Benefit in physical function and quality of life to nonsurgical treatment of varicose veins: Pilot study

BACKGROUND Studies on varicose veins have focused its effects on physical function;however,whether nonsurgical treatments alter muscle oxygenation or physical function remains unclear.Moreover,the differences in such functions between individuals with varicose veins and healthy individuals remain unclear.AIM To investigate changes in physical function and the quality of life(QOL)following nonsurgical treatment of patients with varicose veins and determine the changes in their muscle oxygenation during activity.METHODS We enrolled 37 participants(those with varicose veins,n=17;healthy individuals,n=20).We performed the following measurements pre-and post-nonsurgical treatment in the varicose vein patients and healthy individuals:Calf muscle oxygenation during the two-minute step test,open eyes one-leg stance,30 s sit-to-stand test,visual analog scale(VAS)for pain,Pittsburgh sleep quality index,physical activity assessment,and QOL assessment.RESULTS Varicose veins patients and healthy individuals differ in most variables(physical function,sleep quality,and QOL).Varicose veins patients showed significant differences between pre-and post-nonsurgical treatment—results in the 30 sit-to-stand test[14.41(2.45)to 16.35(4.11),P=0.018],two-minute step test[162.29(25.98)to 170.65(23.80),P=0.037],VAS for pain[5.35(1.90)to 3.88(1.73),P=0.004],and QOL[39.34(19.98)to 26.69(17.02),P=0.005];however,no significant difference was observed for muscle oxygenation.CONCLUSION Nonsurgical treatment improved lower extremity function and QOL in varicose veins patients,bringing their condition close to that of healthy individuals.Future studies should include patients with severe varicose veins requiring surgery to confirm our findings.

Sclerotherapy as the Only Treatment for Varicose Veins

Background: Chronic venous insufficiency (CVI) is a widespread and underdiagnosed condition that affects more than 20% of the general population. The most prevalent manifestation of CVI is varicose veins (VVs), which affect up to 25% of women and 15% of males. Sclerotherapy is a minimally invasive procedure used primarily in treating telangiectasias, reticular veins, and small varicose veins. Objectives: This study aims to evaluate the efficacy and safety of various sclerotherapy techniques in treating varicose veins-related complications. Methods: We conducted a cross-sectional observational interventional study at Jordan University Hospital (JUH) from September 2022 to January 2023. The study involved patients with lower limb varicose veins, assessing their clinical response and monitoring potential treatment complications. Statistical analyses were performed using SPSS software version 21.0. Results: Of 567 patients with diagnosed VVs, 544 were female (95.94%), and 23 were male (4.06%). The primary complaints were pain and cosmetic concerns. Treatments included Foam Aethoxysklerol® 3% (polidocanol) and Micro-foam Aethoxysklerol® 1%. Improvement in symptoms was reported by 538 patients (94.89%). The most common adverse event was hyperpigmentation, reported in 120 patients (21.16%), followed by post-procedural pain in 104 patients (18.34%). Notably, one patient (0.18%) experienced deep vein thrombosis (DVT), one (0.18%) reported telangiectatic matting, and there were two cases (0.36%) of visual disturbances and one allergic reaction. Conclusion: Sclerotherapy is effective and safe for treating VVs with minimal adverse events. It is a viable standalone treatment, reducing complications linked to other methods like radiofrequency ablation and surgery.

Phlebosclerosis: An overlooked complication of varicose veins that affects clinical outcome: A case report

BACKGROUND Phlebosclerosis is a common age-related fibrotic degeneration of the venous wall.It is a disorder rather than a disease,which may cause venous dysfunction and even venous thrombosis.It is rarely reported in patients with varicose veins.CASE SUMMARY The present report describes the case of a 70-year-old man with varicose veins,vitiligo,and phlebosclerosis.Venous angiography revealed blood reflux in the superficial and deep veins.The patient underwent surgery to remove the saphe-nous veins.During the operation,a calcified vein resembling a wooden stick was found,which was surprisingly extracted from the thickened venous wall.A cross-section of this wooden stick-like vein revealed venous fibrosis and calcification,obvious thickening of the venous wall,extensive collagen deposition on the venous wall,hyaline degeneration,and venous sclerosis causing closure of the venous lumen.CONCLUSION This is probably the first report of a wooden stick-like structure being found in the venous wall in patients with varicose veins and venous ulcers.Phlebosclerosis can be observed in the late stage of varicose veins complicated by frequent infections and worse clinical outcomes.Therefore,it is important to be aware of this condition and address it rather than overlook it.

