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1.
Sci Rep ; 14(1): 5836, 2024 03 10.
Artigo em Inglês | MEDLINE | ID: mdl-38462667

RESUMO

Vascular injury such as central venous stenosis (CVS) is a common complication in hemodialysis patients with central venous catheters (CVCs), yet the impact of the microstructure and partial physic characteristics of catheter surface on the chronic injury of central vein has not been elucidated. In this study, the microscopic morphology of tips and bodies of six different brands of polyurethane CVCs was observed and their roughness was assessed. Subsequently, an in vitro model was established to measure the coefficients of friction (COF) between CVCs (tips and bodies) and the vena cava intima of Japanese rabbits under the same condition in a linear reciprocating mode, and changes in the intima of vessels after friction were observed. The study found that there was a significant variation in surface roughness among different brands of CVCs (tips P < 0.001, bodies P = 0.02), and the COF was positively correlated with the catheter surface roughness (tips P = 0.005, R = 0.945, bodies P = 0.01, R = 0.909). Besides, the endovascular roughness increased after friction. These findings suggest that the high roughness surface of CVCs may cause chronic mechanical friction injury to the central venous intima, which is one of the potential factors leading to CVS or occlusion. This provides a breakthrough for reducing complications, improving patient prognosis, and advancing catheter surface lubrication technology.


Assuntos
Cateterismo Venoso Central , Cateteres Venosos Centrais , Doenças Vasculares , Humanos , Coelhos , Animais , Cateterismo Venoso Central/efeitos adversos , Fricção , Cateteres Venosos Centrais/efeitos adversos , Diálise Renal/efeitos adversos , Veias , Doenças Vasculares/etiologia
3.
Eur J Radiol ; 174: 111397, 2024 May.
Artigo em Inglês | MEDLINE | ID: mdl-38452733

RESUMO

PURPOSE: To investigate quantitative changes in MRI signal intensity (SI) and lesion volume that indicate treatment response and correlate these changes with clinical outcomes after percutaneous sclerotherapy (PS) of extremity venous malformations (VMs). METHODS: VMs were segmented manually on pre- and post-treatment T2-weighted MRI using 3D Slicer to assess changes in lesion volume and SI. Clinical outcomes were scored on a 7-point Likert scale according to patient perception of symptom improvement; treatment response (success or failure) was determined accordingly. RESULTS: Eighty-one patients with VMs underwent 125 PS sessions. Treatment success occurred in 77 patients (95 %). Mean (±SD) changes were -7.9 ± 24 cm3 in lesion volume and -123 ± 162 in SI (both, P <.001). Mean reduction in lesion volume was greater in the success group (-9.4 ± 24 cm3) than in the failure group (21 ± 20 cm3) (P =.006). Overall, lesion volume correlated with treatment response (ρ = -0.3, P =.004). On subgroup analysis, volume change correlated with clinical outcomes in children (ρ = -0.3, P =.03), in sodium tetradecyl sulfate-treated lesions (ρ = -0.5, P =.02), and in foot lesions (ρ = -0.6, P =.04). SI change correlated with clinical outcomes in VMs treated in 1 PS session (ρ = -0.3, P =.01) and in bleomycin-treated lesions (ρ = -0.4, P =.04). CONCLUSIONS: Change in lesion volume is a reliable indicator of treatment response. Lesion volume and SI correlate with clinical outcomes in specific subgroups.


Assuntos
Escleroterapia , Malformações Vasculares , Criança , Humanos , Soluções Esclerosantes/uso terapêutico , Estudos Retrospectivos , Malformações Vasculares/diagnóstico por imagem , Malformações Vasculares/terapia , Veias , Resultado do Tratamento
4.
Zhonghua Jie He He Hu Xi Za Zhi ; 47(3): 269-274, 2024 Mar 12.
Artigo em Chinês | MEDLINE | ID: mdl-38448181

