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1.
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
2.
Hautarzt ; 71(1): 6-11, 2020 Jan.
Artigo em Alemão | MEDLINE | ID: mdl-31807791

RESUMO

The chronic venous insufficiency (CVI) of the leg veins is one of the most common diseases in our society. Thus, it is important to know the clinical picture of CVI and the pros and cons of the different treatment options. Of the various treatments available for varicose veins (conservative therapy, operative procedures, endoluminal techniques, foam sclerotherapy), an evidence-based, treatment option should be individually chosen for each patient. In this article, the pros and cons of surgery are compared with endoluminal therapy in order to draw practical conclusions for the treatment decision.


Assuntos
Varizes , Insuficiência Venosa , Humanos , Escleroterapia , Varizes/terapia
3.
Hautarzt ; 71(1): 12-19, 2020 Jan.
Artigo em Alemão | MEDLINE | ID: mdl-31863127

RESUMO

Thermal ablation of saphenous vein varicosis has developed into a standard procedure for treatment of varicose veins. The clinical success of the endovenous thermal procedure is comparable to high ligation and stripping operations and a significant difference between these groups could not be detected in long-term analyses. The only difference is in the genesis of saphenofemoral recurrence detected by duplex ultrasound: neoangiogenesis occurs after high ligation and stripping operation and after endovenous ablation of the great saphenous vein a recurrence occurs predominantly via a residual anterior accessory saphenous vein (AASV). Reduction of costs by an increase in endovenous procedures carried out in an outpatient setting in comparison to stripping operations, which are still frequently carried out in Germany (in comparison to other countries) as an inpatient procedure, have meanwhile been confirmed. An endovenous crossectomy (i.e. high ligation) should be strived for. Nonthermal endoluminal catheter procedures are predominantly reserved for treatment of the short saphenous vein.


Assuntos
Ablação por Cateter , Terapia a Laser , Varizes , Alemanha , Humanos , Ligadura , Veia Safena , Resultado do Tratamento , Varizes/terapia
4.
Vasc Endovascular Surg ; 54(1): 47-50, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31581906

RESUMO

OBJECTIVES: Cyanoacrylate glue is injected for incompetent great saphenous vein (GSV) treatment 5 cm distal to the saphenofemoral junction (SFJ). Although a few reports have investigated the postprocedural remnant stump length, none have focused on the factors affecting glue extension length and the consequent remnant stump length. METHODS: Seventy-nine patients undergoing cyanoacrylate closure using the VenaSeal system at our clinic between August 2018 and November 2018 were investigated. The GSV diameter was measured just before treatment in the supine position 3 cm distal to the SFJ. Cyanoacrylate glue was injected 5 cm distal to the SFJ. RESULTS: The mean glue extension length was 1.13 ± 1.12 cm. The GSV diameter and glue extension length exhibited a significant inversely proportional relationship (P < .001). More specifically, patients with a GSV diameter ≥0.7 cm had a longer remnant stump length than those with a smaller GSV diameter (P < .001). CONCLUSIONS: An increased GSV diameter is likely associated with a decreased glue extension length and, consequently, a longer remnant stump.


Assuntos
Cianoacrilatos/administração & dosagem , Veia Safena , Adesivos Teciduais/administração & dosagem , Varizes/terapia , Adulto , Cianoacrilatos/efeitos adversos , Feminino , Humanos , Injeções Intravenosas , Masculino , Pessoa de Meia-Idade , Veia Safena/diagnóstico por imagem , Veia Safena/fisiopatologia , Adesivos Teciduais/efeitos adversos , Resultado do Tratamento , Ultrassonografia de Intervenção , Varizes/diagnóstico por imagem , Varizes/fisiopatologia
5.
Angiol Sosud Khir ; 25(4): 102-107, 2019.
Artigo em Russo | MEDLINE | ID: mdl-31855206

