Advances in Engineering Venous Valves: The Pursuit of a Definite Solution for Chronic Venous Disease

Chronic venous disease is a common problem with a significant impact upon both afflicted individuals and the healthcare system. Normal venous function requires patency of the axial veins with a series of venous valves, and muscle pumps. Dysfunction of any of the normal structures may lead to venous hypertension and development of chronic venous insufficiency. There is a spectrum of manifestations of chronic venous insufficiency including skin changes and venous leg ulcers. Venous duplex ultrasound may be used to confirm the diagnosis and provide anatomical detail. The treatment of chronic venous insufficiency will be based on the severity of disease and guided by anatomical and pathophysiological considerations. Compressive garments have been a mainstay in treatment. Interventional methods have replaced many traditional surgical techniques but are still typically reserved for unsatisfactory response to conservative measures.

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Evaluation of Peak Reflux Velocities with Vector Flow Imaging and Spectral Doppler Ultrasound in Varicose Veins

Ultrasound International Open ◽

10.1055/a-0643-4430 ◽

2018 ◽

Vol 04 (03) ◽

pp. E91-E98 ◽

Cited By ~ 2

Author(s):

Thor Bechsgaard ◽

Kristoffer Hansen ◽

Andreas Brandt ◽

Ramin Moshavegh ◽

Julie Forman ◽

...

Keyword(s):

Doppler Ultrasound ◽

Varicose Veins ◽

Assessment Tools ◽

Chronic Venous Disease ◽

Venous Disease ◽

Flow Imaging ◽

Venous Valves ◽

Spectral Doppler ◽

Retrograde Blood Flow

Abstract Purpose Spectral Doppler ultrasound (SDUS) is used for quantifying reflux in lower extremity varicose veins. The technique is angle-dependent opposed to the new angle-independent Vector Flow Imaging (VFI) method. The aim of this study was to compare peak reflux velocities obtained with VFI and SDUS in patients with chronic venous disease, i. e., pathological retrograde blood flow caused by incompetent venous valves. Materials and Methods 64 patients with chronic venous disease were scanned with VFI and SDUS in the great or the small saphenous vein, and reflux velocities were compared to three assessment tools for chronic venous disease. A flow rig was used to assess the accuracy and precision of the two methods. Results The mean peak reflux velocities differed significantly (VFI: 47.4 cm/s vs. SDUS: 62.0 cm/s, p<0.001). No difference in absolute precision (p=0.18) nor relative precision (p=0.79) was found. No correlation to disease severity, according to assessment tools, was found for peak reflux velocities obtained with either method. In vitro, VFI was more accurate but equally precise when compared to SDUS. Conclusion Both VFI and SDUS detected the pathologic retrograde flow in varicose veins but measured different reflux velocities with equal precision. VFI may play a role in evaluating venous disease in the future.

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Prosthetic venous valves: Short history and advancements from 2012 to 2020.

Phlebology The Journal of Venous Disease ◽

10.1177/0268355520962451 ◽

2020 ◽

pp. 026835552096245

Author(s):

Constantinos Zervides ◽

Habib Mahdi ◽

Ravit Atara Staub ◽

Hassan Jouni

Keyword(s):

Chronic Venous Disease ◽

High Recurrence Rate ◽

Venous Disease ◽

Venous Valve ◽

Advantages And Disadvantages ◽

Venous Valves ◽

Prosthetic Valves ◽

Patients Experience ◽

The Ideal

Chronic Venous Disease is estimated at 83.6% of the global population. Patients experience pain, discomfort and severe complications with few effective therapies being available. Current strategies for the treatment of malfunctioning venous valves are invasive with a high recurrence rate. A prosthetic venous valve replacement is imminent, possibly providing better outcomes and improved general quality of life. In this review, prosthetic venous valves history is presented and assesses the advantages and disadvantages of developed venous valves. Articles that discussed potential designs of prosthetic venous valves were examined. A systematic search produced thirty-five papers fitting the inclusion criteria. Our understanding of the ideal abilities required in prosthetic valves has evolved. Developed valves are reported for regurgitation, migration and leakage. Issues have been resolved, but we are still away from the ideal valve. Improvements within the last eight years provided information on the importance of sinuses and prosthetic to venous wall-size mismatch.

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Venous Pressure Gradients in Patients with Chronic Venous Disease

Phlebology The Journal of Venous Disease ◽

10.1177/026835558600100110 ◽

1986 ◽

Vol 1 (1) ◽

pp. 47-50 ◽

Cited By ~ 8

Author(s):

Einer Stranden ◽

Per Øgreid ◽

Egil Seem

Keyword(s):

Chronic Venous Insufficiency ◽

Venous Insufficiency ◽

Venous Pressure ◽

Chronic Venous Disease ◽

Venous Disease ◽

Pressure Gradients ◽

Venous Valves ◽

The Mean ◽

The Difference ◽

Pressure Changes

Venous pressure was measured simultaneously in a vein of the calf and the foot in five healthy controls and 10 patients with superficial chronic venous insufficiency (CVI). In both groups ambulatory venous pressure decreased more in the foot veins than in the calf veins. In patients with CVI the mean difference in foot and calf ambulatory venous pressure reduction (AVPR) was 25.5 mmHg, as was found in the controls (24.6 mmHg). During compression of superficial veins the difference in AVPR was reduced in patients but not in controls (11.6 vs 27.0 mmHg, respectively). About 50% of this difference in AVPR could be ascribed to the difference in cannulation height (except for the meaurement with superficial compression in patients where the whole difference in AVPR could be ascribed to the difference in cannulation height). Pressure changes during ambulation in the dorsal foot vein and calf veins may differ considerably, dependent on the existance of a specific foot vein pump and sufficiency of venous valves at the level of the ankle. Therefore, veins proximal to the ankle should be used for pressure recordings in the evaluation of chronic venous insufficiency in the calf.

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

VASA ◽

10.1024/0301-1526/a000327 ◽

2014 ◽

Vol 43 (1) ◽

pp. 47-54 ◽

Cited By ~ 1

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.

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Endovenous stenting in chronic venous disease secondary to iliac vein obstruction

Italian Journal of Vascular and Endovascular Surgery ◽

10.23736/s1824-4777.18.01398-0 ◽

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

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

Acta Phlebologica ◽

10.23736/s1593-232x.19.00437-5 ◽

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

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3D modeling of the vascular system

Journal of Theoretical and Applied Vascular Research ◽

10.24019/jtavr.8 ◽

2016 ◽

Vol 1 (1) ◽

pp. 51-58 ◽

Cited By ~ 1

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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