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Duplex Doppler ultrasound signs of portal hypertension: relative diagnostic value of examination of paraumbilical vein, portal vein and spleen.  


The sonographic parameters in portal hypertension (PHT) were examined in a consecutive population of 118 patients who had PHT diagnosed using specific endoscopic, sonographic and Doppler signs. A patent or enlarged paraumbilical vein was found in 85.6% of patients overall and 82.5% of patients with varices indicating a relatively high sensitivity. A portal vein diameter greater than or equal to 13mm was found in only 41.1% and greater than or equal to 15mm in only 20% of patients. A thrombosed portal vein and reversed portal vein flow were present in 3.4% and 5.3% of patients respectively. These signs have only been reported in the context of PHT and are felt to be specific for PHT, but both have a very low sensitivity. Portal vein velocities were highly variable suggesting that this is not a useful predictor of PHT. Splenomegaly was found in only 53.5% of patients demonstrating its poor sensitivity as a sign of PHT. Varices were found in 73.3% of patients overall, and in 100% of patients with a patent or enlarged paraumbilical vein combined with ascites. No other statistically significant correlation between varices and sonographic findings was demonstrated. We conclude that the presence of a patent or enlarged paraumbilical vein is a practical, useful and sensitive ultrasound sign to look for in the diagnosis of PHT. PMID:1520164

Ditchfield, M R; Gibson, R N; Donlan, J D; Gibson, P R



Combined Transabdominal and Transjugular Recanalization of Thrombosed TIPS, Portal and Proximal Splenic Veins  

SciTech Connect

We present a case of TIPS occlusion in which a small caliber transhepatic safety or anchoring wire in combination witha standard transjugular approach were utilized to recanalize the TIPS,portal and splenic veins. This technique may be a useful adjunct to the typical methods used for recanalization of thrombosed TIPS, portal and splenic veins without the need of large caliber transhepatic sheath access.

Bloss, M.F. [DartmouthHitchcock Medical Center, One Medical Center Dr, Lebanon, NH03756, Department of Radiology (United States); Lenz, J. [Veterans Administration Hospital, White RiverJunction, VT 05001, Department ofRadiology (United States); Gemery, J. [DartmouthHitchcock Medical Center, One Medical Center Dr, Lebanon, NH03756, Department of Radiology (United States)



Laparoscopic management of massive spontaneous external haemorrhage from the umbilical varix due to recanalisation of the paraumbilical vein in a patient with 'Child's Class A' liver cirrhosis.  


Spontaneous external haemorrhage from the umbilical varix is an extremely rare complication of portal hypertension. Bleeding is usually into the peritoneal cavity and the treatment involves urgent laparotomy and ligation of the bleeding varices. We describe a cirrhotic 38-year-old man who presented with spontaneous external haemorrhage from the umbilical varix which was successfully managed laparoscopically by in-situ distal clipping and proximal transcutaneous ligation of the recanalised paraumbilical veins. We therefore feel that laparoscopy can be safely and effectively employed to control external haemorrhage from the umbilical varix associated with liver cirrhosis. This novel technique can help avoid a laparotomy and also help preserve the umbilicus. PMID:22623827

Zachariah, Sanoop K; Krishnankutty, Sreejith L; Raja, Nirmalan



Laparoscopic management of massive spontaneous external haemorrhage from the umbilical varix due to recanalisation of the paraumbilical vein in a patient with 'Child's Class A' liver cirrhosis  

PubMed Central

Spontaneous external haemorrhage from the umbilical varix is an extremely rare complication of portal hypertension. Bleeding is usually into the peritoneal cavity and the treatment involves urgent laparotomy and ligation of the bleeding varices. We describe a cirrhotic 38-year-old man who presented with spontaneous external haemorrhage from the umbilical varix which was successfully managed laparoscopically by in-situ distal clipping and proximal transcutaneous ligation of the recanalised paraumbilical veins. We therefore feel that laparoscopy can be safely and effectively employed to control external haemorrhage from the umbilical varix associated with liver cirrhosis. This novel technique can help avoid a laparotomy and also help preserve the umbilicus.

Zachariah, Sanoop K; Krishnankutty, Sreejith L; Raja, Nirmalan



Endovascular strategy for recanalization of long-segment central vein occlusion with concomitant arteriovenous fistula creation.  


Recanalization of long-segment central vein flush occlusion in hemodialysis patients has been advocated in lieu of central vein bypass and thoracotomy to restore arteriovenous access availability. We report a challenging case of complex central venous flush occlusion in a 50-year-old woman on hemodialysis who presented with right arm and facial swelling. A concise step-by-step description of endovascular strategy with retrograde and antegrade balloon angioplasty techniques for central vein recanalization with concomitant arteriovenous fistula creation is provided. PMID:22944575

Malgor, Rafael D; Wood, Emily A; Gasparis, Antonios P; Hashisho, Mazen



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


PURPOSE: Regional 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. METHODS: From 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). RESULTS: Technical 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. CONCLUSIONS: Transjugular 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. PMID:23636249

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



Sharp Recanalization for Chronic Left Iliac Vein Occlusion  

SciTech Connect

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.

Ito, Nobutake, E-mail:; Isfort, Peter; Penzkofer, Tobias [RWTH Aachen University, Department of Diagnostic and Interventional Radiology, University Hospital (Germany); Grommes, Jochen; Greiner, Andreas [RWTH Aachen University, Department of Vascular Surgery, University Hospital (Germany); Mahnken, Andreas [RWTH Aachen University, Department of Diagnostic and Interventional Radiology, University Hospital (Germany)



Clinical and angiographic outcomes after percutaneous recanalization of chronic total saphenous vein graft occlusion using modern techniques.  


Poor long-term outcomes after percutaneous coronary intervention (PCI) in chronic total occlusion (CTO) of saphenous vein grafts (SVGs) have been reported. However, limited data are available evaluating the use of modern techniques in this group. The aim of the present study was to assess the efficacy and long-term outcomes of PCI in SVG CTO with the routine use of embolic protection devices and drug-eluting stents. A retrospective cohort analysis was conducted of all consecutive patients undergoing PCI to SVG CTO from May 2002 to July 2009 at 2 centers. The indication for PCI was the presence of angina or silent ischemia with evidence of inducible ischemia after functional testing in the territory supplied by the SVG, despite optimal medical therapy. We identified 34 patients with SVG CTO. Of the 34 patients, 23 (68%) underwent successful SVG recanalization with stent implantation. An embolic protection device was used in 78% and 95% of stents implanted were drug-eluting stents. No in-hospital major adverse cardiac events occurred in the successful PCI group; one myocardial infarction occurred in the unsuccessful group. At follow-up (median 18.0 months, interquartile range 10.4 to 48.3), 1 case of myocardial infarction had occurred in the successful group. The in-stent restenosis rate was 68% (n = 13), of which 77% were focal, with target vessel revascularization in 61%. In conclusion, despite the relatively low procedural success rates, the clinical outcomes after successful PCI to SVG CTO with modern techniques were favorable. The repeat revascularization rates were high; however, graft patency was achievable in most after reintervention. PMID:21126616

Al-Lamee, Rasha; Ielasi, Alfonso; Latib, Azeem; Godino, Cosmo; Ferraro, Massimo; Arioli, Francesco; Mussardo, Marco; Piraino, Daniela; Figini, Filippo; Carlino, Mauro; Montorfano, Matteo; Chieffo, Alaide; Colombo, Antonio



Unusual localization of a primary hydatid cyst: a subcutaneous mass in the paraumbilical region.  


Hydatid cyst disease caused by Echinoccus granulosus is not a rare disease and mostly localized in liver and lung. The localization of the disease in the subcutaneous paraumbilical region without any other organ involvement is a unique existence that we present. A 63-year-old Turkish male complaining of abdominal distention and pain had an abdominal mass for one year. When the patient came to our Clinic, we detected a 4x5 cm mass in the left quadrant- paraumbilical region by using ultrasonography. Complete surgical resection of the mass was performed with uneventful post-operative recovery. Histopathological examination of the surgical specimen demonstrated a multive-sicular hydatid cyst. When a subcutaneous cystic mass is detected in a patient, regarding the region where he lives and endemicity, hydatid cyst should be considered. PMID:23852901

Burgazli, K M; Ozdemir, C S; Beken Ozdemir, E; Mericliler, M; Polat, Z P



Sharp Central Venous Recanalization by Means of a TIPS Needle  

SciTech Connect

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.

Honnef, Dagmar, E-mail:; Wingen, Markus; Guenther, Rolf W.; Haage, Patrick [University Hospital, Department of Diagnostic Radiology (Germany)



Recanalization of an occluded popliteal artery following posterior knee dislocation.  


Posterior knee dislocation results in popliteal artery injury in up to one-third of cases. Prompt recognition and treatment of arterial injury is essential for limb salvage. We report a case of complete occlusion of the popliteal artery following posterior knee dislocation treated with saphenous vein bypass without exclusion of the injured arterial segment. Follow-up duplex scanning demonstrated a patent vein graft and a patent ipsilateral popliteal artery. This report suggests that, in some instances, a traumatically occluded popliteal artery may recanalize, and that revascularization with a bypass graft may be the preferred method of repair, particularly in young patients. PMID:10541618

Kirby, L; Abbas, J; Brophy, C



[Imaging of collaterals and their impact on portal venous flow in patients with liver cirrhosis].  


When the portal hypertension syndrome occurs, patients with liver cirrhosis develop three major collateral blood flow pathways. These are gastroesophageal, splenorenal, and paraumbilical ones along the recanalized umbilical veins. Only both the splenorenal pathway of blood return from the portal venous system, which considerably reduces portal blood flow volume and the paraumbilical one that increases portal blood flow are of hemodynamic significance. PMID:22187898

Prozorovski?, K V; Pruchanski?, V S


Power-Pulse Thrombolysis and Stent Recanalization for Acute Post-Liver Transplant Iliocaval Venous Thrombosis  

SciTech Connect

Postoperative inferior vena cava (IVC) thrombosis is a potentially lethal complication in a liver transplant recipient. We report the case of a 57-year-old liver transplant recipient, who developed acute, postoperative, markedly symptomatic complete IVC, ilial-femoral-caval, and left renal vein thrombosis. After treatment with power-pulse tissue plasminogen activator thrombolysis, thrombectomy, and stent placement, the IVC and iliac veins were successfully recanalized. At 2.5-year imaging and laboratory follow-up, the IVC, iliac, and renal veins remained patent and graft function was preserved.

Baccin, Carlos E.; Haskal, Ziv J., E-mail: [New York Presbyterian Hospital/Columbia University Medical Center (United States)



Laser recanalization in high risk patients.  


Laser recanalization was attempted in 13 patients in whom the risk of surgical therapy was increased by severe angina, infection, absent venous conduit, or recent deep venous thrombosis, and in 4 patients at high risk for limb loss due to severe infrapopliteal arterial occlusive disease. Total occlusions of the superficial femoral, tibial, or peroneal arteries were treated. Recanalization was accomplished using Argon laser power and a Spectraprobe-PLR. Two patients also required common femoral artery endarterectomy to improve inflow. Laser recanalization was successful in 9 patients (53%), and 8 (47%) had relief symptoms. None of the 4 patients with tibial and peroneal artery occlusion had successful recanalization or limb salvage. Restenosis or reocclusion developed in 4 patients during the first year after successful recanalization, but only 1 had recurrent symptoms. Limb salvage was initially achieved in 5 of 8 recanalization failures by surgical reconstruction but 3 developed graft infections requiring graft removal in 2 and amputation in 1. Thus, laser recanalization can accomplish limb salvage in selected patients whose medical or surgical risks complicate arterial bypass surgery. PMID:2139708

Seeger, J M; Kaelin, L D; Barbeau, G; Abela, G S



Iatrogenic Obliteration of Ureter with Spontaneous Recanalization  

PubMed Central

We report an unusual case of spontaneous and complete healing of a severe iatrogenic midureteral injury. Following percutaneous nephrostomy and 3 months on our surgical waiting list, the injured ureter underwent complete spontaneous recanalization. The patient is clinically well with no evidence of recurrent obstruction after 2 years of followup. To our knowledge, this is the first reported case of spontaneous recanalization of an iatrogenically induced complete ureteral obliteration.

Mussari, Ben



[Symptomatic laser endoscopic recanalization in inoperable esophageal cancer].  


The results of clinical usage of conventional and original methods of laser endoscopic recanalization in patients with inoperable esophageal cancer were analyzed. It was established, that application of modifications, elaborated in the clinic--combined laser endoscopic recanalization with bougienage and without it have permitted to raise essentially a rate of the complete esophageal recanalization achievement, to reduce a quantity of the procedures needed to restore the tumoral stenotic region passability and to reduce a recanalization course duration. PMID:21548321

Todurov, I M; Nazarenko, O Iu



The pedicled inferior paraumbilical perforator (I-PUP) flap for a volar wrist defect: A reconstructive solution across the ages.  


Full-thickness soft-tissue defects overlying vital forearm or wrist structures frequently result from acute trauma or tumor ablation. These defects present reconstructive challenges, due to the thin pliable skin to be replaced and the non-graftable bed beneath. The authors discuss a case of a renal-transplant patient with a volar wrist SCC, in whom local vascular anatomy deemed microvascular free tissue transfer inappropriate. The authors present a successful novel reconstructive solution; the pedicled inferior paraumbilical perforator flap (I-PUP), a two-staged procedure that incorporates principles of distant flaps - which pre-date microsurgery - combined with techniques and lessons learned in the era of perforator flap surgery. PMID:23473676

Shukla, L; Taylor, G I; Shayan, R



Timely recanalization of lateral sinus thrombosis in children: should we consider hypoplasia of contralateral sinuses in treatment planning?  


The objective of this study was to evaluate long-term clinical and radiological outcomes in children treated with lateral sinus thrombosis secondary to acute mastoiditis considering also contralateral sinus hypoplasia. This study was a retrospective chart review, conducted in tertiary pediatric hospital. Medical reports of eight children with acute mastoiditis and lateral sinus thrombosis from 1998 to 2011 were examined in terms of therapy, clinical recovery and radiological proof of lateral sinus recanalization. Three children presented hypoplasia of contralateral venous drainage system. Condition of sinuses was regularly monitored with MRI. Otologically and neurologically, all children recovered fully. All received antibiotics; six received additional low molecular weight heparin therapy. Mastoidectomy was performed on six cases. Incision and thrombectomy were applied in the other two, one involving internal jugular vein ligation. This latter case presented also contralateral venous hypoplasia; visual impairment proved permanent. The other two children with contralateral sinus hypoplasia recovered fully after steroid, dehydration and low molecular weight heparin therapy. Recanalization occurred in all children except the one with internal jugular vein ligation, in whom good collateral circulation was observed. There were no bleeding complications. Anatomical variations of cerebral venous drainage system can frequently be observed and should be considered in treatment planning. Mastoidectomy with antibiotics and additional low molecular weight heparin treatment is a safe, promising alternative to thrombectomy and internal jugular vein ligation in children with lateral sinus thrombosis following acute mastoiditis, also having contralateral sinus hypoplasia. Recanalization can be expected within two to five months. PMID:23179927

Csákányi, Zsuzsanna; Rosdy, Beáta; Kollár, Katalin; Móser, Judit; Kovács, Eva; Katona, Gábor



Late Spontaneous Recanalization of Chronic Middle Cerebral Artery Occlusion  

PubMed Central

Early spontaneous recanalization of the middle cerebral artery in acute ischemic phase artery is not uncommon, whereas the late spontaneous recanalization of chronic occluded artery is a very rare phenomenon and exact incidence and the timing of this event have not been quantified. We present a case in which late spontaneous recanalization of long-lasting middle cerebral artery occlusion occurred in the absence of surgical, endovascular and thrombolytic treatments.

Ryu, Chang-Woo; Koh, Jun-Seok; Kim, Gook Ki



Patent abdominal subcutaneous veins caused by congenital absence of the inferior vena cava: a case report  

PubMed Central

Introduction Patent paraumbilical and abdominal subcutaneous veins are found frequently as collaterals in patients due to portal hypertension mainly in liver cirrhosis. Case presentation For evaluation of portal hypertension in a 72-year-old Caucasian man without liver cirrhosis, magnetic resonance imaging with gadolinium contrast-enhancement was performed and demonstrated a missing inferior vena cava. A blood return from the lower extremities was shown through enlarged collateral veins of the abdominal wall, vena azygos and hemiazygos continuation, and multiple liver veins emptying into the right cardiac atrium. We describe a rare case of abdominal subcutaneous wall veins as collaterals caused by a congenitally absent infrarenal inferior vena cava with preservation of a hypoplastic suprarenal segment. Conclusion Knowledge of these congenital variations can be of clinical importance and it is imperative for the reporting radiologist to identify these anomalies as they can have a significant impact on the clinical management of the patient.



Angiographic demonstration of recanalization of the basilar artery  

Microsoft Academic Search

This report details the clinical course and angiographic findings of a patient with intermittent vertebrobasilar insufficiency. Recanalization of the basilar artery was demonstrated during anticoagulant therapy. A review of the literature failed to disclose a previous report of this occurrence.

M. Fine; E. Palacios; M. Shannon; O. H. Reichman; G. G. Glista



Varicose Veins  


... Veins Explore Varicose Veins What Are … Related Vein Problems Causes Who Is at Risk Signs & Symptoms Diagnosis Treatments Prevention Living With Clinical Trials Links Spanish Version Related Topics Overweight and Obesity How the Heart Works Related Media Videos Widgets Quizzes Send a link to NHLBI ...


ST-elevation myocardial infarction as a complication of retrograde chronic total occlusion recanalization.  


With the advent of new tools and techniques including the retrograde approach, success rates for recanalization of chronic total occlusion (CTO) have improved. Numerous cardiac and extracardiac complications during retrograde CTO recanalization have been described. To date the development of ST-segment elevation myocardial infarction (STEMI) with retrograde recanalization as a result of atheroembolization has not been reported. We report such a case following retrograde recanalization of a totally occluded right coronary artery. PMID:21805592

Prayaga, Sastry; Uretsky, Barry F; Sachdeva, Rajesh



Late spontaneous recanalization of acute internal carotid artery occlusion.  


Spontaneous internal carotid recanalization has been infrequently observed, and when it has been reported, it has most commonly occurred early after a stroke. We report a case of a patient with late spontaneous recanalization of the internal carotid artery (ICA) that occurred within 6 months to 1 year after the initial diagnosis of occlusion during the course of a stroke. This event allowed the patient to undergo a successful surgical intervention. A suggestion is made about the mechanism of this phenomenon and an implication about changes in the follow-up strategies of these patients is presented. PMID:16616248

Klonaris, Chris; Alexandrou, Andreas; Katsargyris, Athanasios; Liasis, Nikolaos; Bastounis, Elias



Embolus extravasation is an alternative mechanism for cerebral microvascular recanalization  

PubMed Central

Cerebral microvascular occlusion is a common phenomenon throughout life1,2 that could be an underappreciated mechanism of brain pathology. Failure to promptly recanalize microvessels may lead to disruption of brain circuits and significant functional deficits3. Hemodynamic forces and the fibrinolytic system4 are considered the principal mechanisms responsible for recanalization of occluded cerebral capillaries and terminal arterioles. However, using high resolution fixed tissue microscopy and two photon imaging in living mice we found that a large fraction of occluding microemboli failed to be lysed and washed out within 48 hours after internal carotid infusion. Surprisingly, emboli were instead found to translocate outside the vessel lumen within 2-7 days leading to complete re-establishment of blood flow and sparing of the vessel. Recanalization occurred by a previously unknown mechanism of microvascular plasticity involving the rapid envelopment of emboli by endothelial membrane projections which subsequently form a new vessel wall. This was followed by the formation of an endothelial opening through which emboli translocated into the perivascular parenchyma. The rate of embolus extravasation was significantly reduced by pharmacological inhibition of matrix metalloproteinase 2/9 activity. In aged mice, extravasation was markedly delayed, resulting in persistent tissue hypoxia, synaptic damage and cell death. Our study identifies a novel cellular mechanism that may be critical for recanalization of occluded microvessels. Alterations in the efficiency of this protective mechanism may have important implications in microvascular pathology, stroke recovery, and age-related cognitive decline.

Lam, Carson K.; Yoo, Taehwan; Hiner, Bennett; Liu, Zhiqiang; Grutzendler, Jaime



Rescue from hemodialysis by late recanalization of renal artery occlusion  

PubMed Central

We report on a patient with terminal renal insufficiency undergoing hemodialysis since four months. Imaging studies showed complete renal artery occlusion of a single kidney with collateral perfusion. Interventional recanalization of the renal artery was successful with a drop of serum creatinine from 1138 to 163 mol/l sparing the patient from further hemodialysis.

Ringe, Kristina Imeen; Galanski, Michael; Rosenthal, Herbert



Improving the Predictive Accuracy of Recanalization on Stroke Outcome in Patients Treated With Tissue Plasminogen Activator  

Microsoft Academic Search

Background and Purpose—Although early recanalization is a powerful predictor of stroke outcome after thrombolysis, some stroke patients remain disabled despite tissue plasminogen activator (tPA)-induced recanalization. Therefore, we sought to investigate whether the predictive accuracy of early recanalization on stroke outcome is improved when combined with clinical and radiological information. Methods—We evaluated 177 patients with nonlacunar strokes in the middle cerebral

Carlos A. Molina; Andrei V. Alexandrov; Andrew M. Demchuk; Maher Saqqur; Ken Uchino; José Alvarez-Sabín



Catheter-directed thrombolytic therapy combined with angioplasty for hepatic vein obstruction in Budd-Chiari syndrome complicated by thrombosis  

PubMed Central

The aim of this study was to assess the efficacy and safety of catheter-directed thrombolysis combined with angioplasty in the treatment of hepatic vein obstruction in Budd-Chiari syndrome (BCS) complicated by thrombosis. In 14 cases of BCS, the patients with hepatic vein obstruction complicated by thrombosis who underwent catheter-directed urokinase thrombolysis, balloon dilatation and/or stent placement were followed up with an ultrasound examination of the liver. Among the 13 cases of successful treatment, one hepatic vein was recanalized in 12 patients (right hepatic vein, seven cases; left hepatic vein, three cases; middle hepatic vein, one case and accessory hepatic vein, one case) and two hepatic veins (right and left) were recanalized in one patient without serious complications, such as bleeding and pulmonary embolism. There was one patient in whom the treatment was unsuccessful. During an average follow-up period of 24.8±19.6 months, hepatic vein restenosis was observed in one patient in the sixth month after opperation; however, a successful result was obtained following a second balloon dilatation. The remaining 12 patients did not demonstrate any recurrence of restenosis or thrombosis. Catheter-directed thrombolysis combined with angioplasty was observed to be an effective and safe method for the treatment of hepatic vein obstruction in BCS complicated by thrombosis.




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

SciTech Connect

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.

Tanaka, Toshihiro, E-mail:; Guenther, Rolf W., E-mail:; Isfort, Peter, E-mail: [RWTH Aachen University, Department of Diagnostic Radiology, Aachen University Hospital (Germany); Kichikawa, Kimihiko, E-mail: [Nara Medical University, Department of Radiology (Japan); Mahnken, Andreas H., E-mail: [RWTH Aachen University, Department of Diagnostic Radiology, Aachen University Hospital (Germany)



Stent-assisted recanalization in acute basilar artery occlusion.  


Lock-in syndrome is a tragedy due to the occlusion of the vertebrobasilar artery. Intravenous thrombolysis with rTPA was the only approved medicine using in mild to moderate (NIHSS 4-25) acute ischemic stroke happened within 3 hours. Patients with lock-in syndrome often belonged to severe stroke, and are excluded by traditional intra-venous thrombolysis. Intra-arterial thrombolysis is flexible to extend the therapeutic window up to 12 hours in posterior circulation, and with a higher recanalization rate. Stent-assisted recanalization is a life saving procedure for patient with acute basilar artery occlusion(1). A 53-year-old man suffered from sudden onset of dizziness and hemiparesis of right side extremities on 08:15am during work. He was brought to our emergency department on 09:10am and brain computer tomography (CT) was performed on 09:31am. Neurologist evaluated the patient on 10:00am with initial NIHSS 29 and brain stem stroke was impressed. Intubation was performed on 10:20am due to conscious deterioration. We performed intra-arterial thrombolysis with partially recanalization but had a complete recover of neurological deficits on 13:30pm. However, conscious deteriorate was noted again and brain CT perfusion defect at posterior circulation (Figure 1) was noted on 15:41pm. Emergent angioplasty and totally four consecutive balloon-expandable stents (Medtronic Driver 3.0-24mm, 3.5-18mm, 3.5-24mm, 4.0-18mm) were deployed retrograde from the basilar tip to distal portion of left vertebral artery with complete revascularization of basilar artery (Figure 2) and perfusion (Figure 1). Patient was discharged smoothly one month later with mild right arm weakness (mRS 1). PMID:24030044

Chan, Lung; Li, Ai-Hsian; Lai, Yen-Jun; Liu, Hon-Mon



Varicose vein stripping  


... called the superficial saphenous vein is thick and rope-like. Vein stripping usually takes about 1 to ... high blood pressure in a vein (lipodermatosclerosis) Large, rope-like veins that cannot be treated with other, ...


Endovascular recanalization for chronic symptomatic middle cerebral artery total occlusion  

PubMed Central

The optimal treatment of chronic middle cerebral artery (MCA) occlusion is unclear. Angioplasty and stenting may be an alternative treatment for patients with recurrent ischemic symptoms despite medical therapy. Two patients with chronic right MCA occlusion successfully treated with stenting are reported, together with their long term follow-up to illustrate the feasibility of endovascular recanalization. One patient remained asymptomatic at the 29-month follow-up. Another patient developed symptomatic in-stent restenosis at 12?months which resolved after repeat angioplasty. Further larger scale pilot studies are needed to determine the efficacy and long term outcome of this treatment.

Ma, Ning; Mo, Da-Peng; Gao, Feng



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

SciTech Connect

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.

Rajan, Dheeraj K., E-mail:; Saluja, Jasdeep S. [Toronto General Hospital, University Health Network University of Toronto, Division of Vascular and Interventional Radiology, Department of Medical Imaging (Canada)



Timing of Recanalization After Microbubble-Enhanced Intravenous Thrombolysis in Basilar Artery Occlusion  

Microsoft Academic Search

Background and Purpose—Information about early recanalization of basilar artery occlusion after systemic tissue plasminogen activator remains unknown. We aimed to determine the timing of recanalization in basilar artery occlusion treated with systemic thrombolysis, microbubbles, and continuous transcranial Doppler monitoring. Methods—We studied 20 patients with 12 hours basilar artery occlusion treated with intravenous tissue plasminogen activator, 2 hours continuous ultrasound, and

Jorge Pagola; Marc Ribo; Marcos Lange; Marta Rubiera; Carlos A. Molina


Antegrade recanalization of parent artery in internal trapping of vertebral artery dissecting aneurysm: a case report  

Microsoft Academic Search

BackgroundWe describe a case involving technical success with internal trapping using controllable detachable coils yet antegrade recanalization of the occluded vertebral artery, in the vertebral artery dissecting aneurysm. Possible explanations for the antegrade recanalization of the occluded vertebral artery and lessons from the case are also discussed.

Seung Kug Baik; Yong Sun Kim; Hui Jung Lee; Duk Sik Kang



Patterns of recurrent disease after recanalization of femoropopliteal artery occlusions  

SciTech Connect

Purpose. In this prospective study we investigated the site, occurrence, and development of stenoses and occlusions following recanalization of superficial femoral artery occlusions. Methods. Recanalization of an occluded femoropopliteal artery was attempted in 62 patients. Follow-up examinations included clinical examination and color-flow duplex scanning at regular intervals. Arteriography was used to determine the localization of the recurrent disease relative to the initially occluded segment. Results. During a mean follow-up of 23 months (range 0-69 months) 14 high-grade restenoses, indicated by a peak systolic velocity ratio {>=}3.0, were detected by color-flow duplex scanning. Occlusion of the treated segment occurred in 11 patients. The cumulative 3-year primary patency rate for high-grade restenoses and occlusions combined was 44% (SE 9%). By arteriographic examination the site of restenosis was localized in the distal half of the treated vessel segment in 16 of 21 cases. Conclusion. Most restenoses and occlusions occurred during the first year and most disease developed at the previous intervention site. The site of restenosis is more frequently in the distal part of the initially treated segment, a finding that may have therapeutic implications.

Vroegindeweij, Dammis; Tielbeek, Alexander V. [Catharina Hospital, Department of Radiology (Netherlands); Buth, Jaap [Catharina Hospital, Department of Vascular Surgery (Netherlands); Vos, Louwerens D.; Bosch, Harrie C. M. van den [Catharina Hospital, Department of Radiology (Netherlands)



The complete recanalization of PICC-related venous thrombosis in cancer patients: A series of case reports  

PubMed Central

In this study, cancer patients with venous thrombosis associated with the use of peripherally inserted central catheters (PICCs) underwent complete recanalization by the administration of Panax notoginseng saponins (PNS), which vary from heparin or urokinase in that they do not have the same risks associated with thrombolysis, including bleeding. To the best of our knowledge, this is the first study concerning the treatment of cancers with PNS to be reported in the literature. Three cancer patients aged 30–50 years old, two females and one male, were subjected to chemotherapy. On the first day of chemotherapy, a PICC was inserted into the right basilic vein with its tip in the superior vena cava. On the third day of chemotherapy, pain, swelling and skin flushing started. In the following days, particularly days 10–13, a Doppler ultrasound examination confirmed a long thrombus along the PICC line in the axillary vein and brachial veins in each patient. The patients rejected the insertion of an inferior vena cava filter, and neither heparin nor urokinase were administered due to contra-indications. An injection of PNS (200 mg) was administered every day. On days 20–28 of chemotherapy, the thrombus in the axillary and brachial veins disappeared in the three patients. It was concluded that PNS promote blood circulation, which prevents blood stasis and reduces the toxicity of cisplatin. The results suggest that PNS are a feasible and effective treatment option for many types of cancer, but have a broader clinical impact on cancer patients with PICC-related venous thrombosis. Therefore, this study is an original case report of particular interest to cancer patients with PICC-related venous thrombosis.




Vein filter  

US Patent & Trademark Office Database

A vein filter having improved collectability of chyme blood or thrombi and stability of indwelling. The filter includes at least 3 wires radially spreading backward of a head member and connected such that the intervals between any adjacent two wires are connected with threads of an equal length at a substantially equal distance from the head member. At respective connection parts where the threads are connected to the wires, hook parts to be hooked on the inner wall of a blood vessel are provided. The head member is on the apex of a shaft extending back and the rear end of each wire is connected to a slide member slidable along the shaft. The wires are preferably made of shape memory alloy or stainless spring steel.

Okada; Masayosi (Osaka, JP)



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

SciTech Connect

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.

Chu, Hee Ho; Kim, Hyo-Cheol, E-mail:; Jae, Hwan Jun [Seoul National University College of Medicine, Seoul National University Medical Research Center, Seoul National University Hospital, Department of Radiology, Institute of Radiation Medicine, Clinical Research Institute (Korea, Republic of); Yi, Nam-Joon; Lee, Kwang-Woong; Suh, Kyung-Suk [Seoul National University College of Medicine and Seoul National University Hospital, Department of Surgery (Korea, Republic of); Chung, Jin Wook; Park, Jae Hyung [Seoul National University College of Medicine, Seoul National University Medical Research Center, Seoul National University Hospital, Department of Radiology, Institute of Radiation Medicine, Clinical Research Institute (Korea, Republic of)



Spontaneous recanalization of the basilar artery with conservative management months after symptom onset.  


Basilar artery occlusion may be associated with a poor prognosis in the absence of recanalization. Choices in aggressive treatment for this potentially fatal condition vary from intra-arterial or intravenous thrombolysis, endovascular removal, or a combination of the two, with adjunct anti-coagulation therapy. These therapies have proven to be effective in recanalization, whereas conservative management with anti-coagulants alone has had more limited success in the literature. We report a case of basilar artery occlusion managed conservatively with unfractionated heparin, resulting in complete recanalization 3.5 months after symptom onset. Conservative management of basilar artery occlusion with unfractionated heparin was associated with complete recanalization long after symptom onset. PMID:21577354

Oster, Joel M; Aggarwal, Puja



Bovine pericardium buttress limits recanalization of the uncut roux-en-Y in a porcine model  

Microsoft Academic Search

In contrast to the traditional Roux-en-Y reconstruction, an uncut Roux-en-Y provides biliopancreatic diversion and may preserve\\u000a myoelectric continuity. Previous iterations of the uncut Roux have been plagued by recanalization of the uncut staple line\\u000a in the afferent small bowel. Our aim was to determine if bovine pericardium buttress prevents recanalization of the stapled\\u000a smallbowel partition in a porcine model. Sixteen

John M. Morton; Tananchai A Lucktong; Scott Trasti; Timothy M. Farrell



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

SciTech Connect

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.

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



Recanalization results after intracranial stenting of atherosclerotic stenoses.  


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. PMID:19908087

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



Initial results of laser recanalization in lower extremity arterial reconstruction.  


One hundred ninety-five patients have been evaluated for possible laser recanalization (LR). Current laser delivery systems are most appropriate for the treatment of superficial femoral, popliteal, or isolated common iliac artery occlusions, and therefore one half (110) of the patients were initially excluded because of inappropriate disease location. An additional 39 patients were excluded because they showed minimal symptoms or the procedure would have been excessively risky for them. The remaining 46 patients underwent LR for total arterial occlusions, with relief of symptoms and increased ankle brachial indexes in 22 (48%). Of the four patients who could not be surgically reconstructed because of tibial artery occlusion, none was successfully treated. Only one patient required emergency reconstruction for ischemia after LR failure, and no procedures were required for treatment of perforation or bleeding. Successful LR was most likely when isolated lesions less than 15 cm in length, in the common iliac, middle or distal superficial femoral, and above-knee popliteal arteries were treated. Of the 22 patients for whom LR was successful, 11 would have been candidates for standard surgical therapy, six would have been excluded from such therapy by medical or surgical risks, and five had symptoms usually considered too mild to be offered surgery. Thus, at present the impact of LR on the treatment of patients with peripheral vascular disease appears limited. PMID:2521363

Seeger, J M; Abela, G S; Silverman, S H; Jablonski, S K



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

SciTech Connect

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.

Dabitz, Rainer [Klinikum Ingolstadt, Department of Neurology (Germany); Triebe, Stefan [Klinikum Ingolstadt, Department of Diagnostic and Interventional Radiology (Germany); Leppmeier, Ullrich; Ochs, Guenther [Klinikum Ingolstadt, Department of Neurology (Germany); Vorwerk, Dierk [Klinikum Ingolstadt, Department of Diagnostic and Interventional Radiology (Germany)], E-mail:



[Morphological results of stromal stem cells of bone marrow origin into the thrombosed vein in experiment].  


Using the methods of luminescent microscopy, the results of injection of autologous multipotent stromal (mesenchymal) stem cells of bone marrow origin (SSCBMO) containing GFP gene, into thrombosed hindlimb vein were studied in 226 male Wag rats. It was found that the restoration of blood flow through the thrombosed main vein was not always the result of thrombolysis. No signs of incorporation of injected SSCBMO into the wall of thrombosed vessel, clot recanalization or collateral formation were detected. In experimental thrombosis model with thrombin administration and main vein ligation, the thrombosis of its small branches also took place. The restoration of blood flow occured via either blood clot recanalization or obliteration of thrombosed vessels and the outgrowth of the new ones. SSCBMO were found to participate in both of these processes resulting in faster restoration of a blood flow in the tissue microregion of thrombosed vein. Gradually the injected SSCBMO and the structures formed with their participation, were replaced by the own cells of a recipient organism. PMID:23236892

Ma?borodin, I V; Morozov, V V; Novikova, Ia V; Matveeva, V A; Artem'eva, L V; Matveev, A L; Komenko, S V; Marchukov, S V



Periumbilical uptake of Tc-99m MAA on lung perfusion scanning in a patient with superior vena cava obstruction.  


A 25-year-old woman with severe parenchymal lung disease of unknown etiology and existing for more than a decade was referred for ventilation-perfusion scintigraphy because of suspicion of pulmonary embolism. Both ventilation and perfusion images showed, apart from perfusion defects from her severe lung disease, a left apical pneumothorax and signs of recurrent pneumonia of the left lower lobe. Noteworthy was the periumbilical uptake of the Tc-99m macroaggregated albumin (MAA). Her medical history revealed iatrogenic superior vena cava (SVC) obstruction. In this case, the main collateral pathway of portosystemic shunting is probably, after recanalization of the left umbilical vein, a network of smaller paraumbilical veins. PMID:16550019

Balink, H; Nabers, J



Ruptured vertebral artery dissecting aneurysm followed by spontaneous acute occlusion and early recanalization: case report.  


A 47-year-old man presented with a ruptured vertebral artery dissecting aneurysm manifesting as subarachnoid hemorrhage followed by acute occlusion and early recanalization of the affected artery. Cerebral angiography 2 hours after the onset of the symptom showed pearl-and-string sign in the right vertebral artery. Serial angiography showed that the affected artery was occluded at 12 hours but was recanalized on the 4th day. The dissecting aneurysm was resected with side-to-side anastomosis between the bilateral posterior inferior cerebellar arteries. Postoperative cerebral angiography demonstrated disappearance of the lesion and patency of the right posterior inferior cerebellar artery via the anastomosis. Histological examination of the lesion showed hematoma between the media and adventitia, disrupting the internal elastica and intima. Acute occlusion and early recanalization of the affected artery may occur in ruptured vertebral artery dissecting aneurysms. Serial neurological and neuroradiological examinations are essential to decide the timing and method of treatment. PMID:16127257

Endo, Hidehiko; Otawara, Yasunari; Ogasawara, Kuniaki; Ogawa, Akira; Nakamura, Shin-ichi



Balloon Occlusion of the Contralateral Iliac Artery to Assist Recanalization of the Ipsilateral Iliac Artery in Total Aortoiliac Occlusion: A Technical Note  

PubMed Central

Endovascular recanalization of chronic total aortoiliac occlusion is technically challenging. Inability to reenter the true aortic lumen, following retrograde iliac recanalization, is one of the most common causes of failure. We describe a case of a total aortoiliac occlusion where balloon occlusion of the right common iliac artery, following its recanalization from a brachial approach, was used to facilitate antegrade recanalization of the occluded contralateral left common iliac artery.

