Tromboflebite séptica hemorrágica em equino / Hemorrhagic septic thrombophlebitis in horses

Background: Thrombophlebitis represents the main disease of the cardiovascular system of horses, its occurrence is strongly associated with the use of inappropriate materials and techniques. Its clinical presentation varies according to the degree of vessel obstruction and the appearance of complications, in the diagnosis it is essential to assess the extent of damage and the severity of the case. Establishing appropriate treatments, it should be noted that these are mostly clinical, reserving surgical interventions for severe cases, so the aim of the study is report a case of hemorrhagic septic thrombophlebitis treated by partial phlebectomy of the left jugular vein. Case: A 9-year-old male castrated equine, with no defined racial pattern, weighing 345 kg, used in the practice of vaquejada was attended at the Veterinary Hospital (HV) of the Federal University of Campina Grande (UFCG), Campus Patos (PB). During the anamnesis, it was reported that the animal presented colic a month ago, it was treated, recovered and since then, it started presenting an area with increase in volume in the neck region that ruptured the day before the HV attendance, where blood and pus came from. On physical exam, slight edema was noted in the left masseteric region, a volume rise involving the middle and cranial third of the neck with firm consistency in the left jugular sulcus, sensitivity to palpation and little drainage of purulent bloody secretion was observed. Additionally, tachycardia, tachypnea and intestinal hypomotility were found. In turn, in the ultrasound exam, a hypoechoic structure was seen, causing partial obstruction of the vessel, proximal to the fistulated region and total obstruction distal to it. With this information, antibiotic therapy was prescribed, a warm compress followed by the use of anti-inflammatory gel every 8 h. By choice of the owner, the animal returned to the farm, in the next day returned to the Veterinary Hospital, due to...

Association between varicose veins anatomical pattern and procedural complications following endovascular laser photothermolysis for chronic venous insufficiency

We sought to assess clinical characteristics and pattern of collateral network involvement associated with development of truncal (systematized) versus diffuse/non-truncal (non-systematized) varicose veins (VVs) in patients undergoing endovascular laser photothermolysis for chronic venous insufficiency (CVI). Secondly, we aimed to assess whether the type of VVs influenced the procedural complications of endovascular laser therapy. A total of 508 patients with hydrostatic VVs of the lower limbs who underwent endovenous laser treatment were included, out of which 84.1% (n=427) had truncal VVs (group 1) and 15.9% (n=81) had diffuse (non-systematized) VVs (group 2). Patients with truncal varices were significantly older (47.50±12.80 vs 43.15±11.75 years, P=0.004) and those with associated connective tissue disorders were more prone to present diffuse VVs (P=0.004). Patients in group 1 presented a significantly higher number of Cockett 1 (P=0.0017), Cockett 2 (P=0.0137), Sherman (P<0.0001), and Hunter (P=0.0011) perforator veins compared to group 2, who presented a higher incidence of Kosinski perforators (P<0.0001). There were no significant differences regarding postoperative complications: thrombophlebitis (P=0.773), local inflammation (P=0.471), pain (P=0.243), paresthesia (P=1.000), or burning sensation (P=0.632). Patients with more advanced CEAP (clinical, etiologic, anatomic, pathophysiologic) classes were older (P<0.0001), more were males (39.05 vs 27.77%, P=0.0084), more were prone to present ulcers (P<0.0001) and local hyperthermia (P=0.019), and presented for endovenous phlebectomy after a longer time from symptom onset. In patients with CVI, systematized VVs were associated with a more severe clinical status and a distinct anatomical pattern of perforators network compared to non-systematized VVs, which is more common in advanced stages.

Treatment of foot varicose veins: A study of 119 consecutive patients.

Objective To analyze the outcomes of 119 (188 feet) patients undergoing foot varicose vein phlebectomy with and without sclerotherapy between 2013 and 2015. Methods Legs and feet were treated in one single procedure. Clinical and ultrasound assessments were carried out at 7, 30, and 90 days for visualization of the sapheno-femoral and sapheno-popliteal junctions and the deep vein system. Results Mean age was 50 ± 12 years (25-79 years); 67 patients were female (56.3%). Median venous clinical severity score was 4 (range 2-5) before and 1 (range 0-2) at 90 days ( p < 0.001). Edema and transient paresthesia were the most frequent complications (13 (10.92%) and 11 (9.24%) patients, respectively). All complications were resolved at 90 days except one case of edema (resolved after 150 days with compression stockings and lymphatic drainage manual therapy). Conclusions Symptomatic foot varicose vein intervention was safe and effective. Further studies should focus on assessment of vein-specific quality of life questionnaires.