RESUMO

AIM: The purpose of the study was to assess efficacy and safety of heparin sodium gel 1000 IU/g and Detragel® in decreasing the incidence and treatment of the most common local adverse reactions in patients after endured sclerotherapy of reticular veins and telangiectasias. PATIENTS AND METHODS: Our open prospective observational study included a total of sixty 18-to-35-year-old female patients who after undergoing standardized sclerotherapy of reticular veins and telangiectasias on symmetrical portions of lower limbs were given a tube of heparin sodium gel 1000 IU/g or Detragel® to be applied onto the skin of one (left) lower limb in the projection of the sclerotherapy-exposed vessels 2-3 times daily for 10 days followed by putting on a compression class 2 (RAL standard) stocking. The women were allowed to use only the paired stocking on the contralateral extremity. Efficacy and safety of heparin sodium gel 1000 IU/g and Detragel® were evaluated based on the incidence of typical adverse reactions (ecchymoses, phlebitides, hyperpigmentation and neovasculogenesis), as well as on the patient's subjective perceptions. RESULTS: The use of heparin sodium gel 1000 IU/g and Detragel® in addition to compression after sclerotherapy of reticular veins and telangiectasias significantly and comparably decreased the incidence and accelerated the resolution of ecchymoses and phlebitides associated with phlebosclerosing treatment. The Detragel® group patients were found to develop hyperpigmentation or neovasculogenesis significantly less often as compared with the heparin sodium gel 1000 IU/g group women. What is more, using Detragel® was not accompanied by hyperkeratosis, pruritus or formation of a sticky film, the events, however, observed while applying heparin sodium gel 1000 IU/g. CONCLUSION: The use of Detragel® or heparin sodium gel 1000 IU/g for 10 days additionally to compression significantly decreased the incidence of typical undesirable reactions associated with sclerotherapy of reticular veins and telangiectasias. The Detragel® group women turned out to have lower incidence of hyperpigmentation and neovasculogenesis. Besides, Detragel® demonstrated better organoleptic properties.


Assuntos
Anticoagulantes/administração & dosagem , Heparina/administração & dosagem , Soluções Esclerosantes/efeitos adversos , Escleroterapia/efeitos adversos , Telangiectasia/terapia , Varizes/terapia , Administração Tópica , Feminino , Géis/administração & dosagem , Humanos , Hiperpigmentação/etiologia , Hiperpigmentação/prevenção & controle , Incidência , Neovascularização Patológica/etiologia , Neovascularização Patológica/prevenção & controle , Estudos Prospectivos , Meias de Compressão
6.
Angiol Sosud Khir ; 25(4): 108-115, 2019.
Artigo em Russo | MEDLINE | ID: mdl-31855207

RESUMO

AIM: The purpose of the study was to compare the results of using compression knitwear and elastic bandaging in the postoperative period after endovasal laser coagulation in patients with varicose veins. PATIENTS AND METHODS: A total of forty 20-to-55-year-old women with a body mass index of ≤ 35 kg/m2 and CEAP class C2-C3 lower limb varicose veins were randomized into two numerically equal groups. The Study Group included those receiving postoperative compression on the operated leg with the help an elastic stocking, whereas in the Comparison Group compression was achieved by laying an elastic bandage. Both group women underwent laser coagulation of the great saphenous vein and removal of separate veins with the help of Mueller hooks. Efficacy of compression therapy was comparatively assessed based on the results of interviewing the patients prior to intervention and 1 month thereafter, as well as by the level of pain syndrome according to the visual analogue scale at 24 and 48 postoperative hours, by the time spent by the personnel for bandaging of the limb or putting on the compression stocking intraoperatively and at the first dressing, by the degree of lower limb oedema and dynamics of regression thereof, by the area of postoperative haematoma and its dynamics after 2, 7 days and at 1 month. Besides, we evaluated the findings of ultrasonographic angioscanning of lower limb veins at one month postoperatively. RESULTS: The obtained findings demonstrated that efficacy of using a medical compression stocking after the procedure of endovasal laser coagulation in women with varicose veins was comparable to that of elastic bandaging. By the incidence rate and area of extension of postoperative haematomas, degree of pain syndrome, patient-oriented assessment using the Chronic Venous Insufficiency Quality of Life Questionnaire (CIVIQ), condition of veins according to the findings of ultrasonographic angioscanning no significant differences were revealed between the two methods of elastic compression of the leg. However, using a medical stocking appeared to promote a statistically significant 1.4-1.6-fold reduction in the time spent for formation of elastic compression of the lower limb, as well as a decrease in the incidence rate and degree of local oedema of the lower limb in the postoperative period.