Application of Endovenous Laser Treatment Combined with Foam Sclerotherapy for the Minimally Invasive Treatment of Great Saphenous Vein Varicosity

Objective:To evaluate the efficacy of endovenous laser treatment(EVLT)combined with foam sclerotherapy(FS)in the treatment of great saphenous vein varicosity(GSVV).Methods:A total of 50 patients with GSVV,treated between March 2021 and March 2024,were selected and randomly divided into two groups using a random number table.The combination group(25 cases)underwent EVLT combined with FS,while the conventional group(25 cases)underwent EVLT alone.The total effective rate,complication rate,disease severity score,and serological indicators were compared between the two groups.Results:The total effective rate in the combination group was higher,and the complication rate was lower compared to the conventional group(P<0.05).One week after surgery,the disease severity score in the combination group was lower,coagulation function indicators were better,and inflammatory factor levels were lower compared to the conventional group(P<0.05).Conclusion:EVLT combined with FS can improve the clinical efficacy in GSVV patients,prevent postoperative complications,reduce disease severity,protect patients’coagulation function,and alleviate postoperative inflammatory responses,showing significant advantages in combined surgery.

Application of the Trivex system in the treatment of primary severe superficial varicose veins of the lower extremity

Purpose:The aim of this study was to evaluate the clinical effects of the Trivex system in the treatment of primary severe superficial varicose veins of the lower extremity and compare Trivex to the point-form-stripping combined with foam sclerotherapy(FS).Methods:A total of 64 patients(35 females,29 males;mean age,57?11 years[range,29–79 years])with primary severe superficial varicose veins of the lower extremity involving 64 legs were included between October 2015 and July 2019.The maximum diameter of the vein branches was>20 mm,which appeared to be cystic dilatation and forms large-scale in the crus or the thigh.All patients underwent high ligation and endovenous laser ablation or stripping of the trunk under general anesthesia.The surgical time,pain/phlebitis,number of incisions,amount of bleeding,recurrence of varicose vein,incidence of surgical site infections(SSIs),satisfaction score,and improvement in clinical symptoms were evaluated respectively with the patients in two groups:Group A,with patients who underwent treatment with the Trivex system,and Group B,patients who underwent treatment by point-form-stripping combined with FS.Results:All procedures were performed successfully.The average operative time in Group A was 56?11 min,whereas that of Group B was 90?33 min,which was a significant difference(p<0.05).Group A patients felt little pain after surgery,whereas in Group B the level of pain peaked on postoperative day 30,mostly due to thrombophlebitis after FS.There was no recurrence of varicose vein was observed in any patient,however,there were some residual effects in Group B,including the amount of bleeding volume,in-hospital stays,pain/phlebitis,and number of incisions(P<0.05).There were no significant differences with respect to SSIs,improvement in clinical symptoms,and satisfaction scores observed(p>0.05).Conclusions:This study shows that patients benefited from both treatment options.However,primary severe superficial varicose veins of the lower extremity treated with the Trivex system suffered less pain with fewer incisions than severe branches treated with the point-form-stripping combined with foam sclerotherapy(FS).In summary,the Trivex system is a suitable treatment prior to point-form-stripping combined with foam sclerotherapy(FS)for those who demand a high level of appearance,and especially for young patients,the Trivex system is recommended.

