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1.
N Engl J Med ; 384(9): e29, 2021 03 04.
Artigo em Inglês | MEDLINE | ID: mdl-33657307

Assuntos
Pescoço , Veias , Humanos
2.
N Engl J Med ; 384(9): e29, 2021 03 04.
Artigo em Inglês | MEDLINE | ID: mdl-33657308

Assuntos
Pescoço , Veias , Humanos
3.
J Physiol Anthropol ; 40(1): 5, 2021 Feb 10.
Artigo em Inglês | MEDLINE | ID: mdl-33568227

RESUMO

BACKGROUND: Circulating fatty acid-binding protein 4 (FABP4) is a marker for various diseases. It would be highly useful to have simple and less invasive techniques for the assessment of FABP4 concentrations in the clinical research setting. The purpose of the present study was to assess the concordance of circulating FABP4 concentrations in venous and capillary blood both at rest and immediately after acute exercise in healthy young males. RESULTS: Thirty-eight healthy young male adults aged from 19 to 25 years (mean age, 20.8 ± 1.2 years) were recruited. Paired blood samples were taken from the cubital vein (venous) and fingertip (capillary) blood at rest (resting state) and immediately after incremental exercise (exercising state). Blood samples were analyzed to determine the circulating FABP4 concentration using an enzyme-linked immunosorbent assay. Pearson's correlation coefficients for circulating FABP4 concentrations between venous and capillary blood samples indicated a strong positive correlation in both the resting and exercising state (resting state: r = 0.982, exercising state: r = 0.989, both p < 0.001). The mean FABP4 concentration was similar between venous and capillary blood in the resting state (p = 0.178), whereas it was significantly higher in capillary blood than in venous blood in the exercising state (p < 0.001). Furthermore, Bland-Altman plots showed a non-significant bias (- 0.07 ± 0.61 ng/mL, p = 0.453) in the resting state, whereas a significant bias (- 0.45 ± 0.61 ng/mL, p < 0.001) was observed in the exercising state. CONCLUSIONS: These results indicate that capillary blood sampling can slightly overestimate circulating FABP4 concentrations under a physiologically dynamic state. However, the association between the venous and capillary blood in terms of FABP4 concentration was very strong, suggesting that capillary blood sampling can detect changes in FABP4 concentration in both physiologically steady and dynamic states.


Assuntos
Exercício Físico/fisiologia , Proteínas de Ligação a Ácido Graxo/sangue , Adulto , Análise Química do Sangue/normas , Coleta de Amostras Sanguíneas/métodos , Capilares/fisiologia , Humanos , Masculino , Veias/fisiologia , Adulto Jovem
4.
Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi ; 35(2): 206-209, 2021 Feb 15.
Artigo em Chinês | MEDLINE | ID: mdl-33624475

RESUMO

Objective: To investigate the effectiveness of the modified great toe fibular flap using the distal artery pedicle as reflux vein for repairing distal phalanx finger wound. Methods: Between June 2018 and January 2020, 15 patients who suffered tissue defect of the distal phalanx finger were treated, including 12 males and 3 females, the average age was 40.2 years (range, 24-56 years). All of them were caused by machine crush injury. There were 2 cases of thumb, 6 cases of index finger, 3 cases of middle finger, 3 cases of ring finger, and 1 case of little finger. The defects ranged from 1.7 cm×1.3 cm to 3.0 cm×2.0 cm. The time from injury to admission was 0.6-4 hours, with an average of 2.3 hours. The medial fibular proper digital artery was further dissociated to the distal end and anastomosed with the recipient vein as the reflux vein. The area of flaps ranged from 2.0 cm×1.5 cm to 3.2 cm×2.2 cm. Results: All the flaps survived without vascular crisis, and the wounds healed by first intention. Except for 1 case that the suture was too tight, the incision was partially split after the stitches were removed, and it healed spontaneously after dressing change, the other patients had good healing of the donor site incision and normal foot function. All 15 patients were followed up 3-18 months, with an average of 9.3 months. The appearance of finger pulps were satisfactory with full and threaded. The color, texture, and elasticity of the flaps were good, and the two-point discrimination was 6-8 mm at last follow-up. The flexion and extension of fingers were normal. At last follow-up, hand function was evaluated according to the upper limb function evaluation trial standard of the Chinese Medical Association Hand Surgery Society, and the results were 13 cases of excellent and 2 cases of good. Conclusion: Modified great toe fibular flap using the distal arterial pedicle as a reflux vein can improve the venous drainage of the flap and contribute to increase the success rate of the flap without additional injury.


