State of the art on cryo-laser cryo-sclerotherapy in lower limb venous aesthetic treatment.

Here we describe a combination of neodymium:yttrium-aluminium-garnet 1064-nm laser emission and injection of 75% dextrose solution to treat lower limb reticular veins. The strategy is known as cryo-laser cryo-sclerotherapy. Preliminary outcomes are reported, showing ecchymosis in up to 30% of cases and intravenous thrombus in 14%.

A two-cohort feasibility study on polyglycolic acid yarn implantation for abolition of saphenous vein reflux.

Objective: The objective of this study was to evaluate the feasibility and safety of a polyglycolic acid (PGA) yarn implant for nonthermal ablation of saphenous vein reflux.

Methods: In two consecutive cohort studies (TAHOE I and TAHOE II), the feasibility of abolition of great saphenous vein (GSV) reflux by implantation of a PGA yarn was tested under ultrasound guidance in 51 and 30 patients, respectively. The use of tumescent local anesthesia was not required.

Multi-analyte profiling in human carotid atherosclerosis uncovers pro-inflammatory macrophage programming in plaques.

Molecular characterisation of vulnerable atherosclerosis is necessary for targeting functional imaging and plaque-stabilising therapeutics. Inflammation has been linked to atherogenesis and the development of high-risk plaques. We set to quantify cytokine, chemokine and matrix metalloproteinase (MMP) protein production in cells derived from carotid plaques to map the inflammatory milieu responsible for instability.

The use of functional imaging in the diagnosis of carotid patch infection.

Carotid patch infection following carotid patch angioplasty is a rare but serious complication. Accurate diagnosis is vital yet currently ill-defined. We present the use of computed tomography positron emission tomography and leucocyte radioisotope scintigraphy and highlight their potential role in the diagnosis of equivocal carotid patch infection.

Open repair versus fenestrated endovascular aneurysm repair of juxtarenal aneurysms.

Background: Open repair is the gold standard management for juxtarenal aneurysms. Fenestrated endovascular aneurysm repair (FEVAR) is indicated for high-risk patients. The long-term outcomes of FEVAR are largely unknown, and there is no Level I comparative evidence.

Ambulatory varicosity avulsion later or synchronized (AVULS): a randomized clinical trial.

Objective: A randomized clinical trial assessing the difference in quality of life and clinical outcomes between delayed and simultaneous phlebectomies in the context of endovenous truncal vein ablation.

Background: Endovenous ablation has replaced open surgery as the treatment of choice for truncal varicose veins. Timing of varicosity treatment is controversial with delayed and simultaneous pathways having studies advocating their benefits.

A study to evaluate patterns of superficial venous reflux in patients with primary chronic venous disease.

Objective: This study assessed patterns of superficial reflux in patients with primary chronic venous disease.

Methods: Retrospective review of all patient venous duplex ultrasonography reports at one institution between 2000 and 2009. Legs with secondary, deep or no superficial reflux were excluded.

The disparate management of superficial venous thrombosis in primary and secondary care.

Objectives: Superficial venous thrombosis is common and traditionally considered a benign condition requiring only symptomatic treatment. Recent evidence, however, advocates more aggressive management. Extensive guidance is available but actual practice is unknown.

Retrograde mechanochemical ablation of the small saphenous vein for the treatment of a venous ulcer.

We present the first case of retrograde ablation of the small saphenous vein to treat active venous ulceration. A 73-year-old gentleman with complicated varicose veins of the left leg and a non-healing venous ulcer despite previous successful endovenous treatment to his left great saphenous vein underwent mechanochemical ablation of his small saphenous vein with the ClariVein® system, under local anaesthetic, using a retrograde cannulation technique. Post-operatively the patient had improved symptomatically and the ulcer size had reduced.

Socio-economic impact of endovenous thermal ablation techniques.

Varicose veins are common and cause extensive morbidity; however, the value of treatment is under-appreciated. Many procedures allow the treatment of varicose veins with minimal cost and extensive literature supporting differing minimally invasive approaches. In this article, we investigate the current literature regarding treatment options, clinical outcome and the cost-benefit economics associated with varicose vein treatment.

Cyanoacrylate glue for the treatment of great saphenous vein incompetence in the anticoagulated patient.

The Sapheon Venaseal Closure System (Sapheon Inc, Santa Rosa, Calif), using cyanoacrylate glue, has provided a new modality of treatment, with patients treated without both tumescent anesthesia and postoperative compression. We present the first case of great saphenous vein occlusion performed using glue while the patient was fully anticoagulated with warfarin. This was tolerated well, and the treated vein showed complete early occlusion at 8 weeks; however at 6 months, extensive recanalization was demonstrated on duplex imaging.

Smooth muscle cells in human atherosclerosis: proteomic profiling reveals differences in expression of Annexin A1 and mitochondrial proteins in carotid disease.

Smooth muscle cells (SMC) contribute to the development and stability of atherosclerotic lesions. The molecular mechanisms that mediate their properties are incompletely defined. We employed proteomics and in vitro functional assays to identify the unique characteristics of intimal SMC isolated from human carotid endarterectomy specimens and medial SMC from thoracic aortas and carotids.

Investigation and treatment of a complicated inflammatory aortoiliac aneurysm.

Inflammatory abdominal aortic aneurysms (IAAAs) account for 5% to 10% of all abdominal aortic aneurysms, occurring primarily in males. Their true etiology is unknown. Symptoms and signs of IAAA are so variable that they present to a wide range of specialties.

Blunt trauma of the anterior tibial artery in professional footballers.

Three cases of blunt trauma to the anterior tibial artery in professional footballers are described. Each case was managed conservatively, allowing the players to promptly return to competitive fixtures. We hope the outcomes of the cases described might be helpful for teams facing the challenge of managing similar injuries.

Diagnosis and surgical management of free-floating thrombus within the carotid artery.

Objective: Free-floating thrombus (FFT) of the carotid artery is a rare condition of currently unknown etiology. Less than 150 cases have been described in the published world literature to date.

Design And Setting: We present 6 consecutive cases of carotid FFT, identified prospectively from 5000 carotid duplex scans over a 34-month period in a single tertiary center for vascular surgery.

The patients' perspective of carotid endarterectomy.

Introduction: No studies as yet have directly evaluated the patients' perspective of carotid endarterectomy (CEA). Here, we determine patient satisfaction, understanding, and perception of CEA.

Methods: Consecutive patients were identified from a prospectively maintained carotid database.

Hydronephrosis after embolization of internal iliac artery aneurysms.

The treatment of internal iliac artery aneurysms is aimed at the prevention of rupture. Traditionally, this is undertaken surgically; however, endovascular techniques are an acceptable alternative and these techniques are also not without complication. Herein, the authors describe the endovascular treatment of two patients with internal iliac aneurysms.