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At least 595 records · Page 33Linked to original sources
PubMed1998

Budd-Chiari syndrome, portal vein and mesenteric vein thrombosis in a patient homozygous for factor V Leiden mutation treated by TIPS and thrombolysis.

We present the first case of Budd-Chiari syndrome in association with portal and mesenteric vein thrombosis in a patient homozygous for the factor V Leiden mutation. She was treated by transjugular intrahepatic portosystemic stent (TIPS) placement followed by local thrombolytic therapy. Venous outflow from the liver was established and the thrombi in the portal and mesenteric veins were lysed completely. This therapeutic approach may be used for such patients with this severe thrombotic event, who generally have a poor prognosis.

Adult↗
PubMed2005

Causes of telengiectasias, reticular veins, and varicose veins.

Study of surgical specimens and direct observation by angioscopy has revealed that the varicose venous wall, the valvular annulus, and the valves themselves undergo profound changes. Morphologic investigations have shown dilation of the valve annulus, bulging valve leaflets, commissural dilation, leaflet stretching, and eventually complete destruction of the valves. The venous wall has been seen to undergo changes of thickening in some segments and thinning in others. Our investigations show that inflammation and subsequent remodeling of the venous valves and wall are the fundamental mechanisms underlying the observed lesions. Hemodynamic forces, such as blood pressure changes in the wall and sheer stress, as well as varying planes of laminar and turbulent flow, induce activation of leukocytes and endothelial cells. Integrins appear to act as intermediaries and expression of adhesion molecules has been observed. Breakdown of extracellular matrix of the media and adventitia through activation of matrix metalloproteases (MMP) has been observed. In particular, expressions of MMP-1, MMP-2, MMP-9, and tissue inhibitor of metalloproteinase have been studied. Telangiectasias, reticular veins, and true varicose veins appear to be a consequence of the changes induced by venous hypertension and sheer stress.

Angioscopy↗
PubMed1984

[Mesenteric vein thrombosis following percutaneous transhepatic portal vein catheterization for the localization of an insulinoma].

The authors report on a fatal mesenteric vein thrombosis following an uncomplicated percutaneous transhepatic portal vein catheterisation for the localisation of an insulinoma. Several hours after the procedure the patient developed an acute abdomen. An emergency laparotomy revealed a haemorrhagic infarct of the ileum. The resected specimen showed an acute phlebitis with fresh thrombus. The cause of the phlebothrombosis was thought to be intimal damage from high osmolar contrast medium. There was no evidence of damage due to the catheter, either on the phlebogram or pathologically.

Adenoma, Islet Cell↗
PubMed1984

[Sonographic visualization of the left ovarian vein. A contribution to the diagnosis of compression syndrome of the left renal vein].

Amongst 737 sonographic and CT examinations of women aged 18 to 60 years of age, seven cases of ectasia of the left ovarian vein were found (0.95%). The aetiology and significance of this finding in the context of the "compression syndrome of the left renal vein" are discussed. The value to sonography in elucidating this condition is stressed.

Adolescent↗
PubMed2000

A comparative evaluation of polytetrafluoroethylene, umbilical vein, and saphenous vein bypass grafts for femoral-popliteal above-knee revascularization: a prospective randomized Department of Veterans Affairs cooperative study.

PURPOSE: Currently, the choice of a vascular prosthesis for a femoral-popliteal above-knee arterial bypass graft is left to the surgeon's preference, because the available information on comparative evaluations is inconclusive. The Department of Veterans Affairs (VA) Cooperative Study 141 was established to identify whether improved patency exists with different bypass graft materials for patients with femoral-popliteal above-knee bypass grafts. METHODS: Between June 1983 and June 1988, 752 patients at 20 VA medical centers were randomized to receive either an externally supported polytetrafluoroethylene (PTFE; N = 265), human umbilical vein (HUV; N = 261), or saphenous vein (SV; N = 226) for an above-knee femoral-popliteal bypass graft. The indication for the bypass grafting operation was limb salvage in 67.5% of the patients. Patients were observed every 3 months for the first year and every 6 months thereafter. All patients were instructed to take aspirin (650 mg) daily for the duration of the study.Doppler-derived ankle-brachial indices (ABIs) were determined preoperatively and serially postoperatively. A bypass graft was considered to be patent when the Doppler-derived postoperative ABI remained significantly improved (more than 0.15 units higher than their preoperative value) and additional objective information, such as angiograms or operations, did not contradict these observations. Patency failure also included bypass grafts that were removed because of an infection or aneurysmal degeneration. Patency rates were compared by using the Kaplan-Meier life table analysis. RESULTS: The cumulative assisted primary patency rates were statistically similar among the different conduit types at 2 years (SV, 81%; HUV, 70%; PTFE, 69%). After 5 years, above-knee SV bypass grafts had a significantly (P </=.01) better patency rate (73%) than HUV bypass grafts (53%), which had a significantly (P </=.01) better patency rate than PTFE bypass grafts (39%). Limb salvage was slightly worse with PTFE conduits. The number of bypass graft thromboses and major amputations within the first 30 days was highest in the HUV group. CONCLUSION: The overall results of this prospective randomized study suggest that the SV should be considered as the bypass graft of choice for femoral-popliteal above-knee reconstruction and that, when a prosthetic bypass graft is used, an HUV should also be considered as an alternative choice to PTFE.