RESUMO

Pharmacologic prophylaxis is the most commonly used prophylaxis for venous thromboembolism (VTE), but the pharmacologic prophylaxis is limited in patients at high risk of bleeding. Mechanical prophylaxis alone or in combination is an important method of VTE prophylaxis in patients at high risk of bleeding, but the current mainstream mechanical prophylaxis, which includes graded compression stockings, intermittent inflatable compression pumps and plantar venous compression pumps, has some limitations, leading to discomfort for patients wearing them due to the large contact area, and even affecting ability to perform daily activities. Many clinical studies have found that NMES combined with pharmacological prophylaxis has better efficacy and safety than pharmacological prophylaxis alone in preventing VTE in medical and surgical patients, and the preventive effect of NMES alone is not inferior to other mechanical prophylaxis. Besides, it also has the advantages of ease of wear and patient compliance. Currently, clinicians have limited experience and knowledge of NMES. We aimed to present the rationale, progress in clinical research and future perspective of NMES in VTE prophylaxis.


Assuntos
Tromboembolia Venosa , Humanos , Tromboembolia Venosa/prevenção & controle , Veias , Estimulação Elétrica
5.
Nat Commun ; 15(1): 1107, 2024 Feb 06.
Artigo em Inglês | MEDLINE | ID: mdl-38321061

RESUMO

Hierarchical compartmentalization, a hallmark of both primitive and modern cells, enables the concentration and isolation of biomolecules, and facilitates spatial organization of biochemical reactions. Coacervate-based compartments can sequester and recruit a large variety of molecules, making it an attractive protocell model. In this work, we report the spontaneous formation of core-shell cell-sized coacervate-based compartments driven by spontaneous evaporation of a sessile droplet on a thin-oil-coated substrate. Our analysis reveals that such far-from-equilibrium architectures arise from multiple, coupled segregative and associative liquid-liquid phase separation, and are stabilized by stagnation points within the evaporating droplet. The formation of stagnation points results from convective capillary flows induced by the maximum evaporation rate at the liquid-liquid-air contact line. This work provides valuable insights into the spontaneous formation and maintenance of hierarchical compartments under non-equilibrium conditions, offering a glimpse into the real-life scenario.


Assuntos
Células Artificiais , Fenômenos Físicos , Tamanho Celular , Veias
6.
Comput Med Imaging Graph ; 113: 102355, 2024 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-38377630

RESUMO

Automatic retinal arteriovenous classification can assist ophthalmologists in disease early diagnosis. Deep learning-based methods and topological graph-based methods have become the main solutions for retinal arteriovenous classification in recent years. This paper reviews the automatic retinal arteriovenous classification methods from 2003 to 2022. Firstly, we compare different methods and provide comparison tables of the summary results. Secondly, we complete the classification of the public arteriovenous classification datasets and provide the annotation development tables of different datasets. Finally, we sort out the challenges of evaluation methods and provide a comprehensive evaluation system. Quantitative and qualitative analysis shows the changes in research hotspots over time, Quantitative and qualitative analyses reveal the evolution of research hotspots over time, highlighting the significance of exploring the integration of deep learning with topological information in future research.


Assuntos
Vasos Retinianos , Veias , Vasos Retinianos/diagnóstico por imagem , Retina , Artérias
7.
Microsurgery ; 44(2): e31148, 2024 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-38343011

