Frequency of inappropriate endovenous truncal ablation therapy within the vascular quality initiative varicose vein registry.

Quality-of-life outcomes after varicose vein surgery: A 12-month prospective study of 605 patients identifying key prognostic factors.

Early Outcomes of Four-Layer Compression Therapy in Chronic Venous Ulcers: A Two-Year Prospective Study in Resource Limited Setting.

Cost-Effectiveness of the VenoValve versus Compression Therapies and Wound Care for Treatment of Infra-inguinal Deep Vein Reflux.

Pelvic venous disease (PeVD) and lymphedema are traditionally regarded as distinct clinical entities and are usually investigated and managed within separate clinical frameworks. However, both conditions may coexist in patients with chronic edema, raising the question of whether a venous-lymphatic interaction contributes to chronic edema and whether such a relationship is supported by current evidence. A systematic-style review was performed of published literature on pelvic venous disorders, chronic venous disease, and lymphatic dysfunction. Evidence relating to pelvic venous reflux, central venous obstruction, lymphatic pathophysiology, imaging, and treatment outcomes was critically evaluated, with explicit distinction between established evidence, indirect associations, and hypotheses. The evidence base consists predominantly of observational studies and systematic or narrative reviews. Across published cohorts and reviews, the predominant reported outcome measure for reflux-dominant pelvic venous disease is pelvic pain, with pain improvement reported in approximately 70-80% of patients following embolization. In contrast, the predominant reported outcome measure for obstruction-dominant pelvic venous disease is edema, with subjective improvement reported in approximately 60% of patients following iliocaval with or without caval venous stenting, although edema outcomes are rarely quantified and are not distinguished from lymphedema in the available literature. Objective lymphatic dysfunction is frequently reported in advanced chronic venous disease, but pelvic venous pathology has not been systematically evaluated in relation to lymphatic dysfunction or lymphatic assessment. Current evidence does not establish a causal relationship between pelvic venous disease and lymphedema. While venous-lymphatic interaction is biologically plausible, the proposed surgical continuum should be regarded as hypothesis-driven rather than evidence-based. Routine pelvic venous intervention for lymphedema cannot be justified based on existing data, highlighting the need for integrated prospective studies combining venous and lymphatic assessment.

Background: Endovenous ablation methods are commonly used to treat great saphenous vein (GSV) insufficiency. However, great saphenous vein is also a valuable resource in vascular surgery. Therefore, it is important to perform minimal saphenous ablation. The aim of the study was to determine the optimal length of saphenous ablation in treatment. Patients and methods: This retrospective study was performed by measuring preoperative and postoperative venous haemodynamic parameters using plethysmography in 614 patients who required endovenous ablation. Only the segment of great saphenous vein was ablated, where the diameter was superior to 5.5 mm in standing position, starting 1 cm below the saphenofemoral junction. Patients were divided into four groups based on the length of the ablated saphenous vein at the end of 12- month. The study aimed to investigate the optimum length of ablation in dilated and insufficient GSV to preserve the GSV and improve venous haemodynamics. Results: The Mage of 614 patients included in the study was 55.78 ± 15.27 years, of which 379 (61.7%) were female and 235 (38.3%) were male. A statistically significant improvement was observed in the haemodynamic values measured by plethysmography after Endo Venous Laser Ablation (p < .001). However, no statistically significant difference was found between the groups of different lengths in terms of these variables. Conclusions: Endo Venous Laser Ablation effectively treats great saphenous vein insufficiency. To protect the saphenous vein, ablation of only 10 cm from the junction of the saphenous vein may improve venous haemodynamics and reduce patient complaints. Strain gauge-venous occlusion plethysmography and similar methods can be used in conjunction with Doppler ultrasonography to assess venous haemodynamics and determine the optimal treatment.

