥脱术及传统高位结扎分段剥脱术,在单肢手术时间、单肢手术出血量、单肢术后2年复发率三方面进行比较.结果 膝位结扎分段剥脱术与传统高位结扎分段剥脱术之间的单肢平均手术时间、单肢平均手术出血

  20. Cephalic veins in coronary artery bypass surgery

    DEFF Research Database (Denmark)

    Licht, P; Jakobsen, Erik; Lerbjerg, G

    1996-01-01

    Various alternative conduits for aortocoronary bypass grafting have been suggested when the saphenous vein quality is inadequate. During a 10-year period we have used the cephalic vein in 39 patients. Eighteen entered an angiographic follow-up study. A total of 31 arm vein grafts were used with 4...

  1. Cephalic veins in coronary artery bypass surgery

    DEFF Research Database (Denmark)

    Licht, P; Jakobsen, Erik; Lerbjerg, G;

    1996-01-01

    Various alternative conduits for aortocoronary bypass grafting have been suggested when the saphenous vein quality is inadequate. During a 10-year period we have used the cephalic vein in 39 patients. Eighteen entered an angiographic follow-up study. A total of 31 arm vein grafts were used with 4...

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

    Directory of Open Access Journals (Sweden)

    Cleusa Ema Quilici Belczak

    2009-03-01

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

  3. 经鼻内窥镜泪囊窝造口大隐静脉或唇黏膜移植再造泪道:18例分组比较%Lacrimal duct reconstruction with grafting of great saphenous vein or labial mucosa via endoscopic transnasal dacryocystorhinostomy A group comparison in 18 cases

    Institute of Scientific and Technical Information of China (English)

    陶海; 吴海洋; 侯世科

    2009-01-01

    BACKGROUND:There are no ideal methods for treating severe obstruction of lacrimal ducts in the world.How to improve operation method,select suitable transplantation material,elevate therapeutic efficacy,or to be accepted by patients is a topic of worker of diagnosis and treatment of obstruction of lacrimal ducts.OBJECTIVE:To evaluate the efficacy and safety of lacrimal-lake-nasal lacrimal duct reconstruction with grafting of autogenous great saphenous vein or labial mucosa via endoscopic transnasal dacryocystorhinostomy.DESIGN,TIME AND SETTING:This controlled study was conducted at the General Hospital of Armed Police Force from April 2005 to June 2007.PARTICIPANTS:A total of 18 patients(18 eyes)with severe canalicular obstruction combined with lacrimal sac defect or atrophy were enrolled at the General Hospital of Armed Police Force.METHODS:Two groups were set up according to graft material,including a great saphenous vein group(n=9)and a labial mucosa group(n=9).The great saphenous vein group received autogenous great saphenous vein transplantation,whereas the labial mucosa group received autogenous labial mucosa transplantation.Lacrimal duct unobstruction,epiphora improvement and complication were statistically analyzed in patients from both groups following transplantation.MAIN OUTCOME MEASURES:Epiphora improvement during tube wearing after transplantation and irrigation of lacrimal duct after removing the tube were measured.Radioactive nuclide ~(99)Tc~m(TcO_4~-)developing examination was used to detect time of entering nose of nuclide to judge therapeutic efficacy.RESULTS:Epiphora in patients from both groups were alleviated in various degrees during 3 months postoperatively,the period with the silicone tube.In the 12~(th) week after silicone tube was removed,TcO_4~-scintigraphy showed eye-nose time was (8.58±4.3)minutes and(9.16±5.8)minutes respectively.There was no significant difference between both groups(P>0.05).The primarily results showed 6 patients

  4. Arteries masquerading as varicose veins: A trap for phlebologists.

    Science.gov (United States)

    Jones, L; Parsi, K

    2015-12-01

    Ultrasound guided sclerotherapy may be complicated by intra-arterial injections resulting in significant tissue necrosis. Here, we present a 69-year-old man with a history of right small saphenous vein "stripping", presenting for the treatment of symptomatic lower limb varicose veins. Duplex ultrasound of the right lower limb outlined the pathway of venous incompetence. Despite the history of "stripping", the small saphenous vein was present but the sapheno-popliteal junction was ligated at the level of the knee crease. No other unusual findings were reported at the time. During ultrasound guided sclerotherapy, subcutaneous vessels of the right posterior calf were noted to be pulsatile on B-mode ultrasound. Treatment was interrupted. Subsequent angiography and sonography showed absence of the right distal popliteal artery. A cluster of subcutaneous vessels of the right medial and posterior calf were found to be arterial collaterals masquerading as varicose veins. Injection sclerotherapy of these vessels would have resulted in significant tissue loss. This case highlights the importance of vigilance at the time of treatment and the invaluable role of ultrasound in guiding endovenous interventions.

  5. Measurement of hepatic tissue hypoxia using near infrared spectroscopy: comparison with hepatic vein oxygen partial pressure.

    Science.gov (United States)

    El-Desoky, A E; Jiao, L R; Havlik, R; Habib, N; Davidson, B R; Seifalian, A M

    2000-01-01

    Hepatic hypoxia occurs during liver surgery and transplantation. The critical level associated with irreversible hepatocellular damage is unknown. Measurement of hepatic tissue oxygenation and hepatic vein oxygen partial pressure (HVPO(2)) reflects oxygen supply and consumption. Near infrared spectroscopy (NIRS) can be used to monitor hepatic oxyhaemoglobin (HbO(2)), deoxyhaemoglobin (Hb) and cytochrome oxidase (Cyt Ox) oxidation. This study compared regional hepatic tissue oxygenation (HbO(2), Hb and Cyt Ox) using NIRS with HVPO(2). The use of tissue oxygenation measured by NIRS and HVPO(2) as indicators of hepatic tissue hypoxia was also investigated. Large Landrace pigs (n = 5) underwent laparotomy and liver exposure. Systemic and hepatic haemodynamics were monitored continuously. NIRS probes were placed on the liver to record continuously HbO(2), Hb and Cyt Ox. Graded hypoxaemia was achieved by stepwise reduction of the fraction of inspired oxygen (FiO(2)) from 30% (baseline) to 4%. A significant decrease in hepatic arterial blood flow and total hepatic blood flow was seen with severe hypoxaemia while there was no significant change to portal vein blood flow. Oxygen partial pressures in the hepatic artery, portal vein and hepatic vein decreased progressively with all grades of hypoxaemia. There was an immediate reduction of hepatic HbO(2) and simultaneous increase in hepatic Hb with all grades of hypoxaemia. Hepatic Cyt Ox was reduced significantly only with FiO(2) oxygenation parameters measured by NIRS and HVPO(2). HVPO(2) measurement did not predict the reduction in intracellular tissue oxygenation demonstrated by NIRS with a decrease of Cyt Ox oxidation. In conclusion there was a good correlation between the tissue oxygenation parameters measured by NIRS and HVPO(2). However, the reduction of intracellular oxygenation found with severe hypoxaemia was demonstrated only by NIRS.

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

    Directory of Open Access Journals (Sweden)

    Charles Angotti Furtado de Medeiros

    2006-12-01

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

  7. Significance of hepatic arterial responsiveness for adequate tissue oxygenation upon portal vein occlusion in cirrhotic livers.

    Science.gov (United States)

    Mücke, I; Richter, S; Menger, M D; Vollmar, B

    2000-11-01

    We investigated sinusoidal blood flow and hepatic tissue oxygenation during portal vein occlusion in cirrhotic rat livers to examine the effect of cirrhosis on the properties of hepatic microvascular blood flow regulation. After 8 weeks of CCl4/phenobarbital sodium treatment to induce cirrhosis Sprague-Dawley rats were prepared surgically to allow assessment of portal venous and hepatic arterial inflow using miniaturized flow probes with simultaneous analysis of hepatic microcirculation and tissue oxygenation by fluorescence microscopy and polarographic oxymetry. Age-matched noncirrhotic animals served as controls. Upon portal vein occlusion in cirrhotic livers (flow reduction to portal vein occlusion did not cause a deterioration in hepatic tissue pO2 (11 +/- 3 vs. 10 +/- 3 mmHg at baseline). Sinusoidal diameters were found unchanged, disproving a major role of the sinusoidal tone in the regulation of HABR. Microvascular response of cirrhotic livers did not generally differ from that in noncirrhotic livers upon portal inflow restriction. We conclude that HABR in cirrhotic livers operates sufficiently to meet the liver tissue oxygen demand, most probably by an increased relative contribution of arterial perfusion of hepatic sinusoids.

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

    Energy Technology Data Exchange (ETDEWEB)

    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.

  9. Clinical Observation on Radiofrequency Endovenous Obliteration in Treating Great Saphenous Varicose Veins under Ultrasound Monitoring%超声监视引导下行射频闭合术治疗大隐静脉曲张临床观察

    Institute of Scientific and Technical Information of China (English)

    盛丽; 霍树靓; 李亮; 唐晓勇

    2014-01-01

    目的:探讨超声监视引导下行射频闭合术治疗大隐静脉曲张的临床效果及可行性。方法:对大隐静脉曲张患者98例(134条患肢)术前采用彩色多普勒超声进行深静脉功能分级,排除血栓患者,定位标记曲张浅静脉走形,在椎管内麻醉或局部浸润麻醉下行射频闭合手术,术中在彩超监视引导下对小腿曲张团块行点状剥脱、静脉环状缝扎等辅助治疗。结果:98例患者均在超声引导下完成手术治疗,痊愈出院,曲张静脉全部消失,未发生深静脉血栓及肺栓塞等严重并发症,随访6个月无再通、复发。结论:超声监视引导行射频闭合术治疗大隐静脉曲张方法便捷、安全、有目的性,能明显减少手术创口及创面,具微创、美观、并发症少、恢复快、廉价、效果优良等优点。%Objective: To explore clinical effects and the practicability of radiofrequency endovenous obliteration in treating great saphenous varicose veins under ultrasound monitoring. Methods:All 98 patients (134 affected limbs) were classified before the surgery by color Doppler ultrasound according to the functions of deep vein, the patients with thrombosis were removed, the shapes of varicose superficial vein in other patients were fixed and the patients were performed with radiofrequency endovenous obliteration under general anesthesia or local infiltration anesthesia, who received adjunctive therapy of punctuate desquamation and vein ringed transfixion on varicose masses under ultrasound monitoring in the surgery. Results: All 98 patients finished the surgery under ultrasound monitoring, cured and discharged, varicose veins were disappeared totally, severe complications such as deep vein thrombosis, pulmonary embolism and others were not found, there was no repatency or relapse in the follow-ups of six months. Conclusion:Radiofrequency endovenous obliteration in treating great saphenous varicose veins

  10. Preseeding of human vascular cells in decellularized bovine pericardium scaffold for tissue-engineered heart valve : An in vitro and in vivo feasibility study

    NARCIS (Netherlands)

    Yang, Min; Chen, Chang-Zhi; Shu, Yu-Sheng; Shi, Wei-Ping; Cheng, Shao-Fei; Gu, Y. John

    Human vascular cells from saphenous veins have been used for cell seeding on the synthetic scaffolds for constructing tissue-engineered heart valve (TEHV). However, little is known about the seeding of human vascular cells on bovine pericardium, a potential natural scaffold for TEHV. This study was

  11. Preseeding of human vascular cells in decellularized bovine pericardium scaffold for tissue-engineered heart valve : An in vitro and in vivo feasibility study

    NARCIS (Netherlands)

    Yang, Min; Chen, Chang-Zhi; Shu, Yu-Sheng; Shi, Wei-Ping; Cheng, Shao-Fei; Gu, Y. John

    2012-01-01

    Human vascular cells from saphenous veins have been used for cell seeding on the synthetic scaffolds for constructing tissue-engineered heart valve (TEHV). However, little is known about the seeding of human vascular cells on bovine pericardium, a potential natural scaffold for TEHV. This study was

  12. DSA引导下泡沫硬化术与大隐静脉高位结扎联合血管腔内激光术治疗下肢静脉曲张的疗效观察%Contrast effect of foam sclerotherapy of polidocanol and high ligation of great saphenous vein combie with cavity laser surgery for varicose vein of lower extremity

    Institute of Scientific and Technical Information of China (English)

    郭惠庄; 余盛龙; 冯惠岗; 庄炜钊; 黄晨; 唐郁宽; 吴鹏; 谢贞静; 陈汉威

    2015-01-01

    目的:探讨DSA引导下聚多卡醇泡沫硬化术与大隐静脉高位结扎术联合血管腔内激光术治疗下肢静脉曲张的临床疗效。方法选取60例下肢静脉曲张患者(共66条腿),随机分为DSA引导下聚多卡醇泡沫硬化术组(A组,30例共33条腿)及大隐静脉高位结扎术联合血管腔内激光术组(B组,30例共33条腿)。分别对两组患者手术时间、住院费用、术后并发症、治疗效果进行对比评价。结果 A组患者手术时间、住院费用明显低于B组(均P<0.01);A组患者术后皮下瘀血、感觉麻木、皮下脂肪液化感染、皮肤灼伤的发生率均显著低于B组(均P<0.01);两组患者静脉炎的发生率差异无统计学意义(P>0.05);两组患者出院时及术后3个月、6个月、1年治疗效果比较差异均无统计学意义(均P>0.05)。结论 DSA引导下聚多卡醇泡沫硬化剂治疗下肢静脉曲张是一项创伤小、并发症少、安全、有效的治疗方法。%Objective To explore the clinical effect of foam sclerotherapy of polidocanol and high ligation of great saphenous vein combie with cavity laser surgery for varicose vein of lower extremity.Methods A total of 60 cases(66 diseased limbs)of varicose vein of lower extremity patients were randomly divided into two groups, A group treated with foam sclerotherapy of polidocanol (n=30, 33 diseased limbs) , B group treated with high ligation of great saphenous vein combie with cavity laser surgery (n=30, 33 diseased limbs). The operation time, hospitalization expenses, the incidence of complications and the treatment effect were compared.Results The operation time and hospitalization expenses of A group signiifcantly lower than B group,there was signiifcant difference(P0.05). There was no significantly statistical difference in treatment effect of two groups(leaving hospital, after 3 months, after 6 months, after 1 year)(P>0.05). Conclusions Foam

  13. Endovenous laser therapy for varicose veins

    NARCIS (Netherlands)

    Disselhoff, B.C.V.M.

    2008-01-01

    This thesis describes the technique of endovenous laser ablation and the outcome of various series of patients with varicose veins due to reflux in the great saphenous vein, treated by endovenous laser ablation or cryostripping in a single-centre study. This study has shown clear advantages of endov

  14. Avaliação da insuficiência da veia safena magna com classificação C2 e C3 (CEAP pela pletismografia a ar e pelo eco-Doppler colorido Evaluation of the greater saphenous vein with classification C2 e C3 (CEAP by air plethysmography and color Doppler ultrasonography

    Directory of Open Access Journals (Sweden)

    Amélia Cristina Seidel

    2012-09-01

    reflux of the greater saphenous vein (insufficiency in a clinical CEAP C2/C3 by air plethysmography and color Doppler ultrasonography. METHODS: We prospectively investigated 87 limbs with reflux of the greater saphenous vein as ascertained by Doppler ultrasound and 32 limbs without signs or symptoms of the venous disease. All patients underwent clinical examinations using air plethysmography and Doppler ultrasound of the lower limbs. The parameters used with the Doppler ultrasound were: the diameter of the saphenous vein (seven levels and the speed and time of reflux. In the plethysmography, the venous filling index, ejection fraction and residual volume fraction were also considered. RESULTS: Of the 119 limbs, 61 were class C2. In comparing the diameters of the vein of the control group with the study group there were statistically significant differences. There was an exception at the malleolus level. Using the Spearman correlation to analyze the indices for the plethysmography and Doppler ultrasound it showed some difference, but the coefficient of determination (r² showed that they were weak. CONCLUSIONS: The parameters of the plethysmography did not correlate with the degree of reflux in the greater saphenous vein. There was a very weak correlation between their values, time and speed of reflux. Only the venous filling index correlated with venous reflux. The ejection fraction and residual volume fraction were not important for discrimination of clinical severity.

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

    Directory of Open Access Journals (Sweden)

    Bernardo Cunha Senra Barros

    2015-04-01

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

  16. Arterialization of the portal vein improves hepatic microcirculation and tissue oxygenation in experimental cirrhosis.

    Science.gov (United States)

    Yang, W; Koti, R; Glantzounis, G; Davidson, B R; Seifalian, A M

    2003-10-01

    Arterialization of the portal vein (APV) has shown beneficial effects on liver regeneration and function in selected patients undergoing liver resection and transplantation. Whether APV improves liver perfusion and function in cirrhosis is unclear. This study investigated the effect of APV on hepatic haemodynamics and liver function in a rat model of cirrhosis. Male Sprague-Dawley rats (250-300 g) were divided into three groups: normal controls (n = 7), cirrhosis with sham laparotomy (sham; n = 7) and cirrhosis with APV (APV; n = 9). Portal venous blood flow, portal vein pressure and hepatic parenchymal microcirculation (HPM) were measured before and after APV. Hepatic parenchymal oxygenation was assessed by near-infrared spectroscopy and hepatocellular injury by standard liver function tests. Measurements were taken at baseline, after APV and 7 days after surgery. APV increased portal blood flow and pressure in cirrhotic rats without altering intrahepatic portal resistance. APV increased the HPM in cirrhotic rats by a mean(s.e.m.) of 28.5(0.1) per cent on day 0 and 54.6(0.1) per cent by day 7 (P = 0.001). Liver tissue oxygenation was increased by APV and the plasma gamma-glutamyltranspeptidase level was reduced (mean(s.e.m.) 6.0(0.5) versus 3.8(0.3) units/l before and after APV respectively; P = 0.006) at day 7. APV increases portal blood flow, tissue perfusion and oxygenation in cirrhosis. Copyright 2003 British Journal of Surgery Society Ltd. Published by John Wiley & Sons, Ltd.

  17. Repairing nerve gaps by vein conduits filled with lipoaspirate-derived entire adipose tissue hinders nerve regeneration.

    Science.gov (United States)

    Papalia, Igor; Raimondo, Stefania; Ronchi, Giulia; Magaudda, Ludovico; Giacobini-Robecchi, Maria G; Geuna, Stefano

    2013-05-01

    In spite of great recent advancements, the definition of the optimal strategy for bridging a nerve defect, especially across long gaps, still remains an open issue since the amount of autologous nerve graft material is limited while the outcome after alternative tubulization techniques is often unsatisfactory. The aim of this study was to investigate a new tubulization technique based on the employment of vein conduits filled with whole subcutaneous adipose tissue obtained by lipoaspiration. In adult rats, a 1cm-long defect of the left median nerve was repaired by adipose tissue-vein-combined conduits and compared with fresh skeletal muscle tissue-vein-combined conduits and autologous nerve grafts made by the excised nerve segment rotated by 180°. Throughout the postoperative period, functional recovery was assessed using the grasping test. Regenerated nerve samples were withdrawn at postoperative month-6 and processed for light and electron microscopy and stereology of regenerated nerve fibers. Results showed that functional recovery was significantly slower in the adipose tissue-enriched group in comparison to both control groups. Light and electron microscopy showed that a large amount of adipose tissue was still present inside the vein conduits at postoperative month-6. Stereology showed that all quantitative morphological predictors analyzed performed significantly worse in the adipose tissue-enriched group in comparison to the two control groups. On the basis of this experimental study in the rat, the use of whole adipose tissue for tissue engineering of peripheral nerves should be discouraged. Pre-treatment of adipose tissue aimed at isolating stromal vascular fraction and/or adipose derived stem/precursor cells should be considered a fundamental requisite for nerve repair.

  18. 电视内镜下大隐静脉采集术在老年冠状动脉搭桥术中的应用%Endoscopic technique for greater saphenous vein harvesting in elderly patients undergoing coronary artery bypass grafting

    Institute of Scientific and Technical Information of China (English)

    姚建民; 王东文; 庞中一; 张永; 肖志斌; 赵向东; 陆龙; 刘静

    2011-01-01

    Objective To summarize the experiences in greater saphenous vein harvesting during video-assisted endoscopic technique in elderly patients undergoing coronary artery bypass grafting.Methods Between April 2005 and March 2010, 303 elderly patients with coronary heart disease, aged 60 to 84 (68.6±7.3)years, underwent selective coronary artery bypass grafting.Of the 303 patients, 197 cases received video-assisted endoscopic technique for greater saphenous vein harvesting (ESVH), 106 cases had open procedure for greater saphenous vein harvesting (OSVH).There was no difference in sex, body mass, left ventricular ejection fraction (LVEF), the number of bypass grafting and concomitant diseases.The operative efficacy was compared between the two groups.Results The mean operation time duration was (38.3 ± 8.8) min and (35.5 ± 7.2) min in ESVH and OSVH groups respectively (P < 0.01).The subcutaneous hematoma occurred in 8 (4.1%) cases and 2 (1.9%) cases in ESVH group and OSVH group respectively (P > 0.05).There was no abnormal feeling, incision infection and fat necrosis of lower extremity in ESVH group.The incidence of chronic leg edema in ESVH group was 2.0%, which was remarkably lower than that in OSVH group (19.8%, P < 0.05).Leg pain in ESVH group was much less intensive than that in OSVH group.The patients receiving ESVH had shorter hospital stay than those receiving OSVH [(8.4 ± 1.8) vs (13.3 ± 2.8) d, P < 0.001].Conclusion ESVH, as a minimally invasive technique, can significantly reduce postoperative leg incision complications in elderly patients undergoing coronary artery bypass grafting.%目的 介绍老年冠状动脉旁路移植术(CABG)中应用电视内镜采集大隐静脉血管桥的体会.方法 纳入自2005年4月至2010年3月择期行老年CABG患者303例,年龄60~84(68.6±7.3)岁.术中在电视内镜辅助下采集大隐静脉血管桥197例(ESVH组),采取全程切开采集大隐静脉(OSVH)106例,ESVH组

  19. Tissue factor: A potent stimulator of Von Willebrand factor synthesis by human umbilical vein endothelial cells

    Science.gov (United States)

    Meiring, Muriel; Allers, W.; Le Roux, E.

    2016-01-01

    Inflammation and dysfunction of endothelial cells are thought to be triggers for the secretion of Von Willebrand factor. The aim of this study was to examine the effects of the inflammatory cytokines interleukin-6 (IL-6), interleukin-8 (IL-8) and tumour necrosis factor-alpha (TNF-α) and the coagulation factors, tissue factor and thrombin on the release and cleavage potential of ultra-large von Willebrand factor (ULVWF) and its cleavage protease by cultured human umbilical vein endothelial cells (HUVEC). HUVEC were treated with IL-6, IL-8, and TNF-α, tissue factor (TF) and thrombin, and combinations thereof for 24 hours under static conditions. The cells were then exposed to shear stress after which the VWF-propeptide levels and the VWF cleavage protease, ADAMTS13 content were measured. All treatments and their combinations, excluding IL-6, significantly stimulated the secretion of VWF from HUVEC. The VWF secretion from the HUVEC was stimulated most by the combination of TF with TNF-α. Slightly lower levels of ADAMTS13 secretion were found with all treatments. This may explain the thrombogenicity of patients with inflammation where extremely high VWF levels and slightly lower ADAMTS13 levels are present.

  20. Prognosis of complicated clinical course of varicose veins of lower extremities on the basis of analysis of phenotypic characteristics of connective tissue dysplasia

    OpenAIRE

    Tsarev О.А.; Anisimov A.Yu.; Zakharov N.N.

    2015-01-01

    Aim: to identify the phenotypic characteristics of indeterminate connective tissue dysplasia, which help to predict the progression of varicose veins of lower extremities and disease recurrence after surgery. Material and Methods. The long-term results of surgical treatment of 60 patients with varicose veins of lower extremities in a 5-year period after phlebectomy were analyzed. The phenotypic characteristics of indeterminate connective tissue dysplasia were researched. 24 patients had recur...

  1. Use of Brilliant Blue FCF during vein graft preparation inhibits intimal hyperplasia.

    Science.gov (United States)

    Osgood, Michael J; Sexton, Kevin; Voskresensky, Igor; Hocking, Kyle; Song, Jun; Komalavilas, Padmini; Brophy, Colleen; Cheung-Flynn, Joyce

    2016-08-01

    Intimal hyperplasia remains the primary cause of vein graft failure for the 1 million yearly bypass procedures performed using human saphenous vein (HSV) grafts. This response to injury is caused in part by the harvest and preparation of the conduit. The use of Brilliant Blue FCF (FCF) restores injury-induced loss of function in vascular tissues possibly via inhibition of purinergic receptor signaling. This study investigated whether pretreatment of the vein graft with FCF prevents intimal hyperplasia. Cultured rat aortic smooth muscle cells (A7r5) were used to determine the effect of FCF on platelet-derived growth factor-mediated migration and proliferation, cellular processes that contribute to intimal hyperplasia. The effectiveness of FCF treatment during the time of explantation on preventing intimal hyperplasia was evaluated in a rabbit jugular-carotid interposition model and in an organ culture model using HSV. FCF inhibited platelet-derived growth factor-induced migration and proliferation of A7r5 cells. Treatment with FCF at the time of vein graft explantation inhibited the subsequent development of intimal thickening in the rabbit model. Pretreatment with FCF also prevented intimal thickening of HSV in organ culture. Incorporation of FCF as a component of vein graft preparation at the time of explantation represents a potential therapeutic approach to mitigate intimal hyperplasia, reduce vein graft failure, and improve outcome of the autologous transplantation of HSV. Copyright © 2016. Published by Elsevier Inc.

  2. Prognosis of complicated clinical course of varicose veins of lower extremities on the basis of analysis of phenotypic characteristics of connective tissue dysplasia

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    Tsarev О.А.

    2015-12-01

    Full Text Available Aim: to identify the phenotypic characteristics of indeterminate connective tissue dysplasia, which help to predict the progression of varicose veins of lower extremities and disease recurrence after surgery. Material and Methods. The long-term results of surgical treatment of 60 patients with varicose veins of lower extremities in a 5-year period after phlebectomy were analyzed. The phenotypic characteristics of indeterminate connective tissue dysplasia were researched. 24 patients had recurrence of varicose veins of lower extremities associated with disease progression; 36 patients did not have recurrence of varicose veins of lower extremities. Results. All the patients demonstrated the signs of indeterminate connective tissue dysplasia, whereas their frequency was different. There were specified nine phenotypic characteristics of indeterminate connective tissue dysplasia, which were significantly more frequent for patients with recurrence of varicose vein disease of lower extremities: 1 postural abnormality, 2 flat foot, 3 skin pallor, 4 hyperextension of skin, 5 positive "wrist test", 6 positive "pollex test", 7 diastasis recti abdominis, 8 myopia, 9 hematomas which form quickly. Conclusion. The determined sum of phenotypic characters of indeterminate connective tissue dysplasia allows to predict progression of varicose vein disease of lower extremities, and offers new opportunities for improving the results of surgical treatment via developing special therapeutic measures aimed at improving lifestyle and dysplasia treatment.

  3. Bioaccumulation of Ergovaline in Bovine Lateral Saphenous Veins in Vitro

    Science.gov (United States)

    Ergot alkaloids have been associated with vasoconstriction in grazing livestock afflicted with the fescue toxicosis syndrome. Previous in vitro investigations studying how ergot alkaloids cause the observed vasoconstriction have shown that ergovaline has a very distinct receptor affinity and sustain...

  4. Associations of anterior accessory or thigh posterior tributary and great saphenous reflux patterns in early stages of chronic venous valvular insufficiency

    Directory of Open Access Journals (Sweden)

    Carlos Alberto Engelhorn

    2014-07-01

    Full Text Available Varicose veins are a common disorder. Extensive ultrasound (US mapping of lower extremity chronic venous valvular insufficiency includes the great saphenous vein (GSV, anterior accessory saphenous vein (AASV and thigh posterior tributary to GSV such as the posterior accessory saphenous vein (PTSV, PASV. The aim of this study was to determine associations between GSV-AASV-PTSV (including PASV reflux in a specific sample population of Southern Brazilian women, mostly euro descendents, with telangiectasias, reticular veins, varices and/or intermittent edema. US performed in 1016 extremities of 513 women, 43±18 (18-81 years old were included. Women with previous venous thrombosis, surgery, suspicion of pelvic congestion syndrome, and men were excluded. Small saphenous vein and related thigh veins were excluded from analysis. GSV-AASV-PTSV reflux patterns were analyzed; prevalence was compared using χ2 statistics. Reflux prevalence in AASV and/or thigh PTSV was 5.8% (59/1016: 1.3% at PTSV (n=13 and 4.5% at AASV (n=46, significantly lower than GSV reflux: 72% (n=727 (P<0.001. AASV and/or PTSV reflux was associated with GSV reflux (81%, n=48/59; common pattern was diffuse reflux, starting at AASV/PTSV saphenous junctions (56%, n=33/59; otherwise, short, non-diffuse reflux was noted in part of the AASV/PTSV evaluated. Isolated AASV or PTSV reflux was rare (1%, n=11/1016: 9 at the AASV, and 2 at the PTSV. US mapping of AASV/PTSV in early stages of disease, in women without pelvic congestion syndrome, increased reflux detection by 1%, and improved definition of reflux patterns in about 6% of the extremities.

  5. Reconstruction of large skin and soft tissue defect in the front upper of tibia with free flap of anastomosis saphenous vessels%吻合隐血管的游离皮瓣修复胫前中上段大面积皮肤软组织缺损

    Institute of Scientific and Technical Information of China (English)

    周洪杰; 隋海明; 杜全红; 史永安; 迟涛胜; 丛海波

    2015-01-01

    目的 探讨游离皮瓣修复胫前中上段大面积皮肤软组织缺损时吻合受区隐血管的可行性.方法 2009年6月-2014年4月,收治伴有胫前中上段大面积皮肤软组织缺损患者16例,其中男10例,女6例;年龄24~ 56岁,平均34.5岁,经全身支持治疗并多次清创结合VSD治疗后行创面修复手术,术前均设计采用吻合隐血管的游离股前外侧皮瓣移植修复. 结果 14例按术前设计进行,2例改用吻合健侧胫后血管的交腿皮瓣修复(1例隐动脉管径过细,1例隐动脉长段损伤变性栓塞,均不适合行血管吻合),14例吻合隐血管的皮瓣全部成活,其中12例一期愈合,2例皮瓣远端尖部部分坏死,经换药后逐渐愈合.13例经过6个月~2年随访,皮瓣外观无臃肿、质地优良,软组织缺损创面修复满意. 结论 胫前中上段大面积皮肤软组织缺损的游离皮瓣移植修复可选择吻合受区隐血管.%Objective To explore the feasibility of repairing the large area skin and soft tissue defect in thefront upper of tibia by free flap with anastomosis of saphenous vessels.Methods From June,2009 to April,2014,16 cases (10 males and 6 females) of large area skin and soft tissue defect in the front upper of tibia were treatedwith free flap.The ages ranged from 24 to 56 years old,averaged of 34.5 years old.The supportive therapy and repeated debridement combined with VSD,and designed to use free anterolateral thigh flap with anastomosis of saphenous vessels before repairing operation.Results Fourteen patients accorded with preoperative design,in which 2 cases were adopted cross leg flap anastomosis posterior tibia vessels of the healthy side (1 case of saphenous artery diameter too small,and 1 case of saphenous artery long injury degeneration,unsuitable for vascular anastomosis).All 14 flaps survived,expect 2 cases were part-necrosis in the end of the flap,and gradually healed by dressing exchange.Conclusion Reconstruction of large area skin

  6. Stimulation of angiogenesis in rat tissues after administration of mesenchymal stem cells near thrombosed veins

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    И. В. Майбородин

    2015-10-01

    Full Text Available The effect of introduction of autologous multipotent mesenchymal stem cells of bone marrow origin (MSC with a GFP gene and additionally marked by DAPI dye for cellular nuclei into the area close to the thrombosed vein of a rat's hind leg has been studied by using methods of luminescent microscopy. It has been revealed that MSC take are involved in the development of granulations in a place of surgical intervention performed at the time of thrombosis modeling. Restoration of the blood flow in the thrombosed main vein always follows as a result of thrombolysis. No signs of MSC embedded in the walls of the thrombosed vessels have been noticed. Recanalization of blood clots and formation of collaterals hasn't been observed. When modeling thrombosis by introducing athrombin and ligating the main vein, the latter's small tributaries also get thrombosed. Restoration of blood flow in the tributaries occurs with involvement of embedded MSC either through recanalization of blood clots or through obliteration of thrombosed vessels and formation of new ones. Accumulated MSC and the structures generated with their participation are forced out by the organism-recipient's own cells.

  7. Connexin43 Inhibition Prevents Human Vein Grafts Intimal Hyperplasia

    Science.gov (United States)

    Longchamp, Alban; Allagnat, Florent; Alonso, Florian; Kuppler, Christopher; Dubuis, Céline; Ozaki, Charles-Keith; Mitchell, James R.; Berceli, Scott; Corpataux, Jean-Marc

    2015-01-01

    Venous bypass grafts often fail following arterial implantation due to excessive smooth muscle cells (VSMC) proliferation and consequent intimal hyperplasia (IH). Intercellular communication mediated by Connexins (Cx) regulates differentiation, growth and proliferation in various cell types. Microarray analysis of vein grafts in a model of bilateral rabbit jugular vein graft revealed Cx43 as an early upregulated gene. Additional experiments conducted using an ex-vivo human saphenous veins perfusion system (EVPS) confirmed that Cx43 was rapidly increased in human veins subjected ex-vivo to arterial hemodynamics. Cx43 knock-down by RNA interference, or adenoviral-mediated overexpression, respectively inhibited or stimulated the proliferation of primary human VSMC in vitro. Furthermore, Cx blockade with carbenoxolone or the specific Cx43 inhibitory peptide 43gap26 prevented the burst in myointimal proliferation and IH formation in human saphenous veins. Our data demonstrated that Cx43 controls proliferation and the formation of IH after arterial engraftment. PMID:26398895

  8. Feasibility of Stripping Surgery of Great Saphenous Vein Varicosity Performed in One-Day Stay Ward%开展大隐静脉曲张剥脱术日间病房运营模式的可行性探讨

    Institute of Scientific and Technical Information of China (English)

    刘思; 吴洲鹏; 罗艳丽

    2012-01-01

    Objective To explore the feasibility and the security of one-day stay ward in stripping surgery of saphenous vein varicosity. Methods Two hundred and eighty two patients treated in our hospital in 2011 were enrolled in this study, according to the operation mode, these patients were divided into 2 groups, ninety patients in one-day stay ward group and one hundred and ninety two patients in in-patient group. Their clinical features and medical operation indexs (included preoperative waiting time, duration of hospital stay, and medical cost) were retrospectively analyzed. Results There was no statistical differences on clinical features between the two groups. But compared with in-patient group, the preoperative waiting time, duration of hospital stay, and medical cost were shorter or lower in one-day stay ward group (P<0. 05) . Conclusions The one-day stay ward operation mode can decrease preoperative waiting time, duration of hospital stay and medical cost significantly, and it also can ensure the safety of clinical treatment. So it's worthy in the clinical promotion.%目的 探讨采用新型运行流程,开展大隐静脉曲张剥脱术日间病房运营模式的可行性和安全性.方法 回顾性分析笔者所在医院2011年内行大隐静脉曲张剥脱术的282例患者的临床资料,根据运营方式不同将其分为日间手术组(n=90)和住院手术组(n=192).对2组患者的临床特征以及医疗运行指标(包括术前等待时间、住院时间以及医疗费用)进行比较分析.结果 2组患者间的基本临床特征差异均无统计学意义(P>0.05);日间手术组患者的术前等待时间和住院时间较住院手术组短(P<0.05),而医疗费用较低(P<0.05).结论 新型的日间病房运营模式可缩短大隐静脉曲张患者的术前等待时间、住院时间以及医疗费用,同时能够保证其临床治疗的安全性,值得在临床中推广.

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

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    R. G. Bush

    2014-01-01

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

  10. 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.

