CHIVA strategy in chronic venous disease treatment: instructions for users

Along the years, scientific clinical data have been collected concerning the possible saphenous flow restoration without any ablation and according with the CHIVA strategy. Moreover, in 2013 a Cochrane review highlighted the smaller recurrence risk following a CHIVA strategy rather than a saphenous stripping. Nevertheless, the saphenous sparing strategy surely remains a not-so-worldwide-spread and accepted therapeutic option, also because considered not so immediate and easy to perform. Aim of this paper is to provide an easily accessible guide to an everyday use of a saphenous sparing strategy for chronic venous disease, highlighting how even apparently too complicated reflux patterns classifications can be fastly and successfully managed and exploited for a hemodynamic correction.

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ND:YAG 1064 NM LASER REGIMENS IN CHRONIC VENOUS DISEASE TREATMENT DEPENDING ON THE VEINS DIAMETER

10.36074/18.09.2020.v2.19 ◽

2020 ◽

Author(s):

Viktoriia Mishura ◽

Oksana Melekhovets ◽

Y. Melekhovets

Keyword(s):

Chronic Venous Disease ◽

Venous Disease ◽

Disease Treatment

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Summary of evidence of effectiveness of primary chronic venous disease treatment

Journal of Vascular Surgery ◽

10.1016/j.jvs.2010.05.127 ◽

2010 ◽

Vol 52 (5) ◽

pp. 54S-58S ◽

Cited By ~ 2

Author(s):

William Marston

Keyword(s):

Chronic Venous Disease ◽

Venous Disease ◽

Disease Treatment ◽

Primary Chronic Venous Disease

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Segmental saphenous ablation for chronic venous disease treatment

Phlebology The Journal of Venous Disease ◽

10.1177/0268355520946238 ◽

2020 ◽

pp. 026835552094623

Author(s):

Sergio Gianesini ◽

Erica Menegatti ◽

Savino Occhionorelli ◽

Maria Grazia Sibilla ◽

Marianna Mucignat ◽

...

Keyword(s):

Clinical Severity ◽

Chronic Venous Disease ◽

Procedural Pain ◽

Venous Disease ◽

Disease Treatment ◽

Endovenous Laser Ablation ◽

Venous Clinical Severity Score ◽

Endovenous Thermal Ablation ◽

Occlusion Rate ◽

Reflux Recurrence

Background Endovenous thermal ablation for chronic venous disease treatment is recommended over traditional surgery. The present investigation compares endovenous laser ablation (EVLA) with radiofrequency (RF) for segmental endovenous sapheno–femoral junction ablation. Methods This is a retrospective study in which 79 patients underwent a 6 cm great saphenous vein ablation by RF or by EVLA. Primary outcome was occlusion rate. Secondary outcomes included Venous Clinical Severity Score (VCSS), Aberdeen Varicose Vein Questionnaire (AVVQ) score, peri-procedural pain, aesthetic satisfaction. Results At 12 ± 1 months recanalization of shrunk tract was recorded in 5/85 (5.8%) cases (2 RF, 3 EVLA) [OR: 1.6; 95%CI: 0.2–10.4; P = 0.6689]. Two cases (1/44 RF group and 1/38 EVLA group) also showed reflux recurrence [OR: 1.0; 95%CI: 0.06–17.8; P = 1.0000]. No significant differences between groups were found in AVVQ, VCSS, peri-procedural pain, or aesthetic satisfaction. Conclusion Saphenous sparing is feasible and effective by means of both EVLA and RF, representing a possible alternative to surgery.

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Reference Data from the Vascular Laboratory and Application to Chronic Venous Disease Treatment

Journal of Vascular Surgery Venous and Lymphatic Disorders ◽

10.1016/j.jvsv.2019.01.016 ◽

2019 ◽

Vol 7 (2) ◽

pp. 292-293

Author(s):

Joel Crawford ◽

Antonios Gasparis ◽

Nicos Labropoulos

Keyword(s):

Reference Data ◽

Chronic Venous Disease ◽

Venous Disease ◽

Disease Treatment ◽

Vascular Laboratory

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Corrigendum for segmental saphenous ablation for chronic venous disease treatment