Anastomosis, Surgical↗
PubMed2003

Comparison of superficial femoral vein and saphenous vein as conduits for mesenteric arterial bypass.

PURPOSE: Gangrenous bowel, intraabdominal sepsis, and previous failed mesenteric bypass are indications for use of an autogenous conduit for mesenteric arterial reconstruction. Saphenous vein (SV) is often used as the autogenous conduit of choice, but it may be prone to graft stenosis or occlusion. Recent experience with superficial femoral vein (SFV) suggests that it is an excellent alternative conduit for major arterial reconstruction. The purpose of this study was to compare the outcomes of SV and SFV for mesenteric arterial bypass. METHODS: During a 7-year period, 26 patients underwent 43 mesenteric arterial bypass procedures with autogenous conduit. SV was used for 23 bypasses (53%), and SFV was used for 20 bypasses (47%). Indications for revascularization included chronic mesenteric ischemia (n = 15; 58%), acute mesenteric ischemia (n = 9; 35%), and mycotic aneurysm of the paravisceral aorta (n = 2; 7%). Three patients (11%) underwent revascularization with SV grafts and two patients (8%) with SFV grafts after previous failed mesenteric bypass. RESULTS: The 30-day mortality rate was 15%. Three deaths occurred after SV bypass for acute mesenteric ischemia, and one death occurred after a SFV bypass for a ruptured paravisceral mycotic aneurysm. Twenty-two surviving patients were followed for a mean of 31 +/- 6 months. Three of 11 patients (27%) who survived after SV bypass had recurrent mesenteric ischemia develop (acute, n = 1; chronic, n = 2) from graft thrombosis at a mean interval of 32 +/- 22 months after surgery. No patient had recurrent symptoms develop after SFV bypass. One of the three patients with SV graft failure died of acute mesenteric ischemia, and the other two patients underwent successful bypass with SFV. Symptomatic graft failure was significantly more likely to occur in patients receiving SV grafts compared with SFV grafts (P <.05). CONCLUSION: SFV yields acceptable clinical outcomes for mesenteric arterial bypass compared with SV. SFV is a viable alternative to SV when autogenous conduit is indicated for mesenteric arterial reconstruction.

Adult↗
PubMed1985

Secretory patterns of progesterone and gonadotropins in the ovarian branch of the ovarian vein and the jugular vein during and around the second trimester of pregnancy in the cow.

Indwelling catheters were placed in the ovarian branch of the ovarian vein (OBOV) of 14 pregnant beef cows assigned to one of three periods of gestation: Period 1, catheterization on Days 70-100 (n = 5); Period 2, Days 120-150 (n = 5); and Period 3, Days 180-210 (n = 4). Samples were collected from the OBOV twice daily at 0600-0800 h (AM) and 1700-1900 h (PM). Intensive sample collections (every 20 min for 6 h, short-term sampling windows) were performed from the jugular vein (JV) and the OBOV. Average and baseline OBOV progesterone (P4) concentrations per 6-h window as well as the magnitude and amplitude of OBOV P4 pulses decreased from Period 1 to Period 2. The number of pulses per window and the relative increase of pulses above the baseline did not change. There was an increase in the average, but not the baseline, concentration of OBOV P4 from Period 2 to Period 3. The average and baseline concentrations of P4 in the JV as well as luteinizing hormone (LH) and follicle-stimulating hormone (FSH) in the OBOV and JV remained constant from Day 70 to Day 210 of gestation. There was no difference between the OBOV and JV for either LH or FSH, whereas the concentration of P4 in the OBOV was higher than in the JV for all periods. In both the AM and PM OBOV samples, P4 concentrations in Period 2 (AM = 83 ng/ml; PM = 67 ng/ml) were lower than Periods 1 (AM = 343 ng/ml; PM = 333 ng/ml) and 3 (AM = 534 ng/ml; PM = 305 ng/ml). However, no difference could be detected between AM (187 ng/ml) and PM (180 ng/ml) P4 concentrations when all periods were combined. Changes occurred in the concentrations and secretion patterns of P4 in the OBOV during and around the second trimester of gestation that were not reflected by P4 in the JV nor by LH and FSH in either vessel.

