Journal of vascular surgery
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Ultrasound-guided foam sclerotherapy is a generally safe, cost-effective, and practical technique for the treatment of certain venous malformations; however, not all vascular malformation lesions are amenable to the ultrasound-guided method. Venous outflow of the sclerosing agent and extravasation are difficult to check when only ultrasound guidance is used. This study describes a new fluoroscopy-guided technique that uses standardized sclerosing foam for peripheral venous malformations. The short-term efficacy and safety of fluoroscopy-guided foam sclerotherapy for peripheral venous malformations was evaluated. ⋯ Fluoroscopic guidance could have great promise in foam sclerotherapy of peripheral venous malformations, although larger studies are necessary to determine the advantages of this technique over other sclerotherapeutic methods.
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Comparative Study
Decrease in total aneurysm-related deaths in the era of endovascular aneurysm repair.
With the expansion of elective abdominal aortic aneurysm (AAA) repair after the introduction of endovascular aneurysm repair (EVAR), there is a concern that even with a lower operative mortality there could be an increasing number of aneurysm-related deaths. To evaluate this, we looked at national trends in AAA repair volume as well as mortality rates after intact and ruptured AAA repair encompassing the introduction of EVAR. ⋯ Since the introduction of EVAR, the annual number of deaths from intact and ruptured AAA has significantly decreased. This coincided with an increase in intact AAA repair after the introduction of EVAR and a decrease in ruptured AAA diagnosis and repair volume.
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Comparative Study
Surgical intervention for thoracic outlet syndrome improves patient's quality of life.
To assess long-term quality of life outcomes in patients following transaxillary first-rib resection and scalenectomy for thoracic outlet syndrome (TOS). ⋯ The use of the SF-12 and DASH instruments in patients with TOS demonstrated significant improvement in patients postoperatively. Venous TOS patients typically improved both physical and mental scores in shorter periods of time than their neurogenic counterparts. Neurogenic and venous TOS patients returned to full-time work/activity within the same length of time postoperatively. However, neurogenic patients required more secondary interventions. We conclude that in appropriately selected patients with either neurogenic or venous TOS, surgical intervention can improve their quality of life over time.
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To describe the success of diverse recruitment methods in a randomized controlled clinical trial of exercise in persons with peripheral arterial disease (PAD). ⋯ Most participants in a randomized controlled trial of exercise were recruited from newspaper advertising and mailed recruitment letters to patients with known PAD. The highest randomization rates after a baseline visit occurred among participants identified from posted flyers and mailed recruitment letters to PAD patients.