Jaffan, Abdel Aziz A.



Reappraisal of Anatomic Outcome Scales of Coiled Intracranial Aneurysms in the Prediction of Recanalization  

PubMed Central

Objective Several scales are currently used to assess occlusion rates of coiled cerebral aneurysms. This study compared these scales as predictors of recanalization. Methods Clinical data of 827 patients harboring 901 aneurysms treated by coiling were retrospectively reviewed. Occlusion rates were assessed using angiographic grading scale (AGS), two-dimensional percent occlusion (2DPO), and volumetric packing density (vPD). Every scale had 3 categories. Followed patients were dichotomized into either presence or absence of recanalization. Kaplan-Meier analysis was conducted, and Cox proportional hazards analysis was performed to identify surviving probabilities of recanalization. Lastly, the predictive accuracies of three different scales were measured via Harrell's C index. Results The cumulative risk of recanalization was 7% at 12-month, 10% at 24-month, and 13% at 36-month of postembolization, and significantly higher for the second and third categories of every scale (p<0.001). Multivariate-adjusted hazard ratios (HRs) of the second and third categories as compared with the first category of AGS (HR : 3.95 and 4.15, p=0.004 and 0.001) and 2DPO (HR : 4.87 and 3.12, p<0.001 and 0.01) were similar. For vPD, there was no association between occlusion rates and recanalization. The validated and optimism-adjusted C-indices were 0.50 [confidence (CI) : -1.09-2.09], 0.47 (CI : -1.10-2.09) and 0.44 (CI : -1.10-2.08) for AGS, 2DPO, and vPD, respectively. Conclusion Total occlusion should be reasonably tried in coiling to maximize the benefit of the treatment. AGS may be the best to predict recanalization, whereas vPD should not be used alone.

Lee, Jong Young; Cho, Young Dae; Kang, Hyun-Seung; Han, Moon Hee



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

SciTech Connect

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.

Stampfl, Sibylle; Stampfl, Ulrike; Bellemann, Nadine; Sommer, Christof M.; Thierjung, Heidi; Radeleff, Boris; Lopez-Benitez, Ruben [University of Heidelberg Medical Center, Department of Diagnostic Radiology (Germany); Berger, Irina [University of Heidelberg Medical Center, Department of Pathology (Germany); Kauffmann, Guenter W.; Richter, Goetz M., E-mail: goetz_richter@med.uni-heidelberg.d [University of Heidelberg Medical Center, Department of Diagnostic Radiology (Germany)



EkoSonicSV endovascular system for recanalization of the basilar artery occlusion.  


The interventional management of stroke may consist of the use of angioplasty, stenting or mechanical thrombus removal technique. For this purpose several retrieval devices are being used. Recently the new alternative device - EkoSonicSV has been introduced, which is particularly suitable for recanalization of the occluded basilar artery (BA). Here we are presenting a complete recanalization of BA using this device in two patients with stroke over a short period of time together with the intra-arterial use of recombinant tissue plasminogen activator and application of intravascular ultrasound. PMID:21948785

Jonszta, T; Czerný, D; Skoloudík, D; Böhm, M; Klement, P; Procházka, V



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

SciTech Connect

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.

Tapping, C. R.; Uri, I. F.; Dixon, S.; Bratby, M. J.; Anthony, S.; Uberoi, R., E-mail: [John Radcliffe Hospital, Department of Radiology (United Kingdom)



P-030 A self-expanding wingspan stent-assisted recanalization for acute middle cerebral artery occlusion in case of failure or contraindication to intravenous thrombolysis  

Microsoft Academic Search

BackgroundEarly recanalization of occluded intracranial arteries in acute ischemic stroke is one of the most important factors for better clinical outcome. Recanalization with a self-expanding Wingspan stent, which can be deployed rapidly and safely, is an option for treating acute ischemic stroke when intravenous thrombolysis has failed or is contraindicated. We present the feasibility, efficacy and safety of recanalization with

S Sung; T Lee



Prototype vein contrast enhancer  

NASA Astrophysics Data System (ADS)

A proof-of-principle prototype Vein Contrast Enhancer (VCE) has been designed and constructed. The VCE is an instrument that makes vein access easier by capturing an infrared image of peripheral veins, enhancing the vein-contrast using software image processing, and projecting the enhanced vein-image back onto the skin using a modified commercial projector. The prototype uses software alignment to achieve alignment accuracy between the captured infrared image and the projected visible image of better than 0.06 mm. Figure 1 shows the prototype demonstrated in our laboratory.

Zeman, Herbert D.; Lovhoiden, Gunnar; Vrancken, Carlos



[Radiofrequency ablation of the great saphenous vein in lower-limb varicose disease].  


The authors herein share their experience gained in comprehensive treatment of patients diagnosed with lower-limb varicose disease treated by means of one the most state-of-the-art technologies, i. e., radiofrequency ablation. The work deals with the outcomes of managing a total of seventy-eight patients suffering from lower-limb varicose diseases with valvular insufficiency of the great saphenous vein. All the patients were subjected to radiofrequency ablation of the compromised great saphenous vein by means of the portable radiofrequency device "Surgitron" manufactured by the Company "Ellman International" (USA). Examination included ultrasonographic duplex and triplex scanning of the veins of the lower extremities. Intraoperative radiofrequency ablation of the great saphenous vein was performed by means of an original appliance consisting of a metallic probe whose length corresponded to that of the lower extremity concerned, with a figure-of-eight olive at the distal end and external plastic tube catheter. The construction of the probe made it possible to maximally free the great saphenous vein from blood through the lateral ports of the catheter, to reduce the risk of complications, to diminish the duration of the intervention, and to increase its effectiveness. Efficacy of radiofrequency ablation of the great saphenous vein amounted to 93.6%, with recanalization of the greater saphenous vein being established in five (6.4%) patients. Good functional and cosmetically pleasing therapeutic outcomes were observed in the majority of the patients (87.2%). PMID:19806942

Chabbarov, R G; Gavrilov, V A; Piatnitski?, A G; Khvorostukhin, V S



Central Vein Dilatation Prior to Concomitant Port Implantation  

SciTech Connect

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.

Krombach, Gabriele A., E-mail:; Plumhans, Cedric; Goerg, Fabian; Guenther, Rolf W. [University of Technology (RWTH) Aachen, Department of Diagnostic Radiology, University Hospital (Germany)



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

SciTech Connect

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.

Bolia, Amman [Department of Radiology, Clinical Sciences Building, Leicester Royal Infirmary, PO Box 65, Leicester LE2 7LX (United Kingdom); Nasim, Akhtar; Bell, Peter R.F. [Department of Surgery, Clinical Sciences Building, Leicester Royal Infirmary, PO Box 65, Leicester LE2 7LX (United Kingdom)



Endovascular recanalization of acute atherothrombotic carotid artery occlusion holds up progressive stroke  

Microsoft Academic Search

In acute carotid artery occlusion, hemodynamic compromise in addition to artery–artery thromboembolism is the mechanism of ischemia that may lead to a progressive clinical course with enlarging infarcts. The natural course of carotid artery occlusion with a progressive stroke is unfavorable with only about 10% of patients making a good recovery. We report on two patients in whom emergency recanalization

R. du Mesnil de Rochemont; M. Sitzer; T. Neumann-Haefelin; A. Harmjanz; J. Berkefeld



Thrombus Branching and Vessel Curvature are Important Determinants of MCA Trunk Recanalization with Merci Thrombectomy Devices  

PubMed Central

Background Determinants of successful recanalization likely differ for Merci thrombectomy(MT) and intra-arterial pharmacologic fibrinolysis interventions. While the amount of thrombotic material to be digested is an important consideration for chemical lysis, mechanical debulking may be more greatly influenced by other target lesion characteristics. Methods In consecutive acute ischemic stroke patients treated with MT for middle cerebral artery M1 occlusions, we analyzed the influence on recanalization success and clinical outcome of target thrombus size (length) and shape (curvature and branching) on pretreatment T2* gradient echo magnetic resonance imaging (MRI). Results Among 65 patients, pretreatment MRI showed susceptibility vessel signs (SVS) in 45 (69%). Thrombus length averaged 13.03 mm (range 5.56–34.91) and irregular shape (curvature or branching) was present in 17/45 (38%). Presence and length of SVS did not predict recanalization or good clinical outcome. Substantial recanalization (TICI 2b or 3) and good clinical outcome (mRS ?2) were more frequent with regular than irregular SVS shape (57% vs 18%, P=0.013; 39% vs 6%, P=0.017). On multiple regression analysis, the only independent predictor of substantial recanalization was irregular SVS (OR, 0.16; 95% CI, 0.04 to 0.69; P=0.014); and leading predictors of good clinical outcome were baseline NIHSS (OR, 1.20; 95% CI, 1.03 to 1.40; P= 0.019) and irregular SVS (OR, 9.36; 95% CI, 0.98 to 89.4; P=0.052). Conclusions Extension thrombus into MCA division branches and curving shape of the MCA stem, but not thrombus length, decrease technical and clinical success of Merci thrombectomy in M1 occlusions.

Zhu, Liangfu; Liebeskind, David S.; Jahan, Reza; Starkman, Sidney; Salamon, Noriko; Duckwiler, Gary; Vinuela, Fernando; Tateshima, Satoshi; Gonzalez, Nestor; Villablanca, Pablo; Ali, Latisha K.; Kim, Doojin; Ovbiagele, Bruce; Froehler, Michael; Tenser, Matthew; Saver, Jeffrey L.



[Repeated local thrombolysis in a patient with axillary and subclavian vein injury and thrombosis].  


Deep vein thrombosis (DVT) is a disorder with blood clot (thrombus) formation in deep veins. DVT of upper extremities (UE) is rare but serious, bearing in mind its possible complications, disease. UE DVT treatment involves subcutaneous injections of low molecular weight heparins and subsequent switch to oral anticoagulation or thrombolysis; thrombolysis by intravenous administration of a thrombolytic agent is used only if indicated (subclavian vein thrombosis). A case of a professional sportswoman is presented, who was treated for venous thrombosis of subclavian and axillary veins using local thrombolysis. Thrombosis emerged suddenly after a basketball match, during which oedema of the right arm occurred subsequent to the patient being hit with the ball to the armpit area. Venipuncture as well as all catheter repositionings were performed under the duplex ultrasound (DUS) surveillance. Proximal brachial vein was punctured and four French catheters were used to enter subclavian vein. For thrombolysis, 0.2-0.6 mg/hour alteplase (rt-PA) was used. Injury to axillary vein tunica intima was evident the following day after the subclavian and axillary thrombosis was dissolved completely, and thrombosis in the same area recurred immediately after stopping the thrombolytic infusion. Therefore, administration of a thrombolytic agent into the same area was re-introduced and acetylsalicylic acid was added to the medication. This combined therapy resulted in recanalization of the arm as well as the axillary and subclavian areas. Thrombolysis was stopped on the 3rd day of treatment. The method can be used to manage deep vein thromboses of the upper arms even without X-ray control. Local thrombolysis of deep vein thrombosis with ultrasound surveillance is, in indicated patients, a safe method even if a vein injury occurs. PMID:20017444

Sárník, S; Hofírek, I



Complex left profunda femoris vein to renal vein bypass for the management of progressive chronic iliofemoral occlusion.  


Chronic occlusions of the inferior vena cava (IVC) and iliofemoral veins are long-term sequelae of deep venous thrombosis (DVT) that can lead to postthrombotic syndrome (PTS). Patients may present with a wide spectrum of signs and symptoms, ranging from mild discomfort and swelling to severe venous hypertension and ulcerations. We report a 68-year-old man who had a history of left lower extremity DVT after a laminectomy and who developed PTS with nonhealing ulcers. The patient underwent a cross-pubic femorofemoral venous bypass that failed to improve his clinical status. After unsuccessful endovascular attempts for recanalization of the iliofemoral segment, a profunda femoris to IVC bypass was performed. The symptoms recurred 2 years later. Venography revealed restenosis at the caval anastomosis that did not resolve by endovascular means. A surgical revision was performed, and given the quality of the IVC, a jump bypass was created to the left renal vein. The swelling improved and the ulcers healed completely. Twenty-eight months after the complex reconstructions, he remains ulcer-free with mild edema controlled with stockings. Venous reconstructions remain a viable option for patients with symptomatic and recalcitrant nonmalignant obstruction of the large veins. PMID:23122979

Anaya-Ayala, Javier E; Adams, Matthew K; Telich-Tarriba, Jose E; Dresser, Kelly L; Ismail, Nyla; Peden, Eric K



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

SciTech Connect

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.

Janne d'Othee, Bertrand, E-mail:; Walker, T. Gregory; Kalva, Sanjeeva P.; Ganguli, Suvranu; Davison, Brian [Massachusetts General Hospital-Harvard Medical School, Department of Imaging, Division of Vascular Imaging and Intervention (United States)



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


PURPOSE: To investigate the efficacy and safety of mechanical thrombectomy for iliac vein thrombosis using Rotarex and Aspirex catheters in a pig model. MATERIALS AND METHODS: Iliac 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. RESULTS: Thrombus 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. CONCLUSION: The 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. PMID:23748731

Minko, P; Bücker, A; Laschke, M; Menger, M; Bohle, R; Katoh, M



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

SciTech Connect

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.

Smits, Maarten L. J., E-mail: [University Medical Center Utrecht, Department of Radiology (Netherlands); Vanlangenhove, Peter, E-mail:; Sturm, Emiel J. C., E-mail: [Ghent University Hospital, Department of Vascular and Interventional Radiology (Belgium); Bosch, Maurice A. A. J. van den, E-mail: [University Medical Center Utrecht, Department of Radiology (Netherlands); Hav, Monirath, E-mail:; Praet, Marleen, E-mail: [Ghent University Hospital, N. Goormaghtigh Institute of Pathology (Belgium); Vente, Maarten A. D., E-mail: [University Medical Center Utrecht, Department of Radiology (Netherlands); Snaps, Frederic R., E-mail: [University of Liege, Department of Clinical Sciences, Faculty of Veterinary Medicine (Belgium); Defreyne, Luc, E-mail: [Ghent University Hospital, Department of Vascular and Interventional Radiology (Belgium)



A Palm Vein Recognition System  

Microsoft Academic Search

Palm vein pattern recognition is one of the newest bometric techniques researched today. This paper presents a palm vein recognition system that uses blood vessel patterns as personal identifying factor. The vein information is hard to duplicate since veins are internal to the human body. The design details of the palm vein capture device are researched, and preprocessing and feature

Huan Zhang; Dewen Hu



Postpartum ovarian vein thrombosis.  


Ovarian vein thrombosis is a rare occurrence in the postpartum period. Two cases of postpartum ovarian vein thrombosis are presented. The differential diagnosis is extensive because many diseases can present with similar symptoms. Early diagnosis is essential for appropriate treatment and prevention of the potential sequelae that can occur. Computerized tomography with contrast is the optimal imaging modality for the diagnosis. PMID:8285981

Chawla, K; Mond, D J; Lanzkowsky, L



Percutaneous retrograde recanalization of the celiac artery by way of the superior mesenteric artery for chronic mesenteric ischemia.  


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. PMID:22526103

Joseph, George; Chacko, Sujith Thomas



Shorter time to intervention improves recanalization success and clinical outcome post intra-arterial intervention for basilar artery thrombosis.  


Basilar artery thrombosis is associated with poor clinical outcomes and high mortality rate if untreated. Clinical outcome correlates with recanalization success. As arterial clot composition undergoes organization over time and may become more resistant to recanalization therapy, we postulate that recanalization success is time-dependent. We aim to investigate whether time to intervention predicts recanalization success leading to improved clinical outcomes. Forty-nine consecutive patients with basilar artery thrombosis treated with intra-arterial (IA) therapy between 1993 and 2011 were included. Patient demographics, clinical features, clot location, time to intervention and post-procedural thrombolysis in myocardial infarction (TIMI) scores were collected. Recanalization success was defined as a score of TIMI 2-3. Clinical outcome was measured using the 90-day modified Rankin Scale (mRS) score, with good neurological outcome defined as mRS 0-2. The mean patient age was 59.8 years ± 17.9 and 36.7% were females. IA therapy was commenced within 6 hours of stroke onset in 17/49 (34.7%) patients. Of this 6-hour onset group, 17/17 (100%) demonstrated recanalization success (TIMI 2-3) and 10/17 (58.8%) achieved good neurological outcome at 90-days. IA therapy was commenced after 6 hours of stroke onset in 32/49 (65.3%) patients, with 24/32 (75%) and 6/32 (18.75%) patients achieving recanalization success and good outcome, respectively. A shorter delay to IA therapy is significantly associated with recanalization success (p=0.038) and good neurological outcome at 90 days (p=0.009) in patients with acute basilar artery thrombosis. We recommend a systematic approach to minimize time delay to IA therapy for this condition. PMID:22898196

Tan, Mei Lyn; Mitchell, Peter; Dowling, Richard; Tacey, Mark; Yan, Bernard



Antegrade Recanalization of Parent Artery after Internal Trapping of Ruptured Vertebral Artery Dissecting Aneurysm  

PubMed Central

We report a patient with a ruptured vertebral artery (VA) dissecting aneurysm that was treated by internal trapping of the aneurysm and parent artery using detachable coils with subsequent antegrade recanalization of occluded vertebral artery during the follow-up period. A 38-year-old man was admitted with a ruptured right VA dissecting aneurysm just distal to origin of right posterior inferior cerebellar artery. The dissected segment of the VA was occluded by coil embolization. The 14 months follow-up angiography showed that dissected aneurysm was completely occluded, but the parent artery was recanalized in an antegrade fashion. Based on this unique case, the authors suggest that careful angiographic follow-up of dissecting aneurysm is required, even in patients successfully treated with endovascular occlusion of the affected artery and aneurysm.

Sung, Jae Hoon; Byun, Je Hoon



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

SciTech Connect

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.

Lim, Sang Joon; Shim, Hyung Jin [Department of Radiology, College of Medicine, Chung-Ang University, 82-1, Pil-dong 2 ka, Chung-ku, Seoul 100-272 (Korea, Republic of); Kwak, Byung Gook [Department of Internal Medicine, College of Medicine, Chung-Ang University, 82-1, Pil-dong 2 ka, Chung-ku, Seoul 100-272 (Korea, Republic of); Kim, Hyeon Joo; Park, Hyo Jin; Sa, Eun Jin [Department of Radiology, College of Medicine, Chung-Ang University, 82-1, Pil-dong 2 ka, Chung-ku, Seoul 100-272 (Korea, Republic of); Min, Cheol Hong [Department of Internal Medicine, College of Medicine, Chung-Ang University, 82-1, Pil-dong 2 ka, Chung-ku, Seoul 100-272 (Korea, Republic of); Lee, Yong Chul; Kim, Kun Sang [Department of Radiology, College of Medicine, Chung-Ang University, 82-1, Pil-dong 2 ka, Chung-ku, Seoul 100-272 (Korea, Republic of)



Vertebrobasilar recanalization after 12 h of onset using balloon expandable stent and thrombolysis  

Microsoft Academic Search

Basilar artery (BA) thrombosis is a severe condition that has a high percentage of mortality if no treatment is performed.\\u000a Recanalization is the most successful way of reducing mortality and improving outcome in patients with BA thrombosis. We present\\u000a a case of a patient that presented to our hospital 12 h after onset of symptoms in which a combination of techniques

Alfredo Casasco; Hugo Cuellar; Francisco Gilo; Leopoldo Guimaraens; Jacques Theron



Radiofrequency guide wire recanalization of venous occlusions in patients with malignant superior vena cava syndrome.  


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. PMID:21976039

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



[Recanalization of the ductus arteriosus in a child with non-Hodgkin's lymphoma].  


Dissertation describes the case of 7.5-year-old boy with recanalization of the ductus arteriosus. In this patient treated because of the non-Hodgkin lymphoma during the chemotherapy the respiratory failure occurred and mechanical ventilation was required. After the respiratorotherapy in the controlled echocardiography examination the patency of previously closed ductus arteriosus, was described. There was no description of the similar case in available references. PMID:10731982

Aleszewicz-Baranowska, J; Chojnicki, M; Fiszer, R; Sabiniewicz, R; Irga, N; Balcerska, A; Zaborowska-So?tys, M



Percutaneous recanalization of arteries: Status and prospects of laser angioplasty with modified fibre tips  

Microsoft Academic Search

Percutaneous balloon dilatation of arterial stenoses is a firmly established non-surgical treatment of ischaemic disease.\\u000a The number of percutaneous transluminal coronary angioplasties performed per year in the USA approaches the number of coronary\\u000a artery bypass graft operations. A great number of novel percutaneous recanalization schemes address the major problems of\\u000a balloon angioplasty: failure to cross the stenosis (occlusion), failure to

Cornelius Borst



Endovascular recanalization of acute atherothrombotic carotid artery occlusion holds up progressive stroke.  


In acute carotid artery occlusion, hemodynamic compromise in addition to artery-artery thromboembolism is the mechanism of ischemia that may lead to a progressive clinical course with enlarging infarcts. The natural course of carotid artery occlusion with a progressive stroke is unfavorable with only about 10% of patients making a good recovery. We report on two patients in whom emergency recanalization of acute carotid artery occlusion with self-expanding stents restored cerebral blood flow and held up progressive stroke. PMID:15168098

Du Mesnil De Rochemont, R; Sitzer, M; Neumann-Haefelin, T; Harmjanz, A; Berkefeld, J



Popliteal vein aneurysm.  


The incidence of a popliteal vein aneurysm is extremely low. Two cases of this rare venous anomaly are described. The epidemiology, morphology, and diagnostic methods are discussed and the potentially dangerous complications and treatment methods are presented. PMID:16796307

Falkowski, A; Poncyljusz, W; Zawierucha, D; Kuczmik, W



Acute portal vein thrombosis.  


The findings in acute portal vein thrombosis in a patient with chronic calcific pancreatitis and two episodes of pancreatic surgery are described. The diagnosis was made by ultrasound, which showed a dilated portal vein filled with low-level echoes, surrounding hepatic oedema, hypertrophy of the hepatic artery, splenomegaly, collateral vessels and ascites. This was confirmed by computed tomography. The ultrasonic differences in appearance between acute and chronic portal vein thrombosis are discussed, in the context of portal hypertension. The diagnosis of acute portal vein thrombosis should be considered in patients in the appropriate situation who suffer a sudden clinical deterioration with right upper quadrant or abdominal pain. Ultrasound is recommended as the imaging modality of first choice because of the flexibility of its scanning plane and its real time and Doppler capabilities. Computed tomography is valuable in patients with an ileus or heavy pancreatic calcification and for its ability to demonstrate patent vessels on intravenous injection of contrast medium. PMID:3319354

Albertyn, L E



Deep Vein Thrombosis  


... Vein Thrombosis (DVT) Common Signs and Symptoms of PE PE can be fatal, if you experience these signs ... signs and symptoms of these disorders (DVT and PE) can vary by individual and event. Some individuals ...


Duplex Doppler ultrasound of the ligamentum teres and portal vein: a clinically useful adjunct in the evaluation of patients with known or suspected chronic liver disease or portal hypertension.  


The prevalence and potential value of the detection of signs of portal hypertension by duplex Doppler ultrasound (DDU) of the ligamentum teres and portal vein in patients with known or suspected chronic liver disease and/or portal hypertension was studied in 136 consecutive patients undergoing clinical assessment including that of liver histopathology. Portal hypertension was considered to be present when any of the following DDU signs, previously demonstrated to be specific for portal hypertension, were present: an enlarged and/or patent para-umbilical vein, portal vein obstruction or hepatofugal flow in the portal vein. Of 123 patients with parenchymal liver disease, eighty-three had cirrhosis and, of these, portal hypertension was detected on DDU criteria in 86% of alcoholic cirrhotics and 67% of non-alcoholic cirrhotics. Of the 42 patients with non-cirrhotic liver disease, 1 of 7 patients with metastatic liver disease and 3 of 5 patients with alcoholic hepatitis had DDU signs of portal hypertension. Thus, in patients with parenchymal liver disease, DDU had a sensitivity of 73%, specificity of 90% and predictive values of 94 and 62% for positive and negative studies respectively for the detection of cirrhosis. In all 14 patients with portal hypertension secondary to vascular occlusive diseases, DDU examination of the ligamentum teres, portal vein and hepatic vein gave an accurate guide to the site of the occluding lesion. The high positive predictive value of DDU and its ability to aid in localizing the site of increased resistance to flow through the liver suggest that DDU of the ligamentum teres and portal vein is a potentially useful non-invasive adjunct in the assessment of patients with suspected or known liver disease or portal hypertension. PMID:1883980

Gibson, P R; Gibson, R N; Donlan, J D; Ditchfield, M R; Bhathal, P S


Time-resolved Magnetic Resonance Angiography for assessment of recanalization after coil embolization of visceral artery aneurysms  

PubMed Central

Summary Background: Follow-up imaging after coil embolization of visceral artery aneurysms is important for detecting recanalization. However, CT examination is susceptible to coil artifacts, which sometimes makes it difficult to assess recanalization. We report 2 cases where recanalization was successfully visualized using time-resolved magnetic resonance angiography after coil embolization of visceral artery aneurysms (one case of right internal iliac artery aneurysm and one case of splenic artery aneurysm). Repeat coil embolization was successfully performed. Case Report: Case 1. An 80-year-old male patient with right internal iliac artery (IIA) aneurysm underwent coil embolization. Aneurysm was located at the bifurcation of the right IIA and therefore, after making a femorofemoral bypass, the distal part of the right IIA, aneurysm and the common iliac artery were embolized with a coil. One year later, the size of the aneurysm seemed to have increased on CT. However, the details were not determined because of metal artifacts. Thus, time-resolved MRA was performed and showed minute vascular flow inside the aneurysm. Angiography was subsequently performed and blood flow inside the aneurysm was visualized similar to the findings in time-resolved MRA. Coil embolization was performed once more and vascular flow inside the aneurysm disappeared. Case 2. A 36-year-old male patient with a splenic artery aneurysm underwent coil packing with preservation of splenic artery patency. Four years later, coil compaction was suspected in a CT scan, but CT could not evaluate recanalization because of severe metal artifacts. Angiography was subsequently performed, showing recanalization of the aneurysm as did the time-resolved MRA. Therefore, coil embolization of the aneurysm and splenic artery was performed again. Conclusions: Follow-up imaging after coil embolization of visceral artery aneurysms is important for detecting recanalization. However, it is sometimes difficult to assess recanalization with CT because of artifacts caused by metal. In our cases, recanalization of aneurysms was clearly shown by time-resolved MRA and re-embolization was successfully performed. In conclusion, time-resolved MRA appears to be useful in assessment of recanalization of visceral artery aneurysms after coil embolization.

Kurosaka, Kenichiro; Kawai, Tatsuya; Shimohira, Masashi; Hashizume, Takuya; Ohta, Kengo; Suzuki, Yosuke; Shibamoto, Yuta



Recanalization of Acute Intracranial Artery Occlusion Using Temporary Endovascular Bypass Technique  

PubMed Central

Purpose The purpose of this study is to present our preliminary experience of the temporary endovascular bypass (TEB) technique using an Enterprise stent for recanalization of acute intracranial artery (IA) occlusion. Materials and Methods Patients treated by TEB were enrolled in this retrospective study from January 2009 to May 2010. All the procedures consist of temporary partial deployment and subsequent retrieval of Enterprise stent, supplemented by intra-arterial infusion of urokinase (UK) and/or tirofiban. According to the thrombolysis in cerebral infarction (TICI) classification, recanalization was evaluated with initial and postprocedural angiography. Safety was evaluated related to the procedure and clinical outcomes were assessed by National Institute of Health Stroke Scale (NIHSS) score at discharge and modified Rankin scale (mRS) score at 3 months. Results Eleven patients (median NIHSS 12.8, mean age 61.6 years, male: female = 8:3) with acute IA occlusion were treated with TEB. All the patients presented with TICI 0, and the occluded vessel was the middle cerebral artery (n=7), the basilar artery (n=1), and the distal ICA occlusion (n = 3). IV infusion of tissue plasminogen activator (tPA) was done in 4 patients and mechanical thrombolysis with intra-arterial UK was performed in 9. Recanalization was achieved in 73% (8 patients; TICI ? 2). There were no procedure-related complications except for two asymptomatic intracranial hemorrhages. Improvement (? 4 points on the NIHSS) and good outcome (mRS ?2) after 90 days was shown in six patients (55%). One patient died 6 days after procedure. Conclusion TEB may be a valuable treatment option in acute thromboembolic IA occlusion without stent implantation.

Lee, Kyung-Yul; Seo, Kwon Duk; Lim, Soo Mee; Roh, Hong Gee; Kim, Byung Moon



Pelvic Vein Embolisation in the Management of Varicose Veins  

SciTech Connect

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.

Ratnam, Lakshmi A. [St. George's Hospital, Department of Radiology (United Kingdom); Marsh, Petra; Holdstock, Judy M.; Harrison, Charmaine S. [Stirling House, Whiteley Clinic (United Kingdom); Hussain, Fuad F. [Royal Surrey County Hospital, Department of Radiology (United Kingdom); Whiteley, Mark S. [Stirling House, Whiteley Clinic (United Kingdom); Lopez, Anthony, E-mail: [Royal Surrey County Hospital, Department of Radiology (United Kingdom)



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

SciTech Connect

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.

Akpinar, Erhan, E-mail:; Cil, Barbaros E.; Arat, Anil [Hacettepe University, Departments of Radiology (Turkey); Baykal, Atac; Karaman, Kerem [Hacettepe University, Departments of General Surgery (Turkey); Balkanci, Ferhun [Hacettepe University, Departments of Radiology (Turkey)



Subintimal Recanalization of Long Superficial Femoral Artery Occlusions Through the Retrograde Popliteal Approach  

Microsoft Academic Search

Purpose: To investigate the value of the retrograde popliteal artery approach for the percutaneous intentional extraluminal recanalization\\u000a (PIER) of long superficial femoral artery (SFA) occlusions.\\u000a \\u000a \\u000a \\u000a \\u000a Methods: During a period of 17 months, PIER through ultrasound-guided retrograde popliteal artery puncture was performed for 39 long\\u000a SFA occlusions in 37 patients. In six patients, six additional iliac artery stenoses were also treated

Saim Yilmaz; Timur Sindel; Ka?an Çeken; Emel Alimo?lu; Ersin Lüleci



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

SciTech Connect

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.

Vicol, Calin; Dalichau, Harald [Clinic for Thoracic and Cardiovascular Surgery, Georg-August-University Goettingen, Robert-Koch-Str. 40, D-37075 Goettingen (Germany)



Novel devices and specialized techniques in recanalization of peripheral artery chronic total occlusions (CTOs)--a literature review.  


Currently, recanalization of chronic total occlusions (CTOs) in peripheral arteries remains a challenging obstacle encountered by clinical practitioners. Percutaneous CTO interventions are associated with low rates of procedural success using standard guidewires and catheters. When guidewires cannot cross the occluded segment or fail to reenter the true lumen after subintimal crossing of the occlusion, successful recanalization may be unachievable. In the last few years, the emergence of novel devices and new techniques has dramatically improved the success rates of the revascularization for CTOs. This paper reviews the published data of current devices and specialized techniques of percutaneous intervention to relieve CTOs. PMID:22459363

Liang, Gang Zhu; Zhang, Fu Xian



Rate of Recanalization and Safety of Endovascular Embolization of Intracranial Saccular Aneurysms Framed with GDC 360 Coils  

PubMed Central

Summary Coil compaction and recanalization of cerebral aneurysms treated with coil embolization continue to be of great concern, especially in patients that presented with subarachnoid hemorrhage. The incidence of recanalization reported by previous studies ranges from 12 to 40 percent in experienced centers. We reviewed the incidence of recanalization requiring retreatment in patients treated with GDC 360 framing coils. A retrospective review of every patient who underwent coil embolization with GDC 360 coils for saccular aneurysms at our institution from December 2004 to March 2008 was performed. We studied the patients’ demographics, clinical presentation, aneurysm size and configuration, type of coils used to embolize the aneurysm, the percentage of coils that were GDC 360 in any given aneurysm, the need for remodeling techniques like stent and/or balloon for embolization, immediate complications, cases in which we were unable to frame with the GDC 360 coil, and rate of recanalization on follow-up. A total of 110 patients (33 men, 77 women) and 114 aneurysms were treated with GDC 360 coils. Ninety-eight aneurysms were framed with the GDC 360 coils. There were two patients in whom the initial GDC 360 coil intended for framing had to be pulled out and exchanged for another type of coil. There were five procedure related complications (4.4%). Four patients required intra-arterial abciximab due to thrombus formation. One patient that presented with a grade III subarachnoid hemorrhage had aneur-ysm rupture while the coil was being advanced. A total of 50 patients (15 men and 35 women) underwent follow-up femoral cerebral angio-grams at least six months after coiling (mean follow-up was 15 months). Forty-four of the patients with follow-up had the GDC 360 coil used as a framing coil. Three patients (6%) required retreatment due to recanalization. Every patient with recanalization requiring treatment had aneurysms of the anterior communicating complex that presented with subarachnoid hemorrhage. The rate of recanalization of cerebral aneur-ysms embolized with GDC 360 framing coils was lower in our case series compared to the existing literature reports. Patients with aneurysms of the anterior communicating artery were at increased incidence of recanalization in our patient cohort.

Ortiz, R.; Song, J.; Niimi, Y.; Berenstein, A.



Preoperative assessment of alternative veins.  


Duplex ultrasonography, with or without color flow, has replaced phlebography as the technique of choice to select veins for autogenous bypass grafts. Although anatomic location and length are well-defined by ultrasound, evaluation of the venous wall itself is still imperfect. In situ diameters are less than those of arterialized veins. Ultrasonic search is most valuable in the examination of patients with good veins obscured by a layer of fat. Preoperative knowledge of variant anatomy and location of major veins and their branches facilitates bypass surgery. The preoperative vein mapping should be available in the operating room to guide the placement of incisions for unroofing and exploration directly over veins and vein segments that have a high likelihood of being usable. The finding of a useful vein when none is apparent on physical examination may enable the construction of an autogenous bypass in lieu of a less desirable prosthetic graft or leg amputation. PMID:8564029

Salles-Cunha, S X; Beebe, H G; Andros, G



Elastomechanical properties of bovine veins.  


Veins have historically been discussed in qualitative, relative terms: "more compliant" than arteries, subject to "lower pressures". The structural and compositional differences between arteries and veins are directly related to the different functions of these vessels. Veins are often used as grafts to reroute flow from atherosclerotic arteries, and venous elasticity plays a role in the development of conditions such as varicose veins and valvular insufficiency. It is therefore of clinical interest to determine the elastomechanical properties of veins. In the current study, both tensile and vibration testing are used to obtain elastic moduli of bovine veins. Representative stress-strain data are shown, and the mechanical and failure properties reported. Nonlinear and viscoelastic behavior is observed, though most properties show little strain rate dependence. These data suggest parameters for constitutive modeling of veins and may inform the design and testing of prosthetic venous valves as well as vein grafts. PMID:20129420

Rossmann, Jenn Stroud



Retinal Vein Occlusions  

Microsoft Academic Search

Retinal vein occlusion (RVO) is a common cause of vision loss in elderly people. The complex pathogenesis of central RVO (CRVO), hemi-RVO (HRVO) and branch RVO (BRVO) makes it an interdisciplinary task. Treatment of RVO should aim at eliminating the complications and vision-disturbing effects of RVO but also include prophylactic measures in order to avoid recurrence of the disease. Problems

Wolf Buehl; Stefan Sacu; Ursula Schmidt-Erfurth



Thrombolysis in anterior versus posterior circulation strokes: timing of recanalization, ischemic tolerance, and other differences.  


Previous studies have suggested a greater ischemic tolerance in posterior circulation as compared to anterior cerebral circulation. We aimed to investigate whether a differential response exists between anterior and posterior circulation strokes. Two hundred and four middle cerebral artery (MCA) patients and 28 basilar artery occlusion (BAO) patients treated with intravenous recombinant tissue plasminogen activator were included. Transcranial Doppler assessed recanalization at different time points. Patients were divided in three groups: total time of ischemia (TTI)<6, 6-24, or>24 hours. We calculated the percentage of recovery (admission National Institutes of Health Stroke Scale [NIHSS]- discharge NIHSS/admission NIHSS)×100. Mean time to treatment was longer in BAO patients (P=.031). Early recanalization was more frequent among MCA occlusions (41% vs 29%; P=.039); the rate of persisting occlusion at 24 hours was similar (P=.933). Clinical recovery according to TTI was similar in each group: <6 hours: BAO 84%/MCA 69%; 6-24 hours: BAO 63%/MCA 61%; >24 hours: BAO -44%/MCA 11% (P=.23). For each hour of ischemia MCA patients worsened 1.78% (P=.035) and BAO 1.76% (P=.421). MCA occlusions compared to BAO were independently associated with hemorrhagic transformation (OR: 8.2; P=.043). Our data do not support the theory of increased ischemic tolerance in posterior circulation. Despite longer time-to-treatment, BAO were more resistant to hemorrhagic transformations. PMID:20040010

Pagola, Jorge; Ribo, Marc; Alvarez-Sabin, José; Rubiera, Marta; Santamarina, Estevo; Maisterra, Olga; Delgado-Mederos, Raquel; Ortega, Gemma; Quintana, Manuel; Molina, Carlos A



Deep Vein Thrombosis and Pulmonary Embolism  


... A A Fact Sheet: Deep Vein Thrombosis and Pulmonary Embolism Who is at risk for Deep Vein Thrombosis ... vein thrombosis How can Deep Vein Thrombosis and Pulmonary Embolism be prevented? If you're at risk, you ...