Animals↗
PubMed1996

Rationale for en bloc vein resection in the treatment of pancreatic adenocarcinoma adherent to the superior mesenteric-portal vein confluence. Pancreatic Tumor Study Group.

OBJECTIVE: Tumor invasion of the superior mesenteric-portal vein (SMPV) confluence is often considered a contraindication to pancreaticoduodenectomy for patients with malignant tumors of the pancreas or periampullary region. The authors sought to determine whether pancreaticoduodenectomy with en bloc resection of the SMPV confluence could be safely performed and whether tumors involving the SMPV confluence were associated with pathologic parameters suggesting poor prognosis. SUMMARY BACKGROUND DATA: Several centers have reported high rates of retroperitoneal margin positivity after pancreaticoduodenectomy for tumors of the pancreatic head and periampullary region. Positive-margin or incomplete resection is associated with early tumor recurrence and no survival benefit compared with palliative therapy. Tumor adherence to the lateral of posterior wall of the SMPV confluence often represents the only barrier to complete tumor resection at the time of pancreaticoduodenectomy. METHODS: Data on all patients undergoing pancreaticoduodenectomy for adenocarcinoma of the pancreas or periampullary region over a 3.5-year period were entered prospectively in a pancreatic tumor database. To be considered for surgery, patients were required to fulfill the following computed tomography criteria for resectability: 1) the absence of extrapancreatic disease, 2) no tumor encasement of the superior mesenteric artery or celiac axis, and 3) a patent SMPV confluence. Tumor adherence to the superior mesenteric vein or SMPV confluence was assessed intraoperatively, and en bloc venous resection was performed when necessary to achieve complete tumor extirpation. Data on operative characteristics, morbidity, mortality, tumor size, nodal metastases, margin positivity, perineural invasion, and tumor DNA content were compared for patients who did and did not receive venous resection. RESULTS: Fifty-nine patients underwent pancreaticoduodenectomy, 36 without venous resection and 23 with en bloc resection of the SMPV confluence. No differences in median hospital stay, morbidity, mortality, tumor size, margin positivity, nodal positivity, or tumor DNA content were observed between groups. CONCLUSIONS: When necessary, segmental resection of the SMPV confluence may be performed safely during pancreaticoduodenectomy for periampullary malignant tumors. Tumors invading the SMPV confluence are not associated with histologic parameters suggesting a poor prognosis. Our data suggest that venous involvement is a function of tumor location rather than an indicator of aggressive tumor biology.

Adenocarcinoma↗
PubMed2004

Portal vein occlusion with aberrant left gastric vein functioning as a hepatopetal collateral pathway.

A rare case of an aberrant left gastric vein functioning as a hepatopetal collateral as a result of portal vein occlusion is presented herein. The portal venous phase of multislice computed tomography clearly demonstrated this anatomic variation and provided a reliable vascular "road map" for percutaneous transhepatic portal venous stent placement. Portal hypertension associated with extensive gastrojejunal varices improved dramatically after stent placement.

Adult↗
PubMed1996

An ambulatory treatment of varicose veins associating surgical section and sclerotherapy of large saphenous veins (3S technique). Preliminary study with results at one year.

BACKGROUND: The 3S technique enables treatment of large incontinent greater saphenous veins in patients who, for medical or social reasons, refuse traditional surgical methods. It associates phlebectomy with section-ligation and injection of a sclerosing solution in the proximal and distal segments. The 3S technique is merely one stage in the treatment of the saphenous vein, aimed at suppressing reflux, and associated with sclerosis of the junction. It must always be combined with later sclerotherapy sessions. METHODS: One hundred and eight patients were operated on by the 3S technique, of which 100 had 1-year follow-up. Each patient was checked by duplex scan examination before treatment, and 1 month and 1 year after. RESULTS: We obtained good results without reflux in 96% at the sapheno-femoral junction at 1 year. CONCLUSIONS: Superficial venous insufficiency is a chronic disease with evolution or recurrences. To appreciate the efficiency of 3S technique, it will be better to have 5 years worth of follow-up. This is a preliminary study with a short follow-up.

