Functional repair of the great saphenous vein by external valvuloplasty reduces the vein's diameter: 6-month results of a multicentre study.

Objectives: External valvuloplasty (eVP) is a reconstructive surgical method to repair the function of the terminal and preterminal valves. We evaluated the 6-month outcomes of eVP regarding the diameter of the great saphenous vein (GSV).

Methods: Patients from five vein centres were included in this observational study.

Cellular senescence at the saphenofemoral junction in patients with healthy, primary varicose and recurrent varicose veins - A pilot study.

Objectives: Cellular senescence could play a role in the development of venous disease. Superficial venous reflux at the saphenofemoral junction is a common finding in patients with primary varicose veins. Furthermore, reflux in this essential area is associated with higher clinical stages of the disease and recurrent varicose veins.

"Quality of Life after Varicose Vein Surgery in Patients with High-ligation and Stripping, External Valvuloplasty and Sapheno-femoral Redo Surgery".

Background: High-ligation and stripping (HL/S) and external valvuloplasty (eVP) with the implantation of an external device to restore the valve's function, are surgical methods to eliminate reflux at the saphenofemoral junction. Furthermore, redo-surgery (RedoS) can be performed in terms of same side groin recurrences. It is unclear, if there is a difference in quality of life (QoL) between these 3 surgical treatment options.

Perioperative changes of response to antiplatelet medication in vascular surgery patients.

Introduction: Reduced antiplatelet activity of aspirin (ALR) or clopidogrel (CLR) is associated with an increased risk of thromboembolic events. The reported prevalence data for low-responders vary widely and there have been few investigations in vascular surgery patients even though they are at high risk for thromb-embolic complications. The aim of this prospective observational monocentric study was to elucidate possible changes in ALR or CLR after common vascular procedures.

Minor tributary veins of the common femoral vein near the saphenofemoral junction - A postmortem study.

Objectives: Recurrent varicose veins after surgery are a frequent burden and the saphenofemoral junction is the most common source of reflux. Pre-existing branches of the common femoral vein near the saphenofemoral junction, which may increase due to haemodynamic or other reasons, could play a role in the development of recurrent varices. There exist only a few anatomical data about the prevalence of these minor venous tributaries of the common femoral vein near the saphenofemoral junction.

Multimodal approach of venous recanalization in patients with a critical limb ischemia due to phlegmasia cerulea dolens: A case series of 17 patients in a single center.

Objectives: Advanced phlegmasia cerulea dolens can be a hazardous complication of a deep vein thrombosis and rapid recanalization of the deep venous system is the most important factor.

Method: We describe the outcome of 17 patients with critical limb ischemia due to an advanced phlegmasia cerulea dolens. Venous thrombectomy was performed by a standardized operating procedure.

Surgical thrombectomy for iliofemoral deep vein thrombosis: Patient outcomes at 8.5 years.

Introduction: Deep vein thrombosis (DVT) is a frequent burden and a post-thrombotic syndrome (PTS) can be a serious long-term consequence. Iliofemoral DVT should be associated with severe forms of PTS. Therefore an early thrombus removal has been recommended in specific conditions.

External valvuloplasty of the saphenofemoral junction in insufficient great saphenous veins - six weeks results of a prospective multicentre trial.

: Varicosis of the great saphenous vein (GSV) is a common disease. Most of the therapeutic concepts attempt to remove or destroy the truncal vein. However, the absence of the GSV could be harmful for further treatments of artherosclerotic disease as the GSV is often used as bypass graft in lower extremity or coronary artery revascularisations.

Barrier Patch Implantation during Redo Surgery for Varicose Vein Recurrences in the Groin: 1-Year Results.

Background: Rerecurrences after redo surgery for recurrent varicose veins in the groin are a common problem. The present report looks at the efficacy of an additional barrier patch implantation in reducing these rerecurrences.

Methods: A retrospective review of a prospectively collected database was conducted.

Consensus statement on the symptom-based treatment of chronic venous diseases.

Background: Chronic venous diseases are very common. Early symptoms such as a sensation of swelling and heaviness may occur without objectifiable findings, but are nevertheless perceived as bothersome. Progressive disease - marked by varicose veins and symptoms of chronic venous insufficiency - is associated with considerable impairment in quality of life.

Konsensuspapier zur symptomorientierten Therapie der chronischen Venenerkrankungen.

Hintergrund: Chronische Venenerkrankungen sind eine Volkskrankheit. Venöse Symptome wie Schwellungs- und Schweregefühl können bereits früh ohne sichtbaren Befund auftreten und werden als belastend erlebt. Ein Fortschreiten im Sinne einer objektivierbaren Varikose bzw.

Traumatic Infra-renal Aortic Dissection After a High-energy Trauma: A Case Report of a Primary Missed Diagnosis.

A traumatic infra-renal aortic dissection is a rare but life-threatening injury that follows deceleration injuries. The mechanism of blunt abdominal aortic injury involves both direct and indirect forces. The successful management of patients with traumatic injuries depends on a prompt suspicion of the injury and early diagnosis and therapy.

Efficacy and comfort of medical compression stockings with low and moderate pressure six weeks after vein surgery.

Objective: The first two authors contributed equally to this work. A prospective, randomized study to evaluate efficacy, safety, and comfort of thigh-high, round knitted medical compression stockings (MCSs) with different pressure six weeks after vein surgery.

Methods: Female patients undergoing vein surgery were randomized for a compression therapy with low (18-21 mmHg, group A) or moderate (23-32 mmHg, group B) pressure MCSs.

Effectiveness of antiplatelet therapy in atherosclerotic disease: comparing the ASA low-response prevalence in CVD, CAD and PAD.

