A Popliteal Vein Aneurysm Accompanied by Lower Persistent Sciatic Vein

Popliteal venous aneurysms (PVAs) are rare. Surgical treatment is recommended because of the risk of deep vein thrombosis and fatal pulmonary embolism. A persistent sciatic vein (PSV) is also a rare anomaly. We report a case of a PVA accompanied by a lower PSV. A 70-year-old man was admitted due to left leg heaviness. He had undergone ablation of both great saphenous veins 6 years prior to the admission. Duplex ultrasound showed a PVA on his left leg, which was 3.2 × 2.4 cm in size. The patient was treated with tangential aneurysmectomy with lateral venorrhaphy. His symptom gradually resolved. He received warfarin at a therapeutic range for 3 months. Duplex ultrasound at 6 months later showed no evidence of any recurrent aneurysm or venous reflux. His follow-up has revealed no complications for 18 months. Surgical treatment and perioperative therapeutic anticoagulation are recommended for treating PVAs. Tangential aneurysmectomy with venorrhaphy is the most common and the simplest surgical method.

Endovenous laser ablation of varicose veins with the 1470 nm diode laser using a radial fiber – 1-year follow-up

10.1177/0268355513512825 ◽

2013 ◽

Vol 30 (2) ◽

pp. 86-90 ◽

Cited By ~ 25

Author(s):

E von Hodenberg ◽

C Zerweck ◽

M Knittel ◽

T Zeller ◽

T Schwarz

Keyword(s):

Pulmonary Embolism ◽

Diode Laser ◽

Varicose Veins ◽

Endovenous Laser Ablation ◽

Vein Thrombosis ◽

Saphenous Veins ◽

Superficial Vein Thrombosis ◽

Radial Fiber ◽

Background: Endovenous laser ablation is one of the most accepted treatment options for insufficient great and small saphenous veins. The aim of this study was to investigate the long-term efficacy and safety of the radial fiber (ELVeS-radial kit™) for the 1470 nm diode laser in a 1-year follow-up. Methods: A total of 308 lower limbs with primary insufficiency of great and small saphenous veins or insufficient tributaries were included in the prospective observational cohort study. The primary efficacy endpoint of the study was ultrasonographic proven elimination of venous reflux after at least 1 year. Secondary efficacy and further safety end points after 1 year were as follows: (1) sonographic exclusion of recanalization of the treated vein segments, (2) deep vein thrombosis, clinical pulmonary embolism or superficial vein thrombosis as defined by objective testing, (3) death from any cause, (4) persistent clinical complaints such as pain and paresthesia, (5) recurrent varicose veins. Patient satisfaction was assessed using a CIVIQ-2 questionnaire after 1 year. Results: Follow-up could be completed in 91.2% of the patients. Excellent efficacy numbers with 99.6% occlusion of the treated varicose veins as elimination of reflux could be demonstrated. After 1 year, 96% of the treated veins disappeared completely sonographically; one recanalization was observed. No deep vein thrombosis or pulmonary embolism occurred, three superficial vein thrombosis were diagnosed in follow-up examinations. Four patients died, not related to pulmonary embolism. No persistent pain or paresthesia occurred in the follow-up. Recurrent varicose veins were diagnosed in 10 patients (2.81%). Conclusion: One-year follow-up showed that endovenous laser treatment of varicose veins with 1470 nm diode laser using the radial fiber is highly effective, also regarding in a 1-year follow-up.

Treatment of Varicose Long Saphenous Veins with Sclerosant in Microfoam Form: Long-Term Outcomes

10.1177/026835550001500103 ◽

2000 ◽

Vol 15 (1) ◽

pp. 19-23 ◽

Cited By ~ 42

Author(s):

J. Cabrera ◽

A. Garcí-Olmedo

Keyword(s):

Outcome Measure ◽

Duplex Ultrasound ◽

Lower Limbs ◽

Long Term Outcomes ◽

Vein Thrombosis ◽

Saphenous Veins ◽

Deep Vein ◽

Subsequent Disappearance

Objective: To determine whether the injection of sclerosant in microfoam form offers a clear alternative to surgery in large varices of the lower extremities. Design: Retrospective observational follow-up study (3–6 years). Patients: Five hundred lower limbs in which pretreatment duplex ultrasound demonstrated insufficiency of sapheno-femoral junctions (diameters 9–32 mm) and long saphenous veins. Main outcome measure: Obliteration and subsequent disappearance of treated veins. Results: After ≥ 3 years follow-up, 81% of treated varicose long saphenous veins were obliterated and 96.5% of superficial branches disappeared. The obliteration of saphenous veins required one injection in 86%, two in 10.5% and three in 3.5% of cases. There were no serious complications such as deep vein thrombosis Pulmonary embolism. Conclusion: The quality and stability of outcomes and ease of repeat treatments when required may make sclerotherapy with microfoam a therapeutic approach of choice for the functional and anatomical elimination of extensive pathological venous areas.

