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At least 541 records · Page 30Linked to original sources
PubMed2005

Percutaneous approach to a stent-based ventricle to coronary vein bypass (venous VPASS): comparison to catheter-based selective pressure-regulated retro-infusion of the coronary vein.

AIMS: Percutaneous stent-based ventricle-to-coronary vein bypass (venous VPASS) is a new approach to chronic venous arterialization as a treatment modality in an otherwise no option patient with coronary artery disease. In this study, the efficacy of venous VPASS was compared with catheter-based selective pressure-regulated retro-infusion of arterial blood during acute ischaemia. METHODS AND RESULTS: In seven pigs, venous VPASS was established using a percutaneous ultrasound-guided puncture from the anterior cardiac vein to the left ventricle, with subsequent implantation of an ePTFE-covered stent graft. During left anterior descending artery (LAD) occlusion, coronary venous pressure in the distal anterior cardiac vein increased to 55+/-4 mmHg under conditions of venous VPASS compared with 78+/-5 mmHg during selective pressure-regulated retro-infusion. Significant preservation of regional myocardial function was observed during venous VPASS (67+/-6% baseline) and during selective retro-infusion (83+/-4%) compared with control LAD occlusion (0.4+/-2%). CONCLUSION: Percutaneous implantation of a PTFE covered stent (venous VPASS) was feasible and associated with significant preservation of regional myocardial function during acute ischaemia in pigs at reasonable levels of mean coronary venous pressure to avoid tissue damage during chronic application.

Angioplasty, Balloon, Coronary↗
PubMed2000

Haemostatic factors and risk of varicose veins and chronic venous insufficiency: Edinburgh Vein Study.

Despite much research, the aetiology of venous disease is still poorly understood. Since haemostatic factors are involved in the processes of fibrinolysis and platelet aggregation, it is conceivable that such processes may be implicated in the pathology of varicose veins and chronic venous insufficiency (CVI). The Edinburgh Vein Study examined 1566 men and women aged 18-64 years that were randomly selected from the lists of 12 general practitioners. Each subject completed a questionnaire, underwent a comprehensive clinical examination and had a blood sample taken for the analysis of plasma fibrinogen, tissue plasminogen activator (t-PA) and von Willebrand factor (vWF) antigens. Subjects with trunk varicose veins and those with CVI had higher levels of each haemostatic factor compared with those with no trunk varices and no CVI. Although unit increases in t-PA and vWF were initially associated with a significantly increased risk of CVI in men, and both factors with an elevated risk of trunk varices in women, multiple adjustment for age, smoking status and body mass index reduced the odds ratios to non-significance. However, this does not entirely rule out the possibility of a pathogenic role for haemostatic factors in venous disease, but rather indicates the need for further experimental and epidemiological studies.

Adolescent↗
PubMed1978

Replacement of damaged arteries and veins with vein grafts when replanting crushed, amputated fingers.

Two cases are presented in which multiple vein grafts were used to revascularize several digits in hands injured by severe crushes. One case had partial amputations of 4 digits, and the other had 4 complete amputations. After debriding the damaged parts of the vessels, we interposed vein grafts in both the arterial and venous circulations to the digits. Seven of 8 revascularized digits survived. In crushing injuries, it is essential to debride the vessels proximally and distally to where the intima has not been injured. To bridge the gaps, vein grafts can be used successfully where other methods are undesirable or impossible.

Adolescent↗
PubMedDate not supplied

Intravitreal triamcinolone treatment for macular edema associated with central retinal vein occlusion and hemiretinal vein occlusion.