  11. Ação inibitória da Interleucina - 1ß sobre a proliferação de células musculares lisas cultivadas a partir de veias safenas humanas Inhibitory action of the Interleukin 1ß over the cellular proliferation of smooth muscle cells cultivated from human saphenous veins

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    Luís A.O. Dallan

    2005-06-01

    Full Text Available INTRODUÇÃO: A veia safena é um enxerto coronário eficiente. Porém, sua patência pode ser limitada por desenvolvimento de aterosclerose. Estudos experimentais "ex vivo", por nós realizados anteriormente, demonstraram apoptose (ensaio de TUNEL em veias safenas humanas cultivadas sob pressão arterial por 24 horas. Nessas veias safenas, a expressão gênica da Interleucina-1ß avaliada por RT-PCR em tempo real, também mostrou-se elevada. Não há ainda consenso sobre a ação moduladora das citocinas sobre proliferação/apoptose das células musculares lisas das veias safenas. OBJETIVO: Avaliar a influência da Interleucina -1ß na proliferação inicial de cultura de células primárias de músculo liso de veia safena humana. MÉTODO: Foram cultivadas células primárias de músculo liso de seis diferentes veias safenas humanas (em triplicata. O meio de cultura foi o DMEM, suplementado com 10% de soro fetal bovino. O grupo controle não recebeu Interleucina - 1ß. Nos demais grupos, as células cultivadas receberam, respectivamente, 0,1; 1; 10 e 100 ng/mL de Interleucina - 1ß. A proliferação celular foi avaliada através da quantificação de timidina triciada [³H], incorporada às células recém-proliferadas. RESULTADOS: O tratamento com Interleucina - 1ß diminuiu a proliferação celular, a saber: Grupo controle (sem Interleucina - 1ß: definiu-se esse grupo como apresentando 100±4,5% de proliferação celular. Nos demais grupos, a quantidade de Interleucina - 1ß administrada e a proliferação celular aferida foram, respectivamente, 0,1 ng/mL:112±0,7%; 1 ng/mL:83,8±4,7%; 10 ng/mL:69,1±3,8%; 100 ng/mL:67,3±10,9%; (pOBJECTIVE: The saphenous vein (SV is an effective graft used in coronary artery bypass grafting, although, its patency can be affected by the development of atherosclerosis. We have developed an experimental study demonstrating the development of apoptosis in SV grafts cultivated under arterial hemodynamic

  12. Varicose Veins

    Science.gov (United States)

    Varicose veins are swollen, twisted veins that you can see just under the skin. They usually occur in ... of the body. Hemorrhoids are a type of varicose vein. Your veins have one-way valves that help ...

  13. Increased infiltration of Chlamydophila pneumoniae in the vessel wall of human veins after perfusion

    NARCIS (Netherlands)

    Kupreishvili, K.; Weeme, M.ter; Morré, S.A.; Brule, A.J.C. van den; Huybregts, M.A.J.M.; Quax, P.H.A.; Velden, J. ten; Hinsbergh, V.W.M. van; Stooker, W.; Eijsman, L.; Niessen, H.W.M.

    2008-01-01

    Background: Several studies have suggested an association between Chlamydophila pneumoniae (Cp) infection and atherosclerosis. A recent study detected Cp DNA in the saphenous vein of 12% of all patients before bypass grafting and in 38% of failed grafts. We used a system in which human veins were pe

  14. Assessing the three-dimensional collagen network in soft tissues using contrast agents and high resolution micro-CT: Application to porcine iliac veins.

    Science.gov (United States)

    Nierenberger, Mathieu; Rémond, Yves; Ahzi, Saïd; Choquet, Philippe

    2015-07-01

    The assessment of the three-dimensional architecture of collagen fibers inside vessel walls constitutes one of the bases for building structural models for the description of the mechanical behavior of these tissues. Multiphoton microscopy allows for such observations, but is limited to volumes of around a thousand of microns. In the present work, we propose to observe the collagenous network of vascular tissues using micro-CT. To get a contrast, three staining solutions (phosphotungstic acid, phosphomolybdic acid and iodine potassium iodide) were tested. Two of these stains were showed to lead to similar results and to a satisfactory contrast within the tissue. A detailed observation of a small porcine iliac vein sample allowed assessing the collagen fibers orientations within the medial and adventitial layers of the vein. The vasa vasorum network, which is present inside the adventitia of the vein, was also observed. Finally, the demonstrated micro-CT staining technique for the three-dimensional observation of thin soft tissues samples, like vein walls, contributes to the assessment of their structure at different scales while keeping a global overview of the tissue.

  15. Short-term results of endovascular surgery with tissue plasminogen activator injection for central retinal vein occlusion.

    Science.gov (United States)

    Ishida, Masaaki; Abe, Shinya; Nakagawa, Takuya; Hayashi, Atsushi

    2017-08-12

    To examine the effects of retinal endovascular surgery (REVS) with tissue plasminogen activator injection into the retinal vein in central retinal vein occlusion (CRVO) eyes. Sixteen consecutive CRVO patients with macular edema and decreased visual acuity who were referred to Toyama University Hospital between March 2014 and February 2016 were included in this study. Changes in visual acuity (VA) and central retinal thickness (CRT) were evaluated up to 6 months after REVS. Staining and leakage of the retinal veins in fluorescein angiography (FA) was graded in nine patients. Ten of 16 eyes were determined to be non-ischemic while the remaining six were ischemic. The mean logarithm of the minimum angle of resolution (logMAR) of VA was significantly improved from 0.98 ± 0.58 (mean ± standard deviation) at baseline to 0.78 ± 0.61 at 3 months (p = 0.002), and 0.64 ± 0.60 at 6 months (p = 0.003) after REVS. At 6 months, VA was improved in eight eyes (50%), while the other eight (50%) showed no change; none showed worsening. In the 10 eyes with non-ischemic CRVO, the mean VA was significantly improved at 6 months (p = 0.002), whereas no improvement was found in the six eyes with ischemic CRVO, . In all eyes, the mean CRT was significantly improved from 804 ± 343 μm at baseline to 506 ± 304 μm at 2 months (p = 0.014), 332 ± 229 μm at 3 months (p = 0.0001), and 305 ± 235 μm at 6 months (p = 0.00001). The postoperative complications observed were prolonged vitreous hemorrhage in one eye and neovascular glaucoma in two eyes. For postoperative recurrence of macular edema, sub-tenon injection of triamcinolone acetonide was given to five eyes, and intravitreal injection of an anti-VEGF agent was given to five eyes. Pan-retinal photocoagulation was performed on six eyes with ischemic type CRVO. The FA score was significantly improved after REVS (p = 0.018). REVS using a specially made micro-needle may be a surgical treatment

  16. Prospective clinical study of surgical management of varicose veins of lower limb and its complications

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    Nagaraj H.

    2014-02-01

    Methods: Two years prospective study was conducted in our institution from May 2007 to April 2009. During this period 62 cases of varicose veins of lower limbs were admitted to our hospital of which 50 cases were selected and were studies in detail. After thorough clinical examination and relevant investigation they are all subjected to surgical management. Results: Out of 50 cases studied, 21 (42% had only long saphenous vein involvement, 7 (14% had short saphenous vein involvement and in 5 (10% cases both short and long saphenous system were involved. In addition to long saphenous vein involvement, incompetent perforators were present in 17 (34% cases. Among them prominent veins and pain were the main complain in 38 (78% patients. Itching and pigmentation were present in 4 (8% patients. Ankle edema was present in 6 (12% patients. Pain and ulceration of lower leg were present in 2 (4% patients. After clinical assessment appropriate surgical procedures were followed for each of patients. These cases were followed for 3 year durations. Out of 50 patients 7 (14% patients had recurrence of varicose vein. 7 (14% patient complained of recurrence of pain after 2 years of surgery but no appearance of varicose vein. One patient (2% complained of persistence of pigmentation after surgery. 2 (4% patients complained of persistence of ankle edema and there was complete healing of ulcer which was present earlier. Conclusions: Commonest age group of varicose vein of lower limb was 20 to 40 years. Definite relationship exists between the occupation and the incidence of varicose veins. The patients were in the occupation which required standing for long time had the higher chances of varicose vein. Severity of the symptoms is not proportional to the duration of varicose veins. The involvement of long saphenous vein is more common than the short saphenous vein. Since our study shows very low percentage of recurrence and symptoms related to varicose vein the surgical line of

  17. Spider Veins

    Science.gov (United States)

    ... How to Choose the Best Skin Care Products Spider Veins Treatment Options Learn more about treatment options ... severe venous disease. What you should know about spider veins The exact cause of spider veins is ...

  18. Conventional operation and laser therapy in the treatment of varicose veins

    Institute of Scientific and Technical Information of China (English)

    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.

  19. Autogenous Sapheonus Vein Graft Interposition in Arteriovenous Fistula Formation

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    Alper Uzun

    2013-10-01

    Full Text Available Aim: Other techniques are required due to the negative influence of poor superficial venous system calibration (<1.5-2 mm to the long term patency of the arteriovenous fistula which is documented via preoperative Doppler ultrasound examination. The postoperative outcome of 32 patients were compared prospectively whom autologous saphenous vein bridge graft was interposed between brachial artery/high brachial vein and radial artery/basilic vein. Material and Method: Patients were divided into two groups; patients whom radial artery/basilic vein autologous saphenous vein graft interposition was performed were labelled as Group 1 (17 patients while patients whom brachial artery/high brachial vein autologous saphenous vein graft was interpositioned were labelled as Group 2 (15 patients. Patients were followed up for 12 months. Graft related complications were recorded. Primary and secondary patency rate were calculated. Results: Graft infection, edema or ischemia of the hand or arm, congestive heart failure and mortality was not observed. There was not a significant difference in puncture site complications between two groups. Primary patency rate was 76.5% (13 of 17 in Group 1 while it was 93.3% (14 of 15 for Group 2 (p=0,185. Secondary patency rate was 82.4% (14 of 17 in Group1 and 100% (15 of 15 for Group 2 (p=0.093. Primary and secondary patency rate were similar between two groups. Discussion: We sought to compare the complication and patency rate of the proximal (brachial artery/high brachial vein and distal (radial artery/basilic vein located bridge graft interpositions and could not found statistical difference between two groups. It is reasonable to keep proximal regions for further interventions, so radial artery/basilic vein bridge graft interposition can be recommended as the initial option according to our findings.

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

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    Park, Soon Chan; Kwon, Se Hwan; Oh, Joo Hyeong; Ryu, Kyung Nam; Ahn, Hyung Joon; Park, Ho Chul [Kyunghee University Medical Center, Seoul (Korea, Republic of)

    2009-09-15

    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

  1. Endovenous radiofrequency ablation for the treatment of varicose veins.

    Science.gov (United States)

    Kayssi, Ahmed; Pope, Marc; Vucemilo, Ivica; Werneck, Christiane

    2015-04-01

    Varicose veins are a common condition that can be treated surgically. Available operative modalities include saphenous venous ligation and stripping, phlebectomy, endovenous laser therapy and radiofrequency ablation. Radiofrequency ablation is the newest of these technologies, and to our knowledge our group was the first to use it in Canada. Our experience suggests that it is a safe and effective treatment for varicose veins, with high levels of patient satisfaction reported at short-term follow-up. More studies are needed to assess long-term effectiveness and compare the various available treatment options for varicose veins.

  2. [MANAGEMENT STANDARDS FOR QUALIFIED PHYSICIANS AND MEDICAL FACILITIES FOR ENDOVENOUS ABLATION OF VARICOSE VEINS].

    Science.gov (United States)

    Ogawa, Tomohiro

    2015-05-01

    Endovenous ablation of saphenous veins using laser energy was approved by the Japanese Ministry of Health, Labor and Welfare in 2011 as a more effective, less-invasive method than classical treatment for varicose veins. New medical laser and radiofrequency devices for this purpose were also approved in 2014. A requirement for the treatment of varicose veins with health insurance reimbursement using these devices is a physician with sufficient knowledge of endovenous ablation. The management standards for endovenous ablation set by varicose vein specialist medical societies are used to accredit qualified physicians who have basic clinical experience in the treatment of varicose veins, qualified instructors, and safe, effective medical facilities.

  3. 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

  4. 术前诱导化疗对实验犬隐皮瓣的影响%Effects of neoadjuvant chemotherapy on saphenous flap in a dog model

    Institute of Scientific and Technical Information of China (English)

    王伟; 周晓; 戴捷; 陈森林; 肖腾飞; 汪安兰; 李俊军

    2011-01-01

    , 50 mg/m2) and 5-fluorouracil (5-FU,150 mg/m2 ). Chemotherapeutic drugs were intravenously injected by drip on the 1st, 3rd, 5th day and 21 days apart to each cycle, a total of 2 cycles. The control group only received an injection of same amount of saline and glucose. The flap surgery was performed at 42~49 days and a daily changes of the flaps were recorded after operation. On the 7th day postoperatively, the flap survival area was measured by means of coordinate transformations, then the entire flap was removed for pathological analysis. RESULTS.. A total of 1l dogs survived ( 5 in chemotherapy and 6 in control group). In the 2~3 days postoperation, different degrees of swelling was found in each flap. All flaps survived 1 week after operation. The survival area was similar in non-direct injection side of control group (A group), direct injection side of control group (B group), nondirect injection side of chemotherapy group (C group) and direct injection side of chemotherapy group (D group, F = 0. 051, P = 0. 984 ), which were (89. 26± 9. 97)%, (90. 25 ± 7. 55)%, (88. 11 ± 9. 38)% and (88. 64±11.25)%. Under the observation of light microscope, the epidermis and subcutaneous tissue grew well Some thrombosis and inflammatory cells were found in the saphenous vein of the dogs in B and D groups, while there were no thrombosis in A and C groups. No thrombosis could be seen in the arteria saphena of all the dogs. CONCLUSIONS: The effects of short-term preoperative chemotherapy on saphenous veins are mainly related to the puncture site of mechanical stimulation and injury. The intravenous drugs have no great influence to the accompanying artery of saphenous vein. There was no obvious difference in the survival area of saphenous flap after short-term preoperative chemotherapy. The area with an intravenous injection can be used as flap donor.

  5. Endovascular Radiofrequency Ablation for Varicose Veins

    Science.gov (United States)

    2011-01-01

    treatment plan. The RFA procedure involves the introduction of a guide wire into the target vein under ultrasound guidance followed by the insertion of an introducer sheath through which the RFA catheter is advanced. Once satisfactory positioning has been confirmed with ultrasound, a tumescent anaesthetic solution is injected into the soft tissue surrounding the target vein along its entire length. This serves to anaesthetize the vein, insulate the heat from damaging adjacent structures, including nerves and skin and compresses the vein increasing optimal contact of the vessel wall with the electrodes or expanded prongs of the RF device. The RF generator is then activated and the catheter is slowly pulled along the length of the vein. At the end of the procedure, hemostasis is then achieved by applying pressure to the vein entry point. Adequate and proper compression stockings and bandages are applied after the procedure to reduce the risk of venous thromboembolism and to reduce postoperative bruising and tenderness. Patients are encouraged to walk immediately after the procedure. Follow-up protocols vary, with most patients returning 1 to 3 weeks later for an initial follow-up visit. At this point, the initial clinical result is assessed and occlusion of the treated vessels is confirmed with ultrasound. Patients often have a second follow-up visit 1 to 3 months following RFA at which time clinical evaluation and ultrasound are repeated. If required, additional procedures such as phlebectomy or sclerotherapy may be performed during the RFA procedure or at any follow-up visits. Regulatory Status The Closure System® radiofrequency generator for endovascular thermal ablation of varicose veins was approved by Health Canada as a class 3 device in March 2005, registered under medical device license 67865. The RFA intravascular catheter was approved by Health Canada in November 2007 for the ClosureFast catheter, registered under medical device license 16574. The Closure System

  6. [RADIOFREQUENCY ABLATION FOR THE TREATMENT OF VARICOSE VEINS].

    Science.gov (United States)

    Sugiyama, Satoru; Miyade, Yoshio; Inaki, Yasuhiko

    2015-05-01

    Significant advances in the endovenous technique for treating incompetent saphenous veins could change the surgical strategy in patients with varicose veins. Radiofrequency ablation (RFA) was approved as a new technique for the treatment of varicose veins in Japan in June 2014. In RFA, the ablation temperature is controlled by a sensor at the upper end of the catheter. The vein wall is heated with stable conductive power of 120 degrees C, resulting in endothelial denudation. The RFA method was approved in 1998 in Europe and in 1999 in the USA. The ClosurePLUS catheter was developed in 2003 and ClosureFAST in 2006. High occlusion rates and lower postoperative complication rates were reported with ClosureFAST than with ClosurePLUS. It is expected that this new ablation technique will control saphenous vein reflux with less pain and less ecchymosis after surgery. The treatment of varicose veins is less invasive with RFA devices and will become widely accepted as an alternative to conventional surgery for varicose veins in Japan.

  7. A new HIFU probe for the treatment of the superficial venous insufficiency and varicose veins

    Science.gov (United States)

    Pichardo, Samuel; Curiel, Laura; Milleret, René; Pichot, Olivier; Lacoste, François; Chapelon, Jean-Yves

    2006-05-01

    A previous work showed the feasibility of inducing a localized partial shrinkage of venous tissues with High Intensity Focused Ultrasound (HIFU). A partial shrinkage of the vein wall is proposed to correct the valvular dysfunction on the saphenous vein that is responsible of the superficial venous insufficiency and varicose veins. In the present study, a new real-time imaging HIFU probe is presented which is suited for this type of treatment. The probe is composed of two HIFU elements that focus sound uniformly over a line of 7 mm-length. Geometry of the HIFU elements was calculated by numerical optimization and allows positioning of the focal line 15 mm in-depth from the skin. The probe is compatible with commercial imaging devices used currently in vascular medicine. Once coupled with an imaging probe, the imaging system shows the central perpendicular plan to the focal line. A validation of the compatibility with a commercial ultrasound imaging system was achieved using a precise model fabricated by stereo-lithography. Construction of the probe is underway.

  8. Targeted mesenchymal stem cell and vascular endothelial growth factor strategies for repair of nerve defects with nerve tissue implanted autogenous vein graft conduits.

    Science.gov (United States)

    Eren, Fıkret; Öksüz, Sınan; Küçükodaci, Zafer; Kendırlı, Mustafa Tansel; Cesur, Ceyhun; Alarçın, Emıne; Irem Bektaş, Ezgı; Karagöz, Hüseyın; Kerımoğlu, Oya; Köse, Gamze Torun; Ülkür, Ersın; Gorantla, Vijay

    2016-10-01

    Peripheral nerve gaps exceeding 1 cm require a bridging repair strategy. Clinical feasibility of autogenous nerve grafting is limited by donor site comorbidity. In this study we investigated neuroregenerative efficacy of autogenous vein grafts implanted with tissue fragments from distal nerve in combination with vascular endothelial growth factor (VEGF) or mesenchymal stem cells (MSCs) in repair of rat peripheral nerve defects. Six-groups of Sprague-Dawley rats (n = 8 each) were evaluated in the autogenous setting using a 1.6 cm long peroneal nerve defect: Empty vein graft (group 1), Nerve graft (group 2), Vein graft and nerve fragments (group 3), Vein graft and nerve fragments and blank microspheres (group 4), Vein graft and nerve fragments and VEGF microspheres (group 5), Vein graft and nerve fragments and MSCs (group 6). Nerve fragments were derived from distal segment. Walking track analysis, electrophysiology and nerve histomorphometry were performed for assessment. Peroneal function indices (PFI), electrophysiology (amplitude) and axon count results for group 2 were -9.12 ± 3.07, 12.81 ± 2.46 mV, and 1697.88 ± 166.18, whereas the results for group 5 were -9.35 ± 2.55, 12.68 ± 1.78, and 1566 ± 131.44, respectively. The assessment results did not reveal statistical difference between groups 2 and 5 (P > 0.05). The best outcomes were seen in group 2 and 5 followed by group 6. Compared to other groups, poorest outcomes were seen in group 1 (P ≤ 0.05). PFI, electrophysiology (amplitude) and axon count results for group 1 were -208.82 ± 110.69, 0.86 ± 0.52, and 444.50 ± 274.03, respectively. Vein conduits implanted with distal nerve-derived nerve fragments improved axonal regeneration. VEGF was superior to MSCs in facilitating nerve regeneration. © 2015 Wiley Periodicals, Inc. Microsurgery 36:578-585, 2016. © 2015 Wiley Periodicals, Inc.

  9. Percutaneus treatment of varicose veins with bipolar radiofrequency ablation

    Energy Technology Data Exchange (ETDEWEB)

    Boon, R.; Akkersdijk, G.J.M. [Department of Surgery, Spaarne Hospital, Hoofddorp (Netherlands); Nio, D., E-mail: dnio@spaarneziekenhuis.n [Department of Surgery, Spaarne Hospital, Hoofddorp (Netherlands)

    2010-07-15

    The traditional surgical treatment of an incompetent great saphenous vein (GSV) and small saphenous vein (SSV) is challenged by endovenous techniques. Bipolar radio frequency induced thermo therapy (RFITT) is a new endovenous treatment, which occludes the vein by using the venous wall as a conductor. Linear endovenous energy densitiy (LEED) describes the amount of energy used for vein closure. Material/methods: From March 2007 till April 2009, two cohorts (23 W and 20 W) were compared, respectively 280 and 178 patients. GSV and SSV were separately analyzed. Follow-up was performed at 3 weeks and 1 year post-operatively with duplex ultrasound, to assess vein closure and perioperative complaints. A visual analog scale (VAS) pain score (range 0-10) was documented. For patients operated after October 2008 follow-up was performed at least 6 months after surgery. Results: 528 GSV and 76 SSV were treated. For the GSV a significant difference in LEED 40.8 17.1 in the 20 W cohort was found, resulting in higher occlusion rates 90.6% compared to 82.7% after 3 weeks. Follow-up of 1 year in the 20 W cohort showed 88.7% occlusion. Multivariate analysis showed that pullback speed (OR 3.7, CI 1.1-12.4) and CEAP classification (OR 3.1, CI 1.7-5.6) were significant predictors for vein occlusion. Despite a higher LEED, post-operative complaints were not significantly worse. Conclusion: RFITT is a safe and effective method to treat incompetent saphenous veins. Slower pullback speed with higher LEED results in higher closure rates without causing more pain.

  10. Ultrasound surveillance in endoluminal laser treatment for varicose veins

    Directory of Open Access Journals (Sweden)

    Varetto G

    2013-10-01

    Full Text Available Gianfranco Varetto, Paolo Garneri, Claudio Castagno, Valentina Molinaro, Simone Quaglino, Matteo Ripepi, Emilio Benintende, Lorenzo Gibello, Stefano Zan, Luigi Contessa, Ugo Bertoldo, Pietro Rispoli Vascular Surgery, Department of Surgical Sciences, University of Turin, Turin, Italy Abstract: Venous ultrasonography is an indispensable tool in minimally invasive surgery for the treatment of varicose veins. However, the criteria for defining preoperative imaging parameters, outcome monitoring, and follow up are not well characterized. In this retrospective study, we reviewed the ultrasound periprocedural parameters and the outcomes in 274 patients (280 limbs after endoluminal laser treatment, at early (<30 days and late (1–60 months follow up. Treatment failure was defined as complete recanalization of the saphenous trunk, thigh perforator vein insufficiency, and recanalization of the proximal saphenous trunk. Judicious patient selection correlated with favorable outcome at the follow-up ultrasound examination. Keywords: follow-up, chronic venous disease, intravenous, obliteration

  11. Cryopreserved allograft veins as alternative coronary artery bypass conduits: early phase results.

    Science.gov (United States)

    Laub, G W; Muralidharan, S; Clancy, R; Eldredge, W J; Chen, C; Adkins, M S; Fernandez, J; Anderson, W A; McGrath, L B

    1992-11-01

    Traditional autologous conduits are sometimes unavailable or unsuitable to permit total revascularization during coronary artery bypass grafting. In these patients the results of using nonautologous alternative conduits has been disappointing. Encouraged by the excellent long-term results seen with cryopreserved allograft valves, a clinical protocol was developed to evaluate the use of a commercially cryopreserved allograft saphenous vein (CPV). Our protocol consisted of using CPV when left internal mammary arteries and autologous saphenous vein grafts were unavailable or unsuitable for complete revascularization. Blood group (ABO) typed CPVs were thawed and implanted as required using standard surgical techniques. From December 1989 through June 1991, 19 of 1,602 patients who underwent coronary revascularization had CPVs implanted (1.2%). There were no operative deaths. An attempt was made to evaluate the patency of all grafts with coronary arteriography or ultrafast computed tomographic scans. Fourteen patients were available for patency evaluation. Patency rate in the 14 patients studied at a mean of 7 +/- 2 months (range, 2 to 16 months) were: internal mammary artery, 93% (14/15); saphenous vein graft, 80% (4/5); and CPV, 41% (7/17). The patency of the CPV was significantly less than the patency rate for the saphenous vein and internal mammary artery (p = 0.004). We conclude that the short-term patency rate of CPVs is inferior to that of autologous vessels. Due to its poor patency, we recommend that CPV should only be used when no other autologous conduit is available.

  12. Biological findings from the PheWAS catalog: focus on connective tissue-related disorders (pelvic floor dysfunction, abdominal hernia, varicose veins and hemorrhoids).

    Science.gov (United States)

    Salnikova, Lyubov E; Khadzhieva, Maryam B; Kolobkov, Dmitry S

    2016-07-01

    Pelvic floor dysfunction, specifically genital prolapse (GP) and stress urinary inconsistency (SUI) presumably co-occur with other connective tissue disorders such as hernia, hemorrhoids, and varicose veins. Observations on non-random coexistence of these disorders have never been summarized in a meta-analysis. The performed meta-analysis demonstrated that varicose veins and hernia are associated with GP. Disease connections on the molecular level may be partially based on shared genetic susceptibility. A unique opportunity to estimate shared genetic susceptibility to disorders is provided by a PheWAS (phenome-wide association study) designed to utilize GWAS data concurrently to many phenotypes. We searched the PheWAS Catalog, which includes the results of the PheWAS study with P value Catalog and the NHGRI Catalog data revealed enrichment of genes associated with bone mineral density in GP and with activated partial thromboplastin time in varicose veins of lower extremity. In cross-phenotype associations, genes responsible for peripheral nerve functions seem to predominate. This study not only established novel biologically plausible associations that may warrant further studies but also exemplified an effective use of the PheWAS Catalog data.

  13. Surgical treatment of varicose vein using the tumescent technique of local anesthesia

    Directory of Open Access Journals (Sweden)

    Bjelanović Zoran

    2011-01-01

    Full Text Available Background/Aim. Tumescent local anesthesia (TLA is a technique for local and regional anesthesia of the skin and the subcutaneous tissue, using infiltration of large amounts of a diluted solution of local anesthetic. This technique is applied in plastic surgery, liposuction as well as in dermatology for the entire series of dermatocosmetic procedures. The purpose of this study was to determine efficiency of surgical treatment of varicose vein using TLA as an alternative method to a conventional treatment for varicose vein. Methods. Seventy-two patients with varicose vein were enrolled in the study. All of them were operated on applying TLA, from April 2008 to November 2009. TLA solution consisted of local anesthetics was used. TLA solutions used were: 1% prilocaine-chloride with adrenaline supplement, and 2% lidocaine-chloride and adrenaline in concentration of 0.1%-0.4%. Results. Out of 72 patients, we stripped great saphenous vein from 60 patient and did varicectomy as well as ligation of insufficiently perforating veins. In 12 patients we did partial varicectomy and ligation of perforating veins. There were not any patients with the need for continued surgery, as well as bringing patient to the general anesthesia due to pain during the surgery. One patient came for postoperative opening wound in the groin, one for infection of the wound and one for the formation of seroma in the groin. There were not any allergic reactions or systemic complications in the operations as well as postoperative period. Postoperatively, all the patients were treated with compressive elastic bandage during the period of 6 weeks as well as anticoagulation prophylaxis in the duration of 5 days. Conclusion. Surgery of varicose veins with implementation of TLA is easy and safe method with very low percentage of complications and unwanted effects. It is a good alternative method to classic surgery of varicose veins. The economic aspect is a very important component

  14. Exogenous Bradykinin Inhibits Tissue Factor Induction and Deep Vein Thrombosis via Activating the eNOS/Phosphoinositide 3-Kinase/Akt Signaling Pathway

    Directory of Open Access Journals (Sweden)

    Ruolan Dong

    2015-11-01

    Full Text Available Background/Aims: Bradykinin has been shown to exert a variety of protective effects against vascular injury, and to reduce the levels of several factors involved in the coagulation cascade. A key determinant of thrombin generation is tissue factor (TF. However, whether bradykinin can regulate TF expression remains to be investigated. Methods: To study the effect of bradykinin on TF expression, we used Lipopolysaccharides (LPS to induce TF expression in human umbilical vein endothelial cells and monocytes. Transcript levels were determined by RT-PCR, protein abundance by Western blotting. In the in vivo study, bradykinin and equal saline were intraperitoneally injected into mice for three days ahead of inferior cava vein ligation that we took to induce thrombus formation, after which bradykinin and saline were injected for another two days. Eventually, the mice were sacrificed and tissues were harvested for tests. Results: Exogenous bradykinin markedly inhibited TF expression in mRNA and protein level induced by LPS in a dose-dependent manner. Moreover, the NO synthase antagonist L-NAME and PI3K inhibitor LY294002 dramatically abolished the inhibitory effects of bradykinin on tissue factor expression. PI3K/Akt signaling pathway activation induced by bradykinin administration reduced the activity of GSK-3ß and MAPK, and reduced NF-κB level in the nucleus, thereby inhibiting TF expression. Consistent with this, intraperitoneal injection of C57/BL6 mice with bradykinin also inhibited the thrombus formation induced by ligation of inferior vena cava. Conclusion: Bradykinin suppressed TF protein expression in human umbilical vein endothelial cells and monocytes in vitro; in line with this, it inhibits thrombus formation induced by ligation of inferior vena cava in vivo.

  15. Endovascular treatment of iliac vein compression syndrome

    Institute of Scientific and Technical Information of China (English)

    MENG Qing-you; LI Xiao-qiang; QIAN Ai-min; SANG Hong-fei; RONG Jian-jie; ZHU Li-wei

    2011-01-01

    Background Iliac vein compression syndrome (IVCS),the symptomatic compression of the left common iliac vein between the right common iliac artery and the vertebrae,is not an uncommon condition.The aim of this research was to retrospectively evaluate long-term outcome and the significance of endovascular treatment in patients with left IVCS.Methods Between January 1997 and September 2008,296 patients received interventional therapy in the left common iliac vein.In the second stage,170 cases underwent saphenous vein high ligation and stripping.Two hundred and thirty-one cases were followed up over a period of 6 to 120 months (average 46 months) and evaluated for symptom improvement with color ultrasound and ascending venography.Results The stenotic or occlusive segments of the left iliac vein were successfully dilated in 285 cases,of whom 272 received stent implantation therapy.Most of the patients achieved satisfactory results on discharge.During the follow-up period,varicose veins were alleviated in 98.7% of the patients,and leg swelling disappeared or was obviously relieved in 84% of cases.About 85% of leg ulcers completely healed.The total patency rate was 91.7% as evaluated with color ultrasound and 91.5% with ascending venography.Conclusions Endovascular treatment of IVCS provides effective symptomatic improvement and good long-term patency in most patients.

  16. Endovascular Laser Therapy for Varicose Veins

    Science.gov (United States)

    2010-01-01

    introduction of a guide wire into the target vein under ultrasound guidance followed by the insertion of an introducer sheath through which an optical fibre carrying the laser energy is advanced. A tumescent anesthetic solution is injected into the soft tissue surrounding the target vein along its entire length. This serves to anaesthetize the vein so that the patient feels no discomfort during the procedure. It also serves to insulate the heat from damaging adjacent structures, including nerves and skin. Once satisfactory positioning has been confirmed with ultrasound, the laser is activated. Both the laser fibre and the sheath are simultaneously, slowly and continuously pulled back along the length of the target vessel. At the end of the procedure, homeostasis is then achieved by applying pressure to the entry point. Adequate and proper compression stockings and bandages are applied after the procedure to reduce the risk of venous thromboembolism, and to reduce postoperative bruising and tenderness. Patients are encouraged to walk immediately after the procedure and most patients return to work or usual activity within a few days. Follow-up protocols vary, with most patients returning 1-3 weeks later for an initial follow-up visit. At this point, the initial clinical result is assessed and occlusion of the treated vessels is confirmed with ultrasound. Patients often have a second follow-up visit 1-3 months following ELT at which time clinical evaluation and ultrasound are repeated. If required, sclerotherapy may be performed during the ELT procedure or at any follow-up visits. Regulatory Status Endovascular laser for the treatment of VV was approved by Health Canada as a class 3 device in 2002. The treatment has been an insured service in Saskatchewan since 2007 and is the only province to insure ELT. Although the treatment is not an insured service in Ontario, it has been provided by various medical specialties since 2002 in over 20 private clinics. Methods Literature

  17. Differential diagnosis of isolated calf muscle vein thrombosis and gastrocnemius hematoma by high-frequency ultrasound

    Institute of Scientific and Technical Information of China (English)

    SU Li-ya; GUO Fa-jin; XU Guang; HAN Xiu-jie; SUN Chang-kun; ZHANG Zheng; JING Qing-hong

    2013-01-01

    Background Differential diagnosis of isolated calf muscle vein thrombosis (ICMVT) and gastrocnemius hematoma is essential for early identification of deep vein thrombosis (DVT).This study aimed to investigate the diagnostic value of high-frequency color Doppler ultrasound for differential diagnosis of ICMVT and gastrocnemius hematoma.Methods A retrospective case series of 35 ICMVT (M∶F,21∶14; mean age (64.5±10.6) years) and 23 gastrocnemius hematoma (M∶F,16∶7; mean age (75.4±11.8) years) patients with bilateral/unilateral lower limb pain was conducted between January 2006 and September 2012.Characteristics and the morphology of high-frequency color Doppler ultrasonography of the lower limb deep vein,great saphenous vein,calf muscles,skin,and soft tissue were examined.Results ICMVT hypoechoic signals were characterized by long,tube-like masses on longitudinal sections and oval masses on transverse sections,with apparent muscle thrombosis boundaries,distal and proximal venous connections,and,often,lower limb DVT.Gastrocnemius hematoma hypoechoic signals were characterized by large volumes,enhanced posterior hematoma echo,hyperechoic muscle boundaries,no hematoma blood flow,and no DVT,and clear differences in trauma/exercise-and oral anticoagulant-induced hematomas were readily apparent.According to the measurement,the ratio of long diameter/transverse diameter (D/T) in ICMVT patients was about less than 2.0,whereas in gastrocnemius hematoma patients the ratio was more than 2.0.Early stage isoechoic and hypoechoic signals were detected with gradually increasing ovular anechoic areas.Partial muscle fibers in the hematoma due to muscle fractures were apparent.Conclusion High-frequency color Doppler ultrasound was found to be a sensitive and reliable method for differential diagnosis of ICMVT and gastrocnemius hematoma due to trauma and exercise or prolonged oral anticoagulant use.

  18. Management Strategy for Patients With Chronic Subclavian Vein Thrombosis.

    Science.gov (United States)

    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.

  19. 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.

    2009-01-01

    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 lear

  20. Activity of Ginkgo biloba Extract and Quercetin on Thrombomodulin Expression and Tissue-type Plasminogen Activator Secretion by Human Umbilical Vein Endothelial Cells

    Institute of Scientific and Technical Information of China (English)

    WEN-JUN LAN; XIAO-XIANG ZHENG

    2006-01-01

    In order to investigate the pharmacological properties of Ginkgo biloba extract (GBE) on improving blood circulation, the regulating action of GBE and quercetin (a main flavonoid ingredient in GBE) on thrombomodulin (TM)expression and tissue-type plasminogen activator (t-PA) secretion was studied. Methods Using flow cytometer and gel image system respectively, we evaluated the TM expression and the t-PA secretion by human umbilical vein endothelial cells (HUVECs) in vitro. Results The increase of TM expression on HUVECs surface was induced by GBE rather than quercetin in a dose- and time-dependent manner. Both GBE and quercetin increased the t-PA release significantly.Conclusion The effect of GBE on improving blood circulation may be partly attributed to its promoting TM expression and t-PA secretion by endothelial cells, and quercetin participated in the effect of GBE on t-PA secretion. However, the action of GBE on increasing TM expression needs further study.

