Journal of vascular surgery. Venous and lymphatic disorders
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J Vasc Surg Venous Lymphat Disord · Jan 2022
Vascularized Lymph Node Transfer for Surgical Treatments of Upper Versus Lower Extremity Lymphedema.
The purpose of this study was to compare clinical outcomes after vascularized lymph node transfer (VLNT) for the treatment of lymphedema performed on the upper and lower extremities. ⋯ These results demonstrate that VLNT may be effective in treating patients with advanced-stage lymphedema. However, patients with upper extremity lymphedema demonstrate superior outcomes compared with those with lower extremity lymphedema.
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J Vasc Surg Venous Lymphat Disord · Nov 2021
Deep vein thrombosis and pulmonary embolism among hospitalized coronavirus disease 2019-positive patients predicted for higher mortality and prolonged intensive care unit and hospital stays in a multisite healthcare system.
We assessed the incidence of deep vein thrombosis (DVT) and pulmonary embolism (PE) in hospitalized patients with coronavirus disease 2019 (COVID-19) compared with that in a matched cohort with similar cardiovascular risk factors and the effects of DVT and PE on the hospital course. ⋯ A significantly greater incidence of DVT/PE occurred in hospitalized COVID-19-positive patients compared with a non-COVID-19 cohort matched for cardiovascular risk factors. Patients affected by DVT/PE were more likely to experience greater mortality, to require ICU admission, and experience prolonged ICU stays and LOH compared with COVID-19-positive patients without DVT/PE. Advancements in DVT/PE prevention are needed for patients hospitalized for COVID-19 infection.
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J Vasc Surg Venous Lymphat Disord · Sep 2021
Surgical management of post-thrombotic syndrome in chronic venous thoracic outlet syndrome.
Venous thoracic outlet syndrome (VTOS) is considered chronic when symptoms and venous stenosis or occlusion are present for >3 months after the initial primary upper extremity deep vein thrombosis event. Many of patients with chronic VTOS receive conservative treatment. However, a subset of these patients will have persistent post-thrombotic syndrome symptoms because of underlying causative anatomy. We present the results of a same admission treatment consisting of' transaxillary thoracic outlet decompression (TA-TOD), external venolysis, and, if necessary, treatment of residual intraluminal lesions with percutaneous transluminal angioplasty (PTA) for chronic VTOS. ⋯ The treatment of patients with chronic VTOS using a same admission treatment algorithm consisting of TA-TOD, external venolysis, and PTA is effective. Intermediate follow-up showed a high return to daily activity and significant improvement in functional outcome and physical QOL.
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J Vasc Surg Venous Lymphat Disord · Sep 2021
Review Meta AnalysisIncidence, prognosis, and laboratory indicators of venous thromboembolism in hospitalized patients with coronavirus disease 2019: a systematic review and meta-analysis.
We have summarized the incidence, anticoagulation panels, laboratory characteristics, and mortality of venous thromboembolism (VTE) in hospitalized patients with coronavirus disease 2019 (COVID-19). ⋯ The occurrence of VTE, DVT, and pulmonary embolism has been substantial among hospitalized patients with COVID-19, especially among those with severe COVID-19. Patients with severe COVID-19 and VTE had significantly greater mortality compared with similar patients without VTE. An increased D-dimer level might be an indicator of the occurrence of VTE in patients with COVID-19.
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J Vasc Surg Venous Lymphat Disord · Sep 2021
Virtual reality can reduce anxiety during office-based greater saphenous vein radiofrequency ablation.
Office-based treatment of venous pathology is common and frequently involves the use of anxiolytic medication to reduce anxiety. Virtual reality (VR) has been shown to effectively reduce pain and anxiety in a variety of settings. The objective of the present study was to determine whether VR could be smoothly integrated into office-based vascular procedures and to ascertain whether VR could reduce procedural pain or anxiety. ⋯ VR can be safely and efficiently integrated into office-based vascular procedures. VR was generally well liked and recommended by those who used it. Most importantly, our findings suggest that VR can decrease procedural anxiety. Further research should examine whether this might obviate the need for anxiolytic medication.