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At least 415 records · Page 23Linked to original sources
PubMed2001

Injection of tissue plasminogen activator into a branch retinal vein in eyes with central retinal vein occlusion.

PURPOSE: Central retinal vein occlusion (CRVO) often produces significant and permanent loss of vision in the affected eye. The purpose of this study was to determine if patients with vision loss secondary to CRVO treated with retinal vein cannulation and infusion of tissue plasminogen activator (t-PA) experienced recovery of visual acuity. DESIGN: Prospective, noncomparative, interventional case series. PARTICIPANTS: Thirty eyes of 30 consecutive patients with CRVO underwent the procedure, but two were subsequently excluded. The remaining 28 eyes of 28 patients with CRVO for an average of 4.9 months before intervention (range, 0.25-30 months) and best-corrected visual acuity 20/63 or worse were included in the study. INTERVENTION: All patients underwent pars plana vitrectomy with cannulation and infusion of t-PA into a branch retinal vein. MAIN OUTCOME MEASURES: Change in visual acuity and the development of complications such as vitreous hemorrhage and neovascular glaucoma were monitored. RESULTS: Twenty-two of 28 patients (79%) experienced at least one line of visual improvement during the follow-up period (average, 11.8 months; range, 3-24 months), and the same number had this level of improvement at the last follow-up examination. Fifteen patients (54%) gained 3 or more lines of acuity within 6 months after the procedure, and 14 (50%) had acuity at last follow-up at least 3 lines better than baseline acuity (average, 6.8 lines). Seven patients had postoperative vitreous hemorrhages ranging from 1 week to 11 months after the procedure; two cleared spontaneously. One patient had a postoperative retinal detachment from a peripheral retinal break that was repaired successfully with pneumatic retinopexy. No other serious intraoperative or early postoperative complications were noted. CONCLUSIONS: Vitrectomy with retinal vein cannulation and infusion of t-PA is a relatively safe procedure that may improve vision in eyes with CRVO.

Aged↗
PubMed2003

Subfascial endoscopic perforator vein surgery combined with saphenous vein ablation: results and critical analysis.

OBJECTIVE: This study was undertaken to determine the results of subfascial endoscopic perforator vein surgery (SEPS) combined with ablation of superficial venous reflux. METHODS: Clinical data were retrospectively analyzed for 74 consecutive limbs (65 patients) in which this combination treatment was performed at a university medical center. Preoperatively, 58 lower extremities had an open venous ulcer (CEAP clinical class 6 [C(6)]) and 16 had healed ulceration (C(5)). Preoperative and postoperative ulcer care remained constant. Main outcomes measured included perioperative complications, ulcer healing, and ulcer recurrence. Clinical severity and disability scores were tabulated before and after surgery. Mean patient follow-up was 44 months. RESULTS: Greater saphenous vein (GSV) stripping and varicose vein excision accompanied SEPS in 57 limbs (77%), and SEPS was performed alone or with varicose vein excision in 17 limbs that had previously undergone GSV stripping. Postoperative complications occurred in 12 limbs (16%), all with C(6) disease (P =.04). Ulcer healing occurred in 91% (53 of 58) of limbs with C(6) disease at a mean of 2.9 months (range, 13 days-17 months). Multivariate analysis demonstrated that ulcer healing was negatively affected by previous limb trauma (P =.011). Ulceration recurred in 4 limbs (6%) at 7, 20, 21, and 30 months, respectively. This was associated with a history of limb trauma (P =.027) and preoperative ultrasound evidence of GSV reflux combined with deep venous obstruction (P(R,O); P =.043). Clinical severity and disability scores improved significantly after surgery (both, P <.0001). CONCLUSIONS: Most venous ulcers treated with SEPS with ablation of superficial venous reflux heal rapidly and remain healed during medium-term follow-up. Ulcer healing is adversely affected by a history of severe limb trauma, and ulcer recurrence is similarly affected by a history of limb trauma in addition to superficial venous reflux combined with deep venous obstructive disease. Overall, there was marked improvement of postoperative clinical severity and disability scores compared with those obtained before surgery.

Adult↗
PubMed2002

[Retrograde flow in the left internal jugular vein caused by compression of the left brachiocephalic vein while supine during moderate tidal volume ventilation: case report, evaluation by colour coded duplex sonography and review of literature].