Strategies and challenges in treatment of varicose veins and venous insufficiency

Patients with varicose veins can be treated with conservative or surgical approaches based on the clinical conditions and patient preferences.In the recent decade,the recommendations for managing symptomatic varicose veins have changed dramatically due to the rise of minimally invasive endovascular techniques.The literature was systematically searched on Medline without language restrictions.All papers on the treatment of varicose veins and venous insufficiency with different procedures were included and reviewed.Endovenous laser ablation(EVLA)and radiofrequency ablation(RFA)both are same safe and effective in terms of occlusion rate,and time to return to normal activity.In comparison with RFA or EVLT,Cure conservatrice et Hemodynamique de l’Insufficience Veineuse en Ambulatoire(CHIVA)may cause more bruising and make little or no difference to rates of limb infection,superficial vein thrombosis,nerve injury,or hematoma.In terms of recurrence of varicose veins,there is little or no difference between CHIVA and stripping,RFA,or EVLT.Great saphenous vein recanalization is highest in the ultrasound-guided foam sclerotherapy(FS)group(51%)during 1 year of follow-up.The 2013 National Institute for Health and Care Excellence clinical guidelines recommend surgery as a third-line therapeutic option after EVLA or RFA and sclerotherapy.Although the mechanochemical endovenous ablation(MOCA)is a non-thermal,non-tumescent option and appears to be of similar efficacy to stab avulsion with no potential risk of nerve damage,the overall success rate of MOCA is lower than those of other procedures such as EVLA,RFA,or high ligation and stripping.EVLA is the most cost-effective therapeutic option,with RFA being a close second for the treatment of patients with varicose veins.Endovenous thermal ablation(EVLA or RFA)is recommended as a first-line treatment for varicose veins and has substituted the high ligation of saphenofemoral junctional reflux and stripping of varicose veins.Ultrasound-guided FS is associated with a high recurrence rate and can be used in conjunction with other procedures.MOCA and cyanoacrylate embolization appear promising,but evidence of their effectiveness is required.

Sclerotherapy for Varicose Veins of the Lower Limbs

Summary: The diagnosis of venous insufficiency is increasing. Multiple techniques are available for its treatment. Chemical sclerotherapy has been performed for over 70 years. The technique improves lately. Objective: This study was conducted to assess early results of foam sclerotherapy in Senegal. Patients and Methods: This is a prospective and descriptive study conducted from January 1st, 2012 to December 31st, 2015 at cardiovascular center of Fann University hospital in Dakar, Senegal. Foam sclerotherapy was done in 76 patients. Polidocanol was used in concentration of 2%. Sclerotherapy was done several times in patients, every week, as much as needed to occlude varicose veins. We used venous compression in all patients. Results: Foam sclerotherapy sessions permitted to get globally good results. In fact, tight feeling and painful leg disappear in 97% of patients. Decreases of edema were gotten in 97% of patients. For leg ulcer, 64% of complete healing was obtained. The main ulcer healing time was 47 days (18;72). Some minor complications occurred. No major events, such as deep venous thrombosis or pulmonary embolism, were observed. Conclusion: Foam sclerotherapy is an efficient technique for the treatment of varicose veins of the limbs. Also, it opens good perspectives for vein care.

Varicose Veins, Retinal Tears and Deep Vein Thrombosis, New Insights into the Causes from Adams Disease

Adams disease is the consequence of overly active transient receptor potential cation channels (TRP). This case report presents a patient suffering from multiple vascular problems and may provide new insights into the causes of venous problems. Endothelial and smooth muscle cells in veins contain TRP. These channels when activated excessively result in calcium accumulation, oxygen radical formation and apoptosis of endothelial and smooth muscle cells. The death of critical cells in vein valves, may lead to varicose veins. The loss of endothelial cells in venules may lead to retinal tears. Damage to vein walls may lead to a deep vein thrombosis. Transient receptor potential cation channels may be new drug targets of interest in the treatment or prevention of these conditions.

Effect of Nursing Intervention Based on Caprini Risk Assessment Scale for Venous Thromboembolism in Perioperative Patients with Liver Cancer

Objective:To explore the effect of nursing intervention based on Caprini risk assessment scale for venous thromboembolism(VTE)in perioperative patients with liver cancer.Methods:A total of 128 hepatocellular cancer(HCC)patients who were hospitalized in our department from January 2021 to March 2022 and met the research criteria were selected.According to odd and even numbers in the order of inclusion,64 cases were divided into two groups:a control group and an observation group.The control group received routine nursing intervention during perioperative period,while the observation group received nursing intervention based on Caprini risk assessment scale for VTE.The incidence of VTE and complications were compared between the two groups.Results:The incidence of VTE and postoperative complications in the observation group were lower than those in the control group(P<0.05).Conclusion:Nursing intervention based on Caprini risk assessment scale for VTE can reduce the incidence of perioperative deep vein thrombosis and complications in patients with liver cancer;thus,it is worthy of clinical application.

