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Sample records for recanalized paraumbilical vein

  1. Recanalized umbilical vein in portal hypertension.

    PubMed

    Aagaard, J; Jensen, L I; Sørensen, T I; Christensen, U; Burcharth, F

    1982-12-01

    Experience with splenoportography suggests that patency of the umbilical vein occurs in about 9% of the patients with portal hypertension. A widely patent umbilical vein might serve as a decompressive portosystemic shunt. Percutaneous transhepatic portography was performed in 107 patients with cirrhosis of the liver and portal hypertension. A patent umbilical vein was found in 28 patients (26%). This finding significantly paralleled the number and size of other collateral veins, apart from gastroesophageal varices. No significant relation was found between umbilical vein patency and portal pressure, extrahepatic shunting, variceal bleeding, or ascites. It is concluded that a large patent umbilical vein does not effectively relieve portal hypertension, prevent gastroesophageal varices, or protect against variceal bleeding or ascites. PMID:6983253

  2. Transjugular Endovascular Recanalization of Splenic Vein in Patients with Regional Portal Hypertension Complicated by Gastrointestinal Bleeding

    SciTech Connect

    Luo, Xuefeng; Nie, Ling; Wang, Zhu; Tsauo, Jiaywei; Tang, Chengwei; Li, Xiao

    2013-05-02

    PurposeRegional portal hypertension (RPH) is an uncommon clinical syndrome resulting from splenic vein stenosis/occlusion, which may cause gastrointestinal (GI) bleeding from the esophagogastric varices. The present study evaluated the safety and efficacy of transjugular endovascular recanalization of splenic vein in patients with GI bleeding secondary to RPH.MethodsFrom December 2008 to May 2011, 11 patients who were diagnosed with RPH complicated by GI bleeding and had undergone transjugular endovascular recanalization of splenic vein were reviewed retrospectively. Contrast-enhanced computed tomography revealed splenic vein stenosis in six cases and splenic vein occlusion in five. Etiology of RPH was chronic pancreatitis (n = 7), acute pancreatitis with pancreatic pseudocyst (n = 2), pancreatic injury (n = 1), and isolated pancreatic tuberculosis (n = 1).ResultsTechnical success was achieved in 8 of 11 patients via the transjugular approach, including six patients with splenic vein stenosis and two patients with splenic vein occlusion. Two patients underwent splenic vein venoplasty only, whereas four patients underwent bare stents deployment and two covered stents. Splenic vein pressure gradient (SPG) was reduced from 21.5 ± 7.3 to 2.9 ± 1.4 mmHg after the procedure (P < 0.01). For the remaining three patients who had technical failures, splenic artery embolization and subsequent splenectomy was performed. During a median follow-up time of 17.5 (range, 3–34) months, no recurrence of GI bleeding was observed.ConclusionsTransjugular endovascular recanalization of splenic vein is a safe and effective therapeutic option in patients with RPH complicated by GI bleeding and is not associated with an increased risk of procedure-related complications.

  3. Sharp Recanalization for Chronic Left Iliac Vein Occlusion

    SciTech Connect

    Ito, Nobutake Isfort, Peter; Penzkofer, Tobias; Grommes, Jochen; Greiner, Andreas; Mahnken, Andreas

    2012-08-15

    Endovascular treatment has emerged as a first-line treatment for venous occlusions, but is sometimes challenging with conventional approaches. This article describes a helpful technique using a Roesch-Uchida needle to cross a chronic occlusion of the iliac vein when conventional techniques have failed.

  4. Short-Term Anticoagulant Therapy and Thrombus Location Are Independent Risk Factors for Delayed Recanalization of Deep Vein Thrombosis.

    PubMed

    Zhang, Chuanlin; Fu, Qining; Zhao, Yu; Mu, Shaoyu; Liu, Liping

    2016-01-01

    BACKGROUND Prompt recanalization of the vein containing the thrombus is an important goal during the initial treatment of DVT, and risk factors for delayed recanalization in patients with deep vein thrombosis (DVT) in the lower extremities need to be determined. MATERIAL AND METHODS A total of 174 patients with DVT in lower extremities were recruited from June 2014 to March 2015 at our hospital. Duplex ultrasound scanning was conducted for all patients at 1 and 6 months after baseline evaluation. We divided the patients into recanalization and non-recanalization groups and analyzed risk factors for delayed recanalization. RESULTS The univariate analysis revealed that an oral anticoagulant time of less than 3 months and venous thrombus location were risk factors for delayed recanalization (P<0.01). However, age, gender, hypertension, diabetes, pulmonary embolism, incidence factors, the use of catheter-directed thrombolytic (CDT) drugs, and inferior vena cava filter (IVCF) implantation had no influence on the incidence of delayed recanalization in patients with DVT (P>0.05). The multivariate analysis showed that patients with an anticoagulant time of less than 3 months had a lower incidence of recanalization than those with an anticoagulant time of more than 3 months (OR=2.358, P<0.05). The risk of delayed recanalization in patients with proximal DVT was 7 times higher than that in patients with distal DVT. CONCLUSIONS Duration of anticoagulant treatment of less than 3 months and venous thrombus location are independent risk factors for delayed recanalization of DVT in the lower extremities. PMID:26790571

  5. Short-Term Anticoagulant Therapy and Thrombus Location Are Independent Risk Factors for Delayed Recanalization of Deep Vein Thrombosis

    PubMed Central

    Zhang, Chuanlin; Fu, Qining; Zhao, Yu; Mu, Shaoyu; Liu, Liping

    2016-01-01

    Background Prompt recanalization of the vein containing the thrombus is an important goal during the initial treatment of DVT, and risk factors for delayed recanalization in patients with deep vein thrombosis (DVT) in the lower extremities need to be determined. Material/Methods A total of 174 patients with DVT in lower extremities were recruited from June 2014 to March 2015 at our hospital. Duplex ultrasound scanning was conducted for all patients at 1 and 6 months after baseline evaluation. We divided the patients into recanalization and non-recanalization groups and analyzed risk factors for delayed recanalization. Results The univariate analysis revealed that an oral anticoagulant time of less than 3 months and venous thrombus location were risk factors for delayed recanalization (P<0.01). However, age, gender, hypertension, diabetes, pulmonary embolism, incidence factors, the use of catheter-directed thrombolytic (CDT) drugs, and inferior vena cava filter (IVCF) implantation had no influence on the incidence of delayed recanalization in patients with DVT (P>0.05). The multivariate analysis showed that patients with an anticoagulant time of less than 3 months had a lower incidence of recanalization than those with an anticoagulant time of more than 3 months (OR=2.358, P<0.05). The risk of delayed recanalization in patients with proximal DVT was 7 times higher than that in patients with distal DVT. Conclusions Duration of anticoagulant treatment of less than 3 months and venous thrombus location are independent risk factors for delayed recanalization of DVT in the lower extremities. PMID:26790571

  6. Recanalization of an Occluded Infrainguinal Vein Graft Complicated by Graft Aneurysm

    SciTech Connect

    Kakani, Nirmal; Travis, Simon; Hancock, John

    2007-11-15

    The technique of subintimal angioplasty has been described for the recanalisation of native vessels after occlusion of infrainguinal vascular bypass grafts. We report a case in which an attempt at such treatment resulted in inadvertent but successful recanalisation of the occluded vein graft instead. This was complicated by graft perforation and subsequent graft aneurysm which was successfully treated with a covered stent.

  7. CT-angiographic correlation of collateral venous pathways in isolated splenic vein occlusion: new observations.

    PubMed

    Marn, C S; Glazer, G M; Williams, D M; Francis, I R

    1990-05-01

    The computed tomographic (CT) findings in 18 patients with angiographically proved, isolated splenic vein occlusion (SVO) were retrospectively analyzed. The distribution of venous collateral vessels and the frequency of their occurrence in these patients were then compared with CT findings in 17 patients with proved portal hypertension and normal CT findings in 20 patients. Short gastric and coronary collateral vessels were seen in 61% and 83%, respectively, of patients with SVO and in 71% each in patients with portal hypertension. However, a large gastroepiploic vein was seen only in patients with SVO (11 of 18 patients [61%]). Recanalization of umbilical/paraumbilical veins was seen only in patients with portal hypertension (seven of 17 patients [41%]). Results suggest that collateral vessels in SVO often have a characteristic and distinctive appearance on abdominal CT scans. PMID:2326463

  8. Successful portal-systemic shunt occlusion of a direct shunt between the inferior mesenteric vein and inferior vena cava with balloon-occluded retrograde transvenous obliteration following recanalization after placing a covered stent in the portal and superior mesenteric veins.

    PubMed

    Hayashi, Sadao; Baba, Yasutaka; Senokuchi, Terutoshi; Ueno, Kazuto; Nakajo, Masayuki

    2009-05-01

    Extrahepatic portal-systemic shunts cause portal-systemic encephalopathy. Direct communication between the inferior mesenteric vein (IMV) and the inferior vena cava (IVC) is a relatively rare pathway among the variety of portal-systemic shunts. This report describes a case of successful occlusion of an IMV-IVC shunt. Based on laboratory data and computed tomography findings, a 69-year-old woman with liver cirrhosis was diagnosed with portal-systemic encephalopathy due to a shunt between the IMV and the IVC. Her hepatic coma had not been adequately controlled by oral or intravenous pharmacotherapy. First, we placed a covered stent in the main trunk of the portal vein and the superior mesenteric vein (SMV) to block the SMV hepatofugal flow and splenic vein hepatopetal flow, but this therapy showed only a transient therapeutic effect due to recanalization. Next, we performed balloon-occluded retrograde transvenous obliteration (BRTO) of the portal-systemic shunt. After the BRTO, she has had no episodes of portal-systemic encephalopathy for 2 years. PMID:19499309

  9. Time course and the recanalization rate of superficial vein thrombosis treated with low-molecular-weight heparin.

    PubMed

    Spirkoska, Ana; Jezovnik, Mateja Kaja; Poredos, Pavel

    2015-04-01

    The aim of this study was to follow the thrombus progression and regression in superficial veins of lower limbs in patients with superficial vein thrombosis (SVT) treated with low-molecular-weight heparin. Patients (n = 68) with a first symptomatic SVT of the lower limbs received 2 different dosages of dalteparin. The primary outcome was a change in the diameter and length of thrombus in the affected veins. The regression of thrombus was not significantly different between the groups (P = .19). The reduction in the length of thrombus as well as thrombus diameter was significantly greater in females. At the end of the observation period, the length of thrombus in the distal part was more reduced than in the proximal segments. It seems that the dosage of anticoagulant drug does not have a significant impact on thrombus resolution. PMID:24807875

  10. Treatment of an Unusual Complication of Endovenous Laser Therapy: Multiple Small Arteriovenous Fistulas Causing Complete Recanalization

    SciTech Connect

    Yildirim, Erkan; Saba, Tonguc Ozulku, Mehmet; Harman, Ali Aytekin, Cuneyt Boyvat, Fatih

    2009-01-15

    A 67-year-old woman was admitted to our institution with pain, night cramping, and visible varicose veins on her left leg. Doppler ultrasonography revealed continuous reflux in the great saphenous vein when the patient did the Valsalva maneuver. Endovenous laser therapy was applied to the great saphenous vein. Doppler ultrasonography 7 days later showed recanalization of, and arterialized flow in, the great saphenous vein. There also were small arterial vessels adjunct to the recanalized side. A left femoral angiography via a right femoral approach showed multiple small arteriovenous fistulas between superficial femoral artery muscle branches and the great saphenous vein. A second endovenous laser treatment was done at 80 J/cm, but the recanalization persisted. We offered to treat this endovascularly, but the patient preferred a surgical option. To the best of our knowledge, this is the first report of the demonstration of such a complication with endovenous laser therapy.

  11. Sharp Central Venous Recanalization by Means of a TIPS Needle

    SciTech Connect

    Honnef, Dagmar Wingen, Markus; Guenther, Rolf W.; Haage, Patrick

    2005-06-15

    The purpose of this study was to perform an alternative technique for recanalization of a chronic occlusion of the left brachiocephalic vein that could not be traversed with a guidewire. Restoration of a completely thrombosed left brachiocephalic vein was attempted in a 76-year-old male hemodialysis patient with massive upper inflow obstruction, massive edema of the face, neck, shoulder, and arm, and occlusion of the stented right brachiocephalic vein/superior vena cava. Vessel negotiation with several guidewires and multipurpose catheters proved unsuccessful. The procedure was also non-viable using a long, 21G puncture needle. Puncture of the superior vena cava (SVC) at the distal circumference of the stent in the right brachiocephalic vein/superior vena cava, however, was feasible with a transjugular intrahepatic portosystemic shunt (TIPS) set under biplanar fluoroscopy using the distal end of the right brachiocephalic vein as a target, followed by balloon dilatation and partial extraction of thrombotic material of the left brachiocephalic vein with a wire basket. Finally, two overlapping stents were deployed to avoid early re-occlusion. Venography demonstrated complete vessel patency with free contrast media flow via the stents into the SVC, which was reconfirmed in follow-up examinations. Immediate clinical improvement was observed. Venous vascular recanalization of chronic venous occlusion by means of a TIPS needle is feasible as a last resort under certain precautions.

  12. [Laser angioplasty and recanalization].

    PubMed

    Haude, M; Welge, D; Koch, L; Roth, T; Ge, J; Baumgart, D; Erbel, R

    1997-12-01

    Percutaneous transluminal coronary balloon angioplasty (PTCA) still is the most frequently applied interventional technique for treatment of coronary artery disease. Plastic deformation of the obstructive plaque with creation of splits, intimal tears and dissections is the main mechanism of PTCA for lumen widening. As a result, acute complications due to flow limiting dissections and acute vessel closure can unpredictably occur resulting in myocardial infarction, urgent bypass surgery and death. Furthermore, long-term success of PTCA is limited by restenosis. In order to overcome these limitations of PTCA, alternative interventional techniques were developed, which instead of deforming the obstructive plaque ablate this tissue. These techniques include high and low speed rotational angioplasty, directional atherectomy, the transluminal extraction catheter, ultrasound angioplasty and laser (Light Amplification by Stimulated Emission of Radiation) angioplasty. 308 nm XeCl excimer laser angioplasty today is the laser technique of choice for clinical application. This pulsed laser requires direct contact to the obstructive plaque. It creates fast (< 200 microseconds) expanding gas bubbles which induce plaque ablation. Main indications for 308 nm XeCl excimer laser angioplasty are diffuse and long coronary lesions and total coronary occlusions. Despite promising initial results this technique showed no better acute and long-term results in comparison to PTCA for the treatment of these types of lesions ("Amsterdam-Rotterdam" Study, "Excimer Rotational Balloon Angioplasty Comparison" Study). As a result, this interventional technique was rarely applied for patient treatment. More recently, the concept of plaque ablation by 308 nm XeCl excimer laser angioplasty was renewed for the treatment of in-stent restenosis. This indication is being investigated in the "Laser Angioplasty of Restenosed Stents" trial. First results document the practicability and safety of this approach. Long-term results are awaited. With ongoing miniaturization, laser guidewires were developed for the recanalization of chronic total occlusions. The randomized multicenter "Total Occlusion Trial with Angioplasty assisted by Laser guidewire "Study documented a success rate of laser wire recanalization in up to 66% in contrast to 47.5% for mechanical wires only. Long-term results are still awaited. Technical and procedural progress including saline flush during laser application, homogeneous light distribution and the concept of smooth laser ablation is pushed foreward to make excimer laser angioplasty safer, more predictable and more effective. PMID:9483435

  13. Paraumbilical fat graft for the correction of contour deformity following parotidectomy and prevention of Frey syndrome.

    PubMed

    Balasundaram, I; Nasser, N A

    2016-03-01

    Following parotidectomy, patients develop retromandibular hollowing. A case series of patients for whom a free paraumbilical graft was used to reconstruct the parotid bed defect is presented here. This graft is harvested through a supra/sub-umbilical or suprapubic incision. Over-correction of approximately 50% is required due to atrophy and resorption with time. The graft is harvested with the overlying dermis and the graft should not be filleted, as this can cause necrosis. An antibiotic membrane is placed between the graft and the underlying bed and the graft is secured with Vicryl sutures. Since 1997, 130 patients have been treated successfully with this method. Regarding complications, nine patients developed a seroma, four developed a haematoma, two suffered graft liquefaction, and one suffered an infection with frank suppuration and loss of the graft. However, no complications have been noted in the most recent 70 patients. The incidence of Frey syndrome also appeared to be reduced. The paraumbilical fat graft appears to be a successful and reliable method of correcting facial defects after a superficial or total parotidectomy. The graft can also be used to correct temporal defects and has the added advantage of reducing Frey syndrome. PMID:26439758

  14. Recanalization of an occluded intrahepatic portosystemic covered stent via the percutaneous transhepatic approach.

    PubMed

    Chan, Chih-Yang; Liang, Po-Chin

    2010-01-01

    A 41-year-old woman with liver cirrhosis had recurrent portal hypertension and bleeding from esophageal varices due to complete occlusion of a previously inserted transjugular intrahepatic portosystemic shunt stent. Because recanalization of the stent by the transjugular approach was unsuccessful, ultrasound-guided entry to the splenic vein and portal vein was used. After catheter-directed intrathrombus thrombolysis, successful opening of the stent was achieved and a stent was placed. We herein report a rare case in which thrombolysis and recanalization of a TIPS stent were performed via a percutaneous transhepatic approach. PMID:20592931

  15. Novel Percutaneous Radiofrequency Ablation of Portal Vein Tumor Thrombus: Safety and Feasibility

    SciTech Connect

    Mizandari, Malkhaz; Ao, Guokun; Zhang Yaojun; Feng Xi; Shen Qiang; Chen Minshan; Lau, Wan Yee; Nicholls, Joanna; Jiao Long; Habib, Nagy

    2013-02-15

    We report our experience of the safety of partial recanalization of the portal vein using a novel endovascular radiofrequency (RF) catheter for portal vein tumor thrombosis. Six patients with liver cancer and tumor thrombus in the portal vein underwent percutaneous intravascular radiofrequency ablation (RFA) using an endovascular bipolar RF device. A 0.035-inch guidewire was introduced into a tributary of the portal vein and through which a 5G guide catheter was introduced into the main portal vein. After manipulation of the guide catheter over the thrombus under digital subtraction angiography, the endovascular RF device was inserted and activated around the thrombus. There were no observed technique specific complications, such as hemorrhage, vessel perforation, or infection. Post-RFA portography showed partial recanalization of portal vein. RFA of portal vein tumor thrombus in patients with hepatocellular carcinoma is technically feasible and warrants further investigation to assess efficacy compared with current recanalization techniques.

  16. Varicose Veins

    MedlinePLUS

    ... Previous Section Next Section How Do Varicose Veins Impact My Health? Varicose veins can be cosmetically distressing ... What Causes Varicose Veins? How Do Varicose Veins Impact My Health? How Are Varicose Veins Diagnosed? How ...

  17. The Histological Changes of the Great Saphenous Vein at 2 Years after Cryosclerosis

    PubMed Central

    Balint, Istvan Bence; Bali, Ottilia; Vargovics, Eszter; Simon, Eva; Vizsy, Laszlo

    2014-01-01

    Cryosclerosis was developed at the end of the last decade. It is the endovenous cryoablation of the great saphenous vein and has been forgotten before the era of the endovenous ablation techniques began. The caused histomorphological changes of the vein weren’t described before, especially, years after the procedure. A 31-year-old female patient underwent cryosclerosis 2 years ago. Because of the recanalization of the great saphenous vein and recurrent varicosity, high ligation, cryostripping and phlebectomy of varices were performed. During surgery, a saphenous vein piece was harvested to investigate the histomorphological effect of cryosclerosis. Histological findings verified that recanalization had occurred, the vein wall had undergone remodeling, and the picro-sirius red stain showed collagen deposition in the whole vein wall. Cryosclerosis seems to result in the remodeling of the vein wall. PMID:26217627

  18. Varicose Veins

    MedlinePLUS

    ... the valves are weak or damaged, blood can back up and pool in your veins. This causes ... pregnancy. Doctors often diagnose varicose veins from a physical exam. ... to remove them. NIH: National Heart, Lung, and Blood Institute

  19. Endovascular interventions for central vein stenosis

    PubMed Central

    Agarwal, Anil K.

    2015-01-01

    Central vein stenosis is common because of the placement of venous access and cardiac intravascular devices and compromises vascular access for dialysis. Endovascular intervention with angioplasty and/or stent placement is the preferred approach, but the results are suboptimal and limited. Primary patency after angioplasty alone is poor, but secondary patency can be maintained with repeated angioplasty. Stent placement is recommended for quick recurrence or elastic recoil of stenosis. Primary patency of stents is also poor, though covered stents have recently shown better patency than bare metal stents. Secondary patency requires repeated intervention. Recanalization of occluded central veins is tedious and not always successful. Placement of hybrid graft-catheter with a combined endovascular surgical approach can maintain patency in many cases. In the presence of debilitating symptoms, palliative approach with endovascular banding or occlusion of the access may be necessary. Prevention of central vein stenosis is the most desirable strategy. PMID:26779426

  20. Portal vein thrombosis in cirrhosis.

    PubMed

    Raja, Kaiser; Jacob, Mathew; Asthana, Sonal

    2014-12-01

    Portal vein thrombosis (PVT) is being increasingly recognized in patients with advanced cirrhosis and in those undergoing liver transplantation. Reduced flow in the portal vein is probably responsible for clotting in the spleno-porto-mesenteric venous system. There is also increasing evidence that hypercoagulability occurs in advanced liver disease and contributes to the risk of PVT. Ultrasound based studies have reported a prevalence of PVT in 10-25% of cirrhotic patients without hepatocellular carcinoma. Partial thrombosis of the portal vein is more common and may not have pathophysiological consequences. However, there is high risk of progression of partial PVT to complete PVT that may cause exacerbation of portal hypertension and progression of liver insufficiency. It is thus, essential to accurately diagnose and stage PVT in patients waiting for transplantation and consider anticoagulation therapy. Therapy with low molecular weight heparin and vitamin K antagonists has been shown to achieve complete and partial recanalization in 33-45% and 15-35% of cases respectively. There are however, no guidelines to help determine the dose and therapeutic efficacy of anticoagulation in patients with cirrhosis. Anticoagulation therapy related bleeding is the most feared complication but it appears that the risk of variceal bleeding is more likely to be dependent on portal pressure rather than solely related to coagulation status. TIPS has also been reported to restore patency of the portal vein. Patients with complete PVT currently do not form an absolute contraindication for liver transplantation. Thrombectomy or thromboendovenectomy is possible in more than 75% of patients followed by anatomical end-to-end portal anastomosis. When patency of the portal vein and/or superior mesenteric vein is not achieved, only non-anatomical techniques (reno-portal anastomosis or cavo-portal hemitransposition) can be performed. These techniques, which do not fully reverse portal hypertension, are associated with higher morbidity and mortality risks in the short term. PMID:25755579

  1. Korean Guidelines for Interventional Recanalization of Lower Extremity Arteries.

    PubMed

    Kim, Young Hwan; Bae, Jae Ik; Jeon, Yong Sun; Kim, Chang Won; Jae, Hwan Jun; Park, Kwang Bo; Cho, Young Kwon; Kim, Man Deuk

    2015-01-01

    Peripheral arterial occlusive disease caused by atherosclerosis can present with intermittent claudication or critical limb ischemia. Proper diagnosis and management is warranted to improve symptoms and salvage limbs. With the introduction of new techniques and dedicated materials, endovascular recanalization is widely performed for the treatment of peripheral arterial occlusive disease because it is less invasive than surgery. However, there are various opinions regarding the appropriate indications and procedure methods for interventional recanalization according to operator and institution in Korea. Therefore, we intend to provide evidence based guidelines for interventional recanalization by multidisciplinary consensus. These guidelines are the result of a close collaboration between physicians from many different areas of expertise including interventional radiology, interventional cardiology, and vascular surgery. The goal of these guidelines is to ensure better treatment, to serve as a guide to the clinician, and consequently, to contribute to public health care. PMID:26175569

  2. Korean Guidelines for Interventional Recanalization of Lower Extremity Arteries

    PubMed Central

    Bae, Jae Ik; Jeon, Yong Sun; Kim, Chang Won; Jae, Hwan Jun; Park, Kwang Bo; Cho, Young Kwon; Kim, Man Deuk

    2015-01-01

    Peripheral arterial occlusive disease caused by atherosclerosis can present with intermittent claudication or critical limb ischemia. Proper diagnosis and management is warranted to improve symptoms and salvage limbs. With the introduction of new techniques and dedicated materials, endovascular recanalization is widely performed for the treatment of peripheral arterial occlusive disease because it is less invasive than surgery. However, there are various opinions regarding the appropriate indications and procedure methods for interventional recanalization according to operator and institution in Korea. Therefore, we intend to provide evidence based guidelines for interventional recanalization by multidisciplinary consensus. These guidelines are the result of a close collaboration between physicians from many different areas of expertise including interventional radiology, interventional cardiology, and vascular surgery. The goal of these guidelines is to ensure better treatment, to serve as a guide to the clinician, and consequently, to contribute to public health care. PMID:26175569

  3. Portal vein thrombosis with protein C-S deficiency in a non-cirrhotic patient

    PubMed Central

    Rodríguez-Leal, Gustavo A; Morán, Segundo; Corona-Cedillo, Roberto; Brom-Valladares, Rocío

    2014-01-01

    There are several conditions that can lead to portal vein thrombosis (PVT), including including infection, malignancies, and coagulation disorders. Anew condition of interest is protein C and S deficiencies, associated with hypercoagulation and recurrent venous thromboembolism. We report the case of a non-cirrhotic 63-year-old male diagnosed with acute superior mesenteric vein thrombosis and PVT and combined deficiencies in proteins C and S, recanalized by short-term low molecular heparin plus oral warfarin therapy. PMID:25068006

  4. Transvaginal fluoroscopic recanalization of a proximally occluded oviduct

    SciTech Connect

    Platia, M.P.; Krudy, A.G.

    1985-11-01

    A hysterosalpingogram performed on a patient with infertility showed bilateral interstitial obstruction with partial intramural patency of the right tube and complete intramural obstruction of the left. Recanalization of the tube under fluoroscopy resulted in unilateral tubal patency and an intrauterine pregnancy followed. 7 references, 3 figures.

  5. Vein Problems Related to Varicose Veins

    MedlinePLUS

    ... lakes are varicose veins that appear on the face and neck. Reticular veins are flat blue veins often seen behind the knees. Hemorrhoids are varicose veins in and around the ... STATEMENT FOIA OIG CONTACT US National ...

  6. Varicose Veins

    MedlinePLUS

    ... heart pumps the blood to your lungs to pick up oxygen. The oxygen-rich blood then is pumped ... returns to your heart through your veins to pick up more oxygen. For more information about blood flow, ...

  7. Time window for recanalization in basilar artery occlusion: Speculative synthesis.

    PubMed

    Lindsberg, Perttu J; Pekkola, Johanna; Strbian, Daniel; Sairanen, Tiina; Mattle, Heinrich P; Schroth, Gerhard

    2015-11-17

    Basilar artery occlusion (BAO) is one of the most devastating forms of stroke and few patients have good outcomes without recanalization. Most centers apply recanalization therapies for BAO up to 12-24 hours after symptom onset, which is a substantially longer time window than the 4.5 hours used in anterior circulation stroke. In this speculative synthesis, we discuss recent advances in BAO treatment in order to understand why and under which circumstances longer symptom duration might not necrotize the brainstem and turn therapeutic attempts futile. We raise the possibility that distinct features of the posterior circulation, e.g., highly developed, persistent collateral arterial network, reverse filling of the distal basilar artery, and delicate plasma flow siding the clot, might sustain brittle patency of brainstem perforators in the face of stepwise growth of the thrombus. Meanwhile, the tissue clock characterizing the rapid necrosis of a typical anterior circulation penumbra will not start. During this perilous time period, recanalization at any point would salvage the brainstem from eventual necrosis caused by imminent reinforcement and further building up of the clot. PMID:26574535

  8. Pull-Through Technique for Recanalization of Occluded Portosystemic Shunts (TIPS): Technical Note and Review of the Literature

    SciTech Connect

    Tanaka, Toshihiro Guenther, Rolf W. Isfort, Peter; Kichikawa, Kimihiko; Mahnken, Andreas H.

    2011-04-15

    Transjugular intrahepatic portosystemic shunt (TIPS) dysfunction is an important problem after creation of shunts. Most commonly, TIPS recanalization is performed via the jugular vein approach. Occasionally it is difficult to cross the occlusion. We describe a hybrid technique for TIPS revision via a direct transhepatic access combined with a transjugular approach. In two cases, bare metal stents or polytetrafluoroethylene (PTFE)-covered stent grafts had been placed in TIPS tract previously, and they were completely obstructed. The tracts were inaccessible via the jugular vein route alone. In each case, after fluoroscopy or computed tomography-guided transhepatic puncture of the stented segment of the TIPS, a wire was threaded through the shunt and snared into the right jugular vein. The TIPS was revised by balloon angioplasty and additional in-stent placement of PTFE-covered stent grafts. The patients were discharged without any complications. Doppler sonography 6 weeks after TIPS revision confirmed patency in the TIPS tract and the disappearance of ascites. We conclude that this technique is feasible and useful, even in patients with previous PTFE-covered stent graft placement.

  9. Onyx resorbtion with AVM recanalization after complete AVM obliteration.

    PubMed

    Bauer, Andrew M; Bain, Mark D; Rasmussen, Peter A

    2015-06-01

    Brain arteriovenous malformations (BAVM) are some of the most complex lesions treated by clinical neuroscientists. The recent publication of the ARUBA trial, showing higher complication rates with treatment compared with the natural history over a short period of follow-up, puts even more pressure on the physician to achieve complete BAVM eradication without complication. These lesions are often treated by multimodality therapy with some combination of endovascular embolization, radiosurgery, and microsurgical resection; however, multimodality therapy involves the additive risk of procedural complication with each procedure. While surgical resection has long been accepted as monotherapy with good cure rates, staged pre-operative endovascular embolization has facilitated microsurgical resection with lower blood loss. Endovascular embolization is more often utilized in conjunction with surgical resection, and often the portions of the AVM and feeders that are completely embolized with Onyx or glue may not be surgically resected since they have been "internally obliterated." We present a case where the AVM was preoperatively embolized with Onyx and subsequently partially surgically resected. Post-operative angiography showed complete obliteration or "cure" of the AVM with no filling of the nidus or early venous drainage. The patient presented 12 months later with seizures and imaging showed volume loss in the residual Onyx cast and recanalization of the AVM nidus. The patient subsequently underwent repeat resection with complete removal of the residual AVM and Onyx cast. To our knowledge this is the first published report of volume loss within the Onyx cast leading to recanalization of the AVM nidus. This suggests that extreme care should be taken with partial resection of the AVM nidus or with embolization for cure, as late recanalization may occur. PMID:26015523

  10. Early Spontaneous Recanalization of Sigmoid Sinus Thrombosis Following a Closed Head Injury in a Pediatric Patient : A Case Report and Review of Literature.

    PubMed

    Yun, Jung-Ho; Ko, Jung Ho; Lee, Mee Jeong

    2015-08-01

    Cerebral venous sinus thrombosis (CVST) following a closed head injury in pediatric patients is a rare condition, and an early spontaneous recanalization of this condition is extremely rare. A 10-year-old boy was admitted with a mild, intermittent headache and nausea five days after a bicycle accident. The brain computed tomography showed an epidural hematoma at the right occipital area with pneumocephalus due to a fracture of the occipital skull bone. The brain magnetic resonance imaging and the magnetic resonance venography demonstrated a flow signal loss from the right sigmoid sinus to the right jugular vein. The diagnosis was sigmoid sinus thrombosis, so close observations were selected as a treatment for the patient because of his gradually improving symptoms; however, he complained of vomiting 14 days the after conservative treatment. The patient was readmitted for a further examination of his symptoms. The laboratory and the gastroenterological examinations were normal. Due to concern regarding the worsening of the sigmoid sinus thrombosis, the brain magnetic resonance venography was rechecked and it revealed the recanalization of the venous flow in the sigmoid sinus and in the jugular vein. PMID:26361534

  11. Early Spontaneous Recanalization of Sigmoid Sinus Thrombosis Following a Closed Head Injury in a Pediatric Patient : A Case Report and Review of Literature

    PubMed Central

    Yun, Jung-Ho; Lee, Mee Jeong

    2015-01-01

    Cerebral venous sinus thrombosis (CVST) following a closed head injury in pediatric patients is a rare condition, and an early spontaneous recanalization of this condition is extremely rare. A 10-year-old boy was admitted with a mild, intermittent headache and nausea five days after a bicycle accident. The brain computed tomography showed an epidural hematoma at the right occipital area with pneumocephalus due to a fracture of the occipital skull bone. The brain magnetic resonance imaging and the magnetic resonance venography demonstrated a flow signal loss from the right sigmoid sinus to the right jugular vein. The diagnosis was sigmoid sinus thrombosis, so close observations were selected as a treatment for the patient because of his gradually improving symptoms; however, he complained of vomiting 14 days the after conservative treatment. The patient was readmitted for a further examination of his symptoms. The laboratory and the gastroenterological examinations were normal. Due to concern regarding the worsening of the sigmoid sinus thrombosis, the brain magnetic resonance venography was rechecked and it revealed the recanalization of the venous flow in the sigmoid sinus and in the jugular vein. PMID:26361534

  12. Use of Nitinol Stents Following Recanalization of Central Venous Occlusions in Hemodialysis Patients

    SciTech Connect

    Rajan, Dheeraj K. Saluja, Jasdeep S.

    2007-07-15

    Purpose. To retrospectively review the patency of endovascular interventions with nitinol stent placement for symptomatic central venous occlusions in hemodialysis patients. Methods. A retrospective review of all patients who underwent endovascular interventions for dysfunctional hemodialysis grafts and fistulas was performed from April 2004 to August 2006. A total of 6 patients presented with arm and/or neck and facial swelling and left brachiocephalic vein occlusion. The study group consisted of 3 men and 3 women with a mean age of 79.5 years (SD 11.2 years). Of these 6 patients, 1 had a graft and 5 had fistulas in the left arm. The primary indication for nitinol stent placement was technical failure of angioplasty following successful traversal of occluded central venous segments. Patency was assessed from repeat fistulograms and central venograms performed when patients redeveloped symptoms or were referred for access dysfunction determined by the ultrasound dilution technique. No patients were lost to follow-up. Results. Nitinol stent placement to obtain technically successful recanalization of occluded venous segments was initially successful in 5 of 6 patients (83%). In 1 patient, incorrect stent positioning resulted in partial migration to the superior vena cava requiring restenting to prevent further migration. Clinical success was observed in all patients (100%). Over the follow-up period, 2 patients underwent repeat intervention with angioplasty alone. Primary patency was 83.3% (95% CI 0.5-1.2) at 3 months, and 66.7% at 6 and 12 months (0.2-1.1, 0.1-1.2). Secondary patency was 100% at 12 months with 3 patients censored over that time period. Mean primary patency was 10.4 months with a mean follow-up of 12.4 months. No complications related to recanalization of the occluded central venous segments were observed. Conclusion. Our initial experience has demonstrated that use of nitinol stents for central venous occlusion in hemodialysis patients is associated with good mid-term patency and may exceed historical observations with prior use of Wallstents.

  13. A hybrid approach to recanalization of a chronic iliofemoral occlusion.

    PubMed

    Ahanchi, Sadaf Sadie; Panneton, Jean Michel; Stout, Christopher Lee

    2013-01-01

    The Viabahn covered stent (W. L. Gore and Associates Inc, Flagstaff, Ariz) is made of expanded polytetrafluoroethylene attached to an external nitinol stent and is primarily used in the endovascular treatment of lower extremity arterial occlusive disease. The use of this device as an open conduit for lower extremity revascularization has been rarely reported. We expand on this experience by presenting a case of hybrid endovascular and open iliofemoral bypass in which we used the Viabahn endoprosthesis to recanalize an occluded iliac artery, followed by direct suturing of the distal portion of the Viabahn stent graft to the native common femoral artery bifurcation. PMID:22963813

  14. Successful Endovascular Treatment of Iliac Vein Compression (May-Thurner) Syndrome in a Pediatric Patient

    SciTech Connect

    Oguzkurt, Levent Tercan, Fahri; Sener, Mesut

    2006-06-15

    A 10-year-old boy presented to our clinic with left lower extremity swelling present for 1 year with deterioration of symptoms during the prior month. Laboratory investigation for deep vein thrombosis was negative. Venography and computed tomography scan of the pelvis showed compression of the left common iliac vein by the right common iliac artery. A diagnosis of iliac vein compression syndrome was made. After venography, endovascular treatment was planned. The stenosis did not respond to balloon dilatation and a 12 mm Wallstent was placed with successful outcome. The patient's symptoms improved but did not resolve completely, probably due to a chronically occluded left superficial femoral vein that did not respond to endovascular recanalization. To the best of our knowledge, this is the first case of successful endovascular treatment of iliac vein compression syndrome with stent placement in a pediatric patient.

  15. Crosswire for recanalization of total occlusive coronary arteries.

    PubMed

    Bahl, V K; Chandra, S; Goswami, K C; Manchanda, S C

    1998-11-01

    Coronary angioplasty of total occlusions is technically difficult and is associated with limited success rates. The procedural outcome is mainly determined by the underlying pathological process. Recanalization of total occlusions is aimed at finding the passage with least resistance, without causing dissection or perforation. Several techniques have been advocated to improve the overall success rate. Recently, a new 0.014" Nitinol wire (Crosswire, Terumo) has been introduced as a tool, to achieve higher success rates for total occlusion angioplasty. The wire consists of an extremely flexible Nitinol-core, a platinum/iridium coil at the distal tip, and a hydrophilic polymer coating. Balloon angioplasty was attempted in 30 totally occluded coronary arteries with mean age of occlusion being 5 +/- 4 months (range 2-14 months). The initial five procedures were performed following failure of the conventional angioplasty guidewires. Subsequently, Cross-wire was used electively in all the cases. The lesion was crossed successfully in 90% (27/30) cases. Dissection of the coronary artery with subintimal entry was seen in two (7%) cases, and the rest (three cases) could not be crossed. Balloon angioplasty and stenting (n = 21) were performed with good immediate angiographic results. There were no myocardial infarctions or deaths. Fourteen of 16 patients, who had completed 6 months follow-up, were asymptomatic. Angiographic evidence of in-stent restenosis was demonstrable in one case. Successful recanalization of total coronary occlusions by using Cross-wire can be expected in 83% cases, with reasonable safety. PMID:9829898

  16. Deep Vein Thrombosis

    MedlinePLUS

    Deep vein thrombosis, or DVT, is a blood clot that forms in a vein deep in the body. Most deep vein clots occur in the lower leg or ... vein swells, the condition is called thrombophlebitis. A deep vein thrombosis can break loose and cause a ...

  17. Large Deep White Matter Lesions May Predict Futile Recanalization in Endovascular Therapy for Acute Ischemic Stroke

    PubMed Central

    Tateishi, Yohei; Wisco, Dolora; Aoki, Junya; George, Pravin; Katzan, Irene; Toth, Gabor; Hui, Ferdinand; Hussain, Muhammad S.; Uchino, Ken

    2015-01-01

    Objective This study investigated whether large ischemic lesions in the deep white matter (DWM) on pretreatment diffusion-weighted MRI (DWI) predict futile recanalization. Methods Consecutive acute stroke patients with anterior circulation ischemia who underwent successful arterial recanalization with thrombolysis in cerebral infarction grade 2b or 3 were enrolled. A large DWI-DWM lesion was defined as a hyperintense lesion in the DWM on initial DWI, located mainly between the anterior and posterior horns of the lateral ventricle. The Alberta Stroke Program Early CT score on CT and DWI and stroke volume on initial DWI were recorded. Stroke severity was assessed using the National Institutes of Health Stroke Scale (NIHSS) score. Futile recanalization was defined as a 30-day modified Rankin scale score of 3-6 despite successful recanalization. Univariate and multivariate regression analyses were performed to identify predictors of futile recanalization. Results In 35 of 46 patients (76%) with successful recanalization, futile recanalization was observed in 20 patients (57%). Patients with futile recanalization were older (median age 74 vs. 58 years; p = 0.053), had higher initial NIHSS scores (median 17 vs. 9; p = 0.042), and a higher prevalence of large DWI-DWM lesions (45 vs. 9%; p = 0.022). Logistic regression analysis showed that a large DWI-DWM lesion was an independent predictor of futile recanalization (OR 13.97; 95% CI 1.32-147.73; p = 0.028). Conclusion Patients with large preintervention DWI-DWM lesions may be poor candidates for endovascular therapy. PMID:25999992

  18. What Causes Varicose Veins?

    MedlinePLUS

    ... Weak vein walls may cause weak valves. Normally, the walls of the veins are elastic (stretchy). If these ... become like an overstretched rubber band. This makes the walls of the veins longer and wider, and it ...

  19. Deep Vein Thrombosis

    MedlinePLUS

    ... page from the NHLBI on Twitter. What Is Deep Vein Thrombosis? Espaol Deep vein thrombosis (throm-BO-sis), or DVT, is a blood clot that forms in a vein deep in the body. Blood clots occur when blood ...

  20. Percutaneous Endovascular Recanalization of a Thrombosed Aortic Graft Limb with Stent Placement

    PubMed Central

    Georgakarakos, Efstratios; Kapoulas, Konstantinos

    2014-01-01

    Common practice in recanalization of a thrombosed prosthetic graft limb in an aortoiliac bypass focuses on balloon-catheter thrombectomy and angiographic exploration followed either by open surgical revision or endovascular management. This report describes the technique of percutaneous endovascular recanalization of an early thrombosed aortic graft limb with stent placement and subsequent restoration of patency and adequate limb perfusion, which remains patent after one year. Percutaneous intervention with stent placement and angioplasty for early graft limb recanalization avoids femoral incisions, and complications or morbidity associated with open surgery, while permitting rapid mobilization of the patient. PMID:26798727

  1. Percutaneous Transsplenic Access to the Portal Vein for Management of Vascular Complication in Patients with Chronic Liver Disease

    SciTech Connect

    Chu, Hee Ho; Kim, Hyo-Cheol Jae, Hwan Jun; Yi, Nam-Joon; Lee, Kwang-Woong; Suh, Kyung-Suk; Chung, Jin Wook; Park, Jae Hyung

    2012-12-15

    Purpose: To evaluate the safety and feasibility of percutaneous transsplenic access to the portal vein for management of vascular complication in patients with chronic liver diseases. Methods: Between Sept 2009 and April 2011, percutaneous transsplenic access to the portal vein was attempted in nine patients with chronic liver disease. Splenic vein puncture was performed under ultrasonographic guidance with a Chiba needle, followed by introduction of a 4 to 9F sheath. Four patients with hematemesis or hematochezia underwent variceal embolization. Another two patients underwent portosystemic shunt embolization in order to improve portal venous blood flow. Portal vein recanalization was attempted in three patients with a transplanted liver. The percutaneous transsplenic access site was closed using coils and glue. Results: Percutaneous transsplenic splenic vein catheterization was performed successfully in all patients. Gastric or jejunal varix embolization with glue and lipiodol mixture was performed successfully in four patients. In two patients with a massive portosystemic shunt, embolization of the shunting vessel with a vascular plug, microcoils, glue, and lipiodol mixture was achieved successfully. Portal vein recanalization was attempted in three patients with a transplanted liver; however, only one patient was treated successfully. Complete closure of the percutaneous transsplenic tract was achieved using coils and glue without bleeding complication in all patients. Conclusion: Percutaneous transsplenic access to the portal vein can be an alternative route for portography and further endovascular management in patients for whom conventional approaches are difficult or impossible.

  2. Isolated Cortical Vein Thrombosis with Long Cord Sign

    PubMed Central

    Ban, Seung Pil; Park, Sung Bae; Son, Young-Je

    2015-01-01

    Isolated cortical vein thrombosis (ICVT) is a rare disease, accounting for less than 1% of strokes. A 46-year-old woman presented with progressive left side weakness. Magnetic resonance (MR) imaging with T2*-gradient echo (T2*-GE) sequence showed long cord sign at the right frontal cortex. The patient was treated with low molecular weight heparin, followed by oral warfarin for 6 months. The 3-month follow-up MR imaging showed recanalization of the previously thrombosed cortical vein. She was completely recovered without neurological deficits after 6 months. This provides that MR imaging with T2*-GE sequence can help to diagnosis the ICVT and outcomes of the ICVT are generally favorable. PMID:26713150

  3. Relief of Buttock Claudication by Percutaneous Recanalization of an Occluded Superior Gluteal Artery

    SciTech Connect

    Senechal, Quentin; Auguste, Mario C.; Louail, Bertrand; Lagneau, Pierre; Pernes, Jean Marc

    2000-03-15

    We report a case of a woman presenting with right severe buttock claudication and normal neurological and osteoarticular examination, in whom a guidewire recanalization and percutaneous transluminal angioplasty (PTA) of an occluded right superior gluteal artery (SGA) has provided relief of her symptoms. To our knowledge, this is the first report of percutaneous recanalization of the SGA. PTA can be considered the treatment of choice for buttock claudication caused by SGA stenosis or occlusion.

  4. Critical Use of Balloon Angioplasty after Recanalization Failure with Retrievable Stent in Acute Cerebral Artery Occlusion

    PubMed Central

    Park, Jae Hyun; Jang, Kyeong Sool; Jang, Dong Kyu; Han, Young Min

    2013-01-01

    Objective Sudden major cerebral artery occlusion often resists recanalization with currently available techniques or can results in massive symptomatic intracranial hemorrhage (sICH) after thrombolytic therapy. The purpose of this study was to examine mechanical recanalization with a retrievable self-expanding stent and balloon in acute intracranial artery occlusions. Methods Twenty-eight consecutive patients with acute intracranial artery occlusions were treated with a Solitaire retrievable stent. Balloon angioplasty was added if successful recanalization was not achieved after stent retrieval. The angiographic outcome was assessed by Thrombolysis in Cerebral Infarction (TICI) and the clinical outcomes were assessed by the National Institutes of Health Stroke Scale (NIHSS) and the modified Rankin Scale (mRS). Results At baseline, mean age was 69.4 years and mean initial NIHSS score was 12.5. A recanalization to TICI 2 or 3 was achieved in 24 patients (85%) after stent retrieval. Successful recanalization was achieved after additional balloon angioplasty in 4 patients. At 90-day follow-up, 24 patients (85%) had a NIHSS improvement of ?4 and 17 patients (60%) had a good outcome (mRS ?2). Although there was sICH, there was one death associated with the procedure. Conclusion Mechanical thromboembolectomy with a retrievable stent followed by additional balloon angioplasty is a safe and effective first-line therapy for acute intracranial artery occlusions especially in case of unsuccessful recanalization after stent thrombectomy. PMID:23560170

  5. Effect of coronary artery recanalization on right ventricular function in patients with acute myocardial infarction

    SciTech Connect

    Verani, M.S.; Tortoledo, F.E.; Batty, J.W.; Raizner, A.E.

    1985-05-01

    The effects of coronary artery recanalization by intracoronary administration of streptokinase on left ventricular function during acute myocardial infarction have received increasing attention in recent years. Although myocardial dysfunction is often more pronounced in the right ventricle than in the left ventricle in patients with acute inferior wall myocardial infarction, the effect of coronary artery recanalization on right ventricular dysfunction has not been previously addressed. Accordingly, in this investigation, 54 patients who participated in a prospective, controlled, randomized trial of recanalization during acute myocardial infarction were studied. Among 30 patients with inferior wall infarction, 19 had right ventricular dysfunction on admission; 11 of these 19 had positive uptake of technetium-99m pyrophosphate in the right ventricle, indicative of right ventricular infarction. Patients with successful recanalization exhibited improved right ventricular ejection fraction from admission to day 10. However, control patients and patients who did not undergo recanalization also exhibited improvement. These data indicate that the right ventricular dysfunction commonly associated with inferior wall infarction is often transient, and improvement is the rule, irrespective of early recanalization of the infarct vessel.

  6. Recanalization Results After Intracranial Stenting of Atherosclerotic Stenoses

    SciTech Connect

    Blasel, Stella Yuekzek, Zeynep; Kurre, Wiebke; Berkefeld, Joachim; Neumann-Haefelin, Tobias; Hattingen, Elke; Mesnil de Rochemont, Richard du

    2010-10-15

    The purpose of this investigation was to provide a detailed description of the angiographic results after stenting of high-grade intracranial stenosis using balloon-expandable stents. Forty consecutive patients with symptomatic atherosclerotic intracranial stenosis >50% received endovascular treatment by placement of balloon-expandable stents using the concept of slight underdilation and strict avoidance of overdilation. Intra-arterial digital subtraction angiography images before and after stenting in the same projection were reviewed for pre- and post-therapeutic measurement of the degree of stenosis and evaluation of morphologic criteria like plaque coverage, stent apposition, patency of side branches, and signs of dissection or vasospasm. Stenting decreased the mean percentage stenosis from 76.2 (WASID criteria) to 20.8%. Residual stenosis ranged from 0 to 55% with residual stenosis >50% in two of 40 cases. Technical success rate was 95%. There were no major vessel complications, but minor abnormalities like incomplete stent apposition (8/40) or plaque coverage (7/40), incomplete filling of side branches (13/40), and minor dissections after stenting (2/40) were seen. One case with incomplete stent apposition and two cases with side branch compromise were associated with clinical symptoms. In conclusion, intracranial stenting with slight underdilation avoided major vessel complication and created reliable luminal gain. Suboptimal recanalization results were frequently detected and may be the source of neurological complications in individual cases.

  7. Effect of the Interaction between Recanalization and Collateral Circulation on Functional Outcome in Acute Ischaemic Stroke.

    PubMed

    Mangiafico, Salvatore; Saia, Valentina; Nencini, Patrizia; Romani, Ilaria; Palumbo, Vanessa; Pracucci, Giovanni; Consoli, Arturo; Rosi, Andrea; Renieri, Leonardo; Nappini, Sergio; Limbucci, Nicola; Inzitari, Domenico; Gensini, Gian Franco

    2014-12-01

    Identification of patients with acute ischaemic stroke who could most benefit from arterial recanalization after endovascular treatment remains an unsettled issue. Although several classifications of collateral circulation have been proposed, the clinical role of collaterals is still debated. We evaluated the effect of the collateral circulation in relation to recanalization as a predictor of clinical outcome. Data were prospectively collected from 103 patients consecutively treated for proximal middle cerebral or internal carotid artery occlusion. The collateral circulation was evaluated with a novel semiquantitative-qualitative score, the Careggi collateral score (CCS), in six grades. Both CCS and recanalization grades (TICI) were analysed in relation to clinical outcome. A statistical analysis was performed to evaluate the effect of interaction between recanalization and collateral circulation on clinical outcome. Out of the 103 patients, 37 (36.3%) had poor collaterals, and 65 (63.7%) had good collaterals. Patients with good collaterals had lower basal National Institute of Health Stroke Scale (NIHSS), more distal occlusion, smaller lesions at 24h CT scan and better functional outcome. After multivariate analysis, the interaction between recanalization and collateral grades was significantly stronger as a predictor of good outcome (OR 6.87, 95% CI 2.11-22.31) or death (OR 4.66, 95%CI 1.48-14.73) compared to the effect of the single variables. Collaterals showed an effect of interaction with the recanalization grade in determining a favourable clinical outcome. Assessment of the collateral circulation might help predict clinical results after recanalization in patients undergoing endovascular treatment for acute ischaemic stroke. PMID:25496680

  8. Percutaneous Recanalization of Acute Internal Carotid Artery Occlusions in Patients with Severe Stroke

    SciTech Connect

    Dabitz, Rainer; Triebe, Stefan; Leppmeier, Ullrich; Ochs, Guenther; Vorwerk, Dierk

    2007-02-15

    Background. Sudden symptomatic occlusions of the proximal internal carotid artery (ICA) resulting in severe middle cerebral artery (MCA) ischemia and stroke are usually not accessible by rt-PA thrombolysis and the prognosis is usually very poor. Mechanical recanalization of the proximal ICA combined with intravenous and intra-arterial thrombolysis was therefore used as a rescue procedure. Methods. Ten patients (9 men, 1 woman; mean age 56.1 years) were treated with emergency recanalization of the proximal carotid artery by using stents and/or balloon angioplasty as a rescue procedure. Three patients showed dissection, and 7 had atherothrombotic occlusions. Nine of 10 presented with an initial modified Rankin Scale (mRS) of 5, the remaining patient with mRS 4 (average NIHSS 21.4). After sonographic confirmation of ICA with associated MCA/distal ICA occlusion and bridging with rt-PA (without abciximab) an emergency angiography was performed with subsequent mechanical recanalization by percutaneous transluminal angioplasty (PTA) (n = 1) or primary stenting (n = 9) using self-expanding stents. Distal protection was used in 1 of 10 patients. Results. Recanalization of the proximal ICA was achieved in all. At least partial recanalization of the intracerebral arteries was achieved in all, and complete recanalization in 5. In 4 of 10 patients limited hemorrhage was detected during CT controls. Major complications included 2 patients who had to undergo hemicraniectomy. One patient died from malignant infarction. At the time of discharge from the stroke unit 9 of 10 patients had improved markedly, 5 patients having an mRS of {<=}2, and 3 patients a mRS of 3. At control after a mean of 20 weeks, 7 of 8 (88%) patients had a mRS {<=}2, and 1 a mRS of 3. Conclusions. Primary mechanical recanalization of ICA occlusions by stent and PTA combined with fibrinolysis and/or GPIIb/IIIa-receptor antagonists seems to be feasible to improve patient outcome significantly.

  9. Effect of Heparin on Recanalization in Acute Stroke Patients with Intra-Arterial Thrombi

    PubMed Central

    Mehta, Bijal K.; Kamal, Haris; McMurtray, Aaron; Shafie, Mohammed; Li, Ping

    2015-01-01

    Anticoagulant use, such as heparin, is usually contraindicated in acute stroke patients. We present a study of patients, who were treated with intravenous heparin after a stroke that were also found to have an intraluminal thrombus. Prior studies imply that recanalization is achieved with heparin; however heparin should only prevent thrombus propagation. Therefore it is unclear whether and how IV heparin can achieve recanalization of intraluminal thrombi in acute stroke patients. A retrospective review of all acute stroke patients from a single stroke center who received a therapeutic IV heparin infusion from 5/2006 to 9/2011 were included in the study. We compared patients who had complete/partial recanalization and/or improved flow versus those that did not, with both these groups on a standard intravenous heparin infusion protocol. Demographic data was compared between the groups. Average partial thromboplastin time (PTT) during heparin infusion, time between computed tomography angiographies (CTAs), time from stroke onset to receiving IV heparin, and vessel occluded were also compared between groups. Forty-one patients (19 female, 22 male) were included in the study with a total of 55 vessels (either carotid, middle cerebral artery, anterior cerebral artery, posterior cerebral artery/posterior circulation) having intraluminal thrombi; 31 patients had 41 vessels with either partial or complete recanalization of effected vessels, while 10 patients had 14 vessels that did not have at least one vessel recanalize while on heparin. Using t-test we noted that the average PTT between the vessels that had partial/complete recanalization group (61.74) and nonrecanalization group (66.30) was not statistical significantly different (P=0.37).The average time in days on heparin between vascular imaging studies (CTA/conventional angiogram) in the group of vessels with partial/complete recanalization (7.12 days) and the ones with no change (6.11 days) was not significantly different between the two groups (P=0.59). Patients vessels receiving heparin for <24 hours versus those >24 hours did not significantly differ either (P=0.17). This study compares patient characteristics associated with recanalization of intraluminal thrombi in acute stroke patients on heparin. Recanalization of intraluminal thrombi are not associated with average PTT or duration on heparin. PMID:26487926

  10. Varicose vein - noninvasive treatment

    MedlinePLUS

    ... The vein will harden and then disappear. Laser treatment can be used on the surface of the skin. Small bursts of light make small varicose veins disappear. Phlebectomy treats surface ... guide treatment. This may be done along with other procedures, ...

  11. Portal vein thrombosis.

    PubMed

    Cohen, Ronny; Mallet, Thierry; Gale, Michael; Soltys, Remigiusz; Loarte, Pablo

    2015-01-01

    Portal vein thrombosis (PVT) is the blockage or narrowing of the portal vein by a thrombus. It is relatively rare and has been linked with the presence of an underlying liver disease or prothrombotic disorders. We present a case of a young male who presented with vague abdominal symptoms for approximately one week. Imaging revealed the presence of multiple nonocclusive thrombi involving the right portal vein, the splenic vein, and the left renal vein, as well as complete occlusion of the left portal vein and the superior mesenteric vein. We discuss pathogenesis, clinical presentation, and management of both acute and chronic thrombosis. The presence of PVT should be considered as a clue for prothrombotic disorders, liver disease, and other local and general factors that must be carefully investigated. It is hoped that this case report will help increase awareness of the complexity associated with portal vein thrombosis among the medical community. PMID:25802795

  12. Focus on Varicose Veins

    MedlinePLUS

    ... veins no longer work. Under the pressure of gravity these veins can continue to expand and, in ... flow from the legs toward the heart against gravity, while preventing reverse flow back down the legs. ...

  13. Spatial distribution of perfusion abnormality in acute MCA occlusion is associated with likelihood of later recanalization.

    PubMed

    Siemonsen, Susanne; Forkert, Nils Daniel; Hansen, Anne; Kemmling, Andre; Thomalla, Gtz; Fiehler, Jens

    2014-05-01

    The aim of this study is to investigate whether different spatial perfusion-deficit patterns, which indicate differing compensatory mechanisms, can be recognized and used to predict recanalization success of intravenous fibrinolytic therapy in acute stroke patients. Twenty-seven acute stroke data sets acquired within 6 hours from symptom onset including diffusion- (DWI) and perfusion-weighted magnetic resonance (MR) imaging (PWI) were analyzed and dichotomized regarding recanalization outcome using time-of-flight follow-up data sets. The DWI data sets were used for calculation of apparent diffusion coefficient (ADC) maps and subsequent infarct core segmentation. A patient-individual three-dimensional (3D) shell model was generated based on the segmentation and used for spatial analysis of the ADC as well as cerebral blood volume (CBV), cerebral blood flow, time to peak (TTP), and mean transit time (MTT) parameters derived from PWI. Skewness, kurtosis, area under the curve, and slope were calculated for each parameter curve and used for classification (recanalized/nonrecanalized) using a LogitBoost Alternating Decision Tree (LAD Tree). The LAD tree optimization revealed that only ADC skewness, CBV kurtosis, and MTT kurtosis are required for best possible prediction of recanalization success with a precision of 85%. Our results suggest that the propensity for macrovascular recanalization after intravenous fibrinolytic therapy depends not only on clot properties but also on distal microvascular bed perfusion. The 3D approach for characterization of perfusion parameters seems promising for further research. PMID:24473482

  14. Transjugular Intrahepatic Portosystemic Shunt in a Patient with Cavernomatous Portal Vein Occlusion

    SciTech Connect

    Kawamata, Hiroshi; Kumazaki, Tatsuo; Kanazawa, Hidenori; Takahashi, Shuji; Tajima, Hiroyuki; Hayashi, Hiromitsu

    2000-03-15

    A 23-year-old woman with liver cirrhosis secondary to primary sclerosing cholangitis was referred to us for the treatment of recurrent bleeding from esophageal varices that had been refractory to endoscopic sclerotherapy. Her portal vein was occluded, associated with cavernous transformation. A transjugular intrahepatic portosystemic shunt (TIPS) was performed after a preprocedural three-dimensional computed tomographic angiography evaluation to determine feasibility. The portal vein system was recanalized and portal blood flow increased markedly after TIPS. Esophageal varices disappeared 3 weeks after TIPS. Re-bleeding and hepatic encephalopathy were absent for 3 years after the procedure. We conclude that with adequate preprocedural evaluation, TIPS can be performed safely even in patients with portal vein occlusion associated with cavernous transformation.

  15. Recanalization of Splenic Artery Aneurysm After Transcatheter Arterial Embolization Using N-Butyl Cyanoacrylate

    SciTech Connect

    Matsumoto, Keiji; Ushijima, Yasuhiro Tajima, Tsuyoshi; Nishie, Akihiro; Hirakawa, Masakazu; Ishigami, Kousei; Yamaji, Yukiko; Honda, Hiroshi

    2010-02-15

    A 65-year-old woman who had been diagnosed as having microscopic polyangiitis developed sudden abdominal pain and entered a state of shock. Abdominal CT showed massive hemoperitoneum, and emergent angiography revealed a ruptured splenic artery aneurysm. After direct catheterization attempts failed due to tortuous vessels and angiospasm, transcatheter arterial embolization using an n-butyl cyanoacrylate (NBCA)-lipiodol mixture was successfully performed. Fifty days later, the patient developed sudden abdominal pain again. Repeated angiography demonstrated recanalization of the splenic artery and splenic artery aneurysm. This time, the recanalized aneurysm was embolized using metallic coils with the isolation method. Physicians should keep in mind that recanalization can occur after transcatheter arterial embolization using N-butyl cyanoacrylate, which has been used as a permanent embolic agent.

  16. Biocompatibility and Recanalization Characteristics of Hydrogel Microspheres with Polyzene-F as Polymer Coating

    SciTech Connect

    Stampfl, Sibylle; Stampfl, Ulrike; Bellemann, Nadine; Sommer, Christof M.; Thierjung, Heidi; Radeleff, Boris; Lopez-Benitez, Ruben; Berger, Irina; Kauffmann, Guenter W.; Richter, Goetz M.

    2008-07-15

    The objective of this study was to evaluate inflammatory response and recanalization after embolization with a new spherical embolic agent based on a core and shell design with a hydrogel core of polymethylmethacrylate (PMMA) and a Polyzene-F nanoscale coating in a porcine kidney model. Thirty-six minipigs were enrolled for superselective renal embolization. Polyzene-F-coated PMMA particles and uncoated PMMA particles with a diameter of 300-600 {mu}m were used. Either 4 or 12 weeks post-embolization, arteriography of the embolized kidneys was performed and then compared with pre- and immediate post-embolization arteriograms using a specific recanalization score to determine the extent of recanalization. Using a microscopic inflammation score (Banff classification), the embolized organs were examined for local inflammatory effects which occurred in response to the embolic agent. In Polyzene-F-coated particles, the Banff classification showed an average inflammation score of 0.26 {+-} 0.58 at 4 weeks and of 0.08 {+-} 0.28 at 12 weeks. In uncoated particles, the Banff score measured 0.37 {+-} 0.6 at 4 weeks, which was higher, but without a statistically significant difference. According to the recanalization score used in this study, mild angiographic recanalization was evident in all groups, without statistically significant differences (3.0 {+-} 0.71 in coated particles, 3.09 {+-} 0.81 in uncoated particles; p = 0.74). We conclude that both uncoated hydrogel particles and Polyzene-F-coated embolic agents triggered virtually no inflammatory response and effectively occluded target arteries. This study demonstrates good biocompatibility of the new embolic material. As in other spherical embolic agents, recanalization can occur to some degree.

  17. Central Vein Dilatation Prior to Concomitant Port Implantation

    SciTech Connect

    Krombach, Gabriele A. Plumhans, Cedric; Goerg, Fabian; Guenther, Rolf W.

    2010-04-15

    Implantation of subcutaneous port systems is routinely performed in patients requiring repeated long-term infusion therapy. Ultrasound- and fluoroscopy-guided implantation under local anesthesia is broadly established in interventional radiology and has decreased the rate of complications compared to the surgical approach. In addition, interventional radiology offers the unique possibility of simultaneous management of venous occlusion. We present a technique for recanalization of central venous occlusion and angioplasty combined with port placement in a single intervention which we performed in two patients. Surgical port placement was impossible owing to occlusion of the superior vena cava following placement of a cardiac pacemaker and occlusion of multiple central veins due to paraneoplastic coagulopathy, respectively. In both cases the affected vessel segments were dilated with balloon catheters and the port systems were placed thereafter. After successful dilatation, the venous access was secured with a 25-cm-long, 8-Fr introducer sheath, a subcutaneous pocket prepared, and the port catheter tunneled to the venipuncture site. The port catheter was introduced through the sheath with the proximal end connected to a 5-Fr catheter. This catheter was pulled through the tunnel in order to preserve the tunnel and, at the same time, allow safe removal of the long sheath over the wire. The port system functioned well in both cases. The combination of recanalization and port placement in a single intervention is a straightforward alternative for patients with central venous occlusion that can only be offered by interventional radiology.

  18. Successful Recanalization of a Longstanding Right Common Iliac Artery Occlusion with a Radiofrequency Guidewire

    SciTech Connect

    Tapping, C. R.; Uri, I. F.; Dixon, S.; Bratby, M. J.; Anthony, S.; Uberoi, R.

    2012-10-15

    We describe a case of successful recanalization of a longstanding right common iliac occlusion with a radiofrequency (RF) guidewire. The patient had been symptomatic with claudication for 3 years, and a preliminary attempt to cross the lesion using conventional techniques proved unsuccessful. Using low and medium intensity RF pulses and a PowerWire, a tract through the occlusion was established, which allowed subsequent stenting with an excellent angiographic result and a good immediate clinical response. We propose this as a useful technique in the peripheral arterial system for occlusive lesions not amenable to traditional recanalization techniques.

  19. Thrombolysis, Complete Recanalization, Diffusion Reversal, and Luxury Perfusion in Hyperacute Stroke.

    PubMed

    Sakamoto, Yuki; Ouchi, Takahiro; Okubo, Seiji; Abe, Arata; Aoki, Junya; Nogami, Akane; Sato, Takahiro; Hokama, Hiroyuki; Ogawa, Yutaro; Suzuki, Shizuka; Mishina, Masahiro; Kimura, Kazumi

    2016-01-01

    A 59-year old man was admitted to our stroke care unit 1.8 hours after onset of cardioembolic stroke. Administration of issue-plasminogen activator achieved complete recanalization, and his lesion on diffusion-weighted imaging (DWI) disappeared and single photon emission computed tomography showed luxury perfusion. DWI reversal and luxury perfusion were sometimes observed in hyperacute stroke patients, especially timely reperfusion was achieved. However, the relationships between DWI reversal and luxury perfusion were not well known. Transient DWI reversal may be associated with luxury perfusion in patients treated with t-PA, via early complete recanalization achieved by thrombolysis. PMID:26521167

  20. Endovascular recanalization of symptomatic portomesenteric venous obstruction after pancreaticoduodenectomy and radiation.

    PubMed

    Hoffer, Eric K; Krohmer, Steven; Gemery, John; Zaki, Bassem; Pipas, J Marc

    2009-12-01

    Intraoperative radiation therapy (RT) may improve outcomes after pancreaticoduodenectomy for periampullary cancer; however, there is a 20% risk of late portomesenteric venous obstruction. This retrospective study evaluated the percutaneous treatment of portomesenteric venous obstruction that occurred a mean of 10 months after pancreaticoduodenectomy and intraoperative RT. Five patients with medically refractory ascites and portomesenteric obstruction on computed tomographic angiography had successful recanalization with elimination of the pressure gradient and no procedural complications. One patient showed no improvement clinically. Recurrent ascites after stent occlusion was successfully treated in two patients. Percutaneous transhepatic recanalization appears to be a safe and effective therapy in this population. PMID:19854066

  1. Subintimal Recanalization of Occluded Stents: The Substent Technique

    SciTech Connect

    Diamantopoulos, Athanasios Katsanos, Konstantinos; Spiliopoulos, Stavros; Karnabatidis, Dimitris; Siablis, Dimitris

    2013-08-01

    PurposeApplication of metal stents is complicated by neointimal hyperplasia leading to vessel restenosis and reocclusion. Treatment options in cases presenting with complete occlusion of the stented segment and recurrent critical limb ischemia (CLI) are limited. We present the option of the subintimal/substent technique in dealing with occluded stents.MethodsThe study included patients presenting with recurrent CLI due to impaired blood flow as a result of complete occlusion of previously inserted metal stents and unsuccessful intraluminal crossing of the lesion via either the antegrade or retrograde approach. In these cases, crossing the occlusion through the subintimal/substent plane was attempted. Primary end points included technical success, safety of the procedure, clinical improvement, and limb salvage, while secondary end points were patient survival, primary patency, and vessel restenosis rates at 1-year follow-up. Study end points were calculated by Kaplan-Meier survival analysis.ResultsBetween July 2006 and October 2011, a total of 14 patients (mean age 69.14 {+-} 12.59 years, 12 men) were treated with the substent technique and included in the analysis. Technical success rate was 85.71 % (12 of 14), with a total lesion length of 193.57 {+-} 90.78 mm. The mean occluded stented segment length was 90.21 {+-} 44.34 mm. In 10 (83.33 %) of 12 cases, a new stent had to be placed by the side of the old occluded one, while the remaining two cases (16.67 %) were treated only with balloon angioplasty. No serious adverse events were noted during the immediate postprocedural period. All successfully treated patients improved clinically. Estimated limb salvage was 90.9 %, and patient survival rate was 90.0 % at 1 year's follow-up. Primary patency was 45.50 % and vessel restenosis 77.30 %.ConclusionSubintimal recanalization of occluded metal stents through the substent plane is a valuable alternative treatment option, especially in patients with recurrent CLI with few alternatives.

  2. Percutaneous Aspiration Thrombectomy for Arterial Thromboembolism during Infrainguinal Endovascular Recanalization

    PubMed Central

    Wei, Li-Ming; Zhu, Yue-Qi; Liu, Fang; Zhang, Pei-Lei; Li, Xiao-Cong; Zhao, Jun-Gong; Lu, Hai-Tao

    2015-01-01

    Objectives To evaluate the efficacy of percutaneous aspiration thrombectomy (PAT) for infrainguinal arterial thromboembolism in patients undergoing endovascular recanalization (EVR) and to investigate the predictors for thromboembolic complications. Materials and Methods In total, 23 patients (23 limbs) who underwent PAT for thromboembolism (PAT group, PG) during EVR and 237 patients (302 limbs) who underwent successful EVR without thromboembolic complications (control group, CG) were enrolled. Immediate post-operation and follow-up outcomes were compared between the two groups. Multivariate analysis was performed to identify the predictors of thromboembolic complications. Technical success of PAT was defined as achievement of <30% residual stenosis and restoration of mTIMI grade 3. Results The technical success rate was 95.7% in PG. After intervention, the anklebrachial index (ABI), restoration of blood flow and improvement in dorsal/plantar arterial pulse score showed no significant differences between PG and CG. During follow-up in PG, a sustained ABI improvement was observed in 63.6% (70.9% in CG), an improvement in walking distance in 68.8% (79.9% in CG,), ulcer healing in 75.0% (71.7% in CG) and restenosis/occlusion in 31.8% (25.2% in CG). The limb salvage rate was 100% in PG (96.0% in CG), and pain relief was observed in 66.7% patients with critical limb ischaemia (81.6% in CG). Superficial femoral artery involvement [0.233; 95% confidence interval (CI), 0.1080.461; P < 0.001], de-novo lesion occlusion (683.8; 95% CI, 36.512804.6; P < 0.001) and intraluminal angioplasty (118.4; 95% CI, 8.01758.0; P = 0.001) was associated with high incidence of thromboembolism. Conclusion PAT is a safe and effective treatment for thromboembolism during infrainguinal arterial EVR. SFA involvement, de-novo lesion occlusion and intraluminal angioplasty may be predictors of thromboembolic complications. PMID:26484672

  3. "Sudden Drop" in Blood Pressure is Associated With Recanalization After Thrombolysis.

    PubMed

    Yan, Shenqiang; Liu, Keqin; Cao, Jin; Liebeskind, David S; Lou, Min

    2015-07-01

    We aim to investigate whether the phenomenon of "sudden drop" in blood pressure (BP) within the first 2 hours is associated with vessel recanalization.We retrospectively examined clinical and imaging data from a consecutive series of patients with stroke with large vessel occlusion treated with intravenous thrombolysis (IVT). BP was monitored every 15 minutes during the first 2 hours, then every 30 minutes for 6 hours, and then every hour for 16 hours.We observed the phenomenon of "sudden drop" in systolic BP (?20 mm Hg) in 82 (50.9%) patients in the first 2 hours and vessel recanalization in 87 (54.0%) patients 24 hours after treatment. This phenomenon was independently associated with recanalization (odds ratio 2.100; 95% confidence interval: 1.085-4.062; P = 0.028) after adjusting for the history of atrial fibrillation, coronary heart disease, and hypertension.The phenomenon of "sudden drop" in systolic BP with 20 mm Hg or greater between 2 continuous measurements within the first 2 hours is associated with recanalization after IVT in patients with large vessel occlusion, especially for middle cerebral artery occlusion. PMID:26222844

  4. Primary Stent Placement for Recanalization of Iliac Artery Occlusions: Using a Self-Expanding Spiral Stent

    SciTech Connect

    Kim, Jae-Kyu; Kim, Yun-Hyeon; Chung, Sang-Yeung; Kang, Heoung-Keun

    1999-07-15

    Purpose: To report the clinical results for recanalizations of an occluded iliac artery by a self-expanding spiral stent. Methods: We attempted to recanalize 36 iliac artery occlusions in 34 patients [33 men, 1 woman, aged 51-75 years (average 61.6 years)]. The average lesion length was 6.92 cm (range 1-14 cm). The patients' chief complaints were intermittent claudication and resting pain. Fontaine classification was assigned before and after the procedure. Technical and clinical success were also analyzed. Results: Forty-five stents were successfully deployed in 34 patients. All 36 lesions (13 in the external iliac artery, 12 in the common iliac artery, and 11 in both) were patently recanalized on angiography. The follow-up period ranged from 6 months to 36 months (mean 11.9 months). Fourteen stents (39%) with incomplete expansion were dilated with a balloon catheter. Good technical (100%) and clinical (94%) results were obtained. The only complication was one hematoma at the puncture site. Reocclusions were noted in two lesions (5%) at 1 week and 15 months, respectively. Conclusion: A self-expanding spiral stent is a safe and effective device for recanalization of an iliac artery occlusion as the primary stent without any previous intervention.