Assuntos
Bandagens Compressivas , Fotocoagulação a Laser/métodos , Varizes/terapia , Procedimentos Endovasculares , Feminino , Humanos , Qualidade de Vida , Meias de Compressão , Resultado do Tratamento , Varizes/complicações , Varizes/cirurgia , Insuficiência Venosa/etiologia , Insuficiência Venosa/cirurgia , Insuficiência Venosa/terapia
7.
Medicine (Baltimore) ; 98(52): e18418, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31876715

RESUMO

RATIONALE: Brain arteriovenous malformation (BAVM)-associated varix is always asymptomatic, and no special treatment is needed. However, there is no consensus regarding how to address a varix that has led to clinical manifestation. PATIENT CONCERNS: An 11-year-old girl was admitted complaining of left hemiparesis for 4 days. She was previously healthy and denied any history of similar ictus. She was alert, and a physical examination performed upon admission was unremarkable except for the left hemiparesis. DIAGNOSES: Head magnetic resonance imaging (MRI) showed a linear and round flow void and perilesional edema in the region of the right basal ganglia, indicating a BAVM. Gadolinium-enhanced MRI showed peripheral enhancement of the round lesion. Computed tomography angiography (CTA) showed that the BAVM was fed by the ipsilateral posterior cerebral artery and anterior choroidal artery and drained into the vein of Galen. A large varix was also noted at the top of the BAVM and was consistent with the round flow void observed at the right basal ganglia on MRI. The Spetzler-Martin grading scale was grade IV INTERVENTIONS:: The patient experienced a TAE of the BAVM nidus with liquid embolic agent. OUTCOMES: A follow-up investigation showed regression of the varix, although there was still some residual BAVM. The patient experienced a favorable recovery. LESSONS: In the case of a BAVM-associated symptomatic varix, if surgical resection cannot readily be performed, initial TAE of the BAVM nidus can be attempted.


Assuntos
Malformações Arteriovenosas Intracranianas/terapia , Varizes/terapia , Criança , Angiografia por Tomografia Computadorizada , Embolização Terapêutica/métodos , Feminino , Humanos , Malformações Arteriovenosas Intracranianas/diagnóstico , Malformações Arteriovenosas Intracranianas/diagnóstico por imagem , Imagem por Ressonância Magnética , Neuroimagem
8.
Expert Rev Med Devices ; 16(11): 931-940, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31622557

RESUMO

Introduction: Varicose veins are a common disease, causing significant impairment of quality of life to afflicted individuals. Conventional surgery has represented the traditional treatment for years, with significant post-operative complications. By the end of the 20th century, novel approaches had been developed to induce biochemical sclerosis into the treated vein in order to exclude it from blood circulation.Areas covered: Foaming techniques for treatment of varicose veins, both clinically-approved methods and those under experimental studies. A brief description of cavitation, which is the basis of microbubbles formation, and an overview of foam properties have been also provided, including a discussion on clinical efficacy and safety profile.Expert commentary: Foam sclerotherapy has rapidly gained popularity since it represents the most minimally invasive and cost-effective procedure in the short term. Several different methods of foam preparation have been described in literature. In general, the foam generation method may affect characteristics such as stability and bubble size distribution, which in turn affect the therapeutic action of foam itself. Therefore, the selection of a suitable foaming technique is of importance for treatment success. Future developments on foaming techniques are expected to make sclerotherapy, already an effective treatment, even safer and more versatile therapeutic procedure.


Assuntos
Eletrônica Médica/métodos , Varizes/terapia , Humanos , Escleroterapia , Resultado do Tratamento , Ultrassom
9.
N Engl J Med ; 381(10): 912-922, 2019 09 05.
Artigo em Inglês | MEDLINE | ID: mdl-31483962