This report describes a 67-year-old healthy woman with retrograde flow in the left jugular vein in the supine position during moderate tidal ventilation detected by colour coded duplexsonography. In the upright position, an alternating flow could be found with antegrade direction during inspiration and retrograde flow during expiration. CT scan showed no abnormality in the mediastinum. CT-angiography in full inspiration demonstrated a normal contrast-enhanced left brachiocephalic vein. This finding suggests respiration-dependent compression of the left brachiocephalic vein between the aortic arch and the sternum in the supine position. The clinical relevance for patients with morning headaches is discussed. In cases of this phenomenon it is not advisable to use veins of the left arm for contrast media injection in CT- or MR-angiography.

Aged↗
PubMed1984

Biogenic grafts in arterial surgery--long-term results (I. The homologous vein--II. The modified heterologous bovine carotid artery--III. The human umbilical vein).

This report summarizes the authors' experience with homologous vein grafts, modified heterologous bovine carotid artery grafts and human umbilical vein grafts in reconstructive vascular surgery. The homologous saphenous vein, taken from living donors, was implanted in 21 patients. The high percentage of early and late complications (28% and 38%, respectively), the difficult availability and the development of modern materials appear to suggest that these grafts, at least the type used in this study, should no longer be employed. The experience with 102 femoro-popliteal and femoro-tibial bypasses in 140 revascularization operations carried out with modified heterologous bovine carotid artery grafts (Solcograft) is presented. The cumulative patency rate was 43% after 5 years for the above-knee and 33% for the below-knee femoro-popliteal bypasses. The high early and late complication rates (37% and 35%) lead us to believe that this graft should also no longer be employed. The human umbilical cord vein (Meadox-Dardik-Biograft) was used in performing 68 femoro-popliteal and 15 femoro-crural bypasses in 60 limbs of 57 patients. The patency rates calculated according to the standard life table method was 36% for the above-knee (after 5 years) and 32% for the below-knee femoro-popliteal bypass (after 4 years) and 31% (after 3 years) for the femoro-tibial bypass, respectively. On the understanding that other materials should be preferred in the individual case, this material still seems to be recommendable as a graft of second or third choice.

Adolescent↗
PubMed2004

Femoral and iliac vein stenoses after prolonged femoral vein catheter insertion.

BACKGROUND/AIMS: Catheterization of the femoral vein is a safe and recommended method of temporary access for haemodialysis. In some patients, however, because of the lack of other possibilities, it is necessary to maintain long-term femoral cannulation. The aim of the study was to evaluate the frequency of stenosis after prolonged femoral cannulation. METHODS: The 24 patients incorporated in the study were divided into two groups. Group 1 consisted of 10 end-stage kidney failure patients (four females and six males, aged 32-75 years, average 55.6+/-13.6 years) in whom femoral catheters were maintained for less than 2 weeks (5-14 days, average 9.3+/-3.6 days). Group 2 included 14 chronic haemodialysis patients (six females and eight males aged 23-65 years, average 49.5+/-13.27 years). The time of catheter maintenance ranged from 2 to 16 weeks (average 6.4+/-4.2 weeks). Femoral and iliac vein status was evaluated using magnetic resonance imaging. RESULTS: A feature of venous stenosis of both the femoral and iliac veins was disclosed in four patients in whom femoral cannulation lasted more than 4 weeks. There were no stenoses in group 1. CONCLUSION: Long-term femoral cannulation for more than 4 weeks may be associated with a significant risk of stenosis in the femoral and/or external iliac veins.

Adult↗
PubMed1996

Unusual alpha-adrenoceptor subtype in canine saphenous vein: comparison to mesenteric vein.