  5. Stent-assisted mechanical recanalization for symptomatic subacute or chronic middle cerebral artery occlusion

    PubMed Central

    Guo, Dong; Ma, Ji; Li, Teng-Fei; Zhu, Ming; Han, Xin-Wei; Shui, Shao-Feng

    2015-01-01

    To assess the feasibility and short-term effects of treating patients with subacute or chronic middle cerebral artery (M1) occlusion by stent-assisted mechanical recanalization. Six patients with cerebral arteries occlusion underwent surgery. Six cerebral arteries occlusion in 5 patients were successfully recanalized. On postoperative day 1, four patients symptoms were relieved and two patients symptoms were exacerbated, of which one was significantly improved after 3 days, the other ones symptoms were recovered to preoperative levels in 2 weeks. No patients died after surgery. No stroke or transient ischemic attack occurred. The average follow-up of was 4.2 months, no worsening of condition, recurrence or death occurred. The results indicate that for patients with subacute or chronic middle cerebral artery (M1) occlusion, mechanical recanalization was technically feasible under the premise of strict case screening. Mechanical recanalization is able to improve ischemic symptoms and promote dysfunction restoration. But its long-term effect remains to be evaluated by further large samples, long-term follow-up studies.

  6. Hemodynamic Characteristics Regarding Recanalization of Completely Coiled Aneurysms: Computational Fluid Dynamic Analysis Using Virtual Models Comparison

    PubMed Central

    Park, Wonhyoung; Song, Yunsun; Park, Kye Jin; Koo, Hae-Won; Yang, Kuhyun

    2016-01-01

    Purpose Hemodynamic factors are considered to play an important role in initiation and progression of the recurrence after endosaccular coiling of the intracranial aneurysms. We made paired virtual models of completely coiled aneurysms which were subsequently recanalized and compared to identify hemodynamic characteristics related to the recurred aneurysmal sac. Materials and Methods We created paired virtual models of computational fluid dynamics (CFD) in five aneurysms which were initially regarded as having achieved complete occlusion and then recurred during follow-up. Paired virtual models consisted of the CFD model of 3D rotational angiography obtained in the recurred aneurysm and the control model of the initial, parent artery after artificial removal of the coiled and recanalized aneurysm. Using the CFD analysis of the virtual model, we analyzed the hemodynamic characteristics on the neck of each aneurysm before and after its recurrence. Results High wall shear stress (WSS) was identified at the cross-sectionally identified aneurysm neck at which recurrence developed in all cases. A small vortex formation with relatively low velocity in front of the neck was also identified in four cases. The aneurysm recurrence locations corresponded to the location of high WSS and/or small vortex formation. Conclusion Recanalized aneurysms revealed increased WSS and small vortex formation at the cross-sectional neck of the aneurysm. This observation may partially explain the hemodynamic causes of future recanalization after coil embolization. PMID:26958410

  7. Sudden Drop in Blood Pressure is Associated With Recanalization After Thrombolysis

    PubMed Central

    Yan, Shenqiang; Liu, Keqin; Cao, Jin; Liebeskind, David S.; Lou, Min

    2015-01-01

    Abstract We aim to investigate whether the phenomenon of sudden drop in blood pressure (BP) within the first 2 hours is associated with vessel recanalization. We retrospectively examined clinical and imaging data from a consecutive series of patients with stroke with large vessel occlusion treated with intravenous thrombolysis (IVT). BP was monitored every 15 minutes during the first 2 hours, then every 30 minutes for 6 hours, and then every hour for 16 hours. We observed the phenomenon of sudden drop in systolic BP (?20?mm Hg) in 82 (50.9%) patients in the first 2 hours and vessel recanalization in 87 (54.0%) patients 24 hours after treatment. This phenomenon was independently associated with recanalization (odds ratio 2.100; 95% confidence interval: 1.0854.062; P?=?0.028) after adjusting for the history of atrial fibrillation, coronary heart disease, and hypertension. The phenomenon of sudden drop in systolic BP with 20?mm Hg or greater between 2 continuous measurements within the first 2 hours is associated with recanalization after IVT in patients with large vessel occlusion, especially for middle cerebral artery occlusion. PMID:26222844

  8. Percutaneous Extraluminal (Subintimal) Recanalization of a Brachial Artery Occlusion Following Cardiac Catheterization

    SciTech Connect

    Bolia, Amman; Nasim, Akhtar; Bell, Peter R.F.

    1996-05-15

    A 47-year-old woman presented with disabling right arm claudication 10 weeks after Sones cardiac catheterization via a brachial artery cut-down. A technique of extraluminal recanalization of the brachial artery occlusion, used to treat this patient, is described.

  9. Endovenous Laser Ablation of the Small Saphenous Vein Sparing the Saphenopopliteal Junction

    SciTech Connect

    Janne d'Othee, Bertrand Walker, T. Gregory; Kalva, Sanjeeva P.; Ganguli, Suvranu; Davison, Brian

    2010-08-15

    To assess outcomes after endovenous laser ablation (EVLA) of the small saphenous vein (SSV). Retrospective review was performed of all consecutive EVLA procedures performed over a 39-month period at three neighboring vein practices for symptomatic, duplex ultrasound-proven incompetence of the SSV. EVLA was performed under ultrasound guidance with an 810- or 980-nm diode laser in continuous mode using the pullback method while sparing the deep, most cephalad segment of the SSV near the saphenopopliteal junction. Follow-up after EVLA included patient symptoms, physical examination, and duplex ultrasound. Pretreatment variables were similar across all three practices. EVLA was performed to treat 67 incompetent SSVs in 63 patients (86% women; mean age and 95% confidence interval, 50 {+-} 3 years; range, 20-82 years). Average energy delivered was 92 J/cm. Immediate technical success and occlusion of the treated vein at 1-2 weeks was 100%. Imaging follow-up length was 243 {+-} 65 days (range, 3-893 days). Clinical follow-up (243 {+-} 66 days) showed symptomatic improvement in 66 (99%) of 67 patients; one patient had recanalization with recurrent reflux by ultrasound (2%). Complications included one case of paresthesias lasting beyond 1 month of follow-up (2%) and three cases of superficial phlebitis (4%), but no deep vein thrombosis, skin burns, or other complications. Although ablation involved only the superficial portion of the SSV and spared its deep segment in the popliteal fossa, SSV occlusion typically extended up to the saphenopopliteal junction or to a gastrocnemial collateral, without popliteal vein involvement. EVLA of the SSV is safe and effective when the saphenopopliteal junction and popliteal fossa are avoided. This approach may help reduce the risk of paresthesias or other complications while maintaining low recanalization rates.

  10. Mechanical Thrombectomy of Iliac Vein Thrombosis in a Pig Model Using the Rotarex and Aspirex Catheters

    SciTech Connect

    Minko, P. Bücker, A.

    2013-06-08

    PurposeTo investigate the efficacy and safety of mechanical thrombectomy for iliac vein thrombosis using Rotarex and Aspirex catheters in a pig model.Materials and MethodsIliac vein thrombosis was induced in six pigs by means of an occlusion-balloon catheter and thrombin injection. The presence of thrombi was verified by digital subtraction angiography (DSA) and computed tomography (CT). Thrombectomy was performed using 6F and 8F Rotarex and 6F, 8F, and 10F Aspirex catheters (Straub Medical AG, Wangs, Switzerland). After intervention, DSA and CT were repeated to evaluate the efficacy of mechanical thrombectomy and to exclude local complications. In addition, pulmonary CT was performed to rule out pulmonary embolism. Finally, all pigs were killed, and iliac veins were dissected to perform macroscopic and histological examination.ResultsThrombus induction was successfully achieved in all animals as verified by DSA and CT. Subsequent thrombectomy lead to incomplete recanalization of the iliac veins with residual thrombi in all cases. However, the use of the 6F and 8F Rotarex catheters caused vessel perforation and retroperitoneal hemorrhage in all cases. Application of the Aspirex device caused one small transmural perforation in a vessel treated with a 10F Aspirex catheter, and this was only seen microscopically. Pulmonary embolism was detected in one animal treated with the Rotarex catheters, whereas no pulmonary emboli were seen in animals treated with the Aspirex catheters.ConclusionThe Aspirex catheter allowed subtotal and safe recanalization of iliac vein thrombosis. In contrast, the use of the Rotarex catheter caused macroscopically obvious vessel perforations in all cases.

  11. Radiofrequency ablation of hepatocellular carcinoma extended into the portal vein: Preliminary results

    PubMed Central

    Giorgio, A.; de Stefano, G.; Di Sarno, A.; Farella, N.; Giorgio, V.; Scognamiglio, U.; Mariniello, A.; Liorre, G.; Perrotta, A.; Mariniello, N.

    2009-01-01

    Introduction We report our preliminary results of radiofrequency (RF) ablation of hepatocellular carcinoma (HCC) and neoplastic portal thrombus (NPT) in cirrhotic patients. Methods Ten patients (7 males and 3 females; mean age 68 yrs) with 10 HCC nodules (37–49 mm) extended into the main portal vein (MPV) underwent RF ablation. Diagnosis of NPT was achieved by fine-needle biopsy. RF ablation was performed firstly on the NPT and then on the HCC. RF ablation was considered successful when complete necrosis of the HCC and complete recanalization of the MPV were achieved. HCC necrosis was evaluated using contrast-enhanced CT. Recanalization of the portal vessels (PV) was analyzed using Color Doppler (CD). RF ablation was performed under ultrasonographic (US) guidance using a perfused electrode needle. Results Complete necrosis of the HCC with complete recanalization of the PV was observed in 7 patients (success rate: 70%). In the remaining 3, necrosis of the HCC ranged from 70% to 95%, and recanalization of the PV was not complete. No major complications occurred. In 2 cases, mild ascites and increased aspartate aminotransferase/alanine aminotransferase (AST/ALT) values were observed. The follow-up ranged from 4 to 24 months; 1 and 2-year survival rates were 77% and 77%, respectively. At the last follow-up, the 7 successful patients were alive and the portal system was still patent. The 3 unsuccessful patients died within 5 months due to progressive disease. Conclusion RF ablation can destroy HCC and NPT achieving a high rate of efficacy and low rate of complications. However, to confirm these results a control group and a longer follow-up are required. PMID:23396977

  12. Transsinusoidal Portal Vein Embolization with Ethylene Vinyl Alcohol Copolymer (Onyx): A Feasibility Study in Pigs

    SciTech Connect

    Smits, Maarten L. J.; Vanlangenhove, Peter Sturm, Emiel J. C.; Bosch, Maurice A. A. J. van den; Hav, Monirath Praet, Marleen; Vente, Maarten A. D.; Snaps, Frederic R.; Defreyne, Luc

    2012-10-15

    Purpose: Portal vein embolization is performed to increase the future liver remnant before liver surgery in patients with liver malignancies. This study assesses the feasibility of a transsinusoidal approach for portal vein embolization (PVE) with the ethylene vinyl alcohol copolymer, Onyx. Methods: Indirect portography through contrast injection in the cranial mesenteric artery was performed in eight healthy pigs. Onyx was slowly injected through a microcatheter from a wedged position in the hepatic vein and advanced through the liver lobules into the portal system. The progression of Onyx was followed under fluoroscopy, and the extent of embolization was monitored by indirect portography. The pigs were euthanized immediately (n = 2), at 7 days (n = 4), or at 21 days postprocedure (n = 2). All pigs underwent necropsy and the ex vivo livers were grossly and histopathologically analyzed. Results: Transsinusoidal PVE was successfully performed in five of eight pigs (63%). In 14 of 21 injections (67%), a segmental portal vein could be filled completely. A mean of 1.6 liver lobes per pig was embolized (range 1-2 lobes). There were no periprocedural adverse events. Focal capsular scarring was visible on the surface of two resected livers, yet the capsules remained intact. Histopathological examination showed no signs of recanalization or abscess formation. Mild inflammatory reaction to Onyx was observed in the perivascular parenchyma. Conclusions: The porcine portal vein can be embolized through injection of Onyx from a wedged position in the hepatic vein. Possible complications of transsinusoidal PVE and the effect on contralateral hypertrophy need further study.

  13. Vein graft failure.

    PubMed

    Owens, Christopher D; Gasper, Warren J; Rahman, Amreen S; Conte, Michael S

    2015-01-01

    After the creation of an autogenous lower extremity bypass graft, the vein must undergo a series of dynamic structural changes to stabilize the arterial hemodynamic forces. These changes, which are commonly referred to as remodeling, include an inflammatory response, the development of a neointima, matrix turnover, and cellular proliferation and apoptosis. The sum total of these processes results in dramatic alterations in the physical and biomechanical attributes of the arterialized vein. The most clinically obvious and easily measured of these is lumen remodeling of the graft. However, although somewhat less precise, wall thickness, matrix composition, and endothelial changes can be measured in vivo within the healing vein graft. Recent translational work has demonstrated the clinical relevance of remodeling as it relates to vein graft patency and the systemic factors influencing it. By correlating histologic and molecular changes in the vein, insights into potential therapeutic strategies to prevent bypass failure and areas for future investigation are explored. PMID:24095042

  14. Vein graft failure

    PubMed Central

    Owens, Christopher D.; Gasper, Warren J.; Rahman, Amreen S.; Conte, Michael S

    2013-01-01

    Following the creation of an autogenous lower extremity bypass graft, the vein must undergo a series of dynamic structural changes to stabilize the arterial hemodynamic forces. These changes, commonly referred to as remodeling, include an inflammatory response, the development of a neointima, matrix turnover, and cellular proliferation and apoptosis. The sum total of these processes results in dramatic alterations in the physical and biomechanical attributes of the arterialized vein. The most clinically obvious and easily measured of these is lumen remodeling of the graft. However, though somewhat less precise, wall thickness, matrix composition, and endothelial changes can be measured in vivo within the healing vein graft. Recent translational work has demonstrated the clinical relevance of remodeling as it relates to vein graft patency and the systemic factors influencing it. By correlating histologic and molecular changes in the vein, insights into potential therapeutic strategies to prevent bypass failure and areas for future investigation are explored. PMID:24095042

  15. Evaluation of Endarterectomy Recanalization under Ultrasound Guidance in Symptomatic Patients with Carotid Artery Occlusion

    PubMed Central

    Liu, Yumei; Jia, Lingyun; Liu, Beibei; Meng, Xiufeng; Yang, Jie; Li, Jingzhi; Zhou, Yinghua; Jiao, Liqun; Hua, Yang

    2015-01-01

    Rigorous screening and good imaging would help perform surgery on carotid artery occlusion CAO safely and effectively. The purpose of this study was to retrospectively evaluate carotid endarterectomy (CEA) recanalization in patients with common carotid artery occlusion (CCAO) or internal carotid artery occlusion (ICAO) with color Doppler flow imaging (CDFI). A total of 59 patients undergoing CEA were enrolled. According to the results of CEA, the patients were divided into successful recanalization (group A) and unsuccessful recanalization (group B) groups. The original diameter, lesion length, proximal-to-distal diameter ratio and echo characteristics of the lesion within the lumen of the carotid artery were recorded before CEA and compared between the two groups. In regards to the achievement of repatency by CEA, the overall success rate was 74.6% (44/59), the success rate in CCAO patients was 75.9% (22/29) and the success rate in ICAO patients was 73.3% (22/30). There was no significant difference in the success rates between the CCAO and ICAO patients (?2 = 0.050, P = 0.824). The overall rate of stroke and death within 30 postoperative days was 5.1% (3/59). For the CCAO patients, the lesion length in group A was shorter than that in group B (t = 3.221, P = 0.004). For the ICAO patients, the original diameter of the distal ICA was broader (t = 6.254, P = 0.000) and the proximal-to-distal ICA diameter ratio was smaller (t = 8.036, P = 0.000) in group A than in group B. The rate of recanalization for lumens with a homogeneous echo pattern (hypoecho or isoecho) was significantly higher than that for lumens with echo heterogeneity for both the CCAO and ICAO patients (?2 = 14.477, P = 0.001; ?2 = 10.519, P = 0.003). However, for both the CCAO and ICAO patients, there was no difference in the rate of recanalization between patients with hypoecho and isoecho lesions (?2 = 0.109, P = 0.742; ?2 = 0.836, P = 0.429). The original diameter, proximal-to-distal ICA diameter ratio, lesion length and echo characteristics may affect the success of CEA recanalization in patients with CCAO and ICAO. CDFI is helpful in screening patients with carotid artery occlusion and may improve the success rate of CEA. PMID:26636827

  16. Percutaneous Retrograde Recanalization of the Celiac Artery by Way of the Superior Mesenteric Artery for Chronic Mesenteric Ischemia

    SciTech Connect

    Joseph, George Chacko, Sujith Thomas

    2013-02-15

    A 52-year-old man presented with recurrent postprandial abdominal pain, sitophobia, and progressive weight loss. Chronic mesenteric ischemia (CMI) due to subtotal occlusion of the superior mesenteric artery (SMA) and flush occlusion of the celiac artery (CA) was diagnosed. Retrograde recanalization of the CA by way of a collateral channel from the SMA was performed using contemporary recanalization equipment. The CA and SMA were then stented, resulting in sustained resolution of CMI-related symptoms.

  17. The Effectiveness of Additional Treatment Modalities after the Failure of Recanalization by Thrombectomy Alone in Acute Vertebrobasilar Arterial Occlusion

    PubMed Central

    Kim, Seong Mook; Sohn, Sung-Il; Hong, Jeong-Ho; Chang, Hyuk-Won; Lee, Chang-Young

    2015-01-01

    Objective Acute vertebrobasilar artery occlusion (AVBAO) is a devastating disease with a high mortality rate. One of the most important factors affecting favorable clinical outcome is early recanalization. Mechanical thrombectomy is an emerging treatment strategy for achieving a high recanalization rates. However, thrombectomy alone can be insufficient to complete recanalization, especially for acute stroke involving large artery atheromatous disease. The purpose of this study is to investigate the safety and efficacy of mechanical thrombectomy in AVBAO. Methods Fourteen consecutive patients with AVBAO were treated with mechanical thrombectomy. Additional multimodal treatments were intra-arterial (IA) thrombolysis, balloon angioplasty, or permanent stent placement. Recanalization by thrombectomy alone and multimodal treatments were assessed by the Thrombolysis in Cerebral Infarction (TICI) score. Clinical outcome was determined using the National Institutes of Health Stroke Scale (NIHSS) at 7 days and the modified Rankin Scale (mRS) at 3 months. Results Thrombectomy alone and multimodal treatments were performed in 10 patients (71.4%) and 4 patients (28.6%), respectively. Successful recanalization (TICI 2b-3) was achieved in 11 (78.6%). Among these 11 patients, 3 (27.3%) underwent multimodal treatment due to underlying atherosclerotic stenosis. Ten (71.4%) of the 14 showed NIHSS score improvement of >10. Overall mortality was 3 (21.4%) of 14. Conclusion We suggest that mechanical thrombectomy is safe and effective for improving recanalization rates in AVBAO, with low complication rates. Also, in carefully selected patients after the failure of recanalization by thrombectomy alone, additional multimodal treatment such as IA thrombolysis, balloons, or stents can be needed to achieve successful recanalization. PMID:26713141

  18. Multivariate dynamic prediction of ischemic infarction and tissue salvage as a function of time and degree of recanalization.

    PubMed

    Kemmling, Andr; Flottmann, Fabian; Forkert, Nils Daniel; Minnerup, Jens; Heindel, Walter; Thomalla, Goetz; Eckert, Bernd; Knauth, Michael; Psychogios, Marios; Langner, Soenke; Fiehler, Jens

    2015-09-01

    Benefit of endovascular recanalization beyond established treatment time windows likely exists in select stroke patients. However, there is currently no imaging model that predicts infarction adjusting for elapsed time between the pathologic snapshot of admission imaging until endovascular recanalization. We trained and cross validated a multivariate generalized linear model (GLM) that uses computer tomography perfusion and clinical data to quantify patient-specific dynamic change of tissue infarction depending on degree and time of recanalization. Multicenter data of 161 patients with proximal anterior circulation occlusion undergoing endovascular therapy were included. Multivariate voxelwise infarct probability was calculated within the GLM. The effect of increasing time to treatment and degree of recanalization on voxelwise infarction was calculated in each patient. Tissue benefit of successful relative to unsuccessful recanalization was shown up to 15?hours after onset in individual patients and decreased nonlinearly with time. On average, the relative reduction of infarct volume at the treatment interval of 5?hours was 53% and this salvage effect decreased by 5% units per hour to <5% after 10 additional hours to treatment. Treatment time-adjusted multivariate prediction of infarction by perfusion and clinical status may identify patients who benefit from extended time to recanalization therapy. PMID:26154867

  19. Tissue Plasminogen Activator for preclinical stroke research: Neither rat nor human dose mimics clinical recanalization in a carotid occlusion model

    PubMed Central

    Tomkins, Amelia J.; Hood, Rebecca J.; Levi, Christopher R.; Spratt, Neil J.

    2015-01-01

    Tissue plasminogen activator (tPA) is the only approved thrombolytic therapy for acute ischemic stroke, yet many patients do not recanalize. Enhancing thrombolytic efficacy of tPA is a major focus of stroke research. Traditionally, a rat dose of 10?mg/kg has been used in rodent models. Recent studies suggested that the clinical human dose (0.9?mg/kg) may better mimic clinical recanalization. These studies only compared the rat and clinical doses, and so we aimed to test recanalization efficacy of multiple tPA doses ranging from 0.9 to 10?mg/kg in a model of endothelial injury and vessel stenosis. The common carotid artery of rats was crushed and stenosed to allow in-situ occlusive thrombus formation (Folts model of physiological thrombus). Intravenous tPA was administered 60 minutes post-occlusion (n?=?6-7/group). Sustained recanalization rates were 0%, 17%, 67% and 71%, for 0.9, 1.8, 4.5, and 10?mg/kg, respectively. Median time to sustained recanalization onset decreased with increasing dosage. We conclude that 10?mg/kg of tPA is too effective, whereas 0.9?mg/kg is ineffective for lysis of occlusive thrombi formed in situ. Neither dose mimics clinical tPA responses. A dose of 2x the clinical dose is a more appropriate mimic of clinical tPA recanalization in this model. PMID:26522691

  20. Recanalization of Obstructed Tenckhoff Peritoneal Dialysis Catheter: Wire/Stylet Manipulation Combined with Endoluminal Electrocauterization

    SciTech Connect

    Lim, Sang Joon; Shim, Hyung Jin; Kwak, Byung Gook; Kim, Hyeon Joo; Park, Hyo Jin; Sa, Eun Jin; Min, Cheol Hong; Lee, Yong Chul; Kim, Kun Sang

    1998-09-15

    We report the results of fluoroscopically guided wire/stylet manipulation combined with endoluminal electrocauterization in seven patients with obstructed Tenckhoff peritoneal dialysis catheters. In preparation for clinical application, electrocauterization was performed using a stone basket to recanalize surgically removed Tenckhoff catheters obstructed with omental fat ingrowing through the side holes. All ingrowing omental fat was removed easily by electrocauterization with the rotating movement of a stone basket. The technique was then applied in vivo in seven cases with ingrowing omental fat and malpositioned catheter; six (86%) were successfully recanalized. Among those six cases with initial success, four maintained good catheter function with durable patency (mean 261.3 days). No significant complication was noted.

  1. Mechanical recanalization of total coronary occlusions with the use of a new guide wire.

    PubMed

    Reimers, B; Camassa, N; Di Mario, C; Akiyama, T; Di Francesco, L; Finci, L; Colombo, A

    1998-04-01

    The mechanical approach in the recanalization of total coronary occlusions consisted of the use of a new 0.014-inch standard coronary guide wire with jointless spring coil design that improves steering characteristics and tip stiffness. In addition, a 0.014-inch soft tip wire with hydrophilic coating and low-profile 1.5 mm over-the-wire balloons were used. The first wire was used selectively in 86 patients to treat 95 total occlusions, of which 51 (54%) were older than 3 months. Unfavorable angiographic characteristics were present in 79 (83%) of 95 lesions. Overall crossing success was 71% (67 of 95 lesions). Complications were one coronary perforation with cardiac tamponade necessitating emergency bypass surgery. In conclusion, the mechanical approach with the use of the standard coronary guide wire with jointless spring coil design provides a high success rate in the recanalization of unfavorable total occlusions. PMID:9539493

  2. [Fallopian tube recanalization with a catheter system--experience in the use of a balloon catheter].

    PubMed

    Shinmoto, H; Ido, K; Sumi, K; Nagai, T; Izumi, S; Kondo, Z; Narimatsu, Y; Izutsu, M; Yuasa, Y; Nakatsuka, S

    1991-02-25

    Fallopian tube obstruction is one of the most difficult problems in the treatment of infertility. This report gives the results of a pilot study on the transcervical recanalization of the occlusive fallopian tube. Selective catheterization of the uterine cornu was applied through a balloon catheter, which was wedged at the internal uterine os. In 16 occlusive fallopian tubes of 11 cases, the catheterization procedure was attempted and accomplished with a 87.5% success rate. Recanalization was successful in 75.0% of the affected tubes. Subsequent pregnancy was confirmed in three cases. This convenient technique is safe and effective and it will be accepted as the first choice in the diagnosis and treatment of fallopian tube obstruction. PMID:2034520

  3. Standard varicose vein surgery.

    PubMed

    Perkins, J M T

    2009-01-01

    This article examines the practice of standard varicose vein surgery including sapheno-femoral and sapheno-popliteal ligation, perforator surgery and surgery for recurrent varicose veins. The technique of exposure of the sapheno-femoral junction and the sapheno-popliteal junction is outlined and advice given on avoidance of complications for both. The evidence regarding methods of closure over the ligated sapheno-femoral junction is examined as is the requirement for stripping and the use of different types of stripper. The requirement to strip the small saphenous vein and the extent of dissection necessary in the popliteal fossa is also examined. Complications of standard varicose vein surgery are outlined. The frequency of wound infection, nerve injury, vascular injury and venous thromboembolism are listed and strategies to avoid these complications are examined. PMID:19307439

  4. What Are Varicose Veins?

    MedlinePLUS

    ... body in the veins is darker because your body parts have used up the oxygen in the blood. ... on the legs, ankles, and feet because those body parts are farthest from the heart. Gravity pulls blood ...

  5. Varicose vein stripping

    MedlinePLUS

    ... ankle. Your surgeon will then thread a thin, flexible plastic wire into the vein through your groin ... Your legs will be wrapped with bandages to control swelling and bleeding for 3 to 5 days ...

  6. Deep vein thrombosis - discharge

    MedlinePLUS

    You were treated for deep venous thrombosis (DVT). This is a condition in which a blood clot forms in a vein that is not on ... especially if it gets worse upon taking a deep breath in You cough up blood

  7. Contralateral approach to iliac artery recanalization with kissing nitinol stents present in the aortic bifurcation.

    PubMed

    Joseph, George; Hooda, Amit; Thomson, Viji Samuel

    2015-01-01

    A 69-year-old man, who had earlier undergone reconstruction of the aortic bifurcation with kissing nitinol stents, presented with occlusion of the left external iliac artery. The occlusion was successfully and safely recanalized using contralateral femoral approach with passage of interventional hardware through the struts of the stents in the aortic bifurcation. Presence of contemporary flexible nitinol stents with open-cell design in the aortic bifurcation is not a contraindication to the use of the contralateral femoral approach. PMID:26702686

  8. Radiofrequency Guide Wire Recanalization of Venous Occlusions in Patients with Malignant Superior Vena Cava Syndrome

    SciTech Connect

    Davis, Robert M.; David, Elizabeth; Pugash, Robyn A.; Annamalai, Ganesan

    2012-06-15

    Fibrotic central venous occlusions in patients with thoracic malignancy and prior radiotherapy can be impassable with standard catheters and wires, including the trailing or stiff end of a hydrophilic wire. We report two patients with superior vena cava syndrome in whom we successfully utilized a radiofrequency guide wire (PowerWire, Baylis Medical, Montreal, Quebec, Canada) to perforate through the occlusion and recanalize the occluded segment to alleviate symptoms.

  9. Salpingitis Isthmica Nodosa: Technical Success and Outcome of Fluoroscopic Transcervical Fallopian Tube Recanalization

    SciTech Connect

    Houston, J. Graeme; Machan, Lindsay S.

    1998-01-15

    Purpose: To evaluate the technical success and outcome of fallopian tube recanalization (FTR) in salpingitis isthmica nodosa (SIN). Methods: SIN is a well-recognized pathological condition affecting the proximal fallopian tube and is associated with infertility and ectopic pregnancy. We reviewed the presentations, films, and case records of all patients attending for FTR for infertility from 1990 to 1994. Technical success and total, intrauterine, and ectopic pregnancy rates at follow-up were determined. Results: SIN was observed in 22 of 349 (6%) patients. FTR was attempted in 34 tubes in these 22 patients. Technical success was achieved in 23 of 34 (68%) tubes affected by SIN. In 5 of the 11 failed recanalizations, failure was due to distal obstruction. At least one tube was patent on selective postprocedural salpingography in 17 of 22 (77%) patients. There were no recorded perforations or complications. At follow-up (mean 14 months), total, intrauterine, and ectopic pregnancy rates were 23%, 18%, and 4.5%, respectively. Conclusion: FTR in SIN is technically successful and, compared with previously reported results in unselected infertility patients, is associated with only a slightly less favorable intrauterine pregnancy rate and a comparable ectopic pregnancy rate. The findings of SIN at FTR should not discourage attempted fluoroscopic transcervical recanalization.

  10. Mesenteric vein thrombosis: CT identification

    SciTech Connect

    Rosen, A.; Korobkin, M.; Silverman, P.M.; Dunnick, N.R.; Kelvin, F.M.

    1984-07-01

    Superior mesenteric vein thrombosis was identified on computed tomographic scans in six patients. In each case, contrast-enhanced scans showed a high-density superior mesenteric vein wall surrounding a central filling defect. Four fo the six patients had isolated superior mesenteric vein thrombosis. A fifth patient had associated portal vein and splenic vein thrombosis, and the sixth patient had associated portal vein and inferior vena cava thrombosis. One of the six patients had acute ischemic bowel disease. The other five patients did not have acute ischemic bowel symptoms associated with their venous occlusion. This study defines the computed tomographic appearance of mesenteric vein thrombosis.

  11. Real-Time MRI-Guided Endovascular Recanalization of Chronic Total Arterial Occlusion in a Swine Model

    PubMed Central

    Raval, Amish N.; Karmarkar, Parag V.; Guttman, Michael A.; Ozturk, Cengizhan; Sampath, Smita; DeSilva, Ranil; Aviles, Ronnier J.; Xu, Minnan; Wright, Victor J.; Schenke, William H.; Kocaturk, Ozgur; Dick, Alexander J.; Raman, Venkatesh K.; Atalar, Ergin; McVeigh, Elliot R.; Lederman, Robert J.

    2006-01-01

    Background Endovascular recanalization (guidewire traversal) of peripheral artery chronic total occlusion (CTO) can be challenging. X-Ray angiography resolves CTO poorly. Virtually blind device advancement during X-ray-guided interventions can lead to procedure failure, perforation and hemorrhage. Alternatively, magnetic resonance imaging (MRI) may delineate the artery within the occluded segment to enhance procedural safety and success. We hypothesized that real-time MRI (rtMRI) guided CTO recanalization can be accomplished in an animal model. Methods and Results Carotid artery CTO was created by balloon injury in 19 lipid overfed swine. After 68 weeks, two underwent direct necropsy analysis for histology, three underwent primary X-ray-guided CTO recanalization attempts, and the remaining 14 underwent rtMRI-guided recanalization attempts in a 1.5T interventional MRI system. rtMRI intervention used custom CTO catheters and guidewires that incorporated MRI receiver antennae to enhance device visibility. The mean length of the occluded segments was 13.3 1.6cm. rtMRI-guided CTO recanalization was successful in 11/14 swine and only 1/3 swine using X-ray alone. After unsuccessful rtMRI (n = 3), X-ray-guided attempts also were all unsuccessful. Conclusions Recanalization of long CTO is feasible entirely using rtMRI guidance. Low profile clinical-grade devices will be required to translate this experience to humans. Endovascular recanalization of chronic total arterial occlusion (CTO) is challenging under conventional X-ray guidance because devices are advanced almost blindly. MRI can image CTO borders and luminal contents, and could potentially guide these procedures. We test the feasibility of real-time MRI guided wire traversal in a swine model of peripheral artery CTO using custom active MRI catheters. PMID:16490819

  12. Diagnosis of deep vein thrombosis, and prevention of deep vein thrombosis recurrence and the post-thrombotic syndrome in the primary care medicine setting anno 2014

    PubMed Central

    Michiels, Jan Jacques; Michiels, Janneke Maria; Moossdorff, Wim; Lao, Mildred; Maasland, Hanny; Palareti, Gualtiero

    2015-01-01

    The requirement for a safe diagnostic strategy of deep vein thrombosis (DVT) should be based on an overall objective post incidence of venous thromboembolism (VTE) of less than 1% during 3 mo follow-up. Compression ultrasonography (CUS) of the leg veins has a negative predictive value (NPV) of 97%-98% indicating the need of repeated CUS testing within one week. A negative ELISA VIDAS safely excludes DVT and VTE with a NPV between 99% and 100% at a low clinical score of zero. The combination of low clinical score and a less sensitive D-dimer test (Simplify) is not sensitive enough to exclude DVT and VTE in routine daily practice. From prospective clinical research studies it may be concluded that complete recanalization within 3 mo and no reflux is associated with a low or no risk of PTS obviating the need of MECS 6 mo after DVT. Partial and complete recanalization after 3 to more than 6 mo is usually complicated by reflux due to valve destruction and symptomatic PTS. Reflux seems to be a main determinant for PTS and DVT recurrence, the latter as a main contributing factor in worsening PTS. This hypothesis is supported by the relation between the persistent residual vein thrombosis (RVT = partial recanalization) and the risk of VTE recurrence in prospective studies. Absence of RVT at 3 mo post-DVT and no reflux is predicted to be associated with no recurrence of DVT (1.2%) during follow-up obviating the need of wearing medical elastic stockings and anticoagulation at 6 mo post-DVT. The presence or absence of RVT but with reflux at 3 to 6 mo post-DVT is associated with both symptomatic PTS and an increased risk of VTE recurrence in about one third in the post-DVT period after regular discontinuation of anticoagulant treatment. To test this hypothesis we designed a prospective DVT and postthrombotic syndrome (PTS) Bridging the Gap Study by addressing at least four unanswered questions in the treatment of DVT and PTS. Which DVT patient has a clear indication for long-term compression stocking therapy to prevent PTS after the initial anticoagulant treatment in the acute phase of DVT? Is 3 mo the appropriate point in time to determine candidates at risk to develop DVT recurrence and PTS? Which high risk symptomatic PTS patients need extended anticoagulant treatment? PMID:25685720

  13. Ovarian vein thrombosis

    PubMed Central

    Jenayah, Amel Achour; Saoudi, Sarra; Boudaya, Fethia; Bouriel, Ines; Sfar, Ezzeddine; Chelli, Dalenda

    2015-01-01

    Ovarian vein thrombosis (OVT) is a rare cause of abdominal pain that may mimic a surgical abdomen. It is most often diagnosed during the postpartum period. In this report, we present four cases of postoperative ovarian vein thrombosis. The complications of OVT can be significant, and the diagnosis relies on a careful examination of the radiographic findings. It can occur with lower quadrant abdominal pain, especially in the setting of recent pregnancy, abdominal surgery, pelvic inflammatory disease, or malignancy. Diagnosis can be made with confidence using ultrasound, computed tomography or magnetic resonance imaging. Treatment of ovarian vein thrombosis is particularly important in the post-partum patients, with anticoagulation therapy being the current recommendation. PMID:26526119

  14. Pelvic Vein Embolisation in the Management of Varicose Veins

    SciTech Connect

    Ratnam, Lakshmi A.; Marsh, Petra; Holdstock, Judy M.; Harrison, Charmaine S.; Hussain, Fuad F.; Whiteley, Mark S.; Lopez, Anthony

    2008-11-15

    Pelvic vein incompetence is common in patients with atypical varicose veins, contributing to their recurrence after surgery. Therefore, refluxing pelvic veins should be identified and treated. We present our experience with pelvic vein embolisation in patients presenting with varicose veins. Patients presenting with varicose veins with a duplex-proven contribution from perivulval veins undergo transvaginal duplex sonography (TVUS) to identify refluxing pelvic veins. Those with positive scans undergo embolisation before surgical treatment of their lower limb varicose veins. A total of 218 women (mean age of 46.3 years) were treated. Parity was documented in the first 60 patients, of whom 47 (78.3%) were multiparous, 11 (18.3%) had had one previous pregnancy, and 2 (3.3%) were nulliparous. The left ovarian vein was embolised in 78%, the right internal iliac in 64.7%, the left internal iliac in 56.4%, and the right ovarian vein in 42.2% of patients. At follow-up TVUS, mild reflux only was seen in 16, marked persistent reflux in 6, and new reflux in 3 patients. These 9 women underwent successful repeat embolisation. Two patients experienced pulmonary embolisation of the coils, of whom 1 was asymptomatic and 1 was successfully retrieved; 1 patient had a misplaced coil protruding into the common femoral vein; and 1 patient had perineal thrombophlebitis. The results of our study showed that pelvic venous embolisation by way of a transjugular approach is a safe and effective technique in the treatment of pelvic vein reflux.

  15. [Deep vein thrombosis prophylaxis.

    PubMed

    Sandoval-Chagoya, Gloria Alejandra; Laniado-Laborn, Rafael

    2013-01-01

    Background: despite the proven effectiveness of preventive therapy for deep vein thrombosis, a significant proportion of patients at risk for thromboembolism do not receive prophylaxis during hospitalization. Our objective was to determine the adherence to thrombosis prophylaxis guidelines in a general hospital as a quality control strategy. Methods: a random audit of clinical charts was conducted at the Tijuana General Hospital, Baja California, Mexico, to determine the degree of adherence to deep vein thrombosis prophylaxis guidelines. The instrument used was the Caprini's checklist for thrombosis risk assessment in adult patients. Results: the sample included 300 patient charts; 182 (60.7 %) were surgical patients and 118 were medical patients. Forty six patients (15.3 %) received deep vein thrombosis pharmacologic prophylaxis; 27.1 % of medical patients received deep vein thrombosis prophylaxis versus 8.3 % of surgical patients (p < 0.0001). Conclusions: our results show that adherence to DVT prophylaxis at our hospital is extremely low. Only 15.3 % of our patients at risk received treatment, and even patients with very high risk received treatment in less than 25 % of the cases. We have implemented strategies to increase compliance with clinical guidelines. PMID:24290023

  16. Living with Deep Vein Thrombosis

    MedlinePLUS

    ... page from the NHLBI on Twitter. Living With Deep Vein Thrombosis NHLBI Resources Pulmonary Embolism (Health Topics) Non-NHLBI Resources Deep Vein Thrombosis (MedlinePlus) Pulmonary Embolism (MedlinePlus) Clinical Trials ...

  17. Recanalization of Aged Venous Thrombotic Occlusions with the Aid of a Rheolytic System: An Experimental Study

    SciTech Connect

    Vicol, Calin; Dalichau, Harald

    1996-04-15

    Purpose: The suitability of a rheolytic system for recanalization of aged venous thrombotic occlusions was tested in an animal experiment. Methods: The system consists of a flush-suction catheter and a high-pressure liquid pump. Thrombosis was experimentally induced in 13 venous segments of 10 adult goats. Results: After a mean period of 12 days, a complete thrombectomy using the flush-suction system was achieved in 12 cases. No complications such as perforation or dissection were observed. Conclusion: This system seems to be an appropriate device for percutaneous transluminal venous thrombectomy, even in older occlusions.

  18. Spontaneous Recanalization of Superior Mesenteric Artery Occlusion Following Angioplasty and Stenting of Inferior Mesenteric Artery

    SciTech Connect

    Akpinar, Erhan Cil, Barbaros E.; Arat, Anil; Baykal, Atac; Karaman, Kerem; Balkanci, Ferhun

    2006-02-15

    An 84-year-old woman with a history of hypertension and coronary artery disease was admitted with a progressively worsening diffuse abdominal pain. Computed tomography scan of the abdomen and angiography revealed occlusion of the origin and proximal portion of superior mesenteric artery. Aortography also showed severe origin stenosis of inferior mesenteric artery and that the distal part of the superior mesenteric artery was supplied by a prominent marginal artery of Drummond. Patient was effectively treated with percutaneous transluminal angioplasty and stenting of the inferior mesenteric artery. Follow-up imaging studies demonstrated patency of the stent and spontaneous recanalization of superior mesenteric artery occlusion.

  19. Collateral veins in left renal vein stenosis demonstrated via CT.

    PubMed

    Lien, H H; Lund, G; Talle, K

    1983-02-01

    Twelve patients with left renal vein stenosis from tumor compression were studied with CT. All had distended collateral veins in the perirenal space which either formed a radiating or a cobweb pattern or appeared as marked longitudinal veins. Inferior phrenic vein branches were seen in seven patients and were considerably enlarged in two. Other major veins possibly taking part in collateral circulation could not be recognized due to obliteration of fat planes. The renal fascia was thickened in eleven patients, probably due to edema. A close study of the perirenal space with CT may give valuable information about collateral development. PMID:6840101

  20. Treatment of arteriovenous malformation with high-flow fistula and bilateral transverse-sigmoid sinuses stenosis resulting diffuse cortical vein engorgement and symptoms resembling carotid-cavernous fistula.

    PubMed

    Chen, Kuo-Wei; Su, I-Chang; Lee, Jing-Er; Liu, Hon-Man

    2015-01-01

    Patients harboring arteriovenous malformations (AVMs) may present with focal neurological deficit, seizures, hemorrhage or be completely asymptomatic. This diversity in manifestation of AVM is related to the individual characteristics of AVMs such as size, location, configuration of feeding arteries, and drainage veins. Treating the AVMs with high-flow fistula and downstream sinuses occlusion is challenging. The authors reported their experience of treating this kind of AVM. The high venous pressure caused diffuse cortical venous regurgitation and engorgement of left superior ophthalmic vein and symptoms resembling carotid-venous fistula. To avoid possible reflux of embolization materials to cortical veins and facilitate surgical treatment, the bilateral transverse sinuses were re-canalized first. The venous pressure was measured through left transverse sinus, and it decreased significantly from 50 mmHg to 20 mmHg after bilateral sinus stenting. The AVM was then embolized and excised uneventfully. PMID:26425162

  1. Efficacy of Salpingography and Transcervical Recanalization in Diagnosis, Categorization, and Treatment of Fallopian Tube Obstruction

    SciTech Connect

    Lang, Erich K.; Dunaway, Herbert E.

    2000-11-15

    Purpose: The efficacy of selective salpingography (SS) and transcervical recanalization (TCR) in diagnosis, categorization, and determination of optimal treatment modality for fallopian tube obstruction was investigated.Methods: SS and, in some patients, TCR was performed in 430 patients with a diagnosis of obstruction of one or both fallopian tubes, as determined by hysterosalpingograms (HSG). All patients (age 21-46 years) had an infertility problem for at least 18 months.Results: In 196 patients, 325 tubes were patent on SS. TCR recanalized 243 tubes in 176 patients. Disease of the distal tube was demonstrated in 66 patients. There were 39 live babies in a group of 176 patients with successful TCR. Best live birth rate was in 7 of 12 (58%) patients with underlying endometriosis, followed by postsurgical strictures in inflammatory disease, 6 of 31 (19%), and salpingitis isthmica nodosa in 25 of 168 (15%). There were no pregnancies in patients with cobblestone pattern of the distal tubes.Conclusions: SS and TCR were capable of correcting obstruction of the proximal tubes in 243 of 465 tubes in 176 of 234 patients (75%). With patency of the proximal tube restored, the distal tube could be assessed for changes indicative of damage to the ciliated epithelium which was likely to reduce the ability to become pregnant. This allowed for the triage of patients into groups benefiting from the relatively inexpensive and low complication TCR or patients in need of in vitro fertilization or similar assisted reproductive technologies.

  2. Spontaneous thrombosis of giant intracranial aneurysm and posterior cerebral artery followed by also spontaneous recanalization

    PubMed Central

    de Aguiar, Guilherme Brasileiro; Pagotto, Mário Vítor Caldeira; Conti, Mario Luiz Marques; Veiga, José Carlos Esteves

    2016-01-01

    Background: Spontaneous complete thrombosis of a giant aneurysm and its parent artery is a rare event. Their spontaneous recanalization is even rarer, with few reports. Case Description: A 17-year-old male patient presenting blurred vision and headache, with a history of seizures, was referred to our service. After further investigation with cranial computed tomography, magnetic resonance imaging (MRI), and cerebral angiography (CAG), it was diagnosed a thrombosed aneurysm of the posterior cerebral artery (PCA) and also complete thrombosis of the PCA. Three years later, he experienced visual worsening. A new MRI scan indicated flow both through the aneurysm and the left PCA, which was further confirmed by CAG. We decided for a noninterventional treatment combined with strict clinical follow-up. The patient continues to present with the previous neurological deficit, without recurrence of headaches. Conclusions: Thrombosis is not the final event in the natural history of giant aneurysms, and partial thrombosis does not preclude the risk of rupture. Thrombosed aneurysms may display additional growth brought about by wall dissections or intramural hemorrhages. Their treatment may be either surgical or involve endovascular procedures such as embolization. Thrombosed giant aneurysms are dynamic and unstable lesions. A noninterventional treatment is feasible, but aneurysmal growth or recanalization may suggest the need for a more active intervention.

  3. Deep vein thrombosis.

    PubMed

    Emanuele, Patricia

    2008-09-01

    This article reviews the incidence, causes, risk factors, diagnosis, treatment, complications, and prevention of deep vein thrombosis (DVT). Various employees, including long-distance drivers or travelers, sedentary office workers, females taking estrogen, those who are obese, those who have cancer, and those who are hospitalized, may be at risk for developing this condition. Genetic testing can determine some inherited factors predisposing workers to clotting. Low-molecular weight heparins can be used to manage DVT on an outpatient basis. PMID:18792613

  4. Mechanical Recanalization following i.v. Thrombolysis: A Retrospective Analysis regarding Secondary Hemorrhagic Infarctions and Parenchymal Hematomas

    PubMed Central

    Hltje, J.; Bonk, F.; Anstadt, A.; Terborg, C.; Pohlmann, C.; Urban, P. P.; Brning, R.

    2015-01-01

    Introduction. In acute stroke by occlusion of the proximal medial cerebral artery (MCA) or the distal internal carotid artery, intravenous thrombolysis is an established treatment. Another option is mechanical recanalization. It remains unclear if the combination of both methods poses an additional bleeding risk. The aim of this retrospective analysis is to determine the proportion of hemorrhagic infarctions and parenchymal hematomas. Methods. Inclusion criteria were an occlusion of the carotid T or proximal MCA treated with full dose thrombolysis and mechanical recanalization. 31 patients were selected. Devices used were Trevo, Penumbra Aspiration system, Penumbra 3D Retriever, and Revive. The initial control by computed tomography was carried out with a mean delay to intervention of 10.9 hours (SD: 8.5 hours). Results. A slight hemorrhagic infarction (HI1) was observed in 2/31 patients, and a more severe HI2 occurred in two cases. A smaller parenchymal hematoma (PH1) was not seen and a space-occupying PH2 was seen in 2/31 cases. There was no significant difference in the probability of intracranial bleeding after successful (thrombolysis in cerebral infarctions 2b and 3) or unsuccessful recanalization. Conclusion. The proportion of intracranial bleeding using mechanical recanalization following intravenous thrombolysis appears comparable with reports using thrombolysis alone. PMID:26640710

  5. Liver Transplantation in the Presence of Old Portal Vein Thrombosis

    PubMed Central

    Kakaei, F.; Nikeghbalian, S.; Salahi, H.; Bahador, A.; Kazemi, K.; Dehghani, M.; Shamsaeefar, A.; Sanei, B.; Ghaffaripour, S.; Rajaei, E.; Gholami, S.; Malek-Hosseini, S. A.

    2010-01-01

    Background: Portal vein thrombosis (PVT) has been mentioned as a potential obstacle to liver transplantation (LTx). Objective: To review the impact of PVT on orthotopic liver transplant (OLT) outcome. Method: Between January 2006 and April 2009, 440 OLT were performed in Shiraz Transplant Unit of whom, 35 (7.9%) cases had old PVT with recanalization. Data were retrospectively collected regarding the demographics, indication for OLT, Child-Turgot-Pugh classification, pre-transplant diagnosis of PVT, perioperative course and managements, relapse of PVT, early post-operative mortality and morbidity. All patients received liver from deceased donors, underwent thrombendvenectomy with end-to-end anastomosis without interposition graft and evaluated daily for 5 days and thereafter, biweekly by duplex sonography during the follow-up period for 2 months. They were treated by therapeutic doses of heparin followed by warfarin to maintain an INR of 22.5. Results: The causes of end-stage liver disease were hepatitis B in 11, cryptogenic cirrhosis in 11, primary sclerosing cholangitis in 5 and other causes in 8 recipients. Extension of thrombosis was through confluence of superior mesenteric and splenic vein in 32 and to superior mesenteric vein in 3 patients. The meanSD operation time was 7.21.5 hrs. The meanSD transfusion requirement was 5.42.8 units of packed cells. The meanSD duration of hospital stay in these patients was 17.710.9 days. Eight patients died; 1 developed early in-hospital PVT, 1 had hepatic vein thrombosis, and 1 died of in-hospital ischemic cerebrovascular accident, despite a full anticoagulant therapy. The meanSD follow-up period for those 28 patients discharged from hospital was 16.67.9 months; none of them developed relapse of PVT. The overall mortality and morbidity was 28% and 32%, respectively. There was no relapse of PVT in the other patients. Conclusion: The presence of PVT at the time of OLT is not a contraindication for the operation but those with PVT have a more difficult surgery, develop more postoperative complications, and experience a higher in-hospital mortality. PMID:25013563

  6. Percutaneous Recanalization of Coronary Chronic Total Occlusions: Current Devices and Specialized Wire Crossing Techniques

    PubMed Central

    2010-01-01

    Treatment of coronary chronic total occlusions (CTOs) remains a challenging obstacle, posing a considerable barrier to achieving successful complete revascularization. By nature of their complexity, percutaneous CTO interventions are associated with lower rates of procedural success, higher complication rates, greater radiation exposure and longer procedure times compared with non-CTO interventions. In the last few years, development in guidewires, devices and the emergence of new techniques from Japanese centers resulted in higher success rates in the hands of experienced operators. The impact of drug eluting stents on restenosis has improved long-term outcomes after successful recanalization. Successful revascularization is associated with improved long-term survival, reduced symptoms, improved left ventricular function and reduced need for coronary bypass surgery. This paper reviews the current devices and specialized crossing techniques of percutaneous intervention to relieve CTOs. PMID:20514329

  7. Cryo-recanalization in a case of carcinoid tumor - An interesting case report.

    PubMed

    Chawla, Rakesh K; Madan, Arun; Chawla, Aditya; Arora, Harsh Nandini

    2015-01-01

    The term "cryotherapy" comes from the Greek cryo (????) meaning cold, and therapy (????????) meaning cure. Cryosurgery is the application of extreme cold to destroy abnormal or diseased tissue. Carcinoid tumors of the lung are a fascinating but uncommon group of pulmonary neoplasms. In the past, these tumors were grouped with benign or less aggressive malignant pulmonary tumors, namely bronchial adenomas. Recent studies have revealed that carcinoid lung tumors are the most indolent form of a spectrum of bronchopulmonary neuroendocrine tumors that, at its extreme, include small cell carcinoma of the lung as its most malignant member. They commonly present as endobronchial obstructions, and if complete, can be life-threatening and require immediate intervention.[1] Recently, we have treated a patient of carcinoid tumor of lung who was managed with cryo-recanalization with excellent response. PMID:26628773

  8. Lattice Boltzmann method simulating hemodynamics in the three-dimensional stenosed and recanalized human carotid bifurcations

    NASA Astrophysics Data System (ADS)

    Kang, XiuYing

    2015-01-01

    By using the lattice Boltzmann method (LBM) pulsatile blood flows were simulated in three-dimensional moderate stenosed and recanalized carotid bifurcations to understand local hemodynamics and its relevance in arterial atherosclerosis formation and progression. The helical flow patterns, secondary flow and wall dynamical pressure spatiotemporal distributions were investigated, which leads to the disturbed shear forces in the carotid artery bifurcations. The wall shear stress distributions indicated by time-averaged wall shear stress (TAWSS), oscillatory shear index (OSI), and the relative residence time (RRT) in a cardiac cycle revealed the regions where atherosclerotic plaques are prone to form, extend or rupture. This study also illustrates the point that locally disturbed flow may be considered as an indicator for early atherosclerosis diagnosis. Additionally the present work demonstrates the robust and highly efficient advantages of the LBM for the hemodynamics study of the human blood vessel system.

  9. Endovascular Recanalization Therapy in Acute Ischemic Stroke: Updated Meta-analysis of Randomized Controlled Trials

    PubMed Central

    Hong, Keun-Sik; Ko, Sang-Bae; Lee, Ji Sung; Yu, Kyung-Ho; Rha, Joung-Ho

    2015-01-01

    Background and Purpose Recent randomized clinical trials (RCTs) have demonstrated benefits of endovascular recanalization therapy (ERT) contrary to earlier trials. We aimed to estimate the benefits of ERT added to standard therapy in acute ischemic stroke. Methods From a literature search of RCTs testing ERT, we performed a meta-analysis to estimate an overall efficacy and safety of ERT for all trials, stent-retriever trials, and RCTs comparing ERT and intravenous tissue plasminogen activator (IV-TPA). Results We identified 15 relevant RCTs including 2,899 patients. For all trials, ERT was associated with increased good outcomes (odds ratio [OR] 1.79; 95% confidence interval [CI] 1.34, 2.40; P<0.001) compared to the control. ERT also increased no or minimal disability outcomes, good neurological recovery, good activity of daily living, and recanalization. ERT did not significantly increase symptomatic intracranial hemorrhage (SICH) (OR 1.19; 95% CI 0.83, 1.69; P=0.345) or death (OR 0.87; 95% CI 0.71, 1.05; P=0.151). In contrast, ERT significantly reduced extreme disability or death (OR 0.77; 95% CI 0.61, 0.97; P=0.025). Restricting to five stent-retriever trials comparing ERT plus IV-TPA vs. IV-TPA alone, the benefit was even greater for good outcome (OR 2.39; 95% CI 1.88, 3.04; P<0.001) and extreme disability or death (OR 0.57; 95% CI 0.41, 0.78; P=0.001). Restricting to eight RCTs comparing ERT (plus IV-TPA in six trials) with IV-TPA alone showed similar efficacy and safety. Conclusions This updated meta-analysis shows that ERT substantially improves clinical outcomes and reduces extreme disability or death without significantly increasing SICH compared to standard therapy. PMID:26437993

  10. Brachiocephalic Vein Stenting and Body-Floss Technique as a Treatment of CVD in Dialysis-Dependent Patient Case Report and Literature Review

    PubMed Central

    Kryci?ska, R?a; Trznadel, Agata; Kuchalska, Paulina; Lis, Micha?; Do??ga-Kozierowski, Bartosz; Dy?, Krzysztof; Drelichowski, Stanis?aw; Witkiewicz, Wojciech

    2015-01-01

    Summary Background Given the increasing number of elderly hemodialysis-dependent patients with concomitant chronic diseases the successful creation and maintenance of reliable vascular access become a real challenge. In current literature central vein disease (CVD) is defined as at least 50% narrowing up to total occlusion of central veins of the thorax including superior vena cava (SVC), brachiocephalic (BCV), subclavian (SCV) and internal jugular vein (IJV). The incidence of CVD has been reported to be as high as 23% in the total dialysis population and 41% in those with access related complains. Case Report 61-year-old man has been admitted to the local radiology department with symptoms of the superior vena cava syndrome. The venography revealed occlusion of the right brachiocephalic vein. Due to Tortuosity and lack of stamp of right subclavian vein contributed to the decision to perform recanalization by body floss technique. In a further step we have performed PTA of obstructed vein segment using 740 mm balloon. Due to the presence of residual stenosis it was decided to implant two self expanding stents 1040 mm. After the procedure the patient was discharged in good condition and transferred to dialysis center. Conclusions Main objective was the salvage of a functioning arteriovenous fistula. Performed endovascular intervention is a safe and effective approach to correct CVD for a short term. To ensure long lasting effects the patient will require enhanced follow-up and inevitable reinterventions. For that matter, prevention of CVD remains critical. PMID:26000070

  11. The economics of vein disease.

    PubMed

    Sales, Clifford M; Podnos, Joan; Levison, Jonathan

    2007-09-01

    The management of cosmetic vein problems requires a very different approach than that for the majority of most other vascular disorders that occur in a vascular surgery practice. This article focuses on the business aspects of a cosmetic vein practice, with particular attention to the uniqueness of these issues. Managing patient expectations is critical to the success of a cosmetic vein practice. Maneuvering within the insurance can be difficult and frustrating for both the patient and the practice. Practices should use cost accounting principles to evaluate the success of their vein work. Vein surgery--especially if performed within the office--can undergo an accurate break-even analysis to determine its profitability. PMID:17911565

  12. The Management of Varicose Veins

    PubMed Central

    Lin, Fan; Zhang, Shiyi; Sun, Yan; Ren, Shiyan; Liu, Peng

    2015-01-01

    This study aimed to review the current management modalities for varicose veins. There are a variety of management modalities for varicose veins. The outcomes of the treatment of varicose veins are different. The papers on the management of varicose veins were reviewed and the postoperative complications and efficacy were compared. Foam sclerotherapy and radiofrequency ablation were associated with less pain and faster recovery than endovenous laser ablation and surgical stripping. Patients undergoing endovenous laser ablation and radiofrequency ablation are most likely to have a faster recovery time and earlier return to work in comparison with those undergoing conventional high ligation and stripping. A randomized controlled study in multiple centers is warranted to verify which approach is better than others for the treatment of varicose veins. PMID:25594661

  13. Varicose veins - what to ask your doctor

    MedlinePLUS

    ... veins do you perform? Sclerotherapy? Heat ablation or laser ablation? Vein stripping? Questions to ask about different procedures for varicose veins are: How does this treatment work? When would it be a good choice for ...

  14. Immediate- and short-term outcome following recanalization of long chronic total occlusions (> 50 mm) of native coronary arteries with the Frontrunner catheter.

    PubMed

    Loli, Akil; Liu, Rex; Pershad, Ashish

    2006-06-01

    Thirty percent of diagnostic angiograms have at least 1 chronic total occlusion (CTO). The 10-year survival of patients with a CTO is improved if they have the CTO successfully recanalized. The success of recanalization with conventional wires is 50% and the impact of new technology on recanalization is unknown. This abstract reports a single center experience with one such new device, the Lumend Frontrunner catheter in revascularization of this difficult lesion subset. A consecutive series of 18 patients with CTO's of native coronary arteries were enrolled in this single center, single operator series. The mean age of the CTO was 5.3 years. The indication for attempt at recanalization was ischemia in the territory of the CTO on SPECT imaging. Success was defined as TIMI flow restoration and < 40% residual stenosis. Primary success (defined as TIMI 3 Flow restoration and < 40% residual stenosis) was achieved in 77% of patients. At 30 days and out to 6 months, clinical TVR was 11% (2/18) in this difficult lesion subset. Conventional predictors of failure to recanalize CTOs do not appear to hold true with the use of the Frontrunner catheter. In this small series, dual cusp injections and use of the Microglide catheter appears to correlate with favorable outcomes. Fluoroscopy times and contrast use are high when attempting recanalization of CTOs with this technology. PMID:16775901

  15. Acute ischemic stroke treated with intravenous tissue plasminogen activator in a patient taking dabigatran with radiographic evidence of recanalization.

    PubMed

    Sangha, Navdeep; El Khoury, Ramy; Misra, Vivek; Lopez, George

    2012-11-01

    Dabigatran etexelate is a new oral direct thrombin inhibitor that has been approved by the US Food and Drug Administration to prevent stroke in patients with nonvalvular atrial fibrillation. A 51-year-old man with a history of atrial fibrillation who was taking dabigatran presented with an acute ischemic stroke. The patient had a normal international normalized ratio, activated partial thromboplastin time, and an elevated thrombin time of 26.4 seconds. Recanalization of the middle cerebral artery with intravenous tissue plasminogen activator was apparent on digital subtraction angiography, and there was no evidence of intracerebral hemorrhage on the repeat computed tomographic scan. This is the first report of a patient who was taking dabigatran etexilate and who had an ischemic stroke caused by a middle cerebral artery occlusion, with an elevated thrombin time and radiographic recanalization with intravenous tissue plasminogen activator without evidence of hemorrhagic transformation. PMID:22683118

  16. Successful recanalization of occluded intrahepatic inferior vena cava in post-liver transplant Budd-Chiari syndrome.

    PubMed

    Garg, Deepak; Lopera, Jorge Enrique

    2013-07-01

    Budd-Chiari syndrome following a liver transplant is an uncommon phenomenon. We present a case of endovascular management of a focal circumferential inferior vena cava (IVC) occlusion at the anastomosis that developed 10 years after orthotopic liver transplantation. It was successfully recanalized using the stiff end of the guidewire and percutaneous transluminal angioplasty with a high-pressure balloon. During a 14-month follow up, the IVC remained patent and did not require further intervention. PMID:23475545

  17. Vein matching using artificial neural network in vein authentication systems

    NASA Astrophysics Data System (ADS)

    Noori Hoshyar, Azadeh; Sulaiman, Riza

    2011-10-01

    Personal identification technology as security systems is developing rapidly. Traditional authentication modes like key; password; card are not safe enough because they could be stolen or easily forgotten. Biometric as developed technology has been applied to a wide range of systems. According to different researchers, vein biometric is a good candidate among other biometric traits such as fingerprint, hand geometry, voice, DNA and etc for authentication systems. Vein authentication systems can be designed by different methodologies. All the methodologies consist of matching stage which is too important for final verification of the system. Neural Network is an effective methodology for matching and recognizing individuals in authentication systems. Therefore, this paper explains and implements the Neural Network methodology for finger vein authentication system. Neural Network is trained in Matlab to match the vein features of authentication system. The Network simulation shows the quality of matching as 95% which is a good performance for authentication system matching.

  18. Venous Recanalization by Metallic Stents After Failure of Balloon Angioplasty or Surgery: Four-Year Experience

    SciTech Connect

    Nazarian, Gwen K.; Austin, William R.; Wegryn, Scott A.; Bjarnason, Haraldur; Stackhouse, Daniel J.; Castaneda-Zuniga, Wilfrido R.; Hunter, David W.

    1996-04-15

    Purpose: This retrospective study describes our updated experience in treating venous stenoses and occlusions with metallic endovascular stents. Methods: Gianturco, Palmaz, and Wallstent stents were placed in 55 patients over a 4-year period. Stent sites included the subclavian veins (9), innominate veins (3), superior vena cava (4), inferior vena cava (3), iliac veins (29), femoral veins (5), and portal veins (6). The most common indications for stent placement were malignant stenoses and chronic pelvic venous occlusions. Venoplasty and/or urokinase were used as ancillary therapy. Patients were anticoagulated for 3-6 months. Follow-up included clinical assessment and duplex ultrasound. Results: Lifetable analysis shows 59%, 63%, and 72% primary, primary assisted, and secondary 1-year patency rates, respectively. The 4-year primary patency rates were the same. Duration of patency depended on the venous site. Death was a complication of stent placement in 2 patients and 12 patients died within 6 months after stent placement from primary disease progression. Although early failures were more common in stents placed across occlusions than stenoses, 1-year secondary patency rates were comparable. Primary patency rates were only slightly lower in patients with malignant obstruction than in patients with benign disease. Conclusion: Endovascular stent placement provides a nonsurgical alternative for reestablishment of venous flow and symptomatic relief in patients with benign as well as malignant venous obstruction.

  19. Retinal Vein Occlusion.

    PubMed

    Sawada, Osamu; Ohji, Masahito

    2016-01-01

    The primary treatment against macular edema with retinal vein occlusion (RVO) has changed from observation in central RVO (CRVO) and laser photocoagulation in branch RVO (BRVO) to administration of intravitreal agents based on anti-vascular endothelial growth factor (VEGF) or anti-inflammatory strategies. Anti-VEGF treatment such as ranibizumab, bevacizumab, or aflibercept improved vision by 13.9-16.2 letters (best-corrected visual acuity) after 12 months versus baseline in patients with macular edema secondary to CRVO. A long-term study showed that reduced follow-up and fewer retreatments resulted in worsening visual acuity. Intravitreal therapy with anti-inflammatory agents stabilized visual acuity in CRVO. However, increased intraocular pressure and cataract progression were frequently observed. Anti-VEGF agents such as ranibizumab or bevacizumab improved visual acuity by 15.5-18.3 letters in patients with macular edema secondary to BRVO after 12 months. The improved vision remained during the long-term follow-up. There was no significant difference between standard care and intravitreal triamcinolone groups in BRVO, and increased intraocular pressure and cataract progression occurred frequently in the triamcinolone group. Anti-VEGF intravitreal administration resulted in good vision in CRVO and BRVO patients and is employed as a primary therapy. Anti-VEGF therapy requires frequent observations and intravitreal injections to maintain good vision. PMID:26501219

  20. How Are Varicose Veins Diagnosed?

    MedlinePLUS

    ... of Intramural Research Research Resources Research Meeting Summaries Technology Transfer Clinical Trials What Are Clinical Trials? Children & ... a dermatologist. This type of doctor specializes in skin conditions. Physical Exam To check for varicose veins in ...

  1. Varicose veins and venous insufficiency

    MedlinePLUS

    ... Visible, swollen veins Mild swelling of feet or ankles Itching Severe symptoms include: Leg swelling Leg or ... periods Skin color changes of the legs or ankles Dry, irritated, scaly skin that can crack easily ...

  2. Varicose Veins and Venous Insufficiency

    MedlinePLUS

    ... About Us Patient Section Who Are Interventional Radiologists? Multimedia Insurance Coverage IR Treatments Abdominal aortic aneurysms Angiography ... radiology Interventional radiology case studies Developed by ACR Multimedia gallery Multimedia Archive Varicose Veins and Venous Insufficiency ...

  3. How Are Varicose Veins Treated?

    MedlinePLUS

    ... Intramural Research Research Resources Research Meeting Summaries Technology Transfer Clinical Trials What Are Clinical Trials? Children & Clinical ... shun) therapy uses lasers or radiowaves to create heat to close off a varicose vein. Your doctor ...

  4. Fluoroscopically Guided Transcervical Fallopian Tube Recanalization of Post-Sterilization Reversal Mid-Tubal Obstructions

    SciTech Connect

    Houston, J. Graeme; Anderson, David; Mills, John; Harrold, Anthony

    2000-03-15

    Purpose: To assess the technical success and early outcome of fluoroscopically guided transcervical fallopian tube recanalization (FTR) in mid-tubal occlusion following sterilization reversal surgery.Methods: From July 1995 to January 1998, patients with greater than 12 months secondary infertility underwent hysterosalpingography (HSG). FTR was performed in proximal or mid-tubal occlusion. Cases of FTR in mid-tubal occlusion were included in this study. Technical success (defined as complete tubal patency) using a standard guidewire and hydrophilic glidewire, the number of patients with at least one patent tube, and the intrauterine and ectopic pregnancy rates were determined.Results: Twenty-six infertile patients with previous sterilization reversal underwent HSG. Eight of 26 (31%) patients (mean age 32 years, range 23-37 years), had attempted FTR for mid-tubal occlusion at the site of surgical anastomosis. Fourteen tubes were attempted as there were two previous salpingectomies. Technical success was achieved in eight of 14 (57%) tubes attempted, resulting in five of eight (62%) patients having at least one patent tube. At follow-up (mean 18 months, range 12-28 months) in these five patients there was one intrauterine pregnancy. There were no ectopic pregnancies.Conclusions: FTR in mid-tubal obstruction in infertile patients following sterilization reversal surgery is technically feasible and may result in intrauterine pregnancy. In this small group there was a lower technical success rate and lower pregnancy rate than in unselected proximal tubal occlusion.

  5. Angiophagy prevents early embolus washout but recanalizes microvessels through embolus extravasation.

    PubMed

    Grutzendler, Jaime; Murikinati, Sasidhar; Hiner, Bennett; Ji, Lingling; Lam, Carson K; Yoo, Taehwan; Gupta, Shobhana; Hafler, Brian P; Adelman, Ron A; Yuan, Peng; Rodriguez, Guadalupe

    2014-03-01

    Occlusion of the microvasculature by blood clots, atheromatous fragments, or circulating debris is a frequent phenomenon in most human organs. Emboli are cleared from the microvasculature by hemodynamic pressure and the fibrinolytic system. An alternative mechanism of clearance is angiophagy, in which emboli are engulfed by the endothelium and translocate through the microvascular wall. We report that endothelial lamellipodia surround emboli within hours of occlusion, markedly reducing hemodynamic washout and tissue plasminogen activator-mediated fibrinolysis in mice. Over the next few days, emboli are completely engulfed by the endothelium and extravasated into the perivascular space, leading to vessel recanalization and blood flow reestablishment. We find that this mechanism is not limited to the brain, as previously thought, but also occurs in the heart, retina, kidney, and lung. In the lung, emboli cross into the alveolar space where they are degraded by macrophages, whereas in the kidney, they enter the renal tubules, constituting potential routes for permanent removal of circulating debris. Retina photography and angiography in patients with embolic occlusions provide indirect evidence suggesting that angiophagy may also occur in humans. Thus, angiophagy appears to be a ubiquitous mechanism that could be a therapeutic target with broad implications in vascular occlusive disorders. Given its biphasic nature-initially causing embolus retention, and subsequently driving embolus extravasation-it is likely that different therapeutic strategies will be required during these distinct post-occlusion time windows. PMID:24598589

  6. Mechanical Recanalization of Subacute Vessel Occlusion in Peripheral Arterial Disease with a Directional Atherectomy Catheter

    SciTech Connect

    Massmann, Alexander Katoh, Marcus; Shayesteh-Kheslat, Roushanak; Buecker, Arno

    2012-10-15

    Purpose: To retrospectively examine the technical feasibility and safety of directional atherectomy for treatment of subacute infrainguinal arterial vessel occlusions. Methods: Five patients (one woman, four men, age range 51-81 years) with peripheral arterial disease who experienced sudden worsening of their peripheral arterial disease-related symptoms during the last 2-6 weeks underwent digital subtraction angiography, which revealed vessel occlusion in native popliteal artery (n = 4) and in-stent occlusion of the superficial femoral artery (n = 1). Subsequently, all patients were treated by atherectomy with the SilverHawk (ev3 Endovascular, USA) device. Results: The mean diameter of treated vessels was 5.1 {+-} 1.0 mm. The length of the occlusion ranged 2-14 cm. The primary technical success rate was 100%. One patient experienced a reocclusion during hospitalization due to heparin-induced thrombocytopenia. There were no further periprocedural complications, in particular no peripheral embolizations, until hospital discharge or during the follow-up period of 1 year. Conclusion: The recanalization of infrainguinal arterial vessel occlusions by atherectomy with the SilverHawk device is technically feasible and safe. In our limited retrospective study, it was associated with a high technical success rate and a low procedure-related complication rate.

  7. Benefits of endoscopic vein harvesting.

    PubMed

    Marty, B; von Segesser, L K; Tozzi, P; Guzmann, J; Frascarolo, P; Muller, X; Hayoz, D

    2000-09-01

    The purpose of this study was to evaluate and compare the benefits of endoscopic saphenous vein harvesting (EVH) with the traditional incision technique (TIT) for coronary artery bypass grafting (CABG) in respect to the technical procedure and clinical outcome. In a prospective nonrandomized, case-matched study the greater saphenous vein was harvested for CABG in 22 patients using the endoscopic technique and in 18 patients with the traditional method. Comparisons were made for the operating time, length of incision and vein harvested, graft quality, postoperative complications, and pain assessment. Patient demographics were well matched. EVH required smaller incisions than did the TIT (10.5 +/- 6.6 vs. 31.2 +/- 7.8 cm, respectively; p < 0.0001). Harvest time and vein quality were comparable in the two groups. Total vein operating time was shorter following the endoscopic technique (60 +/- 24 vs. 100 +/- 35 minutes, respectively; p < 0.0001). EVH had fewer complications (NS), and postoperative pain was significantly less (p = 0.0034). The major advantages of endoscopic vein harvesting are a significant reduction of postoperative pain and strikingly better cosmetic results. Wound complications seem to be less frequent. PMID:11036289

  8. Management of superficial vein thrombosis.

    PubMed

    Cosmi, B

    2015-07-01

    Superficial vein thrombosis (SVT) is less well studied than deep vein thrombosis (DVT), because it has been considered to be a minor, self-limiting disease that is easily diagnosed on clinical grounds and that requires only symptomatic relief. The most frequently involved sites of the superficial vein system are the lower limbs, especially the saphenous veins, mostly in relation to varicosities. Lower-limb SVT shares the same risk factors as DVT; it can propagate into the deep veins, and have a complicated course with pulmonary embolism. Clinical diagnosis may not be accurate, and ultrasonography is currently indicated for both confirmation and evaluation of SVT extension. Treatment aims are symptom relief and prevention of venous thromboembolism (VTE) in relation to the thrombotic burden. SVT of the long saphenous vein within 3cm of the saphenofemoral junction (SFJ) is considered to be equivalent to a DVT, and thus deserving of therapeutic anticoagulation. Less severe forms of lower-limb SVT not involving the SFJ have been included in randomized clinical trials of surgery, compression hosiery, non-steroidal anti-inflammatory drugs, unfractionated heparin, and low molecular weight heparins, with inconclusive results. The largest randomized clinical trial available, on 3004 patients with lower-limb SVT not involving the SFJ, showed that fondaparinux 2.5mg once daily for 6weeks is more effective than placebo in reducing the risk of the composite of death from any cause and symptomatic VTE (0.9% versus 5.9%). Further studies are needed to define the optimal management strategies for SVT of the lower limbs and other sites, such as the upper limbs. PMID:25903684

  9. Endovascular treatment of cerebral venous sinus thrombosis (CVST): Is a complete recanalization required for a good clinical outcome?

