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At least 703 records · Page 39Linked to original sources
PubMed1993

Central vein occlusion study of photocoagulation. Manual of operations. Central Vein Occlusion Study Group.

This paper is the complete protocol (Manual of Operations) used in the Central Vein Occlusion Study (CVOS). The CVOS is a randomized clinical trial and natural history study of central retinal vein occlusion supported by the National Eye Institute. The administrative structure includes a Data and Safety Monitoring Board, 9 clinical centers, a coordinating center, and a photograph reading center. The Manual of Operations describes study design, organization, policies, and procedures. Procedures described in detail include measurement of visual acuity, fundus and iris photography, fluorescein angiography, and quality control.

Adult↗
PubMed1993

Central vein occlusion study of photocoagulation therapy. Baseline findings. Central Vein Occlusion Study Group.

OBJECTIVE: Description of the patients recruited into the Central Vein Occlusion Study (CVOS) and of the status of their eyes at time of study entry. This population is currently being followed for evaluation of photocoagulation treatment for eyes with central retinal vein occlusion (CVO) and natural history. DESIGN: Prospective multicenter cohort study incorporating 2 natural history groups and 2 randomized controlled clinical trials. SETTING: Eight ophthalmic practices in the USA and 1 in France, primarily associated with academic centers. PATIENTS: Seven hundred and twenty-five patients with CVO (728 eyes) divided into 4 study groups on the basis of the perfusion status of the retina and presence of decreased vision associated with macular edema: perfused, nonperfused, indeterminate, and macular edema. INTERVENTIONS: Nonperfused group: random assignment to panretinal photocoagulation or watchful waiting. Macular edema group: random assignment to grid pattern photocoagulation or watchful waiting. Natural history groups: no intervention. MAIN OUTCOME MEASURES: Description of population and eyes based upon clinical examination and central assessment of fundus angiography, iris photographs, and stereo color fundus photographs. MAIN RESULTS: Mean age for the 725 patients is 65 years, with 43% of patients in the study age 70 or older. Despite the older age of this population, more than half (53%) of the patients are male. One hundred and eighty-one patients were randomized into the nonperfused group and 155 into the macular edema group. Follow-up in the CVOS will be completed in February 1994 when most patients are expected to have completed the planned 3 years. CONCLUSIONS: Recruitment has been successfully completed in this prospective study and the design and baseline results are presented.

Adult↗
PubMedDate not supplied

[Coronary veins and coronary sinus tributary veins in Africans].

This anatomical study carried out on 40 African adults hearts studied branches of the coronary sinus. By using of injection of the coronary arteries and corrosion of the myocardium, the study identified certain peculiarities of the small coronary vein and the posterior descending interventricular vein in Africans.

Adult↗
PubMed1994

Stripping of the long saphenous vein in the treatment of primary varicose veins.

Eighty-nine legs with long saphenous vein (LSV) reflux and saphenofemoral junction incompetence were treated by saphenofemoral ligation and multiple avulsions; patients were randomized to undergo additional stripping of the LSV from groin to upper calf (n = 43) or no additional treatment (n = 46). At a median of 21 months after surgery recurrence was evaluated by duplex ultrasonography, photoplethysmography, clinical examination and patient assessment. Fewer persisting incompetent LSVs in the calf were found (21 versus 38) and median (interquartile range) photoplethysmographic refilling times were longer (20 (13-27) versus 14 (11-21) s) when the LSV was stripped than after saphenofemoral ligation alone (both P < 0.1). More patients were completely satisfied (65 versus 37 percent and were recurrence-free (65 versus 17 per cent) when the LSV had been stripped compared with saphenofemoral ligation alone (P < 0.05 and P < 0.001 respectively). The addition of LSV stripping to saphenofemoral ligation and multiple avulsions results in a better overall outcome.

Adult↗
PubMed1991

Doppler demonstration of cystic vein dilatation secondary to portal vein thrombosis.

High-resolution duplex ultrasound was used to demonstrate vascular dilatation in the gallbladder wall in eight patients with portal vein thrombosis. Gallbladder thickening, combined with a higher incidence of gallstone disease in patients with chronic hepatic disease can be misinterpreted as acute cholecystitis. The Doppler is helpful in detecting the vascular cause of the gallbladder wall thickening thus helping to reduce the frequency of inappropriate cholecystectomy.

Dilatation, Pathologic↗
PubMed2000

Patterns of reflux and severity of varicose veins in the general population--Edinburgh Vein Study.

