Endovascular mechanical thrombectomy of iliofemoral venous stent occlusion with the novel RevCore thrombectomy system: case reports and literature review.

Venous in-stent restenosis is not completely understood, and the currently available treatment is usually unsatisfactory. We describe the cases of two patients treated with the RevCore thrombectomy system (Inari Medical), designed for venous in-stent thrombosis. Case 1 involves a 62-year-old woman with post-thrombotic syndrome from iliac vein stent placement 15 years earlier.

Azygos vein stenting as an alternate route for inferior vena cava obstruction.

Chronic venous insufficiency, caused by inferior vena cava occlusion, can lead to thromboembolic complications and tissue loss. We present two cases of azygos vein stenting (AVS) in which vena cava recanalization techniques were exhausted. In the first case, the left iliac vein and vena cava were recanalized and stented; however, the right iliac vein had been previously resected and required AVS.

A systematic review of the treatment of residual below the knee venous reflux after endovenous thermal ablation of the great saphenous vein.

Background: Great saphenous vein (GSV) antireflux procedures have evolved during the past few decades to reduce elevated venous pressure. Untreated reflux in the below knee (BK) GSV (BK-GSV) can lead to persistent venous hypertension and deterioration of the venous circulation. The purpose of the present systematic review was to study the influence of BK-GSV intervention on venous disease progression.

An algorithm combining VVSYmQ® and VCSS scores may help to predict disease severity in C2 patients.

Objectives: The purpose was to assess whether combining patient reported scores (VVSymQ®) and physician reported scores (VCSS) stratifies disease severity in C2 patients.

Methods: Consecutive patients were pooled from the VANISH-1 and VANISH-2 cohorts. VCSS and VVSymQ® were calculated for each patient.

Clinical response to combination therapy in the treatment of varicose veins.

Background: Varicose vein ablation procedures are being performed with increasing frequency; however, there is a lack of consensus on the relative efficacy of combined treatment of saphenous incompetence and symptomatic varicosities vs a staged approach. In this study, we examined the impact on symptom severity when a procedure to eliminate varicosities was added to standard endovenous saphenous ablation.

Methods: The Varicose Vein Module of the American Venous Registry was established by the American Venous Forum in 2010 and collected data from 48 physicians during a 5-year period.

Saphenous vein histopathology 5.5 years after cyanoacrylate closure.

VenaSeal (Medtronic, Minneapolis, Minn) is a cyanoacrylate polymer adhesive for the treatment of patients with chronic venous insufficiency. As an implanted device, questions remain about how long cyanoacrylate persists after closure. In this report, a 65-year-old man was examined 5.

Venous duplex ultrasound protocol for iliocaval disease.

Venous duplex ultrasound imaging of the retroperitoneal iliac veins and vena cava has been slow to be adopted into everyday use; however, current ultrasound technology allows more depth of penetration with improved image resolution. Gray-scale, color flow, and pulsed wave Doppler modalities are ideal for evaluation of the femoral-iliocaval outflow tract. Additional tools, such as chroma tint, power Doppler, and penetration harmonics, are useful for image optimization.

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.

Thirty-sixth-month follow-up of first-in-human use of cyanoacrylate adhesive for treatment of saphenous vein incompetence.

Objective: The objective of this study was to evaluate the long-term safety and effectiveness of endovenous cyanoacrylate (CA)-based closure of incompetent great saphenous veins.

Methods: This was a prospective, single-arm, single-center feasibility study conducted at the Canela Clinic (La Romana, Dominican Republic) to assess the effectiveness and safety of a CA-based adhesive for great saphenous vein closure at 36 months after treatment. Thirty-eight subjects were treated by injection of small boluses of CA under ultrasound guidance and without the use of perivenous tumescent anesthesia or postprocedure graduated compression stockings.

Septic arthritis and arthropathy of the rotator cuff: remember this association.

Objective: To describe occurrences of septic glenohumeral arthritis among patients with arthropathy of the rotator cuff, and to highlight the importance of correct diagnosis and surgical procedures.

Methodology: Eight surgical drains were installed in seven patients with glenohumeral pyoarthritis. All the patients presented arthropathy of the rotator cuff (four males and three females).

Use of the Clinical, Etiologic, Anatomic, and Pathophysiologic classification and Venous Clinical Severity Score to establish a treatment plan for chronic venous disorders.