  1. Endoscopic vein harvest in elective off-pump coronary artery bypass grafting

    Institute of Scientific and Technical Information of China (English)

    Nai-kuan CHOU; Meng-lin LEE; Shoei-shen WANG

    2009-01-01

    While traditional open vein harvest was related to postoperative wound complications, endoscopic vein harvest was developed to minimize the morbidity in the greater saphenous vein harvest procedure. In this study, these two procedures were compared for postoperative wound healing and long-term graft patency. We reviewed all consecutive patients undergoing elective off-pump coronary artery bypass grafting from January 2004 to December 2005 and collected data regarding wound complications and coronary events. Wound complications included dehiscence, excessive discharge, edema, altered sensation, cellulitis, hema-toma, pain scale, and superlicial and deep wound infection. Coronary events were defined as diagnosis of myocardial infarction during the first year's follow-up. A total of 392 patients were included in our series, among whom 44 were excluded from the study due to emergent operation, preoperative intra-aortic balloon pump support, or the greater saphenous vein varicose characteristic, 78 belonged to open vein harvest group, and 270 to endoscopic vein harvest group. Wound complications were significantly less in the endoscopic group (5.2%) compared to the open group (19.2%) (P=0.0002). There was no significant difference on preopera-tive risk factors, total operative time, or hospitalization days. During one-year follow-up, both the early and late graft patency rates were similar between the two groups. Endoscopic vein harvest is safe and effective, which carries less risk for wound complica-tions and is associated with better satisfaction and cosmetic result than the traditional greater saphenous vein harvest procedure. The endoscopic vein harvest also demonstrates a great long-term patency.

  2. Endoscopic Saphenous harvesting with an Open CO2 System (ESOS trial for coronary artery bypass grafting surgery: study protocol for a randomized controlled trial

    Directory of Open Access Journals (Sweden)

    Campanella Antonio

    2011-11-01

    Full Text Available Abstract Background In coronary artery bypass grafting surgery, arterial conduits are preferred because of more favourable long-term patency and outcome. Anyway the greater saphenous vein continues to be the most commonly used bypass conduit. Minimally invasive endoscopic saphenous vein harvesting is increasingly being investigated in order to reduce the morbidity associated with conventional open vein harvesting, includes postoperative leg wound complications, pain and patient satisfaction. However, to date the short and the long-term benefits of the endoscopic technique remain controversial. This study provides an interesting opportunity to address this gap in the literature. Methods/Design Endoscopic Saphenous harvesting with an Open CO2 System trial includes two parallel vein harvesting arms in coronary artery bypass grafting surgery. It is an interventional, single centre, prospective, randomized, safety/efficacy, cost/effectiveness study, in adult patients with elective planned and first isolated coronary artery disease. A simple size of 100 patients for each arm will be required to achieve 80% statistical power, with a significant level of 0.05, for detecting most of the formulated hypotheses. A six-weeks leg wound complications rate was assumed to be 20% in the conventional arm and less of 4% in the endoscopic arm. Previously quoted studies suggest a first-year vein-graft failure rate of about 20% with an annual occlusion rate of 1% to 2% in the first six years, with practically no difference between the endoscopic and conventional approaches. Similarly, the results on event-free survival rates for the two arms have barely a 2-3% gap. Assuming a 10% drop-out rate and a 5% cross-over rate, the goal is to enrol 230 patients from a single Italian cardiac surgery centre. Discussion The goal of this prospective randomized trial is to compare and to test improvement in wound healing, quality of life, safety/efficacy, cost-effectiveness, short

  3. Assessment of the efficacy and safety of steam vein sclerosis as compared to classic surgery in lower extremity varicose vein management.

    Science.gov (United States)

    Woźniak, Witold; Mlosek, Robert K; Ciostek, Piotr

    2015-04-01

    For the last 10 years, endovenous thermal ablation methods have gradually predominated over the classic Babcock procedure in varicose vein treatment. Steam vein sclerosis is the newest thermal ablation technique. To assess the efficacy and safety of steam vein sclerosis as compared to the Babcock procedure in lower extremity varicose vein treatment. One hundred and two adult subjects with varicose veins of clinical grade C2 to C6 according to the CEAP classification, treated with varicose vein surgery between 2010 and 2012, were enrolled in the study. These were subdivided into two groups: the study group of 52 patients treated with endovenous steam vein sclerosis and the control group of 50 patients treated with the Babcock procedure. A single lower extremity with isolated great or small saphenous vein insufficiency was operated on in each subject. The groups were compared for demography, disease severity, involved veins, potential perioperative and postoperative complications, as well as treatment efficacy based on the VCSS score reduction. There were no statistically significant differences between the groups in terms of demography, disease severity, involved veins, or perioperative and postoperative complications. The treatment efficacy of both methods, assessed based on the recurrence rate and the quantitative VCSS score reduction, was similar. Clinically significant recanalisation was observed in 1 (1.9%) patient in the study group. The efficacy and safety analysis shows that steam vein sclerosis is a safe, simple method which can be recommended as effective varicose vein treatment.

  4. 激光联合消痔灵治疗大隐静脉曲张%Treatment of Laser Photocoagulation Integrated with Xiaozhiling Injection in Patients with Great Saphe-nous Varicosis

    Institute of Scientific and Technical Information of China (English)

    王春喜; 魏志成; 王晓玲

    2014-01-01

    目的:探讨激光联合消痔灵治疗大隐静脉曲张370例的疗效。方法:370例大隐静脉曲张患者,458条肢体,选择810 nm波长半导体激光器,行血管内激光光凝术;对曲张的属支静脉行消痔灵局部注射。结果:术后当天即自由活动,曲张静脉均于手术后10 d内完全消失;随访2~6年无复发。结论:激光联合消痔灵治疗下肢静脉曲张,操作简便、创伤小、美观、恢复快。%Objective To investigate the therapeutic results of laser photocoagulation integrated with Xiao-zhiling (消痔灵)injection in patients with great saphenous varicosis. Methods Three hundred and seventy patients with varicosis of great saphenous vein, including 458 legs were treated. The laser wire being delivered into saphenous vein through 5F conductor, the intravenous photocoagulations were made with 810 nm laser wave length; the Chinese medicine of Xiao zhiling was injected into the other branches of superficial varicosis. Results The patients’limbs moved freely after operation. The incisions were healed better without edema, hae-matoma and other complications. Being followed-up from 2 to 6 years in those patients, the great saphenous veins were identified to be obliterans without any reoccurrence. Conclusion The laser photocoagulation inte-grated with Xiaozhiling injection is a convenient, minitraumatic, aesthetic and quick restorative therapeutic meth-od in patients with great saphanous vein varicosis.

  5. A comparison of genome-wide DNA methylation patterns between different vascular tissues from patients with coronary heart disease.

    Science.gov (United States)

    Nazarenko, Maria S; Markov, Anton V; Lebedev, Igor N; Freidin, Maxim B; Sleptcov, Aleksei A; Koroleva, Iuliya A; Frolov, Aleksei V; Popov, Vadim A; Barbarash, Olga L; Puzyrev, Valery P

    2015-01-01

    Epigenetic mechanisms of gene regulation in context of cardiovascular diseases are of considerable interest. So far, our current knowledge of the DNA methylation profiles for atherosclerosis affected and healthy human vascular tissues is still limited. Using the Illumina Infinium Human Methylation27 BeadChip, we performed a genome-wide analysis of DNA methylation in right coronary artery in the area of advanced atherosclerotic plaques, atherosclerotic-resistant internal mammary arteries, and great saphenous veins obtained from same patients with coronary heart disease. The resulting DNA methylation patterns were markedly different between all the vascular tissues. The genes hypomethylated in athero-prone arteries to compare with atherosclerotic-resistant arteries were predominately involved in regulation of inflammation and immune processes, as well as development. The great saphenous veins exhibited an increase of the DNA methylation age in comparison to the internal mammary arteries. Gene ontology analysis for genes harboring hypermethylated CpG-sites in veins revealed the enrichment for biological processes associated with the development. Four CpG-sites located within the MIR10B gene sequence and about 1 kb upstream of the HOXD4 gene were also confirmed as hypomethylated in the independent dataset of the right coronary arteries in the area of advanced atherosclerotic plaques in comparison with the other vascular tissues. The DNA methylation differences observed in vascular tissues of patients with coronary heart disease can provide new insights into the mechanisms underlying the development of pathology and explanation for the difference in graft patency after coronary artery bypass grafting surgery.

  6. A comparison of genome-wide DNA methylation patterns between different vascular tissues from patients with coronary heart disease.

    Directory of Open Access Journals (Sweden)

    Maria S Nazarenko

    Full Text Available Epigenetic mechanisms of gene regulation in context of cardiovascular diseases are of considerable interest. So far, our current knowledge of the DNA methylation profiles for atherosclerosis affected and healthy human vascular tissues is still limited. Using the Illumina Infinium Human Methylation27 BeadChip, we performed a genome-wide analysis of DNA methylation in right coronary artery in the area of advanced atherosclerotic plaques, atherosclerotic-resistant internal mammary arteries, and great saphenous veins obtained from same patients with coronary heart disease. The resulting DNA methylation patterns were markedly different between all the vascular tissues. The genes hypomethylated in athero-prone arteries to compare with atherosclerotic-resistant arteries were predominately involved in regulation of inflammation and immune processes, as well as development. The great saphenous veins exhibited an increase of the DNA methylation age in comparison to the internal mammary arteries. Gene ontology analysis for genes harboring hypermethylated CpG-sites in veins revealed the enrichment for biological processes associated with the development. Four CpG-sites located within the MIR10B gene sequence and about 1 kb upstream of the HOXD4 gene were also confirmed as hypomethylated in the independent dataset of the right coronary arteries in the area of advanced atherosclerotic plaques in comparison with the other vascular tissues. The DNA methylation differences observed in vascular tissues of patients with coronary heart disease can provide new insights into the mechanisms underlying the development of pathology and explanation for the difference in graft patency after coronary artery bypass grafting surgery.

  7. [Treatment of lower limb varicose veins in 2015: The present and the future].

    Science.gov (United States)

    Jacquet, R

    2015-01-01

    The introduction of intravenous therapy (ultrasound-guided foam sclerotherapy, laser, radiofrequency) has considerably changed radical treatment of superficial venous insufficiency. The recent granting of reimbursable status for radio frequency thermal ablation has led us to propose radical synthetic treatment for varicose veins. The treatment is based on Doppler ultrasound exploration with detailed varicose cartography, taking into account the affected area (large or small saphenous vein), the site of the point or points of leakage, the diameter of the incontinent saphenous vein, whether the saphenous vein and tributaries are rectilinear or sinuous, and the depth of the varicose network in relation to the skin surface. The decision to implement radical therapy is based on the stage of the disease, particularly in the event of trophic lesions, and takes into consideration both the functional and aesthetic impairment caused by the varicose disorder. All of the foregoing factors affect the choice of treatment, which is also based upon the availability of the various technical approaches mentioned, upon full control of the benefits and limitations of each of the various methods, and upon informed patient consent with regard to the various options proposed: surgery, essentially involving stripping and phlebectomy or endovenous treatments: chemical ablation via ultrasound-guided foam sclerotherapy, and laser or radiofrequency thermal ablation.

  8. Effect of Puumala hantavirus infection on Human Umbilical Vein Endothelial Cell hemostatic function: platelet interactions, increased tissue factor expression and fibrinolysis regulator release

    Directory of Open Access Journals (Sweden)

    Marco eGoeijenbier

    2015-03-01

    Full Text Available Puumala virus (PUUV infection causes over 5000 cases of hemorrhagic fever in Europe annually and can influence the hemostatic balance extensively. Infection might lead to hemorrhage, while a recent study showed an increased risk of myocardial infarction during or shortly after PUUV infection. The mechanism by which this hantavirus influences the coagulation system remains unknown. Therefore we aimed to elucidate mechanisms explaining alterations seen in primary and secondary hemostasis during PUUV infection. By using low passage PUUV isolates to infect primary human umbilical vein endothelial cells (HUVECs we were able to show alterations in the regulation of primary- and secondary hemostasis and in the release of fibrinolysis regulators. Our main finding was an activation of secondary hemostasis due to increased tissue factor expression leading to increased thrombin generation in a functional assay. Furthermore, we showed that during infection platelets adhered to HUVECs and subsequently specifically to PUUV virus particles. Infection of HUVECs with PUUV did not result in increased von Willebrand factor while they produced more plasminogen activator inhibitor type-1 (PAI-1 compared to controls. The PAI-1 produced in this model formed complexes with vitronectin. This is the first report that reveals a potential mechanism behind the pro-coagulant changes in PUUV patients, which could be the result of increased thrombin generation due to an increased tissue factor expression on endothelial cells during infection. Furthermore, we provide insight into the contribution of endothelial cell responses regarding hemostasis in PUUV pathogenesis.

  9. Varicose vein - noninvasive treatment

    Science.gov (United States)

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

  10. Endovascular vein harvest: systemic carbon dioxide absorption.

    Science.gov (United States)

    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.

  11. Endovascular radiofrequency ablation. Effect on the vein diameter using the ClosureFast(®) catheter.

    Science.gov (United States)

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

    2016-01-01

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

  12. Measurement of the circumferential mechanical properties of the umbilical vein: experimental and numerical analyses.

    Science.gov (United States)

    Karimi, Alireza; Navidbakhsh, Mahdi; Rezaee, Taraneh; Hassani, Kamran

    2015-01-01

    Coronary artery disease is responsible for almost 30% of all deaths worldwide. The saphenous vein and umbilical vein (UV) are the most common veins using for treatment as a coronary artery bypass graft (CABG). The mechanical properties of UV belonging to its long-term patency for CABG are very important. However, there is a lack of knowledge on the linear elastic and nonlinear hyperelastic mechanical properties of the UV. In this study, 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) are used to determine the elastic modulus, maximum stress and strain of eight human UVs under circumferential loading. The nonlinear mechanical behaviour of the UV is computationally investigated using Mooney-Rivlin hyperelastic model. A numerical finite element analysis is also carried out to simulate the constitutive modelling versus its numerical results. The results show that the Almansi-Hamel strain definition overestimates the elastic modulus while Green-St Venant strain definition underestimates the elastic modulus at different stress definitions. The true stress-true strain definition, which gives more accurate measurements of the tissue's response using the instantaneous values, reveals the Young's modulus and maximum stress of 2.18 and 6.01 MPa, respectively. The Mooney-Rivlin material model is well represented by the nonlinear mechanical behaviour of the UV. The findings of this study could have implications not only for understanding the extension and rupture mechanism of UV but also for interventions and surgeries, including balloon angioplasty, bypass and stenting.

  13. Varicose vein stripping

    Science.gov (United States)

    ... vein stripping; Venous reflux - vein stripping; Venous ulcer - veins Images Circulatory system References American Family Physician. Management of varicose veins. www.aafp.org/afp/2008/1201/p1289.html . ...

  14. Deep Vein Thrombosis

    Science.gov (United States)

    Deep vein thrombosis, or DVT, is a blood clot that forms in a vein deep in the body. Most deep vein ... the condition is called thrombophlebitis. A deep vein thrombosis can break loose and cause a serious problem ...

  15. Microdissection of distal artery perforator of the medial leg and design of skin flap pedicled with nutrient vessels of the saphenous nerve%小腿内侧远端动脉穿支显微解剖与隐神经营养血管皮瓣设计

    Institute of Scientific and Technical Information of China (English)

    张发惠; 郑和平; 张国栋

    2007-01-01

    以胫后动脉肌间隙支、内踝前动脉穿支和以踝管区动脉穿支血管蒂的3种隐神经-大隐静脉营养血管远端蒂皮瓣或复合瓣,旋转轴点在内踝平面,适宜小腿远段、踝足部及其远侧的组织缺损修复.%BACKGROUND: The distally based skin flap pedicled with nutrient vessels of saphenous nerve has provided a method with higher achievement ratio to repair the tissue defect of ankle and foot, due to its high rotation point, lacking of distributive characteristics of distally pedicled vessels description for the specific operations, so it is still difficult in clinical application.OBJECTIVE: To investigate the distal artery perforators of medial leg, so as to suggest an anatomical theory for the reasonable design of the distally based compound flap pedicled with nutrient vessels of saphenous nerve-great saphenous vein.DESIGN: A single sample experiment.SETTING: Researching Center of Clinical Anatomy, Military Institute of Orthopaedics, Fuzhou General Hospital of Nanjing Military Area Command of Chinese PLA.MATERIALS: The experiment was carried out in the Researching Center of Clinical Anatomy, Military Institute of Orthopaedics, Fuzhou General Hospital of Nanjing Military Area Command of Chinese PLA from May to October, 2004.Thirty-four adult specimens perfused with red emulsion at lateral arteries of upper lower limbs were provided by the Researching Center of Clinical Anatomy, Military Institute of Orthopaedics, Fuzhou General Hospital of Nanjing Military Area Command of Chinese PLA.METHODS: Specimens of the distal medial legs were dissected with microscope taking the most prominent point of medial malleolus as the pivot point.MAIN OUTCOME MEASURES: ① Distal artery perforators of medial leg; ② Distal nutrient vessels of saphenous nerve-great saphenous vein; ③ Blood supply correlation of nutrient vessel with neighboring muscle, bone and skin.RESULTS: ① The distal artery perforators of medial leg derived from 9 main

  16. Plasma tissue factor pathway inhibitor levels as a marker for postoperative bleeding after enoxaparin use in deep vein thrombosis prophylaxis in orthopedics and general surgery.

    Science.gov (United States)

    Hakki, S I; Fareed, J; Hoppensteadt, D A; Abdullah, H; Camblin, J; Nasseri, A F; Hamadeh, O; Wright, T

    2000-10-01

    Low-molecular-weight heparins (LMWH) are widely used as antithrombotic prophylactic pharmaceutical agents in orthopedic and general surgery. Their antithrombotic characteristics are expressed by plasma mediators such as anti-Xa, anti-IIa, and increased release of tissue factor pathway inhibitor (TFPI) from vascular endothelium. The purpose of this clinical research is to study the relation between plasma levels of these mediators and postoperative bleeding. Forty-one consecutive patients undergoing hip or knee arthroplasty (n = 36) and colectomy (n = 5) received the standard enoxaparin (a LMWH) dose preoperatively (general surgery) or immediately postoperatively (orthopedic surgery). Major bleeding was defined as a postoperative drop of > or = 5 g/dL) of hemoglobin. The authors observed that there was a linear relationship between an increase in free/total TFPI ratio levels and postoperative bleeding. When that ratio increased by > 60%, the hemoglobin dropped to > 5 g/dL (n = 17). This relationship between free/total TFPI ratio increase and postoperative bleeding was statistically significant (P bleed (hemoglobin drop was less than 5 g/dL) (n = 24) had a ratio increase (if any) of less than 50%. However, the authors did not observe any statistical relationship between anti-Xa, anti-IIa, or prothrombin time and postoperative bleeding in patients receiving LMWH for deep vein thrombosis prophylaxis in orthopedic and general surgery patients. The authors recommend a pre- and postoperative ratio level measurement whenever major bleeding is anticipated, as adjustments of LMWH dose or frequency might be necessary.

  17. Adsorption of fibronectin and vitronectin onto Primaria and tissue culture polystyrene and relationship to the mechanism of initial attachment of human vein endothelial cells and BHK-21 fibroblasts.

    Science.gov (United States)

    Steele, J G; Dalton, B A; Johnson, G; Underwood, P A

    1995-09-01

    The two cell culture substrata, tissue culture polystyrene (TCPS) and Primaria, were compared in order to determine whether a nitrogen-containing surface such as Primaria attracts cells by a different mechanism to an oxygen-containing surface (TCPS). The amounts of vitronectin (Vn) and fibronectin (Fn) which adsorb from the fetal bovine serum (FBS) component of the culture medium onto Primaria and TCPS were determined. Primaria adsorbed two- to threefold more Fn than TCPS, but adsorbed similar amounts of Vn from medium containing FBS. The Fn and Vn binding sites on Primaria were distinct, as adsorption was non-competitive between these two proteins. The amounts of Fn and Vn that adsorbed onto the two surfaces were compared to the concentration dependence of the cell attachment activities of Fn and Vn. Whereas the amounts of Fn which adsorbed onto TCPS were suboptimal for cell attachment, Primaria adsorbed an Fn surface density that was supraoptimal for attachment of human vein endothelial cells and BHK-21 fibroblasts. We conclude that Primaria differs from TCPS in that both Fn and Vn mediate initial cell attachment to Primaria when the culture medium contains FBS, whereas cell attachment to TCPS is dependent upon Vn.

  18. Traumatic lesions of internal saphenous nerve and branches.

    Science.gov (United States)

    Rodrigues, Flávio Freinkel; Skartz, Issac; Dozza, Diego Cassol; Moscovici, Maurício; Suchmacher, Mendel

    2009-09-01

    To show a rare lesion that sometimes simulates vascular disorder of the lower extremities. Three patients were operated and the follow-up period was eight months, the surgical technique was neurotomy of the infrapatellar and descendent branches. In two cases there were almost total pain resolution, and in other case improvement only. Surgical treatment yields good results in this type of internal saphenous nerve lesion, and could be useful as an alternative to conservative treatment.

  19. 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

    2013-01-01

    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 fo

  20. 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.

    2013-01-01

    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 for

  1. Classical varicose vein surgery in a diverse ethnic community.

    Science.gov (United States)

    Murli, N L; Navin, I D

    2008-08-01

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

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

    Science.gov (United States)

    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.

  3. Interrelationship of oxygen supply by hepatic artery and portal vein: rapid analysis of ischemia-reflow-induced changes in hepatic oxygenation in experimental and clinical subjects by tissue near-infrared spectroscopy.

    Science.gov (United States)

    Tokuka, A; Tanaka, A; Kitai, T; Yanabu, N; Mori, S; Sato, B; Tanaka, K; Yamaoka, Y; Hirao, K

    1994-01-01

    The rapid changes in extracellular oxygenation and intracellular oxidation during ischemia and reflow were measured in deep liver tissue by a novel method combining tissue near-infrared spectroscopy with multicomponent curve-fitting analysis. This method enabled us to make real-time measurements of oxygen saturation (SO2) and amount (THB) of hemoglobin in the liver sinusoid as parameters of extracellular oxygenation state and of redox transition of cytochrome aa3 as intracellular oxidation state. Clamping of the hepatic artery in rabbit decreased the THB with a transient fall of SO2. Clamping of the portal vein decreased both SO2 and THB. The decreases of SO2 and THB caused by Pringle's maneuver were larger than the sum of decreases by hepatic artery and portal vein. These changes in SO2 were correlated with intramitochondrial oxidation state as measured by cytochrome aa3. These results indicate the presence of an interrelationship of oxygen supply by hepatic artery and portal vein. This method was clinically applied during and after clamping of hepatic artery and portal vein in 19 cases of hepatic resection with or without chronic hepatic diseases. The decrease in SO2 values before and after clamping (SO2D) and the slope of SO2 recovery (SO2R) after release were calculated. SO2D and SO2R values of the portal vein in cirrhotics were significantly higher and lower, respectively, than those in the normal liver. These data indicate that the present method provides a rapid and reliable method of quantifying hepatic oxygenation during liver surgery and its perioperative management.

  4. Nanopatterning of collagen scaffolds improve the mechanical properties of tissue engineered vascular grafts.

    Science.gov (United States)

    Zorlutuna, P; Elsheikh, A; Hasirci, V

    2009-04-13

    Tissue engineered constructs with cells growing in an organized manner have been shown to have improved mechanical properties. This can be especially important when constructing tissues that need to perform under load, such as cardiac and vascular tissue. Enhancement of mechanical properties of tissue engineered vascular grafts via orientation of smooth muscle cells by the help of topographical cues have not been reported yet. In the present study, collagen scaffolds with 650, 500, and 332.5 nm wide nanochannels and ridges were designed and seeded with smooth muscle cells isolated from the human saphenous vein. Cell alignment on the construct was shown by SEM and fluorescence microscopy. The ultimate tensile strength (UTS) and Young's modulus of the scaffolds were determined after 45 and 75 days. Alamar Blue assay was used to determine the number of viable cells on surfaces with different dimensioned patterns. Presence of nanopatterns increased the UTS from 0.55 +/- 0.11 to as much as 1.63 +/- 0.46 MPa, a value within the range of natural arteries and veins. Similarly, Young's modulus values were found to be around 4 MPa, again in the range of natural vessels. The study thus showed that nanopatterns as small as 332.5 nm could align the smooth muscle cells and that alignment significantly improved mechanical properties, indicating that nanopatterned collagen scaffolds have the potential for use in the tissue engineering of small diameter blood vessels.

  5. Portal Vein Thrombosis

    OpenAIRE

    Hakan Demirci

    2016-01-01

    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...

  6. Focus on Varicose Veins

    Science.gov (United States)

    ... veins, which are the visible purple or greenish-blue veins that appear in our legs. Spider veins or teleangiectesias are tiny veins that you ... reduce leg swelling and decrease the risk of blood clots. Prescription ... sclerosing solution into spider, reticular or varicose veins. This is a minimally ...

  7. Endovenous laser with miniphlebectomy for treatment of varicose veins and effect of different levels of laser energy on recanalization. A single center experience.

    Science.gov (United States)

    Golbasi, Ilhan; Turkay, Cengiz; Erbasan, Ozan; Kemaloğlu, Cemal; Sanli, Suat; Turkay, Mehtap; Bayezid, Ömer

    2015-01-01

    Varicose veins, associated with great saphenous vein (GSV) incompetence, are traditionally treated with conventional surgery. In recent years, minimally invasive alternatives to surgical treatment such as the endovenous laser ablation (EVLA) and radiofrequency (RF) ablation have been developed with promising results. Residual varicose veins following EVLA, regress untouched, or phlebectomy or foam sclerotherapy can be concomitantly performed. The aim of the present study was to investigate the safety and efficacy of EVLA with different levels of laser energy in patients with varicose veins secondary to saphenous vein reflux. From February 2006 to August 2011, 740 EVLA, usually with concomitant miniphlebectomies, were performed in 552 patients. A total of 665 GSV, 53 small saphenous veins (SSV), and 22 both GSV and SSV were treated with EVLA under duplex USG. At 84 patients, bilateral intervention is made. In addition, miniphlebectomy was performed in 540 patients. A duplex ultrasound (US) is performed to patients preoccupying chronic venous insufficiency (with visible varicose veins, ankle edema, skin changes, or ulcer). Saphenous vein incompetence was diagnosed with saphenofemoral, saphenopopliteal, or truncal vein reflux in response to manual compression and release with patient standing. The procedures were performed under local anesthesia with light sedation or spinal anesthesia. Endovenous 980-nm diode laser source was used at a continuous mode. The mean energy applied per length of GSV during the treatment was 77.5 ± 17.0 J (range 60-100 J/cm). An US evaluation was performed at first week of the procedure. Follow-up evaluation and duplex US scanning were performed at 1 and 6 months, and at 1 and 2 years to assess treatment efficacy and adverse reactions. Average follow-up period was 32 ± 4 months (3-55 months). There were one patient with infection and two patients with thrombus extension into the femoral vein after EVLA. Overall occlusion rate was

  8. Scattering removal for finger-vein image restoration.

    Science.gov (United States)

    Yang, Jinfeng; Zhang, Ben; Shi, Yihua

    2012-01-01

    Finger-vein recognition has received increased attention recently. However, the finger-vein images are always captured in poor quality. This certainly makes finger-vein feature representation unreliable, and further impairs the accuracy of finger-vein recognition. In this paper, we first give an analysis of the intrinsic factors causing finger-vein image degradation, and then propose a simple but effective image restoration method based on scattering removal. To give a proper description of finger-vein image degradation, a biological optical model (BOM) specific to finger-vein imaging is proposed according to the principle of light propagation in biological tissues. Based on BOM, the light scattering component is sensibly estimated and properly removed for finger-vein image restoration. Finally, experimental results demonstrate that the proposed method is powerful in enhancing the finger-vein image contrast and in improving the finger-vein image matching accuracy.

  9. 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 ...

  10. The care of patients with varicose veins and associated chronic venous diseases: clinical practice guidelines of the Society for Vascular Surgery and the American Venous Forum.

    Science.gov (United States)

    Gloviczki, Peter; Comerota, Anthony J; Dalsing, Michael C; Eklof, Bo G; Gillespie, David L; Gloviczki, Monika L; Lohr, Joann M; McLafferty, Robert B; Meissner, Mark H; Murad, M Hassan; Padberg, Frank T; Pappas, Peter J; Passman, Marc A; Raffetto, Joseph D; Vasquez, Michael A; Wakefield, Thomas W

    2011-05-01

    The Society for Vascular Surgery (SVS) and the American Venous Forum (AVF) have developed clinical practice guidelines for the care of patients with varicose veins of the lower limbs and pelvis. The document also includes recommendations on the management of superficial and perforating vein incompetence in patients with associated, more advanced chronic venous diseases (CVDs), including edema, skin changes, or venous ulcers. Recommendations of the Venous Guideline Committee are based on the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) system as strong (GRADE 1) if the benefits clearly outweigh the risks, burden, and costs. The suggestions are weak (GRADE 2) if the benefits are closely balanced with risks and burden. The level of available evidence to support the evaluation or treatment can be of high (A), medium (B), or low or very low (C) quality. The key recommendations of these guidelines are: We recommend that in patients with varicose veins or more severe CVD, a complete history and detailed physical examination are complemented by duplex ultrasound scanning of the deep and superficial veins (GRADE 1A). We recommend that the CEAP classification is used for patients with CVD (GRADE 1A) and that the revised Venous Clinical Severity Score is used to assess treatment outcome (GRADE 1B). We suggest compression therapy for patients with symptomatic varicose veins (GRADE 2C) but recommend against compression therapy as the primary treatment if the patient is a candidate for saphenous vein ablation (GRADE 1B). We recommend compression therapy as the primary treatment to aid healing of venous ulceration (GRADE 1B). To decrease the recurrence of venous ulcers, we recommend ablation of the incompetent superficial veins in addition to compression therapy (GRADE 1A). For treatment of the incompetent great saphenous vein (GSV), we recommend endovenous thermal ablation (radiofrequency or laser) rather than high ligation and inversion stripping

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

    DEFF Research Database (Denmark)

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

    1999-01-01

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

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

    DEFF Research Database (Denmark)

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

    1999-01-01

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

  13. Subsartorial Entrapment of the Saphenous Nerve of a Competitive.

    Science.gov (United States)

    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.

  14. Sclerotherapy of Varicose Veins and Spider Veins

    Science.gov (United States)

    ... you as to whether the procedure was a technical success when it is completed. Your interventional radiologist ... Varicose Veins) Phlebectomy of Varicose Veins Contrast Materials Anesthesia Safety Sponsored by Please note RadiologyInfo.org is ...

  15. Vein Problems Related to Varicose Veins

    Science.gov (United States)

    ... telangiectasias. Spider veins involve the capillaries, the smallest blood vessels in the body. Spider veins often appear on the legs and face. They're red or blue and usually look like a spider web or ...

  16. STUDY OF CULTURING CARDIOVASCULAR TISSUE IN VITRO

    Institute of Scientific and Technical Information of China (English)

    成少飞; 叶清

    2004-01-01

    Objective To evaluate the feasibility of utilizing vascular cells combined with folded and framed culture model to develop completely autologous human tissue without using any scaffold material under the principles of Tissue Engineering. Methods Human vascular cells cultured from ascending aorta (group A) and saphenous vein (group B) were seeded into 15cm-dishes (each n =12 ) and cultured to form cell sheets over a period of four weeks with Dulbecco's modified Eagle's medium supplemented with lmmol/L L-ascorbic acid 2-phosphate. Thereafter, cell sheets (6 samples of each group) were four-layer folded and cultured in a newly developed frame device for additional four weeks. Controls remained under standard culture conditions. Tissue development was evaluated by light and electron microscopy, biochemical assays. Results The formation of multi-layered cell sheets and production of extracellular matrix were observed in each group after the initial four weeks. Analysis of the folded and framed neo-tissue revealed a solid structure with increased matrix formation and tissue organization compared to the control groups after additional four weeks. DNA assay indicated significantly lower cell proliferation in folded and framed cell sheets than in that of unframed counterparts. Yet hydroxyproline assay demonstrated significant increase of collagen content in the framed aortic and venous derived tissues, which contained 82 % and 42 % that of human pericardium. Conclusion It is feasible to obtain completely autologous human cardiovascular tissue with the alternative new approach. Numerous issues including improvement of mechanical strength of neo-tissue remain to be investingated.

  17. 头静脉周围血管营养皮瓣修复皮肤缺损45例%Repairing skin and soft tissue defect in 45 cases by vasculotrophic flaps around cephalic vein

    Institute of Scientific and Technical Information of China (English)

    王宣生; 周巨良; 应素兰; 石小龙; 王振翼; 李庆泰

    2014-01-01

    Objective To discuss the clinical effect of treating skin defect with vasculotrophic flaps around cephalic veins. Methods We used 45 vasculotrophic flaps around cephalic veins to treat 45 patients with skin defect, from February 2008 to March 2012. The follow-up time was 6 months to 1 year, 10 months on average. Based on the surgical methods, the surgical flaps were divided into two classes, one was antegrade flap, with the flap at the distal end of the pedicle. And the other was retrograde flap, with the flap at the proximal of the pedicle. Type I of the second class:reflux vein could be found inside the wound surface, and the cephalic vein inside the flap was anastomosed with the reflux vein inside the wound surface. Type II of the second class: reflux vein could not be found inside the wound surface, and the cephalic vein inside the flap tissues was ligated. Flaps were cut from deep fascial layer, the pedicle width has cephalic vein as the center, not less than 3.0 cm, and the flap length-to-width ratio should not be greater than 5:1. The pedicle of free flap has a strip of skin for reducing tension during suturing. The superficial cutaneous nerves should be kept when cutting the skin flaps. Results Through the method of vasculotrophic flaps around cephalic veins, 45 flaps all survived. As the cutaneous nerve was kept when cutting the flaps, the sensory function of the body was good. Conclusion The cephalic veins exist inside the fascia tissues, and have more concentrated arteries around to supply blood, which provide nutrition to cephalic veins and peripheral tissues. Various vasculotrophic flaps around cephalic veins could be designed by utilizing these tissues for blood supply. As the skin flaps only contain cephalic veins and don't injure nerves and arteries, the damage to the limb is small and higher survival rate, so it has broad application prospects.%目的:探讨头静脉周围血管营养皮瓣修复皮肤缺损的临床疗效。方法对2008年2

  18. 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.

  19. 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.

  20. Sclerofoam assisted laser therapy for saphenous refluxes: an innovative tumescence-free technique

    Directory of Open Access Journals (Sweden)

    Francesco Zini

    2015-06-01

    Full Text Available Endovenous laser (EL and radiofrequency devices have continuously increased their appealing in the last decade. Even if miniinvasive, such procedure still requires multiple high volume injections of tumescent anesthesia: a medical act that is not totally complications- free. Aim of the present investigation is to evaluate the feasibility of a hybrid technique (so called sclerofoam assisted laser therapy, SFALT combining foam sclerotherapy (FS and EL in a tumescence free approach. Fourty primary chronic venous disease patients (8 males, 32 females, C2-4EpAsPr presenting a sapheno-femoral reflux both at the Valsalva and compression/relaxation maneuver underwent a SFALT procedure. Diameters were measured at mid-thigh in supine. It consists in a EL fiber introduction into the great saphenous vein (GSV, shrinking it for a single cm at 200 J/cm. After a shrunk plug is created, keeping the fiber stuck in it, 5 cc of foam sclerotherapy [Tessari method, 1% polidocanol (POL or 1% sodium tetradecyl sulfate (STS] are injected through the same 6 Fr EL introducer. The consequent spasm allows a following EL mediated shrinkage by means of a significantly reduced fluence. Clinical and sonographic follow up were performed at one and three weeks. At 3 weeks follow up all the 40 cases presented a shrunk GSV, without recanalization signs. Neither major nor minor complications were reported. At the mid-thigh the standing GSV caliber decreased from a preoperative mean value of 0.6±0.2 cm to a post FS injection 0.3±0.1 cm value (P<0.05, showing no statistical difference among STS and POL. SFALT approach is feasible, safe and with potentially interesting outcomes. More investigations are needed in order to define the proper fluence parameters and the chance of eliminating the even mild sedation. This technique offers the chance of a possible tumescence free GSV treatment, even in case of major calibers vessels.