Right Inguinal Varicose Vein in Connection with Femoral Vein Following Intravenous Drug Abuse: A Rare Radiologic Finding

Varicose veins are enlarged, protuberant superficial veins that are palpable beneath the skin. The causes of such a venous pathology may be primary, secondary, or congenital. The major agents leading to the development of varicose veins include: Hereditary, prolonged standing, Increasing age, Heavy lifting, Prior superficial or deep vein clots, Female gender and Multiple pregnancies. In this manuscript, we report a case of inguinal varicose vein in connection with femoral vein, resulted from direct intravenous injection of drug. The diagnosis was made based on Doppler sonography.

Clinical effect of preventive nursing on the rate of deep vein thrombosis in patients with lung cancer: A meta-analysis

Objective:To explore the clinical effect of preventive nursing intervention on deep venous thrombosis rate,nursing satisfaction and average hospitalization time after treatment of lung cancer.Methods:Chinese databases(Wanfang,Weipu and China Knowledge Network)and English databases(Pubmed,Cochrane and Scopus)were searched and read references for relevant research.Statistical analysis was performed using Review Manager 5.3.The odds ratio(OR)and the mean difference(MD)were used as the combined effect values of the comparison groups.Sensitivity analysis was performed by changing the effect model or excluding the literature with a large weight ratio,and the symmetry of the funnel plot was observed for publication bias test.Results:A total of 14 Chinese studies included.Compared with routine nursing intervention,preventive nursing intervention could significantly reduce the rate of deep vein thrombosis after lung cancer treatment[OR=0.16(0.10,0.23)],improve nursing satisfaction[OR=6.42(3.32,12.41)]and shorten the average hospital stay[MD=-7.41(-8.16,-6.65)],without heterogeneous existing.And regardless of whether the lung cancer patient was undergoing resection or chemotherapy,the effect of preventive nursing intervention to reduce the rate of deep vein thrombosis was very significant.Conclusion:Preventive nursing intervention is beneficial to patients with lung cancer,which can significantly reduce the formation rate of deep vein thrombosis,which is worthy of clinical promotion.

Nursing Care of Patients With Transcatheter Closure of Atrial Septal Defect via Femoral Vein

Objective:To explore the operative nursing coordination method for the treatment of congenital atrial septal defect(ASD)by transcatheter closure of atrial septal defect via femoral vein.It provides useful experience for the treatment of congenital heart disease.Methods a total of 12 patients undergoing minimally invasive atrial septal defect closure via femoral vein from January 2017 to November 2017 in our department of cardiac surgery were selected as the subjects.All patients received transesophageal ultrasound guided ASD occlusion by femoral vein.The operation and nursing contents include preoperative care,the cooperation of the itinerant nurses,the coordination of the instrument nurses and the postoperative nursing.Results the operation of 12 patients in this group was successful.The diameter of the occluder was 17.1+4.5 mm during the operation.The time of tracheal intubation was 2.4+0.7 h,from the femoral vein to the sheath tube time was 38.7+9.4 min,the occupancy of ICU was 12.5+2.6 h after the operation.The average time of hospitalization was 4.5+1.8 D.There were 2 cases of shunt 1mm immediately after operation.After 24h reexamination,the shunt disappeared,the heart murmur disappeared in the rest of the patients.No residual shunt and other complications occurred.

Progress of Comprehensive Nursing on the Prevention of Postoperative DVT of Gynecologic Tumor

Deep vein thrombosis (DVT) is the second reason of death due to tumor. In order to find more effective methods for prevention of DVT due to gynecologic tumor, the advances of study and practice in this aspect should be summarized. As an important and effective measure for prevention of DVT, the comprehensive nursing is to be analyzed carefully. Lots of practices show that proper nursing measures can prevent effectively the occurrence of postoperative DVT. Virchow thought that DVT is caused by three factors: injury of venous wall, slowed blood flow and hypercoagulability. Thus, the prevention measures are presented on the factors such as application of sequential decompression elastic socks, intraoperative intervention etc. Clinical nursing pathway is shown to be very effective method recently. More effective measures and related facilities for prevention of DVT should be built in the future. Physical and psychological methods should be combined in the nursing of DVT.

