Publications by authors named "Michael Sichlau"

Objective: To report the prevalence and severity of nonpelvic symptoms for patients with venous-origin chronic pelvic pain (VO-CPP) and to describe outcomes after pelvic vein stenting and embolization.

Methods: We retrospectively reviewed outcomes of 45 women with VO-CPP who underwent treatment with iliac vein stenting and/or embolization. Patients completed symptom-severity questionnaires before and after treatment that assessed for pelvic pain, and multiple other symptoms, including brain fog, anxiety, depression, musculoskeletal pain, fatigue, migraines and more.

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Objectives: Comorbidities associated with venous origin chronic pelvic pain (VO-CPP) were evaluated pre and post venous treatment to assess change.

Materials And Methods: 45 women with VO-CPP were treated with venous stenting and/or embolization. Four surveys assessed symptoms pre- and post-treatment: IPPS (chronic pelvic pain), PUF (interstitial cystitis), OHQ (dysautonomia), and modified ROME III (IBS).

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Objectives: Patients with pelvic congestion syndrome (PCS) often report overlapping somatic symptoms and syndromes. The objective of this study was to explore the prevalence of co-existing symptoms and self-reported syndrome diagnoses among women with PCS and to inform future research hypotheses.

Methods: A brief online survey was offered to members of a PCS support group website.

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Article Synopsis
  • - A study was conducted to investigate the prevalence of left common iliac vein (LCIV) compression in female patients with postural orthostatic tachycardia syndrome (POTS), as some patients showed symptom improvement after pelvic venous insufficiency (PVI) treatment.
  • - Radiologists analyzed CT images of 216 women, revealing that 69% of POTS patients had significant LCIV compression (>50%), compared to only 40% in age-matched controls.
  • - The results indicate a strong correlation between LCIV compression and POTS, suggesting many women with POTS may have a higher chance of iliac venous obstruction, which warrants further assessment for potential treatment benefits.
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  • - The study explored the use of an automated digital patient engagement (DPE) platform to measure health-related quality of life (HRQoL) for patients receiving treatments for liver cancer (HCC) post-transarterial radioembolization (TARE) with yttrium-90.
  • - Results showed a high survey completion rate of 78.4%, with minimal instances (4 out of 35) of patients reporting worsened symptoms over time.
  • - The findings indicated that the DPE platform is an effective tool for gathering and analyzing patient-reported outcomes in a clinical setting.
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Background: The ATTRACT trial (Acute Venous Thrombosis: Thrombus Removal with Adjunctive Catheter-Directed Thrombolysis) previously reported that pharmacomechanical catheter-directed thrombolysis (PCDT) did not prevent postthrombotic syndrome (PTS) in patients with acute proximal deep vein thrombosis. In the current analysis, we examine the effect of PCDT in ATTRACT patients with iliofemoral deep vein thrombosis.

Methods: Within a large multicenter randomized trial, 391 patients with acute deep vein thrombosis involving the iliac or common femoral veins were randomized to PCDT with anticoagulation versus anticoagulation alone (No-PCDT) and were followed for 24 months to compare short-term and long-term outcomes.

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Three patients with complete iliocaval thrombosis causing symptomatic leg swelling failed initial treatment with standard pharmacomechanical techniques. The occluded segments of the inferior vena cava and iliac veins were subsequently treated with the AngioVac Cannula (AngioDynamics, Latham, New York) and extracorporeal venous bypass circuit. In each patient, symptoms improved after treatment.

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Most pancreatic arteriovenous malformations (PAVM) present due to gastrointestinal bleeding or abdominal pain, but these patients may be asymptomatic. Increased portal vein flow from these malformations can lead to portal hypertension and gastrointestinal bleeding. Diagnosis is often made by imaging, and early diagnosis has led to successful surgical resection or percutaneous embolization.

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Musculoskeletal tumors, both primary neoplasms and metastatic lesions, present a therapeutic challenge for the physician who wishes to provide palliative pain relief using the least invasive approach. The increasing sophistication of imaging modalities such as CT in precisely localizing neoplasm, coupled with the widespread use of radiofrequency ablation (RFA) for treatment of other types of tumor, has generated interest in using RFA to treat musculoskeletal tumors. Primary bone tumors (eg, osteoid osteoma) and metastatic bone tumors have been successfully treated with RFA.

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Purpose: Early and midterm results of endovenous laser treatment (EVLT) of the saphenous veins for the treatment of symptomatic insufficiency are promising. However, technical factors contributing to success or failure of saphenous vein EVLT have not been fully investigated. This study was performed to test the hypothesis that treatment success is related to achieving a critical threshold of energy delivery relative to the length of vein treated.

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Herein a case of cutaneous thermal injury in the leg of a patient who underwent endovenous laser (EVL) ablation of an incompetent great saphenous vein (GSV) is reported. Follow-up ultrasonography (US) of the site of skin burn showed that the burn was directly over thrombosed superficial tributaries originating from the GSV, but medial to the treated GSV. At the level of skin burn, the thrombosed GSV was 22 mm deep, but the tributaries were 1 mm deep.

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  • A study compared the effects of Embospheres (ES) and polyvinyl alcohol (PVA) particles used in uterine artery embolization (UAE) on pain and ischemia in patients, suggesting ES caused less uterine ischemia in animal models.
  • The research involved a retrospective analysis of 72 UAE patient records, comparing morphine sulfate dosages and subjective pain scores between those treated with ES and those with PVA.
  • Results showed no significant differences in pain levels or morphine usage between the two groups, although there was a notable trend toward the use of more embolic material with ES.
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Objective: We aimed to assess the delayed effects of uterine artery embolization on ovarian arterial perfusion and function by performing ovarian sonography immediately before and after uterine artery embolization, as well as several months later.

Conclusion: Although persistent loss of detectable arterial perfusion after uterine artery embolization occurs in some women, most patients reestablish arterial perfusion and do not develop symptoms of ovarian failure.

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