Assuntos
Traumatismos dos Dedos , Falanges dos Dedos da Mão , Hallux , Adulto , Feminino , Fíbula , Traumatismos dos Dedos/cirurgia , Humanos , Masculino , Pessoa de Meia-Idade , Veias , Adulto Jovem
5.
J Surg Oncol ; 123(5): 1232-1237, 2021 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-33567142

RESUMO

BACKGROUND: The internal mammary artery/vein (IMA/V) are commonly used recipients for free flap breast reconstruction, but requires costal cartilage resection and limits future use of the IMA. This study aimed to evaluate the feasibility of the thoracoacromial artery/vein (TAA/V) as recipients for deep inferior epigastric artery perforator (DIEP) flap breast reconstruction compared with using the IMA/V. METHODS: Medical charts of patients who underwent free DIEP flap breast reconstruction using the TAA/V or the IMA/V as recipient vessels were reviewed. Patient and vessel characteristics, time for vessel preparation and anastomosis, and postoperative pain were compared between TAA/V and IMA/V groups. RESULTS: Thirty-four patients were included; 12 in TAA/V group, and 22 in IMA/V group. There was no flap failure in both groups. There were statistically significant differences between TAA/V and IMA/V groups in vessel preparation time (10.9 ± 3.7 min vs. 24.1 ± 6.0 min, p < .001), anastomosis time (31.2 ± 12.1 min vs. 42.1 ± 11.2 min, p = .017), and total dose of acetaminophen (4566.7 ± 1015.6 mg vs. 5436.4 ± 1323.3 mg, p = .041). CONCLUSIONS: The TAA/V could be safely used as recipient vessels for DIEP flap breast reconstruction with shorter time and less postoperative pain.


Assuntos
Neoplasias da Mama/cirurgia , Artérias Epigástricas/cirurgia , Mamoplastia/métodos , Artéria Torácica Interna/cirurgia , Retalho Perfurante/irrigação sanguínea , Artérias Torácicas/cirurgia , Veias/cirurgia , Adulto , Idoso , Neoplasias da Mama/patologia , Feminino , Seguimentos , Humanos , Pessoa de Meia-Idade , Retalho Perfurante/transplante , Prognóstico , Estudos Retrospectivos
6.
Khirurgiia (Mosk) ; (1): 90-92, 2021.
Artigo em Russo | MEDLINE | ID: mdl-33395518

RESUMO

We report a complex reconstruction of arteriovenous fistula (AVF). Proximal stenosis of cephalic vein was followed by aneurysms of fistulous veins (distal segment of cephalic vein and median cubital vein) complicated by AVF thrombosis. Blood outflow from AVF was retrograde. One week after thrombosis, an aneurysm of median cubital vein containing dense clots was excised. We resected cephalic vein wall and repaired the vessel. Anastomosis with the brachial artery was created distal to the last anastomosis. Proximal cephalic vein repair was performed using resected aneurysm walls. After a year, AVF has been successfully used for hemodialysis.


Assuntos
Derivação Arteriovenosa Cirúrgica , Artéria Braquial/cirurgia , Diálise Renal , Doenças Vasculares/cirurgia , Veias/cirurgia , Aneurisma/etiologia , Aneurisma/cirurgia , Derivação Arteriovenosa Cirúrgica/efeitos adversos , Derivação Arteriovenosa Cirúrgica/métodos , Artéria Braquial/diagnóstico por imagem , Humanos , Resultado do Tratamento , Doenças Vasculares/etiologia , Grau de Desobstrução Vascular , Procedimentos Cirúrgicos Vasculares/métodos , Insuficiência Venosa/etiologia , Insuficiência Venosa/cirurgia , Trombose Venosa/etiologia , Trombose Venosa/cirurgia
9.
Microsurgery ; 41(2): 200-201, 2021 02.
Artigo em Inglês | MEDLINE | ID: mdl-33449374
10.
Methods Mol Biol ; 2206: 179-192, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-32754818

RESUMO

Xenograft models allow for an in vivo approach to monitor cellular functions within the context of a host microenvironment. Here we describe a protocol to generate a xenograft model of venous malformation (VM) based on the use of human umbilical vein endothelial cells (HUVEC) expressing a constitutive active form of the endothelial tyrosine kinase receptor TEK (TIE2 p.L914F) or patient-derived EC containing TIE2 and/or PIK3CA gene mutations. Hyperactive somatic TIE2 and PIK3CA mutations are a common hallmark of VM in patient lesions. The EC are injected subcutaneously on the back of athymic nude mice to generate ectatic vascular channels and recapitulate histopathological features of VM patient tissue histology. Lesion plugs with TIE2/PIK3CA-mutant EC are visibly vascularized within 7-9 days of subcutaneous injection, making this a great tool to study venous malformation.


