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1.
J Vasc Surg Venous Lymphat Disord ; 4(2): 172-8, 2016 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-26993863

RESUMO

OBJECTIVE: The goal of this study was to determine the prevalence of and predictors to indicate bilateral venous duplex ultrasound (DU) to detect contralateral asymptomatic deep venous thrombosis (DVT) in patients with acute symptomatic lower extremity DVT. METHODS: Venous DU reports along with medical records of the patients were collected from February 2005 to April 2012 in a tertiary university hospital in Botucatu, Brazil. All patients with DVT detected in one lower extremity routinely underwent contralateral limb venous DU examination. Exclusion criteria were previous DVT in the contralateral asymptomatic limb, thrombophlebitis, workup for pulmonary embolism, and bilateral symptomatic lower extremities. RESULTS: Scans were done in 579 patients to rule out contralateral lower extremity DVT whenever DVT was confirmed in the ipsilateral lower extremity; of these, 108 patients (18.6%) had an abnormal finding on DU examination for DVT in the contralateral limb, which was proximal DVT in 71.5%. Age >60 years (odds ratio [OR], 3.33; 95% confidence interval [CI], 1.447-7.670), malignant disease (OR, 5.21; 95% CI, 1.943-14.015), and the association of trauma plus malignant disease (OR, 7.11; 95% CI, 1.640-30.863) were the main predictors. CONCLUSIONS: Age >60 years, malignant disease, lower extremity trauma, inpatient status, and recent hospitalization are risk factors associated with a high incidence of asymptomatic contralateral lower extremity DVT in patients with ipsilateral lower extremity DVT. Therefore, we recommend routine performance of a venous DU examination on the contralateral lower extremity whenever these risk factors are present in patients with ipsilateral lower extremity DVT.


Assuntos
Ultrassonografia Doppler Dupla , Trombose Venosa/diagnóstico por imagem , Doença Aguda , Idoso , Brasil , Feminino , Humanos , Extremidade Inferior , Masculino , Pessoa de Meia-Idade , Prevalência , Fatores de Risco , Tromboflebite/diagnóstico por imagem
2.
Trials ; 15: 497, 2014 Dec 19.
Artigo em Inglês | MEDLINE | ID: mdl-25527165

RESUMO

BACKGROUND: The prevalence of chronic venous disease is high and occurs more frequently in females. According to the clinical, etiological, anatomical, and pathological classification (CEAP) definition, the reticular veins are included in the C1 class and are mainly associated with aesthetic complaints. Several invasive techniques are used for treatment, including mini phlebectomy, laser ablation, and radiofrequency ablation. However, a wide range of sclerosing agents may serve as minimally invasive alternatives, promoting chemical sclerosis of the vein wall. Although this technique is routinely performed around the world, there is no consensus on the most efficacious and safe chemical agent to be used. METHODS/DESIGN: Inclusion criteria are women between 18 and 69 years old with at least 10 cm long reticular veins in the lower limbs, on the outer side of the leg/thigh. Patients with CEAP 2 to 6, or with allergies, pregnancy, performing breastfeeding, or with any dermatologic or clinical problems will be excluded. Patients with venous ultrasound mapping showing involvement of saphenous trunks and/or a deep venous system will also be excluded. Patients will be randomized into two groups, one receiving 75% pure glucose and the other group receiving 0.2% polidocanol diluted in 70% glucose. Just one limb and one session per patient will be performed. The sclerosing agent volume will not exceed 5 mL. Clinical follow-up will include visits on days 7 and 60, always with photographic documentation. DISCUSSION: This project aims to enroll 96 patients and subject them to a double-blind treatment after the randomization process. The design is intended to evaluate efficacy through a primary end point and safety through a secondary end point. Forty-eight patients have currently been enrolled. Preliminary results for these patients showed that 25 received treatment, 2 were excluded, and 22 returned after 7 days and showed no greater adverse events. To date, establishing efficacy criteria has not been possible, and no patients have reached the 60-day return point. These data may help doctors choose the best chemical agent for the treatment of reticular veins. TRIAL REGISTRATION: ClinicalTrials.gov Identifier: NCT02054325, 3/02/2014.


Assuntos
Solução Hipertônica de Glucose/administração & dosagem , Extremidade Inferior/irrigação sanguínea , Polietilenoglicóis/administração & dosagem , Projetos de Pesquisa , Soluções Esclerosantes/administração & dosagem , Escleroterapia/métodos , Telangiectasia/terapia , Varizes/terapia , Adolescente , Adulto , Idoso , Brasil , Doença Crônica , Protocolos Clínicos , Método Duplo-Cego , Feminino , Solução Hipertônica de Glucose/efeitos adversos , Humanos , Pessoa de Meia-Idade , Polidocanol , Polietilenoglicóis/efeitos adversos , Estudos Prospectivos , Soluções Esclerosantes/efeitos adversos , Escleroterapia/efeitos adversos , Telangiectasia/diagnóstico , Fatores de Tempo , Resultado do Tratamento , Varizes/diagnóstico , Adulto Jovem
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