Metamorphosis: Less Is More in Varicose Vein Surgery
This interesting paper by Somasundaram et al. is focused on office based varicose vein surgery, with segmental radiofrequency ablation of the saphenous vein without treating the collateral veins, as the first option. Classically, varicose vein treatment includes the extraction or elimination of all veins involved; therefore, the non-treat ment of any of the affected veins is considered a technical failure.1 Nevertheless, selective treatment of varicose veins without treating all the affected ones is one of the accepted strategies in the CHIVA method1,2 and other haemodynamic approaches.
Post-zygotic mutations in GNAQ/GNA11 genes encoding heterotrimeric G protein alpha subunits account for skin mosaic conditions with vascular or pigmentary anomalies (Shirley et al. 2013; Thomas et al. 2016; Couto et al. 2017; Siegel et al. 2018). We sought to delineate the phenotype of 32 patients with skin capillary malformations (CMs) harbouring an activating post-zygotic mutation in GNA11 or GNAQ in affected skin. Nevus flammeus, ipsilateral segmental overgrowth, varicose veins and macrocephaly were associated with GNAQ mutations, whereas cutis marmorata, nevus anemicus, and ipsilateral hypotrophy were associated with GNA11 mutations.
Conclusions: Adjunct sclerotherapy showed complication rate of roughly one tenth and one fifth of the treated cases in immediate and early postoperative follow-up. PMID: 31687213 [PubMed]
Conclusion: All patients with lower leg pigmentation with or without visible varicose vein should undergo vascular US to rule out any venous insufficiency.
Publication date: Available online 5 November 2019Source: Journal of Vascular Surgery: Venous and Lymphatic DisordersAuthor(s): Zhenyu Guo, Xu Li, Tao Wang, Jianjun Liu, Bin Chen, Longhua FanAbstractBackgroundLower limb chronic venous disease (CVD), resulting from iliac vein compression syndrome (IVCS), manifests as a series of symptoms ranging from varicose veins to venous ulcerations. Stent implantation has been considered an effective treatment method; however, the management of CVD has rarely been reported. In the present study, we evaluated the treatment and outcomes of patients with CVD.MethodsWe performed a retrospe...
CONCLUSION: EVLA and RF therapies in saphenous vein insufficiency are effective, minimally invasive, safe, easy to use treatment modalities with good patient satisfaction and high occlusion rates. KEY WORDS: EVLA, Radiofrquency, Venousinsufficiency. PMID: 31661439 [PubMed - as supplied by publisher]
Conclusions: In conclusion, our study results show that although HLS seems to be an effective method for the treatment of a GSV diameter of ≥10 mm with a low recurrence rate, it does not statistically significantly differ from EVLA at 1,470 nm wavelength and RFA. Therefore, we believe that EVLA at 1,470 nm wavelength and RFA can be preferred over HLS with low pain scores in this patient population. PMID: 31635532 [PubMed - as supplied by publisher]
ConclusionThe PCS is associated with an increase in the incidence and severity of the CVD symptoms.
Chronic venous disease (CVD) includes a broad spectrum of conditions like telangiectasias, reticular veins, varicose veins, edema, skin changes, and ulcerations. Several studies have shown the association of higher homocysteine levels with a severe form of CVD. The aim was to assess the homocysteine level in various stages of primary CVD and its relation with severity.
Authors: Critello CD, Pullano SA, Matula TJ, de Franciscis S, Serra R, Fiorillo AS Abstract 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 und...
Orthostatic hypotension (OH) is a sustained fall in blood pressure on standing that can cause symptoms of organ hypoperfusion. OH is associated with increased morbidity and mortality and leads to a significant number of hospital admissions. OH can be caused by volume depletion, blood loss, cardiac pump failure, large varicose veins, medications, or defective activation of sympathetic nerves and reduced norepinephrine release upon standing. Neurogenic OH is a frequent and disabling problem in patients with synucleinopathies such as Parkinson disease, multiple system atrophy, and pure autonomic failure, and it is commonly as...