    PubMed

    Lozano-Ros, A; Luque-Buzo, E; Garca-Pastor, A; Castro-Reyes, E; Daz-Otero, F; Vzquez-Alen, P; Fernndez-Bullido, Y; Villanueva-Osorio, J A; Gil-Nez, A

    2016-02-01

    The usual therapy in cerebral venous sinus thrombosis (CVST) is based on anticoagulant treatment with adjusted-dose unfractionated heparin. When medical treatment fails, endovascular techniques, such as mechanical thrombectomy, are available. We report a case of a 21-year-old woman with a diagnosis of left CVST, treated by a neurointerventional approach with mechanical thrombectomy using the Penumbra() System. Despite the fact that only incomplete recanalization was achieved, a gradual resolution of the thrombus and a progressive clinical improvement occurred. PMID:26517947

  10. Evaluation of uterine artery recanalization and doppler parameters after bilateral uterine artery ligation in women with postpartum hemorrhage

    PubMed Central

    Kaplanoglu, Mustafa; Karateke, Atilla; Un, Burak; Gunsoy, Levend; Baloglu, Ali

    2015-01-01

    Aim: The evaluation of the uterine artery recanalization rate and color Doppler parameters during follow-up after bilateral uterine artery ligation (BUAL) for postpartum hemorrhage (PPH) related to uterine atony. Material and method: A total of 40 female patients who underwent BUAL for PPH related to uterine atony and 96 females who gave birth without complication at Hatay Obstetrics and Gynecology Hospital between January 2009 and December 2012 (48 months) were included in the study. The patients uterine artery recanalization rate and all subjects color Doppler ultrasonographic parameters (PI, RI, PSV and EDV) were evaluated at the 6th and 12th months. Result: No statistically significant difference was found between the age, obstetric history (gravida and parity), BMI, type of delivery, birth weight and gestational age when the demographic data of the groups were evaluated. The patient group UtA recanalization rate was 32.5% and 37.5% for the left and right UtA respectively at the 12-month follow-up. No statistically significant difference was found in the comparison of 6- and 12-month right and left uterine artery diameters and color doppler parameters of the patient group (UtA diameters P=0.322 and P=0.787, RI index P=0.390 and P=0.094, PI index P=0.949 and P=0.374, PSV P=0.335 and P=0.085, EDV P=0.173 and P=0.418, respectively). However, right and left ovarian volume was found to significantly increase during follow-up in patient group (P<0.001 for both right and left ovary). On the other hand, a statistically significant difference was found between the patient group and the control group in the comparison of the 6- and 12-month right and left uterine artery values (6th month; P<0.001 for both UtA diameters, RI, PI, PSV, EDV; 12th month; P<0.001 for right UtA diameter, RI, PI, PSV, EDV and P=0.002 for left UtA diameter). A statistically significant difference was found only in right ovary volume in the 6th month evaluation of the patient and control group ovary volumes (P=0.011). Discussion: The recanalization rate and isolated uterine blood supply during low-term follow-up are low following the BUAL technique. The evaluation of future fertility results will be helpful in determining the reliability of this procedure in a definite manner. PMID:26221335

  11. Endovascular Treatment of In-Stent Occlusion: New Technique for Recanalization of Long Superficial Femoral Artery Occlusion (Direct Stent Puncture Technique)

    SciTech Connect

    Palena, Luis Mariano Cester, Giacomo; Manzi, Marco

    2012-04-15

    In-stent reocclusion is a frequent complication of endovascular treatment and stenting, especially in the superficial femoral artery. Neointimal hyperplasia is the main cause of this problem, but in many cases, it occurs as a result of the presence of stent strut fractures. The two treatment options are endovascular and surgical intervention. The effectiveness of endovascular interventions in patients with critical limb ischemia has been well established, but in some cases, crossing the occluded stent is difficult. We describe a new technique to recanalize long in-stent superficial femoral artery occlusions characterized by direct stent puncture, followed by retrograde-antegrade recanalization after antegrade failures.

  12. Blackberry Yellow Vein Disease Complex

    Technology Transfer Automated Retrieval System (TEKTRAN)

    A new virus disease has emerged in the Midsouth and Southeastern United States and was named blackberry yellow vein disease (BYVD). Originally, it was thought the disease was caused by Tobacco ringspot virus (TRSV) as the virus was found in many diseased plants and symptoms were very similar to thos...

  13. Quartz Vein in the Gunsight Formation

    USGS Multimedia Gallery

    Quartz vein in biotite-rich rock in the Gunsight Formation of the Mesoproterozoic Lemhi Group. Bluish green copper-bearing minerals coat the quartz vein. Pale pinkish cobalt bloom and white caliche coat adjacent biotite-rich wallrock....

  14. Who Is at Risk for Varicose Veins?

    MedlinePLUS

    ... fetus puts pressure on the veins in the mother's legs. Varicose veins that occur during pregnancy usually get better within 3 to 12 months of delivery. Overweight or Obesity Being overweight or obese can put extra pressure ...

  15. Endovascular recanalization of infrapopliteal occlusions in patients with critical limb ischemia

    PubMed Central

    Singh, Gagan D.; Armstrong, Ehrin J.; Yeo, Khung-Keong; Singh, Satinder; Westin, Gregory G.; Pevec, William C.; Dawson, David L.; Laird, John R.

    2014-01-01

    Background Endovascular therapies are increasingly used for treatment of critical limb ischemia (CLI). Infrapopliteal (IP) occlusions are common in CLI, and successful limb salvage may require restoration of arterial flow in the distribution of a chronically occluded vessel. We sought to describe the procedural characteristics and outcomes of patients with IP occlusions who underwent endovascular intervention for treatment of CLI. Methods All patients with IP interventions for treatment of CLI from 2006 to 2012 were included. Angiographic and procedural data were compared between patients who underwent intervention for IP occlusions vs IP stenosis. Restenosis was determined by Doppler ultrasound imaging. Limb salvage was the primary end point of the study. Additional end points included primary patency, primary assisted patency, secondary patency, occlusion crossing success, procedural success, and amputation-free survival. Results A total of 187 patients with CLI underwent interventions for 356 IP lesions, and 77 patients (41%) had interventions for an IP occlusion. Patients with an intervention for IP occlusion were more likely to have zero to one vessel runoff (83% vs 56%; P < .001) compared with interventions for stenosis. Compared with IP stenoses, IP occlusions were longer (118 ± 86 vs 73 ± 67 mm; P < .001) and had a smaller vessel diameter (2.5 ± 0.8 vs 2.7 ± 0.5 mm; P =.02). Wire crossing was achieved in 83% of IP occlusions, and the overall procedural success for IP occlusions was 79%. The overall 1-year limb salvage rate was 84%. Limb salvage was highest in the stenosis group, slightly lower in the successful occlusion group, and lowest in the failed occlusion group (92% vs 75% vs 58%, respectively; P = .02). Unsuccessfully treated IP occlusions were associated with a significantly higher likelihood of major amputation (hazard ratio, 5.79; 95% confidence interval, 1.89–17.7) and major amputation or death (hazard ratio, 2.69; 95% confidence interval, 1.09–6.63). Conclusions Successful endovascular recanalization of IP occlusions can be achieved with guidewire and support catheter techniques in most patients. In patients selected for an endovascular-first approach for IP occlusions in CLI, this strategy can be successfully implemented with favorable rates of limb salvage. PMID:24393279

  16. Pharmacological and non-pharmacological recanalization strategies in acute ischemic stroke.

    PubMed

    Frendl, Anita; Csiba, Lszl

    2011-01-01

    According to the guidelines of the European Stroke Organization (ESO) and the American Stroke Association (ASA), acute stroke patients should be managed at stroke units that include well organized pre- and in-hospital care. In ischemic stroke the restoration of blood flow has to occur within a limited time window that is accomplished by fibrinolytic therapy. Newer generation thrombolytic agents (alteplase, pro-urokinase, reteplase, tenecteplase, desmoteplase) have shorter half-life and are more fibrin-specific. Only alteplase has Food and Drug Administration (FDA) approval for the treatment of acute stroke (1996). The National Institute of Neurological Disorders and Stroke (NINDS) trial proved that alteplase was effective in all subtypes of ischemic strokes within the first 3?h. In the European cooperative acute stroke study III trial, intravenous (IV) alteplase therapy was found to be safe and effective (with some restrictions) if applied within the first 3-4.5?h. In middle cerebral artery (MCA) occlusion additional transcranial Doppler insonication may improve the breakdown of the blood clot. According to the ESO and ASA guidelines, intra-arterial (IA) thrombolysis is an option for recanalization within 6?h of MCA occlusion. Further trials on the IA therapy are needed, as previous studies have involved relatively small number of patients (compared to IV trials) and the optimal IA dose of alteplase has not been determined (20-30?mg is used most commonly in 2?h). Patients undergoing combined (IV?+?IA) thrombolysis had significantly better outcome than the placebo group or the IV therapy alone in the NINDS trial (Interventional Management of Stroke trials). If thrombolysis fails or it is contraindicated, mechanical devices [e.g., mechanical embolus removal in cerebral ischemia (MERCI)- approved in 2004] might be used to remove the occluding clot. Stenting can also be an option in case of acute internal carotid artery occlusion in the future. An intra-aortic balloon was used to increase the collateral blood flow in the Safety and Efficacy of NeuroFlo() Technology in Ischemic Stroke trial (results are under evaluation). Currently, there is no approved effective neuroprotective drug. PMID:21660098

  17. Update of the Korean Clinical Practice Guidelines for Endovascular Recanalization Therapy in Patients with Acute Ischemic Stroke

    PubMed Central

    Hong, Keun-Sik; Ko, Sang-Bae; Yu, Kyung-Ho; Jung, Cheolkyu; Park, Sukh Que; Kim, Byung Moon; Chang, Chul-Hoon; Bae, Hee-Joon; Heo, Ji Hoe; Oh, Chang Wan; Lee, Byung-Chul; Kim, Bum-Tae; Kim, Bum-soo; Chung, Chin-Sang; Yoon, Byung-Woo; Rha, Joung-Ho

    2016-01-01

    Patients with severe stroke due to acute large cerebral artery occlusion are likely to be severely disabled or dead without timely reperfusion. Previously, intravenous tissue plasminogen activator (IV-TPA) within 4.5 hours after stroke onset was the only proven therapy, but IV-TPA alone does not sufficiently improve the outcome of patients with acute large artery occlusion. With the introduction of the advanced endovascular therapy, which enables more fast and more successful recanalization, recent randomized trials consecutively and consistently demonstrated the benefit of endovascular recanalization therapy (ERT) when added to IV-TPA. Accordingly, to update the recommendations, we assembled members of the writing committee appointed by the Korean Stroke Society, the Korean Society of Interventional Neuroradiology, and the Society of Korean Endovascular Neurosurgeons. Reviewing the evidences that have been accumulated, the writing members revised recommendations, for which formal consensus was achieved by convening a panel composed of 34 experts from the participating academic societies. The current guideline provides the evidence-based recommendations for ERT in patients with acute large cerebral artery occlusion regarding patient selection, treatment modalities, neuroimaging evaluation, and system organization. PMID:26846761

  18. Surgical Access to Jejunal Veins for Local Thrombolysis and Stent Placement in Portal Vein Thrombosis

    SciTech Connect

    Schellhammer, Frank; Esch, Jan Schulte am; Hammerschlag, Sascha; Knoefel, Wolfram Trudo; Fuerst, Guenter

    2008-07-15

    Portal vein thrombosis is an infrequent entity, which may cause high morbidity and mortality. We report a case of portal vein thrombosis due to benign stenosis following partial pancreatoduodenectomy with segmental replacement of the portal vein by a Gore-tex graft. Using a surgical access to jenunal veins, local thrombolysis, mechanical fragmentation of thrombus, and stent placement were successfully performed.

  19. phenoVein-A Tool for Leaf Vein Segmentation and Analysis.

    PubMed

    Bhler, Jonas; Rishmawi, Louai; Pflugfelder, Daniel; Huber, Gregor; Scharr, Hanno; Hlskamp, Martin; Koornneef, Maarten; Schurr, Ulrich; Jahnke, Siegfried

    2015-12-01

    Precise measurements of leaf vein traits are an important aspect of plant phenotyping for ecological and genetic research. Here, we present a powerful and user-friendly image analysis tool named phenoVein. It is dedicated to automated segmenting and analyzing of leaf veins in images acquired with different imaging modalities (microscope, macrophotography, etc.), including options for comfortable manual correction. Advanced image filtering emphasizes veins from the background and compensates for local brightness inhomogeneities. The most important traits being calculated are total vein length, vein density, piecewise vein lengths and widths, areole area, and skeleton graph statistics, like the number of branching or ending points. For the determination of vein widths, a model-based vein edge estimation approach has been implemented. Validation was performed for the measurement of vein length, vein width, and vein density of Arabidopsis (Arabidopsis thaliana), proving the reliability of phenoVein. We demonstrate the power of phenoVein on a set of previously described vein structure mutants of Arabidopsis (hemivenata, ondulata3, and asymmetric leaves2-101) compared with wild-type accessions Columbia-0 and Landsberg erecta-0. phenoVein is freely available as open-source software. PMID:26468519

  20. Clinical and Ultrasonographic Evaluation of Lower-extremity Vein Thrombosis in Behcet Syndrome: An Observational Study.

    PubMed

    Seyahi, Emire; Cakmak, Osman Serdal; Tutar, Burcin; Arslan, Caner; Dikici, Atilla Suleyman; Sut, Necdet; Kantarci, Fatih; Tuzun, Hasan; Melikoglu, Melike; Yazici, Hasan

    2015-11-01

    Vascular involvement can be seen in up to 40% of patients with Behcet syndrome (BS), the lower-extremity vein thrombosis (LEVT) being the most common type. The aim of the current study was to compare venous Doppler findings and clinical features between BS patients with LEVT and control patients diagnosed as having LEVT due to other causes.All consecutive 78 patients (71 men, 7 women; mean age 38.6??10.3 years) with LEVT due to BS and 50 control patients (29 men, 21 women; mean age 42.0??12.5 years) who had LEVT due to other causes, or idiopathic, were studied with the help of a Doppler ultrasonography after a detailed clinical examination. Patterns of venous disease were identified by cluster analyses. Clinical features of chronic venous disease were assessed using 2 classification systems. Venous claudication was also assessed.Patients with BS were more likely to be men, had significantly earlier age of onset of thrombosis, and were treated mainly with immunosuppressives and less frequently with anticoagulants. Furthermore, they had significantly more bilateral involvement, less complete recanalization, and more frequent collateral formation. While control patients had a disorganized pattern of venous involvement, BS patients had a contiguous and symmetric pattern, involving all deep and superficial veins of the lower extremities, with less affinity for crural veins. Clinical assessment, as measured by the 2 classification systems, also indicated a more severe disease among the BS patients. In line, 51% of the BS patients suffered from severe post-thrombotic syndrome (PTS) and 32% from venous claudication, whereas these were present in 8% and 12%, respectively, among the controls. Among BS patients, a longer duration of thrombosis, bilateral femoral vein involvement, and using no anticoagulation along with immunosuppressive treatment when first diagnosed were found to be associated independently with severe PTS.Lower-extremity vein thrombosis associated with BS, when compared to LEVT due to other causes, had distinctive demographic and ultrasonographic characteristics, and had clinically a more severe disease course. PMID:26554787

  1. Immunohistochemistry comparing endoscopic vein harvesting vs. open vein harvesting on saphenous vein endothelium

    PubMed Central

    2014-01-01

    Objective The present study attempts to compare the immunohistochemistry (IHC) of von Willebrand factor (vWf) , endothelial cadherin, Caveolin and endothelial Nitric Oxide Synthase (eNOS) in VasoView Endoscopic Vein Harvesting (EVH) versus traditional Open Vein Harvesting (OVH) techniques for Coronary Artery Bypass Graft (CABG) Surgery performed in Javad al Aemeh Hospital of Mashhad, Iran in 2013,. Methods and materials Forty-seven patients were scheduled for CABG (30 EVH and 17 OVH) among whom patients with relatively same gender and similar age were selected. Three separate two cm vein samples were harvested from each patients saphenous vein. Each portion was collected from distal, middle and proximal zones of the saphenous vein. The tissues were deparaffinized, and antigen retrieval was done using EZ-retriever followed by an immunohistochemistry evaluation with vWf, e-cadherin, Caveolin and eNOS. In addition, demographic questioner as of Lipid profile, FBS, BMI, and cardiovascular risk factors were collected. Data analyses, including parametric and nonparametric tests were undertaken using the SPSS 16 software. A P value??0.05). Qualitative report of vWf, e-cadherin, Caveolin and eNOS reveals no significant difference between the EVH and OVH (P?>?0.05). Conclusion This study indicates that VasoView EVH technique causes no endothelial damage in comparison with OVH. This study could be a molecular confirmation for the innocuous of EVH technique. PMID:24938544

  2. Nephrotic Syndrome Associated with Renal Vein Thrombosis

    PubMed Central

    Kang, Sung Kyew; Park, Sung Kwang

    1987-01-01

    The coexistence of nephrotic syndrome and renal vein thrombosis has been of medical interest since Rayers description in 1840. Renal vein thrombosis has been underdiagnosed because of its variable clinical and radiological findings but it becomes a more frequently recognizable clinical entity since diagnosis can be easily established by modern angiographic techniques. Generally it has been believed that renal vein thrombosis may cause nephrotic syndrome. But recent articles strongly suggest that renal vein thrombosis is a complication of the nephrotic syndrome rather than a cause. We report three cases of nephrotic syndrome associated with renal vein thrombosis. PMID:3154812

  3. Deep vein thrombosis risk stratification.

    PubMed

    Nitta, Daisuke; Mitani, Haruo; Ishimura, Rieko; Moriya, Manabu; Fujimoto, Yo; Ishiwata, Sugao; Yamaguchi, Tetsu; Ohno, Minoru

    2013-01-01

    Pulmonary thromboembolism (PTE) is a life-threatening disease which always presents in patients with deep vein thrombosis (DVT). There are few statements in guidelines regarding indications for anticoagulation based on the location of DVT. We investigated whether the relative risk of PTE depends on thrombus location and bleeding complications with anticoagulation therapy. Between January 1 and July 10, 2007, 461 patients underwent lower extremity venous ultrasound studies, and 129 patients were diagnosed as DVT (60 males, 66.9 13.3 years). We retrospectively studied the incidence of PTE and bleeding complications associated with anticoagulation therapy. Average follow-up period was 536 324 days. Above and below knee thrombosis was present in 60 and 69 patients, respectively. Warfarin was administered in 60 patients. Nine patients developed PTE. Multivariate analysis showed the absence of anticoagulation therapy and location of DVT (above knee) to be significantly correlated with onset of PTE (anticoagulation; P < 0.01, location; P = 0.02). However, the incidence of bleeding was not significantly different between above knee and below knee vein thrombosis (P = 0.72). In conclusion, below knee vein thrombosis carries a relatively low risk of PTE, but the incidence of bleeding complications does not depend on thrombosis location. This suggests that the indication of anticoagulation therapy should be based on DVT location. PMID:23774241

  4. Recanalization and Reperfusion Therapies of Acute Ischemic Stroke: What have We Learned, What are the Major Research Questions, and Where are We Headed?

    PubMed Central

    Gomis, Meritxell; Dvalos, Antoni

    2014-01-01

    Two placebo-controlled trials have shown that early administration of intravenous recombinant tissue plasminogen activator (rt-PA) after ischemic stroke improves outcomes up to 4.5?h after symptoms onset; however, six other trials contradict these results. We also know from analysis of the pooled data that benefits from treatment decrease as time from stroke onset to start of treatment increases. In addition to time, another important factor is patient selection through multimodal imaging, combining data from artery status, and salvageable tissue measures. Nonetheless, at the present time randomized controlled trials (RCTs) cannot demonstrate any beneficial outcomes for neuroimaging mismatch selection after 4.5?h from symptoms onset. By focusing on cases of large arterial occlusion, we know that recanalization is crucial, so endovascular treatment is an approach of interest. The use of intra-arterial thrombolysis was tested in two small RCTs that demonstrated clear benefits in terms of higher recanalization and also in clinical outcomes. But a new paradigm of stroke treatment may have begun with mechanical thrombectomy. In this field, Merci devices have been overtaken by fully deployed closed-cell self-expanding stents (stent-retrievers or stent-trievers). However, despite the high rate of recanalization achieved with stent-retrievers compared with other recanalization treatments, the use of these devices cannot clearly demonstrate better outcomes. Thus, futile recanalization occurs when successful recanalization fails to improve functional outcome. Recently, three RCTs, namely synthesis, IMS-III, and MR-rescue, have not been demonstrated any clear benefit for endovascular treatment. Most likely, these trials were not adequately designed to prove the superiority of endovascular treatment because they did not use optimal target populations, vascular status was not evaluated in all patients, relatively high rates of patients did not have enough mismatch, time from baseline neuroimaging to recanalization were too long or the devices used are now obsolete relative to stent-retrievers. Several RCTs currently underway are trying to determine whether bridging therapy is more effective than intravenous treatment and if mechanical thrombectomy is more effective than best medical treatment in patients ineligible for intravenous thrombolysis. PMID:25477857

  5. Comparison of Pregnancy Outcome between Ultrasound- Guided Tubal Recanalization and Office-Based Microhysteroscopic Ostial Dilatation in Patients with Proximal Blocked Tubes

    PubMed Central

    Seyam, Emaduldin Mostafa; Hassan, Momen Mohamed; Tawfeek Mohamed Sayed Gad, Mohamed; Mahmoud, Hazem Salah; Ibrahim, Mostafa Gamal

    2016-01-01

    Background The current research to the best of my knowledge is the first to compare the pregnancy outcome between ultrasound-guided tubal recanalization (UGTR) using a special fallopian tubal catheter, and office-based micrhysteroscopic ostial dilatation (MHOD) using the same tubal catherter in infertile women with previously diagnosed bilateral proximal tubal obstruction (PTO). Materials and Methods This prospective study reported the pregnancy outcomes for 200 women in private infertility care center in Arafa hospital in Fayoum and in El Minya University Hospital in the period between January 2010 and October 2013 treated as outpatients for their bilateral PTO after the routine hysterosalpingography (HSG). A Cook’s catheter, special fallopian tubal catheter, were used to recanalize the blocked tubes in 100 women (group A) under UGTR, and the same Cook’s tubal catheter was used through 2mm microhysteroscope to cannulate both ostia using MHOD in another 100 women (group B). Pregnancy outcome was determined after the procedures for a 12-month period follow-up. Results The number of the recanalization of PTO was not significantly different between two groups. As of the 200 blocked fallopian tubes in group A, 140 tubes (70%) were successfully recanalized by passing the ultrasound-guided special cannula, while 150 tubes (75%) were successfully recanalized in group B, using the same tubal catheter through a 2mm microhysteroscope. The cumulative pregnancy rate after the two procedures was not statistically different between two groups. It was 25.9% in group A, while it was 26.3% in group B, after a 12-month period follow-up. Conclusion UGTR is highly recommended as the first step to manage infertile women due to PTO, as it is easier procedure; however, there is possible to obtain nearly similar results after MHOD. PMID:26985337

  6. Vein harvesting and techniques for infrainguinal bypass.

    PubMed

    Albäck, Anders; Saarinen, Eva; Venermo, Maarit

    2016-04-01

    In order to achieve good long term results after bypass surgery, alongside with good inflow and outflow arteries, the bypass graft material also has an important role. The best patency and limb salvage rates are achieved with autologous vein. If great saphenous vein is not available, acceptable long-term results can be achieved with arm veins and lesser saphenous vein. The quality and size of the vein are important. A small-caliber vein, increased wall thickness, postphlebitic changes and varicosities are associated with a risk of early failure. Preoperative vein mapping with ultrasound reduces readmissions and postoperative surgical site infections. During the mapping, the vein to be used and its main tributaries are marked with a permanent marker pen. To reduce wound complication rates we recommend bridged incisions in vein harvesting. Endoscopic vein harvesting seems to have no benefit compared to open techniques in lower limb bypasses, and has been associated with higher risk of primary patency loss at one year. With deep tunneling of the graft the problems caused by wound infection can be avoided. PMID:26837257

  7. Combined Retrograde-Antegrade Arterial Recanalization Through Collateral Vessels: Redefinition of the Technique for Below-the-Knee Arteries

    SciTech Connect

    Graziani, L. Morelli, L. G.

    2011-02-15

    The effectiveness of below-the-knee PTA to obtain successful revascularization in patients with critical limb ischemia (CLI) has been well established, and many centers have adopted endovascular intervention as the first-line treatment in patients with chronic lower-extremity disease. The well-known complex and multilevel arterial disease in patients with CLI have lead to interventionists to continuously implement different technologies and techniques. The aim of the present study was to standardize and redefine a technique characterized for combined retrograde-antegrade recanalization of a native leg artery through a collateral arterial branch by using a single access. This concept has been well described in coronary arteries and recently in pelvic and tibial arteries.

  8. Recanalization of Acute and Subacute Femoropopliteal Artery Occlusions with the Rotarex Catheter: One Year Follow-up, Single Center Experience

    SciTech Connect

    Duc, Sylvain R. Schoch, Eric; Pfyffer, Markus; Jenelten, Regula; Zollikofer, Christoph L.

    2005-06-15

    Purpose:To assess the efficacy and safety of a new rotational catheter for percutaneous removal of fresh and organized thrombi in the femoropopliteal artery.Methods:Forty-one limbs in 38 patients (age 56-90 years, mean 75.6 years) with acute, subacute or chronic femoropopliteal occlusions of 1-180 days' duration (mean 31.6 days) were treated with the Rotarex device. The Fontaine stage was mainly IIB (Rutherford 2-3, 22 patients) or III (Rutherford 4, 14 patients). The length of occlusion varied from 2 to 35 cm (mean 13.1 cm). After recanalization percutaneous transluminal angioplasty (PTA) was performed if there was a residual stenosis of >25%. Patients were followed up with color Doppler ultrasound at 48 hr and clinically with Doppler pressures and oscillometry at 3, 6, and 12 months.Results:After an average of two passages with the Rotarex catheter all but two limbs required PTA for residual stenosis >25%. Five patients needed additional stenting. Major complications were one groin hematoma requiring blood transfusion and one arteriovenous fistula spontaneously thrombosing after unsuccessful primary prolonged balloon dilation. Distal embolizations occurred in 10 patients; 6 clinically relevant emboli were aspirated. All occlusions were technically successfully recanalised there were 2 early reocclusions after 1 day and two at 2 weeks. Brachial-ankle indices improved from an average of 0.41 before to 0.93 after recanalization. Primary and secondary patency rates were 62% / 84% after 6 months and 39% / 68% after 1 year. The amputation-free survival at 12 months was 100%.Conclusion:The Rotarex mechanical thrombectomy device is an efficient, quick, easy to handle, and safe tool for the treatment of acute, subacute or even chronic peripheral arterial thromboembolic occlusions. It can be used for short or long occlusions with equal success, provided the obstruction is not heavily calcified and has been safely passed with a guidewire first.

  9. Deep Vein Thrombosis of the Left Lower Limb in a 12 Year-Old Female Child with Ulcerative Colitis – Case Report

    PubMed Central

    Krzesiek, Elżbieta; Zaleska-Dorobisz, Urszula; Iwańczak, Barbara; Dorobisz, Andrzej T.

    2016-01-01

    Summary Background Inflammatory bowel disease includes ulcerative colitis and Crohn’s disease. Case Report This case report presents a patient with ulcerative colitis, with thrombotic complication of the left common iliac vein that occurred at the age of 11, two years after diagnosis. After a year of anticoagulation and compression therapy, although exacerbations of underlying disease occurred in the first 6 months of treatment, there was no recurrence of deep venous thrombosis, partial recanalization within affected venous system has been achieved and the patient is remission of ulcerative colitis for the last six months. Conclusions In children, thromboembolic complications occur about 7 times less often than in adults, but increases in the case of hospitalized children. In children with IBD this complication can occur independently og disease activity even in patients with any other risk factors. PMID:26966473

  10. Clay veins: Their occurrence, characteristics, and support

    SciTech Connect

    Chase, F.E.; Ulery, J.P.

    1987-01-01

    These detrimental aspects have prompted the Bureau of Mines to investigate the physical characteristics of and roof instability problems associated with clay veins. The investigators found that clay veins normally occur in more stable, less rapidly subsiding coal basins. Clay veins result when tensile stresses develop fissures that are later infilled. These fissures can be propagated by compactional processes and/or tectonic stresses during and subsequent to coalification. The Bureau also found that associated faults, fractures, and slickenside planes commonly parallel clay veins and disrupt the lateral continuity of the immediate and, sometimes, main roof. When clay veins parallel or subparallel the direction of face advance, the roof is segmented into cantilever beams, causing unstable conditions. Consequently, the strate on either side of the clay veins should be bolted and strapped together to form a beam.

  11. Portal vein thrombosis during pregnancy

    PubMed Central

    Dasari, Papa; Balusamy, Sathyalakshmy

    2013-01-01

    A 22-year-old primigravida was diagnosed to have portal vein thrombosis during 20th week of gestation by ultrasound examination which was carried out to rule out congenital fetal anomalies. She had splenomegaly and thrombocytopenia. Investigations did not reveal any prothrombotic disorder. She was managed with anticoagulants which were started at 31?weeks of pregnancy. Labour was induced at 40?weeks of gestation and she delivered a healthy neonate without any complications. Anticoagulants were restarted after delivery and continued through the postpartum period and up to 6?months thereafter. PMID:23715832

  12. Five-year results from the prospective European multicentre cohort study on radiofrequency segmental thermal ablation for incompetent great saphenous veins

    PubMed Central

    Proebstle, T M; Alm, B J; Göckeritz, O; Wenzel, C; Noppeney, T; Lebard, C; Sessa, C; Creton, D; Pichot, O

    2015-01-01

    Background This was a prospective study of radiofrequency segmental thermal ablation (RFA) for the treatment of incompetent varicose great saphenous veins (GSVs). The present report describes long-term follow-up at 5 years. Methods The 5-year follow-up of this multicentre European study included assessment of the Venous Clinical Severity Score (VCSS), and GSV occlusion and reflux on duplex imaging. Results A total of 225 patients had 295 GSVs treated by RFA, achieving an initial vein occlusion rate of 100 per cent. With 80·0 per cent compliance, Kaplan–Meier analyses showed a GSV occlusion rate of 91·9 per cent and a reflux-free rate of 94·9 per cent at 5 years. Among the 15 GSVs noted with reflux during follow-up, only three showed full recanalization of the GSV at 1 week, 6 months and 3 years. Of the 12 legs with partial recanalization, reflux originated at the saphenofemoral junction in ten, with a mean length of the patent segment of 5·8 (range 3·2–10) cm; only six patients were symptomatic. Mean(s.d.) VCSS scores improved from 3·9(2·1) at baseline to 0·6(1·2), 0·9(1·3) and 1·3(1·7) at 1, 3 and 5 years. Conclusion At 5 years RFA proved to be an efficient endovenous treatment for incompetent GSVs in terms of sustained clinical and anatomical success for the vast majority of treated patients. PMID:25627262

  13. Deep Vein Thrombosis (DVT) / Pulmonary Embolism (PE) - Blood Clot Forming in a Vein

    MedlinePLUS

    ... Espaol (Spanish) Recommend on Facebook Tweet Share Compartir Deep Vein Thrombosis and Pulmonary Embolism (DVT/PE) are often underdiagnosed and serious, but preventable medical conditions. Deep vein thrombosis (DVT) is a medical condition that ...

  14. Coronary vein graft disease: Pathogenesis and prevention

    PubMed Central

    Parang, Pirouz; Arora, Rohit

    2009-01-01

    Not long after coronary artery bypass grafting surgery was described, several reports presented follow-up angiographic data on large cohorts of patients, demonstrating that approximately one-half of saphenous vein grafts fail within 10 to 15 years of surgery and that graft failure is associated with worse clinical outcomes. Three processes are responsible for vein graft failure. Thrombosis, intimal hyperplasia and accelerated atherosclerosis contribute to graft failure in the acute, subacute and late postoperative periods, respectively. Studies have shown that perioperative antiplatelet therapy can reduce early thrombosis and graft failure. As in native coronaries, intensive lipid lowering can attenuate the process of atherosclerosis in vein grafts. Intimal hyperplasia in the vein graft is thought to be an adaptation of the vein to higher pressures in the arterial circulation. This process is further promoted by the loss of inhibition from the endothelial layer, which is injured during surgery. A new no-touch technique for harvesting grafts may be effective in preventing disruption to the endothelial layer, and subsequent intimal hyperplasia and graft loss. Off-pump surgery and endoscopic vein harvesting, which are known to reduce surgical morbidity, have been shown to be no worse than on-pump surgery and open vein harvesting, respectively, in terms of vein graft patency. Various gene therapies can prevent intimal hyperplasia in animal models, but human data obtained so far have been disappointing. Placing an external stent around a vein graft may reduce tangential wall stress and subsequent intimal hyperplasia. PMID:19214303

  15. Remodelling of the Superior Caval Vein After Angioplasty in an Infant with Superior Caval Vein Syndrome

    SciTech Connect

    Mert, Murat Saltik, Levent; Gunay, Ilhan

    2004-08-15

    An 8-month old girl was presented with superior caval vein syndrome early after cardiac surgery. Angiography showed severe stenosis of the superior caval vein with 50 mmHg pressure gradient. Following balloon angioplasty, the pressure gradient was reduced to 7 mmHg with some residual stenosis of the superior caval vein. When the patient was reevaluated 5 months after the procedure, angiography revealed a normal diameter of the superior caval vein without a pressure gradient.

  16. Idiopathic Bilateral External Jugular Vein Thrombosis

    PubMed Central

    Hindi, Zakaria; Fadel, Ehab

    2015-01-01

    Patient: Male, 21 Final Diagnosis: Idiopathic bilateral external jugular vein thrombosis Symptoms: Face engorgement neck swelling Medication: Clinical Procedure: None Specialty: Hematology Objective: Unknown ethiology Background: Vein thrombosis is mainly determined by 3 factors, which constitute a triad called Virchows triad: hypercoagulability, stasis, and endothelial injury. Venous thrombosis commonly occurs in the lower extremities since most of the blood resides there and flows against gravity. The veins of the lower extremities are dependent on intact valves and fully functional leg muscles. However, in case of valvular incompetency or muscular weakness, thrombosis and blood stasis will occur as a result. In contrast, the veins of the neck, specially the jugulars, have distensible walls which allow flexibility during respiration. In addition, the blood directly flows downward towards the heart. Nevertheless, many case reports mentioned the thrombosis of internal jugular veins and external jugular veins with identified risk factors. Jugular vein thrombosis has previously been associated in the literature with a variety of medical conditions, including malignancy. Case Report: This report is of a case of idiopathic bilateral external jugular vein thrombosis in a 21 year-old male construction worker of Southeast Asian origin with no previous medical history who presented with bilateral facial puffiness of gradual onset over 1 month. Doppler ultrasound and computed tomography were used in the diagnosis. Further work-up showed no evidence of infection or neoplasia. The patient was eventually discharged on warfarin. The patient was assessed after 6 months and his symptoms had resolved completely. Conclusions: Bilateral idiopathic external jugular veins thrombosis is extremely rare and can be an indicator of early malignancy or hidden infection. While previous reports in the literature have associated jugular vein thrombosis with malignancy, the present case shows that external jugular vein thrombosis can also be found in persons without malignancy. PMID:26301793

  17. Normal distal pulmonary vein anatomy

    PubMed Central

    Klimek-Piotrowska, Wies?awa; Pi?tek, Katarzyna; Koziej, Mateusz; Ho?da, Jakub

    2016-01-01

    Background. It is well known that the pulmonary veins (PVs), especially their myocardial sleeves play a critical role in the initiation and maintenance of atrial fibrillation. Understanding the PV anatomy is crucial for the safety and efficacy of all procedures performed on PVs. The aim of this study was to present normal distal PV anatomy and to create a juxtaposition of all PV ostium variants. Methods. A total of 130 randomly selected autopsied adult human hearts (Caucasian) were examined. The number of PVs ostia was evaluated and their diameter was measured. The ostium-to-last-tributary distance and macroscopic presence of myocardial sleeves were also evaluated. Results. Five hundred forty-one PV ostia were identified. Four classical PV ostia patterns (two left and two right PVs) were observed in 70.8% of all cases. The most common variant was the classical pattern with additional middle right PV (19.2%), followed by the common ostium for the left superior and the inferior PVs (4.44%). Mean diameters of PV ostia (for the classical pattern) were: left superior = 13.8 2.9 mm; left inferior = 13.3 3.4 mm; right superior = 14.3 2.9 mm; right inferior = 13.7 3.3 mm. When present, the additional middle right PV ostium had the smallest PV ostium diameter in the heart (8.2 4.1 mm). The mean ostium-to-last-tributary (closest to the atrium) distances were: left superior = 15.1 4.6 mm; left inferior = 13.5 4.0 mm; right superior = 11.8 4.0 mm; right inferior = 11.0 3.7 mm. There were no statistically significant differences between sexes in ostia diameters and ostium-to-last-tributary distances. Conclusion. Only 71% of the cases have four standard pulmonary veins. The middle right pulmonary vein is present in almost 20% of patients. Presented data can provide useful information for the clinicians during interventional procedures or radiologic examinations of PVs. PMID:26793429

  18. Normal distal pulmonary vein anatomy.

    PubMed

    Klimek-Piotrowska, Wies?awa; Ho?da, Mateusz K; Pi?tek, Katarzyna; Koziej, Mateusz; Ho?da, Jakub

    2016-01-01

    Background. It is well known that the pulmonary veins (PVs), especially their myocardial sleeves play a critical role in the initiation and maintenance of atrial fibrillation. Understanding the PV anatomy is crucial for the safety and efficacy of all procedures performed on PVs. The aim of this study was to present normal distal PV anatomy and to create a juxtaposition of all PV ostium variants. Methods. A total of 130 randomly selected autopsied adult human hearts (Caucasian) were examined. The number of PVs ostia was evaluated and their diameter was measured. The ostium-to-last-tributary distance and macroscopic presence of myocardial sleeves were also evaluated. Results. Five hundred forty-one PV ostia were identified. Four classical PV ostia patterns (two left and two right PVs) were observed in 70.8% of all cases. The most common variant was the classical pattern with additional middle right PV (19.2%), followed by the common ostium for the left superior and the inferior PVs (4.44%). Mean diameters of PV ostia (for the classical pattern) were: left superior = 13.8 2.9 mm; left inferior = 13.3 3.4 mm; right superior = 14.3 2.9 mm; right inferior = 13.7 3.3 mm. When present, the additional middle right PV ostium had the smallest PV ostium diameter in the heart (8.2 4.1 mm). The mean ostium-to-last-tributary (closest to the atrium) distances were: left superior = 15.1 4.6 mm; left inferior = 13.5 4.0 mm; right superior = 11.8 4.0 mm; right inferior = 11.0 3.7 mm. There were no statistically significant differences between sexes in ostia diameters and ostium-to-last-tributary distances. Conclusion. Only 71% of the cases have four standard pulmonary veins. The middle right pulmonary vein is present in almost 20% of patients. Presented data can provide useful information for the clinicians during interventional procedures or radiologic examinations of PVs. PMID:26793429

  19. Enhancing the contrast of subcutaneous veins

    NASA Astrophysics Data System (ADS)

    Zeman, Herbert D.; Lovhoiden, Gunnar

    1999-07-01

    A technique for enhancing the contrast of subcutaneous veins has been demonstrated. This technique uses a near infrared light source and one or more infrared sensitive CCD TV cameras to produce a contrast enhanced image of the subcutaneous veins. This video image of the veins is projected back onto the patient's skin using an LCD vein projector. The use of an infrared transmitting filter in front of the video cameras prevents any positive feedback from the visible light from the video projector from causing instabilities in the projected image. The demonstration contrast enhancing illuminator has been tested on adults, both Caucasian and African-American, and it enhances veins quite well in most cases. Preliminary studies on a 9 month old girl indicate promise for pediatric use.

  20. MiR-145 facilitates proliferation and migration of endothelial progenitor cells and recanalization of arterial thrombosis in cerebral infarction mice via JNK signal pathway

    PubMed Central

    Chen, Rongbo; Chen, Siqia; Liao, Juan; Chen, Xiaopu; Xu, Xiaoling

    2015-01-01

    Arterial thrombosis in cerebral infarction severely affects patients lives. Classical treatment including surgery and medication both had significantly adverse effects, making it necessary to find novel strategy. Endothelial progenitor cells (EPCs) have been shown to enhance the recanalization of thrombosis, while leaving its molecular mechanism unclear. EPCs were separated from peripheral blood, and were transfected by microRNA (miR)-145. The growth, proliferation and migration abilities were quantified by MTT, clone formation and Transwell assays, respectively. Cell apoptosis was evaluated by flow cytometry. The activation of JNK signaling pathway was measured by Western blotting, followed by JNK inhibitor SP600125. In a mouse cerebral infarction model, miR-145 transfected EPCs were injected to observe the condition of arterial thrombosis. MiR-145 transfection enhanced growth, migration and proliferation of EPCs without induction of apoptosis. MiR-145 exerts its effects via JNK signaling pathway, as the blocking inhibited cell migration/proliferation. In vivo injection of miR-145 transfected EPCs also potentiated cell proliferation and migration, in addition to the recanalization of arterial thrombosis. MiR-145 facilitates proliferation and migration of EPCs and recanalization of arterial thrombosis in cerebral infarction mice via JNK signal pathway. This study provided new insights regarding infarction treatment. PMID:26722607

  1. Preduodenal portal vein in the adult.

    PubMed

    Papaziogas, T; Papaziogas, B; Paraskevas, G; Lazaridis, C; Patsas, A

    2000-09-01

    We present three cases of preduodenal portal vein in adult people, which were diagnosed in our department. All of them were identified during elective operation for cholelithiasis, caused some technical difficulties to the performance of the operation, but led to no major intraoperative or postoperative complications. None of them had any preoperative symptoms, which could be related to this anomaly. The preduodenal portal vein is a rare congenital anomaly, which is usually discovered in infants or children due to the obstruction of the duodenum. In adults, it is often asymptomatic, and is usually discovered as an accidental finding during laparotomy for other reason. The postcontrast CT can set the diagnosis, when this anomaly is suspected. Despite its rarity, this anomaly is of great surgical importance, because it can predispose to intraoperative complications including hemorrhage from the abnormal vein, or damage to the biliary tract or the distented duodenum. The anterior position of the portal vein results from the persistence of the ventral anastomosis between the two vitelline veins and the distal portion of the right vitelline vein, with subsequent atrophy of the cranial part of the left vitelline and dorsal anastomotic vein. PMID:11244931

  2. [FEATURES LIVER TRANSPLANTATION IN PORTAL VEIN THROMBOSIS].

    PubMed

    Abbasov, P A

    2015-07-01

    In 2012 - 2013 years in 265 patients for liver transplantation was performed, including in 224 (84.5%)--from a living donor, in 41 (15.5%)--from the dead body. Using a Foley catheter to stop bleeding, and the imposition of vascular sutures during endovenectomy in portal vein thrombosis (PVT) and its possible damage under all conditions. In particular, PVT IV degree (Grade IV) in order to restore blood flow in the graft using the left gastric and renal vein is an alternative, if they are cryopreserved vein may be suitably used. PMID:26591211

  3. Cardiac vein angioplasty for biventricular pacing.

    PubMed

    Sandler, David A; Feigenblum, David Y; Bernstein, Neil E; Holmes, Douglas S; Chinitz, Larry A

    2002-12-01

    Biventricular pacing for the treatment of congestive heart failure has consistently demonstrated improvement in quality-of-life and reduction in heart failure symptoms. Though the over-the-wire systems will be helpful in overcoming many existing obstacles to optimal lead placement, anatomic variability will still limit overall success. Cardiac vein angioplasty may be required for deployment of leads into tortuous or obstructed cardiac veins. This case report describes the angioplasty of a focal cardiac vein stenosis allowing for successful implantation of a left ventricular pacing lead. The safety of this procedure is unknown, though the risks may be acceptable in certain patients. PMID:12520686

  4. Selecting a treatment for primary varicose veins.

    PubMed Central

    Tremblay, J; Lewis, E W; Allen, P T

    1985-01-01

    The treatment of varicose veins includes injection/compression sclerotherapy and surgical stripping or ligation or both. Surgery appears to be favoured when the saphenous system is involved or when the patient is 35 to 64 years old or presents with ankle edema or flare. On the other hand, sclerotherapy has been found to be more effective in patients with dilated superficial veins or incompetent perforating veins in the lower legs and to be more acceptable and less expensive than surgical treatment. PMID:3891060

  5. Hand vein recognition based on orientation of LBP

    NASA Astrophysics Data System (ADS)

    Bu, Wei; Wu, Xiangqian; Gao, Enying

    2012-06-01

    Vein recognition is becoming an effective method for personal recognition. Vein patterns lie under the skin surface of human body, and hence provide higher reliability than other biometric traits and hard to be damaged or faked. This paper proposes a novel vein feature representation method call orientation of local binary pattern (OLBP) which is an extension of local binary pattern (LBP). OLBP can represent the orientation information of the vein pixel which is an important characteristic of vein patterns. Moreover, the OLBP can also indicate on which side of the vein centerline the pixel locates. The OLBP feature maps are encoded by 4-bit binary values and an orientation distance is developed for efficient feature matching. Based on OLBP feature representation, we construct a hand vein recognition system employing multiple hand vein patterns include palm vein, dorsal vein, and three finger veins (index, middle, and ring finger). The experimental results on a large database demonstrate the effectiveness of the proposed approach.

  6. Impact of Laser Fiber Design on Outcome of Endovenous Ablation of Lower-Extremity Varicose Veins: Results from a Single Practice

    SciTech Connect

    Prince, Ethan A. Soares, Gregory M.; Silva, MaryLou; Taner, Anil; Ahn, SunHo; Dubel, Gregory J.; Jay, Bryan S.

    2011-06-15

    The design of laser fibers used for endovenous laser ablation (EVLA) in the management of lower-extremity varicose vein disease may affect treatment success. The purpose of this investigation is to report our experience using the gold-tip NeverTouch VenaCure laser fiber (AngioDynamics, Queensbury, NY) and to compare that to our experience with standard bare-tip fibers. A retrospective chart review of 363 consecutive EVLA treatments using the gold-tip laser fiber was performed. Demographic data including patient age, sex, history of previous varicose vein stripping, vein identity, laterality, treatment length, total applied energy in joules (J), use of adjuvant sclerotherapy and ambulatory phlebectomy, treatment-related complications, and treatment failure, which was defined as recanalization of any portion of the treated vein during follow-up as assessed by duplex ultrasound examination-were entered into a spreadsheet. These data were compared with a control group of 471 EVLA treatments performed with a standard bare-tip laser fiber. Data were analyzed using independent-samples Student's t test, chi-square test, and multivariate analysis. Demographic data were similar between the two groups. Treatments with the gold-tip fiber had a failure rate of 11.1%, whereas treatment with a bare-tip fiber had a failure rate of 2.3% during a similar follow-up period. This difference was highly statistically significant (p < 0.0001). Multivariate analysis showed fiber type as the most significant factor associated with treatment failure. We conclude that laser fiber design has a significant effect on treatment success in the performance of EVLA.

  7. Ultrastructure of internal jugular vein defective valves

    PubMed Central

    Tisato, V; Menegatti, E; Mascoli, F; Gianesini, S; Salvi, F; Secchiero, P

    2015-01-01

    Objectives To study the ultrastructure of intraluminal defects found in the internal jugular vein by using a scanning electron microscopy. Methods Using a scanning electron microscopy, intraluminal septa and/or defective valves blocking the flow in the distal internal jugular vein of seven patients were studied together with the adjacent wall and compared with control specimen. Results The internal jugular veins wall showed a significant derangement of the endothelial layer as compared to controls. Surprisingly, no endothelial cells were found in the defective cusps, and the surface of the structure is covered by a fibro-reticular lamina. Conclusions Although the lack of endothelial cells in the internal jugular vein intraluminal obstacles is a further abnormality found in course of chronic cerebrospinal venous insufficiency, our investigation cannot clarify whether this finding is primary or caused by progressive loss of endothelium in relation to altered haemodynamic forces and/or to a past post-thrombotic/inflammatory remodelling. PMID:24972760

  8. Portal vein thrombosis in liver transplantation.

    PubMed

    Charco, R; Fuster, J; Fondevila, C; Ferrer, J; Mans, E; Garca-Valdecasas, J C

    2005-11-01

    In the initial experience of liver transplantation, complete thrombosis and portal vein occlusion were considered to be absolute contraindications for liver transplantation. The incidence of portal thrombosis in patients being prepared for transplantation varies between 5% and 15% according to published series. There are 2 surgical techniques to solve absent or low portal vein flow due to thrombosis. The most widely used technique is thrombectomy and the second technique is insertion of a shunt with a venous graft in the permeable portion of the superior mesenteric vein or in a vein in the splanchnic territory. Portal thrombosis recurrence rates vary among series, ranging from 0% to 25% or even 30%, depending on its extension and severity and also on time the transplantation was performed. Although overall survival is somewhat lower, there are no significant differences in most of the series when patients with portal thrombosis who underwent transplantation are compared with those without. PMID:16386579

  9. Subclavian vein catheterisation for parenteral nutrition.

    PubMed Central

    Fletcher, J. P.; Little, J. M.

    1988-01-01

    Two hundred and twenty-six central venous catheters were placed in 195 consecutive patients requiring central venous catheterisation for total parenteral nutrition (TPN). Of these 226 catheters, 198 were placed percutaneously into the subclavian vein by the infraclavicular route. In 99 consecutive subclavian catheter insertions, a 12G needle with introducing sheath was used to puncture the vein (Group 1). The Seldinger method of catheterisation was used in another 99 consecutive subclavian catheter insertions (Group 2), the vein being punctured with a 19G needle. Pneumothorax occurred on three occasions (3.0%) in Group 1 but did not occur in Group 2. However, there were two episodes of pleural extravasation in Group 2 (2.0%) which may have been due to guide wire perforation of a central vein; this complication did not occur in Group 1. Although the Seldinger technique of insertion should reduce the incidence of pneumothorax, care should be taken in passage of the guide wire. PMID:3136691

  10. Abdominal collateral vein as an unconventional vascular access for hemodialysis in patient with central vein occlusion.

    PubMed

    Str?ecki, Pawe?; Flisi?ski, Mariusz; Serafin, Zbigniew; Wiechecka-Korenkiewicz, Joanna; Manitius, Jacek

    2014-01-01

    A 65-year-old female patient with chronic kidney disease stage 5 and a history of spleen neoplasm with dissemination within peritoneum is presented. During 5years of hemodialysis therapy, bilateral occlusion of brachiocephalic and iliac vein developed as a consequence of vein catheterization. An attempt to cannulate inferior vena cava was unsuccessful. A cannulation of dilated collateral abdominal veins with dialysis needles allowed to perform several hemodialysis sessions in the patient. PMID:24796505

  11. Variant anatomy of internal jugular vein branching

    PubMed Central

    Deepak, Chris A.; Sarvadnya, Jagadish J.; Sabitha, K. S.

    2015-01-01

    The knowledge of both normal and abnormal anatomy of the veins of the neck is important for clinicians performing catheterization and surgeons operating in the region of the neck. The presence of such anomalous communications may also be important for radiologists performing angiographic and sonographic studies. This study presents three cases of variant anatomy in posterior branching and abnormal branching of internal jugular vein found during our routine neck dissection.

  12. Primary leiomyosarcoma of the innominate vein.

    PubMed

    Illuminati, Giulio; Miraldi, Fabio; Mazzesi, Giuseppe; D'urso, Antonio; Ceccanei, Gianluca; Bezzi, Marcello

    2007-01-01

    Primary venous leiomyosarcoma is rare. We report the case of a primary leiomyosarcoma of the left innominate vein, with neoplastic thrombus extending into the left jugular and subclavian veins. The tumor was curatively resected en bloc with anterior mediastinal and laterocervical lymphatics, through a median sternotomy prolonged into left cervicotomy. Primary venous sarcomas may be associated with prolonged survival in individual cases, with curative resection recommended as the standard treatment, in the absence of distant spread. PMID:17349340

  13. Subclavian vein thrombosis: A continuing challenge

    SciTech Connect

    Hill, S.L.; Berry, R.E. )

    1990-07-01

    Subclavian vein thrombosis is a relatively uncommon but potentially morbid disease entity. To determine the frequency, cause, and best mode of treatment of this problem, we performed a chart review of all patients with a diagnosis of subclavian vein thrombosis at two major metropolitan hospitals during a 6-year period. A total of 40 patients were identified with subclavian vein thrombosis, which represented 3.5% of all venous thromboses detected during the 6-year period. No side or sex predilection was noted and the majority of patients were outpatients. The cause was fairly evenly divided among intravenous catheters (32%), anatomic abnormalities (45%), and carcinoma with postoperative radiation (22.5%). Despite the increasing use of the subclavian veins for pacemaker leads, hyperalimentation, and permanent intravenous access for chemotherapy, there has not been an increase in diagnosed subclavian vein thrombosis. Anatomic abnormalities with compression of the vein respond well to either heparinization or lytic therapy but require surgery if the venous abnormality persists. Treatment consisted of lytic therapy in 20%, heparinization in 55%, and elevation with removal of the central line in 25% of patients. All patients responded well to treatment, with a decrease in swelling and symptoms; no patient progressed to venous gangrene and only one (2.5%) had a documented pulmonary embolus. Medical treatment provides excellent long-term benefit in most cases unless complicated by an anatomic abnormality.

  14. Veins Improve Fracture Toughness of Insect Wings

    PubMed Central

    Dirks, Jan-Henning; Taylor, David

    2012-01-01

    During the lifetime of a flying insect, its wings are subjected to mechanical forces and deformations for millions of cycles. Defects in the micrometre thin membranes or veins may reduce the insect’s flight performance. How do insects prevent crack related material failure in their wings and what role does the characteristic vein pattern play? Fracture toughness is a parameter, which characterises a material’s resistance to crack propagation. Our results show that, compared to other body parts, the hind wing membrane of the migratory locust S. gregaria itself is not exceptionally tough (1.04±0.25 MPa√m). However, the cross veins increase the wing’s toughness by 50% by acting as barriers to crack propagation. Using fracture mechanics, we show that the morphological spacing of most wing veins matches the critical crack length of the material (1132 µm). This finding directly demonstrates how the biomechanical properties and the morphology of locust wings are functionally correlated in locusts, providing a mechanically ‘optimal’ solution with high toughness and low weight. The vein pattern found in insect wings thus might inspire the design of more durable and lightweight artificial ‘venous’ wings for micro-air-vehicles. Using the vein spacing as indicator, our approach might also provide a basis to estimate the wing properties of endangered or extinct insect species. PMID:22927966

  15. Scattering Removal for Finger-Vein Image Restoration

    PubMed Central

    Yang, Jinfeng; Zhang, Ben; Shi, Yihua

    2012-01-01

    Finger-vein recognition has received increased attention recently. However, the finger-vein images are always captured in poor quality. This certainly makes finger-vein feature representation unreliable, and further impairs the accuracy of finger-vein recognition. In this paper, we first give an analysis of the intrinsic factors causing finger-vein image degradation, and then propose a simple but effective image restoration method based on scattering removal. To give a proper description of finger-vein image degradation, a biological optical model (BOM) specific to finger-vein imaging is proposed according to the principle of light propagation in biological tissues. Based on BOM, the light scattering component is sensibly estimated and properly removed for finger-vein image restoration. Finally, experimental results demonstrate that the proposed method is powerful in enhancing the finger-vein image contrast and in improving the finger-vein image matching accuracy. PMID:22737028

  16. Nutcracker Syndrome Complicated by Left Renal Vein Thrombosis

    PubMed Central

    Mallat, Faouzi; Hmida, Wissem; Jaidane, Mehdi; Mama, Nadia; Mosbah, Faouzi

    2013-01-01

    Isolated renal vein thrombosis is a rare entity. We present a patient whose complaint of flank pain led to the diagnosis of a renal vein thrombosis. In this case, abdominal computed tomography angiography was helpful in diagnosing the nutcracker syndrome complicated by the renal vein thrombosis. Anticoagulation was started and three weeks later, CTA showed complete disappearance of the renal vein thrombosis. To treat the Nutcracker syndrome, we proposed left renal vein transposition that the patient consented to. PMID:24349817

  17. Pulmonary Vein Stenosis in a Newborn: A Commonly Overlooked Diagnosis

    PubMed Central

    Bravo-valenzuela, Nathalie Jeanne Magioli; Silva, Guilherme Ricardo Nunes; Varella, Marcela Pinto

    2015-01-01

    The diagnosis of primary pulmonary vein stenosis is often overlooked because its symptoms overlap lung diseases and pulmonary arterial hypertension. Its diagnosis may be difficult because the condition is progressive and associated with other defects. We present a case of pulmonary vein stenosis in a newborn with stenosis of the left-sided common pulmonary vein, diffuse hypoplasia of the superior right pulmonary vein, and atresia of the inferior right pulmonary vein. PMID:26457207

  18. Design and Rationale of the Mechanical Retrieval and Recanalization of Stroke Clots Using Embolectomy (MR RESCUE) Trial

    PubMed Central

    Kidwell, Chelsea S.; Jahan, Reza; Alger, Jeffry R.; Schaewe, Timothy J.; Guzy, Judy; Starkman, Sidney; Elashoff, Robert; Gornbein, Jeffrey; Nenov, Val; Saver, Jeffrey L.

    2012-01-01

    SUMMARY Rationale Multimodal imaging has the potential to identify acute ischemic stroke patients most likely to benefit from late recanalization therapies. Aims The general aim of the MR RESCUE Trial is to investigate whether multimodal imaging can identify patients who will benefit substantially from mechanical embolectomy for the treatment of acute ischemic stroke up to 8 hours from symptom onset. Design MR RESCUE is a randomized, controlled, blinded-outcome clinical trial. Population Studied Acute ischemic stroke patients with large vessel intracranial internal carotid artery (ICA) or middle cerebral artery (MCA) M1 or M2 occlusion enrolled within 8 hours of symptom onset are eligible. The study sample size is 120 patients. Study Intervention Patients are randomized to endovascular embolectomy employing the Merci Retriever (Concentric Medical, Mountain View, California) or the Penumbra System (Penumbra, Alameda, California) vs. standard medical care, with randomization stratified by penumbral pattern. Outcomes The primary aim of the trial is to test the hypothesis that the presence of substantial ischemic penumbral tissue visualized on multimodal imaging (MRI or CT) predicts patients most likely to respond to mechanical embolectomy for treatment of acute ischemic stroke due to a large vessel, intracranial occlusion up to 8 hours from symptom onset. This hypothesis will be tested by analyzing whether pretreatment imaging pattern has a significant interaction with treatment as a determinant of functional outcome based on the distribution of scores on the modified Rankin Scale (mRS) measure of global disability assessed 90 days post-stroke. Nested hypotheses test for 1) treatment efficacy in patients with a penumbral pattern pretreatment, and 2) absence of treatment benefit (equivalency) in patients without a penumbral pattern pretreatment. An additional aim will only be tested if the primary hypothesis of an interaction is negative: that patients treated with mechanical embolectomy have improved functional outcome vs. standard medical management. PMID:22974139

  19. Deep vein thrombosis: a clinical review

    PubMed Central

    Kesieme, Emeka; Kesieme, Chinenye; Jebbin, Nze; Irekpita, Eshiobo; Dongo, Andrew

    2011-01-01

    Background: Deep vein thrombosis (DVT) is the formation of blood clots (thrombi) in the deep veins. It commonly affects the deep leg veins (such as the calf veins, femoral vein, or popliteal vein) or the deep veins of the pelvis. It is a potentially dangerous condition that can lead to preventable morbidity and mortality. Aim: To present an update on the causes and management of DVT. Methods: A review of publications obtained from Medline search, medical libraries, and Google. Results: DVT affects 0.1% of persons per year. It is predominantly a disease of the elderly and has a slight male preponderance. The approach to making a diagnosis currently involves an algorithm combining pretest probability, D-dimer testing, and compression ultrasonography. This will guide further investigations if necessary. Prophylaxis is both mechanical and pharmacological. The goals of treatment are to prevent extension of thrombi, pulmonary embolism, recurrence of thrombi, and the development of complications such as pulmonary hypertension and post-thrombotic syndrome. Conclusion: DVT is a potentially dangerous condition with a myriad of risk factors. Prophylaxis is very important and can be mechanical and pharmacological. The mainstay of treatment is anticoagulant therapy. Low-molecular-weight heparin, unfractionated heparin, and vitamin K antagonists have been the treatment of choice. Currently anticoagulants specifically targeting components of the common pathway have been recommended for prophylaxis. These include fondaparinux, a selective indirect factor Xa inhibitor and the new oral selective direct thrombin inhibitors (dabigatran) and selective factor Xa inhibitors (rivaroxaban and apixaban). Others are currently undergoing trials. Thrombolytics and vena caval filters are very rarely indicated in special circumstances. PMID:22287864

  20. An anomalous left external jugular vein draining into right subclavian vein.

    PubMed

    Vadgaonkar, Rajanigandha; Rai, Rajalakshmi; Ranade, Anu V; Pai, Mangala M; Prabhu, Latha V; Ashwin, K; Jiji, P J

    2008-01-01

    Knowledge of the varying drainage patterns of superficial veins of head & neck, in particular, jugular veins are not only important for anatomists but also for the surgeons operating at this level and to clinicians in general. The variations are important also for interventional radiologists, who perform trans-jugular procedures, such as port implantations and trans-jugular intra-hepatic porto-systemic shunts or selective venous samplings. Results of recent studies report that the superficial veins, especially the external jugular vein, have been increasingly utilized for cannulation to conduct diagnostic and therapeutic procedures. We report a very unusual left-sided presentation of external jugular vein in an embalmed male cadaver. Embryological evaluations of the anomaly was done & compared with available literature, which showed that the observed variation is rare (Fig. 1, Ref. 12). PMID:19166133

  1. Successful Recanalization of Acute Superior Mesenteric Artery Thromboembolic Occlusion by a Combination of Intraarterial Thrombolysis and Mechanical Thrombectomy with a Carotid Filter

    SciTech Connect

    Zelenak, Kamil; Sinak, Igor; Janik, Jan; Mikolajcik, Anton; Mistuna, Dusan

    2013-06-15

    Acute superior mesenteric artery (SMA) occlusion is a life-threatening disease, and acute intestinal ischemia develops from the sudden decrease in perfusion to the intestines. The key to saving the patient's life is early diagnosis, and prompt revascularization of the SMA can prevent intestinal infarction and decrease the risk of bowel segment necrosis. Computed tomographic angiography may be useful for rapid diagnosis. We report recanalization of an SMA occlusion in an 80-year-old man with a combination of intraarterial thrombolysis and mechanical thrombectomy with a carotid filter.

  2. Retrograde pedal access with a 20-gauge intravenous cannula after failed antegrade recanalization of a tibialis anterior artery in a diabetic patient: a case report

    PubMed Central

    Colkesen, Yucel

    2015-01-01

    Retrograde tibiopedal approach is being used frequently in below-the-knee vascular interventions. In patients with diabetic foot pathology, complex anatomy often requires a retrograde technique when the distal vascular anatomy and puncture site is suitable. The dorsalis pedis and posterior tibial arteries can be punctured because of their relatively superficial position. We report a retrograde puncturing technique in patients with chronic total occlusions. After failed antegrade recanalization, puncturing and cannulation of a tiny dorsalis pedis artery with a narrow bore [20-gauge (0.8 mm)] intravenous cannula is described. PMID:26257023

  3. Veining Failure and Hydraulic Fracturing in Shales

    NASA Astrophysics Data System (ADS)

    Mighani, S.; Sondergeld, C. H.; Rai, C. S.

    2014-12-01

    During the hydraulic fracturing, the pressurized fluid creates new fractures and reactivates existing natural fractures forming a highly conductive Stimulated Reservoir Volume (SRV) around the borehole. We extend the previous work on Lyons sandstone and pyrophyllite to anisotropic shale from the Wolfcamp formation. We divide the rock anisotropy into two groups: a) conventional and b) unconventional (shaly) anisotropy. X-ray Computed Tomography (CT), compressional velocity anisotropy, and SEM analysis are used to identify three causes of anisotropy: bedding planes, clay lamination, and calcite veins. Calcite vein is a subsequently filled with calcite bonded weakly to the matrix. Velocity anisotropy and visual observations demonstrate the calcite filled veins to be mostly subparallel to the fabric direction. Brazilian tests are carried out to observe the fracture initiation and propagation under tension. High speed photography (frame rate 300,000 frame/sec) was used to capture the failure. Strain gauges and Acoustic Emission (AE) sensors recorded the deformation leading up to and during failure. SEM imaging and surface profilometry were employed to study the post-failure fracture system and failed surface topology. Fracture permeability was measured as a function of effective stress. Brazilian tests on small disks containing a centered single vein revealed the shear strength of the veins. We interpret the strain data and number, frequency, and amplitude of AE events which are correlated well with the observed fracture process zone, surface roughness, and permeability. The unpropped fracture has enhanced permeability by two orders of magnitude. The observed anisotropic tensile failure seems to have a universal trend with a minimum strength occurring at 15o orientation with respect to the loading axis. The veins at 15o orientation with respect to the loading axis were easily activated at 30% of the original failure load. The measured strength of the vein is as low as 6% of the matrix. Surface roughness measurements show the vein to be as rough as the main tensile fracture in the matrix. The observations suggest that fracking through a deviated well reduces the breakdown pressure significantly and can activate a large number of veins with enhanced conductivity without the need for excessive proppant injection.

  4. Optimization of subcutaneous vein contrast enhancement

    NASA Astrophysics Data System (ADS)

    Zeman, Herbert D.; Lovhoiden, Gunnar; Deshmukh, Harshal

    2000-05-01

    A technique for enhancing the contrast of subcutaneous veins has been demonstrated. This techniques uses a near IR light source and one or more IR sensitive CCD TV cameras to produce a contrast enhanced image of the subcutaneous veins. This video image of the veins is projected back onto the patient's skin using a n LCD video projector. The use of an IR transmitting filter in front of the video cameras prevents any positive feedback from the visible light from the video projector from causing instabilities in the projected image. The demonstration contrast enhancing illuminator has been tested on adults and children, both Caucasian and African-American, and it enhances veins quite well in all cases. The most difficult cases are those where significant deposits of subcutaneous fat are present which make the veins invisible under normal room illumination. Recent attempts to see through fat using different IR wavelength bands and both linearly and circularly polarized light were unsuccessful. The key to seeing through fat turns out to be a very diffuse source of RI light. Results on adult and pediatric subjects are shown with this new IR light source.

  5. The anatomy of the cardiac veins in mice

    PubMed Central

    Ciszek, Bogdan; Skubiszewska, Daria; Ratajska, Anna

    2007-01-01

    Although the cardiac coronary system in mice has been the studied in detail by many research laboratories, knowledge of the cardiac veins remains poor. This is because of the difficulty in marking the venous system with a technique that would allow visualization of these large vessels with thin walls. Here we present the visualization of the coronary venous system by perfusion of latex dye through the right caudal vein. Latex injected intravenously does not penetrate into the capillary system. Murine cardiac veins consist of several principal branches (with large diameters), the distal parts of which are located in the subepicardium. We have described the major branches of the left atrial veins, the vein of the left ventricle, the caudal veins, the vein of the right ventricle and the conal veins forming the conal venous circle or the prepulmonary conal venous arch running around the conus of the right ventricle. The venous system of the heart drains the blood to the coronary sinus (the left cranial caval vein) to the right atrium or to the right cranial caval vein. Systemic veins such as the left cranial caval, the right cranial caval and the caudal vein open to the right atrium. Knowledge of cardiac vein location may help to elucidate abnormal vein patterns in certain genetic malformations. PMID:17553104

  6. Laser ablation of cutaneous leg veins.

    PubMed

    Almeida, Jose I; Raines, Jeffrey K

    2008-12-01

    Patients presenting with lower-extremity telangiectasias, commonly known as spider veins, are a frequent presentation for vascular surgeons. The use of lasers in the treatment of lower-extremity spider veins has gained increased popularity during the past 5 years. This technology, driven by consumer demand, has been effective in treating vessels that are refractory to sclerotherapy treatment, vessels that arise from telangiectatic matting, and in patients who experience a phobia to needles. One laser wavelength per machine limits what the practitioner can do. That is, each type of vein responds best to a specific wavelength. Light skin is more forgiving to complications than dark skin. The devices are a complement to good sclerotherapy, not a substitute. PMID:19028771

  7. Pulmonary Vein Stenosis Mimicking Nonspecific Interstitial Pneumonia

    PubMed Central

    Linga, Karthika R.; Khoor, Andras; Phelan, Jonathan A.; Mira-Avendano, Isabel

    2015-01-01

    Pulmonary vein stenosis (PVS) is a known complication after catheter ablation of arrhythmias. Surprisingly, little information is available on its manifestations in the lung. We describe the case of a 39-year-old woman who presented from an outside hospital with worsening shortness of breath after catheter ablation of pulmonary veins for atrial fibrillation. After an initial diagnosis of pneumonia and its nonimprovement with antibiotics, a surgical lung biopsy was done and interpreted as nonspecific interstitial pneumonia (NSIP) with vascular changes consistent with pulmonary arterial hypertension. Later, she was admitted to our institution where a transthoracic echocardiogram (TTE) and subsequent computed tomography (CT) angiogram of the heart showed severe stenosis of all four pulmonary veins. The previous lung biopsy was rereviewed and reinterpreted as severe parenchymal congestion mimicking NSIP. Our case demonstrates that PVS is an underrecognized complication of catheter ablation, and increased awareness among both clinicians and pathologists is necessary to avoid misdiagnosis. PMID:26779359

  8. Successful liver allograft inflow reconstruction with the right gastroepiploic vein.

    PubMed

    Pinheiro, Rafael S; Cruz, Ruy J; Nacif, Lucas S; Vane, Matheus F; D'Albuquerque, Luiz Ac

    2016-02-01

    Portal vein thrombosis is a common complication in cirrhotic patients. When portal vein thrombectomy is not a suitable option, a large collateral vessel can be used for allograft venous inflow reconstruction. We describe an unusual case of successful portal revascularization using the right gastroepiploic vein. The patient underwent a cadaveric orthotopic liver transplantation with end-to-end anastomosis of the portal vein to the right gastroepiploic vein. Six months after liver transplantation the patient is well with good liver function. The use of the right gastroepiploic vein for allograft venous reconstruction is feasible and safe, with a great advantage of avoiding the need of venous jump graft. PMID:26818551

  9. How Vein Sealing Boosts Fracture Opening

    NASA Astrophysics Data System (ADS)

    Nüchter, Jens-Alexander

    2015-04-01

    Veins from from cracks. As such, a stage of brittle failure and fracturing is to be set apart from a stage of opening and sealing. The process of fracture opening requires distortion of the host rocks to create space for the evolving vein. To keep a crack arrested and, at the same time, to widen or stabilize the cavity, the stress intensity factor K_I=(P-S3)(πa) must remain below the fracture toughness K_IC of the host rock, and P-S3 >0 (P and S3 denote pore fluid pressure and absolute minimum principal stress, respectively and 'a' refers to the half-length of the fracture). For purely elastic distortion of the host rocks, maximum aperture W0=K_IC (1-ν^2)/(E(π/8)^1/2))(2a)^1/2 depends on on K_IC, Poisson's ratio ν, and Young's modulus E of the host rocks. Owing to the low values for rock K_IC typically ranging between 0.1 and 1 MPa m^1/2, veins formed by purely elastic distortion of the host rocks are restricted to high aspect ratios 2a/W. In metamorphic rocks, veins with low aspect ratios are common; inelastic deformation and viscous creep in the host rocks must have contributed to final vein shapes. In the present study, I use finite element models to simulate fracture opening and cavity formation supported by viscous creep distributed in the host rock. Simulations are carried out on 2D plate models containing elliptical fractures. The walls of the fractures are coated by thin layers simulating incipient sealing; a residual cavity prevails in the centre of the model veins. Constant displacement is applied to the plate boundaries oriented normal to the cracks. I run a series of models with various viscosity contrasts between the rocks and the sealing. The results of these models indicate the following. (1) Fracture opening is most effective when the viscosity of the sealing ηs exceeds the viscosity of the host rocks ηr (2) The rate of fracture opening increases with increasing values for ηs/ηr . (3) An increase in the thickness of the sealing layer causes an increase in the fracture opening rates. (4) At constant strain rates, the rate of fracture opening increases with increasing strain. These results suggest that vein sealing boosts the rate of fracture opening, and contributes to development of low-aspect ratio veins.