  1. Recurrent varicose veins of the legs. Analysis of a social problem.

    Science.gov (United States)

    Cardia, G; Catalano, G; Rosafio, I; Granatiero, M; De Fazio, M

    2012-01-01

    The present study was aimed at assessing the experience of a single referral center with recurrent varicose veins of the legs (RVL) over the period 1993-2008. Among a total of 846 procedures for Leg Varices (LV), 74 procedures were for RVL (8.7%). The causes of recurrence were classified as classic: insufficient crossectomy (13); incompetent perforating veins (13); reticular phlebectasia (22); small saphenous vein insufficiency (9); accessory saphenous veins (4); and particular: post-hemodynamic treatment (5); incomplete stripping (1); Sapheno-Femoral Junction (SFJ) vascularization (5); post-thermal ablation (2). For the "classic" RVL the treatment consisted essentially of completing the previous treatment, both if the problem was linked to an insufficient earlier treatment and if it was due to a later onset. The most common cause in our series was reticular phlebectasia; when the simple sclerosing injections are not sufficient, this was treated by phlebectomy according to Mueller. The "particular" cases classified as 1, 2 and 4 were also treated by completing the traditional stripping procedure (+ crossectomy if this had not been done previously), considered to be the gold standard. In the presence of a SFJ neo-vascularization, with or without cavernoma, approximately 5 cm of femoral vein were explored, the afferent vessels ligated and, if cavernoma was present, it was removed. Although inguinal neo-angiogenesis is a possible mechanism, some doubt can be raised as to its importance as a primary factor in causing recurrent varicose veins, rather than their being due to a preexisting vein left in situ because it was ignored, regarded as insignificant, or poorly evident. In conclusion, we stress that LV is a progressive disease, so the treatment is unlikely to be confined to a single procedure. It is important to plan adequate monitoring during follow-up, and to be ready to reoperate when new problems present that, if left, could lead the patient to doubt the

  2. Portal Vein Thrombosis

    Directory of Open Access Journals (Sweden)

    Ronny Cohen

    2015-01-01

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

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

    Directory of Open Access Journals (Sweden)

    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.

  4. Human vascular smooth muscle cells and endothelial cells cocultured on polyglycolic acid (70/30) scaffold in tissue engineered vascular graft

    Institute of Scientific and Technical Information of China (English)

    WEN Shao-jun; ZHAO Li-min; WANG Shen-guo; LI Jing-xing; CHEN Hua-ying; LIU Jie-lin; LIU Ya; LUO Yi; Roo Changizi

    2007-01-01

    Background Current prosthetic, small diameter vascular grafts showing poor long term patency rates have led to the pursuit of other biological materials. Biomaterials that successfully integrate into surrounding tissue should match not only the mechanical properties of tissues, but also topography. Polyglycolic acid (70/30) has been used as synthetic grafts to determine whether human vascular smooth muscle cells and endothelial cells attach, survive and secrete endothelin and 6-keto-prostaglandin F1α (6-keto-PGF1α).Methods Endothelial cells and smooth muscle cells were isolated from adult human great saphenous vein. They were seeded on polyglycolic acid scaffold in vitro separately to grow vascular patch (Groups A and B respectively) and cocultured in vitro to grow into vascular patch (Group C). Smooth muscle cells and endothelial cells were identified by immunohistochemical analysis and growth of cells on polyglycolic acid was investigated using scanning electron microscopy. The levels of endothelin and 6-keto-PGF1α in the culturing solutions were examined by radioimmunology to measure endothelial function.Results Seed smooth muscle cells adhered to polyglycolic acid scaffold and over 28 days grew in the interstices to form a uniform cell distribution throughout the scaffold. Then seed endothelial cells formed a complete endothelial layer on the smooth muscle cells. The levels of endothelin and 6-keto-prostaglandin F1 alpha in the culturing solution were (234±29) pg/ml and (428+98) pg/ml respectively in Group C and (196+30) pg/ml and (346±120) pg/ml in Group B; both significantly higher than in Groups A and D (blank control group, all P<0.05 ).Conclusions Cells could be grown successfully on polyglycolic acid and retain functions of secretion. Our next step is to use human saphenous vein smooth muscle cells and endothelial cells to grow tubular vascular grafts in vitro.

  5. Chronic venous insufficiency patterns in lower extremity veins detected by Doppler Ultrasound

    Directory of Open Access Journals (Sweden)

    Özhan Özgür

    2013-12-01

    Full Text Available Objective: The aim of this study was to reveal patterns ofchronic venous insufficiency of lower extremity detectedby color Doppler ultrasound and clarify its clinical implicationsin the patients with varicose veins symptoms.Methods: Between 2006 to 2011, a total of 2006 patientspresented with symptoms of venous insufficiency wereincluded in study. A total of 3938 lower extremity venoussystems were examined using color Doppler US. Weclassified four patterns considering combinations of superficialand deep venous insufficiency.Results: Of 2006 patients, 966 had either single venousinsufficiency (790, 82% or combined insufficiency (176,18%. Superficial venous insufficiency was observedat the saphenoefemoral junction (SFJ in 25.5%, at theGreat Saphenous Vein (GSV in 57.6%, at the GiacominiVein in 2.4%, at the saphenopopliteal junction in 1.8% andfinally at the Small Saphenous Vein (SSV in 9.1% of thepatients. We found multilevel venous insufficiency showingconnections at the rate of 51%. We described fourpatterns as Pattern 1: SFJ insufficiency combined withGSV (97.9%, GSV branching (7.1%, and perforatingvein (20.8% insufficiency, Pattern 2: Deep venous insufficiencycombined with SFJ (63.6%, GSV (76.4%, andSSV (16.4% insufficiency, Pattern 3: SPJ insufficiencycombined with SSV insufficiency (95.5% and Pattern 4:Giacomini Vein insufficiency combined with GSV (67.9%and SSV (75% insufficiency.Conclusion: Chronic venous insufficiency may show fourdifferent patterns. Our results revealed that SFJ and GSVinsufficiency combination and deep venous insufficiencyand GSV insufficiency combinations are the most commoninsufficiency patterns seen in lower extremity.Key words: Doppler ultrasound, varicose veins, venous insufficiency

  6. Nicht-operative invasive Therapie der Perforansinsuffizienz // Nonoperative Therapy in the Treatment of Varicose Vein Disease

    Directory of Open Access Journals (Sweden)

    Zerweck C

    2016-01-01

    Full Text Available Nonoperative therapy options in the treatment of varicose vein disease have gained more in importance over the last decade. A profound, catheter- based varicose vein therapy must accomplish powerful therapy solutions for all kinds of varicose vein anatomies, such as saphenous veins, side branches and incompetent perforating veins. This overview, focused on thermal ablation techniques such as laser-, radiofrequencyor steamablation and other chemical sclerotherapy options provides also step-by-step guidance and tricks on perforating vein ablation. The enormous quantity of incompetent perforating vein ablation studies shows great interest in this method and occupies an important place in the field of chronic venous disease therapy. p bKurzfassung: /bNicht-operative Therapieverfahren gewinnen in der modernen Varizentherapie zunehmend an Bedeutung. Um eine uneingeschränkte Varizensanierung mit kathetergestützten Therapieverfahren durchführen zu können, sind analog zur operativen Sanierung für sämtliche Varizenformen potente Okklusionsverfahren notwendig. Diese Arbeit soll einen Überblick zum derzeitigen Stand der Ablationserfolge von inkompetenten Perforansvenen geben. Neben den thermischen Ablationsverfahren wie Laser-, Radiowellen- und Dampfablation sowie sonstigen chemischen Sklerosierungsarten gibt die Arbeit praktische Anleitung und Tipps zur Durchführung einer Perforansvenenablation. Die große Anzahl von Studien zur Perforansvenen ablation zeigt, dass die Behandlung mit Kathetersystemen einen bedeutenden und festen Platz in der Therapie der Perforansvarikosis hat.

  7. The umbilical and paraumbilical veins of man.

    OpenAIRE

    Martin, B F; Tudor, R G

    1980-01-01

    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 persis...

  8. Veias linfonodais: uma causa pouco conhecida de varizes Lymph node veins: a little-known cause of varicose veins

    Directory of Open Access Journals (Sweden)

    André Paciello Romualdo

    2008-12-01

    Full Text Available As veias linfonodais fazem parte de uma rede venosa no triângulo de Scarpa, que liga em vários pontos o sistema venoso superficial às veias profundas, e podem tanto ser causa de incompetência do sistema venoso superficial quanto estar envolvidas na recorrência pós-safenectomia. Na rotina diária dos exames de Doppler venoso de membros inferiores, temos notado de maneira cada vez mais freqüente a associação das veias linfonodais com varizes primárias e recorrentes. A adequada caracterização dessas veias pode ajudar na compreensão do mecanismo fisiopatológico do aparecimento das varizes e permitir um controle e tratamento mais dirigidos. Este artigo lança luz sobre os aspectos anatômicos e fisiológicos das veias linfonodais, objetivando chamar a atenção dos profissionais envolvidos no diagnóstico de doenças venosas dos membros inferiores para uma causa pouco difundida de varizes.Lymph node veins are part of a venous network in Scarpa"s triangle, communicating in many points the superficial venous system and the deep veins, and may either be the cause of incompetence of the superficial venous system, or be involved in recurrent varicose veins after saphenous vein stripping. In the daily routine of venous Doppler examination of the lower extremities, an increasingly frequent association of lymph node veins with primary and/or recurrent varicose veins has been noticed. Appropriate characterization of these veins may help to understand the pathophysiological mechanism of varicose vein appearance and provide a more focused approach to follow-up and treatment. This article sheds some light on the anatomical and physiological aspects of lymph node veins, drawing the attention of professionals involved in the diagnosis of venous disorders of the lower extremities to a little-known cause of varicose veins.

  9. Replantation of composite tissue masses severed from dorsal fingers by vein bridging%桥接静脉法再植手指背侧离断复合组织块

    Institute of Scientific and Technical Information of China (English)

    从飞; 宋保平; 欧学海; 蔡鹰; 付华; 冯东旭

    2013-01-01

    Objective To explore the clinical effect of replantation of composite tissue masses severed from dorsal fingers by vein bridging. Methods 13 cases with composite tissue masses severed from dorsal fingers were replanted by vein bridging (only venous anastomosis) from June 2006 to August 2011. The effectiveness was evaluated after operation by observing the survival and complications of the composite tissue masses. Postoperative follow up ranged from 6 to 24 months, evaluating the appearance and function of the hand. Results Complete survival of the replanted composite tissue masses of the hand was achieved in 9 cases. Partial necrosis was seen in 2 cases. 2 cases had complete loss of the tissue masses. By 6 months to 2 years follow-up, the replanted tissue masses had a better appearance and lower elasticity. According to the function evaluation of the total active motion (TAM) scales, the result was excellent in 8,good in 3 and fair in 2, and the excellent and good rate was 84.6%. Conclusion It is an effective method that replantation of composite tissue masses severed from dorsal fingers by vein bridging, which has a high survival rate and good effect.%目的:探讨通过桥接静脉建立血液循环的方法再植手指背离断复合组织块的疗效。方法2006年6月-2011年8月,对13例合并肌腱或骨质离断的手指背复合组织块离断伤患者,急诊应用桥接静脉建立血液循环的方法再植离断组织块,术后观察其成活情况及并发症。结果本组9例再植组织块完全成活,2例完全坏死,2例部分坏死。所有病例随访6~24个月,再植组织块外观可,弹性稍差。依据中华医学会手外科分会上肢功能评定标准,优8例,良3例,差2例,优良率84.6%。结论桥接静脉法再植手指背侧离断复合组织块成活率较高,临床效果良好,是一种有效的治疗方法。

  10. The rat saphenous flap: a fasciocutaneous free flap model without panniculus carnosus.

    Science.gov (United States)

    Mutaf, M; Tasaki, Y; Tanaka, K; Fujii, T

    1995-10-01

    The rat saphenous flap is described as a new experimental model for free flap studies. This is a fasciocutaneous free flap based on the saphenofemoral vascular pedicle. The flap may include the entire medial aspect of the lower leg between the knee and ankle. Thirty flaps were harvested from 15 inbred rats. Each flap was transferred to the anterior neck of a recipient rat of the same inbred strain so that 15 flaps were vascularized free flaps using the standard end-to-end microvascular technique and the other 15 flaps were nonvascularized free grafts. All but two (technical failure) of the vascularized flaps showed complete survival, whereas all nonvascularized flaps completely necrosed 2 weeks after transfer. It was concluded that the rat saphenous flap has several advantages such as a long and consistent vascular pedicle, ease of harvest, and an all-or-none survival pattern. Furthermore, as a unique feature of this flap, histological analysis revealed that the rat saphenous flap is composed of the skin and underlying fascia without panniculus carnosus. We therefore suggest that the rat saphenous flap is the first true fasciocutaneous free flap model in the rat. In this paper, in addition to illustrating the anatomy of the saphenous vessels and describing a new fasciocutaneous free flap model based on these vessels, we have documented some anatomical details of the rat leg that have never been described in the literature related to the rat anatomy.

  11. TH 胶胃冠状静脉栓塞治疗门脉高压上消化道出血%Clinical analysis of gastric coronary vein embolization with medical TH tissue adhesive for the treatment of portal hypertention

    Institute of Scientific and Technical Information of China (English)

    张蕾

    2015-01-01

    Objective:To discuss the clinical methods and short - term effects of gastric coronary veins embolization with medical TH tissue adhesive for the treatment of portal hypertention and gastric - esophageal varices. Methods:Retro - anal-ysis of 36 cases underwent embolization and splenctomy. Results:Condition of gastric - esophageal vein varices was im-proved after the operations. Postoperative rehemorhage rate for 1 years was 5. 6%(2 / 36). The rate was decreased signifi-cantly compared with those of conventional surgical methods. Conclusion:Operation of gastric - esophageal embolization with medical TH tissue adhesive for the treatment of portal hypertention is safe with less injury and the effects are satisfacto-ry.%目的:探讨应用 TH 胶(含显影剂的α-氰基丙烯酸正辛酯)行胃冠状静脉栓塞治疗门脉高压食管胃底静脉曲张的方法,评价其近期疗效。方法对我院行该术式治疗的36例门脉高压症患者作回顾性分析。结果栓塞术后食管胃底静脉曲张减轻,术后1年再出血率5.6%(2/36),与传统断流术相比有显著下降(P <0.01)。结论应用 TH 胶胃冠状静脉栓塞治疗门脉高压消化道出血,手术较安全,创伤小,止血彻底,再出血率低,临床疗效满意。

  12. [Right ovarian vein syndrome].

    Science.gov (United States)

    Arvis, G

    1985-01-01

    Right ovarian vein syndrome is revealed in pregnancy by right lumbar pains, and even by nephritic colics. It results from a congenital malposition of the right ovarian vein, which presses the right ureter on the external iliac artery. Diagnosis is by intravenous urography and retrograde ureteral pyelography. If pain persists despite treatment by analgesics, it may be necessary to place a double-J catheter, and to operate after delivery to ligate the ovarian vein.

  13. Postpartum renal vein thrombosis.

    Science.gov (United States)

    Rubens, D; Sterns, R H; Segal, A J

    1985-01-01

    Renal vein thrombosis in adults is usually a complication of the nephrotic syndrome. Rarely, it has been reported in nonnephrotic women postpartum. The thrombosis may be a complication of the hypercoagulable state associated with both the nephrotic syndrome and pregnancy. Two postpartum patients with renal vein thrombosis and no prior history of renal disease are reported here. Neither patient had heavy proteinuria. In both cases, pyelonephritis was suspected clinically and the diagnosis of renal vein thrombosis was first suggested and confirmed by radiologic examination. Renal vein thrombosis should be considered in women presenting postpartum with flank pain.

  14. Preseeding of human vascular cells in decellularized bovine pericardium scaffold for tissue-engineered heart valve: an in vitro and in vivo feasibility study.

    Science.gov (United States)

    Yang, Min; Chen, Chang-Zhi; Shu, Yu-Sheng; Shi, Wei-Ping; Cheng, Shao-Fei; Gu, Y John

    2012-08-01

    Human vascular cells from saphenous veins have been used for cell seeding on the synthetic scaffolds for constructing tissue-engineered heart valve (TEHV). However, little is known about the seeding of human vascular cells on bovine pericardium, a potential natural scaffold for TEHV. This study was aimed to assess the basic in vitro and in vivo characteristics of the human vascular cells seeded on decellularized bovine pericardium. In vitro, bovine pericardium samples with cell seeding were inspected on day 7, 14, and 21 by histology, scanning electron microscopy, and immunohistochemistry. In vivo, experiments were performed in nude mice by bilateral dorsal incision for the implantation of decellularized bovine pericardium with and without cell seeding. Results demonstrated that a total of 8-10 × 10(6) cells were obtained within 4-5 wk by the primary co-culture, which were detected positive for von Willebrand factor, α-smooth muscle actin antibodies, and fibronectin, indicating the presence of endothelial cells, smooth muscle cells, and fibroblasts, respectively. In vitro, the seeded cells showed a steady increase of endothelial activity from day 1 to day 7 and remained stable until day 21. After 30 days of implantation in vivo, the cells on the decellularized bovine pericardium could differentiate directionally and show all the identities of human endothelial cells, smooth muscle cells, and fibroblasts. These results indicate that the human vascular cells from the saphenous vein are an optional cell source for seeding on decellularized bovine pericardium scaffold for constructing TEHV. Copyright © 2012 Wiley Periodicals, Inc.

  15. Intensity Variation Normalization for Finger Vein Recognition Using Guided Filter Based Singe Scale Retinex

    OpenAIRE

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

    2015-01-01

    Finger vein recognition has been considered one of the most promising biometrics for personal authentication. However, the capacities and percentages of finger tissues (e.g., bone, muscle, ligament, water, fat, etc.) vary person by person. This usually causes poor quality of finger vein images, therefore degrading the performance of finger vein recognition systems (FVRSs). In this paper, the intrinsic factors of finger tissue causing poor quality of finger vein images are analyzed, and an int...

  16. What Causes Varicose Veins?

    Science.gov (United States)

    ... blood flow, and thin, stretched walls. The middle image shows where varicose veins might appear in a leg. Figure A shows ... blood flow, and thin, stretched walls. The middle image shows where varicose veins might appear in a leg. Older age or ...

  17. Nursing Experience in the Treatment of Lower Extremity Varicose Veins%下肢静脉曲张腔内激光治疗的护理

    Institute of Scientific and Technical Information of China (English)

    邹燕慧

    2015-01-01

    大隐静脉曲张是外科常见病,近年来下肢静脉曲张微创外科治疗技术得到了飞速发展。静脉曲张腔内激光治疗术具有美观,手术创伤、创口和并发症少,术后恢复快,住院时间短等优点。我科于2013年引进激光静脉曲张治疗系统治疗大隐静脉曲张23例,与传统的手术方法相比较,具有微创、美观、彻底三大特点。%Varicosis of great saphenous vein is a common surgical disease,in recent years,varicose veins of lower extremity treated with minimal y invasive surgery technology has been rapid development.Has the advantages of beautiful appearance,varicose veins endovenous laser treatment,surgical trauma,the wound and few complications,postoperative quick recovery,short hospitalization time and other advantages.In our department in 2013 the introduction of laser system for treating varicose vein treatment of varicosis of great saphenous vein in 23 cases,compared with the traditional surgical method,with minimal y invasive,beautiful,completely three characteristics.

  18. Oestradiol levels in varicose vein blood of patients with and without pelvic vein incompetence (PVI): diagnostic implications.

    Science.gov (United States)

    Asciutto, G; Mumme, A; Asciutto, K C; Geier, B

    2010-07-01

    To assess the difference in the oestradiol levels of blood taken from varicose veins in patients with and without pelvic vein incompetence (PVI). Women of child-bearing age with symptomatic primary or recurrent varicose veins of the great saphenous vein (GSV) were included in a prospective study. Patients underwent duplex ultrasonography and pelvic vein phlebography. They were divided into a group with PVI (PVI group) and a control group with GSV reflux alone (VV group). Blood samples were collected from the GSV at the sapheno-femoral junction or lower in the thigh as well as from the arm. Oestradiol levels were determined by electroluminescence. Between January and December 2007, 40 women were studied, of which 19 showed phlebographic evidence of PVI (PVI group), while 21 were included in the VV group. Phlebography revealed an incompetent ovarian vein in 14 (74%) patients of the PVI group, dilated uterine and ovarian plexuses in 12 (63%) and an incompetent internal iliac vein in six cases (32%). In the PVI group, the median oestradiol level in GSV samples was 121 pgml(-1) (range: 12-4300), while in the VV group the median level was 75 pgml(-1) (range: 9-1177). In the upper limb, the PVI group patients had a median level of 78 pgml(-1) (range: 15-121) and the VV group patients 68 pgml(-1) (range: 13-568). The ratio of lower limb/upper extremity was significantly higher (pPVI group (median: 1.9; range: 0.7-33) than in those of the VV group (median: 1.1; range: 0.8-13). A threshold ratio of 1.4 showed the highest combined sensitivity and specificity in differentiating patients with PVI from those without. In patients with varicose veins arising from the GSV, oestradiol levels were significantly higher in the lower limb than in the upper extremity in the subgroup with associated PVI. It may be possible to use this observation as a diagnostic test in patients with suspected PVI. This deserves further study. Copyright 2010 European Society for Vascular Surgery

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

    Directory of Open Access Journals (Sweden)

    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.

  20. [Forensic medical implications in the course of sclerotherapy of varicose veins].

    Science.gov (United States)

    Natali, J; Farman, T

    1996-11-01

    Complications are exceptional compared to the number of sclerosis treatments performed. We report 58 case-files with medico-legal implications. Intraarterial injections are by far the most severe complications: we observed 40 such cases with the following consequences: 7 major amputations including 2 above the knee and 5 below the knee, 6 minor peripheral amputations of one or more toes, 27 severe sequelae, mainly due to retraction of the triceps sural muscle. This type of accident occurs more readily after attempted sclerosis of the lesser saphenous vein "crosse", although other localizations can be involved: inguinal area by sclerosis of the greater saphenous vein "crosse", the lower third of the leg with direct injection into the anterior or posterior tibial artery or its branches. Subcutaneous injections of the sclerosis agent produce either simple inflammatory reactions or skin necrosis. Neurological disorders can be observed by direct damage to the nerve. Sensorial complications may occur by lesion of a cutaneous branch of the popliteal sciatic nerve. Other cases involve motor disorders. Pulmonary thromboembolic events (4 cases) appear to be exception when modern criteria for the diagnosis of phlebitis are used. General allergic and anaphylactic reactions are very rare and often related to overdose. The same is true for toxic reactions. One case of septicemia occurred after incision of post-sclerosis clots. From a medicolegal point of view, the responsibility of the practician is usually confirmed for severe accidents (intraarterial injections) leading to trophic disorders. For necrosis or limited eschars, the question is debated.

  1. A Novel Seeding and Conditioning Bioreactor for Vascular Tissue Engineering

    Directory of Open Access Journals (Sweden)

    Julia Schulte

    2014-07-01

    Full Text Available Multiple efforts have been made to develop small-diameter tissue engineered vascular grafts using a great variety of bioreactor systems at different steps of processing. Nevertheless, there is still an extensive need for a compact all-in-one system providing multiple and simultaneous processing. The aim of this project was to develop a new device to fulfill the major requirements of an ideal system that allows simultaneous seeding, conditioning, and perfusion. The newly developed system can be actuated in a common incubator and consists of six components: a rotating cylinder, a pump, a pulse generator, a control unit, a mixer, and a reservoir. Components that are in direct contact with cell media, cells, and/or tissue allow sterile processing. Proof-of-concept experiments were performed with polyurethane tubes and collagen tubes. The scaffolds were seeded with fibroblasts and endothelial cells that were isolated from human saphenous vein segments. Scanning electron microscopy and immunohistochemistry showed better seeding success of polyurethane scaffolds in comparison to collagen. Conditioning of polyurethane tubes with 100 dyn/cm2 resulted in cell detachments, whereas a moderate conditioning program with stepwise increase of shear stress from 10 to 40 dyn/cm2 induced a stable and confluent cell layer. The new bioreactor is a powerful tool for quick and easy testing of various scaffold materials for the development of tissue engineered vascular grafts. The combination of this bioreactor with native tissue allows testing of medical devices and medicinal substances under physiological conditions that is a good step towards reduction of animal testing. In the long run, the bioreactor could turn out to produce tissue engineered vascular grafts for human applications “at the bedside”.

  2. Congenital preduodenal portal vein

    Energy Technology Data Exchange (ETDEWEB)

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

    1991-03-15

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

  3. Umbilical and portal vein calcification following umbilical vein catheterization

    Energy Technology Data Exchange (ETDEWEB)

    Schneider, K.; Fendel, H.; Hartl, M.

    1989-07-01

    Calcifications of the umbilical vein and intrahepatic branches of the portal vein developed in a newborn who had inserted an umbilical vein catheter for 11 days postnatally. The calcified intrahepatic portal veins can still be demonstrated sonographically at the age of three years, whereby these calcifications were no longer detectable radiologically. (orig.).

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

    Science.gov (United States)

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

  5. Deep vein thrombosis.

    Science.gov (United States)

    Bandyopadhyay, Gargi; Roy, Subesha Basu; Haldar, Swaraj; Bhattacharya, Rabindra

    2010-12-01

    Occlusive clot formation in the veins causes venous thrombosis, the site most common in the deep veins of leg, called deep vein thrombosis. The clot can block blood flow and when it breaks off, called an embolism which in turn can damage the vital organs. Venous thrombosis occurs via three mechanisms ie, Virchow's triad. The mechanisms are decreased flow rate of blood, damage to the blood vessel wall and an increased tendency of the blood to clot. There are several factors which can increase a person's risk for deep vein thrombosis. The symptoms of deep vein thrombosis in the legs are pain, swelling and redness of the part. One variety of venous thrombosis is phlegmasia alba dolens where the leg becomes pale and cool. Investigations include Doppler ultrasound examination of the limb, D-dimer blood test, plethysmography of the legs, x-rays to show vein in the affected area (venography). Hospitalisation is necessary in some cases with some risk factors. The mainstream of treatment is with anticoagulants, mostly low molecular weight heparin for 6 months. Deep venous thrombosis is a rising problem. Early diagnosis and treatment is associated with a good prognosis.

  6. Mesenteric vein thrombosis: CT identification

    Energy Technology Data Exchange (ETDEWEB)

    Rosen, A.; Korobkin, M.; Silverman, P.M.; Dunnick, N.R.; Kelvin, F.M.

    1984-07-01

    Superior mesenteric vein thrombosis was identified on computed tomographic scans in six patients. In each case, contrast-enhanced scans showed a high-density superior mesenteric vein wall surrounding a central filling defect. Four fo the six patients had isolated superior mesenteric vein thrombosis. A fifth patient had associated portal vein and splenic vein thrombosis, and the sixth patient had associated portal vein and inferior vena cava thrombosis. One of the six patients had acute ischemic bowel disease. The other five patients did not have acute ischemic bowel symptoms associated with their venous occlusion. This study defines the computed tomographic appearance of mesenteric vein thrombosis.

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

    Directory of Open Access Journals (Sweden)

    G.A. Wolff I

    2010-12-01

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

  8. Reducing intimal hyperplasia in vein grafts harvested by a no-touch harvesting technique

    Institute of Scientific and Technical Information of China (English)

    2009-01-01

    Objective To investigate the effect of no-touch harvesting technique in reducing vein graft intimal hyperplasia. Methods This longitudinal trial compared graft angiostenosis of two groups undergoing jugular vein to carotid artery interposition grafting in rabbit model. Conventional group:12 rabbits had their veins stripped,distended,and stored in heparinized saline solution. No-touch group:12 rabbits had veins removed with surrounding tissues,but were not distended,and stored in heparinized blood. The graft...

  9. Early Results of Endovenous Ablation with a 980-nm Diode Laser for an Incompetent Vein of Giacomini

    Energy Technology Data Exchange (ETDEWEB)

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

    2011-08-15

    We wanted to evaluate the effectiveness of endovenous ablation of the incompetent vein of Giacomini using a 980-nm diode laser. A total of 18 patients (18 limbs, 4%) had the incompetent vein of Giacomini. Retrograde reflux originating from the great saphenous vein was noted in sixteen limbs and paradoxical diastolic anterograde reflux from the saphenopopliteal junction was observed in two limbs. After tumescent anesthesia, laser ablation using a 980-nm wavelength laser fiber was performed under ultrasound and/or fluoroscopic guidance. Patients were evaluated clinically and with duplex ultrasound at one week and at one, three, six and twelve months after laser ablation for the technical and clinical success. In the 18 limbs, the technical success rate was 100%. Continued closure of the vein of Giacomini was seen in 18 of 18 limbs after one month, in 12 of 12 limbs after three and six months and in six of six limbs after twelve months. No recanalization of the vein and no major complications occurred. Endovenous laser ablation with a 980-nm wavelength is an effective and safe procedure for treating an incompetent vein of Giacomini.

  10. Advantages of using volar vein repair in finger replantations.

    Science.gov (United States)

    Mersa, Berkan; Kabakas, Fatih; Pürisa, Hüsrev; Özçelik, Ismail Bülent; Yeşiloğlu, Nebil; Sezer, Ilker; Tunçer, Serdar

    2014-01-01

    Providing adequate venous outflow is essential in finger replantation surgeries. For a successful result, the quality and quantity of venous repairs should be adequate to drain arterial inflow. The digital dorsal venous plexus is a reliable source of material for venous repairs. Classically, volar digital veins have been used only when no other alternative was available. However, repairing volar veins to augment venous outflow has a number of technical advantages and gives a greater chance of survival. Increasing the repaired vein:artery ratio also increases the success of replantation. The volar skin, covering the volar vein, is less likely to be avulsed during injury and is also less likely to turn necrotic, than dorsal skin, after the replantation surgery. Primary repair of dorsal veins can be difficult due to tightness ensuing from arthrodesis of the underlying joint in flexion. In multiple finger replantations, repairing the volar veins after arterial repair and continuing to do so for each finger in the same way without changing the position of the hand and surgeon save time. In amputations with tissue loss, the size discrepancy is less for volar veins than for dorsal veins. We present the results of 366 finger replantations after volar vein repairs.

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

    Directory of Open Access Journals (Sweden)

    Yu.O. Syniachenko

    2017-04-01

    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.

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

    DEFF Research Database (Denmark)

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

    2013-01-01

    BACKGROUND: Adductor-canal-blockade is a new technique for pain relief after knee surgery. This block could cause nerve injury and the aim of this follow-up study was to determine the prevalence of saphenous nerve injury in patients receiving adductor-canal-blockade for pain treatment after total...... knee arthroplasty. METHODS: All patients included in two former studies of adductor-canal-blockade following total knee arthroplasty were invited to participate in this follow-up study 3-6 months after surgery. We examined the cutaneous area on the medial aspect of the lower leg (medial crural branch......, 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-canal...

  13. Above-knee vein harvest for coronary revascularization increases ASEPSIS score.

    Science.gov (United States)

    Akowuah, Enoch; Shrivastava, Vivek; Ponniah, Alan; Jamnadas, Binal; Chilton, Gary; Cooper, Graham

    2006-02-01

    The long saphenous vein may be harvested from the thigh or the lower leg, depending on the operating surgeon's preference. This prospective study compared the incidence of altered wound healing between these two sites in 175 patients undergoing routine coronary artery bypass grafting over a 3-month period. The patients were divided into 3 groups. In group A, the vein harvest site was restricted to above the upper border of the patella. Group B included harvest sites that started at the ankle but extended above the level of the upper border of the patella. In group C, the vein harvest site was restricted to below the upper border of the patella. The wounds were assessed daily using the ASEPSIS scoring system. In group A, significantly more patients (24%) had an ASEPSIS score > 10, compared to group B (3%) and group C (2%). The mean ASEPSIS score was significantly lower in group C than groups A or B, 1.5 +/- 2.4 vs. 6.5 +/- 3.2 or 3.7 +/- 1.7, respectively. The ASEPSIS score is reduced when vein harvest is restricted to below the level of the knee.

  14. 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.

  15. Retinal vein occlusion

    Science.gov (United States)

    ... decrease the risk of retinal vein occlusion. These measures include: Eating a low-fat diet Getting regular exercise Maintaining an ideal weight Not smoking Aspirin or other blood thinners may help prevent blockages in the other eye. Controlling diabetes may ...

  16. 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...

  17. Deep Vein Thrombosis

    African Journals Online (AJOL)

    OWNER

    Il s'agissait de la main et les recherches en ligne. Des termes ..... Cerrato D, Ariano G, and Fiacchino F : Deep vein ... Surg 1988; 75: 1053–7. 19. Salzman ... Alikhan R, Cohen AT, Combe S, Samama .... Kakkar AK, Williamson RCN. Thrombo.

  18. [Ovarian vein syndrome].

    Science.gov (United States)

    Ferrero Doria, R; Guzmán Valls, P; López Alba, J; Tomás Ros, M; Rico Galiano, J L; Fontana Compiano, L O

    1996-04-01

    The Ovarian Vein Syndrome has been the subject of controversy ever since first described as such by Clark in 1964. This is an uncommon entity within urologic sings and symptoms which appears as a recurrent nephritic colic coinciding with menstruation or during the immediately preceding days. The authors review a clinical case from our Urology Service, including some considerations on the case.

  19. Cucumber vein yellowing virus

    Science.gov (United States)

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

  20. Squash vein yellowing virus

    Science.gov (United States)

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

  1. Endovenous treatments for varicose veins

    NARCIS (Netherlands)

    R.R. van den Bos (Renate)

    2011-01-01

    textabstractEndovenous treatment is currently one of the most frequently used methods for treating varicose veins in the Netherlands. Varicose veins are tortuous and enlarged veins due to weakening in the vein’s wall or valves. They are manifestations of chronic venous disease (CVD), which may lead

  2. 膝上主干内翻剥脱联合泡沫硬化剂治疗下肢静脉曲张%Theinvaginated vein striping upper knee and foam sclerotherapy in the treatment of varicose vein

    Institute of Scientific and Technical Information of China (English)

    王小凯; 冯苏; 袁福康; 高新宝; 田志龙; 贾高磊

    2016-01-01

    Objective To evaluate the invaginated vein striping upper knee and foam sclerotherapy in the treatment of varicose vein.Methods From Feb 2012 to Feb 2014, 124 patients with varicose veins were received limited invaginated vein striping and foam sclerotherapy. Primary end points were postoperative limb symptoms,petechiae, saphenous nerve injury, superficial thrombophlebitis, deep venous thrombosis and recurrence rate.Results All patients’ varicose veins disappeared, and all clinical symptoms remission. No remained varicose veins, no serious complications, and the satisifed cosmetic effects achieved.Conclusion Treatment of varicose veins of the lower limbs by the invaginated vein striping upper knee and foam sclerotherapy has the beneift of mini-invasion, fast recovery, and good curative-effect.%目的:探讨膝上主干内翻剥脱联合泡沫硬化剂治疗下肢静脉曲张(great saphenous varicose veins,GSVV)的手术方法及技巧,寻求微创性与有效性兼顾的外科治疗方法。方法回顾性分析2012-02—2014-02徐州市中心医院血管外科124例下肢静脉曲张患者应用膝上主干内翻剥脱联合泡沫硬化剂治疗的临床资料。内翻剥脱大隐静脉主干至膝关节水平。小腿曲张静脉应用泡沫硬化剂(foam sclerotherapy)治疗。主要观察指标为术后患肢症状改善情况、血栓性浅静脉炎、深静脉血栓形成、隐神经损伤及术后复发的发生率。结果所有患者术后患肢下肢静脉曲张消失,症状缓解,无隐神经损伤,未出现严重并发症。结论在血管外科治疗下肢静脉曲张的方法中膝上主干内翻剥脱联合泡沫硬化剂治疗是简单、微创、有效的治疗方法。

  3. Hepatic venous outflow reconstruction in adult right lobe living donor liver transplantation without middle hepatic vein

    Institute of Scientific and Technical Information of China (English)

    WU Hong; LU Qiang; CHEN Zhe-yu; MA Yu-kui; LI Jin; YANG Jia-yin; YAN Lü-nan; LI Bo; ZENG Yong; WEN Tian-fu; ZHAO Ji-chun; WANG Wen-tao; XU Ming-qing

    2007-01-01

    Background It is difficult and challenging to reconstruct hepatic venous outflow in adult right lobe living donor liver transplantation (LDLT) without the middle hepatic vein (MHV). Excessive perfusion of the portal vein and venous outflow obstruction will lead to acute congestion of the graft, ultimately resulting in primary nonfunction. Although various reconstruction patterns have been explored in many countries, there is currently no clear consensus. In this study we describe a technique to prevent "chocking" of the graft at the outflow anastomosis with the inferior vena cava (IVC) in LDLT using right lobe graft without the MHV.Methods A retrospective analysis was conducted on clinical data from 55 recipients undergoing LDLT using right lobe grafts without the MHV or reconstruction of hepatic venous outflow. The donor's right hepatic vein (RHV) was anastomosed with a triangular opening of the recipient IVC; the inferior right hepatic vein (IRHV), if large enough, was anastomosed directly to the IVC. The great saphenous vein (GSV) was used for reconstruction of significant MHV tributaries.Results No deaths occurred in any of the donors. Of the 55 recipients, complications occurred in 6, including hepaticvein stricture (1 case), small-for-size syndrome (1), hepatic artery thrombosis (1), intestinal bleeding (1), bile leakage (1),left subphrenic abscess and pulmonary infection (1). A total of three patients died, one from small-for-size syndrome and two from multiple system organ failure.Conclusions The multiple-opening vertical anastomosis was reconstructed with hepatic vein outflow. This technique alleviates surgical risk of living donors, ensures excellent venous drainage, and prevents vascular thromboses and primary nonfunction.