1. We investigated the nature of the adrenoceptors in the dog saphenous vein (DSV) and dog mesenteric vein (DMV) to determine the nature of the unexpected interactions of phenylephrine and methoxamine with rauwolscine in the DSV, i.e. the ability of the putative alpha 2-adrenoceptor antagonist to inhibit competitively contractions to these alpha 1-agonists. Radioligand binding studies were performed in parallel with contractility studies. 2. Functionally, in the DSV, phenylephrine and methoxamine-induced, contractions were antagonized by rauwolscine with Schild slopes of -0.52 and -0.46, respectively and apparent pA2 values of 8.5 and 9.2, respectively. Such antagonism was not observed in the DMV. In the DSV, prazosin competes for [3H]-rauwolscine binding sites with a high and a low affinity binding site (Ki of 1.49 +/- 0.65 and 94.7 +/- 51 microM, n = 6, respectively). 3. Pretreatment with 100 microM chloroethylclonidine (CEC) for 15 min abolished [3H]-prazosin binding in microsomes from both veins and reduced binding (Bmax) of [3H]-rauwolscine in microsomes by 55.1 +/- 0.8% (n = 3) in the DSV but did not affect the Bmax in the DMV. CEC pretreatment in the venular rings denuded of endothelium caused persistent contraction in the DSV but not in the DMV. In the DSV, CEC appeared to interact with a single [3H]-rauwolscine binding site. In both the DSV and the DMV, CEC (100 microM) caused a significant shift in the EC50 values for phenylephrine and methoxamine. Maximum responses in the DMV were significantly attenuated while those in the DSV were unaffected when total tension was considered. 4. Studies of the functional interactions of the DSV and the DMV with WB 4101 or 5-methylurapidil (5-MU) suggested the presence of alpha 1D-adrenoceptors in the DSV and alpha 1A-adrenoceptors in the DMV. The receptors inactivated by CEC in the DMV and DSV may represent some or all of the receptors with properties of alpha 1D and alpha 1A-receptors present in the two veins. Studies of radioligand binding interactions of these two antagonists with [3H]-prazosin, were consistent with the presence of some alpha 1D-receptors in DSV and alpha 1A-receptors in DMV. These findings raise questions about the selectivity of CEC in differentiating alpha 1-adrenoceptor subtypes. 5. B-HT 920 caused contractions in the DSV smaller than those to the alpha 1-agonists but the maximum was not affected by CEC pretreatment. The EC50 values were shifted to the left after CEC. In radioligand binding studies, B-HT 920 competition for [3H]-rauwolscine binding was not significantly affected by CEC pretreatment. 6. These results suggest the presence of unusual alpha-adrenoceptors in the DSV. In addition to alpha 2-adrenoceptors, receptors recognizing rauwolscine as well as prazosin, WB 4101, phenylephrine and methoxamine and susceptible to inactivation by CEC are present. They appear to be, in part, unusual alpha 1D-adrenoceptors.

Adrenergic alpha-Agonists↗
PubMed1987

Aberrant course of the left gastric vein in the human. Possibility of a persistent left portal vein.

Two livers with an aberrant course of the left gastric vein were found in 245 Japanese cadavers. The left gastric vein collects branches from the lesser curvature of the stomach, enters the left side of the hepatogastric ligament from the cardiac region and runs towards the left side of hepatic hilus. The vein enters the liver at the left side and joins an intrahepatic branch ramified from the portal vein.

Humans↗
PubMed2004

Intrahepatic portosystemic venous shunt passing through the left inferior phrenic vein and draining into the left renal vein.

We report a case of an intrahepatic portosystemic venous shunt (IPSVS) passing through the left inferior phrenic vein and draining into the left renal vein and then to the inferior vena cava. We incidentally detected the IPSVS while performing a transcatheter arterial embolisation for the treatment of hepatocellular carcinoma. IPSVS with the left inferior phrenic vein as the draining vein is very rare. The complete pathway of this IPSVS could be clearly demonstrated by multidetector row CT during arterial portography.

Aged↗
PubMed2005

Comparison of endovenous treatment with an 810 nm laser versus conventional stripping of the great saphenous vein in patients with primary varicose veins.

BACKGROUND: Patients with varicose veins seek medical assistance for many reasons, including esthetic ones. The development of suitable and more flexible instruments, along with less invasive techniques, enables the establishment of new therapeutic procedures. OBJECTIVE: To compare endovenous great saphenous vein photocoagulation with an 810 nm diode laser and the conventional stripping operation in the same patient. METHODS: Twenty patients selected for operative treatment of primary great saphenous vein insufficiency on duplex scanning were assigned to a bilateral random comparison. In all cases, both techniques were performed, one on each lower limb. Clinically, evaluation was assessed on the seventh, thirtieth, and sixtieth postoperative days. Patients underwent examination with duplex ultrasonography and air plethysmography during the follow-up. RESULTS: Patients who received endovenous photocoagulation presented with the same pain but fewer swellings and less bruising than the stripping side. Most patients indicated that the limb operated on by laser received more benefits than the other. There was only one recanalization and no adverse effects. The venous filling time showed better hemodynamics in both techniques. CONCLUSION: The endovenous great saphenous vein photocoagulation is safe and well tolerated and presents results comparable to those of conventional stripping.

Adult↗
PubMed2005

An anomaly in persistent right umbilical vein of portal vein diagnosed by ultrasonography.