Advances of Prevention and Nursing of Deep Venous Thrombosis after Gynecological Tumor Operation

Emainly includes deep venous thrombosis(DVT)and pulmonary thromboembolism(PTE).DVT is caused by the thrombogenesis of red blood cells,platelets and fibrous protein which obstructs the venous backflow leading to inflam-matory changes in the wall of the vein.PTE is caused by the caducous blood clots of DVT that runs with the blood to the lungs.Because DVT and PTE are the venous thromboembolic disease process in two stages,the prevention of DVT and PTE is very important for preventing the rapid onset of PTE and high mortality rate of the postoperative complications.The changes of female hormones and the blood concentration and lipid metabolism disorders make venous thromboembolism more likely to occur during pregnancy.Once the pulmonary vessels were blocked,the patients’life would be threatened severely.To find a more effective way to prevent postoperative venous thrombosis in gynecology we review the prevention and treatment of deep venous thrombosis after gynecological surgery in this paper.

Assessment of nurses’knowledge of the prevention of hospital-associated venous thromboembolism in a tertiary health institution in Nigeria

Objective:This study assessed the level of nurses’knowledge of the prevention of venous thromboembolism(VTE)in a tertiary health institution.Materials and Methods:This descriptive cross-sectional study was conducted with 328 eligible respondents,selected using a random sampling method in a teaching hospital in Nigeria.A self-administered structured questionnaire was used to collect data on the basic knowledge,risk factors,and preventive measures of VTE.Results:Findings from the study revealed that 51.2%scored above the mean score of 28.6±3.1.The educational status of the respondents had a significant influence on their knowledge of risk factors of VTE(F=4.696,P=0.031).Conclusion:The overall knowledge of nurses is satisfactory,although the majority could not answer correctly questions on the administration of prefilled anticoagulants and identification of some key risk factors of VTE.

Occlusion Effect of a Long-pulsed 532nm Laser on Veins

Laser treatment represents an attractive option to other methods of vessel diseases especially varicose veins. A long pulse (30-50ms) 532nm laser was used in our experiments, with the pulse duration matching the thermal relaxation time of the vessels and the green laser matching the absorption spectrum peak of the blood.Laser irradiates nude vein vessels directly or exterior skin to finish operation faster and to acquire the practical data for upper enteron varicose vein treatment in several animal experiments performed in vivo. The 5Jenergy pulse allows us to finely occlude rabbit or dog's vein vessels up to 2 mm in diameter when irradiating them off external skin. Blood vessels are occluded at once, and later biopsy specimens show the immediate and long-term lasting occlusion effect. While vessels are irradiated directly, they are usually irradiated to perforate, detailed causes are still under investigation. Animal experiments showed that the long pulse green laser therapy is a safe and effective solution to the vein's occlusion, which promises such laser with high energy of each pulse and 30-50 ms duration is an ideal candidate for vessel diseases treatment.