Incidence of deep venous thrombosis in COVID-19 hospitalized patients during the first peak of the Italian outbreak

10.1177/0268355520975592 ◽

2020 ◽

pp. 026835552097559

Author(s):

Domenico Baccellieri ◽

Luca Bertoglio ◽

Luca Apruzzi ◽

Vincenzo Ardita ◽

Armando D’Angelo ◽

...

Keyword(s):

Risk Factors ◽

Pulmonary Embolism ◽

Duplex Ultrasound ◽

Tertiary Hospital ◽

Hospitalized Patients ◽

High Rate ◽

Vein Thrombosis ◽

Therapeutic Anticoagulation ◽

Medical Wards ◽

Objectives A high rate of thrombotic events has been reported in COVID-19 population. The study aims to assess the incidence of deep vein thrombosis (DVT) in COVID-19 patients admitted to a single tertiary hospital. Methods From April 2nd to April 18th, 2020, hospitalized patients with SARS-CoV-2 infection were screened by lower limb duplex ultrasound (DUS). Patients were on (low molecular weight heparin) LMWH prophylaxis in medical wards, and on therapeutic anticoagulation in intensive care unit (ICU). DVT risk factors, reported by the Padua prediction score and blood tests, were retrieved from institutional electronic charts. The study primary endpoint was the incidence of DVT in the in-hospital COVID-19 population and its association with clinical and laboratory risk factors. The secondary endpoint was the association of DVT with mortality. Results Two hundred patients (median age 62 years, 72% male, 40 in ICU) received DUS screening. DVT was observed in 29 patients (14.5%), with proximal extension in 16 patients, and in association with symptoms in four patients. The DVT rate was similar in ICU (12.5%) and non-ICU patients (15%). Eighty-seven patients underwent a computed tomography angiography (CTA) that showed pulmonary embolism in 35 patients (40.2%) not associated with DVT in 25/35 cases (71.4%). DVT in the ten patients with pulmonary embolism were symptomatic in four and with a proximal localization in eight cases. A D-dimer level ≥5 mg/l at admission was predictive of DVT (OR 1.02; IC95% 1.03-1.16; p = .003). At the multivariate analysis in-hospital mortality was predicted by age (OR 1.06; 95% CI 0.02-1.15; p = .004) and by being an ICU patient (OR 1.23; 95% CI 0.30-2.25; p = .01). Conclusions Despite LMWH prophylaxis or full anticoagulant therapy, the incidence of DVT, mainly asymptomatic, in hospitalized COVID-19 patients was 14.5%. Further research should focus on the appropriate antithrombotic therapy for COVID-19 patients.

Combined endovenous laser treatment and ambulatory phlebectomy for the treatment of saphenous vein incompetence

10.1258/phleb.2008.008002 ◽

2008 ◽

Vol 23 (4) ◽

pp. 172-177 ◽

Cited By ~ 19

Author(s):

I M Jung ◽

S I Min ◽

S C Heo ◽

Y J Ahn ◽

K-T Hwang ◽

...

Keyword(s):

Pulmonary Embolism ◽

Laser Treatment ◽

Saphenous Vein ◽

Duplex Ultrasound ◽

Vein Thrombosis ◽

Single Procedure ◽

Saphenous Veins ◽

Effective Treatment Modality ◽

Deep Vein ◽

Endovenous Laser Treatment

Objectives The aim of this retrospective study is to assess the safety and effectiveness of endovenous laser treatment (EVLT) combined with ambulatory phlebectomy (AP) as a single procedure for treating saphenous vein incompetence. Methods The study enrolled 148 patients with saphenofemoral or saphenopopliteal junction reflux associated with saphenous vein incompetence and enlarged branch veins. Patients were treated with EVLT (135 great saphenous veins, 41 small saphenous veins) concomitantly with AP as a single procedure. All patients were followed up by clinical assessment and duplex ultrasound at one week and 12 weeks after the procedure. Results No postprocedural deep vein thrombosis and pulmonary embolism occurred. Saphenous vein recanalization rate at three months was 5.7%. Residual varicosities were found in 11.4% of the patients at three months after procedure, but only 2.3% of those required subsequent interventions. Conclusion Combined EVLT and AP could be a safe and effective treatment modality for the saphenous vein incompetence.