AIM: To detect the anomaly in the persistent right umbilical vein (PRUV) of portal vein (PV) with deviation of the ligamentum tere and left-sided gallbladder. METHODS: A total of 5783 candidates for routine analysis were evaluated for hepatic vascular abnormalities by ultrasonography. RESULTS: Ten candidates (0.17%) had a portal vein anomaly with a rightward-deviated ligamentum tere. The blood-flow velocity in the PRUV of the portal vein (17.7+/-3.0 cm/s) of the 10 cases was similar to that of the right anterior portal trunk (17.6+/-4.1 cm/s). However, the vessel diameter of the PRUV (eta12.4+/-4.4 mm) was larger than the right anterior portal trunk (eta6.1+/-0.9 mm). Therefore, flow volume in the anomalous portion (0.97+/-0.30 L/min) was more than that in the right anterior portal trunk (0.18+/-0.05 L/min). CONCLUSION: The anomaly plays an important role in intra-hepatic PV flow.

Adult↗
PubMed2001

[Role of embryogenesis of the left renal vein and spermatic veins in etiopathogenesis of idiopathic varicocele].

The aim of this work was to clearly illustrate that the haemodynamic pathogenesis of the varicocele can be a consequence of a retrograde flux along the internal spermatic vein. The reflux is due to the use of a different path of drainage along the internal spermatic vein, which uses some collateral routes of the vessel, and mainly the nephrogenital branch. The diminishing pressure in the final segment of the internal spermatic vein is the focal points of the pathogenesis of the disease. The ontogenetic processes that lead to the formation of the left renal vein help in explaining the almost general one-sidedness of the disorder, its frequency and the fact that it is mostly the young who are affected by it. In fact, the variability of the timing and of the extension of the involution of the primitive venous system and of the processes of evolution which lead to the morphological definition of the tracts of the genital flow down, lead to the various manifestations of the idiopathic varicocele. This theory which also takes into account the physiological mechanisms of the venous drainage to the testicle in an anti-gravitation sense is part of the patterns that, under the diaphragm, rule the entire venous return of the blood toward to the heart.

Epididymis↗
PubMed2002

[The usefulness of monitoring hepatic venous oxygen saturation and mild hypothermia anesthesia in two patients with portal vein tumor emboli during combined portal vein and pancreas resection].

Two patients, a 48-year-old woman and a 61-year-old man, with portal vein tumor emboli underwent pancreaticoduodenectomy combined with portal vein resection. In order to protect the liver during occlusion of the portal vein, we induced mild hypothermia with surface cooling and hepatic oxygen status was monitored by hepatic venous oxygen saturation (ShvO2). During the temporary occlusion of the portal vein, the woman showed a marked decrease in ShvO2, significantly lower than 20%, and continued for about one hour, but on the other hand the man did not. But as the body temperature was raised, they showed the same tendency of decreased ShvO2. Postoperatively, her serum GOT, GPT, T-bilirubin were 104 UI.dl-1, 58 UI.dl-1, 1.95 mg.dl-1 and his data were 62, 42, 1.01 respectively. No other complication were observed. These results suggest that ShvO2 monitoring and mild hypothermia are clinically useful in detecting hepatic oxygen supply/demand unbalance and in protecting the liver.

Anesthesia↗
PubMed2002

[Technology for sclerosurgical treatment of upper veno-venous reflux of the large subcutaneous vein in varicose vein patients].

Under analysis were results of a complex ultrasound examination and the following treatment of 101 patients with varicose disease which had developed due to a high veno-venous ejection. The decision on the method of treatment depended on the variant of reflux spread and the degree of dilatation of the large subcutaneous vein. Four variants of spreading the reflux were established: in the inguinal area only (3.8%), along the femur to the level of the knee articulation (13.6%), femur and the upper third of the shin (66.8%), from the groin to the malleolus (15.8%). Selective interventions consisting in scleroobliteration or removal of the large subcutaneous vein within the limits of the femur or upper third of the shin were fulfilled in 84.2% of the patients. Sclerotherapy was used in veins having the diameter from 5 to 7 mm, sclerosurgery--with the diameter from 8 to 10 mm, surgical treatment in veins with the diameter more than 10 mm. The effectiveness of liquidation of the reflux was 95.2%.

Adolescent↗
PubMedDate not supplied

Prospective randomised study of cephalic vein cut-down versus subclavian vein puncture technique in the implantation of subcutaneous venous access devices.