Assuntos
Xenoenxertos/patologia , Células Endoteliais da Veia Umbilical Humana/patologia , Malformações Vasculares/patologia , Veias/patologia , Animais , Células Cultivadas , Classe I de Fosfatidilinositol 3-Quinases/metabolismo , Modelos Animais de Doenças , Xenoenxertos/metabolismo , Células Endoteliais da Veia Umbilical Humana/metabolismo , Humanos , Camundongos , Camundongos Nus , Receptor TIE-2/metabolismo , Malformações Vasculares/metabolismo , Veias/metabolismo
11.
Vasc Endovascular Surg ; 55(1): 58-63, 2021 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-33256561

RESUMO

PURPOSE: To report our clinical experience with IVUS-guided percutaneous deep vein arterialization (pDVA) to treat chronic critical limb ischemia (cCLI) patients with no-endovascular or surgical options approach due to creation of an arteriovenous fistula (AVF). MATERIALS AND METHODS: In a 2 years period, 14 no-option cCLI patients were treated with percutaneous deep vein arterialization (pDVA) by creating an AVF with a IVUS-guided system between posterior tibial artery and its satellite deep vein. Technical success was defined as successful AVF creation and venous perfusion of the wound site. Patients' characteristics, procedure details, mortality and wound outcomes were assessed prospectively. RESULTS: Successful pDVA was successfully performed in all patients (mean age 82 years) without any procedural complications. Clinical improvement was achieved in all patients with resolution of rest pain, tissue formation of granulation tissue or both; only 3 major amputations were performed within the study period with a limb salvage rate of 78%. Median wound healing time was 4.8 months. CONCLUSION: pDVA is a safe and feasible revascularization technique alternative in no-option cCLI patients.


Assuntos
Derivação Arteriovenosa Cirúrgica , Diabetes Mellitus , Pé/irrigação sanguínea , Isquemia/cirurgia , Doença Arterial Periférica/cirurgia , Artérias da Tíbia/cirurgia , Ultrassonografia de Intervenção , Veias/cirurgia , Idoso , Idoso de 80 Anos ou mais , Amputação , Derivação Arteriovenosa Cirúrgica/efeitos adversos , Estado Terminal , Feminino , Humanos , Isquemia/diagnóstico por imagem , Isquemia/fisiopatologia , Salvamento de Membro , Masculino , Pessoa de Meia-Idade , Doença Arterial Periférica/diagnóstico por imagem , Doença Arterial Periférica/fisiopatologia , Estudos Prospectivos , Fluxo Sanguíneo Regional , Artérias da Tíbia/diagnóstico por imagem , Artérias da Tíbia/fisiopatologia , Fatores de Tempo , Resultado do Tratamento , Veias/diagnóstico por imagem , Veias/fisiopatologia , Cicatrização
13.
Vasc Endovascular Surg ; 55(3): 228-233, 2021 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-33308082