RESUMO

BACKGROUND: In breast reconstruction with free flaps, retrograde venous anastomosis into the internal mammary vein (IMV) is often unavoidable. Utility of a crossing vein between the right and left IMV, one of the anatomical foundations which make retrograde flow possible, has been reported but only with a few detailed features. This study evaluated the presence, actual location, and diameter of the crossing veins using preoperative imaging such as contrast-enhanced computed tomography (CECT), or contrast-enhanced magnetic resonance imaging (CEMRI). Moreover, this is a preliminary non-invasive study to clarify these processes on a larger scale. METHODS: We included 29 cases of unilateral breast reconstruction performed between July 2018 and September 2023 at our institution using unipedicled or bipedicled free deep inferior epigastric artery perforator (DIEP) flaps with retrograde venous anastomosis to only one IMV at the level of anastomosis. No congestion or necrosis was observed. In the final 24 cases with sufficient imaging coverage of preoperative contrast-enhanced images (15 CECT and 9 CEMRI), the crossing veins of IMVs were detected and the number, localization, and diameter were measured. RESULTS: In 20 cases of 24 images, the crossing veins between IMVs were completely identified (83%). In 18 of the cases, only one crossing vein was established immediately ventral to the xiphoid process, averaging 19.3 ± 7.18 mm caudal to the fibrous junction between the sternal body and xiphoid process. The average diameter of the veins was 1.57 ± 0.42 mm. In two other cases, the second crossing vein originated on the dorsal surface of the sternum, but it was a very thin vein of about 0.4 mm. Three images indicated incomplete identification of the crossing vein at the xiphoid process, and in one case, no crossing vein was observed between bilateral IMVs. CONCLUSION: The contrast-enhanced imaging study revealed an anatomic feature that the crossing veins (about 1.5 mm in diameter) connecting the right and left IMVs are located just ventral to the xiphoid process. Furthermore, the crossing veins can be identified on contrast-enhanced images, and refinement of this method is expected to lead to future non-invasive anatomical investigations in an even larger number of cases.


Assuntos
Retalhos de Tecido Biológico , Mamoplastia , Retalho Perfurante , Humanos , Veias/diagnóstico por imagem , Veias/cirurgia , Mamoplastia/métodos , Retalhos de Tecido Biológico/cirurgia , Tomografia Computadorizada por Raios X , Imageamento por Ressonância Magnética , Artérias Epigástricas/diagnóstico por imagem , Artérias Epigástricas/cirurgia , Retalho Perfurante/irrigação sanguínea
8.
J Clin Apher ; 39(1): e22106, 2024 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-38334167

RESUMO

INTRODUCTION: Donor vein assessment for the selection of good quality veins is crucial for a successful apheresis procedure. This study intends to find out the effectiveness of a vein assessment scoring tool (VST) used and found to be effective in selecting whole blood donors to reduce the difficulty in identifying good quality veins for the plateletpheresis procedure. MATERIALS AND METHODS: This was a prospective observational study on platelet apheresis donors with the application of a VST consisting of three vein descriptor parameters (vein visibility, vein palpability, and vein size) with 5 Likert-type responses constituting a score of 0-12 for each arm. Two vein assessors independently evaluated the vein in both arms and marked their responses blinded from each other as well from the principal investigator. The scores were then calculated and analyzed at the end of the study for their association with phlebotomy and procedural outcomes. RESULTS: A total of 190 donors were recruited. The mean scores for the arms with successful and failed phlebotomy were 9.1 and 9.4 (SD 2.3), respectively. The intra-class correlation Alpha Cronbach value was 0.834 and 0.837 for total scoring in the left arm and right arm, respectively, between the two assessors. Scores neither showed a correlation with other outcomes like low flow alarms, hematoma formation, number of phlebotomy attempts, and procedure completion. CONCLUSION: The study showed that the vein score tool did not truly predict the phlebotomy outcome in apheresis donors, though there was a good degree of inter-assessor reliability.


Assuntos
Plaquetoferese , Veias , Humanos , Plaquetoferese/métodos , Reprodutibilidade dos Testes , Doadores de Sangue , Flebotomia/métodos
9.
Circ Res ; 134(5): 529-546, 2024 03.
Artigo em Inglês | MEDLINE | ID: mdl-38348657