The aim of the present study was to evaluate the results of a prospective randomised trial comparing cephalic vein cut-down (CCD) versus percutaneous subclavian vein puncture with the Seldinger technique (PSP) in the implantation of subcutaneous permanent central venous access devices (SPCVAD) in order to better define the safer technique in outpatient surgery. Fifty patients were randomly divided into two groups: CCD--17 males, 8 females (age range: 35-75 years; mean: 60 years); PSP--17 males, 8 females (age range: 17-75 years; mean: 63 years). The two groups were compared in terms of implant morbidity, technical failure, operative time, patient acceptance, and healthcare costs. Data were analysed statistically using the chi-square test (P < 0.05 was considered significant) and Student's t-test. Technical failure occurred in 2 PSP patients (8%) and in 4 CCD patients (16%) (P = 0.663; chi 2 = 0.189). Mean operative time was 40 min in PSP (range: 35-70 min) and 50 in CCD (range: 35-60 min) (p = 0.108, T = -1.64). Patients were requested to define the pain experiences as a result of the operation as mild, moderate or severe: 23 PSP patients reported mild to moderate pain (92% of cases), and 2 patients severe pain (8%). The same figures were obtained in the CCD group, i.e. 23 (92%) and 2 (8%) patients, respectively (P = 0.377; chi 2 = 0.781). In our institute both types of implant cost $1260; in the case of PSP there is an additional cost of $120 for postoperative chest x-rays, making a total cost of $1380 per implant. The data of this randomised trial show that the implantation of a totally implantable vascular access device is a surgical procedure with a limited rate of morbidity in both cephalic vein cut-down and subclavian vein percutaneous puncture, with no statistically significant difference between the two in terms of associated morbidity, technical failure, operative time and patient acceptance.

Adolescent↗
PubMedDate not supplied

[Iatrogenic traumatic lesions of femoral veins during varicose veins surgery].

Traumatic lesions of the femoral veins during varicose veins surgery are very uncommon and they raise several therapeutic difficulties. They occur in 1/1000 cases of varicose veins operated. The authors describe four cases of lesions of this type that were seen and treated for the last six years, probably because there was an increase in the number of varicose veins operated on in the Lisbon area. The authors discuss the surgical options and they concluded that these complications can be minimized with good anatomical and surgical skills, specially of the saphenous-femoral and saphenous-popliteal junctions.

Adult↗
PubMed2006

Endovenous laser ablation of saphenous vein is an effective treatment modality for lower extremity varicose veins.

We present our first experiences with the use of a new minimally invasive treatment of lower extremity varicose veins. We studied the occlusion rates of the great saphenous vein (GSV) with laser ablation, its failure rates, and its complications. Sixty-six limbs in 62 consecutive patients were treated and followed-up for 1 year. All of the patients had incompetent GSV proven by means of duplex scanning. The GSV segment from 2 cm distal to the sapheno-femoral junction to just above the knee was ablated by using laser energy. In addition, all patients had stab avulsions of the varicose veins of the leg with Crochet hooks. All patients were followed postoperatively on the 3rd day, 1 month, 3 months, and 1 year after surgery. All patients were treated as day-case surgeries. Among 62 patients studied, 46 patients were women (74%) and 16 were men (26%). The median age of the patients was 53 years (range 28-69 years). Median operation time was 65 min (range 40-140 min). Successful treatment (total obliteration of the GSV on duplex) was accomplished in 64 of 66 limbs (97%). In two cases, recanalization of the lower one-third of the treated segment of the GSV was noted after 3 months. There were no instances of neuropathy or skin burn. Endovenous laser ablation of varicose veins is effective in inducing thrombotic vessel occlusion and is associated with only minor adverse effects. The procedure seems to be a promising alternative for surgical stripping of the GSV.

Adult↗
PubMedDate not supplied

Internal mammary artery subclavian vein fistula following internal jugular vein catheterization. A case report and review of the literature.

We have recently treated a patient with an arteriovenous fistula that developed after a right internal jugular vein catheterization. The patient was found to have a pulsatile hematoma and a bruit five days after removal of a temporary pacemaker catheter. Digital subtraction arteriography documented a fistula between the right internal mammary artery and subclavian vein. The fistula was surgically repaired via the cervical route. To our knowledge, an arteriovenous fistula between the internal mammary artery and subclavian vein has not been previously described as a complication of a percutaneous internal jugular vein catheterization.

Adult↗
PubMed1990

Superior mesenteric vein inflow for liver transplantation when the portal vein is occluded.

An alternative solution to the problem of liver transplantation in the patient with an occluded portal vein is described. It uses a bridge graft of donor iliac vein from the superior mesenteric vein at the base of the colonic mesentery. The graft is tunnelled over the pancreas and under the stomach to the region of the liver hilum to provide portal inflow. This procedure was employed successfully in four patients, with patency for more than 2 years in the patient with the longest follow-up. By this approach it is routinely possible to perform a transplant procedure in a recipient with an occluded portal vein.

Adult↗