RESUMO

BACKGROUND: Thoracic central venous obstruction (TCVO) is a common condition which can impact the ability to achieve central venous access (CVA) in patients on hemodialysis. The Surfacer® Inside-Out® Catheter Access System is designed to enable repeated right-side central venous access in patients with TCVO. METHODS: We retrospectively analyzed medical records of 10 dialysis patients who presented with TCVO and underwent the Inside-Out procedure with the Surfacer System to obtain CVA between 2017 and 2020. Patient demographics, hemodialysis vascular access history, and procedural data were identified and analyzed. The mean patient age was 62.4 ± 19.6 years (25.9-89.1 years) with 7 of the 10 patients being male. Eight patients (80.0%) were diagnosed with chronic kidney disease with time on hemodialysis ranging from 3 to 13 years. The remaining 2 required CVA to treat acute-on-chronic kidney injury due to septic shock. Patients in our series had a mean of 2.8 ± 1.6 previous catheters placed prior to the Surfacer procedure. RESULTS: CVA was achieved in all 10 patients with 1 patient requiring a second attempt to achieve access due to the inability to initially traverse the iliac vein with the device, possibly due to a history of kidney transplantation. One multimorbid patient died shortly after the successful procedure, possibly due to cardiac decompensation. Mean total procedure time for the 7 patients having only dialysis catheter placement using the Surfacer device was 67.2 ± 19.1 minutes (49-103 minutes). The remaining 3 patients received a Hemodialysis Reliable Outflow (HeRO) graft in conjunction with the Inside-Out procedure. All vascular accesses functioned properly during the immediate time period following placement. No adverse events associated with the use of Surfacer device were encountered. CONCLUSIONS: Data presented from our patient series confirms the effectiveness of the Surfacer System to safely achieve CVA in dialysis patients with TCVOs with a history of multiple catheter placements.


Assuntos
Cateterismo Venoso Central/instrumentação , Cateteres de Demora , Cateteres Venosos Centrais , Nefropatias/terapia , Diálise Renal , Tórax/irrigação sanguínea , Doenças Vasculares/complicações , Veias , Adulto , Idoso , Idoso de 80 Anos ou mais , Cateterismo Venoso Central/efeitos adversos , Desenho de Equipamento , Feminino , Humanos , Nefropatias/complicações , Nefropatias/diagnóstico , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Resultado do Tratamento , Doenças Vasculares/diagnóstico por imagem , Veias/diagnóstico por imagem
14.
Cir. plást. ibero-latinoam ; 46(4): 471-474, oct.-dic. 2020. ilus
Artigo em Espanhol | IBECS | ID: ibc-198734

RESUMO

La ferulización arterial es una modificación de la técnica de envoltura del sitio de aneurisma en aorta que se realiza en cirugía cardiotorácica. En microcirugía, modificamos la técnica sin envolver completamente el sitio de anastomosis cuando se presenta una angulación, sino solo ferulizándolo para disminuir la angulación de la anastomosis arterial causada por la turbulencia del paso del flujo sanguíneo y el alargamiento del pedículo empleando un injerto de vena como puente entre el vaso receptor y el pedículo del colgajo. Presentamos un caso de resección de carcinoma mandibular y reconstrucción con colgajo libre de tensor de fascia lata que a las 32 horas de la cirugía sufre sangrado profuso por avulsión de la microanastomosis arterial. Utilizamos 16 cm de vena safena para reconstruir el desgarro en el pedículo arterial y elongarlo, de cara a disminuir la tensión en la microanastomosis del vaso receptor y el pedículo del colgajo libre. Tras la microanastomosis se presenta angulación del pedículo y retardo de 10 segundos en el llenado capilar tras punción con aguja del colgajo libre. Reservamos 4 cm del injerto de vena para ferulizar el sitio de angulación de la microanastomosis arterial con el injerto de vena, observando disminución del ángulo de la microanastomosis y llenado capilar de 2 a 3 segundos, mejorando así la perfusión del colgajo libre


Arterial splinting is a modification of the aortic aneurysm site wrapping technique performed in cardiothoracic surgery. In microsurgery, we modify the technique without completely wrapping the anastomosis site when angulation occurs, but only splinting it to decrease angulation of the arterial anastomosis caused by turbulence in the passage of blood flow and lengthening of the pedicle using a vein graft such as bridge between the recipient vessel and the flap pedicle. We present a case of resection of mandibular carcinoma and reconstruction with fascia lata tensor free flap that, 32 hours after surgery, suffered profuse bleeding due to avulsion of the arterial microanastomosis. We used 16 cm of the saphenous vein to reconstruct the tear in the arterial pedicle and lengthen it in order to decrease the tension in the microanastomosis of the recipient vessel and the pedicle of the free flap. After microanastomosis, angulation of the pedicle occurs and noticed a 10-second delay in capillary filling after needle puncture of the free flap. We reserved 4 cm of the vein graft to splinting the angulation site of the arterial microanastomosis with the vein graft, achieving a decrease in the angle of the microanastomosis and a capillary filling of 2 to 3 seconds, thus improving the perfusion of the free flap