Aged↗
PubMed1993

Compression of the left brachiocephalic vein: cause of high signal intensity of the left sigmoid sinus and internal jugular vein on MR images.

To study the asymmetry in signal intensity of the sigmoid sinuses, internal jugular veins (IJVs), or both sets of structures on magnetic resonance (MR) images, the authors reviewed 226 serial sets of routine MR imaging studies. Cerebral digital subtraction angiography was performed in 20 patients with a markedly higher intensity and/or enhancement on the left; 15 of them also underwent venography. With every sequence, the left sigmoid sinus, IJV, or both were higher in signal intensity significantly more often than the right (range, P = .0001 to .0129). Angiography revealed hemostasis in the left IJV in 16 patients that disappeared during full inspiration in 14. In 13, venography revealed that the left brachiocephalic vein was compressed to occlusion between the aortic arch and the sternum during tidal volume ventilation. The occlusion disappeared at full inspiration, when the distance between the aortic arch and the sternum increased. This hemostasis could be the major cause of the frequent increased signal intensity of the left sigmoid sinus and IJV on MR images.

Adolescent↗
PubMed1996

Different fibrinolytic potentials between human umbilical vein endothelial cells and human adult vein endothelial cells.

Endothelial cells play a central role in fibrinolysis due to their production of both tissue plasminogen activator (t-PA) and plasminogen activator inhibitor type-1 (PAI-1). The purpose of this study was to test the hypothesis that the production of t-PA and PAI-1 from human umbilical vein endothelial cells (HUVEC) and from human adult vein endothelial cells (HAVEC) adopt the same pathways for the regulation of fibrinolysis, and that differences in PAI-1 and t-PA production are only quantitative. HUVEC and HAVEC cultures were exposed to phorbol ester (PMA), endotoxin (LPS) or thrombin, singly or in combination with forskolin or H7. The conditioned medium was collected after 16 h and analyzed for t-PA and PAI-1 antigens. The basal production of both t-PA and PAI-1 was significantly higher from HUVEC than from HAVEC. Exposure to PMA, thrombin or forskolin gave a similar response from the two cell types. In contrast, the results from HUVEC and HAVEC differed significantly, not only in magnitude but also in direction, when the cells were exposed to forskolin coincubated with PMA, LPS or thrombin, and in magnitude alone when exposed to LPS only. The results indicate that there are not only quantitative but also qualitative differences in the production of t-PA and PAI-1 from HUVEC and HAVEC. These differences must be taken into account when data from cells of different origin are compared.

Adult↗
PubMed1994

Comparative studies on vascular endothelium in vitro. I. Cytokine effects on the expression of adhesion molecules by human umbilical vein, saphenous vein and femoral artery endothelial cells.

Endothelial cells (ECs) are very responsive to proinflammatory cytokines. ECs are stimulated by these substances to increase expression of cell surface adhesion molecules, leading to dramatically altered interactions with leukocytes. In these interactions, E-selectin, intercellular adhesion molecule-1 (ICAM-1) and vascular cell adhesion molecule-1 (VCAM-1) are suggested to play the most important role. Recent evidence has suggested diversity in the responses of ECs from different regions of the vascular system. Human umbilical vein ECs (HUVECs) are the most often used EC culture model, although there are few studies comparing their response with other human EC types from the adult organism. In this study the expression of E-selectin, ICAM-1 and VCAM-1 on cultured human adult ECs from the saphenous vein (HSVECs) and from the femoral artery (HAFECs), as well as HUVECs was studied. Using a cell enzyme immunoassay as well as immunoelectron microscopical methods, we found that both HSVECs and HAFECs respond in a similar way to HUVECs to exogenous stimulation by IL-1 beta, TNF alpha or LPS. IL-1 beta and TNF alpha increased the expression of E-selectin on the cytoplasmic membranes of HUVECs, HSVECs and HAFECs and elicited even similar absolute quantities of this molecule, comparing the different cell types. ICAM-1 and VCAM-1 appeared to be regulated dose dependently by IL-1 beta, independent of the EC type. HUVECs as well as HSVECs and HAFECs gave a reproducible constitutive ICAM-1 expression, whereas E-selectin and VCAM-1 were absent on nonstimulated ECs.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1999

Comparison of tissue factor pathway in human umbilical vein and adult saphenous vein endothelial cells: implications for newborn hemostasis and for laboratory models of endothelial cell function.