  10. Portal Vein Aneurysm Presenting with Obstructive Jaundice

    PubMed Central

    Lall, Chandana; Verma, Sadhna; Gulati, Rajesh; Bhargava, Puneet

    2012-01-01

    To the best of our knowledge, a portal vein aneurysm presenting with obstructive jaundice has not been reported in the literature. The preferred treatment for these aneurysms is surgical and a shunting procedure should be considered in cases with portal hypertension to preserve portal vein flow when portal hypertension is present or is secondary to the aneurysm itself. In our case, due to patient's advanced age and co-morbidities, an endoscopic biliary stent was placed which led to successful resolution of symptoms of obstructive jaundice. PMID:23029637

  11. Imaging of Postpartum Ovarian Vein Thrombosis

    PubMed Central

    Bilgin, Mehmet; Sevket, Osman; Yildiz, Seyma; Sharifov, Rasul; Kocakoc, Ercan

    2012-01-01

    Postpartum ovarian vein thrombosis (OVT) is a rare but serious complication. Clinical findings of OVT are nonspecific. Postpartum OVT, which is a clinically difficultly diagnosed entity, must be thought of in differential diagnosis in cases of postpartum acute abdomen. OVT can be accurately diagnosed by appropriate noninvasive radiologic modalities to start early therapy with anticoagulants and intravenous antibiotics. In this paper, we review the imaging findings of a case with postpartum ovarian vein thrombosis that had been followed up for 6 months by ultrasonography (US), color Doppler US, computed tomography (CT), and magnetic resonance imaging (MRI). PMID:23133765

  12. Superficial Vein Thrombophlebitis in a Football Athlete.

    PubMed

    Schleich, Kevin T; Smoot, M Kyle

    2016-03-01

    A 22-year-old professional football player presented to a preparticipation physical examination with a 2-week history of left leg discomfort extending from the groin to the knee over the previous 2 weeks. He was found to have superficial vein thrombophlebitis (SVT) of the left great saphenous vein extending from the knee to within approximately 1.6 cm of the saphenofemoral junction. There is paucity in the literature regarding the management of SVT, particularly in actively training athletes. This case addresses the considerations of anticoagulation management for SVT as well as the unique challenge of managing anticoagulation therapy in an athlete that is actively training. PMID:25961158

  13. Effect of Diameter of Saphenous Vein on Stump Length after Radiofrequency Ablation for Varicose Vein

    PubMed Central

    Kim, Jusung; Cho, Sungsin; Joh, Jin Hyun; Ahn, Hyung-Joon; Park, Ho-Chul

    2015-01-01

    Purpose: Radiofrequency ablation (RFA) has gained popularity for treatment of varicose veins. The diameter of the saphenous vein should be considered before RFA because occlusion of the vein may differ depending on its diameter. Until now, however, there have been few data about the correlation between the diameter of the saphenous vein and the stump length after RFA. The purpose of our study was to investigate its correlation. Materials and Methods: A retrospective review was performed from prospectively collected data of RFA patients between March 2009 and December 2011. Preoperatively, the saphenous vein diameter was measured. Ablation was initiated 2 cm distal from the junction. Postoperatively, stump length was measured at 1 week and 6 months. After 2 years, we measured the length from the saphenofemoral junction to the leading point of occlusion for great saphenous vein, and length from the saphenopopliteal junction to the leading point of occlusion for small saphenous vein. The paired t-test, independent t-test, and correlation analysis were used for statistical analysis. P-value <0.05 was considered statistically significant. Results: During the study period, RFA was performed in 201 patients. Endovenous heat-induced thrombosis developed in 3 patients (1.5%). After 2 years, the stump length was obtained in 74 limbs. The mean diameter and stump length of the saphenous vein were 6.71.8 mm and 12.58.5 mm, respectively. Correlation analysis showed that the Pearson correlation coefficient of these factors was ?0.017. Conclusion: There was no correlation between the diameter of saphenous vein and stump length. PMID:26719839

  14. Lower Energy Endovenous Laser Ablation of the Great Saphenous Vein with 980 nm Diode Laser in Continuous Mode

    SciTech Connect

    Kim, Hyun S. Nwankwo, Ikechi J.; Hong, Kelvin; McElgunn, Patrick S.J.

    2006-02-15

    Purpose. To assess clinical outcomes, complication rates, and unit energy applied using 980 nm diode endovenous laser treatment at 11 watts for symptomatic great saphenous vein (GSV) incompetence and reflux disease. Methods. Thirty-four consecutive ablation therapies with a 980 nm diode endovenous laser at 11 watts were studied. The diagnosis of GSV incompetence with reflux was made by clinical evaluation and duplex Doppler examinations. The treated GSVs had a mean diameter of 1.19 cm (range 0.5-2.2 cm). The patients were followed with clinical evaluation and color flow duplex studies up to 18.5 months (mean 12.19 months {+-} 4.18). Results. Using 980 nm diode endovenous laser ablation in continuous mode, 100% technical success was noted. The mean length of GSVs treated was 33.82 cm (range 15-45 cm). The mean energy applied during the treatment was 1,155.81 joules (J) {+-} 239.50 (range 545.40-1620 J) for a mean treatment duration of 90.77 sec {+-} 21.77. The average laser fiber withdrawal speed was 0.35 cm/sec {+-} 0.054. The mean energy applied per length of GSV was 35.16 J/cm {+-} 8.43. Energy fluence, calculated separately for each patient, averaged 9.82 J/cm{sup 2} {+-} 4.97. At up to 18.5 months follow-up (mean 12.19 months), 0% recanalization was noted; 92% clinical improvement was achieved. There was no major complication. Minor complications included 1 patient with hematoma at the percutaneous venotomy site, 1 patient with thrombophlebitis on superficial tributary varices of the treated GSV, 24% ecchymoses, and 32% self-limiting hypersensitivity/tenderness/'pulling' sensation along the treatment area. One patient developed temporary paresthesia. Four endovenous laser ablation treatments (12%) were followed by adjunctive sclerotherapies for improved cosmetic results. Conclusion. Endovenous laser ablation treatment of GSV using a 980 nm diode laser at 11 watts in continuous mode appears safe and effective. Mean energy applied per treated GSV length of 35.16 J/cm or mean laser fluence of 9.82 J/cm{sup 2} appears adequate, resulting in 0% recanalization and low minor complication rates.

  15. Endovascular Laser Therapy for Varicose Veins

    PubMed Central

    2010-01-01

    Executive Summary Objective The objective of the MAS evidence review was to conduct a systematic review of the available evidence on the safety, effectiveness, durability and costeffectiveness of endovascular laser therapy (ELT) for the treatment of primary symptomatic varicose veins (VV). Background The Ontario Health Technology Advisory Committee (OHTAC) met on November 27, 2009 to review the safety, effectiveness, durability and cost-effectiveness of ELT for the treatment of primary VV based on an evidence-based review by the Medical Advisory Secretariat (MAS). Clinical Condition VV are tortuous, twisted, or elongated veins. This can be due to existing (inherited) valve dysfunction or decreased vein elasticity (primary venous reflux) or valve damage from prior thrombotic events (secondary venous reflux). The end result is pooling of blood in the veins, increased venous pressure and subsequent vein enlargement. As a result of high venous pressure, branch vessels balloon out leading to varicosities (varicose veins). Symptoms typically affect the lower extremities and include (but are not limited to): aching, swelling, throbbing, night cramps, restless legs, leg fatigue, itching and burning. Left untreated, venous reflux tends to be progressive, often leading to chronic venous insufficiency (CVI). A number of complications are associated with untreated venous reflux: including superficial thrombophlebitis as well as variceal rupture and haemorrhage. CVI often results in chronic skin changes referred to as stasis dermatitis. Stasis dermatitis is comprised of a spectrum of cutaneous abnormalities including edema, hyperpigmentation, eczema, lipodermatosclerosis and stasis ulceration. Ulceration represents the disease end point for severe CVI. CVI is associated with a reduced quality of life particularly in relation to pain, physical function and mobility. In severe cases, VV with ulcers, QOL has been rated to be as bad or worse as other chronic diseases such as back pain and arthritis. Lower limb VV is a common disease affecting adults and estimated to be the seventh most common reason for physician referral in the US. There is a strong familial predisposition to VV with the risk in offspring being 90% if both parents affected, 20% when neither is affected, and 45% (25% boys, 62% girls) if one parent is affected. Globally, the prevalence of VV ranges from 5% to 15% among men and 3% to 29% among women varying by the age, gender and ethnicity of the study population, survey methods and disease definition and measurement. The annual incidence of VV estimated from the Framingham Study was reported to be 2.6% among women and 1.9% among men and did not vary within the age range (40-89 years) studied. Approximately 1% of the adult population has a stasis ulcer of venous origin at any one time with 4% at risk. The majority of leg ulcer patients are elderly with simple superficial vein reflux. Stasis ulcers are often lengthy medical problems and can last for several years and, despite effective compression therapy and multilayer bandaging are associated with high recurrence rates. Recent trials involving surgical treatment of superficial vein reflux have resulted in healing and significantly reduced recurrence rates. Endovascular Laser Therapy for VV ELT is an image-guided, minimally invasive treatment alternative to surgical stripping of superficial venous reflux. It does not require an operating room or general anesthesia and has been performed in outpatient settings by a variety of medical specialties including surgeons (vascular or general), interventional radiologists and phlebologists. Rather than surgically removing the vein, ELT works by destroying, cauterizing or ablating the refluxing vein segment using heat energy delivered via laser fibre. Prior to ELT, colour-flow Doppler ultrasonography is used to confirm and map all areas of venous reflux to devise a safe and effective treatment plan. The ELT procedure involves the introduction of a guide wire into the target vein under ultrasound guidance followed by the inse

  16. Splenic Vein Thrombosis with Oesophageal Varices: A Late Complication of Umbilical Vein Catheterization

    PubMed Central

    Vos, L. J. M.; Potocky, V.; Brker, F. H. L.; Vries, J. A. De; Postma, L.; Edens, E.

    1974-01-01

    On the basis of observations made on three infants, a description is given of a late complication of umbilical vein catheterization not hitherto reported. The children showed the symptoms of thrombosis of the splenic vein with secondary splenomegaly and marked gastric and/or esophageal varices, while the portal vein showed no abnormality. The diagnosis was preoperatively established by means of selective angiography of the superior mesenteric artery and the splenic artery. Treatment in these three cases consisted of splenectomy, with good clinical and radiological results. ImagesFig. 1.Fig. 2.Fig. 3.Fig. 4.Fig. 5.Fig. 6. PMID:4842977

  17. Axillary vein thrombosis mimicking muscular strain.

    PubMed Central

    Louis, J

    1999-01-01

    Axillary vein thrombosis may occur on strenuous activity with a clinical picture similar to a simple strain. It carries significant morbidity but a good outcome is possible with early treatment. The aetiology, investigation, and treatment are discussed. Images Figure 1 Figure 1 PMID:10353060

  18. Complete guidewire retention after femoral vein catheterization.

    PubMed

    Cat, Bahar Gulcay; Guler, Sertac; Soyuduru, Murat; Guven, Ibrahim; Ramadan, Hayri

    2015-01-01

    Central venous catheters (CVCs) are often used for various purposes in the emergency departments (ED). The main uses of CVCs in the EDs are emergent hemodialysis, in situations where peripheral vein catheterization cannot be achieved, and continuous invasive hemodynamic monitoring. The complications related to CVC insertion are usually mechanical and observed in the near term after the procedure. Retained CVC guidewire after catheterization is a rare complication in the published reports and usually related with intra- or postoperative settings and jugular or subclavian vein. The present study reported a young female patient who underwent left femoral vein catheterization 6 months earlier in an intensive care unit of another hospital and was diagnosed with complete guidewire retention in the ED. To the best of the authors' knowledge, this is the first case in published reports with a diagnosis of retained CVC guidewire with retrograde migration into the femoral vein. Surprisingly, the patient developed no thrombotic or embolic complication during this 6-month period. PMID:26657235

  19. Hepatic myospherulosis complicating portal vein embolisation

    PubMed Central

    Lui, P C W; Luk, I S C; Lee, C K L; Lui, Y H; Leung, C Y; Choi, C H

    2004-01-01

    Aims: Myospherulosis is a rare condition characterised by sac-like structures containing spheroid bodies in cysts or cystic spaces in the tissue. This condition has not previously been reported in the liver. The association with previous portal vein embolisation using a mixture of butyl 2-cyanoacrylate and ethiodised oil and the proposed mechanism of pathogenesis are discussed. Methods: Samples from 8 patients treated by hepatectomy after portal vein embolisation using a mixture of butyl 2-cyanoacrylate and ethiodised oil were retrieved from the archives of the United Christian Hospital, Hong Kong. The histological specimens were reviewed. A panel of histochemical and immunohistochemical stains was used. Results: All cases showed hepatic myospherulosis within the veins. The veins were denuded of endothelium, which was replaced by granulation tissue and fibrous tissue with a lymphoplasmacytic infiltrate. Foreign body-type giant cells (six cases) and eosinophilic infiltrates (seven cases) were noted in most cases. Both parent bodies and endobodies were stained red by Papanicolaou and Massons trichrome and stained blue by solochrome cyanine. The endobodies showed immunoreactivity towards glycophorin A. They were negative for Alcian blue, periodic acid Schiff, Grocott, and Ziehl-Neelsen stains. Conclusions: The endobodies of myospherulosis may be misdiagnosed as fungi or algae by the unwary. The clinical history, intravascular location, lack of staining with periodic acid Schiff and Grocott stains, and positive glycophorin A staining are generally sufficient for a confident diagnosis of myospherulosis. PMID:14747440

  20. How Is Deep Vein Thrombosis Diagnosed?

    MedlinePLUS

    ... check your blood pressure and your heart and lungs. Diagnostic Tests Your doctor may recommend tests to find out whether you have DVT. Common Tests The most common test for diagnosing deep vein blood clots is ultrasound. This test uses sound waves to create pictures ...

  1. Endoscopic vein harvesting: technique, outcomes, concerns & controversies

    PubMed Central

    Sarang, Zubair

    2013-01-01

    The choice of the graft conduit for coronary artery bypass grafting (CABG) has significant implications both in the short- and long-term. The patency of a coronary conduit is closely associated with an uneventful postoperative course, better long-term patient survival and superior freedom from re-intervention. The internal mammary artery is regarded as the primary conduit for CABG patients, given its association with long-term patency and survival. However, long saphenous vein (LSV) continues to be utilized universally as patients presenting for CABG often have multiple coronary territories requiring revascularization. Traditionally, the LSV has been harvested by creating incisions from the ankle up to the groin termed open vein harvesting (OVH). However, such harvesting methods are associated with incisional pain and leg wound infections. In addition, patients find such large incisions to be cosmetically unappealing. These concerns regarding wound morbidity and patient satisfaction led to the emergence of endoscopic vein harvesting (EVH). Published experience comparing OVH with EVH suggests decreased wound related complications, improved patient satisfaction, shorter hospital stay, and reduced postoperative pain at the harvest site following EVH. Despite these reported advantages concerns regarding risk of injury at the time of harvest with its potential detrimental effect on vein graft patency and clinical outcomes have prevented universal adoption of EVH. This review article provides a detailed insight into the technical aspects, outcomes, concerns, and controversies associated with EVH. PMID:24251019

  2. Endoscopic vein harvesting: technique, outcomes, concerns & controversies.

    PubMed

    Raja, Shahzad G; Sarang, Zubair

    2013-11-01

    The choice of the graft conduit for coronary artery bypass grafting (CABG) has significant implications both in the short- and long-term. The patency of a coronary conduit is closely associated with an uneventful postoperative course, better long-term patient survival and superior freedom from re-intervention. The internal mammary artery is regarded as the primary conduit for CABG patients, given its association with long-term patency and survival. However, long saphenous vein (LSV) continues to be utilized universally as patients presenting for CABG often have multiple coronary territories requiring revascularization. Traditionally, the LSV has been harvested by creating incisions from the ankle up to the groin termed open vein harvesting (OVH). However, such harvesting methods are associated with incisional pain and leg wound infections. In addition, patients find such large incisions to be cosmetically unappealing. These concerns regarding wound morbidity and patient satisfaction led to the emergence of endoscopic vein harvesting (EVH). Published experience comparing OVH with EVH suggests decreased wound related complications, improved patient satisfaction, shorter hospital stay, and reduced postoperative pain at the harvest site following EVH. Despite these reported advantages concerns regarding risk of injury at the time of harvest with its potential detrimental effect on vein graft patency and clinical outcomes have prevented universal adoption of EVH. This review article provides a detailed insight into the technical aspects, outcomes, concerns, and controversies associated with EVH. PMID:24251019

  3. Why Do Some Pregnant Women Get Varicose Veins?

    MedlinePLUS

    ... Bullies Pregnant? What to Expect Why Do Some Pregnant Women Get Varicose Veins? KidsHealth > Parents > Q&As > Pregnancy & Infants > Why Do Some Pregnant Women Get Varicose Veins? Print A A A Text ...

  4. Fenethylline as a possible etiology for retinal vein occlusion.

    PubMed

    Al-Ghadyan, A; Rushood, A A; Alhumeidan, A A

    2009-01-01

    We are report 3 cases of hemorrhagic central retina vein occlusion following continuous use of fenethylline hydrochloride. The hemorrhage, the edema and the engorged veins showed marked improvement after discontinuing the drug and laser supplement in one case. PMID:20214057

  5. Anatomical variation of the inferior mesenteric vein's drainage pattern

    NASA Astrophysics Data System (ADS)

    Zilaie, Mina

    The purpose of this project is to report the variable drainage pattern of the inferior mesenteric vein (IMV) as reported by medical students' observations recorded on anatomical variation data sheets (n = 192). A meta-analysis on the drainage pattern of the inferior mesenteric vein as described in various anatomy resources was conducted (n = 40). The inferior mesenteric vein was observed to drain into the splenic vein, the superior mesenteric vein, and the junction between the superior mesenteric vein and the splenic vein. Anatomy resources do not commonly report all three drainage sites. It is imperative that all these common drainage sites of the inferior mesenteric vein are stated in anatomy resources, so that students are taught realistic human anatomy including its common variations.

  6. What Are the Signs and Symptoms of Varicose Veins?

    MedlinePLUS

    ... around the varicose vein. Signs of telangiectasias are clusters of red veins that you can see just under the surface of your skin. These clusters usually are found on the upper body, including ...

  7. What Are the Signs and Symptoms of Deep Vein Thrombosis?

    MedlinePLUS

    ... Twitter. What Are the Signs and Symptoms of Deep Vein Thrombosis? The signs and symptoms of deep ... serious, possibly life-threatening problems if not treated. Deep Vein Thrombosis Only about half of the people ...

  8. Comparison between mechanical properties of human saphenous vein and umbilical vein

    PubMed Central

    2012-01-01

    Background As a main cause of mortality in developed countries, Coronary Artery Disease (CAD) is known as silent killer with a considerable cost to be dedicated for its treatment. Coronary Artery Bypass Graft (CABG) is a common remedy for CAD for which different blood vessels are used as a detour. There is a lack of knowledge about mechanical properties of human blood vessels used for CABG, and while these properties have a great impact on long-term patency of a CABG. Thus, studying these properties, especially those of human umbilical veins which have not been considered yet, looks utterly necessary. Methods Umbilical vein, as well as human Saphenous vein, are respectively obtained after cesarean and CABG. First, histological tests were performed to investigate different fiber contents of the samples. Having prepared samples carefully, force-displacement results of samples were rendered to real stressstrain measurements and then a fourth-order polynomial was used to prove the non-linear behavior of these two vessels. Results Results were analyzed in two directions, i.e. circumferentially and longitudinally, which then were compared with each other. The comparison between stiffness and elasticity of these veins showed that Saphenous veins stiffness is much higher than that of umbilical vein and also, it is less stretchable. Furthermore, for both vessels, longitudinal stiffness was higher than that of circumferential and in stark contrast, stretch ratio in circumferential direction came much higher than longitudinal orientation. Conclusion Blood pressure is very high in the region of aorta, so there should be a stiff blood vessel in this area and previous investigations showed that stiffer vessels would have a better influence on the flow of bypass. To this end, the current study has made an attempt to compare these two blood vessels stiffness, finding that Saphenous vein is stiffer than umbilical vein which is somehow as stiff as rat aortic vessels. As blood vessels stiffness is directly related to elastin and mainly collagen content, results showed the lower amount of these two contents in umbilical vein regarding Saphenous vein. PMID:22917177

  9. A case of non-cirrhotic portal hypertension associated with anti-retroviral therapy in a Japanese patient with human immunodeficiency virus infection.

    PubMed

    Yajima, Keishiro; Uehira, Tomoko; Otera, Hiroshi; Koizumi, Yusuke; Watanabe, Dai; Kodama, Yoshinori; Kuzushita, Noriyoshi; Nishida, Yasuharu; Mita, Eiji; Mano, Masayuki; Shirasaka, Takuma

    2014-09-01

    The diagnosis of non-cirrhotic portal hypertension (NCPH), a rare but potentially life-threatening complication in human immunodeficiency virus (HIV)-positive individuals, often occurs only after the emergence of fatal manifestations such as bleeding of esophageal varices. We herein report a female Japanese HIV patient who developed NCPH approximately 4 years after discontinuation of 65 months of didanosine (ddI) administration. The patient presented with severe ascites, bloody bowel discharge, extreme abdominal swelling, and symptoms of portal hypertension but no sign of liver cirrhosis. Examination revealed esophageal varices, oozing-like bleeding from a wide part of the colon, significant atrophy of the right lobe of the liver, and arterio-portal shunting and recanalization from the left medial segment branch of the portal vein to a paraumbilical vein, but no visible obstruction of the main trunk of the portal vein. Treatment for esophageal varices consisted of coagulation therapy with argon plasma after enforcement by endoscopic sclerotherapy and oral administration of ?-blockers for elevated portal blood pressure. The patient has not experienced gastrointestinal bleeding in the approximately 5 years since the diagnosis of NCPH. Reviewing this case suggests the importance of suspecting NCPH in HIV patients with liver dysfunction of unknown etiology with a history of ddI and other purine analogs use, as well as the importance of controlling portal hypertension and esophageal varices in the treatment of NCPH. PMID:25034388

  10. Adventitial cystic disease of the common femoral vein presenting as deep vein thrombosis.

    PubMed

    Kim, Young-Kyun; Chun, Ho Jong; Hwang, Jeong Kye; Kim, Ji Il; Kim, Sang Dong; Park, Sun-Cheol; Moon, In Sung

    2013-08-23

    Adventitial cystic disease of the common femoral vein is a rare condition. We herein report the case of a 50-year-old woman who presented with painless swelling in her left lower leg that resembled deep vein thrombosis. She underwent femoral exploration and excision of the cystic wall. The presentation, investigation, treatment, and pathology of this condition are discussed with a literature review. PMID:23978427

  11. 21 CFR 880.6970 - Liquid crystal vein locator.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 21 Food and Drugs 8 2014-04-01 2014-04-01 false Liquid crystal vein locator. 880.6970 Section 880... Devices 880.6970 Liquid crystal vein locator. (a) Identification. A liquid crystal vein locator is a... skin by displaying the color changes of heat sensitive liquid crystals (cholesteric esters)....

  12. 21 CFR 880.6970 - Liquid crystal vein locator.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 21 Food and Drugs 8 2013-04-01 2013-04-01 false Liquid crystal vein locator. 880.6970 Section 880... Devices 880.6970 Liquid crystal vein locator. (a) Identification. A liquid crystal vein locator is a... skin by displaying the color changes of heat sensitive liquid crystals (cholesteric esters)....

  13. 21 CFR 880.6970 - Liquid crystal vein locator.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 21 Food and Drugs 8 2012-04-01 2012-04-01 false Liquid crystal vein locator. 880.6970 Section 880... Devices 880.6970 Liquid crystal vein locator. (a) Identification. A liquid crystal vein locator is a... skin by displaying the color changes of heat sensitive liquid crystals (cholesteric esters)....

  14. 21 CFR 880.6970 - Liquid crystal vein locator.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 21 Food and Drugs 8 2011-04-01 2011-04-01 false Liquid crystal vein locator. 880.6970 Section 880... Devices 880.6970 Liquid crystal vein locator. (a) Identification. A liquid crystal vein locator is a... skin by displaying the color changes of heat sensitive liquid crystals (cholesteric esters)....

  15. 21 CFR 880.6970 - Liquid crystal vein locator.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Liquid crystal vein locator. 880.6970 Section 880... Devices 880.6970 Liquid crystal vein locator. (a) Identification. A liquid crystal vein locator is a... skin by displaying the color changes of heat sensitive liquid crystals (cholesteric esters)....

  16. 21 CFR 870.4885 - External vein stripper.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false External vein stripper. 870.4885 Section 870.4885...) MEDICAL DEVICES CARDIOVASCULAR DEVICES Cardiovascular Surgical Devices 870.4885 External vein stripper. (a) Identification. An external vein stripper is an extravascular device used to remove a section...

  17. Hydrops fetalis associated with chorioangioma and thrombosis of umbilical vein.

    PubMed

    Sivasli, Ercan; Tekşam, Ozlem; Haliloğlu, Mithat; Güçer, Safak; Orhan, Diclehan; Gürgey, Aytemiz; Tekinalp, Gülsevin

    2009-01-01

    Placental chorioangioma and thrombosis of an umbilical vein varix are rare etiologic factors of non-immune hydrops fetalis. Herein, we report a patient who had hydrops fetalis associated with placental chorioangioma and thrombosis of an umbilical vein varix. This is the first report of coexistence of non-immune hydrops fetalis with placental chorioangioma and thrombosis of an umbilical vein varix. PMID:20112613

  18. Retinal vein-to-vein anastomoses in Sturge-Weber syndrome documented by ultra-widefield fluorescein angiography.

    PubMed

    Quan, Ann V; Moore, Grant H; Tsui, Irena

    2015-06-01

    We report the case of a 6-year-old boy with Sturge-Weber syndrome and unilateral glaucoma in his left eye. He was born with a port wine mark involving his upper left eyelid. On ultra-widefield fluorescein angiography, he was found to have several vein-to-vein anastomoses in his left retina. To our knowledge, this is the first documentation of retinal vein-to-vein anastomoses in Sturge-Weber syndrome. PMID:25944745

  19. Transcutaneous laser treatment of leg veins.

    PubMed

    Meesters, Arne A; Pitassi, Luiza H U; Campos, Valeria; Wolkerstorfer, Albert; Dierickx, Christine C

    2014-03-01

    Leg telangiectasias and reticular veins are a common complaint affecting more than 80% of the population to some extent. To date, the gold standard remains sclerotherapy for most patients. However, there may be some specific situations, where sclerotherapy is contraindicated such as needle phobia, allergy to certain sclerosing agents, and the presence of vessels smaller than the diameter of a 30-gauge needle (including telangiectatic matting). In these cases, transcutaneous laser therapy is a valuable alternative. Currently, different laser modalities have been proposed for the management of leg veins. The aim of this article is to present an overview of the basic principles of transcutaneous laser therapy of leg veins and to review the existing literature on this subject, including the most recent developments. The 532-nm potassium titanyl phosphate (KTP) laser, the 585-600-nm pulsed dye laser, the 755-nm alexandrite laser, various 800-983-nm diode lasers, and the 1,064-nm neodymium yttrium-aluminum-garnet (Nd:YAG) laser and various intense pulsed light sources have been investigated for this indication. The KTP and pulsed dye laser are an effective treatment option for small vessels (<1 mm). The side effect profile is usually favorable to that of longer wavelength modalities. For larger veins, the use of a longer wavelength is required. According to the scarce evidence available, the Nd:YAG laser produces better clinical results than the alexandrite and diode laser. Penetration depth is high, whereas absorption by melanin is low, making the Nd:YAG laser suitable for the treatment of larger and deeply located veins and for the treatment of patients with dark skin types. Clinical outcome of Nd:YAG laser therapy approximates that of sclerotherapy, although the latter is associated with less pain. New developments include (1) the use of a nonuniform pulse sequence or a dual-wavelength modality, inducing methemoglobin formation and enhancing the optical absorption properties of the target structure, (2) pulse stacking and multiple pass laser treatment, (3) combination of laser therapy with sclerotherapy or radiofrequency, and (4) indocyanin green enhanced laser therapy. Future studies will have to confirm the role of these developments in the treatment of leg veins. The literature still lacks double-blind controlled clinical trials comparing the different laser modalities with each other and with sclerotherapy. Such trials should be the focus of future research. PMID:24220848

  20. Novel Vein Patterns in Arabidopsis Induced by Small Molecules.

    PubMed

    Carland, Francine; Defries, Andrew; Cutler, Sean; Nelson, Timothy

    2016-01-01

    The critical role of veins in transporting water, nutrients, and signals suggests that some key regulators of vein formation may be genetically redundant and, thus, undetectable by forward genetic screens. To identify such regulators, we screened more than 5000 structurally diverse small molecules for compounds that alter Arabidopsis (Arabidopsis thaliana) leaf vein patterns. Many compound-induced phenotypes were observed, including vein networks with an open reticulum; decreased or increased vein number and thickness; and misaligned, misshapen, or nonpolar vascular cells. Further characterization of several individual active compounds suggests that their targets include hormone cross talk, hormone-dependent transcription, and PIN-FORMED trafficking. PMID:26574596

  1. Primary leiomyosarcoma of saphenous vein presenting as deep venous thrombosis.

    PubMed

    Fremed, Daniel I; Faries, Peter L; Schanzer, Harry R; Marin, Michael L; Ting, Windsor

    2014-12-01

    Only a small number of venous leiomyosarcomas have been previously reported. Of these tumors, those of saphenous origin comprise a minority of cases. A 59-year-old man presented with symptoms of deep vein thrombosis and was eventually diagnosed with primary leiomyosarcoma of great saphenous vein origin. The tumor was treated with primary resection and femoral vein reconstruction with autologous patch. Although extremely rare, saphenous leiomyosarcoma can present as deep vein thrombosis. Vascular tumors should be included in the differential diagnosis of atypical extremity swelling refractory to conventional deep vein thrombosis management. PMID:24347138

  2. Conditions of vein formation in the southern Appalachian foreland: constraints from vein geometries and fluid inclusions

    NASA Astrophysics Data System (ADS)

    Foreman, J. Lincoln; Dunne, William M.

    The Nolichucky Shale in the Whiteoak Mountain thrust sheet of the southern Appalachian foreland contains four coeval bed-normal calcite vein sets that trended 015, 055, 090 and 320 before thrusting. The pretectonic veins were displaced by syn-tectonic bed-parallel slickensided calcite veins during local Alleghanian thrusting. Fluid inclusion thermometry indicates precipitation of both bed-normal and bed-parallel veins from NaCl-CaCl 2 brines (27 wt% NaCl-equiv. salinity), at 80-110C for bed-normal veins and 110C for bed-parallel veins. These temperatures correspond to burial depths of 2.4-3.6 km, which were attained after the middle Mississippian. These pressure-corrected homogenization temperatures are comparable to time-temperature indicators, such as CAI and illite crystallinity, and indicate that inclusions were trapped near-maximum burial conditions and were not deformed after trapping. This conclusion is supported by the absence of petrographic evidence for inclusion failure and a worst-case mechanical analysis that indicates a lack of brittle deformation to inclusions after trapping. The four coeval bed-normal vein sets could not be formed by one simple stress field, nor by the development of a single structure, but required the interaction of at least two stress components or structures. It is proposed that the interaction of the Alleghanian and Ouachita orogenic stress components, beyond the limits of thrusting, produced the sets as coeval Alleghanian orthogonal (055,320) and Ouchita sub-orthogonal (015, 090) mode I fractures.

  3. Pulmonary vein stenosis: Etiology, diagnosis and management

    PubMed Central

    Pazos-López, Pablo; García-Rodríguez, Cristina; Guitián-González, Alba; Paredes-Galán, Emilio; Álvarez-Moure, María Ángel De La Guarda; Rodríguez-Álvarez, Marta; Baz-Alonso, José Antonio; Teijeira-Fernández, Elvis; Calvo-Iglesias, Francisco Eugenio; Íñiguez-Romo, Andrés

    2016-01-01

    Pulmonary vein stenosis (PVS) is rare condition characterized by a challenging diagnosis and unfavorable prognosis at advance stages. At present, injury from radiofrequency ablation for atrial fibrillation has become the main cause of the disease. PVS is characterized by a progressive lumen size reduction of one or more pulmonary veins that, when hemodynamically significant, may raise lobar capillary pressure leading to signs and symptoms such as shortness of breath, cough, and hemoptysis. Image techniques (transesophageal echocardiography, computed tomography, magnetic resonance and perfusion imaging) are essential to reach a final diagnosis and decide an appropriate therapy. In this regard, series from referral centers have shown that surgical and transcatheter interventions may improve prognosis. The purpose of this article is to review the etiology, assessment and management of PVS. PMID:26839659

  4. Endovascular Radiofrequency Ablation for Varicose Veins

    PubMed Central

    2011-01-01

    Executive Summary Objective The objective of the MAS evidence review was to conduct a systematic review of the available evidence on the safety, effectiveness, durability and costeffectiveness of endovascular radiofrequency ablation (RFA) for the treatment of primary symptomatic varicose veins. Background The Ontario Health Technology Advisory Committee (OHTAC) met on August 26th, 2010 to review the safety, effectiveness, durability, and cost-effectiveness of RFA for the treatment of primary symptomatic varicose veins based on an evidence-based review by the Medical Advisory Secretariat (MAS). Clinical Condition Varicose veins (VV) are tortuous, twisted, or elongated veins. This can be due to existing (inherited) valve dysfunction or decreased vein elasticity (primary venous reflux) or valve damage from prior thrombotic events (secondary venous reflux). The end result is pooling of blood in the veins, increased venous pressure and subsequent vein enlargement. As a result of high venous pressure, branch vessels balloon out leading to varicosities (varicose veins). Symptoms typically affect the lower extremities and include (but are not limited to): aching, swelling, throbbing, night cramps, restless legs, leg fatigue, itching and burning. Left untreated, venous reflux tends to be progressive, often leading to chronic venous insufficiency (CVI). A number of complications are associated with untreated venous reflux: including superficial thrombophlebitis as well as variceal rupture and haemorrhage. CVI often results in chronic skin changes referred to as stasis dermatitis. Stasis dermatitis is comprised of a spectrum of cutaneous abnormalities including edema, hyperpigmentation, eczema, lipodermatosclerosis and stasis ulceration. Ulceration represents the disease end point for severe CVI. CVI is associated with a reduced quality of life particularly in relation to pain, physical function and mobility. In severe cases, VV with ulcers, QOL has been rated to be as bad or worse as other chronic diseases such as back pain and arthritis. Lower limb VV is a very common disease affecting adults estimated to be the 7th most common reason for physician referral in the US. There is a very strong familial predisposition to VV. The risk in offspring is 90% if both parents affected, 20% when neither affected and 45% (25% boys, 62% girls) if one parent affected. The prevalence of VV worldwide ranges from 5% to 15% among men and 3% to 29% among women varying by the age, gender and ethnicity of the study population, survey methods and disease definition and measurement. The annual incidence of VV estimated from the Framingham Study was reported to be 2.6% among women and 1.9% among men and did not vary within the age range (40-89 years) studied. Approximately 1% of the adult population has a stasis ulcer of venous origin at any one time with 4% at risk. The majority of leg ulcer patients are elderly with simple superficial vein reflux. Stasis ulcers are often lengthy medical problems and can last for several years and, despite effective compression therapy and multilayer bandaging are associated with high recurrence rates. Recent trials involving surgical treatment of superficial vein reflux have resulted in healing and significantly reduced recurrence rates. Endovascular Radiofrequency Ablation for Varicose Veins RFA is an image-guided minimally invasive treatment alternative to surgical stripping of superficial venous reflux. RFA does not require an operating room or general anaesthesia and has been performed in an outpatient setting by a variety of medical specialties including surgeons and interventional radiologists. Rather than surgically removing the vein, RFA works by destroying or ablating the refluxing vein segment using thermal energy delivered through a radiofrequency catheter. Prior to performing RFA, color-flow Doppler ultrasonography is used to confirm and map all areas of venous reflux to devise a safe and effective treatment plan. The RFA procedure involves the introduction of a guide wire into the target vein under ultrasound guidance followed by the insertion of an introducer sheath through which the RFA catheter is advanced. Once satisfactory positioning has been confirmed with ultrasound, a tumescent anaesthetic solution is injected into the soft tissue surrounding the target vein along its entire length. This serves to anaesthetize the vein, insulate the heat from damaging adjacent structures, including nerves and skin and compresses the vein increasing optimal contact of the vessel wall with the electrodes or expanded prongs of the RF device. The RF generator is then activated and the catheter is slowly pulled along the length of the vein. At the end of the procedure, hemostasis is then achieved by applying pressure to the vein entry point. Adequate and proper compression stockings and bandages are applied after the procedure to reduce the risk of venous thromboembolism and to reduce postoperative bruising and tenderness. Patients are encouraged to walk immediately after the procedure. Follow-up protocols vary, with most patients returning 1 to 3 weeks later for an initial follow-up visit. At this point, the initial clinical result is assessed and occlusion of the treated vessels is confirmed with ultrasound. Patients often have a second follow-up visit 1 to 3 months following RFA at which time clinical evaluation and ultrasound are repeated. If required, additional procedures such as phlebectomy or sclerotherapy may be performed during the RFA procedure or at any follow-up visits. Regulatory Status The Closure System radiofrequency generator for endovascular thermal ablation of varicose veins was approved by Health Canada as a class 3 device in March 2005, registered under medical device license 67865. The RFA intravascular catheter was approved by Health Canada in November 2007 for the ClosureFast catheter, registered under medical device license 16574. The Closure System also has regulatory approvals in Australia, Europe (CE Mark) and the United States (FDA clearance). In Ontario, RFA is not an insured service and is currently being introduced in private clinics. Methods Literature Search The MAS evidencebased review was performed to support public financing decisions. The literature search was performed on March 9th, 2010 using standard bibliographic databases for studies published up until March, 2010. Inclusion Criteria English language full-reports and human studies Original reports with defined study methodologyReports including standardized measurements on outcome events such as technical success, safety, effectiveness, durability, quality of life or patient satisfaction Reports involving RFA for varicose veins (great or small saphenous veins)Randomized controlled trials (RCTs), systematic reviews and meta-analysesCohort and controlled clinical studies involving ? 1 month ultrasound imaging follow-up Exclusion Criteria Non systematic reviews, letters, comments and editorials Reports not involving outcome events such as safety, effectiveness, durability, or patient satisfaction following an intervention with RFAReports not involving interventions with RFA for varicose veinsPilot studies or studies with small samples (< 50 subjects) Summary of Findings The MAS evidence search on the safety and effectiveness of endovascular RFA ablation of VV identified the following evidence: three HTAs, nine systematic reviews, eight randomized controlled trials (five comparing RFA to surgery and three comparing RFA to ELT), five controlled clinical trials and fourteen cohort case series (four were multicenter registry studies). The majority (12?14) of the cohort studies (3,664) evaluating RFA for VV involved treatment with first generation RFA catheters and the great saphenous vein (GSV) was the target vessel in all studies. Major adverse events were uncommonly reported and the overall pooled major adverse event rate extracted from the cohort studies was 2.9% (105?3,664). Imaging defined treatment effectiveness of vein closure rates were variable ranging from 68% to 96% at post-operative follow-up. Vein ablation rate at 6-month follow-up was reported in four studies with rates close to 90%. Only one study reported vein closure rates at 2 years but only for a minority of the eligible cases. The two studies reporting on RFA ablation with the more efficient second generation catheters involved better follow-up and reported higher ablation rates close to 100% at 6-month follow-up with no major adverse events. A large prospective registry trial that recruited over 1,000 patients at thirty-four largely European centers reported on treatment success in six overlapping reports on selected patient subgroups at various follow-up points up to 5 year. However, the follow-up for eligible recruited patients at all time points was low resulting in inadequate estimates of longer term treatment efficacy. The overall level of evidence of randomized trials comparing RFA with surgical ligation and vein stripping (n = 5) was graded as low to moderate. In all trials RFA ablation was performed with first generation catheters in the setting of the operating theatre under general anaesthesia, usually without tumescent anaesthesia. Procedure times were significantly longer after RFA than surgery. Recovery after treatment was significantly quicker after RFA both with return to usual activity and return to work with on average a one week less of work loss. Major adverse events occurring after surgery were higher [(1.8% (n=4) vs. 0.4% (n = 1) than after RFA but not significantly. Treatment effectiveness measured by imaging defined vein absence or vein closure was comparable in the two treatment groups. Significant improvements in vein symptoms and quality of life over baseline were reported for both treatment groups. Improvements in these outcomes were significantly greater in the RFA group than the surgery group in the peri-operative period but not in later follow-up. Follow-up in these trials was inadequate to evaluate longer term recurrence for either treatment. Patient satisfaction was reported to be high for both treatments but was higher for RFA. The studies comparing endovascular treatment approaches for VV (RFA and ELT) were more limited. Three RCT studies compared RFA (two with the second generation catheter) with ELT but mainly focused on peri-procedural outcomes such as pain, complications and recovery. Vein ablation rates were not evaluated in the trials, except for one small trial involving bilateral VV. Pain responses in patients undergoing ablation were extremely variable and up to 2 weeks, mean pain levels were significantly less with RFA than ELT ablation but differences were not significant at one month. Recovery, evaluated as return to usual activity or return to work, however, was similar in the treatment groups. Vein symptom and QOL improvements were improved in both groups but were significantly better in the RFA group than the ELT group at 2 weeks, but not at one month. Vein ablation rates were evaluated in several controlled clinical studies comparing the treatments between centers or within centers between individuals or over time. Comparisons in these studies were inconsistent with vein ablation rates for RFA reported to be similar to, higher than and lower than those with ELT. Economic Analysis RFA and surgical vein stripping, the main comparator reimbursed by the public system, are comparable in clinical benefits. Hence a cost-analysis was conducted to identify the differences in resources and costs between both procedures and a budgetary impact analysis (BIA) was conducted to project costs over a 5- year period in the province of Ontario. The target population of this economic analysis was patients with symptomatic varicose veins and the primary analytic perspective was that of the Ministry of Health and Long-Term Care. The average case cost (based on Ontario hospital costs and medical resources) for surgical vein stripping was estimated to be $1,799. In order to calculate a procedural cost for RFA it was assumed that the hospital cost and physician labour fees, excluding anaesthesia and surgical assistance, were the same as vein stripping surgery. The manufacturer also provided details on the generator with a capital cost of $27,500 and a lifespan of 5 years and the disposables (catheter, sheath, guidewire) with a cost of $673 per case. The average case cost for RFA was therefore estimated to be $1,356. One-way sensitivity analysis was also conducted with hospital cost of RFA varied to 60% that of vein stripping surgery (average cost per case = $627.08) to calculate an impact to the province. Historical volumes of vein stripping surgeries in Ontario were used to project surgeries in a linear fashion up to five years into the future. Volumes for RFA and ELT were calculated based on share capture from the surgery market based on discussion with clinical expert opinion and existing private data based on discussion with the manufacturer. RFA is expected to compete with ELT and capture some of the market. If ELT is reimbursed by the public sector then numbers will continue to increase from previous private data and share capture from the conventional surgical treatment market. Therefore, RFA cases will also increase since it will be capturing a share of the ELT market. A budget impact to the province was then calculated by multiplying volumes by the cost of the procedure. RFA is comparable in clinical benefits to vein stripping surgery. It has the extra upfront cost of the generator and cost per case for disposables but does not require an operating theater, anaesthetist or surgical assistant fees. The impact to the province is expected to be 5 M by Year 5 with the introduction of new ELT and RFA image guided endovascular technologies and existing surgery for varicose veins. Conclusion The conclusions on the comparative outcomes between endovascular RFA and surgical ligation and saphenous vein stripping and between endovascular RFA and laser ablation for VV treatment are summarized in the table below (ES Table 1). ES Table 1 Outcome comparisons of RFA vs. surgery and RFA vs ELT for varicose veins Outcome Comparisons RFA vs Surgery RFA vs ELT Post procedural pain, minor complications RFA < Surgery RFA < ELT Recovery RFA < Surgery RFA ~ ELT Major adverse events RFA < Surgery RFA ~ ELT Effectiveness - Imaging vein occlusion/ absence RFA ~ Surgery RFA ? ELT Effectiveness -Vein symptom improvement RFA ~ Surgery RFA ~ ELT Effectiveness - Quality Of Life RFA ~ Surgery RFA ~ ELT Recurrence RFA ? Surgery RFA ? ELT Patient satisfaction RFA > Surgery RFA ? ELT Patient preference RFA > Surgery RFA ? ELT Procedure costs RFA < Surgery RFA ~ ELT Budget impact RFA < Surgery RFA ~ ELT ELT refers to endovascular laser ablation; RFA, radiofrequency ablation The outcomes of the evidence-based review on these treatments for VV based on different perspectives are summarized below: RFA First versus Second Generation Catheters and Segmental Ablation Ablation with second generation catheters and segmental ablation offered technical advantages with improved ease and significant decreases in procedure time. RFA ablation with second generation catheters is also no longer restricted to smaller (< 12 mm diameter) saphenous veins. The safety profile with the new device and method of energy delivery is as good as or improved over the first generation device. No major adverse events were reported in two multicenter prospective cohort studies in 6 month follow-up with over 500 patients. Post-operative complications such as bruising and pain were significantly less with RFA ablation with second generation catheters than ELT in two RCT trials.RFA treatment with second generation catheters has ablation rates that are higher than with first generation catheters and are more comparable with the consistently high rates of ELT. Endovascular RFA versus Surgery RFA has a quicker recovery attributable to decreased pain and lower minor complications.RFA, in the short term was comparable to surgery in treatment effectiveness as assessed by imaging defined anatomic outcomes such as vein closure, flow or reflux. Other treatment outcomes such as symptomatic relief and HRQOL were significantly improved in both groups and between group differences in the early peri-operative period were likely influenced by pain experiences. Longer term follow-up was inadequate to evaluate recurrence after either treatment.Patient satisfaction was high after both treatments but was higher for RFA than surgery. Endovascular RFA versus ELT RFA has significantly less post-operative pain than ELT but differences were not significant when pain was adjusted for analgesic use and pain differences between groups did not persist at 1 month follow-up.Treatment effectiveness, measured as symptom relief and QOL improvement were similar between the endovascular treatments in the short term (within 1 month) Treatment effectiveness measured as imaging defined vein ablation was not measured in any RCT trials (only for bilateral VV disease) and results were inconsistently reported in observational trials.Longer term follow-up was not available to assess recurrence after either treatment. System Outcomes RFA Replacing Surgery or Competing with ELT RFA may offer system advantages in that the treatment can be offered by several medical specialties in outpatient settings and because it does not require an operating theatre or general anaesthesia. The treatment may result in decanting of patients from OR with decreased pre-surgical investigations, demand on anaesthetists time, hospital stay and wait time for VV treatment. It may also provide more reliable outpatient scheduling. Procedure costs may be less for endovascular approaches than surgery but the budget impact may be greater with insurance of RFA because of the transfer of cases from the private market to the public payer system.Competition between RFA and ELT endovascular approaches is likely to continue to stimulate innovation and technical changes to advance patient care and result in competitive pricing. PMID:23074413

  5. Clinical evaluation of vein contrast enhancement

    NASA Astrophysics Data System (ADS)

    Lovhoiden, Gunnar; Deshmukh, Harshal; Zeman, Herbert D.

    2002-05-01

    A clinical study is underway to compare an experimental infrared (IR) device, OnTarget OnTarget at LeBonheur Children's Medical Center, Methodist Healthcare, in Memphis, TN, while the adult study site is the clinical research center at Bowld Hospital, also in Memphis, TN. Early results on 35 pediatric and 25 adult subjects indicate that OnTarget years' experience in accessing veins in pediatric subjects, and that it could be very helpful to a phlebotomist with limited experience when accessing veins in both adult and pediatric subjects. The study uses monitor based OnTarget area of the patients anatomy enlarged and contrast enhanced on a LCD monitor. The phlebotomist can then compare the OnTarget or feel when examining a subject.

  6. Computational haemodynamics in stenotic internal jugular veins.

    PubMed

    Caiazzo, Alfonso; Montecinos, Gino; Mller, Lucas O; Haacke, E Mark; Toro, Eleuterio F

    2015-03-01

    An association of stenotic internal jugular veins (IJVs) to anomalous cerebral venous hemodynamics and Multiple Sclerosis has been recently hypothesized. In this work, we set up a computational framework to assess the relevance of IJV stenoses through numerical simulation, combining medical imaging, patient-specific data and a mathematical model for venous occlusions. Coupling a three-dimensional description of blood flow in IJVs with a reduced one-dimensional model for major intracranial veins, we are able to model different anatomical configurations, an aspect of importance to understand the impact of IJV stenosis in intracranial venous haemodynamics. We investigate several stenotic configurations in a physiologic patient-specific regime, quantifying the effect of the stenosis in terms of venous pressure increase and wall shear stress patterns. Simulation results are in qualitative agreement with reported pressure anomalies in pathological cases. Moreover, they demonstrate the potential of the proposed multiscale framework for individual-based studies and computer-aided diagnosis. PMID:24671429

  7. Deep dorsal vein arterialisation in vascular impotence.

    PubMed

    Wespes, E; Corbusier, A; Delcour, C; Vandenbosch, G; Struyven, J; Schulman, C C

    1989-11-01

    A series of 12 patients with vasculogenic impotence (4 arterial lesions; 8 arterial and venous lesions) underwent deep dorsal vein arterialisation after pre-operative assessment by a multidisciplinary approach. Cumulative graft patency was 58% (7 of 12 patients) up to 21 months but only 4 patients developed almost normal erections. Digital angiography, with and without the intracavernous injection of papaverine, was performed during follow-up to determine the vascular physiological status. At flaccidity, the corpora cavernosa were never opacified in the absence of a venocorporeal shunt. The penile glans was always visualised. Opacification of the deep dorsal vein and the circumflex system decreased with penile rigidity, resulting from their compression between Buck's fascia and the tunica albuginea. Intracavernous pressure recorded before and after the surgical procedure showed a marked increase when a caverno-venous shunt was performed. Hypervascularisation of the glans occurred in 2 cases. The relevance of this new surgical technique and its functional mechanism are discussed. PMID:2611627

  8. Pulmonary vein stenosis: Etiology, diagnosis and management.

    PubMed

    Pazos-Lpez, Pablo; Garca-Rodrguez, Cristina; Guitin-Gonzlez, Alba; Paredes-Galn, Emilio; lvarez-Moure, Mara ngel De La Guarda; Rodrguez-lvarez, Marta; Baz-Alonso, Jos Antonio; Teijeira-Fernndez, Elvis; Calvo-Iglesias, Francisco Eugenio; iguez-Romo, Andrs

    2016-01-26

    Pulmonary vein stenosis (PVS) is rare condition characterized by a challenging diagnosis and unfavorable prognosis at advance stages. At present, injury from radiofrequency ablation for atrial fibrillation has become the main cause of the disease. PVS is characterized by a progressive lumen size reduction of one or more pulmonary veins that, when hemodynamically significant, may raise lobar capillary pressure leading to signs and symptoms such as shortness of breath, cough, and hemoptysis. Image techniques (transesophageal echocardiography, computed tomography, magnetic resonance and perfusion imaging) are essential to reach a final diagnosis and decide an appropriate therapy. In this regard, series from referral centers have shown that surgical and transcatheter interventions may improve prognosis. The purpose of this article is to review the etiology, assessment and management of PVS. PMID:26839659

  9. Leiomyosarcoma arising from the inferior mesenteric vein.

    PubMed

    Clemente, Gennaro; Sarno, Gerardo; Barbaro, Brunella; Nuzzo, Gennaro

    2009-01-01

    Leyomiosarcomas arising from the portal/mesenteric venous system are very rare tumours, and only a few cases have been reported in the global literature. As the other leyomiosarcomas of vascular origin, they are associated with a poor prognosis. The present report describes the case of a 66-year-old woman with a leyomiosarcoma of the inferior mesenteric vein, unexpectedly found during a CT scan performed for another indication. A brief review of the literature is also given. The patient underwent radical surgical excision and enjoys a good health, without radiological signs of recurrence, 24 months after surgery. In this case, an early incidental diagnosis determined an early treatment and, probably, a favourable prognosis. This is the second case of leyomiosarcoma of the inferior mesenteric vein reported in the literature. PMID:21686492

  10. Finger vein extraction using gradient normalization and principal curvature

    NASA Astrophysics Data System (ADS)

    Choi, Joon Hwan; Song, Wonseok; Kim, Taejeong; Lee, Seung-Rae; Kim, Hee Chan

    2009-02-01

    Finger vein authentication is a personal identification technology using finger vein images acquired by infrared imaging. It is one of the newest technologies in biometrics. Its main advantage over other biometrics is the low risk of forgery or theft, due to the fact that finger veins are not normally visible to others. Extracting finger vein patterns from infrared images is the most difficult part in finger vein authentication. Uneven illumination, varying tissues and bones, and changes in the physical conditions and the blood flow make the thickness and brightness of the same vein different in each acquisition. Accordingly, extracting finger veins at their accurate positions regardless of their thickness and brightness is necessary for accurate personal identification. For this purpose, we propose a new finger vein extraction method which is composed of gradient normalization, principal curvature calculation, and binarization. As local brightness variation has little effect on the curvature and as gradient normalization makes the curvature fairly uniform at vein pixels, our method effectively extracts finger vein patterns regardless of the vein thickness or brightness. In our experiment, the proposed method showed notable improvement as compared with the existing methods.

  11. Atypical penile Mondor's disease - involvement of the circumflex vein.

    PubMed

    Arora, Rahul; Sonthalia, Sidharth; Gera, Tanu; Sarkar, Rashmi

    2015-04-01

    Mondor's disease is a rare condition characterised by superficial thrombophlebitis of subcutaneous veins, most commonly over the anterior chest wall. Penile Mondor's disease is rarer, arising out of thrombophlebitis of the penile veins. It typically involves the dorsal vein of the penis and presents with a cord-like indurated lesion with a beaded feel, palpable along the length of the involved vein. Though penile Mondor's disease involving the dorsal vein of the penis has been reported by many authors, we report a peculiar case of penile Mondor's disease in a 26-year-old sexually active man with thrombophlebitis of the circumflex vein of the penis with sparing of the dorsal vein. Diagnosis was confirmed on Doppler ultrasonography of the penile venous system. Despite exhaustive history taking, no cause could be elicited. The lesion completely subsided within three days with daily local hot fomentation. We propose the term 'atypical penile Mondor's disease' for such a case. PMID:24867818

  12. Large retroperitoneal hemangioma encompassing the renal vein

    PubMed Central

    Mossanen, Matthew; Dighe, Manjiri; Gore, John; Mann, Gary

    2015-01-01

    Retroperitoneal hemangioma (RH) is a rare and benign vascular malformation. RH may be detected incidentally or present with symptoms due to local invasion of adjacent structures. Management options include surgical resection, as well as serial observation with routine imaging. We describe a retroperitoneal hemangioma encompassing the renal vein that was discovered during diagnosis of acute appendicitis, and characterize diagnostic magnetic resonance imaging (MRI) findings seen with this condition. PMID:26834900

  13. [Leiomyosarcoma of brachiocephalic vein: case report].

    PubMed

    Forte, A; Leonetti, G; Bosco, M; Manfredelli, S; Dezzi, C; Bezzi, M; Urbano, V

    2006-10-01

    Primary leiomyosarcoma of venous origin is a rare but frequently lethal disease. Clinical symptoms can be different, often not much evident or absolutely absent. Preoperative diagnosis is difficult also with modern imaging and only pathological examination can identify this malignant tumor. Successful therapy requires early surgery but the long-term survival is poor. A case of leiomyosarcoma arising from veins has been presented. PMID:17147852

  14. Metabolic effects of portal vein sensing.

    PubMed

    Mithieux, G

    2014-09-01

    The extrinsic gastrointestinal nerves are crucial in the sensing of nutrients and hormones and its translation in terms of control of food intake. Major macronutrients like glucose and protein are sensed by the extrinsic nerves located in the portal vein walls, which signal to the brain and account for the satiety phenomenon they promote. Glucose is sensed in the portal vein by neurons expressing the glucose receptor SGLT3, which activate the main regions of the brain involved in the control of food intake. Proteins indirectly act on food intake by inducing intestinal gluconeogenesis and its sensing by the portal glucose sensor. The mechanism involves a prior antagonism by peptides of the μ-opioid receptors present in the portal vein nervous system and a reflex arc with the brain inducing intestinal gluconeogenesis. In a comparable manner, short-chain fatty acids produced from soluble fibre act via intestinal gluconeogenesis to exert anti-obesity and anti-diabetic effects. In the case of propionate, the mechanism involves a prior activation of the free fatty acid receptor FFAR3 present in the portal nerves and a reflex arc initiating intestinal gluconeogenesis. PMID:25200297

  15. How I treat splanchnic vein thrombosis.

    PubMed

    Ageno, Walter; Dentali, Francesco; Squizzato, Alessandro

    2014-12-11

    Antithrombotic treatment of splanchnic vein thrombosis (SVT) is a clinical challenge. Depending on the site of thrombosis, patients are at risk of developing liver insufficiency, portal hypertension, or bowel infarction and may experience recurrence in both the splanchnic veins and other vein segments. To prevent recurrence, anticoagulant therapy should be started as soon as possible after diagnosis and is often continued for an indefinite period of time. However, active bleeding is not infrequent at the time of SVT diagnosis, and major risk factors for bleeding, such as esophageal varices or a low platelet count, are frequently present in these patients. In real-world clinical practice, a proportion of SVT patients are left untreated because the risks associated with anticoagulant therapy are felt to exceed its benefits. However, the majority of patients receive anticoagulant drugs, with heterogeneous timing of initiation, drug choice, and dosages. Evidence to drive treatment decisions is limited because no randomized controlled trials have been carried out in these patients. This review provides practical guidance for the use of anticoagulant drugs in patients presenting with SVT, including symptomatic as well as incidentally detected events. PMID:25320239

  16. Percutaneous Transumbilical Portal Vein Embolization in a Patient with a Ruptured Hepatocellular Carcinoma Supplied by the Portal Vein

    SciTech Connect

    Kim, Soo Chin; Kim, Hyo-Cheol Chung, Jin Wook; Jae, Hwan Jun; Park, Jae Hyung

    2011-02-15

    We describe a case of a ruptured hepatocellular carcinoma supplied by the portal vein that was successfully treated with portal vein embolization via a percutaneous transumbilical approach. A contrast material-enhanced computed tomographic (CT) scan showed the presence of a large hypervascular tumor on portal venous phase as well as right hepatic vein thrombosis and hemoperitoneum that prevented portal vein embolization by the use of the percutaneous and transjugular transhepatic approach. The use of percutaneous transumbilical portal vein embolization can be an alternative option in this situation.

  17. Percutaneous Intraluminal Recanalization of Long, Chronic Superficial Femoral and Popliteal Occlusions Using the Frontrunner XP CTO Device: A Single-Center Experience

    SciTech Connect

    Charalambous, Nikolas Schaefer, Philipp J.; Trentmann, Jens; Huemme, Tim. H.; Stoehring, Christine; Mueller-Huelsbeck, Stefan; Heller, Martin; Jahnke, Thomas

    2010-02-15

    The purpose of this study was to examine the safety and efficacy of the Frontrunner XP CTO (chronic total occlusion) Catheter (Cordis) for recanalization of long femoropopliteal artery occlusions. A Frontrunner catheter was used to treat 26 CTOs in SFA after guidewire failure (68.3 {+-} 8.8 years). Sixty-seven percent of patients had severe claudication. Critical lower limb ischemia with rest pain or minor tissue loss was present in three and eight patients, respectively. All the lesions were considered complex (TASC B, C, and D); 68% of the lesions were heavily calcified. The mean lesion length was 17.6 cm (range, 10-42 cm). The initial attempt to cross the occlusion with the CTO guidewire V18 was unsuccessful in 26 of 76 limbs (34.26%). A secondary attempt using the Frontrunner catheter (crossover approach, 27%; antegrade, 73%) performed in all 26 failed cases was successful in 17 limbs (65.38%), increasing the technical success rate to 88.12%. The main reasons for failure with the Frontrunner were inability to cross the lesion due to heavy calcification (six of nine) and inability to re-enter the true lumen after subintimal passage of the occluded segment (three of nine). The mean fluoroscopy time was 22.9 min. Minor complications included one distal extension of the dissection with involvement of the first popliteal segment and one perforation in the occluded segment. No major complications were seen. In conclusion, recanalization with the Frontrunner CTO catheter is a simple and safe method with a high technical success rate in the endovascular treatment of long superficial femoral artery occlusions and should be an alternative method after guidewire failure.

  18. Quantitative modeling of quartz vein sealing

    NASA Astrophysics Data System (ADS)

    Wendler, Frank; Okamoto, Atsushi; Schwarz, Jens-Oliver; Enzmann, Frieder; Blum, Philipp

    2014-05-01

    Mineral precipitation significantly effects many aspects of fluid-rock interaction across all length scales, as the dynamical change of permeability, of mechanical interaction and redistribution of dissolved material. The hydrothermal growth of quartz establishes one of the most important mineralization processes in fractures. Tectonically caused fracturing, deformation and fluid transport leaves clear detectable traces in the microstructure of the mineralized veins. As these patterns give hints on the deformation history and the fluid pathways through former fracture networks, accurate spatio-temporal modeling of vein mineralization is of special interest, and the objective of this study. Due to the intricate polycrystalline geometries involved, the underlying physical processes like diffusion, advection and crystal growth have to be captured at the grain scale. To this end, we adapt a thermodynamically consistent phase-field model (PFM), which combines a kinetic growth law and mass transport equations with irreversible thermodynamics of interfaces and bulk phases. Each grain in the simulation domain is captured by a phase field with individual orientation given by three Euler angles. The model evolves in discrete time steps using a finite difference algorithm on a regular grid, optimized for large grain assemblies. The underlying processes are highly nonlinear, and for geological samples, boundary conditions as well as many of the physical parameters are not precisely known. One motivation in this study is to validate the adequately parameterized model vs. hydrothermal experiments under defined (p,T,c) conditions. Different from former approaches in vein growth simulation, the PFM is configured using thermodynamic data from established geochemical models. Previously conducted batch flow experiments of hydrothermal quartz growth were analyzed with electron backscatter diffraction (EBSD) and used to calibrate the unknown kinetic anisotropy parameters. In the simulations, we study the sealing of syntaxial veins of 300 microns aperture by epitaxial overgrowth of preexisting grains from the rock surface. Results from 3D simulations conducted in the limit of low Damkhler numbers explain the observed transition regime in competitive crystal growth for blocky-elongate veins. The initial formation of quartz crystal bridges, especially pronounced in the regime of low supersaturation, is observed. The morphological evolution of micro-ensembles of grain neighbourhoods from the rock sample compares well to that of the simulations. To juxtapose larger polycrystal domains, the variation of grain number, texture and porosity as function of scaled distance from the initial wall is calculated. Velocity profiles from solutions of the isothermal incompressible Navier-Stokes equation are used to record permeability evolution and to evaluate deviations from the cubic law. Both, the geometry of the microstructure and the permeability of the flow pathway, are used as upscaling parameters for larger scale (fracture scale) simulations.

  19. Development of HIFU Therapy System for Lower Extremity Varicose Veins

    NASA Astrophysics Data System (ADS)

    Ota, Ryuhei; Suzuki, Jun; Yoshinaka, Kiyoshi; Deguchi, Juno; Takagi, Shu; Miyata, Tetsuro; Matsumoto, Yoichiro

    2009-04-01

    High-intensity focused ultrasound (HIFU) treatment utilizing microbubbles was investigated in the present study. It is known that microbubbles have the potential to enhance the heating effects of an ultrasound field. In this study, the heat accompanying microbubble oscillation was used to occlude varicose veins. Alteration of veins was observed after ultrasound irradiation. Veins were resected by stripping. In this study, two vein conditions were adopted during HIFU irradiation; non-compressed and compressed. Compressing the vein was expected to improve occlusion by rubbing the altered intima under compressed conditions. The frequency of the ultrasound was 1.7 MHz, the intensity at the focus was 2800 W/cm2, and the irradiation time was 20 s. In this study, the contrast agent Levovist was chosen as a microbubble source, and the void fraction (ratio of total gas volume to liquid) in the vein was fixed at 10-5. Under non-compressed conditions, changes were observed only at the adventitia of the vein anterior wall. In contrast, under compressed conditions, changes were observed from the intima to the adventitia of both the anterior and posterior walls, and they were partly stuck together. In addition, more experiments with hematoxylin-eosin staining suggested that the changes in the vein were more substantial under the latter conditions. From these results, it was confirmed that the vein was occluded more easily with vein compression.

  20. Automated detection of periventricular veins on 7 T brain MRI

    NASA Astrophysics Data System (ADS)

    Kuijf, Hugo J.; Bouvy, Willem H.; Zwanenburg, Jaco J. M.; Viergever, Max A.; Biessels, Geert Jan; Vincken, Koen L.

    2015-03-01

    Cerebral small vessel disease is common in elderly persons and a leading cause of cognitive decline, dementia, and acute stroke. With the introduction of ultra-high field strength 7.0T MRI, it is possible to visualize small vessels in the brain. In this work, a proof-of-principle study is conducted to assess the feasibility of automatically detecting periventricular veins. Periventricular veins are organized in a fan-pattern and drain venous blood from the brain towards the caudate vein of Schlesinger, which is situated along the lateral ventricles. Just outside this vein, a region-of- interest (ROI) through which all periventricular veins must cross is defined. Within this ROI, a combination of the vesselness filter, tubular tracking, and hysteresis thresholding is applied to locate periventricular veins. All detected locations were evaluated by an expert human observer. The results showed a positive predictive value of 88% and a sensitivity of 95% for detecting periventricular veins. The proposed method shows good results in detecting periventricular veins in the brain on 7.0T MR images. Compared to previous works, that only use a 1D or 2D ROI and limited image processing, our work presents a more comprehensive definition of the ROI, advanced image processing techniques to detect periventricular veins, and a quantitative analysis of the performance. The results of this proof-of-principle study are promising and will be used to assess periventricular veins on 7.0T brain MRI.

  1. A vein display system based on three-dimensional reconstruction

    NASA Astrophysics Data System (ADS)

    Wang, Danting; Zhou, Ya; Hu, Xiaoming; Wu, Zhaoguo; Dai, Xiaobin

    2014-10-01

    Venipuncture is the most common way of all invasive medical procedures. A vein display system can make vein access easier by capturing the vein information and projecting a visible vein image onto the skin, which is correctly aligned with the subject's vein. The existing systems achieve correct alignment by the design of coaxial structure. Such a structure causes complex optical and mechanical design and big physical dimensions inevitably. In this paper, we design a stereovision- based vein display system, which consists of a pair of cameras, a DLP projector and a near-infrared light source. We recover the three-dimensional venous structure from image pair acquired from two near-infrared cameras. Then the vein image from the viewpoint of projector is generated from the three-dimensional venous structure and projected exactly onto skin by the DLP projector. Since the stereo cameras get the depth information of vessels, the system can make sure the alignment of projected veins and the real veins without a coaxial structure. The experiment results prove that we propose a feasible solution for a portable and low-cost vein display device.

  2. Variations of Gonadal Veins: Embryological Prospective and Clinical Significance

    PubMed Central

    Gupta, Raman; Aggarwal, Navita

    2015-01-01

    Introduction: An adequate knowledge of anomalies of gonadal veins will help the radiologists and surgeons in recognition and protection of these veins which play major roles in thermo-regulation that is essential for the efficient functioning of testis on which the survival of the human species depends. Aim: The aim of this work is to present an analysis of the anatomical variations of gonadal veins. An effort has also been made to explicate the possible embryological model of development of such variants and to present the variable clinical aspects concerning them. Materials and Methods: Gonadal veins in 60 dissection room cadavers were examined for variations from the classic anatomic description. Result: In the present study, out of 60 cases, male: female ratio was 2:1(40:20) in which no variation was found in ovarian veins. In the 18 (45%) cases, testicular veins showed variations which consist of duplication and atypical drainage. Discussion: Variations of drainage of gonadal vein are due to error of embryological development in venous shift and alteration in anastomotic channel of post-cardinal, supra-cardinal and sub cardinal veins. Conclusion: The gonadal veins present numeric variations as well as variations in its site of drainage, which attributed to the various pathological conditions as varicocele and pelvic congestion syndrome, leading to infertility in patients. Hence, in -depth knowledge of these developmental anomalies of gonadal veins is important. PMID:25859438

  3. [Strain-gauge plethysmography in the evaluation of the evolution of deep vein thrombosis of the legs].

    PubMed

    Tanzini, G; Salvestrini, F; Palasciano, G; Setacci, C; Papi, F; Piccolotti, T

    1984-07-31

    Previous research has shown that MVO (Maximum Venous Outflow), VR (Venous Reflux), VE (Venous Emptying) and the respiratory waves recording are useful in differentiating occlusion and recanalization in postphlebitic syndrome. In the present work strain-gauge plethysmography was employed to quantitate the venous function after deep venous thrombosis of the legs. The studies were performed in a vascular laboratory with controlled temperature (23 to 25 C); records were obtained by a plethysmograph Parks mod. 270 connected to a Hewlett-Packard multi-channel mod. 7700. 17 patients (12 males, 5 females), mean age 55 years (range 24-75) that presented femoropopliteal thrombophlebitis documented by phlebography at the admission to the hospital were examined. MVO with and without superficial veins occlusion was measured by a mercury in silastic strain-gauge placed circumferentially about the calf. A pneumatic cuff thigh was inflated to 60 mm Hg. VE was measured in patients lying in inclined bed with the lower extremities 100 cm below the heart level compressing the calf with a pneumatic cuff 10 times for 5 seconds; the strain-gauge was placed on the foot level. VR after Valsalva's maneuver and the respiratory waves were recorded by a strain-gauge positioned at the maximum girth about the calf in patients lying on inclinated bed with the lower extremities 50 cm below the heart level. The result are here indicated: (Table: see text) There was differences in the evolution of venous function after deep venous thrombosis of the legs for each patient. Strain-gauge plethysmography may become evaluable non invasive technique in the evaluation of deep venous thrombosis evolution in the legs. The therapeutic assessment of postphlebitic syndrome. PMID:6477745

  4. [Modern imaging in cerebral vein angioma].

    PubMed

    Zouaoui, A; Maillard, J C; Ganthier, V; Chedid, G; Dangeard, S

    1995-06-01

    Cerebral venous angiomas are vascular malformations of the brain which, before the advent of modern imaging, and in particular MRI, were thought to be rare. They have a specific angiographic aspect called "caput Meduse" as it corresponds to the description of a large draining vein to which converge numerous radial veins located in the white matter. These true vascular malformations have characteristic histological features making it possible to differentiate them from other vascular malformations, notably cavernomas. These lesions are less scanty than classically believed, being the most frequent malformations encountered in post-mortem examination series. The circumstances in which cerebral venous angiomas are discovered vary considerably, and haemorrhage can be the revealing sign. Some authors regard these malformations as "abnormalities" of white matter veins and not as pathological entities, since they derive from a change in development during embryogenesis, but this theory is not supported by any anatomical evidence. The same authors attribute the bleeding to an associated cavernoma. Whereas CT enables venous angiomas and possible associated cavernomas to be detected, only repeated MRI explorations performed after the finding of venous angioma and hemorrhage can permit, by analysis of signal changes, to confirm or invalidate the non-pathological theory of the venous malformation and its tendency to bleed. Apart from hemorrhages, since gadolinium is used MRI is the most reliable and least invasive means to diagnose angiomas and to detect associated occult angiographic malformations. For this reason, nowadays only hemorrhages require an angiography in search of an arteriovenous malformation demanding prompt treatment. Moreover, MRI makes it possible to detect angiographically occult malformations. PMID:7629574

  5. Portal vein arterialization technique for liver transplantation patients

    PubMed Central

    Zhang, Kun; Jiang, Yi; Lv, Li-Zhi; Cai, Qiu-Cheng; Yang, Fang; Hu, Huan-Zhang; Zhang, Xiao-Jin

    2014-01-01

    Liver transplantations were performed on two patients with hepatic failure caused by liver cirrhosis. Hard obsolete thrombi and portal venous sclerosis were observed in the major portal veins of both patients. The arteria colica media of one recipient and the portal vein of the donor were anastomosed end-to-end. The hepatic artery of the first donor was anastomosed end-to end with the gastroduodenal artery of the first recipient; meanwhile, the portal vein of the second donor was simultaneously anastomosed end- to-end with the common hepatic artery of the second recipient. The blood flow of the portal vein, the perfusion of the donor liver and liver function were satisfactory after surgery. Portal vein arterialization might be an effective treatment for patients whose portal vein reconstruction was difficult. PMID:25232274

  6. Extracorporeal shock waves as curative therapy for varicose veins?

    PubMed Central

    Angehrn, Fiorenzo; Kuhn, Christoph; Sonnabend, Ortrud; Voss, Axel

    2008-01-01

    In this prospective design study the effects of low-energy partially focused extracorporeal generated shock waves (ESW) onto a subcutaneous located varicose vein left vena saphena magna (VSM) are investigated. The treatment consisted of 4 ESW applications within 21 days. The varicose VSM of both sides were removed by surgery, and samples analyzed comparing the treated and untreated by means of histopathology. No damage to the treated varicose vein in particular and no mechanical destruction to the varicose veins wall could be demonstrated. However, an induction of neo-collagenogenesis was observed. The thickness of the varicose veins wall increased. Optimization of critical application parameters by investigating a larger number of patients may turn ESW into a non-invasive curative varicose treatment. PMID:18488887

  7. Deep vein thrombosis chemoprophylaxis in plastic surgery.

    PubMed

    Gold, Alan

    2013-07-01

    The practice of plastic surgery is a unique mixture of art and science, and both must be carefully balanced to provide the best possible care for patients. To do that, clinicians should be practicing evidence-based medicine. This article discusses the prevalence and risks associated with deep vein thrombosis and the reasons and options for its possible chemoprophylaxis. Until evidence-based medicine best-practice recommendations can be developed, it would be prudent for clinicians to empirically select and consistently apply a risk stratification system and prophylaxis regimen of their choice for the benefit of their patients. PMID:23830748

  8. Pediatric aneurysms and vein of Galen malformations

    PubMed Central

    Rao, V. R. K.; Mathuriya, S. N.

