Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 2.475
Filtrar
1.
Angiol Sosud Khir ; 26(4): 49-60, 2020.
Artigo em Russo | MEDLINE | ID: mdl-33332306

RESUMO

Presented in the article is a prospective study of endovascular embolization of ovarian veins in female patients suffering from primary pelvic varicose veins, with the assessment of the immediate and remote results, as well as a 1-year follow up. AIM: The aim of our investigation was a comprehensive clinical and instrumental assessment of efficacy of endovascular embolization in women with pelvic varicose veins. PATIENTS AND METHODS: Our single-centre study included a total of 29 female patients presenting with pelvic varicose veins and undergoing embolization of ovarian veins using microcoils, in 5 cases the procedure was supplemented with injecting a foam sclerosant. RESULTS: The technical success of endovascular occlusion of ovarian veins amounted to 100%. Two women immediately after the operation were subjected to a redo intervention: in one case - resection of the ovarian vein and in the second case - repositioning of the microcoils. In the remote period, one patient due to recurrent relapses underwent repeat embolization followed by retroperitoneal resection of the ovarian vein. The findings of the clinical methods of examination demonstrated a decrease in the intensity of manifestations of pelvic varicose veins according to the pelvic venous clinical severity score and visual analogue scale, as well as improvement of the women's quality of life. CONCLUSION: Endovascular occlusion of ovarian veins is a highly effective, minimally invasive, and safe method of treatment of female patients with incompetent ovarian veins. Endovascular treatment may be regarded as a method of choice in management of the primary form of pelvic varicose veins.


Assuntos
Embolização Terapêutica , Varizes , Feminino , Humanos , Pelve , Flebografia , Estudos Prospectivos , Qualidade de Vida , Resultado do Tratamento , Varizes/diagnóstico , Varizes/terapia
3.
Rev Med Suisse ; 16(712): 2042-2045, 2020 Oct 28.
Artigo em Francês | MEDLINE | ID: mdl-33112517

RESUMO

Pelvic congestion syndrome is an underdiagnosed disease, defined as chronic pelvic pain lasting more than 6 months, associated with pelvic varicose veins in premenopausal women. Diagnose is based on imagery after exclusion of other causes of pelvic pains. Echography is first line diagnostic modality. Conservative treatment is often insufficient and pelvic veins embolization is required to improve symptoms.


Assuntos
Embolização Terapêutica , Dor Pélvica/complicações , Dor Pélvica/diagnóstico , Varizes/complicações , Feminino , Humanos , Dor Pélvica/terapia , Pelve/diagnóstico por imagem , Síndrome , Resultado do Tratamento , Varizes/diagnóstico , Varizes/terapia
4.
J Vasc Interv Radiol ; 31(10): 1560-1569, 2020 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-32855049

RESUMO

PURPOSE: The purpose of this study was to determine the efficacy and safety of embolization treatment in pelvic venous disorders in women refluxing in the ovarian and or internal iliac veins in women with chronic pelvic pain. MATERIALS AND METHODS: A retrospective study conducted from January 2000 to June 2017 in 617 patients diagnosed with pelvic venous disorders (PeVDs) with a mean age of 43.2 ± 7.2 years were treated using an embolization procedure. A total of 520 were included, and 97 patients were excluded. The main inclusion criteria were PeVD symptoms for more than 6 months and transvaginal Doppler ultrasonography (TV-DUS) diagnosis of varicose veins in the pelvis with a diameter greater than 6 mm. The main objective was to embolize the 4 main pelvic venous plexi (ovarian and internal iliac veins) whenever possible. Follow-up was performed using clinical symptoms (visual analog scale) and TV-DUS at 1, 3, 6, and 12 months and then every year up to 5 years. RESULTS: The technical success (embolization of the 4 main pelvic veins) was achieved in 84.4% of the patients. The average follow-up was 58.7 ± 5.7 months. The visual analog scale was improved from 7.63 ± 0.9 points pretreatment to 0.91 ± 1.5 at 5 years. A total of 26 patients (5%) presented with symptom recurrence and pelvic varicose veins. There were 57 minor complications (10.9%) and 11 major complications (2.1%), with 7 cases (1.34%) of device migration to the lung. CONCLUSIONS: The embolization of pelvic varicose veins is a safe and effective procedure. The selection of the embolic agents and the number of veins needed to be treated.