Phlebology The Journal of Venous Disease ◽

10.1177/0268355520979862 ◽

2020 ◽

pp. 026835552097986

Keyword(s):

Chronic Venous Disease ◽

Venous Disease ◽

Disease Treatment

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Clinical Efficacy of Medicinal Leech Therapy in Treating Third- and Fourth-Degree Hemorrhoids

Journal of Coloproctology ◽

10.1055/s-0041-1730012 ◽

2021 ◽

Author(s):

Abdul Mobeen ◽

Ashfaque Ahmad ◽

Mohd Aleemuddin Quamri ◽

Abdul Nasir Ansari

Keyword(s):

Therapeutic Option ◽

Subjective Assessment ◽

Medicinal Leech ◽

Chronic Venous Disease ◽

Venous Disease ◽

Antiinflammatory Action ◽

Fourth Degree ◽

Unani Medicine ◽

Leech Therapy ◽

Mucous Discharge

Abstract Objectives Hemorrhoids are characterized by bleeding, mucous discharge, itching, pain, and prolapse. This condition is known as bawaseer in Unani medicine, and Hirudinaria granulosa has been used for its treatment in Irsal-e Alaq, or medicinal leech therapy (MLT), for centuries. Hirudinaria granulosa with antithrombotic and antiinflammatory action is used in the treatment of chronic venous disease and hemorrhoids. The present study was aimed to investigate the efficacy of MLT in third and fourth-degree hemorrhoids. Methods A single-centre prospective, clinical trial with a pre and postanalysis design was conducted at the hospital of the National Institute of Unani Medicine. Twenty male and female patients, with a mean age of 38 years, presenting moderate symptoms assessed with the colorectal evaluation of clinical therapeutics scale (CORECTS) questionnaire were included in the study. Hirudinaria granulosa were applied around the pile mass for 15 minutes weekly, for 4 weeks. The efficacy of the treatment was measured by an objective and subjective assessment using the CORECTS. Results When analyzed by the clinician, MLT reduced the symptoms' severity score in the following domains: pain (55% improvement; p < 0.001); anorectal itching (30% improvement; p < 0.10); and bleeding (10% improvement; p < 0.7963). Significant improvement (p < 0.001) was reported in the CORECTS score in relation to pain (44.09% improvement; p < 0.001), itching (38.55% improvement; p < 0.001), swelling (44% improvement; p < 0.001), bleeding (17.28% improvement; p < 0.007), discomfort (34.01% improvement; p < 0.001), and wellbeing (32.35 %improvement; p < 0.001), giving an average overall opinion on the therapy of 4/10. Conclusion The results of the study albeit smaller in sample size show that MLT is an effective and safe therapeutic option in reducing the symptoms of 3rd and 4th degree haemorrhoids.

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Optimal sizing of iliac vein stents

Phlebology The Journal of Venous Disease ◽

10.1177/0268355517718763 ◽

2017 ◽

Vol 33 (7) ◽

pp. 451-457 ◽

Cited By ~ 33

Author(s):

Seshadri Raju ◽

William J Buck ◽

William Crim ◽

Arjun Jayaraj

Keyword(s):

Therapeutic Option ◽

Femoral Vein ◽

Iliac Vein ◽

Chronic Venous Disease ◽

Venous Disease ◽

Initial Procedure ◽

The Common ◽

The Right ◽

Vein Stenosis ◽

Scaling Rule

Background Iliac vein stenting has emerged as a therapeutic option in chronic venous disease. The optimal stent size is unknown but should match normal caliber at a minimum. Methods Teleology: The iliac-femoral outflow caliber was measured by Duplex in healthy volunteers to determine normal caliber. Patient IVUS data: The distribution curve of IVUS planimetry data in 345 chronic venous disease limbs was analyzed: values at the right tail end of the curve should approach normal values according to distribution theory. The optimal stent size was also projected using Poiseuille equation and Young’s scaling rule. Results The optimal stent sizes in the common iliac, external iliac, and common femoral vein segments are: 16, 14, and 12 mm diameters, respectively. Conclusion Stent correction of iliac vein stenosis should aim to restore the lumen to the minimum recommended caliber during the initial procedure and later re-interventions.

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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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