OBJECTIVES: several studies have used duplex ultrasound to assess valvular incompetence in symptomatic patients. This cross-sectional survey was performed to determine, for the first time in a general population sample, the relationship between trunk varices and the presence of reflux in lower limb venous segments. MATERIALS AND METHODS: 1238 subjects (554 male, 684 female), aged 18-64 years, were randomly selected. The presence and severity of any trunk varices was assessed and classified into Grades 1-3; hyphenweb and reticular varices were noted. The presence or absence of reflux > or = 0.5 s in five deep and three superficial venous segments in each leg was assessed using duplex ultrasound. RESULTS: the prevalence of reflux increased in both superficial and deep segments with more severe grades of trunk varices (p< or = 0.01), except the upper SFV in women. Fifteen per cent of females showed reflux confined to the superficial system, compared with 9% of males (p< or = 0.001); 22% of males showed deep reflux, compared with 11% of females (p < or = 0.001). 71% of men and 48% of women with Grade 2-3 trunk varices had mixed deep and superficial reflux. Above-knee popliteal segments had a higher prevalence of reflux than lower SFV segments in all groups. There was no consistent relationship between the presence of hyphenweb or reticular varices and deep or superficial reflux. CONCLUSION: segmental venous reflux can be detected in the deep and superficial leg veins of subjects without trunk varices, but superficial and mixed reflux are increasingly found in subjects with more severe varices.

Adolescent↗
PubMed1990

Portal vein thrombosis of the adolescent: indications for autologous internal jugular vein interposition meso-caval shunt.

Endoscopic sclerotherapy is now the treatment of first choice for oesophageal varices. However, in spite of its efficiency and safety, recurrent bleeding remains possible and oesophageal sclerosis does not cure other potentially incapacitating symptoms related to portal hypertension. This report describes four adolescents with prehepatic hypertension for whom sclerotherapy was inadequate. They were treated successfully by an autologous internal jugular vein interposition mesocaval shunt. This operation is safe, decompresses the whole splanchnic territory and obviates the need for long term endoscopic surveillance.

Adolescent↗
PubMed2003

Randomized evaluation of polytetrafluoroethylene-covered stent in saphenous vein grafts: the Randomized Evaluation of polytetrafluoroethylene COVERed stent in Saphenous vein grafts (RECOVERS) Trial.

BACKGROUND: Treatment of lesions located in saphenous vein grafts (SVGs) is associated with increased procedural risk and a high rate of restenosis. METHODS AND RESULTS: We conducted a randomized, multicenter trial to evaluate the usefulness of a polytetrafluoroethylene (PTFE)-covered stent compared with a bare stainless steel (SS) stent for prevention of restenosis and major adverse cardiac events (MACE) in patients undergoing SVG treatment. The primary end point was angiographic restenosis at 6 months. Secondary end points were 30-day and 6-month MACE rates, defined as the cumulative of death, myocardial infarction (MI), and target lesion revascularization. Between September 1999 and January 2002, 301 patients with SVG lesions were randomized to either the PTFE-covered JoStent coronary stent graft (PTFE group, n=156) or the SS JoFlex stent (control group, n=145). Angiographic and procedural success rates were similar between the 2 groups (97.4% versus 97.9% and 87.3% versus 93.8%, respectively). The incidence of 30-day MACE was higher in the PTFE group (10.9% versus 4.1%, P=0.047) and was mainly attributed to MI (10.3% versus 3.4%, P=0.037). The primary end point, the restenosis rate at 6-month follow-up, was similar between the 2 groups (24.2% versus 24.8%, P=0.237). Although the 6-month non-Q-wave MI rate was higher in the PTFE group (12.8% versus 4.1%, P=0.013), the cumulative MACE rate was not different (23.1% versus 15.9%, P=0.153). CONCLUSIONS: The study did not demonstrate a difference in restenosis rate and 6-month clinical outcome between the PTFE-covered stent and the SS stent for treatment of SVG lesions. However, a higher incidence of nonfatal myocardial infarctions was found in patients treated with the PTFE-covered stent.

Adult↗
PubMed1997

[En bloc vein resection in the treatment of pancreatic tumors adherent to the superior mesenteric-portal vein confluence].

Contraindication is often considered to pancreaticoduodenectomy for patients with malignant tumors of the pancreatic head. From 1989 through 1995, 15 patients with tumors of the pancreatic head adherent to the superior mesenteric-portal vein confluence (SMPV) underwent pancreaticoduodenectomy with en bloc resection of SMPV. There was no perioperative mortality. Follow-up data showed a mean survival of 17.1 months among 7 deaths, which was significantly longer than an average of 3.8 months among previous 17 patients who abandoned radical resection (P < 0.001). We consider that pancreaticoduodenectomy with en bloc resection of SMPV is feasible in some cases.

Aged↗
PubMed1999

[Spontaneous rupture of the left external iliac vein. A complication of deep vein thrombophlebitis?].

A 52 years old woman was hospitalized on suspicion of left femoral venous thrombosis. Within 24 hours she went into shock, and laparotomy was performed on suspicion of a ruptured abdominal aortic aneurysm. The operative finding was a ruptured iliac vein, which was repaired and anticoagulant treatment was started. Unfortunately the patient never stabilized and died from cardiovascular collapse within 12 hours.

Anticoagulants↗
PubMed1992

[Experimental heterotopic transplantation of the liver with anastomosis of the portal vein to the distal end of the splenic vein].