Assuntos
Dor Crônica/prevenção & controle , Embolização Terapêutica , Ovário/irrigação sanguínea , Dor Pélvica/prevenção & controle , Pelve/irrigação sanguínea , Varizes/terapia , Veias , Adulto , Dor Crônica/diagnóstico , Dor Crônica/etiologia , Embolização Terapêutica/efeitos adversos , Embolização Terapêutica/instrumentação , Feminino , Humanos , Pessoa de Meia-Idade , Dor Pélvica/diagnóstico , Dor Pélvica/etiologia , Recidiva , Estudos Retrospectivos , Fatores de Tempo , Resultado do Tratamento , Varizes/diagnóstico por imagem , Veias/diagnóstico por imagem
6.
Acta Gastroenterol Belg ; 83(2): 331-333, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32603056

RESUMO

In this paper we present the case of a male 55-year old patient with known ulcerative colitis and nodular regenerative hyperplasia, a rare form of noncirrhotic portal hypertension. He presented four visits to the emergency department with rapidly progressive anal discomfort. After two weeks a transjugular intrahepatic portosystemic shunt was placed using the gun-sight technique with immediate relief of the unbearable anal pain and pressure. To our knowledge, this is the first case where transjugular intrahepatic portosystemic shunt placement is applied for non- bleeding, congestive anorectal varices.


Assuntos
Hemorragia Gastrointestinal , Derivação Portossistêmica Transjugular Intra-Hepática , Varizes , Canal Anal , Hemorragia Gastrointestinal/terapia , Humanos , Hiperplasia , Masculino , Pessoa de Meia-Idade , Reto , Varizes/terapia
8.
Ann Vasc Surg ; 68: 569.e1-569.e7, 2020 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-32283303

RESUMO

BACKGROUND: Pelvic congestion syndrome (PCS) is defined as noncyclical pelvic pain or discomfort caused by dilated parauterine, paraovarian, and vaginal veins. PCS is typically characterized by ovarian venous incompetence that may be due to pelvic venous valvular insufficiency, hormonal factors, or mechanical venous obstruction. METHODS: We describe a case of a 38-year-old multiparous female with a history of pelvic pressure, vulvar varices, and dyspareunia. She underwent left gonadal vein coil embolization in 2014 for PCS that lead to symptomatic relief of her pain. Four years later, the patient returned for recurrent symptoms. Magnetic resonance venogram demonstrated dilated pelvic varices. The previously embolized left gonadal vein remained thrombosed, and there was no evidence of right gonadal vein insufficiency. However, catheter-based venography revealed a large, dilated, and incompetent median sacral vein. RESULTS: Pelvic venography demonstrated left gonadal vein embolization without any evidence of reflux. The right gonadal vein was also nondilated without reflux. Internal iliac venography showed large cross-pelvic collaterals and retrograde flow via a large, dilated median sacral vein. Coil embolization of the median sacral vein resulted in a dramatic reduction of pelvic venous reflux and resolution of symptoms. CONCLUSIONS: Recurrence of PCS can occur after ovarian vein embolization through other tributaries in the venous network. The median sacral vein is a rare cause of PCS. We present an interesting case of a successfully treated recurrent PCS with coil embolization of an incompetent median sacral vein.


Assuntos
Embolização Terapêutica , Ovário/irrigação sanguínea , Dor Pélvica/terapia , Pelve/irrigação sanguínea , Varizes/terapia , Insuficiência Venosa/terapia , Adulto , Embolização Terapêutica/instrumentação , Feminino , Humanos , Dor Pélvica/diagnóstico por imagem , Dor Pélvica/fisiopatologia , Recidiva , Retratamento , Síndrome , Resultado do Tratamento , Varizes/diagnóstico por imagem , Varizes/fisiopatologia , Insuficiência Venosa/diagnóstico por imagem , Insuficiência Venosa/fisiopatologia
10.
Vascular ; 28(5): 597-603, 2020 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-32281494

