Abstract:
OBJECTIVE:The objective of this study was to assess the differences in clinical outcomes in patients treated with endovenous saphenous vein obliteration with technical outcome of either complete occlusion (CO), near complete occlusion (NCO), defined as < or =5-cm segment of flow in treated vein, or recanalization, defined as >5-cm segment of flow in treated vein. STUDY DESIGN:The study was designed as a prospective registry with follow-up at intervals through 24 months. The subjects were 286 patients from 30 clinical sites with saphenous vein reflux as measured with duplex scanning. A total of 319 limb treatments were performed. Intervention included endovenous catheter obliteration of insufficient saphenous veins with temperature controlled radiofrequency heat, without high ligation of the saphenofemoral junction. The main outcome measures were status of occlusion of treated vein segments, presence of varicose veins and reflux, clinical symptoms scores, physician evaluation of procedure success, and patient satisfaction. RESULTS:At 12 months, 83.6% of treated limbs were classified as CO, 5.6% were categorized as NCO, and 10.8% were recanalized. At 24 months, 85.2% of treated veins were CO, 3.5% were NCO, and 11.3% were recanalized. Varicose veins were present in 95% of limbs before treatment. The presence of varicose veins in limbs with CO was 10.5%, 7.3%, 5.7%, and 8.3% at 1 week, 6 months, 12 months, and 24 months, respectively. The presence of varicose veins in NCO limbs was similar at each interval. Overall, 91.4% of 232 limbs followed to 12 months and 90.1% of 142 limbs at 24 months were free of saphenous vein reflux, regardless of technical outcome. Paresthesia was reported in 3.9% of limbs at 1 year and in 5.6% at 2 years. The pretreatment mean symptom severity score was 2.0. Mean posttreatment symptom scores decreased to 0.07, 0.0, and 0.50 for CO, NCO, and recanalized limbs, respectively, at 6 months. At 12 months, the mean scores were 0.06, 0.0, and 0.32 for CO, NCO, and recanalized limbs, respectively; at 24 months, the scores were at 0.10, 0.40, and 0.63. Patient satisfaction was achieved in 195 of 212 patients (92%) at 1 year and in 121 of 128 (94.5%) at 2 years. CONCLUSION:Endovenous vein obliteration without high ligation dramatically reduces the presence of varicosities and reflux and, when performed with the prescribed pull-back methodology, is comparable with vein stripping at 1 and 2 years. Patient satisfaction with the procedure is high at 2 years, regardless of technical outcome. At 2 years, the closure procedure is a viable alternative to stripping.
journal_name
J Vasc Surgjournal_title
Journal of vascular surgeryauthors
Merchant RF,DePalma RG,Kabnick LSdoi
10.1067/mva.2002.124231subject
Has Abstractpub_date
2002-06-01 00:00:00pages
1190-6issue
6eissn
0741-5214issn
1097-6809pii
S0741521402688299journal_volume
35pub_type
杂志文章,多中心研究abstract:BACKGROUND:Iliofemoral deep vein thrombosis (DVT) is associated with severe postthrombotic morbidity when treated with anticoagulation alone. Catheter-directed thrombolysis (CDT), with or without the addition of mechanical techniques, is increasingly recommended for patients with iliofemoral DVT, although its effect on...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2011.10.032
更新日期:2012-03-01 00:00:00
abstract:OBJECTIVE:Little is known about the natural history and management of aneurysmal aortic arch branch vessels (AABVs). The objectives of this study were to assess the natural history of aneurysmal AABVs and to examine the outcomes of operative intervention. METHODS:A retrospective review of the Yale radiologic database ...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2018.03.412
更新日期:2018-12-01 00:00:00
abstract::To determine the influence of unilateral internal carotid arterial occlusion (ICO) on Doppler frequency spectral analysis (DFSA) of the patent contralateral carotid artery, a retrospective review of 154 patients between July 1987 and December 1991 with angiographically confirmed ICO was performed, correlating duplex a...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:
更新日期:1992-09-01 00:00:00
abstract:PURPOSE:Carotid endarterectomy (CEA) has proven to be effective in the prevention of stroke in patients with significant internal carotid artery (ICA) stenosis. However, whether increased cerebral blood flow after CEA improves the cerebral metabolism in patients with asymptomatic ICA flow lesions is unknown. Localized ...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1067/mva.2002.126555
更新日期:2002-09-01 00:00:00
abstract::In a series of six patients, a single-bar anterior external fixator was used to treat combined vascular and orthopedic injuries of the leg. This method of external fixation facilitated operative vascular exposure without sacrificing bony stability or alignment. It may be the preferred method of external fixation for t...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:
更新日期:1987-10-01 00:00:00
abstract:OBJECTIVE:Duplex ultrasound (DUS) imaging for vein bypass graft (VBG) surveillance is confounded by technical and physiologic factors that reduce the sensitivity for detecting impending graft failure. In contrast, three-dimensional computed tomography angiography (CTA) offers high-fidelity anatomic characterization of ...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2015.06.220
