Choosing the Most Appropriate Treatment Option for Pelvic Venous Disease: Stenting versus Embolization

2021 ◽  
Vol 38 (02) ◽  
pp. 182-188
Author(s):  
Mari E. Tanaka ◽  
Oleksandra Kutsenko ◽  
Gloria Salazar
Keyword(s):  
Treatment Option ◽  
Pelvic Pain ◽  
Chronic Venous Disease ◽  
Venous Disease ◽  
Central Venous ◽  
Central Venous Stenosis ◽  
Appropriate Treatment ◽  
Ongoing Development ◽  
Venous Stents ◽  
Vein Reflux

AbstractPelvic venous disease (PeVD) in women encompasses a wide variety of entities all resulting in pelvic pain and varices. Successful treatment with percutaneous interventions is dependent on identifying underlying factors contributing to the disease and addressing them with either embolization of incompetent veins or stenting for venous stenoses. There are a multitude of embolization methods with marked practice heterogeneity. Moreover, with the ongoing development of dedicated venous stents in the treatment of chronic venous disease, there are more opportunities to consider this modality for the treatment of PeVD, as many patients present with combined vein reflux and central venous stenosis. The necessity to address both and the order of interventions in these patients is still to be elucidated. Here, we describe when to choose stenting or embolization for PeVD, their limitations, and our practice and identify further areas of research in this field.

scholarly journals A Case of Successful Iliofemoral Vein Stenting from Great Saphenous Vein Access

2018 ◽  
Vol 21 (6) ◽  
pp. E472-E475
Author(s):  
Hae Won Jung ◽  
Chul-Min Ahn ◽  
Young-Guk Ko
Keyword(s):  
Clinical Significance ◽  
Treatment Option ◽  
Saphenous Vein ◽  
Great Saphenous Vein ◽  
Good Alternative ◽  
Iliac Vein ◽  
Chronic Venous Disease ◽  
Venous Disease ◽  
Vein Access ◽  
Successful Case

Chronic venous disease is strongly associated with morbidity and leads to considerable medical costs. Therefore, its clinical significance is very important. Currently, iliac vein stenting is the first treatment option for chronic venous disease due to iliac vein obstruction. For iliac vein stenting, ipsilateral femoral or popliteal vein access is common. However, great saphenous vein access may be a good alternative if there is obstruction in the ipsilateral femoropopliteal vein. Until now, there has been no reported case of successful iliac vein stenting using great saphenous vein access. We report the first successful case of iliofemoral vein stenting from great saphenous vein access.

A study to evaluate patterns of superficial venous reflux in patients with primary chronic venous disease

2014 ◽  
Vol 30 (7) ◽  
pp. 455-461 ◽  
Author(s):  
Mahim I Qureshi ◽  
Manj Gohel ◽  
Louise Wing ◽  
Andrew MacDonald ◽  
Chung S Lim ◽  
...  
Keyword(s):  
Saphenous Vein ◽  
Great Saphenous Vein ◽  
Chronic Venous Disease ◽  
Duplex Ultrasonography ◽  
Venous Disease ◽  
Venous Reflux ◽  
History Of ◽  
Primary Chronic Venous Disease ◽  
Saphenofemoral Junction ◽  
Vein Reflux

Objective This study assessed patterns of superficial reflux in patients with primary chronic venous disease. Methods Retrospective review of all patient venous duplex ultrasonography reports at one institution between 2000 and 2009. Legs with secondary, deep or no superficial reflux were excluded. Results In total, 8654 limbs were scanned; 2559 legs from 2053 patients (mean age 52.3 years) were included for analysis. Great saphenous vein reflux predominated (68%), followed by combined great saphenous vein/small saphenous vein reflux (20%) and small saphenous vein reflux (7%). The majority of legs with competent saphenofemoral junction had below-knee great saphenous vein reflux (53%); incompetent saphenofemoral junction was associated with combined above and below-knee great saphenous vein reflux (72%). Isolated small saphenous vein reflux was associated with saphenopopliteal junction incompetence (61%), although the majority of all small saphenous vein reflux limbs had a competent saphenopopliteal junction (57%). Conclusion Superficial venous reflux does not necessarily originate from a saphenous junction. Large prospective studies with interval duplex ultrasonography are required to unravel the natural history of primary chronic venous disease.