Previous researchers have mainly examined the general recovery of patients with chronic venous disease after iliac vein stent placement for iliac vein compression syndrome. However, little is known about the specific challenges faced by patients who remain in an unresolved postoperative recovery phase after stenting. In this study, we aimed to explore the challenges faced by patients with chronic venous disease during unresolved postoperative recovery after iliac vein stenting. A descriptive phenomenological design was employed. Purposive sampling was used to recruit 12 patients from a teaching hospital in Taiwan. Semistructured interviews were conducted between January 2024 and July 2025, and the data were analyzed using Colaizzi's 7-step method with NVivo-assisted coding. Findings indicated that patients with iliac vein compression syndrome experienced a central phenomenon of internalized distress. Four major themes emerged: (1) severe physical discomfort and restricted mobility, reflecting persistent and unpredictable symptoms; (2) resigned endurance, with suppressed distress until nearing emotional breakdown; (3) feeling trapped and regretful, leading to delayed but urgent help-seeking; and (4) breaking free from constraints and regaining physical control, achieved through self-soothing and behavioral adjustments. Patients with unresolved recovery from chronic venous disease after iliac vein stenting experience multidimensional distress that extends beyond physical symptoms. These findings underscore the importance of postoperative care that integrates continuous psychological support, culturally sensitive communication, and proactive follow-up. Developing personalized tools to assess well-being and guide tailored interventions may enhance recovery outcomes in this vulnerable population.

Thermal versus Non-thermal Ablation for Treatment of Great Saphenous Veins in Patients with Lower Extremity Superficial Venous Disease.

An arteriovenous fistula (AVF) is the preferred permanent vascular access for long-term hemodialysis (HD) in patients with chronic kidney disease (CKD). Once adequately matured, an AVF provides usability over a long period of time. However, in rare cases, patients may develop fistula dysfunction accompanied by forearm swelling and/or signs of tissue injury with ischemic features in the setting of venous hypertension. This report presents three cases of patients with wrist AVFs who developed forearm venous hypertension and hand ulcers secondary to venous occlusion in the proximal forearm, an uncommon etiology of hand ischemia. These cases highlight the importance of a comprehensive clinical evaluation and timely intervention to alleviate symptoms while preserving vascular access integrity.

Comparison of venous morphology, chronic venous disease stage and venous symptoms in high-impact activities versus low-impact activities.

To describe the technical feasibility and early clinical outcomes of basilic vein to fistula outflow vein transposition as an autogenous salvage option for malfunctioning forearm arteriovenous fistulas (AVFs) with venous outflow obstruction at the elbow level and a patent basilic vein. This single-center retrospective technical note reviewed nine patients who underwent basilic vein to fistula outflow vein transposition between December 2023 and March 2026. Clinical indications, reasons for selecting surgical transposition over further endovascular treatment, operative details, time to postoperative dialysis use, complications, reinterventions, and individual access outcomes were summarized descriptively. The mean age was 67.8 ± 7.2years; seven patients were male. Hypertension was present in all patients and diabetes mellitus in two patients. The main clinical triggers for intervention were venous hypertension during hemodialysis, thrombotic occlusion of the cephalic outflow vein, and inadequate dialysis blood flow. The mean preoperative basilic vein diameter was 2.0 ± 0.28mm. After reconstruction, all patients had restoration of a normal access thrill and resolution of abnormal fistula pulsatility, while intradialytic venous hypertension improved compared with the preoperative status. All AVFs were successfully used for hemodialysis within 48h after surgery. Two patients had wound hemorrhage that resolved after bedside management. During follow-up, five patients required reintervention for restenosis, including PTA and open thrombectomy. No early thrombosis, hematoma, nerve injury, wound infection, clinically significant steal syndrome, or access abandonment occurred during the available follow-up. In patients with a functioning forearm AVF, preserved arterial inflow, elbow-level venous outflow obstruction, and a suitable basilic vein, basilic vein-to-fistula outflow vein transposition may represent a practical autogenous salvage option. These findings should be interpreted as preliminary technical experience.