    2011-01-01

    Pediatric aneurysms are different from adult aneurysms – they are more rare, are giant and in the posterior circulation more frequently than in adults and may be associated with congenital disorders. Infectious and traumatic aneursyms are also seen more frequently. Vein of Galen malformations are even rarer entities. They may be of choroidal or mural type. Based on the degree of AV shunting they may present with failure to thrive, with hydrocephalus or in severe cases with heart failure. The only possible treatment is by endovascular techniques – both transarterial and transvenous routes are employed. Rarely transtorcular approach is needed. These cases should be managed by an experienced neurointerventionist. PMID:22069420

  9. Superior Mesenteric Vein Thrombosis Mimicking Acute Appendicitis

    PubMed Central

    Gaspary, Micah J.; Auten, Jonathan; Durkovich, David; Gable, Preston

    2011-01-01

    Abdominal pain is one of the most common presenting complaints to the emergency department. Mesenteric venous thrombosis represents an important cause to consider in patients with acute abdominal pain. The diagnosis is often delayed, and cases traditionally have been identified either at laparotomy or at autopsy. In this case, we describe a 21-year-old female with acute onset of right lower quadrant pain attributable to a hyperhomocysteinemia related non-occlusive superior mesenteric vein thrombosis. This case highlights how the use of computed tomography in select cases can lead to earlier recognition of this condition and increasingly allow for non-surgical treatment. PMID:21691540

  10. Science Linking Pulmonary Veins and Atrial Fibrillation

    PubMed Central

    Mahida, Saagar; Sacher, Frederic; Derval, Nicolas; Berte, Benjamin; Yamashita, Seigo; Hooks, Darren; Denis, Arnaud; Amraoui, Sana; Hocini, Meleze; Haissaguerre, Michel; Jais, Pierre

    2015-01-01

    Over the past few decades, significant progress has been made in understanding the mechanistic basis of atrial fibrillation (AF). One of the most important discoveries in this context has been that pulmonary veins (PV) play a prominent role in the pathogenesis of AF. PV isolation has since become the most widely used technique for treatment of paroxysmal AF. Multiple studies have demonstrated that the electrophysiological and anatomical characteristics of PVs create a proarrhythmogenic substrate. The following review discusses the mechanistic links between PVs and AF. PMID:26835098

  11. Endovenous saphenous vein ablation in patients with acute isolated superficial-vein thrombosis

    PubMed Central

    2015-01-01

    Objective: The possible benefits of endovenous saphenous ablation (EVSA) as initial treatment in patients presenting with isolated superficial-vein thrombosis (SVT) and saphenous vein reflux include: (1) definitive treatment of the underlying pathology and (2) elimination of the saphenous vein as a path for pulmonary emboli, which (3) may eliminate the need for anticoagulation. Methods: In a ten-year review of 115 limbs presenting with acute isolated SVT, 72 limbs (71 patients) with saphenous reflux were given a choice of two treatments following an explanation of the risks and benefits of each. Group I limbs (n?=?41) were treated with office EVSA using radiofrequency or laser with or without thrombophlebectomy if performed within 45 days of diagnosis. Post-treatment anticoagulants were not given. Group II limbs (n?=?31) were treated with compression hose and repeat Duplex within one week, with added anticoagulants if SVT extended into the thigh. Results: In group I, mean interval from diagnosis to treatment was 13.7 days. One calf deep vein thrombosis was noted. In group II no complications were noted. In late follow-up of group II patients, 12/29 underwent EVSA more than 45 days after initial presentation. Conclusions: The safety and efficacy of EVSA and thrombophlebectomy appear indistinguishable from conservative measures and may be offered as initial treatment to patients presenting with SVT and saphenous reflux. PMID:24307241

  12. The fate of calf perforator veins after saphenous vein laser ablation

    PubMed Central

    Ozkan, Ugur

    2015-01-01

    PURPOSE We aimed to assess hemodynamic changes in calf perforator veins (PVs) after endovenous laser ablation (EVLA) of saphenous veins. METHODS The series comprised 60 limbs of 41 patients (27 female, 14 male; median age, 43 years [range, 2278 years]) who underwent EVLA for varicose veins. All patients were prospectively evaluated by means of color Doppler ultrasonography before and after the procedure. RESULTS EVLA did not change the rate of incompetent PVs (preoperatively, 154/483 [32%] vs. postoperatively, 167/501 [33%]; P = 0.173), but significantly increased the total number of all PVs (n=483 vs. n=501, P = 0.036). Following EVLA, 28% of the limbs had thrombosis of PVs, 34% had new US-detectable PVs, 42% showed new competency, and 52% showed new incompetency. New competent PVs were found more commonly in the medial leg (ablation site) than the lateral leg (nonablation site) (28.3% vs. 11.7%, P = 0.016), while new incompetent PVs were found more commonly in nonablation site than ablation site (31.7% vs. 18.3%, P = 0.086). Additionally, new competent PVs in the posterior leg were found more often in patients who had small saphenous vein ablation than patients who did not (30% vs. 0%, P = 0.002). CONCLUSION EVLA induces numerous changes in calf PVs. These changes seem to result from flow offloading in ablation site and onloading in nonablation site in the early postablation period. PMID:26268299

  13. Finger-Vein Verification Based on Multi-Features Fusion

    PubMed Central

    Qin, Huafeng; Qin, Lan; Xue, Lian; He, Xiping; Yu, Chengbo; Liang, Xinyuan

    2013-01-01

    This paper presents a new scheme to improve the performance of finger-vein identification systems. Firstly, a vein pattern extraction method to extract the finger-vein shape and orientation features is proposed. Secondly, to accommodate the potential local and global variations at the same time, a region-based matching scheme is investigated by employing the Scale Invariant Feature Transform (SIFT) matching method. Finally, the finger-vein shape, orientation and SIFT features are combined to further enhance the performance. The experimental results on databases of 426 and 170 fingers demonstrate the consistent superiority of the proposed approach. PMID:24196433

  14. Finger-vein verification based on multi-features fusion.

    PubMed

    Qin, Huafeng; Qin, Lan; Xue, Lian; He, Xiping; Yu, Chengbo; Liang, Xinyuan

    2013-01-01

    This paper presents a new scheme to improve the performance of finger-vein identification systems. Firstly, a vein pattern extraction method to extract the finger-vein shape and orientation features is proposed. Secondly, to accommodate the potential local and global variations at the same time, a region-based matching scheme is investigated by employing the Scale Invariant Feature Transform (SIFT) matching method. Finally, the finger-vein shape, orientation and SIFT features are combined to further enhance the performance. The experimental results on databases of 426 and 170 fingers demonstrate the consistent superiority of the proposed approach. PMID:24196433

  15. Advantages of using volar vein repair in finger replantations.

    PubMed

    Mersa, Berkan; Kabakas, Fatih; Prisa, Hsrev; zelik, Ismail Blent; Ye?ilo?lu, Nebil; Sezer, Ilker; Tuner, Serdar

    2014-01-01

    Providing adequate venous outflow is essential in finger replantation surgeries. For a successful result, the quality and quantity of venous repairs should be adequate to drain arterial inflow. The digital dorsal venous plexus is a reliable source of material for venous repairs. Classically, volar digital veins have been used only when no other alternative was available. However, repairing volar veins to augment venous outflow has a number of technical advantages and gives a greater chance of survival. Increasing the repaired vein:artery ratio also increases the success of replantation. The volar skin, covering the volar vein, is less likely to be avulsed during injury and is also less likely to turn necrotic, than dorsal skin, after the replantation surgery. Primary repair of dorsal veins can be difficult due to tightness ensuing from arthrodesis of the underlying joint in flexion. In multiple finger replantations, repairing the volar veins after arterial repair and continuing to do so for each finger in the same way without changing the position of the hand and surgeon save time. In amputations with tissue loss, the size discrepancy is less for volar veins than for dorsal veins. We present the results of 366 finger replantations after volar vein repairs. PMID:23982066

  16. Architecture of the pulmonary veins: relevance to radiofrequency ablation

    PubMed Central

    Ho, S; Cabrera, J; Tran, V; Farre, J; Anderson, R; Sanchez-Quintana, D

    2001-01-01

    BACKGROUNDRadiofrequency ablation of tissues in pulmonary veins can eliminate paroxysmal atrial fibrillation.?OBJECTIVETo explore the characteristics of normal pulmonary veins so as to provide more information relevant to radiofrequency ablation.?METHODS20 structurally normal heart specimens were examined grossly. Histological sections were made from 65pulmonary veins.?RESULTSThe longest myocardial sleeves were found in the superior veins. The sleeves were thickest at the venoatrial junction in the left superior pulmonary veins. For the superior veins, the sleeves were thickest along the inferior walls and thinnest superiorly. The sleeves were composed mainly of circularly or spirally oriented bundles of myocytes with additional bundles that were longitudinally or obliquely oriented, sometimes forming mesh-like arrangements. Fibrotic changes estimated at between 5% and 70% across three transverse sections were seen in 17veins that were from individuals aged 30to 72years.?CONCLUSIONSThe myocardial architecture in normal pulmonary veins is highly variable. The complex arrangement, stretch, and increase in fibrosis may produce greater non-uniform anisotropic properties.???Keywords: arrhythmias; catheter ablation; fibrillation; cardiac veins PMID:11514476

  17. Supernumerary umbilical vein in a hydropic neonate with hypertrophic cardiomyopathy.

    PubMed

    Karatza, Ageliki; Tsamandas, Athanassios; Varvarigou, Anastasia; Davlouros, Periklis; Pavlou, Vassiliki; Mantagos, Stefanos

    2011-01-01

    The anomalies of the umbilical vessels are uncommon, with the exception of a single umbilical artery. We report a term female infant with fetal hydrops, hypertrophic cardiomyopathy, and a four-vessel umbilical cord consisting of two umbilical arteries and two umbilical veins. The presence of two veins in the umbilical cord has been attributed to persistence of both the normal left umbilical vein and the caudal part of the right umbilical vein. This fetal vascular pathology has been reported very rarely and may be associated with increased risk of congenital malformations and adverse perinatal outcome. PMID:21355676

  18. Absence of the superior petrosal veins and sinus: Surgical considerations

    PubMed Central

    Matsushima, Ken; Ribas, Eduardo Santamaria Carvalhal; Kiyosue, Hiro; Komune, Noritaka; Miki, Koichi; Rhoton, Albert L.

    2015-01-01

    Background: The superior petrosal vein, one of the most constant and largest drainage pathways in the posterior fossa, may result in complications if occluded. This study calls attention to a unique variant in which the superior petrosal veins and sinus were absent unilaterally, and the venous drainage was through the galenic and tentorial drainage groups. Methods: This study examines one venogram and another anatomic specimen in which the superior petrosal vein and sinus were absent. Results: The superior petrosal veins, described as 13 bridging veins, emptying into the superior petrosal sinus, are the major drainage pathways of the petrosal group of posterior fossa veins. In the cases presented, the superior petrosal vein and sinus were absent and venous drainage was through the galenic and tentorial groups, including the lateral mesencephalic or bridging vein on the tentorial cerebellar surface. Conclusions: In cases in which the superior petrosal sinus and veins are absent, care should be directed to preserving the collateral drainage through the galenic and tentorial tributaries. Although surgical strategies for intraoperative management and preservation of venous structures are still controversial, knowledge of the possible anatomical variations is considered to be essential to improve surgical outcomes. PMID:25745589

  19. 3D MR angiographic visualization and artery-vein separation

    NASA Astrophysics Data System (ADS)

    Lei, Tianhu; Udupa, Jayaram K.; Saha, Punam K.; Odhner, Dewey

    1999-05-01

    The common approach for artery-vein separation applies a presaturation pulse to obtain different image intensity representations in MRA data for arteries and veins. However, when arteries and veins do not run in opposite directions as in the brain, lungs, and heart, this approach fails. This paper presents an image processing approach devised for artery-vein separation. The anatomic separation utilizes fuzzy connected object delineation. The first step of this separation method is the segmentation of the entire vessel structure from the background via absolute connectedness by using scale-based affinity. The second step is to separate artery from vein via relative connectedness. After 'seed' points are specified inside artery and vein in the vessel- only image, the operation is performed in an iterative fashion. The small regions of the bigger aspects of artery and vein are separated in the initial iteration. Further regions are added with the subsequent iterations so that the small aspects of artery and vein are included in alter iterations. Shell rendering is used for 3D display. Combining the strengths of fuzzy connected object definition, object separation, and shell rendering, high- quality volume rendering of vascular information in MRA data has been achieved. MS-325 contrast-enhanced MRA were used to illustrate this approach. Several examples of 3D display of arteries and veins are included to show the considerable promise of this new approach.

  20. Suitability of Varicose Veins for Endovenous Treatments

    SciTech Connect

    Goode, S. D.; Kuhan, G.; Altaf, N.; Simpson, R.; Beech, A.; Richards, T.; MacSweeney, S. T.; Braithwaite, B. D.

    2009-09-15

    The aim of the study was to assess the suitability of radiofrequency ablation (RFA), endovenous laser ablation (EVLA), and foam sclerotherapy (FS) for patients with symptomatic varicose veins (VVs). The study comprised 403 consecutive patients with symptomatic VVs. Data on 577 legs from 403 consecutive patients with symptomatic VVs were collected for the year 2006. Median patient age was 55 years (interquartile range 45-66), and 62% patients were women. A set of criteria based on duplex ultrasonography was used to select patients for each procedure. Great saphenous vein (GSV) reflux was present in 77% (446 of 577) of legs. Overall, 328 (73%) of the legs were suitable for at least one of the endovenous options. Of the 114 legs with recurrent GSV reflux disease, 83 (73%) were suitable to receive endovenous therapy. Patients with increasing age were less likely to be suitable for endovenous therapy (P = 0.03). Seventy-three percent of patients with VVs caused by GSV incompetence are suitable for endovenous therapy.

  1. Mesocaval "H" graft using antogenous vein graft.

    PubMed Central

    Nay, H R; Fitzpatrick, H F

    1976-01-01

    A group of 22 patients with bleeding esophageal varices were treated by creating mesocaval "H" shunts using autogenous veins as the "H" graft. The right external iliac vein was selected as the graft because of its appropriate size in diameter and length, its strength and elasticity. Details in operative technique are outlined. The age of our patients ranged from 24 to 75 years (average age 49), 19 patients had preoperative endoscopy, 10 patients received intraarterial pitressin drip to control hemorrhage, and surgery was done within 10 days of admission in 18 patients. There were two postoperative deaths (both patients Childs Class C), and very few postoperative problems. Right leg edema was a temporary and minimal problem. Encephalopathy was a major problem in only three patients, all of whom had poor hepatic reserve preoperatively. There has been no recurrent variceal bleeding in any of these patients. Our previous experimental data in dogs indicated that the long term patency of these shunts could be assured. Images Fig. 1. Figs. 4 a to c. Figs. 4 a to c. Fig. 5. PMID:1082311

  2. Vein arterialization for lower limb revascularization.

    PubMed

    Houlind, Kim; Christensen, Johnny K; Jepsen, Jørn M

    2016-04-01

    Conventional bypass surgery is only possible when patent distal arterial outflow vessels are available. In patients with critical limb ischemia and occluded distal arteries, attempts have been made to establish retrograde perfusion through either deep or superficial pedal veins. Though historical results were disappointing, more recently limb salvage has been achieved after adopting a principle of 1) placing the anastomosis distally, and 2) actively destroying the distal valves. Experimental, para-clinical, and clinical data confirm that direct tissue nutrition is improved, angiogenesis stimulated, and collaterals opened. Only a limited number of cases have been reported in the literature and a number of different operative techniques have been described. The results in terms of limb salvage and wound healing vary widely. Generally, results are poorer than what would have been expected if femoro-distal arterial bypass had been possible. Recently, hybrid approaches have been developed to avoid extensive distal incisions by endovascular destruction of valves and closure of side branches. Also, a totally endovascular technique, including the position of a stent graft between the vein and artery, has been proposed and tested. These developments may in the future improve results by limiting incisional wound complications and make this treatment available to more patients who would otherwise have no other alternative than amputation. PMID:26683823

  3. The histopathology of varicose vein disease.

    PubMed

    Somers, Pamela; Knaapen, Michiel

    2006-01-01

    Varicosity is a complex venous pathology affecting the lower extremities. The exact etiology and physiopathology of varicose vein disease remain, however, unclear. Several theories exist from incompetence of the valves to a disturbance of the smooth muscle cells (SMC) and extra-cellular matrix (ECM) organization providing a weakness of the venous wall. Multiple studies have been performed to explain the underlying mechanisms of varicosity inducing alterations in the expression patterns of the endothelium, SMC, and ECM. In that respect, most attention has been focused on the alteration of the endothelium due to blood stasis and hypoxia inducing migration/proliferation of the medial SMC into the intima. Also, studies in the deformation of the ECM induced by alterations of the expression patterns of the metalloproteinases (MMP) and their inhibitors (TIMPs) have been put forward to explain the etiology of varicosity. However, less attention has been paid to the hormonal changes that occur during pregnancy and menopause, crucial factors to be involved in the etiology of varicosity. Since alteration of the estrogen receptor-b (ERb) expression could enhance directly the cellular volume of SMC and thus the disorganization of the contractile-elastic units, hypertrophy of SMC must be accounted a pivotal role that could induce the weakness of the venous wall. Altogether, this review summarizes an overview of the latest findings of varicosity with respect to the histopathological changes of the different cellular components of the varicose vein wall related to functional and morphologic alterations. PMID:17067976

  4. Neonatal vitelline vein aneurysm with thrombosis: prompt treatment should be needed.

    PubMed

    Kim, Soo-Hong; Yu, Hyeong Won; Kim, Hyun-Young; Jo, Heui Seung

    2015-12-01

    Vitelline veins are a pair of embryonic structures. The veins develop the portal vein system. Serious problems occur if the vitelline vein does not regress and becomes an aneurysm. Thrombus formation in the vitelline vein aneurysm could lead to portal vein thrombosis and portal hypertension unless promptly and correctly treated. Though vitelline vein aneurysm is an extremely rare anomaly, it rapidly progresses to portal vein thrombosis that requires prompt diagnosis and treatment. We reported a case of neonatal vitelline vein aneurysm and thrombosis that was cured by prompt operation. PMID:26665130

  5. A rare variation of the profunda femoris vein in the popliteal fossa.

    PubMed

    Jiji, P J; D'Costa, S; Prabhu, L V; Nayak, S R; Skariah, S

    2007-10-01

    The profunda femoris artery is normally accompanied by a profunda femoris vein (deep femoral vein), which begins at the adductor magnus with various tributaries and drains into the femoral vein at the femoral triangle. Very rarely, the profunda femoris vein establishes communication with the popliteal vein. We present an anomalous profunda femoris vein in a 62-year-old male cadaver whose vein was located in the popliteal fossa as a direct communicating channel between the popliteal vein and the femoral vein. PMID:17909683

  6. Neonatal vitelline vein aneurysm with thrombosis: prompt treatment should be needed

    PubMed Central

    Kim, Soo-Hong; Yu, Hyeong Won; Jo, Heui Seung

    2015-01-01

    Vitelline veins are a pair of embryonic structures. The veins develop the portal vein system. Serious problems occur if the vitelline vein does not regress and becomes an aneurysm. Thrombus formation in the vitelline vein aneurysm could lead to portal vein thrombosis and portal hypertension unless promptly and correctly treated. Though vitelline vein aneurysm is an extremely rare anomaly, it rapidly progresses to portal vein thrombosis that requires prompt diagnosis and treatment. We reported a case of neonatal vitelline vein aneurysm and thrombosis that was cured by prompt operation. PMID:26665130

  7. Variation of the Rex shunt for treating concurrent obstruction of the portal and superior mesenteric veins.

    PubMed

    Salzedas-Netto, Alcides Augusto; Duarte, Alexandre Alberto Barros; Linhares, Marcelo Moura; Mattar, Regina Helena; Medeiros, Karina Lcio; Cury, Edson Khodor; Filho, Gaspar de Jesus Lopes; Gonzalez, Adriano Miziara; Martins, Jos Luiz

    2011-10-01

    Children with extrahepatic portal vein obstruction can be managed successfully by surgical intervention and should be evaluated for potential meso-Rex bypass. A Rex shunt variation is described to treat portal and superior mesenteric vein thrombosis. This technique uses the internal jugular vein as a conduit between the splenic vein and the left portal vein with splenic preservation. PMID:22008343

  8. Identification of left pulmonary vein ostia using centerline tracking

    NASA Astrophysics Data System (ADS)

    Rettmann, M. E.; Holmes, D. R., III; Packer, D. L.; Robb, R. A.

    2009-02-01

    With the increasing popularity of cardiac ablation therapy, studies of the procedural effects on left atrial and pulmonary vein morphology are becoming more important. Of particular interest is evaluation of atrial and pulmonary vein remodeling following ablation therapy using structural imaging. One challenge that arises when comparing pulmonary vein morphology across subjects is defining the ostial location. Strategies for defining this important anatomical location include volume renderings from multiple angles, or drawing lines in cross-sectional images. Drawbacks of these techniques include subjectivity between raters as well as limited use of three dimensional volumetric information. In this work, we describe a method for automatically identifying the pulmonary vein ostia from CT images using a single user selected seedpoint. The technique makes use of the full three dimensional volumetric information, by computing a centerline along each pulmonary vein and defining the ostium using oblique cross-sectional image planes along the curve axis. The ostium is defined as the point at which there is a spike in the oblique cross-sectional area. The method is demonstrated on each of the four pulmonary veins in four patient datasets, for a total of sixteen applications of the algorithm. The results are compared against manual delineations of the pulmonary vein ostia, with overall mean distances ranging from approximately 1.5 to 5.0 mm. In conclusion, although the pulmonary veins exhibit variable anatomic shapes and orientations across different patient datasets, our proposed automated method produces results comparable to manual delineation of the ostia.

  9. Antenatal diagnosis of aneurysmal malformation of the vein of Galen.

    PubMed

    Darji, Parth J; Gandhi, Viplav S; Banker, Hiral; Chaudhari, Hemang

    2015-01-01

    Vein of Galen malformation (VGAM) results from an aneurysmal aberration with an arteriovenous shunting of blood. Vein of Galen aneurysmal malformations are the most frequent arteriovenous malformations in infants and fetuses. The congenital malformation develops during weeks 6-11 of fetal development. Infants often die from high-output congestive heart failure. PMID:26643190

  10. Looking after your health. 3. Avoiding varicose veins.

    PubMed

    Randall, Sara

    2015-02-01

    This article is to summarise key concepts for the health of the midwife with particular focus on standing for prolonged periods. One of the resultant factors relating to standing postures is the slow but avoidable progression of varicose veins. There is a strong genetic bias to these veins, which can be distressing, but here we will highlight awareness and current research. PMID:26333251

  11. Perivascular mast cells regulate vein graft neointimal formation and remodeling

    PubMed Central

    Grassia, Gianluca; Cambrook, Helen; Ialenti, Armando; MacRitchie, Neil; Carberry, Jaclyn; Lawrence, Catherine

    2015-01-01

    Objective. Emerging evidence suggests an important role for mast cells in vein graft failure. This study addressed the hypothesis that perivascular mast cells regulate in situ vascular inflammatory and proliferative responses and subsequent vein graft neointimal lesion formation, using an optimized local mast cell reconstitution method. Methods and Results. Neointimal hyperplasia was induced by insertion of a vein graft into the right carotid artery in wild type and mast cell deficient KitW?sh/W?sh mice. In some experiments, mast cells were reconstituted systemically (tail vein injection of bone marrow-derived mast cells) or locally (directly into the right neck area) prior to vein grafting. Vein graft neointimal lesion formation was significantly (P < 0.05) reduced in KitW?sh/W?sh mice. Mast cell deficiency reduced the number of proliferating cells, and inhibited L-selectin, CCL2, M-CSF and MIP-3? expression in the vein grafts. Local but not systemic mast cell reconstitution restored a perivascular mast cell population that subsequently promoted neointimal formation in mast cell deficient mice. Conclusion. Our data demonstrate that perivascular mast cells play a key role in promoting neointima formation by inducing local acute inflammatory and proliferative responses. These results suggest that ex vivo intraoperative targeting of mast cells may have therapeutic potential for the prevention of pathological vein graft remodeling. PMID:26312183

  12. Options for revascularization: artery versus vein: technical considerations.

    PubMed

    Shuck, John; Masden, Derek L

    2015-02-01

    Vascular grafts, as either interpositional conduits or bypass grafts, can be used for revascularization procedures in the upper extremity. Vein grafts are more readily available and can be easier to harvest. Arterial grafts may provide superior patency rates compared with vein grafts. Arterial grafts can be located and harvested with consistent and reliable anatomy throughout the body. PMID:25455359

  13. Blackberry Yellow Vein Disease is Caused by Multiple Virus Complexes

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Blackberry yellow vein disease, with symptoms of vein clearing, yellow mottling, ringspots and plant decline has been observed in blackberry in the southeastern United States since about 2000. At least six viruses have been identified by cloning and sequencing of double-stranded RNA from diseased p...

  14. Portal Vein Embolization: What Do We Know?

    SciTech Connect

    Denys, Alban; Prior, John; Bize, Pierre; Duran, Rafael; Baere, Thierry De; Halkic, Nermin; Demartines, Nicolas

    2012-10-15

    Portal vein embolization (PVE) has been developed to increase the size of the future remnant liver (FRL) left in place after major hepatectomy, thus reducing the risk of postoperative liver insufficiency. PVE consist in embolizing preoperatively portal branches of the segments that will be resected. Indication is based on preoperative measurements of the FRL by computed tomography and its ratio with either the theoretical liver volume or by direct measurement of the functional liver volume. After PVE, the volume and function of the FRL increases in 3 to 6 weeks, permitting extensive resections in patients otherwise contraindicated for liver resection. The PVE technique is variable from one center to another; however n-butyl-cyano-acrylate provides an interesting compromise between hypertrophy rate and procedure risk.

  15. [Effort thrombosis of the right subclavian vein].

    PubMed

    Tamar, Michael; Farah, Raymond

    2012-11-01

    This case report illustrates a primary upper extremity DVT of the right subclavian vein in an otherwise healthy young male. The pathogenesis of primary upper extremity DVT may be anatomical, such as thoracic outlet syndrome, vascular microtrauma e.g. effort thrombosis, or both. After examining the patient's clinical presentation and imaging results, a diagnosis of effort thrombosis, or "Paget-Schroetter syndrome" was made. Due to the clear insulting factor, the mild clinical presentation, and the fast response to anti-coagulant treatment, a conservative treatment was followed, which included anti-coagulation and close follow-up, as advised by the American College of Chest Physician's evidence-based clinical practice guidelines. PMID:23367728

  16. Internal Jugular Vein Thrombosis following Oropharyngeal Infection

    PubMed Central

    Bostanci, Asli; Turhan, Murat

    2015-01-01

    Internal jugular vein thrombosis (IJVT) is a rare condition which may lead to life-threatening complications such as sepsis and pulmonary embolism. Prolonged central venous catheterization, intravenous (IV) drug use, trauma, and radiotherapy are the most frequent causes of the IJVT. IJVT that develops after the oropharyngeal infection is a quite rare situation today. In this paper, a 37-year-old woman was presented; swelling occurred on her neck after acute tonsillitis and she was diagnosed with IJVT through Doppler ultrasonography and magnetic resonance imaging and managed without complications. Early diagnosis and conservative treatment with broad-spectrum IV antibiotics and anticoagulant agents have a critical importance for the prevention of fatal complications. PMID:26457221

  17. Deep vein thrombosis prophylaxis: friend or foe.

    PubMed

    Rahman, Siamak

    2009-01-01

    This article reviews certain aspects of venous thromboembolism, a major cause of morbidity and mortality among hospitalized patients. Deep vein thrombosis is a frequent complication of various surgical procedures. Knowing predisposing factors, including hereditary causes, and triggering risk factors will help us identify patients with high risk of venous thromboembolism. The prophylaxis recommendations by American College of Chest Physicians are made for groups of patients, for whom the benefits seem to outweigh the risks. However, those readers who want to adopt the American College of Chest Physicians' guidelines in their practices are urged to review in detail the pharmacology of the drugs used for thromboprophylaxis, relevant clinical studies, and case reports of spinal hematoma. Each patient might have different risks for thrombosis or bleeding and the potential for adverse consequences due to the prophylaxis. What is best for the group (the epidemiologic perspective) is not necessarily what is best for the individual patient (the clinical perspective). PMID:19092638

  18. Portal vein thrombosis in liver cirrhosis

    PubMed Central

    Kinjo, Nao; Kawanaka, Hirofumi; Akahoshi, Tomohiko; Matsumoto, Yoshihiro; Kamori, Masahiro; Nagao, Yoshihiro; Hashimoto, Naotaka; Uehara, Hideo; Tomikawa, Morimasa; Shirabe, Ken; Maehara, Yoshihiko

    2014-01-01

    Portal vein thrombosis (PVT) is considered to be a frequent complication of liver cirrhosis. However, unlike PVT in patients without cirrhosis, very few data are available on the natural history and management of PVT in cirrhosis, despite its association with potentially life-threatening conditions, such as gastroesophageal bleeding and acute intestinal ischemia. Moreover, no consensus regarding PVT in cirrhosis exists. Suggested causes of PVT in cirrhosis include reduced portal blood flow velocity, multiple congenital or acquired thrombophilic factors, inherited or acquired conditions, and derangement of liver architecture. However, the understanding of PVT in cirrhosis is incomplete. In addition, information on the management of PVT in cirrhosis is inadequate. The aims of this review are to: (1) assemble data on the physiopathological mechanism, clinical findings, diagnosis and management of PVT in cirrhosis; (2) describe the principal factors most frequently involved in PVT development; and (3) summarize the recent knowledge concerning diagnostic and therapeutic procedures. PMID:24575165

  19. Connexin43 Inhibition Prevents Human Vein Grafts Intimal Hyperplasia

    PubMed Central

    Longchamp, Alban; Allagnat, Florent; Alonso, Florian; Kuppler, Christopher; Dubuis, Céline; Ozaki, Charles-Keith; Mitchell, James R.; Berceli, Scott; Corpataux, Jean-Marc

    2015-01-01

    Venous bypass grafts often fail following arterial implantation due to excessive smooth muscle cells (VSMC) proliferation and consequent intimal hyperplasia (IH). Intercellular communication mediated by Connexins (Cx) regulates differentiation, growth and proliferation in various cell types. Microarray analysis of vein grafts in a model of bilateral rabbit jugular vein graft revealed Cx43 as an early upregulated gene. Additional experiments conducted using an ex-vivo human saphenous veins perfusion system (EVPS) confirmed that Cx43 was rapidly increased in human veins subjected ex-vivo to arterial hemodynamics. Cx43 knock-down by RNA interference, or adenoviral-mediated overexpression, respectively inhibited or stimulated the proliferation of primary human VSMC in vitro. Furthermore, Cx blockade with carbenoxolone or the specific Cx43 inhibitory peptide 43gap26 prevented the burst in myointimal proliferation and IH formation in human saphenous veins. Our data demonstrated that Cx43 controls proliferation and the formation of IH after arterial engraftment. PMID:26398895

  20. IVC agenesis: a rare cause of deep vein thrombosis.

    PubMed

    Man, Louise; Hendricks, Nicholas; Maitland, Hillary

    2016-04-01

    We present the case of a healthy, young Caucasian female who presented to an outside hospital with phlegmasia cerulea dolens of both lower extremities. Computed tomography angiography revealed inferior vena cava (IVC) occlusion. She was initiated on heparin infusion and transferred to University of Virginia Medical Center. Our evaluation revealed aplasia of the IVC from the infrahepatic segment to the confluence of the common iliac veins and acute bilateral iliac vein thromboses. An extensive network of collateral veins was noted. These findings were consistent with IVC agenesis. She was not pregnant or using contraception. Primary thrombophilia workup was negative. She underwent bilateral iliac vein thrombolysis and was started on anticoagulation. While IVC agenesis is rare, it carries risk for development of thrombotic sequelae and bears consideration when evaluating young patients with unexplained deep vein thrombosis, especially if extensive and bilateral. PMID:26507132

  1. Disastrous Portal Vein Embolization Turned into a Successful Intervention.

    PubMed

    Dobrocky, Tomas; Kettenbach, Joachim; Lopez-Benitez, Ruben; Kara, Levent

    2015-10-01

    Portal vein embolization (PVE) may be performed before hemihepatectomy to increase the volume of future liver remnant (FLR) and to reduce the risk of postoperative liver insufficiency. We report the case of a 71-year-old patient with hilar cholangiocarcinoma undergoing PVE with access from the right portal vein using a mixture of n-butyl-2-cyanoacrylate and ethiodized oil. During the procedure, nontarget embolization of the left portal vein occurred. An aspiration maneuver of the polymerized plug failed; however, the embolus obstructing portal venous flow in the FLR was successfully relocated into the right portal vein while carefully bypassing the plug with a balloon catheter, inflating the balloon, and pulling the plug into the main right portal vein. PMID:25212417

  2. Aging techniques for deep vein thrombosis: a systematic review.

    PubMed

    Dharmarajah, B; Sounderajah, V; Rowland, S P; Leen, E L S; Davies, A H

    2015-03-01

    Deep vein thrombosis is common with an incidence of 1 in 1000. Acute thrombus removal for extensive proximal deep vein thrombosis using catheter-directed techniques highlights the need for accurate assessment of thrombus age. This systematic review summarises experimental and clinical evidence of imaging techniques for aging deep vein thrombosis. Ultrasound elastography and magnetic resonance imaging were highlighted as the most studied imaging modalities. Elastography was shown to distinguish between acute and chronic clots, despite demonstrating difficulty in accurate aging of clots older than 10 days in rat models. Elastography is noted as a feasible adjunct to current first-line imaging for deep vein thrombosis using duplex ultrasonography. Combinations of magnetic resonance imaging techniques can identify acute, sub-acute and chronic thrombi using endogenous contrast agents and provide objective standardisation of the diagnostic process, with reduced onus upon operator dependency. Further validation is required of these novel imaging techniques prior to clinical implementation for deep vein thrombosis aging. PMID:24668998

  3. Design of a clinical vein contrast enhancing projector

    NASA Astrophysics Data System (ADS)

    Zeman, Herbert D.; Lovhoiden, Gunnar; Deshmukh, Harshal

    2001-06-01

    A clinical study has been initiated to compare an experimental IR device, the Vein Contrast Enhancer (VCE), with standard techniques for finding veins for venipuncture. The aims of this proposal are (1) to evaluate the performance of the VCE in a clinical setting, specifically by comparing its sensitivity of detection with existing vein-finding techniques used by experienced nurses or phlebotomists, (2) to study its usefulness in subjects who are obese, who have difficult venous access or thrombosed veins, or whose veins are not visible or difficult to palpate, and (3) to show that it performs as well on subjects with darkly pigmented skin as on subjects with lightly pigmented skin. The VCE will first be studied in adult subjects, and then in pediatric subjects.

  4. Combined portal vein resection for hilar cholangiocarcinoma

    PubMed Central

    Bai, Tao; Chen, Jie; Xie, Zhi-Bo; Ma, Liang; Liu, Jun-Jie; Zhu, Shao-Liang; Wu, Fei-Xiang; Li, Le-Qun

    2015-01-01

    Background: Surgery is the only curative therapy for patients with hilar cholangiocarcinoma (HCCA). Combined portal vein resection (PVR) could achieve negative resection margins in HCCA patients with portal vein invasion. This systematic review aimed to analysis the efficiency of combined PVR for HCCA. Methods: MEDLINE, EMBASE, the Cochrane Library, the Chinese National Knowledge Infrastructure database, and clinical trial registries were searched through April 2015. Risk ratios (RRs), and 95% confidence intervals (CIs) were calculated. Results: The analysis included 21 retrospective studies, altogether involving 2403 patients (patients with PVR, n=637; patients without PVR, n=1766). Patients with PVR were likely to have more advanced HCCA (lymphatic invasion: RR=1.14, 95% CI 1.02 to 1.28; perineural invasion: RR=1.31, 95% CI 1.05 to 1.63) and suffered less curative resections (RR=0.89, 95% CI 0.75 to 0.99). Postoperative morbidity was similar between patients with or without PVR (RR=1.06, 95% CI 0.94 to 1.02). Patients with PVR suffered higher mortality rate (RR=1.52, 95% CI 1.06 to 2.18), and worse 5-year survival rate (RR=0.67, 95% CI 0.49 to 0.91). Conclusion: Combined PVR for HCCA patients would not increase postoperative morbidity rate. However, ascribed to PVR group concluded more advanced HCCA patients; patients with PVR had increased postoperative mortality rate and worse survival rate. The results still need further high quality trails for validation.

  5. Development of HIFU Treatment for Lower Extremity Varicose Veins

    NASA Astrophysics Data System (ADS)

    Senoo, Naohiko; Ushijima, Hiroyuki; Suzuki, Jun; Yoshinaka, Kiyoshi; Deguchi, Juno; Takagi, Shu; Miyata, Tetsuro; Matsumoto, Yoichiro

    2011-09-01

    High-intensity focused ultrasound (HIFU) has recently been developed as a noninvasive therapeutic method. In our study, a novel noninvasive therapy with HIFU was proposed for occlusion of lower extremity varicose veins. The temperature increase caused by HIFU is used to occlude varicose veins. Occluded veins became fibrotic, resulting in complete recovery. Our final goal is the medical application of HIFU treatment for varicose veins. In this study, we attempted to occlude the veins of rabbits. Prior to venous occlusion experiments, the area heated by HIFU was investigated using bovine serum albumin (BSA) gel, which denatures at >70 C. The results indicate that the size of the heated area mainly depends on intensity at the focal point and the exposure time. A tendency was also seen for the heated area to extend toward the transducer with increasing exposure time. In animal experiments, skin burns during HIFU exposure represented a critical problem. We therefore examined the safe range of HIFU intensities in abdominal exposure experiments before conducting venous occlusion experiments. The ultrasound frequency was 1.7 MHz. Intensity at the focal point was 900 W/cm2, and the exposure time was 20 s. Rabbits underwent chemical depilation and echo gel was applied to the exposed skin to fill the boundary gap. Target veins were compressed during HIFU exposure to avoid thermal dissipation, and hyaluronan water solution was injected between the veins and skin to maintain the distance between the skin and veins at ?5 mm. Veins were then exposed to HIFU and occluded. The capability of HIFU treatment to occlude lower extremity varicose veins was verified by the present study.

  6. A Novel Device for True Lumen Re-Entry After Subintimal Recanalization of Superficial Femoral Arteries: First-in-Man Experience and Technical Description

    SciTech Connect

    Airoldi, Flavio Faglia, Ezio Losa, Sergio Tavano, Davide; Latib, Azeem; Mantero, Manuela Lanza, Gaetano Clerici, Giacomo

    2011-02-15

    Subintimal angioplasty (SAP) is frequently performed for the treatment of critical limb ischemia (CLI) and has been recognized as an effective technique for these patients. Nevertheless, this approach is limited by the lack of controlled re-entry into the true lumen of the target vessel. We describe a novel device for true lumen re-entry after subintimal recanalization of superficial femoral arteries (SFA). We report our experience with six patients treated between April 2009 and January 2010 with a novel system designed to facilitate true lumen re-entry. The device was advanced by ipsilateral antegrade approach through a 6-French sheath. Successful reaccess into the true lumen was obtained in five of six patients without complications. The patient in whom the reaccess to the true lumen was not possible underwent successful bypass surgery. At 30 days follow-up, the SFA was patent in all patients according to echo-Doppler examination. Our preliminary experience indicates that this novel re-entry device increases the success rate of percutaneous revascularization of chronically occluded SFA.

  7. Percutaneous closure of patent ductus arteriosus in interrupted inferior caval vein through femoral vein approach

    PubMed Central

    Tefera, Endale; Bermudez-Caete, Ramon

    2014-01-01

    Percutaneous closure of the patent arterial duct in patients with interrupted inferior caval vein poses a technical challenge. A 12-year-old girl with a patent ductus arteriosus (PDA) and interrupted inferior caval vein is described in this report. The diagnosis of interrupted inferior caval vein and azygos continuation was made in the catheterization laboratory. A catheter was advanced and snared in the descending aorta. An exchange wire was advanced through the catheter and snared in the descending aorta. Then, an Amplatzer TorqVue 2 delivery sheath was advanced over the wire from the venous side and again snared in the descending aorta. An Amplatzer duct occluder (ADO) size 8/6 was advanced through the sheath while still holding the sheath with a snare. The device was opened. The sheath was then unsnared once the aortic disc was completely out. The sheath and the device were pulled back into the duct and the device was successfully implanted. The device was then released and it attained a stable position. An aortic angiogram was performed which showed complete occlusion. PMID:24701089

  8. Percutaneous closure of patent ductus arteriosus in interrupted inferior caval vein through femoral vein approach.

    PubMed

    Tefera, Endale; Bermudez-Caete, Ramon

    2014-01-01

    Percutaneous closure of the patent arterial duct in patients with interrupted inferior caval vein poses a technical challenge. A 12-year-old girl with a patent ductus arteriosus (PDA) and interrupted inferior caval vein is described in this report. The diagnosis of interrupted inferior caval vein and azygos continuation was made in the catheterization laboratory. A catheter was advanced and snared in the descending aorta. An exchange wire was advanced through the catheter and snared in the descending aorta. Then, an Amplatzer TorqVue 2 delivery sheath was advanced over the wire from the venous side and again snared in the descending aorta. An Amplatzer duct occluder (ADO) size 8/6 was advanced through the sheath while still holding the sheath with a snare. The device was opened. The sheath was then unsnared once the aortic disc was completely out. The sheath and the device were pulled back into the duct and the device was successfully implanted. The device was then released and it attained a stable position. An aortic angiogram was performed which showed complete occlusion. PMID:24701089

  9. Leaf hydraulic conductance varies with vein anatomy across Arabidopsis thaliana wild-type and leaf vein mutants.

    PubMed

    Caringella, Marissa A; Bongers, Franca J; Sack, Lawren

    2015-12-01

    Leaf venation is diverse across plant species and has practical applications from paleobotany to modern agriculture. However, the impact of vein traits on plant performance has not yet been tested in a model system such as Arabidopsis thaliana. Previous studies analysed cotyledons of A.?thaliana vein mutants and identified visible differences in their vein systems from the wild type (WT). We measured leaf hydraulic conductance (Kleaf ), vein traits, and xylem and mesophyll anatomy for A.?thaliana?WT (Col-0) and four vein mutants (dot3-111 and dot3-134, and cvp1-3 and cvp2-1). Mutant true leaves did not possess the qualitative venation anomalies previously shown in the cotyledons, but varied quantitatively in vein traits and leaf anatomy across genotypes. The WT had significantly higher mean Kleaf . Across all genotypes, there was a strong correlation of Kleaf with traits related to hydraulic conductance across the bundle sheath, as influenced by the number and radial diameter of bundle sheath cells and vein length per area. These findings support the hypothesis that vein traits influence Kleaf , indicating the usefulness of this mutant system for testing theory that was primarily established comparatively across species, and supports a strong role for the bundle sheath in influencing Kleaf . PMID:26047314

  10. Ipomoviruses: Squash vein yellowing virus, Cucumber vein yellowing virus, Cassava brown streak virus, and Ugandan cassava brown streak virus

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Ipomoviruses including Squash vein yellowing virus, Cucumber vein yellowing virus and Cassava brown streak virus are currently causing significant economic impact on crop production in several regions of the world. Only recently have results of detailed characterization of their whitefly transmissi...

  11. [Leiomyosarcoma of the great veins: a case involving the left iliac vein extending to the inferior vena cava].

    PubMed

    Biasi, G; Gonano, N; Santarelli, R; Fregonese, V; Andolfato, G; Pfeiffer, P; Nozzon, L

    1993-01-01

    Large veins LMS is a rare slow growing malignant tumor originating from smooth muscle cells of the media. The authors report a case of LMS of the left common iliac vein propagating to the Inferior Vena Cava that presented with a left femoral-iliac deep thrombophlebitis. CT scan showed an uneven solid mass approximately 5 cm large within the left side of the pelvis. The mass displaced the left iliac artery and compressed the left iliac vein without a significant cleavage surface between the mass itself and the vascular structures. Location was next to the spine, medially and anteriorily to the psoas muscle. A thrombosis could be noticed within the distal segment of the inferior Vena Cava and within the proximal segment of the left iliac vein. US scan with fine needle biopsy of the mass didn't yield significant information. At surgical exploration a neoplastic mass involving and blocking the left iliac vein was found. Veinotomy performed on the iliac vein and on the distal segment of the Inferior Vena Cava but without infiltration of the vein walls. Surgical treatment consisted of asportation of the neoplastic mass, resection of the left iliac vein and thrombectomy of the Inferior Vena Cava. Histologic examination of the operated specimen revealed a mixoid LMS with vascular origin without involvement of the surrounding lymph nodes. Absence of clinical and radiological signs of relapse eight months after surgery makes further surgical and complementary (drug- and radiotherapy) treatments currently unnecessary. PMID:8248317

  12. Coil Protruding into the Common Femoral Vein Following Pelvic Venous Embolization

    SciTech Connect

    Marsh, Petra Holdstock, Judith M.; Bacon, Jennifer L.; Lopez, Anthony J.; Whiteley, Mark S.; Price, Barrie A.

    2008-03-15

    Pelvic venous embolization is performed for pelvic congestion syndrome and prior to lower limb varicose vein surgery in females with associated pelvic venous insufficiency. The procedure is analogous to varicocele embolization in males, although refluxing internal iliac vein tributaries may also be embolized. We report a case of inadvertent coil placement in the common femoral vein while embolizing the obturator vein, during pelvic vein embolization for recurrent lower limb varicose veins. There were no clinical consequences and the coil was left in situ. We advise caution when embolizing internal iliac vein tributaries where there is clinically significant communication with veins of the lower limb.

  13. Influence of vein fabric on strain distribution and fold kinematics

    NASA Astrophysics Data System (ADS)

    Torremans, Koen; Muchez, Philippe; Sintubin, Manuel

    2014-05-01

    Abundant pre-folding, bedding-parallel fibrous dolomite veins in shale are found associated with the Nkana-Mindola stratiform Cu-Co deposit in the Central African Copperbelt, Zambia. These monomineralic veins extend for several meters along strike, with a fibrous infill orthogonal to low-tortuosity vein walls. Growth morphologies vary from antitaxial with a pronounced median surface to asymmetric syntaxial, always with small but quantifiable growth competition. Subsequently, these veins were folded. In this study, we aim to constrain the kinematic fold mechanism by which strain is accommodated in these veins, estimate paleorheology at time of deformation and investigate the influence of vein fabric on deformation during folding. Finally, the influence of the deformation on known metallogenetic stages is assessed. Various deformation styles are observed, ultimately related to vein attitude across tight to close lower-order, hectometre-scale folds. In fold hinges, at low to average dips, veins are (poly-)harmonically to disharmonically folded as parasitic folds in single or multilayer systems. With increasing distance from the fold hinge, parasitic fold amplitude decreases and asymmetry increases. At high dips in the limbs, low-displacement duplication thrusts of veins at low angles to bedding are abundant. Slickenfibres and slickenlines are sub-perpendicular to fold hinges and shallow-dipping slickenfibre-step lineations are parallel to local fold hinge lines. A dip isogon analysis of reconstructed fold geometries prior to homogeneous shortening reveals type 1B parallel folds for the veins and type 1C for the matrix. Two main deformation mechanisms are identified in folded veins. Firstly, undulatory extinction, subgrains and fluid inclusions planes parallel the fibre long axis, with deformation intensity increasing away from the fold hinges, indicate intracrystalline strain accumulation. Secondly, intergranular deformation through bookshelf rotation of fibres, via collective parallel rotation of fibres and shearing along fibre grain boundaries, is clearly observed under cathodoluminescence. We analysed the internal strain distribution by quantifying simple shear strain caused by deflection of the initially orthogonal fibres relative to layer inclination at a given position across the fold. Shear angle, and thus shear strain, steadily increases towards the limbs away from the fold hinge. Comparison of observed shear strain to theoretical distribution for kinematic mechanisms, amongst other lines of evidence, clearly points to pure flexural flow followed by homogeneous shortening. As flexural flow is not the expected kinematic folding mechanism for competent layers in an incompetent shale matrix, our analysis shows that the internal vein fabric in these dolomite veins can exhibit a first-order influence on folding mechanisms. In addition, quantitative analysis shows that these veins acted as rigid objects with high viscosity contrast relative to the incompetent carbonaceous shale, rather than as semi-passive markers. Later folding-related syn-orogenic veins, intensely mineralised with Cu-Co sulphides, are strongly related to deformation of these pre-folding veins. The high viscosity contrast created by the pre-folding fibrous dolomite veins was therefore essential in creating transient permeability for subsequent mineralising stages in the veining history.

  14. A Novel Approach for the Treatment of Spider Veins

    PubMed Central

    Mujadzic, Mirsad; Ritter, Edmond F.; Given, Kenna S.

    2015-01-01

    Background Spider veins on the lower limbs are very common and have been reported to be present in 41% of women over 50. Sclerotherapy as a traditional treatment for spider veins has a low cost, though it may have adverse sequelae. Lasers have shown fewer but still substantial complications as well. Its lower efficacy relative to sclerotherapy has limited laser application for the treatment of spider veins. Objectives To present a new alternative in management of spider veins which involves a low voltage current delivered via an insulated micro needle with beveled tip. Methods Thirty female patients were treated with the Given Needle. The technique utilizes a micro needle with an insulated shaft with an exposed beveled tip, which is inserted into a hand piece connected to a mono-polar electrical generator. The needle is introduced through the skin into or on the spider vein. The current is then applied with obliteration of the vein. Results Twenty patients (66%) had more than a 70% resolution. The most common complication was skin erythema, which developed in 15 patients, followed by bruising in 13 patients. Both of these complications resolved in 2-3 weeks. Conclusions A novel approach for the treatment of spider veins has been described. The development of an insulated micro needle with an exposed beveled tip utilizing low current has minimized adjacent tissue damage and improved efficacy. The low cost, low level of complications, and comparable results offer a valuable alternative to sclerotherapy and laser treatment. Level of Evidence 4 Therapeutic PMID:26246022

  15. Palm Vein Verification Using Multiple Features and Locality Preserving Projections

    PubMed Central

    Bu, Wei; Wu, Xiangqian; Zhao, Qiushi

    2014-01-01

    Biometrics is defined as identifying people by their physiological characteristic, such as iris pattern, fingerprint, and face, or by some aspects of their behavior, such as voice, signature, and gesture. Considerable attention has been drawn on these issues during the last several decades. And many biometric systems for commercial applications have been successfully developed. Recently, the vein pattern biometric becomes increasingly attractive for its uniqueness, stability, and noninvasiveness. A vein pattern is the physical distribution structure of the blood vessels underneath a person's skin. The palm vein pattern is very ganglion and it shows a huge number of vessels. The attitude of the palm vein vessels stays in the same location for the whole life and its pattern is definitely unique. In our work, the matching filter method is proposed for the palm vein image enhancement. New palm vein features extraction methods, global feature extracted based on wavelet coefficients and locality preserving projections (WLPP), and local feature based on local binary pattern variance and locality preserving projections (LBPV_LPP) have been proposed. Finally, the nearest neighbour matching method has been proposed that verified the test palm vein images. The experimental result shows that the EER to the proposed method is 0.1378%. PMID:24693230

  16. Angiosperm leaf vein evolution was physiologically and environmentally transformative

    PubMed Central

    Boyce, C. Kevin; Brodribb, Tim J.; Feild, Taylor S.; Zwieniecki, Maciej A.

    2009-01-01

    The veins that irrigate leaves during photosynthesis are demonstrated to be strikingly more abundant in flowering plants than in any other vascular plant lineage. Angiosperm vein densities average 8?mm of vein per mm2 of leaf area and can reach 25?mm?mm?2, whereas such high densities are absent from all other plants, living or extinct. Leaves of non-angiosperms have consistently averaged close to 2?mm?mm?2 throughout 380 million years of evolution despite a complex history that has involved four or more independent origins of laminate leaves with many veins and dramatic changes in climate and atmospheric composition. We further demonstrate that the high leaf vein densities unique to the angiosperms enable unparalleled transpiration rates, extending previous work indicating a strong correlation between vein density and assimilation rates. Because vein density is directly measurable in fossils, these correlations provide new access to the physiology of extinct plants and how they may have impacted their environments. First, the high assimilation rates currently confined to the angiosperms among living plants are likely to have been unique throughout evolutionary history. Second, the transpiration-driven recycling of water that is important for bolstering precipitation in modern tropical rainforests might have been significantly less in a world before the angiosperms. PMID:19324775

  17. Femoral vein size in newborns and infants: preliminary investigation

    PubMed Central

    Akingbola, Olugbenga A; Nielsen, James; Hopkins, Robert L; Frieberg, Edwin M

    2000-01-01

    Background: The femoral vein is an important site for central venous access in newborns and infants. The objectives of this study are to determine whether age or weight can be used clinically to predict the size of the femoral vein in newborns and infants, and to compare the size of the vein in each individual in both the supine and reverse Trendelenburg positions. Results: Analysis was done in 24 euvolemic individuals, each studied in both the supine and reverse Trendelenburg positions. Twelve of these individuals were newborns and 12 were infants. We used two-factor analysis of variance to explore differences between groups and multiple linear regression analysis to estimate the strength of the relationship between variables. In the infant group, there was a correlation between femoral vein diameter and weight. There was no correlation between weight and vessel size in newborns. In both the newborn and infant groups, vessel diameter increased with subjects in the reverse Trendelenburg position (P < 0.01). Conclusion: Weight is predictive of femoral vein diameter in infants, but not in newborns. In infants, weight might serve as a more sensitive index for estimating size of the femoral vein in order to determine accurately the size of intravascular catheter appropriate for cannulation. The diameter of the femoral vein increases in the reverse Trendelenburg position compared with that in the supine position in both newborns and infants. A large prospective study is required to validate these findings. PMID:11056748

  18. Preoperative Portal Vein Embolization for Extended Hepatectomy

    PubMed Central

    Hemming, Alan W.; Reed, Alan I.; Howard, Richard J.; Fujita, Shiro; Hochwald, Steven N.; Caridi, James G.; Hawkins, Irvin F.; Vauthey, Jean-Nicolas

    2003-01-01

    Objective To examine the authors experience with preoperative ipsilateral portal vein embolization (PVE) and assess its role in extended hepatectomy. Summary Background Data Extended hepatectomy (five or more liver segments) has been associated with higher complication rates and increased postoperative liver dysfunction than have standard hepatic resections involving lesser volumes. Recently, PVE has been used in patients who have a predicted (postresection) future liver remnant (FLR) volume less than 25% of total liver volume in an attempt to increase the FLR and reduce complications. Methods Sixty patients from 1996 to 2002 were reviewed. Thirty-nine patients had PVE preoperatively. Eight patients who had PVE were not resected either due to the discovery of additional unresectable disease after embolization but before surgery (n = 5) or due to unresectable disease at surgery (n = 3). Therefore, 31 patients who had PVE subsequently underwent extended hepatic lobectomy. A comparable cohort of 21 patients who had an extended hepatectomy without PVE were selected on the basis of demographic, tumor, and liver volume characteristics. Patients had colorectal liver metastases (n = 30), hepatocellular carcinoma (n = 15), Klatskin tumors (n = 9), peripheral cholangiocarcinoma (n = 3), and other tumors (n = 3). The 52 resections performed included 42 extended right hepatectomies, 6 extended left hepatectomies, and 4 right hepatectomies extended to include the middle hepatic vein and the caudate lobe but preserving the majority of segment 4. Concomitant vascular reconstruction of either the inferior vena cava or hepatic veins was performed in five patients. Results There were no differences between PVE and non-PVE groups in terms of tumor number, tumor size, tumor type, surgical margin status, complexity of operation, or perioperative red cell transfusion requirements. The predicted FLR was similar between PVE and non-PVE groups at presentation. After PVE the FLR was higher than in the non-PVE group. No complications were observed after PVE before resection. There was no difference in postoperative mortality, with one death from liver failure in the non-PVE group and no operative mortality in the PVE group. Postoperative peak bilirubin was higher in the non-PVE than the PVE group, as were postoperative fresh-frozen plasma requirements. Liver failure (defined as the development of encephalopathy, ascites requiring sustained diuretics or paracentesis, or coagulopathy unresponsive to vitamin K requiring fresh-frozen plasma after the first 24 hours postresection) was higher in the non-PVE patients than the PVE patients. The hospital stay was longer in the non-PVE than the PVE group. Conclusions Preoperative PVE is a safe and effective method of increasing the remnant liver volume before extended hepatectomy. Increasing the remnant liver volume in patients with estimated postresection volumes of less than 25% appears to reduce postoperative liver dysfunction. PMID:12724635

  19. Ovarian Vein Thrombosis as a Complication of Laparoscopic Surgery

    PubMed Central

    Gupta, Anu; Gupta, Natasha; Blankstein, Josef; Trester, Richard

    2015-01-01

    Ovarian vein thrombosis (OVT) is an extremely rare but life-threatening complication of the postpartum period. It has never been reported as a complication of laparoscopic surgery. We report a case of right ovarian vein thrombosis that occurred in the postoperative period after patient underwent laparoscopic salpingectomy for a right side ectopic pregnancy. She presented with 1-week history of abdominal pain and fever. A complete workup for fever was performed and was found negative. Computed tomography of the abdomen and pelvis revealed right ovarian vein thrombosis. The patient was treated with anticoagulant therapy and responded well. PMID:26788386

  20. A phyllosilicate-sulfide vein in Kaidun. [Abstract only

    NASA Technical Reports Server (NTRS)

    Ivanov, A. V.; Zolensky, M. E.; Brandstatter, F.; Kurat, G.; Kononkova, N. N.

    1994-01-01

    A fragment of a carbonaceous chondrite (#53.12, maximal dimension about 2 mm) containing a phyllosilicate-sulfide vein was found during an inspection of small pieces of the Kaidun meteorite. Phyllosilicate veins are apparently rare in carbonaceous chondrites and have so far only been reported from the Y82162 CI chondrite. In hand sample the vein was visible on two perpendicular faces. The polished section prepared from one side displays a complex structure. A single vein, 150 microns in width, bifurcates, and each branch narrows toward a large rounded object (RO). The section contains abundant ROs, most of them less than or equal to 100 microns in diameter. The vein has sharp contacts to the surrounding matrix, whereas the RO contacts are diffuse. The phyllosilicate in the main vein has a massive texture along the contact, which becomes platy toward the vein center where the crystals protrude into an open space. The texture of the largest RO resembles that of a barred olivine (BO) chondrule. Some of the smaller ROs also texturally resemble chondrules. The BO chondrule contains rounded sulfide-silicate objects and small metal grains covered by oxides. Phyllosilicates of the main vein consist mainly of serpentine. The phyllosilicate near the contact with the matrix has low contents of minor elements and a high Mg/Fe ratio. The composition changes in a regular manner toward the center: Al, Na, Ca, Ni, and S increase, indicating increasing amounts of sulfates admixed. The phyllosilicate vein could only have formed after a substantial rock was formed. Mechanical stress probably opened a crack that was subsequently filled by phyllosilicate, pyrrhotite, and finally by a (Fe,Mg)-sulfate. The source of the matter mobilized to form the vein could have been within the rock itself or outside. No compositional or mineralogical zoning is apparent at the vein-rock contacts. The nature of the transporting agent (liquid H2O or vapor) must also remain an enigma. M. Zolensky has recently observed similar phyllosilicate-filled veins in dark, wet clasts in the Al Rais CR chondrite.

  1. Total Anomalous Pulmonary Venous Connection to the Portal Vein

    SciTech Connect

    Wyttenbach, Marina; Carrel, Thierry; Schuepbach, Peter; Tschaeppeler, Heinz; Triller, Juergen

    1996-03-15

    Anomalous pulmonary venous return represents a rare congenital anomaly with wide anatomic and physiologic variability. We report a case of a newborn with a rare form of total infracardiac anomalous pulmonary venous connection (TAPVC). The pulmonary veins draining both lungs formed two vertical veins, which joined to a common pulmonary trunk below the diaphragm. This venous channel connected to the portal vein through the esophageal hiatus. The diagnosis was suggested by color Doppler sonography and confirmed by intravenous digital subtraction angiography, which allowed definition of the anatomy.

  2. Unusual Presentation of Renal Vein Thrombosis in a Preterm Infant

    PubMed Central

    Yang, Chang-Yo; Fu, Ren-Huei; Lien, Reyin; Yang, Peng-Hong

    2014-01-01

    Neonatal renal vein thrombosis is the most common vascular condition in the newborn kidney, which could lead to serious complication in infants undergoing intensive care. In this study, we report the case of a preterm infant with left renal vein and inferior vena cava thrombosis, presented with gross hematuria, thrombocytopenia, transient hypertension, and adrenal hemorrhage. Supportive care was offered instead of heparin therapy or thrombolytic agents. In conclusion, our case teaches that, despite the lack of a clinically obvious shock event, renal vein thrombosis should be considered in a macrohematuric newborn without renal failure. PMID:26955561

  3. Endoscopic vein harvest of the lesser saphenous vein in the supine position: a unique approach to an old problem

    PubMed Central

    Brandt, C. Phillip; Greene, G. Clark; Maggart, Michael L.; Hall, William C.; Harville, Lacy E.; Pollard, Thomas R.; Stouffer, Chadwick W.

    2013-01-01

    OBJECTIVES To obtain a suitable conduit from the lesser (short) saphenous system for use in coronary artery bypass surgery. We wanted to perform this while the patient was in the supine position as to not disrupt the standard operation, and at the same time, utilizing the endoscopic vein harvest technique with its obvious abilities to decrease vein harvest morbidity. We also theorized that through endoscopic techniques instead of the open technique we could harvest greater lengths of conduit, thus providing quality vein segments for additional grafts if needed. METHODS We were able to perform endoscopic vein harvest while in the supine position with one unique centrally located incision that has not been previously described. RESULTS The lesser saphenous vein harvested in the described technique provided excellent conduit for our patients that were conduit poor. The endoscopic technique allowed increased length of harvested segments, by giving us the ability to travel under the gastrocnemius muscle with minimal morbidity as opposed to the open technique, where the traditional endpoint is the aforementioned muscle. Conduits were harvested successfully from 14 of 16 candidates. No wound infections or healing problems were experienced. Neurovascular integrity was maintained in all patients. CONCLUSIONS Endoscopic vein harvest of the lesser saphenous vein with the patient in the supine position is safe, effective and affords conduits for a unique subset of patients undergoing coronary artery bypass grafting. PMID:23049078

  4. Application of cryopreserved vein grafts as a conduit between the coronary vein and liver graft to reconstruct portal flow in adult living liver transplantation.

    PubMed

    Wu, Tsung-Han; Chou, Hong-Shiue; Pan, Kuang-Tse; Lee, Ching-Song; Wu, Ting-Jun; Chu, Sung-Yu; Chen, Miin-Fu; Lee, Wei-Chen

    2009-01-01

    Adult-to-adult living donor liver transplantation is an alternative to donation from a deceased individual, and can help relieve the shortage of liver donations available for adult patients in Asian countries. When transplant candidates have thrombosis and deterioration of the portal vein, living donor liver transplantation is relatively contraindicated because portal veins in the grafts are short and vein grafts may not be available to reconstruct the portal vein. From June 2003 to May 2007, 82 adult living donor liver transplantations were performed at Chang-Gung Memorial Hospital. Three patients had portal vein thrombosis and marked fibrosis of the portal vein and cryopreserved vein grafts were used to reconstruct portal flow from the engorged coronary vein to the graft portal vein. All vein grafts are patent and all patients have normal liver function at 21-36 months after transplantation. When cryopreserved vein grafts are available, adult living donor liver transplantation can be successfully performed in patients with marked deterioration of the portal vein. The short distance from the engorged coronary vein to the graft portal vein may decrease the incidence of re-thrombosis of the venous conduit. PMID:19659513

  5. Diagnosis of recurrent deep vein thrombosis.

    PubMed

    Schellong, S M

    2013-08-01

    Deep vein thrombosis is a chronic disease with a continuing risk of recurrence. In a patient with recurrence long term prognosis and treatment are significantly altered both carrying their own risks not only in the acute phase but mainly in the long term perspective. Thus, accurate diagnosis of recurrence is of utmost importance for the fate of the patient. Diagnosis of a first DVT episode is well established and follows an algorithm including clinical prediction rules, D-Dimer testing and compression ultrasound. Due to the previous episode the efficiency of all three elements is impaired in a patient with suspected recurrence. This opens up areas of uncertainty which have to be filled by individual clinical judgement. Guidelines reflect this difficulty by providing mainly weak recommendations based on sparse data. The present review summarizes what is known about the performance of tools for DVT diagnosis, discusses recent guidelines, and finally gives personally weighed recommendations how to deal with this peculiar diagnostic situation. In conclusion, it will turn out that the well accepted diagnostic algorithm for a first DVT may be applied as well if the lower efficiency is regarded. Compression ultrasound largely benefits from a baseline assessment at the end of the previous episode. The order of tests may be discussed according to local and regional attitudes. PMID:23817606

  6. Deep vein thrombosis prophylaxis in trauma patients.

    PubMed

    Toker, Serdar; Hak, David J; Morgan, Steven J

    2011-01-01

    Deep vein thrombosis (DVT) and pulmonary embolism (PE) are known collectively as venous thromboembolism (VTE). Venous thromboembolic events are common and potentially life-threatening complications following trauma with an incidence of 5 to 63%. DVT prophylaxis is essential in the management of trauma patients. Currently, the optimal VTE prophylaxis strategy for trauma patients is unknown. Traditionally, pelvic and lower extremity fractures, head injury, and prolonged immobilization have been considered risk factors for VTE; however it is unclear which combination of risk factors defines a high-risk group. Modalities available for trauma patient thromboprophylaxis are classified into pharmacologic anticoagulation, mechanical prophylaxis, and inferior vena cava (IVC) filters. The available pharmacologic agents include low-dose heparin (LDH), low molecular weight heparin (LMWH), and factor Xa inhibitors. Mechanical prophylaxis methods include graduated compression stockings (GCSs), pneumatic compression devices (PCDs), and A-V foot pumps. IVCs are traditionally used in high risk patients in whom pharmacological prophylaxis is contraindicated. Both EAST and ACCP guidelines recommend primary use of LMWHs in trauma patients; however there are still controversies regarding the definitive VTE prophylaxis in trauma patients. Large randomized prospective clinical studies would be required to provide level I evidence to define the optimal VTE prophylaxis in trauma patients. PMID:22084663

  7. Mars Opportunity rover finds gypsum veins

    NASA Astrophysics Data System (ADS)

    Showstack, Randy

    2011-12-01

    Bright linear features about the width of a human thumb that were found on Mars by NASA's Mars Exploration Rover Opportunity appear to be gypsum veins deposited by groundwater, a team of scientists announced at a 7 December news briefing at the AGU Fall Meeting in San Francisco, Calif. To me, this is the single most powerful piece of evidence for liquid water on Mars that has been discovered by the Opportunity rover, said Steve Squyres, a geoscientist at Cornell University in Ithaca, N. Y., and principal investigator for NASA Mars Exploration Rovers Opportunity and Spirit. We have found sulfates before. Those sulfates were formed somewhere; we don't know where. They have been moved around by the wind, they've been mixed with other materials. It's a big, jumbled, fascinating mess. This stuff was formed right here. There was a fracture in the rock, water flowed through it, gypsum was precipitated from the water. End of story. Okay, there is no ambiguity about this. This is what makes it so cool.

  8. Clinical Trials in Branch Retinal Vein Occlusion

    PubMed Central

    Panakanti, Tandava Krishnan; Chhablani, Jay

    2016-01-01

    Branch retinal vein occlusion (BRVO) is the second most common retinal vascular disorder. The management of macular edema has changed considerably over time. The laser is considered the gold standard treatment for over two decades. However, visual recovery with laser is usually slow and incomplete. The advent of intravitreal agents, specifically anti-vascular endothelial growth factors (VEGF) have heralded a new era which promises rapid recovery of vision and quality of vision. Randomized clinical trials have reported optimal results with anti-VEGF agents (ranibizumab, bevacizumab, and aflibercept) compared to laser therapy or steroids. However, nearly 50% of the patients require repeat intravitreal anti-VEGF therapy up to 4 years after initiating therapy to sustain the visual gains. The adverse events (systemic and ocular) of these agents are minimal. Monotherapy with anti-VEGF agents have been found to provide better results than any combination with laser. This review article summarizes evidence from randomized controlled trials evaluating treatment options for the treatment of macular edema secondary to BRVO with a special focus on anti-VEGF therapy. PMID:26957837

  9. [Recanalisation therapy of deep leg and pelvic vein thrombosis].

    PubMed

    Mumme, A; Hummel, T

    2015-05-01

    The conservative treatment of deep leg and pelvic vein thrombosis leads to permanent damage of recanalised veins, which in cases of long distance clots as well as involvement of the pelvic level, increase the risk of developing a postthrombotic syndrome. Such subsequent damage of the deep veins can only be avoided if occluded veins are rapidly recanalised and the function of the valves is successfully reestablished. Recanalisation may consist of surgical, fibrolytic and interventional methods and aims to minimize any subsequent damage; however no potential benefit of recanalisation versus standard treatment has yet been proven by means of methodologically adequate comparative studies. Thus, the indications for recanalisation must remain strict and be founded on a thorough risk-benefit assessment. PMID:25995092

  10. Personal authentication using hand vein triangulation and knuckle shape.

    PubMed

    Kumar, Ajay; Prathyusha, K Venkata

    2009-09-01

    This paper presents a new approach to authenticate individuals using triangulation of hand vein images and simultaneous extraction of knuckle shape information. The proposed method is fully automated and employs palm dorsal hand vein images acquired from the low-cost, near infrared, contactless imaging. The knuckle tips are used as key points for the image normalization and extraction of region of interest. The matching scores are generated in two parallel stages: (i) hierarchical matching score from the four topologies of triangulation in the binarized vein structures and (ii) from the geometrical features consisting of knuckle point perimeter distances in the acquired images. The weighted score level combination from these two matching scores are used to authenticate the individuals. The achieved experimental results from the proposed system using contactless palm dorsal-hand vein images are promising (equal error rate of 1.14%) and suggest more user friendly alternative for user identification. PMID:19447728

  11. Axillary vein thrombosis in adolescent onset systemic sclerosis.

    PubMed Central

    Leak, A; Patel, K J; Tuddenham, E G; Pearson, J D; Woo, P

    1990-01-01

    A 16 year old girl with a two year history of systemic sclerosis developed left axillary vein thrombosis. Prolonged euglobulin clot lysis time, anti-endothelial cell antibodies, and raised von Willebrand factor antigen were shown. Images PMID:2383084

  12. Portal Vein Thrombosis Following Laparoscopic Sleeve Gastrectomy for Morbid Obesity

    PubMed Central

    Rosenberg, Jacob M.; Tedesco, Maureen; Yao, Dorcas C.

    2012-01-01

    Introduction: Portal vein thrombosis has been documented after laparoscopic general surgery and has been uncommonly observed after laparoscopic bariatric surgery. Among bariatric operations, the sleeve gastrectomy is being performed with ever-increasing frequency. Here we report the case of a man who presented with portal vein thrombosis after laparoscopic sleeve gastrectomy. Case Description: A 41-y-old man underwent an uneventful laparoscopic sleeve gastrectomy for the treatment of morbid obesity, and presented on postoperative day 10 with nonfocal abdominal pain, nausea, vomiting, and leukocytosis. Computed tomography revealed portal vein thrombosis, which was found in the setting of Clostridium difficile colitis. Discussion: Portal vein thrombosis may be identified with increasing frequency as the number of laparoscopic bariatric operations continues to increase. A high index of suspicion is necessary to diagnose this rare, but potentially lethal, complication. PMID:23484577

  13. Squash vein yellowing virus affecting watermelon in Puerto Rico

    Technology Transfer Automated Retrieval System (TEKTRAN)

    In this study, we report the first detection of Squash vein yellowing virus (SqVYV)-induced watermelon vine decline outside of the continental U.S. This has implications for management of cucurbit virus diseases throughout the Caribbean....