Low-dose subcutaneous heparin in prevention of deep-vein thrombosis

Drug and Therapeutics Bulletin ◽

10.1136/dtb.10.23.89 ◽

1972 ◽

Vol 10 (23) ◽

pp. 89-91

Keyword(s):

Pulmonary Embolism ◽

Deep Vein Thrombosis ◽

Venous Thrombosis ◽

Low Dose ◽

Fatal Pulmonary Embolism ◽

Vein Thrombosis ◽

Subcutaneous Heparin ◽

Prevention And Treatment ◽

Deep Vein ◽

Low Dosage

Earlier this year1 we discussed the prevention and treatment of venous thrombosis and concluded that heparin in low dosage seemed the most promising drug for preventing deep-vein thrombosis postoperatively, although the optimum regimen was not yet known. Sharnoff and his associates who began this work 10 years ago claim to have shown that this treatment largely prevents fatal pulmonary embolism.2

Anticoagulant therapies for acute venous thromboembolism: a comparison between those discharged directly from the emergency department versus hospital in two Canadian cities

BMJ Open ◽

10.1136/bmjopen-2018-022063 ◽

2018 ◽

Vol 8 (10) ◽

pp. e022063 ◽

Cited By ~ 3

Author(s):

Tammy J Bungard ◽

Bruce Ritchie ◽

Jennifer Bolt ◽

William M Semchuk

Keyword(s):

Emergency Department ◽

Pulmonary Embolism ◽

Venous Thromboembolism ◽

Severity Index ◽

Vein Thrombosis ◽

Risk Patients ◽

Acute Venous Thromboembolism ◽

Record Review ◽

ObjectiveTo compare the characteristics/management of acute venous thromboembolism (VTE) for patients either discharged directly from the emergency department (ED) or hospitalised throughout a year within two urban cities in Canada.DesignRetrospective medical record review.SettingHospitals in Edmonton, Alberta (n=4) and Regina, Saskatchewan (n=2) from April 2014 to March 2015.ParticipantsAll patients discharged from the ED or hospital with acute deep vein thrombosis or pulmonary embolism (PE). Those having another indication for anticoagulant therapy, pregnant/breast feeding or anticipated lifespan <3 months were excluded.Primary and secondary outcomesPrimarily, to compare proportion of patients receiving traditional therapy (parenteral anticoagulant±warfarin) relative to a direct oral anticoagulant (DOAC) between the two cohorts. Secondarily, to assess differences with therapy selected based on clot burden and follow-up plans postdischarge.Results387 (25.2%) and 665 (72.5%) patients from the ED and hospital cohorts, respectively, were included. Compared with the ED cohort, those hospitalised were older (57.3 and 64.5 years; p<0.0001), more likely to have PE (35.7% vs 83.8%) with a simplified Pulmonary Embolism Severity Index (sPESI) ≥1 (31.2% vs 65.2%), cancer (14.7% and 22.3%; p=0.003) and pulmonary disease (10.1% and 20.6%; p<0.0001). For the ED and hospital cohorts, similar proportions of patients were prescribed traditional therapies (72.6% and 71.1%) and a DOAC (25.8% and 27.4%, respectively). For the ED cohort, DOAC use was similar between those with a sPESI score of 0 and ≥1 (35.1% and 34.9%, p=0.98) whereas for those hospitalised lower risk patients were more likely to receive a DOAC (31.4% and 23.8%, p<0.055). Follow-up was most common with family physicians for those hospitalised (51.5%), while specialists/VTE clinic was most common for those directly discharged from the ED (50.6%).ConclusionsTraditional and DOAC therapies were proportionately similar between the ED and hospitalised cohorts, despite clear differences in patient populations and follow-up patterns in the community.