Human Greater and Canine Lateral Saphenous Veins  

Microsoft Academic Search

Canine lateral saphenous vein and human greater saphenous vein were studied together to determine similarities and differences. Helical strips of both vessels contracted to norepinephrine with similar sensitivity. Canine veins developed more isometric tension than human veins treated similarly. Histological studies show canine veins to have little connective tissue and a single circular layer of smooth muscle. Human veins have

Michael R. Goldberg; Paul D. Joiner; Albert L. Hyman; Philip J. Kadowitz



Revascularization-outcome paradox: not only time and collaterals status, but also complete recanalization contribute to good neurological outcome.  


The rate of successful recanalization in endovascular trials has not always mirrored the rate of good clinical outcomes, creating a revascularization-outcome paradox. In early experience with the new generation of stent-based thrombectomy devices, 45-77% of patients have achieved good 90-day outcomes despite treatment up to eight-hours after symptom onset. These rates of good functional outcome are clearly higher than those previously reported with other endovascular strategies. We propose that among the factors influencing this difference is the far higher complete recanalization rate and the high ratio of Thrombolysis in Myocardial Infarction 3/Thrombolysis in Myocardial Infarction 2 recanalization obtained with stent retrievers in comparison with previous generation mechanical thrombectomy devices. Recently, we achieved Thrombolysis in Myocardial Infarction 3 in 94% of patients and Thrombolysis in Myocardial Infarction 2 in 6% in a series of patients with acute middle cerebral artery occlusions who were managed with stent-thrombectomy within eight-hours of symptom onset. Good outcomes were achieved in 77%. Extent of recanalization appears to interact with time and collateral supply in determining clinical outcomes. PMID:24024916

Cohen, José E; Leker, Ronen R



Vertebrobasilar recanalization techniques before the placement of stent-retrievers: reopening is not synonymous with good outcome.  


OBJECTIVES: To evaluate the recanalization rate and clinical outcome three months after endovascular treatment for vertebrobasilar occlusion before the placement of stentrievers. MATERIAL AND METHODS: We reviewed all cases of basilar thrombosis treated with endovascular techniques at our center. We reviewed the clinical outcomes with the main objective of determining the recanalization rate and the secondary objective of evaluating the outcome using the modified Rankin scale (mRS) three months after treatment. We assessed clinical and angiographic variables and correlated them with outcome and complications. RESULTS: We reviewed a total of 27 consecutive patients (mean age, 58.1±15.5 y; median National Institutes of Health Stroke Scale (NIHSS), 21, interquartile range, 18-29; median Glasgow coma score (GCS) 7, interquartile range, 4-9.5). The mean time between the onset of symptoms and endovascular treatment was 26.3±41.7hours. Complete or partial recanalization was achieved in 23 (85.1%) patients. Three months after treatment, 16 (59.2%) had died and 6 (22.2%) had good outcome (mRS ? 2). CONCLUSION: Endovascular treatment achieved a high rate of recanalization of occlusions of the basilar artery. Nevertheless, a high percentage of the patients did not have a good outcome. New materials might improve the prognosis in these patients. PMID:22770874

Delgado Acosta, F; Jiménez Gómez, E; de Asís Bravo Rodríguez, F; Oteros Fernández, R; Ochoa Sepúlveda, J J



Successful percutaneous recanalization of thrombosed major aortopulmonary collateral artery in palliated tetralogy of fallot with pulmonary atresia.  


We report the case of a 25-year-old male with palliated tetralogy of Fallot and pulmonary atresia presenting with thrombotic occlusion of a major aortopulmonary collateral artery to the right lung. Percutaneous intervention was successful in recanalizing this vessel, resulting in symptomatic improvement. PMID:22967228

Caruana, Maryanne; Cullen, Shay; Mullen, Michael



Cerebral vein thrombosis  

Microsoft Academic Search

Advances in neuroimaging have modified our knowledge on cerebral vein thrombosis (CVT). This disease is now diagnosed more\\u000a frequently, and increasing evidence as to what are the most common risk factors and on the natural history of the disease\\u000a is becoming available. Most patients with CVT have a benign prognosis: only a minority of patients die during the acute phase

Francesco Dentali; Walter Ageno



Vein of Galen malformation  

Microsoft Academic Search

Since 1984, 43 patients with true vein of Galen ancurysmal malformations have been referred to us and managed according to our patient selection, technique, and follow-up guidelines. Thirty-four were embolized transarterially with bucrilate (isobutyl cyanoacrylate) or enbucrilate (N-butyl cyanoacrylate) embolization. No cutdown or hypotension during or after the embolization was used and no balloon catheter was employed. Forty-seven percent of

P. Lasjaunias; R. Garcia-Monaco; G. Rodesch; K. Ter Brugge; M. Zerah; M. Tardieu; D. Victor



Diffusion weighted imaging reversibility in the brainstem following successful recanalization of acute basilar artery occlusion.  


Acute basilar artery occlusion (ABAO) is a devastating disease that can produce significant brainstem injury. Pretreatment diffusion weighted imaging (DWI) demonstrating extensive brainstem involvement has been shown to predict a poor outcome regardless of reperfusion. This case report describes a patient presenting with coma secondary to ABAO. MRI at presentation demonstrated significant DWI abnormality in the majority of the bilateral pons. The basilar artery was endovascularly recanalized 8 h after stroke onset, and the patient had a marked clinical recovery with no deficit at 3 months. Follow-up imaging revealed significant reversal of the pontine lesion. This finding of brainstem DWI reversibility cautions against the use of DWI to select ABAO patients for intra-arterial stroke therapy. The degree of apparent diffusion coefficient reduction on pretreatment MRI may not adequately identify which DWI abnormal brainstem tissue is potentially reversible. PMID:21990621

Yoo, Albert J; Hakimelahi, Reza; Rost, Natalia S; Schaefer, Pamela W; Hirsch, Joshua A; González, R Gilberto; Rabinov, James D



Recanalization of a chronic totally occluded left anterior descending artery after enhanced external counterpulsation therapy.  


We present a case of a 52 y/o male with history of hypertension and high cholesterol who suffered an acute myocardial infarction. His catheterization revealed severe 3-vessel coronary artery disease with total occlusion of left anterior descending (LAD) artery at the mid segment with anterior and apical wall dyskinesia and estimated ejection fraction of 30%. After 3 years of medical therapy the patient had NYHA class II heart failure symptoms without angina. Enhanced external counterpulsation (EECP) therapy was offered as adjunctive therapy. After completing therapy patient started to develop angina and a new catheterization showed recanalization of LAD with TIMI I flow and normal ejection fraction without wall motion abnormalities. Patient underwent successful coronary artery bypass graft. PMID:19610581

Salgado, Víctor; Salgado, Carlos; Medina, Arturo


Techniques for transcatheter recanalization of completely occluded vessels and pathways in patients with congenital heart disease  

PubMed Central

Occlusions of major vessels in patients with congenital heart disease may occur due to a variety of factors. These occlusions are often felt to be best addressed surgically; however, we and others have been successful in recanalizing most of these vessels in the catheterization laboratory. Most of these patients will require multiple procedures in the catheterization laboratory to ensure vessel patency and to facilitate vessel growth. Physicians performing the procedure should have a thorough understanding of the anatomic considerations for the intended procedure and have access to a variety of devices and equipment to optimize the result of the procedure. In this article, we review some of the technical aspects that are vital for the success of the procedure.

Latson, Larry A; Qureshi, Athar M



Percutaneous recanalization of chronic total occlusions: wherein lies the body of proof?  


Although interventional technology and skills have markedly advanced, percutaneous coronary intervention (PCI) for coronary chronic total occlusion (CTO) lesions remains challenging. Indeed, CTO PCI is technically complex, carries the potential for a relatively high likelihood of failure and acute complications, and requires specifically skilled operators and a demanding use of resources. In addition, controversy persists surrounding appropriate indications for attempting CTO revascularization. Finally, there is a wide uncertainty on the actual benefits achieved with successful CTO recanalization. A growing number of studies have reported procedural results and/or assessed functional effects and long-term clinical outcomes of CTO PCI. We therefore sought to review and critically appraise the evidence base for procedural outcomes and potential clinical benefits of CTO PCI. PMID:23351815

Tamburino, Corrado; Capranzano, Piera; Capodanno, Davide; Dangas, George; Zimarino, Marco; Bass, Theodore A; Mehran, Roxana; Antoniucci, David; Colombo, Antonio; La Manna, Alessio; Di Salvo, Maria E; Stone, Gregg W



Intracranial and internal jugular vein thrombosis secondary to ENT infections: A report of 3 cases.  


We report 3 cases of rare, life-threatening intracranial and internal jugular vein (IJV) thrombosis that were caused by common ENT infections. These infections included otitis media in a 6-year-old girl, tonsillitis in a 21-year-old woman, and odontogenic sepsis in a 56-year-old woman. All 3 patients were treated with culture-directed systemic antibiotics; 2 of them also required surgical drainage (the child and the older adult). The 2 adults also received therapeutic anticoagulation, which was continued until venous recanalization was documented; the duration of combined antibiotic and anticoagulation treatment was 6 weeks. All 3 patients made uneventful recoveries. Significant morbidities associated with intracranial and IJV thrombosis were avoided as a result of prompt diagnosis and judicious treatment. PMID:24170472

Riffat, Faruque; Forer, Martin; Wignall, Andrew; Veivers, David; Patel, Nirmal


Impact of untreated portal vein thrombosis on pre and post liver transplant outcomes in cirrhosis.  


Background and aims. Most portal vein thromboses (PVT) in cirrhotics are discovered incidentally. While case series demonstrate improved portal vein patency with anti-coagulation, there is little information on impact of PVT on morbidity and mortality. This study aimed to compare morbidity and mortality in cirrhotics with untreated PVT with those without PVT. Material and methods. Cirrhotics evaluated for orthotopic liver transplant in a single large transplant center were prospectively followed. Subjects had contrast CT or MRI at initial evaluation and serial imaging every 6 months until transplantation, removal from the list or death. Univariate and multivariate Cox regression analysis were used to assess associations between new PVT and factors of interest. Results. Of the 290 prospectively followed cirrhotics who met inclusion criteria, PVT was detected in 70 (24.1%)-47 had PVT at the time of initial evaluation and 23 developed one during the pre-transplant study period. A third of the patients with PVT had re-canalization or spontaneous resolution of thrombus while awaiting transplantation. There was no difference in the pre or posttransplant mortality between cirrhotics with and without PVT. Conclusion. Cirrhotics with untreated PVT fared equally well as those without PVT before and after transplantation. Further studies with larger numbers of patients are needed to determine if anticoagulation therapy truly improves outcomes in cirrhotics with portal vein thrombosis. PMID:24114826

Bv, John; R, Konjeti; A, Aggarwal; R, Lopez; A, Atreja; C, Miller; Nn, Zein; Wd, Carey


Percutaneous Transhepatic Portography for the Treatment of Early Portal Vein Thrombosis After Surgery  

SciTech Connect

We treated three cases of early portal vein thrombosis (PVT) by minimally invasive percutaneous transhepatic portography. All patients developed PVT within 30 days of major hepatic surgery (one case each of orthotopic liver transplantation, splenectomy in a previous liver transplant recipient, and right extended hepatectomy with resection and reconstruction of the left branch of the portal vein for tumor infiltration). In all cases minimally invasive percutaneous transhepatic portography was adopted to treat this complication by mechanical fragmentation and pharmacological lysis of the thrombus. A vascular stent was also positioned in the two cases in which the thrombosis was related to a surgical technical problem. Mechanical fragmentation of the thrombus with contemporaneous local urokinase administration resulted in complete removal of the clot and allowed restoration of normal blood flow to the liver after a median follow-up of 37 months. PVT is an uncommon but severe complication after major surgery or liver transplantation. Surgical thrombectomy, with or without reconstruction of the portal vein, and retransplantation are characterized by important surgical morbidity and mortality. Based on our experience, minimally invasive percutaneous transhepatic portography should be considered an option toward successful recanalization of early PVT after major liver surgery including transplantation. Balloon dilatation and placement of a vascular stent could help to decrease the risk of recurrent thrombosis when a defective surgical technique is the reason for the thrombosis.

Adani, Gian Luigi, E-mail:; Baccarani, Umberto; Risaliti, Andrea [University Hospital of Udine, Department of Surgery and Transplantation (Italy); Sponza, Massimo; Gasparini, Daniele [University Hospital of Udine, Department of Interventional Radiology (Italy); Bresadola, Fabrizio; Anna, Dino de; Bresadola, Vittorio [University Hospital of Udine, Department of Surgery and Transplantation (Italy)



Chronic retinal vein occlusion in glaucoma  

Microsoft Academic Search

Asymptomatic chronic retinal vein occlusion that occurs in chronic simple glaucoma is described. The condition is characterized by marked elevation of retinal vein pressure with collateral vessels and vein loops at the optic disc in cases of central vein occlusion, or retinal veno-venous anastomoses along a horizontal line temporal and nasal to the disc in hemisphere vein occlusion. No patient

R A Hitchings; G L Spaeth



Prediction of clinical outcome with baseline and 24-hour perfusion CT in acute middle cerebral artery territory ischemic stroke treated with intravenous recanalization therapy  

Microsoft Academic Search

Introduction  We sought to determine whether Alberta Stroke Program Early CT Scores (ASPECTS) derived from baseline noncontrast CT (NCCT)\\u000a and perfusion CT (CTP) imaging maps can predict clinical outcome after recanalization therapy in acute ischemic stroke of\\u000a the middle cerebral artery (MCA) territory and whether changes in the ASPECTS from baseline to 24 h after recanalization therapy\\u000a can help predict clinical outcome.

Ji-Yong Lee; Seo Hyun Kim; Myeong Sub Lee; Sang Hyun Park; Sung Soo Lee



Percutaneous laser-assisted recanalization of long chronic iliac artery occlusions: primary and mid-term results  

Microsoft Academic Search

We report the primary and mid-term outcome of patients with long chronic iliac artery occlusions after percutaneous excimer-laser-assisted interventional recanalization. Between 2000 and 2001, 43 patients with 46 chronic occlusions of either the common iliac artery (n=27), the external iliac artery ( n=13) or both (n=3) underwent laser-assisted percutaneous transluminal angioplasty and implantation of stents. The average length of the

Jörn O. Balzer; Verena Gastinger; Axel Thalhammer; Ralf G. Ritter; Edelgard Lindhoff-Last; Thomas Schmitz-Rixen; Thomas J. Vogl



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

SciTech Connect

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.

Massmann, Alexander, E-mail:; Katoh, Marcus [Saarland University Hospital, Department of Diagnostic and Interventional Radiology (Germany); Shayesteh-Kheslat, Roushanak [Saarland University Hospital, Department of General Surgery, Visceral, Vascular, and Pediatric Surgery (Germany); Buecker, Arno [Saarland University Hospital, Department of Diagnostic and Interventional Radiology (Germany)



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

SciTech Connect

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.

Houston, J. Graeme [Department of Radiology, Ninewells Hospital and Medical School, Tayside University Hospitals NHS Trust, Dundee DD1 9SY, Scotland (United Kingdom); Anderson, David; Mills, John; Harrold, Anthony [Assisted Conception Unit, Ninewells Hospital and Medical School, Tayside University Hospitals NHS Trust, Dundee DD1 9SY, Scotland (United Kingdom)



Delayed aneurysm regrowth and recanalization after Guglielmi detachable coil treatment. Case report.  


Guglielmi detachable coil (GDC) treatment for complicated cerebral aneurysms is an attractive option that has become widely accepted in recent years. This technique is usually considered only if the patient harbors an aneurysm that is not a good candidate for surgical clipping. However, the definition of "surgical candidate" varies among institutions, and many patients worldwide are being treated with GDCs as primary therapy. Although most centers currently perform follow-up angiography at 6 months to 1 year, others do not routinely perform it after an initially good result. The authors present a case that indicates longer follow up may be necessary and illustrates some of the pitfalls of GDC treatment. This 56-year-old man presented to the emergency room with a Hunt and Hess Grade II subarachnoid hemorrhage and was found to have a wide-necked basilar apex aneurysm. Because of associated medical comorbidities, it was decided to treat the aneurysm with endovascular techniques. The patient did well on follow-up angiography at 1 year postprocedure. However, at approximately 2 years follow up, the aneurysm was demonstrated to have dramatically recanalized and regrown, requiring open surgical intervention. Endovascular coiling was insufficient to treat this aneurysm and complicated definitive surgical management because a large coil mass had been placed in the operative field. It can be inferred from this case that angiographic follow up of these types of lesions may be beneficial up to 2 years after GDC treatment. PMID:9647186

Mericle, R A; Wakhloo, A K; Lopes, D K; Lanzino, G; Guterman, L R; Hopkins, L N



Learning from the pulmonary veins.  


The purpose of this article is to review the basic embryology and anatomy of the pulmonary veins and the various imaging techniques used to evaluate the pulmonary veins, as well as the radiologic findings in diseases affecting these structures. Specific cases highlight the clinical importance of the imaging features, particularly the findings obtained with multidetector computed tomography (CT). Pulmonary vein disease can be broadly classified into congenital or acquired conditions. Congenital disease, which often goes unnoticed until patients are adults, mainly includes (a) anomalies in the number or diameter of the vessels and (b) abnormal drainage or connection with the pulmonary arterial tree. Acquired disease can be grouped into (a) stenosis and obstruction, (b) hypertension, (c) thrombosis, (d) calcifications, and (e) collateral circulation. Pulmonary vein stenosis or obstruction, which often has important clinical repercussions, is frequently a result of radiofrequency ablation complications, neoplastic infiltration, or fibrosing mediastinitis. The most common cause of pulmonary venous hypertension is chronic left ventricular failure. This condition is difficult to differentiate from veno-occlusive pulmonary disease, which requires a completely different treatment. Pulmonary vein thrombosis is a rare, potentially severe condition that can have a local or distant cause. Calcifications have been described in rheumatic mitral valve disease and chronic renal failure. Finally, the pulmonary veins can act as conduits for collateral circulation in cases of obstruction of the superior vena cava. Multidetector CT is an excellent modality for imaging evaluation of the pulmonary veins, even when the examination is not specifically tailored for their assessment. PMID:23842969

Porres, Diego Varona; Morenza, Oscar Persiva; Pallisa, Esther; Roque, Alberto; Andreu, Jorge; Martínez, Manel


Inflammation in Retinal Vein Occlusion  

PubMed Central

Retinal vein occlusion is a common, vision-threatening vascular disorder. The role of inflammation in the pathogenesis and clinical consequences of retinal vein occlusion is a topic of growing interest. It has long been recognized that systemic inflammatory disorders, such as autoimmune disease, are a significant risk factor for this condition. A number of more recent laboratory and clinical studies have begun to elucidate the role inflammation may play in the molecular pathways responsible for the vision-impairing consequences of retinal vein occlusion, such as macular edema. This improved understanding of the role of inflammation in retinal vein occlusion has allowed the development of new treatments for the disorder, with additional therapeutic targets and strategies to be identified as our understanding of the topic increases.

Deobhakta, Avnish; Chang, Louis K.



Real-time ultrasound perfusion imaging in acute stroke: assessment of cerebral perfusion deficits related to arterial recanalization.  


We investigated whether real-time ultrasound perfusion imaging (rt-UPI) is able to detect perfusion changes related to arterial recanalization in the acute phase of middle cerebral artery (MCA) stroke. Twenty-four patients with acute territorial MCA stroke were examined with rt-UPI and transcranial color-coded duplex ultrasound (TCCD). Ultrasound studies were consecutively performed within 24 h and 72-96 h after stroke onset. Real-time UPI parameters of bolus kinetics (time to peak, rt-TTP) and of refill kinetics (plateau A and slope ? of the exponential replenishment curve) were calculated from regions of interest of ischemic versus normal brain tissue; these parameters were compared between early and follow-up examinations in patients who recanalized. At the early examination, there was a delay of rt-TTP in patients with MCA occlusion (rt-TTP [s]: 13.09 ± 3.21 vs. 10.16 ± 2.6; p = 0.01) and a lower value of the refill parameter ? (? [1/s]: 0.62 ± 0.34 vs. 1.09 ± 0.58; p = 0.01) in ischemic compared with normal brain tissue, whereas there were no differences of the parameters A and Ax?. At follow-up, the delay of rt-TTP was reversible once recanalization of an underlying MCA obstruction was demonstrated: rt-TTP [s], 13.09 ± 3.21 at 24 h versus 10.95 ± 1.5 at 72-96 h (p = 0.03). Correspondingly, ? showed a higher slope than at the first examination: ? [1/s]: 0.55 ± 0.29 at 24 h versus 0.71 ± 0.27 at 72-96 h (p = 0.04). We conclude that real-time UPI can detect hemodynamic impairment in acute MCA occlusion and subsequent improvement following arterial recanalization. This offers the chance for bedside monitoring of the hemodynamic compromise (e.g. during therapeutic interventions such as systemic thrombolysis). PMID:23453375

Bolognese, Manuel; Artemis, Dimitrios; Alonso, Angelika; Hennerici, Michael G; Meairs, Stephan; Kern, Rolf



Chronic Recanalization of Dissection of the Distal Anterior Cerebral Artery: Case Report and Review of the Literature  

PubMed Central

The natural history of atraumatic idiopathic dissection of the distal anterior cerebral artery is still unclear. We present a 38-year-old man who had dissection of the left A2 segment of this vessel associated with subintimal hematoma and infarction. Because of complete stroke in acute stage, he did not undergo surgery. About three months later, administration of aspirin (100 mg/day) was started. At nine months, magnetic resonance angiography revealed complete recanalization of the A2 dissection. To assess the outcome of dissection, we should observe the patient for at least one year.

Asano, Shuichiro; Hara, Tetsuo



Numerical Modelling of Vein Microstructures  

NASA Astrophysics Data System (ADS)

Mineral veins occur in a variety of forms (syntaxial, antitaxial, etc.), and with various microstructures (fibrous, stretched crystals, vuggy, etc.). These structures can, if correctly interpreted, provide useful insight into the geological and tectonic conditions at which the veins formed (Oliver and Bons 2001). Durney and Ramsay (1973) defined the base for the modern classification and interpretation of vein (micro-) structures. Numerical modelling, not available then, has since been added as a tool to better understand the formation of vein (micro-) structures, focussing on three aspects in particular: 1) What determines the habit of growing vein crystals? In particular, what determines the formation of a fibrous habit? (Bons 2001, Hilgers et al. 2001) 2) The formation of fibrous pressure fringes. The complex internal structures of the fringes appear mostly the result of the relative rotation of object and fringes (Koehn et al. 2001). 3) Competition between growing crystals, which for example explains the development of a conical c-axes CPO in zeolite films (Bons and Bons 2003). References: Bons, P.D. 2001. Development of crystal morphology during unitaxial growth in a progressively widening vein: I. The numerical model. Journal of Structural Geology 23, 865-872. Bons, A.J., Bons, P.D. 2003. The development of oblique preferred orientations in zeolite films and membranes. Microporous and Mesoporous Materials 62, 9-16. Durney DW, Ramsay JG (1973) Incremental strains measured by syntectonic crystal growths. In: Gravity and Tectonics (eds De Jong KA, Scholten K), John Wiley and Sons, New York, pp. 67-96. Hilgers, C., Koehn, D., Bons, P.D., Urai, J.L. 2001. Development of crystal morphology during unitaxial growth in a progressively widening vein: II. Numerical simulations of the evolution of antitaxial fibrous veins. Journal of Structural Geology 23, 873-885. Koehn, D., Aerden, D.G.A.M., Bons, P.D., Passchier, C.W. 2001. Computer experiments to investigate complex fibre patterns in natural antitaxial strain fringes. Journal of Metamorphic Geology 19, 217-232. Oliver, N.H.S., Bons, P.D. 2001. Mechanisms of fluid flow and fluid-rock interaction in fossil metamorphic-hydrothermal systems inferred from vein-wallrock patterns, geometry, and microstructure. Geofluids 1, 137-163.

Bons, P. D.



Commercialization of vein contrast enhancement  

NASA Astrophysics Data System (ADS)

An ongoing clinical study of an experimental infrared (IR) device, the Vein Contrast Enhancer (VCE) that visualizes surface veins for medical access, indicates that a commercial device with the performance of the existing VCE would have significant clinical utility for even a very skilled phlebotomist. A proof-of-principle prototype VCE device has now been designed and constructed that captures IR images of surface veins with a commercial CCD camera, transfers the images to a PC for real-time software image processing to enhance the vein contrast, and projects the enhanced images back onto the skin with a modified commercial LCD projector. The camera and projector are mounted on precision slides allowing for precise mechanical alignment of the two optical axes and for measuring the effects of axes misalignment. Precision alignment of the captured and projected images over the entire field-of-view is accomplished electronically by software adjustments of the translation, scaling, and rotation of the enhanced images before they are projected back onto the skin. This proof-of-principle prototype will be clinically tested and the experience gained will lead to the development of a commercial device, OnTarget!, that is compact, easy to use, and will visualize accessible veins in almost all subjects needing venipuncture.

Lovhoiden, Gunnar; Deshmukh, Harshal; Vrancken, Carlos; Zhang, Yong; Zeman, Herbert D.; Weinberg, Devin



Subfascial endoscopic perforator vein surgery.  


Chronic venous insufficiency is a tremendous health care problem in western societies. Venous disease can affect any combination of the superficial, deep, and perforator venous systems of the lower extremities. Generally the superficial venous deficits are addressed through sclerotherapy, enovenous ablation, stab phlebectomy, and or stripping. Patients with advanced clinical sequelae (lipodermatosclerosis or ulceration) of CVI should also be evaluated for the presence of incompetent perforating veins. Open surgical approached to the calf perforating veins (ie. Linton procedure) were complicated by significant wound complications and have largely been replaced by the less invasive Subfascial Endoscopic Perforator Surgery (SEPS). The use of SEPS in patients with ulceration has been shown to be safe and to reduce the time that patients will have ulcers during follow-up. This chapter will review the pathophysiology, diagnosis, and treatment of incompetent perforating veins of the legs with particular attention to surgical issues. PMID:16387265

Iafrati, Mark D



Isolated bilateral external iliac vein aplasia.  


We present a case of 11-year-old girl with a history of prominent superficial veins over abdomen and thorax since birth. A superficial vein extending from either inguinal region joined in umbilical region and extended up to right supraclavicular region. Other features of Klippel-Trenaunay syndrome like nevus, limb edema were absent. On radiological investigations both external iliac veins could not be visualized and venous return from lower limbs was draining into the right subclavian vein via these superficial veins. Both external iliac veins could not be identified during surgery. PMID:22729029

Onkar, Deepali; Onkar, Prashant; Mitra, Kajal



Pharmacological and Non-Pharmacological Recanalization Strategies in Acute Ischemic Stroke  

PubMed Central

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.

Frendl, Anita; Csiba, Laszlo



The surgical anatomy of varicose veins.  


Varicose veins are managed largely in ignorance of important aspects of normal anatomy. In a study of 60 dissected legs the following observations were made: 1. The long saphenous vein--normally lies on the deep fascia enclosed with an envelope of fibrous tissue, which presumably compresses the vein rhythmically on exercise to aid centripetal flow. Thick walled and straight it is never varicose, and, communicating regularly with only one or two of the 60 or so perforating veins in the lower limb, its removal by stripping in operations for varicose veins is unjustifiable. In 18% of legs its femoral part is thin walled, superficial, and sometimes multipartite: in such legs varicose veins are commoner than usual, a point of aetiological interest. 2. The tributaries of the long saphenous vein--below the knee normally drain indirectly into it via an arch vein lying parallel but in a posterior and superficial plane, communicating with it both above and below. To reach it, for instance, the pre-tibial tributaries must cross the long saphenous vein. Varicosities of these tributaries and the arch vein therefore overlie the long saphenous vein and are sometimes attributed to it. Similarly the upper end of the arch vein is often erroneously thought to be the long saphenous vein itself dilated up to an incompetent thigh perforator. 3. Perforating veins--are found all over the limb but mainly at intermuscular septa. Minor ones communicate with small muscle veins, major ones with the main deep veins. The major ones medially above the ankle differ from the rest in running a short (1 cm) and unprotected course from subcutaneous fat to posterior tibial veins through the wide gap between soleus and tibia. They are therefore peculiarly susceptible to damage, and their incompetence is peculiarly direct an its effect, which anatomical weakness may account for the prevalence of medial venous ulceration. PMID:7071165

Thomson, H


Hepatic vein obstruction (Budd-Chiari)  


Hepatic vein obstruction prevents blood from flowing out of the liver and back to the heart. This blockage can cause liver damage. Obstruction of this vein can be caused by a tumor or growth pressing on the vessel, or ...


Retinal Vein Occlusion: Current Treatment  

Microsoft Academic Search

Retinal vein occlusion (RVO) is a pathology noted for more than 150 years. Although a lot has been written on the matter, it is still a frequent condition with multifactorial etiopathogenesis with many unclear aspects. The RVO pathogenesis has varied systemic and local implications that make it difficult to elaborate treatment guidelines. The management of the patient with RVO is

Rosangela Lattanzio; Ana Torres Gimeno; Maurizio Battaglia Parodi; Francesco Bandello



[Complications in varicose vein operations].  


Although operations on varicous veins are regarded as easy and low-risk, severe complications with the involvement of arteries, veins and nerves can occur during the course of such operations and, in reconstruction, demand the whole spectrum of vascular surgery. Therefore, surgeons operating on varicous veins and on out-patients should possess sufficient experience in vascular surgery and be able to admit their patients to a centre of vascular surgery in the case of severe complications without unnecessary loss of time. Beside a perfectly done operation sufficient preoperative diagnostic examinations and postoperative care of the patient have to be claimed. The treatment of varicous veins in a hospital must be possible also in the future. The extent of the procedure is usually greater during stationary treatment and bilateral operations are feasible. Therefore, from the economic point of view, a stationary assignment for a few days does not seem more expensive than several single operations with subsequent outpatient treatment and repeated diagnostic examinations in ambulatory settings. PMID:11503468

Balzer, K



An interesting clinical case: variant of the cephalic vein emptying into the internal jugular vein.  


This case report describes a 45-year-old patient who was referred to our center for surgical creation of long-term vascular access. Angiographic mapping revealed the left cephalic vein draining directly into the internal jugular vein rather than the axillary vein. The patient was scheduled for an ulnar artery to cephalic vein fistula. PMID:22780845

Lum, Craig; Ladenheim, Eric D



Home therapy with LMWH in deep vein thrombosis: randomized study comparing single and double daily administrations.  


The aim of this study was to assess the effectiveness of low-molecular-weight heparin (LMWH) treatment of deep vein thrombosis (DVT) in terms of the evolution of thrombosis, the incidence of adverse events, and compliance with heparin treatment using 2 types of LMWH available on the market administered in therapeutic doses throughout the period of treatment (Nadroparin) or at therapeutic doses only during the first month of treatment followed by a prophylactic phase at half dose (Parnaparin). A randomized prospective study was carried out on patients under observation with a recent diagnosis of DVT. The objectives of the study were to confirm the effectiveness of therapy with LMWH in terms of prevention of the risk of thromboembolism, of relapse of DVT, and of hemorrhagic complications, and to complete an evaluation of venous recanalization and residual valve competence in the 2 groups of patients. From December 2002 to June 2005, we randomized a total of 91 patients (51 in the Parnaparin group and 40 in the Nadroparin group). Overall, there was 1 case of nonfatal pulmonary embolism (1.1%) at 7 days into therapy with LMWH. There were 3 cases (3.3%) of progression of thrombosis despite therapy with LMWH, 2 cases (5%) in the Nadroparin group, and 1 case (2%) in the Parnaparin group (P = NS), and after suspension of the therapy, there was 1 case of relapse of thrombosis. Three of the 4 thrombotic events occurred in patients with active neoplasia. Moreover, only 1 major hemorrhagic event (1.1%) required blood transfusion. The Doppler ultrasound in the follow-up showed a complete resolution of 56% of the vein thromboses at an average of 6.1 +/- 4.6 (mean +/- SD) months. Valve competence recovered in 65.9% of cases with no significant difference between the 2 heparin groups. Home treatment of sural and femoral-popliteal DVT using LMWH represents a safe and effective method in the prevention of pulmonary embolism and encourages the process of recanalization of the thrombosed vessel, especially in cases of sural and/or popliteal DVT. Administration can be carried out with the same degree of safety at the therapeutic dose throughout the period of treatment or can be halved after the first month of treatment. In patients with active neoplasia, treatment with oral anticoagulant therapy must be considered. PMID:17626986

Bellosta, Raffaello; Ferrari, Patrizio; Luzzani, Luca; Carugati, Claudio; Cossu, Luisa; Talarico, Matteo; Sarcina, Antonio


Splenic vein aneurysm: a rare clinical entity.  


A 52-year-old man presented with complaints of generalized malaise along with pain in left hypochondrium and diarrhea. The color Doppler and subsequent contrast enhanced CT scan revealed changes of portal hypertension and saccular dilatation of splenic vein along with partial thrombus in portal vein and superior mesenteric vein. PMID:22733582

Gupta, Amit; Kumar Singhal, Madhu; Maheshwarappa, Ravishanker Pillenahalli; Meena, Mangi Lal



Early recovery of wall motion abnormalities after recanalization of chronic totally occluded coronary arteries: A dobutamine echocardiographic, prospective, single-center experience  

Microsoft Academic Search

Background Patients with symptomatic myocardial ischemia from a chronic totally occluded coronary (TOC) artery are usually referred for coronary artery bypass surgery. Because guide wire technology has improved considerably in recent years, percutaneous coronary angioplasty has become a useful technique in opening chronic TOC arteries. We evaluated the early functional results of successful percutaneous recanalization by performing dobutamine stress echocardiography

Riccardo Rambaldi; Jaap N. Hamburger; Marcel L. Geleijnse; Don Poldermans; Geert J. Kimman; Aric A. Aiazian; Paolo M. Fioretti; Folkert J. Ten Cate; Jos R. T. C. Roelandt; Patrick W. Serruys



Use of autogenous saphenous vein as a conduit for mesenterico-left portal vein bypass.  


The authors describe a case of extrahepatic portal vein (EHPV) thrombosis and portal hypertension treated with a variant of mesenterico-left portal vein bypass (MLPVB) or Rex shunt. In this case, a segment of autogenous greater saphenous vein was used to bridge the distance between the left gastric vein inflow and the left portal vein. Use of such nontraditional conduit in similar circumstances may expand the application of portal revascularization/decompression procedures in treating these patients. PMID:17560237

Query, Julie A; Sandler, Anthony D; Sharp, William J



Etiology and Management of Branch Retinal Vein Occlusion  

Microsoft Academic Search

Retinal vein occlusion is one of the vascular disorders affecting vision. Branch retinal vein occlusion and central retinal vein occlusion are the two basic types of vein occlusion. Branch retinal vein occlusion is three times more common than central retinal vein occlusion and is second only to diabetic retinopathy as the most common retinal vascular cause of visual impairment. The

Sadaf Hamid; Sajid Ali Mirza; Ishrat Shokh


Management of varicose veins and venous insufficiency.  


Chronic venous disease, reviewed herein, is manifested by a spectrum of signs and symptoms, including cosmetic spider veins, asymptomatic varicosities, large painful varicose veins, edema, hyperpigmentation and lipodermatosclerosis of skin, and ulceration. However, there is no definitive stepwise progression from spider veins to ulcers and, in fact, severe skin complications of varicose veins, even when extensive, are not guaranteed. Treatment options range from conservative (eg, medications, compression stockings, lifestyle changes) to minimally invasive (eg, sclerotherapy or endoluminal ablation), invasive (surgical techniques), and hybrid (combination of ?1 therapies). Ms L, a 68-year-old woman with varicose veins, is presented. She has had vein problems over the course of her life. Her varicose veins recurred after initial treatment, and she is now seeking guidance regarding her current treatment options. PMID:23268520

Hamdan, Allen



Septic postpartum ovarian vein thrombosis.  


This report describes the clinical findings and outcome of a patient suffering from septic postpartum ovarian vein thrombosis. Treatment modalities are well described and range from hysterectomy and thrombectomy to the use of vena cava filters in combination with anticoagulation and antibiotics. Defervescence with a combination infusion of tissue plasminogen and heparin were used. This treatment approach has been found particularly successful in cases of ilio-femoral, hepatic, renal and vena caval thromboses. PMID:12370730

Rajab, Khalil E; Malik, Neelam; Skirman, Jonathan H



Current treatment of varicose veins  

Microsoft Academic Search

Opinion statement  Varicose veins (VVs) of the lower limbs are a common complaint that can take many forms, ranging from a nonpathologic condition\\u000a to an invalidating chronic disorder. When they have not been neglected, uncomplicated VVs have often been treated by sclerotherapy\\u000a or surgery, with variably successful results. Currently, the best way of assessing VVs has been to carry out routine

François Becker



Preservation of arm veins for arterial reconstruction.  