  14. Why Do Some Pregnant Women Get Varicose Veins?

    MedlinePLUS

    ... found in the legs, genital area, and rectum ( hemorrhoids are just a type of varicose veins). Varicose ... Recovering From Delivery How Do You Treat Pregnancy Hemorrhoids and Constipation? Medical Care During Pregnancy 10 Things ...

  15. Duplication of the right internal jugular vein: A case report.

    PubMed

    Bathala, Srinivasalu; Makura, Zvoru G

    2015-06-01

    We present a case of duplication of the right internal jugular vein (IJV) in a patient who underwent neck dissection as part of the management of carcinoma of the larynx. The patient was a 63-year-old man who presented to the otolaryngology department with a 7-month history of hoarseness and a 3-week history of noisy breathing. Flexible endoscopy detected a transglottic tumor that had extended beyond the vocal folds. The patient underwent a total laryngectomy and bilateral selective neck dissection at levels II-VI. Intraoperatively, the right IJV was noted to be duplicated. The duplicate segment was approximately 10 cm in length, and it rejoined the normal vein before the normal vein joined the subclavian vein. PMID:26053982

  16. The role of statins in deep vein thrombosis.

    PubMed

    Leon, Maria-Magdalena; Cojocaru, Elena; Cobzaru, Roxana; Didii, Amalia; Mitu, F

    2012-01-01

    Deep vein thrombosis (DVT) represents the formation of a blood clot in one of the deep veins of our body, predominantly occurring in the legs. According to international guidelines, the goal of the treatment in deep vein thrombosis is to prevent the progression and the recurrences of thrombotic process. The aim of this article is to explain the pathogenetic mechanism of deep vein thrombosis and the benefits of statins in such a disease. The vasoprotective effects of statins are related to their anti-thrombotic and anti-inflammatory properties. The administration of statins is associated with a lower incidence of venous thromboembolism (VTE) in the general population. It also helps in reducing the frequency of recurrences, being prescribed after an optimal 6 to 12 month anticoagulation. The study of these properties creates new opportunities for the use of statins in the prevention of post-thrombotic syndrome and recurrent venous thromboembolism (VTE). PMID:23272535

  17. Posttransplant Complex Inferior Venacava Balloon Dilatation After Hepatic Vein Stenting

    SciTech Connect

    Kohli, Vikas; Wadhawan, Manav; Gupta, Subhash; Roy, Vipul

    2010-02-15

    Orthotopic and living related liver transplantation is an established mode of treatment of end-stage liver disease. One of the major causes of postoperative complications is vascular anastomotic stenosis. One such set of such complications relates to hepatic vein, inferior vena cava (IVC), or portal vein stenosis, with a reported incidence of 1-3%. The incidence of vascular complications is reported to be higher in living donor versus cadaveric liver transplants. We encountered a patient with hepatic venous outflow tract obstruction, where the hepatic vein had been previously stented, but the patient continued to have symptoms due to additional IVC obstruction. The patient required double-balloon dilatation of the IVC simultaneously from the internal jugular vein and IVC.

  18. Endovascular Treatment of a Portal Vein Tear During TIPSS

    SciTech Connect

    Owen, Richard J.T.; Rose, John D.G.

    2000-03-15

    During a transjugular portosystemic stent-shunt (TIPSS) procedure a portal vein laceration occurred with subsequent intraperitoneal hemorrhage. A PTFE-covered nitinol stent was successfully placed eliminating the leak and creating a functioning portosystemic shunt. This case demonstrates both the importance of portal vein puncture more than 1 cm from the bifurcation and the necessity of maintaining a stock of available stent-grafts.

  19. The persistent embryonic vein in Klippel-Trenaunay syndrome.

    PubMed

    Oduber, Charlène E U; Young-Afat, Danny A; van der Wal, Allard C; van Steensel, Maurice A M; Hennekam, Raoul C M; van der Horst, Chantal M A M

    2013-08-01

    Klippel-Trenaunay syndrome (KTS) is a congenital malformation syndrome with prominent vascular anomalies. A persistent embryonic vein (PEV) may be located on the affected leg(s) of patients with KTS. Our understanding of PEVs of the legs is limited and their nomenclature is confusing. The objective of this study was to obtain further insight in the prevalence, nomenclature and etiology of PEVs of the legs in KTS and to propose a standardized description of anomalous leg veins in KTS. We investigated 70 KTS patients for the presence of PEVs (lateral marginal vein, LMV) of the legs by duplex ultrasonography. We performed histopathological analysis of a surgically excised PEV (LMV) of a typical KTS patient, and we conducted an extensive literature study. Duplex ultrasonography showed LMVs in 12/70 (17.1%) patients. The terms used to describe PEVs in the leg are quite variable, while indicating only two types: lateral marginal vein (LMV) and persistent sciatic vein (PSV). The histology of the excised LMV showed remarkable similarity with that of varicose veins found in the general population. In conclusion, the prevalence of LMVs in our KTS cohort is 17.1%. Two PEVs can be found in the legs and we propose nomenclature based on anatomical criteria, thereby using only the terms persistent lateral marginal vein and persistent sciatic vein, combined with the patency of the deep venous system. We hypothesize that PEVs are most likely caused by a genetic defect leading to abnormal venous pattern formation, which is further supported by our histopathological findings. PMID:23966121

  20. SUBCLAVIAN VEIN THROMBOSIS FOLLOWING FRACTURE OF THE CLAVICLE: CASE REPORT

    PubMed Central

    Terra, Bernardo Barcellos; Cocco, Luiz Fernando; Ejnisman, Benno; Fernandes, Hélio Jorge Alvachian; dos Reis, Fernando Baldy

    2015-01-01

    Deep vein thrombosis in the upper limbs is uncommon in the orthopedic literature. We report on a case of subclavian vein thrombosis that occurred during conservative treatment of a fracture in the middle third of the clavicle. This is difficult to diagnose and requires a high degree of suspicion. Treating it may prevent fatal thromboembolism. In some rare cases, it has been described in association with fractures of the clavicle.

  1. Robust Finger Vein ROI Localization Based on Flexible Segmentation

    PubMed Central

    Lu, Yu; Xie, Shan Juan; Yoon, Sook; Yang, Jucheng; Park, Dong Sun

    2013-01-01

    Finger veins have been proved to be an effective biometric for personal identification in the recent years. However, finger vein images are easily affected by influences such as image translation, orientation, scale, scattering, finger structure, complicated background, uneven illumination, and collection posture. All these factors may contribute to inaccurate region of interest (ROI) definition, and so degrade the performance of finger vein identification system. To improve this problem, in this paper, we propose a finger vein ROI localization method that has high effectiveness and robustness against the above factors. The proposed method consists of a set of steps to localize ROIs accurately, namely segmentation, orientation correction, and ROI detection. Accurate finger region segmentation and correct calculated orientation can support each other to produce higher accuracy in localizing ROIs. Extensive experiments have been performed on the finger vein image database, MMCBNU_6000, to verify the robustness of the proposed method. The proposed method shows the segmentation accuracy of 100%. Furthermore, the average processing time of the proposed method is 22 ms for an acquired image, which satisfies the criterion of a real-time finger vein identification system. PMID:24284769

  2. Intimal changes in varicose veins: an ultrastructural study.

    PubMed

    Wali, Mahmoud A; Eid, Refaat A

    2002-06-01

    In order to study the structural changes in the intimal layer of varicose veins, we prospectively collected a total of 23 vein specimens from both the normal proximal thigh long saphenous (LSV) in 3 young trauma patients and from the unstripped proximal LSV near the sapheno-femoral junction and the distal calf blowouts in 10 primary varicose veins patients. Paraffin sections stained with hematoxylin and eosin were examined under the light microscope while ultra-thin sections were examined under the transmission electron microscope (TEM). Compared with the normal control LSV, varicose vein sections showed increase in the diameter of the lumen, hypertrophy of the wall and elongation and invagination of the intima. Along these invaginations, endothelial cells were compressed, elongated and thinned out. The cells also showed progressive degeneration and were finally lost into the lumen, leaving only the basal lamina to form the luminal surface. This invited blood components like platelets and red blood cells to stick to the bare intima and to penetrate through the wall. This may form the basis of the clinical condition of superficial thrombophlebitis, which sometimes complicates cases of varicose veins. In conclusion, varicose veins showed increased diameter of the lumen and hypertrophy, elongation and invagination of the intima. There was marked degeneration of the endothelial cells and desquamation of the endothelial layer. PMID:12596886

  3. Thrombosis of the portal vein in eleven dogs.

    PubMed

    Van Winkle, T J; Bruce, E

    1993-01-01

    Case records from the small animal necropsy service of the University of Pennsylvania (Philadelphia, PA) from January 1981 through August 1990 were searched for reports of animals with grossly visible portal vein thrombi. Eleven dogs identified from their case materials as having portal vein thrombosis were used for this study. The age of the dogs ranged from 2 to 13 years, and there were five spayed females and six males--four intact and two castrated. Seven breeds were represented (Lhasa Apso, German Wire haired Pointer, Shetland Sheepdog, Dalmatian, Irish Wolfhound, Old English Sheepdog, and Siberian Husky), and the remaining four cases were identified as mixed breeds. The weight of the dogs ranged from 7.7 to 50 kg, and most of them were considered overweight. Dogs with microthrombi and tumor emboli in the portal vein were excluded. No age, sex, or breed predisposition was found. Thrombi were also detected in the pulmonary arteries in five of the dogs and both the pulmonary arteries and aorta in one dog. The portal thrombi extended into the mesenteric veins in three dogs, resulting in infarction of the jejunum. One of these dogs and two other dogs had chronic occlusion of the portal vein, with the formation of secondary portosystemic shunts. Conditions also present in dogs with portal vein thrombi included pancreatic necrosis (four dogs), peritonitis (two dogs), distant neoplasia (three dogs), and therapy with steroids (ten dogs). PMID:8442325

  4. Towards measurement of outcome for patients with varicose veins.

    PubMed Central

    Garratt, A M; Macdonald, L M; Ruta, D A; Russell, I T; Buckingham, J K; Krukowski, Z H

    1993-01-01

    OBJECTIVE--To develop a valid and reliable outcome measure for patients with varicose veins. DESIGN--Postal questionnaire survey of patients with varicose veins. SETTING--Surgical outpatient departments and training general practices in Grampian region. SUBJECTS--373 patients, 287 of whom had just been referred to hospital for their varicose veins and 86 who had just consulted a general practitioner for this condition and, for comparison, a random sample of 900 members of the general population. MAIN MEASURES--Content validity, internal consistency, and criterion validity. RESULTS--281(76%) patients (mean age 45.8; 76% female) and 542(60%) of the general population (mean age 47.9; 54% female) responded. The questionnaire had good internal consistency as measured by item-total correlations. Factor analysis identified four important health factors: pain and dysfunction, cosmetic appearance, extent of varicosity and complications. The validity of the questionnaire was demonstrated by a high correlation with the SF-36 health profile, which is a general measure of patients' health. The perceived health of patients with varicose veins, as measured by the SF-36, was significantly lower than that of the sample of the general population adjusted for age and a lower proportion of women. CONCLUSION--A clinically derived questionnaire can provide a valid and reliable tool to assess the perceived health of patients with varicose veins. IMPLICATIONS--The questionnaire may be used to justify surgical treatment of varicose veins. PMID:10132081

  5. Flow Reversal Promotes Intimal Thickening in Vein Grafts

    PubMed Central

    He, Yong; Fernandez, Chessy M.; Jiang, Zhihua; Tao, Ming; OMalley, Kerri A.; Berceli, Scott A.

    2014-01-01

    Objective Following vascular interventions, unidentified mechanisms disrupt the homeostasis of a focal narrowing to initiate an intimal thickening response. We hypothesize that perturbations in the hemodynamic microenvironment are the initiating event for this disruption of homeostasis and intimal thickening in vein bypass grafts. The objective of this study was to investigate the relation between local flow perturbations and its influence on the vein graft architecture. Methods An external ligature was used to create an 80% focal mid-graft stenosis in bilateral rabbit carotid vein grafts. A unilateral distal ligation created a 9-fold flow rate difference between high and low flow grafts. Vein grafts (n=10) were harvested at 28 days and serially sectioned for morphologic evaluation and vein graft reconstruction. Computational fluid dynamics analyses were performed to examine the hemodynamic environment within these complex flow regions. Results The largest intimal thickening occurred exclusively within the region immediately distal to the maximum stenosis in high flow grafts, which was characterized by persistent flow separation and reversal for the entire cardiac cycle. In low to moderate shear stress regions, less than 5 Pa, the typical inverse correlation between intimal thickness and wall shear was observed. Conclusions Regions of vein bypass grafts exposed to persistent flow reversal are most at risk for intimal thickening and loss of lumen. PMID:24342069

  6. Vein graft adaptation and fistula maturation in the arterial environment

    PubMed Central

    Lu, Daniel Y; Chen, Elizabeth Y; Wong, Daniel J; Yamamoto, Kota; Protack, Clinton D; Williams, Willis T; Assi, Roland; Hall, Michael R; Sadaghianloo, Nirvana; Dardik, Alan

    2014-01-01

    Veins are exposed to the arterial environment during two common surgical procedures, creation of vein grafts and arteriovenous fistulae (AVF). In both cases veins adapt to the arterial environment that is characterized by different hemodynamic conditions and increased oxygen tension compared to the venous environment. Successful venous adaptation to the arterial environment is critical for long term success of the vein graft or AVF, and in both cases is generally characterized by venous dilation and wall thickening. However, AVF are exposed to a high flow, high shear stress, low pressure arterial environment, and adapt mainly via outward dilation with less intimal thickening. Vein grafts are exposed to a moderate flow, moderate shear stress, high pressure arterial environment, and adapt mainly via increased wall thickening with less outward dilation. We review the data that describe these differences, as well as the underlying molecular mechanisms that mediate these processes. Despite extensive research, there are few differences in the molecular pathways that regulate cell proliferation and migration or matrix synthesis, secretion, or degradation currently identified between vein graft adaptation and AVF maturation that account for the different types of venous adaptation to arterial environments. PMID:24582063

  7. Hemorrhoids and varicose veins: a review of treatment options.

    PubMed

    MacKay, D

    2001-04-01

    Hemorrhoids and varicose veins are common conditions seen by general practitioners. Both conditions have several treatment modalities for the physician to choose from. Varicose veins are treated with mechanical compression stockings. There are several over-the-counter topical agents available for hemorrhoids. Conservative therapies for both conditions include diet, lifestyle changes, and hydrotherapy which require a high degree of patient compliance to be effective. When conservative hemorrhoid therapy is ineffective, many physicians may choose other non-surgical modalities: injection sclerotherapy, cryotherapy, manual dilation of the anus, infrared photocoagulation, bipolar diathermy, direct current electrocoagulation, or rubber band ligation. Injection sclerotherapy is the non-surgical treatment for primary varicose veins. Non-surgical modalities require physicians to be specially trained, own specialized equipment, and assume associated risks. If a non-surgical approach fails, the patient is often referred to a surgeon. The costly and uncomfortable nature of treatment options often lead a patient to postpone evaluation until aggressive intervention is necessary. Oral dietary supplementation is an attractive addition to the traditional treatment of hemorrhoids and varicose veins. The loss of vascular integrity is associated with the pathogenesis of both hemorrhoids and varicose veins. Several botanical extracts have been shown to improve microcirculation, capillary flow, and vascular tone, and to strengthen the connective tissue of the perivascular amorphous substrate. Oral supplementation with Aesculus hippocastanum, Ruscus aculeatus, Centella asiatica, Hamamelis virginiana, and bioflavonoids may prevent time-consuming, painful, and expensive complications of varicose veins and hemorrhoids. PMID:11302778

  8. phenoVein—A Tool for Leaf Vein Segmentation and Analysis1[OPEN

    PubMed Central

    Pflugfelder, Daniel; Huber, Gregor; Scharr, Hanno; Hülskamp, Martin; Koornneef, Maarten; Jahnke, Siegfried

    2015-01-01

    Precise measurements of leaf vein traits are an important aspect of plant phenotyping for ecological and genetic research. Here, we present a powerful and user-friendly image analysis tool named phenoVein. It is dedicated to automated segmenting and analyzing of leaf veins in images acquired with different imaging modalities (microscope, macrophotography, etc.), including options for comfortable manual correction. Advanced image filtering emphasizes veins from the background and compensates for local brightness inhomogeneities. The most important traits being calculated are total vein length, vein density, piecewise vein lengths and widths, areole area, and skeleton graph statistics, like the number of branching or ending points. For the determination of vein widths, a model-based vein edge estimation approach has been implemented. Validation was performed for the measurement of vein length, vein width, and vein density of Arabidopsis (Arabidopsis thaliana), proving the reliability of phenoVein. We demonstrate the power of phenoVein on a set of previously described vein structure mutants of Arabidopsis (hemivenata, ondulata3, and asymmetric leaves2-101) compared with wild-type accessions Columbia-0 and Landsberg erecta-0. phenoVein is freely available as open-source software. PMID:26468519

  9. Emergency department investigation of deep vein thrombosis

    PubMed Central

    Kilroy, D; Ireland, S; Reid, P; Goodacre, S; Morris, F

    2003-01-01

    Objectives: To apply a previously validated clinical model for predicting pre-test probability of deep vein thrombosis (DVT) to patients attending an emergency department with symptoms suggestive of DVT and assess its reproducibility in the patient population. To measure the diagnostic value of the SimpliRED D-dimer assay in effectively excluding DVT. Method: Prospective study between March 1999 and October 2000 of adult patients attending with suspected DVT. Patients were assessed using Wells' clinical prediction tool and risk stratified. SimpliRED D-dimer estimations were then performed and compression ultrasonography arranged. The pre-test probabilities of DVT in the low, moderate, and high risk groups of Wells' original cohort were compared with the authors' figures and the sensitivity, specificity, and predictive values of the SimpliRED assay calculated for the patient population. Results: Application of Wells' criteria to patients in the department permitted stratification into high, moderate, and low risk groups (prevalence of DVT 58.3%, 8.9%, and 1.5% respectively). SimpliRED D-dimer assay sensitivity was 63.4% with specificity of 74.8%, with a likelihood ratio of 2.52 for a positive test and 0.49 for a negative test. Conclusions: Clinical risk stratification allowed patients to be categorised into high, moderate, and low risk groups, albeit with less discriminatory power than originally described by Wells. The low sensitivity of the SimpliRED D-dimer assay when used routinely in a busy emergency department raises substantial doubt over the use of this test to rule out DVT, even in low risk patients. PMID:12533363

  10. Retinal Vein Occlusion in Benin City, Nigeria

    PubMed Central

    Uhumwangho, Odarosa M; Oronsaye, Darlingtess

    2016-01-01

    Background: Retinal vein occlusion (RVO) is the most common occlusive retinal vascular disorder and results in varying degrees of visual loss. Aim: To determine the pattern of presentation, risk factors, and treatment outcomes in a group of patients with RVO seen in a tertiary hospital in Nigeria. Materials and Methods: Medical records of patients who presented to the University of Benin Teaching Hospital, Benin City, Nigeria in whom a diagnosis of RVO was made over a 5 years period were reviewed. Data obtained were analyzed with the GraphPad Instat Software, Inc. version V2.05a program, San Diego, Califonia and a P < 0.05 considered significant. Results: There were 20 patients made of 14 (70.0%) males and 6 (30.0%) females with a mean age of 62.7 ± 10.4 years. There were 15 (68.2%) eyes with central RVO, 3 (13.6%) eyes with branch RVO, and 4 (18.2%) eyes with hemi RVO. Bilateral involvement occurred in 2 (10.0%) patients. Risk factors included hypertension 14 (70.0%), diabetes mellitus 9 (45.0%), and glaucoma 5 (22.7%). Multiple risk factors were present in 14 (70.0%) patients. Complications included macula edema 15 (68.2%), retinal neovascularization 5 (22.7%), neovascular glaucoma 3 (13.6%), and vitreous hemorrhage 2 (9.1%). Eyes which had definitive treatment with intravitreal antivascular endothelial growth factors and laser photocoagulation for macula edema and retinal neovascularization, respectively, had better visual acuity compared to eyes which did not receive these treatment, P = 0.002. Conclusion: The incidence and visual loss that occurs from RVO can be reduced by modifying known risk factors and early institution of appropriate therapy for complications that occur. PMID:27013853

  11. [Portal vein stenting as a bridge to chemotherapy for perihilar cancer with portal vein stenosis - a case report].

    PubMed

    Tsukamoto, Tadashi; Kanazawa, Akishige; Shimizu, Sadatoshi; Sakae, Masayuki; Kurihara, Shigeaki; Tashima, Tetsuzo; Deguchi, Sota; Goto, Wataru; Kotsuka, Masaya; Ishikawa, Akira; Yoshii, Mami; Nakajima, Takayoshi; Mori, Yukihiro; Ohira, Go; Tachimori, Akiko; Tamamori, Yutaka; Yamamoto, Atsushi; Inoue, Toru; Yamashita, Yoshito; Nishiguchi, Yukio

    2014-11-01

    The stenting strategy for portal vein stenosis in cases with unresectable hilar malignancies reduces portal hypertension and maintains portal vein blood flow. This not only improves quality of life, but also leads to aggressive therapy with anticancer agents. A 65-year-old woman presented with painless jaundice 8 months after left hemihepatectomy with lymph node dissection for intrahepatic cholangiocellular carcinoma. Seven months after biliary stenting for bile duct stenosis, progressing pancytopenia and ascites were noted. Imaging studies revealed portal vein stenosis by the tumor at the hepatic hilum. Percutaneous transhepatic portal vein stent placement was performed, and pancytopenia and ascites improved immediately thereafter. Chemotherapy for recurrence of intrahepatic cholangiocellular carcinoma at the hepatic hilum has been initiated, and the patient has been alive 15 months since. PMID:25731245

  12. Measurement of Vein Diameter for Peripherally Inserted Central Catheter (PICC) Insertion: An Observational Study.

    PubMed

    Sharp, Rebecca; Cummings, Melita; Childs, Jessie; Fielder, Andrea; Mikocka-Walus, Antonina; Grech, Carol; Esterman, Adrian

    2015-01-01

    Choosing an appropriately sized vein reduces the risk of venous thromboembolism associated with peripherally inserted central catheters. This observational study described the diameters of the brachial, basilic, and cephalic veins and determined the effect of patient factors on vein size. Ultrasound was used to measure the veins of 176 participants. Vein diameter was similar in both arms regardless of hand dominance and side. Patient factors-including greater age, height, and weight, as well as male gender-were associated with increased vein diameter. The basilic vein tended to have the largest diameter statistically. However, this was the case in only 55% of patients. PMID:26339941

  13. Transradial Approach for Transcatheter Selective Superior Mesenteric Artery Urokinase Infusion Therapy in Patients with Acute Extensive Portal and Superior Mesenteric Vein Thrombosis

    SciTech Connect

    Wang Maoqiang Guo Liping; Lin Hanying; Liu Fengyong; Duan Feng; Wang Zhijun

    2010-02-15

    The purpose of this investigation was to assess the feasibility and effectiveness of transradial approach for transcatheter superior mesenteric artery (SMA) urokinase infusion therapy in patients with acute extensive portal and superior mesenteric venous thrombosis. During a period of 7 years, 16 patients with acute extensive thrombosis of the portal (PV) and superior mesenteric veins (SMV) were treated by transcatheter selective SMA urokinase infusion therapy by way of the radial artery. The mean age of the patients was 39.5 years. Through the radial sheath, a 5F Cobra catheter was inserted into the SMA, and continuous infusion of urokinase was performed for 5-11 days (7.1 {+-} 2.5 days). Adequate anticoagulation was given during treatment, throughout hospitalization, and after discharge. Technical success was achieved in all 16 patients. Substantial clinical improvement was seen in these 16 patients after the procedure. Minor complications at the radial puncture site were observed in 5 patients, but trans-SMA infusion therapy was not interrupted. Follow-up computed tomography scan before discharge demonstrated nearly complete disappearance of PV-SMV thrombosis in 9 patients and partial recanalization of PV-SMV thrombosis in 7 patients. The 16 patients were discharged 9-19 days (12 {+-} 6.0 days) after admission. Mean duration of follow-up after hospital discharge was 44 {+-} 18.5 months, and no recurrent episodes of PV-SMV thrombosis developed during that time period. Transradial approach for transcatheter selective SMA urokinase infusion therapy in addition to anticoagulation is a safe and effective therapy for the management of patients with acute extensive PV-SMV thrombosis.

  14. Dual Balloon-Occluded Retrograde Transvenous Obliteration of Gastric Varix Draining into the Left Adrenal Vein and Left Inferior Phrenic Vein

    SciTech Connect

    Nishida, Norifumi Ninoi, Teruhisa; Kitayama, Toshiaki; Yamamoto, Akira; Sakai, Yukimasa; Sato, Kimihiko; Hamuro, Masao; Nakamura, Kenji; Inoue, Yuichi; Yamada, Ryusaku

    2004-09-15

    A 66-year-old woman with a gastric varix, draining into a dilated left adrenal vein and a left inferior phrenic vein, was treated with dual balloon-occluded retrograde transvenous obliteration (B-RTO). Under balloon occlusion of the left adrenal vein and the left inferior phrenic vein, retrograde injection of a sclerosant (5% ethanolamine oleate) into the gastric varix was performed. Two weeks later, disappearance of flow in the gastric varix was confirmed on endoscopic ultrasound examination.

  15. Huebnerite veins near Round Mountain, Nye County, Nevada

    SciTech Connect

    Shawe, D.R.; Foord, E.E.; Conklin, N.M.

    1984-01-01

    Small huebnerite-bearing quartz veins occur in and near Cretaceous (about 95 m.y. old) granite east and south of Round Mountain. The veins are short, lenticular, and strike mostly northeast and northwest in several narrow east-trending belts. The quartz veins were formed about 80 m.y. ago near the end of an episode of doming and metamorphism of the granite and emplacement of aplite and pegmatite dikes in and near the granite. An initial hydrothermal stage involved deposition of muscovite, quartz, huebnerite, fluorite, and barite in the veins. Veins were then sheared, broken, and recrystallized. A second hydrothermal stage, possibly associated with emplacement of a rhyolite dike swarm and granodiorite stock about 35 m.y. ago, saw deposition of more muscovite, quartz, fluorite, and barite, and addition of scheelite, tetrahedrite-tennantite, several sulfide minerals, and chalcedony. Finally, as a result of near-surface weathering, secondary sulfide and numerous oxide, tungstate, carbonate, sulfate, phosphate, and silicate minerals formed in the veins. Depth of burial at the time of formation of the veins, based on geologic reconstruction, was about 3-3.5 km. The initial hydrothermal stage ended with deposition of quartz at a temperature of about 210/sup 0/C and pressures of about 240 to 280 bars from fluids with salinity of about 5 wt % sodium chloride. Fluorite then was deposited at about 250/sup 0/ to 280/sup 0/C from solutions of similar salinity and containing a small amount of carbon dioxide. During shearing that followed initial mineralization, quartz was recrystallized at a temperature of 270/sup 0/ to 290/sup 0/C and in association with fluids of about 5 wt % sodium chloride equivalent and containing carbon dioxide. Late-stage fluorite was deposited from fluids with similar salinity but devoid of carbon dioxide at a temperature of about 210/sup 0/C. 76 refs., 38 figs., 8 tabs.

  16. Structural and mechanical characterisation of bridging veins: A review.

    PubMed

    Famaey, Nele; Ying Cui, Zhao; Umuhire Musigazi, Grace; Ivens, Jan; Depreitere, Bart; Verbeken, Erik; Vander Sloten, Jos

    2015-01-01

    Bridging veins drain the venous blood from the cerebral cortex into the superior sagittal sinus (SSS) and doing so they bridge the subdural space. Despite their importance in head impact biomechanics, little is known about their properties with respect to histology, morphology and mechanical behaviour. Knowledge of these characteristics is essential for creating a biofidelic finite element model to study the biomechanics of head impact, ultimately leading to the improved design of protective devices by setting up tolerance criteria. This paper presents a comprehensive review of the state-of-the-art knowledge on bridging veins. Tolerance criteria to prevent head injury through impact have been set by a number of research groups, either directly through impact experiments or by means of finite element (FE) simulations. Current state-of-the-art FE head models still lack a biofidelic representation of the bridging veins. To achieve this, a thorough insight into their nature and behaviour is required. Therefore, an overview of the general morphology and histology is provided here, showing the clearly heterogeneous nature of the bridging vein complex, with its three different layers and distinct morphological and histological changes at the region of outflow into the superior sagittal sinus. Apart from a complex morphology, bridging veins also exhibit complex mechanical behaviour, being nonlinear, viscoelastic and prone to damage. Existing material models capable of capturing these properties, as well as methods for experimental characterisation, are discussed. Future work required in bridging vein research is firstly to achieve consensus on aspects regarding morphology and histology, especially in the outflow cuff segment. Secondly, the advised material models need to be populated with realistic parameters through biaxial mechanical experiments adapted to the dimensions of the bridging vein samples. Finally, updating the existing finite element head models with these parameters will render them truly biofidelic, allowing the establishment of accurate tolerance criteria and, ultimately, better head protection devices. PMID:25052244

  17. Fluid overpressure estimates from the aspect ratios of mineral veins

    NASA Astrophysics Data System (ADS)

    Philipp, Sonja L.

    2012-12-01

    Several hundred calcite veins and (mostly) normal faults were studied in limestone and shale layers of a Mesozoic sedimentary basin next to the village of Kilve at the Bristol Channel (SW-England). The veins strike mostly E-W (239 measurements), that is, parallel with the associated normal faults. The mean vein dip is 73°N (44 measurements). Field observations indicate that these faults transported the fluids up into the limestone layers. The vein outcrop (trace) length (0.025-10.3 m) and thickness (0.1-28 mm) size distributions are log-normal. Taking the thickness as the dependent variable and the outcrop length as the independent variable, linear regression gives a coefficient of determination (goodness of fit) of R2 = 0.74 (significant with 99% confidence), but natural logarithmic transformation of the thickness-length data increases the coefficient of determination to R2 = 0.98, indicating that nearly all the variation in thickness can be explained in terms of variation in trace length. The geometric mean of the aspect (length/thickness) ratio, 451, gives the best representation of the data set. With 95% confidence, the true geometric mean of the aspect ratios of the veins lies in the interval 409-497. Using elastic crack theory, appropriate elastic properties of the host rock, and the mean aspect ratio, the fluid overpressure (that is, the total fluid pressure minus the normal stress on the fracture plane) at the time of vein formation is estimated at around 18 MPa. From these results, and using the average host rock and water densities, the depth to the sources of the fluids (below the present exposures) forming the veins is estimated at between around 300 m and 1200 m. These results are in agreement to those obtained by independent isotopic studies and indicate that the fluids were of rather local origin, probably injected from sill-like sources (water sills) inside the sedimentary basin.

  18. Assessment of the efficacy and safety of steam vein sclerosis as compared to classic surgery in lower extremity varicose vein management

    PubMed Central

    Mlosek, Robert K.; Ciostek, Piotr

    2015-01-01

    Introduction For the last 10 years, endovenous thermal ablation methods have gradually predominated over the classic Babcock procedure in varicose vein treatment. Steam vein sclerosis is the newest thermal ablation technique. Aim To assess the efficacy and safety of steam vein sclerosis as compared to the Babcock procedure in lower extremity varicose vein treatment. Material and methods One hundred and two adult subjects with varicose veins of clinical grade C2 to C6 according to the CEAP classification, treated with varicose vein surgery between 2010 and 2012, were enrolled in the study. These were subdivided into two groups: the study group of 52 patients treated with endovenous steam vein sclerosis and the control group of 50 patients treated with the Babcock procedure. A single lower extremity with isolated great or small saphenous vein insufficiency was operated on in each subject. The groups were compared for demography, disease severity, involved veins, potential perioperative and postoperative complications, as well as treatment efficacy based on the VCSS score reduction. Results There were no statistically significant differences between the groups in terms of demography, disease severity, involved veins, or perioperative and postoperative complications. The treatment efficacy of both methods, assessed based on the recurrence rate and the quantitative VCSS score reduction, was similar. Clinically significant recanalisation was observed in 1 (1.9%) patient in the study group. Conclusions The efficacy and safety analysis shows that steam vein sclerosis is a safe, simple method which can be recommended as effective varicose vein treatment. PMID:25960788

  19. A rabbit pulmonary vein myocyte isolation method based on simultaneous heart and pulmonary vein perfusion.

    PubMed

    Gao, Lin-Lin; Zhang, Miao-Miao; Zhang, Liang-Pin; Yang, Shu-Lin; Yao, Ke-Jun; Song, Yuan-Long

    2016-02-25

    Myocytes in the pulmonary veins (PV) play a pivotal role in the development of paroxysmal atrial fibrillation (AF). It is therefore important to understand physiological characteristics of these cells. Studies on these cells are, however, markedly impeded by the fact that single PV myocytes are very difficult to obtain due to lack of effective isolation methods. In this study, we described a novel PV myocyte isolation method. The key aspect of this method is to establish a combination of retrograde heart perfusion (via the aorta) and anterograde PV perfusion (via the pulmonary artery). With this simultaneous perfusion method, a better perfusion of the PV myocytes can be obtained. As results, the output and viability of single myocytes isolated by simultaneous heart and PV perfusion method were increased compared with those in conventional retrograde heart perfusion method. PMID:26915322

  20. Impact of misplaced subclavian vein catheter into jugular vein on transpulmonary thermodilution measurement variables*

    PubMed Central

    Yu, Wen-qiao; Zhang, Yun; Zhang, Shao-yang; Liang, Zhong-yan; Fu, Shui-qiao; Xu, Jia; Liang, Ting-bo

    2016-01-01

    Objective: The subclavian vein (SCV) is usually used to inject the indicator of cold saline for a transpulmonary thermodilution (TPTD) measurement. The SCV catheter being misplaced into the internal jugular (IJV) vein is a common occurrence. The present study explores the influence of a misplaced SCV catheter on TPTD variables. Methods: Thirteen severe acute pancreatitis (SAP) patients with malposition of the SCV catheter were enrolled in this study. TPTD variables including cardiac index (CI), global end-diastolic volume index (GEDVI), intrathoracic blood volume index (ITBVI), and extravascular lung water index (EVLWI) were obtained after injection of cold saline via the misplaced SCV catheter. Then, the misplaced SCV catheter was removed and IJV access was constructed for a further set of TPTD variables. Comparisons were made between the TPTD results measured through the IJV and misplaced SCV accesses. Results: A total of 104 measurements were made from TPTD curves after injection of cold saline via the IJV and misplaced SCV accesses. Bland-Altman analysis demonstrated an overestimation of +111.40 ml/m2 (limits of agreement: 6.13 and 216.70 ml/m2) for GEDVI and ITBVI after a misplaced SCV injection. There were no significant influences on CI and EVLWI. The biases of +0.17 L/(minm2) for CI and +0.17 ml/kg for EVLWI were revealed by Bland-Altman analysis. Conclusions: The malposition of an SCV catheter does influence the accuracy of TPTD variables, especially GEDVI and ITBVI. The position of the SCV catheter should be confirmed by chest X-ray in order to make good use of the TPTD measurements. PMID:26739527

  1. Evaluation of endoscopic vein extraction on structural and functional viability of saphenous vein endothelium

    PubMed Central

    2011-01-01

    Objectives Endothelial injury during harvest influences graft patency post CABG. We have previously shown that endoscopic harvest causes structural and functional damage to the saphenous vein (SV) endothelium. However, causes of such injury may depend on the extraction technique. In order to assess this supposition, we evaluated the effect of VirtuoSaph endoscopic SV harvesting technique (VsEVH) on structural and functional viability of SV endothelium using multiphoton imaging, biochemical and immunofluorescence assays. Methods Nineteen patients scheduled for CABG were prospectively identified. Each underwent VsEVH for one portion and "No-touch" open SV harvesting (OSVH) for another portion of the SV. A two cm segment from each portion was immersed in GALA conduit preservation solution and transported overnight to our lab for processing. The segments were labeled with fluorescent markers to quantify cell viability, calcium mobilization and generation of nitric oxide. Morphology, expression, localization and stability of endothelial caveolin, eNOS, von Willebrand factor and cadherin were evaluated using immunofluorescence, Western blot and multiphoton microscopy (MPM). Results Morphological, biochemical and immunofluorescence parameters of viability, structure and function were well preserved in VsEVH group as in OSVH group. However, tonic eNOS activity, agonist-dependent calcium mobilization and nitric oxide production were partially attenuated in the VsEVH group. Conclusions This study indicates that VirtuoSaph endoscopic SV harvesting technique preserves the structural and functional viability of SV endothelium, but may differentially attenuate the vasomotor function of the saphenous vein graft. Ultramini-Abstract Endoscopic extraction preserved the structure and function, but attenuated the calcium mobilization and nitric oxide generation in human SV endothelium. PMID:21663646

  2. Alteration and vein mineralization, Ladwig uranium mine, Jefferson County, Colorado

    USGS Publications Warehouse

    Wallace, Alan R.

    1979-01-01

    Uranium ore at the Ladwig mine, Jefferson County, Colo., occurs in steeply dipping, northwest-striking faults and related fractures with a carbonate-adularia assemblage that forms in altered wallrocks and fills veins. The faults occur between large intrusive pegmatites and garnetiferous gneisses of Precambrian age, and were reactivated as the result of the early Paleocene uplift of the Front Range foothills. Mineralization in the deposit includes both wallrock alteration and vein filling. Alteration was intense but local, and chiefly involved the carbonatization of mafic minerals in the wallrocks. Felsic minerals in the wallrocks are relatively unaltered. The veins are filled with an adularia-pitchblende-carbonate assemblage with minor related sulfides and coffinite. Many of the iron-bearing carbonates in both the alteration and vein assemblages have been altered to hematite. The mineralization and alteration are believed to have formed in response to initially high amounts of CO2 and the subsequent release of dissolved CO2 by boiling or effervescence. Uranium, carried in a dicarbonate complex, was precipitated directly as pitchblende when the CO2 was released. The expulsion of H+ during boiling created a net oxidizing environment which oxidized the iron-bearing carbonates. Late stage calcite and sulfides were deposited in existing voids in the veins.

  3. Palm vein recognition based on directional empirical mode decomposition

    NASA Astrophysics Data System (ADS)

    Lee, Jen-Chun; Chang, Chien-Ping; Chen, Wei-Kuei

    2014-04-01

    Directional empirical mode decomposition (DEMD) has recently been proposed to make empirical mode decomposition suitable for the processing of texture analysis. Using DEMD, samples are decomposed into a series of images, referred to as two-dimensional intrinsic mode functions (2-D IMFs), from finer to large scale. A DEMD-based 2 linear discriminant analysis (LDA) for palm vein recognition is proposed. The proposed method progresses through three steps: (i) a set of 2-D IMF features of various scale and orientation are extracted using DEMD, (ii) the 2LDA method is then applied to reduce the dimensionality of the feature space in both the row and column directions, and (iii) the nearest neighbor classifier is used for classification. We also propose two strategies for using the set of 2-D IMF features: ensemble DEMD vein representation (EDVR) and multichannel DEMD vein representation (MDVR). In experiments using palm vein databases, the proposed MDVR-based 2LDA method achieved recognition accuracy of 99.73%, thereby demonstrating its feasibility for palm vein recognition.

  4. Finger Vein Recognition Based on Personalized Weight Maps

    PubMed Central

    Yang, Gongping; Xiao, Rongyang; Yin, Yilong; Yang, Lu

    2013-01-01

    Finger vein recognition is a promising biometric recognition technology, which verifies identities via the vein patterns in the fingers. Binary pattern based methods were thoroughly studied in order to cope with the difficulties of extracting the blood vessel network. However, current binary pattern based finger vein matching methods treat every bit of feature codes derived from different image of various individuals as equally important and assign the same weight value to them. In this paper, we propose a finger vein recognition method based on personalized weight maps (PWMs). The different bits have different weight values according to their stabilities in a certain number of training samples from an individual. Firstly we present the concept of PWM, and then propose the finger vein recognition framework, which mainly consists of preprocessing, feature extraction, and matching. Finally, we design extensive experiments to evaluate the effectiveness of our proposal. Experimental results show that PWM achieves not only better performance, but also high robustness and reliability. In addition, PWM can be used as a general framework for binary pattern based recognition. PMID:24025556

  5. [Assessment of primary varicose veins with plethysmographic techniques].

    PubMed

    Hirai, M; Takagi, T; Sai, N; Kubota, H; Hibi, M; Kawamura, M; Naiki, K

    1990-06-01

    Venous hemodynamics were evaluated by simultaneous strain gauge- and photo-plethysmographic techniques in 40 normal limbs (normal group), 74 limbs with primary varicose veins (varicosis group) and 28 limbs with postthrombotic syndrome (thrombosis group). Furthermore, the venous function of 52 limbs with primary varicose veins was assessed before and after surgical treatment of varicose veins. The mean 1/2-refilling time in varicosis and thrombosis group was significantly shorter than that in normal group. With application of tourniquets, limbs in varicosis group showed improvement in 1/2-refilling time. Varicosis group showed a significantly higher value in expelled volume during exercise than thrombosis group, and no significant difference compared with normal group. With tourniquets, the value in varicosis group was higher than that in normal group. From these results, the pathogenesis of primary varicose veins might be characterized as a high degree of venous congestion of the leg and valvular incompetence of the superficial vein system. Postoperative recording showed the improvement in venous function. However, in early stage after the operation, all parameters were lower than those in normal group. These values normalized 3 months after surgery. PMID:2398867

  6. Anatomical analysis of azygos vein system in human cadavers.

    PubMed

    Kutoglu, T; Turut, M; Kocabiyik, N; Ozan, H; Yildirim, M

    2012-01-01

    The azygos system veins vary greatly in their mode of origin, course, tributaries, anastomoses and termination. Therefore, we aimed to investigate the types of azygos system in this study. Our research was made in Anatomy departments on 48 conserved cadavers aging between 27-70 years, of which 35 were males and 13 females. In the research, the diameters and levels of the azygos vein, the hemiazygos vein, the accessory hemiazygos vein and the superior intercostal vein were investigated. The subjects were classified in Anson's system with a basis of vertical and horizontal connections in the azygos venous system the classification included primitive or embryological types, transient type, unicolon type as three basic types and their eleven subgroups. According to this classification (amongst 48 cadavers), one (2.1%) of our subjects was found to be Type I, 44 (91.7%) of them were found to be Type II, and one (2.1%) was found to be Type III. These values were similar to those in the literature, however two (4.2%) subjects did not fit in any otherwise defined groups and were named as atypic group. It is very important to identify the variations of the azygos system in the computed tomography and magnetic resonance imaging of mediastinum. The abnormal azygos venous system may easily be confused with aneurysm, lymphadenopathy and other abnormalities like tumor. It is important to keep these kinds of variations in mind while performing the mediastinal operations or surgery of large vessels. PMID:23303031

  7. Sequential vein growth with fault displacement: An example from the Austin Chalk Formation, Texas

    NASA Astrophysics Data System (ADS)

    Lee, Young-Joon; Wiltschko, David V.; Grossman, Ethan L.; Morse, John W.; Lamb, William M.

    1997-10-01

    To determine the opening and precipitation history and characteristics of vein-forming fluids, analyses of oxygen and carbon isotopes and trace elements were carried out on multilayered crack-seal calcite veins in the Austin Chalk Formation near San Antonio, Texas. The veins developed within the normal fault zones possessing unique chemical and textural characteristics which indicate sequential vein development. They are composed of alternating millimeter- to submillimeter-thick calcite veinlets and host lithons, occasionally crosscut by coarse, equant-grained secondary calcite veins. Regular changes in ?18O (e.g., -2.6 to -5.6, Pee Dee belemnite (PDB)) of the calcite veinlets along the length of veins suggest that the individual calcite veinlets were sequentially developed. A systematic ?18O decrease in the vein opening direction primarily resulted from a continuous increase in temperature of the ascending fluids delivered to the Austin Chalk. Relatively constant ?13C (approximately +1.40.4, PDB) for the multilayered veins and most secondary veins indicates that the composition of fluids from which the calcite veins precipitated was initially buffered by the bulk chalk. There is no spatial variation in trace element composition of the calcite veinlets along the length of veins. Low Sr concentrations in both calcite veinlets and secondary veins relative to those of the host chalk reflect a low partition coefficient of Sr in calcite during vein formation. Normal faults in the Cretaceous Austin Chalk were conduits to upwardly mobile vein-forming fluids.

  8. ULTRASOUND GUIDED FOAM SCLEROTHERAPY - THE SIMPLEST, LEAST INVASIVE, AND CHEAPEST METHOD FOR VARICOSE VEIN TREATMENT.

    PubMed

    Krnić, Anton

    2015-06-01

    The aim is to present our experience and observations regarding varicose vein treatment by means of ultrasound guided foam sclerotherapy (UGFS). The study included 81 patients, 54 with insufficient main stem superficial veins in one limb and 27 with both limbs affected. Great saphenous vein insufficiency was diagnosed in 68, small saphenous insufficiency in 18, anterior accessory saphenous vein insufficiency in 11, and Giacomini vein insufficiency in 3 limbs. Seven limbs had combined insufficiency of great saphenous vein and small saphenous vein, and 1 limb had combined insufficiency of Giacomini vein and small saphenous vein. UGFS was employed to treat main stem vein reflux and their tributaries. Within a month after treatment, all main stem veins were occluded and only small corrections were performed occasionally to treat residual varices. Regarding side effects, skin darkening and hard lumps at the sites of varicose veins were most commonly observed. We also recorded several episodes of thrombophlebitis. Few patients experienced dry cough, visual disturbances and headache following the treatment. After six months, repeat UGFS of main stem veins had to be performed in few patients. Very few patients expressed dissatisfaction a year after treatment, mainly because of residual skin darkening. In conclusion, UGFS proved to be the simplest, quickest and cheapest method of varicose vein treatment. According to our experience, it yielded satisfactory functional and cosmetic results. Side effects do occur, but are acceptable, in particular at long term. PMID:26415309

  9. Stibnite vein from D?bowina near Bardo (polish Sudetes)

    NASA Astrophysics Data System (ADS)

    Kotula, Piotr

    2013-09-01

    In the contact zone of the Bardo Structure and K?odzko-Z?oty Stok Intrusion and K?odzko Metamorphic, metasomatic orebearing quartz-carbonate veins rich in Sb, Zn, Cu, Ag, Au, Pb are present. In 1771 the mine ,,Reiche Silber Gluck within stibnite vein was founded in D?bowina near Bardo. Its entrance was discovered again in 2007. The stibnite vein is mainly build of stibnite and sphalerite and of quartz and dolomite rich in Mn. Stibnite crystallizes as columnar or forming radiate centres and aciculars. Its crystals reach size to 2 mm. Sphalerite appears as individual anhedral and polymineralic grained concentrations reaching size to 2,5 mm. Earlier pyrite and arsenopyrite crystallized - they occur locally in this deposit. There were found also in the deposit tetrahedrite rich in Ag, what wasn't reported earlier in studies from the mine in D?bowina.

  10. Finger Vein Recognition Based on a Personalized Best Bit Map

    PubMed Central

    Yang, Gongping; Xi, Xiaoming; Yin, Yilong

    2012-01-01

    Finger vein patterns have recently been recognized as an effective biometric identifier. In this paper, we propose a finger vein recognition method based on a personalized best bit map (PBBM). Our method is rooted in a local binary pattern based method and then inclined to use the best bits only for matching. We first present the concept of PBBM and the generating algorithm. Then we propose the finger vein recognition framework, which consists of preprocessing, feature extraction, and matching. Finally, we design extensive experiments to evaluate the effectiveness of our proposal. Experimental results show that PBBM achieves not only better performance, but also high robustness and reliability. In addition, PBBM can be used as a general framework for binary pattern based recognition. PMID:22438735

  11. An endoscopic subcutaneous dissector for obtaining vein grafts.

    PubMed

    Hallock, G G; Rice, D C

    1998-12-01

    Recent improvements in internal mechanical retractors have resulted in a commercially available endoscopic subcutaneous dissector that has an inverted pistol grip for ease of retraction, an end-mounted endoscope channel, and a distal, translucent spoon-shaped shield that maintains the optical cavity. This provides an effective reach that is valuable for the minimally invasive harvest of any long, narrow structure--the greater saphenous vein in particular--as shown in this preliminary study with 2 patients. Such extracted vein grafts taken grossly from above and below the knee appear normal. Long-term histological changes and rates of conduit patency are still unknown. The limited-access incisions necessary for this endoscopic vein harvest definitely are smaller, and can be oriented transversely to minimize further the disfigurement from any resulting scar when compared with traditional methods. PMID:9869131

  12. PORTAL VEIN EMBOLIZATION USING AN ADAPTED HYSTEROSALPINGOGRAPHY CATHETER

    PubMed Central

    STEINBRCK, Klaus; ALVES, Jefferson; FERNANDES, Reinaldo; ENNE, Marcelo; PACHECO-MOREIRA, Lcio Filgueiras

    2014-01-01

    Background Portal vein embolization is an accepted procedure that provides hypertrophy of the future remnant liver in order to reduce post-hepatectomy complications. Aim To present a series submitted to portal vein embolization using an adapted hysterosalpingography catheter via transileocolic route. Methods Were performed right portal branch embolization in 19 patients using hysterosalpingography catheter. For embolizing the vessel, was used Gelfoam powder with absolute alcohol solution. Indications for hepatectomy were colorectal liver metastases in all cases. Results An adequate growth of the future remnant liver was achieved in 15 patients (78.9%) and second time hepatectomy could be done in 14 (73.7%). In one patient (5.2%), tumor progression prevented surgery. One patient presented acute renal failure after portal embolization. Conclusions The hysterosalpingography catheter is easy to handle and can be introduced into the portal vein with a wire guide. There were no major post-embolization complication. Its use is safe, cheap and effective. PMID:25184773

  13. Branch portal vein pyaemia secondary to amoebic liver abscess.

    PubMed

    Kenny, Conor; Sohan, Oliver; Murray, Lois; Fox, Thomas Peter

    2015-01-01

    We describe a case of a young returning traveller who contracted amoebic dysentery while visiting India. She presented to a major London Hospital several months later with features suggestive of amoebic liver abscesses, a known sequelae of amoebiasis. MRI with intravenous contrast demonstrated an area of likely occlusion of the portal vein. The patient was treated with intravenous metronidazole for 10?days followed by diloxanide furoate, an intraluminal agent. The largest abscess was drained acutely under ultrasound guidance. The portal vein occlusion was treated medically without the use of anticoagulation. A repeat ultrasound at 6?weeks post-treatment confirmed patency of the portal vein indicating spontaneous recanalisation with antimicrobial therapy alone. PMID:26055593

  14. [Deep vein thrombosis revealing myeloproliferative syndrome in two adolescents].

    PubMed

    Bertrand, A; Heissat, S; Caron, N; Viremouneix, L; Pracros, J-P; Javouhey, E; Lachaux, A; Mialou, V

    2014-05-01

    Deep vein thrombosis occurs in 30% of patients with essential thrombocythemia, but rarely at initial diagnosis. We report two pediatric patients with essential thrombocythemia revealed by atypical deep vein thrombosis. First, a 16-year-old girl presented Budd-Chiari syndrome revealed by a hemorrhagic shock. Clinical exam revealed isolated splenomegaly. A search for thrombophilia found a factor V Leiden homozygous mutation and a Jak2 mutation. Bone marrow biopsy confirmed the diagnosis of a myeloproliferative disorder. The second case, a 17-year-old girl, had a routine examination by her physician that revealed splenomegaly. Ultrasonography displayed thrombus in the splenic and portal vein. An isolated Jak2 mutation was found and a myeloproliferative disorder was confirmed by bone marrow biopsy. The diagnosis of myeloproliferative disorder was made in both patients presenting atypical venous thrombosis with a Jak2 mutation and confirmed by bone marrow biopsy. These initial presentations of myeloproliferative disorders are rare in childhood and possibly underdiagnosed. PMID:24709317

  15. SWI enhances vein detection using gadolinium in multiple sclerosis

    PubMed Central

    Mazzoni, Lorenzo N; Moretti, Marco; Grammatico, Matteo; Chiti, Stefano; Massacesi, Luca

    2015-01-01

    Susceptibility weighted imaging (SWI) combined with the FLAIR sequence provides the ability to depict invivo the perivenous location of inflammatory demyelinating lesions one of the most specific pathologic features of multiple sclerosis (MS). In addition, in MS white matter (WM) lesions, gadolinium-based contrast media (CM) can increase vein signal loss on SWI. This report focuses on two cases of WM inflammatory lesions enhancing on SWI images after CM injection. In these lesions in fact the CM increased the contrast between the parenchyma and the central vein allowing as well, in one of the two cases, the detection of a vein not visible on the same SWI sequence acquired before CM injection. PMID:25815209

  16. Intimal hyperplasia in autogenous veins used for arterial replacement.

    PubMed

    Gunstensen, J; Smith, R C; El-Maraghi, N; Julian, J; Belbeck, L

    1982-03-01

    This study compares the effects on intimal hyperplasia of different methods of manipulating a vein graft before using it as an arterial substitute. Grafts that were denuded of endothelium showed the most intimal hyperplasia, while those that were washed with saline, dilated with saline or crushed did not differ appreciably from each other with respect to the degree of intimal hyperplasia. The hyperplasia was well developed and stabilized at 3 weeks, which coincided with restoration of the endothelial surface. The similarity between the last three methods of graft manipulation suggests that minor endothelial disruption produced at the time of harvesting the vein is equalized after insertion of the vein into the arterial circulation. PMID:7066776

  17. Palm-vein classification based on principal orientation features.

    PubMed

    Zhou, Yujia; Liu, Yaqin; Feng, Qianjin; Yang, Feng; Huang, Jing; Nie, Yixiao

    2014-01-01

    Personal recognition using palm-vein patterns has emerged as a promising alternative for human recognition because of its uniqueness, stability, live body identification, flexibility, and difficulty to cheat. With the expanding application of palm-vein pattern recognition, the corresponding growth of the database has resulted in a long response time. To shorten the response time of identification, this paper proposes a simple and useful classification for palm-vein identification based on principal direction features. In the registration process, the Gaussian-Radon transform is adopted to extract the orientation matrix and then compute the principal direction of a palm-vein image based on the orientation matrix. The database can be classified into six bins based on the value of the principal direction. In the identification process, the principal direction of the test sample is first extracted to ascertain the corresponding bin. One-by-one matching with the training samples is then performed in the bin. To improve recognition efficiency while maintaining better recognition accuracy, two neighborhood bins of the corresponding bin are continuously searched to identify the input palm-vein image. Evaluation experiments are conducted on three different databases, namely, PolyU, CASIA, and the database of this study. Experimental results show that the searching range of one test sample in PolyU, CASIA and our database by the proposed method for palm-vein identification can be reduced to 14.29%, 14.50%, and 14.28%, with retrieval accuracy of 96.67%, 96.00%, and 97.71%, respectively. With 10,000 training samples in the database, the execution time of the identification process by the traditional method is 18.56 s, while that by the proposed approach is 3.16 s. The experimental results confirm that the proposed approach is more efficient than the traditional method, especially for a large database. PMID:25383715

  18. Palm-Vein Classification Based on Principal Orientation Features

    PubMed Central

    Zhou, Yujia; Liu, Yaqin; Feng, Qianjin; Yang, Feng; Huang, Jing; Nie, Yixiao

    2014-01-01

    Personal recognition using palmvein patterns has emerged as a promising alternative for human recognition because of its uniqueness, stability, live body identification, flexibility, and difficulty to cheat. With the expanding application of palmvein pattern recognition, the corresponding growth of the database has resulted in a long response time. To shorten the response time of identification, this paper proposes a simple and useful classification for palmvein identification based on principal direction features. In the registration process, the Gaussian-Radon transform is adopted to extract the orientation matrix and then compute the principal direction of a palmvein image based on the orientation matrix. The database can be classified into six bins based on the value of the principal direction. In the identification process, the principal direction of the test sample is first extracted to ascertain the corresponding bin. One-by-one matching with the training samples is then performed in the bin. To improve recognition efficiency while maintaining better recognition accuracy, two neighborhood bins of the corresponding bin are continuously searched to identify the input palmvein image. Evaluation experiments are conducted on three different databases, namely, PolyU, CASIA, and the database of this study. Experimental results show that the searching range of one test sample in PolyU, CASIA and our database by the proposed method for palmvein identification can be reduced to 14.29%, 14.50%, and 14.28%, with retrieval accuracy of 96.67%, 96.00%, and 97.71%, respectively. With 10,000 training samples in the database, the execution time of the identification process by the traditional method is 18.56 s, while that by the proposed approach is 3.16 s. The experimental results confirm that the proposed approach is more efficient than the traditional method, especially for a large database. PMID:25383715

  19. Automatic classification of retinal vessels into arteries and veins

    NASA Astrophysics Data System (ADS)

    Niemeijer, Meindert; van Ginneken, Bram; Abrmoff, Michael D.

    2009-02-01

    Separating the retinal vascular tree into arteries and veins is important for quantifying vessel changes that preferentially affect either the veins or the arteries. For example the ratio of arterial to venous diameter, the retinal a/v ratio, is well established to be predictive of stroke and other cardiovascular events in adults, as well as the staging of retinopathy of prematurity in premature infants. This work presents a supervised, automatic method that can determine whether a vessel is an artery or a vein based on intensity and derivative information. After thinning of the vessel segmentation, vessel crossing and bifurcation points are removed leaving a set of vessel segments containing centerline pixels. A set of features is extracted from each centerline pixel and using these each is assigned a soft label indicating the likelihood that it is part of a vein. As all centerline pixels in a connected segment should be the same type we average the soft labels and assign this average label to each centerline pixel in the segment. We train and test the algorithm using the data (40 color fundus photographs) from the DRIVE database1 with an enhanced reference standard. In the enhanced reference standard a fellowship trained retinal specialist (MDA) labeled all vessels for which it was possible to visually determine whether it was a vein or an artery. After applying the proposed method to the 20 images of the DRIVE test set we obtained an area under the receiver operator characteristic (ROC) curve of 0.88 for correctly assigning centerline pixels to either the vein or artery classes.

  20. Clinical examination of varicose veins--a validation study.

    PubMed Central

    Kim, J.; Richards, S.; Kent, P. J.

    2000-01-01

    The aim of this study was to determine the accuracy of clinical tests compared to colour duplex imaging in patients with primary varicose veins using a prospective, blinded comparison study. A total of 44 patients (70 limbs) with primary, previously untreated varicose veins presenting to the vascular laboratory of a university teaching hospital were studied. The patients underwent physical examination using the cough test, the tap test, Trendelenbergs' test, Perthes' test and hand-held Doppler (HHD) assessment prior to undergoing colour duplex scanning. Reflux was detected on duplex scanning, at the sapheno-femoral junction in 39/70 limbs (54%), the long saphenous vein in 47/70 limbs (64%) and the sapheno-popliteal junction in 9/70 limbs (13%). The cough test had low sensitivity (0.59) and specificity (0.67). The tap test had low sensitivity (0.18) and high specificity (0.92). The Trendelenberg test had high sensitivity (0.91) but low specificity (0.15). Perthes' test had a high sensitivity (0.97) but low specificity (0.20). Hand-held Doppler assessment of reflux at the sapheno-femoral junction, in the long saphenous vein and at the sapheno-popliteal junction had high sensitivity (0.97, 0.82, and 0.80, respectively) and specificity (0.73, 0.92, and 0.90, respectively) of detecting reflux. Clinical tests used in the examination of patients with primary varicose veins are inaccurate. Assessment using hand-held Doppler is more accurate. Courses and clinical textbooks should be revised to replace these tests with instruction in how to use hand-held Doppler in the clinical examination of patients with varicose veins. PMID:10858678

  1. A case of an additional right external iliac vein surrounding the right external iliac artery and lacking the right common iliac vein.

    PubMed

    Hayashi, Shogo; Naito, Munekazu; Yakura, Tomiko; Kumazaki, Toshimasa; Itoh, Masahiro; Nakano, Takashi

    2016-01-01

    A case of an additional right external iliac vein lacking a right common iliac vein was found in an 84-year-old female cadaver during a dissection course at Aichi Medical University in 2014. The findings are reported and discussed from the embryological and clinical viewpoints. The right and left iliac venous systems were macroscopically observed with attention to the homonymous arteries and the inferior vena cava. In this cadaver, a preaortic external iliac vein originated from a right external iliac vein and drained directly into the inferior vena cava. The preaortic and right external iliac veins surrounded the right external iliac artery. In addition, the right internal iliac vein drained into the left common iliac vein, and the right obturator vein drained into the right external iliac vein. Our findings suggested that normal external iliac veins developed from the ventral limb of the iliac venous system in this case. Our case has clinical importance for surgical complications such as hemorrhages in pelvic operations, phlebography, and especially central venous cauterization of the right femoral vein. PMID:25715700

  2. [Surgical treatment of the lower extremities varicose veins throughout the ages].

    PubMed

    Kzka, Mariusz; Snarska, Agnieszka; Drygalski, Tomasz; Dolecki, Miros?aw

    2007-01-01

    The authors describe a historical review of surgical treatment of varicose veins from antiques to modern methods. Diseases of the veins have been recognized and attempts of their surgical resection have been described since antiquity. Hippocrates wrote about surgical treatment of varicose veins, Celsus and also Galien himself described varicose veins ligatures. The end of 19th century with Trendelenburg and Madelung was a start of modern period of varicose vein surgery. Parallel to surgical the less invasive methods of varicose veins treatment developed and gave a base for modern sclerotherapy. PMID:18409363

  3. Finger vein recognition using local line binary pattern.

    PubMed

    Rosdi, Bakhtiar Affendi; Shing, Chai Wuh; Suandi, Shahrel Azmin

    2011-01-01

    In this paper, a personal verification method using finger vein is presented. Finger vein can be considered more secured compared to other hands based biometric traits such as fingerprint and palm print because the features are inside the human body. In the proposed method, a new texture descriptor called local line binary pattern (LLBP) is utilized as feature extraction technique. The neighbourhood shape in LLBP is a straight line, unlike in local binary pattern (LBP) which is a square shape. Experimental results show that the proposed method using LLBP has better performance than the previous methods using LBP and local derivative pattern (LDP). PMID:22247670

  4. Finger Vein Recognition Using Local Line Binary Pattern

    PubMed Central

    Rosdi, Bakhtiar Affendi; Shing, Chai Wuh; Suandi, Shahrel Azmin

    2011-01-01

    In this paper, a personal verification method using finger vein is presented. Finger vein can be considered more secured compared to other hands based biometric traits such as fingerprint and palm print because the features are inside the human body. In the proposed method, a new texture descriptor called local line binary pattern (LLBP) is utilized as feature extraction technique. The neighbourhood shape in LLBP is a straight line, unlike in local binary pattern (LBP) which is a square shape. Experimental results show that the proposed method using LLBP has better performance than the previous methods using LBP and local derivative pattern (LDP). PMID:22247670

  5. Subclavian Vein Stent Fracture and VenousMotion.

    PubMed

    Mallios, Alexandros; Taubman, Kevin; Claiborne, Paul; Blebea, John

    2015-10-01

    Primary subclavian vein stents are not recommended for venous thoracic outlet syndrome before surgical decompression by first rib resection due to a high risk of fracture because they are compressed between the clavicle and first rib. After rib removal, however, stent insertion has been advocated for venous restenosis, and it is felt that stent fracture is unlikely to occur. We present a case suggesting that repetitive differential vein movement during respiration may be one of the causative factors for stent fractures occurring in this anatomic region. PMID:26122410

  6. Varicose vein treatment: considerations for a radiology group practice.

    PubMed

    Soares, Gregory M

    2005-07-01

    Varicose vein management presents an exciting opportunity for the expansion of the interventional components of many practices. Although vein practice development has been addressed by other specialists, concerns unique to radiologists have only lately become important. Radiology groups are well suited to support the addition of this service line, and it may serve as a showcase for further clinical growth. Success depends on appropriate business planning, clinical and administrative infrastructure, and intelligent marketing. This article describes requisites for the successful development of a phlebology practice by a radiology group. PMID:17411890

  7. Chylous ascites caused by acute pancreatitis with portal vein thrombosis

    PubMed Central

    Park, Dong Eun

    2011-01-01

    Chylous ascites is defined as the accumulation of chyle in the peritoneum due to obstruction or rupture of the peritoneal or retroperitoneal lymphatic glands. Chylous ascites that arises from acute pancreatitis with portal vein thrombosis is very rare. We report here on a case of chylous ascite that was caused by acute pancreatitis with portal vein thrombosis, in which the patient showed an impressive response to conservative therapy with total parenteral nutrition and octerotide. We also review the relevant literature about chylous ascites with particular reference to the management of this rare disease. PMID:22319743

  8. 3D Multispectral Light Propagation Model For Subcutaneous Veins Imaging

    SciTech Connect

    Paquit, Vincent C; Price, Jeffery R; Meriaudeau, Fabrice; Tobin Jr, Kenneth William

    2008-01-01

    In this paper, we describe a new 3D light propagation model aimed at understanding the effects of various physiological properties on subcutaneous vein imaging. In particular, we build upon the well known MCML (Monte Carlo Multi Layer) code and present a tissue model that improves upon the current state-of-the-art by: incorporating physiological variation, such as melanin concentration, fat content, and layer thickness; including veins of varying depth and diameter; using curved surfaces from real arm shapes; and modeling the vessel wall interface. We describe our model, present results from the Monte Carlo modeling, and compare these results with those obtained with other Monte Carlo methods.

  9. Central retinal vein occlusion in a migraine patient.

    PubMed

    Benninger, Felix; Saban, Tal; Steiner, Israel

    2015-11-01

    We describe a 31-year-old woman with a history of migraines without aura, who presented to our emergency department due to a monocular visual disturbance. This was misdiagnosed as being related to her migraine, however, it was subsequently found to be caused by a central retinal vein occlusion. Patients suffering from migraine can experience visual disturbances in the form of auras. The neuropathological basis for this phenomenon is thought to be a spreading depression in the visual cortex, causing a hemifield active visual phenomenon. Missing the diagnosis of central retinal vein occlusion is common, especially in the setting of an initially normal fundoscopy examination. PMID:26115899

  10. Dermatomyositis-Related Nonischemic Central Retinal Vein Occlusion.

    PubMed

    Wang, Yvonne; Morgan, Michael L; Espino Barros Palau, Angelina; Lee, Andrew G; Foroozan, Rod

    2015-09-01

    A 25-year-old woman with dermatomyositis suffered a right central retinal vein occlusion (CRVO) with visual acuity of 20/40. Examination of the right eye showed vitreous cells, suggesting inflammation of the central retinal vein leading to a CRVO as the presumed mechanism. She was admitted to hospital, and extensive evaluation was negative. She was maintained on corticosteroids to manage her dermatomyositis. One month later, she had macular edema and elevated intraocular pressure. Both resolved with dorzolamide, timolol, and intravitreal bevacizumab, and vision returned to 20/20 in the right eye. PMID:25815857

  11. Gonadal vein leiomyosarcoma: A case report with radiological findings

    PubMed Central

    Matsuzono, Tomoko; Chan, Cyrus Yin-Ho; Chan, May Yuk-May

    2015-01-01

    Summary A 56 year old postmenopausal lady presented with a rapidly enlarging pelvis mass. Clinical and ultrasonographic features were compatible with a rapidly enlarging fibroid with possible sarcomatous changes, and hence, computated tomography (CT) scan was performed to further delineate the nature and extent of the disease. However, CT scan revealed a huge tumour arising from the retroperitoneal space along the course of the left gonadal vein with typical radiological features of a gonadal vein leiomyosarcoma which were described in previous literatures. With joint collaboration with the surgeons, radical surgery with optimal debulking was subsequently performed for the patient and the diagnosis was confirmed intra-operatively and histologically. PMID:26361567

  12. Hepatocellular Carcinoma Invading the Main Portal Vein: Treatment with Transcatheter Arterial Chemoembolization and Portal Vein Stenting

    SciTech Connect

    Zhang Xuebin Wang Jianhua Yan Zhiping Qian Sheng Liu Rong

    2009-01-15

    To retrospectively analyze the therapeutic results of percutaneous transhepatic portal vein stenting (PTPVS) and transcatheter arterial chemoembolization (TACE) treatment in 58 patients with hepatocellular carcinoma (HCC) invading the main portal vein (MPV). A total of 58 procedures of PTPVS were performed, immediately after which TACE was undertaken to control HCC. The clinical effects, complications, digital subtraction angiographic appearance, stent patency rates, cumulative survival rates, and predictive factors for survival were evaluated. The Kaplan-Meyer method and the log rank test were used for survival analysis. Multivariable analysis was also conducted by the Cox proportional hazard model. No patient died during stent placement or within the first 24 h. No severe procedure-related complications were observed. After stent placement, the mean {+-} standard deviation portal venous pressure levels decreased from 41.43 {+-} 8.56 cmH{sub 2}O to 37.19 {+-} 7.89 cmH{sub 2}O (p < 0.01). At the time of analysis, 9 of the 58 patients survived. The 60-, 180-, 360-, and 720-day cumulative patency rates were 98.1%, 71.0%, 52.6%, and 42.1%, respectively, with a mean patency time of 552.9 {+-} 88.2 days and a median patency time of 639.00 {+-} 310.00 (95% confidence interval [95% CI], 31.40-1246.60) days. The 60-, 180-, 360-, and 720-day cumulative survival rates for the total study population were 74.1%, 27.1%, 17.2%, and 13.8%, respectively, with a median survival time of 113 {+-} 27.29 (95% CI, 59.51-166.49) days. In the univariate analysis, the following six variables were significantly associated with the prognosis: (1) HCC type; (2) Child-Pugh grade; (3) MPV stenosis/occlusion; (4) arteriovenous shunt; (5) iodized oil deposition; and (6) number of TACE procedure. In addition, having diffuse-type HCC and Child-Pugh grade B disease were each independent factors associated with decreased survival time in the multivariate analysis. PTPVS-TACE is feasible and may be useful to control HCC invading the MPV.

  13. The Distant Morphological and Petrological Features of Shock Melt Veins in the Suizhou L6 Condrite

    SciTech Connect

    X Xie; Z Sun; M Chen

    2011-12-31

    The morphology and petrology of distinct melt veins in the Suizhou L6 chondrite have been investigated using scanning electron microscopy, electron microprobe analyses, and Raman spectroscopy, synchrotron energy-dispersive diffraction, and transmission electron microscopy. It is found that the melt veins in the Suizhou meteorite morphologically are the simplest, straightest, and thinnest among all shock veins known from meteorites. At first glance, these veins look like fine fractures, but petrologically they are solid melt veins of chondritic composition and consist of fully crystalline materials of two distinct lithological assemblages, with no glassy material remaining. The Suizhou melt veins contain the most abundant high-pressure mineral species when compared with all other veins known in chondrites. Thus, these veins in Suizhou are classified as shock veins. All rock-forming and almost all accessory minerals in the Suizhou shock veins have been transformed to their high-pressure polymorphs, and no fragments of the precursor minerals remain in the veins. Among the 11 high-pressure mineral phases identified in the Suizhou veins, three are new high-pressure minerals, namely, tuite after whitlockite, xieite, and the CF phase after chromite. On the basis of transformation of plagioclase into maskelynite, it is estimated that the Suizhou meteorite experienced shock pressures and shock temperatures up to 22 GPa and 1000 C, respectively. Shearing and friction along shock veins raised the temperature up to 1900-2000 C and the pressure up to 24 GPa within the veins. Hence, phase transition and crystallization of high-pressure minerals took place only in the Suizhou shock veins. Fast cooling of the extremely thin shock veins is regarded as the main reason that up to 11 shock-induced high-pressure mineral phases could be preserved in these veins.

  14. Geometry and texture of quartz veins in Wadi Atalla area, Central Eastern Desert, Egypt

    NASA Astrophysics Data System (ADS)

    Akawy, Ahmed

    2007-02-01

    Several quartz vein sets with varying orientation, geometry and internal structure were recognized in the Atalla area. The veins were associated with the deformation phases affecting the area. En echelon and extensional veins are the main geometrical types. Syn-kinematic veins associated with the major northeast-over-southwest thrust faults were later boudinaged, folded and re-folded. En echelon veins, fibrous veins, and extensional veins are associated with the NNW-SSE faults. Other veins are associated with the NW-SE, N-S, NE-SW and E-W faults. Veins are concentrated at the intersection zones between faults. The internal structure of the veins comprises syntaxial, antitaxial, and composite types and reflects a change from a compressive stress regime to an extensional one. Chocolate-tablet structures and synchronous and co-genetic vein networks indicate later multi-directional extension of the area. Interaction between cracking and sealing of fractures is a common feature in the study area indicating that it was easy for the pore pressure to open pre-existing fractures instead of creating new ones. The reopening of pre-existing fractures rather than creating new ones is also indicated by the scattering of vein data around ?3. There is an alteration and change in characteristics of the wall rock due to increase in fluid flow rate. Fault-valving probably is also a cause of the complex geometry of some veins.