Assuntos
Humanos , Masculino , Pessoa de Meia-Idade , Derivação Arteriovenosa Cirúrgica/métodos , Artérias/cirurgia , Microcirurgia/métodos , Procedimentos Cirúrgicos Reconstrutivos/instrumentação , Aneurisma Aórtico/cirurgia , Veias/transplante , Enxerto Vascular/métodos , Retalhos de Tecido Biológico/cirurgia , Mandíbula/cirurgia
15.
BMJ Case Rep ; 13(12)2020 Dec 21.
Artigo em Inglês | MEDLINE | ID: mdl-33370935

RESUMO

We report the case of a 35-year-old woman who presented with recurrent macroscopic haematuria and known diagnosis of Klippel-Trenaunay syndrome. Imaging and cystoscopy identified an extensive venous malformation involving a large area of the bladder wall. Holmium laser therapy was ineffective at obtaining symptom control. Following a multidisciplinary team meeting, transvenous sclerotherapy with sodium tetradecyl sulphate was performed under image guidance. A reduction in venous density was observed on cystoscopy and the patient has had complete resolution of symptoms within 6 weeks and continued to be asymptomatic up to 24-month follow-up. We propose that transvenous sclerotherapy is considered first-line treatment in this clinical setting.


Assuntos
Hematúria/terapia , Síndrome de Klippel-Trenaunay-Weber/complicações , Escleroterapia/métodos , Malformações Vasculares/terapia , Veias/patologia , Administração Intravenosa , Adulto , Cistoscopia , Feminino , Hematúria/etiologia , Humanos , Síndrome de Klippel-Trenaunay-Weber/terapia , Lasers de Estado Sólido/uso terapêutico , Angiografia por Ressonância Magnética , Soluções Esclerosantes/administração & dosagem , Tetradecilsulfato de Sódio/administração & dosagem , Resultado do Tratamento , Bexiga Urinária/irrigação sanguínea , Bexiga Urinária/diagnóstico por imagem , Bexiga Urinária/patologia , Malformações Vasculares/diagnóstico , Malformações Vasculares/etiologia , Malformações Vasculares/patologia , Veias/diagnóstico por imagem , Veias/efeitos dos fármacos
16.
Angiol Sosud Khir ; 26(4): 71-77, 2020.
Artigo em Russo | MEDLINE | ID: mdl-33332308

RESUMO

Modern vascular surgery has the data on a substantial role of the endothelium in pathogenesis of vascular diseases. Endothelial dysfunction is associated with a wide range of pathological processes including those in chronic diseases of lower-limb veins. The discovery of the endothelial glycocalyx made it possible to evaluate its role in the development of endothelial dysfunction as a trigger mechanism in impairment of venous blood flow. The understanding of the unifying role of endothelial dysfunction in pathology in various fields of medicine provides a possibility of predicting the development of serious socially significant diseases such as cardiovascular diseases, diabetes mellitus, obstetrical complications, and to correct the conditions associated therewith. The present study was aimed at carrying out a systematic literature review, thus making it possible to evaluate the role of the endothelial glycocalyx in the development of endothelial dysfunction, as well as to determine therapy with sulodexide capable of decreasing the probability of the onset of endothelial dysfunction at the expense of an anti-inflammatory, antithrombotic, and angioprotective effect on the endothelial wall.


Assuntos
Glicocálix , Doenças Vasculares , Anti-Inflamatórios , Endotélio Vascular , Humanos , Veias
18.
Adv Chronic Kidney Dis ; 27(5): 390-396, 2020 09.
Artigo em Inglês | MEDLINE | ID: mdl-33308504

RESUMO

The coronavirus (coronavirus disease-2019) pandemic has changed care delivery for patients with end-stage kidney disease. We explore the US healthcare system as it pertains to dialysis care, including existing policies, modifications implemented in response to the coronavirus disease-2019 crisis, and possible next steps for policy makers and nephrologists. This includes policies related to resource management, use of telemedicine, prioritization of dialysis access procedures, expansion of home dialysis modalities, administrative duties, and quality assessment. The government has already established policies that have instated some flexibilities to help providers focus their response to the crisis. However, future policy during and after the coronavirus disease-2019 pandemic can bolster our ability to optimize care for patients with end-stage kidney disease. Key themes in this perspective are the importance of policy flexibility, clear strategies for emergency preparedness, and robust health systems that maximize accessibility and patient autonomy.