The results of surgery for lower extremity salvage have improved steadily over the past decade. One of the principles accounting for this advance is the preferential use of autogenous veins for peripheral bypass surgery. Nonautogenous and prosthetic grafts to the infrageniculate (below knee) level have patency rates significantly lower than autogenous bypasses. Currently, the technical limits of bypass surgery often depend upon the availability of adequate venous conduits. The saphenous vein has been the conduit of choice for distal arterial bypasses. However, some patients lack saphenous veins as a result of previous vein harvesting for coronary or other arterial surgery, phlebitis, variations in venous anatomy, previous vein stripping, or other conditions. In these patients, arm veins (cephalic and basilic) have been used successfully for limb salvage. There are several requirements for the successful use of arm veins. These include a detailed knowledge of the anatomy of the cephalic and basilic veins, education of patients and health care professionals, nursing protocols to preserve arm veins, and the training of surgical nurses in the demanding technical maneuvers for arm vein implantation. This paper will address these subjects. PMID:1599859

Apyan, R L; Schneider, P A; Andros, G



Shifts in leaf vein density through accelerated vein formation in C4 Flaveria (Asteraceae)  

PubMed Central

Background and Aims Leaf venation in many C4 species is characterized by high vein density, essential in facilitating rapid intercellular diffusion of C4 photosynthetic metabolites between different tissues (mesophyll, bundle sheath). Greater vein density has been hypothesized to be an early step in C4 photosynthesis evolution. Development of C4 vein patterning is thought to occur from either accelerated or prolonged procambium formation, relative to ground tissue development. Methods Cleared and sectioned tissues of phylogenetically basal C3 Flaveria robusta and more derived C4 Flaveria bidentis were compared for vein pattern in mature leaves and vein pattern formation in developing leaves. Key Results In mature leaves, major vein density did not differ between C3 and C4 Flaveria species, whereas minor veins were denser in C4 species than in C3 species. The developmental study showed that both major and minor vein patterning in leaves of C3 and C4 species were initiated at comparable stages (based on leaf length). An additional vein order in the C4 species was observed during initiation of the higher order minor veins compared with the C3 species. In the two species, expansion of bundle sheath and mesophyll cells occurred after vein pattern was complete and xylem differentiation was continuous in minor veins. In addition, mesophyll cells ceased dividing sooner and enlarged less in C4 species than in C3 species. Conclusions Leaf vein pattern characteristic to C4 Flaveria was achieved primarily through accelerated and earlier offset of higher order vein formation, rather than other modifications in the timing of vein pattern formation, as compared with C3 species. Earlier cessation of mesophyll cell division and reduced expansion also contributed to greater vein density in the C4 species. The relatively late expansion of bundle sheath and mesophyll cells shows that vein patterning precedes ground tissue development in C4 species.

McKown, Athena D.; Dengler, Nancy G.



Portal vein aneurysm in a dog.  


Portal vein aneurysm (PVA) is a rare abnormal dilatation of the portal vein, which has not been reported in dogs. We describe the findings of ultrasound and computed tomography in a case of PVA in a young male toy poodle, with the final diagnosis established by explorative surgical observation. The dog had an aneurysmal fusiform dilatation in the extrahepatic portal vein with portal hypertension and multiple portsystemic shunts. This is the first report of canine PVA. PMID:22571895

Miyawaki, Shingo; Washizu, Makoto; Maeda, Sadatoshi; Shibata, Sanae; Watanabe, Kazuhiro; Yamazoe, Kazuaki



Hemodialysis-associated subclavian vein stenosis  

Microsoft Academic Search

Hemodialysis-associated subclavian vein stenosis. This study was undertaken to evaluate hemodialysis-associated subclavian vein stenosis (SVS) and to clarify treatment of this condition. Forty-seven patients underwent upper arm venography to evaluate fistula dysfunction. Subclavian vein stenosis was documented in 12. Eleven of 12 had elevated venous dialysis pressure (196 ± 8.9 mm Hg), and six had arm edema. All 12 had

Steve J Schwab; L Darryl Quarles; John P Middleton; Richard H Cohan; Moshin Saeed; Vincent W Dennis



Jugular vein thrombosis associated with distant malignancy.  

PubMed Central

We describe two patients who developed internal jugular vein thrombosis associated with primary malignant disease arising outside the neck, and in one patient it was the presenting feature. Computed tomography was performed and the findings characteristic of internal jugular vein thrombosis are illustrated. We conclude that malignant disease should be considered in patients presenting with spontaneous internal jugular vein thrombosis with no other predisposing factors and that computed tomography is of value in confirming the diagnosis. Images Figure 1 Figure 2

Carrington, B. M.; Adams, J. E.



Periorbital rejuvenation: reticular vein treatment.  


The safety profile of certain techniques, such as sclerotherapy, is questionable in a region as precarious as the periorbital region, where complications related to vision would be catastrophic. Other safe techniques such as phlebectomy can be performed with successful outcomes but are operator dependent, require a reasonable degree of technical ability, and can result in scarring and other complications. The aim of this article is to explore newer, laser-based treatment of these periorbital veins, discuss the physiology and the therapeutic efficacy, and better delineate the safety profile and evolution of the technique that has led to the present treatment paradigm. PMID:23369597

Chauhan, Nitin; Ellis, David A F



Deep Vein Thrombosis in Children  

PubMed Central

We describe a rare case of deep vein thrombosis (DVT) in children, highlight the importance of early diagnosis of rare disease with potential complications. In a 5 year old boy presented with persistent leg pain without any obvious cause. Detailed investigation led to diagnosis of DVT. As there are common differential diagnoses for leg pain in children, pediatricians usually have a low index of suspicious of DVT in children. This case highlight that paediatricians must consider DVT in their differential diagnosis when children present with leg pain.

Aabideen, Kanakkande; Ogendele, Michael; Ahmad, Ijaz; Amegavie, Laweh



Ovarian Vein and Caval Thrombosis  

PubMed Central

We present an illustrative case of postpartum ovarian vein thrombosis and describe its clinical presentation, differential diagnosis, and management. This pathologic process may produce clinical complications or a catastrophic outcome. These adverse events may be avoided if an expeditious diagnosis is made and appropriate treatment is instituted. This mandates a high index of suspicion, the ability to rule out the presence of other processes that may produce similar symptoms in the postpartum patient, and the appropriate triage of specific patients to either medical or surgical management.

Takach, Thomas J.; Cervera, Roberto D.; Gregoric, Igor D.



MRI-based Selection for Intra-arterial Stroke Therapy: Value of Pre-treatment DWI Lesion Volume in Selecting Acute Stroke Patients Who Will Benefit from Early Recanalization  

PubMed Central

Background and Purpose Recent studies demonstrate that an acute diffusion weighted imaging(DWI) lesion volume >70cm3 predicts poor outcome in stroke patients. We sought to determine if this threshold could identify patients treated with intra-arterial therapy(IAT) who would do poorly despite reperfusion. In patients with initial infarcts <70cm3, we sought to determine what effect recanalization and time to recanalization had on infarct growth and functional outcome. Methods We retrospectively studied 34 consecutive anterior circulation stroke patients who underwent pre-treatment DWI and perfusion weighted imaging(PWI) and subsequent IAT. Recanalization success and time to recanalization were recorded. Initial DWI and MTT lesion and final infarct volumes were determined. Patients were stratified based on initial infarct volume, recanalization status and time to recanalization. Statistical tests were performed to assess differences in clinical and imaging outcomes. Good clinical outcome was defined as a 3-month mRS?2. Results Among patients with initial infarcts >70cm3, all had poor outcomes despite a 50% recanalization rate, with mean infarct growth of 114cm3. These patients also had the largest MTT volumes(p<0.04). Patients with initial infarct volumes <70cm3 who recanalized early had the best clinical outcomes(p<0.008) with a 64% rate of mRS?2 and the least infarct growth(p<0.03), with mean growth of 18cm3. Conclusion This study supports the use of an acute DWI lesion volume threshold as an imaging selection criterion for IAT. It also confirms the importance of early reperfusion in selected patients.

Yoo, Albert J.; Verduzco, Luis A.; Schaefer, Pamela W.; Hirsch, Joshua A.; Rabinov, James D.; Gonzalez, R. Gilberto



Below-the-Belt Dermatological Conditions: Spider Veins, Varicose Veins, Cellulite, Pedicures  


... it comes to treating spider and varicose veins, cellulite and problems stemming from pedicures, there are many ... vein - which is then reabsorbed by the body. Cellulite Cellulite is a hormonally based condition unique to ...


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

SciTech Connect

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.

Mert, Murat [Istanbul University, Institute of Cardiology, Department of Cardiovascular Surgery (Turkey)], E-mail:; Saltik, Levent [Istanbul University, Cerrahpasa Medical School, Department of Pediatric Cardiology (Turkey); Gunay, Ilhan [Istanbul University, Institute of Cardiology, Department of Cardiovascular Surgery (Turkey)



Treatment of central retinal vein occlusion by injection of tissue plasminogen activator into a retinal vein  

Microsoft Academic Search

Purpose: To report the injection of tissue plasminogen activator into a retinal vein to treat central retinal vein occlusion.Methods: An 81-year-old woman with visual loss of the right eye secondary to central retinal vein occlusion developed central retinal vein occlusion and visual loss in her left eye. Treatment of her left eye with topical ocular hypotensive medications, pentoxifylline, and laser

Jeffrey N. Weiss



Location of the Susceptibility Vessel Sign on T2*-Weighted MRI and Early Recanalization within 1 Hour after Tissue Plasminogen Activator Administration  

PubMed Central

Background We have recently reported that the susceptibility vessel sign (SVS) at the proximal portion of the horizontal (M1) middle cerebral artery (MCA) on T2*-weighted MRI is a strong predictor for no early recanalization after intravenous recombinant tissue plasminogen activator (t-PA) therapy. However, it is unclear whether the presence of the SVS at other locations, such as distal M1, the vertical portion (M2) of the MCA, and distal branches (MCA distal), is a predictor for no early recanalization in acute ischemic stroke patients. Methods The SVS was defined as a hypointense signal of the MCA on T2*-weighted MRI on admission. The locations of the SVS were classified as M1 proximal, M1 distal, and MCA distal. M1 proximal SVS was defined as an SVS at the origin of the M1. M1 distal SVS was any M1 SVS not including the origin of the M1. MCA distal SVS was an SVS further away from M1. Early recanalization was defined as a new appearance of at least one of the distal branches on MRA within 1 h after t-PA therapy. A good outcome at 3 months was defined as a modified Rankin Scale (mRS) score of 0-1. Results Consecutive acute stroke patients admitted to our stroke center and treated with t-PA between October 2005 and October 2012 were enrolled. There were 158 patients [median age, 78 (71-84) years; 84 (53%) males; median National Institutes of Health Stroke Scale score, 16 (10-20)]. Internal carotid artery occlusion was seen in 18 (72%) of the 25 patients with M1 proximal SVS, in 3 (14%) of the 22 patients with M1 distal SVS, in 4 (9%) of the 44 patients with MCA distal SVS, and in 18 (27%) of the 67 patients with No SVS (p < 0.001). Twenty-four (96%) of the 25 patients with M1 proximal SVS had no early recanalization, while 16 (73%) of the 22 patients with M1 distal SVS, 25 (57%) of the 44 patients with MCA distal SVS, and 36 (54%) of the 67 patients with No SVS had no early recanalization (p < 0.001, 0.140, and 0.846, respectively, compared to the patients with No SVS). Multivariate analysis showed that only M1 proximal SVS was significantly associated with no early recanalization (odds ratio 16.80, 95% confidence interval 2.04-138.17, p = 0.009). Among the 95 patients with a premorbid mRS score of 0-1, none (0%) of the 16 patients with M1 proximal SVS, 5 (36%) of the 14 patients with M1 distal SVS, 12 (48%) of the 25 patients with MCA distal SVS, and 13 (33%) of the 40 patients with No SVS achieved a good outcome (p = 0.011, 1.000, and 0.295, respectively, compared to the patients with No SVS). Conclusion M1 proximal SVS on T2*-weighted MRI is a strong predictor for no early recanalization, and all patients with it had a poor outcome. However, M1 distal SVS and MCA distal SVS were not predictors for no early recanalization, and half of the patients had a poor outcome.

Aoki, Junya; Kimura, Kazumi; Shibazaki, Kensaku; Sakamoto, Yuki; Saji, Naoki; Uemura, Junichi



Early Recanalization After Intravenous Administration of Recombinant Tissue Plasminogen Activator as Assessed by Pre and Post-Thrombolytic Angiography in Acute Ischemic Stroke Patients  

Microsoft Academic Search

Background and Purpose—Recanalization rates after the intravenous (IV) recombinant tissue plasminogen activator (rt-PA) treatment have been poorly studied in acute stroke. Methods—CT angiography was performed before IV rt-PA in all patients and digital subtraction angiography was undertaken for intra-arterial thrombolysis in cases of no improvement after rt-PA infusion. Results—Forty-five patients were treated with IV rt-PA. Initial CT angiography showed relevant

Kyung-Yul Lee; Sang Won Han; Seo Hyun Kim; Hyo Seok Nam; Sung Whan Ahn; Dong Joon Kim; Sang Hyun Seo; Dong Ik Kim; Ji Hoe Heo



High Rate of Complete Recanalization and Dramatic Clinical Recovery During tPA Infusion When Continuously Monitored With 2MHz Transcranial Doppler Monitoring  

Microsoft Academic Search

Background and Purpose—Clot dissolution with tissue plasminogen activator (tPA) can lead to early clinical recovery after stroke. Transcranial Doppler (TCD) with low MHz frequency can determine arterial occlusion and monitor recanalization and may potentiate thrombolysis. Methods—Stroke patients receiving intravenous tPA were monitored during infusion with portable TCD (Multigon 500M; DWL MultiDop-T) and headframe (Marc series; Spencer Technologies). Residual flow signals

Andrei V. Alexandrov; Andrew M. Demchuk; Robert A. Felberg; Ioannis Christou; Philip A. Barber; W. Scott Burgin; Marc Malkoff; Anne W. Wojner; James C. Grotta



The Accuracy of Plain Skull X-ray Examination as a Predictor of Recanalization Following Guglielmi Detachable Coil Embolisation in the Treatment of Cerebral Aneurysms.  


Summary: We evaluated the accuracy of plain skull x-ray series as an imaging modality for the follow-up of cerebral aneurysm recanalization after Guglielmi Detachable Coil (GDC) embolisation. We retrospectively reviewed of 100 consecutive follow-up angiograms and skull x-ray examinations in 78 patients harboring 82 aneurysms and in whom 85 procedures were performed. Angiography was performed between 1 and 54 months (mean: 10.8 months) after embolisation. The skull series (AP, lateral and Towne's projections) were taken at the time of follow-up angiography. Each follow-up angiogram and skull series were compared to the immediate post-coiling, correlating presence or absence of coil compaction on the skull series and recanalization of the aneurysm at angiography. In 97 (97%) examinations, skull x-ray findings correlated with the angiographic findings. In three cases, skull x-ray examination suggested compaction when no recanalization was seen angiographically; in these three cases, the aneurysms were small and found to be more thrombosed than baseline. In no case did angiographic recanalization occur in the absence of compaction on skull series. These findings yield 100% sensitivity, 95% specificity, 93% positive predictive value, 100% negative predictive value and 97% accuracy. The location, size, configuration and neck/dome ratio of the aneurysm were not related to the correlation between angiography and skull x-ray exam. Skull x-ray series is a safe, accurate, and costeffective mode of follow-up for patients with GDC-treated aneurysms. The possibility of it replacing angiography still requires a more comparative skull x-ray modality in follow-up studies. PMID:20667198

Hwang, G J; Berenstein, A; Niimi, Y; Setton, A; Pryor, J; Baltsavias, G; Albert, R; Hartman, J



D-dimers increase in acute ischemic stroke patients with the large artery occlusion, but do not depend on the time of artery recanalization  

Microsoft Academic Search

D-dimers are one of the basic laboratory markers of fibrinolytic system activity. The aim of this prospective study was to\\u000a detect changes in D-dimer levels in acute stroke patients as a function of the time of artery recanalization and the therapy\\u000a used. During a 12-month period, 80 acute ischemic stroke patients admitted to the hospital within a 6-h time window

David Školoudík; Michal Bar; Daniel Ša?ák; Petr Bardo?; Martin Roubec; Kate?ina Langová; Roman Herzig; Petr Ka?ovský



The Accuracy of Plain Skull X-ray Examination as a Predictor of Recanalization Following Guglielmi Detachable Coil Embolisation in the Treatment of Cerebral Aneurysms  

PubMed Central

Summary We evaluated the accuracy of plain skull x-ray series as an imaging modality for the follow-up of cerebral aneurysm recanalization after Guglielmi Detachable Coil (GDC) embolisation. We retrospectively reviewed of 100 consecutive follow-up angiograms and skull x-ray examinations in 78 patients harboring 82 aneurysms and in whom 85 procedures were performed. Angiography was performed between 1 and 54 months (mean: 10.8 months) after embolisation. The skull series (AP, lateral and Towne's projections) were taken at the time of follow-up angiography. Each follow-up angiogram and skull series were compared to the immediate post-coiling, correlating presence or absence of coil compaction on the skull series and recanalization of the aneurysm at angiography. In 97 (97%) examinations, skull x-ray findings correlated with the angiographic findings. In three cases, skull x-ray examination suggested compaction when no recanalization was seen angiographically; in these three cases, the aneurysms were small and found to be more thrombosed than baseline. In no case did angiographic recanalization occur in the absence of compaction on skull series. These findings yield 100% sensitivity, 95% specificity, 93% positive predictive value, 100% negative predictive value and 97% accuracy. The location, size, configuration and neck/dome ratio of the aneurysm were not related to the correlation between angiography and skull x-ray exam. Skull x-ray series is a safe, accurate, and cost-effective mode of follow-up for patients with GDC-treated aneurysms. The possibility of it replacing angiography still requires a more comparative skull x-ray modality in follow-up studies.

Hwang, G.J.; Berenstein, A.; Niimi, Y.; Setton, A.; Pryor, J.; Baltsavias, G.; Albert, R.; Hartman, J.



Can tuffisite veins help dictate eruption styles?  

Microsoft Academic Search

The ability of magmas to degas during ascent may affect eruption style. The permeability of the magma and\\/or the conduit wall rocks may therefore dictate whether an eruption will be explosive or effusive. Fractures increase permeability. Fractures filled by veins of autoclastic, cataclastic and tuffisitic glass shards and crystal fragments are common in shallow conduit systems. These veins have the

S. Kolzenburg; M. J. Heap; Y. Lavallee; J. K. Russell; P. G. Meredith; D. B. Dingwell



Superficial Dorsal Vein Rupture Imitating Penile Fracture  

PubMed Central

Dorsal vein rupture of the penis is a rare condition, and few cases have been reported in the literature. Herein we report a 41-year-old man who presented with mildly painful and acute swollen penis, which initially imitated a penile fracture but was surgically explored and shown to be a superficial dorsal vein rupture.

Topsakal, Medih; Kavukcu, Ender; Karadeniz, Tahir



Branch Retinal Vein Occlusion: Classification and Treatment  

Microsoft Academic Search

Branch retinal vein occlusion (BRVO) refers to a heterogeneous group of disorders with different clinical aspects, courses, and probably therapy. Depending on the site of the arteriovenous crossing, we can roughly divide BRVO into 3 main groups: major BRVO, hemispheric retinal vein occlusion, and macular BRVO. Main treatment options include laser treatment, corticosteroid administration, anti-VEGF drugs, and sheathotomy with or

Maurizio Battaglia Parodi; Francesco Bandello



[Arteriovenous dissection for branch retinal vein occlusion].  


Arteriovenous dissection (AVD) is a surgical maneuver to separate the retinal artery and vein at the crossing site in patients with branch retinal vein occlusion (BRVO). The published studies showed an evidence level 3. AVD seems to be maintainable in patients with recent onset of BRVO and decimal visual acuity < or =0.4. PMID:18317778

Feltgen, N; Hattenbach, L-O; Mirshahi, A; Hansen, L



Postpartum ovarian vein thrombophlebitis: sonographic diagnosis  

Microsoft Academic Search

Background: We describe our experience with sonographic diagnosis of ovarian vein thrombosis, an uncommon but dangerous postpartum complication. Methods: We retrospectively reviewed the medical records of seven patients in our institution who developed postpartum ovarian vein thrombophlebitis within the past 5 years. Results: In all cases the diagnosis was made by ultrasound, which showed tubular hypoechoic masses lateral to the

I. Hadas-Halpern; M. Patlas; D. Fisher



21 CFR 880.6970 - Liquid crystal vein locator.  

Code of Federal Regulations, 2013 CFR

...2013-04-01 2013-04-01 false Liquid crystal vein locator. 880.6970 Section 880...Miscellaneous Devices § 880.6970 Liquid crystal vein locator. (a) Identification. A liquid crystal vein locator is a device used to...



21 CFR 880.6970 - Liquid crystal vein locator.  

Code of Federal Regulations, 2010 CFR

...2009-04-01 2009-04-01 false Liquid crystal vein locator. 880.6970 Section 880...Miscellaneous Devices § 880.6970 Liquid crystal vein locator. (a) Identification. A liquid crystal vein locator is a device used to...



21 CFR 880.6970 - Liquid crystal vein locator.  

Code of Federal Regulations, 2010 CFR

...2010-04-01 2010-04-01 false Liquid crystal vein locator. 880.6970 Section 880...Miscellaneous Devices § 880.6970 Liquid crystal vein locator. (a) Identification. A liquid crystal vein locator is a device used to...



Enhancing the contrast of subcutaneous veins  

NASA Astrophysics Data System (ADS)

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.

Zeman, Herbert D.; Lovhoiden, Gunnar



A Reappraisal of Saphenous Vein Grafting  

PubMed Central

Autologous saphenous vein grafting has been broadly used as a bypass conduit, interposition graft, and patch graft in a variety of operations in cardiac, thoracic, neurovascular, general vascular, vascular access, and urology surgeries, since they are superior to prosthetic veins. Modified saphenous vein grafts (SVG), including spiral and cylindrical grafts, and vein cuffs or patches, are employed in vascular revascularization to satisfy the large size of the receipt vessels or to obtain a better patency. A loop SVG helps flap survival in a muscle flap transfer in plastic and reconstructive surgery. For dialysis or transfusion purposes, a straight or loop arteriovenous fistula created in the forearm or the thigh with an SVG has acceptable patency. The saphenous vein has even been used as a stent cover to minimize the potential complications of standard angioplasty technique. However, the use of saphenous vein grafting is now largely diminished in treating cerebrovascular disorders, superior vena cava syndrome, and visceral revascularization due to the introduction of angioplasty and stenting techniques. The SVG remains the preferable biomaterial in coronary artery bypass, coronary ostioplasty, free flap transfer, and surgical treatment of Peyronie disease. Implications associated with saphenous vein grafting in vascular access surgery for the purpose of dialysis and chemotherapy are considerable. Vascular cuffs and patches have been developed as an important and effective means of enhancing the patency rates of the grafts by linking the synthetic material to the receipt vessel. In addition, saphenous veins can be a cell source for tissue engineering. We review the versatile roles that saphenous vein grafting has played as well as its current status in therapy.

Yuan, Shi-Min; Jing, Hua



Symptomatic varix of the facial vein.  


Varices of the facial and neck region are extremely rare, and the most prevalent varices in this region affect the orbital vein. To date, no report on a patent and symptomatic varix of the facial vein has been published, because these varices are particularly rare and most often thrombosed at the time of diagnosis. We present a patient with a prominent patent varix of the right facial vein. After a magnetic resonance imaging scan and duplex ultrasonography, the lesion was treated via surgical exploration, ligation, and complete excision. At 6 months of follow-up, no signs of recurrence were noted. PMID:23988543

Teraa, Martin; Schellekens, Pascal P A; Moll, Frans L; de Borst, Gert Jan



Fatal lower extremity varicose vein rupture.  


Varicose vein rupture is a rare cause of death, although varicosities are a common pathology. We present three cases of sudden death due to varicose vein rupture. After a review of the literature, the case circumstances and the findings of imaging examination, performed in two cases, are presented. One of them had undergone a post-mortem computed tomography angiography (PMCTA), and one a PMCTA as well as a post-mortem magnetic resonance (PMMR) imaging prior to conventional autopsy. One of the cases presented herein is, to our knowledge, the youngest known fatality due to varicose vein rupture. PMID:21144790

Ampanozi, Garyfalia; Preiss, Ulrich; Hatch, Gary M; Zech, Wolf Dieter; Ketterer, Thomas; Bolliger, Stephan; Thali, Michael J; Ruder, Thomas D



Retinal vein occlusions: The potential impact of a dysregulation of the retinal veins  

Microsoft Academic Search

A retinal vein occlusion (RVO) is a sight threatening disease. It can be divided into central vein occlusion and branch retinal\\u000a vein occlusion. The pathogenesis of the condition remains to be solved. Mechanical compression of the vessel wall or thrombotic\\u000a occlusion of the vessel lumen, sometimes combined with rheological disorders, are often assumed pathomechanisms. Accordingly,\\u000a the therapy relies either on

Stephan A. Fraenkl; Maneli Mozaffarieh; Josef Flammer



Histological appearances of the long saphenous vein.  


The long saphenous vein is frequently used as a graft in both coronary artery and femoro-distal bypass surgery. The histological changes which are seen after implantation into the arterial system have been well documented in the past, but little attention has been focused on the histological appearances of the donor long saphenous vein prior to grafting. In this study, samples of the long saphenous vein in excess of that required for bypass have been examined. In none of the veins did the histological appearances conform to the described normal. All showed evidence of intimal fibrosis which contained elastic tissue and enmeshed smooth muscle cells. The longitudinal and circular muscle layers showed evidence of muscle cell hypertrophy with increase in intervening connective tissue. Elsewhere, similar histological changes have been attributed to 'arterialization'. This study shows that many of the changes are present prior to grafting and may be important in graft failure. PMID:2614575

Milroy, C M; Scott, D J; Beard, J D; Horrocks, M; Bradfield, J W



Visual loss following sclerotherapy for varicose veins  

Microsoft Academic Search

The authors report the case of a 66-year-old lady referred to the acute eye clinic with left homonymous hemianopia following sclerotherapy for left lower limb varicose veins and review the literature on sclerotherapy-induced visual loss.

James Chiung Yoong Leong; Nicholas Robert Johnston



Evaluating Diagnostic Decisions for Deep Vein Thrombosis.  

National Technical Information Service (NTIS)

Prompt diagnosis of proximal lower extremity deep vein thrombosis (PDVT) in outpatients is critical because of the risk of pulmonary embolism. Our primary purpose was to determine the accuracy of orthopaedists' and orthopaedic physical therapists' estimat...

D. L. Riddle B. Hillner P. Wells W. Zuelzer



Isolated inferior mesenteric portal hypertension with giant inferior mesenteric vein and anomalous inferior mesenteric vein insertion  

PubMed Central

Extrahepatic portal hypertension is not an uncommon disease in childhood, but isolated inferior mesenteric portal varices and lower gastrointestinal (GI) bleed have not been reported till date. A 4-year-old girl presented with lower GI bleed. Surgical exploration revealed extrahepatic portal vein obstruction with giant inferior mesenteric vein and colonic varices. Inferior mesenteric vein was joining the superior mesenteric vein. The child was treated successfully with inferior mesenteric – inferior vena caval anastomosis. The child was relieved of GI bleed during the follow-up.

Prasad, G. Raghavendra; Billa, Srikar; Bhandari, Pavaneel; Hussain, Aijaz



Building Palm Vein Capturing System for Extraction  

Microsoft Academic Search

The palm vein pattern is unique to individuality which pattern does not change over time apart from size. This feature makes it suitable for one-to-many matching, for which fingerprint and face recognition may not be robust. In this paper, we set up a creatively vein-image capturing system and present a novel framework, composed of image enhancement, feature extraction, noise removal,

Jing-Wein Wang; Tzu-Hsiung Chen



Human Identification Using Palm-Vein Images  

Microsoft Academic Search

This paper presents two new approaches to improve the performance of palm-vein-based identification systems pre- sented in the literature. The proposed approach attempts to more effectively accommodate the potential deformations, rotational and translational changes by encoding the orientation preserving features and utilizing a novel region-based matching scheme. We systematically compare the previously proposed palm-vein identification approaches with our proposed ones

Yingbo Zhou; Ajay Kumar



Patterns and distribution of isolated calf deep vein thrombosis  

Microsoft Academic Search

Purpose: In the search for calf deep vein thrombosis (DVT) with color-flow duplex scanning (CFDS), most vascular laboratories investigate only the posterior tibial and peroneal veins. Few laboratories assess the soleal and gastrocnemial veins. This study was designed to determine the patterns and distribution of isolated calf DVT, including the soleal and gastrocnemial veins. Methods: In the last 3 years,

Nicos Labropoulos; K. Michael Webb; Steven S. Kang; M. Ashraf Mansour; Dusty R. Filliung; Jeffrey Buckman; William H. Baker



Mechanical properties of the fetal ductus venosus and umbilical vein  

Microsoft Academic Search

Summary During fetal circulatory compromise, velocity pulsations in the precordial veins increase and are commonly transmitted through the ductus venosus into the umbilical vein, indicating a serious prognosis. The nature of the pulsations and their transmission into the periphery, specifically the umbilical vein, is poorly understood. We present information on the mechanical properties of fetal veins as a basis for

Leif Rune Hellevik; Torvid Kiserud; Fridtjov Irgens; Nikos Stergiopulos; Mark Hanson



Biometric identification through palm and dorsal hand vein patterns  

Microsoft Academic Search

Hand vein patterns are among the biometric traits being investigated today for identification purposes, attracting interest from both the research community and industry. This paper presents a multimodal system that combines hand-palm vein and hand-dorsal vein biometrics information at the score level. The palm and dorsal veins are considered as texture samples being automatically extracted from the user's hand image.

Sanchit; Mauricio Ramalho; Paulo Lobato Correia; Luis Ducla Soares



Veins improve fracture toughness of insect wings.  


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

Dirks, Jan-Henning; Taylor, David



Veins Improve Fracture Toughness of Insect Wings  

PubMed Central

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.

Dirks, Jan-Henning; Taylor, David



Assessment of Recanalization after Intra-Arterial Thrombolysis in Patients with Acute Ischemic Stroke : Proposed Modification of the Qureshi Grading System  

PubMed Central

Objective We aimed to investigate the correlation between the success of recanalization and a modified version of the Qureshi grading system in acute ischemic stroke patients. Methods We retrospectively analyzed the intra-arterial thrombolysis (IAT) records of 37 patients who were evaluated by Thrombolysis in Myocardial Infarction (TIMI) and a modified version of the Qureshi grading systems as follows : 1) post-IAT Qureshi grade, 2) modified ? Qureshi grade : pre-IAT group grade - post-IAT group grade (grade 1 : Qureshi grades 0-2 and grade 2 : Qureshi grade 3-5) and 3) ? Qureshi grade (post-IAT Qureshi grade - pre-IAT Qureshi grade). Successful recanalization was defined as follows : 1) post-IAT TIMI grades 2 and 3, 2) post-IAT Qureshi grade 0-2, 3) modified ? Qureshi grade=1, and 4) ? Qureshi grade of ?2 and/or post-IAT Qureshi grade=0. We investigated the correlation between the post-IAT TIMI grade and the modified Qureshi grade and also compared the various grading systems with modified Rankin Scale scores for evaluating the clinical outcome at 3 months. Results The post-IAT Qureshi grade and ? Qureshi grade and/or post-IAT Qureshi grade were significantly correlated with the TIMI grade (?=0.976 and, 0.942, respectively). Further, post-IAT Qureshi grade and ? Qureshi grade and/or post-IAT Qureshi grade showed a significantly stronger association with clinical outcome than did the post-IAT TIMI grade (p=0.001 and, 0.000 vs. 0.083, respectively). Conclusion Our preliminary results suggest that the modified Qureshi grading system is a useful tool for assessing the success of recanalization after IAT.

Kim, Jae Hoon; Moon, Byung Gwan; Lee, Seung Jin; Kim, Joo Seung



Scattering Removal for Finger-Vein Image Restoration  

PubMed Central

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.

Yang, Jinfeng; Zhang, Ben; Shi, Yihua



Veias linfonodais: uma causa pouco conhecida de varizes Lymph node veins: a little-known cause of varicose veins  

Microsoft Academic Search

Lymph node veins are part of a venous network in Scarpa's triangle, communicating in many points the superficial venous system and the deep veins, and may either be the cause of incompetence of the superficial venous system, or be involved in recurrent varicose veins after saphenous vein stripping. In the daily routine of venous Doppler examination of the lower extremities,

André Paciello Romualdo; Roberto de Moraes Bastos; Alessandro Cappucci; Mathias Fatio; Andréa Tsunoda; Pollyanna Campos; Alberto Lobo Machado; Eduardo Hideki


Effects of Hemicastration or hCG-treatment on Steroids in Testicular Vein and Jugular Vein Blood of Stallions  

Microsoft Academic Search

The relationships among testicular vein and jugular vein concentrations of androgens and estrogens were studied in anesthetized stal- lions. Blood was sampled from a vein on the surface of the testis and simultaneously from an artery on the surface of the testis and from the jugular vein. Concentrations of total 173- hydroxy-androgens and total estrogens were measured for all samples



Deep vein thrombosis: a clinical review  

PubMed Central

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.

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



Optimization of subcutaneous vein contrast enhancement  

NASA Astrophysics Data System (ADS)

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.

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



The anatomy of the cardiac veins in mice  

PubMed Central

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.

Ciszek, Bogdan; Skubiszewska, Daria; Ratajska, Anna



Oversized vein grafts develop advanced atherosclerosis in hypercholesterolemic minipigs  

PubMed Central

Background Accelerated atherosclerosis is the main cause of late aortocoronary vein graft failure. We aimed to develop a large animal model for the study of pathogenesis and treatment of vein graft atherosclerosis. Methods An autologous reversed jugular vein graft was inserted end-to-end into the transected common carotid artery of ten hypercholesteroemic minipigs. The vein grafts were investigated 12-14 weeks later with ultrasound and angiograpy in vivo and microscopy post mortem. Results One minipig died during follow up (patent vein graft at autopsy), and one vein graft thrombosed early. In the remaining eight patent vein grafts, the mean (standard deviation) intima-media thickness was 712 ?m (276 ?m) versus 204 ?m (74 ?m) in the contralateral control internal jugular veins (P < .01). Advanced atherosclerotic plaques were found in three of four oversized vein grafts (diameter of graft > diameter of artery). No plaques were found in four non-oversized vein grafts (P < .05). Conclusions Our model of jugular vein graft in the common carotid artery of hypercholesterolemic minipigs displayed the components of human vein graft disease, i.e. thrombosis, intimal hyperplasia, and atherosclerosis. Advanced atherosclerosis, the main cause of late failure of human aortocoronary vein grafts was only seen in oversized grafts. This finding suggests that oversized vein grafts may have detrimental effects on patient outcome.



Portal Vein Aneurysm Presenting with Obstructive Jaundice  

PubMed Central

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.

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



Atrioesophageal fistula after cryoballoon pulmonary vein isolation.  


The risk of atrioesophageal fistula after cryoballoon pulmonary vein isolation is thought to be much lower than after radiofrequency ablation, seeing that no data exist on this complication so far. We report for the first time on the occurrence of an atrioesophageal fistula 4 weeks after cryoballoon ablation at the site of the left inferior pulmonary vein. We suggest that even when using cryothermal ablation technique, an imaging modality to assess the proximity of esophagus and left atrium should be routinely performed to avoid this fatal complication. PMID:22486804

Stöckigt, Florian; Schrickel, Jan W; Andrié, René; Lickfett, Lars



[Advanced esophageal carcinoma recanalization].  


Advanced esophageal carcinoma has poor prognosis with 5-year survival of less than 20%. This poor prognosis is the same for squamous cell carcinoma and adenocarcinoma. Surgical therapy, external radiation and chemotherapy with curative intent are usually impossible because of the advanced disease. Dysphagia is the most frequent symptom affecting quality of life. Bougies or balloon dilation improves dysphagia only short-term (few days). Nd-YAG laser, ACP and photodynamic therapy all have mid-range effect and require repetition after few weeks. Brachytherapy and esophageal self-expanding stent insertion have longer benefit. Stent insertion provides fastest improvement of dysphagia; however, complications in later setting occur in30% and require further endoscopic treatment. Brachytherapy has slower onset of benefit but has fewer complications and longer benefit. Brachytherapy is suitable for patients wit expected lifespan more than 3 months. Most important contraindication of brachytherapy is tracheo-esophageal fistula. PMID:19202963

Molnárová, A



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

SciTech Connect

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.

Kim, Hyun S., E-mail:; Nwankwo, Ikechi J.; Hong, Kelvin [Johns Hopkins University School of Medicine, Russell H. Morgan Department of Radiology and Radiological Science (United States); McElgunn, Patrick S.J. [Johns Hopkins University School of Medicine, Department of Dermatology (United States)



Surgical treatment of pacemaker induced left innominate vein occlusion using a spiral vein graft.  


Superior vena cava syndrome due to transvenous pacing leads is an uncommon but potentially life-threatening complication. This case involves a 54-year-old man who developed left innominate vein occlusion due to a pacemaker lead. This complication induced a progressive swelling on the left side of his face, neck, arm, and upper chest. The left innominate vein occlusion was surgically treated using a composite spiral saphenous vein graft. Postoperatively, the patient has received anticoagulation therapy with warfarin to prevent thrombosis and, thereby, the long-term patency of the graft. He has undergone follow-up on a regular outpatient basis without showing any recurrence of clinical symptoms. PMID:11707053

Inoue, T; Otaki, M; Nakamoto, S; Zang, Z; Oku, H



Varicose Veins: Role of Mechanotransduction of Venous Hypertension  

PubMed Central

Varicose veins affect approximately one-third of the adult population and result in significant psychological, physical, and financial burden. Nevertheless, the molecular pathogenesis of varicose vein formation remains unidentified. Venous hypertension exerted on veins of the lower extremity is considered the principal factor in varicose vein formation. The role of mechanotransduction of the high venous pressure in the pathogenesis of varicose vein formation has not been adequately investigated despite a good progress in understanding the mechanomolecular mechanisms involved in transduction of high blood pressure in the arterial wall. Understanding the nature of the mechanical forces, the mechanosensors and mechanotransducers in the vein wall, and the downstream signaling pathways will provide new molecular targets for the prevention and treatment of varicose veins. This paper summarized the current understanding of mechano-molecular pathways involved in transduction of hemodynamic forces induced by blood pressure and tries to relate this information to setting of venous hypertension in varicose veins.