RESUMO

BACKGROUND: Endovenous laser ablation and ultrasound-guided foam sclerotherapy are recommended alternatives to surgery for the treatment of primary varicose veins, but their long-term comparative effectiveness remains uncertain. METHODS: In a randomized, controlled trial involving 798 participants with primary varicose veins at 11 centers in the United Kingdom, we compared the outcomes of laser ablation, foam sclerotherapy, and surgery. Primary outcomes at 5 years were disease-specific quality of life and generic quality of life, as well as cost-effectiveness based on models of expected costs and quality-adjusted life-years (QALYs) gained that used data on participants' treatment costs and scores on the EuroQol EQ-5D questionnaire. RESULTS: Quality-of-life questionnaires were completed by 595 (75%) of the 798 trial participants. After adjustment for baseline scores and other covariates, scores on the Aberdeen Varicose Vein Questionnaire (on which scores range from 0 to 100, with lower scores indicating a better quality of life) were lower among patients who underwent laser ablation or surgery than among those who underwent foam sclerotherapy (effect size [adjusted differences between groups] for laser ablation vs. foam sclerotherapy, -2.86; 95% confidence interval [CI], -4.49 to -1.22; P<0.001; and for surgery vs. foam sclerotherapy, -2.60; 95% CI, -3.99 to -1.22; P<0.001). Generic quality-of-life measures did not differ among treatment groups. At a threshold willingness-to-pay ratio of £20,000 ($28,433 in U.S. dollars) per QALY, 77.2% of the cost-effectiveness model iterations favored laser ablation. In a two-way comparison between foam sclerotherapy and surgery, 54.5% of the model iterations favored surgery. CONCLUSIONS: In a randomized trial of treatments for varicose veins, disease-specific quality of life 5 years after treatment was better after laser ablation or surgery than after foam sclerotherapy. The majority of the probabilistic cost-effectiveness model iterations favored laser ablation at a willingness-to-pay ratio of £20,000 ($28,433) per QALY. (Funded by the National Institute for Health Research; CLASS Current Controlled Trials number, ISRCTN51995477.).


Assuntos
Procedimentos Endovasculares , Terapia a Laser , Qualidade de Vida , Escleroterapia , Varizes/terapia , Adulto , Análise Custo-Benefício , Procedimentos Endovasculares/economia , Feminino , Seguimentos , Humanos , Análise de Intenção de Tratamento , Terapia a Laser/economia , Masculino , Pessoa de Meia-Idade , Anos de Vida Ajustados por Qualidade de Vida , Escleroterapia/economia , Escleroterapia/métodos , Inquéritos e Questionários , Resultado do Tratamento , Ultrassonografia de Intervenção , Varizes/cirurgia
10.
Georgian Med News ; (291): 13-19, 2019 Jun.
Artigo em Russo | MEDLINE | ID: mdl-31418723

RESUMO

The aim of the study was the analysis of serum VEGF level in patients with varicose veins before and after the endovenous laser ablation (EVLA) and to study the role of VEGF in recurrence of the disease. The research involved 216 persons. The study group included 136 patients with varicose veins. Control group included 80 healthy persons. All 136 persons were treated by endovenous laser ablation. To establish the presence of recurrent veins we conducted several observations of patients in period of 1/2-1-3-6-12 months after the treatment and then every 6 month during 3 years. Serum samples were collected from patients' before the operation and 3-6 month after the operation. Serum VEGF level were significantly higher in study group (86,63 pg/ml) comparing to control group 24.10 pg/ml (р 0,01). Mean level of VEGF before the operation were 86.83 pg/ml and in 3 month after the operation decreased to 24.98 pg/ml (р=0,01). In recurrent cases VEGF level were 3 times higher than in non-recurrent cases (р=0,01). There is a direct correlation of VEGF level and recurrence r=0,40, also direct correlation established between the СЕАР clinical class and VEGF level r=0,64.


Assuntos
Terapia a Laser , Varizes/sangue , Varizes/terapia , Fator A de Crescimento do Endotélio Vascular/sangue , Humanos , Recidiva , Resultado do Tratamento
11.
Rozhl Chir ; 98(6): 248-251, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31331181

