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Moreno O, Kumar K, Lurie F, Passman MA, Jacobowitz G, Aziz F, Henke P, Wakefield T, Obi A. A mapping review of Pacific Vascular Symposium 6 initiatives. J Vasc Surg Venous Lymphat Disord 2024; 12:101723. [PMID: 38135216 DOI: 10.1016/j.jvsv.2023.101723] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2023] [Revised: 11/08/2023] [Accepted: 11/11/2023] [Indexed: 12/24/2023]
Abstract
OBJECTIVE The 2010 Pacific Vascular Symposium 6 (PVS6) brought venous disease content experts together with a goal of addressing critical issues collated together in the next decade with concrete plans to achieve these goals. This mapping review aims to provide a broader representation of how progress in critical issues of chronic venous disease has been made by extrapolating scientific publications related to the PVS6 initiatives. METHODS We performed a mapping review identifying original or systematic review/meta-analysis articles related to PVS 6 initiatives (aims) that addressed one of the following key objectives: scales to measure chronic venous disease, effectiveness of interventional deep venous thrombus removal, development of a deep venous valve, and biomarkers related to venous disease. Searches were undertaken in PubMed, Ovid Medline, Cochrane Library, Embase (Elsevier), CINAHL (EBSCO), and Scopus. We extracted descriptive information about the studies and predefined variables for each specific aim, showing what and where research exists on the aims included. RESULTS A total of 2138 articles were screened from 3379 retrieved articles from six electronic databases. We mapped 186 included articles, finding that the total number of publications significantly increased after the 2010 PVS6 meeting. Aim results were visually summarized. The largest body of data addressed catheter-based thrombus removal strategies for acute iliofemoral deep venous thrombosis. Primary research on artificial venous valves and venous biomarkers remained limited. No new post-thrombotic syndrome (PTS) score has been developed. CONCLUSIONS This mapping review identified and characterized the available evidence and gaps in our knowledge of chronic venous disease that exist visually, which may guide where more significant investments for the future should be targeted.
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Affiliation(s)
- Oscar Moreno
- Section of Vascular Surgery, Department of Surgery, University of Michigan, Ann Arbor, MI
| | - Kiran Kumar
- Section of Vascular Surgery, Department of Surgery, University of Michigan, Ann Arbor, MI
| | - Fedor Lurie
- Section of Vascular Surgery, Department of Surgery, University of Michigan, Ann Arbor, MI; Jobst Vascular Institute of ProMedica, Toledo, OH
| | - Marc A Passman
- UAB Vein Program and Clinic, Department of Surgery, The University of Alabama at Birmingham, Birmingham, AL
| | - Glen Jacobowitz
- Section of Vascular Surgery, Department of Surgery, New York University, New York, NY
| | - Faisal Aziz
- Division of Vascular Surgery, Department of Surgery, The Pennsylvania State University, Hershey, PA
| | - Peter Henke
- Section of Vascular Surgery, Department of Surgery, University of Michigan, Ann Arbor, MI
| | - Thomas Wakefield
- Section of Vascular Surgery, Department of Surgery, University of Michigan, Ann Arbor, MI
| | - Andrea Obi
- Section of Vascular Surgery, Department of Surgery, University of Michigan, Ann Arbor, MI.
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Cifuentes S, Ulloa JH, Rasmussen TE. An Implantable Bioprosthetic Venous Valve to Establish Deep Vein Competence for Post-Thrombotic Syndrome. JAMA Surg 2023; 158:316-317. [PMID: 36652222 DOI: 10.1001/jamasurg.2022.6362] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
This article discusses the VenoValve bioprosthetic device, which is designed to improve valvular competence in the deep venous system of the lower extremities and treat deep venous insufficiency.
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Affiliation(s)
- Sebastian Cifuentes
- Division of Vascular and Endovascular Surgery, Mayo Clinic, Rochester, Minnesota
| | - Jorge H Ulloa
- Division of Vascular and Endovascular Surgery, Fundacion Santa Fe de Bogota, Bogota, Colombia
| | - Todd E Rasmussen
- Division of Vascular and Endovascular Surgery, Mayo Clinic, Rochester, Minnesota
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Bhardwaj R, Bhambhani A, Patibandla S, Mirza M, Aggrawal G. Venous Intervention. INDIAN JOURNAL OF CARDIOVASCULAR DISEASE IN WOMEN 2022. [DOI: 10.25259/ijcdw_13_2022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
Any overview of the treatment of venous disease should begin with a brief examination of its history. From the first rudimentary attempt at venous thrombectomy in the early 1920s to the evolution of percutaneous and mechanical thrombectomy and endovascular stents in the 21st century. It is the aim of this review to provide a comprehensive summary of the state of the art of venous disease treatment at the turn of the new century.
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Affiliation(s)
- Rajeev Bhardwaj
- Department of Cardiology, Maharishi Markandeshwar Institute of Medical Sciences and Research, Ambala, Haryana, India,
| | - Anupam Bhambhani
- Department of Cardiology, Maharishi Markandeshwar Institute of Medical Sciences and Research, Ambala, Haryana, India,
| | - Sivaji Patibandla
- Department of Cardiology, Maharishi Markandeshwar Institute of Medical Sciences and Research, Ambala, Haryana, India,
| | - Mehroz Mirza
- Department of Cardiology, Maharishi Markandeshwar Institute of Medical Sciences and Research, Ambala, Haryana, India,
| | - Gaurav Aggrawal
- Department of Cardiology, Maharishi Markandeshwar Institute of Medical Sciences and Research, Ambala, Haryana, India,
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Siddiqa A, Haider A, Fortuzi K, Adrish M, Ishak C. May-Thurner Syndrome: A Rare Case of Unilateral Deep Vein Thrombosis in an Elderly Woman. AMERICAN JOURNAL OF CASE REPORTS 2021; 22:e929897. [PMID: 34460807 PMCID: PMC8420678 DOI: 10.12659/ajcr.929897] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Patient: Female, 78-year-old
Final Diagnosis: May-Thurner syndrome
Symptoms: Lower extremity edema • lower extremity pain
Medication: —
Clinical Procedure: —
Specialty: Critical Care Medicine • Hematology • General and Internal Medicine • Radiology
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Affiliation(s)
- Ayesha Siddiqa
- Department of Internal Medicine, BronxCare Health System, Bronx, NY, USA
| | - Asim Haider
- Department of Internal Medicine, BronxCare Health System, Bronx, NY, USA
| | - Ked Fortuzi
- Department of Internal Medicine, BronxCare Health System, Bronx, NY, USA
| | - Muhammad Adrish
- Department of Internal Medicine, BronxCare Health System, Bronx, NY, USA.,Department of Pulmonary Critical Care, BronxCare Health System, Bronx, NY, USA
| | - Charbel Ishak
- Department of Interventional Radiology, BronxCare Health System, Bronx, NY, USA
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Bosevski M, Krstevski G, Di Micco P, Fidalgo A, Loring M, Porras JA, Mellado M, Sánchez Muñoz-Torrero JF, Vela JR, Tzoran I, Monreal M. Risk for post-thrombotic syndrome after lower-limb deep vein thrombosis: location of the thrombus or residual thrombi? ANGIOLOGII︠A︡ I SOSUDISTAI︠A︡ KHIRURGII︠A︡ = ANGIOLOGY AND VASCULAR SURGERY 2021; 27:62-72. [PMID: 34166345 DOI: 10.33529/angio2021108] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
BACKGROUND Many works aimed to determine factors that influence the onset of postthrombotic syndrome after an acute episode of deep venous thrombosis. We aimed to compare the prognostic value of the most proximal extent of thrombus (proximal and distal DVT) versus the residual thrombosis as identified by venous ultrasonography performed during follow-up. METHOD We conducted a retrospective study of prospectively collected 1183 consecutive cohort patients in the RIETE registry after a first episode of deep venous thrombosis and assessed for postthrombotic syndrome after 12 months. RESULTS Multivariate analysis revealed that: residual thrombosis (OR 1.40; 95% CI 0,88-2,21), the presence of cancer (OR 1.38; 95% CI: 0,64-2,97), immobility (OR 1.31; 95% CI 0,70-2,43) and estrogen-containing drugs use (OR 2.08, 95% CI 0,63-6,83), all had a predictive value for the occurrence of PTS. CONCLUSION Our study results revealed that ultrasound finding of residual thrombosis is more predictive than proximal location of thrombus for postthrombotic syndrome after episode of deep venous thrombosis. Real life data from a large group of patients from the RIETE registry substantiates that.
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Affiliation(s)
- M Bosevski
- University Cardiology Clinic, Vascular Centre, Faculty of Medicine, Skopje, R.N. Macedonia
| | - G Krstevski
- University Cardiology Clinic, Vascular Centre, Faculty of Medicine, Skopje, R.N. Macedonia
| | - P Di Micco
- Department of Internal Medicine and Emergency Room, Ospedale Buon Consiglio Fatebenefratelli, Naples, Italy
| | - A Fidalgo
- Department of Internal Medicine, Hospital Universitario de Salamanca, Salamanca, Spain
| | - M Loring
- Department of Internal Medicine, Hospital Comarcal de Axarquía, Málaga, Spain
| | - J A Porras
- Department of Internal Medicine, Hospital Universitario Joan XXIII de Tarragona, Tarragona, Spain
| | - M Mellado
- Department of Angiology and Vascular Surgery, Hospital del Mar, Barcelona, Spain
| | | | - J R Vela
- Department of Internal Medicine, Hospital Universitario Miguel Servet, Zaragoza, Spain
| | - I Tzoran
- Department of Hematology and Bone Marrow Transplantation, Rambam Health Care Campus, Haifa, Israel
| | - M Monreal
- Department of Internal Medicine, Hospital Germans Trias i Pujol Badalona, Barcelona, Universidad Autónoma de Barcelona, Barcelona, Spain
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Jin W, Yu G, Huang J, Lu K, Huang C. Timing of Endovascular Interventions for Iliac Vein Compression Syndrome With Thrombus. Clin Appl Thromb Hemost 2021; 27:10760296211026974. [PMID: 34151610 PMCID: PMC8221663 DOI: 10.1177/10760296211026974] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
The aim of this study is to explore the timing and method of endovascular intervention for iliac vein compression syndrome (IVCS) with thrombus. Data from 111 patients with IVCS, complicated acute deep vein thrombosis (DVT), or post-thrombotic syndrome (PTS) who underwent endovascular interventions were analyzed retrospectively. Patients were divided into Group A (DVT group), including 56 patients with IVCS and iliofemoral DVT, with or without femoropopliteal DVT, with sudden lower limb swelling, and Group B (PTS group) included 55 patients with IVCS and PTS, including 18 with lower extremity wet ulcers and 32 with lower limb infections. Interventional therapies were used to treat the thrombus and eliminate stenosis and occlusion of the iliac vein. In both groups, clinical symptoms in the lower limbs after surgery were reduced significantly, and PTS incidence was low during long-term follow-up. The cumulative patency rate was 75.2% in the DVT group and 88.6% in the PTS group. Comprehensive interventional therapies are safe and effective in patients with IVCS and thrombi. Long-term efficacy in the PTS group tended to be better than that in the DVT group.
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Affiliation(s)
- Wenxu Jin
- Department of Vascular Surgery, 89657The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
| | - Guanfeng Yu
- Department of Vascular Surgery, 89657The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
| | - Jingyong Huang
- Department of Vascular Surgery, 89657The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
| | - Kangkang Lu
- Department of Breast and Thyroid Surgery, 89657The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
| | - Chongqing Huang
- Department of Vascular Surgery, 89657The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
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May-Thurner syndrome and the risk of pulmonary embolism in patients with acute deep venous thrombosis. J Vasc Surg Venous Lymphat Disord 2018; 6:433-440.e1. [PMID: 29909851 DOI: 10.1016/j.jvsv.2018.01.007] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2017] [Accepted: 01/02/2018] [Indexed: 12/17/2022]
Abstract
OBJECTIVE Pulmonary embolism (PE) is the most common complication of deep venous thrombosis (DVT). May-Thurner syndrome (MTS) is known to increase the risk of DVT, but an association between MTS and PE has not been established. This study investigated an association between MTS and the risk of PE in patients with acute lower extremity DVT. METHODS Between June 2014 and September 2016, there were 112 patients with DVT at our hospital who underwent venous angiography and computed tomography pulmonary angiography. Data related to the patients' demographics, risk factors, disease onset time, side of DVT, D-dimer level, Doppler ultrasound, venous angiography, and computed tomography pulmonary angiography were collected. Associations between MTS and PE were analyzed. RESULTS The 112 DVT patients included 79 with MTS. The rate of DVT in the left lower extremity was higher in the MTS group (98.7%) than in the non-MTS group (48.5%; P < .001). PE was less common in the MTS group (50.6%) than in the non-MTS group (78.8%; P = .006). The multinomial logistic analysis revealed a significant negative correlation between MTS and PE. The correlation remained after applying adjustment models I, II, and III. Model I adjusted for risk factors, DVT side, and D-dimer tertile (odds ratio [OR], 0.17; 95% confidence interval [CI], 0.04-0.68; P = .0125); model II adjusted for sex, age, risk factors, onset time, DVT side, D-dimer level, and D-dimer tertile (OR, 0.15; 95% CI, 0.03-0.71; P = .0162); and model III adjusted for sex, age, risk factors, onset time, DVT side, D-dimer level, D-dimer tertile, iliofemoral DVT, mixed (both iliofemoral and femoropopliteal) DVT, and femoropopliteal DVT (OR, 0.35; 95% CI, 0.06-2.08; P = .2501). CONCLUSIONS DVT patients with concomitant MTS have a decreased risk of PE compared with those without MTS. This finding extends previous reports of increased PE risk after DVT and calls for better understanding of shared risk factors and underlying mechanisms.
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Aziz F, Raffetto JD, Diaz JA, Myers DD, Ozsvath KJ, Carman TL, Lal BK. Practice patterns of adjunctive therapy for venous leg ulcers. Phlebology 2016; 32:19-26. [PMID: 26769720 DOI: 10.1177/0268355515625526] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Objectives Venous leg ulcers (VLU) are the most severe clinical sequelae of venous reflux and post thrombotic syndrome. There is a consensus that ablation of refluxing vein segments and treatment of significant venous obstruction can heal VLUs. However, there is wide disparity in the use and choice of adjunctive therapies for VLUs. The purpose of this study was to assess these practice patterns among members of the American Venous Forum. Methods The AVF Research Committee conducted an online survey of its own members, which consisted of 16 questions designed to determine the specialty of physicians, location of treatment, treatment practices and reimbursement for treatment of VLUs Results The survey was distributed to 667 practitioners and a response rate of 18.6% was achieved. A majority of respondents (49.5%) were vascular specialists and the remaining were podiatrists, dermatologists, primary care doctors and others. It was found that 85.5% were from within the USA, while physicians from 14 other countries also responded. Most of the physicians (45%) provided adjunctive therapy at a private office setting and 58% treated less than 5 VLU patients per week. All respondents used some form of compression therapy as the primary mode of treatment for VLU. Multilayer compression therapy was the most common form of adjunctive therapy used (58.8%) and over 90% of physicians started additional modalities (biologics, negative pressure, hyperbaric oxygen and others) when VLUs failed compression therapy, with a majority (65%) waiting less than three months to start them. Medicare was the most common source of reimbursement (52.4%). Conclusions Physicians from multiple specialties treat VLU. While most physicians use compression therapy, there is wide variation in the selection and point of initiation for additional therapies once compression fails. There is a need for high-quality data to help establish guidelines for adjunctive treatment of VLUs and to disseminate them to physicians across multiple specialties to ensure standardized high-quality treatment of patients with VLUs.
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Affiliation(s)
- Faisal Aziz
- 1 Vascular Surgery, Penn State Heart and Vascular Institute, Penn State Hershey College of Medicine, Hershey, PA, USA
| | - Joseph D Raffetto
- 2 Vascular Surgery, VA Boston HCS, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Jose A Diaz
- 3 Vascular Surgery, University of Michigan, Ann Arbor, MI, USA
| | - Daniel D Myers
- 3 Vascular Surgery, University of Michigan, Ann Arbor, MI, USA
| | | | - Teresa L Carman
- 5 Vascular Medicine, University Hospitals Case Medical Center, Cleveland, OH, USA
| | - Brajesh K Lal
- 6 Vascular Surgery, University of Maryland School of Medicine, Baltimore, MD, USA
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Mousa AY, AbuRahma AF. May–Thurner Syndrome: Update and Review. Ann Vasc Surg 2013; 27:984-95. [DOI: 10.1016/j.avsg.2013.05.001] [Citation(s) in RCA: 139] [Impact Index Per Article: 12.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2012] [Revised: 05/07/2013] [Accepted: 05/08/2013] [Indexed: 01/27/2023]
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Gloviczki P, Comerota AJ, Dalsing MC, Eklof BG, Gillespie DL, Gloviczki ML, Lohr JM, McLafferty RB, Meissner MH, Murad MH, Padberg FT, Pappas PJ, Passman MA, Raffetto JD, Vasquez MA, Wakefield TW. The care of patients with varicose veins and associated chronic venous diseases: Clinical practice guidelines of the Society for Vascular Surgery and the American Venous Forum. J Vasc Surg 2011; 53:2S-48S. [PMID: 21536172 DOI: 10.1016/j.jvs.2011.01.079] [Citation(s) in RCA: 826] [Impact Index Per Article: 63.5] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2011] [Revised: 01/12/2011] [Accepted: 01/15/2011] [Indexed: 12/20/2022]
Affiliation(s)
- Peter Gloviczki
- Division of Vascular and Endovascular Surgery, Mayo Clinic, Rochester, Minnesota 55905, USA.
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