RESUMO

OBJECTIVES: Although many published series have shown the results of ultrasound-guided catheter-directed foam sclerotherapy, little is known about the outcomes and complications in older patients. METHODS: A total of 152 patients older than 65 years (group 1: 61.8% male, mean age 69.0 ± 4.5 years) and 244 patients younger than 65 years (group 2: 48.8% male, mean age 45.7 ± 11.2 years) were included in the study. Ultrasound-guided catheter-directed foam sclerotherapy was performed in patients with great saphenous vein valvular incompetence and saphenofemoral junction incompetence. Occlusion status was recorded by ultrasonography. Venous clinical severity score and visual analog score were calculated pre- and post-intervention. RESULTS: Complete occlusion rate of the great saphenous vein at 12 months post-procedure for the groups 1 and 2 was 86.4% and 86.3%, respectively. Venous clinical severity score and visual analog score were significantly different before ultrasound-guided catheter-directed foam sclerotherapy and four weeks after ultrasound-guided catheter-directed foam sclerotherapy (p < 0.001) in both the groups. There were no observed major complications in both the groups. CONCLUSIONS: With low complication rate and acceptable total occlusion rate, ultrasound-guided catheter-directed foam sclerotherapy can be considered a reliable treatment for older patients.


Assuntos
Veia Safena/diagnóstico por imagem , Soluções Esclerosantes/administração & dosagem , Escleroterapia , Ultrassonografia de Intervenção , Varizes/terapia , Adulto , Fatores Etários , Idoso , Idoso de 80 Anos ou mais , Bases de Dados Factuais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Soluções Esclerosantes/efeitos adversos , Escleroterapia/efeitos adversos , Fatores de Tempo , Resultado do Tratamento , Ultrassonografia de Intervenção/efeitos adversos , Varizes/diagnóstico por imagem , Adulto Jovem
11.
PLoS One ; 15(4): e0231218, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32343695

RESUMO

The study aims to explore the comprehensive reasons for patients' non-compliance with graded elastic compression stockings (GECS) as the treatment for lower limb varicose veins. Phenomenological analysis was applied in this qualitative study. The patients diagnosed with lower limb varicose veins and undergoing elective surgery who showed non-compliance with GECS as the treatment were invited to have semi-structured, in-depth, face-to-face interviews. Colaizzi method was employed to analyze the data for emerging themes associated with the reasons for patients' non-compliance. Four main themes and nine subthemes related to the reasons for non-compliance with GECS for lower limb varicose veins were summarized. The main themes that emerged were (1) gaps in the knowledge of GECS therapy as a treatment for lower limb varicose veins, (2) few recommendations from the doctors and nurses, (3) disadvantages of GECS, and (4) sociopsychological factors. These themes provide data for policy and planning to improve patients' compliance with GECS in China. Patients, healthcare professionals, and policy makers should share the responsibility to improve patients' compliance with GECS therapy.


Assuntos
Cooperação do Paciente , Meias de Compressão , Varizes/terapia , Adulto , Idoso , Atitude , China , Feminino , Humanos , Extremidade Inferior , Masculino , Pessoa de Meia-Idade , Participação do Paciente , Pesquisa Qualitativa
13.
Int J Hyperthermia ; 37(1): 231-244, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32133898

RESUMO

Purpose: Varicose veins are a common pathology that can be treated by endovenous thermal procedures like radiofrequency ablation (RFA). Such catheter-based techniques consist in raising the temperature of the vein wall to 70 to 120 °C to induce vein wall coagulation. Although effective, this treatment option is not suited for all types of veins and can be technically challenging.Materials and methods: In this study, we used High-Intensity Focused Ultrasound (HIFU) as a non-invasive thermal ablation procedure to treat varicose veins and we assessed the long-term efficacy and safety of the procedure in a sheep model. In vivo experiments were first conducted on two saphenous veins to measure the temperature rise induced at the vein wall during HIFU ablation and were compared with reported RFA-induced thermal rise. Thermocouples were inserted in situ to perform 20 measurements during 8-s ultrasound pulses at 3 MHz. Eighteen saphenous veins of nine anesthetized sheep (2-2.5 % Isoflurane) were then exposed to similar pulses (85 W acoustic, 8 s). After treatments, animals recovered from anesthesia and were followed up 30, 60 and 90 days post-treatment (n = 3 animals per group). At the end of the follow-up, vein segments and perivenous tissues were harvested and histologically examined.Results: Temperatures induced by HIFU pulses were found to be comparable to reported RFA treatments. Likewise, histological findings were similar to the ones reported after RFA and laser-based coagulation necrosis of the vein wall, thrombotic occlusions and vein wall fibrosis.Conclusion: These results support strongly the effectiveness and safety of HIFU for ablating non-invasively veins.