桃红四物汤联合射频消融治疗下肢静脉曲张合并血栓性静脉炎临床研究

[目的]探究桃红四物汤联合射频消融治疗下肢静脉曲张合并血栓性静脉炎患者的临床疗效。[方法]选择2020年1月至2022年1月于医院治疗的下肢静脉曲张合并血栓性静脉炎患者100例,采用随机数字表法分为射频消融组与桃红四物汤联合组各50例,射频消融组给予患者射频消融治疗,桃红四物汤联合组给予患者桃红四物汤联合射频消融治疗,治疗前、后检测两组患者可溶性血管细胞黏附分子-1(sVCAM-1)、肿瘤坏死因子-α(TNF-α)、白介素-1β(IL-1β)、D-二聚体、一氧化氮(NO)、血栓素B2(TXB2)、内皮素-1(ET-1)、血管性血友病因子(vWF)、6-酮-前列腺素F1α(6-Keto-PGF1α)、纤维蛋白原、血细胞比容、血浆黏度水平,给予患者皮肤温度、肿胀程度、皮肤颜色、疼痛程度评价,比较两组临床疗效。[结果]治疗后,桃红四物汤联合组TNF-α、sVCAM-1、IL-1β、D-二聚体、TXB2、6-Keto-PGF1α、ET-1、vWF、纤维蛋白原、血细胞比容、血浆黏度水平及皮肤温度、肿胀程度、皮肤颜色、疼痛程度评分低于射频消融组(P<0.05);桃红四物汤联合组NO水平、总有效率较射频消融组高(P<0.05)。[结论]给予下肢静脉曲张合并血栓性静脉炎患者桃红四物汤联合射频消融治疗,可抑制炎症,减少血管内皮损伤,改善血液流变学及微循环,缓解患者临床症状,提升患者临床疗效。

一种新的临时心脏起搏器置入方法及综合护理策略

目的:探讨经肘正中静脉行临时心脏起搏器置入术的可行性、安全性、舒适度和情感差异,并总结相应的综合护理策略。方法:选取2020年6月—2022年3月于我院行临时心脏起搏器置入术病人136例,采用随机数字表法分为股静脉组(F组)和肘正中静脉组(M组),各68例。统计两组病人的手术成功率、电极脱位率以及并发症发生率,并采用Kolcaba舒适状况量表(GCQ)、Zung焦虑自评量表(SAS)和Zung抑郁自评量表(SDS)进行舒适状况评价及情感评定,总结综合护理经验。结果:两组病人手术均成功,与M组比较,F组的电极脱位率和并发症发生率更高(P<0.05)。术后,与F组比较,M组GCQ评分更高(P<0.05),而SAS评分和SDS评分更低(P<0.05),相应的护理策略可以改善M组病人GCQ评分,差异均有统计学意义(P<0.05),但对F组GCQ改善不明显,差异无统计学意义(P>0.05);同时两组SAS评分和SDS评分均进一步降低,差异有统计学意义(P<0.05)。结论:与传统股静脉路径比较,经肘正中静脉置入临时心脏起搏器疗效确切,安全性更高、舒适度更佳且情绪更平稳,辅助于综合护理对病人获益更大。

中医护理预防髋关节置换术后下肢深静脉血栓的Meta分析

目的系统评价髋关节置换术后中医护理预防下肢深静脉血栓形成的临床效果。方法计算机检索PubMed、国家知识基础设施数据库(CNKI)、维普资讯中文期刊服务平台(VIP)、万方学术期刊全文数据库(Wanfang)中关于髋关节置换术后中医护理预防下肢深静脉血栓形成的文献,检索时间为2012—2022年11月。采用Cochrane干预措施系统评价手册(5.1.0版)偏倚风险评估工具对纳入的随机对照研究进行质量评价,运用RevMan5.4软件对纳入文献进行Meta分析。结果纳入11项研究,涉及1087例患者,其中研究组597例,对照组508例。Meta分析结果显示:中医护理下肢深静脉血栓发生率低于常规护理[RR=0.18,95%CI(0.09~0.35),Z=5.03,P<0.00001]。中医护理髋关节置换术后患者纤维蛋白原降低程度较常规护理明显[MD=-0.47,95%CI(-0.77~-0.16),Z=2.96,P=0.003],差异有统计学意义(P<0.05)。中医护理凝血酶原时间[MD=1.86,95%CI(-1.64~5.36),Z=1.04,P=0.30]、活化部分凝血活酶时间[MD=3.77,95%CI(-1.84~9.38),Z=1.32,P=0.19]与常规护理比较差异无统计学意义(P>0.05)。结论研究结果表明,髋关节置换术后,中医护理对预防下肢深静脉血栓形成有一定效果,且能显著降低纤维蛋白原,但在改善凝血酶原时间和活化部分凝血活酶时间方面,其效果与常规护理相比差异无统计学意义,受纳入范围和纳入研究质量的影响,上述结论尚待更多高质量的试验予以证实。