  15. Arteries masquerading as varicose veins: A trap for phlebologists.

    PubMed

    Jones, L; Parsi, K

    2015-12-01

    Ultrasound guided sclerotherapy may be complicated by intra-arterial injections resulting in significant tissue necrosis. Here, we present a 69-year-old man with a history of right small saphenous vein "stripping", presenting for the treatment of symptomatic lower limb varicose veins. Duplex ultrasound of the right lower limb outlined the pathway of venous incompetence. Despite the history of "stripping", the small saphenous vein was present but the sapheno-popliteal junction was ligated at the level of the knee crease. No other unusual findings were reported at the time. During ultrasound guided sclerotherapy, subcutaneous vessels of the right posterior calf were noted to be pulsatile on B-mode ultrasound. Treatment was interrupted. Subsequent angiography and sonography showed absence of the right distal popliteal artery. A cluster of subcutaneous vessels of the right medial and posterior calf were found to be arterial collaterals masquerading as varicose veins. Injection sclerotherapy of these vessels would have resulted in significant tissue loss. This case highlights the importance of vigilance at the time of treatment and the invaluable role of ultrasound in guiding endovenous interventions. PMID:25062681

  16. Ileocolic Arteriovenous Fistula with Superior Mesenteric Vein Aneurism: Endovascular Treatment

    SciTech Connect

    Gregorio, Miguel Angel de; Gimeno, Maria Jose; Medrano, Joaquin; Schoenholz, Caudio; Rodriguez, Juan; D'Agostino, Horacio

    2004-09-15

    We report a case of a venous aneurysm secondary to an acquired ileocolic arteriovenous fistula in a 64-year-old woman with recurrent abdominal pain and history of appendectomy. The aneurysm was diagnosed by ultrasound and computed tomography. Angiography showed an arteriovenous fistula between ileocolic branches of the superior mesenteric artery and vein. This vascular abnormality was successfully treated with coil embolization.

  17. How I treat isolated distal deep vein thrombosis (IDDVT).

    PubMed

    Palareti, Gualtiero

    2014-03-20

    Thromboses limited to infrapopliteal leg deep veins (isolated distal deep vein thrombosis [IDDVT]) are frequently diagnosed in subjects with suspected pulmonary embolism or DVT and account for one-fourth to one-half of all diagnosed leg DVTs. Despite their frequency, the natural history of IDDVTs and their real risk of thromboembolic complications are still uncertain because of the scarcity of prospective, blind, nonintervention studies. Therefore it is still debated whether they warrant diagnosis and treatment. Diagnosis is based on ultrasonographic examination, which is more operator dependent and less sensitive in distal than in proximal veins. The available data seem to support the view that most IDDVTs are self-limiting and inconsequential for patients, though in some cases they can be associated with complications and warrant diagnosis and treatment. The available guidelines for treatment of IDDVTs give different indications ranging from serial imaging of the deep veins for 2 weeks to detect and treat only in case of proximal extension, to giving oral anticoagulation in all IDDVT patients for 3 months. I review this issue, focusing on possible and suggested treatments in symptomatic IDDVT patients, and describe our current therapeutic approach to these patients. PMID:24472834

  18. Ultrasound diagnosis of portal vein thrombosis following splenectomy.

    PubMed Central

    Tudway, D.; Sangster, G.

    1986-01-01

    We present a case of clinically unsuspected portal vein thrombosis occurring soon after splenectomy in a patient with chronic lymphocytic leukaemia. Ultrasound provided a means of easy and accurate diagnosis and allowed frequent reassessment of the thrombus during the period of its resolution under conservative management. Images Figure 1 Figure 2 Figure 3 PMID:3309914

  19. Characteristics of whitefly transmission of Squash vein yellowing virus

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Squash vein yellowing virus (SqVYV), a recently described ipomovirus, is transmitted by the whitefly, Bemisia tabaci Gennadius, B strain. Understanding the characteristics of transmission is essential for developing management strategies for this virus, which is the causal agent for watermelon vine ...

  20. Physiological effects of Squash vein yellowing virus infection on watermelon

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Squash vein yellowing virus (SqVYV) is the cause of viral watermelon vine decline. In this study, watermelon plants of different ages were inoculated with SqVYV to characterize the physiological response to infection and provide new insights into watermelon vine decline. Physiological responses to...

  1. Complete nucleotide sequence of Nootka lupine vein-clearing virus

    Technology Transfer Automated Retrieval System (TEKTRAN)

    The complete genome sequence of Nootka lupine vein-clearing virus (NLVCV) was determined to be 4,172 nucleotides in length containing four open reading frames ORFs with a similar genetic organization and conceptual translations of virus species in the genus Carmovirus, family Tombusviridae. The orde...

  2. Squash vein yellowing virus and its effects on watermelon

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Squash vein yellowing virus (SqVYV), a novel whitefly-transmitted member of the Potyviridae was recently shown to cause a watermelon vine decline in Florida. Watermelon plants were grown under whitefly-free conditions in a greenhouse and inoculated with buffer (mock), SqVYV, or SqVYV and Papaya rin...

  3. A case of portal vein arterialization after a liver transplant.

    PubMed

    Melandro, Fabio; Lai, Quirino; Levi Sandri, Giovanni B; Guglielmo, Nicola; Di Laudo, Marco; Morabito, Vincenzo; Pretagostini, Renzo; Berloco, Pasquale B; Rossi, Massimo

    2013-06-01

    Hepatic artery thrombosis represents a potentially deadly complication after a liver transplant. Portal vein arterialization recently has been proposed as a bridge approach in patients with hepatic artery thrombosis needing a retransplant. We report the case of a 53-year-old man treated with a liver transplant for a cryptogenetic cirrhosis. One month after a liver transplant, a hepatic artery thrombosis was documented, and a portal vein arterialization as bridge therapy for another liver transplant was performed. After surgery, improvement in the patient's liver functioning was seen. No signs of portal hypertension or hepatic abscesses were documented. Unfortunately, 8 months after the liver transplant, the patient experienced a severe urinary infection caused by a multidrug-resistant Klebsiella and died. An increase in the oxygen supply to the liver parenchyma after portal vein arterializations represents rationale use for managing hepatic artery thromboses. Several cases of treating post liver transplant hepatic artery thromboses have been reported in the literature. Portal vein arterializations can be used as bridge therapy in well-selected situations of post-liver transplant hepatic artery thromboses. Strict surveillance should be used to prevent the onset of complications that can exclude a patient from a transplant. The correct timing for retransplant is not fully known, but we think the shorter the time to retransplant, the better is the patient survival. PMID:23767946

  4. Laparoscopic nephroureterectomy with a circumaortic left renal vein.

    PubMed

    Kundavaram, Chandan; Gomella, Patrick T; Healy, Kelly A; Klinge, Matthew; Hubosky, Scott

    2012-12-01

    Renal vasculature anomalies can present technical challenges to laparoscopic urologic surgery. The use of preoperative imaging has made it possible to recognize and plan for such aberrant vascular anatomy. We describe a patient with a circumaortic left renal vein who underwent successful laparoscopic radical nephroureterectomy for the management of urothelial carcinoma of the renal pelvis. PMID:23228298

  5. Effects of beet necrotic yellow vein virus in spinach cultivars

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Beet Necrotic Yellow Vein Virus (BNYVV) causes one of the most economically destructive sugar beet diseases, rhizomania, which may reduce sugar yield by 100%. The virus has rod shaped particles containing four to five single stranded RNAs and is transmitted by the root-infecting parasite Polymyxa be...

  6. Diagnosing iliofemoral vein occlusion from radionuclide blood pool venography

    SciTech Connect

    McCalley, M.G.; Braunstein, P.

    1987-03-01

    There have been reports regarding the efficacy of Tc-99m labeled RBC venograms. The authors have found that potentially dangerous iliac vein occlusions can be missed unless especially careful attention is paid in looking for any asymmetry of the iliac vessels with respect to intensity, thickness, and/or definition, along the whole or at least 50% of one of the vessel's length, and the presence or absence of blood pool activity in the most proximal portion of the left common iliac vein, i.e., whether the activity arises from the IVC or the aorta. Eight (21%) of 38 consecutive labeled RBC venograms performed at this institution over six months produced findings that met criteria and/or. Iliofemoral vein occlusion was confirmed in six of the eight patients (16% of all patients). Thus, while the above criteria are not pathognomonic for iliofemoral vein occlusion, their rigid application has enabled the authors to detect a significant proportion of patients with iliofemoral occlusions which would otherwise have gone undetected. All eight cases were confirmed by further workup with direct injection radionuclide venography or contrast venography.

  7. CT mapping of the vertebral level of right adrenal vein

    PubMed Central

    Degenhart, Christoph; Strube, Hanna; Betz, Matthias J.; Pallauf, Anna; Bidlingmaier, Martin; Fischer, Evelyn; Reincke, Martin; Reiser, Maximilian F.; Wirth, Stefan

    2015-01-01

    PURPOSE We aimed to evaluate the accuracy of multidetector computed tomography (MDCT) venous mapping for the localization of the right adrenal veins (RAV) in patients suffering from primary aldosteronism. METHODS MDCT scans of 75 patients with primary aldosteronism between March 2008 and November 2011 were evaluated by two readers (a junior [R1] and a senior [R2] radiologist) according to the following criteria: quality of RAV depiction (scale, 15), localization of the RAV confluence with regard to the inferior vena cava, and depiction of anatomical variants. Results were compared with RAV venograms obtained during adrenal vein sampling and corroborated by laboratory testing of cortisol in selective RAV blood samples. Kappa statistics were calculated for interobserver agreement and for concordance of MDCT mapping with the gold standard. RESULTS Successful RAV sampling was achieved in 69 of 75 patients (92%). Using MDCT mapping, adrenal veins could be visualized in 78% (R1, 54/69) and 77% (R2, 53/69) of patients. MDCT mapping led to correct identification of RAV in 70% (R1, 48/69) and 88% (R2, 61/69) of patients. Venograms revealed five cases of anatomical variants, which were correctly identified in 60% (R1, R2). MDCT-based localizations were false or misleading in 16% (R1, 11/69) and 7% (R2, 5/69) of cases. CONCLUSION Preinterventional MDCT mapping may facilitate successful catheterization in adrenal vein sampling. PMID:25430527

  8. Hyperhomocysteinemia: a new risk factor for central retinal vein occlusion.

    PubMed Central

    Vine, A K

    2000-01-01

    PURPOSE: Previous studies have documented that an elevated plasma homocysteine level is a risk factor for vascular disease. The purpose of this study is to determine whether hyperhomocysteinemia is a risk factor for central retinal vein occlusion. METHODS: This case-controlled study involved reassessment of 74 patients with documented central retinal vein occlusion. Control subjects consisted of individuals referred to the same clinic for assessment of a nonretinal vascular disease. Hyperhomocysteinemia was defined as a total plasma homocysteine level above the 95th percentile in the control group. RESULTS: The mean total plasma homocysteine level was 11.58 mumol/L for cases and 9.49 mumol/L for controls. Of the 74 patients with a central retinal vein occlusion, 21.6% had total plasma homocysteine levels above the 95th percentile in the control group (odds ratio, 6.53; 95% confidence interval, 1.81 to 23.50, P = .003). Hyperhomocysteinemia was present in 55% of cases with bilateral disease, 30% of ischemic cases, and 31% of cases with severe visual loss. CONCLUSION: Hyperhomocysteinemia is a risk factor for central retinal vein occlusion. Images FIGURE 1 PMID:11190038

  9. Deep Vein Thrombosis - Multiple Languages: MedlinePlus

    MedlinePLUS

    ... of All Topics All Deep Vein Thrombosis - Multiple Languages To use the sharing features on this page, please enable JavaScript. Arabic (العربية) Bosnian (Bosanski) French (français) Russian (Русский) Somali (af Soomaali) Spanish (español) ...

  10. Internal jugular vein pyogenic capillary hemangioma: a case report.

    PubMed

    Cera, Chiara; Calvagna, Cristiano; Sgorlon, Giada; Zamolo, Francesca; Pancrazio, Francesco; Adovasio, Roberto

    2015-02-01

    Internal jugular vein hemangioma, also called pyogenic granuloma, is a rare tumor. Such a neoformation was accidentally discovered and excised in a middle-aged man. Histologic and immunohistochemical investigations were performed, and this case is compared with the poor amount of similar ones described in the literature. PMID:25462549

  11. Mathematical modeling of radiofrequency ablation for varicose veins.

    PubMed

    Choi, Sun Young; Kwak, Byung Kook; Seo, Taewon

    2014-01-01

    We present a three-dimensional mathematical model for the study of radiofrequency ablation (RFA) with blood flow for varicose vein. The model designed to analyze temperature distribution heated by radiofrequency energy and cooled by blood flow includes a cylindrically symmetric blood vessel with a homogeneous vein wall. The simulated blood velocity conditions are U = 0, 1, 2.5, 5, 10, 20, and 40 mm/s. The lower the blood velocity, the higher the temperature in the vein wall and the greater the tissue damage. The region that is influenced by temperature in the case of the stagnant flow occupies approximately 28.5% of the whole geometry, while the region that is influenced by temperature in the case of continuously moving electrode against the flow direction is about 50%. The generated RF energy induces a temperature rise of the blood in the lumen and leads to an occlusion of the blood vessel. The result of the study demonstrated that higher blood velocity led to smaller thermal region and lower ablation efficiency. Since the peak temperature along the venous wall depends on the blood velocity and pullback velocity, the temperature distribution in the model influences ablation efficiency. The vein wall absorbs more energy in the low pullback velocity than in the high one. PMID:25587351

  12. [Vein and arterial renal thrombosis in a newborn (author's transl)].

    PubMed

    Barrio Corrales, F; Alvarado, F; Nistal, M; Ruza, F

    1976-01-01

    A case of arterial and venous thrombosis in a newborn is presented. The etiopathogenic aspects are discussed, and the possible relationship between arterial and venous thrombosis in comparison with clinical renal vein thrombosis are evaluated. Appropriated treatment for these patients is presented. PMID:999096

  13. Mathematical Modeling of Radiofrequency Ablation for Varicose Veins

    PubMed Central

    Choi, Sun Young; Kwak, Byung Kook

    2014-01-01

    We present a three-dimensional mathematical model for the study of radiofrequency ablation (RFA) with blood flow for varicose vein. The model designed to analyze temperature distribution heated by radiofrequency energy and cooled by blood flow includes a cylindrically symmetric blood vessel with a homogeneous vein wall. The simulated blood velocity conditions are U = 0, 1, 2.5, 5, 10, 20, and 40?mm/s. The lower the blood velocity, the higher the temperature in the vein wall and the greater the tissue damage. The region that is influenced by temperature in the case of the stagnant flow occupies approximately 28.5% of the whole geometry, while the region that is influenced by temperature in the case of continuously moving electrode against the flow direction is about 50%. The generated RF energy induces a temperature rise of the blood in the lumen and leads to an occlusion of the blood vessel. The result of the study demonstrated that higher blood velocity led to smaller thermal region and lower ablation efficiency. Since the peak temperature along the venous wall depends on the blood velocity and pullback velocity, the temperature distribution in the model influences ablation efficiency. The vein wall absorbs more energy in the low pullback velocity than in the high one. PMID:25587351

  14. Lymphatic and portal vein absorption of organochlorine compounds in rats.

    PubMed

    Jandacek, Ronald J; Rider, Therese; Yang, Qing; Woollett, Laura A; Tso, Patrick

    2009-02-01

    The route of absorption of ingested compounds is a determinant of their distribution and metabolism. Portal vein absorption results in direct transport to the liver, where metabolism may take place before extrahepatic delivery. Lymphatic absorption can result in delivery of parent compound to nonhepatic tissues. Understanding the fate of an ingested compound requires determination of the importance of each of these routes. Portal vein absorption can be estimated from the difference in concentrations of an ingested compound between the portal vein and peripheral vessel blood. To make these estimations, one must make assumptions on the basis of estimates of flow rate and dilution. We report here methodology that allows a direct measurement of portal vein absorption that is independent of these assumptions. Mesenteric lymph was diverted from rats by cannulation. Portal blood was sampled after duodenal infusion of a bolus of compound of interest along with a portal absorption marker, 3-O-methylglucose. Since lymph was diverted, the appearance in portal blood was solely the result of portal absorption. Absorption was quantified by the areas under the curve for the compound and marker. Portal absorption was a function of the octanol/water partition coefficients for four organochlorine compounds: hexachlorobenzene, pentachlorophenol, DDT, and its metabolite 1,1,1-trichloro-2,2-bischlorophenylethylene. PMID:19056760

  15. [Dynamic structure of blood flow in the smallest veins of the brain].

    PubMed

    Ivanov, K P; Levkovich, Iu I

    1990-01-01

    Intravital microfilming by means of contact epiobjective was used to investigate the blood flow inside the smallest veins (D from 10 to 100). The blood flow in the veins was shown to consist of separate streams of erythrocytes. PMID:2334806

  16. Classical varicose vein surgery in a diverse ethnic community.

    PubMed

    Murli, N L; Navin, I D

    2008-08-01

    Chronic venous disorders range from telangiactasia or spider veins to varicose veins, venous swellings, skin changes and venous ulcerations. The aim of this study is to assess outcome of varicose vein surgery in the ethnically diverse population of Penang, Malaysia. This study is a retrospective analysis of patients seen from 1999 to 2004. All patients who presented to the outpatient clinic of our surgical department with saphenofemoral junction (SFJ) and/or saphenopopliteal junction (SPJ) reflux associated with incompetence of the great saphenous vein (GSV) or small saphenous vein (SSV) respectively underwent classical varicose varicose vein surgery. A single surgeon at a single institution performed the surgeries. Data from pre-operative, post-operative and follow-up procedures were recorded in case report forms. A total of 202 cases were treated. Of these, 200 were qualified by the inclusion criteria and follow-ups, with 23 who were treated bilaterally. Of those treated, Chinese comprised 47.5%, Indians 27.0%, Malays 12.5% and foreigners 13.0% (largely Indonesian Chinese, British and Americans). The average age was 52.1 years. Indians had the highest average BMI of 29.2, compared to the Chinese who had the lowest of 24.6. Based on occupation, housewives (43.0%), blue collar workers (19.0%), salespersons (12.0%) and factory workers (9.5%) were among those afflicted with varicose veins. While local Chinese predominated in the business groups (salespersons and food-related workers), the Indians and Malays in this study were mainly factory workers and/or blue collar workers. Symptomatology in descending order of severity included pain in 80.0% of cases, swelling in 65.5%, heaviness in 53.5%, cramps in 53.0%, lipodermatosclerosis in 39.0%, superficial thrombophlebitis in 33.5%, venous ulceration in 32.0%, eczema 22.0% and cellulitis in 12.5% of patients. Post surgery pains dropped to 9.9%, cramps 6.4%, heaviness 5.5% and swelling 5.3% (p<0.0001 in all groups). Indians had the highest rate of venous ulcers (35.2% of all Indians treated) possibly due to their high BMI and low socioeconomic background. In cases of venous ulcers, gram negative infections (49.8%) were more common than gram positive infections at 18.8%. Operative procedures performed included great saphenous vein high ligation in 96.5% of cases, stripping 93.5% and multiple avulsions in 98.5%, saphenous popliteal junction ligation with multiple avulsions in 13.0% and subfascial ligation in 10.5%. Operative complications included induration (40.0% of cases), bruising in 49.5%, pains in 15.0%, paraesthesia in 3.5%, wound infection in 4.0%, deep venous thrombosis in 3.0% and ulcer recurrence in 7.5%. A total of 96.2% of patients treated expressed satisfaction with varicose vein surgery. Late presentations of chronic venous insufficiency, possibly as a result of poor understanding and inadequate education on diet, weight control, use of stockings and change in lifestyle by patients, employers and general practitioners are probably the cause of high rates of severe chronic venous disease especially venous ulcerations in the local community. However, classical varicose vein surgery is widely applicable across diverse ethnicities with a high rate of success. PMID:19248688

  17. Automatic determination of the artery vein ratio in retinal images

    NASA Astrophysics Data System (ADS)

    Niemeijer, Meindert; van Ginneken, Bram; Abrmoff, Michael D.

    2010-03-01

    A lower ratio between the width of the arteries and veins (Arteriolar-to-Venular diameter Ratio, AVR) on the retina, is well established to be predictive of stroke and other cardiovascular events in adults, as well as an increased risk of retinopathy of prematurity in premature infants. This work presents an automatic method that detects the location of the optic disc, determines the appropriate region of interest (ROI), classifies the vessels in the ROI into arteries and veins, measures their widths and calculates the AVR. After vessel segmentation and vessel width determination the optic disc is located and the system eliminates all vessels outside the AVR measurement ROI. The remaining vessels are thinned, vessel crossing and bifurcation points are removed leaving a set of vessel segments containing centerline pixels. Features are extracted from each centerline pixel that are used to assign them a soft label indicating the likelihood the pixel is part of a vein. As all centerline pixels in a connected segment should be the same type, the median soft label is assigned to each centerline pixel in the segment. Next artery vein pairs are matched using an iterative algorithm and the widths of the vessels is used to calculate the AVR. We train and test the algorithm using a set of 25 high resolution digital color fundus photographs a reference standard that indicates for the major vessels in the images whether they are an artery or a vein. We compared the AVR values produced by our system with those determined using a computer assisted method in 15 high resolution digital color fundus photographs and obtained a correlation coefficient of 0.881.

  18. Differential effects of prostaglandins on canine intrapulmonary arteries and veins.

    PubMed

    Altura, B M; Chand, N

    1981-08-01

    1 The sensitivity and contractility of isolated canine intrapulmonary arteries and veins to a variety of primary prostaglandin compounds was studied.2 Intrapulmonary arteries produced no measurable contractile responses to prostaglandin A(1) (PGA(1)), PGA(2), PGB(1), PGD(2), PGE(1), PGE(2) or to PGF(1alpha). However, high concentrations of both PGB(2) (> 10(-7) M) and PGF(2alpha) (> 10(-6) M) elicited concentrated-related, but weak, contractile responses, measuring only 5-25% of KCl-induced maximum contractions.3 Intrapulmonary arteries, partially contracted by 5-hydroxytryptamine (5-HT), exhibited concentration-related relaxations in response to PGE(1); PGE(2), PGA(1) or PGA(2) produced only weak superimposed contractions.4 In contrast to intrapulmonary arteries, intrapulmonary veins contracted in a concentration-related fashion to all prostaglandins tested, where the contractile sensitivity was (based on EC(50) s and threshold concentrations): PGB(2) > PGB(1) > PGD(2) > PGF(2alpha) > PGA(2) > PGA(1) > PGF(1alpha) > PGE(2) > PGE(1).5 In terms of the ability to generate maximum contractile responses on intrapulmonary veins, the prostaglandins were also variable, with PGA(2) and PGB(2) being the most potent and PGD(2) the least potent.6 Intrapulmonary veins, partially contracted by 5-HT, exhibited concentration-related relaxations to PGE(1) at low concentrations, followed by secondary contractile responses at higher concentrations.7 Neither PGA(1) nor PGA(2) (3.4 x 10(-8) to 3.4 x 10(-5) M) inhibited or potentiated 5-HT responses of intrapulmonary arteries.8 These data suggest that there are species, regional and major qualitative and quantitative, differences in the responsiveness of intrapulmonary arteries and veins to prostaglandin. PMID:7272585

  19. Strategies to reduce intraluminal clot formation in endoscopically harvested saphenous veins

    PubMed Central

    Brown, Emile N.; Kon, Zachary N.; Tran, Richard; Burris, Nicholas S.; Gu, Junyen; Laird, Patrick; Brazio, Philip S.; Kallam, Seeta; Schwartz, Kimberly; Bechtel, Lisa; Joshi, Ashish; Zhang, Shaosong; Poston, Robert S.

    2010-01-01

    Objective Residual clot strands within the excised saphenous vein are an increasingly recognized sequela of endoscopic vein harvest. We hypothesized that endoscopic visualization facilitated by sealed carbon dioxide insufflation causes stagnation of blood within the saphenous vein. In the absence of prior heparin administration, this stasis provokes clot formation. Methods Forty consecutive patients having coronary artery bypass grafting underwent endoscopic vein harvest using sealed (Guidant VasoView, n = 30; Guidant Corp, Minneapolis, Minn) or open (Datascope ClearGlide, n = 10; Datascope Corp, Montvale, NJ) carbon dioxide insufflation followed by ex vivo assessment of intraluminal saphenous vein clot via optical coherence tomography. In the sealed carbon dioxide insufflation groups, clot formation was compared with (preheparinized, n = 20) and without (control, n = 10) heparin administration before endoscopic vein harvest, either at a fixed dose or titrated to an activated clotting time greater than 300 seconds. Risk factors for clot formation were assessed. Results Residual saphenous vein clot was a universal finding in control veins (sealed carbon dioxide insufflation endoscopic vein harvest without preheparinization). At either dose used, heparin given before endoscopic vein harvest significantly decreased saphenous vein clot burden. A similar reduction in clot was observed when using open carbon dioxide insufflation endoscopic vein harvest without preheparinization. Intraoperative blood loss and blood product requirements were similar in all groups. Patient age and preoperative maximum amplitude of the thrombelastography tracing showed a linear correlation with saphenous vein clot volume. Conclusion By enabling the quantification of this issue as never before possible, optical coherence tomography screening revealed that intraluminal saphenous vein clot is frequently found after endoscopic vein harvest. Systemic heparinization before harvest or an open carbon dioxide endoscopic vein harvest system are benign changes in practice that can significantly lessen this complication. PMID:17976458

  20. First report of soybean vein necrosis disease caused by soybean vein necrosis-associated virus in Wisconsin and Iowa

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Several viral diseases of soybean (Glycine max) have been previously identified in the north-central U.S. soybean production area, which includes Wisconsin and Iowa (Hartman et al., 1999). In September 2012, soybean plants with symptoms similar to those reported for soybean vein necrosis disease (SV...

  1. Pulmonary Vein Pseudoaneurysm Secondary to Blunt Trauma: A Novel Management Strategy.

    PubMed

    Goh, Mui Heng; Teo, Li Tserng; Pua, Uei

    2016-03-01

    Traumatic pulmonary vein pseudoaneurysm is an extremely rare condition that is challenging to manage. We present a unique case of a pulmonary vein pseudoaneurysm from blunt trauma in a patient with previous ipsilateral decortication. The patient was treated with percutaneous transparenchymal access to the pulmonary vein pseudoaneurysm. PMID:26897211

  2. Stent-graft treatment for extrahepatic portal vein hemorrhage after pancreaticoduodenectomy

    PubMed Central

    Igami, Tsuyoshi; Komada, Tomohiro; Mori, Yoshine; Yokoyama, Yukihiro; Ebata, Tomoki; Naganawa, Shinji; Nagino, Masato

    2015-01-01

    We report a case of intraperitoneal hemorrhage from the extrahepatic portal vein after pancreaticoduodenectomy for distal bile duct carcinoma. A stent-graft was deployed from the superior mesenteric vein to the main portal vein using a transhepatic approach. After the procedure, the patient remained free of intraperitoneal hemorrhage and was discharged 2 months later. PMID:26137314

  3. Pregnancy causes diminished myogenic tone and outward hypotrophic remodeling of the cerebral vein of Galen

    PubMed Central

    van der Wijk, Anne-Eva; Schreurs, Malou P H; Cipolla, Marilyn J

    2013-01-01

    Pregnancy increases the risk of several complications associated with the cerebral veins, including thrombosis and hemorrhage. In contrast to the cerebral arteries and arterioles, few studies have focused on the effect of pregnancy on the cerebral venous side. Here, we investigated for the first time the effect of pregnancy on the function and structure of the cerebral vein of Galen in rats. Our major finding was that cerebral veins from late-pregnant (LP, n=11) rats had larger lumen diameters and thinner walls than veins from nonpregnant (NP, n=13) rats, indicating that pregnancy caused outward hypotrophic remodeling of the vein of Galen. Moreover, veins from NP animals had a small amount of myogenic tone at 10 mm Hg (3.9±1.0%) that was diminished in veins during pregnancy (0.8±0.3% P<0.01). However, endothelium-dependent and -independent vasodilation of the veins was unchanged during pregnancy. Using immunohistochemistry, we show that the vein of Galen receives perivascular innervation, and that serotonergic innervation of cerebral veins is significantly higher in veins from LP animals. Outward hypotrophic remodeling and diminished tone of cerebral veins during pregnancy may contribute to the development of venous pathology through elevated wall tension and wall stress, and possibly by promoting venous blood stasis. PMID:23281424

  4. Palliative Portal Vein Stent Placement in Malignant and Symptomatic Extrinsic Portal Vein Stenosis or Occlusion

    SciTech Connect

    Novellas, Sebastien; Denys, Alban Bize, Pierre; Brunner, Philippe; Motamedi, Jean Paul; Gugenheim, Jean; Caroli, Francois-Xavier; Chevallier, Patrick

    2009-05-15

    This article evaluates the results of portal vein (PV) stent placement in patients with malignant extrinsic lesions stenosing or obstructing the PV and causing symptomatic PV hypertension (PVHT). Fourteen patients with bile duct cancer (n = 7), pancreatic adenocarcinoma (n = 4), or another cancer (n = 3) underwent percutaneous transhepatic portal venous stent placement because of gastroesophageal or jejunal varices (n = 9), ascites (n = 7), and/or thrombocytopenia (n = 2). Concurrent tumoral obstruction of the main bile duct was treated via the transhepatic route in the same session in four patients. Changes in portal venous pressure, complications, stent patency, and survival were evaluated. Mean {+-} standard deviation (SD) gradient of portal venous pressure decreased significantly immediately after stent placement from 11.2 mmHg {+-} 4.6 to 1.1 mmHg {+-} 1.0 (P < 0.00001). Three patients had minor complications, and one developed a liver abscess. During a mean {+-} SD follow-up of 134.4 {+-} 123.3 days, portal stents remained patent in 11 patients (78.6%); stent occlusion occurred in 3 patients, 2 of whom had undergone previous major hepatectomy. After stent placement, PVHT symptoms were relieved in four (57.1%) of seven patients who died (mean survival, 97 {+-} 71.2 days), and relieved in six (85.7%) of seven patients still alive at the end of follow-up (mean follow-up, 171.7 {+-} 153.5 days). Stent placement in the PV is feasible and relatively safe. It helped to relieve PVHT symptoms in a single session.

  5. Duplex ultrasound, clinical score, thrombotic risk, and D-dimer testing for evidence based diagnosis and management of deep vein thrombosis and alternative diagnoses in the primary care setting and outpatient ward.

    PubMed

    Michiels, J J; Moosdorff, W; Maasland, H; Michiels, J M; Lao, M U; Neumann, H A; Dulicek, P; Stvrtinova, V; Barth, J; Palareti, G

    2014-02-01

    Deep vein thrombosis (DVT) has an annual incidence of 0.2% in the urban population. First episodes of calf vein thrombosis (CVT) and proximal DVT are frequently elicited by risk factors, including varicose veins, cancer, pregnancy/postpartum, oral contraceptives below the age of 50 years, immobility or surgery. Leg pain and tenderness in the calf and popliteal fossa on physical examination may result from other conditions than DVT labeled as alternative diagnosis (AD) Congenital venous thrombophilia is present in every third first DVT, increased FVIII in every fourth first DVT, and FV Leiden/FII mutation in 40% of women on oral anticonceptive pill before reaching the menopause. Routine thrombophilia testing for FV Leiden/prothrombin mutation and FVIII as main risk factor for venous thrombosis is recommended. Primary superficial venous thrombosis (SVT) and DVT patients with a autosomal dominant family history of DVT are candidates for thrombophilia testing for congenital AT, PC and PS deficiency. The requirement for a safe diagnostic strategy of CVT and DVT should be based on an objective post-test incidence of venous thromboembolism (VTE) of less than 0.1% with a negative predictive value for exclusion of DVT of 99.9% during 3 months follow-up. Modification of the Wells score by elimination of the "minus 2 points" for AD is mandatory and will improve the diagnostic accuracy of CVT/DVT suspicion in the primary care setting and outpatient ward. The sequential use of complete DUS, ELISA D-dimer testing and modified clinical Wells' score assessment is safe and effective for the exclusion and diagnosis of CVT, DVT and AD. About 10% to 20% of patients with DVT develop overt post-thrombotic syndrome (PTS) at one year post-DVT, and both PTS and DVT recurrences further increase to about 30% during long-term follow-up. Objective risk stratification of PTS complications using DUS for recanalization and reflux and D-dimer testing will become an integral part in routine clinical practice to assess the optimal duration of wearing medical elastic stockings and anticoagulation for the prevention DVT recurrence as the best option to reduce the incidence and costs of suffering from irreversible PTS. PMID:24452081

  6. The association of calcite veins with stylolites in the Smackover Formation of north Louisiana

    SciTech Connect

    Denham, M.E.; Tieh, T.T. )

    1991-03-01

    Small calcite veins in the grainstones of the Upper Smackover Formation of north Louisiana provide insight into the role of stylolites in the late stages of diagenesis of these carbonate rocks. The veins always occur in groups, ranging from a few to swarms. In the two cores examined, vein widths varied from 5 {mu}m to 1 mm and lengths varied from 100 {mu}m to several millimeters. Most veins have one end that terminates at a stylolite; some have both ends terminated by stylolites. The same vein never appears on both sides of a large stylolite, although some veins do cut smaller stylolites. Sets of parallel veins occur at angles to each other in the same swarm - one set cutting the other. The original mineralogy of the veins is calcite. It appears lenticular in thin-section with the long axis of the grains perpendicular to the vein length. Preliminary electron microprobe analyses show the calcite to be relatively pure, containing less than 1% by weight MgCO{sub 3}. However, the calcite does contain slightly more iron than the surrounding micritic matrix. Anhydrite and dolomite frequently replace the calcite in the vein. This replacement generally occurs at the terminus of a vein in a stylolite. Dissolution of the calcite in the veins to produce fracture porosity is also common. The veins are remnants of localized episodic fluid pressure increases that occurred during the latter stages of diagenesis of the Smackover. The same process that formed the veins may have opened the stylolites to fluids that caused the replacement of the veins as well as the later creation of secondary porosity.

  7. Outcome of Endovenous Laser Ablation of Varicose Veins

    PubMed Central

    Rustempasic, Nedzad; Cvorak, Alemko; Agincic, Alija

    2014-01-01

    ABSTRACT Introduction: In Bosnia and Herzegovina according to available data, treatment of incompetent superficial lower extremity varicose veins by endovenous laser ablation (EVLA) has been introduced two years ago and so far no paper has been published regarding results of EVLA treatment of patients from our country. We wanted to present our results with EVLA treatment. Aim of study: to evaluate and compare primary posttreatment outcomes of endovenous laser ablation (EVLA) with classical surgical method of varicose vein treatment. Patients and methods: The study was clinical and prospective. It was carried out at Clinic for vascular surgery in Sarajevo where fifty-eight (58) patients received surgical treatment for varicose veins and in Aesthetic Surgery Center Nasa mala klinika in Sarajevo were sixty-one (61) patients with varicose veins were treated by endovenous laser ablation. Total 119 patients (limbs) with pathologic reflux only in great saphenous vein were evaluated between 1st of January 2013 and 31st of April 2014. Following primary outcome endpoints were evaluated smean day of return to normal everyday activities, patient subjective quantification of pain during first seven days after intervention, incidence of deep venous thrombosis (DVT), incidence of wound bleeding requiring surgical intervention, incidence of peri-saphenous vein hematoma and infection rate. Results: Mean of return to normal activities (expressed in days after intervention); EVLA vs. stripping (surgery) =1.21vs12.24, T test 13,619; p=0, 000, p<0,05. T test was used for comparing Mean value of visual pain analog scale for the first 7 days between groups, for all seven days pain was significantly higher in surgical group of patients as compared to EVLA group; p<0,05. Incidence of hematoma greater than 1% of total body surface area was significantly higher in patients receiving surgical treatment; Pearson Chi Square=23,830, p<0,05; odds ratio:10,453. Incidences of infection, deep venous thrombosis and posttreatment bleeding were not statistically different between analyzed groups; EVLA vs Surgery (Pearson Chi Square =3,237; p>0,05; Pearson Chi Square=2,139, p>0,05, Pearson Chi Square=2,139, p>0,05, respectively.) Conclusion: EVLA offers better patient recovery in terms of significantly lower post treatment pain, faster return to everyday activities and lower incidence of bruising (hematomas). PMID:25568583

  8. Radiofrequency Ablation of Typical Atrial Flutter via Right Jugular Vein due to Bilateral Obstructed Iliac Veins in a Patient with Dilated Cardiomyopathy

    PubMed Central

    Aksu, Tolga; Guler, Tumer Erdem; Golcuk, Sukriye Ebru; Ozcan, Kazım Serhan; Erden, Ismail

    2015-01-01

    Ablation of cavotricuspid isthmus (CTI) is the gold standard method in the treatment of isthmus dependent atrial flutter (AFl). Venous access was obtained usually via right or left femoral veins. In rare cases of obstruction of iliofemoral veins, ablation of CTI can be performed only through the superior approach. We present a 74-year-old woman of typical AFl and dilated cardiomyopathy that was ablated through the right jugular vein because of obstruction of the left and the right iliac veins. This is the first report of successful ablation of CTI in a patient with dilated cardiomyopathy via superior approach. PMID:25692044

  9. Reversed vein bypass to infrapopliteal arteries. Modern results are superior to or equivalent to in-situ bypass for patency and for vein utilization.

    PubMed Central

    Taylor, L M; Edwards, J M; Phinney, E S; Porter, J M

    1987-01-01

    In recent years many reports have attributed improved patency and improved vein utilization with lower extremity arterial bypass to infrapopliteal arteries to the use of the in-situ vein graft technique (ISVB). This report describes 110 reversed vein bypasses (RVB) to infrapopliteal arteries performed from 1980-1986. Thirty-three per cent of these patients did not have an intact ipsilateral greater saphenous vein. One hundred per cent of patients had autogenous RVB performed using a variety of techniques, including vein splicing, use of arm veins, lesser saphenous veins, branch veins, and use of graft origins distal to the common femoral artery. The life table patency figures for these grafts are 90%, 85%, and 85% at 1 year, 3 years, and 5 years, respectively. The life table limb salvage at 5 years is 93%. These figures for patency, vein utilization, and limb salvage for modern RVB to infrapopliteal arteries are clearly equal to or superior to any reported figures for ISVB. Results for RVB are greatly improved when compared with historic controls, as are results for ISVB. There is no evidence to date demonstrating superiority of one technique versus another. Images Figs. 1A and B. Fig. 2. Figs. 3A-C. Fig. 4. PMID:3800467

  10. Embolization therapy for bleeding from jejunal loop varices due to extrahepatic portal vein obstruction.

    PubMed

    Yoshimatsu, Rika; Yamagami, Takuji; Ishikawa, Masaki; Kajiwara, Kenji; Kakizawa, Hideaki; Hiyama, Eiso; Tashiro, Hirotaka; Murakami, Yoshiaki; Ohge, Hiroki; Awai, Kazuo

    2016-02-01

    Four patients underwent embolization therapy for hemorrhage from varices in the jejunal loop after choledochojejunostomy existing in hepatopetal collateral veins due to chronic extrahepatic portal vein obstruction through the afferent veins using microcoils and/or n-butyl cyanoacrylate. In all four patients, all afferent veins were successfully embolized and successful hemostasis was achieved without liver dysfunction. However, recurrence of the varices and rebleeding occurred within a year in two patients. Embolization for hemorrhage from varices in the jejunal loop after choledochojejunostomy through afferent veins is acceptable in terms of safety and is useful to achieve hemostasis in emergencyt circumstances. PMID:26330264

  11. Novel Vein Patterns in Arabidopsis Induced by Small Molecules1[OPEN

    PubMed Central

    Cutler, Sean

    2016-01-01

    The critical role of veins in transporting water, nutrients, and signals suggests that some key regulators of vein formation may be genetically redundant and, thus, undetectable by forward genetic screens. To identify such regulators, we screened more than 5000 structurally diverse small molecules for compounds that alter Arabidopsis (Arabidopsis thaliana) leaf vein patterns. Many compound-induced phenotypes were observed, including vein networks with an open reticulum; decreased or increased vein number and thickness; and misaligned, misshapen, or nonpolar vascular cells. Further characterization of several individual active compounds suggests that their targets include hormone cross talk, hormone-dependent transcription, and PIN-FORMED trafficking. PMID:26574596

  12. Endovenous Laser Ablation of Incompetent Perforator Veins: A New Technique in Treatment of Chronic Venous Disease

    SciTech Connect

    Ozkan, Ugur

    2009-09-15

    The aim of this study was to assess the feasibility of endovenous laser ablation of incompetent perforator veins in a patient with incompetency of the small saphenous vein and multiple perforator veins. Two different methods were used to ablate seven perforator veins with a laser giving 50-60 J/cm energy. Total occlusion was observed in six perforators, and partial ablation in one perforator, at 1-month follow-up. To our knowledge, endovenous laser ablation of incompetent perforator veins is easy and a good therapeutic method.

  13. Necrotizing Fasciitis Following Endoscopic Harvesting of the Greater Saphenous Vein for Coronary Artery Bypass Graft

    PubMed Central

    Liliav, Benjamin; Kasabian, Armen

    2011-01-01

    The greater saphenous vein (GSV) remains the most commonly harvested conduit for revascularization in coronary artery bypass grafting (CABG). Published literature shows that minimally invasive vein harvesting techniques have a significantly lower incidence of wound infection rates than conventional open vein harvesting techniques have. We report a case of necrotizing fasciitis, an infection with a mortality rate of 30% to 50%, after endoscopic harvesting of the greater saphenous vein to be used as a conduit in a CABG procedure. Though minimally invasive vein harvesting techniques have advantages of smaller incisions and a decreased overall rate of wound infection, clinicians should be aware of this potentially lethal infection that may occur. PMID:21902951

  14. Ultrasound mapping of the long saphenous vein in coronary artery bypass graft surgery

    PubMed Central

    Soo, Alan; Noel, Dennis; MacGowan, Simon

    2013-01-01

    Long saphenous vein is the most common conduit utilized for surgical coronary revascularization. Ultrasound-assisted vein assessment is superior to traditional clinical examination of the long saphenous vein in discerning path and suitability for use as a conduit. Preoperative ultrasound mapping of the long saphenous vein is easy and rapidly accomplished allowing optimal surgical site selection, avoiding unnecessary surgical dissection and potential wound complications. We describe the technique of ultrasound mapping of the long saphenous vein and its application to conduit harvest in coronary artery bypass graft (CABG) surgery. PMID:23470614

  15. [Experiences with homologous umbilical cord veins in vascular reconstructive surgery].

    PubMed

    Huber, A; Oehy, K; Zürcher, B; Vogt, B

    1980-06-01

    12 homologous umbilical cord veins prepared according to the method of MINDICH from February to November 1978 were used as either femoro-femoral or femoro-popliteal bypass. 6 of the 12 implanted umbilical veins after an average of 4 months were still open and showed good results, whereas 4 were blocked by thrombosis due to bad outflow conditions or dissection. On two implants that had had to be removed, histological examinations were used, and these showed a destruction of the graft's wall. In contrast to the advantages of their problem-free availability and good technical suitability stands the destruction of these grafts observed by us and hence the questionable nature of tenacity in the receiver. Further experiences of longer duration dealing with this interesting subject of vascular substitute are needed. PMID:7440195

  16. Deep Vein Thrombosis Provoked by Inferior Vena Cava Agenesis

    PubMed Central

    Haddad, Raad A.; Saadaldin, Mazin; Kumar, Binay; Bachuwa, Ghassan

    2015-01-01

    Inferior vena cava agenesis (IVCA) is a rare congenital anomaly that can be asymptomatic or present with vague, nonspecific symptoms, such as abdominal or lower back pain, or deep vein thrombosis (DVT). Here, we present a 55-year-old male who came with painless swelling and redness of his left lower limb. On examination, swelling and redness were noted extending from the left foot to the upper thigh; it was also warm compared to his right lower limb. Venous Doppler ultrasound was done which showed DVT extending up to the common femoral vein. Subsequently, computed-tomography (CT) of the chest and abdomen was done to exclude malignancy or venous flow obstruction; it revealed congenital absence (agenesis) of the infrarenal inferior vena cava (IVC). PMID:26788400

  17. Disseminated cysticercosis with a right common femoral vein thrombosis

    PubMed Central

    Singh, Utpal Kant; Prasad, Rajniti; Bhushan, Prashant; Mishra, Om P

    2013-01-01

    Disseminated cysticercosis is an uncommon presentation of cysticercosis. Less than 10 cases of disseminated cysticercosis have been reported worldwide in children. We report the case of an 8-year-old boy with disseminated cysticercosis, who had presented with a swelling of the body for 1?month and proptosis of the eyeballs for 14?days. On examination, he had bilateral proptosis, subcutaneous nodules and hypertrophy of muscles of the limbs, neck and face. The CT cranium was normal, but the orbit showed bilateral bulky extraocular muscles heterogeneous in their whole length. The MRI cranium and whole body showed multiple non-enhancing vesicular cysts involving the brain, extraocular muscle, heart, trunk and muscles of the extremities and subcutaneous tissues. A Doppler study of the femoral vein showed thrombosis of the right common femoral vein. He was managed with corticosteroid, albendazole, phenytoin sodium, low-molecular-weight heparin followed by warfarin for 6?months and recovered completely. PMID:23391957

  18. Osteochondroma mimicking deep vein thrombosis in a young cricketer.

    PubMed

    Watura, Christopher; Patel, Samir

    2012-01-01

    Osteochondromas are bony outgrowths covered by thin cartilaginous caps, accounting for 35% of all benign bone tumours. The majorities are solitary and usually arise at the metaphysis of long bones. They may be associated with bursa formation, while vascular complications are rare. We report a 34-year-old man who presented with a 2-week history of pain, stiffness and swelling of the left lower leg following a cricket match. Clinically, a deep vein thrombosis (DVT) was suspected but D-dimer test was negative. Initial Doppler ultrasound scan (USS) was reported as showing a haematoma and possible DVT. A repeat Doppler USS did not detect a DVT, however the popliteal vein appeared collapsed and a pedunculated osteochondroma of the proximal tibia was found. An MRI confirmed this and also showed an extensive oedema around the calf muscles tracking distally in all compartments, most likely the result of a ruptured bursa. PMID:23188850

  19. Primary Aneurysm of the Medial Marginal Vein of the Foot.

    PubMed

    Casian, D; Culiuc, V

    2015-01-01

    The primary superficial venous aneurysms of the foot are very rare. A 34-year-old female patient developed a dorsal foot mass during the second trimester of pregnancy with no history of previous trauma, puncture, or infection. One year later, she was referred to the surgical department for excision of "foot hygroma." Based on the clinical findings, the venous aneurysm was suspected and duplex ultrasound confirmed the diagnosis of the aneurysm of the medial marginal vein of the foot. Excision of aneurysm with bipolar ligation of marginal vein was performed under local anesthesia. The postoperative evolution was uneventful. The authors hope that the presented case report will increase the awareness of general practitioners, dermatologists, and surgeons regarding the superficial venous aneurysms of lower limbs. PMID:26576318

  20. Implementing AORN recommended practices for prevention of deep vein thrombosis.

    PubMed

    Van Wicklin, Sharon A

    2011-11-01

    One to two people per 1,000 are affected by deep vein thrombosis (DVT) or pulmonary embolism in the United States each year. AORN published its new "Recommended practices for prevention of deep vein thrombosis" to guide perioperative RNs in establishing organization-wide protocols for DVT prevention. Strategies for successful implementation of the recommended practices include taking a multidisciplinary approach to protocol development, providing education and guidance for performing preoperative patient assessments and administering DVT prophylaxis, and having appropriate resources and the facility's policy and procedure for DVT prevention readily available in the practice setting. Hospital and ambulatory patient scenarios have been included as examples of appropriate execution of the recommended practices. PMID:22035814

  1. Asymptomatic anomalous pulmonary veins in a Siberian Husky.

    PubMed

    Abraham, L A; Slocombe, R F

    2003-07-01

    A 2-year-old, neutered male Siberian Husky presented with depression, weight loss and an inability to prehend food and water. Cerebrospinal fluid was collected under general anaesthesia prior to euthanasia. The elevated white cell count comprised mostly mononuclear cells. Histological changes within the brain were variable and multifocal. Non-suppurative meningitis secondary to lymphoma was diagnosed. At necropsy, abnormal venous drainage of the right cranial and middle lung lobes was found. A dilated major pulmonary vein from these lobes passed across the lateral aspect of the right caudal lung lobe prior to entering the heart, and subpleural veins from the affected lobes were enlarged and tortuous. These vascular abnormalities were considered incidental. There were no apparent congenital abnormalities of the heart and the animal's clinical signs were related to lymphoma of the brain. PMID:15084052

  2. Relation between retinal vein occlusions and axial length.

    PubMed Central

    Aritrk, N.; Oge, Y.; Erkan, D.; Sll, Y.; Mohajer, F.

    1996-01-01

    AIMS: To evaluate the ocular axial length as a risk factor for development of central retinal vein occlusion (CRVO) and branch retinal vein occlusion (BRVO). METHODS: Ocular axial lengths were measured, by A-scan ultrasonography, in 17 patients with CRVO and 41 patients with BRVO and compared with those of contralateral unaffected eyes and 66 age matched controls. RESULTS: In 17 patients with CRVO the mean axial length of affected eyes was 22.25 (SD 0.19) mm and of unaffected eyes was 22.61 (0.13) mm. In 41 patients with BRVO the mean axial length of affected eyes was 22.89 (0.11) mm and of unaffected eyes was 22.99 (0.12) mm. CONCLUSION: These findings confirm that the axial lengths in CRVO and BRVO were significantly shorter than in the controls. This significant difference may be a risk factor in the development of CRVO and BRVO. PMID:8795376

  3. [Management of deep-vein thrombosis: A 2015 update].

    PubMed

    Messas, E; Wahl, D; Pernod, G

    2016-02-01

    Deep vein thrombosis (DVT) is a frequent and multifactor disease, with two major complications, post thrombotic syndrome and pulmonary embolism. Both transient (surgery, plaster immobilization, bed rest/hospitalization) and chronic/persistent (age, cancer, clinical or biological thrombophilia) risk factors modulate treatment duration. Diagnostic management relies on clinical evaluations, probability followed by laboratory tests or imaging. So far, compression ultrasound is the diagnostic test of choice to make a positive diagnosis of DVT. Anticoagulants at therapeutic dose for at least 3 months constitute the cornerstones of proximal (i.e. involving popliteal or more proximal veins) DVT therapeutic management. The arrival of new oral anticoagulants should optimize ambulatory management of DVT. PMID:26357937

  4. Primary Aneurysm of the Medial Marginal Vein of the Foot

    PubMed Central

    Casian, D.; Culiuc, V.

    2015-01-01

    The primary superficial venous aneurysms of the foot are very rare. A 34-year-old female patient developed a dorsal foot mass during the second trimester of pregnancy with no history of previous trauma, puncture, or infection. One year later, she was referred to the surgical department for excision of foot hygroma. Based on the clinical findings, the venous aneurysm was suspected and duplex ultrasound confirmed the diagnosis of the aneurysm of the medial marginal vein of the foot. Excision of aneurysm with bipolar ligation of marginal vein was performed under local anesthesia. The postoperative evolution was uneventful. The authors hope that the presented case report will increase the awareness of general practitioners, dermatologists, and surgeons regarding the superficial venous aneurysms of lower limbs. PMID:26576318

  5. 3D and multispectral imaging for subcutaneous veins detection.

    PubMed

    Paquit, Vincent C; Tobin, Kenneth W; Price, Jeffery R; Mriaudeau, Fabrice

    2009-07-01

    The first and perhaps most important phase of a surgical procedure is the insertion of an intravenous (IV) catheter. Currently, this is performed manually by trained personnel. In some visions of future operating rooms, however, this process is to be replaced by an automated system. Experiments to determine the best NIR wavelengths to optimize vein contrast for physiological differences such as skin tone and/or the presence of hair on the arm or wrist surface are presented. For illumination our system is composed of a mercury arc lamp coupled to a 10nm band-pass spectrometer. A structured lighting system is also coupled to our multispectral system in order to provide 3D information of the patient arm orientation. Images of each patient arm are captured under every possible combinations of illuminants and the optimal combination of wavelengths for a given subject to maximize vein contrast using linear discriminant analysis is determined. PMID:19582050

  6. Clinicopathological comparisons of open vein harvesting and endoscopic vein harvesting in coronary artery bypass grafting patients in Mashhad

    PubMed Central

    Amouzeshi, Ahmad; Teshnisi, Mohamad Abbassi; Zirak, Nahid; Shamloo, Alireza Sepehri; Hoseinikhah, Hamid; Alizadeh, Behzad; Moeinipour, Aliasghar

    2016-01-01

    Introduction Harvesting of the greater saphenous vein is almost an inevitable part of coronary artery bypass grafting (CABG) operations, and it is done by two main techniques, i.e., conventional or open vein harvesting (OVH) and the minimally-invasive endoscopic vein harvesting (EVH). This study aimed to compare these two techniques in off-pump CABG procedures with respect to clinical and pathological outcomes. Methods This cohort study was conducted on CABG candidates during a one-year period from October 2013 through September 2014 in the Department of Cardiac Surgery at Mashhad University of Medical Sciences. Eighty-seven patients voluntarily underwent EVH, and another 86 patients matched for age, gender, and other cardiovascular risk factors were selected for OVH. They were followed up for six weeks, and the main outcome measures were infections of the wound, pain, duration of hospital stay, and the costs of hospitalization. Paired sample t-test, independent t-test, or their non-parametric equivalents and the chi-squared test were used by SPSS version 17.0 for data analysis. Results The mean duration of time for vein harvesting was shorter in the EVH group (p < 0.001), and the pain score was lower (p = 0.04). No infections occurred at the site of the wound. The length of hospital stay was not significantly different for the two groups (OVH versus EVH: 8.5 ± 3.3 versus 8.4 ± 3.2 days; p-value: 0.08). Hospitalization costs were significantly higher in the EVH group (OVH versus EVH: 5.8 ± 4.7 versus 7.3 ± 2.0 million Tomman; p-value: 0.008), yet no difference was diagnosed with respect to endothelial damage in the vein grafts harvested by the EVH and OVH techniques. Conclusion EVH is considered as a minimally invasive and safe vein harvesting technique in our Center, and it can reduce the harvesting time and post-operative pain. In addition, its efficiency was similar to that of OVH.

  7. Fetal umbilical vein transplantation for the repair of middle cerebral artery injury

    PubMed Central

    Hou, Xuhui; Yuan, Yi; Yin, Jian; Yang, Songbai; Xie, Lili; Wang, Shiji

    2013-01-01

    It is necessary to investigate the longitudinal tensile mechanical characteristics of the middle cerebral artery and the fetal umbilical vein prior to applying fetal umbilical vein transplantation for repair of injured middle cerebral artery. Fifteen fresh fetal umbilical vein specimens and 15 normal human fresh cadaver middle cerebral artery specimens were collected for longitudinal tensile testing at the speed of 0.5 mm/min and at normal human temperature. The results showed that under 16.0 kPa physiological stress, the strain value of fetal umbilical vein specimens was larger, while the maximal stress and elastic modulus values were less than those of middle cerebral artery specimens. Our findings indicate that fetal umbilical vein has good elastic properties and the stress-strain curve of the fetal umbilical vein is similar to that of the middle cerebral artery. Fetal umbilical vein transplantation can, therefore, potentially repair the injured middle cerebral artery. PMID:25206646

  8. Remodeling in vein expresses arterial phenotype in hyperhomocysteinemia

    PubMed Central

    Basu, Poulami; Qipshidze, Natia; Tyagi, Suresh C; Sen, Utpal

    2011-01-01

    Accumulating evidences suggest that homocysteine, a non-protein amino acid, is involved in vessel remodeling and blood flow at elevated level, although the exact mechanism is unclear. Here we hypothesized that homocysteine affects vein in such a way that vein develops arterial phenotype. We tested our hypothesis employing wild type (WT, C57BL/6J) and CBS+/- (cystathionine ?-synthase heterozygote, a genetic model of hyperhomocysteinemia) supplemented with or without folic acid (FA, a homocysteine lowering agent). Vena cava blood flow was measured by ultrasound transonic flow probe. Tissue collagen and elastin were detected by histochemistry. Super oxide was detected by dihydroethidium (DHE) staining. Expressions of MMP-2, -9, -12, TIMP -2,-4, were measured by Western blot. MMP-13, TIMP-1, -3, and vein and aortic markers, EphB4 and EphrinB2, respectively were measured by RT-PCR. The results indicated relatively low blood flow and significant increase of collagen/elastin ratio in the CBS+/- mice compared to WT. Although FA treatment did not alter blood flow in CBS+/- mice, the collagen/elastin ratio was normalized. A relatively increased content of super oxide and gelatinase activity was observed in CBS+/- vena cava vs WT and normalized by FA treatment. Western blot analyses showed significant increase in MMP-9,-12 and decrease in TIMP-2, -4 expressions. Expressions of MMP-13, TIMP-1 and -3, Ephrin B2 were increased, whereas EphB4 was decreased with reverse change in FA treatment, with no change in MMP-13 and TIMP-1. We conclude that chronic HHcy causes vascular remodeling that expresses arterial phenotype in vein. PMID:22162783

  9. Exercise reduces angiotensin II responses in rat femoral veins.

    PubMed

    Chies, Agnaldo Bruno; Rossignoli, Patrícia de Souza; Baptista, Rafaela de Fátima Ferreira; de Lábio, Roger William; Payão, Spencer Luiz Marques

    2013-06-01

    The control of blood flow during exercise involves different mechanisms, one of which is the activation of the renin-angiotensin system, which contributes to exercise-induced blood flow redistribution. Moreover, although angiotensin II (Ang II) is considered a potent venoconstrictor agonist, little is known about its effects on the venous bed during exercise. Therefore, the present study aimed to assess the Ang II responses in the femoral vein taken from sedentary and trained rats at rest or subjected to a single bout of exercise immediately before organ bath experiments. Isolated preparations of femoral veins taken from resting-sedentary, exercised-sedentary, resting-trained and exercised-trained animals were studied in an organ bath. In parallel, the mRNA expression of prepro-endothelin-1 (ppET-1), as well as the ETA and ETB receptors, was quantified by real-time PCR in this tissue. The results show that, in the presence of L-NAME, Ang II responses in resting-sedentary animals were higher compared to the other groups. However, this difference disappeared after co-treatment with indomethacin, BQ-123 or BQ-788. Moreover, exercise reduced ppET-1 mRNA expression. These reductions in mRNA expression were more evident in resting-trained animals. In conclusion, either acute or repeated exercise adapts the rat femoral veins, thereby reducing the Ang II responses. This adaptation is masked by the action of locally produced nitric oxide and involves, at least partially, the ETB- mediated release of vasodilator prostanoids. Reductions in endothelin-1 production may also be involved in these exercise-induced modifications of Ang II responses in the femoral vein. PMID:23528515

  10. Consensus for the Treatment of Varicose Vein with Radiofrequency Ablation

    PubMed Central

    Joh, Jin Hyun; Kim, Woo-Shik; Jung, In Mok; Park, Ki-Hyuk; Lee, Taeseung; Kang, Jin Mo

    2014-01-01

    The objective of this paper is to introduce the schematic protocol of radiofrequency (RF) ablation for the treatment of varicose veins. Indication: anatomic or pathophysiologic indication includes venous diameter within 2–20 mm, reflux time ≥0.5 seconds and distance from the skin ≥5 mm or subfascial location. Access: it is recommended to access at or above the knee joint for great saphenous vein and above the mid-calf for small saphenous vein. Catheter placement: the catheter tip should be placed 2.0 cm inferior to the saphenofemoral or saphenopopliteal junction. Endovenous heat-induced thrombosis ≥class III should be treated with low-molecular weight heparin. Tumescent solution: the composition of solution can be variable (e.g., 2% lidocaine 20 mL+500 mL normal saline+bicarbonate 2.5 mL with/without epinephrine). Infiltration can be done from each direction. Ablation: two cycles’ ablation for the first proximal segment of saphenous vein and the segment with the incompetent perforators is recommended. The other segments should be ablated one time. During RF energy delivery, it is recommended to apply external compression. Concomitant procedure: It is recommended to do simultaneously ambulatory phlebectomy. For sclerotherapy, it is recommended to defer at least 2 weeks. Post-procedural management: post-procedural ambulation is encouraged to reduce the thrombotic complications. Compression stocking should be applied for at least 7 days. Minor daily activity is not limited, but strenuous activities should be avoided for 2 weeks. It is suggested to take showers after 24 hours and tub baths, swimming, or soaking in water after 2 weeks. PMID:26217628

  11. Postpartum Ovarian Vein and Inferior Vena Cava Thrombosis

    PubMed Central

    Ada, Sibel; elik, Sebahattin; Topta?, Tayfur

    2014-01-01

    Postpartum ovarian vein thrombosis (POVT), which generally occurs 215 days postpartum, is a rare complication. It can be confused with acute appendicitis, pelvic infection, ovarian torsion, tubo-ovarian abscess, and pyelonephritis. It is associated with morbidity and mortality. Here, we present a patient with postpartum OVT and IVC diagnosed by US and CT findings. She was treated successfully with no further need for any interventional procedures. PMID:25114685

  12. Superior vena cava repair with left brachiocephalic vein flap

    PubMed Central

    Tsubochi, Hiroyoshi; Endo, Shunsuke; Minegishi, Kentaro; Endo, Tetsuya

    2016-01-01

    Interposition with a vascular prosthesis or patch closure using autologous pericardium has been applied for superior vena cava (SVC) reconstruction during surgery for thoracic malignancies such as thymic epithelial tumors or lymphadenopathy that invade the SVC. We herein report a novel and simple method for repair of the SVC using a left brachiocephalic vein flap. This procedure is useful to repair the anterior wall of the distal portion of the SVC, which is a common site of invasion of thoracic malignancies. PMID:26932999

  13. Interposition vein graft for giant coronary aneurysm repair

    NASA Technical Reports Server (NTRS)

    Firstenberg, M. S.; Azoury, F.; Lytle, B. W.; Thomas, J. D.

    2000-01-01

    Coronary aneurysms in adults are rare. Surgical treatment is often concomitant to treating obstructing coronary lesions. However, the ideal treatment strategy is poorly defined. We present a case of successful treatment of a large coronary artery aneurysm with a reverse saphenous interposition vein graft. This modality offers important benefits over other current surgical and percutaneous techniques and should be considered as an option for patients requiring treatment for coronary aneurysms.

  14. Force-Sensing Microneedle for Assisted Retinal Vein Cannulation*

    PubMed Central

    Gonenc, Berk; Gehlbach, Peter; Handa, James; Taylor, Russell H.; Iordachita, Iulian

    2014-01-01

    Retinal vein cannulation (RVC) is a challenging procedure proposed for drug delivery into the very small retinal veins. The available glass cannulas for this procedure are both hard to visualize and fragile thereby limiting the feasibility of both robot-assisted and manual RVC approaches. In this study, we develop and test a new force-sensing RVC instrument that can be easily integrated with the existing manual and robotic devices. The tool enables (1) the measurement of the forces required for puncturing retinal veins in vivo and (2) an assistive method to inform the operator of the needle piercing the vessel wall. The fiber Bragg grating based sensor can be inserted into the eye through a small (? 0.9 mm) opening and provides a quantitative assessment at the tool tip with a resolution smaller than 0.25 mN. Assessment of forces during vessel penetration in the chorioallantoic membranes of chicken embryos have revealed a consistent sharp drop in tool tip force upon vessel puncture that has been used as a signature to provide auditory feedback to the user to stop needle advancement and begin drug delivery. PMID:25580178

  15. Blood vessel classification into arteries and veins in retinal images

    NASA Astrophysics Data System (ADS)

    Kondermann, Claudia; Kondermann, Daniel; Yan, Michelle

    2007-03-01

    The prevalence of diabetes is expected to increase dramatically in coming years; already today it accounts for a major proportion of the health care budget in many countries. Diabetic Retinopathy (DR), a micro vascular complication very often seen in diabetes patients, is the most common cause of visual loss in working age population of developed countries today. Since the possibility of slowing or even stopping the progress of this disease depends on the early detection of DR, an automatic analysis of fundus images would be of great help to the ophthalmologist due to the small size of the symptoms and the large number of patients. An important symptom for DR are abnormally wide veins leading to an unusually low ratio of the average diameter of arteries to veins (AVR). There are also other diseases like high blood pressure or diseases of the pancreas with one symptom being an abnormal AVR value. To determine it, a classification of vessels as arteries or veins is indispensable. As to our knowledge despite the importance there have only been two approaches to vessel classification yet. Therefore we propose an improved method. We compare two feature extraction methods and two classification methods based on support vector machines and neural networks. Given a hand-segmentation of vessels our approach achieves 95.32% correctly classified vessel pixels. This value decreases by 10% on average, if the result of a segmentation algorithm is used as basis for the classification.

  16. Fossil evidence for Cretaceous escalation in angiosperm leaf vein evolution

    PubMed Central

    Feild, Taylor S.; Brodribb, Timothy J.; Iglesias, Ari; Chatelet, David S.; Baresch, Andres; Upchurch, Garland R.; Gomez, Bernard; Mohr, Barbara A. R.; Coiffard, Clement; Kvacek, Jiri; Jaramillo, Carlos

    2011-01-01

    The flowering plants that dominate modern vegetation possess leaf gas exchange potentials that far exceed those of all other living or extinct plants. The great divide in maximal ability to exchange CO2 for water between leaves of nonangiosperms and angiosperms forms the mechanistic foundation for speculation about how angiosperms drove sweeping ecological and biogeochemical change during the Cretaceous. However, there is no empirical evidence that angiosperms evolved highly photosynthetically active leaves during the Cretaceous. Using vein density (DV) measurements of fossil angiosperm leaves, we show that the leaf hydraulic capacities of angiosperms escalated several-fold during the Cretaceous. During the first 30 million years of angiosperm leaf evolution, angiosperm leaves exhibited uniformly low vein DV that overlapped the DV range of dominant Early Cretaceous ferns and gymnosperms. Fossil angiosperm vein densities reveal a subsequent biphasic increase in DV. During the first mid-Cretaceous surge, angiosperm DV first surpassed the upper bound of DV limits for nonangiosperms. However, the upper limits of DV typical of modern megathermal rainforest trees first appear during a second wave of increased DV during the Cretaceous-Tertiary transition. Thus, our findings provide fossil evidence for the hypothesis that significant ecosystem change brought about by angiosperms lagged behind the Early Cretaceous taxonomic diversification of angiosperms. PMID:21536892

  17. Finger vein recognition based on the hyperinformation feature

    NASA Astrophysics Data System (ADS)

    Xi, Xiaoming; Yang, Gongping; Yin, Yilong; Yang, Lu

    2014-01-01

    The finger vein is a promising biometric pattern for personal identification due to its advantages over other existing biometrics. In finger vein recognition, feature extraction is a critical step, and many feature extraction methods have been proposed to extract the gray, texture, or shape of the finger vein. We treat them as low-level features and present a high-level feature extraction framework. Under this framework, base attribute is first defined to represent the characteristics of a certain subcategory of a subject. Then, for an image, the correlation coefficient is used for constructing the high-level feature, which reflects the correlation between this image and all base attributes. Since the high-level feature can reveal characteristics of more subcategories and contain more discriminative information, we call it hyperinformation feature (HIF). Compared with low-level features, which only represent the characteristics of one subcategory, HIF is more powerful and robust. In order to demonstrate the potential of the proposed framework, we provide a case study to extract HIF. We conduct comprehensive experiments to show the generality of the proposed framework and the efficiency of HIF on our databases, respectively. Experimental results show that HIF significantly outperforms the low-level features.

  18. The inferior cochlear vein: surgical aspects in cochlear implantation.

    PubMed

    Guo, Rui; Zhang, HongLei; Chen, Wei; Zhu, XiaoQuan; Liu, Wei; Rask-Andersen, Helge

    2016-02-01

    The patency of the inferior cochlear vein (ICV) may be challenged in cochlear implantation (CI) due to its location near the round window (RW). This may be essential to consider during selection of different trajectories for electrode insertion aiming at preserving residual hearing. Venous blood from the human cochlea is drained through the ICV. The vein also drains blood from the modiolus containing the spiral ganglion neurons. Surgical interference with this vein could cause neural damage influencing CI outcome. We analyzed the topographical relationship between the RW and ICV bony channel and cochlear aqueduct (CA) from a surgical standpoint. Archival human temporal bones were further microdissected to visualize the CA and its accessory canals (AC1 and AC2). This was combined with examinations of plastic and silicone molds of the human labyrinth. Metric analyses were made using photo stereomicroscopy documenting the proximal portion of the AC1, the internal aperture of the CA and the RW. The mean distance between the AC1 and the anterior rim of the RW was 0.81 mm in bone specimens and 0.67 mm assessed in corrosion casts. The AC1 runs from the floor of the scala tympani through the otic capsule passing parallel to the CA to the posterior cranial fossa. The mean distance between the CA and AC1 canal was 0.31 and 0.25 mm, respectively. PMID:25700831

  19. How to implement an office-based vein program.

    PubMed

    Shammas, Nicolas W; Hauber, William

    2014-09-01

    Peripheral venous disease is a highly prevalent problem affecting over 25-30 million people in the United States. Office-based treatment of superficial veins for chronic venous insufficiency is a fast-growing area with a recent surge of interest by cardiologists in this field. We describe our own experience with establishing a vein clinic in a single-specialty, cardiology-based office, and provide tips and tricks on how you can start your own vein program. A program based on the mission of providing high-quality, appropriate care to patients and with knowledgeable providers and staff is of paramount importance for the reputation and growth of the clinic. Other important factors needed for success include diligent oversight by a director and/or supervisor, an efficient precertification process, prompt billing and coding, and establishing an internal database or participation in a national venous database to track outcomes and complications. Regular meetings of all clinic participants that discuss quality, outcomes, and operational issues are essential to help standardize care and meet the recently launched Intersocietal Accreditation Commission standards. PMID:25198494

  20. Fabrication of subcutaneous veins phantom for vessel visualization system

    NASA Astrophysics Data System (ADS)

    Cheng, Kai; Narita, Kazuyuki; Morita, Yusuke; Nakamachi, Eiji; Honda, Norihiro; Awazu, Kunio

    2013-09-01

    The technique of subcutaneous veins imaging by using NIR (Near Infrared Radiation) is widely used in medical applications, such as the intravenous injection and the blood sampling. In the previous study, an automatic 3D blood vessel search and automatic blood sampling system was newly developed. In order to validate this NIR imaging system, we adopted the subcutaneous vein in the human arm and its artificial phantom, which imitate the human fat and blood vessel. The human skin and subcutaneous vein is characterized as the uncertainty object, which has the individual specificity, non-accurate depth information, non-steady state and hardly to be fixed in the examination apparatus. On the other hand, the conventional phantom was quite distinct from the human's characteristics, such as the non-multilayer structure, disagreement of optical property. In this study, we develop a multilayer phantom, which is quite similar with human skin, for improvement of NIR detection system evaluation. The phantom consists of three layers, such as the epidermis layer, the dermis layer and the subcutaneous fat layer. In subcutaneous fat layer, we built a blood vessel. We use the intralipid to imitate the optical scattering characteristics of human skin, and the hemoglobin and melanin for the optical absorption characteristics. In this study, we did two subjects. First, we decide the fabrication process of the phantom. Second, we compared newly developed phantoms with human skin by using our NIR detecting system, and confirm the availability of these phantoms.