PURPOSE: To assess the efficacy of intravitreal triamcinolone treatment for macular edema from central retinal vein occlusion (CRVO) and hemiretinal vein occlusion (HRVO). METHODS: This study was a retrospective medical records review of 24 eyes of 24 patients (mean age, 71 years) that were injected with 4 mg of intravitreal triamcinolone acetonide for treatment of macular edema due to CRVO (n = 21) and HRVO (n = 3). Of the 24 eyes, 14 were injected once, 6 were injected twice, 3 were injected 3 times, and 1 received 4 injections. Mean follow-up time was 10 months (range, 3-24 months). The average time between onset of symptoms and first injection was 5.4 months (range, 2-48 months). Available documents on pre- and postinjection optical coherence tomography central foveal thickness in 23 of 39 total injections were evaluated. RESULTS: All injections resulted in reduction in central foveal thickness as determined by optical coherence tomography. The mean central foveal thickness decreased to 55% of preinjection values ([n = 23] 635 vs. 352 mum, respectively; P < 0.001). The average gain in visual acuity was 1.3 Snellen lines (range, -3-7) over the course of the study period. Ten eyes gained > or =2 lines of visual acuity, 3 eyes improved 1 line, 7 eyes remained the same, and 4 eyes worsened. There was no correlation between improvement in foveal thickness and corresponding visual gain (P = 0.24). None of the eyes of diabetic patients (n = 6) or patients with ischemic CRVO (n = 2) improved in visual acuity. The difference in mean baseline (20/167) and mean final visual acuity (20/91) was statistically significant (P = 0.015). The mean best postinjection visual acuity (20/67) was also significantly higher than the mean final visual acuity (P = 0.019). When diabetic and ischemic CRVO patients were excluded, the difference between mean baseline visual acuity and mean final visual acuity was found to be highly significant ([n = 16] 20/133 vs. 20/67, respectively; P < 0.001), while mean final and best postinjection visual acuities (20/50) did not differ (P = 0.085). Eight of 16 phakic eyes showed progression of cataract, 2 of which underwent cataract extraction. Nine of 18 patients without a history of glaucoma developed ocular hypertension and required glaucoma medication during postinjection follow-up. Trabeculectomy was performed on two eyes with glaucoma. Two other eyes developed epiretinal membranes, one of which underwent vitrectomy. CONCLUSIONS: Intravitreal triamcinolone may be effective in treating macular edema from CRVO and HRVO. Subjects with concurrent diabetes or ischemic central retinal vein were less likely to have visual improvement.

Adult↗
PubMed1992

Recurrent varicose veins. Part 2: Injection of incompetent perforating veins using ultrasound guidance.

Treatment options following duplex evaluation of recurrent varicose veins are discussed and a method of injecting incompetent perforating veins using ultrasound guidance is described. The results of duplex evaluation 6 months postinjection using this technique are presented. These early results indicate that sclerosant injection employing ultrasound guidance is an effective and safe method of treating incompetent perforating veins.

Adult↗
PubMed2002

Occlusion of a saphenous vein graft aneurysm with a vein-covered stent.

A 67-year-old man was admitted with unstable angina, 15 years after saphenous vein graft bypass surgery. Cardiac catheterization demonstrated a large saccular aneurysm arising from the proximal segment of the vein graft to the obtuse marginal artery. Intravascular ultrasound revealed the opening of the aneurysm that measured 15 mm in length. The aneurysm was successfully occluded by deployment of a vein-covered stent.

Aged↗
PubMed1997

Unusual spontaneous hepatic vein to paraumbilical vein shunt in a patient with Budd-Chiari syndrome and cirrhosis: a case report.

A very unusual portosystemic shunt was identified using color flow Doppler sonography in an adult male with Budd-Chiari syndrome and cirrhosis secondary to a hypercoagulability state. Hepatofugal blood flow was demonstrated between the middle hepatic vein and a recanalized paraumbilical vein, resulting clinically in prominent periumbilical veins. The clinical and radiological features are described.

Adult↗
PubMed1999

Arterialisation of the portal vein with an aortoportal jump graft for portal vein thrombosis following liver resection for malignancy.

Fibrolamellar hepatocellular carcinoma (FHCC) is a variant of hepatocellular carcinoma, which mainly affects a young age group and carries a relatively good prognosis. It is widely accepted that aggressive curative resection is still the best option for FHCC. We report here a case of successful arterialisation of the portal vein with an aortoportal jump graft for portal vein thrombosis, which developed postoperatively in an already comprised portal vein with tumour invasion following an extensive liver resection for FHCC.

Adolescent↗
PubMed2006

Is circumferential pulmonary vein isolation preferable to stepwise segmental pulmonary vein isolation for patients with paroxysmal atrial fibrillation?