BackgroundStasis dermatitis with hyperpigmented skin lesions is a distressing condition for patients with chronic venous hypertension. There are no randomized studies evaluating lasers for the treatment of these patients. Lasers can be an attractive option for treating hyperpigmentation associated with stasis dermatitis.MethodsThis prospective, randomized, 3-arm, open-label, vehicle-controlled study will enroll patients scheduled to undergo treatment for stasis dermatitis with hyperpigmented skin lesions. Patients will be allocated to either Q-switched Nd: YAG 1064nm short-pulse nanoseconds, Nd: YAG 1064nm ultra-short-pulse picoseconds, or cold cream vehicle control. All treatments are scheduled for six visits with pre-defined dates, with a final follow-up visit at 28- to 35-days intervals. Primary outcomes include colorimetry analysis, secondary outcomes pre- and post-photographic analysis, and DLQI quality-of-life assessment.ConclusionsThe results of this trial will provide high-quality evidence to guide clinical practice on optimal management of hyperpigmented skin lesions secondary to stasis dermatitis.

Effectiveness of micronized purified flavonoid fraction in early-stages chronic venous disease - CEAP C0s/C1: A systematic review and meta-analysis.

Glucagon-Like Peptide-1 Receptor Agonists are Associated with Fewer Venous Thromboembolic Events and Limb Complications in Obese Patients with Chronic Venous Insufficiency.

Lower extremity artery disease (LEAD), abdominal aortic aneurysm (AAA), and chronic venous disease (CVD) are frequently underdiagnosed vascular conditions that contribute significantly to morbidity, mortality, and diminished quality of life, representing a considerable public health burden. The discovery of novel molecular biomarkers is crucial to improving early diagnosis, enabling accurate risk stratification, uncovering disease mechanisms, and facilitating the development of targeted therapies.This study aimed to investigate alterations in small nuclear RNAs (snRNAs) in peripheral blood mononuclear cells (PBMCs) of patients with LEAD, AAA, and CVD. The snRNA expression profiles were analyzed using snRNA-seq data and the DESeq2 package. In parallel, miRNA-seq data were used to identify differentially expressed microRNAs (miRNAs) associated with snRNA dysregulation.Using a strict selection criterion, we identified 4 (RNU6-4P, RNU6-18P, RNU6-36P, and RNU2-48P) and 2 (RNVU1-19 and RNU1-146P) dysregulated snRNAs in patients with LEAD and CVD, respectively. Three miRNA-snRNA interactions involving miRNAs differentially expressed in these diseases were identified and confirmed in silico using the IntaRNA platform. Genetic variants located within dysregulated snRNAs indicate a potential functional association between selected snRNAs and vascular biology, particularly in relation to platelet function, blood pressure regulation, and smoking.Obtained findings underscore the potential of snRNAs as novel biomarkers and offer insights into their possible involvement in the vascular pathophysiological mechanisms underlying LEAD and CVD.

Purpose: Venous leg ulcers are chronic wounds that are associated with chronic venous insufficiency, which significantly reduces the quality of life in elderly residents and increases the risk of infection and the need for prolonged care. Case Report: We present a case involving an 82-year-old female resident of a long-term care facility with a venous leg ulcer on the left leg. Treatment was administered from April to December 2024 and included wound management according to modern care principles (tissue care, infection/inflammation control, moisture management, and epithelialisation support [TIME]), nursing care planning based on activities of daily living, and multidisciplinary collaboration. Complete wound healing with full granulation and epithelialisation was achieved through individualised local care of the chronic wound, effective exudate management, inflammation and exudate control, nutritional support, appropriate analgesia, and gradual mobilisation as part of physical therapy. At the conclusion of treatment, the pain had resolved, sleep had improved, the fear of limb amputation had decreased, and her psychological well-being had improved. Conclusion: Comprehensive, continuous, and interdisciplinary care of an elderly resident with a venous leg ulcer in an institutional setting can lead to successful healing with appropriate dressing selection, compression therapy, inflammation control, and support with activities of daily living. Key factors for a favourable outcome include realistic goal setting, regular evaluation of treatment progress, and empowerment of the resident and the family.

