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Biomedical subjects

S E Zimmet

Publications and source records attributed to S E Zimmet.

8 recordsLinked to original sources
PubMed2001

Endovenous laser treatment of the incompetent greater saphenous vein.

PURPOSE: To assess the safety and preliminary efficacy of endovenous laser treatment (EVLT), a novel percutaneous technique for occlusion of the incompetent greater saphenous vein (GSV). MATERIALS AND METHODS: Ninety GSVs in 84 patients with reflux at the saphenofemoral junction (SFJ) into the GSV were treated endovenously with pulses of laser energy and evaluated in a prospective, nonrandomized, consecutive enrollment multicenter study. Patients were evaluated at 1 week and at 1, 3, 6, and 9 months to determine efficacy and complications. RESULTS: Eighty-seven of 90 GSVs (97%) were closed 1 week after initial treatment with endovenous laser. The remaining three GSVs were closed after repeat treatment. Eighty-nine of 90 GSVs (99%) remained closed for as long as 9 months according to serial duplex ultrasonography. Sonographic evaluation demonstrated 73% reduction in GSV diameter at 6 months (61 patients) and 81% reduction in GSV diameter at 9 months (26 patients) after EVLT. One patient developed a transient localized skin paresthesia. There have been no other minor or major complications. CONCLUSIONS: EVLT of the incompetent GSV appears to be an extremely safe technique that yields impressive short-term results. Long-term follow-up is awaited.

Adolescent↗
PubMed1999

Venous leg ulcers: modern evaluation and management.

BACKGROUND: Venous leg ulcers are common in the adult population and cause a significant social economic burden. Despite their prevalence, venous leg ulcers are often managed inadequately. OBJECTIVE: To provide an overview of venous ulceration, including a review of the current understanding of the pathophysiology of venous ulceration and the implications for management of venous ulceration. METHODS: A review of the literature. RESULTS: Modern methods of investigation have led to an improvement in our understanding of the pathophysiology of venous disease. In many patients, superficial and/or perforator venous disease is the only underlying hemodynamic abnormality. Although compression should serve as the cornerstone of treatment of venous ulceration, surgery and/or sclerotherapy can treat incompetent superficial and perforator veins. Important hemodynamic improvement is obtained, and the long-term prognosis of these patients is greatly improved. CONCLUSION: One must define the basic underlying abnormality of the venous system to form a rational, individualized management plan for the patient with venous ulceration.

Adult↗
PubMed1996

Hyaluronidase in the prevention of sclerotherapy-induced extravasation necrosis. A dose-response study.

BACKGROUND: A previous study found hyaluronidase to be effective in the prevention of necrosis following intradermal sodium tetradecyl sulfate and 23.4% sodium chloride. There are no published dose-response studies of hyaluronidase used in this manner. OBJECTIVE: To conduct a dose-response study using hyaluronidase in the prevention of necrosis following intradermal 23.4% sodium chloride. METHODS: Study I evaluated control vs hyaluronidase groups (150, 300, 450 units; all in volume of 3 mL) in the prevention of necrosis following intradermal 0.25 mL 23.4% sodium chloride. Incidence and size of necrosis were compared between groups. In study II, hyaluronidase was administered in doses ranging from 18.75 to 900 units (all in volume of 3 mL) immediately following the intradermal instillation of 0.25 mL of 23.4% sodium chloride. A control group had no therapy. The incidence of necrosis was compared between groups. A dose-response curve was constructed. Both studies were randomized and blinded and used Sprague-Dawley rats. RESULTS: A statistically significant protective effect was found in the treated vs the untreated groups in both studies. Maximal protection was achieved by 75 units of hyaluronidase and was not improved upon by higher doses. CONCLUSION: In the event of extravasation with 23.4% sodium chloride, in the model studied, one can expect maximal protection with a dose of 75 units of hyaluronidase.

Animals↗
PubMed1993

The prevention of cutaneous necrosis following extravasation of hypertonic saline and sodium tetradecyl sulfate.

BACKGROUND: Most authors have recommended treating extravasation during sclerotherapy by infiltrating the area with 0.9% sodium chloride and/or procaine. OBJECTIVE: To evaluate interventions in the prevention of necrosis following intradermal injection of 23.4% sodium chloride and 3% sodium tetradecyl sulfate. METHODS: Following intradermal 23.4% sodium chloride (Study I) or 3% sodium tetradecyl sulfate (Study II), subjects (Sprague-Dawley rats) received either no treatment or injections of 0.9% sodium chloride, sterile water, 1% procaine, or hyaluronidase. Groups were compared regarding incidence and size of necrosis. RESULTS: In study I, hyaluronidase treated groups had significantly fewer and smaller areas of necrosis than other groups. In study II, the hyaluronidase group developed significantly fewer ulcers than the 0.9% sodium chloride group. The 0.9% sodium chloride group had significantly larger ulcers than other groups. CONCLUSION: In the model studied, hyaluronidase was the only effective treatment in the prevention of necrosis. Following 3% sodium tetradecyl sulfate, 0.9% sodium chloride was associated with larger ulcers than other groups.

Animals↗
PubMed1992

Leg ulcers.

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Blood Circulation↗