更新日期:2015-12-01 00:00:00
abstract:OBJECTIVE:This study proposes to establish a simulation-based technique for evaluating shear accumulation in stent grafts and to use the technique to assess the performance of a novel branched stent graft system. METHODS:Computational fluid dynamics models, with transient boundary conditions, particle injection, and r...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2016.07.108
更新日期:2017-06-01 00:00:00
abstract:PURPOSE:The composition and mechanical properties of abdominal aortic aneurysms (AAAs) were studied. METHODS:Stereologic study was used to measure volume fractions of the components of the aortic wall. Histochemical methods with picrosirus red and safranin O were developed to differentiate collagen from ground substan...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/0741-5214(94)90169-4
更新日期:1994-07-01 00:00:00
abstract:PURPOSE:The objective of this study was to assess the usefulness of gadolinum-enhanced magnetic resonance angiography (MRA) for defining anatomic features relevant to performing aortic surgery for aneurysmal disease. METHODS:Anatomic data defined by MRA, including abdominal aortic aneurysm (AAA) size and character, as...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/s0741-5214(95)70197-4
更新日期:1995-04-01 00:00:00
abstract:PURPOSE:Post-carotid endarterectomy, thrombosis, and intimal hyperplasia may be decreased by the inhibition of platelet adhesion and activation. In this study, a novel agent, saratin, was used to inhibit platelet-to-collagen adhesion in a rat carotid endarterectomy model. Saratin is a recombinant protein isolated from ...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1067/mva.2001.116801
更新日期:2001-10-01 00:00:00
abstract:OBJECTIVE:Although endovascular abdominal aortic aneurysm (AAA) repair (EVAR) is widely accepted for elective surgery, the uptake of emergency EVAR for ruptured AAA (REVAR) has trailed behind. This study was intended to identify the barriers to widespread application of REVAR in Australia and New Zealand. METHODS:A cr...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2016.01.037
更新日期:2016-08-01 00:00:00
abstract:BACKGROUND:Development in endograft design has extended endovascular treatment to include thoracoabdominal aortic aneurysms (TAAA). We report our experience using fenestrated and branched endografts in the management of TAAA. METHODS:We analyzed a cohort of consecutive patients treated electively for TAAA using endova...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2012.01.008
更新日期:2012-07-01 00:00:00
abstract:OBJECTIVES:Postoperative limb compression is widely used after venous surgery to prevent thromboembolism and to reduce hemorrhage, edema, hematoma, and pain. Only limited studies have been published regarding the most adequate postoperative compression therapy after varicose vein surgery. This study evaluated the effec...
journal_title:Journal of vascular surgery
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1016/j.jvs.2010.08.033
更新日期:2011-01-01 00:00:00
abstract:OBJECTIVES:We undertook a quantitative systematic review of randomized controlled trials (RCTs) and observational studies to determine the effectiveness of cerebrospinal fluid (CSF) drainage to prevent paraplegia in thoracic aneurysm (TA) and thoracoabdominal aortic aneurysm (TAAA) surgery. METHODS:We included RCTs an...
journal_title:Journal of vascular surgery
pub_type: 杂志文章,meta分析,评审
doi:10.1016/j.jvs.2004.03.017
更新日期:2004-07-01 00:00:00
abstract::Extracranial carotid artery aneurysm is a rare condition with relatively significant morbidity and mortality. When surgery is not indicated, endovascular techniques are emerging as the preferred treatment. However, even this approach may be contraindicated due to anatomic factors. We present a case of a high-lying ext...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2013.04.044
更新日期:2014-03-01 00:00:00
abstract::Type B dissections complicated by pain, malperfusion, or aneurysm expansion mandate surgical intervention. Success of this therapy is predicated on exclusion and thrombosis of the false lumen of the aneurysm. We report a case where cessation of flow was achieved using covered stent grafts in conjunction with coil embo...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2008.03.012
更新日期:2008-08-01 00:00:00
abstract:OBJECTIVE:Increasing use of primary arteriovenous fistulae (pAVFs) is a desired goal in hemodialysis patients (National Kidney Foundation /Dialysis Outcome Quality Initiative guidelines). However, in many instances, pAVFs fail to adequately mature due to ill-defined mechanisms. We therefore investigated pAVFs with colo...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2005.02.019
更新日期:2005-06-01 00:00:00
abstract:PURPOSE:The purpose of this study was to determine whether endogenous basic fibroblast growth factor (bFGF) production contributes to the intimal hyperplastic response to injury in a model of rabbit femoral artery balloon injury. Inhibition of de novo production of bFGF protein was targeted by intramural adenoviral gen...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/s0741-5214(98)70299-x