BACKGROUND: Stepwise segmental pulmonary vein isolation (SPVI) and circumferential pulmonary vein isolation (CPVI) have been developed to treat patients with atrial fibrillation (AF), but the preferable approach for paroxysmal AF (PAF) has not been established. METHODS AND RESULTS: One hundred and ten patients with symptomatic PAF were randomized into a stepwise SPVI group (n=55) or CPVI group (n=55). Systemic SPVI combined with left atrial linear ablation tailored by inducibility of AF was performed in the stepwise SPVI group. Circumferential linear ablation around the left and right-sided pulmonary veins (PVs) guided by 3-dimensional electroanatomic mapping was performed in the CPVI group. The endpoints of ablation are non-induciblity of AF in the stepwise SPVI group and continuity of circular lesions combined with PV isolation in the CPVI group. After the initial procedures, atrial tachyarrhythmis (ATa) recurred within the first 3 months in 23 of the 55 patients (41.8%) who underwent stepwise SPVI and in 20 of the 55 patients (36.4%) who had CPVI (p=0.69). Repeat procedures were performed in 7 patients from the stepwise SPVI group and 5 from the CPVI group (p=0.76). During the 3-9 months after the last procedure, 46 patients (83.6%) from the CPVI group and 43 (78.2%) from the stepwise SPVI group did not have symptomatic ATa while not taking anti-arrhythmic drugs (p=0.63). Severe subcutaneous hematoma or PV stenosis occurred in 3 patients. CONCLUSIONS: The efficacy of stepwise SPVI is comparable to that of CPVI for patients with PAF.

Adult↗
PubMed2000

Anastomosis of the ovarian vein to the hepatic portal vein in sheep induces ovarian hyperstimulation associated with increased LH pulsatility, but only in the absence of the contralateral ovary.

In this study, two experiments were performed, the first of which examined the ovarian response in ewes that were subject to unilateral ovariectomy (ULO) at different intervals (0-14 days) after surgical anastomosis (AN) of the ovarian vein to the mesenteric vein (n=7 ewes), or sham operation (SO; n=4 ewes). Hypertrophy and development of multiple follicular and luteal structures on AN ovaries were observed after ULO, while SO ovaries remained of normal size and appearance after ULO. The second experiment involving 11 ewes (five AN; six SO) aimed to clarify the mechanism by which AN following ULO-induced ovarian hypertrophy and increased follicle development. The results confirmed that there were more large (>5 mm) follicles on AN compared with SO ovaries; however, their rate of atresia was similar. Oestradiol and progesterone concentrations in follicular fluid of class 1 follicles (5-9 mm) were higher in AN ovaries than those in control follicles of the same size collected in the late follicular phase of an induced oestrous cycle. In AN ewes, intrafollicular progesterone concentrations increased while follicular aromatase activity and intrafollicular oestradiol, inhibin A, follistatin and activin A concentrations all decreased as follicle size increased. Oestradiol and progesterone concentrations were substantially higher in ovarian venous blood than in hepatic venous blood, both in AN and SO ewes, whereas inhibin A levels were not significantly modified by passage through the liver in either group. Mean plasma LH concentration, and LH pulse frequency and amplitude increased markedly after AN but were not affected by SO. Plasma FSH showed only a small transient increase after AN, presumably due to the maintenance of inhibin feedback. Injection of prostaglandin F(2)(alpha) 4 days later did not further modify LH or FSH secretion in either group. Full ovariectomy (FO) 9-14 days after AN or SO increased LH secretion markedly in SO ewes but to a lesser degree in AN ewes; FO induced a large and rapid increase in FSH levels in both groups. In conclusion, AN of the ovary to the liver via the mesenteric vein provides a useful model for studying the feedback between the ovary and the hypothalamo-pituitary system and the mechanisms controlling follicle development. The present results indicate that the pattern of LH secretion is an important factor controlling the terminal phase of follicle development in the ewe.

Activins↗
PubMed1991

Catheterization of the caudal vena cava via the lateral saphenous vein in the ewe, cow, and gilt: an alternative to utero-ovarian and medial coccygeal vein catheters.

Current methods for obtaining venous blood from the reproductive organs of livestock often have a low rate of success or involve intensive surgical procedures that may impair ovarian function. Therefore, the caudal vena cava was catheterized via the lateral saphenous vein to determine the feasibility of using this method for chronic sampling of blood draining from the reproductive organs of ewes (n = 6), cows (n = 6), and gilts (n = 7). Blood samples were collected at 2-cm (ewes and gilts) or 5-cm (cows) intervals during insertion of catheters. Correct placement, defined as the position at which plasma concentrations of progesterone or estrogen were at least threefold greater than in jugular venous plasma, varied among species and among animals within species. It seemed, however, that a majority of catheters would be placed correctly if secured at 48 to 52 cm in ewes, 52 cm in gilts, and 90 to 100 cm in cows. Saphenous vein catheters were secured for sequential sampling of vena caval blood during the follicular phase of ewes (n = 25), cows (n = 4), and gilts (n = 5). Catheters remained patent for the duration of sampling in all individuals. Concentrations of estrogen in jugular and vena caval plasma were correlated (ewe P less than .0003; cow P less than .0001; gilt P less than .0001). Profiles of progesterone and estrogen revealed an episodic pattern of secretion in vena caval but not jugular plasma. Catheterization of the vena cava via the saphenous vein is a relatively simple and noninvasive method for obtaining blood containing uterine and ovarian hormones before their metabolism.