scholarly journals Central Venous Disease Increases the Risk of Microbial Colonization in Hemodialysis Catheters

2021 ◽  
Vol 8 ◽  
Author(s):  
Xianhui Liang ◽  
Yamin Liu ◽  
Bohan Chen ◽  
Ping Li ◽  
Peixiang Zhao ◽  
...  
Keyword(s):  
Univariate Analysis ◽  
Hemodialysis Patients ◽  
Microbial Colonization ◽  
Catheter Removal ◽  
Venous Disease ◽  
Central Venous ◽  
Indwelling Catheters ◽  
Central Venous Stenosis ◽  
Fibrin Sheath ◽  
Wbc Count

Objectives: Tunneled-cuffed catheters (TCCs) are widely used in maintenance hemodialysis patients. However, microbial colonization in catheters increases the likelihood of developing various complications, such as catheter-related infection (CRI), catheter failure, hospitalization, and death. Identification of the risk factors related to microorganism colonization may help us reduce the incidence of these adverse events. Therefore, a retrospective analysis of patients who underwent TCC removal was conducted.Methods: From a pool of 389 adult patients, 145 were selected for inclusion in the study. None of the patients met the diagnostic criteria for CRI within 30 days before recruitment. The right internal jugular vein was the unique route evaluated. The catheter removal procedure was guided by digital subtraction angiography. Catheter tips were collected for culture. Biochemical and clinical parameters were collected at the time of catheter removal.Results: The average age of this cohort was 55.46 ± 17.25 years. A total of 45/145 (31.03%) patients were verified to have a positive catheter culture. The proportions of gram-positive bacteria, gram-negative bacteria, and fungi were 57.8, 28.9, and 13.3%, respectively. History of CRI [odds ratio (OR) = 2.44, 95% confidence interval (CI) 1.09 to 5.49], fibrin sheath (OR = 2.93, 95% CI 1.39–6.19), white blood cell (WBC) count ≥5.9 × 109/l (OR = 2.31, 95% CI 1.12–4.77), moderate (OR = 4.87, 95% CI 1.61–14.78) or severe central venous stenosis (CVS) (OR = 4.74, 95% CI 1.16–19.38), and central venous thrombosis (CVT) (OR = 3.41, 95% CI 1.51–7.69) were associated with a significantly increased incidence of microbial colonization in a univariate analysis. Central venous disease (CVD) elevated the risk of microbial colonization, with an OR of 3.37 (1.47–7.71, P = 0.004). A multivariate analysis showed that both CVS and CVT were strongly associated with catheter microbial colonization, with ORs of 3.06 (1.20–7.78, P = 0.019) and 4.13 (1.21–14.05, P = 0.023), respectively. As the extent of stenosis increased, the relative risk of catheter microbial colonization also increased. In patients with moderate and severe stenosis, a sustained and significant increase in OR from 5.13 to 5.77 was observed.Conclusions: An elevated WBC count and CVD can put hemodialysis patients with TCCs at a higher risk of microbial colonization, even if these patients do not have the relevant symptoms of infection. Avoiding indwelling catheters is still the primary method for preventing CRI.