Wound care dressing selection requires careful consideration of both exudate management capabilities and effectiveness in protecting adjacent skin. The ability to sustain a therapeutic, moisture-balanced wound environment that minimises pain and safeguards periwound integrity is essential for healing. A product evaluation was conducted to measure the effectiveness of the Sol-Care™ Dressings (Sol-Millennium Medical) in managing various wound presentations. Outcomes were evaluated based on: exudate management; protection of the periwound skin; and improvement in outcomes. The Sol-Care™ Dressings were found to control exudate and maintain periwound skin integrity effectively in complex wound types: an ischaemic ulcer; a chronic venous insufficiency wound; and a venous malleolar ulcer presenting with high exudate levels and maceration risk. The case studies demonstrated that these dressings prevented periwound maceration, improved patient comfort and supported favourable wound progression, including when applied as a primary dressing and combined with compression therapy. This evaluation shows how dressing selection influences patient outcomes and underscores the significance of key product attributes in evidence-based wound management.

Network Meta-Analysis of Randomized Controlled Trials Evaluating Long-Term Outcomes of Interventional Approaches for Great Saphenous Vein Insufficiency.

Chronic venous disease (CVD) is characterized by progressive venous wall remodeling, extracellular matrix dysregulation, and chronic inflammation. MicroRNAs (miRNAs) regulate vascular processes, but their expression in human venous tissue across disease stages remains incompletely defined. We evaluated global miRNA expression in great saphenous veins across CVD severity. In this cross-sectional pilot study, paraffin-embedded vein samples were obtained from patients with CVD and classified according to CEAP criteria into early-stage (C2-C3; G1) and advanced-stage (C4-C5; G2). Vein segments from patients without venous reflux undergoing arterial revascularization served as controls. Global miRNA expression profiling was performed using the GeneChip® miRNA 4.0 Array with multiple-testing correction. Direct statistical comparison between G1 and G2 was not performed. Twenty-seven samples were analyzed (6 controls, 12 G1, 9 G2). A total of 155 miRNAs were significantly dysregulated in CVD compared with controls. Most miRNAs were detected in both G1 and G2 comparisons, whereas 36 were identified only in the G1 vs control comparison, and two (hsa-miR-7977 and hsa-miR-23a-5p) only in the G2 vs control comparison. miRNA profiling suggests stage-associated expression patterns in human saphenous veins, indicating early molecular remodeling during CVD progression. These findings are exploratory and require independent validation.

Incompetent perforator veins (IPVs) are a critical driver of refractory venous leg ulcers (VLUs). Guideline-endorsed endovenous thermal ablation techniques face substantial implementation barriers due to high device costs and incompatibility with value-based payment models, creating a significant treatment gap. This report introduces Percutaneous Ablation of Perforator Veins using Electrocoagulation (PAPS-PEC)-a novel adaptation of the PAPS principle that leverages ubiquitous electrosurgical equipment to offer a safe, effective, and economically sustainable solution. We present PAPS-PEC application in a 68-year-old male with a recurrent VLU (30×50 mm, CEAP C6) subtended by two IPVs. The office-based procedure was performed under local anesthesia. An 18-gauge electrosurgical needle was guided into each IPV to deliver targeted direct-current energy (10 W, 15 s per quadrant), achieving immediate occlusion confirmed by intraprocedural sonography. The procedure was well-tolerated with no adverse events. Complete ulcer re-epithelialization was achieved at 3 months. At one year, duplex ultrasound confirmed sustained IPV occlusion with no ulcer recurrence. The patient's clinical status improved markedly, with the Venous Clinical Severity Score (VCSS) decreasing from 14 to 4 and the CIVIQ-14 score from 50 to 22. PAPS-PEC is a safe, effective, and exceptionally cost-effective office-based modality for treating IPV-related VLUs. By repurposing existing technology, it directly addresses the economic and accessibility barriers of current standards. These promising findings warrant larger prospective studies to validate its role as a standard-of-care option in managing advanced chronic venous insufficiency, especially in resource-constrained settings.