Assuntos
Ablação por Cateter/métodos , Ablação por Ultrassom Focalizado de Alta Intensidade/métodos , Ultrassonografia/métodos , Varizes/diagnóstico por imagem , Varizes/terapia , Animais , Modelos Animais de Doenças , Feminino , Temperatura Alta , Ovinos
16.
Hautarzt ; 71(4): 301-308, 2020 Apr.
Artigo em Alemão | MEDLINE | ID: mdl-32100054

RESUMO

For several decades, compression therapy, which is associated with few side effects, has been a basis for the conservative treatment of patients with phlebological and lymphological diseases. For the practical implementation of compression therapy, many different materials are available, some with system-specific advantages and disadvantages. Medical adaptive compression systems (MAK) are still a relatively new treatment option in Germany. Apart from the very good practical experience in clinical everyday life, the compilation of the scientific evidence of compression therapy also shows that the scientific data situation is significantly better than for many other medical areas, especially for the treatment of patients with venous diseases. It is important to note that compression therapy must reliably guarantee adequate compression pressure. If these conditions are met, it can be assumed on the basis of the currently available data that the clinical effectiveness of the different compression systems is comparably good. These aspects have now also been well tested for MAK, so that these analogies can be drawn. Therapists today can therefore choose between different, very effective therapy options and take individual factors, patient wishes and economic aspects into account when making their selection.


Assuntos
Bandagens Compressivas , Pele/irrigação sanguínea , Úlcera Varicosa/terapia , Varizes/terapia , Insuficiência Venosa/terapia , Alemanha , Humanos , Pressão , Meias de Compressão , Resultado do Tratamento
17.
Ann Vasc Surg ; 66: 356-361, 2020 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-31931130

RESUMO

BACKGROUND: We investigated the outcome of vein stenting placement for chronic proximal venous outflow obstruction (PVOO) in a predominantly Asian-American cohort to improve patient selection, enhance technical approach, and better define quality measurements of this emerging vascular intervention. METHODS: A total of 462 consecutive patients, 73% Asian American (n = 336), who underwent iliac vein stenting for chronic PVOO from October 2013 to July 2016 were reviewed. Postoperative outcomes at five follow-up visits were assessed. Wilcoxon-Mann-Whitney and Kruskal-Wallis tests were run for demographic and operative variables. Ordered logistic regressions were run for the outcome at each time point, and Chi-squared tests as well as Fisher's exact tests were used for categorical variables. RESULTS: Follow-up was maintained in 90% of patients, with a mean follow-up time of 695 days. Asian-American patients were more likely to present with varicose veins (77.4% vs. 54.8%, P < 0.001), and non-Asian patients were more likely to present with active ulceration (26.2% vs. 5.1%, P < 0.001). Asian-American patients were more likely to have bilateral stents placed (61.6% vs. 50%, P = 0.026) and were less likely to have reinterventions (11.3% vs. 27.8%, P < 0.001), a history of deep vein thrombosis (8.3% vs. 29.4%, P < 0.001), or intraoperative findings of chronic postphlebitic changes (17.6% vs. 33.3%, P < 0.001). Kruskal-Wallis tests were significant for improvement in patients of all the Clinical, Etiology, Anatomy, Pathophysiology classes at 30 days (P = 0.041), 90 days (P = 0.045), 6 months (P = 0.041), and 1 year (P < 0.01). The Asian-American population had improved but comparatively lower follow-up scores at the 30-day mark (48% significantly improved or better vs. 63%, P = 0.008) but higher follow-up scores at the >1 year mark (80% significantly improved or better vs. 59%, P < 0.001). CONCLUSIONS: Asian-American patients undergoing vein stent placement for chronic PVOO had comparatively worse outcomes than non-Asian patients at 30 days and better outcomes after one year. These patient groups had different outcomes postoperatively and outcomes which evolve differently over time.


Assuntos
Americanos Asiáticos , Procedimentos Endovasculares/instrumentação , Veia Ilíaca , Síndrome de May-Thurner/terapia , Stents , Varizes/terapia , Insuficiência Venosa/terapia , Doença Crônica , Procedimentos Endovasculares/efeitos adversos , Feminino , Humanos , Veia Ilíaca/diagnóstico por imagem , Masculino , Síndrome de May-Thurner/diagnóstico por imagem , Síndrome de May-Thurner/etnologia , Pessoa de Meia-Idade , Cidade de Nova Iorque/epidemiologia , Estudos Retrospectivos , Medição de Risco , Fatores de Risco , Fatores de Tempo , Resultado do Tratamento , Varizes/diagnóstico por imagem , Varizes/etnologia , Insuficiência Venosa/diagnóstico por imagem , Insuficiência Venosa/etnologia
18.
Int J Pediatr Otorhinolaryngol ; 131: 109892, 2020 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-31978748