RESUMO

INTRODUCTION: Catheter-Based Endovenous Laser Ablation (EVLA) is a commonly used alternative to surgical treatment of varicose veins. Recently, catheterization methods have proved to be methods of choice due to the preference of patients who value minimal invasiveness. Research of EVLA currently focuses on optimization of the procedure, which includes study of the benefits of the individual types of laser generators and the wavelengths used. In this observational study we compared our early results in a non-selected population of consecutive patients treated with two different types of lasers. METHODS: In the period from February 2010 to June 2017, EVLA was performed in a total of 1747 consecutive patients (74% were female) with venous reflux. The average vein width was 8.5 mm (525 mm). Our study sought to compare a more economical 1470nm diode laser (DL) generator (Velas 2, China) - used to operate on 630 patients - with a Nd-Yag crystal generator (Fotona - Slovenia) used in 1117 patients. All operations were performed using the same methodology, in an outpatient setting, in one specialized center. All procedures were completed in local tumescent anesthesia under peroperative ultrasound control. Postoperative sonography was performed in all patients. RESULTS: The results did not show a statistically significant difference in early closure rates (98.8% for Nd-Yag versus 99.8 for DL p-ns). Early recurrence was observed in 9 patients (15 vein segments) and managed successfully with early re-intervention and closure in all cases. The causes of incomplete closure included mainly the known risk factors (anticoagulation therapy, history of varicophlebitis). There was no correlation with larger venous diameter. In 6 patients, thrombus prolapse was observed in the deep femoral vein lumen. All cases were successfully cured after a week of low-molecular-weight heparin therapy. Only one case of low-risk pulmonary embolism was reported in a patient who failed to follow the regime recommendations. CONCLUSION: This evidence did not show a significant difference in closure reliability and the amount of complications of the endovenous laser ablation of large and small saphenous vein with a 1060nm Nd-Yag crystal compared to the more economical 1470nm diode laser generator.


Assuntos
Ablação por Cateter , Terapia a Laser , Varizes , Insuficiência Venosa , Feminino , Humanos , Extremidade Inferior , Masculino , Reprodutibilidade dos Testes , Veia Safena , Resultado do Tratamento , Varizes/terapia , Insuficiência Venosa/terapia
12.
Urologiia ; (3): 114-121, 2019 Jul.
Artigo em Russo | MEDLINE | ID: mdl-31356023

RESUMO

Recurrent and bilateral varicocele represent two least studied aspects of the disease. There is no recommendation in current urological and andrological guidelines in various countries on the diagnosis and treatment of such patients. The first experience of successful surgical treatment of a patient with recurrent varicocele due to May-Thurner syndrome is presented in this paper. The patient had a severe form of the disease and admitted with the varicocele recurrence after 5 previous intervention with chronic pelvic pain syndrome, erectile dysfunction, chronic calculous prostatitis and varicose veins of the pelvic organs. The patient underwent balloon angioplasty and stenting of the left iliac vein on 28th March, 2017 in the City hospital named after E.O. Mukhin. There was almost complete resolution of pelvic pain in the immediate postoperative period (within 1 hour). One week after surgery the patient noted a recovery of erection without any therapy. Three months later, a 45% reduction in the maximum diameter of the prostatic veins was noted according to transrectal ultrasound (TRUS) as well as a lack of antegrade blood flow according to the color Doppler TRUS at rest and during Valsalva's test. There was no deterioration of symptoms during follow-up. Overall, the venous blood flow in prostate was decreased which accompanied by the reducing in pain syndrome and restoration of sexual function without medical therapy. The reduction of diameter of testicular and epididymal varicose veins was seen 6 months after surgery. The diameter of veins of pampiniform plexus in supine position at rest was less than 2 mm. There was no retrograde flow neither in supine, nor in stand position during Valsalva maneuver. Thus, X-ray endovascular angioplasty and stenting of the iliac veins in case of arterio-venous crossing at the lower level is a pathogenetically justified and highly effective treatment of varicocele and varicose veins of the pelvic organs in men.


Assuntos
Síndrome de May-Thurner , Varicocele , Varizes , Humanos , Masculino , Síndrome de May-Thurner/diagnóstico por imagem , Síndrome de May-Thurner/terapia , Ultrassonografia Doppler em Cores , Varizes/diagnóstico por imagem , Varizes/terapia , Veias
13.
Rozhl Chir ; 98(5): 223-226, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31159545

RESUMO

Varicose veins of lower extremities represent a common medical condition with minimally invasive percutaneous endovenous ablation techniques as a treatment of choice. A very rare complication is a catheter migration in the deep venous system. In the literature only 7 cases have been published so far, with only 2 cases with migration to the systemic circulation and heart involvement. In this paper we present an interesting case report from the perspective of a thoracic surgeon with the finding of a laser ablation catheter remnant in the left pleural cavity during thoracoscopic exploration for a spontaneous hemothorax in a 47-year old male patient after collapse. A similar complication affecting the pleural cavity has not been published before. In this paper we discuss possible routes of the cathether migration into the left pleural cavity, impending complications when a part of the catheter is left behind in the body and the means of prevention of these serious potentially fatal complications even after many years following the initial treatment.