In this work we have undertaken a comparative study of human umbilical vein endothelial cells (HUVECs) and human saphenous vein endothelial cells (HSVECs) with respect to functional and antigenic tissue factor (TF), tissue factor pathway inhibitor (TFPI), and TF mRNA. Monolayers of each cell type (passage 2, except where specified) were grown to confluence and then activated for 4 h with either 50 U/mL IL-1-alpha or 10 microg/mL tumor necrosis factor-alpha. Activated factor X appearing in supernatant was measured using a chromogenic assay, and both Northern blots and quantitative RT-PCR were performed to assess concentrations of TF mRNA accompanying activation. The role of TFPI was separately determined by ELISA for supernatant TFPI antigen, and by measurements of production of activated factor X in the presence of 0, 5, 15, or 50 microg/mL of an antibody directed against TFPI. To address a non-TF pathway endothelial cell function, antigenic concentrations of tissue plasminogen activator for both cell types was also determined by ELISA. HUVECs were found to produce 2.4- to 3.5-fold more functional TF. No significant HUVEC-HSVEC differences were detected in TF antigen, supernatant TFPI, anti-TFPI affinity for endothelial cell-associated TFPI, TF mRNA or its amplification products, and tissue plasminogen activator. Immunostaining for TF antigen, however, may have failed to detect a modest HUVEC-HSVEC difference. Our finding with respect to functional TF indicates that HUVECs and HSVECs are not equivalent in terms of models for endothelial cell function in small children versus adults.

Adult↗
PubMedDate not supplied

A historical review of the histology of patent autogenous vein grafts and vein patches.

The literature on the histological changes occurring in autogenous vein grafts and patches was reviewed. Over 307 grafts (235 animal and 72 human) and 30 patches (28 animal and 2 human) have been described. Grafts were investigated from patients who died on the operating table up to 22 years after operation. Intimal thickening and various changes in the media (including necrosis and replacement fibrosis) occurred. Dilatation of vein grafts has occurred, and anerysm formation has been reported. Atheroma has been described in the grafts from 5 patients.

Aneurysm↗
PubMed2000

[An update on the treatment of central retinal vein thrombosis (retinal vein occlusion)].

The paper reviews the actual therapeutical means in a severe invalid eye disease. The treatment is not able to improve the retinal blood flow, being more effective on the main symptoms and complications. The isovolumetric hemodilution method as an up-to-date method in the treatment of central retinal vein occlusion, appears to bring better recuperation hopes, by a higher improvement of the local anatomical and hemodynamical factors. That is the reason why we shall expose it widely in our paper. Unfortunately, despite its complexity, the treatment of central retinal vein occlusion is not satisfactory from the point of view of the high number of patients that remain with a low visual acuity. The main goal of the therapy is the recovery of visual function, but a few aspects and especially the late presentation for ophthalmological examination, reduce the objective of treatment to prevent complications.

Humans↗
PubMed2002

Radiofrequency ablation of the long saphenous vein without high ligation versus high ligation and stripping for primary varicose veins: pros and cons.

Primary varicose vein disease is prevalent in our society, and although it is infrequently the cause of serious venous insufficiency, it often is associated with symptoms of local discomfort. These symptoms eventually may outweigh any cosmetic concerns of patients with this disease. Greater saphenous vein (GSV) reflux is the most important pathophysiologic component of primary venous insufficiency. To date, the surgical treatment of GSV reflux has evolved into 1 of 3 procedures: high ligation of the saphenofemoral junction, with or without perforator ligation; high ligation and stripping of the GSV; and high ligation with retrograde sclerotherapy of the GSV. High ligation and stripping of the GSV to below the knee enjoys the most durable success yet is associated with significant perioperative morbidity. A new treatment, radiofrequency ablation of the GSV without high ligation, recently has been described and promises a less invasive alternative to stripping with decreased morbidity and increased patient acceptance. The results of high ligation and stripping of the GSV will be compared with those with radiofrequency ablation of the GSV without high ligation.

Catheter Ablation↗