Atta, Hussein M.



Central retinal vein occlusion and thrombophilia  

Microsoft Academic Search

Central retinal vein occlusion is one of the commonest vascular diseases of the eye. The pathogenesis is multifactorial with both local factors and systemic diseases being aetiologically important. Many thrombophilic conditions have recently been identified and studies looking at their potential role in CRVO have been undertaken. The aim of this review is to critically appraise these studies as to

C D Fegan



Management of Retinal Vein Occlusion – Consensus Document  

Microsoft Academic Search

Retinal vein occlusion (RVO) can have severe consequences for the people affected by the disease, including visual loss with costly social repercussions. Currently, there is no European consensus with regard to the management of RVO. Following a careful review of the medical literature as well as the data from several clinical trials, a collaborative group of retina specialists put forth

Gabriel Coscas; Anat Loewenstein; Albert Augustin; Francesco Bandello; Maurizio Battaglia Parodi; Paolo Lanzetta; Jordi Monés; Marc de Smet; Gisèle Soubrane; Giovanni Staurenghi



Management of Central Retinal Vein Occlusion  

Microsoft Academic Search

The management of central retinal vein occlusion (CRVO) is discussed briefly. Since the prognosis, complications, visual outcome and management of nonischemic and ischemic CRVO are very different, the first essential step in the management of CRVO is to determine which type of CRVO one is dealing with. The various parameters which help to differentiate the two types reliably are described

Sohan Singh Hayreh



Modified incision for long saphenous vein harvest.  


We describe a modification of the standard open technique of long saphenous vein harvesting that, by avoiding dissection in the region of the medial malleolus, can reduce the incidence of leg wound related complications after coronary artery bypass grafting. PMID:9692491

Chukwuemeka, A; John, L



Thrombosis of the cerebral veins and sinuses  

Microsoft Academic Search

hrombosis of the cerebral veins and sinuses is a distinct cere- brovascular disorder that, unlike arterial stroke, most often affects young adults and children. The symptoms and clinical course are highly variable. A teenag- er who has had recent headaches after starting oral contraception, a woman who has had seizures after delivery in the obstetrical ward, and a comatose man

Jan Stam



Portal vein embolization before major hepatectomy  

Microsoft Academic Search

Abstract Abstract Abstract Abstract To discuss the rationale, techniques and the unsolved issues regarding preoperative portal vein embolization (PVE) before major hepatectomy. After a systematic search of Pubmed, we reviewed and retrieved literature related to PVE. Preoperative PVE is an approach that is gaining increasing acceptance in the preoperative treatment of selected patients prior to major hepatic resection. Induction of

Hai Liu; Yong Fu


Preoperative portal vein embolization for hepatocellular carcinoma  

Microsoft Academic Search

As a countermeasure to portal tumor thrombi, which are a serious danger in liver cancer, we did portal vein embolization (PVE) during percutaneous transhepatic portography. Our 21 patients later underwent hepatic resection. After PVE, portal pressure increased and there was slight liver function damage, but this procedure was safer than transarterial embolization (TAE). We examined the pathologic specimens to view

Hiroaki Kinoshita; Katsuji Sakai; Kazuhiro Hirohashi; Sumito Igawa; Osamu Yamasaki; Shoji Kubo



A secure cryptosystem from palm vein biometrics  

Microsoft Academic Search

This paper proposes a novel technique to generate an irrevocable cryptographic key from the biometric template. The biometric trait considered here is the palm vein. The technique proposed here utilises the minutiae features extracted from the pattern generated. The features include bifurcation points and ending points. Since other cryptographic keys are probable to theft or guess, keys generated from the

B. Prasanalakshmi; A. Kannammal



Morphometric analysis of the gonadal veins in human foetuses.  


Professional literature data demonstrates morphometric features of the gonadal veins in adults. The length of the gonadal veins and their outlet angles in 130 human foetuses (71 males, 59 females), between the 4th and 6th month of prenatal life, were studied by means of anatomical, digital and statistical methods. In all specimens the left gonadal veins entered the left renal artery, and the right gonadal veins terminated in the inferior vena cava. In all age ranges the left gonadal veins were longer than the right ones (P < or = 0.01), and the outlet angles of the left gonadal veins were larger than these angles on the right side (P < or = 0.01). The correlation coefficient between the length of the left and right testicular veins was r1 = 0.975 (P < or = 0.01). The correlation coefficients between the length of the testicular veins and foetal age were r2 = 0.591 for the right testicular vein and r3 = 0.578 for the left testicular vein (P < or = 0.01). A low correlation between the outlet angles of the testicular veins and foetal age was observed, for the right side r4 = 0.187, and for the left side r5 = 0.177 (P < or = 0.05). The correlation coefficient between the length of the left and right ovarian veins in foetuses aged 4-6 months was r6 = 0.855 (P < or = 0.01). The correlation coefficients between the length of the ovarian veins and foetal age were r7 = 0.578 for the right ovarian vein and r8 = 0.566 for the left ovarian vein (P < or = 0.01). No correlation between the outlet angles of the ovarian veins and foetal age was observed (P > 0.05). PMID:16163853

Szpinda, Micha?; Elminowska-Wenda, Gabriela; Wi?niewski, Marcin; Frackiewicz, Piotr



Technical challenges in TIPS creation via the right subclavian vein.  


This report describes a 64-year-old man with Laennec cirrhosis requiring a transjugular intrahepatic portosystemic shunt (TIPS) to alleviate ascites before surgical mesh repair of a large symptomatic umbilical hernia. During the procedure, both internal jugular veins and the right external jugular vein were found to be occluded. The right subclavian vein was accessed and a TIPS was successfully created. Some of the technical challenges encountered in performing the procedure from the right subclavian vein are described. PMID:18951043

Contractor, Sohail G; Merkulov, Alex; Uppuluri, Pranay C; Bhatti, Waseem; Phatak, Tej



Intermittent axillary vein obstruction in a competitive canoeist.  

PubMed Central

The case is reported of a competitive canoeist with intermittent axillary vein obstruction secondary to shoulder girdle muscle hypertrophy. The anatomy of the axilla, pathology of the axillary vein, and reported cases of sports injuries involving the axillary vein are discussed. This would appear to be the first report of such an occurrence in a canoeist. Images Figure 1 Figure 2

Livesey, J R



Medical conditions underlying recurrence of retinal vein occlusion  

Microsoft Academic Search

Seventeen patients with recurrent retinal vein occlusion were investigated for underlying medical conditions and compared with 61 patients with single retinal vein occlusion (26 with central, 35 with branch vein occlusion). The two study groups were comparable for age, sex, and weight. Patients with recurrence had a significantly increased prevalence rate of hypertension (88% versus 48%: p less than 0.01),

P M Dodson; A J Kubicki; K G Taylor; E E Kritzinger



Spermatic vein phlebography in patients with testicular tumors.  


The performance of funicular lymphography and spermatic vein phlebography during orchiectomy in patients with testicular tumors demonstrates the close proximity of the spermatic vein to the lymph nodes draining the testicles. In the case of metastatic lymph node involvement the spermatic vein phlebography may add supplementary diagnostic information. The examination was proved successful in eight patients with malignant testicular tumors. PMID:904745

Karparov, M; Gospodinov, G; Baldjiisky, A; Zlatanov, T; Karadimov, A



Intra-vascular leiomyoma of the popliteal vein.  

PubMed Central

A large mass in the popliteal fossa was found to be a leiomyoma of the popliteal vein with portions of tumour both inside and outside the vein. This is only the second recorded case of a benign smooth muscle tumour of a peripheral vein. Images Figure 1

Grimer, R. J.; Armstrong, G. R.



Hydrops fetalis associated with chorioangioma and thrombosis of umbilical vein.  


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

Sivasli, Ercan; Tek?am, Ozlem; Halilo?lu, Mithat; Güçer, Safak; Orhan, Diclehan; Gürgey, Aytemiz; Tekinalp, Gülsevin


Vein of Galen Aneurysms: Presentation and Endovascular Management  

Microsoft Academic Search

Background: We present our experience with managing 13 cases of vein of Galen aneurysm with a special focus on endovascular strategies. This clinical review deals with the multivariable clinical presentation of vein of Galen aneurysms and the role of transarterial endovascular treatment. Methods: Thirteen patients diagnosed with vein of Galen aneurysms have been reviewed. Clinical presentation, diagnostic modalities and treatment

Tamer Hassan; Mahmoud Nassar; Mamdouh Elghandour



Venous thrombosis in subclavian, axillary, brachial veins with extension to internal jugular vein, right sigmoid sinus and simultaneous pulmonary embolism  

PubMed Central

We present a rare case of Venous Thrombosis in Subclavian, Axillary, Brachial Veins with extension to Internal Jugular vein, right sigmoid sinus and simultaneous Pulmonary embolism during the treatment with low molecular weight heparin.

Tamizifar, Babak; Beigi, Arash; Rismankarzadeh, Maryam



Absence of the right iliac vein and an unusual connection between both common femoral veins.  


The aim of the study is to report a case of a rare congenital anomaly of the venous system and to emphasize its clinical importance. We describe a case of aplasia of the right common and external iliac veins in a healthy seven-year-old boy who was referred for Doppler ultrasound examination for further evaluation of an abnormal varicosity in the suprapubic region. Colour Doppler ultrasound revealed a dilated, arch-shaped vein. Contrast-enhanced magnetic resonance angiography showed the absence of the right common iliac vein and external iliac vein. It also clearly demonstrated the aberrant venous structure, originating from the right common femoral vein and draining to the left common femoral vein. In conclusion, in our case, the patient’s life was threatened because the aberrant venous connection crossing within subcutaneous fatty tissue was not protected from external trauma and possible abdominal surgical interventions. Additional attention should be given to avoid such injuries, which can cause significant haemorrhage. PMID:22431769

Yahyayev, A; Bulakci, M; Yilmaz, E; Ucar, A; Sayin, O A; Yekeler, E



Azygos vein to pulmonary vein fistula is a pathway for cerebral embolism.  


A 43-year-old man was admitted for right upper and lower limb weakness and aphasia. He had suffered dizziness and transient blindness 6 months ago and had also been found lying in the bathroom on another occasion. Multiple cerebral infarctions were confirmed by brain CT scan and MRI. Diffuse nodes in the mediastinum and postperitoneum had been found in pulmonary CT scans and MRI scans since 1999. Pulmonary CT scan revealed multiple bilateral pneumatoceles in the lungs. Contrast CT scan showed an enlarged azygos vein on the right side of the spinal column and an enlarged azygos arch. CT scan-guided biopsy revealed a few fibers, fat, and vascular tissues in the mass. Transcranial Doppler bubble test showed gas microembolic signals in both middle cerebral arteries. Pulmonary digital subtraction angiogram confirmed an enlarged azygos vein. A fistula was found between the pulmonary and azygos veins with turbulent flow from pulmonary to azygos at rest. Cavography revealed that the pulmonary vein appeared simultaneously with the superior cava vein during Valsalva maneuver. In summary, the pathway of cerebral embolism was based on three pathologic mechanisms: (1) increased inferior vena cava pressure, (2) enlarged right azygos aneurysm, and (3) the presence of a fistula between the azygos and pulmonary veins. PMID:20822995

Huang, Yining; Sun, Wei; Li, Fan; Sun, Weiping



Internal vein texture and vein evolution of the epithermal Shila-Paula district, southern Peru  

NASA Astrophysics Data System (ADS)

The epithermal Shila-Paula Au-Ag district is characterized by numerous veins hosted in Tertiary volcanic rocks of the Western Cordillera (southern Peru). Field studies of the ore bodies reveal a systematic association of a main E-W vein with secondary N55-60°W veins—two directions that are also reflected by the orientation of fluid-inclusion planes in quartz crystals of the host rock. In areas where this pattern is not recognized, such as the Apacheta sector, vein emplacement seems to have been guided by regional N40°E and N40°W fractures. Two main vein-filling stages are identified. stage 1 is a quartz-adularia-pyrite-galena-sphalerite-chalcopyrite-electrum-Mn silicate-carbonate assemblage that fills the main E-W veins. stage 2, which contains most of the precious-metal mineralization, is divided into pre-bonanza and bonanza substages. The pre-bonanza substage consists of a quartz-adularia-carbonate assemblage that is observed within the secondary N45-60°W veins, in veinlets that cut the stage 1 assemblage, and in final open-space fillings. The two latter structures are finally filled by the bonanza substage characterized by a Fe-poor sphalerite-chalcopyrite-pyrite-galena-tennantite-tetrahedrite-polybasite-pearceite-electrum assemblage. The ore in the main veins is systematically brecciated, whereas the ore in the secondary veins and geodes is characteristic of open-space crystallization. Microthermometric measurements on sphalerite from both stages and on quartz and calcite from stage 2 indicate a salinity range of 0 to 15.5 wt% NaCl equivalent and homogenization temperatures bracketed between 200 and 330°C. Secondary CO2-, N2- and H2S-bearing fluid inclusions are also identified. The age of vein emplacement, based on 40Ar/39Ar ages obtained on adularia of different veins, is estimated at around 11 Ma, with some overlap between adularia of stage 1 (11.4±0.4 Ma) and of stage 2 (10.8±0.3 Ma). A three-phase tectonic model has been constructed to explain the vein formation. Phase 1 corresponds to the assumed development of E-W sinistral shear zones and associated N60°W cleavages under the effects of a NE-SW shortening direction that is recognized at Andean scale. These structures contain the stage 1 ore assemblage that was brecciated during ongoing deformation. Phase 2 is a reactivation of earlier structures under a NW-SE shortening direction that allowed the reopening of the preexisting schistosity and the formation of scarce N50°E-striking S2-cleavage planes filled by the stage 2 pre-bonanza minerals. Phase 3 coincides with the bonanza ore emplacement in the secondary N45-60°W veins and also in open-space in the core of the main E-W veins. Our combined tectonic, textural, mineralogical, fluid-inclusion, and geochronological study presents a complete model of vein formation in which the reactivation of previously formed tectonic structures plays a significant role in ore formation.

Chauvet, Alain; Bailly, Laurent; André, Anne-Sylvie; Monié, Patrick; Cassard, Daniel; Tajada, Fernando Llosa; Vargas, Juan Rosas; Tuduri, Johann



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

SciTech Connect

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.

Charalambous, Nikolas, E-mail:; Schaefer, Philipp J.; Trentmann, Jens; Huemme, Tim. H.; Stoehring, Christine [University Hospital of Schleswig-Holstein, Department of Diagnostic Radiology (Germany); Mueller-Huelsbeck, Stefan [Academic Hospitals Flensburg, Department of Radiology (Germany); Heller, Martin; Jahnke, Thomas [University Hospital of Schleswig-Holstein, Department of Diagnostic Radiology (Germany)



A comparison of MR and duplex Doppler ultrasound for vascular assessment prior to orthotopic liver transplantation.  


A prospective blinded comparison of duplex Doppler ultrasound (DDU) and a magnetic resonance angiography (MRA) 2-D time-of-flight technique was performed to assess the hepatic vasculature in 23 adult patients referred for orthotopic liver transplantation. Both techniques confirmed patency of the inferior vena cava in all patients, demonstrated a complete portal vein occlusion in one patient, and accurately defined the vascular and organ anatomy in a patient with situs inversus. The results were confirmed at surgery in 18 of the patients who have subsequently undergone liver transplantation. In one patient a partial portal vein thrombosis was found at surgery which was not detected by either imaging technique. MRA was more sensitive overall in detecting porto-systemic collaterals (31 locations in 17 patients) compared with ultrasound (24 locations in 17 patients), although ultrasound detected more patients with recanalized para-umbilical veins (DDU: 10 patients; MRA: 8 patients). These results indicate that a simple MRA technique can equal duplex Doppler ultrasound for the non-invasive assessment of patency of the hepatic vasculature and should be considered when DDU examination is equivocal or technically inadequate. MRA may provide additional information on the presence and size of porto-systemic collaterals which may be of value in monitoring portal hypertension. PMID:8013191

Lomas, D J; Britton, P D; Alexander, G J; Calne, R Y



[The analyze of recurrent varicose veins development after surgical treatment of lower limbs varicose veins].  


Possible development of recurrent varicose veins (RVV) is one of the main reasons for abandonment of patients to undergo varicose veins surgical treatment. Regardless of the increase in the number of the treatment the primary method of improving the surgical technique is to identify the causes of earlier failures. The aim of this study was to determine the mechanisms responsible for the development of recurrent varicose veins after surgical treatment of primary varicose veins. We studied 507 patients (680 limbs) with primary varicose veins of the lower limbs operated in the years 1996-2007 using the classical technique. The results of pre-and postoperative signs, duplex studies and operational protocols were analyzed. Follow-up was 36-156 months (mean 89.7 +/- 31.2 months). RVV development was observed in 36.9% of operated limbs. Irregularities of surgical techniques and neovascularization were responsible for the development of changes to 87.6% and disease progression in the development of changes in 27.4% of limbs with RVV. At 15.5% of limbs with RVV occurred more than one cause of relapse. In logistic regression combined effects of several factors shown to exist only significant relationship between development and the presence of RVV stumps in sapheno-femoral junction (SFJ) and the presence of inefficient SFJ tributaries of the stumps. The risk of development of new varicose veins was independent on the correctness of the implementation of the first treatment. The most common cause of development of RW were imperfections of surgical treatment, principally in the form of leaving the stumps with insufficient SFJ tributaries, or the development of neovascularization. It appears that improving the quality of treatment may favorably affect the development of a decreased incidence of recurrent varicose veins. PMID:21812233

Gabriel, Marcin; Zieli?ski, Pawe?; Pawlaczyk, Katarzyna; Krasi?ski, Zbigniew; Stanisi?, Micha?; Dzieciuchowicz, ?ukasz



In situ saphenous vein bypass--forty years later.  


In situ saphenous vein bypass, which was performed first by Rob in 1959, but introduced by Hall in 1962, has been widely applied as an alternative to the reversed bypass. Now, forty years later, it seems appropriate to review its current place and technique. Of the presumed original benefits of the in situ operation, it is now clear that the hemodynamic flow of converging (in situ) versus diverging vein (reversed) boundaries plus better vein/artery size match are the main advantages. It is now popular belief that the reversed saphenous vein graft to the popliteal artery has no significant hemodynamic disadvantage because the vein is of comparable diameter at the knee and in the groin. In contrast, vein bypass from the groin to the ankle strongly favors the in situ procedure because of the convergence of the walls of the vein below the knee and better vein/artery size match. The most controversial facet of the in situ operation has been the question of valvulotome is superior to lyse valves and whether to perform the operation open as originally described, or closed to avoid skin complications from a long groin to ankle incision. Preoperative vein mapping is advantageous for all saphenous vein conduit operations. For open leg in situ procedures, skin bridges and incisions made directly over the vein, directed by mapping, will minimize skin complications. Use of endoscopic in situ techniques is ideal but only with an experienced endoscopist. Valve lysis has improved but is still not foolproof. PMID:15815835

Connolly, John E



An interconnected duplicated femoral vein and its clinical significance.  


Anatomical variations in the femoral vein are of great clinical importance especially in cases of deep vein thrombosis (DVT). Knowledge of the variable anatomy of the femoral vein is important to minimise false-negative findings on ultrasound examination in patients with DVT and help to explain the 'silent' DVT. Furthermore, the presence of a duplicated femoral vein itself is associated with higher incidence of DVT. These venous anomalies are usually due to the truncular venous malformation. In the present study, while dissecting the right lower limb, we found a case of variation of the femoral vein. In this case, besides a duplicated femoral vein, we also noticed a 3rd interconnecting channel near the apex of the femoral triangle joining the two veins. This variation has not been reported previously by other authors. Considering its uniqueness and clinical importance, we decided to report this case. PMID:23749717

Khan, Aaijaz Ahmed; Asari, Mohd Asnizam; Hassan, Asma; Aiman, Nurul



Doppler spectral characteristics of infrainguinal vein bypasses.  


With the aim of assessing the velocity profile of femoropopliteal and femorocrural vein bypasses, 128 patients undergoing infrainguinal vein bypass surgery entered a postoperative Duplex surveillance protocol, which included clinical assessment and Duplex scanning, using Doppler spectral analysis. Doppler spectra were obtained at three sites in each graft and the following waveform parameters recorded: maximum systolic velocity, minimum diastolic velocity and resistance index. In patent reconstructions systolic velocity decreased by 30% during the first 6 months after surgery. In the absence of arteriovenous fistulas the initially antegrade diastolic velocity was replaced by a retrograde flow within 3 months, whereas a forward flow in diastole was sustained in grafts with patent fistulas. Abnormal Duplex findings in 31 patients led to angiography and revision in 13 cases. Four revised grafts failed, while nine remained patent at follow-up 1-12 months later. Ten (56%) of 18 non-revised bypasses with abnormal Duplex findings failed within 9 months compared to 1 (1%) of 76 bypasses with a normal velocity profile (p < 0.00001). In conclusion, Ultrasound Duplex scanning with spectral analysis provides valuable information concerning haemodynamics of infrainguinal vein bypasses and identifies grafts at risk of thrombosis. Inclusion of low resistance index (< 0.75) as an additional criteria for detection of stenoses appears to improve the sensitivity of Duplex scanning. PMID:8270061

Nielsen, T G; von Jessen, F; Sillesen, H; Schroeder, T V



Development of HIFU Therapy System for Lower Extremity Varicose Veins  

SciTech Connect

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/cm{sup 2}, and the irradiation time was 20 s. In this study, the contrast agent Levovist registered was chosen as a microbubble source, and the void fraction (ratio of total gas volume to liquid) in the vein was fixed at 10{sup -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.

Ota, Ryuhei; Yoshinaka, Kiyoshi; Takagi, Shu; Matsumoto, Yoichiro [Department of Mechanical Engineering, University of Tokyo 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-8656 (Japan); Suzuki, Jun; Deguchi, Juno; Miyata, Tetsuro [Vascular Surgery, Department of Surgery, University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-0033 (Japan)



Retrograde approach for endovascular salvage of an infrapopliteal vein bypass.  


Endovascular treatment through femoropopliteal and infragenicular percutaneous transluminal angioplasty, both in native vessels and in bypass salvage, has been an emerging technique in recent years. However, in some cases, a difficult anterograde access in distal occlusions has limited the technical success of this procedure. Combined subintimal arterial flossing with antegrade-retrograde intervention is used as a resource technique to obtain precise recanalization in these cases. Here, we present the case of a retromalleolar access of the posterior tibial artery, based on subintimal arterial flossing with antegrade-retrograde intervention technique, to achieve femoral-posterior tibial bypass salvage. PMID:22284773

Cenizo Revuelta, Noelia; Gastambide, Victoria; San-Norberto, Enrique M; Ibáñez, Maria-Antonia; Martín-Pedrosa, Miguel; Taylor, James; Gutiérrez, Vicente; Vaquero, Carlos



Diagnosis of uterine vein thrombosis on transvaginal ultrasound.  


Deep venous thrombosis (DVT) is a potentially serious medical disorder, which may result in pulmonary embolism and death. Compression ultrasound is the investigation modality of choice for the diagnosis of DVT of the lower limb. Diagnosis of proximal thrombosis involving the pelvic veins is difficult and is usually made only after the thrombus extends into the veins of the lower limb. We present six cases of incidental uterine vein thrombosis diagnosed by transvaginal ultrasound. Our aim is to describe the technique of the examination of pelvic veins and criteria that could be used to diagnose uterine vein thrombosis. We also highlight difficulties in the management of women diagnosed with asymptomatic uterine vein thrombi as there is little evidence to guide clinicians in choosing between different treatment options. Copyright © 2013 ISUOG. Published by John Wiley & Sons Ltd. PMID:23716379

Mavrelos, D; Cohen, H; Pateman, K; Hoo, W; Foo, X; Jurkovic, D



Internal Jugular Vein Entrapment in a Multiple Sclerosis Patient  

PubMed Central

We describe a multiple sclerosis patient presenting with compression of the internal jugular vein caused by aberrant omohyoid muscle. Previously this patient underwent balloon angioplasty of the same internal jugular vein. Ten months after this endovascular procedure, Doppler sonography revealed totally collapsed middle part of the treated vein with no outflow detected. Still, the vein widened and the flow was restored when the patient's mouth opened. Thus, the abnormality was likely to be caused by muscular compression. Surgical exploration confirmed that an atypical omohyoid muscle was squeezing the vein. Consequently, pathological muscle was transected. Sonographic control three weeks after surgical procedure revealed a decompressed vein with fully restored venous outflow. Although such a muscular compression can be successfully managed surgically, future research has to establish its clinical relevance.

Simka, Marian; Majewski, Eugeniusz; Fortuna, Marek; Zaniewski, Maciej



Late failure of reversed vein bypass grafts.  

PubMed Central

Late failure of reversed vein bypass grafts is preceded by the appearance of stenotic lesions, which progress to total occlusion. These lesions appear either as intrinsic graft lesions or as new arteriosclerotic lesions in contiguous arteries. The present study summarizes the University of Pennsylvania experience with these lesions in 521 vein grafts inserted from 1979 to 1985. The grafts were grouped according to the site of the distal anastomosis; 231 above-knee popliteal (FP AK), 171 below-knee popliteal (FP BK), and 119 tibial (FT). The overall incidence of stenotic lesions was essentially identical with the three grafts (21%), but the relative incidence of intrinsic graft to arterial lesions was higher with the more distal grafts. The most common graft lesions developed adjacent to the proximal anastomosis, which is the narrowest part of a reversed vein graft. The popliteal artery was the most common site of outflow stenosis. There was negligible incidence of tibial lesions. The most common inflow arterial lesion was located in the common femoral and iliac arteries. The superficial femoral artery (SFA) was a rare site of inflow stenosis, even though it was at risk because 96 grafts originated from the SFA or popliteal artery. Sixty-seven per cent of the graft and 52% of the arterial lesions were treated successfully by percutaneous transluminal angioplasty; the rest had minor surgical revisions. This resulted in a 19%, 10%, and 9% improvement in 5-year patency for the FT, FP BK, and FP AK bypasses. These results justify an aggressive policy of graft surveillance to identify and treat stenotic graft lesions before graft occlusion.

Berkowitz, H D; Greenstein, S; Barker, C F; Perloff, L J



Accuracy of clinical assessment of deep-vein thrombosis  

Microsoft Academic Search

The clinical diagnosis of deep-vein thrombosis is generally thought to be unreliable. From experience, we hypothesised that this widely held view might be incorrect. We developed a clinical model and prospectively tested its ability in three tertiary care centres to stratify symptomatic outpatients with suspected deep-vein thrombosis into groups with high, moderate, or low probability groups of deep-vein thrombosis. We

Philip S. Wells; Jack Hirsh; David R. Anderson; Anthony W. A. Lensing; Gary Foster; Clive Kearon; Jeffrey Weitz; Robert D'Ovidio; Alberto Cogo; Paolo Prandoni; Antonio Girolami; Jeffrey S. Ginsberg



Partial anomalous connection of both superior pulmonary veins.  


Several patterns of anomalous pulmonary venous drainage have been described in the literature, and bilateral partial pulmonary anomalous vein connection (PAPVC) has been described as a rare congenital cardiac anomaly. We report an unusual type of bilateral PAPVC, involving both the superior right and left pulmonary veins draining into the left brachiocephalic vein in a young adult who was symptomatic with dyspnea and a dry cough. PMID:22818314

Marianeschi, Stefano M; Cannata, Aldo; Uricchio, Nicola; Pedretti, Stefano; Vignati, Gabriele



Kinematics of crystal growth in syntectonic fibrous veins  

Microsoft Academic Search

Abstract--Detaded observations of a set of fibrous antitaxial calcite veins in a slate reveal that some,of the calcite fibres do not connect material markers,on both sides of the vein and can therefore not have tracked the full opening trajectory dunng,vein growth. Thts calls for a better understanding,of the mechanisms,of fibre formation and reliable criteria to test the tracking hypothesis. Based

J. L. Urai; P. F. Williams; H VANROERMUND



Computed tomography angiography demonstration of portal vein anomaly type V.  


Computed tomography (CT) angiography is fast replacing the diagnostic conventional angiography and digital subtraction angiography. A case of a type V portal vein anomaly, which was diagnosed by Doppler ultrasound and confirmed on CT angiography, is presented. Demonstration of the portal vein branching pattern and its anomalies assumed importance and significance after split liver and segmental transplantation techniques were developed. There are 5 variations of portal vein branching that have been described. PMID:15100539

Balaji, Malapally Chowda Reddy; Kalita, Aroop Jyoti; Ravindranath, Kancharla; Mathai, Varughese; Sreekanth, Kandikattu


Renal angiomyolipoma with renal vein invasion.  


Renal angiomyolipoma is a uncommon benign tumor, considered an hamartoma. The lesion, usually benign, can be single or multiple and well-circumscribed. In letterature only few cases of infiltrating angiomyolipomas have been described. The aim of the paper is to describe a paradigmatic case of a giant kidney angiomyolipoma, not associ- ated with tuberous sclerosis, invading the pelvis and the renal vein. The lesion have been discovered incidentally during abdominal ultrasound for other pathology. Owing to the extent of the lesion and the appreciable risk of bleeding, we opted for surgical treatment. PMID:23820662

Di Cristofano, Francesca; Petrucci, Federico; Zeccolini, Guglielmo; Leo, Genesio; Cicero, Calogero; Del Biondo, Dario; Celia, Antonio



Deep vein thrombosis chemoprophylaxis in plastic surgery.  


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

Gold, Alan



Arm vein reconstruction for limb salvage: long-term outcome.  

PubMed Central

A series of 42 consecutive patients undergoing infrainguinal vascular reconstruction for limb salvage using vein harvested from the arm were followed prospectively to determine the long-term graft patency and stenosis rates. Vein harvested from the arm ('arm vein') was used for secondary or tertiary reconstruction in 22 patients (52.4%). The outflow was to a single calf vessel in 37 grafts (88.1%). The cumulative primary, primary assisted and secondary graft patency rates were 35.6%, 49.6% and 59.5% at 2 years, respectively, and the limb salvage rate was 69.0% at 2 years. Eight grafts developed stenoses detected by a graft surveillance programme. Six stenoses were dilated successfully with percutaneous transluminal angioplasty (PTA) and one was treated with an interposition vein graft. Bypass using arm vein is time-consuming and technically demanding as multiple anastomoses are often required. Arm vein grafts, however, have no greater incidence of stenosis than long saphenous vein grafts and these stenoses may be dilated with PTA with good results. The long-term outcome suggests that an arm vein graft is an important treatment option in the absence of the long saphenous vein.

Tisi, P. V.; Crow, A. J.; Shearman, C. P.



Posttransplant bilioportal fistula with portal vein thrombosis: a case report.  


An 8-year-old female patient, known to have post-Kasai biliary atresia with mild intrapulmonary shunting, underwent living donor liver transplantation because of recurrent cholangitis. After the treatment of postoperative biliary stricture with percutaneous transhepatic biliary drainage, the patient subsequently developed hematochezia with portal vein thrombosis. The intraoperative findings showed portal vein thrombosis with a bilioportal fistula. We performed closure of the bilioportal fistula and reconstruction of the portal vein with a native internal jugular vein interposition graft. A bilioportal fistula due to percutaneous hepatobiliary procedures is a reportedly a rare complication following liver transplantation. The patient is currently doing well after a successful surgical intervention. PMID:21094871

Kasahara, M; Sakamoto, S; Fukuda, A; Shigeta, T; Tanaka, H; Mastuno, N; Hashimoto, M; Kondo, Y; Nosaka, S; Nakazawa, A



Hepatocavopathy and isolated splenic vein thrombosis due to hypercoagulability state.  


We report a patient with protein C and protein S deficiency and factor V Leiden mutation presenting with splenic vein thrombosis and with a web between the hepatic venous confluence and vena cava inferior. These two findings were thought to be due to the hypercoagulable state of the patient. Interestingly, there was no need for invasive procedures as the inferior accessory hepatic vein was patent. Hepatic venous flow was being maintained by the inferior accessory hepatic vein or a dominant collateral vein. PMID:16245227

Akarsu, Mesut; Seçil, Mustafa; Yener, Serkan; Topalak, Omer



Architecture of the pulmonary veins: relevance to radiofrequency ablation  

PubMed Central

BACKGROUND—Radiofrequency ablation of tissues in pulmonary veins can eliminate paroxysmal atrial fibrillation.?OBJECTIVE—To explore the characteristics of normal pulmonary veins so as to provide more information relevant to radiofrequency ablation.?METHODS—20 structurally normal heart specimens were examined grossly. Histological sections were made from 65 pulmonary veins.?RESULTS—The 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 17 veins that were from individuals aged 30 to 72 years.?CONCLUSIONS—The 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

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



Two cases of jugular vein thrombosis in severely burned patients  

PubMed Central

Here we present two cases of jugular vein thrombosis in burn patients, with diagnosis, risk factor analysis, and treatment approaches. Severely burned patients have high risk of deep vein thrombosis occurrence due to multiple surgeries. The deep vein catheter should be carefully performed. Once deep vein thrombosis is detected, a wide ultrasonography helps to find other thrombosis sites. During the acute phase, low molecular weight heparin can be used. Upon long-term anti-thrombosis treatment, combined use of herbal medicine during rehabilitation is helpful.

Cen, Hanghui; He, Xiaojie



Tunneled-cuffed catheter implanted into the accessory hemiazygos vein because of occlusion of the left innominate vein.  


Hemodialyzed patients are at risk of multiple catheterizations. Nephrologists performing such procedures need to be familiar with congenital and acquired vascular abnormalities. We describe a successful insertion and use of a cuffed-tunneled catheter in a patient with unusual anatomy of the central venous system. Computed tomography angiography revealed thrombosis of the right subclavian vein and bilateral occlusion of innominate veins. The left internal jugular and subclavian veins joined to form a large vessel that drained through the accessory hemiazygos and azygos veins into the superior vena cava. The catheter was implanted through the left internal jugular vein into the accessory hemiazygos vein. The presented case demonstrates that the catheter can be implanted into distended collateral, especially when no other location is possible. PMID:22099255

Letachowicz, Krzysztof; Ko?odziej, Marian; Mi?dzybrodzki, Krzysztof; Letachowicz, Waldemar; Weyde, Wac?aw; S?siadek, Marek; Klinger, Marian



Pulmonary embolism and deep vein thrombosis.  


Pulmonary embolism is the third most common cause of death from cardiovascular disease after heart attack and stroke. Sequelae occurring after venous thromboembolism include chronic thromboembolic pulmonary hypertension and post-thrombotic syndrome. Venous thromboembolism and atherothrombosis share common risk factors and the common pathophysiological characteristics of inflammation, hypercoagulability, and endothelial injury. Clinical probability assessment helps to identify patients with low clinical probability for whom the diagnosis of venous thromboembolism can be excluded solely with a negative result from a plasma D-dimer test. The diagnosis is usually confirmed with compression ultrasound showing deep vein thrombosis or with chest CT showing pulmonary embolism. Most patients with venous thromboembolism will respond to anticoagulation, which is the foundation of treatment. Patients with pulmonary embolism should undergo risk stratification to establish whether they will benefit from the addition of advanced treatment, such as thrombolysis or embolectomy. Several novel oral anticoagulant drugs are in development. These drugs, which could replace vitamin K antagonists and heparins in many patients, are prescribed in fixed doses and do not need any coagulation monitoring in the laboratory. Although rigorous clinical trials have reported the effectiveness and safety of pharmacological prevention with low, fixed doses of anticoagulant drugs, prophylaxis remains underused in patients admitted to hospital at moderate risk and high risk for venous thromboembolism. In this Seminar, we discuss pulmonary embolism and deep vein thrombosis of the legs. PMID:22494827

Goldhaber, Samuel Z; Bounameaux, Henri



Superior Mesenteric and Portal Vein Thrombosis following Laparoscopic Nissen Fundoplication  

Microsoft Academic Search

This case report describes superior mesenteric and portal vein thrombosis after laparoscopic Nissen fundoplication. As a thromboembolic prophylaxis, 2,500 IU of dalteparin was given preoperatively. After postoperative day 19, the patient experienced gradually increasing abdominal pain, mostly related to meals. Physical examination and laboratory tests were normal. CT scan revealed a portal and superior mesenteric vein thrombosis. Dalteparin and warfarin

Esko Kemppainen; Arto Kokkola; Jukka Sirén; Tuula Kiviluoto



Vein recognition method base on angle matrix of feature point  

Microsoft Academic Search

In the course of capturing vein images from image capturing devices, displacement deviation, angle deviation and scale changes are inherent. In order to overcome these problems arosed by above factors, an approach to vein image recognition using the angle matrixes of feature points is presented in this paper. In the phase of feature extraction, all feature points and multisection points

Kang Wenxiong; Deng Feiqi



Pregnancy and Delivery in Patients with Portal Vein Cavernoma  

Microsoft Academic Search

Background: Portal vein cavernoma (PVC) is a rare disease resulting from extrahepatic portal vein thrombosis and development of collateral venous circulation. The management of pregnancy and delivery in woman with PVC has rarely been described. Cases: Two primiparous women are presented to illustrate the management of PVC during pregnancy and discuss the delivery route according to the symptoms and the

Guillaume Ducarme; Aurelie Plessier; Claire Thuillier; Pierre François Ceccaldi; Dominique Valla; Dominique Luton



Increased distensibility in dependent veins following prolonged bedrest.  