Animals↗
PubMed1997

[Colored Doppler ultrasound-guided fine-needle aspiration biopsy of portal vein thrombosis: value in diagnosis and assessment of therapeutic efficacy for portal vein thrombosis].

OBJECTIVE: To investigate the value of colored Doppler ultrasound-guided fine-needle aspiration(FNA) biopsy of portal vien thrombosis(PVT) in diagnosis and assessment of therapeutic efficacy for PVT. METHODS: Cytologic findings from 25 portal vien thrombosis patients who underwent FNA were reviewed before and after hepatic arterial chemo-embolization(HAE) and portal vien chemotherapy. RESULTS: 1. Biopsy specimens sufficient for histologic analysis were obtained in all cases (100%). No complications resulted from this procedure. 2. The blood flow within the portal vien with thrombosis could be detected by colored Doppler systems in 25 cases before the patients accepted the treatment. The proliferation and a trabecular cellular arrangement presented in all the cell blocks. Of the 25 cases, 4 (16.0%) demonstrated necrosis of the tumor thrombi and the disappearance of blood flow within portal vein thrombi three weeks after the treatment. Among the 4, 2 were followed-up clinically and underwent second stage resection. 21 (84.0%) cases had no significant change in portal vein thrombosis pathologically and ultrasonically after the treatment. CONCLUSION: Colored Doppler ultrasound-guided FNA biopsy of portal vein thrombi is a safe, accurate, sampling-reliable biopsy technique.

Adult↗
PubMedDate not supplied

Evaluation of inferior right hepatic vein-preserving hepatectomy with resection of the superior right hepatic vein.

BACKGROUND/AIMS: If the superior right hepatic vein (SRHV) is resected, segment 6 will be drained by the inferior right hepatic vein (IRHV) and congestion will not occur. However, early postoperative liver function and long-term regeneration of segment 6 after IRHV-preserving hepatectomy remains unclear. METHODOLOGY: Three patients undergoing IRHV-preserving hepatectomy were examined. One (case 1) had liver metastasis from sigmoid colon cancer and two (cases 2 and 3) had hepatocellular carcinoma. Resection of segments 7 and 8 along with the SRHV was performed in cases 1 and 2. Anterior sectionectomy and resection of segment 4a along with the SRHV and middle hepatic vein (MHV) was performed in case 3. The volume of each sector was calculated by summation of each CT area. RESULTS: The warm ischemic time of the three cases was 50-78 min, operative blood loss was 496-914 g, and operating time was 4-7 h. There was no significant change in diameter of the IRHV and MHV before and after surgery. Intraoperative color Doppler ultrasonography was a useful technique for evaluating intrahepatic venous communication. Part of segment 6 had previously been resected in case 1, and at outpatient follow-up this segment was found to have become atrophic. In cases 2 and 3, the remnant posterior sector became hypertrophic. CONCLUSIONS: IRHV-preserving hepatectomy can retain a greater proportion of liver parenchyma than right hepatectomy. Postoperative liver function was well maintained in our patients and there were no serious complications. Long-term follow-up showed hypertrophy of the remnant posterior sector except in one case. To minimize surgical damage, for example in patients with poor liver function or preoperative complications, IRHV-preserving hepatectomy should be considered.

Carcinoma, Hepatocellular↗
PubMedDate not supplied

Tailoring transection of segment V vein for optimal sharing of middle hepatic vein in right-lobe living donor liver transplantation.