  4. Varicosity of the pulmonary veins

    Energy Technology Data Exchange (ETDEWEB)

    Leicher-Dueber, A.; Lindner, P.; Schild, H.; Plewe, G.

    1986-04-01

    Varicosity of the pulmonary veins is a rare anomaly of the pulmonary vascular system. The varices do not usually change in size over years, do not cause symptoms and need no therapy. However, raised left atrial pressure can cause increase in the diameter of pulmonary vein varices. A case of lung vein varicosity in the right middle and upper lobe associated with coarctation of the aorta and an anomalous upper-middle lobe vein was observed over a period of 10 years. Increase in left atrial pressure (aortic and relative mitral regurgitation) led to enlargement of the pulmonary veins.

  5. Molecular cloning and tissue distribution of mRNA encoding porcine 5-HT7 receptor and its comparison with the structure of other species.

    Science.gov (United States)

    Bhalla, Pankaj; Saxena, Pramod R; Sharma, Hari S

    2002-09-01

    The effects of 5-hydroxytriptamine (5-HT, serotonin) are mediated via five main receptor types of which the 5-HT7 receptor is the most recently characterised member. The 5-HT7 receptor has been shown to participate in mediating cranial blood vessels dilatation that may result in migraine headache. We report here the cDNA cloning, sequencing and tissue distribution of porcine 5-HT7 receptor and illustrate its comparison with corresponding receptor of known species. Employing a combination of reverse transcriptase and inverse polymerase chain reaction we amplified and sequenced a full length cDNA from the porcine cerebral cortex. The deduced amino acid sequence comparison confirmed that the cloned porcine receptor belongs to 5-HT7 receptor as described for human and other species and showing overall homology of 92-96%. The expression of 5-HT7 receptor mRNA was observed in porcine central (cerebral cortex, trigeminal ganglion and cerebellum) as well as in peripheral (pulmonary and coronary arteries, superior vena cava and saphenous vein) tissues. The established cDNA sequence and tissue distribution of porcine 5-HT7 receptor will be helpful in exploring the role of this receptor in pathophysiological processes and to predict as a potential therapeutic target for antimigraine drug development.

  6. eNOS transfection of adipose-derived stem cells yields bioactive nitric oxide production and improved results in vascular tissue engineering.

    Science.gov (United States)

    McIlhenny, Stephen; Zhang, Ping; Tulenko, Thomas; Comeau, Jason; Fernandez, Sarah; Policha, Aleksandra; Ferroni, Matthew; Faul, Elizabeth; Bagameri, Gabor; Shapiro, Irving; DiMuzio, Paul

    2015-11-01

    This study evaluates the durability of a novel tissue engineered blood vessel (TEBV) created by seeding a natural vascular tissue scaffold (decellularized human saphenous vein allograft) with autologous adipose-derived stem cells (ASC) differentiated into endothelial-like cells. Previous work with this model revealed the graft to be thrombogenic, likely due to inadequate endothelial differentiation as evidenced by minimal production of nitric oxide (NO). To evaluate the importance of NO expression by the seeded cells, we created TEBV using autologous ASC transfected with the endothelial nitric oxide synthase (eNOS) gene to produce NO. We found that transfected ASC produced NO at levels similar to endothelial cell (EC) controls in vitro which was capable of causing vasorelaxation of aortic specimens ex vivo. TEBV (n = 5) created with NO-producing ASC and implanted as interposition grafts within the aorta of rabbits remained patent for two months and demonstrated a non-thrombogenic surface compared to unseeded controls (n = 5). Despite the xenograft nature of the scaffold, the TEBV structure remained well preserved in seeded grafts. In sum, this study demonstrates that upregulation of NO expression within adult stem cells differentiated towards an endothelial-like lineage imparts a non-thrombogenic phenotype and highlights the importance of NO production by cells to be used as endothelial cell substitutes in vascular tissue engineering applications.

  7. OUR EXPERIENCE IN THE MANAGEMENT OF VARICOSE VEINS OF THE LOWER LIMB

    Directory of Open Access Journals (Sweden)

    Ravikumar

    2014-04-01

    Full Text Available Varicose veins of the lower limb are a common problem .It is known as the ‘penalty against gravity’. The prevalence has been variously reported from as little as 2% to over 20% in population studies. This enormous variation results from the different populations studied, different definitions applied and the different assessment or examination techniques used. Western studies have shown that 20% population suffers from varicose vein and 1% has skin changes proceeding to venous ulceration. In India incidence of varicose veins seems to be far less common because in India most patients present late with complications of varicose veins such as pain, edema, pigmentation and ulceration. We present our experience in the management of varicose veins of the lower limb over 2 years at our institution. AIMS AND OBJECTIVES: 1. To study the incidence of varicose veins according to age, sex and occupation.2.To study spectrum of clinical presentation in varicose veins. 3. To study effect of surgery in healing of varicose ulcers if present. MATERIALS AND METHODS: A total of 50 patients admitted to our institution between 2010 and 2012 were included in this study. It is found that varicose veins and their associated symptoms and complications constitute the most common chronic vascular disorders leading to surgical treatment. The incidence is on rise. It is more common in middle-aged group. The majority of the patients were males in the study. Patients presented with spectrum of symptoms and signs, with pain being more common presenting symptom with or without venous ulcer. The study revealed increased incidence of varicosity in the left lower limb as compared to the right lower limb. Most of the patients presented to the hospital for one of the other complications, not for the cosmetic purpose. Long saphenous system is the most common venous system affected. CONCLUSION: Operative line of treatment is the primary procedure in the management of varicose veins

  8. Quantitative Evaluation of Therapeutic Efficacy of Endovenous Laser Treatment for Distal Varicose Veins by Tc-99m RBC Venography

    Energy Technology Data Exchange (ETDEWEB)

    Kang, Do Young; Song, Ki Hoon; Sim, Seung Joo; Kim, Ki Ho [College of Medicine, Univ. of Donga, Busan (Korea, Republic of)

    2003-07-01

    Endovenous laser treatment (EVLT) has been shown to be effective for elimination of greater saphenous (GSV) incompetence. While the result of GSV closure has been studied in detail, the effects in distal GSV and its tributaries following EVLT are still not completely understood. In addition, the optimal time for treatment of remaining varicose veins is not established. We evaluated the clinical and radiological changes of distal varicose veins after EVLT and determined the optimal time for additional treatment of distal varicose veins following EVLT by Tc-99m RBC. Forty GSV (30 patients) were treated with 940 nm or 810 nm diode laser at usual energy setting. Clinical and Duplex evaluation were performed at I week, and at various monthly intervals (2-6 months) following the initial treatment. Tc-99m venography was performed as usual protocol at I month and at every 3 months after EVLT. The distal varicose veins were quantified by determining the ratio of mean counts per pixel in the target and background areas and then comparing the pre-EVLT and post-EVLT values. Thirty-eight (95.0%) GSV were closed following EVLT and remained closed at 1-21 months follow-up examination. The reduction rate of distal varicose veins measured by Tc-99m venography was 22.8% at l month, 42.7% at 3 months, 61.5% at 6 months, and 72.4% at 9 months after EVLT. Fifteen legs (37.5%) required additional phlebectomy at 1 to 3 months after EVLT, while the others (62.5%) showed spontaneous regression of distal veins from one month during follow-up period. Therapeutic efficacy of EVLT for distal varicose vein can be well-evaluated quantitatively by Tc-99m RBC venography. Theses results suggest that after EVLT for GSV, the 'wait' policy would be necessary, rather than the 'wasting' of distal veins concurrently with EVLT.

  9. Portal vein arterialization increases hepatocellular apoptosis and inhibits liver regeneration.

    Science.gov (United States)

    Schleimer, Karina; Stippel, Dirk L; Kasper, Hans U; Prenzel, Klaus; Gaudig, Cindy; Tawadros, Samir; Hoelscher, Arnulf H; Beckurts, K Tobias E

    2008-10-01

    Portal vein arterialization is performed in particular situations to guarantee sufficient blood flow in the portal vein. In addition, some authors have postulated a proliferation-promoting influence of portal vein arterialization on the liver tissue. However, portal vein arterialization is an unphysiological procedure: It increases portal blood flow and blood pressure as well as oxygenation of the liver tissue. On the other hand, it reduces the influx of hepatotrophic factors from the portal venous blood. The aim of these experiments was to investigate apoptosis and proliferation of hepatocytes during various conditions of the portal perfusion. After 70% liver resection in Lewis rats, the following four experimental groups were formed differing in portal perfusion: (I) hyperperfused, nonarterialized; (II) flow-regulated, nonarterialized; (III) hyperperfused, arterialized; (IV) flow-regulated, arterialized. A warm ischemia of 30 min was kept in all groups. Portal vein arterialization of 70% reduced rat livers significantly reduced liver regeneration as shown by a significant reduction in liver weight, body weight, and liver function after 6 wk, in contrast to the group with 70% liver mass reduction and portal venous inflow of the portal vein. Furthermore, we found a significantly elevated number of apoptotic hepatocytes after portal vein arterialization. These results were independent from blood flow regulation of the arterialized portal vein, which caused no improvement of the results. Portal vein arterialization should be performed only temporarily and is clinically not recommended as a permanent option, because of the increased hepatocellular apoptosis and the very distinctive, negative long-term effects on liver weight.

  10. Fabrication and characterisation of biomimetic, electrospun gelatin fibre scaffolds for tunica media-equivalent, tissue engineered vascular grafts

    Energy Technology Data Exchange (ETDEWEB)

    Elsayed, Y. [Advanced Materials Group, University of Surrey, Guildford, Surrey GU2 7XH (United Kingdom); Lekakou, C., E-mail: C.Lekakou@surrey.ac.uk [Advanced Materials Group, University of Surrey, Guildford, Surrey GU2 7XH (United Kingdom); Labeed, F. [Centre of Biomedical Engineering, University of Surrey, Guildford, Surrey GU2 7XH (United Kingdom); Tomlins, P. [National Physical Laboratory (NPL), Teddington, Middlesex TW11 0LW (United Kingdom)

    2016-04-01

    It is increasingly recognised that biomimetic, natural polymers mimicking the extracellular matrix (ECM) have low thrombogenicity and functional motifs that regulate cell–matrix interactions, with these factors being critical for tissue engineered vascular grafts especially grafts of small diameter. Gelatin constitutes a low cost substitute of soluble collagen but gelatin scaffolds so far have shown generally low strength and suture retention strength. In this study, we have devised the fabrication of novel, electrospun, multilayer, gelatin fibre scaffolds, with controlled fibre layer orientation, and optimised gelatin crosslinking to achieve not only compliance equivalent to that of coronary artery but also for the first time strength of the wet tubular acellular scaffold (swollen with absorbed water) same as that of the tunica media of coronary artery in both circumferential and axial directions. Most importantly, for the first time for natural scaffolds and in particular gelatin, high suture retention strength was achieved in the range of 1.8–1.94 N for wet acellular scaffolds, same or better than that for fresh saphenous vein. The study presents the investigations to relate the electrospinning process parameters to the microstructural parameters of the scaffold, which are further related to the mechanical performance data of wet, crosslinked, electrospun scaffolds in both circumferential and axial tubular directions. The scaffolds exhibited excellent performance in human smooth muscle cell (SMC) proliferation, with SMCs seeded on the top surface adhering, elongating and aligning along the local fibres, migrating through the scaffold thickness and populating a transverse distance of 186 μm and 240 μm 9 days post-seeding for scaffolds of initial dry porosity of 74 and 83%, respectively. - Highlights: • Novel crosslinked electrospun gelatin scaffolds of specific fibre layer orientation • These scaffolds have compliance equivalent to that of coronary

  11. SURGICAL TREATMENT OF POSTPARTUM ILIOFEMORAL DEEP VEIN THROMBOSIS--CASE REPORTS.

    Science.gov (United States)

    Cazan, I; Strobescu, Cristina; Baroi, Genoveva; Cazan, Simona; Lefter, G; Popa, R F

    2016-01-01

    The writing committee for Antithrombotic Therapy for Venous Thromboembolic Disease of the 2008 ACCP guidelines made the following recommendations for thrombus removal strategies in patients with deep vein thrombosis (DVT): open surgical thrombectomy is recommended in patients with acute iliofemoral DVT to reduce symptoms and post-thrombotic morbidity; whenever available, catheter-directed thrombolysis is preferred to surgical venous thrombectomy, the risk of hemorrhage being diminished; surgical venous thrombectomy is recognized to be efficient in cases where catheter-directed thrombolysis is unavailable or the patients are not suitable candidates for such a procedure. Randomized studies comparing surgical thrombectomy and anticoagulant therapy in patients with iliofemoral DVT (IFDVT) showed that at 6 months, 5 years, and 10 years the patients in the thrombectomy group presented increased permeability, lower venous pressure, less edema, and fewer postthrombotic symptoms compared to the patients receiving anticoagulant therapy. In this article we present 3 cases of IFDVT in postpartum patients diagnosed by Doppler ultrasound of the deep venous system. The 3 patients received anticoagulant therapy prior to surgery. Surgery consisted in thrombectomy of the common, superficial and deep femoral veins, external and internal iliac veins, and femoral-saphenous arteriovenous fistula. The patients received postoperative antithrombotic therapy and were followed-up at 3, 6 and 9 months by Doppler ultrasound of the deep venous system.

  12. Retroaortic left renal vein joining the left common iliac vein

    Energy Technology Data Exchange (ETDEWEB)

    Brancatelli, G.; Galia, M.; Finazzo, M.; Sparacia, G.; Pardo, S.; Lagalla, R. [Dept. of Radiology ' ' P. Cignolini' ' , Univ. of Palermo (Italy)

    2000-11-01

    Retroaortic left renal vein joining the left common iliac vein is a rare congenital anomaly in the development of the inferior vena cava. To our knowledge, only one case has been reported in the literature; however, its imaging features have never been described. A 27-year-old male presented with a 1-year history of recurrent right flank pain, dysuria, hematuria, and fever (39 C). Computed tomography and MR venography showed a retroaortic left renal vein joining the left common iliac vein. We present the CT and MR venography findings and discuss their feasibility in showing this congenital anomaly. (orig.)

  13. A RARE CASE OF EXTENSIVE THROMBOSIS OF INFERIOR VENA CAVA, PORTAL VEIN, SPLENIC VEIN AND SUPERIOR MESENTRIC VEIN

    Directory of Open Access Journals (Sweden)

    Giridhar

    2015-03-01

    Full Text Available While the most common presentation of venous thromboembolic disease is deep vein thrombosis (DVT or pulmonary thromboembolism, rarer manifestations are thrombosis of jugular vein, cerebral sinus and inferior vena cava. Here we are presenting a rare case of inferior vena caval thrombosis with multiple thrombus in portal vein, splenic vein and superior mesenteric vein

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

    Directory of Open Access Journals (Sweden)

    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.

  15. Cephalic vein aneurysm.

    Science.gov (United States)

    Faraj, Walid; Selmo, Francesca; Hindi, Mia; Haddad, Fadi; Khalil, Ismail

    2007-11-01

    Cephalic vein aneurysms are rare malformations that may develop in any part of the vascular system, and their history, presentation, and management vary depending on their site. The etiology of venous aneurysms remains unclear, although several theories have been elaborated. Venous aneurysms are unusual vascular malformations that occur equally between the sexes and are seen at any age; they can present as either a painful or a painless subcutaneous mass. No serious complications have been reported from upper extremity venous aneurysms. Surgical excision is the definitive management for most of these. The case reported here presented with a painless and mobile, soft, subcutaneous mass that caused only cosmetic concern.

  16. Intensity Variation Normalization for Finger Vein Recognition Using Guided Filter Based Singe Scale Retinex.

    Science.gov (United States)

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

    2015-07-14

    Finger vein recognition has been considered one of the most promising biometrics for personal authentication. However, the capacities and percentages of finger tissues (e.g., bone, muscle, ligament, water, fat, etc.) vary person by person. This usually causes poor quality of finger vein images, therefore degrading the performance of finger vein recognition systems (FVRSs). In this paper, the intrinsic factors of finger tissue causing poor quality of finger vein images are analyzed, and an intensity variation (IV) normalization method using guided filter based single scale retinex (GFSSR) is proposed for finger vein image enhancement. The experimental results on two public datasets demonstrate the effectiveness of the proposed method in enhancing the image quality and finger vein recognition accuracy.

  17. Intensity Variation Normalization for Finger Vein Recognition Using Guided Filter Based Singe Scale Retinex

    Directory of Open Access Journals (Sweden)

    Shan Juan Xie

    2015-07-01

    Full Text Available Finger vein recognition has been considered one of the most promising biometrics for personal authentication. However, the capacities and percentages of finger tissues (e.g., bone, muscle, ligament, water, fat, etc. vary person by person. This usually causes poor quality of finger vein images, therefore degrading the performance of finger vein recognition systems (FVRSs. In this paper, the intrinsic factors of finger tissue causing poor quality of finger vein images are analyzed, and an intensity variation (IV normalization method using guided filter based single scale retinex (GFSSR is proposed for finger vein image enhancement. The experimental results on two public datasets demonstrate the effectiveness of the proposed method in enhancing the image quality and finger vein recognition accuracy.

  18. Historical Overview of Varicose Vein Surgery

    NARCIS (Netherlands)

    van den Bremer, Jephta; Moll, Frans L.

    2010-01-01

    Varicose veins are as old as Hippocrates. Varicose vein treatments come and go. Surgery for varicose vein disease is one of the commonest elective general surgical procedures. The history of varicose vein surgery has been traced. We note the first descriptions of varicose veins, and we particularly

  19. Inflammatory pseudotumor causing deep vein thrombosis after metal-on-metal hip resurfacing arthroplasty.

    LENUS (Irish Health Repository)

    Memon, Adeel Rasool

    2013-01-01

    Metal-on-metal hip resurfacings have recently been associated with a variety of complications resulting from adverse reaction to metal debris. We report a case of extensive soft tissue necrosis associated with a huge pelvic mass causing extensive deep vein thrombosis of the lower limb secondary to mechanical compression of the iliac vein. This is a rare and unusual cause of deep vein thrombosis after metal-on-metal hip resurfacing arthroplasty.

  20. Treatment of portal vein tumor thrombus using ~(125)Iodine seed implantation brachytherapy

    Institute of Scientific and Technical Information of China (English)

    2010-01-01

    We reported two cases of liver metastasis with portal vein tumor thrombus that developed after liver transplantation for hepato cellular carcinoma (HCC). Both the patients were women aged 43 and 55 years, who had liver metastasis and portal vein tumor thrombus formation after liver transplantations for HCC. For the treatment of portal vein tumor thrombus, 125I seeds were implanted into the hepatic tissue under the guidance of preoperative computed tomography (CT) images with a total radiation dose of 130 Gy...

  1. phenoVein - A software tool for leaf vein segmentation and analysis

    OpenAIRE

    Bühler, Jonas; Rishmawi, Louai; Pflugfelder, Daniel; Huber, Gregor; Scharr, Hanno; Hülskamp, Martin; Koornneef, Maarten; SCHURR, ULRICH; Jahnke, Siegfried

    2015-01-01

    phenoVein is a software tool dedicated to automated segmenting and analyzing images of leaf veins. It includes comfortable manual correction features. Advanced image filtering automatically emphasizes veins from background and compensates for local brightness inhomogeneities. Phenotypical leaf vein traits being calculated are total vein density, vein lengths and widths and skeleton graph statistics. For determination of vein widths, a model based vein edge estimation approach has been impleme...

  2. Repeated upper limb salvage in a case of severe traumatic soft-tissue and brachial artery defect.

    Science.gov (United States)

    Noaman, Hassan Hamdy; Shiha, Anis Elsayed

    2002-01-01

    We present the case of a 9-year-old male patient who suffered a gunshot injury to the right arm. The patient arrived in shock, his right arm severely traumatized, with soft-tissue loss involving the anterior surface and both sides of the right arm. The humerus was exposed. There was brachial artery defect and damage to the lateral fibers of the median nerve. The mangled extremity severity score (MESS) was 8 points. The patient was treated with general resuscitation, blood transfusion, and debridement. A venous graft, 12 cm in length, to bridge the brachial artery defect, and tendon transfer, triceps to the biceps, was performed in one step. Postoperatively, there was a normal radial pulse, normal skin color, normal temperature, and normal movement of the fingers without pain. Unfortunately, the patient then sustained a second trauma to the right arm 3 weeks later, rupturing the graft. This time he lost 1,500 cc of blood. After another blood transfusion, we performed a second reverse saphenous vein graft. The patient stayed at the hospital for 3 weeks. At follow-up 12 months later, the limb has good function and, except for the presence of a scar and skin graft, is equal in appearance to the left side.

  3. Subfailure overstretch injury leads to reversible functional impairment and purinergic P2X7 receptor activation in intact vascular tissue

    Directory of Open Access Journals (Sweden)

    Weifeng Luo

    2016-09-01

    Full Text Available Vascular stretch injury is associated with blunt trauma, vascular surgical procedures, and harvest of human saphenous vein for use in vascular bypass grafting. A model of subfailure overstretch in rat abdominal aorta was developed to characterize surgical vascular stretch injury. Longitudinal stretch of rat aorta was characterized ex vivo. Stretch to the haptic endpoint where the tissues would no longer lengthen, occurred at twice the resting length. The stress produced at this length was greater than physiologic mechanical forces but well below the level of mechanical disruption. Functional responses were determined in a muscle bath and this subfailure overstretch injury led to impaired smooth muscle function that was partially reversed by treatment with purinergic receptor (P2X7R antagonists. These data suggest that vasomotor dysfunction caused by subfailure overstretch injury may be due to activation of P2X7R. These studies have implications for our understanding of mechanical stretch injury of blood vessels and offer novel therapeutic opportunities.

  4. 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.

  5. Agenesis of the iliac veins.

    Science.gov (United States)

    Thomas, M L; Posniak, H V

    1984-01-01

    Three case reports of patients with the rare anomaly of agenesis of the iliac veins are presented. It is emphasised that full phlebographic investigation should be carried out in such patients before surgical treatment is considered. It is pointed out that surgical ablation may exacerbate the symptoms of leg swelling and varicose veins for which the patients seek advice.

  6. Infrared imaging of varicose veins

    Science.gov (United States)

    Noordmans, Herke Jan; de Zeeuw, Raymond; Verdaasdonk, Ruud M.; Wittens, Cees H. A.

    2004-06-01

    It has been established that varicose veins are better visualized with infrared photography. As near-infrared films are nowadays hard to get and to develop in the digital world, we investigated the use of digital photography of varicose veins. Topics that are discussed are illumination setup, photography and digital image enhancement and analysis.

  7. 10-Minute Conultation Varicose veins

    Institute of Scientific and Technical Information of China (English)

    2012-01-01

    A 55 year old woman presents with a history of tortuous veins on both legs and a related ache towards the end of the day.She finds these veins unsightly and would like to know whether she can have them treated.

  8. Preliminary fabrication of tissue engineered veins containing valves using bone marrow mesenchymal stem cells and biodegradable scaffolds in vitro%骨髓间充质干细胞联合可降解支架体外构建组织工程带瓣静脉

    Institute of Scientific and Technical Information of China (English)

    刘池拽; 殷恒讳; 吕伟明; 曾晨光; 刘畅; 王文见; 全大萍; 项鹏; 王深明

    2014-01-01

    背景:临床上治疗慢性静脉功能不全的主要方法是静脉瓣膜修复及带瓣静脉段移植,但这些方法创伤较大,且带瓣静脉来源有限。组织工程学和再生医学在修复病变血管方面取得的进步,而以自体来源的内皮细胞为种子细胞的组织工程带瓣静脉也见于了报道,但存在排出反应。  目的:构建一个有可自我更新、修复、类似天然瓣膜结构并具有功能的带瓣静脉。方法:麻醉取 Beagle 犬的骨髓获取骨髓间充质干细胞,采用密度梯度离心和贴壁法获取骨髓间充质干细胞,并进行细胞的传代、冻存复苏、流式细胞仪检测和定向诱导分化。采用热致相分离技术,以聚(乳酸-乙醇酸)共聚物为基材,利用自制带瓣静脉模具制备三维组织工程带瓣静脉支架,制备组织工程带瓣静脉支架,并研究其形态结构。将骨髓间充质干细胞种植在支架上构建可降解的带瓣静脉,在体外培养2周。%BACKGROUND:Chronic venous insufficiency is a major health problem worldwide. Clinical treatments include venous valve repair and venous segment containing valve transplantation. However, these are invasive procedures, and the supply of vein containing valves is limited. Significant progress in the fields of tissue engineering and regenerative medicine has been made towards the creation of tissue engineered vascular grafts for the repair of damaged or malformed vessels. It has been reported that using tissue engineering, a tissue engineered vein containing valves constructed with self-derived endothelial cells and al ogeneic acellular matrices can provide the complex physiological valve structure and mechanical stability, but this elicited an immunogenic response. OBJECTIVE:To create a viable and functional vein containing valves, which has the ability to grow, repair, and imitate natural tissues. METHODS:Bone marrow mesenchymal stem cells were obtained from

  9. Persistência da veia ciática Persistent sciatic vein

    Directory of Open Access Journals (Sweden)

    Bárbara Borges Cardoso

    2010-09-01

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

  10. Pulmonary vein and atrial wall pathology in human total anomalous pulmonary venous connection

    NARCIS (Netherlands)

    Douglas, Yvonne L.; Jongbloed, Monique R. M.; den Hartog, Wietske C. E.; Bartelings, Margot M.; Bogers, Ad J. J. C.; Ebels, Tjark; DeRuiter, Marco C.; Gittenberger-de Groot, Adriana C.

    2009-01-01

    Background: Normally, the inside of the left atrial (LA) body and pulmonary veins (PVs) is lined by vessel wall tissue covered by myocardium. In total anomalous pulmonary venous connection (TAPVC), no connection of the PVs with the LA body exists. These veins have an increased incidence of PV

  11. [Use of laser technologies in treatment of chronic venous insufficiency in patients with a wide ostial segment of the main trunks of subcutaneous veins].

    Science.gov (United States)

    Luk'ianenko, M Iu; Starodubtsev, V B; Karpenko, A A; Sergeevichev, D S

    2014-01-01

    Presented herein is the authors' experience in endovascular laser obliteration of the major trunks of the grate saphenous vein (GSV) with a wide ostial segment (measuring from 15 to 34 mm) in patients presenting with chronic venous insufficiency. Group One patients (n=32) underwent crossectomy followed by endovasal laser obliteration (EVLO) of the GSV's trunk on the femur. Group Two patients (n=46) were not subjected to crossectomy, whereas obliteration of the GSV's trunk was carried out immediately from the ostium. In Group One we managed to achieve obliteration of the GSV's trunk in 32 patients (100%) with no additional interventions, and in Group Two this was achieved in 42 (91.3%) patients. Four patients (8.7%) required performing a secondary procedure of EVLO after which obliteration of the trunk was achieved in all patients of Group Two. There was no evidence of deep-vein thrombosis.

  12. Sagittal vein thrombosis caused by central vein catheter.

    Directory of Open Access Journals (Sweden)

    Feridoun Sabzi

    2015-03-01

    Full Text Available Cerebral venous thrombosis, including thrombosis of cerebral veins and major dural sinuses, is an uncommon disorder in the general population. However, it has a higher frequency among patients younger than 40 years of age, patients with thrombophilia, pregnant patients or those receiving hormonal contraceptive therapy or has foreign body such as catheter in their veins or arterial system. In this case report, we described clinical and radiological findings in a patient with protein C-S deficiency and malposition of central vein catheter.

  13. 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.

  14. The Role of Pulmonary Veins in Cancer Progression from a Computed Tomography Viewpoint

    Science.gov (United States)

    Chang, Hung; Liao, Tzu-Yao; Wen, Ming-Sheng; Yu, Chih-Teng

    2016-01-01

    Background. We studied the role of pulmonary veins in cancer progression using computed tomography (CT) scans. Methods. We obtained data from 260 patients with pulmonary vein obstruction syndrome (PVOS). We used CT scans to investigate pulmonary lesions in relation to pulmonary veins. We divided the lesions into central and peripheral lesions by their anatomical location: in the lung parenchymal tissue or pulmonary vein; in the superior or inferior pulmonary vein; and by unilateral or bilateral presence in the lungs. Results. Of the 260 PVOS patients, 226 (87%) had central lesions, 231 (89%) had peripheral lesions, and 190 (75%) had mixed central and peripheral lesions. Among the 226 central lesions, 93% had lesions within the superior pulmonary vein, either bilaterally or unilaterally. Among the 231 peripheral lesions, 65% involved bilateral lungs, 70% involved lesions within the inferior pulmonary veins, and 23% had obvious metastatic extensions into the left atrium. All patients exhibited nodules within their pulmonary veins. The predeath status included respiratory failure (40%) and loss of consciousness (60%). Conclusion. CT scans play an important role in following tumor progression within pulmonary veins. Besides respiratory distress, PVOS cancer cells entering centrally can result in cardiac and cerebral events and loss of consciousness or can metastasize peripherally from the pulmonary veins to the lungs.

  15. Neonatal renal vein thrombosis.

    Science.gov (United States)

    Brandão, Leonardo R; Simpson, Ewurabena A; Lau, Keith K

    2011-12-01

    Neonatal renal vein thrombosis (RVT) continues to pose significant challenges for pediatric hematologists and nephrologists. The precise mechanism for the onset and propagation of renal thrombosis within the neonatal population is unclear, but there is suggestion that acquired and/or inherited thrombophilia traits may increase the risk for renal thromboembolic disease during the newborn period. This review summarizes the most recent studies of neonatal RVT, examining its most common features, the prevalence of acquired and inherited prothrombotic risk factors among these patients, and evaluates their short and long term renal and thrombotic outcomes as they may relate to these risk factors. Although there is some consensus regarding the management of neonatal RVT, the most recent antithrombotic therapy guidelines for the management of childhood thrombosis do not provide a risk-based algorithm for the acute management of RVT among newborns with hereditary prothrombotic disorders. Whereas neonatal RVT is not a condition associated with a high mortality rate, it is associated with significant morbidity due to renal impairment. Recent evidence to evaluate the effects of heparin-based anticoagulation and thrombolytic therapy on the long term renal function of these patients has yielded conflicting results. Long term cohort studies and randomized trials may be helpful to clarify the impact of acute versus prolonged antithrombotic therapy for reducing the morbidity that is associated with neonatal RVT.

  16. 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

  17. [Surgery of essential varicose veins].

    Science.gov (United States)

    Maraval, M

    1994-03-15

    Idiopathic varicose veins of the lower limbs are a frequent but benign disorder. Surgery is only a moment in the course of the disease. Although not the only treatment of essential varicose veins, surgery by an experienced team performing crossectomy, stripping by intussusception using a stripper, and phlebectomy gives fully satisfactory results, both to patient and to physician, in over 80% of cases. New techniques were recently developed that, at present, have not confirmed early hopes.

  18. Portal Vein Thrombosis in non cirrhotic patients

    NARCIS (Netherlands)

    M.C.W. Spaander (Manon)

    2010-01-01

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

  19. Changes in pathomorphology and ultrastructure of parasagital sinus cerebral tissues after ligating middle part of superior sagittal sinus and their backflow veins in rabbits%家兔上矢状窦中1/3及其回流静脉结扎后窦旁脑组织病理结构的变化

    Institute of Scientific and Technical Information of China (English)

    唐忠; 袁贤瑞; 粟枫; 罗端午

    2011-01-01

    目的 探讨家兔上矢状窦(SSS)中1/3及其回流静脉结扎后邻近脑组织病理结构的改变.方法 家兔SSS中1/3及其回流静脉被结扎,结扎后不同时间取窦旁脑组织行组织学和超微结构观察:结果结扎后4 h,HE染色显示窦旁脑组织水肿明显,可见神经元变性,表现为核同缩,部分细胞致密、深染,突起消失,血管周隙增宽,可见血管扩张;尼氏染色显示神经元胞体肿胀,染色较淡,形态不规则.细胞排列散乱;电镜下观察发现神经元及胶质细胞水肿,线粒体结构模糊、部分嵴丢失呈空泡变,内质网扩张,核膜模糊;结扎后8 h损伤最严重,之后逐渐恢复,至90d基本恢复正常.结论家兔SSS中1/3及其回流静脉结扎后可引起窦旁脑组织结构改变,但随时间延长可逐渐恢复正常.%Objective To explore the effect of ligating the middle parts of the superior sagittal sinuses (SSS) and their backflow veins on the pathomorphology and ultrastructures of the parasagital sinus cerebral tissues. Methods The middle parts of SSS and their back flow veins were hgated in the rabbits. The changes in the parasagital sinus cerebral tissues pathomorphology and ultrastrncture were observed respectively by light and electron microscopes at different time after the ligation. Results The neuronal degeneration, the nerve cells and glial cell edema, the fuzzy mitochondrial structures, endoplasmic reticula expansion and so on were found in the parasagittsl sinus cerebral tissues 4 hours after the ligation of SSS and their back flow veins. The above-mentioned changes become most significant 8 hours after the ligation and gradurally improved along with the prolongation of time after the ligation. The return of the parasagittal sinus cerebral tissues to almost normal was observed 90 days after the ligation. Conclusion The changes in the pathomorphology and ultrastructures of the parasagittal sinus cerebral tissues can be produced by the ligating the

  20. Electrospun Polycaprolactone Scaffolds for Small-Diameter Tissue Engineered Blood Vessels

    Science.gov (United States)

    Lee, Carol Hsiu-Yueh

    Cardiovascular disease is the leading cause of death in the United States with many patients requiring coronary artery bypass grafting. The current standard is using autografts such as the saphenous vein or intimal mammary artery, however creating a synthetic graft could eliminate this painful and inconvenient procedure. Large diameter grafts have long been established with materials such as DacronRTM and TeflonRTM, however these materials have not proved successful in small-diameter (biodegradable polymer (polycaprolactone) we utilize our expertise in electrospinning and femtosecond laser ablation to create a novel tri-layered tissue engineered blood vessel containing microchannels. The benefits of creating a tri-layer is to mimic native arteries that contain an endothelium to prevent thrombosis in the inner layer, aligned smooth muscle cells in the middle to control vasodilation and constriction, and a mechanically robust outer layer. The following work evaluates the mechanical properties of such a graft (tensile, fatigue, burst pressure, and suture retention strength), the ability to rapidly align cells in laser ablated microchannels in PCL scaffolds, and the biological integration (co-culture of endothelial and smooth muscle cells) with electrospun PCL scaffolds. The conclusions from this work establish that the electrospun tri-layers provide adequate mechanical strength as a tissue engineered blood vessel, that laser ablated microchannels are able to contain the smooth muscle cells, and that cells are able to adhere to PCL fibers. However, future work includes adjusting microchannel dimensions to properly align smooth muscle cells along with perfect co-cultures of endothelial and smooth muscle cells on the electrospun tri-layer.