Displacement of blood to the lower portion of the body that follows a postural transition from recumbent to erect is augmented by a prolonged period of recumbency (bedrest). Information is scarce as to what extent this augmented blood-volume shift to dependent veins is attributable to increased distensibility of the veins. Accordingly, we studied the effect of 5 weeks of horizontal bedrest on the pressure-distension relationship in limb veins. Elevation of venous distending pressure was induced by exposure of the body except the tested limb to supra-atmospheric pressure with the subject seated in a pressure chamber with one arm, or supine with a lower leg, protruding through a hole in the chamber door. Diameter changes in response to an increase of intravenous pressure (distensibility) from 60 to about 140 mmHg were measured in the brachial and posterior tibial veins using ultrasonographic techniques. Prior to bedrest, the distensibility was substantially less in the tibial than in the brachial vein. Bedrest increased (P < 0.01) pressure distension in the tibial vein by 86% from 7 +/- 3% before to 13 +/- 3% after bedrest. In the brachial vein, bedrest increased (P < 0.05) pressure distension by 36% from 14 +/- 5% before to 19 +/- 5% after bedrest. Thus, removal of the gravity-dependent pressure components that act along the blood vessels in erect posture increases the distensibility of dependent veins. PMID:19347352

Kölegård, Roger; Mekjavic, Igor B; Eiken, Ola



Exercise-Induced Deep Vein Thrombosis of the Upper Extremity  

Microsoft Academic Search

Paget-Schroetter syndrome or effort-related upper extremity deep vein thrombosis is a rare condition that usually afflicts young healthy individuals, most commonly males. The cause is multifactorial but almost always involves extrinsic compression of the subclavian vein at the thoracic inlet, causing venous stenosis from repetitive trauma. The diagnosis of this condition may be difficult, and its delay may contribute to

Leonardo R. Brandão; Suzan Williams; Walter H. A. Kahr; Clodagh Ryan; Michael Temple; Anthony K.C. Chan



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...


Identification of left pulmonary vein ostia using centerline tracking  

NASA Astrophysics Data System (ADS)

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.

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



Microstructural evolution of syntaxial veins formed by advective flow  

NASA Astrophysics Data System (ADS)

Veins are common in Earth's crust, and are formed by a wide range of processes, which lead to crystal growth in dilation sites. The first-order processes in vein formation have been identified, but it is much less clear how these can be diagnosed from field studies. In order to better understand the microstructural evolution during vein growth, we grew veins of analogue material [alum, KAl(SO4)2·12H2O] in a transmitted-light cell from an advecting supersaturated fluid. Real-time observation shows the effects of flow rate and supersaturation on the evolving microstructure: (1) along-vein trends in growth rate caused by decreasing supersaturation, and (2) growth competition between clear crystals in the absence of nucleation and primary fluid inclusions. Although the overall trends in growth rate are in agreement with previous work, the local effects at the scale of individual grains reported here are less well understood; these new data form a basis for better interpretation of natural microstructures. To explore the possible effects of experimentally observed processes during vein growth, we simulate the growth kinetics of a quartz vein at various conditions of advective flow in Earth's crust. Results show that in general the along-vein changes in growth rate occur at length scales much larger than a typical outcrop.

Hilgers, Christoph; Dilg-Gruschinski, Karin; Urai, Janos L.



P Wave Polarity During Pacing in Pulmonary Veins  

Microsoft Academic Search

Introduction: Recent studies have demonstrated that premature depolarizations that trigger atrial fibrillation often arise in pulmonary veins. The purpose of this study was to evaluate whether P wave polarity is helpful in distinguishing which of the 4 pulmonary veins is the site of orgin of a premature depolarization.

Hung-Fat Tse; Chu-Pak Lau; Kathy L. Lee; Frank Pelosi; Hakan Oral; Bradley P. Knight; S. Adam Strickberger; Fred Morady



The Incidence of Portal Vein Thrombosis at Liver Transplantation  

PubMed Central

The incidence of portal vein thrombosis was examined in 885 patients who received orthotopic liver transplantations for various end-stage liver diseases between 1989 and 1990. The thrombosis was classified into four grades. Grade 1 was thrombosis of intrahepatic portal vein branches, grade 2 was thrombosis of the right or left portal branch or at the bifurcation, grade 3 was partial obstruction of the portal vein trunk, and grade 4 was complete obstruction of the portal vein trunk. Among the 849 patients without previous portosystemic shunt, 14 patients (1.6%) had grade 1, 27 patients (3.2%) had grade 2, 27 patients (3.2%) had grade 3 and 49 patients (5.8%) had grade 4 portal vein thrombosis. The incidence of portal vein thrombosis was highest (34.8%) in the patients with hepatic malignancy in the cirrhotic liver, followed by those with Budd-Chiari syndrome (22.2%) and postnecrotic cirrhosis of various causes (15.7%). The patients with encephalopathy, ascites, variceal bleeding, previous splenectomy and small liver had significantly higher incidences of portal vein thrombosis than the others. The total incidence of portal vein thrombosis among the 36 patients with previous portosystemic shunt was 38.9%, which was significantly higher than that (13.8%) of those without shunt.

Nonami, Toshiaki; Yokoyama, Itsuo; Iwatsuki, Shunzaburo; Starzl, Thomas E.



Design and implementation of a contactless palm vein recognition system  

Microsoft Academic Search

This paper presents an innovative contactless palm vein recognition system. We design a hand sensor that could capture the palm vein image using low-resolution web camera. The design of the sensor is simple and low-cost, and we do not need to install specialized infrared sensor. We allow subjects to position their hands freely above the sensor and they can move

Goh Kah Ong Michael; Tee Connie; Lau Siong Hoe; Andrew Teoh Beng Jin



Veins Theory: A Model of Global Discourse Cohesion and Coherence  

Microsoft Academic Search

In this paper, we propose a generalization of Centering Theory (CT) (Grosz, Joshi, Weinstein (1995)) called Veins Theory (VT), which extends the applicability of centering rules from local to global discourse. A key facet of the theory involves the identification of «veins» over discourse structure trees such as those defined in RST, which delimit domains of referential accessibility for each

Dan Cristea; Nancy Ide; Laurent Romary



Reduction of intimal and medial thickening in sheathed vein grafts  

Microsoft Academic Search

Background. Arterial pressures are described as an important factor in the development of graft degeneration and in reduced patency rate in vein bypass grafts. Sheathing of the graft with a pressure resistant mesh tubing might slow down this development.Methods. Saphenous vein grafts were implanted into the carotid arteries of five pigs in order to evaluate the influence on myointimal hyperplasia

Heinz Robert Zurbrügg; Markus Wied; Gianni D. Angelini; Roland Hetzer



Design of a clinical vein contrast enhancing projector  

NASA Astrophysics Data System (ADS)

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.

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



Systemic factors contributory to retinal vein occlusion.  


This study was undertaken in 79 patients with retinal vein occlusion to assess the different systemic mechanisms contributing to the occlusion, namely, intrinsic vessel disease and abnormalities of the blood constituents and blood viscosity. In 55 patients older than 50 years of age, important associations were hypertension, abnormal results on glucose tolerance test, hyperlipidemia, chronic lung disease, and elevated serum IgA levels. In the 24 patients younger than 50 years of age, male incidence was high and important associations were head injuries, hyperlipidemia, and the use of estrogen-containing preparations. Hyperviscosity and cryofibrinogenemia were prominent in both groups. The pathogenesis of retinal venous occlusion is complex involving interaction between the vessel wall and blood constituents. PMID:626551

McGrath, M A; Wechsler, F; Hunyor, A B; Penny, R



NET impact on deep vein thrombosis  

PubMed Central

Deep vein thrombosis (DVT) is a major health problem that requires improved prophylaxis and treatment. Inflammatory conditions such as infection, cancer and autoimmune diseases are risk factors for DVT. We and others have recently shown that extracellular DNA fibers produced in inflammation and known as neutrophil extracellular traps (NETs) contribute to experimental DVT. NETs stimulate thrombus formation and coagulation and are abundant in thrombi in animal models of DVT. It appears that, in addition to fibrin and VWF, NETs represent a third thrombus scaffold. Here we review how NETs stimulate thrombosis and discuss known and potential interactions of NETs with endothelium, platelets, red blood cells, coagulation factors and how NETs could influence thrombolysis. We propose that drugs which inhibit NET formation or facilitate NET degradation may prevent or treat DVT.

Fuchs, Tobias A.; Brill, Alexander; Wagner, Denisa D.



Vein quality in infrainguinal revascularisation: assessment by angioscopy and histology.  

PubMed Central

The concept of vein quality has been slow to gain widespread acceptance, but an increasing body of evidence suggests that vein quality is relevant to the success of bypass grafting for peripheral vascular disease. The angioscope represents an additional tool for monitoring and preparing vein grafts during infrainguinal revascularisation. Within the overall theme of vein quality, this paper presents the cumulative experience with vascular endoscopy at Bristol Royal Infirmary. In clinical studies, the diagnostic role of angioscopy in quality control was evaluated by grafting preexisting, angioscopically detected, intraluminal abnormalities and correlating them with histological appearances. There were significant associations between angioscopy/histology grades and graft patency. To enable quantification of images, an innovative computerised video image processing method has been developed and validated against simultaneous ultrasound measurements of segments of saphenous vein. The therapeutic applications of angioscopy in vein graft preparation were studied prospectively in patients undergoing in situ femoropopliteal/distal bypasses by randomisation to full angioscopic or conventional preparation. There was a significant reduction in wound morbidity. Completion angioscopy and arteriography were complementary in the detection of technical defects. Harvested vein was maintained in organ culture to assess further the influence of pre-existing pathology and the potentially traumatic effects of angioscopy on development of neointimal hyperplasia. There was a significant correlation between the extent of pre-existing abnormality and smooth muscle cell proliferative activity in culture and although angioscopy caused endothelial cell loss, this did not stimulate neointimal hyperplasia in vitro. This work confirms that vein quality can be evaluated prospectively by angioscopy and that substandard vein is associated with inferior patency rates. Angioscopic and histological evaluation, together with vein organ culture studies, have definite application in helping to elucidate the mechanisms underlying graft failure. Images Figure 1 Figure 2 Figure 3 Figure 5 Figure 6 Figure 8

Wilson, Y. G.



Puerperal ovarian vein thrombosis: two case reports.  


Ovarian vein thrombosis (OVT) is an uncommon but potentially serious complication in the early postpartum. Two case studies seem to prove the point: Case 1 A 24-year-old woman was transferred to our hospital with the chief complaint of abdominal pain radiating to the right thigh, vomit, diarrhea, and a slight pyrexia (37.6 °C rectal). Five days earlier, she had a spontaneous vaginal delivery after labor induction. The woman appeared slightly distressed because of pain; vital signs were found to be normal and the CRP elevated (129.9 mg/L). Abdominal examination was remarkable for tenderness by palpation in the right lower quadrant with no rebound tenderness or guarding. Pelvic examination was remarkable for mild right adnexal tenderness. Abdominal-pelvic computer tomography with contrast medium revealed a 2.5-cm OVT having extended into the inferior vena cava for 14 cm with a slight peripheral edema. The patient was treated with nadroparin 0.6 cc (5700 IU) bid and warfarin 5 mg since the attainment of the therapeutic INR range. Case 2 A 31-year-old twin-pregnant woman had an emergency cesarean section at 35 gestational weeks because of hypertension complicated by increased liver enzymes, diuresis contraction, and continuous lower back pain bilaterally radiating to the groins. One day after delivery, CT scan that was performed because of onward anemia showed a pelvic, perihepatic, and perisplenic blood effusion, and a 1-cm right OVT extended to the inferior vena cava below renal veins for 28 mm. She underwent exploratory laparotomy and blood transfusion, and because of respiratory insufficiency she was transferred to a second level center with ICU facility, where she was placed under a suprarenal inferior vena cava filter, and AngioJet Rheolytic Thrombectomy for acute pulmonary embolism was performed. PMID:22890415

Angelini, Marta; Barillari, Giovanni; Londero, Ambrogio P; Bertozzi, Serena; Bernardi, Sergio; Petri, Roberto; Driul, Lorenza; Marchesoni, Diego



Balloon-Occluded Retrograde Transvenous Obliteration of Gastric Varix Draining via the Left Inferior Phrenic Vein into the Left Hepatic Vein  

SciTech Connect

We encountered a patient with gastric varix draining not via the usual left suprarenal vein but via the left inferior phrenic vein joining the left hepatic vein. Transfemoral balloon-occluded retrograde transvenous obliteration (BRTO) of the varix was performed under balloon occlusion of the left inferior phrenic vein via the left hepatic vein and retrograde injection of the sclerosing agent (5% of ethanolamine oleate) into the gastric varix. Disappearance of the gastric varix was confirmed on endoscopic examination 2 months later.

Ibukuro, Kenji; Mori, Koichi; Tsukiyama, Toshitaka; Inoue, Yoshihiro [Department of Radiology, Mitsui Memorial Hospital, 1-Kanda Izumicho, Chiyoda-ku, Tokyo 101-8643 (Japan); Iwamoto, Yukako; Tagawa, Kazumi [Department of Gastroenterology, Mitsui Memorial Hospital, 1-Kanda Izumicho, Chiyoda-ku, Tokyo 101-8643 (Japan)



Treatment of hepatic encephalopathy by retrograde transcaval coil embolization of an ileal vein-to-right gonadal vein portosystemic shunt  

SciTech Connect

A 43-year-old non-cirrhotic woman suffered from encephalopathy caused by an extrahepatic portosystemic shunt between the ileal vein and inferior vena cava via the right gonadal vein. Percutaneous transcatheter embolization with stainless steel coils was performed by the retrograde systemic venous approach. Encephalopathy improved dramatically.

Nishie, Akihiro; Yoshimitsu, Kengo; Honda, Hiroshi; Kaneko, Kuniyuki; Kuroiwa, Toshiro; Fukuya, Tatsuro; Irie, Hiroyuki [Kyushu University, Department of Radiology, Faculty of Medicine (Japan); Ninomiya, Toshiharu; Yoshimitsu, Takahiro; Hirakata, Hideki; Okuda, Seiya [Kyushu University, Department of Internal Medicine II, Faculty of Medicine (Japan); Masuda, Kouji [Kyushu University, Department of Radiology, Faculty of Medicine (Japan)



Treatment of hepatic encephalopathy by retrograde transcaval coil embolization of an ileal vein-to-right gonadal vein portosystemic shunt  

Microsoft Academic Search

A 43-year-old non-cirrhotic woman suffered from encephalopathy caused by an extrahepatic portosystemic shunt between the ileal\\u000a vein and inferior vena cava via the right gonadal vein. Percutaneous transcatheter embolization with stainless steel coils\\u000a was performed by the retrograde systemic venous approach. Encephalopathy improved dramatically.

Akihiro Nishie; Kengo Yoshimitsu; Hiroshi Honda; Kuniyuki Kaneko; Toshiro Kuroiwa; Tatsuro Fukuya; Hiroyuki Irie; Toshiharu Ninomiya; Takahiro Yoshimitsu; Hideki Hirakata; Seiya Okuda; Kouji Masuda



Visual disturbance following sclerotherapy for varicose veins, reticular veins and telangiectasias: a systematic literature review.  


The objective of the study was to review the literature reporting visual disturbance (VD) following sclerotherapy for varicose veins. Underlying mechanisms will be discussed. A literature search of the databases Medline and Google Scholar was performed. Original articles including randomized trials, case series and case reports reporting VD in humans following sclerotherapy for varicose veins were included. Additional references were also obtained if they had been referenced in related publications. The search yielded 4948 results of which 25 reports were found to meet the inclusion criteria. In larger series with at least 500 included patients the prevalence of VD following sclerotherapy ranges from 0.09% to 2%. In most reports foam sclerotherapy was associated with VD (19); exclusive use of liquid sclerosant was reported in two cases, some reports included foam and liquid sclerosant (4). There were no persistent visual disorders reported. VD occurred with polidocanol and sodium tetradecyl sulphate in different concentrations (0.25-3%). Various forms of foam preparation including various ways of foam production and the liquid - air ratio (1 or 2 parts of liquid mixed with 3, 4 or 5 parts of air) were reported in association with the occurrence of VD. VDs following sclerotherapy for varicose veins are rare and all reported events were transient. Bubble embolism or any kind of embolism seems unlikely to be the only underlying mechanism. A systemic inflammatory response following sclerotherapy has been suggested. Further research to clarify the mechanism of action of sclerosants is required. PMID:23202140

Willenberg, T; Smith, P C; Shepherd, A; Davies, A H



Visual disturbance following sclerotherapy for varicose veins, reticular veins and telangiectasias: a systematic literature review.  


The objective of the study was to review the literature reporting visual disturbance (VD)following sclerotherapy for varicose veins. Underlying mechanisms will be discussed. A literature search of the databases Medline and Google Scholar was performed. Original articles including randomized trials, case series and case reports reporting VD in humans following sclerotherapy for varicose veins were included. Additional references were also obtained if they had been referenced in related publications. The search yielded 4948 results of which 25 reports were found to meet the inclusion criteria. In larger series with at least 500 included patients the prevalence of VD following sclerotherapy ranges from 0.09% to 2%. In most reports foam sclerotherapy was associated with VD (19); exclusive use of liquid sclerosant was reported in two cases, some reports included foam and liquid sclerosant (4). There were no persistent visual disorders reported. VD occurred with polidocanol and sodium tetradecyl sulphate in different concentrations (0.25–3%). Various forms of foam preparation including various ways of foam production and the liquid –air ratio (1 or 2 parts of liquid mixed with 3, 4 or 5 parts of air) were reported in association with the occurrence of VD. VDs following sclerotherapy for varicose veins are rare and all reported events were transient. Bubble embolism or any kind of embolism seems unlikely to be the only underlying mechanism. A systemic inflammatory response following sclerotherapy has been suggested. Further research to clarify the mechanism of action of sclerosants is required. PMID:23761921

Willenberg, T; Smith, P C; Shepherd, A; Davies, A H



Superior mesenteric and portal vein thrombosis following laparoscopic nissen fundoplication.  


This case report describes superior mesenteric and portal vein thrombosis after laparoscopic Nissen fundoplication. As a thromboembolic prophylaxis, 2,500 IU of dalteparin was given preoperatively. After postoperative day 19, the patient experienced gradually increasing abdominal pain, mostly related to meals. Physical examination and laboratory tests were normal. CT scan revealed a portal and superior mesenteric vein thrombosis. Dalteparin and warfarin treatment was started, and symptoms relieved rapidly. In a control Doppler ultrasound 1 month after the onset of the treatment, a good flow in the portal and superior mesenteric vein was seen. Possible mechanisms are discussed. PMID:10867463

Kemppainen, E; Kokkola, A; Sirén, J; Kiviluoto, T



Total Anomalous Pulmonary Venous Connection to the Portal Vein  

SciTech Connect

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.

Wyttenbach, Marina [Department of Diagnostic Radiology, Division of Children's Radiology, University Hospital, Inselspital, CH-3010 Bern (Switzerland); Carrel, Thierry; Schuepbach, Peter [Department of Thoracic and Cardiovascular Surgery, University Hospital, Inselspital, CH-3010 Bern (Switzerland); Tschaeppeler, Heinz; Triller, Juergen [Department of Diagnostic Radiology, Division of Children's Radiology, University Hospital, Inselspital, CH-3010 Bern (Switzerland)



Polysplenia syndrome with preduodenal portal vein detected in adults.  


Polysplenia syndrome, defined as the presence of multiple spleens of almost equal volume, is a rare condition involving congenital anomalies in multiple organ systems. We report this anomaly in a 41-year-old female who underwent a left lateral sectionectomy due to recurrent cholangitis and impacted left lateral duct stones. Polysplenia syndrome with preduodenal vein was diagnosed preoperatively by computed tomography (CT) and surgery was done safely. Although the polysplenia syndrome with preduodenal portal vein (PDPV) in adult is rarely encountered, surgeons need to understand the course of the portal vein and exercise caution in approaching the biliary tract. PMID:19009663

Seo, Hyung-Il; Jeon, Tae Yong; Sim, Mun Sup; Kim, Suk



Polysplenia syndrome with preduodenal portal vein detected in adults  

PubMed Central

Polysplenia syndrome, defined as the presence of multiple spleens of almost equal volume, is a rare condition involving congenital anomalies in multiple organ systems. We report this anomaly in a 41-year-old female who underwent a left lateral sectionectomy due to recurrent cholangitis and impacted left lateral duct stones. Polysplenia syndrome with preduodenal vein was diagnosed preoperatively by computed tomography (CT) and surgery was done safely. Although the polysplenia syndrome with preduodenal portal vein (PDPV) in adult is rarely encountered, surgeons need to understand the course of the portal vein and exercise caution in approaching the biliary tract.

Seo, Hyung-Il; Jeon, Tae Yong; Sim, Mun Sup; Kim, Suk




PubMed Central

OBJECTIVE Venous thrombus resolution sets up an early intense inflammatory reaction, from which vein wall damage results. Tissue response to injury includes matrix metalloproteinase (MMP) activation and extracellular matrix protein turnover. This study sought to determine the effect of exogenous MMP inhibition and its potential attenuation of early vein wall injury. METHODS Rats received treatment beginning 24 hours after a stasis venous thrombosis by near occlusive ligation, and until harvest at day 7. Three groups were evaluated: 1). Vehicle saline controls (NaCl); 2). LMWH (Lovenox, 3 mg/Kg per day SQ); 3). Doxycycline (DOXY; 30 mg/Kg per day PO). Thrombus size (mg/mm), levels of TNF? and d-Dimer by colorimetric assay, and ED-1 counts by immunohistochemistry were assessed. Vein wall assessment included stiffness by tensiometry, IL? protein levels by ELISA, MMP2 and -9 by zymography, and histological analysis of intimal thickness (IT). Comparisons were by t-Test to control. A P < .05 was considered significant. RESULTS Thrombi sizes were similar at both days 2 and 7 for all three groups, while thrombus TNF? was increased in 2d LMWH and DOXY treated groups (NaCl = 1.0±.8, LWMH = 9 ±3*, DOXY = 27±5*, pg/mg protein, N = 6 - 8, P < .05); and at 7d in the DOXY group (NaCl = 3.0±2.5, DOXY = 23±4.2*, pg/mg protein, N = 5, P < .05). Vein wall stiffness was less with LMWH treatment at 7d, but not with DOXY, as compared with controls (NaCl = .33±.05, LMWH =.17±.03*, DOXY = .43±.09 N/mm, N = 5-7, P < .05). Vessel-wall IL-1? was reduced only in the DOXY group at 7d (NaCl = 26±3, LMWH = 38±17, DOXY = 6±3* pg/mg protein, N = 4 - 6, P < .05) as was the IT score versus controls (NaCl = 2.2±.6, LMWH =1.7±.3, DOXY = 0.8 ± .20*, IT score, N = 4 -6, P < .05). Zymographic MMP9 activity was significantly reduced at 2 days in the LMWH and DOXY groups (NaCl = 85±24, LMWH = 23±7*, DOXY = 13±5* U/mg protein, N = 6 - 8, P < .05). MMP2 zymographic activity, thrombi monocyte cell counts, and d-Dimer activity were not significantly different across groups. CONCLUSIONS Treatment with LMWH or DOXY did not alter size of DVT, mildly altered thrombus composition, and differentially affected vein wall injury, despite similar reductions in early MMP9 activity. Whether exogenous MMP inhibition affects long-term vein wall fibrosis will require further study.

Sood, Vikram; Luke, Cathy; Miller, Erin; Mitsuya, Mayo; Upchurch, Gilbert R.; Wakefield, Thomas W.; Myers, Dan D.; Henke, Peter K.



Nitroprusside modulates pulmonary vein arrhythmogenic activity  

PubMed Central

Background Pulmonary veins (PVs) are the most important sources of ectopic beats with the initiation of paroxysmal atrial fibrillation, or the foci of ectopic atrial tachycardia and focal atrial fibrillation. Elimination of nitric oxide (NO) enhances cardiac triggered activity, and NO can decrease PV arrhythmogensis through mechano-electrical feedback. However, it is not clear whether NO may have direct electrophysiological effects on PV cardiomyocytes. This study is aimed to study the effects of nitroprusside (NO donor), on the ionic currents and arrhythmogenic activity of single cardiomyocytes from the PVs. Methods Single PV cardiomyocytes were isolated from the canine PVs. The action potential and ionic currents were investigated in isolated single canine PV cardiomyocytes before and after sodium nitroprusside (80 ?M,) using the whole-cell patch clamp technique. Results Nitroprusside decreased PV cardiomyocytes spontaneous beating rates from 1.7 ± 0.3 Hz to 0.5 ± 0.4 Hz in 9 cells (P < 0.05); suppressed delayed afterdepolarization in 4 (80%) of 5 PV cardiomyocytes. Nitroprusside inhibited L-type calcium currents, transient outward currents and transient inward current, but increased delayed rectified potassium currents. Conclusion Nitroprusside regulates the electrical activity of PV cardiomyocytes, which suggests that NO may play a role in PV arrhythmogenesis.



Diagnosis of recurrent deep vein thrombosis.  


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

Schellong, S M



Two Scimitar Veins in an Adult  

PubMed Central

Scimitar syndrome is a rare but serious congenital condition that consists of anomalous pulmonary venous drainage of the right lung to the inferior vena cava. The appearance on chest radiography resembles a curved Turkish sword, or scimitar. Scimitar syndrome is associated with other anomalies, including hypoplasia of the right lung, dextroposition of the heart, anomalous systemic arterial supply to the right lung, and atrial septal defect. Clinical manifestations in infants include severe tachypnea and cyanosis. Adult patients may present with dyspnea and increased fatigue. Few adult cases have been reported in the medical literature. Classical surgical repair involves diversion of the scimitar venous flow into the left atrium with a baffle, requiring the use of cardiopulmonary bypass and deep hypothermic circulatory arrest. Herein, we report the case of a 42-year-old woman with 2 scimitar veins who underwent corrective surgery at our center without the use of cardiopulmonary bypass. We also comment on the importance of a patient's lung hypoplasia in the decision to repair the defect through a right thoracotomy.

Schwill, Simon; Prete, Jennifer Del; Cooley, Denton A.; Morales, David L.S.



[Juguler vein gunshot injury from blank cartridges].  


Blank cartridge guns, which are produced for self-defence needs and considered harmless, can be easily purchased by adults due to lack of legal regulations. We present this case because injuries caused by gunshot from blank cartridges may be fatal and are rarely encountered in emergency departments. A 3-year-old boy was brought to the emergency department since he had a wound on his neck caused accidentally by gunshot from blank cartridges. He had a moderate general condition and pale appearance. There was an irregular-edged, defective wound 2 cm above the sternal notch in midline localization with a dimension of 3 x 4 cm. Computed tomography of the thorax revealed contusion in the apex of the left lung. A 2-mm plastic piece embedded in the left internal jugular vein was removed during the operation. A mass education on danger and harm of these guns as well as legal regulations for restricted use seem to be necessary. Also, physicians should keep in mind that blank cartridge guns can cause fatal injuries. PMID:16100674

Ikizceli, Ibrahim; Av?aro?ullari, Levent; Sözüer, Erdo?an Mütevelli; Ozdemir, Ca?lar; Tu?cu, Harun; Sever, Hasan; Duymaz, Hikmet



Deep Vein Thrombosis Prophylaxis in Trauma Patients  

PubMed Central

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.

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



Mars Opportunity rover finds gypsum veins  

NASA Astrophysics Data System (ADS)

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.”

Showstack, Randy



Splanchnic vein thrombosis in myeloproliferative neoplasms.  


Splanchnic vein thrombosis (SVT) is one of the most important complications of myeloproliferative neoplasms (MPN). Although MPN are common causes of SVT, the pathophysiological mechanisms underlying this predisposition, their epidemiology and natural history are not fully understood. Studies have concentrated on the generalized prothrombotic environment generated by MPN and their relationship with abnormal blood counts, thereby furthering our knowledge of arterial and venous thrombosis in this population. In contrast, there are few studies that have specifically addressed SVT in the context of MPN. Recent research has demonstrated in patients with MPN the existence of factors increasing the risk of SVT such as the presence of the JAK2 V617F mutation and its 46/1 haplotype. Features unique to the circulating blood cells, splanchnic vasculature and surrounding micro-environment in patients with MPN have been described. There are also abnormalities in local haemodynamics, haemostatic molecules, the spleen, and splanchnic endothelial and endothelial progenitor cells. This review considers these important advances and discusses the contribution of individual anomalies that lead to the development of SVT in both the pre-neoplastic and overt stage of MPN. Clinical issues relating to epidemiology, recurrence and survival in these patients have also been reviewed and their results discussed. PMID:23855810

Sekhar, Mallika; McVinnie, Kathryn; Burroughs, Andrew K



Deep vein thrombosis prophylaxis in trauma patients.  


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

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



Portal Vein Thrombosis Following Laparoscopic Sleeve Gastrectomy for Morbid Obesity  

PubMed Central

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.

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



Effect of dihydroquercetin on the tone of isolated rat veins.  


Dihydroquercetin effects on the tone of isolated segments of the portal vein of rats were studied. Dihydroquercetin did not modify the basal venous tone, but reduced the amplitude of contractions induced by KCl and norepinephrine hydrotartrate. PMID:23667873

Ivanov, I S; Sidekhmenova, A V; Nosarev, A V; Tyukavkina, N A; Plotnikov, M B



Angioplasty of acquired pulmonary vein stenosis using covered stent.  


One of the most serious complications post-catheter ablation of atrial fibrillation is the development of pulmonary vein stenosis. Controversy currently exists about the optimal treatment approach. The use of balloons and larger stents (?10 mm) results in more optimal outcome than just balloon angioplasty alone; however, even with stent implantation, recurrent restenosis may occur in 30 to 50% of patients. We report the case of a 28-year-old man who developed recurrent left inferior pulmonary vein stenosis following radiofrequency ablation for atrial fibrillation. This was initially stented with good result but soon after developed restenosis and required balloon angioplasty. Following the third episode of restenosis, stenting of the pulmonary vein was performed using a covered stent. The pulmonary vein has remained patent for the last 5 years. © 2013 Wiley Periodicals, Inc. PMID:23592594

Tehrani, Shana; Lipkin, David



Posttransplant Complex Inferior Venacava Balloon Dilatation After Hepatic Vein Stenting  

SciTech Connect

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.

Kohli, Vikas, E-mail: [Indraprastha Apollo Hospital, Pediatric Cardiology and Congenital Cardiac Surgery Unit (India); Wadhawan, Manav [Indraprastha Apollo Hospital, Department of Gastroenterology and Hepatology (India); Gupta, Subhash [Indraprastha Apollo Hospital, Department of Liver Transplant (India); Roy, Vipul [Indraprastha Apollo Hospital, Department of Cardiology (India)



[Left ovarian vein thrombosis after cesarean section: a case report].  


To investigate the clinical presentation, diagnosis and therapy of the postpartum ovarian vein thrombosis. Retrospective analysis was made of one case in our hospital of postpartum ovarian vein thrombosis. Literature was reviewed to investigate the clinical presentation,diagnosis and therapy of postpartum ovarian vein thrombosis. The patient presented with fever, abdominal pain, lower back pain, and ultrasound showed pyelectasis. Her blood and urine bacterial culture was negative, and the antibiotic treatment had no significant effect, which was diagnosed by CT finally. The patient's blood routine returned to normal 3 days after anti-inflammatory and anticoagulant therapy, and thrombosis was significantly reduced. She was followed-up and her condition was stable. Postpartum ovarian vein thrombosis patients often present with high temperature with unknown causes and one side abdominal pain, and CT diagnosis is needed. Timely and effective anti-inflammatory and anticoagulant therapy can significantly improve the prognosis. PMID:22692328

Guo, Xiao-yue; Wei, Yuan; Zhang, Li-hua; He, Hao-jie; Wang, Yan; Zhao, Yang-yu



[Branch retinal vein occlusion: high time for cardiovascular risk management].  


Cardiovascular risk management is common in patients suffering from manifest cardiovascular disease, hypertension, hyperlipidaemia and diabetes mellitus. It is generally accepted that medication is the most effective treatment for reducing cardiovascular morbidity and mortality in these patients. Remarkably, cardiovascular risk management is rare in patients suffering from branch retinal vein occlusion. This common retinal vascular disorder in middle aged and elderly people occurs where a thickened retinal artery compresses the affected vein. Although thrombosis is involved, procoagulant disorders are only present in selected cases. On the other hand, prior diabetes, hypertension, and peripheral artery disease are associated with an increased risk of developing branch retinal vein occlusion up to a decade later, and retinal vascular disorder is associated with an increased risk of subsequently developing hypertension, diabetes, congestive heart failure, and cerebrovascular disease later on. Therefore, branch retinal vein occlusion is a marker of developing cardiovascular disease and warrants adequate cardiovascular risk management. PMID:23693011

Bredie, Sebastian J H



Compliance in Anastomoses With and Without Vein Cuff Interposition  

Microsoft Academic Search

Objective to compare anastomotic compliance in end-to-side anastomoses with and without vein cuff interposition. Materials polytetrafluoroethylene graft to bovine carotid artery without (standard) and with vein interposition (Linton-patch and Miller-cuff). Methods zonewise compliance measurement of end-to-side anastomoses in anin-vitro circulation system. The zone most distal to the suture-line served as reference compliance. Resultsdirectly distal to the suture-line the compliance of

D. Piorko; P. Knez; K. Nelson; T. Schmitz-Rixen



Branch retinal vein occlusion associated with quetiapine fumarate  

PubMed Central

Background To report a case of branch retinal vein occlusion in a young adult with bipolar mood disorder treated with quetiapine fumarate. Case Presentation A 29 years old gentleman who was taking quetiapine fumarate for 3 years for bipolar mood disorder, presented with sudden vision loss. He was found to have a superior temporal branch retinal vein occlusion associated with hypercholesterolemia. Conclusion Atypical antipsychotic drugs have metabolic side effects which require regular monitoring and prompt treatment.



Retinal vein occlusions: a review for the internist  

Microsoft Academic Search

Retinal vein occlusion (RVO) is a disease that is often associated with a variety of systemic disorders including arterial\\u000a hypertension, diabetes mellitus, dyslipidemia and systemic vasculitis. There are various types of RVO, categorized on the\\u000a basis of the site of occlusion and on the type of consequent vascular damage. Central retinal vein occlusion (CRVO) is the\\u000a most clinically relevant type

Rossella Marcucci; Francesco Sofi; Elisa Grifoni; Andrea Sodi; Domenico Prisco


[Saphenous vein stripping in an outpatient service. 800 cases].  


During the period from January to June 1991, 800 patients with varicose veins of the legs underwent, without hospitalisation, stripping of the saphenous vein, multiple phlebectomies by micro-incisions using the Muller technique and elastic compression. Careful patient selection, thorough pre-operative evaluation and perfect surgical technique made it possible to perform the procedure on an out-patient basis and in addition to obtain a good functional result and a very good esthetic result. PMID:1528973

Sciannameo, F; Alberti, D; Ronca, P


Rupture of the superficial dorsal vein of the penis.  


Unusual causes of acute penis, such as the rupture of a superficial vein of the penis, can mimic fractured penis. The diagnosis in such cases is mostly after exploration. The author describes a case where a high index of clinical suspicion led to the diagnosis of the rupture of a superficial dorsal vein of the penis without exploration. The patient had a successful recovery with conservative management. PMID:16409616

Sharma, Gyanendra R



The cutoff value of saphenous vein diameter to predict reflux  

PubMed Central

Purpose Increased saphenous vein diameter is a common consequence of saphenous vein reflux. Until now, there have been no reports about the correlation between diameter and reflux of saphenous vein in Korea. The aim of this study was to investigate the correlation between saphenous vein reflux and diameter changes. Methods From April 2009 to August 2012, 777 patients were sent to the vascular laboratory for evaluation of venous reflux. The diameter of the saphenous vein was measured with B-mode imaging, and reflux was quantified based on valve closure time using Doppler spectral tracings. Receiver operating characteristics curve analysis was applied to determine the best saphenous vein diameter cutoff for predicting reflux. Results The mean diameters of normal great saphenous vein (GSV) and refluxed GSV were 5.0 ± 2.4 mm and 6.4 ± 2.0 mm, respectively. The mean diameters of normal small saphenous vein (SSV) and refluxed SSV were 3.1 ± 1.3 mm and 5.2 ± 2.7 mm, respectively. The diameter differences between the normal and refluxed GSV and SSV were 1.4 mm and 2.1 mm, respectively, and these differences were statistically significant (P < 0.0001). A GSV threshold diameter of 5.05 mm had the best positive predictive value for reflux. The sensitivity and specificity at 5.05 mm were 76% and 60%, respectively. The best SSV diameter for predicting reflux was 3.55 mm. The sensitivity and specificity at 3.55 mm were 87% and 71%, respectively. Conclusion GSV diameter of ?5.05 mm had the best positive predictive value for pathologic reflux. For pathologic reflux of SSV, the best cutoff diameter was 3.55 mm.

Park, Ho-Chul



The persistent embryonic vein in Klippel-Trenaunay syndrome.  


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

Oduber, Charlène Eu; Young-Afat, Danny A; van der Wal, Allard C; van Steensel, Maurice Am; Hennekam, Raoul Cm; van der Horst, Chantal Mam



Portal vein thrombosis and pulmonary artery thromboembolism after laparoscopic colectomy.  


Portal vein thrombosis is a rare and potentially lethal complication of laparoscopic colectomy. In this paper, we present a case of portal vein thrombosis and pulmonary artery thromboembolism on the 11(th) day after laparoscopic colectomy without an evident congenital thrombotic disorder. Laparoscopic surgeons and their patients should be aware of such events, because the patients are usually discharged before the symptoms begin. PMID:21091380

Shinozaki, Masaru; Hata, Keisuke; Matsukura, Mitsuru; Mizuno, Yasuhiro; Takei, Junko; Tsurita, Giichiro



Balloon-Occluded Retrograde Transvenous Obliteration of Gastric Varix Via the Pericardiacophrenic Vein  

SciTech Connect

We encountered a case of gastric varix without a gastrorenal shunt that drained through the left pericardiacophrenic vein, which entered the left brachiocephalic vein. For this case we successfully performed balloon-occluded retrograde transvenous obliteration, in which sclerotic agents were infused via the left pericardiacophrenic vein approached from the left subclavian vein.