To be useful in clinical practice and in the evaluation of clinical therapies for chronic venous disorders, a measurement instrument should be objective, inclusive of all severities of venous disease, and rapidly performed by clinicians. The Clinical, Etiologic, Anatomic, and Pathophysiologic classification helps us identify the etiology, whether it is congenital, nonthrombotic, or post-thrombotic; anatomic segments involved, whether deep, superficial, or perforators; and pathophysiologic data, such as reflux or obstruction. The Venous Clinical Severity Score can be used to observe patients longitudinally, especially after interventions, although the total score is biased with regard to advanced disease, such as C4 through C6.

Glenoumeral dislocation: a prospective randomized study comparing spazo and kocher maneuvers.

Objective: To evaluate and to compare the Spaso and Kocher reduction maneuvers in terms of efficiency, time of reduction, facileness, pain, discomfort to the patient, complications and risks, besides promoting the comparison between the two maneuvers, aiming to ground the emergency conduct.

Methods: A prospective study with 105 patients with acute shoulder dislocations were enrolled in the study between February 2011 and September 2012. The patients were randomized into two groups and they were submitted to the reduction of dislocation using the Spaso maneuver (group A) or the Kocher technique (group B) by first, second or third-year orthopedic surgery residents from our service.

Two-year follow-up of first human use of cyanoacrylate adhesive for treatment of saphenous vein incompetence.

Objectives: To evaluate the safety and effectiveness of endovenous cyanoacrylate-based embolization of incompetent great saphenous veins.

Methods: Incompetent great saphenous veins in 38 patients were embolized by cyanoacrylate bolus injections under ultrasound guidance without the use of perivenous tumescent anesthesia or graduated compression stockings. Follow-up was performed over a period of 24 months.

First human use of cyanoacrylate adhesive for treatment of saphenous vein incompetence.

Objective: The primary objective of this study was to assess the feasibility of an endovenous cyanoacrylate (CA) adhesive implant, delivered with a catheter-based administration system engineered with a nonstick surface, for the treatment of incompetent great saphenous veins (GSVs). The primary safety end point was the rate of serious adverse events related to the procedure. The primary efficacy end point was vein occlusion during follow-up.

Novel vein closure procedure using a proprietary cyanoacrylate adhesive: 30-day swine model results.

Purpose: To conduct a pilot study to demonstrate a novel method of using a proprietary cyanoacrylate (CA) for closure of superficial veins.

Materials And Methods: Right and left superficial epigastric veins from two swine models were utilized due to the vein's similarities with the human great saphenous vein. Under ultrasound guidance, access was gained and a 5-F delivery catheter was advanced to the junction of the superficial epigastric and abdominus rectus veins.

Cyanoacrylate adhesive for the closure of truncal veins: 60-day swine model results.

Background: The introduction of cyanoacrylate (CA) within a blood vessel triggers polymerization, followed by an inflammatory reaction.

Methods: A sheath was positioned 2.0 cm caudad to the junction of the superficial epigastric and abdominus rectus veins in 2 swine, followed by ultrasound-guided injection of 0.

Radiofrequency endovenous ClosureFAST versus laser ablation for the treatment of great saphenous reflux: a multicenter, single-blinded, randomized study (RECOVERY study).

Purpose: The present study was designed to address the hypothesis that radiofrequency (RF) thermal ablation, as represented by the ClosureFAST system, is associated with improved recovery and quality-of-life (QOL) parameters compared with 980-nm endovenous laser (EVL) thermal ablation of the great saphenous vein (GSV).

Materials And Methods: Eighty-seven veins in 69 patients were randomized to ClosureFAST or 980-nm EVL treatment of the GSV. The study was prospective, randomized, single-blinded, and carried out at five American sites and one European site.

Laser ablation of cutaneous leg veins.

Patients presenting with lower-extremity telangiectasias, commonly known as spider veins, are a frequent presentation for vascular surgeons. The use of lasers in the treatment of lower-extremity spider veins has gained increased popularity during the past 5 years. This technology, driven by consumer demand, has been effective in treating vessels that are refractory to sclerotherapy treatment, vessels that arise from telangiectatic matting, and in patients who experience a phobia to needles.

Ambulatory phlebectomy in the office.

Ambulatory phlebectomy is a minor, office-based surgical procedure designed to remove varicose veins. It is a perfect complement to endovenous thermal ablation of the saphenous vein. With this combination, patients can expect all varicose veins to vanish following a 1-hour procedure that employs only local anesthesia in the comfort of a physician's office.