Aplicação De Diferentes Pinças Hemostáticas Em Veias De Equinos: Estudo Morfológico / Application Of Different Hemostatic Clamps In Horse’s Veins: A Morphological Study / Aplicación De Diferentes Pinzas Hemostaticas En Venas De Equinos: Estudio Morfologico

Foi realizada a avaliação morfológica da veia cefálica submetida à pinçamento em cinco equinos hígidos. Foram testadas as pinças hemostáticas: Diffenbach bulldog, De Bakey bulldog, Rochester reta e De Bakey com cremalheira. Após 15 minutos da aplicação das referidas pinças, foi realizada a flebectomia parcial e coletadas as amostras referentes a cada segmento do vaso pinçado e do segmento controle sem pinçamento. Das peças procedeu-se as preparações histológicas dos segmentos da veia nas colorações de Hematoxilina-Eosina e Tricrômio de Masson. Os cortes histológicos foram avaliados por microscopia óptica. Foi realizada análise morfológica das veias, utilizando para isto uma escala de avaliação de lesões vasculares após pinçamento. As pinças com serrilhamento transversal e fechamento tipo cremalheira causaram as maiores alterações, observou se marcada vacuolização das células musculares e desarranjo na túnica media com perda marcada das células endoteliais da túnica intima do vaso estudado.

Morphologic evaluation of the cephalic vein of five healthy horses submitted to clamping was done. Hemostatic clamps tested were Dieffenbach bulldog, De Bakey bulldog, Rochester straight and De Bakey with ratchets. Fifthen minutes after mentioned clamps were applied partial phlebotomy was performed and histologic sections of the veins were prepared and stained with Hematoxylin-Eosin and Masson Trichrome. After the stained preparations were evaluated by light microscopy. The morphological analysis of the veins was performed using a rating scale of vascular lesions after clamping. The hemostatic clamps with transverse serration and ratcheted mechanism caused major changes, pronounced vacuolization of the muscle cells, derangement of the medium tunic and marked loss of endothelial cells of the intima tunic was observed in the vessel studied.

Evaluacion morfológica de la vena cefálica de cinco equinos saludables sometida a pinzamiento fue realizada. Las pinzas hemostáticas evaluadas fueron Diffenbach bulldog, De Bakey Bulldog, Rochester recta y De Bakey cremallera. Despues de 15 minutos de aplicadas las pinzas mencionadas fue realizada la flebectomía y los diferentes cortes histológicos de las venas fueron preparados y coloraciones de Hematoxilina-Eosina y Tricrimico de Mansson fueron evaluadas por microscopia de luz. El análisis morfológico de la vena fue realizado usando una escala de lesiones vasculares post pinzamiento. Las pinzas hemostáticas con serrillamiento transversal y cierre de tipo cremallera fueron las que generaron mas cambios, marcada vacuolizacion de las células musculares en la túnica media y perdida evidente del numero de células endoteliales en la túnica intima de la vena estudiada.

Aplicação De Diferentes Pinças Hemostáticas Em Veias De Equinos: Estudo Morfológico / Application Of Different Hemostatic Clamps In Horses Veins: A Morphological Study / Aplicación De Diferentes Pinzas Hemostaticas En Venas De Equinos: Estudio Morfologico

Foi realizada a avaliação morfológica da veia cefálica submetida à pinçamento em cinco equinos hígidos. Foram testadas as pinças hemostáticas: Diffenbach bulldog, De Bakey bulldog, Rochester reta e De Bakey com cremalheira. Após 15 minutos da aplicação das referidas pinças, foi realizada a flebectomia parcial e coletadas as amostras referentes a cada segmento do vaso pinçado e do segmento controle sem pinçamento. Das peças procedeu-se as preparações histológicas dos segmentos da veia nas colorações de Hematoxilina-Eosina e Tricrômio de Masson. Os cortes histológicos foram avaliados por microscopia óptica. Foi realizada análise morfológica das veias, utilizando para isto uma escala de avaliação de lesões vasculares após pinçamento. As pinças com serrilhamento transversal e fechamento tipo cremalheira causaram as maiores alterações, observou se marcada vacuolização das células musculares e desarranjo na túnica media com perda marcada das células endoteliais da túnica intima do vaso estudado. (AU)

Morphologic evaluation of the cephalic vein of five healthy horses submitted to clamping was done. Hemostatic clamps tested were Dieffenbach bulldog, De Bakey bulldog, Rochester straight and De Bakey with ratchets. Fifthen minutes after mentioned clamps were applied partial phlebotomy was performed and histologic sections of the veins were prepared and stained with Hematoxylin-Eosin and Masson Trichrome. After the stained preparations were evaluated by light microscopy. The morphological analysis of the veins was performed using a rating scale of vascular lesions after clamping. The hemostatic clamps with transverse serration and ratcheted mechanism caused major changes, pronounced vacuolization of the muscle cells, derangement of the medium tunic and marked loss of endothelial cells of the intima tunic was observed in the vessel studied.(AU)

Evaluacion morfológica de la vena cefálica de cinco equinos saludables sometida a pinzamiento fue realizada. Las pinzas hemostáticas evaluadas fueron Diffenbach bulldog, De Bakey Bulldog, Rochester recta y De Bakey cremallera. Despues de 15 minutos de aplicadas las pinzas mencionadas fue realizada la flebectomía y los diferentes cortes histológicos de las venas fueron preparados y coloraciones de Hematoxilina-Eosina y Tricrimico de Mansson fueron evaluadas por microscopia de luz. El análisis morfológico de la vena fue realizado usando una escala de lesiones vasculares post pinzamiento. Las pinzas hemostáticas con serrillamiento transversal y cierre de tipo cremallera fueron las que generaron mas cambios, marcada vacuolizacion de las células musculares en la túnica media y perdida evidente del numero de células endoteliales en la túnica intima de la vena estudiada.(AU)