No Benefit of Wearing Compression Stockings after Endovenous Thermal Ablation of Varicose Veins: A Systematic Review and Meta-Analysis.

OBJECTIVE: This meta-analysis was conducted to investigate whether compression stockings were necessary after endovenous thermal ablation of varicose veins. DATA SOURCES: Electronic databases, including MEDLINE, EMBASE, and the Cochrane Library database, were searched from inception to 10 March 2021 to identify all the related trials. METHODS: Random or fixed effects models were used to generate pooled mean difference (MD) or standardised mean difference (SMD) for continuous data, risk ratios (RRs) for dichotomous data, and related 95% confidence intervals (95% CIs). The quality of evidence was graded with a specific tool (GRADEpro GDT) from the GRADE working group. RESULTS: A total of seven randomised controlled trials (RCTs) comprising 1 146 patients were included in this meta-analysis. Wearing compression stockings was correlated with lower post-operative pain scores from a 0 to 100 mm visual analogue scale (MD -8.00; 95% CI -12.01 - -3.99; p < .001). No difference was observed between wearing compression stockings or not in quality of life (SMD 0.45; 95% CI 0.14 - 1.04), major complications (RR 0.64; 95% CI 0.26 -1.59), target vein occlusion rates (RR 0.99; 95% CI 0.96 - 1.02), or time to return to work (MD -0.43; 95% CI 1.06 - 0.19). CONCLUSION: After endovenous thermal ablation of varicose veins, wearing compression stockings was not associated with a better outcome except for mild pain relief. Post-operative compression stockings may be unnecessary after endovenous thermal ablation.

Stent graft placement versus angioplasty for hemodialysis access failure: a meta-analysis.

BACKGROUND: Hemodialysis is a common treatment for end-stage renal disease, and maintenance of access patency remains a key issue. Angioplasty is recommended as the first choice for access stenosis, but it poses a risk of a high rate of restenosis. Stent graft placement can generate a high patency rate of dialysis access. This study aimed to compare the primary patency of the treatment area and access circuit between stent grafts and angioplasty in dialysis access failure. MATERIALS AND METHODS: Three electronic databases, namely, PubMed, Cochrane Library of Systematic Reviews, and EMBASE, were searched from the database inception to September 2017 without language restriction. Randomized controlled trials comparing the primary patency of the treatment area and access circuit between stent graft and angioplasty were included. Two independent reviewers assessed the quality of the trials and extracted relevant data. RESULTS: Four trials satisfied our inclusion criteria. Our pooled results suggested that stent graft placement was associated with significantly higher primary patency of treatment area (hazard ratio: 0.65, 95% confidence interval: 0.55-0.77, P < 0.0001, I2 = 0) and access circuit (hazard ratio: 0.76, 95% confidence interval: 0.65-0.88, P = 0.0004, I2 = 0) in hemodialysis access compared with those of standard angioplasty. CONCLUSIONS: The patency of hemodialysis access may be higher after stent graft placement combined with standard angioplasty than after angioplasty alone.

Aneurysmal Degeneration of an Aortorenal Bypass for Takayasu Renal Artery Stenosis: A Novel Endovascular Intervention.

We report an aneurysm degeneration of a vein graft in a previous aortorenal bypass performed 5 years earlier for severe right renal artery stenosis due to Takayasu arteritis. The patient was a 31-year-old woman who suffered from refractory hypertension. The autogenous bypass adopting great saphenous vein was performed from her infrarenal abdominal aorta to her right renal artery. Five years after the operation, the patient complained vague discomfort in her abdomen. Three-dimensional computed tomography angiography reconstruction demonstrated the existence of an aneurysm with a maximum diameter of 1.5 cm at the distal portion of a previous aortorenal vein graft, and >75% stenosis of the right renal artery. The replacement of a previous vein graft bypass with autograft or artificial graft is reported in literature. In this case, we attempted endovascular procedures by embolization of the aneurysm and revascularization of the right renal artery using coils and Viabahn stents.

Impact of gender on the prognosis of carotid body tumor after surgical resection.

BACKGROUND: Carotid body tumors (CBTs) are rare neuroendocrine neoplasms, but the prognosis of patients with resected CBTs has seldom been elucidated. This study was conducted to investigate the association between variables, especially sex, and the prognosis of carotid body tumor resection. METHODS: This was a large-volume single-center retrospective cohort study. Patients who were diagnosed with CBTs between 2009 and 2020 at our center were analyzed retrospectively. Their preoperative, surgical, and follow-up data were collected, and the association between variables and outcomes of CBT resection was assessed by correlation analysis, multivariate logistic regression, and multivariate Cox regression as appropriate. RESULTS: A total of 326 patients (66.6% were females) were included. Males developed larger CBTs than females (4.3 ± 1.8 cm vs. 3.8 ± 1.4 cm, P = .003). Males were more likely to develop succinate dehydrogenase B (SDHB) mutations (P = .019) and had worse relapse-free survival rates (P = .024). Although tumor size and Shamblin classification had positive relationships with neurological complications and intraoperative blood loss, they did not affect the overall survival rate of patients, which was only influenced by remote metastasis (P = .007) and local recurrence (P = .008). CONCLUSIONS: Compared to females, males with CBT resection were found to have more SDHB mutations and worse relapse-free survival rates, which may lead to the deterioration of prognosis. Tumor size and Shamblin classification cannot predict the overall survival rate of patients with excised CBTs.

Level of plasma catecholamine predicts surgical outcomes of carotid body tumors: Retrospective cohort study.

BACKGROUNDS: Carotid body tumors (CBTs) are rare neoplasms and some of them produce catecholamine. Although operations for catecholamine-producing CBTs are safe, the relationship between prognosis and endocrine function has not been analyzed before. METHODS: Patients diagnosed with CBTs in our department between 2009 and 2018 were analyzed. Plasma catecholamine was examined as a variable of surgical outcomes and prognosis by using statistical methods. RESULTS: Patients who suffered CBTs and underwent operations were divided into two groups according to their plasma catecholamine. Patients in the normal group had more or heavier surgical complications, such as neurological complications (P = .008) and blood loss (P = .03), than those in the high group. However, overall survival, local recurrence, and remote metastasis were not varied significantly in both groups. CONCLUSIONS: A high level of plasma catecholamine was a predictor for the improved operative outcomes of CBTs. Hence, nonfunctional CBTs had further short-term surgical complications.