Duffy antigen / receptor for chemokines correlates with inflammatory reaction in rats with venous hypertension: implication for the pathogenesis of primary chronic venous disease

VASA ◽  
2014 ◽  
Vol 43 (1) ◽  
pp. 47-54 ◽  
Author(s):  
Weibin Huang ◽  
Weiwei Qin ◽  
Lei Lv ◽  
Haoyv Deng ◽  
Hao Zhang ◽  
...  
Keyword(s):  
Mononuclear Cells ◽  
Early Stage ◽  
Antigen Receptor ◽  
Venous Hypertension ◽  
Skin Tissue ◽  
Chronic Venous Disease ◽  
Venous Disease ◽  
Dependent Manner ◽  
Time Points ◽  
Duffy Antigen

Background: Duffy antigen / receptor for chemokines (DARC) possesses high affinity for several chemokine subgroups of CC and CXC. Although DARC has been shown to play a role in many inflammatory diseases, its effect on chronic venous disease (CVD) remains unidentified. We explored whether the expression of DARC in skin tissue was activated under venous hypertension as well as the relationships between DARC and inflammation. Materials and methods: The inflammation in a rat model of venous hypertension caused by a femoral arterial-venous fistula (AVF) was studied. At specified intervals the pressure in the femoral veins was recorded within 42 days. Hindlimb skin specimens were harvested at different time points. The expressions of DARC, interleukin-8 (IL-8), and monocyte chemotactic protein-1 (MCP-1) in skin tissue were examined. Mononuclear cells infiltrated in skin tissue were detected. Results: Femoral venous pressures in AVF groups increased significantly at different time points (P < 0.01). DARC was expressed in skin tissue and its expression level increased significantly in AVF groups from the 7nd day on and was enhanced in a time-dependent manner within 42 days (P < 0.05). Meanwhile, both MCP-1 and IL-8 had higher levels, accompanied by increased mononuclear cells infiltrating into skin tissue (P < 0.05). Conclusions: A rat AVF model which can maintain venous hypertension for at least 42 days is competent for researching the pathogenesis of CVD. DARC, which plays a role in the inflammation of skin tissue under venous hypertension, may become a new molecular target for diagnosis and treatment of CVD at a very early stage.

Endovenous stenting in chronic venous disease secondary to iliac vein obstruction

2019 ◽  
Vol 26 (2) ◽  
Author(s):  
Mohamed A. Taha ◽  
Tristan Lane ◽  
Joseph Shalhoub ◽  
Alun H. Davies
Keyword(s):  
Iliac Vein ◽  
Chronic Venous Disease ◽  
Venous Disease

Nédemax® Mese (Leucoselect®, Lymphaselect®, Bromelain) in the treatment of chronic venous disease: a multicenter, observational study

2019 ◽  
Vol 20 (1) ◽  
Author(s):  
Rino Albrigo ◽  
Cinzia Andreoni ◽  
Gaetano Anello ◽  
Maria G. Barboni ◽  
Elena Barzaghi ◽  
...  
Keyword(s):  
Observational Study ◽  
Chronic Venous Disease ◽  
Venous Disease ◽  
Multicenter Observational Study

3D modeling of the vascular system

2016 ◽  
Vol 1 (1) ◽  
pp. 51-58 ◽  
Author(s):  
Jean François Uhl ◽  
Maxime Chahim ◽  
François Cros ◽  
Amina Ouchene ◽  
◽  
...  
Keyword(s):  
Augmented Reality ◽  
3D Modeling ◽  
Vascular System ◽  
Arterial System ◽  
Chronic Venous Disease ◽  
Venous Disease ◽  
Software Products ◽  
Operative Planning ◽  
Morphological Modeling ◽  
Pre Treatment

The 3D modeling of the vascular system could be achieved in different ways: In the venous location, the morphological modeling by MSCT venography is used to image the venous system: this morphological modeling tool accurately investigates the 3D morphology of the venous network of our patients with chronic venous disease. It is also a fine educational tool for students who learn venous anatomy, the most complex of the human body. Another kind of modeling (mathematical modeling) is used to simulate the venous functions, and virtually tests the efficacy of any proposed treatments. To image the arterial system, the aim of 3D modeling is to precisely assess and quantify the arterial morphology. The use of augmented reality before an endovascular procedure allows pre-treatment simulation, assisting in pre-operative planning as well as surgical training. In the special field of liver surgery, several 3D modeling software products are available for computer simulations and training purposes and augmented reality.

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