Assuntos
Ablação por Cateter , Migração de Corpo Estranho , Hemotórax , Terapia a Laser , Varizes , Migração de Corpo Estranho/complicações , Hemotórax/etiologia , Humanos , Masculino , Pessoa de Meia-Idade , Pelve , Veia Safena , Varizes/terapia
14.
Dtsch Med Wochenschr ; 144(11): 705-708, 2019 06.
Artigo em Alemão | MEDLINE | ID: mdl-31163465

RESUMO

ENDOVENOUS LASER ABLATION: Treatment with longer wavelengths and radial fibers should be used. RADIOFREQUENCY ABLATION: Results after 5 years show a very good efficacy and safety. FURTHER ENDOVENOUS TREATMENTS: Data is limited. The short-term studies show a good efficacy of nonthermal ablation methods. FOLLOW-UP STUDIES: There is no data about a 10 year follow-up until now. Data with comparison of surgical and endovenous therapy show after 5 years show more sonographical reflux in patients treated with first generation endothermal treatment without any differences in the clinical outcome.


Assuntos
Procedimentos Endovasculares , Varizes/terapia , Insuficiência Venosa/terapia , Doença Crônica , Humanos , Terapia a Laser , Ablação por Radiofrequência
16.
Angiol Sosud Khir ; 25(2): 88-95, 2019.
Artigo em Russo | MEDLINE | ID: mdl-31149994

RESUMO

AIM: The study was aimed at assessing efficacy and safety of using a micronized purified flavonoid fraction in the perioperative period in patients scheduled for endovascular surgical intervention for CEAP clinical class C2 lower limb varicose veins. PATIENTS AND METHODS: This study enrolled a total of 1519 patients with CEAP C2a,sEpAs (primary varicose vein with valvular incompetence of the great and/or small saphenous vein) who were subdivided into two groups. Group One included 1039 patients who in the perioperative period were prescribed a micronized purified flavonoid fraction at a daily dose of 1000 mg and who continued therapy, including visit 4. Group Two was composed of 480 patients taking no venoactive agents. The main criterion for assessing efficacy of the micronized purified flavonoid fraction was the incidence rate of typical adverse events in the compared groups of patients after surgical intervention. RESULTS: The patients receiving the micronized purified flavonoid fraction were found to have adverse events significantly less often as compared with those in the control group: ecchymosis 7.1 versus 11.0% (p=0.01), haematoma 0.5 vs 1.3% (p=0.1), paresthesia 0.5 vs 1.7% (p=0.02), thrombophlebitis 0.2 vs 0.6% (p=0.2), pigmentation 0.6 vs 3.3% (p=0.001), heat-induced thrombosis 0.3 vs 1.3% (p=0.02). The total incidence rate of adverse events in patients receiving and those not receiving the micronized purified flavonoid fraction amounted to 7.6 vs 15.0%, respectively (<0.001). DISCUSSION: The micronized purified flavonoid fraction prescribed in the perioperative period, owing to a pluripotent mechanism, adapts the venous system and microcirculatory bed of the lower extremities to operative stress, decreasing the anti-inflammatory response to endovascular intervention, lowering thereby the incidence of undesirable events. CONCLUSION: Prescription of the micronized purified flavonoid fraction in the perioperative period ensures a significant decrease in the incidence of typical adverse events developing after endovascular surgical treatment for CEAP clinical class C2 varicose veins and may be recommended for real clinical practice.


Assuntos
Flavonoides , Varizes , Flavonoides/uso terapêutico , Humanos , Microcirculação , Veia Safena , Resultado do Tratamento , Varizes/terapia
17.
Medicine (Baltimore) ; 98(25): e16042, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-31232937