RESUMO

BACKGROUND: Mature endothelial cells (ECs) are heterogeneous, with subtypes defined by tissue origin and position within the vascular bed (ie, artery, capillary, vein, and lymphatic). How this heterogeneity is established during the development of the vascular system, especially arteriovenous specification of ECs, remains incompletely characterized. METHODS: We used droplet-based single-cell RNA sequencing and multiplexed error-robust fluorescence in situ hybridization to define EC and EC progenitor subtypes from E9.5, E12.5, and E15.5 mouse embryos. We used trajectory inference to analyze the specification of arterial ECs (aECs) and venous ECs (vECs) from EC progenitors. Network analysis identified candidate transcriptional regulators of arteriovenous differentiation, which we tested by CRISPR (clustered regularly interspaced short palindromic repeats) loss of function in human-induced pluripotent stem cells undergoing directed differentiation to aECs or vECs (human-induced pluripotent stem cell-aECs or human-induced pluripotent stem cell-vECs). RESULTS: From the single-cell transcriptomes of 7682 E9.5 to E15.5 ECs, we identified 19 EC subtypes, including Etv2+Bnip3+ EC progenitors. Spatial transcriptomic analysis of 15 448 ECs provided orthogonal validation of these EC subtypes and established their spatial distribution. Most embryonic ECs were grouped by their vascular-bed types, while ECs from the brain, heart, liver, and lung were grouped by their tissue origins. Arterial (Eln, Dkk2, Vegfc, and Egfl8), venous (Fam174b and Clec14a), and capillary (Kcne3) marker genes were identified. Compared with aECs, embryonic vECs and capillary ECs shared fewer markers than their adult counterparts. Early capillary ECs with venous characteristics functioned as a branch point for differentiation of aEC and vEC lineages. CONCLUSIONS: Our results provide a spatiotemporal map of embryonic EC heterogeneity at single-cell resolution and demonstrate that the diversity of ECs in the embryo arises from both tissue origin and vascular-bed position. Developing aECs and vECs share common venous-featured capillary precursors and are regulated by distinct transcriptional regulatory networks.


Assuntos
Células Endoteliais , Canais de Potássio de Abertura Dependente da Tensão da Membrana , Adulto , Humanos , Animais , Camundongos , Hibridização in Situ Fluorescente , Artérias , Encéfalo , Veias
11.
J Cardiovasc Surg (Torino) ; 65(1): 5-11, 2024 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-38300165

RESUMO

Acute deep venous thrombosis (DVT) is a common health problem, affecting millions of patients in Europe and the United States annually. Europe and US national clinical practice guidelines are formulated by evaluation of the available scientific evidence, with expert opinion to create pragmatic guidance for the optimal patient management, representing the best available knowledge at the time of publication, and providing the best evidence-based recommendations for vascular patient care and venous pathologies. We here focus on the novel recommendations proposed by European and US guidelines for acute DVT, denoting main differences between the two panels. This review gives vascular surgeons the opportunity to identify the key points of the two largest Vascular Committees guidelines, in order to use them and offer their best individualized treatment approach to the specific patient's anatomy, lesion, and history.


Assuntos
Trombose Venosa , Humanos , Estados Unidos , Trombose Venosa/terapia , Trombose Venosa/tratamento farmacológico , Veias , Europa (Continente)
12.
Nature ; 627(8002): 165-173, 2024 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-38326613

RESUMO

The arachnoid barrier delineates the border between the central nervous system and dura mater. Although the arachnoid barrier creates a partition, communication between the central nervous system and the dura mater is crucial for waste clearance and immune surveillance1,2. How the arachnoid barrier balances separation and communication is poorly understood. Here, using transcriptomic data, we developed transgenic mice to examine specific anatomical structures that function as routes across the arachnoid barrier. Bridging veins create discontinuities where they cross the arachnoid barrier, forming structures that we termed arachnoid cuff exit (ACE) points. The openings that ACE points create allow the exchange of fluids and molecules between the subarachnoid space and the dura, enabling the drainage of cerebrospinal fluid and limited entry of molecules from the dura to the subarachnoid space. In healthy human volunteers, magnetic resonance imaging tracers transit along bridging veins in a similar manner to access the subarachnoid space. Notably, in neuroinflammatory conditions such as experimental autoimmune encephalomyelitis, ACE points also enable cellular trafficking, representing a route for immune cells to directly enter the subarachnoid space from the dura mater. Collectively, our results indicate that ACE points are a critical part of the anatomy of neuroimmune communication in both mice and humans that link the central nervous system with the dura and its immunological diversity and waste clearance systems.


Assuntos
Aracnoide-Máter , Encéfalo , Dura-Máter , Animais , Humanos , Camundongos , Aracnoide-Máter/anatomia & histologia , Aracnoide-Máter/irrigação sanguínea , Aracnoide-Máter/imunologia , Aracnoide-Máter/metabolismo , Transporte Biológico , Encéfalo/anatomia & histologia , Encéfalo/irrigação sanguínea , Encéfalo/imunologia , Encéfalo/metabolismo , Dura-Máter/anatomia & histologia , Dura-Máter/irrigação sanguínea , Dura-Máter/imunologia , Dura-Máter/metabolismo , Encefalomielite Autoimune Experimental/imunologia , Encefalomielite Autoimune Experimental/metabolismo , Perfilação da Expressão Gênica , Imageamento por Ressonância Magnética , Camundongos Transgênicos , Espaço Subaracnóideo/anatomia & histologia , Espaço Subaracnóideo/irrigação sanguínea , Espaço Subaracnóideo/imunologia , Espaço Subaracnóideo/metabolismo , Líquido Cefalorraquidiano/metabolismo , Veias/metabolismo
13.
Sensors (Basel) ; 24(4)2024 Feb 09.
Artigo em Inglês | MEDLINE | ID: mdl-38400290

RESUMO

FV (finger vein) identification is a biometric identification technology that extracts the features of FV images for identity authentication. To address the limitations of CNN-based FV identification, particularly the challenge of small receptive fields and difficulty in capturing long-range dependencies, an FV identification method named Let-Net (large kernel and attention mechanism network) was introduced, which combines local and global information. Firstly, Let-Net employs large kernels to capture a broader spectrum of spatial contextual information, utilizing deep convolution in conjunction with residual connections to curtail the volume of model parameters. Subsequently, an integrated attention mechanism is applied to augment information flow within the channel and spatial dimensions, effectively modeling global information for the extraction of crucial FV features. The experimental results on nine public datasets show that Let-Net has excellent identification performance, and the EER and accuracy rate on the FV_USM dataset can reach 0.04% and 99.77%. The parameter number and FLOPs of Let-Net are only 0.89M and 0.25G, which means that the time cost of training and reasoning of the model is low, and it is easier to deploy and integrate into various applications.


Assuntos
Identificação Biométrica , Extremidades , Resolução de Problemas , Tecnologia , Veias/diagnóstico por imagem , Processamento de Imagem Assistida por Computador
14.
Sensors (Basel) ; 24(4)2024 Feb 19.
Artigo em Inglês | MEDLINE | ID: mdl-38400488

RESUMO

In addressing challenges related to high parameter counts and limited training samples for finger vein recognition, we present the FV-MViT model. It serves as a lightweight deep learning solution, emphasizing high accuracy, portable design, and low latency. The FV-MViT introduces two key components. The Mul-MV2 Block utilizes a dual-path inverted residual connection structure for multi-scale convolutions, extracting additional local features. Simultaneously, the Enhanced MobileViT Block eliminates the large-scale convolution block at the beginning of the original MobileViT Block. It converts the Transformer's self-attention into separable self-attention with linear complexity, optimizing the back end of the original MobileViT Block with depth-wise separable convolutions. This aims to extract global features and effectively reduce parameter counts and feature extraction times. Additionally, we introduce a soft target center cross-entropy loss function to enhance generalization and increase accuracy. Experimental results indicate that the FV-MViT achieves a recognition accuracy of 99.53% and 100.00% on the Shandong University (SDU) and Universiti Teknologi Malaysia (USM) datasets, with equal error rates of 0.47% and 0.02%, respectively. The model has a parameter count of 5.26 million and exhibits a latency of 10.00 milliseconds from the sample input to the recognition output. Comparison with state-of-the-art (SOTA) methods reveals competitive performance for FV-MViT.


Assuntos
Fontes de Energia Elétrica , Extremidades , Humanos , Entropia , Reconhecimento Psicológico , Veias
15.
Ther Adv Cardiovasc Dis ; 18: 17539447241234655, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38400698

RESUMO

Misplacement of pericardiocentesis catheter in central veins is a rare complication that can be managed with several methods. In this case, we report a percutaneous image-guided plug-assisted management of a misplaced pericardiocentesis catheter into the inferior vena cava through a transhepatic tract successfully occluded. This minimally invasive technique was not previously described in this setting and had a favorable long-term outcome.


Clinical case of a minimally invasive technique guided by imaging to fix a complication of a misplaced drainage catheter for pericardial hemorrhageThis clinical case reports how to manage, using a minimally invasive technique guided by imaging, an accidental puncture of the liver and the inferior vena cava during a pericardial hemorrhage drainage. The outcome was good, with technical success and a favorable outcome for the patient.


Assuntos
Pericardiocentese , Veia Cava Inferior , Humanos , Veia Cava Inferior/diagnóstico por imagem , Pericardiocentese/efeitos adversos , Veias , Cateteres
16.
Medicine (Baltimore) ; 103(7): e36923, 2024 Feb 16.
Artigo em Inglês | MEDLINE | ID: mdl-38363945

RESUMO

RATIONALE: Klippel-Trenaunay syndrome (KTS) is a rare congenital venous malformation, it had been found to be caused by mutations of the phosphatidylinositol 4, 5-diphosphate 3-kinase catalytic subunit alpha (PIK3CA) gene. Currently KTS is defined as a triad of skin wine pigmented spots, varicose veins and malformations of the lower extremities, and hypertrophy of bone and soft tissue, involving urinary system up to 6% to 30%. When the urinary system is involved, KTS is often presented as painless massive gross hematuria. PATIENT CONCERNS: This article describes a woman who was hospitalized with painless massive gross hematuria. Physical examination revealed significant hypertrophy of the right lower limb with varicose veins, port-wine stains in the skin, and right perineal hemangiomatous changes with swelling. The patient was admitted to hospital 4 times for repeated hematuria and infection. DIAGNOSES: By physical examination, CT urography, ureteroscopy and cystoscopy, the patient was diagnosed to have Klippel-Trenaunay syndrome, involving the urinary system. INTERVENTIONS: The patient hematuria improved after multiple indwelling D-J tubes and anti-inflammatory treatment. OUTCOMES: The final symptoms of hematuria improved significantly, follow-up so far has not recurred. LESSONS: This case presents the possibility of painless gross hematuria with KTS. Most of patients can be improved by conservative treatment. Cystoscopic laser therapy is the preferred treatment for poor bleeding control. Cystectomy and nephrectomy should be considered when life-threatening.


Assuntos
Síndrome de Klippel-Trenaunay-Weber , Varizes , Feminino , Humanos , Síndrome de Klippel-Trenaunay-Weber/complicações , Síndrome de Klippel-Trenaunay-Weber/diagnóstico , Hematúria/etiologia , Veias/anormalidades , Varizes/complicações , Hipertrofia
18.
Int J Mol Sci ; 25(3)2024 Jan 26.
Artigo em Inglês | MEDLINE | ID: mdl-38338837

RESUMO

One of the early symptoms of chronic venous disease (CVD) is varicose veins (VV) of the lower limbs. There are many etiological environmental factors influencing the development of chronic venous insufficiency (CVI), although genetic factors and family history of the disease play a key role. All these factors induce changes in the hemodynamic in the venous system of the lower limbs leading to blood stasis, hypoxia, inflammation, oxidative stress, proteolytic activity of matrix metalloproteinases (MMPs), changes in microcirculation and, consequently, the remodeling of the venous wall. The aim of this review is to present current knowledge on CVD, including the pathophysiology and mechanisms related to vein wall remodeling. Particular emphasis has been placed on describing the role of inflammation and oxidative stress and the involvement of extracellular hemoglobin as pathogenetic factors of VV. Additionally, active substances used in the treatment of VV were discussed.


