The treatment of varicose veins comprises conservative and active options. Every patient with varices has to be informed on the conservative modalities and should apply them in daily life. Compression therapy, as the most important part of the conservative treatment, should be considered individually for any patient according to the varicose-type, the grade of chronic venous insufficiency and the compliance of the patient. Active treatment modalities are clearly indicated in varices with complications such as trophic skin changes, varicophlebitis or when varices cause pain. But the cosmetic problem should not be underestimated. Morphologic and hemodynamic information obtained by noninvasive duplex technique allows the individualization of the surgical strategy for each patient. Besides surgical techniques used being less and less traumatic (invagination stripping, stab evulsion phlebectomy), more and more interventions are realized under ambulatory conditions in local anesthesia, even crossectomy with partial stripping of truncal varices. More important and complex operations, interventions involving more than one saphenous vein or reinterventions in recurrent varices are still performed under hospital conditions. They require only a short hospitalization time (2 to 4 days). Considering this very favourable evolution in surgery with a net trend to ambulatory, thus more economic treatment, the indications for sclerotherapy--a traditionally ambulatory modality with high recurrence-rate--are limited to reticular varices and telangiectasies.
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Front Immunol
January 2025
Department of Rheumatology and Immunology, the Second Affiliated Hospital of Xiamen Medical College, Xiamen, China.
Introduction: Systemic lupus erythematosus (SLE) complicated by thrombotic microangiopathy (TMA) and non-cirrhotic portal hypertension (NCPH) is rare. We present a case of a female patient with SLE who developed TMA and NCPH and responded positively to rituximab and plasma exchange treatment.
Case Description: A 53-year-old woman was admitted with 6 h of confusion.
J Hepatocell Carcinoma
January 2025
Department of Interventional and Vascular Surgery, Peking University First Hospital, Beijing, People's Republic of China.
Purpose: Portal vein tumor thrombus (PVTT)-related severe symptomatic portal hypertension (SPH) leads to a poor prognosis in patients with advanced hepatocellular carcinoma (HCC). Traditional transjugular intrahepatic portosystemic shunt (TIPS) using covered plus bare stent can effectively relieve SPH, however, the bare segment is susceptible to obstruction due to PVTT invasion. This study aimed to evaluate the safety and efficacy of fully covered stent-TIPS (FCS-TIPS) for treatment of PVTT-related SPH in advanced HCC patients.
View Article and Find Full Text PDFEur J Vasc Endovasc Surg
January 2025
Department of Phlebology, Skin and Vein Clinic Oosterwal, Alkmaar, the Netherlands.
Objective: The aim of this study was to compare anterior accessory saphenous vein (AASV) reflux after standard endovenous laser ablation (EVLA) vs. flush EVLA (fEVLA) of the great saphenous vein (GSV).
Methods: This was as randomised, single blind, controlled trial (Dutch Trial Register, NL5283).
J Clin Pathol
January 2025
Institute of Liver Studies, King's College Hospital, London, UK
Aims: To reveal clinicopathological characteristics of alcoholic foamy degeneration (AFD)-an uncommon form of alcoholic liver injury.
Methods: Clinicopathological features of AFD (n=9) were examined in comparison to those of severe alcoholic hepatitis (SAH; n=12).
Results: Patients with AFD presented with either biochemical liver dysfunction (n=1) or clinical jaundice (n=8).
Ann Surg Oncol
January 2025
Division of Pancreatic Surgery, Department of General Surgery, West China Hospital, Sichuan University, Chengdu, Sichuan, China.
Introduction: Laparoscopic distal pancreatectomy (LDP) has the advantages of reduced blood loss, shorter hospital stays, and a better postoperative quality of life compared with open distal pancreatectomy (ODP). Meanwhile, spleen-preserving laparoscopic distal pancreatectomy is the preferred technique for low-grade malignant and benign tumors located in pancreatic body and tail, since it preserves the immune function of the spleen. The splenic-vessel-preserving (SVP) Kimura technique and splenic vessel resection Warshaw technique are the two primary procedures.
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