RESUMO

BACKGROUND: Many pairwise meta-analyses (MAs) related to therapies of varicose veins have been published, but their reporting and methodological quality remain unclear. The present study was designed to assess the overall quality of pairwise MAs related to therapies of varicose veins. METHODS: We will systematically search 4 electronic databases, including PubMed, EMBASE, Cochrane Library, Chinese Biomedical Database, to identify pairwise MAs related to therapies of varicose veins. The search time-span was set from inception to March 2019. The pairwise MAs related to therapies of varicose veins will be included in our overview. The reporting and methodological quality of included MAs will be assessed using preferred reporting items for systematic review and meta-analysis and a measurement tool to assess systematic reviews 2, respectively. Meanwhile, we will extract some general characteristics of included MAs, including first author; published year, journal, sample size, number of studies, number of randomized controlled trials and intervention details, and so on. All literatures screening, quality assessment, and data extraction will be independently completed by 2 of all reviewers, and any disagreement will be resolved by discussion. Besides, an increasingly popular method - evidence mapping, will be used to present the whole evidence landscape related to therapies of varicose veins. The assessment results will be presented as percentage and event/total. The Excel 2016 will be used to manage and analyze data. RESULTS: The results of the overview will be submitted to a peer-reviewed journal for publication. CONCLUSION: This overview will summarize the overall reporting and methodological quality related to therapies of varicose veins. PROSPERO REGISTRATION NUMBER: CRD42019126722.


Assuntos
Protocolos Clínicos/normas , Metanálise como Assunto , Varizes/terapia , Humanos
18.
Rev Assoc Med Bras (1992) ; 65(4): 518-523, 2019 May 02.
Artigo em Inglês | MEDLINE | ID: mdl-31066803

RESUMO

The Guidelines Project, an initiative of the Brazilian Medical Association, aims to combine information from the medical field in order to standardize producers to assist the reasoning and decision-making of doctors. The information provided through this project must be assessed and criticized by the physician responsible for the conduct that will be adopted, depending on the conditions and the clinical status of each patient.


Assuntos
Embolização Terapêutica/métodos , Dor Pélvica/terapia , Pelve/irrigação sanguínea , Varizes/terapia , Brasil , Dor Crônica , Tomada de Decisão Clínica , Feminino , Humanos , Reprodutibilidade dos Testes , Síndrome , Resultado do Tratamento
19.
Ann Vasc Surg ; 60: 477.e1-477.e6, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31075472

RESUMO

Pulsating varicose veins are a rare clinical finding and are mainly derived from tricuspid regurgitation or right heart failure. The precise causes and optimal treatment of this phenomenon have been poorly recorded in the literature. Here, we describe a 56-year-old woman who presented to our medical center with bilateral varicose veins, heaviness, and edema in her lower limbs. The duplex revealed an arterial-like pulsating flow in the superficial and deep veins of the lower extremities, in addition to severe tricuspid regurgitation. Symptoms improved after the patient was given compression therapy using elastic stockings. In this article, we also review six other cases from the literature and discuss the therapies that would be reasonable in some conditions.


Assuntos
Extremidade Inferior/irrigação sanguínea , Insuficiência da Valva Tricúspide/complicações , Varizes/etiologia , Feminino , Humanos , Pessoa de Meia-Idade , Fluxo Pulsátil , Fluxo Sanguíneo Regional , Índice de Gravidade de Doença , Meias de Compressão , Resultado do Tratamento , Insuficiência da Valva Tricúspide/diagnóstico por imagem , Insuficiência da Valva Tricúspide/fisiopatologia , Varizes/diagnóstico por imagem , Varizes/fisiopatologia , Varizes/terapia
20.
Pol Merkur Lekarski ; 46(274): 153-156, 2019 Apr 29.
Artigo em Polonês | MEDLINE | ID: mdl-31099760

RESUMO

Lower limb veins diseases belong to frequently occurring disease syndromes. It covers 62% of adult Poles. They are not only an aesthetic problem. They can cause a lot of subjective and objective ailments significantly reducing the quality of life - from asymptomatic spider veins to permanent pain in lower limbs, especially in standing, fixed edema, skin lesions and ulceration. Superficial chronic venous insufficiency is due to incompetence of the saphenofemoral junction and great or small saphenous vein. Conventional surgery involves high ligation, stripping and phlebectomy. Recently, at the beginning of XXI century, minimally invasive endovenous techniques which became as alternatives to conventional surgery. Currently, the number of possible methods of treatment of venous disease available for use exceeds ten.


Assuntos
Varizes , Insuficiência Venosa , Adulto , Humanos , Qualidade de Vida , Veia Safena , Resultado do Tratamento , Varizes/terapia
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