Assuntos
Varizes , Insuficiência Venosa , Humanos , Varizes/etiologia , Varizes/patologia , Veias/patologia , Insuficiência Venosa/patologia , Extremidade Inferior/patologia , Doença Crônica , Inflamação/patologia
19.
Khirurgiia (Mosk) ; (2): 52-58, 2024.
Artigo em Russo | MEDLINE | ID: mdl-38344960

RESUMO

OBJECTIVE: To analyze the comprehensive program for prevention of thromboembolic complications in orthopedic patients. MATERIAL AND METHODS: We have analyzed thromboembolic complications in orthopedic patients after surgeries on large joints over the past 5 years (2018-2022). CONCLUSION: A comprehensive approach to prevention and treatment of thromboembolic complications including ultrasound, early surgical prevention of pulmonary embolism can significantly improve postoperative outcomes after joint replacement surgery. Vacuum aspiration retrograde thrombectomy is effective, feasible and safe for acute ilio-femoral venous thrombosis reducing hospital-stay (p=0.0124) and restoring vein patency. Widespread thromboembolic complications, especially for pulmonary embolism in 2022, are likely due to a new coronavirus infection and require careful screening of patients with risk factors with appropriate preventive antithrombotic therapy.


Assuntos
Embolia Pulmonar , Trombose Venosa , Humanos , Trombose Venosa/diagnóstico , Trombose Venosa/etiologia , Trombose Venosa/prevenção & controle , Embolia Pulmonar/diagnóstico , Embolia Pulmonar/etiologia , Embolia Pulmonar/prevenção & controle , Veias , Trombectomia/efeitos adversos , Fatores de Risco , Complicações Pós-Operatórias/diagnóstico , Complicações Pós-Operatórias/etiologia , Complicações Pós-Operatórias/prevenção & controle
20.
Khirurgiia (Mosk) ; (2): 45-51, 2024.
Artigo em Russo | MEDLINE | ID: mdl-38344959

RESUMO

OBJECTIVE: To improve the results of treatment of deep vein thrombosis of the upper extremities sing endovascular technologies. MATERIAL AND METHODS: We analyzed safety and effectiveness of treatment in 24 patients with deep vein thrombosis of the upper extremities. All ones were divided into 2 homogeneous groups by 12 people each. In the first group, conventional anticoagulation was performed. In the second group, we used additional regional catheter thrombolysis with alteplase and, if necessary, venous stenting or balloon angioplasty for residual stenosis. Patients received apixaban at baseline and throughout 6 postoperative months. After 12 months, we performed ultrasound and clinical examination to identify deep vein patency and venous outflow disorders. Vein recanalization was evaluated as follows: <50% - minimal, 50-99% - partial, 100% - complete. The quality of life of patients was studied using the SF-36 questionnaire. RESULTS: In the first group, we observed complete vein recanalization in 25% of cases, partial - in 33%, minimal - in 41% of cases; in the second group - 83.3% and 16.7% of patients, respectively. In the first group, clinical manifestations of venous outflow disorders were absent in 25% of patients, mild disorders - 25%, moderate - 8.3%, severe - 41.7% of patients. In the second group, venous outflow was not impaired in 83.7% of patients, mild violations occurred in 16.7% of patients. In the first group, physical health was equal to 44.2±1.7 scores, psychological health - 49.3±2.3 scores; in the second group - 69.3±5.7 and 71.3±5.4 scores, respectively. CONCLUSION: Endovascular treatment improved postoperative outcomes.


Assuntos
Trombose Venosa , Humanos , Trombose Venosa/diagnóstico , Trombose Venosa/etiologia , Trombose Venosa/terapia , Qualidade de Vida , Veias , Terapia Trombolítica/efeitos adversos , Terapia Trombolítica/métodos , Stents , Extremidade Superior , Resultado do Tratamento , Estudos Retrospectivos
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