更新日期:1998-01-01 00:00:00
abstract:PURPOSE:Endovascular repair (EVR) is a less-invasive method for the treatment of abdominal aortic aneurysms (AAAs) as compared with open surgical repair (OSR). The potential benefits of EVR include increased patient acceptance, less resource utilization, and cost savings. This study was designed to determine whether th...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/s0741-5214(99)70237-5
更新日期:1999-06-01 00:00:00
abstract:OBJECTIVE:Central aortic stiffness and chronic obstructive pulmonary disease (COPD) are associated with increased incidence of devastating aortopathies. However, the exact mechanism leading to elevated aortic stiffness in patients with COPD is unknown. The purpose of this study was to quantify flow and shear hemodynami...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2017.06.110
更新日期:2018-07-01 00:00:00
abstract:OBJECTIVE:Transcatheter embolization with coils and other agents has been described as a treatment method for type II endoleak after endovascular aortic aneurysm repair (EVAR). Type I endoleak has not been treated commonly with such therapies, although most investigators believe they warrant definitive intervention. Th...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/s0741-5214(03)00729-8
更新日期:2003-10-01 00:00:00
abstract:OBJECTIVE:Spinal cord ischemia (SCI) is a potentially devastating complication of thoracic endovascular aortic repair (TEVAR) that can result in varying degrees of short-term and permanent disability. This study was undertaken to describe the clinical outcomes, long-term functional impact, and influence on survival of ...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2013.02.036
更新日期:2013-09-01 00:00:00
abstract:INTRODUCTION:While definitive therapy awaits level I evidence, controversy persists regarding the optimal operation for treatment of advanced chronic venous insufficiency (CVI). We propose a pragmatic approach to the correction or amelioration of venous hypertension resulting from hydrodynamic and hydrostatic venous re...
journal_title:Journal of vascular surgery
pub_type: 临床试验,杂志文章,多中心研究,随机对照试验
doi:10.1067/mva.2003.131
更新日期:2003-03-01 00:00:00
abstract:OBJECTIVE:Hostile infrarenal neck characteristics are associated with complications such as type Ia endoleak after endovascular aneurysm repair. Aortic neck angulation has been identified as one such characteristic, but its association with complications has not been uniform between studies. Neck angulation assumes tri...
journal_title:Journal of vascular surgery
pub_type: 杂志文章,多中心研究
doi:10.1016/j.jvs.2015.08.110
更新日期:2016-03-01 00:00:00
abstract:OBJECTIVE:A mycotic aneurysm of the aorta and adjacent arteries is a dreadful condition, threatening life, organs, and limbs. With regard to the aortic segment involved, repair by either in situ replacement or extra-anatomic reconstruction can be quite challenging. Even when surgery has been successful, the prognosis i...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1067/mva.2001.110356
更新日期:2001-01-01 00:00:00
abstract:OBJECTIVE:Preprocedural computed tomography angiography (CTA) assists in evaluating vascular morphology and disease distribution and in treatment planning for patients with lower extremity peripheral artery disease (PAD). The aim of the study was to determine the predictive value of radiographic findings on CTA and tec...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2017.02.031
更新日期:2017-09-01 00:00:00
abstract:OBJECTIVE:To examine the outcome of a comprehensive follow-up program for autogenous arteriovenous hemodialysis access (AVF) when performed by the hemodialysis access surgeon. METHODS:Patients with first time AVFs between 2000 and 2005 underwent history and physical examination between the third and sixth postoperativ...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2007.01.013
更新日期:2007-05-01 00:00:00
abstract:OBJECTIVE:The treatment of femoropopliteal peripheral artery disease (PAD) using paclitaxel-coated devices (PCDs) has been shown to improve patency in several randomized trials. However, a recent meta-analysis of trial data suggested an increased risk of mortality with PCD usage. Although subsequent studies have found ...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2020.08.146
更新日期:2020-10-07 00:00:00
abstract::Fenestrated-branched endovascular repair has been applied to treat chronic postdissection thoracoabdominal aortic aneurysms (TAAAs). We report a patient with diffuse postdissection aortic aneurysm involving the arch and thoracoabdominal aorta treated in a staged fashion with redo aortic arch repair using the frozen el...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2018.09.042
更新日期:2019-01-01 00:00:00
abstract:OBJECTIVE:The purpose of this study was to evaluate and report our treatment policies in the management of nonpulmonary arterial aneurysms in Behçet disease and to assess the prognosis in a cohort of 25 patients diagnosed between 1996 and 2007 by formally reassessing their outcome at the present time. METHODS:We ident...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2011.07.049
更新日期:2012-01-01 00:00:00