RESUMO

A nine-year-old boy came to our clinic for the appearance of a voluminous swelling at the base of the neck in the jugular area after coughing. He underwent fibroscopy and a contrast-enhanced chest computed tomography (CT) scan, which did not indicate pathological findings even during the Valsalva maneuvre. After a color-Doppler ultrasound of the epiaortic vessels was obtained, a diagnosis of idiopathic phlebectasia of the internal jugular veins was made. The cause of the jugular phlebectasia remains unclear, and no treatment is indicated for this rare, benign, and self-limiting condition.


Assuntos
Veias Jugulares/diagnóstico por imagem , Varizes/diagnóstico por imagem , Criança , Dilatação Patológica , Humanos , Masculino , Tomografia Computadorizada por Raios X , Ultrassonografia Doppler em Cores , Manobra de Valsalva , Varizes/etiologia , Varizes/terapia
19.
World Neurosurg ; 137: 18-23, 2020 05.
Artigo em Inglês | MEDLINE | ID: mdl-31954912

RESUMO

BACKGROUND: Cavernous sinus dural arteriovenous fistulas (CS dAVFs) occasionally behave aggressively (e.g., intracranial hemorrhage, venous infarction, seizures) depending on the drainage flow and presence of a collateral route of cortical or basal cerebral venous drainage. When a CS dAVF with aggressive behavior is encountered, a radical cure is required to avoid catastrophic deficits. However, conventional transvenous cavernous sinus (CS) embolization via the inferior petrosal sinus does not always achieve shunt obliteration. We herein report a case of surgical venous drainage disconnection in an 83-year-old woman with a CS dAVF. CASE DESCRIPTION: The patient presented with coma and anisocoria due to intracranial hemorrhage. Because of the patient's critical condition, we had no choice but to perform emergency decompressive craniectomy and hematoma evacuation without detailed preoperative hemodynamic information obtained by digital subtraction angiography. Postoperative digital subtraction angiography showed a CS dAVF with retrograde venous drainage of the deep middle cerebral vein (DMCV) and varix formation in the affected DMCV, causing hemorrhagic episodes. Five days after admission, the patient's neurologic state worsened because of rebleeding from the varix, which had increased in size. The percutaneous transvenous approach failed because of compartmentalization within the CS. Open surgery was performed; the deep vasculature was exposed by the transsylvian approach, and the arterialized DMCV was permanently clipped at its proximal segment with disconnection from the venous varix and fistulous point. Shunt obliteration was successfully achieved. CONCLUSIONS: Surgical venous drainage disconnection from the fistulous point may be an alternative radical therapy for CS dAVFs with aggressive behaviors.


Assuntos
Malformações Vasculares do Sistema Nervoso Central/terapia , Embolização Terapêutica/métodos , Varizes/terapia , Idoso de 80 Anos ou mais , Anisocoria/etiologia , Encefalopatias/cirurgia , Seio Cavernoso , Coma/etiologia , Craniectomia Descompressiva/métodos , Feminino , Giro do Cíngulo , Hérnia/complicações , Herniorrafia/métodos , Humanos , Hemorragias Intracranianas/terapia , Complicações Pós-Operatórias/etiologia , Complicações Pós-Operatórias/terapia , Ruptura Espontânea/etiologia , Ruptura Espontânea/terapia
20.
Hautarzt ; 71(1): 20-23, 2020 Jan.
Artigo em Alemão | MEDLINE | ID: mdl-31925487

RESUMO

BACKGROUND: Foam sclerotherapy is well established in the treatment of varicose veins of different sizes. METHODS: A literature review was performed to determine whether specific anatomical findings could be a limitation for foam sclerotherapy. RESULTS: The following anatomical aspects are relevant as a potential limitation for foam sclerotherapy: treatment of pudendal veins, varicose veins in patients with chronic lymphedema and lymph fistulas. CONCLUSION: In some indications foam sclerotherapy is the treatment of choice. It is an effective and safe treatment option.


Assuntos
Escleroterapia , Varizes , Humanos , Soluções Esclerosantes , Resultado do Tratamento , Varizes/terapia
SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA