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Tegos TJ, Kalodiki E, Sabetai MM, Stavropoulos P, Nicolaides AN. New Information on the Value of Plaque Characterisation — Relation to Symptoms. Acta Chir Belg 2020. [DOI: 10.1080/00015458.2000.12098561] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Affiliation(s)
- T. J. Tegos
- Irvine Laboratory for Cardiovascular Investigation and Research, Department of Vascular Surgery, Imperial College of Science, Technology and Medicine, at St Mary’s Hospital, Praed St., Paddington, London W2 1NY, UK
| | - E. Kalodiki
- Irvine Laboratory for Cardiovascular Investigation and Research, Department of Vascular Surgery, Imperial College of Science, Technology and Medicine, at St Mary’s Hospital, Praed St., Paddington, London W2 1NY, UK
| | - M. M. Sabetai
- Irvine Laboratory for Cardiovascular Investigation and Research, Department of Vascular Surgery, Imperial College of Science, Technology and Medicine, at St Mary’s Hospital, Praed St., Paddington, London W2 1NY, UK
| | - P. Stavropoulos
- Irvine Laboratory for Cardiovascular Investigation and Research, Department of Vascular Surgery, Imperial College of Science, Technology and Medicine, at St Mary’s Hospital, Praed St., Paddington, London W2 1NY, UK
| | - A. N. Nicolaides
- Irvine Laboratory for Cardiovascular Investigation and Research, Department of Vascular Surgery, Imperial College of Science, Technology and Medicine, at St Mary’s Hospital, Praed St., Paddington, London W2 1NY, UK
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Lattimer C, Rudolphi P, Recke A, Geroulakos G, Kalodiki E, Kahle B. Comparison of Four Haemodynamic Tests that Quantify Superficial Venous Insufficiency. J Vasc Surg Venous Lymphat Disord 2020. [DOI: 10.1016/j.jvsv.2019.12.064] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Caggiati A, Lattimer C, Kalodiki E, Oberto S, Bergamo G, Kontothanassis D. Underwater Sonography of Leg Veins. J Vasc Surg Venous Lymphat Disord 2019. [DOI: 10.1016/j.jvsv.2019.02.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Lattimer C, Kalodiki E, Azzam M, Geroulakos G. Haemodynamic Performance of Low Strength Below Knee Graduated Elastic Compression Stockings in Health, Venous Disease, and Lymphoedema. J Vasc Surg 2016. [DOI: 10.1016/j.jvs.2016.05.053] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Abstract
Objective: To determine the role of liquid crystal thermography (LCT) in preoperative marking of varicose veins and incompetent perforating veins. Design: Single patient group study comparing techniques. Setting: Teaching hospital vascular laboratory. Patients: Two hundred patients (265 legs) referred to St Mary's Hospital Vascular Laboratory for preoperative varicose vein marking. Methods: Patients were studied using LCT and duplex ultrasonography to identify calf perforating veins. Results: In part I of the study LCT identified 47 ‘areas at risk’, 42 of which were demonstrated to contain incompetent perforating veins on duplex examination (positive predictive value 89%). Thirty-eight of these 42 patients were explored at operation and 36 (95%) were confirmed as incompetent. The remaining two perforating veins could not be located. In part II of the study LCT identified 327 ‘areas at risk’, 299 of which were demonstrated to contain incompetent perforating veins on duplex examination (positive predictive value 91%). Conclusion: LCT is useful in the identification of incompetent perforating veins, it is easy to perform, less time consuming, cheaper and can replace duplex scanning.
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Affiliation(s)
- E. Kalodiki
- Irvine Laboratory for Cardiovascular Investigation and Research, Academic Surgical Unit, St Mary's Hospital Medical School, Imperial College of Science Technology and Medicine, London W2, UK
| | - L. Calahoras
- Irvine Laboratory for Cardiovascular Investigation and Research, Academic Surgical Unit, St Mary's Hospital Medical School, Imperial College of Science Technology and Medicine, London W2, UK
| | - G. Geroulakos
- Irvine Laboratory for Cardiovascular Investigation and Research, Academic Surgical Unit, St Mary's Hospital Medical School, Imperial College of Science Technology and Medicine, London W2, UK
| | - A. N. Nicolaides
- Irvine Laboratory for Cardiovascular Investigation and Research, Academic Surgical Unit, St Mary's Hospital Medical School, Imperial College of Science Technology and Medicine, London W2, UK
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Abstract
Objective: A methodological report of duplex ultrasound examination of the venous system, with Particular consideration of the best position for examining the patient. Design: Single patient group, comparison of duplex ultrasound imaging with phlebography. getting: Teaching hospital vascular laboratory. Patients: Patients referred for assessment of their venous system. Main outcome measures: Duplex ultrasound scanning of the lower limb, ascending phlebography. Results: Our results of duplex ultrasound scanning in the diagnosis of deep vein thrombosis as compared with Phlebography show a sensitivity of 94% and a specificity of 91%. Conclusions: We found it advantageous to examine the Patient standing during proximal vein imaging and sitting for distal venous examination. Veins dilated as a result of gravitational effects are visualized more easily. The examiner, by resting the elbow on his/her distal Thigh, has a more stable hand, facilitating the test. The Patient, by resting the heel on the edge of the examiner's chair, relaxes the calf muscles, thus simplifying the augmentation manoeuvre. The inflation of a tourniquet applied to the distal thigh dilates the calf veins.
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Affiliation(s)
- E. Kalodiki
- Irvine Laboratory for Cardiovascular Investigation and Research, Academic Surgical Unit, St Mary's Hospital Medical School and Imperial College, London W2, UK
| | - L. Calahoras
- Irvine Laboratory for Cardiovascular Investigation and Research, Academic Surgical Unit, St Mary's Hospital Medical School and Imperial College, London W2, UK
| | - A. N. Nicolaides
- Irvine Laboratory for Cardiovascular Investigation and Research, Academic Surgical Unit, St Mary's Hospital Medical School and Imperial College, London W2, UK
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Lattimer CR, Kalodiki E, Azzam M, Geroulakos G. Haemodynamic Performance of Low Strength Below Knee Graduated Elastic Compression Stockings in Health, Venous Disease, and Lymphoedema. Eur J Vasc Endovasc Surg 2016; 52:105-12. [PMID: 27161999 DOI: 10.1016/j.ejvs.2016.04.001] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2015] [Accepted: 04/01/2016] [Indexed: 11/29/2022]
Abstract
OBJECTIVE To test the in vivo haemodynamic performance of graduated elastic compression (GEC) stockings using air-plethysmography (APG) in healthy volunteers (controls) and patients with varicose veins (VVs), post-thrombotic syndrome (PTS), or lymphoedema. Responsiveness data were used to determine which group benefited the most from GEC. METHODS There were 12 patients per group compared using no compression, knee-length Class 1 (18-21 mmHg) compression, and Class 2 (23-32 mmHg) compression. Stocking/leg interface pressures (mmHg) were measured supine in two places using an air-sensor transducer. Stocking performance parameters, investigated before and after GEC, included the standard APG tests (working venous volume [wVV], venous filling index [VFI], venous drainage index [VDI], ejection fraction [EF]) and the occlusion plethysmography tests (incremental pressure causing the maximal increase in calf volume [IPMIV], outflow fraction [OF]). Results were expressed as median and interquartile range. RESULTS Significant graduated compression was achieved in all four groups with higher interface pressures at the ankle. Only the VVs patients had a significant reduction in their wVV (without: 133 [109-146] vs. class1: 93 [74-113] mL) and the VFI (without: 4.6 [3-7.1] vs. class1: 3.1 [1.9-5] mL/s), both at p <.05. The IPMIV improved significantly in all groups except in the PTS group (p <.05). The OF improved only in the controls (without: 43 [38-51] vs. class1: 50 [48-53] %) and the VVs patients (without: 47 [39-58] vs. class1: 56 [50-64] %), both at p <.05. There were no significant differences in the VDI or the EF with GEC. Compression dose-response relationships were not observed. CONCLUSION Patients with varicose veins improved the most, whereas those with PTS improved the least. Performance seemed to depend more on disease pathophysiology than compression strength. However, the lack of responsiveness to compression strength may be related to the low external pressures used. Stocking performance tests may have value in selecting those patients who benefit most from compression.
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Affiliation(s)
- C R Lattimer
- Josef Pflug Vascular Laboratory, Ealing Hospital, Middlesex, UK; Department of Surgery and Cancer, Imperial College, London, UK; West London Vascular and Interventional Centre, Northwick Park Hospital, Harrow, UK.
| | - E Kalodiki
- Josef Pflug Vascular Laboratory, Ealing Hospital, Middlesex, UK; Department of Surgery and Cancer, Imperial College, London, UK
| | - M Azzam
- Josef Pflug Vascular Laboratory, Ealing Hospital, Middlesex, UK
| | - G Geroulakos
- Josef Pflug Vascular Laboratory, Ealing Hospital, Middlesex, UK; Department of Surgery and Cancer, Imperial College, London, UK; West London Vascular and Interventional Centre, Northwick Park Hospital, Harrow, UK
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Hoppensteadt D, Kalodiki E, Maia P, Silva de Castro A, Kumar E, Guler N, Jeske W, Kahn D, Walenga J, Coyne E, Fareed J. Resourcing of Heparin and Low-Molecular-Weight Heparins from Bovine, Ovine, and Porcine Origin: Studies to Demonstrate the Biosimilarities. J Vasc Surg Venous Lymphat Disord 2016. [DOI: 10.1016/j.jvsv.2015.10.042] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Mosti G, De Maeseneer M, Cavezzi A, Parsi K, Morrison N, Nelzen O, Rabe E, Partsch H, Caggiati A, Simka M, Obermayer A, Malouf M, Flour M, Maleti O, Perrin M, Reina L, Kalodiki E, Mannello F, Rerkasem K, Cornu-Thenard A, Chi YW, Soloviy M, Bottini O, Mendyk N, Tessari L, Varghese R, Etcheverry R, Pannier F, Lugli M, Carvallo Lantz AJ, Zamboni P, Zuolo M, Godoy MF, Godoy JM, Link DP, Junger M, Scuderi A. Society for Vascular Surgery and American Venous Forum Guidelines on the management of venous leg ulcers: the point of view of the International Union of Phlebology. INT ANGIOL 2015; 34:202-218. [PMID: 25896614] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Affiliation(s)
- G Mosti
- Department of Angiology, Barbantini Clinic, Lucca, Italy
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Wittens C, Davies AH, Bækgaard N, Broholm R, Cavezzi A, Chastanet S, de Wolf M, Eggen C, Giannoukas A, Gohel M, Kakkos S, Lawson J, Noppeney T, Onida S, Pittaluga P, Thomis S, Toonder I, Vuylsteke M, Kolh P, de Borst GJ, Chakfé N, Debus S, Hinchliffe R, Koncar I, Lindholt J, de Ceniga MV, Vermassen F, Verzini F, De Maeseneer MG, Blomgren L, Hartung O, Kalodiki E, Korten E, Lugli M, Naylor R, Nicolini P, Rosales A. Editor's Choice - Management of Chronic Venous Disease: Clinical Practice Guidelines of the European Society for Vascular Surgery (ESVS). Eur J Vasc Endovasc Surg 2015; 49:678-737. [PMID: 25920631 DOI: 10.1016/j.ejvs.2015.02.007] [Citation(s) in RCA: 493] [Impact Index Per Article: 54.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
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Poredoš P, Jezovnik M, Kalodiki E, Andreozzi G, Antignani PL, Clement D, Comerota A, Fareed J, Fletcher J, Fras Z, Griffin M, Markel A, Martini R, Mignano A, Nicolaides A, Novo G, Novo S, Roztočil K, Visona A. Medical management of patients with peripheral arterial disease. INT ANGIOL 2015; 34:75-93. [PMID: 24916346] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
Peripheral arterial disease (PAD) is one of the most frequent manifestations of atherosclerosis and is associated with atherosclerosis in the coronary and carotid arteries, leading to a highly increased incidence of cardiovascular events. Major risk factors of PAD are similar to those that lead to atherosclerosis in other vascular beds. However, there are differences in the power of individual risk factors in the different vascular territories. Cigarette smoking and diabetes mellitus represent the greatest risks of PAD. For prevention of the progression of PAD and accompanying cardiovascular events similar preventative measures are used as in coronary artery disease (CAD). However, recent data indicate that there are some differences in the efficacy of drugs used in the prevention of atherothrombotic events in PAD. Antiplatelet treatment is indicated in virtually all patients with PAD. In spite of the absence of hard evidence- based data on the long term efficacy of aspirin, it is still considered as a first line treatment and clopidogrel as an effective alternative. The new antiplatelet drugs ticagrelol and prasugrel also represent promising options for treatment of PAD. Statin therapy is indicated to achieve the target low density lipoprotein cholesterol level of ≤2.5 mmol/L (100 mg/dL) and there is emerging evidence that lower levels are more effective. Statins may also improve walking capacity. Antihypertensive treatment is indicated to achieve the goal blood pressure (<140/90 mmHg). All classes of antihypertensive drugs including beta-blockers are acceptable for treatment of hypertension in patients with PAD. Diabetic patients with PAD should reduce their glycosylated haemoglobin to ≤7%. As PAD patients represent the group with the highest risk of atherothrombotic events, these patients need the most intensive treatment and elimination of risk factors of atherosclerosis. These measures should be as comprehensive as those in patients with established coronary and cerebrovascular disease.
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Affiliation(s)
- P Poredoš
- Department of Vascular Disease, University Clinical Centre Ljubljana, Ljubljana, Slovenia -
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Kalodiki E, Fareed J, Syed D, Geroulakos G, Hoppensteadt D, Lattimer CR. Blood Sampled Directly from Varicose Veins Reveals Activation of Inflammatory Processes. J Vasc Surg Venous Lymphat Disord 2015; 3:119. [PMID: 26993700 DOI: 10.1016/j.jvsv.2014.10.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
- E Kalodiki
- Josef Pflug Vascular Laboratory, Imperial College London, London, United Kingdom, and Thrombosis and Hemostasis Research Laboratory, Loyola University Medical Center, Maywood, Ill
| | - J Fareed
- Thrombosis and Hemostasis Research Laboratory, Loyola University Medical Center, Maywood, Ill
| | - D Syed
- Thrombosis and Hemostasis Research Laboratory, Loyola University Medical Center, Maywood, Ill
| | - G Geroulakos
- Josef Pflug Vascular Laboratory, Imperial College London, London, United Kingdom
| | - D Hoppensteadt
- Thrombosis and Hemostasis Research Laboratory, Loyola University Medical Center, Maywood, Ill
| | - C R Lattimer
- Josef Pflug Vascular Laboratory, Imperial College London, London, United Kingdom
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Lattimer C, Kalodiki E, Mendoza E. Venous Drainage in Controls and Patients With Chronic Venous Insufficiency. J Vasc Surg Venous Lymphat Disord 2015; 3:125-6. [DOI: 10.1016/j.jvsv.2014.10.027] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Lattimer C, Azzam M, Kalodiki E, Geroulakos G. Quantifying Saphenous Recirculation in Patients With Superficial Venous Insufficiency. J Vasc Surg Venous Lymphat Disord 2015; 3:133. [DOI: 10.1016/j.jvsv.2014.10.045] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Affiliation(s)
- A Caggiati
- Department of Anatomy, Sapienza University of Rome, Rome, Italy
| | - E Kalodiki
- The Ealing Hospital, Imperial College London, London, UK
| | - H Partsch
- Medical University of Vienna, Vienna, Austria
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Andreozzi GM, Kalodiki E, L Gašpar L, Martini R, Minar E, Angelides N, Nicolaides AN, Novo S, Visonà A, Prior M, Arosio E, Hussein EA, Poredos P, Antignani PL, Avram R, Roztocil K, Stvrtinova V, Kozak M, Vacula I. Consensus Document on Intermittent Claudication from the Central European Vascular Forum (C.E.V.F.)-3rd revision (2013) with the sharing of the Mediterranean League of Angiology and Vascular Surgery, and the North Africa and Middle East Chapter of International Union of Angiology. INT ANGIOL 2014; 33:329-347. [PMID: 25056165] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
This paper is the review of the Consensus Document on Intermittent Claudication of the Central European Vascular Forum (CEVF), published in 2008, and and shared with the North Africa and Middle East Chapter of International Union of Angiology and the Mediterranean League of Angiology and Vascular Surgery. The Document presents suggestions for general practitioners and vascular specialists for more precise and appropriate management of PAD, particularly of intermittent claudication, and underlines the investigations that should be required by GPs and what the GP should expect from the vascular specialist (angiologist, vascular surgeon). The idea of the Faculty is to produce a short document, which is an easy reference in daily clinical practice, both for the GPs and vascular specialists.
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Lattimer C, Kalodiki E, Kafeza M, Azzam M, Geroulakos G. Quantifying the Degree Graduated Elastic Compression Stockings Enhance Venous Emptying. J Vasc Surg 2014. [DOI: 10.1016/j.jvs.2013.11.083] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Lattimer C, Geroulakos G, Kalodiki E. Thigh Compression Significantly Improves Venous Emptying After Deep Vein Thrombosis. J Vasc Surg Venous Lymphat Disord 2014; 2:111. [DOI: 10.1016/j.jvsv.2013.10.024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Lattimer C, Kalodiki E, Azzam M, Geroulakos G, Fareed J, Hoppensteadt D. Regional and Systemic Prothrombotic Biomarkers in Varicose Vein Patients and Healthy Controls. J Vasc Surg Venous Lymphat Disord 2014; 2:114. [DOI: 10.1016/j.jvsv.2013.10.033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Lattimer CR, Kalodiki E, Azzam M, Makris GC, Somiayajulu S, Geroulakos G. Interim results on abolishing reflux alongside a randomized clinical trial on laser ablation with phlebectomies versus foam sclerotherapy. INT ANGIOL 2013; 32:394-403. [PMID: 23822942] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
AIM The early results of a randomised clinical trial comparing local anaesthesia endovenous laser ablation (EVLA) with concurrent phlebectomies versus ultrasound-guided foam sclerotherapy (UGFS) into the great saphenous vein (GSV) revealed that laser was more expensive but the results on abolition of reflux were similar. The interim results at 15 month follow-up are reported. METHODS Evaluations included ultrasound, the venous clinical severity score (VCSS), the Aberdeen varicose vein questionnaire (AVVQ) and the saphenous treatment score (STS). The global absence of reflux defined technical success. Adjuvant sclerotherapy to areas of reflux was administered on patient choice. RESULTS Occlusion of the GSV was more effective with EVLA at 42/44 (95.5%) versus 31/46 (67.4%) for UGFS. However both techniques were equally effective at abolishing global venous reflux. The number of legs (N.=100) with total reflux abolition, above-knee, below-knee or combined reflux and loss to follow-up was 18, 6, 12, 8, 6 with EVLA and 20, 8, 11, 7, 4 with UGFS, respectively. The VCSS, AVVQ and STS reduced compared to baseline (P<0.0005), but there was no statistical difference between the groups. The AVVQ remained unchanged between 3-15 months (P=0.601). Also during this time, 19/46(41%) UGFS versus 9/44(20%) EVLA legs received adjuvant treatment (2.1 times increase). However, overall, adjuvant foam was given 4.7 times more frequently in the UGFS patients. CONCLUSION EVLA and UGFS are equally effective at abolishing global venous reflux with overall success of 41% and 43%, respectively. The high reflux rate was not related to deterioration in quality of life indicating that this reflux was largely asymptomatic.
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Affiliation(s)
- C R Lattimer
- Department of Medicine, Science and Technology, Imperial College, London, UK.
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Nicolaides A, Fareed J, Kakkar AK, Comerota AJ, Goldhaber SZ, Hull R, Myers K, Samama M, Fletcher J, Kalodiki E, Bergqvist D, Bonnar J, Caprini JA, Carter C, Conard J, Eklof B, Elalamy I, Gerotziafas G, Geroulakos G, Giannoukas A, Greer I, Griffin M, Kakkos S, Lassen MR, Lowe GDO, Markel A, Prandoni P, Raskob G, Spyropoulos AC, Turpie AG, Walenga JM, Warwick D. Key Questions to be Answered. Clin Appl Thromb Hemost 2013. [DOI: 10.1177/1076029612474840x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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Lattimer CR, Kalodiki E, Azzam M, Geroulakos G. Reflux time estimation on air-plethysmography may stratify patients with early superficial venous insufficiency. Phlebology 2013; 28:101-8. [DOI: 10.1177/0268355513476205] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Objectives It has been suggested that quantification of haemodynamic parameters of venous disease may complement clinical assessment and may help identify a group of patients with severe venous disease or alternatively patients with early venous disease. However, there has been very little work to prove this hypothesis. The venous filling index (VFI) of air-plethysmography (APG) can quantify severity and treatment effect but has limited discriminatory value. However, the components of the VFI, total venous volume (VV) and time to reach 90% of VV (VFT90), have never been fully studied. The aim was to investigate the contribution of VV and VFT90 to an elevated VFI and determine their relationship to great saphenous vein (GSV) diameter and clinical severity scoring. Method Ninety-three consecutive patients/legs (22–78 years) with primary GSV reflux (>0.5 seconds) awaiting endovenous treatment were recruited. CEAP (clinical, aetiological, anatomical and pathological elements) assessments were: 33 (35.5%) C2, 14 (15.0%) C3, 29 (31.2%) C4a, 5 (5.4%) C4b, 7 (7.5%) C5 and 5 (5.4%) C6. The median venous clinical severity score (VCSS) was 6 (2–20) and the averaged GSV diameter at three sites was 7.5 mm (4–12). The VFI, VV and VFT90 were recorded using APG. Results There was no correlation between the VV and the VFT90 ( r = −0.103, P = 0.324). The VFI, VV and VFT90 significantly correlated ( P < 0.0005, Spearman) with the GSV diameter: r = 0.623, r = 0.567, r = −0.432, respectively, and the C of CEAP ( P < 0.05): r = 0.4, r = 0.225, r = −0.343, respectively. None of the 25 (26.9%) patients with a VFT90 > 25 seconds were among the 17 (18.3%) patients in categories C4b–6 or with a VCSS > 9 ( P = 0.005, Fisher's exact test, corrected odds ratio: 17.3). Conclusions The VFT90 complements the VFI as a marker of severe superficial venous insufficiency. However, in contrast to the VFI, it may have discriminatory value in stratifying patients with early disease into two groups based on the severity of haemodynamic impairment.
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Affiliation(s)
- C R Lattimer
- Ealing Hospital & Imperial College, London SW7 2AZ, UK
| | - E Kalodiki
- Ealing Hospital & Imperial College, London SW7 2AZ, UK
| | - M Azzam
- Ealing Hospital & Imperial College, London SW7 2AZ, UK
| | - G Geroulakos
- Ealing Hospital & Imperial College, London SW7 2AZ, UK
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Nicolaides A, Fareed J, Kakkar AK, Comerota AJ, Goldhaber SZ, Hull R, Myers K, Samama M, Fletcher J, Kalodiki E, Bergqvist D, Bonnar J, Caprini JA, Carter C, Conard J, Eklof B, Elalamy I, Gerotziafas G, Geroulakos G, Giannoukas A, Greer I, Griffin M, Kakkos S, Lassen MR, Lowe GDO, Markel A, Prandoni P, Raskob G, Spyropoulos AC, Turpie AG, Walenga JM, Warwick D. Periprocedural Management of Antithrombotic Therapy and Use of Bridging Anticoagulation. Clin Appl Thromb Hemost 2013; 19:220-3. [DOI: 10.1177/1076029612474840v] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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Nicolaides A, Fareed J, Kakkar AK, Comerota AJ, Goldhaber SZ, Hull R, Myers K, Samama M, Fletcher J, Kalodiki E, Bergqvist D, Bonnar J, Caprini JA, Carter C, Conard J, Eklof B, Elalamy I, Gerotziafas G, Geroulakos G, Giannoukas A, Greer I, Griffin M, Kakkos S, Lassen MR, Lowe GDO, Markel A, Prandoni P, Raskob G, Spyropoulos AC, Turpie AG, Walenga JM, Warwick D. Cost-Effectiveness of Prevention and Treatment of VTE. Clin Appl Thromb Hemost 2013; 19:224-5. [DOI: 10.1177/1076029612474840w] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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Nicolaides A, Fareed J, Kakkar AK, Comerota AJ, Goldhaber SZ, Hull R, Myers K, Samama M, Fletcher J, Kalodiki E, Bergqvist D, Bonnar J, Caprini JA, Carter C, Conard J, Eklof B, Elalamy I, Gerotziafas G, Geroulakos G, Giannoukas A, Greer I, Griffin M, Kakkos S, Lassen MR, Lowe GDO, Markel A, Prandoni P, Raskob G, Spyropoulos AC, Turpie AG, Walenga JM, Warwick D. Introduction. Clin Appl Thromb Hemost 2013; 19:118-20. [DOI: 10.1177/1076029612474840a] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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Nicolaides A, Fareed J, Kakkar AK, Comerota AJ, Goldhaber SZ, Hull R, Myers K, Samama M, Fletcher J, Kalodiki E, Bergqvist D, Bonnar J, Caprini JA, Carter C, Conard J, Eklof B, Elalamy I, Gerotziafas G, Geroulakos G, Giannoukas A, Greer I, Griffin M, Kakkos S, Lassen MR, Lowe GDO, Markel A, Prandoni P, Raskob G, Spyropoulos AC, Turpie AG, Walenga JM, Warwick D. Burns. Clin Appl Thromb Hemost 2013; 19:161. [DOI: 10.1177/1076029612474840g] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
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Nicolaides AN, Fareed J, Kakkar AK, Comerota AJ, Goldhaber SZ, Hull R, Myers K, Samama M, Fletcher J, Kalodiki E, Bergqvist D, Bonnar J, Caprini JA, Carter C, Conard J, Eklof B, Elalamy I, Gerotziafas G, Geroulakos G, Giannoukas A, Greer I, Griffin M, Kakkos S, Lassen MR, Lowe GD, Markel A, Prandoni P, Raskob G, Spyropoulos AC, Turpie AG, Walenga JM, Warwick D. Prevention and treatment of venous thromboembolism--International Consensus Statement. INT ANGIOL 2013; 32:111-260. [PMID: 24402349] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
The aim of this document is to provide a clear and concise account of the evidence regarding efficacy or harm for various methods available to prevent and manage venous thromboembolism (VTE).
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Nicolaides A, Fareed J, Kakkar AK, Comerota AJ, Goldhaber SZ, Hull R, Myers K, Samama M, Fletcher J, Kalodiki E, Bergqvist D, Bonnar J, Caprini JA, Carter C, Conard J, Eklof B, Elalamy I, Gerotziafas G, Geroulakos G, Giannoukas A, Greer I, Griffin M, Kakkos S, Lassen MR, Lowe GDO, Markel A, Prandoni P, Raskob G, Spyropoulos AC, Turpie AG, Walenga JM, Warwick D. The Problem and the Need for Prevention. Clin Appl Thromb Hemost 2013; 19:121-2. [DOI: 10.1177/1076029612474840b] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
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Nicolaides A, Fareed J, Kakkar AK, Comerota AJ, Goldhaber SZ, Hull R, Myers K, Samama M, Fletcher J, Kalodiki E, Bergqvist D, Bonnar J, Caprini JA, Carter C, Conard J, Eklof B, Elalamy I, Gerotziafas G, Geroulakos G, Giannoukas A, Greer I, Griffin M, Kakkos S, Lassen MR, Lowe GDO, Markel A, Prandoni P, Raskob G, Spyropoulos AC, Turpie AG, Walenga JM, Warwick D. Heparin-Induced Thrombocytopenia. Clin Appl Thromb Hemost 2013; 19:208-13. [DOI: 10.1177/1076029612474840s] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
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Nicolaides A, Fareed J, Kakkar AK, Comerota AJ, Goldhaber SZ, Hull R, Myers K, Samama M, Fletcher J, Kalodiki E, Bergqvist D, Bonnar J, Caprini JA, Carter C, Conard J, Eklof B, Elalamy I, Gerotziafas G, Geroulakos G, Giannoukas A, Greer I, Griffin M, Kakkos S, Lassen MR, Lowe GDO, Markel A, Prandoni P, Raskob G, Spyropoulos AC, Turpie AG, Walenga JM, Warwick D. Diagnosis and Anticoagulant Treatment. Clin Appl Thromb Hemost 2013; 19:187-98. [DOI: 10.1177/1076029612474840n] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
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Nicolaides A, Fareed J, Kakkar AK, Comerota AJ, Goldhaber SZ, Hull R, Myers K, Samama M, Fletcher J, Kalodiki E, Bergqvist D, Bonnar J, Caprini JA, Carter C, Conard J, Eklof B, Elalamy I, Gerotziafas G, Geroulakos G, Giannoukas A, Greer I, Griffin M, Kakkos S, Lassen MR, Lowe GDO, Markel A, Prandoni P, Raskob G, Spyropoulos AC, Turpie AG, Walenga JM, Warwick D. Prevention and Treatment of Venous Thromboembolism. Clin Appl Thromb Hemost 2013; 19:116-8. [DOI: 10.1177/1076029612474840] [Citation(s) in RCA: 46] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
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Nicolaides A, Fareed J, Kakkar AK, Comerota AJ, Goldhaber SZ, Hull R, Myers K, Samama M, Fletcher J, Kalodiki E, Bergqvist D, Bonnar J, Caprini JA, Carter C, Conard J, Eklof B, Elalamy I, Gerotziafas G, Geroulakos G, Giannoukas A, Greer I, Griffin M, Kakkos S, Lassen MR, Lowe GDO, Markel A, Prandoni P, Raskob G, Spyropoulos AC, Turpie AG, Walenga JM, Warwick D. Thrombolytic Therapy. Clin Appl Thromb Hemost 2013; 19:198-204. [DOI: 10.1177/1076029612474840o] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023] Open
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Nicolaides A, Fareed J, Kakkar AK, Comerota AJ, Goldhaber SZ, Hull R, Myers K, Samama M, Fletcher J, Kalodiki E, Bergqvist D, Bonnar J, Caprini JA, Carter C, Conard J, Eklof B, Elalamy I, Gerotziafas G, Geroulakos G, Giannoukas A, Greer I, Griffin M, Kakkos S, Lassen MR, Lowe GDO, Markel A, Prandoni P, Raskob G, Spyropoulos AC, Turpie AG, Walenga JM, Warwick D. Surgical Thrombectomy. Clin Appl Thromb Hemost 2013; 19:205-6. [DOI: 10.1177/1076029612474840q] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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Lattimer CR, Kalodiki E, Azzam M, Geroulakos G. Responsiveness of individual questions from the venous clinical severity score and the Aberdeen varicose vein questionnaire. Phlebology 2012. [DOI: 10.1258/phleb.2012.012080] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Objectives The venous clinical severity score (VCSS) and the Aberdeen varicose vein questionnaire (AVVQ) improve after treating chronic venous insufficiency (CVI). The aim was to examine how and why they improve by evaluating the change in each individual question. Methods This was an analysis on prospectively collected data from a clinical study on 100 patients (58% female) with CVI (C2 = 34, C3 = 14, C4a = 29, C4b = 9, C5 = 7, C6 = 7) who were randomized to endovenous laser ablation ( n = 50) or foam sclerotherapy ( n = 50). The change scores (performance) of each question of the VCSS (questions 1–10) and the AVVQ (questions 1–13) were calculated by subtracting the score at three weeks, and three months, from the pre-treatment score. Results Both the median, interquartile range (IQR), VCSS and the AVVQ scores improved from 6 (4) and 21.4 (15.1) at baseline to 3 (4) and 18.6 (12.1) at three weeks ( P < 0.0005, P = 0.031) to 2 (3) and 8.8 (13.6) at three months, ( P < 0.0005, P < 0.0005), respectively. The performance of the first three questions of the VCSS (pain, extent of varicosities, oedema) were the most contributory to the overall score. Questions 5, 7, 8, 9 on ulceration improved the most individually but did not contribute significantly to the overall score. Questions 5, 9 of the AVVQ on stocking use and ulceration failed to contribute statistically to the overall improvement at three months. Conclusion The majority of the individual questions of the VCSS and AVVQ responded to change. However, the cause of a poor response was multifactorial with statistical dilution playing a significant role. Stratification of patients according to ulceration may allow better comparisons.
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Lattimer CR, Azzam M, Kalodiki E, Geroulakos G. Venous filling time using air-plethysmography correlates highly with great saphenous vein reflux time using duplex. Phlebology 2012; 29:90-7. [DOI: 10.1258/phleb.2012.012042] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
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Kalodiki E, Lewis B, Fareed J. New oral anticoagulant in atrial fibrillation: are they comparable? INT ANGIOL 2012; 31:307-309. [PMID: 22801395] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
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Kalodiki E, Stvrtinova V, Allegra C, Andreozzi G, Antignani PL, Avram R, Brkljacic B, Cadariou F, Dzsinich C, Fareed J, Gaspar L, Geroulakos G, Jawien A, Kozak M, Lattimer CR, Minar E, Partsch H, Passariello F, Patel M, Pécsvárady Z, Poredos P, Roztocil K, Scuderi A, Sparovec M, Szostek M, Skorski M. Superficial vein thrombosis: a consensus statement. INT ANGIOL 2012; 31:203-216. [PMID: 22634973] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Affiliation(s)
- E Kalodiki
- Ealing Hospital and Imperial College, London, SW7 2AZ, UK.
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Lattimer C, Azzam M, Kalodiki E, Shawish E, Trueman P, Geroulakos G. Cost and Effectiveness of Laser with Phlebectomies Compared with Foam Sclerotherapy in Superficial Venous Insufficiency. Early Results of a Randomised Controlled Trial. J Vasc Surg 2012. [DOI: 10.1016/j.jvs.2012.03.251] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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Harenberg J, Kalodiki E, Walenga JM. Ensuring safety of biosimilar low-molecular-weight heparins: a consensus statement of the International Union of Angiology . INT ANGIOL 2012; 31:101-104. [PMID: 22466973] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
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Lattimer CR, Azzam M, Kalodiki E, Shawish E, Trueman P, Geroulakos G. Cost and effectiveness of laser with phlebectomies compared with foam sclerotherapy in superficial venous insufficiency. Early results of a randomised controlled trial. Eur J Vasc Endovasc Surg 2012; 43:594-600. [PMID: 22386383 DOI: 10.1016/j.ejvs.2012.01.032] [Citation(s) in RCA: 45] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2011] [Accepted: 01/30/2012] [Indexed: 11/16/2022]
Abstract
OBJECTIVES Quantify endovenous laser ablation (EVLA) with concurrent phlebectomies and ultrasound-guided foam sclerotherapy (UGFS) in cost and effectiveness at 3 weeks and 3 months. DESIGN Single-centre, prospective, randomised controlled trial. PATIENTS One hundred patients (100 legs), C(2-6), age 21-78, M:F 42:58, with primary varicose veins received either EVLA under local anaesthetic or UGFS. METHODS Assessments included duplex, Aberdeen varicose vein questionnaire (AVVQ), venous clinical severity score (VCSS), venous filling index (VFI), visual analogue 7-day pain score and analgesia requirements. Additional treatments with UGFS were performed, if required. Micro-costing, using individually timed treatments, was based on consumables, staff pay and overheads. RESULTS Changes in AVVQ, VCSS and VFI values (3 months) did not demonstrate any significant difference between groups. At 3 months, the above-knee GSV occlusion rate (without co-existing reflux) was not significantly different between the groups (74% vs 69%; EVLA vs UGFS; P = .596). Of the 9 haemodynamic failures in each group, 7 EVLA patients and 4 UGFS patients had co-existing cross-sectional above-knee GSV occlusion at some point. However, UGFS significantly outperformed EVLA in cost, treatment duration, pain, analgesia requirements and recovery. CONCLUSIONS UGFS is 3.15 times less expensive than EVLA (£230.24 vs £724.72) with comparable effectiveness but 56% (versus 6%) required additional foam (ISRCTN:03080206).
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Affiliation(s)
- C R Lattimer
- Josef Pflug Vascular Unit, Ealing Hospital & Imperial College, London SW7 2AZ, UK
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Pierce IT, Gatehouse PD, Kalodiki E, Lattimer C, Geroulakos G, Xu XY, Firmin DN. Magnetic resonance venous velocity mapping during intermittent pneumatic compression of the calf and foot. Phlebology 2011; 27:352-9. [DOI: 10.1258/phleb.2011.011053] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Objective Assessment and optimization of intermittent pneumatic compression (IPC) devices for prophylaxis of deep vein thrombosis has previously used duplex ultrasound. The aim was to investigate novel magnetic resonance (MR) venous velocity mapping (VM) for IPC research and development. Methods Twelve normal subjects were scanned in the supine position using realtime MR VM with sequential foot and calf IPC (120 mmHg) at 1.5 T. Measurements were taken in the popliteal vein at baseline using both cuffs and each cuff individually recording 60 seconds continuously. Temporal resolution was 310 ms per independent image, at 1 ×1 mm spatial resolution. Results Peak velocity ( Vp) measurements: baseline, Vp = 2.1 cm/second (range = 1.1–3.5); using both compression cuffs, Vp = 41.5 cm/second (18.0–58.1); calf cuff alone, Vp = 40.6 cm/second (18.1–62.2); foot cuff alone, Vp = 7.9 cm/second (4.2–15.3). Flow volume measurements per compression cycle ( F): baseline, F = 2.3 cm3 (0.5–11.4); both compression cuffs, F = 7.1 cm3 (2.5–24.6); calf cuff only, F = 7.1 cm3 (2.4–24.5); foot cuff only, F = 2.6 cm3 (0.9–10.7). The foot cuff contribution was insignificant when combined with the calf cuff ( P < 0.01). The MR venous VM results were similar to those reported elsewhere using ultrasound. Conclusion This novel technique for MR venous VM can measure the realtime variations in venous blood flow during IPC.
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Affiliation(s)
- I T Pierce
- Cardiovascular MR Unit, Royal Brompton Hospital Trust
- National Heart and Lung Institute (NHLI), Imperial College London
| | - P D Gatehouse
- Cardiovascular MR Unit, Royal Brompton Hospital Trust
- National Heart and Lung Institute (NHLI), Imperial College London
| | - E Kalodiki
- Vascular Unit, Ealing Hospital and Imperial College London
| | - C Lattimer
- Vascular Unit, Ealing Hospital and Imperial College London
| | - G Geroulakos
- Vascular Unit, Ealing Hospital and Imperial College London
| | - X Y Xu
- Department of Chemical Engineering, Imperial College London, London, UK
| | - D N Firmin
- Cardiovascular MR Unit, Royal Brompton Hospital Trust
- National Heart and Lung Institute (NHLI), Imperial College London
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Griffin M, Nicolaides A, Bond D, Geroulakos G, Kalodiki E. The Efficacy of a New Stimulation Technology to Increase Venous Flow and Prevent Venous Stasis. J Vasc Surg 2010. [DOI: 10.1016/j.jvs.2010.10.046] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Griffin M, Nicolaides AN, Bond D, Geroulakos G, Kalodiki E. The efficacy of a new stimulation technology to increase venous flow and prevent venous stasis. Eur J Vasc Endovasc Surg 2010; 40:766-71. [PMID: 20650668 DOI: 10.1016/j.ejvs.2010.06.019] [Citation(s) in RCA: 54] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2010] [Accepted: 06/20/2010] [Indexed: 11/27/2022]
Abstract
OBJECTIVES Electrical stimulation of calf muscles has been shown to be effective in prevention of DVT. The aim was to determine: (a) dependence of venous blood velocity and ejected volume on the rates of stimulated calf contractions: (b) clinical factors affecting efficacy in healthy individuals. METHODS The maximum intensity stimulus tolerated was applied to calves of 24 volunteers. In popliteal veins, peak systolic velocities (PSV), ejected volume per individual stimulus (stroke volume SV) and ejected total volume flow per minute (TVF) of expelled blood were determined using ultrasound. Stimulation rates from 2 to 120 beats per minute (bpm) were applied. RESULTS Mean baseline popliteal PSV was 10 cm/s. For stimulation rates between 2 and 8 bpm, the PSV was 10 times higher and reached 96-105 cm/s. Stroke volume (SV) per individual stimulus decreased in a similar fashion. With increasing rates of stimulation the TVF increased by a factor of 12 times (from 20 ml/min to 240 ml/min). CONCLUSION Electrical stimulation is an effective method of activating the calf muscle pump. Enhancements of popliteal blood velocity and volume flow are key factors in the prevention of venous stasis and DVT. Further studies are justified to determine the stimulation rates in those with a compromised venous system.
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Affiliation(s)
- M Griffin
- The Vascular Noninvasive Screening and Diagnostic Centre, 30 Weymouth Street, London W1G 7BS, UK.
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Kalodiki E, Fareed J, Tapson VF, Hoppensteadt DA, Sussman I, Carter CA, Parker S, Harenberg J, Hull R, Rao G, Lovinger DF, Ried LD, Kakkar A, Talarico L, Ofuso F, Bussey HI, Fanikos J, Groce JB, Skinner N, Ahluwalia M, Iqbal O, Jackson CM, Jeske WP, Georges M, Ramacciotti E, Tapson VF, Van Thiel D, Wahi R, Walenga J. A consensus conference on complex biologics and low molecular weight heparins. INT ANGIOL 2010; 29:193-196. [PMID: 20351676] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/29/2023]
Affiliation(s)
- E Kalodiki
- Under the auspices of the North American Thrombosis Forum (NATF), the International Union of Angiology (IUA) and the South Asian Society of Atherosclerosisand Thrombosis (SASAT).
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Kalodiki E. Harry Hubert Grayson Eastcott. West J Med 2010. [DOI: 10.1136/bmj.c1423] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Griffin M, Nicolaides A, Bond D, Geroulakos G, Kalodiki E. The Efficacy of New VEINOPLUS Stimulation Technology to Increase Venous Flow and Prevent Venous Stasis. J Vasc Surg 2010. [DOI: 10.1016/j.jvs.2009.11.012] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Nicolaides AN, Allegra C, Bergan J, Bradbury A, Cairols M, Carpentier P, Comerota A, Delis C, Eklof B, Fassiadis N, Georgiou N, Geroulakos G, Hoffmann U, Jantet G, Jawien A, Kakkos S, Kalodiki E, Labropoulos N, Neglen P, Pappas P, Partsch H, Perrin M, Rabe E, Ramelet AA, Vayssaira M, Ioannidou E, Taft A. Management of chronic venous disorders of the lower limbs: guidelines according to scientific evidence. INT ANGIOL 2008; 27:1-59. [PMID: 18277340] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/25/2023]
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Kalodiki E, Ellis M, Kakkos SK, Williams A, Davies AH, Geroulakos G. Immediate Hemodynamic Effect of the Additional Use of the SCD EXPRESS™ Compression System in Patients with Venous Ulcers Treated with the Four-layer Compression Bandaging System. Eur J Vasc Endovasc Surg 2007; 33:483-7. [PMID: 17224283 DOI: 10.1016/j.ejvs.2006.11.033] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2006] [Accepted: 11/26/2006] [Indexed: 11/21/2022]
Abstract
OBJECTIVES To test the hypothesis that the SCD EXPRESS intermittent pneumatic compression applied in combination with a four-layer bandage in patients with venous ulcers increases popliteal vein volume flow and velocity. DESIGN Twenty limbs of 18 patients with venous leg ulcers were studied, median age 76 years. The Total Volume Flow (TVF) and the Peak Systolic Velocity (PSV) were recorded in the popliteal vein using duplex ultrasonography. Measurements were made (i) without bandage, (ii) with four layer bandage and (iii) following the application of the SCD Compression System on top of a four-layer bandage for at least 15 minutes. RESULTS The median VCSS was 17 (range, 12-22) while the median VSDS for reflux was 4.5 (range, 1-7.5). The median TVF was 71 mL/min (inter-quartile range 57-101) without bandage, 112 (IQR 89-148) with four-layer bandage and 291 (IQR 241-392) with the addition of the SCD System (P<.001, Wilcoxon signed ranks test). The median PSV was 8.4 cm/sec (IQR 6.8-14) without bandage, 13 (9.0-19) with four-layer bandage and 27 (21-31) with the addition of the SCD System (P<.001, Wilcoxon signed ranks test). Both TVF and PSV increased slightly with the addition of the four-layer bandage. However, with the addition of the SCD System these parameters increased three fold. CONCLUSIONS The SCD EXPRESS Compression System accelerates venous flow in the legs of patients with venous ulcers already treated with a four-layer bandage. The combination of four-layer compression with the SCD System on healing venous ulcers needs to be tested by a clinical effectiveness study.
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Kalodiki E, Giannoukas AD. Intermittent Pneumatic Compression (IPC) in the Treatment of Peripheral Arterial Occlusive Disease (PAOD) – A Useful Tool or Just Another Device? Eur J Vasc Endovasc Surg 2007; 33:309-10. [PMID: 17196406 DOI: 10.1016/j.ejvs.2006.11.006] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2006] [Accepted: 11/14/2006] [Indexed: 11/24/2022]
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Kalodiki E. Report on the Tripartite Meeting of the 7th Annual European Venous Forum, the Venous Forum of the Royal Society of Medicine and the American Venous Forum held at the Royal Society of Medicine, London 29 June–1st July 2006. ACTA ACUST UNITED AC 2007. [DOI: 10.1016/j.ejvsextra.2006.10.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/01/2022]
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