  1. Relationship between patient-reported symptoms, limitations in daily activities, and psychological impact in varicose veins.

    Science.gov (United States)

    Mallick, Rajiv; Lal, Brajesh Kumar; Daugherty, Claire

    2017-03-01

    The objective of this study was to evaluate the relationship between patient-reported symptoms, functional limitations, and psychological impact of varicose veins (VVs) vs pathophysiologic mechanism, incorporating demographic and behavioral factors. We conducted a pooled analysis from two clinical studies (Efficacy and Safety Study of Polidocanol Injectable Foam for the Treatment of Saphenofemoral Junction Incompetence [VANISH-1] and Polidocanol Endovenous Microfoam Versus Vehicle for the Treatment of Saphenofemoral Junction Incompetence [VANISH-2]) in patients with VVs (superficial venous reflux only). Health outcomes were classified on the basis of the Wilson-Cleary conceptual framework continuum linking clinical and anatomic factors (Clinical, Etiology, Anatomy, and Pathophysiology [CEAP] clinical class and great saphenous vein [GSV] diameter, respectively) to patient-reported outcomes: Varicose Vein Symptoms Questionnaire (VVSymQ) score; modified Venous Insufficiency Epidemiologic and Economic Study on Quality of Life/Symptoms (m-VEINES-QOL/Sym) limitations in daily activities (functional limitations hereafter) score; and m-VEINES-QOL/Sym psychological impact score. Association of clinical and anatomic categories with each of the patient-reported outcomes was assessed using analysis of variance for statistical significance and standardized mean differences for clinical meaningfulness. Hierarchical regression modeling was applied to evaluate the direct association of the VVSymQ symptom score with the m-VEINES-QOL/Sym functional limitations score and the indirect association with the m-VEINES-QOL/Sym psychological impact score, adjusting for clinical, behavioral, and demographic factors. Among 516 patients, approximately three-fourths were women (mean age, 49 years), approximately 70% were overweight or obese, 42% were C2 and 32% were C3, and 88% reported never or only intermittently wearing compression stockings. VVSymQ (symptom) scores did not vary by GSV

  2. EndoVascular Laser Therapy (EVLT of Varicose Veins

    Directory of Open Access Journals (Sweden)

    S. Akhlaghpour

    2005-08-01

    Full Text Available Introduction & Background: Tens of millions of people – up to 40% of women and 25% of men – suffer from lower limb varicose veins. Several risk factors are also identified including genetics, gender, age, obesity, hor-mones, pregnancy, and occupation. Sclerotheraphy is commonly used to treat small varicose veins. Medium-sized and large varicose veins can be removed by a surgical procedure called Stab avulsion or phlebectomy. EVLT is a new alternative surgical method for varicose veins. Patients & Methods: Using 980nm and 940nm diode laser with a 600micron bare-tipped fiber endoluminally under ultrasound and Doppler monitoring, we treated 43 patients in Noor Vein Clinic, Tehran, Iran. Results: The procedure was well tolerated by all patients with just a local anesthesia. No major complications were encountered. We noticed that 980nm and 940nm are the perfect wave lengths causing less post-operational discomfort for patients with enhanced recovery time due to fewer traumas to the adjacent tissues. One small size skin burn and local paresthesia were observed. Conclusion: We concluded that EVLT with diode laser is a safe, fast, and effective method with low recurrence rate.

  3. Vein wall remodeling after deep vein thrombosis: differential effects of low molecular weight heparin and doxycycline.

    Science.gov (United States)

    Sood, Vikram; Luke, Cathy; Miller, Erin; Mitsuya, Mayo; Upchurch, Gilbert R; Wakefield, Thomas W; Myers, Dan D; Henke, Peter K

    2010-02-01

    Venous thrombus resolution sets up an early intense inflammatory reaction, from which vein wall damage results. Tissue response to injury includes matrix metalloproteinase (MMP) activation and extracellular matrix protein turnover. This study sought to determine the effect of exogenous MMP inhibition and its potential attenuation of early vein wall injury. Rats received treatment beginning 24 hr after a stasis venous thrombosis by near occlusive ligation and until harvest at day 7. Three groups were evaluated: (1) vehicle saline controls (NaCl), (2) low molecular weight heparin (LMWH; Lovenox, 3 mg/kg daily SQ), and (3) doxycycline (DOXY, 30 mg/kg daily PO). Thrombus size (mg/mm), levels of tumor necrosis factor alpha (TNF alpha) and D-dimer by colorimetric assay, and monocytes counts by immunohistochemistry were assessed. Vein wall assessment included stiffness by tensiometry, interleukin 1beta (IL-1 beta protein levels by enzyme-linked immunosorbent assay, MMP2 and -9 by zymography, and histological analysis of intimal thickness (IT). Comparisons were by t-test to control. p DOXY-treated groups (NaCl = 1.0 +/- 0.8, LWMH = 9 +/- 3, DOXY = 27 +/- 5 pg/mg protein, n = 6-8, p DOXY group (NaCl = 3.0 +/- 2.5, DOXY = 23 +/- 4.2 pg/mg protein, n = 5, p DOXY, compared to controls (NaCl = 0.33 +/- 0.05, LMWH = 0.17 +/- 0.03, DOXY = 0.43 +/- 0.09 N/mm, n = 5-7, p DOXY group at 7 days (NaCl = 26 +/- 3, LMWH = 38 +/- 17, DOXY = 6 +/- 3 pg/mg protein, n = 4-6, p DOXY = 0.8 +/- 0.20, n = 4-6, p DOXY groups (NaCl = 85 +/- 24, LMWH = 23 +/- 7( *), DOXY = 13 +/- 5 U/mg protein, n = 6-8, p DOXY did not alter the size of deep vein thrombosis, mildly altered thrombus composition, and differentially affected vein wall injury, despite similar reductions in early MMP9 activity. Whether exogenous MMP inhibition affects long-term vein wall fibrosis will require further study. Copyright 2010 Annals of Vascular Surgery Inc. Published by Elsevier Inc. All rights reserved.

  4. 导管引导下泡沫硬化剂疗法治疗大隐静脉曲张%Catheter-directed foam sclerotherapy of incompetent saphenous reflux: early results

    Institute of Scientific and Technical Information of China (English)

    刘小平; 郭伟; 贾鑫; 杜昕; 熊江; 尹太; 张宏鹏; 刘蒙

    2009-01-01

    Objective To describe observation of availability of catheter-directed foam sclerotherapy for the great saphenous vein varicosis. Methods A selective series of 30 patients of vein varicosis were treated with foam sclerotherapy using a standard technique for foam delivery from April 2008 to August 2008. Patients were treated with 1% polidocanol foam through a catheter, which was inserted percutaneously over a guidewire in the great saphenous vein (GSV). All successfully treated patients were examined by colour duplex two weeks after the procedure. Results Thirty patients with an insufficiency reflux of the GSV were treated with the catheter-directed foam sclerotherapy. Primary technical success was achieved in all the patients. The concentrations (1.0%) and doses (6 to 8 ml) of polidocanol was mainly we used. Five patients experienced transient scotomas and developed segmental phlebitis of a collateral vein. The intervention was well tolerated in all patients without the occurrence of serious side effects. In 27 of the 30 treated patients (90% ) , a closure of the GSV was found at control visits 2 weeks, 3 months after treatment. Conclusion The use of an endovascular catheter inserted percutaneously over a guidewire is feasible in most patients and has resulted in high primary occlusion rates.%目的 探讨导管引导下的泡沫硬化剂疗法治疗下肢静脉曲张的临床效果.方法 选择2008年4月至8月间有微创治疗意愿的30例(条)中重度下肢静脉曲张患者.其中男性11例,女性19例;年龄34-85岁,平均年龄52岁.病史2~30年,平均20年.对其进行导管引导下患肢大隐静脉主干内注射1%聚桂醇泡沫硬化剂,观察大隐静脉主干的闭合情况.结果 30条患肢均在导管引导下成功注射硬化剂,平均每条患肢应用6.2 ml泡沫硬化剂,27条(90%)大隐静脉主干治疗后即刻可见反流消失.术后早期大隐静脉走行轻微浅静脉炎5例(条),2周内自行缓解,无严重

  5. The posterior intercostal vein: a thermoregulatory gateway to the internal vertebral venous plexus.

    Science.gov (United States)

    Hoogland, P V; Wessels, Q; Vorster, W; Groen, R J M; Wettstein, R; Greyling, L M; Kotzé, S H

    2013-09-01

    The internal vertebral venous plexus (IVVP) plays a putative role in thermoregulation of the spinal cord. Cold cutaneous venous blood may cool, while warm venous blood from muscles and brown fat areas may warm the spinal cord. The regulating mechanisms for both cooling and warming are still unknown. Warm venous blood mainly enters the IVVP via the intervertebral veins. In the thoracic area these veins are connected to the posterior intercostal veins. In this study, anatomical structures were investigated that might support the mechanisms by which warmed venous blood from the intercostal muscles and the recently described paravertebral patches of brown adipose tissue are able to drain into the vertebral venous plexus. Therefore, tissue samples from human cadavers (n = 21) containing the posterior intercostal vein and its connections to the IVVP and the azygos veins were removed and processed for histology. Serial sections revealed that the proximal parts of the posterior intercostal veins contained abundant smooth muscle fibers at their opening into the azygos vein. Furthermore, the walls of the proximal parts of the posterior intercostal veins contain plicae that allow the vessel to dilate, thereby allowing it to serve as a pressure chamber. It is suggested that a cold induced closure of the intercostal/azygos opening can result in retrograde blood flow from the proximal posterior intercostal vein towards the IVVP. This blood flow would be composed of warm blood from the paravertebral brown adipose tissue and blood containing metabolic heat from the muscles draining into the intercostal veins. Copyright © 2013 Wiley Periodicals, Inc.

  6. Standing posture at work and overweight exacerbate varicose veins: Shimane CoHRE Study.

    Science.gov (United States)

    Kohno, Kunie; Niihara, Hiroyuki; Hamano, Tsuyoshi; Takeda, Miwako; Yamasaki, Masayuki; Mizumoto, Kazuo; Nabika, Toru; Morita, Eishin; Shiwaku, Kuninori

    2014-11-01

    Varicose veins (VV) in legs are commonly observed in the general global population. However, the prevalence of and risk factors for VV in Japan are not clear. This study aimed at clarifying the risk factors for VV in traditional rural areas of Shimane prefecture. Subjects (113 men and 205 women aged ≥45 years) were recruited from health examinations in those areas in 2012. VV were defined as a reflux of blood in the great and/or small saphenous vein and incompetent perforating veins detected by ultrasonography. Risk factors for VV were analyzed using logistic regression models that included various parameters. We also investigated the possible interaction between standing at work and overweight and calculated the synergistic index. VV were found in 20.1% of the subjects (12.4% of men and 24.4% of women). The previously known risk factors of prolonged upright standing posture during work, higher body mass index (BMI), female sex, and age were also significant factors for VV. There was a significant combined effect of overweight (BMI ≥25) and prolonged upright standing posture at work [adjusted odds ratio = 3.42; 95% confidence interval (CI), 1.07-10.89], although the synergistic effect was not significant [synergistic index = 1.3; 95% CI, 0.2-8.7]. The prevalence of VV in the traditional rural area of Shimane prefecture was comparable to that reported previously in European countries. Our results confirm that exposure to both prolonged standing at work and overweight exacerbate VV development. This finding is useful to develop strategies for VV prevention.

  7. Minimally invasive treatments for perforator vein insufficiency.

    Science.gov (United States)

    Kuyumcu, Gokhan; Salazar, Gloria Maria; Prabhakar, Anand M; Ganguli, Suvranu

    2016-12-01

    Incompetent superficial veins are the most common cause of lower extremity superficial venous reflux and varicose veins; however, incompetent or insufficient perforator veins are the most common cause of recurrent varicose veins after treatment, often unrecognized. Perforator vein insufficiency can result in pain, skin changes, and skin ulcers, and often merit intervention. Minimally invasive treatments have replaced traditional surgical treatments for incompetent perforator veins. Current minimally invasive treatment options include ultrasound guided sclerotherapy (USGS) and endovascular thermal ablation (EVTA) with either laser or radiofrequency energy sources. Advantages and disadvantages of each modality and knowledge on these treatments are required to adequately address perforator venous disease.

  8. Role of the Renin–Angiotensin System in the Pathogenesis of Intimal Hyperplasia: Therapeutic Potential for Prevention of Vein Graft Failure?

    Science.gov (United States)

    Osgood, Michael J.; Harrison, David G.; Sexton, Kevin W.; Hocking, Kyle M.; Voskresensky, Igor V.; Komalavilas, Padmini; Cheung-Flynn, Joyce; Guzman, Raul J.; Brophy, Colleen M.

    2014-01-01

    The saphenous vein remains the most widely used conduit for peripheral and coronary revascularization despite a high rate of vein graft failure. The most common cause of vein graft failure is intimal hyperplasia. No agents have been proven to be successful for the prevention of intimal hyperplasia in human subjects. The rennin–angiotensin system is essential in the regulation of vascular tone and blood pressure in physiologic conditions. However, this system mediates cardiovascular remodeling in pathophysiologic states. Angiotensin II is becoming increasingly recognized as a potential mediator of intimal hyperplasia. Drugs modulating the renin–angiotensin system include angiotensin-converting enzyme inhibitors and angiotensin receptor blockers. These drugs are powerful inhibitors of atherosclerosis and cardiovascular remodeling, and they are first-line agents for management of several medical conditions based on class I evidence that they delay progression of cardiovascular disease and improve survival. Several experimental models have demonstrated that these agents are capable of inhibiting intimal hyperplasia. However, there are no data supporting their role in prevention of intimal hyperplasia in patients with vein grafts. This review summarizes the physiology of the rennin–angiotensin system, the role of angiotensin II in the pathogenesis of cardiovascular remodeling, the medical indications for these agents, and the experimental data supporting an important role of the rennin–angiotensin system in the pathogenesis of intimal hyperplasia. PMID:22445245

  9. Modulation of action potential trains in rabbit saphenous nerve unmyelinated fibers.

    Science.gov (United States)

    Zhu, Zhi-Ru; Liu, Yi-Hui; Ji, Wei-Gang; Duan, Jian-Hong; Hu, San-Jue

    2013-01-01

    Usually, the main axon is assumed to faithfully conduct action potentials (APs). Recent data have indicated that neural processing can occur along the axonal path. However, the patterns and mechanisms of temporal coding are not clear. In the present study, single fiber recording was used to analyze activity-dependent modulation of AP trains in the main axons of C fibers in the rabbit saphenous nerve. Trains of 5 superthreshold electrical pulses at interstimulus intervals of 20 or 50 ms were applied to the nerve trunk for 200 s. The interspike intervals (ISIs) for these trains were compared to the input interstimulus intervals. Three basic types of C fibers were observed in response to repeated stimuli: first, the ISI between the first and second AP (ISI1-2) of type 1 was longer than the interstimulus interval; second, the ISI1-2 of type 2 showed wavelike fluctuations around the interstimulus interval, and third, the ISI1-2 of type 3 exhibited shorter intervals for a long period. Furthermore, both 4-aminopyridine-sensitive potassium and hyperpolarization-activated cation currents were involved in the modulation of ISI1-2 of train pulses. These data provide new evidence that multiple modes of neural conduction can occur along the main axons of C fibers.

  10. Endovenous laser treatment combined with other surgical techniques for treatment of varicose veins of lower limbs%腔内激光闭合联合其他手术治疗下肢静脉曲张疗效探讨

    Institute of Scientific and Technical Information of China (English)

    李华刚; 张雨; 马卉; 易维真

    2011-01-01

    Objective To Clinical evaluation of therapeutic effects of endovenous laser treatment (EVLT) combined with other surgical techniques for treatment of varicose veins of lower extremities. Methods 130 patients with 165 suffered limbs underwent single endovenous laser treatment or combined treatments. Three main modus operandi were involved:①endovenous laser treatment combined with high ligation of great saphenous vein(97 limbs); ②endovenous laser treatment combined with external banding valvuloplasty of superficial femoral vein and high ligation of great saphenous vein( 38 limbs) ;③endovenous laser treatment combined with high ligation of great saphenous vein and Subfascial Endoscopic Perforator Surgery (SEPS) ( 25 limbs). Results Occlusion of the varicose veins were obtained in all patients after the initial treatment , but in six cases (3.6%) , varicose veins recurred a second time , which were also successfully treated with EVLT. All patients were followed up for 1 - 20 months (mean 6.8 months) ,all of them put back proper functioning and livelihood.Conclusion Endovenous laser treatment is a treatment for varicose veins with the advantages of safety and effectiveness with minimal invasiveness. Its indications can be expanded by combining with other surgical treatments.%目的 评价经皮静脉腔内激光闭合术联合多种术式治疗下肢静脉曲张的疗效.方法 130 例共165条肢体腔内激光联合多种术式治疗.主要手术方式:①激光治疗联合大隐静脉高位结扎术;②激光治疗联合大隐静脉高位结扎和股浅静脉瓣膜包窄术;③激光治疗联合大隐静脉高位结扎和内镜下交通支静脉离断术.结果 6 例(3.6%) 局部复发经再次激光治愈,其余病例均一次治疗闭塞,随访1~20 个月(平均6.8 个月) ,均恢复正常工作、生活.结论 腔内激光治疗是一种安全、有效、微创的术式,联合手术治疗可以进一步拓宽其手术适应证.

  11. Extrahepatic Portal Vein Obstruction and Portal Vein Thrombosis in Special Situations: Need for a New Classification

    Science.gov (United States)

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

    2015-01-01

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

  12. Extrahepatic portal vein obstruction and portal vein thrombosis in special situations: Need for a new classification

    Directory of Open Access Journals (Sweden)

    Zeeshan A Wani

    2015-01-01

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

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

    Directory of Open Access Journals (Sweden)

    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

  14. Angiosarcoma of common iliac vein

    Science.gov (United States)

    Ibis, Kamuran; Usta, Ufuk; Cosar, Rusen; Ibis, Cem

    2015-01-01

    Angiosarcoma is a rare malignant tumour of endothelial cells. Primary angiosarcoma of venous origin is extremely rare, and has a very poor prognosis. A 63-year-old woman with retroperitoneal mass underwent en bloc resection on a part of iliac vein followed by adjuvant radiotherapy. No recurrence was detected during 3 years of follow-up. PMID:25596292

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

    Directory of Open Access Journals (Sweden)

    João Antonio Corrêa

    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.

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

    Directory of Open Access Journals (Sweden)

    Jorge Enrique Soracco

    2005-01-01

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

  17. Clinical studies on inferior right hepatic veins

    Institute of Scientific and Technical Information of China (English)

    Xue Xing; Hong Li; Wei-Guo Liu

    2007-01-01

    BACKGROUND:Many small veins are called accessory, short hepatic veins in addition to the right, middle and left hepatic veins. The size of these veins varied from a pinhole to 1 cm; the size of inferior right hepatic veins (IRHVs) is thicker than that of short hepatic veins or more than 1 cm occasionally. Adults have a higher incidence rate of the IRHV. DATA SOURCES:A literature search of the PubMed database was conducted and research articles were reviewed. RESULTS:The size of IRHVs is related to the size of the right hepatic vein, i.e. the larger the diameter of the right hepatic vein, the smaller the diameter of the IRHVs, and vice versa. The IRHVs are divided into superior, medial and inferior groups, separately named the superior, medial and inferior right hepatic veins according to the position of the IRHV entering the inferior vena cava. The superior right hepatic vein mainly drains the superior part of segmentⅦ, and the medial right hepatic vein drains the middle part of segmentⅦ. A thicker IRHV mainly drains segmentⅥ and the inferior part of segmentⅦ and a thinner IRHV drains the inferior part of segmentⅤ. CONCLUSIONS:The clinical signiifcance of these studies on IRHVs is varied: (1) Hepatic caudate lobe resection could be introduced after study on the veins of that lobe. (2) It is very important to identify the draining region of the IRHV for guiding hepatic segmentectomy. The postero-inferior area of the right lobe can be preserved along with the hypertrophic IRHV even if the entire main right hepatic vein is resected during segmentectomy ofⅦ andⅧwith right hepatic vein resection for patients with primary liver cancer. (3) The ligation of the major hepatic vein for the treatment of juxtahepatic vein injury is recommended because of severe hemorrhagic shock and dififculty in

  18. Common femoral vein reconstruction using internal jugular vein after blast injury.

    Science.gov (United States)

    Holt, Andrew M; West, Charles A; Davis, James A; Gilani, Ramyar; Askenasy, Eric

    2014-10-01

    Common femoral vein traumatic injuries are rare. Surgical management is controversial and by nature case specific. In this report, we present an unusual case of an isolated common femoral vein injury from a gunshot blast repaired with an interposition internal jugular vein bypass. To our knowledge, this is the first reported case of an isolated common femoral vein reconstructed in this manner.

  19. Who Is at Risk for Varicose Veins?

    Science.gov (United States)

    ... may raise your risk for varicose veins. The normal wear and tear of aging may cause the valves in your veins to weaken and not work well. Gender Women tend to get varicose veins more often than men. Hormonal changes that occur during puberty, pregnancy, and menopause (or ...

  20. Radiological aspects of portal vein embolization

    NARCIS (Netherlands)

    van Lienden, K.P.

    2012-01-01

    This thesis deals with liver regeneration after portal vein embolization (PVE) or portal vein ligation (PVL). Several aspects of these portal vein occlusion techniques are evaluated in clinical and experimental studies. In addition, the role of dynamic liver function tests and CT-volumetry in risk a

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

    DEFF Research Database (Denmark)

    Hougaard, Mikkel; Thayssen, Per; Kaltoft, Anne

    2013-01-01

    OBJECTIVES: We used the Western Denmark Heart Registry to assess one-year and long-term all-cause mortality and stent failure following Percutaneous Coronary Intervention (PCI) with drug-eluting stents (DES) or bare-metal stents (BMS). BACKGROUND: The use of DES compared with BMS during PCI has...

  2. A New Multimodal Biometric System Based on Finger Vein and Hand Vein Recognition

    OpenAIRE

    Randa Boukhris Trabelsi; Alima Damak Masmoudi; Dorra Sellami Masmoudi

    2013-01-01

    As a reliable and robust biological characteristic, the vein pattern increases more and more the progress in biometric researches. Generally, it was shown that single biometric modality recognition is not able to meet high performances. In this paper, we propose a new multimodal biometric system based on fusion of both hand vein and finger vein modalities. For finger vein recognition, we employ the Monogenic Local Binary Pattern (MLBP), and for hand vein recognitionan Improved Gaussian Matche...

  3. Intracavity Laser Surgery Combined together Lauromacrogol Treatment of Lower Extremity Varicose Veins%腔内激光术联合聚桂醇治疗下肢静脉曲张的体会

    Institute of Scientific and Technical Information of China (English)

    徐艳群; 葛玮; 裴锐峰; 丁轶人

    2014-01-01

    Objective To explore the intracavity laser combined together lauromacrogol curative effect for the treatment of lower extremity varicose veins.Method Selection from May 2013 to December 2013 were 33 patients with lower extremity varicose veins (article 49 limb), application of laser cavity closure great saphenous vein trunk, lauromacrogol embolization crus superifcial veins blood vessels, observe its curative effect.Result Limb acid bilges feeling disappear or reduce obviously, shallow varicose veins disappeared, no skin burns, saphenous nerve injury, no deep vein thrombosis. 4 cases were followed up for 5-12 months (8.16%) in local recurrence of varicose veins; leg to outpatient disappears after injection of a small amount of lauromacrogol.Conclusion Intracavity laser combined together lauromacrogol treatment of varicose veins of lower extremities minimally invasive, safe, effective, complementary advantages.%目的:探讨腔内激光联合聚桂醇治疗下肢静脉曲张的疗效。方法选择2013年5月至2013年12月收治的下肢静脉曲张患者33例(49条患肢),应用腔内激光闭合大隐静脉主干,聚桂醇栓塞小腿浅表曲张血管,观察其疗效。结果患肢酸胀感消失或明显减轻,浅静脉曲张消失,无皮肤灼伤,无隐神经损伤,无深静脉血栓形成。随访5~12个月4例(8.16%)出现小腿局部静脉曲张复发,予门诊注射少量聚桂醇后消失。结论腔内激光联合聚桂醇治疗下肢静脉曲张微创、安全、有效,优势互补。

  4. 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.

  5. Effects of tetraethylammonium chloride on sympathetic neuromuscular transmission in saphenous artery of young rabbits.

    Science.gov (United States)

    Holman, M E; Surprenant, A

    1980-08-01

    1. Excitatory junction potentials and electrotonic potentials were recorded from the smooth muscle of the rabbit saphenous artery using intracellular electrodes. 2. Tetraethylammonium chloride (TEA) in concentrations greater than 3.5 mM caused depolarization. Concentrations greater than 5 mM caused spontaneous electrical activity in the form of excitatory junction potentials (e.j.p.s) and all-or-nothing action potentials which were associated with spontaneous mechanical activity. 3. Concentrations of TEA less than 2.5 mM did not alter the resting potential nor the passive membrane properties of the smooth muscle over a range of +/- 15 mV. 4. The following effects were observed in 2.0 mM-TEA. (a) The minimum stimulus strength required for the initiation of an e.j.p. fell by three to fivefold. (b) Single stimuli that elicited only a small e.j.p. in normal solution evoked an all-or-nothing action potential of up to 70 mV amplitude. (c) Whereas in normal solution e.j.p.s could only be recorded up to 7 mm away from the perivascular stimulating electrode e.j.p.s could be recorded at distances of up to 13 mm. (d) The duration of the e.j.p. was prolonged. 5. Based on these results and the effects of TEA reported for other synapses it is proposed that TEA may act to increase the amount of transmitter released per axon, to increase the duration of release and to cause an increased invasion throughout the autonomic ground plexus by nerve impulses. This would imply that in normal solution, in vitro, the action potential may not propagate throughout the whole length of the terminal axon and its many branches due to failure of conduction at one or more points along the terminal portion of the axon.

  6. 冠状动脉旁路移植术静脉移植物内膜增生的治疗策略%Therapeutic Strategies to Reduce Vein Graft Neointima Formation in Coronary Artery Bypass Grafting

    Institute of Scientific and Technical Information of China (English)

    邱雪峰; 董念国

    2009-01-01

    尽管冠状动脉旁路移植术中动脉桥血管被广泛使用且远期通畅率高,但大隐静脉移植物仍是冠状动脉旁路移植术使用最多的桥血管,而大隐静脉移植物术后10年通畅率大约60%.静脉移植物再狭窄的机制包括血栓形成、心内膜增生和粥样硬化等.防治静脉移植物再狭窄的方案包括药物治疗、基因治疗和血管外支架.现就上述治疗方案作一综述.%Although arterial conduits are widely used and have good long-term results in coronary artery bypass grafting, vein grafts remain using most in coronary surgery. Newer studies show a saphenous vein graft patency of about 60% at 10 years postoperatively. The pathology of vein graft disease consists of thrombosis, neointimal hyperplasia, and atherosclerosis. Therapeutic strategies to prevent vein graft disease include pharmacotherapy, gene therapy and external stenting. In this review we have summarized a variety of therapeutic strategies for vein graft disease.

  7. Superficial Dorsal Vein Injury/Thrombosis Presenting as False Penile Fracture Requiring Dorsal Venous Ligation

    Directory of Open Access Journals (Sweden)

    Arash Rafiei, MD

    2014-12-01

    Conclusion: Early exploration of patients with suspected penile fracture provides excellent results with maintenance of erectile function. Also, in the setting of dorsal vein thrombosis, ligation preserves the integrity of the penile tissues and avoids unnecessary complications from conservative management. Rafiei A, Hakky TS, Martinez D, Parker J, and Carrion R. Superficial dorsal vein injury/thrombosis presenting as false penile fracture requiring dorsal venous ligation. Sex Med 2014;2:182–185.

  8. Management of varicose veins and venous insufficiency.

    Science.gov (United States)

    Hamdan, Allen

    2012-12-26

    Chronic venous disease, reviewed herein, is manifested by a spectrum of signs and symptoms, including cosmetic spider veins, asymptomatic varicosities, large painful varicose veins, edema, hyperpigmentation and lipodermatosclerosis of skin, and ulceration. However, there is no definitive stepwise progression from spider veins to ulcers and, in fact, severe skin complications of varicose veins, even when extensive, are not guaranteed. Treatment options range from conservative (eg, medications, compression stockings, lifestyle changes) to minimally invasive (eg, sclerotherapy or endoluminal ablation), invasive (surgical techniques), and hybrid (combination of ≥1 therapies). Ms L, a 68-year-old woman with varicose veins, is presented. She has had vein problems over the course of her life. Her varicose veins recurred after initial treatment, and she is now seeking guidance regarding her current treatment options.

  9. Central retinal vein occlusion: A patient with systemic sclerosis

    Directory of Open Access Journals (Sweden)

    Karadžić Jelena

    2016-01-01

    Full Text Available Introduction. Scleroderma (systemic sclerosis is a severe chronic connective tissue disease, which results in involvement of numerous internal organs. Changes in the eye are the consequences of organ-specific manifestations of scleroderma or adverse effects of immunosuppressive treatment applied. Case report. We reported a 42-year-old woman with systemic sclerosis and acute deterioration of vision in the left eye, with visual acuity 0.9. After thorough clinical examination, including fluorescein angiography and optical coherence tomography, the diagnosis of nonischemic central retinal vein occlusion was made. Further biochemical, rheumatological and immunological investigation, apart from inactive systemic sclerosis, showed normal findings. Therefore, the cause of central retinal vein occlusion could only be attributed to the microvascular changes in systemic sclerosis. After three months, visual acuity deteriorated to 0.6 due to the development of cystoid macular edema. The patient received intravitreal injection of bevacizumab and after a single dose visual acuity improved to 0.9. After a 6- month follow-up, macular edema resolved and visual acuity stabilized. Conclusion. According to our knowledge and current data from the literature, central retinal vein occlusion is a rare vision threatening manifestation of scleroderma. There are only few published case reports on central vein occlusion in scleroderma patients. Examination of the ocular fundus is recommended for evaluation of vascular disease in patients with systemic sclerosis.

  10. Deep vein thrombosis in pregnancy.

    Science.gov (United States)

    Colman-Brochu, Stephanie

    2004-01-01

    This article provides a review of the incidence, pathophysiology, and treatment of deep vein thrombosis (DVT) in pregnancy, a rare but serious complication of pregnancy. The incidence of DVT in pregnancy varies widely, but it is a leading cause of maternal morbidity in both the United States and the United Kingdom. Risk factors during pregnancy include prolonged bed rest or immobility, pelvic or leg trauma, and obesity. Additional risk factors are preeclampsia, Cesarean section, instrument-assisted delivery, hemorrhage, multiparity, varicose veins, a previous history of a thromboembolic event, and hereditary or acquired thrombophilias such as Factor V Leiden. Heparin is the anticoagulant of choice to treat active thromboembolic disease or to administer for thromboprophylaxis, but low molecular-weight heparin is being used with increasing frequency in the pregnant woman. Perinatal nurses should be aware of the symptoms, diagnostic tools, and treatment options available to manage active thrombosis during pregnancy and in the intrapartum and postpartum periods.

  11. FINGER-VEIN RECOGNITION SYSTEMS

    Directory of Open Access Journals (Sweden)

    A.Haritha Deepthi

    2015-10-01

    Full Text Available As the Person‟s/Organization‟s Private information‟s are becoming very easy to access, the demand for a Simple, Convenient, Efficient, and a highly Securable Authentication System has been increased. In considering these requirements for data Protection, Biometrics, which uses human physiological or behavioral system for personal Identification has been found as a solution for these difficulties. However most of the biometric systems have high complexity in both time and space. So we are going to use a Real time Finger-Vein recognition System for authentication purposes. In this paper we had implemented the Finger Vein Recognition concept using MATLAB R2013a. The features used are Lacunarity Distance, Blanket Dimension distance. This has more accuracy when compared to conventional methods.

  12. Mortality after portal vein embolization

    Science.gov (United States)

    Lee, Eung Chang; Park, Sang-Jae; Han, Sung-Sik; Park, Hyeong Min; Lee, Seung Duk; Kim, Seong Hoon; Lee, In Joon; Kim, Hyun Beom

    2017-01-01

    Abstract Portal vein embolization (PVE) is increasingly performed worldwide to reduce the possibility of liver failure after extended hepatectomy, by inducing future liver remnant (FLR) hypertrophy and atrophy of the liver planned for resection. The procedure is known to be very safe and to have few procedure-related complications. In this study, we described 2 elderly patients with Bismuth–Corlette type IV Klatskin tumor who underwent right trisectional PVE involving the embolization of the right portal vein, the left medial sectional portal branch, and caudate portal vein. Within 1 week after PVE, patients went into sepsis combined with bile leak and died within 1 month. Sepsis can cause acute liver failure in patients with chronic liver disease. In this study, the common patient characteristics other than sepsis, that is, trisectional PVE; chronic alcoholism; aged >65 years; heart-related comorbidity; and elevated serum total bilirubin (TB) level (7.0 mg/dL) at the time of the PVE procedure in 1 patient, and concurrent biliary procedure, that is, percutaneous transhepatic biliary drainage in the other patient might have affected the outcomes of PVE. These cases highlight that PVE is not a safe procedure. Care should be taken to minimize the occurrence of infectious events because sepsis following PVE can cause acute liver failure. Additionally, prior to performing PVE, the extent of PVE, chronic alcohol consumption, age, comorbidity, long-lasting jaundice, concurrent biliary procedure, etc. should be considered for patient safety. PMID:28178122

  13. Sudden hearing loss followed by deep vein thrombosis and pulmonary embolism in a patient with factor V Leiden mutation.

    Science.gov (United States)

    Lovato, A; Tormene, D; Staffieri, C; Breda, S; Staffieri, A; Marioni, G

    2014-09-01

    Factor V Leiden (FVL) is by far the most prevalent inherited thrombophilic abnormality in Western countries, and this genetic condition has been associated with sudden sensorineural hearing loss (SSHL). Audiologists should be aware that SSHL may be the precursor of life-threatening thromboembolic events, especially in Caucasians who are more likely to be FVL carriers. Case report. A 41-year-old male patient. Although this is not the first report of SSHL in a FVL carrier, it is the first to describe SSHL occurring in a heterozygous FVL carrier who--within a month--was also diagnosed with deep vein thrombosis of the left common femoral, saphenous, and popliteal veins, and pulmonary embolism of the left pulmonary artery branch serving the posterior basal segment of the inferior lobe. SSHL is an emergency condition that warrants prompt medical examination and treatment. Hematological investigations should be considered in SSHL patients at least for those with a family history of thrombotic events, and for women on estrogen-progestin therapy or during pregnancy, with a view to providing adequate antithrombotic prophylaxis and reducing the risk of other thromboembolic events.