Yoshimatsu, Rika, E-mail:; Yamagami, Takuji; Tanaka, Osamu; Miura, Hiroshi [Kyoto Prefectural University of Medicine, Department of Radiology, Graduate School of Medical Science (Japan); Okuda, Kotaro [Fukuchiyama City Hospital, Department of Internal Medicine (Japan); Nishimura, Tsunehiko [Kyoto Prefectural University of Medicine, Department of Radiology, Graduate School of Medical Science (Japan)



Fibrinolytic activator in the endothelium of the veins of the lower limb.  


The local fibrinolytic acitivity of the femoral, popliteal and soleal veins has been studied using a histochemical technique. The results suggest that the fibrinolytic activity in the soleal veins may be low when compared with that in the femoral and popliteal veins. This may be an aetiological factor responsible for the high incidence of thrombi occurring in the soleal veins. PMID:1000186

Nicolaides, A N; Clark, C T; Thomas, R D; Lewis, J D



Correlation of Perforating Vein Incompetence with Extent of Great Saphenous Insufficiency: Cross Sectional Study  

Microsoft Academic Search

To explore the correlation between perforating vein incompetence and the extent of great saphenous vein insufficiency according to Hach. Methods Duplex ultrasound was used to determine the number of incompetent perforators and diameter of per- forating veins, and the level of great saphenous vein reflux and the presence or absence of deep reflux in 118 lower limbs (59 patients). There

Anton Krniæ; Zvonimir Suèiæ


The comparative anatomy of the forelimb veins of primates.  

PubMed Central

One hundred and thirteen forelimbs taken from 62 individuals belonging to 17 primate genera were dissected to reveal the entire course of the superficial venous system. The course of the deep venous system was also documented in at least one forelimb of each primate genus, and the number and location of perforating veins was recorded in 18 human and 45 non-human primate limbs. In Pan, Gorilla and in about 25% of human specimens the lateral superficial vein was confined to the forearm, while in all other primates, and in the majority of humans, this vein extended from the carpus to the clavicular region. Only Pongo and humans exhibited a second main superficial vein on the medial side of the forearm. In all primates the deep veins of the forelimb usually accompanied the arteries. Thus variation in the deep venous system reflected the different arterial patterns exhibited by these primates. The number of perforating veins in the forelimb was related to the length of the limb. Primate genera with longer forelimbs had more perforators, though not as many as would be expected if the number of perforators scaled linearly with limb length.

Thiranagama, R; Chamberlain, A T; Wood, B A



Hemorrhoids and varicose veins: a review of treatment options.  


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

MacKay, D



Long-term cannulation of the ovarian vein in mares.  


A cannulation technique was developed to collect blood samples from the ovarian vein of mares over an extended period. Ovarian venous cannulae placed in 4 mares remained patent for a mean (+/- SEM) duration of 36.8 (+/- 6.2) days. During mid-diestrus, concentrations of progesterone in the ovarian vein ipsilateral to the corpus luteum (1,663.8 +/- 238.8 ng/ml) were significantly (P less than 0.001) higher than concentrations measured in paired samples from the jugular vein (6.1 +/- 0.3 ng/ml). Concentration of estradiol in the ovarian vein ranged from a mean of 1,053.2 +/- 303.1 pg/ml during diestrus to 3,353.8 +/- 1,052.8 pg/ml during estrus, whereas values for 74% of samples collected concurrently from the jugular vein were near or below the sensitivity of the assay (10 pg/ml). Results of the study indicate that patent long-term ovarian vein cannulation can be achieved in mares. The cannulation technique provides access to important fundamental information on equine reproductive endocrinology, which to our knowledge, has not been available. PMID:1416360

Linford, R L; McCue, P M; Montavon, S; Lasley, B L



Vein development during folding in the upper brittle crust: The case of tourmaline-rich veins of eastern Elba Island, northern Tyrrhenian Sea, Italy  

NASA Astrophysics Data System (ADS)

Detailed structural analysis of tourmaline-rich veins hosted in the contact aureole of the ˜6 Ma Porto Azzurro granite in southeastern Elba Island, northern Tyrrhenian Sea is presented. Using geometric features of the veins, the physical conditions at the time of vein formation are estimated, namely the stress ratio (? = (?2 - ?3)/(?1 - ?3)), driving stress ratio (R? = (Pf - ?3)/(?1 - ?3)) and fluid overpressure (?Po = Pf - ?3). Two vein sets (A veins and B veins) have been recognized based on orientation and thickness distributions and infilling material. Analysis of vein pole distributions indicates ? = 0.57 and R? = 0.24 for the A veins and ? = 0.58 and R? = 0.47 for the B veins, and fluid pressures less than the intermediate stress magnitude. Analysis of geometric features of the veins gives estimated fluid overpressures of between ˜16 MPa (A veins) and ˜32 MPa (B veins). We propose a model for the tectonic environment of vein development, in which formation of secondary permeability in the deforming thermal aureole of the Porto Azzurro pluton was controlled by ongoing development of fracture systems in the hinge zone of a regional NNW-SSE trending fold that favored transport and localization of hydrothermal fluids.

Mazzarini, Francesco; Musumeci, Giovanni; Cruden, Alexander R.



A Case of Persistent Sciatic Artery Aneurysm Accompanied by a Persistent Sciatic Vein  

PubMed Central

A persistent sciatic artery is a rare anomaly. On the other hand, a persistent sciatic vein is frequently associated with Klippel-Trenaunay syndrome. In a 71-year-old female with a complete-type persistent sciatic artery aneurysm, we performed aneurysmectomy and right femoropopliteal bypass surgery. The right popliteal vein drained into the femoral vein via a lower-type persistent sciatic vein and the deep femoral vein. The superficial femoral artery and vein were hypoplastic. Since only 4 cases of a coexisting persistent sciatic artery and vein have been reported, we report this extremely rare case.



Portal Vein Embolization Before Right Hepatectomy  

PubMed Central

Objective To assess the impact of liver hypertrophy of the future liver remnant volume (FLR) induced by preoperative portal vein embolization (PVE) on the immediate postoperative complications after a standardized major liver resection. Summary Background Data PVE is usually indicated when FLR is estimated to be too small for major liver resection. However, few data exist regarding the exact quantification of sufficient minimal functional hepatic volume required to avoid postoperative complications in both patients with or without chronic liver disease. Methods All consecutive patients in whom an elective right hepatectomy was feasible and who fulfilled the inclusion and exclusion criteria between 1998 and 2000 were assigned to have alternatively either immediate surgery or surgery after PVE. Among 55 patients (25 liver metastases, 2 cholangiocarcinoma, and 28 hepatocellular carcinoma), 28 underwent right hepatectomy after PVE and 27 underwent immediate surgery. Twenty-eight patients had chronic liver disease. FLR and estimated rate of functional future liver remnant (%FFLR) volumes were assessed by computed tomography. Results The mean increase of FLR and %FFLR 4 to 8 weeks after PVE were respectively 44 ± 19% and 16 ± 7% for patients with normal liver and 35 ± 28% and 9 ± 3% for those with chronic liver disease. All patients with normal liver and 86% with chronic liver disease experienced hypertrophy after PVE. The postoperative course of patients with normal liver who underwent PVE before right hepatectomy was similar to those with immediate surgery. In contrast, PVE in patients with chronic liver disease significantly decreased the incidence of postoperative complications as well as the intensive care unit stay and total hospital stay after right hepatectomy. Conclusions Before elective right hepatectomy, the hypertrophy of FLR induced by PVE had no beneficial effect on the postoperative course in patients with normal liver. In contrast, in patients with chronic liver disease, the hypertrophy of the FLR induced by PVE decreased significantly the rate of postoperative complications.

Farges, Olivier; Belghiti, Jacques; Kianmanesh, Reza; Marc Regimbeau, Jean; Santoro, Roberto; Vilgrain, Valerie; Denys, Alban; Sauvanet, Alain



Do umbilical vein catheterization and sepsis lead to portal vein thrombosis? A prospective, clinical, and sonographic evaluation.  


Extrahepatic portal vein obstruction (EHPVO) affects 20-30% of all patients with portal hypertension in India. The etiopathogenesis of this disease is unknown. In retrospective studies, umbilical vein cannulation and sepsis have been alleged to cause portal thrombosis. This prospective study was undertaken to detect clinically and by serial sonography whether thrombosis and consequent obstruction of the splenoportal venous system develops after umbilical vein catheterization and sepsis. Forty-seven children who had undergone exchange transfusion for hyperbilirubinemia, belonging to two different age groups, were studied. Twenty-two new-borns (Group A) were studied within 4 weeks of birth and later at 3-month intervals until the age of 12 months and subsequently at 24 months. Another group of 25 children (Group B), 1- to 5-year-olds who had earlier undergone exchange transfusion and 15 healthy newborns (Group C) were also screened. In Group A, seven (29%) neonates had septicemia, and in five, the splenic vein could not be initially visualized. The splenic vein was not seen in five of the 15 newborns in Group A who had no umbilical sepsis. Twenty-one of the 22 neonates in Group A were followed-up, and the splenic vein was well visualized and found patent on subsequent ultrasound in all of them. In Group B, four (16%) children had umbilical sepsis. None of these or the other Group B children showed any thrombosis or obstruction of the splenoportal system. The portal vein and its branches and the splenic vein were visualized in all healthy (Group C) neonates.(ABSTRACT TRUNCATED AT 250 WORDS) PMID:8145094

Yadav, S; Dutta, A K; Sarin, S K



Management of macular edema secondary to central retinal vein occlusion: an evidence-based  

Microsoft Academic Search

Retinal vein occlusions are common retinal vascular disorders with the potential for significant vision-related morbidity.\\u000a Retinal vein occlusions are classified as either branch retinal vein occlusion (BRVO), central retinal vein occlusion (CRVO),\\u000a or hemiretinal vein occlusion (HRVO) based on the specific occlusion site. Decreased vision in patients afflicted with CRVO\\u000a may result from retinal ischemia and\\/or the accumulation of fluid

Ahmad A. Aref; Ingrid U. Scott



Management of macular edema secondary to branch retinal vein occlusion: an evidence-based update  

Microsoft Academic Search

Retinal vein occlusions are common retinal vascular disorders with the potential for significant vision-related morbidity.\\u000a Retinal vein occlusions are classified as either branch retinal vein occlusion (BRVO), central retinal vein occlusion (CRVO),\\u000a or hemiretinal vein occlusion (HRVO) based on the specific occlusion site. The most common cause of decreased vision in patients\\u000a afflicted with BRVO is the accumulation of fluid

Ahmad A. Aref; Ingrid U. Scott



Plasma levels of thyrotropin-releasing-hormone in various splanchnic, renal, suprarenal, and cerebral veins.  


Endogenous TRH levels were determined in plasma obtained selectively via percutaneous transhepatic and femoral catheterization. TRH was measured using a very sensitive RIA method. In the pancreatic veins, internal jugular vein, left testicular vein, and other described veins, normal peripheral levels were found. An involvement of the TRH degrading enzyme (TDE) or a rapid intravasal dilution leading to normal peripheral TRH levels in the veins leaving the brain or pancreas, respectively, is discussed. PMID:3106709

Vardarl, I; Wdowinski, J M; Hoevels, J; Schmidt, R; Schwedes, U; Georgi, M; Usadel, K H



Living donor liver transplantation with alternative porto-left gastric vein anastomosis in patients with post-Kasai extrahepatic portal vein obstruction.  


EPVO is a common cause of prehepatic portal hypertension in pediatric patients and sometimes results in cavernous transformation of the PV. We herein present the cases of two patients who underwent LDLT for EPVO with post-Kasai biliary atresia. PV reconstruction was performed with a porto-left gastric vein anastomosis. The patient who underwent PV reconstruction using an interposition vein graft is doing well without surgical complications, whereas PV anastomotic stenosis was detected three months after LDLT in the patient who did not receive an interposition vein graft. The availability of vein grafts is limited in the LDLT setting. In such cases, performing PV reconstruction with varicose veins using interposition vein grafts is a feasible and valuable alternative option for obtaining a sufficient portal blood flow. Our experiences suggest that using interposition vein grafts may be appropriate for preventing the anastomotic stenosis caused by the fragility of varicose veins. PMID:23480790

Kitajima, Toshihiro; Sakamoto, Seisuke; Uchida, Hajime; Hamano, Ikumi; Kobayashi, Megumi; Kanazawa, Hiroyuki; Fukuda, Akinari; Kasahara, Mureo



Proposition of a new classification of the cerebral veins based on their termination.  


The existing classifications of cerebral veins have certain problems, including limited adequacy to uniquely describe neurovascular networks in three dimensions (3D), mixture of deep and superficial veins, and ambiguity of territories-based parcellations as veins may course on multiple territories. Classification discrepancies exist in subdivision, region drained, and parcellation criteria. Recent developments in diagnostic imaging and computers enable to acquire, create, and manipulate complete vascular networks, which also call for a new classification of cerebral veins. We propose a new classification suitable for the description of the complete cerebral veins, providing a clear separation of the superficial cortical veins from deep veins, and facilitating presentation and exploration of cerebral veins in 3D with respect to surrounding neuroanatomy. It is based on terminating vascular subsystems (rather than draining regions). It divides the cerebral veins into cortical, deep, and posterior fossa veins. The cortical veins are subdivided into two groups: terminating in dural sinuses and terminating in deep veins. The posterior fossa veins are subdivided also into two groups: terminating in dural sinuses and terminating in deep veins. This classification was illustrated with a cerebrovascular model containing over 1,300 vessels. This new classification has many advantages. It is simple, clear and didactically useful; avoids mixture of superficial and deep veins; shows overall hierarchical structure and topographical relationships including tributaries; is useful in analysis of 3D vascular trees extracted from imaging; and may be used in conjunction with the existing parcellations. PMID:21769635

Nowinski, Wieslaw L



Hepatic vein waveforms in liver cirrhosis re-evaluated  

PubMed Central

Objective There are many studies on changes in Doppler waveforms of hepatic veins in cirrhotic liver. It is postulated that dampening of phasic oscillations appears with worsening of liver function. Our aim was to reevaluate the significance of Doppler waveforms of hepatic vein in cirrhotic patients and to correlate with hepatic blood flow. Patients and method One hundred and thirty-five consecutive patients of liver cirrhosis and 60 age and sex matched non-cirrhotic controls were enrolled in this study. Doppler waveforms were obtained from right hepatic vein during normal respiration. Other parameters measured were flow volume of portal trunk, right portal vein and proper hepatic artery. Result Waveforms of the hepatic vein were classified into triphasic, biphasic and flat patterns. Flat waveform was rare and appeared in only 3% cases. There was no correlation between liver dysfunction and patterns of waveforms. Inflow, particularly to the right lobe, was significantly elevated in cases associated with the non-triphasic waveforms. Conclusion This study shows that the flat waveforms have no diagnostic value. Role of hepatic blood flow seems to be important suggesting hemodynamic changes rather than liver dysfunction as a plausible cause of change in waveforms.

Sharma, Dilip; Chataut, Saroj Prasad



Coronary magnetic resonance vein imaging: imaging contrast, sequence, and timing.  


Recently, there has been increased interest in imaging the coronary vein anatomy to guide interventional cardiovascular procedures such as cardiac resynchronization therapy (CRT), a device therapy for congestive heart failure (CHF). With CRT the lateral wall of the left ventricle is electrically paced using a transvenous coronary sinus lead or surgically placed epicardial lead. Proper transvenous lead placement is facilitated by the knowledge of the coronary vein anatomy. Cardiovascular MR (CMR) has the potential to image the coronary veins. In this study we propose and test CMR techniques and protocols for imaging the coronary venous anatomy. Three aspects of design of imaging sequence were studied: magnetization preparation schemes (T(2) preparation and magnetization transfer), imaging sequences (gradient-echo (GRE) and steady-state free precession (SSFP)), and imaging time during the cardiac cycle. Numerical and in vivo studies both in healthy and CHF subjects were performed to optimize and demonstrate the utility of CMR for coronary vein imaging. Magnetization transfer was superior to T(2) preparation for contrast enhancement. Both GRE and SSFP were viable imaging sequences, although GRE provided more robust results with better contrast. Imaging during the end-systolic quiescent period was preferable as it coincided with the maximum size of the coronary veins. PMID:17969081

Nezafat, Reza; Han, Yuchi; Peters, Dana C; Herzka, Daniel A; Wylie, John V; Goddu, Beth; Kissinger, Kraig K; Yeon, Susan B; Zimetbaum, Peter J; Manning, Warren J




PubMed Central

Purpose The purpose of this study was to assess the risk factors for central retinal vein occlusion and associated morbidity and mortality in a Chinese population. Methods The participants included patients with central retinal vein occlusion 40 years old and younger. Predisposing factors, mortality, and systemic complications were examined in this group. Results Unilateral (n = 19) and bilateral (n = 3) central retinal vein occlusions were identified in a total of 22 patients (25 eyes), with a mean follow-up time of 37 months. Hypercholesterolemia (65%), hypertriglyceridemia (64%), and hyperhomocysteinemia (42%) were all identified as risk factors. Three patients (14%) developed stroke and 1 (5%) developed transient ischemic attacks during follow-up. Renal failure and pulmonary hypertension resulted in the death of two patients. The mean initial and final visual acuities (±standard deviation) were 20/400 (±20/250) and 20/500 (±20/320), respectively, and treatments did not result in vision improvement (P = 0.57). The poor visual prognosis was likely due to macular edema in 7 eyes (28%), optic atrophy in 4 eyes (16%), and secondary glaucoma in 3 eyes (12%). Conclusion Morbidity and mortality are high in young Chinese patients with central retinal vein occlusion who may have associated serious complications including stroke, blindness, and death. Central retinal vein occlusion may serve as an initial clinical presentation of serious systemic diseases.

Kuo, Jane Zea-Chin; Lai, Chi-Chun; Ong, Frank Shih-Chang; Shih, Chia-Pang; Yeung, Ling; Chen, Tun-Lu; Chen, Kuan-Jen; Wu, Wei-Chi



Safety of withholding anticoagulation in pregnant women with suspected deep vein thrombosis following negative serial compression ultrasound and iliac vein imaging  

PubMed Central

Background: Compression ultrasonography performed serially over a 7-day period is recommended for the diagnosis of deep vein thrombosis in symptomatic pregnant women, but whether this approach is safe is unknown. We evaluated the safety of withholding anticoagulation from pregnant women with suspected deep vein thrombosis following negative serial compression ultrasonography and iliac vein imaging. Methods: Consecutive pregnant women who presented with suspected deep vein thrombosis underwent compression ultrasonography and Doppler imaging of the iliac vein of the symptomatic leg(s). Women whose initial test results were negative underwent serial testing on 2 occasions over the next 7 days. Women not diagnosed with deep vein thrombosis were followed for a minimum of 3 months for the development of symptomatic deep vein thrombosis or pulmonary embolism. Results: In total, 221 pregnant women presented with suspected deep vein thrombosis. Deep vein thrombosis was diagnosed in 16 (7.2%) women by initial compression ultrasonography and Doppler studies; none were identified as having deep vein thrombosis on serial testing. One patient with normal serial testing had a pulmonary embolism diagnosed 7 weeks later. The overall prevalence of deep vein thrombosis was 7.7% (17/221); of these, 65% (11/17) of cases were isolated to the iliofemoral veins and 12% (2/17) were isolated iliac deep vein thromboses. The incidence of venous thromboembolism during follow-up was 0.49% (95% confidence interval [CI] 0.09%–2.71%). The sensitivity of serial compression ultrasonography with Doppler imaging was 94.1% (95% CI 69.2%–99.7%), the negative predictive value was 99.5% (95% CI 96.9%–100%), and the negative likelihood ratio was 0.068 (95% CI 0.01–0.39). Interpretation: Serial compression ultrasonography with Doppler imaging of the iliac vein performed over a 7-day period excludes deep-vein thrombosis in symptomatic pregnant women.

Chan, Wee-Shian; Spencer, Frederick A.; Lee, Agnes Y. Y.; Chunilal, Sanjeev; Douketis, James D.; Rodger, Marc; Ginsberg, Jeffrey S.



Treatment of macular edema due to retinal vein occlusions  

PubMed Central

Retinal vein occlusion (RVO) is a prevalent retinal vascular disease, second only to diabetic retinopathy. Previously there was no treatment for central retinal vein occlusion (CRVO) and patients were simply observed for the development of severe complications, generally resulting in poor visual outcomes. The only treatment for branch vein occlusion (BRVO) was grid laser photocoagulation, which reduces edema very slowly and provides benefit in some, but not all patients. Within the past year, clinical trials have demonstrated the effects of three new pharmacologic treatments, ranibizumab, triamcinolone acetonide, and dexamethasone implants. The benefit/risk ratio is best for intraocular injections of ranibizumab, making this first-line therapy for most patients with CRVO or BRVO, while intraocular steroids are likely to play adjunctive roles. Standard care for patients with RVO has changed and will continue to evolve as results with other new agents are revealed.

Channa, Roomasa; Smith, Michael; Campochiaro, Peter A



Treatment of macular edema due to retinal vein occlusions.  


Retinal vein occlusion (RVO) is a prevalent retinal vascular disease, second only to diabetic retinopathy. Previously there was no treatment for central retinal vein occlusion (CRVO) and patients were simply observed for the development of severe complications, generally resulting in poor visual outcomes. The only treatment for branch vein occlusion (BRVO) was grid laser photocoagulation, which reduces edema very slowly and provides benefit in some, but not all patients. Within the past year, clinical trials have demonstrated the effects of three new pharmacologic treatments, ranibizumab, triamcinolone acetonide, and dexamethasone implants. The benefit/risk ratio is best for intraocular injections of ranibizumab, making this first-line therapy for most patients with CRVO or BRVO, while intraocular steroids are likely to play adjunctive roles. Standard care for patients with RVO has changed and will continue to evolve as results with other new agents are revealed. PMID:21629578

Channa, Roomasa; Smith, Michael; Campochiaro, Peter A



Pulmonary Septic Emboli due to Azygos Vein Septic Thrombosis  

PubMed Central

The triad of extrapulmonary infection, contiguous septic vein thrombosis, and septic pulmonary embolism is a rare complex but associated with significant morbidity and mortality. Septic azygos vein thrombosis is extremely rare and potentially serious since it may also cause pulmonary emboli and sudden death. We report a case of a 32-year-old woman with history of IV drug abuse who presented with epidural abscess and methicillin-resistant S. aureus (MRSA) bacteremia. Later she developed signs of septic pulmonary embolism secondary to septic azygos vein thrombosis. With early diagnosis, appropriate antimicrobial therapy, and control of the infectious source, resolution of the illness can be expected for most patients with avoidance of potential complications.

Pradhan, Ginius; Muoneke, Mary; Altaqi, Basel



Lack of significant difference between internal spermatic vein and brachial vein ischemia modified albumin levels in patients with varicocele.  


Varicocele is the most common and surgically correctible cause of male infertility in men attending to infertility clinics. Infertility affects 15% of all couples and male factor is the primary or contributing cause in 40% to 60% of cases. Varicocele has been shown to cause male infertility in about 15% of infertile couples. Molecular mechanisms responsible from varicocele induced testicular dysfunction and male infertility have not been completely unknown. Recent years have witnessed a huge amount of scientific works devoted to the mechanism of varicocele associated male infertility and rapid progress in research on its cellular and molecular mechanisms, including apoptosis and oxidative stress of germ cells. Here we evaluated internal spermatic vein and brachal vein ischemia modified albumin (IMA) level in 40 adult male patients with varicocele. IMA level was analyzed using albumin cobalt-binding test. Spermatic vein and brachial vein IMA levels were 0.381 ± 0.135 ABSU (absorbance units) and 0.385 ± 0.131 ABSU, respectively. There was no statistically significant difference between the two areas. IMA levels in the internal spermatic vein of patients with varicocele should not be used as a marker of hypoxia. PMID:23695403

Aliyazicioglu, Yuksel; Ozbek, Emin; Ozcan, Levent; Cakir, S Sami; Dursun, Murat



CD68 expression in aortocoronary saphenous vein bypass grafts.  


Atherosclerosis commonly affects the arteries harvested from patients 70 years of age or older. Saphenous vein grafts appear to maintain a higher patency rate after coronary artery bypass grafting in these subjects. The infiltration of macrophages is an early step in saphenous vein graft atherosclerosis; however, little is known regarding the underlying mechanisms of infiltration. The objective of the present report is to evaluate the presence of CD68-positive cells in the saphenous vein wall and correlate initial CD68-positive infiltration to specific clinical and biochemical parameters and the graft patency rate as estimated in patients undergoing coronary artery bypass grafting. A total of 309 patients were allocated into two groups: A1 patients, who were between 50 and 70 years of age, and A2 patients, who were 70 years or older at the time of vein harvesting. CD68 expression was evaluated by immunohistochemistry. There were no significant differences between A1 and A2 patients regarding macrophage expression within any of the analyzed vascular regions. Saphenous vein macrophages were never present in the tunica intima unless they were also expressed in the media or the adventitia. The patients with CD68-positive cells in the tunica intima had a significantly higher number of bypass stenoses when compared with the subjects who did not have CD68-positive cells in this layer. These findings suggest that the CD68-positive cells (those that have not yet developed into foam cells) present in the intima of saphenous vein grafts might serve as a very early marker of graft occlusion. PMID:23275124

Malinska, Agnieszka; Perek, Bartlomiej; Buczkowski, Piotr; Kowalska, Katarzyna; Ostalska-Nowicka, Danuta; Witkiewicz, Wojciech; Nowicki, Michal



Migration of a fish bone into the right renal vein.  


We describe a patient in whom a fish bone penetrated the duodenum and migrated into the right renal vein. The bone was successfully removed with surgery. The 75-year-old man was admitted to Nippon Medical School Tama Nagayama Hospital because of right upper abdominal pain persisting for 7 days. The patient's medical history was not relevant to the current disorder. Plain radiography showed no abnormalities. Computed tomography revealed a linear object of high intensity that had penetrated the duodenum and migrated into the right renal vein with thrombus. The object was surrounded by a low-density area, suggesting severe inflammation. The patient had eaten fish 1 day before the onset of abdominal pain. We diagnosed duodenal penetration caused by an ingested fish bone. Endoscopic examination showed erosion, but no fish bone or ulceration was detected in the duodenum. The patient was treated conservatively with fasting, peripheral parental nutrition, and intravenous antibiotics. Three days after admission, non-contrast-enhanced computed tomography showed no movement of the foreign body. The patient continued to have pain, and the decision was made to surgically explore the abdomen. Intraoperative ultrasonography showed that the foreign body had migrated completely into the right renal vein with thrombus. Severe inflammation of the right renal vein was observed. Because we could not remove the foreign body without seriously injuring the right renal vein, right nephrectomy was performed. Macroscopic examination of the surgical specimen confirmed the presence of a fish bone with thrombus in the right renal vein. The patient was discharged 9 days after operation, with no complications. PMID:21720094

Iwai, Takuma; Yoshida, Hiroshi; Yokoyama, Tadashi; Maruyama, Hiroshi; Suzuki, Seiji; Matsutani, Takeshi; Matsushita, Akira; Hirakata, Atsushi; Sasajima, Koji; Uchida, Eiji



Experience with Percutaneous Internal Jugular-Innominate Vein Catheterization  

PubMed Central

A specific technique of cannulation of the internal jugular innominate vein, presented herein, is not considered an innocuous procedure, but the incidence of serious complications is very low. In this technique a needle-in-catheter unit aids greatly in advancing the catheter through the vein. More than 62 percent of the catheters were left in place for more than five days. There was an 11.4 percent incidence of positive bacterial or fungal cultures from the catheter tip. Routine follow-up chest x-ray films demonstrated all the catheters in the innominate-superior vena cava venous system. ImagesFigure 1.Figure 2.Figure 3.Figure 4.

McConnell, Richard Y.; Fox, Robert T.



MDCT Findings of Right Circumaortic Renal Vein with Ectopic Kidney  

PubMed Central

Anomalies of renal vasculature combined with ectopic kidneys were found on a multi-detector CT scan. Knowledge of renal vascular variation is very important for surgical exploration, radiologic intervention and staging for urologic cancer. We present an extremely rare case of a right circumaortic renal vein combined with a right ectopic kidney. The right kidney was located at the level between the third and fifth lumbar vertebra. The right circumaortic renal vein crossed the aorta and returned to the inferior vena cava behind the aorta.

Kim, Min-Kyun; Ku, Young Mi; Chun, Chang Woo



Ventilation-perfusion mismatch due to obstruction of pulmonary vein  

SciTech Connect

A lobar perfusion defect in the presence of a normal arterial phase in the pulmonary angiogram may be due to stasis secondary to compression of a pulmonary vein by a hilar or perhilar mass. In this report we present a patient with metastasis to the right lung and hilum by malignant melanoma. A lobar perfusion defect was present in an area of lung that appeared normal by radiograph. This defect was shown to be due to stagnating blood flow reflected by delayed intense capillary phase in that lobe and late opacification of the corresponding draining vein.

Mendelson, D.S.; Train, J.S.; Goldsmith, S.J.; Efremidis, S.C.



Pulsatile Tinnitus Caused by a Dilated Mastoid Emissary Vein  

PubMed Central

Although pulsatile tinnitus can be audible, objective demonstration of this heartbeat-synchronous sound has rarely been successful. We report a rare case of pulsatile tinnitus in a 44-yr-old female patient, which was induced by a large mastoid emissary vein (MEV) and objectively documented by Doppler sonography of the left posterior auricular region. The tinnitus was intermittent and the patient could adapt to the tinnitus without intervention on the mastoid emissary vein. These findings suggest that a single large MEV can cause pulsatile tinnitus in the absence of other vascular abnormalities, and imaging studies of the posterior fossa and Doppler ultrasonography can aid the diagnosis in such cases.

Lee, Seung-Hwan; Kim, Sam Soo; Sung, Kun-Yong



[Segmental portal hypertension caused by splenic vein thrombosis].  


Seventeen cases of segmental portal hypertension due to splenic vein thrombosis are reported. This syndrome may be asymptomatic for a long time and then present suddenly in the form of a serious picture of high digestive haemorrhage due to rupture of gastric fundus varices as a result of hypertrophied submucous collateral drainage circulation. Useful for diagnosis are oesophagogastroduodenoscopy, which points to stomach varices, and splenoportography or splenic artery angiography with venous phase, which highlight pathognomonic dilatation and tortuosity of the gastroepiploic veins. Surgical exploration typically shows: presence of large epiploic vessels, splenomegaly, absence of changes in the liver and in the portal and mesenteric circulation. Curative treatment of choice is splenectomy. PMID:2336152

Olivero, G; Franchello, A; Visetti, E; Orlando, E; Enrichens, F; Foco, A; Ibba, F



Bilateral persistent sciatic vein: report of a case with developmental, histological and clinical aspects.  


OBJECTIVE: Bilateral large variant veins were encountered in the lower extremity. It was aimed to identify the structural characteristics of this rare case and then, regarding the structural features, to overview its formation process and denomination. MATERIAL AND METHOD: During the routine dissection of a 93-year-old male cadaver, bilateral large variant veins were found at the thigh. Valves of the veins were examined and evaluated together with the vascular wall histology. RESULTS: The variant vein was loosely attached to the sciatic nerve by fibrous tissue and had anastomoses with the popliteal vein in the popliteal fossa on each side. The popliteal veins were hypoplastic on both sides. The right variant vein was passing through the fibers of the adductor magnus muscle 56.2 mm above the adductor hiatus, which corresponds to the third perforating branch of deep femoral vein. The left one was turning to the front over the adductor magnus muscle, at the lower border of quadratus femoris muscle. The left variant vein was corresponding to the descending branch of the medial circumflex femoral vein. Both variant veins had one incomplete and three well-developed valves. CONCLUSION: In accordance with the findings, the variant vein was concluded to be an embryonic remnant, rather than an acquired one subsequent to any obstruction of the femoral vein. Regarding their connection with the popliteal vein but not with the internal iliac vein, both variant veins were denominated as "lower type persistent sciatic vein". Such a variation would be important with respect to the risk of complication during popliteal sciatic nerve blockade. PMID:23748841

Koç, Turan; Gilan, Ismail Ya?murhan; Külekçi, Gökçe Deniz; Kurto?lu, Zeliha



The Distant Morphological and Petrological Features of Shock Melt Veins in the Suizhou L6 Condrite  

SciTech Connect

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.

X Xie; Z Sun; M Chen



Geometry and texture of quartz veins in Wadi Atalla area, Central Eastern Desert, Egypt  

NASA Astrophysics Data System (ADS)

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.

Akawy, Ahmed



Hepatocellular Carcinoma Invading the Main Portal Vein: Treatment with Transcatheter Arterial Chemoembolization and Portal Vein Stenting  

SciTech Connect

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.

Zhang Xuebin, E-mail:; Wang Jianhua, E-mail:; Yan Zhiping, E-mail:; Qian Sheng, E-mail:; Liu Rong, E-mail: [Fudan University, Department of Radiology, Zhong Shan Hospital (China)



Standard Care vs. COrticosteroid for REtinal Vein Occlusion (SCORE) Study, Version 6.0.  

National Technical Information Service (NTIS)

Macular edema is a major cause of vision loss in patients with central retinal vein occlusion (CRVO) and branch retinal vein occlusion (BRVO). Currently, there is no effective treatment for macular edema associated with CRVO. For macular edema associated ...



Standard Care vs. COrticosteroid for REtinal Vein Occlusion (SCORE) Study: FPRC Imaging Procedures.  

National Technical Information Service (NTIS)

This document describes a randomized efficacy and safety of intravitreal injection(s) of triamcinoline acetonide with standard care to treat macular edema associated with central retinal vein occlusion amd branch retinal vein occlusion.



Portal and Peripheral Vein Insulin Responses to Intravenous Glucose in the Rhesus Monkey.  

National Technical Information Service (NTIS)

Catheterization of the portal vein and bilateral femoral veins were performed under general anesthesia in 6 healthy male rhesus monkeys. Four days later, sequential, simultaneous peripheral and portal plasma samples were obtained for glucose and immunorea...

E. J. Rayfield R. T. Faulkner W. Czajkowski



The ultrasound appearances of neonatal renal vein thrombosis  

Microsoft Academic Search

Renal vein thrombosis (RVT) is the most frequently occurring vascular condition in the new-born kidney. The predisposing factors include dehydration, sepsis, birth asphyxia, maternal diabetes, polycythaemia and the presence of an indwelling umbilical venous catheter. (RVT) may present clinically with a flank mass, haematuria, hypertension or renal failure. Many imaging modalities have been employed, but ultrasound is the technique most



Aortocoronary saphenous vein graft rupture during diagnostic angiography.  


Coronary saphenous vein graft (SVG) rupture during diagnostic angiography is a very rare but known complication of the procedure. It has typically been reported to occur at the site of pseudoaneurysms or secondary to an interventional procedure involving the graft. We present a case of SVG mid-body rupture during diagnostic angiography that occurred without evidence of pseudoaneurysmal changes. PMID:23008157

Salcedo, Jonathan D; Bhakta, Mayurkumar D; Kern, Morton J



Visualization of human umbilical vein endothelial cells by acoustic microscopy  

Microsoft Academic Search

The morphology and acoustic properties of the human umbilical vein endothelial cells (HUVECs) were evaluated using a scanning acoustic microscope system. HUVECs were cultured for 4days and exposed to the endotoxin for 4h. The frequency of the scanning acoustic microscope was variable between 100 and 210MHz. By changing the measuring frequency, ultrasonic amplitude and phase were measured and the quantitative

Yoshifumi Saijo; Hidehiko Sasaki; Masaaki Sato; Shin-ichi Nitta; Motonao Tanaka



3D and multispectral imaging for subcutaneous veins detection  

Microsoft Academic Search

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

Fabrice Meriaudeau; Vincent C. Paquit; Nicolas Walter; Jeffery R. Price; Kenneth W. Tobin



Cardiovascular risk assessment in patients with retinal vein occlusion  

Microsoft Academic Search

Aim: Patients with retinal vein occlusions (RVO) are at increased risk of cardiovascular disease (CVD). The risk of future CVD was determined using the Framingham algorithm and this risk estimate was used to guide decisions about preventative treatment for CVD in RVO patients.Methods: 107 unselected RVO patients were studied. After excluding 18 patients because of age, missing data, or pre-existing

S C Martin; A Butcher; N Martin; J Farmer; P M Dobson; W A Bartlett; A F Jones



Hematologic abnormalities associated with various types of retinal vein occlusion  

Microsoft Academic Search

Background: The objective of this study was two-fold: (1) to investigate hematologic abnormalities associated with various types of retinal vein occlusion (RVO) and comparison of their prevalence among those various types of RVO; (2) to review the conflicting literature on the subject, to place the information in perspective. Methods: In patients with various types of RVO seen in our clinic

Sohan Singh Hayreh; Bridget M. Zimmerman; Patricia Podhajsky



Varicose vein management: considerations for the diagnostic radiology group practice.  