  1. A Rare Complication of the Thyroid Malignancies: Jugular Vein Invasion

    PubMed Central

    Dikici, Atilla Sleyman; Y?ld?r?m, Onur; Er, Mehmet Emin; K?l?, Fahrettin; Tutar, Onur; Kantarc?, Fatih; Mihmanl?, Ismail

    2015-01-01

    Summary Background Unilateral invasion of the internal jugular vein (IJV) after subtotal thyroidectomy caused by local recurrence of papillary thyroid carcinoma is extremely rare. We report a case of papillary thyroid carcinoma which invades IJV with hypervascular tumor thrombus. Case Report We report a case of a 52-year-old woman with a history of previous thyroid operation who presented with a 2-month history of a painless, growing, hard, solitary mass on the left side of the neck. Clinical examination revealed also ipsilateral cervical lymphadenopathy. Radiological examination showed a necrotic and cystic mass arising from the operated area extending and invading the left jugular vein wall with hypervascular tumor thrombus. Cytological examination of the mass confirmed a papillary thyroid carcinoma (PTC) and enlarged metastatic lymph nodes. Therefore, total thyroidectomy with left neck dissection and segmental resection of the left internal jugular vein were performed, and the tumor thrombus was cleared successfully. Conclusions Invasion of IJV with hypervascular tumor thrombosis is an extremely rare condition in papillary thyroid carcinoma. Thrombosis of IJV is probably underdiagnosed. Early-stage diagnosis is important for long-term survival rates. PMID:26236418

  2. Splanchnic vein thrombosis in the mediterranean area in children.

    PubMed

    El-Karaksy, Hanaa; El-Raziky, Mona

    2011-01-01

    Abdominal venous thrombosis may present as splanchnic venous thrombosis (SVT) (occlusion of portal, splenic, superior or inferior mesenteric veins) or Budd- Chiari Syndrome (BCS) (thrombosis of inferior vena cava and/or hepatic veins). The aim of this review is to report the scanty data available for SVT in the South Mediterranean area. In one Egyptian study, the possible circumstantial risk factors for portal vein thrombosis (PVT) were found in 30% of cases: 19% neonatal sepsis, 8.7% umbilical catheterization, 6% severe gastroenteritis and dehydration. Another Egyptian study concluded that hereditary thrombophilia was common in children with PVT (62.5%), the commonest being factor V Leiden mutation (FVL) (30%). Concurrence of more than one hereditary thrombophilia was not uncommon (12.5%). The first international publication on hepatic veno-occlusive disease (VOD) in Egypt was in 1965 in children who rapidly develop abdominal distention with ascites and hepatomegaly. This disease was more frequent in malnourished children coming from rural areas; infusions given at home may contain noxious substances that were hepatotoxic and infections might play a role. VOD of childhood is rarely seen nowadays. Data from South Mediterranean area are deficient and this may be attributable to reporting in local medical journals that are difficult to access. Medical societies concerned with this topic could help distribute this information. PMID:21869913

  3. Potential Risk Factors for Varicose Veins with Superficial Venous Reflux

    PubMed Central

    Uzun Kulao?lu, Tlin; Fen, Turgay; Kap?s?z, Hasan Fahri

    2014-01-01

    The objective of the study is to evaluate a range of potential risk factors in the etiology of varicose veins with superficial venous reflux. Forty-nine patients attending a cardiovascular surgery clinic for the management of varicose disease between 2009 and 2010 were enrolled for the study. The age range of the patient group was 44,04 15,05 years and female/male (F/M) ratio was 30/19. Twenty-six normal, healthy volunteers with the age of 40,94 13,60 years and with the female/male ratio of 15/11 acted as control subjects. We investigated several parameters including body mass index, age, birth number > 1, standing for a long time (standing for 8 or more hours without taking a break), systemic diseases, family history, venous Doppler f?ndings, the levels of homocysteine, ferritin, vitamin B12, and hemoglobin, sedimentation rate, mean corpuscular volume, low density lipoprotein, and rheumatoid factor of the patient group and the control group. We also determined the contribution of the methylene tetrahydrofolate reductase 677 C>T and 1298 A>C gene polymorphisms and FV Leiden in both groups. In this small study, there appears to be no association between varicose veins and body mass index, smoking, type 2 DM, hypertension, family history, and birth number. A history of increased standing duration period (>8 hours) and rheumatoid factor positivity have association with varicose veins with superficial venous reflux. PMID:25302121

  4. Analysis of the hand vein pattern for people recognition

    NASA Astrophysics Data System (ADS)

    Castro-Ortega, R.; Toxqui-Quitl, C.; Cristóbal, G.; Marcos, J. Victor; Padilla-Vivanco, A.; Hurtado Pérez, R.

    2015-09-01

    The shape of the hand vascular pattern contains useful and unique features that can be used for identifying and authenticating people, with applications in access control, medicine and financial services. In this work, an optical system for the image acquisition of the hand vascular pattern is implemented. It consists of a CCD camera with sensitivity in the IR and a light source with emission in the 880 nm. The IR radiation interacts with the desoxyhemoglobin, hemoglobin and water present in the blood of the veins, making possible to see the vein pattern underneath skin. The segmentation of the Region Of Interest (ROI) is achieved using geometrical moments locating the centroid of an image. For enhancement of the vein pattern we use the technique of Histogram Equalization and Contrast Limited Adaptive Histogram Equalization (CLAHE). In order to remove unnecessary information such as body hair and skinfolds, a low pass filter is implemented. A method based on geometric moments is used to obtain the invariant descriptors of the input images. The classification task is achieved using Artificial Neural Networks (ANN) and K-Nearest Neighbors (K-nn) algorithms. Experimental results using our database show a percentage of correct classification, higher of 86.36% with ANN for 912 images of 38 people with 12 versions each one.

  5. An Ophiovirus isolated from lettuce with big-vein symptoms.

    PubMed

    Roggero, P; Ciuffo, M; Vaira, A M; Accotto, G P; Masenga, V; Milne, R G

    2000-01-01

    Big-vein is a widespread and damaging disease of lettuce, transmitted through soil by the chytrid fungus Olpidium brassicae, and generally supposed to be caused by Lettuce big-vein virus (LBVV; genus Varicosavirus). This virus is reported to have rigid rod-shaped particles, a divided double-stranded RNA genome, and one capsid protein of 48 kD, but has not been isolated or rigorously shown to cause the disease. We provide evidence that a totally different virus, here named Mirafiori lettuce virus (MiLV), is also very frequently associated with lettuce showing big-vein symptoms. MiLV was mechanically transmissible from lettuce to Chenopodium quinoa and to several other herbaceous test plants. The virus was partially purified, and an antiserum prepared, which did not react with LBVV particles in decoration tests. As reported for LBVV, MiLV was labile, soil-transmitted and had a single capsid protein of 48 kD, but the particles morphologically resembled those of ophioviruses, and like these, MiLV had a genome of three RNA segments approximately 8.5, 1.9 and 1.7 kb in size. MiLV preparations reacted strongly in Western blots and in ISEM with antiserum to Tulip mild mottle mosaic virus, an ophiovirus from Japan also apparently Olpidium-transmitted. They reacted weakly but clearly in Western blots with antiserum to Ranunculus white mottle virus, another ophiovirus. When lettuce seedlings were mechanically inoculated with crude or partially purified extracts from MiLV-infected test plants, many became systemically infected with MiLV and some developed big-vein symptoms. Such plants did not react in ELISA using an LBVV antiserum or an antiserum to tobacco stunt virus, and varicosavirus-like particles were never seen in them in the EM after negative staining. We conclude that MiLV is a hitherto undescribed virus assignable to the genus Ophiovirus. The cause or causes of lettuce big-vein disease and the properties of LBVV may need to be re-evaluated in light of our results. PMID:11205109

  6. Embolization of Incompetent Pelvic Veins for the Treatment of Recurrent Varicose Veins in Lower Limbs and Pelvic Congestion Syndrome

    SciTech Connect

    Meneses, Luis Fava, Mario; Diaz, Pia; Andia, Marcelo; Tejos, Cristian; Irarrazabal, Pablo; Uribe, Sergio

    2013-02-15

    We present our experience with embolization of incompetent pelvic veins (IPV) in women with recurrence of varicose veins (VV) in lower limbs, as well as symptoms of pelvic congestion syndrome (PCS), after first surgery. In addition, we evaluated the effects of embolization in decreasing the symptoms of VV before surgery as well as its effects on PCS symptoms. We included 10 women who had consulted a vascular surgeon because of recurrent VV in lower limbs after surgery. All of these patients were included in the study because they also had symptoms of PCS, probably due to IPV. In patients who had confirmed IPV, we performed embolization before a second surgery. VV and PCS were assessed before and at 3 months after embolization (before the second surgery) using a venous clinical severity score (VCSS) and a visual analog pain scale (VAS), respectively. Patients were controlled between 3 and 6 months after embolization. Paired Student t test analysis was used for comparing data before and after embolization. Fifteen vein segments in 10 women were suitable for embolization. There was a significant (p < 0.001) decrease of VCSS after embolization, and recurrence of VV was not detected within a period of 6 months. There was also significant (p < 0.01) relief of chronic pelvic pain related to PCS evaluated using VAS at 3 months after embolization. Embolization decreases the risk of VV recurrence after surgery and also improves PCS symptoms in women with VV in lower limbs and IPV.

  7. Reduction of intimal hyperplasia and enhanced reactivity of experimental vein bypass grafts with verapamil treatment.

    PubMed Central

    el-Sanadiki, M N; Cross, K S; Murray, J J; Schuman, R W; Mikat, E; McCann, R L; Hagen, P O

    1990-01-01

    Recent studies have shown that calcium antagonists exert an antiatherogenic effect in animals fed cholesterol. Vein graft intimal hyperplasia is believed to be an early event in atherosclerotic lesion formation, which is a significant cause of graft failure. Altered vasoreactivity has also been postulated in the etiology of vein graft failure. Therefore this study examined the effect of verapamil treatment on the development of intimal hyperplasia and the vasoreactivity of experimental vein bypass grafts. The right external jugular vein was grafted into the right carotid artery of 30 male New Zealand white rabbits fed normal rabbit chow. The left external jugular vein was used as the control vein. Fifteen animals received verapamil (1.25 mg/day for 28 days) via the femoral vein by means of an osmotic pump. In 15 control animals the pump contained saline. Plasma verapamil concentration was 50.9 +/- 13.2 ng/mL (x +/- SEM), a dose that showed no effect on either blood pressure, total serum cholesterol, or in vitro platelet aggregation to ADP. Fourteen of fifteen grafts were patent in each group, for a patency rate of 93%. Histologic examination using computer morphometry showed significant reduction of intimal hyperplasia at the proximal, middle, and distal graft segments (p less than 0.05). In addition in vitro isometric tension studies of the vein grafts and control veins showed that verapamil causes enhanced reactivity of both vein grafts and control veins in response to norepinephrine and histamine (p less than 0.05). Reactivity of vein grafts to serotonin was unaltered. While none of the normal veins in the control group responded to serotonin, normal veins treated with verapamil contracted readily in response to serotonin. Endothelial-dependent relaxation to acetylcholine was absent in both control and verapamil-treated vein grafts, while normal veins from both groups responded to the same extent to acetylcholine. Because we could not demonstrate any difference in platelet or endothelium function between untreated and verapamil-treated animals, we examined the direct effect of verapamil on smooth muscle. Verapamil significantly inhibited [3H]-thymidine incorporation into DNA in vascular smooth muscle cells in culture in a dose-dependent manner. Verapamil treatment significantly reduces intimal hyperplasia in experimental vein grafts and inhibits smooth muscle cell proliferation in culture. Furthermore the enhanced reactivity to norepinephrine and histamine in the verapamil-treated vessels has no detrimental effect on the patency rate at 4 weeks. Thus by inhibiting intimal hyperplasia, calcium antagonists may improve the long-term patency of vein bypass grafts. Images Figs. 1A-C. PMID:2363608

  8. The Evolution of Fracture Systems in Rocks with Veins: Insights from 3D Discrete Element Models

    NASA Astrophysics Data System (ADS)

    Virgo, S.; Urai, J. L.; Abe, S.

    2014-12-01

    Observations from natural vein systems suggest that preexisting veins can strongly influence orientation, continuity and connectivity of fractures in a rock even in cases where the orientation of the veins is incompatible with the orientation of the stress field. We present a numerical method to model cycles of fracturing and sealing in a rotating stress field to simulate such systems, for different strength ratios of host rock and vein. We study a layered model under vertical stress and uniaxial horizontal extension. This represents common conditions in sedimentary basins with layers of varying composition. The model with fractures that form during the first deformation phase is sealed and deformed again in a different direction to model the effect of a changing horizontal stress field. We find different types of fracture interaction with veins, depending on the strength contrast between veins and host rock and amount of rotation. The crack-seal and crack-jump mechanisms ensue naturally from the models as a result of the strength of the vein material relative to the host rock. Weak veins localize fracturing and reactivate, even in high misorientation to the extension direction. Connecting fractures between reactivated veins form at a higher angle to the veins than expected. In these systems, the connectivity of the fracture network is dramatically increased. Veins stronger than the host rock have less influence on the new fractures. Most fractures crosscut the veins by the step-over mechanism. Deflection occurs for favorable vein orientations but the deflection length is very short. The results are in good agreement with natural crack seal vein networks found in carbonate rocks of the Oman Mountains. We find that preexisting veins can change the fracture behavior of a rock in a way that new fractures do not necessarily align with the principle extension direction and form a highly connected network with reactivated veins that dramatically enhances lateral hydraulic conductivity of the rock. The results allow formulating constitutive rules for the fracture behavior of rocks with veins that can be used to make predictions on the orientation and connectivity of fracture networks on a reservoir scale to use in THMC models. Furthermore they have implications for paleostress analysis based on crack seal vein networks.

  9. COMPUTED TOMOGRAPHIC AND ULTRASONOGRAPHIC CHARACTERISTICS OF CAVERNOUS TRANSFORMATION OF THE OBSTRUCTED PORTAL VEIN IN SMALL ANIMALS.

    PubMed

    Specchi, Swan; Pey, Pascaline; Ledda, Gianluca; Lustgarten, Meghann; Thrall, Donald; Bertolini, Giovanna

    2015-01-01

    In humans, the process of development of collateral vessels with hepatopetal flow around the portal vein in order to bypass an obstruction is called "cavernous transformation of the portal vein." The purpose of this retrospective, cross-sectional, multicentric study was to describe presumed cavernous transformation of the portal vein in small animals with portal vein obstruction using ultrasound and multidetector-row computed tomography (MDCT). Databases from three different institutions were searched for patients with an imaging diagnosis of cavernous transformation of the portal vein secondary to portal vein obstruction of any cause. Images were retrieved and reanalyzed. With MDCT-angiography, two main portoportal collateral pathways were identified: short tortuous portoportal veins around/inside the thrombus and long portoportal collaterals bypassing the site of portal obstruction. Three subtypes of the long collaterals, often coexisting, were identified. Branches of the hepatic artery where involved in collateral circulation in nine cases. Concomitant acquired portosystemic shunts were identified in six patients. With ultrasound, cavernous transformation of the portal vein was suspected in three dogs and one cat based on visualization of multiple and tortuous vascular structures corresponding to periportal collaterals. In conclusion, the current study provided descriptive MDCT and ultrasonographic characteristics of presumed cavernous transformation of the portal vein in a sample of small animals. Cavernous transformation of the portal vein could occur as a single condition or could be concurrent with acquired portosystemic shunts. PMID:25877678

  10. Targeted endovenous treatment of Giacomini vein insufficiency-associated varicose disease: considering the reflux patterns

    PubMed Central

    Atasoy, Mehmet Mahir; Gm?, Burak; Caymaz, ?smail; O?uzkurt, Levent

    2014-01-01

    PURPOSE We aimed to assess the technical feasibility of targeted endovenous treatment of Giacomini vein insufficiency (GVI)-associated varicose disease and report our early results. METHODS We retrospectively screened 335 patients with varicose disease who underwent endovenous laser ablation from September 2011 to January 2013, and determined 17 patients who underwent Giacomini vein ablation. Using a targeted endovenous treatment approach considering the reflux pattern, all healthy great saphenous veins (GSV) or vein segments were preserved while all insufficient veins (Giacomini vein, perforator veins, small saphenous vein, anterior accessory GSV, major tributary veins, or incompetent segments of the GSV) were ablated. Treatment success was analysed using Doppler findings and clinical assessment scores before and after treatment. RESULTS Targeted endovenous treatment was technically successful in all cases. Seven GSVs were preserved totally and three GSVs were preserved partially (10/17, 58%), with no major complications. Clinical assessment scores and Doppler findings were improved in all cases. CONCLUSION Targeted endovenous treatment of GVI-associated varicose disease is safe and effective. In majority of GVI cases saphenous vein can be preserved using this approach. PMID:25205026

  11. Computer-assisted diagnostic tool to quantify the pulmonary veins in sickle cell associated pulmonary hypertension

    NASA Astrophysics Data System (ADS)

    Jajamovich, Guido H.; Pamulapati, Vivek; Alam, Shoaib; Mehari, Alem; Kato, Gregory J.; Wood, Bradford J.; Linguraru, Marius George

    2012-03-01

    Pulmonary hypertension is a common cause of death among patients with sickle cell disease. This study investigates the use of pulmonary vein analysis to assist the diagnosis of pulmonary hypertension non-invasively with CT-Angiography images. The characterization of the pulmonary veins from CT presents two main challenges. Firstly, the number of pulmonary veins is unknown a priori and secondly, the contrast material is degraded when reaching the pulmonary veins, making the edges of these vessels to appear faint. Each image is first denoised and a fast marching approach is used to segment the left atrium and pulmonary veins. Afterward, a geodesic active contour is employed to isolate the left atrium. A thinning technique is then used to extract the skeleton of the atrium and the veins. The locations of the pulmonary veins ostia are determined by the intersection of the skeleton and the contour of the atrium. The diameters of the pulmonary veins are measured in each vein at fixed distances from the corresponding ostium, and for each distance, the sum of the diameters of all the veins is computed. These indicators are shown to be significantly larger in sickle-cell patients with pulmonary hypertension as compared to controls (p-values < 0.01).

  12. Management of superficial vein thrombosis and thrombophlebitis: status and expert opinion document.

    PubMed

    Cesarone, M R; Belcaro, G; Agus, G; Georgiev, M; Errichi, B M; Marinucci, R; Errichi, S; Filippini, A; Pellegrini, L; Ledda, A; Vinciguerra, G; Ricci, A; Cipollone, G; Lania, M; Gizzi, G; Ippolito, E; Bavera, P; Fano, F; Dugall, M; Adovasio, R; Gallione, L; Del Boccio, G; Cornelli, U; Steigerwalt, R; Acerbi, G; Cacchio, M; Di Renzo, A; Hosoi, M; Stuard, S; Corsi, M; Di Ciano, L; Simeone, E; Collevecchio, G; Grossi, M G; Di Giambattista, F; Carestia, F; Zukowski, A

    2007-01-01

    Superficial vein thrombosis is characterized by clotting of superficial veins (ie, following direct trauma) with minimal inflammatory components. Superficial thrombophlebitis is a minimally thrombotic process of superficial veins associated with inflammatory changes and/or infection. Treatments generally include analgesics, elastic compression, anti-inflammatory agents, exercise and ambulation, and, in some cases, local or systemic anticoagulants. It is better to avoid bed rest and reduced mobility. Topical analgesia with nonsteroidal, anti-inflammatory creams applied locally to the superficial vein thrombosis/superficial thrombophlebitis area controls symptoms. Hirudoid cream (heparinoid) shortens the duration of signs/symptoms. Locally acting anticoagulants/antithrombotics (Viatromb, Lipohep, spray Na-heparin) have positive effects on pain and on the reduction in thrombus size. Intravenous catheters should be changed every 24 to 48 hours (depending on venous flow and clinical parameters) to prevent superficial vein thrombosis/superficial thrombophlebitis and removed in case of events. Low molecular weight heparin prophylaxis and nitroglycerin patches distal to peripheral lines may reduce the incidence of superficial vein thrombosis/superficial thrombophlebitis in patients with vein catheters. In case of superficial vein thrombosis/superficial thrombophlebitis, vein lines should be removed. In neoplastic diseases and hematological disorders, anticoagulants may be necessary. Exercise reduces pain and the possibility of deep vein thrombosis. Only in cases in which pain is very severe is bed rest necessary. Deep vein thrombosis prophylaxis should be established in patients with reduced mobility. Antibiotics usually do not have a place in superficial vein thrombosis/superficial thrombophlebitis unless there are documented infections. Prevention of superficial vein thrombosis should be considered on the basis of patient's history and clinical evaluation. PMID:17478877

  13. Histological studies of the dorsal nasal, angularis oculi, and facial veins of sheep (Ovis aries).

    PubMed

    Mitchell, J; Thomalla, L; Mitchell, G

    1998-09-01

    Selective brain cooling (SBC) requires vasoactivity in the superficial veins of the face of the animal. This vasoactivity is possible because of an adequate amount of smooth muscle in the tunica media of each of these superficial vessels, enabling it to act as a "muscle sphincter". In this study, the angularis oculi, dorsal nasal, distal, and proximal parts of the facial veins in sheep were examined histologically to describe an anatomical basis for SBC. Measurements of the tunica media thickness, the lumen diameter, and the ratio of these measurements showed that the relative tunica media thicknesses in the angularis oculi vein and the dorsal nasal vein are statistically smaller (P < 0.001) than in the distal or the proximal parts of the facial vein. In the angularis oculi, dorsal nasal, and distal part of the facial vein, the tunicae mediae were composed of five to seven circularly arranged smooth muscle layers, suggesting their ability to vasoconstrict. The proximal part of the facial vein possesses both circularly and longitudinally arranged smooth muscle layers. The circular smooth muscle layers suggest a vasoconstrictory function, whereas the longitudinal smooth muscle layers suggest a vasoconstrictory function in this part of the facial vein. Both the dorsal nasal and the proximal part of the facial vein, but not the angularis oculi or the distal part of the facial vein, possess endothelial valves near their confluences with other veins. It was concluded from this study that the angularis oculi and the distal part of the facial vein vasoconstrict, whereas the proximal part of the facial vein vasodilates, enabling the necessary changes in blood flow in SBC. PMID:9734068

  14. A Retrospective Study of Preferable Alternative Route to Right Internal Jugular Vein for Placing Tunneled Dialysis Catheters: Right External Jugular Vein versus Left Internal Jugular Vein

    PubMed Central

    Wang, Pei; Wang, Yufei; Qiao, Yingjin; Zhou, Sijie; Liang, Xianhui; Liu, Zhangsuo

    2016-01-01

    Background Right internal jugular vein (IJV) is a preferred access route for tunneled (cuffed) dialysis catheters (TDCs), and both right external jugular vein (EJV) and left IJV are alternative routes for patients in case the right IJV isnt available for TDC placement. This retrospective study aimed to determine if a disparity exists between the two alternative routes in hemodialysis patients in terms of outcomes of TDCs. Methods 49 hemodialysis patients who required TDCs through right EJV (n = 21) or left IJV (n = 28) as long-term vascular access were included in this study. The primary end point was cumulative catheter patency. Secondary end points include primary catheter patency, proportion of patients that never required urokinase and incidence of catheter-related bloodstream infections (CRBSI). Results A total of 20,870 catheter-days were evaluated and the median was 384 (interquartile range, 262605) catheter-days. Fewer catheters were removed in the right EJV group than in the left IJV group (P = 0.007). Mean cumulative catheter patency was higher in the right EJV group compared with the left IJV group (P = 0.031). There was no significant difference between the two groups in the incidence of CRBSI, primary catheter patency or proportion of patients that never required urokinase use. Total indwell time of antecedent catheters was identified as an independent risk factor for cumulative catheter patency by Cox regression hazards test with an HR of 2.212 (95% CI, 1.3633.588; p = 0.001). Conclusions Right EJV might be superior to left IJV as an alternative insertion route for TDC placement in hemodialysis patients whose right IJVs are unavailable. PMID:26751380

  15. Ultrastructure of dragonfly wing veins: composite structure of fibrous material supplemented by resilin.

    PubMed

    Appel, Esther; Heepe, Lars; Lin, Chung-Ping; Gorb, Stanislav N

    2015-10-01

    Dragonflies count among the most skilful of the flying insects. Their exceptional aerodynamic performance has been the subject of various studies. Morphological and kinematic investigations have showed that dragonfly wings, though being rather stiff, are able to undergo passive deformation during flight, thereby improving the aerodynamic performance. Resilin, a rubber-like protein, has been suggested to be a key component in insect wing flexibility and deformation in response to aerodynamic loads, and has been reported in various arthropod locomotor systems. It has already been found in wing vein joints, connecting longitudinal veins to cross veins, and was shown to endow the dragonfly wing with chordwise flexibility, thereby most likely influencing the dragonfly's flight performance. The present study revealed that resilin is not only present in wing vein joints, but also in the internal cuticle layers of veins in wings of Sympetrum vulgatum (SV) and Matrona basilaris basilaris (MBB). Combined with other structural features of wing veins, such as number and thickness of cuticle layers, material composition, and cross-sectional shape, resilin most probably has an effect on the vein's material properties and the degree of elastic deformations. In order to elucidate the wing vein ultrastructure and the exact localisation of resilin in the internal layers of the vein cuticle, the approaches of bright-field light microscopy, wide-field fluorescence microscopy, confocal laser-scanning microscopy, scanning electron microscopy and transmission electron microscopy were combined. Wing veins were shown to consist of up to six different cuticle layers and a single row of underlying epidermal cells. In wing veins of MBB, the latter are densely packed with light-scattering spheres, previously shown to produce structural colours in the form of quasiordered arrays. Longitudinal and cross veins differ significantly in relative thickness of exo- and endocuticle, with cross veins showing a much thicker exocuticle. The presence of resilin in the unsclerotised endocuticle suggests its contribution to an increased energy storage and material flexibility, thus to the prevention of vein damage. This is especially important in the highly stressed longitudinal veins, which have much lower possibility to yield to applied loads with the aid of vein joints, as the cross veins do. These results may be relevant not only for biologists, but may also contribute to optimise the design of micro-air vehicles. PMID:26352411

  16. Absorption of carbon dioxide during endoscopic vein harvest

    PubMed Central

    Zingaro, Carlo; Pierri, Michele Danilo; Massi, Francesco; Matteucci, Marco Luciano Sacha; Capestro, Filippo; D'Alfonso, Alessandro; Aratari, Carlo; Torracca, Lucia

    2012-01-01

    OBJECTIVES Carbon dioxide (CO2) insufflation was used by some devices for endoscopic vein harvest to create a subcutaneous tunnel and facilitate the vein harvest. In the literature, some cases of CO2 micro- and macro-embolisms or hypercarbia during this procedure are described. The purpose of this study was to evaluate if the use of an open CO2 system rather than a sealed system might be associated with different CO2 absorption during the procedure. METHODS Patients were randomized into two groups: those patients in the first group were submitted to endoscopic vein harvest using a sealed CO2 insufflation; in the second group, the harvest was undertaken with an open CO2 insufflation. Partial pressure of CO2 in the arterial blood (PaCO2) and end-tidal CO2 (ETCO2) was recorded following anaesthesia induction and before the endoscopic procedure (T0), every 10min during the endoscopic step (T1) and end after 10min from the CO2 insufflation termination (T2). RESULTS A total of 60 patients were enrolled. PaCO2 increased significantly between T0, T1 and T2 in both groups (P=0.0001) during the endoscopic harvest, but the PaCO2 level was significantly higher in the group that used the sealed system (44.57.9 vs 39.77.9mmHg) at the end of the procedure (P=0.01). No significant differences between end-tidal CO2 measured at the same intervals between groups were detected. CONCLUSIONS There was a constant increase in the blood gas concentration compared with the basal pre-procedure values. Sealed systems were associated with a significantly higher CO2 concentration at the end of the procedure compared with the open ones. PMID:22761115

  17. Rule-Based Model of Vein Graft Remodeling

    PubMed Central

    Hwang, Minki; Garbey, Marc; Berceli, Scott A.; Wu, Rongling; Jiang, Zhihua; Tran-Son-Tay, Roger

    2013-01-01

    When vein segments are implanted into the arterial system for use in arterial bypass grafting, adaptation to the higher pressure and flow of the arterial system is accomplished thorough wall thickening and expansion. These early remodeling events have been found to be closely coupled to the local hemodynamic forces, such as shear stress and wall tension, and are believed to be the foundation for later vein graft failure. To further our mechanistic understanding of the cellular and extracellular interactions that lead to global changes in tissue architecture, a rule-based modeling method is developed through the application of basic rules of behaviors for these molecular and cellular activities. In the current method, smooth muscle cell (SMC), extracellular matrix (ECM), and monocytes are selected as the three components that occupy the elements of a grid system that comprise the developing vein graft intima. The probabilities of the cellular behaviors are developed based on data extracted from in vivo experiments. At each time step, the various probabilities are computed and applied to the SMC and ECM elements to determine their next physical state and behavior. One- and two-dimensional models are developed to test and validate the computational approach. The importance of monocyte infiltration, and the associated effect in augmenting extracellular matrix deposition, was evaluated and found to be an important component in model development. Final model validation is performed using an independent set of experiments, where model predictions of intimal growth are evaluated against experimental data obtained from the complex geometry and shear stress patterns offered by a mid-graft focal stenosis, where simulation results show good agreements with the experimental data. PMID:23533576

  18. Is pulmonary vein isolation still the cornerstone in atrial fibrillation ablation?

    PubMed Central

    Cutler, Michael J.

    2015-01-01

    Radiofrequency catheter ablation for atrial fibrillation (AF) has become a frequently used therapy after failure of at least one antiarrhythmic drug. The cornerstone of AF ablation has been durable pulmonary vein isolation. However, understanding the positive and negative outcomes of catheter ablation of AF is severely limited by diverse ablation methodologies that do not seem to result in durable pulmonary vein isolation. Without durable pulmonary isolation ablation, it is unclear if ablation strategies need to be modified to include extrapulmonary vein ablation targets in combination with pulmonary vein isolation or alone to improve long-term procedural success rates. The marked discrepancy between AF ablation procedure success rates and actual long-term pulmonary vein isolation rates does suggest that targeting other mechanisms can be considered to achieve similar or better results when compared to pulmonary vein isolation alone. PMID:25713728

  19. Postoperative Massive Pulmonary Embolism Due to Superficial Vein Thrombosis of the Upper Limb.

    PubMed

    Cascella, Marco; Viscardi, Daniela; Bifulco, Francesca; Cuomo, Arturo

    2016-04-01

    It is well known that deep vein thrombosis of the upper extremities is linked to high morbidity/mortality, resulting in 12-20% of all documented pulmonary embolism; however, there are few data about thromboembolism originating from a vein and/or a branch of a superficial vein of the upper extremities. Pulmonary embolism secondary to upper limb superficial vein thrombosis (not combined with upper extremities deep vein thrombosis) is a very rare clinical manifestation with few cases reported in the literature. We report a rare case of thrombophlebitis in departure from a superficial branch of the cephalic vein of the right arm, complicated by cardiac arrest secondary to a massive pulmonary embolism in a patient who underwent major surgery for ovarian cancer. We discuss on the numerous thrombotic risk factors, triggering a cascade of reactions and resulting in a potential fatal clinical manifestation. PMID:26985256

  20. Duplication of Right Testicular Vein: Embryological and Clinical Consideration- A Case Report.

    PubMed

    Abraham, Joseph; Sharma, Anshu; Sharma, Mahesh; J P, Jessy; Priyanka

    2015-11-01

    The testis is the organ upon which the survival of the human species depends. Abnormalities of testicular vessels may lead to loss of gametogenesis and hormone production. The gonadal veins are anatomically asymmetric and there are several anatomical variations involving them. In present case, a variation in draining pattern of right gonadal vein was observed during a routine dissection done at Department of Anatomy. Duplication of right gonadal vein near the point of drainage was found. One of the veins was draining in inferior vena cava and other into right renal vein. According to the reviewed literature, a case like this was rarely reported. There was no other vascular abnormality in this case. Variation in gonadal veins remains unnoticed clinically, but these variations are incidental findings during autopsy and surgeries. The presence of such variations can increase risk of varicocoele and infertility in patients. PMID:26673850

  1. Clay veins: their occurrence, characteristics, and support. Report of Investigations/1987

    SciTech Connect

    Chase, F.E.; Ulery, J.P.

    1987-01-01

    Clay veins found in coal mines have caused numerous injuries and fatalities. These structures plague all phases of mining, including entry development, pillar recovery, and panel extraction. Clay veins also increase production costs and may disrupt or halt mining. The occurrence and origins of clay veins were investigated to determine predictive capabilities. The investigators found that clay veins normally occur in more-stable, less-rapidly-subsiding coal basins. Clay veins result when tensile stresses develop fissures that are later infilled. These fissures can be propagated by compactional processes and/or tectonic stresses during and subsequent to coalification. It was found that associated faults, fractures, and slickenside planes accompany parallel clay veins and disrupt the lateral continuity of the immediate and, sometimes, main roof.

  2. Postoperative Massive Pulmonary Embolism Due to Superficial Vein Thrombosis of the Upper Limb

    PubMed Central

    Cascella, Marco; Viscardi, Daniela; Bifulco, Francesca; Cuomo, Arturo

    2016-01-01

    It is well known that deep vein thrombosis of the upper extremities is linked to high morbidity/mortality, resulting in 12-20% of all documented pulmonary embolism; however, there are few data about thromboembolism originating from a vein and/or a branch of a superficial vein of the upper extremities. Pulmonary embolism secondary to upper limb superficial vein thrombosis (not combined with upper extremities deep vein thrombosis) is a very rare clinical manifestation with few cases reported in the literature. We report a rare case of thrombophlebitis in departure from a superficial branch of the cephalic vein of the right arm, complicated by cardiac arrest secondary to a massive pulmonary embolism in a patient who underwent major surgery for ovarian cancer. We discuss on the numerous thrombotic risk factors, triggering a cascade of reactions and resulting in a potential fatal clinical manifestation. PMID:26985256

  3. Renal vein renin activity and prostaglandins A and E in hypertension.

    PubMed

    Pletka, P G; Agar, J W; Rossetti, R; Ethier, M; Hickler, R B; Hull, J D

    1981-01-01

    The relation between renal vein renin activity (RVRA) and renal vein-prostaglandin A (PGA) and prostaglandin E (PGE) concentrations was examined in 50 patients with hypertension who underwent renal vein catheterizations for suspected renovascular hypertension. In 14 patients wih unilateral renal artery stenosis, mean renal vein PGE concentrations were higher in the renal vein draining the nonischemic kidney, while RVRA was increased in the renal vein draining the ischemic kidney. PGE ratios from the two sides were inversely related to RVRA ratios in this group. In the other 36 patients with either bilateral renal artery stenosis, essential hypertension or nonrenovascular unilateral renal disease, RVRA and PGE concentrations were similar in both kidneys. No relation between RVRA and PGA could be established for any group. PMID:7012654

  4. Retro-Aortic Inverted Left Renal Vein: A Rare Anomaly Found in a Renal Donor

    PubMed Central

    Sabouri, Sofia; Hosseini, Ashrafsadat; Shivaei, Seyedeh Shirin

    2015-01-01

    Awareness of the renal vascular anatomy including variants of the renal vein is important for abdominal and renal surgeries, such as renal transplantation. The complex embryological development of the renal vein results in the following variations: additional renal veins on the left side, circum-aortic renal collar and retro-aortic renal veins. In this report, we present a case of a 35-year-old renal donor who had a rare renal vein anomaly that had been shown by computed tomography (CT) angiography. The left renal vein was single, and just before draining into the inferior vena cava (IVC) made two branches craniocaudally, which both passed posteriorly to the aorta and entered separately into the IVC. PMID:25901255

  5. Intensity Variation Normalization for Finger Vein Recognition Using Guided Filter Based Singe Scale Retinex

    PubMed Central

    Xie, Shan Juan; Lu, Yu; Yoon, Sook; Yang, Jucheng; Park, Dong Sun

    2015-01-01

    Finger vein recognition has been considered one of the most promising biometrics for personal authentication. However, the capacities and percentages of finger tissues (e.g., bone, muscle, ligament, water, fat, etc.) vary person by person. This usually causes poor quality of finger vein images, therefore degrading the performance of finger vein recognition systems (FVRSs). In this paper, the intrinsic factors of finger tissue causing poor quality of finger vein images are analyzed, and an intensity variation (IV) normalization method using guided filter based single scale retinex (GFSSR) is proposed for finger vein image enhancement. The experimental results on two public datasets demonstrate the effectiveness of the proposed method in enhancing the image quality and finger vein recognition accuracy. PMID:26184226

  6. Palm vein for efficient person recognition based on 2D Gabor filter

    NASA Astrophysics Data System (ADS)

    Wang, Jixing; He, Yuqing; Zhu, Jiadan; Gao, Xinru; Cui, Yongsheng

    2013-05-01

    Palm vein recognition is a relatively new method in biometrics. This paper presents an effective palm vein feature extraction approach for improving the efficiency of palm vein identification. In this paper, relevant preprocessing steps as rotation and extraction of the Region of Interest are presented. In feature extraction, multiple 2D Gabor filters with 4 orientations are employed to extract the phase information on a palm vein image, which is then merged into unique feature according to an encoding rule. Hamming distance is used for vein recognition. Experiments are carried on a selfmade palm vein database. Experimental results show that the method in this paper achieved a higher correct recognition rate and a faster speed.

  7. Duplication of Right Testicular Vein: Embryological and Clinical Consideration- A Case Report

    PubMed Central

    Sharma, Anshu; Sharma, Mahesh; J P, Jessy; Priyanka

    2015-01-01

    The testis is the organ upon which the survival of the human species depends. Abnormalities of testicular vessels may lead to loss of gametogenesis and hormone production. The gonadal veins are anatomically asymmetric and there are several anatomical variations involving them. In present case, a variation in draining pattern of right gonadal vein was observed during a routine dissection done at Department of Anatomy. Duplication of right gonadal vein near the point of drainage was found. One of the veins was draining in inferior vena cava and other into right renal vein. According to the reviewed literature, a case like this was rarely reported. There was no other vascular abnormality in this case. Variation in gonadal veins remains unnoticed clinically, but these variations are incidental findings during autopsy and surgeries. The presence of such variations can increase risk of varicocoele and infertility in patients. PMID:26673850

  8. Intensity Variation Normalization for Finger Vein Recognition Using Guided Filter Based Singe Scale Retinex.

    PubMed

    Xie, Shan Juan; Lu, Yu; Yoon, Sook; Yang, Jucheng; Park, Dong Sun

    2015-01-01

    Finger vein recognition has been considered one of the most promising biometrics for personal authentication. However, the capacities and percentages of finger tissues (e.g., bone, muscle, ligament, water, fat, etc.) vary person by person. This usually causes poor quality of finger vein images, therefore degrading the performance of finger vein recognition systems (FVRSs). In this paper, the intrinsic factors of finger tissue causing poor quality of finger vein images are analyzed, and an intensity variation (IV) normalization method using guided filter based single scale retinex (GFSSR) is proposed for finger vein image enhancement. The experimental results on two public datasets demonstrate the effectiveness of the proposed method in enhancing the image quality and finger vein recognition accuracy. PMID:26184226

  9. Acute Pancreatitis and Splenic Vein Thrombosis due to Hypertriglyceridemia

    PubMed Central

    Gndz, Ercan; Dursun, Recep; ?er, Mustafa; Zengin, Y?lmaz; Glo?lu, Cahfer

    2015-01-01

    Acute pancreatitis (AP) is a condition characterised by the activation of the normally inactive digestive enzymes due to an etiological factor and digestion of the pancreatic tissues, resulting in extensive inflammation and leading to local, regional, and systemic complications in the organism. It may vary from the mild edematous to the hemorrhagic and severely necrotising form. The most common causes are biliary stones and alcohol abuse. In this case study, we would like to present a patient with AP due to hypertriglyceridemia (HPTG), which is a rare cause of pancreatitis, and splenic vein thrombosis, which is a rare complication of pancreatitis. PMID:25802772

  10. Alteration and vein mineralization, Schwartzwalder uranium deposit, Front Range, Colorado

    USGS Publications Warehouse

    Wallace, Alan R.

    1983-01-01

    The Schwartzwalder uranium deposit, in the Front Range west of Denver, Colorado, is the largest vein-type uranium deposit in the United States. The deposit is situated in a steeply dipping fault system that cuts Proterozoic metamorphic rocks. The host rocks represent a submarine volcanic system with associated chert and iron- and sulfide-rich pelitic rocks. Where faulted, the more competent garnetiferous and quartzitic units behaved brittlely and created a deep, narrow conduit. The ores formed 70-72 m.y. ago beneath 3 km of Phanerozoic sedimentary rocks. Mineralization included two episodes of alteration and three stages of vein-mineralization. Early carbonate-sericite alteration pseudomorphically replaced mafic minerals, whereas the ensuing hematite-adularia episode replaced only the earlier alteration assemblage. Early vein mineralization produced a minor sulfide-adularia-carbonate assemblage. Later vein mineralization generated the uranium ores in two successive stages. Carbonates, sulfides, and adularia filled the remaining voids. Clastic dikes composed of fault gouge and, locally, ore were injected into new and existing fractures. Geologic and chemical evidence suggest that virtually all components of the deposit were derived from major hornblende gneiss units and related rocks. The initial fluids were evolved connate/metamorphic water that infiltrated and resided along the extensive fault zones. Complex fault movements in the frontal zone of the eastern Front Range caused the fluids to migrate to the most permeable segments of the fault zones. Heat was supplied by increased crustal heat flow related to igneous activity in the nearby Colorado mineral belt. Temperatures decreased from 225?C to 125?C during later mineralization, and the pressure episodically dropped from 1000 bars. The CO2 fugacity was initially near 100 bars, and uranium was carried as a dicarbonate complex. Sudden decreases in confining pressure during fault movement caused evolution of CO2 and a consequent increase in pH. Uranium was released with destruction of the uranyl complexes; it was subsequently reduced by aqueous sulfur species, thereby leading to the precipitation of pitchblende.

  11. Portal vein thrombosis: When to treat and how?

    PubMed

    Sharma, Aditya M; Zhu, Daisy; Henry, Zachary

    2016-02-01

    Portal vein thrombosis is an unusual thrombotic condition not frequently seen in the general population; however, it has a higher prevalence in special circumstances such as in liver cirrhosis and hepatic or pancreatic malignancy. It also can be associated with significant morbidity and mortality. In this review, we discuss the current data available to guide therapy in the setting of different associated co-morbidities, hypercoagulable states, and associated thrombosis of the remaining splanchnic circulation. We discuss indications for anticoagulation, including the choice of anticoagulants, as well as the role of conservative 'wait and watch' and invasive therapies, such as thrombolysis, thrombectomy, and transjugular intrahepatic portosystemic shunt. PMID:26584887

  12. A hand vein recognition system based on DSP and CPLD

    NASA Astrophysics Data System (ADS)

    Kang, Wen-Xiong; Chen, Zi-Yi; Yang, Qing-Qiang

    2010-11-01

    The hand vein recognition system based on digital signal processing (DSP) and complex programmable logic device (CPLD) is designed according to the requirements for equipment volume, accuracy and reaction speed. The overall structure and detailed implementation of the system hardware architecture are discussed in this paper. Moreover, the design philosophy and specific realization of system software as well as core algorithms are explored. The recognition system owns many good characteristics, such as high-degree integration, simple structure, flexible programming, convenient application and so on, which make it suitable for circumstances with high requirements for personal identification.

  13. Liomyosarcome de la veine cave infrieure: un cas clinique

    PubMed Central

    Hammoune, Nabil; El Guendouz, Faycal; Elhaddad, Siham; Latib, Rachida; Chami, Imane; Boujida, Najib; Hommadi, Abdelaziz

    2015-01-01

    Le liomyosarcome de la veine cave infrieure est une tumeur maligne rare dveloppe aux dpens des cellules musculaires lisses de la paroi vasculaire. L'imagerie radiologique par tomodensitomtrie ou rsonance magntique nuclaire est un lment important au diagnostic et au bilan d'extension tumorale. Le traitement est chirurgical. Nous illustrons l'apport de l'imagerie travers un cas de liomyosarcome rvl par des pigastralgies paroxystiques, dont le diagnostique tait orient par la TDM, et confirm par ltude histologique. Lvolution tait favorable. Aprs 2 ans de recul, la patiente tait indemne de toute rcidive tumorale. PMID:26161206

  14. Diodia vein chlorosis virus is a group-1 crinivirus.

    PubMed

    Tzanetakis, Ioannis E; Wintermantel, William M; Poudel, Bindu; Zhou, Jing

    2011-11-01

    Members of the family Closteroviridae have emerged as a major problem in agricultural crops in the past two decades. Diodia vein chlorosis virus (DVCV) is an understudied whitefly-transmitted closterovirus. Given the presence of the primary host for the virus in major agricultural production areas in the United States, we characterized the virus at the molecular level, demonstrating that it belongs in the genus Crinivirus, developed detection protocols, evaluated its host range among hosts known to harbor viruses closely related to DVCV, and confirmed transmission by a second whitefly species, Trialeurodes vaporariorum. PMID:21735210

  15. Acquired Pulmonary Vein Isolation in a Patient with Friedreich Ataxia.

    PubMed

    Zipse, Matthew M; Aleong, Ryan G

    2016-03-01

    The electrophysiologic nature of atrial fibrillation (AF) and related atrial arrhythmias in Friedreich ataxia has not previously been characterized. In the presented case, dense atrial scar had progressed to the point of acquired pulmonary vein (PV) isolation before the delivery of a single radiofrequency lesion. AF was induced, and ultimately organized spontaneously into a microreentrant atrial tachycardia. Other atrial tachycardias were also identified near scar border zones; these potentially served as triggers for AF in this patient, independent of the PVs. This case emphasizes the need to address non-PV substrate in some patients undergoing catheter ablation of AF. PMID:26920184

  16. Left Inferior Vena Cava and Right Retroaortic Renal Vein

    PubMed Central

    Nania, Alberto; Capilli, Fabio; Longo, Eugenia

    2016-01-01

    Nowadays, incidental anatomical variants are frequent findings, due to the widespread diffusion of cross-sectional imaging. This case report illustrates a fairly uncommon anatomical variant, that is, the copresence of left inferior vena cava and retroaortic right renal vein reported in a 46-year-old lady, undergoing a staging CT for breast cancer. Although the patient was asymptomatic, the authors highlight potential risks related to the above-mentioned condition and the importance of correct identification and diagnosis of the findings. PMID:26955497

  17. Aneurysm of the pulmonary vein: an unusual cause of stroke.

    PubMed

    Emmert, Alexander; Jebran, Ahmad Fawad; Schmidt, Karsten; Hinterthaner, Marc; Bohnenberger, Hanibal; Bhr, Mathias; Schndube, Friedrich A; Danner, Bernhard C

    2014-11-01

    This clinical report deals with a giant true pulmonary venous aneurysm, which was partially thrombosed. The overall incidence of pulmonary venous aneurysms is unknown, and they are reported only occasionally. We present the case of a previously healthy man with acute onset of ischemic cerebral stroke. The cause was a thrombus in a huge aneurysm of the left superior pulmonary vein. The patient subsequently underwent uncomplicated therapy for stroke, including thrombolysis followed by excision of the giant pulmonary venous aneurysm. As curative therapy we recommend complete resection of this rare entity. PMID:25441803

  18. Intraocular metallic foreign body causing branch retinal vein occlusion.

    PubMed

    Bypareddy, Ravi; Sagar, Pradeep; Chawla, Rohan; Temkar, Shreyas

    2016-01-01

    We report a case of a 40-year-old man with post-traumatic cataract and an intraocular metallic foreign body (IOFB) lying on the retinal surface causing a superotemporal branch retinal vein occlusion. The case was managed using lens aspiration with pars plana vitrectomy and IOFB removal. We only found two previous reports of such a foreign body causing a vascular occlusion. The possibility of a vascular occlusion occurring due to a foreign body within or close to the optic disc is highlighted. PMID:26994054

  19. Inferior mesenteric vein thrombosis in Crohn`s disease: CT diagnosis

    SciTech Connect

    Coralnick, J.R.; Budin, J.A.; Sedarat, A.

    1996-01-01

    Mesenteric vein thrombosis has been described in association with such risk factors as coagulation disorders, postoperative dehydration, sepsis, and trauma. CT and ultrasound have greatly facilitated early diagnosis, and the features of superior mesenteric and portal vein thrombosis are well recognized. We present a case of inferior mesenteric vein thrombosis in a patient with Crohn`s disease. To our knowledge, this entity has not been reported in the radiologic literature. 7 refs., 2 figs.

  20. Meandering right pulmonary vein associated with severe and progressive "idiopathic-like" pulmonary hypertensive vascular disease.

    PubMed

    Cuenca, Sofia; Bret, Montserrat; Del Cerro, Maria Jesus

    2016-03-01

    Congenital anomalies of the pulmonary veins are rare. Meandering right pulmonary vein, considered a part of the Scimitar syndrome spectrum, is often an incidental finding during chest imaging. We present the case of a 4-year-old girl diagnosed with meandering pulmonary vein, who developed pulmonary hypertensive disease with an aggressive course, in spite of absence of hypoxia or elevated pulmonary wedge pressure. PMID:26374461

  1. Efficient Gene Transfer and Durable Transgene Expression in Grafted Rabbit Veins

    PubMed Central

    Du, Liang; Zhang, Jingwan; Clowes, Alexander W.

    2015-01-01

    Abstract Venous bypass grafts are useful treatments for obstructive coronary artery disease. However, their usefulness is limited by accelerated atherosclerosis. Genetic engineering of venous bypass grafts that prevented atherosclerosis could improve long-term graft patency and clinical outcomes. We used a rabbit model of jugular vein-to-carotid interposition grafting to develop gene therapy for vein-graft atherosclerosis. Rabbit veins were easily transduced in situ with a first-generation adenoviral vector; however, most transgene expression (?80%) was lost within 3 days after arterial grafting. This rapid loss of transgene expression was not prevented by transducing veins after grafting or by prolonged ex vivo transduction. However, delaying vein-graft transduction for 28 days (after the vein had adapted to the arterial circulation) prevented this early loss of transgene expression. We used the delayed transduction approach to test the durability of expression of a therapeutic transgene (apolipoprotein A-I) expressed from a helper-dependent adenoviral (HDAd) vector. HDAd DNA and apolipoprotein A-I mRNA were easily detectable in transduced vein grafts. Vector DNA and mRNA declined by 4 weeks, and then persisted stably for at least 6 months. Delaying transduction for 28 days after grafting permitted initiation of vein-graft neointimal growth and medial thickening before gene transfer. However, vein-graft lumen diameter was not compromised, because of gradual outward remodeling of grafted veins. Our data highlight the promise of HDAd-mediated gene therapy, delivered to arterialized vein grafts, for preventing vein-graft atherosclerosis. PMID:25383597

  2. Isolated gastric variceal bleeding caused by splenic lymphoma-associated splenic vein occlusion.

    PubMed

    Chen, Bao-Chung; Wang, Hong-Hau; Lin, Yu-Chieh; Shih, Yu-Lueng; Chang, Wei-Kuo; Hsieh, Tsai-Yuan

    2013-10-28

    Isolated gastric varices (IGV) can occur in patients with left-sided portal hypertension resulting from splenic vein occlusion caused by thrombosis or stenosis. In left-sided portal hypertension, blood flows retrogradely through the short and posterior gastric veins and the gastroepiploic veins, leading to the formation of an IGV. The most common causes of splenic vein occlusion are pancreatic diseases, such as pancreatic cancer, pancreatitis, or a pseudocyst. However, various other cancers, such as colon, gastric, or renal cancers, have also been known to cause splenic vein occlusion. Our patient presented with a rare case of IGV bleeding induced by splenic lymphoma-associated splenic vein occlusion. Splenectomy, splenic artery embolization, and stenting of the splenic vein are the current treatment choices. Chemotherapy, however, is an alternative effective treatment for splenic vein occlusion caused by chemotherapy-sensitive tumors. Our patient responded well to chemotherapy with a cyclophosphamide, hydroxydaunorubicin, oncovin, and prednisolone regimen, and the splenic vein occlusion resolved after the lymphoma regressed. PMID:24187474

  3. Complete renal recovery from severe acute renal failure after thrombolysis of bilateral renal vein thrombosis

    PubMed Central

    Ramadoss, Suresh; Jones, Robert G.; Foggensteiner, Lukas; Willis, Andrew P.; Duddy, Martin J.

    2012-01-01

    A previously healthy young man presented with acute renal failure due to extensive spontaneous deep vein thrombosis, including the inferior vena cava (IVC) and both renal veins. The patient was treated with selectively delivered thrombolytic therapy over a 7-day-period, which resulted in renal vein patency and complete recovery of renal function. A stent was placed over a segment stenosis of the IVC. No thrombophilic factors were identified. Bilateral renal vein thrombosis in young fit individuals is an unusual cause of acute renal failure. Thrombolytic therapy, even with delay, can completely restore renal function. PMID:26019821

  4. Systolodiastolic variations of blood flow during central retinal vein occlusion: exploration by dynamic angiography

    PubMed Central

    Paques, M; Baillart, O; Genevois, O; Gaudric, A; Lévy, B I; Sahel, J

    2005-01-01

    Background/aim: In patients with acute central retinal vein occlusion (CRVO), dynamic angiography may reveal the presence of pulsatile flow (termed here pulsatile venular outflow, PVO) within first order veins (that is, the large veins). The main goal of this study was to investigate the mechanism underlying PVO. Methods: 10 patients with CRVO and PVO were included. Quantitative and qualitative analysis of venous flow on dynamic angiograms allowed the correlation, temporally, of second and first order vein flow on the one hand, and venous flow and systolic cycle on the other. Results: Analysis of the time-velocity curve showed that (1) the onset of arterial systole preceded the onset of PVO by less than 0.08 seconds (n = 5); (2) PVO onset was simultaneous to the time of onset of minimal flow (Vmin) in first order veins (n = 10); (3) the time of onset of maximal flow (Vmax) in first order veins occurred 0.20–0.44 seconds after the onset of PVO (n = 6). Conclusions: During CRVO with severe reduction in blood flow, the presence of PVO is the result of the existence of a distinct haemodynamic regimen in first and second order veins. These data support the hypothesis that second order veins flow is synchronous with the arterial flow, while the delayed peak flow in first order veins may reflect the consequences of the delayed IOP curve and/or of intermittent venous compression. PMID:16024861

  5. Probability of developing proximal deep-vein thrombosis and/or pulmonary embolism after distal deep-vein thrombosis.

    PubMed

    Brateanu, Andrei; Patel, Krishna; Chagin, Kevin; Tunsupon, Pichapong; Yampikulsakul, Pojchawan; Shah, Gautam V; Wangsiricharoen, Sintawat; Amah, Linda; Allen, Joshua; Shapiro, Aryeh; Gupta, Neha; Morgan, Lillie; Kumar, Rahul; Nielsen, Craig; Rothberg, Michael B

    2016-02-29

    Isolated distal deep-vein thrombosis (DDVT) of the lower extremities can be associated with subsequent proximal deep-vein thrombosis (PDVT) and/or acute pulmonary embolism (PE). We aimed to develop a model predicting the probability of developing PDVT and/or PE within three months after an isolated episode of DDVT. We conducted a retrospective cohort study of patients with symptomatic DDVT confirmed by lower extremity vein ultrasounds between 2001-2012 in the Cleveland Clinic Health System. We reviewed all the ultrasounds, chest ventilation/perfusion and computed tomography scans ordered within three months after the initial DDVT to determine the incidence of PDVT and/or PE. A multiple logistic regression model was built to predict the rate of developing these complications. The final model included 450 patients with isolated DDVT. Within three months, 30 (7?%) patients developed an episode of PDVT and/or PE. Only two factors predicted subsequent thromboembolic complications: inpatient status (OR, 6.38; 95?% CI, 2.17 to 18.78) and age (OR, 1.02 per year; 95?% CI, 0.99 to 1.05). The final model had a bootstrap bias-corrected c-statistic of 0.72 with a 95?% CI (0.64 to 0.79). Outpatients were at low risk (?10?%). Inpatients aged

  6. Association of a distinct strain of hollyhock yellow vein mosaic virus and Ludwigia leaf distortion betasatellite with yellow vein mosaic disease of hollyhock (Alcea rosea) in India.

    PubMed

    Srivastava, A; Kumar, S; Raj, S K; Pande, S S

    2014-10-01

    A distinct strain of hollyhock yellow vein mosaic virus (HoYVMV) and Ludwigia leaf distortion betasatellite (LuLDB) were associated with yellow vein mosaic of hollyhock. The viral DNA genome (JQ911766) and betasatellite (JQ408216) shared highest nucleotide sequence identity (89.2 %) with HoYVMV (the only available sequence in GenBank) and 92 % identity with LuLDB. Agroinfiltration of HoYVMV and LuLDB induced yellow vein mosaic symptoms on hollyhock, thereby demonstrating causality of the disease. PMID:24810100

  7. Preoperative portal vein embolization for hepatocellular carcinoma: Consensus and controversy.

    PubMed

    Aoki, Taku; Kubota, Keiichi

    2016-03-28

    Thirty years have passed since the first report of portal vein embolization (PVE), and this procedure is widely adopted as a preoperative treatment procedure for patients with a small future liver remnant (FLR). PVE has been shown to be useful in patients with hepatocellular carcinoma (HCC) and chronic liver disease. However, special caution is needed when PVE is applied prior to subsequent major hepatic resection in cases with cirrhotic livers, and volumetric analysis of the liver segments in addition to evaluation of the liver functional reserve before PVE is mandatory in such cases. Advances in the embolic material and selection of the treatment approach, and combined use of PVE and transcatheter arterial embolization/chemoembolization have yielded improved outcomes after PVE and major hepatic resections. A novel procedure termed the associating liver partition and portal vein ligation for staged hepatectomy has been gaining attention because of the rapid hypertrophy of the FLR observed in patients undergoing this procedure, however, application of this technique in HCC patients requires special caution, as it has been shown to be associated with a high morbidity and mortality even in cases with essentially healthy livers. PMID:27028706

  8. Vein reconstruction of a mycotic internal carotid aneurysm.

    PubMed Central

    Monson, R C; Alexander, R H

    1980-01-01

    Carotid aneurysms are an extremely rare entity; mycotic carotid aneurysms are even more uncommon. Most articles in the past have advocated ligation as treatment of mycotic carotid aneurysms due to the dangers of graft placement in an infected field. Unfortunately, stroke occurs in many patients so treated. As the cerebral complications were so high, bypass using autogenous vein and fine monofilament polypropylene sutures is attractive. This technique was used in a patient having a mycotic carotid aneurysm who was referred to the Vascular Service of the Shands Teaching Hospital. Pre- and postoperative antibiotics, resection of the aneurysm, anastomosis in a noninfected area, and long-term oral antibiotics were felt to be other important aspects of the patient's treatment. This individual is well one year after operation without neurological sequelae. This case suggests that if strict operative and therapeutic guidelines are observed, bypass with autogenous vein is a feasible operative alternative in patients having mycotic carotid aneurysms. The risk of this procedure must be carefully weighed against the devastating neurological sequellae that might result with ligation. Images Fig. 1. Fig. 2. PMID:6986122

  9. [NHG guideline 'Deep-vein thrombosis and pulmonary embolus'].

    PubMed

    de Jong, Jip; Lucassen, Wim A M; Geersing, Geert-Jan; Burgers, Jako S; Wiersma, Tjerk

    2015-01-01

    The revised Dutch College of General Practitioners (Nederlands Huisartsen Genootschap [NHG]) guideline 'Deep-vein thrombosis and pulmonary embolus' includes recommendations for the treatment of patients with deep-vein thrombosis (DVT) and thrombophlebitis, and for the exclusion of pulmonary embolism (PE). The general practitioner (GP) can exclude the presence of DVT or PE in some patients by using a decision rule and a D-dimer test. When using D-dimer test as a point-of-care test, meticulous care is essential during the test procedure and storage of blood. The GP can treat many patients with DVT; the NHG guideline does not advise use of direct oral anticoagulants. In the case of an isolated DVT in the calf, treatment with anticoagulants or ultrasound follow-up can be chosen in consultation with the patient or on the basis of regional agreements. In the case of patients with superficial thrombophlebitis, a wait-and-see approach is usually sufficient. PMID:25761297

  10. Management of subclavian-axillary vein thrombosis: a review

    PubMed Central

    Hicken, Gary J.; Ameli, F. Michael

    1998-01-01

    Objective To study, by literature review, the management of subclavian-axillary vein thrombosis (SAVT) and to make recommendations. Data sources The MEDLINE database and cross-referenced articles. Study selection Key words subclavian-axillary vein thrombosis, venous thrombosis, Paget–Schroetter syndrome, anticoagulation, and thrombolysis were used to extract articles related to SAVT. Data extraction Independent extraction of articles by 2 observers. Data synthesis Although numerous studies are available in the literature, they vary widely in their patient selection, treatment methods, follow-up and conclusions. As such, the management of patients with SAVT remains controversial. Conclusions Anticoagulation remains the initial treatment of choice for acute SAVT although there is definitely a role for thrombolysis and surgery in selected cases. Surgical intervention should be reserved for patients in whom there is a specific indication. Since chronic symptoms depend largely on the etiology of the disease, treatment should be tailored to address the causative factors. A multicentre, prospective study is necessary to evaluate the optimum management strategies for patients with SAVT. PMID:9492744

  11. A method for quickly and exactly extracting hepatic vein

    NASA Astrophysics Data System (ADS)

    Xiong, Qing; Yuan, Rong; Wang, Luyao; Wang, Yanchun; Li, Zhen; Hu, Daoyu; Xie, Qingguo

    2013-02-01

    It is of vital importance that providing detailed and accurate information about hepatic vein (HV) for liver surgery planning, such as pre-operative planning of living donor liver transplantation (LDLT). Due to the different blood flow rate of intra-hepatic vascular systems and the restrictions of CT scan, it is common that HV and hepatic portal vein (HPV) are both filled with contrast medium during the scan and in high intensity in the hepatic venous phase images. As a result, the HV segmentation result obtained from the hepatic venous phase images is always contaminated by HPV which makes accurate HV modeling difficult. In this paper, we proposed a method for quick and accurate HV extraction. Based on the topological structure of intra-hepatic vessels, we analyzed the anatomical features of HV and HPV. According to the analysis, three conditions were presented to identify the nodes that connect HV with HPV in the topological structure, and thus to distinguish HV from HPV. The method costs less than one minute to extract HV and provides a correct and detailed HV model even with variations in vessels. Evaluated by two experienced radiologists, the accuracy of the HV model obtained from our method is over 97%. In the following work, we will extend our work to a comprehensive clinical evaluation and apply this method to actual LDLT surgical planning.

  12. Inorganic phosphate inhibits sympathetic neurotransmission in canine saphenous veins

    SciTech Connect

    Edoute, Y.; Vanhoutte, P.M.; Shepherd, J.T.

    1987-01-01

    Inorganic phosphate has been proposed as the initiator of metabolic vasodilatation in active skeletal muscle. The present study was primarily designed to determine if this substance has an inhibitory effect on adrenergic neurotransmission. Rings of canine saphenous veins were suspended for isometric tension recording in organ chambers. A comparison was made of the ability of inorganic phosphate (3 to 14 mM) to relax rings contracted to the same degree by electrical stimulation, exogenous norepinephrine, and prostaglandin F/sub 2..cap alpha../. The relaxation during electrical stimulation was significantly greater at all concentrations of phosphate. In strips of saphenous veins previously incubated with (/sup 3/H)norepinephrine, the depression of the contractile response caused by phosphate during electrical stimulated was accompanied by a significant reduction in the overflow of labeled neurotransmitter. Thus inorganic phosphate inhibits sympathetic neurotransmission and hence may have a key role in the sympatholysis in the active skeletal muscles during exercise. By contrast, in this preparation, it has a modest direct relaxing action on the vascular smooth muscle.

  13. Arteries are formed by vein-derived endothelial tip cells

    PubMed Central

    Xu, Cong; Hasan, Sana S.; Schmidt, Inga; Rocha, Susana F.; Pitulescu, Mara E.; Bussmann, Jeroen; Meyen, Dana; Raz, Erez; Adams, Ralf H.; Siekmann, Arndt F.

    2014-01-01

    Tissue vascularization entails the formation of a blood vessel plexus, which remodels into arteries and veins. Here we show, by using time-lapse imaging of zebrafish fin regeneration and genetic lineage tracing of endothelial cells in the mouse retina, that vein-derived endothelial tip cells contribute to emerging arteries. Our movies uncover that arterial-fated tip cells change migration direction and migrate backwards within the expanding vascular plexus. This behaviour critically depends on chemokine receptor cxcr4a function. We show that the relevant Cxcr4a ligand Cxcl12a selectively accumulates in newly forming bone tissue even when ubiquitously overexpressed, pointing towards a tissue-intrinsic mode of chemokine gradient formation. Furthermore, we find that cxcr4a mutant cells can contribute to developing arteries when in association with wild-type cells, suggesting collective migration of endothelial cells. Together, our findings reveal specific cell migratory behaviours in the developing blood vessel plexus and uncover a conserved mode of artery formation. PMID:25502622

  14. Inherited coagulation disorders in cirrhotic patients with portal vein thrombosis.

    PubMed

    Amitrano, L; Brancaccio, V; Guardascione, M A; Margaglione, M; Iannaccone, L; D'Andrea, G; Marmo, R; Ames, P R; Balzano, A

    2000-02-01

    The prevalence and pathogenesis of portal vein thrombosis (PVT) in patients with cirrhosis without hepatocellular carcinoma are not clearly defined. The role of thrombophilic genetic factors is well established in other venous thrombotic diseases, as well as in noncirrhotic portal thrombosis. Recently, new, inherited thrombophilic disorders (factor V Leiden [FVL], mutation G20210A of prothrombin [PTHR A(20210)], and mutation TT677 of methylenetetrahydrofolate reductase [MTHFR C677-->T]) have been identified and associated with increased risk of venous thrombosis. The aim of our study was to investigate the role of these thrombophilic disorders in the pathogenesis of PVT in cirrhotic patients. Twenty-three cirrhotic patients with PVT and 40 cirrhotics without PVT were included. A group of 184 patients with deep vein thrombosis (DVT) and 431 healthy persons served as controls. The FVL, PTHR A(20210), and MTHFR C(677)-->T genotypes were identified by a polymerase chain reaction and restriction analysis. The frequencies of FVL, PTHR A(20210) mutation, and homozygous MTHFR C(677)-->T were 13%, 34.8%, and 43.5% in cirrhotic patients with PVT and 7.5%, 2.5%, and 5% in cirrhotic patients without PVT, respectively. Five patients in the former group had associated defects. A thrombophilic genotype was detected in 69.5% of the patients with PVT. Identification of this high-risk group may have implications in patients who are candidates for major surgery or liver transplantation, and may influence the duration of oral anticoagulation. PMID:10655256

  15. The endovenous laser treatment for patients with varicose veins

    PubMed Central

    Liu, Jian-Jun; Fan, Long-Hua; Xu, De-Chun; Li, Xu; Dong, Zhi-Hui; Fu, Wei-Guo

    2016-01-01

    Objective: To evaluate the clinical effect of endovenous laser treatment (EVLT) for patients with varicose veins. Methods: Our series included 117 patients who underwent EVLT combined with high ligation and stripping since the introduction of the technique in our institution. All EVLT procedures were performed with local skin cooling to prevent skin burns, as well as stripping after exsanguinations to prevent thrombotic phlebitis. Results: A total of 146 limbs in 117 patients were ablated by EVLT. Bilateral EVLT was performed in 29 patients, with the remaining 88 patients undergoing unilateral EVLT. The mean age of the patients was 57 years ± 12 years (range: 21 years to 80 years), and 56 were male and 61 were female. Follow-up for all patients lasted three to six months. The most common complication was induration and swelling, which was observed in 64 patients, followed by paraesthesia in 27, and skin burns in 12. Conclusion: The treatment with endovenous laser treatment for patients with varicose veins is safe and effective.

  16. Peripheral nerve regeneration with conduits: use of vein tubes

    PubMed Central

    Sabongi, Rodrigo Guerra; Fernandes, Marcela; dos Santos, Joo Baptista Gomes

    2015-01-01

    Treatment of peripheral nerve injuries remains a challenge to modern medicine due to the complexity of the neurobiological nerve regenerating process. There is a greater challenge when the transected nerve ends are not amenable to primary end-to-end tensionless neurorraphy. When facing a segmental nerve defect, great effort has been made to develop an alternative to the autologous nerve graft in order to circumvent morbidity at donor site, such as neuroma formation, scarring and permanent loss of function. Tubolization techniques have been developed to bridge nerve gaps and have been extensively studied in numerous experimental and clinical trials. The use of a conduit intends to act as a vehicle for moderation and modulation of the cellular and molecular ambience for nerve regeneration. Among several conduits, vein tubes were validated for clinical application with improving outcomes over the years. This article aims to address the investigation and treatment of segmental nerve injury and draw the current panorama on the use of vein tubes as an autogenous nerve conduit. PMID:26170802

  17. A case of angiosarcoma arising from internal jugular vein.

    PubMed

    Kishimoto, Ippei; Kikuchi, Masahiro; Shinohara, Shogo; Fujiwara, Keizo; Kanazawa, Yuji; Tona, Risa; Harada, Hiroyuki; Usami, Yu; Naito, Yasushi

    2015-02-01

    Primary angiosarcoma is a rare disease with a poor prognosis. It most commonly arises in the head and neck region; localization in the deep soft tissue of the neck is extremely rare. We herein present a case of angiosarcoma derived from the right internal jugular vein. A 79-year-old man presented with a 1-month history of a growing right neck mass. Computed tomography, magnetic resonance imaging, positron emission tomography-computed tomography, and fine-needle aspiration cytology revealed a malignant tumor of unknown origin. Right neck dissection was performed for both diagnosis and therapy. Immunostaining of the resected tumor cells revealed positivity for CD31, CD34, factor VIII-related antigen, and D2-40, which allowed for a definitive diagnosis of angiosarcoma. Postoperative radiotherapy (66Gy) was performed on the right neck, including the surgical bed and upper mediastinum. The patient was followed up for 10 months with no recurrence. Only six cases of angiosarcoma arising in the deep soft tissue of the neck have been reported in the English-language literature. The present report is the first to describe angiosarcoma arising from the internal jugular vein. PMID:25597020

  18. Preoperative portal vein embolization for hepatocellular carcinoma: Consensus and controversy

    PubMed Central

    Aoki, Taku; Kubota, Keiichi

    2016-01-01

    Thirty years have passed since the first report of portal vein embolization (PVE), and this procedure is widely adopted as a preoperative treatment procedure for patients with a small future liver remnant (FLR). PVE has been shown to be useful in patients with hepatocellular carcinoma (HCC) and chronic liver disease. However, special caution is needed when PVE is applied prior to subsequent major hepatic resection in cases with cirrhotic livers, and volumetric analysis of the liver segments in addition to evaluation of the liver functional reserve before PVE is mandatory in such cases. Advances in the embolic material and selection of the treatment approach, and combined use of PVE and transcatheter arterial embolization/chemoembolization have yielded improved outcomes after PVE and major hepatic resections. A novel procedure termed the associating liver partition and portal vein ligation for staged hepatectomy has been gaining attention because of the rapid hypertrophy of the FLR observed in patients undergoing this procedure, however, application of this technique in HCC patients requires special caution, as it has been shown to be associated with a high morbidity and mortality even in cases with essentially healthy livers.

  19. Canalization-based vein formation in a growing leaf.

    PubMed

    Lee, Sang-Woo; Feugier, Francois Gabriel; Morishita, Yoshihiro

    2014-07-21

    Vein formation is an important process in plant leaf development. The phytohormone auxin is known as the most important molecule for the control of venation patterning; and the canalization model, in which cells experiencing higher auxin flux differentiate into specific cells for auxin transportation, is widely accepted. To date, several mathematical models based on the canalization hypothesis have been proposed that have succeeded in reproducing vein patterns similar to those observed in actual leaves. However, most previous studies focused on patterning in fixed domains, and, in a few exceptional studies, limited tissue growth - such as cell proliferation at leaf margins and small deformations without large changes in cell number - were dealt with. Considering that, in actual leaf development, venation patterning occurs in an exponentially growing tissue, whether the canalization hypothesis still applies is an important issue to be addressed. In this study, we first show through a pilot simulation that the coupling of chemical dynamics for canalization and tissue growth as independent models cannot reproduce normal venation patterning. We then examine conditions sufficient for achieving normal patterning in a growing leaf by introducing various constraints on chemical dynamics, tissue growth, and cell mechanics; in doing so, we found that auxin flux- or differentiation-dependent modification of the cell cycle and elasticity of cell edges are essential. The predictions given by our simulation study will serve as guideposts in experiments aimed at finding the key factors for achieving normal venation patterning in developing plant leaves. PMID:24632445

  20. Investigation of gold-bearing veins using magnetics and TEM

    NASA Astrophysics Data System (ADS)

    Davis, L.; Groom, R.

    2012-12-01

    Gold-bearing fractures have been mined at Charters Towers, Queensland for a century. The ore occurs in quartz-sulfide veins hosted in granitoids. The gold is found in lenses within the veins. The purpose of our work was to determine if geophysical methods could be used to identify and delineate known lode-bearing veins. The study site is around the Warrior Mine immediately south of the town. Two structures are being mined at 100-300 m depth: Warrior and Sons of Freedom. While IP is typically used to locate disseminated sulfides, we used a different approach: we integrated airborne magnetic data with ground TEM data to map the geometries of the gold-bearing fracture zones. TEM is advantageous because it does not involve injection of current into the ground with the uncertainty of current flow patterns in such resistive, fractured rocks. Fixed loop TEM surveying was utilized as this approach is much faster to perform than moving loop surveys. Although TEM is commonly used for mapping layered structures and strong conductors, it is much less used for detecting weak conductors, such as those found in gold exploration, contaminant plumes, or geotechnical applications. Here the fracture zones are highly weathered and wet thus producing weak conductors. Upon mapping the vertical derivative of the RTP magnetic data, many linear anomalies were noted, including over both mined structures. These anomalies all indicate negative susceptibility, as would be expected because the structures are depleted in magnetite with respect to the granitoids. Modeling of the RTP total field and derivatives confirms a negative susceptibility. The RTP data indicate the approximate dip, which agrees with known information. Depth resolution is limited in standard 3D inversions, which utilize orthogonal grids with the normal axis in the vertical direction. In this study, we use a dipping grid which strikes and dips according to known information, and have obtained good results. TEM surveying at the Warrior site presents challenges as there is an operating mine and many other man-made features. The TEM surveys were carefully planned to minimize their impact on the response. Modeling of the TEM data indicates that the structures which include the mineralized veins are weakly conductive and are actually composed of multiple structures in close proximity. There is a strong correlation between the TEM structural interpretation and the magnetic highs, not only at the mined structures, but also over the three new structures, which are to be studied in future exploration plans including borehole TEM. The EM models were converted to magnetic models with thicknesses of 5 m and susceptibilities between -0.1 and -0.05 (SI), and the simulated magnetic response was in good agreement with the measured data. Interestingly, the rather large negative susceptibilities indicate a greater volume than can be explained by the veins alone. It is expected that this approach will be used to find potential lode-bearing structures in the Charters Towers goldfield. Areas of interest can be first identified in the magnetic data based on the RTP vertical derivative, and then TEM will be performed at these sites. We have demonstrated that, through careful modeling, TEM can be used to understand the geometry of weak conductors.