BACKGROUND/AIMS: Separate reconstruction of multiple V5s (segment V hepatic vein) often resulted in incomplete resolution of hepatic venous congestion (HVC) in the right lobe (RL) grafts. This study intended to obtain single large V5 orifice suitable for middle hepatic vein (MHV) reconstruction. METHODOLOGY: We tried tailoring V5 transection in 3 of 39 RL donors, in whom MHV anatomy would reveal multiple sizable V5 orifices along the classical transection plane. During transection of its ventral half, the liver cut surface was intentionally deviated leftward to obtain single large V5 orifice with small sacrifice of the medial segment. RESULTS: Single V5 and single segment VIII vein were reconstructed with interposition vessel graft. Its final shape resembled the combination of RL graft with MHV trunk at the ventral half and RL graft with MHV reconstruction at the dorsal half. There was no noticeable perfusion defect on follow-up computed tomography of all donor and recipient livers. CONCLUSIONS: We think that this combination of tailoring V5 transection and interposition graft is fully suggestive of the feasibility of modified extended RL graft in donor livers with variant peripheral MHV branching.

Adolescent↗
PubMed1991

Subclavian vein stenosis: complication of subclavian vein catheterization for hemodialysis.

Subclavian vein catheterization is a relatively safe procedure. Few long-term complications have been reported. We recently diagnosed subclavian vein stenosis in a 14-year-old peritoneal dialysis patient. The stenosis occurred 2 years after the use of a subclavian vein catheter for temporary hemodialysis. Stenosis became clinically apparent by progressive painless swelling of the right arm and was documented by venography.

Adolescent↗
PubMed1991

[Valvuloplasty and fixation of the femoral vein for valvular incompetence of deep veins of the lower extremity].

Fifty cases (54 limbs) of valvuloplasty and fixation of the incompetent valve of the femoral vein were reported. Diagnosis was made by clinical features, measurement of ambulatory venous pressure, ascending and descending phlebography, and by intraoperative checking the blood flow. After repairing the highest primary valve of the superficial femoral vein a circular suture around the vein at 2 mm under the repaired valve was made to prevent the recurrence of valvular incompetence. Patients were followed-up for 6 to 45 months (mean 20.2 months) with satisfactory results in all and excellent in 50 limbs (92.6%). The swelling subsided, stasis dermatitis and ulcer healed promptly, the "heavy leg" became light, and venous pressure of post-exercise lowered significantly (P less than 0.01). No retrograde flow of contrast medium was detected during the descending phlebography after operation. The results suggest that this operation is better than simple repair of the incompetent valve.

Adult↗
PubMed1990

[Thrombus propagation and venous drainage disturbance in cerebral sinus-vein thrombosis--38 autopsied cerebral sinus-vein thrombosis].

38 autopsied cases of cerebral sinus-vein thrombosis (CSVT) in our institute were studied. In this study, special attention was paid for the evolution and fate of venous thrombus. 18 cases showed hemorrhagic infarction or intracerebral hematoma (group 1; G 1). In contrast, no cerebral parenchymal changes were observed in the other 20 cases (group 2; G 2). In 13 of 18 cases of G 1, superior sagittal sinus (SSS) were thrombosed. 10 of these 13 cases showed thrombosed cerebral cortical veins (CV) or deep cerebral veins (DV). In contrast, none of 16 cases of G 1 with thrombosed SSS showed thrombosed CV or DV. All cases of the solitary thrombosis of CV or DV (each 2 cases) belong to G 1. Venous thrombi were divided into three stages according to its process of organization; recent thrombus (R), hyalinized thrombus (H), organized thrombus (O). In the venous thrombi of G 1, 6 cases were R, 6 were partly H, 6 were partly 0. In addition to O, R and H were also observed in group O. Distribution of various stage of thrombus in same case suggested that gradual thrombus evolution had occurred before or after the clinical onset in CSVT. This study suggested: (1) CV or DV occlusion may play an important role for the advent of cerebral parenchymal changes in CSVT. (2) Gradual thrombus evolution after the onset is one of possible causes of slow clinical deteoration after the onset. Therefore, prevention of these thrombus propagation with anti-platelet drugs or fibrinolotic therapy should be recommended for the treatment of CSVT. On the contrary, hyperosmolar agents and diuretics may produce potential risk of dehydration, and as a result, accelerate secondary thrombus extension.

Adolescent↗
PubMed1990

Cases from the aerospace medicine residents' teaching file. Case #38. A navigator with nonischemic central retinal vein occlusion progressing to ischemic central retinal vein occlusion.

A case report of a young USAF navigator with nonischemic central retinal vein occlusion progressing to ischemic central retinal vein occlusion is presented. This young man was treated with hyperbaric oxygen therapy early in the course of his disease with complete resolution of his condition. Two years later his vision remained 20/17. This is the first known case of central retinal vein occlusion being treated with hyperbaric oxygen.

Adult↗