Assuntos
Política de Saúde , Falência Renal Crônica/terapia , Nefrologia , Diálise Renal/métodos , Telemedicina/métodos , Instituições de Assistência Ambulatorial , Anastomose Cirúrgica , Artérias/cirurgia , Implante de Prótese Vascular , Centers for Medicare and Medicaid Services, U.S. , Segurança Computacional , Assistência à Saúde/métodos , Assistência à Saúde/normas , Planejamento em Desastres , Acesso aos Serviços de Saúde , Soluções para Hemodiálise/provisão & distribução , Hemodiálise no Domicílio/métodos , Hemodiálise no Domicílio/normas , Humanos , Organização e Administração/normas , Autonomia Pessoal , Equipamento de Proteção Individual , Garantia da Qualidade dos Cuidados de Saúde , Mecanismo de Reembolso , Diálise Renal/instrumentação , Diálise Renal/normas , Telemedicina/normas , Estados Unidos , Veias/cirurgia
19.
J Toxicol Sci ; 45(10): 599-609, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33012728

RESUMO

To assess the influences of blood sampling volumes or sites on toxicological and toxicokinetic (TK) evaluations, 4-week duration animal studies and a single-dose TK study of imipramine were conducted. In the toxicological evaluation, six-week-old Sprague-Dawley rats were divided into no blood and blood sampling groups. Fifty microliters (microsampling) or 100 µL (larger sampling) of blood/time point was collected from the jugular vein (50 µL of data was reported previously as Yokoyama et al., 2020) or the tail vein 6 to 7 times on days 1/2 and in week 4. Although no parameters were affected by the 100 µL sample from the tail vein, the 100 µL jugular vein sampling decreased the red blood cell parameters in females, possibly due to hemorrhage at the sampling site. Regarding the TK assessment, 50 µL of blood/site/time point was collected at 6 time points from the tail and jugular vein of the same male rats after single oral administration of 10 or 100 mg/kg imipramine, which was selected as a representative drug with high distribution volume. Although there were no differences in the AUC0-24hr and Cmax values between the sites, the plasma concentrations at the early time points were significantly lower from the tail vein than the jugular vein. From our studies, 50 µL of jugular and tail vein microsampling did not affect the toxicity parameters or AUC/Cmax. However, appropriate toxicity considerations and/or selection of the blood sampling site may be important in the case of larger sampling volumes or blood concentration assessment.


Assuntos
Coleta de Amostras Sanguíneas/métodos , Imipramina/toxicidade , Veias Jugulares , Pescoço/irrigação sanguínea , Cauda/irrigação sanguínea , Testes de Toxicidade/métodos , Veias , Administração Oral , Animais , Feminino , Imipramina/administração & dosagem , Masculino , Ratos Sprague-Dawley , Toxicocinética
20.
Angiol Sosud Khir ; 26(3): 60-67, 2020.
Artigo em Russo | MEDLINE | ID: mdl-33063753

RESUMO

Lower extremity chronic venous disease is a highly prevalent vascular pathology. Progression of the disease exerts a negative impact on the patients' quality of life and imposes a large economic burden on the healthcare systems. Conventional methods of conservative treatment of chronic venous disease include wearing compression knitwear and pharmacological therapy. Although highly effective, compression therapy appears to be associated with lower compliance due to difficulties putting on and taking off the compression stockings. Therefore, the majority of patients prefer pharmacological therapy with phlebotonic drugs. There are many phlebotropic agents possessing particular indications and recommendations regarding the duration of administration. This article presents a review of the available literature addressing the problems related to prescription of pharmacotherapy to patients with lower limb chronic venous disease, also describing the results of published clinical studies evaluating efficacy and safety of phlebotropic drugs, as well as those concerning the duration of the course administration of drugs depending on the severity of the disease, invasive nature of a surgical intervention performed, or sclerotherapy. Besides, analysed is the role of phleboactive agents in correction of pathophysiological mechanisms of the development and progression of venous disease. This is followed by a review of clinical trials studying the influence of phlebotonics on such links of pathogenesis as leukocyte activation, vein-specific inflammation, endothelial dysfunction, and activation of proteolytic enzymes promoting destruction of the extracellular matrix. Based on the above data, proposed herein are appropriate approaches to determining the duration of the courses of phlebotropic therapy with due regard for the patients' status, underlying once again the importance and necessity of a personalized approach to selection of the optimal duration of venotonic therapy.


Assuntos
Qualidade de Vida , Doenças Vasculares , Duração da Terapia , Humanos , Meias de Compressão , Veias
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