Although acetylsalicylic acid (ASA, aspirin) reduces the risk of ischemic events in patients with atherosclerosis, a substantial number of incidents continue to occur. As only limited data exist we evaluated the antiplatelet effectiveness of ASA in patients with different manifestations of atherosclerosis as in cerebrovascular, coronary artery and peripheral arterial disease (CVD, CAD, PAD). For the evaluation of the antiplatelet effectiveness of ASA we used whole blood aggregometry (Chrono-log Model 590).

Decorin expression with stump recurrence and neovascularization after varicose vein surgery--a pilot study.

Background: An evaluation of the reason for saphenofemoral recurrence (SFR, technical error vs neovascularization) after surgery is necessary to improve the method or find purchase for new therapies. Currently, differentiation by the surgeon or ultrasound are unsatisfying; histology depends mainly on the physician's experience. Decorin, an extracellular matrix component, is up-regulated in angiogenesis with antiangiogenetic effects on neovascularization.

Discordant findings in color-coded duplex-sonography and magnetic resonance angiography in symptomatic internal carotid artery stenosis: implications for diagnostic work-up and early intervention.

Background: Magnetic resonance angiography (MRA) is supposed to be the new 'gold standard' in the diagnosis of atherosclerotic disease of the extracranial arteries.

Methods: A case report is presented on a patient in whom discordant findings of the status of the left internal carotid artery (ICA) were identified in color-coded duplex-sonography and MRA.

Results: Left ICA stenosis was suspected in duplex-sonography, yet not confirmed in contrast-enhanced (CE) MRA reconstruction.

Short-term effects of transcatheter aortic valve implantation on neurohormonal activation, quality of life and 6-minute walk test in severe and symptomatic aortic stenosis.

Objective: This prospective study aimed to determine to what extent clinical symptoms and neurohumoral activation are improved in patients with severe aortic valve stenosis after transcatheter aortic valve implantation (TAVI) with the CoreValve prosthesis.

Methods: From June 2008 to June 2009 consecutive patients with symptomatic severe aortic valve stenosis (area<1 cm(2)), age>or=75 years with a logistic EuroSCORE >or=15% or age>60 years plus additional specified risk factors were evaluated for TAVI. Examinations of study patients were performed before and 30 days after TAVI and comprised assessment of quality of life (Minnesota living with heart failure questionnaire, [MLHFQ]) 6-minute walk test, measurement of B-type natriuretic peptide and echocardiography.

Validity of duplex-ultrasound in identifying the cause of groin recurrence after varicose vein surgery.

Introduction: Often groin recurrences after varicose vein surgery are diagnosed and classified with the help of a duplex ultrasound scan. There are, however, no studies indicating if duplex ultrasound scans can reliably distinguish between the different forms of recurrent vessels, ie, neovascularization or a residual stump. To address this issue, we have conducted a prospective study in which ultrasound scan assessment of groin recurrences was compared to the histological classification of the recurrent groin veins.

A case of contained ruptured aortitis due to Clostridium septicum infection in a patient with a colon malignancy.

We discuss a case of contained ruptured aortitis due to Clostridium septicum infection in a 71-year-old man, who had undergone a right hemicolectomy and cholecystectomy to treat an ascending colon carcinoma. Computed tomography identified a juxtarenal abdominal aneurysm with gas formation in the right psoas muscle. Emergency abdominal exploration revealed a ruptured aortitis.

Reflux patterns in the ovarian and hypogastric veins in patients with varicose veins and signs of pelvic venous incompetence.

Patients with varicose veins who also had clinical and/or duplex ultrasound findings suspicious of pelvic venous incompetence (PVI) underwent selective retrograde catheter phlebography of the pelvic veins. One hundred and one patients (all female, mean age 49.3 years) underwent selective phlebography of the pelvic veins.

Different approaches in the treatment of cystic adventitial disease of the popliteal artery.

Three cases of cystic adventitial disease (CDA) of the popliteal artery and the results of a literature review are described in order to identify the treatment of first choice of this rare clinical entity. Three male patients (mean age 56,3 years) presented at our Institution due to a sudden abrupt of disabling claudication of the lower limb. The eco-color-Doppler examination showed multiple hypoechoic and anechoic masses arising in the wall of the artery consistent with CAD.

Factors influencing early results and complication rates of the thrombolytic treatment of lower limb ischemia with recombinant tissue-type plasminogen activator.

The aim of the study was to determine the effect of comorbidity conditions on the early outcome and complication rates of thrombolytic treatment of lower limb ischaemia with recombinant tissue plasminogen activator (rt-PA). Clinical and procedural data of 82 patients treated for acute/subacute arterial/graft occlusion were analysed retrospectively. Early results and adverse events were recorded and evaluated statistically.

[Management of infected vascular grafts. Are there any factors predictive of early clinical success?].

The aim of the study was to define mortality and limb loss rates and to identify factors predictive of early clinical success in the management of infected vascular grafts. Clinical data of 40 patients were reviewed, evaluating comorbidity factors, laboratory findings, ischaemic symptoms, graft material and time of onset of infections. Diabetes and chronic renal insufficiency were reported in 15% of cases, malignancy in 10%, pathological C-reactive protein in 77.

Ultrasound elastography for the age determination of venous thrombi. Evaluation in an animal model of venous thrombosis.

The exact age determination of venous thrombi is important if thrombolytic therapy or surgical thrombectomy is considered. Clinical symptoms as well as duplex-ultrasound and phlebography are unreliable in this respect and do not allow an exact age estimation. Ultrasound elastography can provide information about the elastic properties of thrombi.