  14. Application of cystoscope in surgical treatment of hepatocellular carcinoma with portal vein tumor thrombus.

    Science.gov (United States)

    Li, Nan; Wei, Xu-Biao; Cheng, Shu-Qun

    2016-06-14

    Development of portal vein tumor thrombus deteriorates the prognosis of hepatocellular carcinoma, while surgical treatment can offer a promising prognosis for selected patients. However, the possibility of residual lesions in portal vein after conventional thrombectomy is a main risk factor leading to postoperative recurrence. Therefore, ensuring the complete removal of tumor thrombus during operation is critical to improve prognosis. For the first time, we report here one case of hepatocellular carcinoma with portal vein tumor thrombus in which cystoscope was successfully applied as a substitute of intravascular endoscope to visualize the cavity of the portal vein. The patient was a 61-year-old man with a 7-cm tumor in the right lobe of the liver, with tumor thrombus invading the right branch and adjacent to the conjunction of the portal vein. After removal of the tumor, the Olympus CYF-VA2 cystoscope was used to check the portal vein from the opening stump of the right branch of the portal vein. In this case, residual thrombus tissue was found near the opening stump and the conjunction of the portal vein. The residual lesion was carefully retrieved from the stump after retraction of the cystoscope. The procedure was repeated until no residual lesion was found. The whole duration time of thrombectomy was 22.5 (15 + 7.5) min. The patient was free from recurrence at 8 months after the procedure. Our work indicated that the cystoscope is a suitable substitute, with a proper size and function to check the portal vein system and ensure the curability of thrombectomy. Although well-designed clinic trails are still needed, this procedure may further improve the postoperative prognosis of hepatocellular carcinoma with portal vein tumor thrombus.

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

    Directory of Open Access Journals (Sweden)

    Claudio Joo Turoni

    2011-01-01

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

  16. Endothelium-dependent hyperpolarization-related relaxations diminish with age in murine saphenous arteries of both sexes

    DEFF Research Database (Denmark)

    Chennupati, R.; Lamers, W. H.; Koehler, S. E.

    2013-01-01

    of saphenous arteries were analysed by wire myography in the absence and presence of stimuli of the endothelium, inhibitors of NOS, and inhibitors and stimulants of small (K(Ca)2.3) and intermediate (K(Ca)3.1) conductance calcium-activated potassium channels. KEY RESULTS Arterial relaxing responses to sodium...... pronounced ACh-induced relaxation, which was significantly reduced in 34- and 64-week-old mice of both sexes. The EDH-related component of ACh-induced relaxations was abolished by TRAM-34 (K(Ca)3.1 blocker) or UCL 1684 (K(Ca)2.3 blocker). Although the maximal relaxation induced by NS309 (K-Ca activator......BACKGROUND AND PURPOSE We investigated the effects of aging on the contributions of NO and endothelium-dependent hyperpolarization (EDH) to endothelium-dependent relaxation in saphenous arteries of male and female C57BL/6J mice aged 12, 34 and 64 weeks. EXPERIMENTAL APPROACH Vasomotor responses...

  17. Undivided Retromandibular Vein Continuing As External Jugular Vein With Facial Vein Draining Into It : An Anatomical Variation

    Directory of Open Access Journals (Sweden)

    Shahnaz Choudhary, Ashwani K Sharma, Harbans Singh

    2010-10-01

    Full Text Available Despite the fact that the blueprint of the whole body is unravelled, faultlessly during the growth anddevelopment of an animal; but amazingly variations do occur. During routine dissection of head and neckin a middle aged cadaver in the Post Graduate Department of Anatomy of this medical college, we foundvariation in the formation of external jugular vein on both sides, which was formed by the continuation ofundivided trunk of retromandibular vein. The facial vein and posterior auricular vein were the tributaries ofexternal jugular vein. The sound anatomical knowledge of variations of the veins of head and neck isessential to the success of surgical procedures. The embryological evaluation of the above anomaly wasdone and compared with the available literature which showed that the observed variation was rare

  18. 下肢静脉曲张术后复发的临床分析%Clinical study of recurrence of varicose veins after varicotomy in lower extremity

    Institute of Scientific and Technical Information of China (English)

    孙岩; 金星; 吴学君; 张十一; 种振岳

    2016-01-01

    Objective To investigate the causes and treatment of recurrence of varicose veins after varicotomy in lower extremity.Methods We retrospectively investigated the clinical data of 73 patients (44 male, 29 female) with varicose vein recurrence admitted to department of vascular surgery from Mar 2007 to Dec 2015. The reasons for postoperative recurrence of varicose veins were concluded that residual saphenous vein was recorded for 19 patients, 28 patients showed perforating vein insufficiency, 9 cases showed reflux of the superficial femoral vein, and 10 cases showed varicose small saphenous veins, while 4 had Budd Chiari syndrome and 3 cases due to cockett syndrome. Different methods were taken for different causes, grades and general condition.Results The operation was smooth and perative incisions were primary healing, with no fatality. All patients recovered well, The median length of hospital stay was 11.3 days; At median 21.3 months follow up, No recurrent symptoms were observed in all patients.Conclusions Several factor such as misdiagnose, mistreatment, irregular operations that may contribute to varicose vein recurrencehave been identified. Deep, superficial and perforating veins should be examined carefully to perform the appropriate surgical intervention. Prevention of varicose vein recurrence after surgical correction requires a more extensive use of preoperative examination, to tailor surgical intervention to suit individual patients.%目的:探讨下肢静脉曲张术后复发的原因及诊治策略。方法回顾性分析2007年3月至2015年12月山东大学附属省立医院血管外科收治的73例下肢静脉曲张术后复发患者的临床资料。男性44例,女性29例。临床表现有浅静脉曲张、下肢水肿、皮肤色素沉着及溃疡。复发的原因:大隐静脉主干及其部分属支残存19例;穿通静脉瓣膜功能不全28例;深静脉瓣膜功能不全9例;出现小隐静脉曲张10例;布加综合征4

  19. Effect of Perineural Dexamethasone on the Duration of Single Injection Saphenous Nerve Block for Analgesia After Major Ankle Surgery. A Randomized, Controlled Study

    DEFF Research Database (Denmark)

    Bjørn, Siska; Linde, Frank; Nielsen, Kristian Kibak;

    2016-01-01

    prolongs the duration of analgesia and postpones as well as reduces opioid-requiring pain. METHODS: Forty patients were included in this prospective, randomized, controlled study. All patients received a continuous sciatic catheter and were randomized to receive a single-injection saphenous nerve block...

  20. 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

    2017-01-01

    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...

  1. Palm Vein Verification Using Gabor Filter

    Directory of Open Access Journals (Sweden)

    Ali Mohsin Al-Juboori

    2013-01-01

    Full Text Available Palm vein authentication is one of the modern biometric techniques, which employs the vein pattern in the human palm to verify the person. The merits of palm vein on classical biometric (e.g. fingerprint, iris, face are a low risk of falsification, difficulty of duplicated and stability. In this research, a new method is proposed for personal verification based on palm vein features. In the propose method, the palm vein images are firstly enhanced and then the features are extracted by using bank of Gabor filters. Then Fisher Discriminated Analysis (FDA is used to reduce the dimension of the features vectors. For vein pattern verification, this work uses Nearest Neighbors method. The EER of the proposed method is 0.2335%.

  2. 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.

  3. [Life-threatening injuries of the subcutaneous ventral abdominal veins in dairy cows].

    Science.gov (United States)

    Schmid, B; Muggli, E; Schmid, T; Nuss, K

    2011-05-01

    Injuries of the superficial veins on the ventral abdomen of dairy cows can result in life-threatening haemorrhage. Treatment of these injuries can be difficult because of the characteristics of the veins. Five cows aged 6.5 to 12 years were referred to the Animal Hospitale Zurich, because of intermittent haemorrhage from a ventral abdominal vein. Four of the cows were near term and one had calved two weeks before referral. Intermittent bleeding was seen from the highly convoluted and dilated subcutaneous tributaries to the cranial superficial epigastric vein (milk vein). The haematocrit of 2 cows was markedly lower than normal. Emergency slaughter of one of the cows was carried out because of advanced age. The other 4 cows were sedated and after application of local anaesthetic, the wounds were debrided and sutured. Two of the cows required a blood transfusion before being operated. There were no postoperative complications. This type of injury seems to occur predominantly in pluriparous dairy cows close to term, in which the tributaries to the milk vein have undergone varicose changes. Treatment should consist of surgical resection of the injured tissue and suturing of the venous wall, subcutaneous tissues and skin.

  4. Small hepatic veins Budd-Chiari syndrome.

    Science.gov (United States)

    Riggio, Oliviero; Marzano, Chiara; Papa, Alessia; Pasquale, Chiara; Gasperini, Maria Ludovica; Gigante, Antonietta; Valla, Dominique Charles; Plessier, Aurélie; Amoroso, Antonio

    2014-05-01

    Budd-Chiari syndrome is a rare disorder characterized by hepatic venous outflow obstruction at any level from the small hepatic veins to the atrio-caval junction, in the absence of heart failure or constrictive pericarditis. Various imaging modalities are available for investigating the gross hepatic vascular anatomy but there are rare forms of this disease where the obstruction is limited to the small intrahepatic veins, with normal appearance of the large hepatic veins at imaging. In this cases only a liver biopsy can demonstrate the presence of a small vessels outflow block. We report two cases of small hepatic veins Budd-Chiari syndrome.

  5. Leiomyosarcoma of the external iliac vein.

    Science.gov (United States)

    Fukuda, Wakako; Taniguchi, Satoshi; Fukuda, Ikuo

    2012-06-01

    Leiomyosarcoma of the iliac vein is an uncommon tumor. We report a case of a 63-year-old Japanese woman with leiomyosarcoma of the right external iliac vein. The patient complained of right inguinal pain and swelling. Computed tomography demonstrated a mass surrounding the right external iliac artery and vein. Metastases in the lungs and liver were found. Complete resection of the tumor along with the involved vessels was performed. Polytetrafluoroethylene grafts were used to reconstruct the vessels. Pathological examination revealed leiomyosarcoma of the external iliac vein. Although the prognosis of leiomyosarcoma is poor, en bloc tumor resection is the treatment of choice.

  6. Sonographic Findings in Fetal Renal Vein Thrombosis.

    Science.gov (United States)

    Gerber, Rebecca E; Bromley, Bryann; Benson, Carol B; Frates, Mary C

    2015-08-01

    We present the sonographic findings of fetal renal vein thrombosis in a series of 6 patients. The mean gestational age at diagnosis was 31.2 weeks. Four cases were unilateral, and 2 were bilateral. The most common findings were renal enlargement and intrarenal vascular calcifications, followed by increased renal parenchymal echogenicity. Inferior vena cava thrombosis was found in 4 patients and common iliac vein thrombosis in 2. Fetal renal vein thrombosis is an uncommon diagnosis with characteristic sonographic findings. The presence of these findings should prompt Doppler interrogation of the renal vein and inferior vena cava to confirm the diagnosis.

  7. Drosophila Smad2 Opposes Mad Signaling during Wing Vein Development

    Science.gov (United States)

    Sander, Veronika; Eivers, Edward; Choi, Renee H.; De Robertis, Edward M.

    2010-01-01

    In the vertebrates, the BMP/Smad1 and TGF-β/Smad2 signaling pathways execute antagonistic functions in different contexts of development. The differentiation of specific structures results from the balance between these two pathways. For example, the gastrula organizer/node of the vertebrates requires a region of low Smad1 and high Smad2 signaling. In Drosophila, Mad regulates tissue determination and growth in the wing, but the function of dSmad2 in wing patterning is largely unknown. In this study, we used an RNAi loss-of-function approach to investigate dSmad2 signaling during wing development. RNAi-mediated knockdown of dSmad2 caused formation of extra vein tissue, with phenotypes similar to those seen in Dpp/Mad gain-of-function. Clonal analyses revealed that the normal function of dSmad2 is to inhibit the response of wing intervein cells to the extracellular Dpp morphogen gradient that specifies vein formation, as measured by expression of the activated phospho-Mad protein. The effect of dSmad2 depletion in promoting vein differentiation was dependent on Medea, the co-factor shared by Mad and dSmad2. Furthermore, double RNAi experiments showed that Mad is epistatic to dSmad2. In other words, depletion of Smad2 had no effect in Mad-deficient wings. Our results demonstrate a novel role for dSmad2 in opposing Mad-mediated vein formation in the wing. We propose that the main function of dActivin/dSmad2 in Drosophila wing development is to antagonize Dpp/Mad signaling. Possible molecular mechanisms for the opposition between dSmad2 and Mad signaling are discussed. PMID:20442782

  8. phenoVein - A tool for leaf vein segmentation and analysis

    OpenAIRE

    Bühler, J.; Rishmawi, L.; Pflugfelder, D.; Huber, G; Scharr, H.; Hülskamp, M; Koornneef, M.; Schurr, U; Jahnke, S.

    2015-01-01

    Precise measurements of leaf vein traits are an important aspect of plant phenotyping for ecological and genetic research. Here, we present a powerful and user-friendly image analysis tool named phenoVein. It is dedicated to automated segmenting and analyzing of leaf veins in images acquired with different imaging modalities (microscope, macrophotography, etc.), including options for comfortable manual correction. Advanced image filtering emphasizes veins from the background and compensates f...

  9. Subclavian artery to internal jugular vein fistula following percutaneous internal jugular vein catheterization.

    Science.gov (United States)

    Merino-Angulo, J; Cortazar, J L; Saez-Garmendia, F; Montejo, M

    1984-01-01

    The percutaneous internal jugular vein approach is now a commonly performed procedure for central venous catheterization. Iatrogenic arteriovenous fistulae are a very infrequent complication. We report an asymptomatic subclavian artery to internal jugular vein fistula following two percutaneous internal jugular vein catheterization attempts.

  10. Comparative stability of sodium tetradecyl sulphate (STD) and polidocanol foam: impact on vein damage in an in-vitro model.

    Science.gov (United States)

    McAree, B; Ikponmwosa, A; Brockbank, K; Abbott, C; Homer-Vanniasinkam, S; Gough, M J

    2012-06-01

    To compare the half-life of STD and polidocanol air-based foams and the damage they inflict upon human great saphenous vein in an in-vitro model. The time for the volume of 3% STD and polidocanol foams to reduce by 10% (T(90)) and 50% (T(50)) was recorded in an incubator at 37 °C. Segments of proximal GSV harvested during varicose vein surgery were filled with foam for 5 or 15 min. Histological analysis determined percentage endothelial cell loss and depth of media injury. Median (±IQR) T(90) and T(50) for polidocanol were 123.3 s (111.7-165.6) and 266.3 s (245.6-383.1) versus 102.03 s (91.1-112) and 213.13 s (201-231.6) for STD (T(90)p = 0.008, T(50)p = 0.004). Median endothelial loss with polidocanol was; 63.5% (62.2-82.8) and 85.9% (83.8-92.5) versus 86.3% (84.8-93.7) and 97.64% (97.3-97.8) for STD after 5 and 15 min (p = 0.076 and p = 0.009). The median depth and % media thickness injured were 0 μm (0-0 μm) and 0% for both assessments with polidocanol versus 37.4 μm (35.3-45.8 and 43.4 μm (42.1-46.7) and 3.5% (3.1-3.6) and 5.3% (3.7-6.0) after 5 and 15 min for STD (p < 0.01 for all comparisons). Although polidocanol foam shows greater stability than STD foam perhaps remaining in the vein for longer, endothelial cell loss and damage to the media were significantly greater with STD. Copyright © 2012. Published by Elsevier Ltd.

  11. [Sequence of venous blood flow alterations in patients after recently endured acute thrombosis of lower-limb deep veins based on the findings of ultrasonographic duplex scanning].

    Science.gov (United States)

    Tarkovskiĭ, A A; Zudin, A M; Aleksandrova, E S

    2009-01-01

    veins (to have occurred in 25% of the cases). Of special interest was the finding that insufficiency of the ostial valve of the great saphenous vein, manifesting itself by a superficial vertical veno-venous reflux, was revealed only in two (6.25%) patients examined 12 months after the onset of the disease, which may be regarded as the third stage of the phlebohaemodynamic alterations. That low prevalence and no evidence of varicose transformation of superficial veins appear to suggest an important part they play in compensation of the venous outflow from the extremity affected.

  12. Generating and analyzing synthetic finger vein images

    NARCIS (Netherlands)

    Hillerström, Fieke; Kumar, Ajay; Veldhuis, Raymond

    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

  13. PORTAL VEIN THROMBOSIS-ULTRASOUND IMAGING

    Directory of Open Access Journals (Sweden)

    Trajkovska Meri

    2016-07-01

    Full Text Available Portal venous system, apart from the main portal vein, includes its tributaries: superior and inferior mesenteric vein, as well as splenic vein, so the term portal venous thrombosis encompasses a broad spectrum of pathological conditions. Usually, one or more causative factors can be recognized, either local endothelial/ flow disturbances, or systemic inherited /acquired conditions. Portal vein thrombosis can be associated with benign or malignant disorders. Weather we are speaking about acute or chronic thrombosis, the clinical presentation is different. Acute thrombosis can be presented in a wide range, from mild abdominal discomfort to a state of intestinal ischemia and life-threatening infarction. Chronic thrombosis is usually recognized when variceal bleeding or other symptoms of portal hypertension express. Fast and accurate diagnosis sometimes is a life-saving procedure, especially in acute vascular alterations. Recently, due to the improvement of imaging procedures the number of patients with diagnosed portal vein thrombosis is increasingly growing. With a negative predictive value of 98% color Doppler ultrasound is considered as imaging modality of choice in detecting portal vein thrombosis. Based on large studies it is presumed that overall risk of getting portal vein thrombosis during lifetime is 1% in general population, but much bigger 5%-15% in cirrhotic patients. Existence of specific ultrasound criteria, if fulfilled, has ensured that diagnosis of portal vein thrombosis is fast and non-invasive. Procedure is convenient for the patient and healthcare providers, and above all, allows prompt treatment preventing further deterioration.

  14. Vein of foramen caecum: imaging findings.

    Science.gov (United States)

    Tutar, Onur; Kandemirli, Sedat Giray; Yildirim, Duzgun; Memis, Emine Sebnem; Bakan, Selim

    2016-07-01

    Vein of foramen caecum has been classically described as a vein that connects nasal mucosa to the superior sagittal sinus in classic anatomy textbooks. However, its existence is controversial in literature. Herein, we demonstrated computed tomography and contrast enhanced magnetic resonance imaging findings of a tubular vascular structure extending to nasal mucosa and superior sagittal sinus.

  15. Improving the management of varicose veins.

    Science.gov (United States)

    Onida, Sarah; Lane, Tristan R A; Davies, Alun H

    2013-01-01

    Up to 30% of the UK population are affected by varicose veins. They are a manifestation of increased venous pressure in the lower limb caused by impaired venous return. Primary varicosities result from poor drainage from the superficial to the deep venous system. Secondary varicosities arise as a result of underlying pathology impeding venous drainage, such as deep venous thrombosis or increased intra-abdominal pressure caused by a mass, pregnancy or obesity. Patients with bleeding varicose veins should be referred to a vascular service immediately. Referral is also indicated in the following cases: symptomatic primary or recurrent varicose veins; lower limb skin changes thought to be caused by chronic venous insufficiency; superficial vein thrombosis and suspected venous incompetence; a venous leg ulcer or healed venous leg ulcer. Imaging is crucial in the assessment of the superficial and deep venous system to enable assessment of venous competence. The gold standard imaging technique is colour duplex ultrasonography. Duplex ultrasound should be used to confirm the diagnosis of varicose veins and the extent of truncal reflux, and to plan treatment for patients with suspected primary or recurrent varicose veins. Superficial vein ligation, phlebectomy and stripping have been the mainstay of treatment. In recent years, new techniques have been developed that are minimally invasive, enabling treatment of superficial venous incompetence with reduced morbidity. NICE recommends that endothermal ablation, in the form of radiofrequency or laser treatment, should be offered as treatment for patients with confirmed varicose veins and truncal reflux.

  16. Retinal vein occlusion: pathophysiology and treatment options

    OpenAIRE

    Niral Karia

    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

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

    Directory of Open Access Journals (Sweden)

    Luiz Marcelo Aiello Viarengo

    2006-09-01

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

  18. 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.

  19. Recurrent cause and surgery effect analysis in varicose veins patients after surgery%下肢静脉曲张术后复发原因及再次手术疗效分析

    Institute of Scientific and Technical Information of China (English)

    甄玲; 涂红梅; 刘吉羊

    2016-01-01

    目的:探讨下肢静脉曲张手术术后复发的原因以及分析再次手术治疗的临床疗效。方法选取2014年2月至2016年1月收治的80例(89条)术后复发下肢静脉曲张的患者为研究对象。采用超声检查和下肢深静脉造影方法判断其复发的原因,根据检查结果采取相应的处理方法。结果大隐静脉全段主干或属枝残留23条,深静脉瓣膜功能不全30条,小隐静脉瓣膜功能不全18条,小隐静脉曲张4条;腹股沟区新生血管形成10条,髂静脉受压综合征2条,布加氏综合征2条。经再次手术后所有患者术后下肢浅静脉曲张治愈率100%,术后无下肢深静脉血栓形成病例,无手术切口感染、延迟愈合病例。结论下肢静脉曲张术前做好全面的诊断,术中注意操作方式方法,有利于降低术后的复发率。针对下肢静脉曲张复发病例,了解复发原因,制定相应的治疗方法,可有效并避免术后复发。%Objective To discuss the cause of relapse after the first surgery of varicose veins,and analyze the clinical efficacy of surgical treatment again. Methods 80 cases(89 strips)of recurrence varicose veins from February 2014 to January 2016 were selected as the research object. Using ultrasound and deep venous angiography to determine the cause of its recurrence,and take the appropriate treatment based on test re-sults. Results Saphenous vein trunk or the whole paragraph belongs to the residual 23 strips,deep venous insufficiency 30 strips,the small sa-phenous vein insufficiency 18 strips,the small saphenous vein 4;groin area neovascularization 10 strips,iliac vein compression syndrome 2 strips, Budd - Chiari syndrome 2 strips. After surgery again,the cure rate was 100% and no postoperative deep venous thrombosis,surgical wound infec-tion,delayed healing happened. Conclusion Varicose veins before surgery to do a comprehensive diagnosis,intraoperative attention to ways and means of

  20. Ferns are less dependent on passive dilution by cell expansion to coordinate leaf vein and stomatal spacing than angiosperms.

    Science.gov (United States)

    Carins Murphy, Madeline R; Jordan, Gregory J; Brodribb, Timothy J

    2017-01-01

    Producing leaves with closely spaced veins is a key innovation linked to high rates of photosynthesis in angiosperms. A close geometric link between veins and stomata in angiosperms ensures that investment in enhanced venous water transport provides the strongest net carbon return to the plant. This link is underpinned by "passive dilution" via expansion of surrounding cells. However, it is not known whether this 'passive dilution' mechanism is present in plant lineages other than angiosperms and is another key feature of the angiosperms' evolutionary success. Consequently, we sought to determine whether the 'passive dilution' mechanism is; (i) exclusive to the angiosperms, (ii) a conserved mechanism that evolved in the common ancestor of ferns and angiosperms, or (iii) has evolved continuously over time. To do this we first we assessed the plasticity of vein and stomatal density and epidermal cell size in ferns in response to light environment. We then compared the relationships between these traits found among ferns with modelled relationships that assume vein and stomatal density respond passively to epidermal cell expansion, and with those previously observed in angiosperms. Vein density, stomatal density and epidermal cell size were linked in ferns with remarkably similar relationships to those observed in angiosperms, except that fern leaves had fewer veins per stomata. However, plasticity was limited in ferns and stomatal spacing was dependent on active stomatal differentiation as well as passive cell expansion. Thus, ferns (like angiosperms) appear to coordinate vein and stomatal density with epidermal cell expansion to some extent to maintain a constant ratio between veins and stomata in the leaf. The different general relationships between vein density and stomatal density in ferns and angiosperms suggests the groups have different optimum balances between the production of vein tissue dedicated to water supply and stomatal tissue for gas exchange.

  1. Papel del tejido perivascular en la regulación del tono vascular: repercusión en el uso de puentes aorto-coronarios para revascularización miocárdica Role of perivascular tissue in vascular tone regulation: repercussion in the use of aortocoronary bypass for myocardial revascularization

    Directory of Open Access Journals (Sweden)

    Patricio López-Jaramillo

    patients with severe coronary disease. The lifespan of these grafts has shown to be longer with arterial tissue even though its use is limited by its restricted availability. This is why the saphenous vein bypasses, although having a greater risk of presenting occlusion, are the most used in these procedures of myocardial reperfusion. The reasons by which the venous grafts are occluded after its insertion in the arterial site are still not clear; nevertheless, it has been proposed that it could be due to different factors such as: surgical mechanical trauma, increment of arterial pressure and diminished friction stress. In 1996 the «no-touch» preparation technique of venous grafts was described, in which the venous bypasses were implanted in the coronary site along with the surrounding perivascular tissue and demonstrated to improve the lifespan of this type of grafts. Recently it has been proposed that the perivascular fat tissue could play a role in the vascular tone regulation and it has been even described the existence of an adipose cell derived relaxing factor (ADRF, whose nature has not been completely cleared yet. The objective of this article is to review the different factors related to the aortocoronary grafts’ occlusion, the possible physiopathologic channels that form this phenomenon, the new surgical alternatives used for vein grafts preparation and the advances in the description of ADRF and its role in vascular tone regulation.

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

    Directory of Open Access Journals (Sweden)

    Chetcuti Karen

    2010-05-01

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

  3. Ecoescleroterapia com microespuma em varizes tronculares primárias Microfoam ultrasound-guided sclerotherapy in primary trunk varicose veins

    Directory of Open Access Journals (Sweden)

    Marcondes Figueiredo

    2006-09-01

    Full Text Available OBJETIVO: Avaliar o tratamento de varizes tronculares primárias por ecoescleroterapia com microespuma. MÉTODOS: A amostra foi constituída de 25 membros de seis pacientes do sexo masculino e 19 do sexo feminino, com incompetência das veias safenas magna (21 membros ou parva (quatro membros. Eles foram avaliados de acordo com a classificação clínica, etiológica, anatômica e fisiopatológica (CEAP e classificados nos graus C³ (10 membros, C4 (seis membros, C5 (cinco membros e C6 (quatro membros. A microespuma (5 ml, preparada pela mistura de 1 ml de polidocanol a 3% e 5 ml de ar, era injetada na veia do paciente, em posição de Trendelenburg, com monitoração por ultra-sonografia com Doppler colorido. Os membros eram enfaixados com atadura inelástica por 3 dias; depois disso, os pacientes usavam meias elásticas, 30-40 mmHg, 3/4 ou 7/8, durante 3 meses. A eficiência do tratamento foi avaliada pelo escore clínico da classificação CEAP para dor, edema e claudicação e pelas alterações ultra-sonográficas 12 meses depois. Os escores clínicos antes e depois do tratamento foram comparados pelo teste de Wilcoxon. RESULTADOS: Houve diminuição significante nos escores clínicos (P OBJECTIVE: To evaluate the treatment of primary trunk varicose veins by microfoam ultrasound-guided sclerotherapy. METHODS: The sample was composed of 25 members of six male and 19 female patients, with incompetence of great saphenous vein (21 and short saphenous vein (4. Patients were assessed according to the clinical, etiologic, anatomical and pathophysiological (CEAP classification and divided into degrees C³ (10, C4 (6, C5 (5 and C6 (4. With the patients in the Trendelenburg position, microfoam (5 ml, prepared by mixture of 1 ml polidocanol at 3% and 5 ml of air, was injected in their vein and monitored by color-flow Doppler ultrasonography. The members were then swaddled with inelastic bandage for 3 days; afterward, the patients used 30-40 mmHg, 3

  4. Acute Pancreatitis and Splenic Vein Thrombosis due to Hypertriglyceridemia

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    Ercan Gündüz

    2015-01-01

    Full Text Available Acute pancreatitis (AP is a condition characterised by the activation of the normally inactive digestive enzymes due to an etiological factor and digestion of the pancreatic tissues, resulting in extensive inflammation and leading to local, regional, and systemic complications in the organism. It may vary from the mild edematous to the hemorrhagic and severely necrotising form. The most common causes are biliary stones and alcohol abuse. In this case study, we would like to present a patient with AP due to hypertriglyceridemia (HPTG, which is a rare cause of pancreatitis, and splenic vein thrombosis, which is a rare complication of pancreatitis.

  5. OCT imaging of myocardium extending to pulmonary vein

    Science.gov (United States)

    Li, Zhifang; Dickfeld, Timm; Tang, Qinggong; Wang, Bohan; Chen, Yu

    2016-02-01

    In this study, we propose to use optical coherence tomography to enable a direct visualization of myocardium extending into the pulmonary vein (PV). The results showed that there are obvious differences in the morphology of myocardium and fibrous tissue in the transition region of myocardial sleeve, which is in agreement with the histological analysis. In addition, the myocardial area in transition point has three layers in the depth of 1 mm, and the depth-resolved myocardial fiber show different orientation in the different layers. This characteristic was applied for segmentation of the structures of myocardium extending into PV.

  6. Acute Pancreatitis and Splenic Vein Thrombosis due to Hypertriglyceridemia.

    Science.gov (United States)

    Gündüz, Ercan; Dursun, Recep; İçer, Mustafa; Zengin, Yılmaz; Güloğlu, Cahfer

    2015-01-01

    Acute pancreatitis (AP) is a condition characterised by the activation of the normally inactive digestive enzymes due to an etiological factor and digestion of the pancreatic tissues, resulting in extensive inflammation and leading to local, regional, and systemic complications in the organism. It may vary from the mild edematous to the hemorrhagic and severely necrotising form. The most common causes are biliary stones and alcohol abuse. In this case study, we would like to present a patient with AP due to hypertriglyceridemia (HPTG), which is a rare cause of pancreatitis, and splenic vein thrombosis, which is a rare complication of pancreatitis.

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

    Directory of Open Access Journals (Sweden)

    HP Pant

    2015-06-01

    Full Text Available BACKGROUND Varicosity of lower limb is a common problem in agricultural country like Nepal. Doppler ultrasound is a standard investigation modality for confirmation of diagnosis, evaluation of severity and venous mapping to plan treatment. We aim to find out the epidemiology, common pattern of incompetance, severity assessment by doppler and association of the important doppler variables with skin changes. METHODOLOGY Doppler venous study was done in 56 patients from june 2013 to july 2014. Patients with deep vein thrombosis and peripheral arterial disease were excluded. Altogether 56 patients, 96 limbs were studied. Data was entered in preformed proforma. Doppler study was conducted by senior radiologist with linear probes. Data was entered in SPSS software version 16 and statistical significance was calculated using chi square test. RESULTS Bilateral limb involvement was seen in 40 patients and unilateral in 16 patuents only. Skin related changes were seen in 58 limbs. Saphenofemoral junction incompetance was seen in 79(82.2% limbs and was most common pattern of incompetance. Overall, superficial veins were involved in 88(91.7% limbs and deep in 30(31.2% limbs. Prolonged duration of varicosity (>9 year (p=0.000, bilateral limb involvement(p=0.024, reflux in deep venous system(p=0.002, larger Greater Saphenous Vein (GSV size(p=0.003, prolonged duration of reflux(p=0.000 and perforator incompetence (p=0.002 were associated with skin changes. GSV diameter more than 7 mm was associated with reflux significantly (P=0.002. CONCLUSION Superficial vein incompetance is common pattern compared to deep venous system. Sapheno Femoral Junction (SFJ incompetance is the commonest pattern. Larger caliber of vein, prolonged duration of reflux, reflux in deep venous system and perforator insufficiency are significantly associated with skin changes.DOI: http://dx.doi.org/10.3126/jcmsn.v10i3.12770 Journal of College of Medical Sciences-Nepal, 2014, Vol-10, No-3

  8. 静脉动脉化法治疗皮肤大面积套脱伤的实验研究%An experimental study on the application of arterialization of the vein in treating extensive degloving injury of the skin

    Institute of Scientific and Technical Information of China (English)

    王晓南; 阚世廉

    2014-01-01

    Objective To investigate the influence on the survival of extensively degloved skin by increasing perfusion via venous arterialization.Methods Extensive degloving injury model was created by making 3.3:1 distal-based skin avulsion in 20 rear legs of 10 healthy Japanese white rabbits.The legs of each rabbit were randomly assigned as the experimental side and control side.On the experimental side,nutrition vessels from the posterior tibial artery and vein were severed and the proximal artery was anastomosed to the distal vein.Both the greater and lesser saphenous veins were anastomosed.On the control side only the greater and lesser saphenous veins were anastomosed.Results On the experimental side 60.2% of the degloved skin survived,while 50.5% of the degloved skin survived on the control side.The difference was statistically significant (P < 0.05).Skin contraction was 26.9% on the experimental side and 31.9% on the control side,the difference not being significant (P > 0.05).Blood gas analysis of groin veins was 41.32 mmHg on the control side and 60.35 mmHg on the experimental side for venous blood PaO2.The difference was statistically significant (P < 0.05).Conclusion Arterialization of the vein can augment blood perfusion of degloved skin and increase skin survival.However,as a non-physiological blood circulation,it also promotes blood congestion,tissue swelling and fibrosis of the degloved skin.%目的 探讨以静脉动脉化法增加血液灌注对大面积套脱皮肤成活的影响.方法 选取健康日本大耳白兔10只,将其双后肢随机分为实验侧和对照侧,制成3.3:1的皮肤逆行套脱伤的动物模型,实验侧将小腿近端胫后动静脉发出的皮肤营养血管切断,将动脉近端与静脉远端吻合,并吻合大隐静脉和小隐静脉;而对照侧只吻合大隐静脉和小隐静脉.结果 对照侧套脱皮肤平均成活50.5%,实验侧套脱皮肤平均成活60.2%,两者差异有统计学意义(P<0.05);

  9. [Parasitism of the vena cava and adrenal veins in chronic chagasic patients].

    Science.gov (United States)

    Teixeira, V de P; Almeida, H de O; dos Reis, M A; Silveira, S A; Araujo, M B

    1989-01-01

    The occurrence of nest of trypanosoma cruzi in the smooth muscle cells of the central veins of the adrenal glands and the inferior vena cava was studied in 21 chronic Chagas' patients, by serial sections. Nine patients presented parasites in the adrenal veins, with a total of 24 nests, and only one nest was found in the inferior vena cava. The area of muscular tissue examined was of 2944.3 mm2 for the adrenal veins and of 47808.6 mm2 for the vena cava, giving a relation of 0.815 nests/100 mm2 for the adrenal vein and of 0.002 for the vena cava. Thus the smooth muscle of the adrenal vein was 407 times more parasited than the muscular wall of the inferior vena cava. This higher parasitism of the adrenal vein by trypanosoma cruzi in chronic Chagas' disease may be determined by its greater corticosteroid concentration, which can reduce the anti-trypanosomal defenses.

  10. Reducing intimal hyperplasia in vein grafts harvested by a no-touch harvesting technique

    Institute of Scientific and Technical Information of China (English)

    Hai-chen Wang; Wu-jun Xue; Miao-miao Liu

    2009-01-01

    Objective To investigate the effect of no-tonch harvesting technique in reducing vein graft intimal hyperplasin. A4othods This longitudinal trial compared graft ungiestenosis of two groups undergoing jugular vein to carotid artery interposition grafting in rabbit model. Conventional group: 12 rabbits had their veins stripped, distended, and stored in heparinized saline solution. No-touch group: 12 rabbits had veins removed with surrounding tissues, but were not distended, and stored in heparinized blood. The grafts were removed 4 weeks following grafting, and morphometry and immunohistochemistry assessment were performed. Results The intimal thickness, degree of anginstennsis and proliferation index of vascular smooth muscle cells of no-touch group were significantly reduced (P< 0.01) compared with those of the conventional group. The proliferating cell nuclear antigen pnsitive-staining cells were significantly increased (P<0.01) in the conventional group compared with whose in the no-touch group. Conclusion Harvesting the vein graft with no-touch harvesting technique could significantly reduce intimul hyperpinsin of the vein graft.