A model of heterotopic liver transplantation had been studied. The graft was laid under the recipient liver and the portal blood flow was supplied by anastomosis with the distal part of the splenic vein. Both liver can then receive portal blood through two parallel portal circulation. Liver function of transplant was satisfactory at three months after transplantation. Their had been no alteration of the recipient liver during the same period.

Anastomosis, Surgical↗
PubMed1992

[A case of invasive thymoma which had grown in the SVC via left innominate vein through thymic vein].

A 66-year-old male was referred to our department with mediastinal tumor. The chest X-ray and the chest CT showed a large tumor adjacent to pulmonary artery and descending aorta. Cavogram revealed a filling defect of the SVC. He underwent complete resection of the tumor, resection of the SVC and reconstruction of the SVC with ringed PTFE. The main tumor was 12 x 7 cm in size and the tumor in the SVC was 20 x 15 mm in size. Histopathological findings showed a lymphocytic thymoma. Compact invaded nest of tumor cell was found in the innominate vein. The tumor in the SVC was invasive to the intima of the SVC, but its media and adventure were intact. This case is rare among patients with invasive thymoma as far as the growth is concerned.

Aged↗
PubMed1991

[Venous insufficiency following lack of a healthy superficial femoral vein and popliteal vein].

Using the superficial femoral yein in ultimate arterial reconstructive surgery we have not found distinct signs of venous insufficiency concerning the clinical status, the strain gauge plethysmography and the measurement of limb circumference. For special indications the use of the superficial femoral vein presents a valuable addition to our armamentarium of arterial substitutes.

Adult↗
PubMed1991

Bilateral versus unilateral high ligation and stripping of the greater saphenous vein for varicose veins.

The problem of long waiting list of patients for varicose vein surgery may be eased by bilateral operation when both limbs are involved and not in two separate operations as is the practice in many surgical centers. We found that patients undergoing unilateral high ligation and stripping did not differ from patients who had bilateral limb operation in terms of complications, morbidity and length of hospitalization. Most of our patients were released after one day of hospitalization. Therefore, we recommend bilateral operation when there is an indication, rather than two unilateral operations.

Female↗
PubMed1980

Varicose veins. Do not do phlebography unnecessarily; preserve the great saphenous vein!

Phlebography should be performed only on special indications, chiefly for the diagnosis of thrombosis. A non-invasive method such as venous plethysmography is valuable in assessing deep venous insufficiency. Local exstirpation of varices and perforants and percutaneous paired sutures round superficial varices are recommended instead of stripping, as the saphenous vein may be needed for arterial reconstruction in risk groups, e.g. all male smokers. Peripheral arterial pulsations should always be checked to ascertain that the symptoms are not due to arteriosclerotic occlusion.

Humans↗
PubMed1995

A randomized clinical trial of early panretinal photocoagulation for ischemic central vein occlusion. The Central Vein Occlusion Study Group N report.

PURPOSE: To answer whether prophylactic panretinal photocoagulation (PRP) in ischemic central vein occlusion (CVO) prevents development of 2 clock hours of iris neovascularization or any angle neovascularization (TC-INV/ANV) or whether it is more appropriate to apply PRP only when TC-INV/ANV occurs. METHODS: Multicenter randomized controlled clinical trial in eyes with ischemic CVO. Eyes were assigned to immediate prophylactic PRP (90 eyes) or to frequent close observation (91 eyes). If TC-INV/ANV developed, untreated eyes received PRP and previously treated eyes received supplemental PRP. RESULTS: In both groups, TC-INV/ANV developed less often in prophylactically treated than untreated eyes, but the difference was not statistically significant when adjusted for baseline imbalance. Treatment of TC-INV/ANV was followed by prompt regression (within 1 month) in 18 (56%) of 32 previously untreated eyes and in 4 (22%) of 18 eyes that had had prophylactic treatment. All eyes except eight eventually stabilized without neovascularization. TC-INV/ANV was correlated with the amount of nonperfused retina (P = 0.0001) and extent of retinal hemorrhage (P = 0.03). Males were at higher risk than females for TC-INV/ANV (P = 0.01), as were patients with occlusions of less than one month duration (P = 0.01). CONCLUSIONS: Prophylactic PRP does not totally prevent TC-INV/ANV, and prompt regression of TC-INV/ANV in response to PRP is more likely to occur in eyes that have not been treated previously. The authors recommend careful observation with frequent follow-up examinations in the early months (including undilated slit-lamp examination of the iris and gonioscopy) and prompt PRP of eyes in which TC-INV/ANV develops.

Adult↗
PubMed1996

[Video endoscopy-assisted saphenous vein occlusion--minimal invasive concept for treatment of varicose veins].

Videoendoscopy-assisted saphena occlusion (VASO) is an minimally invasive technique for the treatment of varicosis with crossectomy, dissection of perforating veins and occlusion of the saphena by endoscopic control. The advantages are lower level of pain, remobilisation without problems, and fewer complications of wound healing. Early results correspond to stripping.

Endoscopes↗