  11. Establishing a hemodialysis vascular access with autologous vein transplantation%自体静脉移植建立的血液透析血管通路

    Institute of Scientific and Technical Information of China (English)

    张凡; 王涛; 吴晓波; 朱军; 程悦; 莫立稳

    2014-01-01

    BACKGROUND:Currently, literatures about autologous vein transplantation are few, and the research on the effect of different parts of autologous vein transplantation are not found yet. OBJECTIVE:To summarize the experiences of establishing the fistula using autologous vein transplantation so as to investigate the method of improving the success rate of surgery. METHODS:We analyzed retrospectively the data of 40 cases of establishing the fistula using autologous vein transplantation, and then compared the successful rate of autologous vein transplantation fistula, blood flow and operating time, thereby analyzing the influence of diabetes melitus on the successful rate of autologous vein transplantation fistula. RESULTS AND CONCLUSION:The successful rates of autologous vein transplantation fistula at different parts ranging from high to low were as folows: the cephalic vein, great saphenous vein, basilic vein and smal saphenous vein. Blood flow of the upper limb for vein transplantation fistula was obviously higher than that of the lower limb (P < 0.05). The operating time of autologous vein transplantation fistula was longer in the upper limbs than in the lower limbs (P < 0.01). For patients with diabetes melitus, the successful rate of autologous vein transplantation was markedly lower than those with no diabetes melitus (P < 0.01). For the hemodialysis patients with poor upper limb superficial vein, autologous vein transplantation is a better way of establishing the vascular access. Vein transplantation of the upper limbs is better than that of the lower limbs in success rate and operating time. Autologous vein transplantation fistula is not suitable for the patients with diabetes melitus.%背景:目前关于自体静脉移植建立内瘘的文章较少,尤其针对不同部位自体静脉移植效果的总结尚未见报道。目的:总结自体静脉移植内瘘的建立经验,探索提高手术成功率的方法。方法:回顾性分析40例自体静

  12. Radiological features of azygous vein aneurysm.

    Science.gov (United States)

    Choudhary, Arabinda Kumar; Moore, Michael

    2014-04-01

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

  13. Portal vein gas in emergency surgery

    Directory of Open Access Journals (Sweden)

    Mahmood Hind

    2008-07-01

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

  14. Is Transcatheter Aortic Valve Implantation of Living Tissue-Engineered Valves Feasible? An In Vitro Evaluation Utilizing a Decellularized and Reseeded Biohybrid Valve.

    Science.gov (United States)

    Koenig, Fabian; Lee, Jang-Sun; Akra, Bassil; Hollweck, Trixi; Wintermantel, Erich; Hagl, Christian; Thierfelder, Nikolaus

    2016-08-01

    Transcatheter aortic valve implantation (TAVI) is a fast-growing, exciting field of invasive therapy. During the last years many innovations significantly improved this technique. However, the prostheses are still associated with drawbacks. The aim of this study was to create cell-seeded biohybrid aortic valves (BAVs) as an ideal implant by combination of assets of biological and artificial materials. Furthermore, the influence of TAVI procedure on tissue-engineered BAV was investigated. BAV (n=6) were designed with decellularized homograft cusps and polyurethane walls. They were seeded with fibroblasts and endothelial cells isolated from saphenous veins. Consecutively, BAV were conditioned under low pulsatile flow (500 mL/min) for 5 days in a specialized bioreactor. After conditioning, TAVI-simulation was performed. The procedure was concluded with re-perfusion of the BAV for 2 days at an increased pulsatile flow (1100 mL/min). Functionality was assessed by video-documentation. Samples were taken after each processing step and evaluated by scanning electron microscopy (SEM), immunohistochemical staining (IHC), and Live/Dead-assays. The designed BAV were fully functioning and displayed physiologic behavior. After cell seeding, static cultivation and first conditioning, confluent cell layers were observed in SEM. Additionally, IHC indicated the presence of endothelial cells and fibroblasts. A significant construction of extracellular matrix was detected after the conditioning phase. However, a large number of lethal cells were observed after crimping by Live/Dead staining. Analysis revealed that the cells while still being present directly after crimping were removed in subsequent perfusion. Extensive regions of damaged cell-layers were detected by SEM-analysis substantiating these findings. Furthermore, increased ICAM expression was detected after re-perfusion as manifestation of inflammatory reaction. The approach to generate biohybrid valves is promising. However

  15. Inhibition of vein graft stenosis with a c-jun targeting DNAzyme in a cationic liposomal formulation containing 1,2-dioleoyl-3-trimethylammonium propane (DOTAP)/1,2-dioleoyl-sn-glycero-3-phosphoethanolamine (DOPE).

    Science.gov (United States)

    Li, Yue; Bhindi, Ravinay; Deng, Zhou J; Morton, Stephen W; Hammond, Paula T; Khachigian, Levon M

    2013-10-09

    Coronary artery bypass grafting (CABG) is among the most commonly performed heart surgical procedures. Saphenous vein graft failure due to stenosis impedes the longer-term success of CABG. A key cellular event in the process of vein graft stenosis is smooth muscle cell hyperplasia. In this study, we evaluated the effect of a DNAzyme (Dz13) targeting the transcription factor c-Jun in a rabbit model of vein graft stenosis in a cationic liposomal formulation containing 1,2-dioleoyl-3-trimethylammonium propane (DOTAP)/1,2-dioleoyl-sn-glycero-3-phosphoethanolamine (DOPE). Dz13 in DOTAP/DOPE has undergone preclinical toxicological testing, and a Phase I clinical trial we recently conducted in basal cell carcinoma cancer patients demonstrates that it is safe and well tolerated after local administration. Effects of Dz13 in a formulation containing DOTAP/DOPE on smooth muscle cell (SMC) growth and c-Jun expression were assessed. Dz13 transfection was determined by cellular uptake of carboxyfluorescein-labeled Dz13. Autologous jugular vein to carotid artery transplantation was performed in New Zealand White rabbits to investigate the effect of the Dz13 in DOTAP/DOPE formulation on intimal hyperplasia. Dz13/DOTAP/DOPE reduced SMC proliferation and c-Jun protein expression in vitro compared with an impotent form of Dz13 bearing a point mutation in its catalytic domain (Dz13.G>C). The Dz13(500 μg)/DOTAP/DOPE formed lipoplexes that were colloidally stable for up to 1h on ice (0°C) and 30 min at 37°C, allowing sufficient uptake by the veins. Dz13 (500 μg) inhibited neointima formation 28 d after end-to-side transplantation. This formulation applied to veins prior to transplantation may potentially be useful in efforts to reduce graft failure. © 2013.

  16. 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.

  17. A Primary Primitive Neuroectodermal Tumor Arising from Left Subclavian Vein and Extending along Left Brachiocephalic Vein and Superior Vena Cava into Right Atrium.

    Science.gov (United States)

    Wang, Jian; Wang, Weici; Li, Yiqing; Jin, Bi; Yu, Miao; Liu, Wenqi; Yao, Shaohua; Liao, Yonggui; Ouyang, Chenxi

    2015-01-01

    Primitive neuroectodermal tumor (PNET) is an extremely rare malignancy thought to be derived from fetal neuroectodermal precursor cells. It usually occurs in central and peripheral nervous system or soft tissue and bone, while intravenous or intracavitary PNET is considered as an extremely rare tumor. We reported a case of a 44-year-old woman who presented with the left unilateral facial and neck swelling. Magnetic resonance imaging revealed a tape-shaped solid mass within left subclavian vein, left brachiocephalic vein, superior vena cava, and right atrium; the proximal end proportion occupied almost the entire right atrium with a pedicle flip protruded into the right ventricle. Ultrasonography revealed an irregular hypoechnoic mass arising from the left subclavian vein, which extended along the left brachiocephalic vein and superior vena cava into the right atrium and up to the right ventricle. Positron emission tomography-computed tomography revealed several hypermetabolic thyroid nodules with no evidence of intravenous hyperactive lesion. The patient underwent tumor resection under cardiopulmonary bypass. At 15 days postoperatively, total thyroidectomy and resection of the left subclavian vein were simultaneously performed. The patient received chemotherapy and radiotherapy later. Histologically, the neoplasm displayed small, round, blue cells with hyperchromatic nuclei and scant cytoplasm. The neoplastic cells showed a strong immunopositivity for CD99, synaptophysin, CD56, CD57, and friend leukemia integration 1, thus confirming a diagnosis of the PNET. Histopathological examination of the thyroid showed papillary carcinoma. Thus, this PNET had no definitive organ or tissue of origin, which primarily originated from the left subclavian vein with tumor extension along the superior vena cava to the right ventricle.

  18. Effect of different puncture sites of vein indwelling trocar for infants with congenital heart disease%不同部位静脉留置针穿刺在先天性心脏病患儿输液中的效果

    Institute of Scientific and Technical Information of China (English)

    郑中燕; 李娜; 梁洁

    2013-01-01

    Objective To compare successful rates among 3 different puncture sites of vein indwelling trocar for infants with congenital heart disease,and analyze failure reasons.Methods A total of 327 infants with congenital heart disease were randomly divided into 3 groups:the superficial temporal vein group with 106 cases,the dorsal hand vein group with 120 cases and the great saphenous vein group with 101 cases.The successful rates and influencing factors of these three groups were observed and analyzed.Results The successful puncture rate of superficial temporal vein group (92.45%) was higher than the dorsal hand vein group (80.83%) and the great saphenous vein group (80.20%),and the differences were statistically significant (x2 =6.151 8,6.371 5,respectively; P < 0.05).The difference of successful rate between the dorsal hand vein group and great saphenous vein group was not statistically significant (P > 0.05).The differences of failure rates among three groups due to infants' struggle,over-quick withdrawal,quality of indwelling needles and etc were all not statistically significant (P > 0.05).The failure rate in the superficial temporal vein group due to non turgor vitalis was 0.00%,obviously lower than that in the dorsal hand vein group (7.50%) and the great saphenous vein group(5.94%),and the differences were statistically significant (x2 =8.7048,6.985 2,respectively; P < 0.01).There was no significant difference of failure rates due to non turgor vitalis between the dorsal hand vein group and the great saphenous vein group (P > 0.05).Conclusions Superficial temporal vein should be considered as the first choice for infants with congenital heart disease who need vein indwelling trocar puncture,so as to improve the successful puncture rate.%目的 探讨先天性心脏病患儿不同部位给予静脉留置针穿刺的成功率及失败原因.方法 将327例先天性心脏病患儿按随机数字表法随机分为颞浅静脉组106

  19. Hand vein recognition based on orientation of LBP

    Science.gov (United States)

    Bu, Wei; Wu, Xiangqian; Gao, Enying

    2012-06-01

    Vein recognition is becoming an effective method for personal recognition. Vein patterns lie under the skin surface of human body, and hence provide higher reliability than other biometric traits and hard to be damaged or faked. This paper proposes a novel vein feature representation method call orientation of local binary pattern (OLBP) which is an extension of local binary pattern (LBP). OLBP can represent the orientation information of the vein pixel which is an important characteristic of vein patterns. Moreover, the OLBP can also indicate on which side of the vein centerline the pixel locates. The OLBP feature maps are encoded by 4-bit binary values and an orientation distance is developed for efficient feature matching. Based on OLBP feature representation, we construct a hand vein recognition system employing multiple hand vein patterns include palm vein, dorsal vein, and three finger veins (index, middle, and ring finger). The experimental results on a large database demonstrate the effectiveness of the proposed approach.

  20. Ventriculoatrial shunting via the azygos vein.

    Science.gov (United States)

    Balasubramaniam, C; DuBois, J J; Laurent, J P; Pokorny, W J; Harberg, F J; Cheek, W R

    1990-06-01

    The treatment of hydrocephalus has evolved through many stages but the "cure" is still elusive. It is not unusual for the neurosurgeon to find that the commonly used routes for catheter placement or sites for drainage of cerebrospinal fluid (CSF) cannot be employed. The azygos vein was used to gain access to the right atrium when the CSF could not be drained into the peritoneal cavity, nor could the neck veins be used to place the catheter into the right atrium. The azygos vein is a convenient and safe route to reach the right atrium in selected patients.

  1. Portal Decompression Using the Inferior Mesenteric Vein

    Directory of Open Access Journals (Sweden)

    Paolo Gorini

    1998-01-01

    Full Text Available We report five patients with variceal hemorrhage, in three cases secondary to diffuse thrombosis of the portal, superior mesenteric and splenic veins. Mesenteric angiography demonstrated patency of the inferior mesenteric vein (IMV in each, and successful portal decompression by anastomosis of the IMV to the left renal vein (n=4 or the inferior vena cava (n=1 was accomplished. Bleeding was permanently controlled: four patients have survived from one to eight years post-operatively. Because shunt procedures utilizing the IMV are technically straightforward, subtotally decompress the portal system and avoid the right upper quadrant, they may be advantageous in certain clinical settings.

  2. [FEATURES LIVER TRANSPLANTATION IN PORTAL VEIN THROMBOSIS].

    Science.gov (United States)

    Abbasov, P A

    2015-07-01

    In 2012 - 2013 years in 265 patients for liver transplantation was performed, including in 224 (84.5%)--from a living donor, in 41 (15.5%)--from the dead body. Using a Foley catheter to stop bleeding, and the imposition of vascular sutures during endovenectomy in portal vein thrombosis (PVT) and its possible damage under all conditions. In particular, PVT IV degree (Grade IV) in order to restore blood flow in the graft using the left gastric and renal vein is an alternative, if they are cryopreserved vein may be suitably used.

  3. Varicose veins--Who should be referred?

    Science.gov (United States)

    Onida, Sarah; Davies, Alun H; Franklin, Ian

    2015-11-01

    Varicose veins are a common, progressive condition in the UK, with significant negative effects on patients' quality of life. Despite their prevalence, access to secondary care for the assessment and treatment of varicose veins can be variable throughout the country.The National Institute of Health and Care Excellence guidelines developed in 2013 provide evidence-based guidance on the referral, assessment, and management of the patient with venous disease.In this article, we review the development of the guidelines for the management of varicose veins over the last 15 years, highlighting the latest changes in referral criteria.

  4. Decreased plasma levels of activated factor VII in patients with deep vein thrombosis

    NARCIS (Netherlands)

    Schut, A. M.; Meijers, J. C. M.; Lisman-van Leeuwen, Y.; van Montfoort, M. L.; Roest, M.; de Groot, P. G.; Urbanus, R. T.; Coppens, M.; Lisman, T.

    2015-01-01

    BackgroundThe initiating trigger in the development of deep vein thrombosis (DVT) remains unidentified. It has been suggested that tissue factor (TF)-bearing microparticles play a key role, which indicates a role for the TF pathway in the initiation of DVT. ObjectiveTo assess the role of the TF path

  5. VeinPLUS: A Transillumination and Reflection-based Hand Vein Database

    OpenAIRE

    Gruschina, Alexander

    2015-01-01

    This paper gives a short summary of work related to the creation of a department-hosted hand vein database. After the introducing section, special properties of the hand vein acquisition are explained, followed by a comparison table, which shows key differences to existing well-known hand vein databases. At the end, the ROI extraction process is described and sample images and ROIs are presented.

  6. [Retinal vein occlusion in a young patient].

    Science.gov (United States)

    Zemba, Mihail; Ochinciuc, Uliana; Sarbu, Laura; Avram, Corina; Camburu, Raluca; Stamate, Alina

    2013-01-01

    We present a case report of a 27 years old pacient with central retinal vein occlussion and macular edema. The pacient has a significant reduction of the macular aedema with complete recovery of vision after the treatment.

  7. Vein of Galen Malformation: Outcome after Embolization

    Directory of Open Access Journals (Sweden)

    J Gordon Millichap

    2003-12-01

    Full Text Available The neurodevelopmental outcome after endovascular treatment of vein of Galen malformation (VOGM in 27 patients seen between 1983 and 2002 was assessed by chart review and parental questionnaires at the University of California, San Francisco.

  8. 小切口治疗单纯下肢大隐静脉曲张(附120例报告)%Clinical significance of mini-incision treatment in simple varicose veins in 120 cases

    Institute of Scientific and Technical Information of China (English)

    沈华; 龚凯

    2008-01-01

    目的 探讨治疗单纯下肢大隐静脉曲张的手术方式.方法 回顾性分析本院和同济医院自2000年至2006年共120例单纯下肢大隐静脉曲张的临床资料.120例采用小切口大隐静脉高位接扎、分段抽剥,属支及交通支结扎术.分析该手式操作要点及术后并发症处理的临床意义.结果 120例患者术后均顺利康复,随访1~5年,无一例复发.术后22倒出现患肢踝关节以下肿胀,全部患肢均有不同程度皮下瘀斑,无患肢深静脉血栓形成和切口感染.结论 该术式是单纯下肢静脉曲张的基本治疗方法,属微创手术,易于在基层医院开展.术中快速止血、彻底结扎交通支,术后加压包扎,活动踝关节,早期下床活动,能显著减少术后并发症的发生率.%Objective To explore the operative method in simple varicose vein of lower extremities. Methods The data of 120 cases of simple varicose veins of lower extremities under mini - incision high ligation of great saphenous vein and ligation of perforators from 2000 to 2006 in Nanxiang Hospital and Tongji Hospital were retrospectively studied. Results 120 cases were all cured and left hospital. Followed up 1 year to 5 years, no case recurred. 22 cases appeared swelling blow ankle in operative legs. All patients had sub dermal ecchymosis with different degress in operative legs,there was no infection of ineisional wound and deep venous thrombosis. Conclnsion Mini-incision high ligation of great saphenous vein and ligation of perforators is a basic operative method for simple varicose veins of lower extremities, which can be applied in basic level hospitals. Close haemostasis, completely ligation,pressure dressing postoperative, ankle acting and early ambulation can reduce postoperative complications significantly.

  9. 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.

  10. CT in thrombosed dilated posterior epidural vein

    Energy Technology Data Exchange (ETDEWEB)

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

    1987-05-01

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

  11. Primary leiomyosarcoma of the innominate vein.

    Science.gov (United States)

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

    2007-01-01

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

  12. Branch Retinal Vein Occlusion and Its Management

    Institute of Scientific and Technical Information of China (English)

    Desmond; Archer

    1992-01-01

    The natural course of Branch Retinal Vein Occlusion is determined by the site and completeness of the occlusion, the integrity of arterial perfusion to the affected sector and the efficiency of the developing collateral circulation. Most patients with tributary vein occlusion have some capillary fall out and microvascular incompetence in the distribution of the affected retina and vision is significantly compromised in over 50% of patients who have either chronic macular oedema or ischemia involving the...

  13. Portal vein thrombosis in children and adolescents.

    Science.gov (United States)

    Schettino, Graziela C M; Fagundes, Eleonora D T; Roquete, Mariza L V; Ferreira, Alexandre R; Penna, Francisco J

    2006-01-01

    To review the literature on portal vein thrombosis in children and adolescents, focusing on its diagnosis, complications and treatment. The medical literature of the past 10 years was reviewed using the PubMed and MEDLINE search engines, with major focus on portal vein thrombosis and its clinical outcomes. The following keywords or expressions were used for the web search: portal vein thrombosis, extra-hepatic portal vein obstruction, prognosis, children, portal hypertension, esophagogastric varices. Additionally, we also reviewed the articles cited in the references of the initially selected papers, as well as relevant textbooks. Portal vein thrombosis is one of the most common causes of portal hypertension among children. The initial clinical manifestation is characterized either by episodes of upper gastrointestinal bleeding or by splenomegaly on routine clinical examination. The major complications include upper gastrointestinal bleeding, hypersplenism secondary to splenomegaly, growth retardation, and portal biliopathy. The diagnosis is made by abdominal Doppler ultrasonography. Treatment is targeted at the complications and includes primary and secondary prophylaxis against upper gastrointestinal bleeding (which results from the rupture of esophageal varices), and portosystemic shunting in selected cases. Portal vein thrombosis is one of the major triggers of upper gastrointestinal bleeding in children. Bleeding episodes have a remarkable effect on the quality of life of affected patients. Thus, appropriate diagnosis and treatment are needed in order to reduce morbidity and mortality.

  14. 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.

  15. Endovenous laser treatment of lower extremity varicose veins:problems and solutions%静脉腔内激光治疗术在治疗下肢浅静脉曲张中的问题和对策

    Institute of Scientific and Technical Information of China (English)

    黄英; 蒋米尔

    2009-01-01

    下肢浅静脉曲张最常见的病因是原发性深静脉瓣膜功能不全(primary deep venous insufficiency, PDVI) 和大隐静脉(great saphenous vein,GSV) 功能不全。根据不同的病因,传统手术包括各种深静脉瓣膜重建、交通静脉结扎、曲张浅静脉结扎及抽剥术,除手术和麻醉风险外,还存在术后遗留手术瘢痕影响肢体美观,住院及康复时间延长,以及不能避免术后复发等问题。

  16. Evaluation of leg varicose veins by MR venography

    Energy Technology Data Exchange (ETDEWEB)

    Kojima, Yoshifumi; Shiraishi, Tomokuni; Taira, Mitsuru [Kansai Medical Univ., Neyagawa, Osaka (Japan). Kohri Hospital; Imamura, Atsushi; Yamada, Hitoshi; Okuno, Masafumi; Kamiyama, Yasuo

    1998-11-01

    Preoperative evaluation was conducted on 30 patients with leg varicose veins by MR venography (MRV), and compared with conventional venography, MR images were performed by the 3D-SMASH Method. Compared with venography, MRV could more clearly demonstrate leg varicose veins with perforating veins than venography. It could detected fine varicose veins more than 2 mm in diameter, and deep veins. Furthermore, 3D observation enables accurate detection of the location of perforating vein. In conclusion, MRV is useful for the diagnosis of leg varicose vein. (author)

  17. Lower Limb Varicose Vein or Swelling Secondary to Cockett Syndrome%Cockett 综合征继发下肢静脉曲张或下肢肿胀25例

    Institute of Scientific and Technical Information of China (English)

    朱健; 王孝运; 陈健

    2016-01-01

    目的:探讨 Cockett 综合征继发下肢静脉曲张或下肢肿胀的治疗方法及疗效。方法2014年3月~2015年3月我科对25例经血管造影明确诊断的 Cockett 综合征(继发下肢静脉曲张22例,下肢肿胀3例)行髂静脉经皮腔内血管成形术(percutaneous transluminal angiography,PTA),19例支架置入,22例静脉曲张二期行大隐静脉高位结扎联合点式剥脱术。结果25例均行髂静脉 PTA,下肢静脉曲张17例行髂静脉支架置入,下肢肿胀2例行髂静脉支架置入。22例下肢静脉曲张介入术后1个月行下肢大隐静脉高位结扎联合点式剥脱术。术后无明显下肢肿胀、下肢感染、深静脉血栓形成等并发症。术后1个月随访下肢肿胀治愈20例,好转5例。25例随访3~15个月,平均12.4月,无一例出现下肢明显肿胀、下肢静脉曲张复发及下肢深静脉血栓形成。结论Cockett 综合征行髂静脉 PTA,根据髂静脉狭窄情况决定是否行支架置入,术后下肢肿胀能够明显缓解,对于继发下肢静脉曲张的患者1个月后再行大隐静脉高位结扎联合点式剥脱术,手术效果显著。%Objective To explore the treatment method and curative effect for lower limb varicose vein or swelling secondary to Cockett syndrome. Methods From March 2014 to March 2015,a total of 25 cases of lower limb varicose vein (22 cases)or swelling (3 cases)secondary to Cockett syndrome were treated with percutaneous transluminal angiography (PTA).Stents were placed in the veins in 19 cases,and 22 patients with varicose veins were treated with the great saphenous vein high ligation and point type stripping at secondary stage. Results The operations were successful.The iliac vein PTA was performed in all the 25 patients.The iliac vein stent implantation was performed in 17 cases of varicose veins and 2 cases of lower limb swelling.The saphenous vein high ligation and point type stripping was performed

  18. Scattering Removal for Finger-Vein Image Restoration

    OpenAIRE

    Jinfeng Yang; Ben Zhang; Yihua Shi

    2012-01-01

    Finger-vein recognition has received increased attention recently. However, the finger-vein images are always captured in poor quality. This certainly makes finger-vein feature representation unreliable, and further impairs the accuracy of finger-vein recognition. In this paper, we first give an analysis of the intrinsic factors causing finger-vein image degradation, and then propose a simple but effective image restoration method based on scattering removal. To give a proper description of f...

  19. An effective preprocessing method for finger vein recognition

    Science.gov (United States)

    Peng, JiaLiang; Li, Qiong; Wang, Ning; Abd El-Latif, Ahmed A.; Niu, Xiamu

    2013-07-01

    The image preprocessing plays an important role in finger vein recognition system. However, previous preprocessing schemes remind weakness to be resolved for the high finger vein recongtion performance. In this paper, we propose a new finger vein preprocessing that includes finger region localization, alignment, finger vein ROI segmentation and enhancement. The experimental results show that the proposed scheme is capable of enhancing the quality of finger vein image effectively and reliably.

  20. 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

  1. Augmented reality based real-time subcutaneous vein imaging system

    OpenAIRE

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

    2016-01-01

    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. V...

  2. Leaf vein segmentation using Odd Gabor filters and morphological operations

    OpenAIRE

    Katyal, Vini; Aviral

    2012-01-01

    Leaf vein forms the basis of leaf characterization and classification. Different species have different leaf vein patterns. It is seen that leaf vein segmentation will help in maintaining a record of all the leaves according to their specific pattern of veins thus provide an effective way to retrieve and store information regarding various plant species in database as well as provide an effective means to characterize plants on the basis of leaf vein structure which is unique for every specie...

  3. Nutcracker Syndrome Complicated by Left Renal Vein Thrombosis

    Directory of Open Access Journals (Sweden)

    Faouzi Mallat

    2013-01-01

    Full Text Available Isolated renal vein thrombosis is a rare entity. We present a patient whose complaint of flank pain led to the diagnosis of a renal vein thrombosis. In this case, abdominal computed tomography angiography was helpful in diagnosing the nutcracker syndrome complicated by the renal vein thrombosis. Anticoagulation was started and three weeks later, CTA showed complete disappearance of the renal vein thrombosis. To treat the Nutcracker syndrome, we proposed left renal vein transposition that the patient consented to.

  4. Nutcracker syndrome complicated by left renal vein thrombosis.

    Science.gov (United States)

    Mallat, Faouzi; Hmida, Wissem; Jaidane, Mehdi; Mama, Nadia; Mosbah, Faouzi

    2013-01-01

    Isolated renal vein thrombosis is a rare entity. We present a patient whose complaint of flank pain led to the diagnosis of a renal vein thrombosis. In this case, abdominal computed tomography angiography was helpful in diagnosing the nutcracker syndrome complicated by the renal vein thrombosis. Anticoagulation was started and three weeks later, CTA showed complete disappearance of the renal vein thrombosis. To treat the Nutcracker syndrome, we proposed left renal vein transposition that the patient consented to.

  5. Gonadal vein tumor thrombosis due to renal cell carcinoma.

    Science.gov (United States)

    Haghighatkhah, Hamidreza; Karimi, Mohammad Ali; Taheri, Morteza Sanei

    2015-01-01

    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.

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

    Directory of Open Access Journals (Sweden)

    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.

  7. 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.

  8. Pretreatment with intraluminal rapamycin nanoparticle perfusion inhibits neointimal hyperplasia in a rabbit vein graft model

    Directory of Open Access Journals (Sweden)

    Kai Liu

    2010-10-01

    -PLGA-NP perfusion may inhibit neointimal hyperplasia in vein grafts by penetrating into local tissue and limiting cell proliferation.Keywords: autograft, stenosis, jugular vein, transplants

  9. [Calcified deep vein thrombosis in a patient with recurrent deep vein thrombosis and sarcoidosis].

    Science.gov (United States)

    Krmek, Dubravka Zupanić; Brajković, Ivana; Bekić, Dinko; Krnić, Antun; Jurković, Petar; Pavlović, Tomislav

    2013-12-01

    In this article, we present a rare case of calcified deep vein thrombosis in a 42-year-old female patient with frequent relapses of pulmonary sarcoidosis since 1995, for which she was on maintenance therapy with corticosteroids and with consequential secondary diabetes. Recent femoral vein thrombosis was diagnosed with color Doppler in 2012. At the same time, calcified occlusive thrombus in vena cava inferior from the level of renal vein to the confluence of hepatic veins was diagnosed on abdominal multi-slice computed tomography (MSCT). Digital subtraction venography (DSV) revealed a well-developed collateral circulation through the paravertebral veins, azygos and hemiazygos vein. There were no risk factors for thrombosis other than sarcoidosis and diabetes. Deep vein thrombosis is rarely described with sarcoidosis, but according to literature reports, it usually appears as a recurrence and simultaneously at multiple locations. According to the current knowledge, we cannot say for sure whether it is a disease with an increased risk of deep vein thrombosis or there is a combination of multiple risk factors present simultaneously.

  10. Perivenous application of fibrin glue prevents the early injury of jugular vein graft to arterial circulation in rabbits

    Institute of Scientific and Technical Information of China (English)

    WAN Li; LI Dian-yuan; YANG Bing; WU Qing-yu

    2006-01-01

    Background Placement of an external support has been reported to prevent intimal hyperplasia of vein grafts. However, it is limited by potential complications. In the present study, we investigated the effect of fibrin glue on preventing vein graft failure as perivenous application. Methods Twenty-four rabbits were divided into non-supported group (n=12) and fibrin glue group (n=12). All animals underwent unilateral jugular vein into common carotid artery interposition grafting and then fibrin glue was applied as perivenous support. Samples of tissues were harvested after 4 weeks. Results The vein grafts with fibrin glue demonstrated a statistically significant decrease in proliferating cell nuclear antigen in the medial/intimal region [13.38% (11.26%-15.11%)] compared with non-supported vein grafts [31.22% (27.15%-35.98%)] (P<0.001). Light microscopy showed remarkable attenuation of endothelial cell loss and numerous microvessels in neoadventitia in the fibrin glue group compared with the non-supported group. The smooth muscle cells migrated into adventitia significantly in fibrin glue group, whereas the smooth muscle cells migrated into intima in non-supported group.Conclusion Perivenous support of vein graft with fibrin glue in vivo can attenuate the severe injury encountered in the non-supported vein grafts exposed to artery.

  11. Standards of the Polish Ultrasound Society - update. Sonography of the lower extremity veins.

    Science.gov (United States)

    Małek, Grzegorz; Nowicki, Andrzej

    2014-09-01

    This article has been prepared on the basis of the Ultrasonography Standards of the Polish Ultrasound Society (2011) and updated based on the latest findings and reports. Ultrasound examination of the lower extremity veins is relatively easy and commonly used to confirm or rule out venous thrombosis. However, a relatively easy compression test frequently requires experience, particularly in situations when imaging is difficult (due to lymphedema, dressing or thick tissues). The technique is time-consuming and requires assessment of each deep vein every 1 cm. Lesions in the deep veins cannot be ruled out when the vessels are assessed in only 2-3 points - a full examination is needed. The value of the method is the highest when the proximal section is assessed and the lowest when crural veins are evaluated. Doppler sonography is the basic method used when patients are prepared for a surgery of varicose veins. The assessment of the superficial veins prior to this procedure is tedious and requires knowledge of anatomy together with numerous variants. A considerable challenge is posed by re-assessment of recurrent varicose veins following a previous surgery. The Standards include anatomic nomenclature proposed by the Polish Society for Vascular Surgery and Polish Society of Phlebology, which should facilitate communication with clinicians. The most beneficial patient positions have been thoroughly discussed in terms of safety and effectiveness of the examination. Sometimes during such an examination, no venous pathology is found, but other changes with symptoms that suggest deep thrombophlebitis are detected. In such a situation, it is necessary to conduct an initial (or complete, if possible) assessment of lesions as well as provide recommendations connected with further, more detailed diagnosis.

  12. Effects of albendazole nanoparticles in mice with hepatic echinococosis: Portal vein cannulation versus intravenous administration.

    Science.gov (United States)

    Zhu, Di-Wen; Zhang, Ming-Xing; Bao, Ying-Jun; Gu, Jun-Peng; Ji, Wei-Zheng; Zhang, Hai-Xiao; Ren, Wei-Xin

    2015-07-01

    To compare the ABZ and its metabolites concentration in cyst tissue of hepatic alveolar echinococcosis administered by different routes, forty male Wistar rats receiving albendazole nanoparticles from tail vein and portal vein were divided into two groups, the concentration of ABZ and its metabolites ABZSO, ABZSO2, in the cyst tissue, were analyzed by HPLC at 2, 4, 8, 24, 36 h after administration. The parent drug and its metabolites were detected in plasm and the cyst tissue after portal cannulation and intravenous administration. The last results were the concentration of ABZ in the portal cannulation group was higher than in the intravenous group at every time point (p < 0.05). Compared to the intravenous group, the portal cannulation administration of ABZ led to a lower plasm concentration of ABZ. The concentration of ABZ and the active ABZSO were significantly higher in the portal cannulation group than that of the intravenous group.

  13. Veining Failure and Hydraulic Fracturing in Shales

    Science.gov (United States)

    Mighani, S.; Sondergeld, C. H.; Rai, C. S.

    2014-12-01

    During the hydraulic fracturing, the pressurized fluid creates new fractures and reactivates existing natural fractures forming a highly conductive Stimulated Reservoir Volume (SRV) around the borehole. We extend the previous work on Lyons sandstone and pyrophyllite to anisotropic shale from the Wolfcamp formation. We divide the rock anisotropy into two groups: a) conventional and b) unconventional (shaly) anisotropy. X-ray Computed Tomography (CT), compressional velocity anisotropy, and SEM analysis are used to identify three causes of anisotropy: bedding planes, clay lamination, and calcite veins. Calcite vein is a subsequently filled with calcite bonded weakly to the matrix. Velocity anisotropy and visual observations demonstrate the calcite filled veins to be mostly subparallel to the fabric direction. Brazilian tests are carried out to observe the fracture initiation and propagation under tension. High speed photography (frame rate 300,000 frame/sec) was used to capture the failure. Strain gauges and Acoustic Emission (AE) sensors recorded the deformation leading up to and during failure. SEM imaging and surface profilometry were employed to study the post-failure fracture system and failed surface topology. Fracture permeability was measured as a function of effective stress. Brazilian tests on small disks containing a centered single vein revealed the shear strength of the veins. We interpret the strain data and number, frequency, and amplitude of AE events which are correlated well with the observed fracture process zone, surface roughness, and permeability. The unpropped fracture has enhanced permeability by two orders of magnitude. The observed anisotropic tensile failure seems to have a universal trend with a minimum strength occurring at 15o orientation with respect to the loading axis. The veins at 15o orientation with respect to the loading axis were easily activated at 30% of the original failure load. The measured strength of the vein is as low as 6

  14. Evaluation of corporal fibrosis in cadaveric pericardium and vein grafts for tunica albuginea substitution in rats

    Institute of Scientific and Technical Information of China (English)

    SomboonLeungwattanakij; VaewvadeeTiewthanom; WayneJ.G.Hellstrom

    2003-01-01

    Aim: To evaluate the degree of corporal fibrosis in rats with cadaveric pericardium or vein as grafting materials for tunica albuginea substitution. Materials and methods: Thirty male Sprague-Dawley rats (300g~325g) were divided at random into 3 groups of 10 animals each: group 1 was the sham-operated controls and groups 2 and 3 underwent wedge excision of tunica albuginea and replacement with cadaveric pericardium and vein grafts,respectively. Four months later, rats were sacrificed and the penis removed to assess the degree of fibrosis using RTPCR technique for TGF-β1 mRNA expression. The tissues were fixed in 10% formalin, paraffin-embedded and stained with Masson's trichrome and Verhoff's van Giesen for collagen and elastic fibers. Results: Four monthsafter grafting, there was minimal fibrosis surrounding the patch in the vein graft rats and moderate fibrosis in the pericardial graft rats. The degree of penile fibrosis in the pericardial graft rats was significantly higher than that in the controls (P0.05).Conclusion: The degree of penile fibrosis of cadaveric pericardial graft was significantly higher than that of the control group, while in the vein graft group it was comparable to the latter. The authors believe that the vein graft may be a more ideal substance to be used as the tunica albuginea substitute than the pericardial graft in the surgical treatment of Peyronie's disease.

  15. Role of PTFE Patch Saphenoplasty in Reducing Neovascularization and Recurrence in Varicose Veins.

    Science.gov (United States)

    Vashist, M G; Sin