The purpose of this brief article is to suggest some specific considerations that diagnostic radiology groups must make prior to embarking upon a varicose veins practice component. There are many excellent sources for further information, including the Web sites and practice management components of organizations such as the Society of Interventional Radiology, American College of Phlebology, International Vein Congress, and Union Internationale Phlebologie, all of which also hold excellent meetings or sections. Major points addressed in the article will include business plans, physician and group requirements, physical space and equipment requirements, and personnel issues. Though vein practice is clearly a major undertaking, the nature of varicose venous disease is such that there is a serendipitous overlap between the skill sets of the interventional radiologists and those required of the treating phlebologist. Consequently, with the proper motivation, self-education, and ongoing training, the addition of a varicose vein practice component can be extremely gratifying and rewarding for the physician, his radiology group, and most importantly the patients whom they serve. PMID:21326671

Soares, Gregory M



Pneumatosis intestinalis and portal vein gas after blunt abdominal trauma  

Microsoft Academic Search

The authors report on a 2-year-old boy in whom pneumatosis intestinalis (PI) and portal vein gas (PVG) resulted from blunt abdominal trauma after child abuse. The presumed pathophysiology of PI and PVG is mechanical in this setting. Its presence establishes mucosal injury but does not necessarily imply intestinal necrosis.

Brooke Gurland; Stephen E Dolgin; Edward Shlasko; Unsup Kim



Pulmonary veins in high-altitude residents: a morphometric study.  

PubMed Central

The thickness of the media of pulmonary veins and arteries was morphometrically assessed in 12 normal adults resident at altitudes over 3000 m and 12 resident at sea level. The pulmonary veins in the latter group were very thin walled. The average thickness of the pulmonary venous media in the group of highlanders was significantly thicker but this appeared to be due to prominent medial hypertrophy in seven individuals, five others having normal or near-normal pulmonary veins. In six of the 12 highlanders bundles of longitudinal smooth muscle cells occurred in the venous intima. There was close correlation between the thickness of the venous and that of the arterial media, suggesting an individual reactivity with a simultaneous response of all pulmonary vascular smooth muscle to high-altitude hypoxia. Hypertrophy of the media of pulmonary veins is likely to be an expression of venoconstriction and narrowing of the venous lumen may be enhanced by the development of longitudinal smooth muscle cells in the intima. Possibly venoconstriction is one of the factors responsible for high-altitude pulmonary oedema. Images

Wagenvoort, C A; Wagenvoort, N



Superior mesenteric vein rotation: a CT sign of midgut malrotation  

Microsoft Academic Search

Computed tomography (CT) of the pancreas, with its excellent display of peripancreatic anatomy, allows visualization of the major vessels entering the mesenteric root. In scans of the normal upper abdomen obtained at or just below the level of the uncinate process of the pancreas, the proximal superior mesenteric vein (SMV) easily can be identified lying on the right ventral aspect

D. M. Nichols; D. K. Li



Percutaneous Pulmonary Vein Cryoablation to Treat Atrial Fibrillation  

Microsoft Academic Search

Background: Cryothermic tissue injury, unlike hyperthermic tissue injury, preserves tissue architecture and causes less thrombus formation, and thus may prevent venous stenosis and stroke in ablating pulmonary veins (PVs) to treat patients with atrial fibrillation (AF). We investigate the feasibility, efficacy, safety and clinical outcome of using percutaneous cryoablation to treat such patients.

Tom Wong; Vias Markides; Nicholas S. Peters; D. Wyn Davies



Cerebral vein thrombosis in childhood systemic lupus erythematosus  

Microsoft Academic Search

We describe three cases of cerebral vein thrombosis (CVT) in girls with systemic lupus erythematosus. Severe, persistent, unremitting headache was a common manifestation. In the first patient, although the clinical features were suggestive of CVT, the diagnosis was delayed and she had a significant cerebral infarct. In the other two patients the diagnosis was made earlier and led to more

Yosef Uziel; Ronald M. Laxer; Susan Blaser; Maureen Andrew; Rayfel Schneider; Earl D. Silverman



Retinal vein occlusion during flare of multicentric Castleman's disease  

PubMed Central

We report a case of successive bilateral retinal vein occlusion in a human immunodeficiency virus (HIV)-positive male with multicentric Castleman’s disease treated successfully with a single injection of intravitreal bevacizumab. Castleman’s disease should be a differential diagnosis of occlusive retinovascular disease and, occasionally, ocular manifestation can lead to systemic diagnosis.

Kozak, Igor; Reid, Erin G



Analysis of deep vein thrombosis in burn patients  

Microsoft Academic Search

Objective: Deep vein thrombosis (DVT) represents a major cause of morbidity in surgical patients. Controversial reports exist on the incidence of DVT in burn patients. We report our experience over a 10-year period. Methods: Patients admitted to our Burn Unit over the period 1991–2001 and diagnosed with DVT were identified. Their records were retrospectively reviewed for demographic factors, extent and

A. M Fecher; M. S O’Mara; I. W Goldfarb; H Slater; R Garvin; T. J Birdas; P. F Caushaj



Changing Features of Proximal Vein Thrombosis Over Time  

Microsoft Academic Search

Recently, the sensitivity of impedance plethysmography (IPG) for the diagnosis of acute deep-vein thrombosis (DVT) in symptomatic outpatients has been questioned. In order to verify whether a change in the venographic pattern of DVT has occurred over years, accounting for the decreased sensitivity of IPG, the authors compared two series of consecutive venograms demonstrating proximal DVT, performed between 1984-1988 (166

Alberto Cogo; Paolo Prandoni; Sabina Villalta; Paola Polistena; Enrico Bernardi; Paolo Simioni; Mario Vigo; Lino Benedetti; Antonio Girolami



Management of closed space infections associated with endoscopic vein harvest.  


Wound complications are uncommon following endoscopic saphenous vein harvest. However, closed space infections within the endoscopic tunnel may occur and are difficult to manage. We describe the management of closed space infection in 3 patients and a method that allows drainage without unroofing the endoscopic tunnel. PMID:10750805

Allen, K B; Fitzgerald, E B; Heimansohn, D A; Shaar, C J



Vein graphite deposits: geological settings, origin, and economic significance  

NASA Astrophysics Data System (ADS)

Graphite deposits result from the metamorphism of sedimentary rocks rich in carbonaceous matter or from precipitation from carbon-bearing fluids (or melts). The latter process forms vein deposits which are structurally controlled and usually occur in granulites or igneous rocks. The origin of carbon, the mechanisms of transport, and the factors controlling graphite deposition are discussed in relation to their geological settings. Carbon in granulite-hosted graphite veins derives from sublithospheric sources or from decarbonation reactions of carbonate-bearing lithologies, and it is transported mainly in CO2-rich fluids from which it can precipitate. Graphite precipitation can occur by cooling, water removal by retrograde hydration reactions, or reduction when the CO2-rich fluid passes through relatively low-fO2 rocks. In igneous settings, carbon is derived from assimilation of crustal materials rich in organic matter, which causes immiscibility and the formation of carbon-rich fluids or melts. Carbon in these igneous-hosted deposits is transported as CO2 and/or CH4 and eventually precipitates as graphite by cooling and/or by hydration reactions affecting the host rock. Independently of the geological setting, vein graphite is characterized by its high purity and crystallinity, which are required for applications in advanced technologies. In addition, recent discovery of highly crystalline graphite precipitation from carbon-bearing fluids at moderate temperatures in vein deposits might provide an alternative method for the manufacture of synthetic graphite suitable for these new applications.

Luque, F. J.; Huizenga, J.-M.; Crespo-Feo, E.; Wada, H.; Ortega, L.; Barrenechea, J. F.



A quantitative approach to lower extremity vein repair  

Microsoft Academic Search

Objective: We prospectively investigated the patency of venous repair in a quantitative fashion with measurement of vein blood flow velocities after lower extremity injuries caused by either military or civilian trauma. Material and Methods: During a 10-year study period (March 1990 to December 2000), surgical intervention was performed after lower extremity vascular injuries in 130 patients. Most of these patients

Erkan Kuralay; Ufuk Demirkiliç; Ertugrul Özal; Bilgehan Savas Öz; Faruk Cingöz; Celalettin Gunay; Vedat Yildirim; Mehmet Arslan; Harun Tatar



Historic milestones in the management of lower limb varicose veins \\  

Microsoft Academic Search

Lower limb varices have been known and described for more than 3500 years. Through the ages, numer- ous modalities have been used in the management of this condition. Many of these methods evolved and, after some modifications, remain in use. Surgical techniques of major importance in the management of varices of the greater saphenous vein include crosscutting of the venous

Marek Durakiewicz


Ileocolic Arteriovenous Fistula with Superior Mesenteric Vein Aneurism: Endovascular Treatment  

Microsoft Academic Search

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.

Miguel Angel De Gregorio; Maria José Gimeno; Joaquin Medrano; Caudio Schönholz; Juan Rodriguez; Horacio D’Agostino



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...


Multimodal Biometric Cryptosystem Involving Face, Fingerprint and Palm Vein  

Microsoft Academic Search

The proposed scheme involves an idea of including three biometric traits of a person where in the sense even if one fails the other trait could be utilised for verification or identity.Moreover the concept of cryptosystem is involved , where one of the biometric trait - the palm vein itself acts as a key to utilise the stored template database.

B. Prasanalakshmi; A. Kannammal; R. Sridevi



Clinical approach to splanchnic vein thrombosis: risk factors and treatment.  


Splanchnic vein thrombosis (SVT) is an unusual manifestation of venous thromboembolism which involves one or more abdominal veins (portal, splenic, mesenteric and supra-hepatic veins). SVT may be associated with different underlying disorders, either local (abdominal cancer, liver cirrhosis, intra-abdominal inflammation or surgery) or systemic (hormonal treatment, thrombophilic conditions). In the last decades, myeloproliferative neoplasm (MPN) emerged as the leading systemic cause of SVT. JAK2 mutation, even in the absence of known MPN, showed a strong association with the development of SVT, and SVT was suggested to be the first clinical manifestation of MPN. Recently, an association between SVT, in particular supra-hepatic vein thrombosis, and paroxysmal nocturnal hemoglobinuria has also been reported. SVT occurs with heterogeneous clinical presentations, ranging from incidentally detected events to extensive thrombosis associated with overt gastrointestinal bleeding, thus representing a clinical challenge for treatment decisions. In the absence of major contraindications, anticoagulant therapy is generally recommended for all patients presenting with acute symptomatic SVT, but there is no consensus about the use of anticoagulant drugs in chronic or incidentally detected SVT. High quality evidence on the acute and long-term management is substantially lacking and the risk to benefit-ratio of anticoagulant therapy in SVT still needs to be better assessed. PMID:23026649

Riva, Nicoletta; Donadini, Marco P; Dentali, Francesco; Squizzato, Alessandro; Ageno, Walter



[Blood flow in the umbilical vein and artery in pregnancy].  


Transplacental gas exchange and supply of nutritive substances to the foetus is guaranteed by an increase of umbilical blood flow (Qnv). It was investigated, whether the umbilical blood flow (Qnv) is influenced by physiological conditions during pregnancy and if changes occur in the umbilical blood flow velocity wave forms. In this study, 31 pregnant women between the 24th to 40th week of gestation were examined with a pulsed wave duplex scanner ADR Kranzbühler 8150. The mean flow velocity (Vnv) of the umbilical vein and the diameter of the vessel were parameters, which were included in the calculation of the umbilical blood flow. The flow profile of the umbilical artery allowed determination of the maximum systolic frequency (Fmax) and the end-diastolic frequency (Fmin). Based on these data, three indices--RI, PI, S/D ratio were calculated. The blood flow of the umbilical vein (Qnv) shows a linear increase up to the 36th week of gestation and remains at this level thereafter. The increase of umbilical blood flow (Qnv) is mainly caused by an increase of the diameter of the umbilical vein (81%, 26th-40th week of gestation) and to a lesser degree by an increase of the mean flow velocity (Vnv) (18%, 26th-40th week of gestation). The diameter of the vein is highly correlated both with the foetal birth weight (r = 0.60) and the umbilical blood flow (Qnv) (r = 0.73). Throughout pregnancy, flow velocity waveforms showed significant changes of the maximum systolic frequency (Fmax) from 973 Hz (SD 128 Hz; 26th week of gestation) to 1130 Hz (SD 152 Hz; 40th week of gestation) and an increase of the end-diastolic frequency (Fmin) from 246 Hz (SD 58 Hz; 26th week of gestation) to 423 Hz (SD 91 Hz; 40th week of gestation). The higher increase of the end-diastolic frequency (Fmin) results in a decrease of the resistance index (RI), pulsatility index (PI) and SD-ratio. None of the investigated cases showed an end-diastolic frequency (Fmin) of less than 200 Hz. These results reveal, that determination of the blood flow of the umbilical vein mainly depends on measuring the diameter of the vessel rather than on measurements of the blood flow velocity (Qnv) of the vein. With the presently available equipment, accurate measurements of the diameter are very difficult. The increase of blood flow of the umbilical vein is not proportional to the foetal growth; moreover, it remains constant from the 36th week of gestation.(ABSTRACT TRUNCATED AT 400 WORDS) PMID:1936859

Künzel, W; Jovanovic, V; Grüssner, S



Classical varicose vein surgery in a diverse ethnic community.  


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

Murli, N L; Navin, I D



Strategies to reduce intraluminal clot formation in endoscopically harvested saphenous veins  

PubMed Central

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.

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.



Atresia of right pulmonary veins and anomalous left pulmonary venous drainage into portal circulation  

Microsoft Academic Search

Šamánek, M., T?ma, S., Benešová, D., Povýšilová, V., Pražský, F., and ?ápová, E. (1974).Thorax, 29, 446-450. Atresia of right pulmonary veins and anomalous left pulmonary venous drainage into portal circulation. An anomaly of pulmonary venous drainage in a male newborn infant is described whereby the left pulmonary veins entered the portal vein and the right pulmonary veins were atretic. A

M. Šamánek; S. T?ma; D. Benešová; V. Povýšilová; F. Pražský; E. ?ápová



Laser Chorioretinal Venous Anastomosis for Progressive Nonischemic Central Retinal Vein Occlusion  

Microsoft Academic Search

The use of high or medium-intensity lasers to create an anastomotic connection between a retinal vein and a choroidal vein for the treatment of nonischemic central retinal vein occlusion (CRVO) has shown encouraging results. We established communication between an obstructed retinal vein and the choroid using a modified laser application in the eye of a 17-year-old boy with progressive nonischemic

Chih-Hsin Chen; Chien-Hsiung Lai; Hsi-Kung Kuo


Effect of taleeq (leech therapy) in dawali (varicose veins).  


Dawali (varicose vein) is first described in Ebers Papyrus over 3500 years ago. Dawali is a disease in which veins of legs and feet become dilated, tortuous, and greenish in colour due to excess accumulation of blood which is derived from saudavi madda & balgham ghaleez. The aetiology of varicose veins is still incompletely under stood, despite the fact that it is a very common disease affecting all ages from teenagers to elderly people. The complication of varicose veins like venous eczema, venous pigmentation, lipodermatosclerosis, superficial thrombophlebitis, venous ulceration, etc impair health related quality of life significantly. The objective of the study is to evaluate the efficacy of Taleeq in Dawali and to provide safe & cost effective alternative treatment. Randomized controlled clinical open trial was conducted in regimenal unit of NIUM Hospital. 50 patients were divided into 2 groups, 30 in test & 20 in control group. Test group was treated with Taleeq on alternate day & control group was treated with grade 2 compression stockings & limb elevation for 2 months. Response was measured by assessment of pain / leg discomfort, limb girth at calf, ankle, and feet, pigmentation area & colour on every 15(th) day. Hb% was assessed on every 15(th) day to check anaemia. Effect on anatomy of vein was assessed by colour flow Doppler USG. Test group showed significant reduction in pain, limb girth, pigmentation, number of perforators. Control group showed significant reduction in pain & limb girth, but there was no improvement on pigmentation. Both groups do not show significant improvement on SFJ & SPJ incompetency. Test group has major effects in improvement of all parameters. Study stresses that leech therapy should be administered in combination with compression stockings & other effective treatment modalities like weight normalization for obese patients, physical therapy, dietary modification etc for optimal results. PMID:22557433

Nigar, Zar; Alam, Md Anwar



Automatic determination of the artery vein ratio in retinal images  

NASA Astrophysics Data System (ADS)

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.

Niemeijer, Meindert; van Ginneken, Bram; Abràmoff, Michael D.



Effect of Taleeq (Leech Therapy) in Dawali (Varicose Veins)  

PubMed Central

Dawali (varicose vein) is first described in Ebers Papyrus over 3500 years ago. Dawali is a disease in which veins of legs and feet become dilated, tortuous, and greenish in colour due to excess accumulation of blood which is derived from saudavi madda & balgham ghaleez. The aetiology of varicose veins is still incompletely under stood, despite the fact that it is a very common disease affecting all ages from teenagers to elderly people. The complication of varicose veins like venous eczema, venous pigmentation, lipodermatosclerosis, superficial thrombophlebitis, venous ulceration, etc impair health related quality of life significantly. The objective of the study is to evaluate the efficacy of Taleeq in Dawali and to provide safe & cost effective alternative treatment. Randomized controlled clinical open trial was conducted in regimenal unit of NIUM Hospital. 50 patients were divided into 2 groups, 30 in test & 20 in control group. Test group was treated with Taleeq on alternate day & control group was treated with grade 2 compression stockings & limb elevation for 2 months. Response was measured by assessment of pain / leg discomfort, limb girth at calf, ankle, and feet, pigmentation area & colour on every 15th day. Hb% was assessed on every 15th day to check anaemia. Effect on anatomy of vein was assessed by colour flow Doppler USG. Test group showed significant reduction in pain, limb girth, pigmentation, number of perforators. Control group showed significant reduction in pain & limb girth, but there was no improvement on pigmentation. Both groups do not show significant improvement on SFJ & SPJ incompetency. Test group has major effects in improvement of all parameters. Study stresses that leech therapy should be administered in combination with compression stockings & other effective treatment modalities like weight normalization for obese patients, physical therapy, dietary modification etc for optimal results.

Nigar, Zar; Alam, Md. Anwar



Surgical Treatment of Varicose Veins: Effect of Rationing  

PubMed Central

INTRODUCTION A substantial part of vascular surgical workload is devoted to the treatment of varicose veins. To control demand for cosmetic venous surgery, primary care trusts in Somerset introduced clinical criteria in 2000 for the referral and treatment of varicose veins based on the presence of skin change or ulceration, a history of bleeding, or two or more episodes of thrombophlebitis. PATIENTS AND METHODS A comparison of workload and case mix for the referral and treatment of new patients presenting with varicose veins to the Taunton and Somerset Hospital was carried out over two 6-month periods, before and after the introduction of clinically based assessment criteria. RESULTS A total of 134 operations for varicose veins were carried out in 2000 and 85 such operations in 2002/03 after the introduction of new referral criteria (P = 0.001). Of these, 69% (92/134) were day-case procedures in 2000 compared to only 48% (41/85) in 2002/03 (P = 0.004). There was no significant difference in the type of cases (e.g. single, bilateral or recurrent surgery) performed as a day-case (P = 0.34) or as an in-patient (P = 0.43) over the two periods. There was, however, a significant difference (P = 0.007) in the mean ages of patients in the two periods (48.5 years in period 1; 57.8 years in period 2) and in the average ASA grade (1.15 in period 1; 1.42 in period 2; P = 0.0002). CONCLUSION The introduction of clinical criteria for the referral and treatment of varicose veins reduced workload by 37%.

Re Harris, Mark; Davies, R Justin; Brown, Suki; Jones, Stephen M; Eyers, Paul S; Chester, John F



ACR Appropriateness Criteria® Suspected upper extremity deep vein thrombosis.  


Upper-extremity venous thrombosis often presents as unilateral arm swelling. The differential diagnosis includes lesions compressing the veins and causing a functional venous obstruction, venous stenosis, an infection causing edema, obstruction of previously functioning lymphatics, or the absence of sufficient lymphatic channels to ensure effective drainage. The following recommendations are made with the understanding that venous disease, specifically venous thrombosis, is the primary diagnosis to be excluded or confirmed in a patient presenting with unilateral upper-extremity swelling. Contrast venography remains the best reference-standard diagnostic test for suspected upper-extremity acute venous thrombosis and may be needed whenever other noninvasive strategies fail to adequately image the upper-extremity veins. Duplex, color flow, and compression ultrasound have also established a clear role in evaluation of the more peripheral veins that are accessible to sonography. Gadolinium contrast-enhanced MRI is routinely used to evaluate the status of the central veins. Delayed CT venography can often be used to confirm or exclude more central vein venous thrombi, although substantial contrast loads are required. The ACR Appropriateness Criteria(®) are evidence-based guidelines for specific clinical conditions that are reviewed every 2 years by a multidisciplinary expert panel. The guideline development and review include an extensive analysis of current medical literature from peer-reviewed journals and the application of a well-established consensus methodology (modified Delphi) to rate the appropriateness of imaging and treatment procedures by the panel. In those instances in which evidence is lacking or not definitive, expert opinion may be used to recommend imaging or treatment. PMID:22954541

Desjardins, Benoit; Rybicki, Frank J; Kim, Hyun S; Fan, Chieh-Min; Flamm, Scott D; Gerhard-Herman, Marie D; Kalva, Sanjeeva P; Koss, Scott A; Mansour, M Ashraf; Mohler, Emile R; Narra, Vamsi R; Schenker, Matthew P; Tulchinsky, Mark; Weiss, Clifford



Electron petrography of shock-produced veins in the Tenham chondrite  

Microsoft Academic Search

Electron microscopy of the minerals in, and adjacent to the black veins of the Tenham meteorite reveals that the minerals have undergone varying degrees of shock. The orthopyroxenes of the bulk of the meteorite have been transformed to clinopyroxenes in areas adjacent to the veins, and to majorite in the black vein itself. The majorite, which occurs in both equant

G. D. Price; A. Putnis; S. O. Agrell



Treatment of Branch Retinal Vein Occlusion induced Macular Edema with Bevacizumab  

Microsoft Academic Search

BACKGROUND: Branch retinal vein occlusion is a frequent cause of visual loss with currently insufficient treatment options. We evaluate the effect of Bevacizumab (Avastin®) treatment in patients with macular edema induced by branch retinal vein occlusion. METHODS: Retrospective analysis of 32 eyes in 32 patients with fluorescein angiography proven branch retinal vein occlusion, macular edema and Bevacizumab treatment. Outcome measures

Mathias Abegg; Christoph Tappeiner; Ute Wolf-Schnurrbusch; Daniel Barthelmes; Sebastian Wolf; Johannes Fleischhauer



Syn-metamorphic gold mineralisation, Invincible Vein, NW Otago Schist, New Zealand  

Microsoft Academic Search

The Invincible Vein fills a fault zone which strikes northeast and dips steeply southeast in the lower Rees Valley, NW Otago. The vein cuts north striking foliation in lower greenschist facies Otago Schist. Structures associated with the fault zone are both brittle and ductile, and the fault zone has had a complex history of post-mineralisation reactivation. Mineralised vein material filling

R. Hay; D. Craw



A new HIFU probe for the treatment of the superficial venous insufficiency and varicose veins  

Microsoft Academic Search

A previous work showed the feasibility of inducing a localized partial shrinkage of venous tissues with High Intensity Focused Ultrasound (HIFU). A partial shrinkage of the vein wall is proposed to correct the valvular dysfunction on the saphenous vein that is responsible of the superficial venous insufficiency and varicose veins. In the present study, a new real-time imaging HIFU probe

Samuel Pichardo; Laura Curiel; René Milleret; Olivier Pichot; François Lacoste; Jean-Yves Chapelon



Efficacy of pulmonary vein isolation for the elimination of chronic atrial fibrillation in cardiac valvular surgery  

Microsoft Academic Search

Background. Haissaguerre and colleagues emphasize the importance of the pulmonary veins as a source of ectopic foci for initiating paroxysmal atrial fibrillation (AF). We hypothesized that ectopic foci from the pulmonary veins could also act as drivers for maintaining chronic AF, and that surgical ablation of the pulmonary vein orifices could terminate chronic AF.Methods. Using a computerized 48-channel mapping system,

Taijiro Sueda; Katsuhiko Imai; Osamu Ishii; Kazumasa Orihashi; Masanobu Watari; Kenji Okada



Hyperbaric Oxygenation after Portal Vein Emobilization for Regeneration of the Predicted Remnant Liver  

Microsoft Academic Search

Background. Liver failure often develops after extensive liver resection. Preoperative portal vein embolization to induce compensatory hypertrophy in the predicted remnant liver decreases clinical complications after hepatectomy. The aim of this study was to examine whether hyperbaric oxygenation (HBO) after portal vein embolization increases compensatory hypertrophy of the predicted liver remnant. We performed portal vein ligation and HBO in rats

Tadashi Uwagawa; Yasuki Unemura; Yoji Yamazaki



Deep venous thrombosis due to compression of external iliac vein by the penile prosthesis reservoir  

Microsoft Academic Search

Penile implant surgery has a high rate of success and a very high patient satisfaction rate. Compression of the external iliac vein by the reservoir of the penile implant is an extremely rare occurrence. We describe a case of deep vein thrombosis due to compression of the external iliac vein, which required replacement of the penile implant reservoir.

Daniel G da Justa; Fernando J Bianco; Adrian Ogle; Chirpriya B Dhabuwala



Multimodality treatment in hepatocellula r carcinoma patients with tumor thrombi in portal vein  

Microsoft Academic Search

AIM To compare the therapeutic effect and significances of multimodality treatment for hepatocellular carcinoma (HCC) with tumor thrombi in portal vein (PVTT). METHODS HCC patients (n = 147) with tumor trombi in the main portal vein or the first branch of portal vein were divided into four groups by the several therapeutic methods. There were conservative treatment group in 18

Jia Fan; Zhi Quan Wu; Zhao You Tang; Jian Zhou; Shuang Jian Qiu; Zeng Chen Ma; Xin Da Zhou; Sheng Long Ye


Endothelial Healing in Vein Grafts Proliferative Burst Unimpaired by Genetic Therapy of Neointimal Disease  

Microsoft Academic Search

Background—Although inhibition of neointimal hyperplasia by cell cycle gene blockade therapy results in improved endothelial cell function in experimental vein grafts, little is known either about endothelial healing immediately after vein grafting or about the effect of this therapy on the healing process. Methods and Results—Scanning electron microscopy demonstrated an immediate decrease in vein graft endothelial cell density associated with

Afshin Ehsan; Michael J. Mann; Giorgio Dell' Acqua; Koichi Tamura; Ruediger Braun-Dullaeus; Victor J. Dzau


The clinical and hemodynamic results after axillary – to – popliteal vein valve transplantation  

Microsoft Academic Search

Purpose: To evaluate the results of axillary vein to popliteal vein valve transplantation (VVTX), we reviewed the clinical, phlebographic, and noninvasive hemodynamic results in 15 patients.Methods: All patients had postthrombotic destruction of deep venous valves as determined by ascending phlebography, whereas descending phlebography demonstrated grade III or IV reflux in all patients. A segment of valve-bearing axillary vein was transplanted

John D. L. Bry; Paula A. Muto; Thomas F. O'Donnell; Lois A. Isaacson



A Model For Syntectonic Fibrous Vein Growth Inferred From Microtextures. Ouachitas Orogen, Arkansas  

NASA Astrophysics Data System (ADS)

Veins from the Lower Ordovician Mazarn Formation in the Arkansas' Ouachitas show two processes of vein growth, 1) continuous localized fracturing and filling and 2) recrystallization, tied to the deformation history of the area under study. Evidence for continuous localized fracturing includes the presence of veinlets near or at the vein-host interface. Veinlets are long and narrow features parallel to the main body of the vein, filled mainly with quartz, between 5 and 25 ?m wide. Veinlets cut and displaced host grains. Displacement of host grains is evident because the material precipitated on veinlets show different luminescence than host grains. Remnants of these veinlets are observed in completely recrystallized fibers. Evidence for recrystallization includes, 1) wide fibers (more than 100 ?m) with fluid inclusion trails parallel to fiber length that span the entire fiber length, 2) luminescence in the central part of the vein is different than luminescence in the external part of the vein (close to host-vein interface), 3) remnants of original luminescence in the central part of the vein suggesting that recrystallization is a later process. We hypothesize that in this region folding followed by flattening gave rise to boudinage of resistant layers accompanying abundant pressure solution providing the vein forming material. Precipitation of material took place along necks of boudins, which fractured repeatedly allowing veins to grow in width and length. Late thrust faults led to open system conditions which gave rise to new vein growth and recrystallization. Recrystallization altered the shape of previously formed veins.

Cervantes, P.; Wiltschko, D. V.



Ramification of the portal vein at the porta hepatis in humans  

Microsoft Academic Search

Summary The ramification of the portal vein at the porta hepatis was studied by anatomic dissection performed in 32 formalin fixed human livers. In all the specimens there were branches which ran towards the caudate lobe, arising from the portal vein and either from the left or the right portal branches. Tri-and quadrifurcation of the portal vein was observed. In

LJ Franceschini; JR Ortale



A methodology to construct training images for vein-type deposits  

Microsoft Academic Search

Fracture models of vein formation can produce realistic training images (TIs) for use in multiple-point geostatistics. Vein formation is modeled by applying flow simulation to a fracture model to mimic the flow of an ore-bearing fluid through fractured rock. TIs are generated by assuming that veins form in areas of high flow where there would be preferential deposition of the

J. B. Boisvert; O. Leuangthong; J. M. Ortiz; C. V. Deutsch



Design and implementation of a contactless palm print and palm vein sensor  

Microsoft Academic Search

This paper presents an innovative contactless palm print and palm vein recognition system. We design a hand sensor that could capture the palm print and palm vein image using low-resolution web camera. Both the visible and infrared images can be captured at the same time, and we do not need specialized infrared sensor to image the vein pattern. The design

Michael Goh Kah Ong; Connie Tee; Andrew Teoh Beng Jin



Prostacyclin release from the human saphenous vein in diabetics is lower than in nondiabetics  

Microsoft Academic Search

The balance between prostacyclin and thromboxane has been suggested to be of great importance for the maintenance of patency in veins. In order to investigate prostacyclin and thromboxane release, segments from the human saphenous veins were investigated in 53 patients. Twenty-seven patients (10 males, 17 females) underwent surgery for varicose veins. Twenty-six patients (14 nondiabetics, 12 diabetics) underwent surgery for

Jan S. Brunkwall; David Bergqvist



Iron content (PIXE) in competent and incompetent veins is related to the vein wall morphology and tissue antioxidant enzymes.  


Impaired venous drainage of the lower extremities determines a cascade of pathologic events leading to chronic venous disease (CVD). It is believed that the one cause of CVD is red blood cell extravasation and local iron overload that could generate free radicals and iron-dependent inflammation. The aim of this study was to investigate the relationship between: the intracellular iron deposits in varicose veins and tissue oxidative state measured by: the Proton Induced X-ray Emission Spectroscopy (Fe(PIXE)), (tSOD), (tGPx), (tTBARs) and (boxDNA). Patients with diagnosed CVD were qualified for surgical procedure. Entire trunk of the great saphenous vein (GSV) was extracted. Part located near medial ankle was considered competent (C) in duplex ultrasonography (USG) examination. The incompetent (I) part was extracted from GSV where USG showed incompetent valves and massive venous reflux. The difference between local tFe(PIXE), tTBARS, boxDNA, tGPx, tSOD in incompetent and competent part of vein tissue was statistically significant. Intima/media ratio directly correlated with Fe(PIXE) C/I concentration. Iron deposition in competent vs incompetent part of vein was also related to the oxidative stress parameters (boxDNA). The findings from this pilot study suggest that Fe(PIXE) measurement may be useful for explaining the progression of chronic venous disease. PMID:22321300

Krzy?ciak, Wirginia; Kowalska, Joanna; Kózka, Mariusz; Papie?, Monika A; Kwiatek, Wojciech M



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...


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...


Vein replacement with fresh vital veins: a comparison of transplantation in RT-1-different rat strain combinations.  

PubMed Central

Transplantation of the intrathoracic inferior vena cava into the abdominal inferior vena cava of the recipient was performed in inbred rat strains of the following combinations: Syngeneic F344 leads to F344, RT-1-identical allogeneic LEW leads to F344, and RT-1-different allogeneic CAP leads to F344. In the RT-1-different combination subgroups with presensitization (blood, skin) were formed. The transplanted veins were evaluated at different times, macro- and microscopically. To test humoral immunology reactivity, we used a modified hemagglutination test, to analyse cell-mediated reactivity, subsequent skin grafts. The following results were obtained: 1) Aside from sporadic mononuclear cells caused by the operation technique, syngeneic vein grafts do not show any macroscopically visible and microscopically detectable changes. 2) Weakly allogeneic vein grafts do not lead to microscopically detectable changes in the graft. Strongly allogeneic vein grafts cause temporary mononuclear cell infiltration, which subsides within 21 days, without influencing the morphologic structure of the vessel wall. 3) In the RT-1-identical allogeneic strain combination, only accelerated skin graft rejection time indicates systemic sensitization, in the strongly allogeneic system, the increase of hemagglutinating antibodies also does this. 4) In both the RT-1-identical allogeneic strain combination and the RT-1-different allogeneic one, a proven sensitization does not lead to a permanent morphologic alteration. 5) Only presensitization with strong antigens (skin) leads to a macroscopically visible, as well as microscopically detectable, rejection reaction. Images Figs. 1a-d.

Thiede, A; Engemann, R; Korner, H H; Deltz, E; Muller-Ruchholtz, W



Photodynamic therapy of vein grafts: Suppression of intimal hyperplasia of the vein graft but not the anastomosis  

Microsoft Academic Search

Purpose: There is no clinically useful therapy for the suppression of vein bypass graft intimal hyperplasia (IH). Photodynamic therapy (PDT), a technique that uses light to activate otherwise biologically inert photosensitizers to produce cytotoxic effects, has been demonstrated to successfully inhibit experimental IH in balloon-injured arteries. The purpose of this study was to investigate the efficacy of PDT as a

Glenn M. LaMuraglia; Michael L. Klyachkin; Farzin Adili; William M. Abbott



Prevalence of varicose veins and chronic venous insufficiency in men and women in the general population: Edinburgh Vein Study  

Microsoft Academic Search

STUDY OBJECTIVE: To determine the prevalence of varicose veins and chronic venous insufficiency (CVI) in the general population. DESIGN: Cross sectional survey. SETTING: City of Edinburgh. PARTICIPANTS: Men and women aged 18-64 years selected randomly from age-sex registers of 12 general practices. MAIN RESULTS: In 1566 subjects examined, the age adjusted prevalence of trunk varices was 40% in men and

C. J. Evans; F. G. Fowkes; C. V. Ruckley; A. J. Lee



Palliative Portal Vein Stent Placement in Malignant and Symptomatic Extrinsic Portal Vein Stenosis or Occlusion  

SciTech Connect

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.

Novellas, Sebastien [Hopital Archet, Department of Radiology and Interventional Radiology (France); Denys, Alban, E-mail:; Bize, Pierre, E-mail: pierrebize@bluewin.c [Centre Hospitalier Universitaire Vaudois, Department of Radiology and Interventional Radiology (Switzerland); Brunner, Philippe; Motamedi, Jean Paul [Hopital Archet, Department of Radiology and Interventional Radiology (France); Gugenheim, Jean [Hopital Archet, Department of Surgery (France); Caroli, Francois-Xavier [Hopital Archet, Department of Medical Oncology (France); Chevallier, Patrick [Hopital Archet, Department of Radiology and Interventional Radiology (France)



Lemierre syndrome variant: Staphylococcus aureus associated with thrombosis of both the right internal jugular vein and the splenic vein after the exploration of a river cave  

Microsoft Academic Search

Background  Lemierre syndrome is a rare and potentially fatal entity characterized by septic emboli from thrombosis of the internal jugular\\u000a vein after oropharyngeal infection. The etiologic agent is not always an anaerobic bacterium. We report a patient with a Lemierre\\u000a syndrome variant who presented with thrombosis of both the right internal jugular vein and the splenic vein as well as septic

Can Boga; Hakan Ozdogu; Banu Diri; Levent Oguzkurt; Suheyl Asma; Mahmut Yeral



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

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.

Taylor, L M; Edwards, J M; Phinney, E S; Porter, J M



Endovenous Laser Ablation of Incompetent Perforator Veins: A New Technique in Treatment of Chronic Venous Disease  

SciTech Connect

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.

Ozkan, Ugur, E-mail: [Baskent University, Faculty of Medicine, Department of Radiology (Turkey)



Necrotizing fasciitis following endoscopic harvesting of the greater saphenous vein for coronary artery bypass graft.  


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

Liliav, Benjamin; Yakoub, Danny; Kasabian, Armen


Internal jugular vein: Peripheral vein adrenocorticotropic hormone ratio in patients with adrenocorticotropic hormone-dependent Cushing's syndrome: Ratio calculated from one adrenocorticotropic hormone sample each from right and left internal jugular vein during corticotrophin releasing hormone stimulation test  

PubMed Central

Background: Demonstration of central: Peripheral adrenocorticotropic hormone (ACTH) gradient is important for diagnosis of Cushing's disease. Aim: The aim was to assess the utility of internal jugular vein (IJV): Peripheral vein ACTH ratio for diagnosis of Cushing's disease. Materials and Methods: Patients with ACTH-dependent Cushing's syndrome (CS) patients were the subjects for this study. One blood sample each was collected from right and left IJV following intravenous hCRH at 3 and 5 min, respectively. A simultaneous peripheral vein sample was also collected with each IJV sample for calculation of IJV: Peripheral vein ACTH ratio. IJV sample collection was done under ultrasound guidance. ACTH was assayed using electrochemiluminescence immunoassay (ECLIA). Results: Thirty-two patients participated in this study. The IJV: Peripheral vein ACTH ratio ranged from 1.07 to 6.99 (n = 32). It was more than 1.6 in 23 patients. Cushing's disease could be confirmed in 20 of the 23 cases with IJV: Peripheral vein ratio more than 1.6. Four patients with Cushing's disease and 2 patients with ectopic ACTH syndrome had IJV: Peripheral vein ACTH ratio less than 1.6. Six cases with unknown ACTH source were excluded for calculation of sensitivity and specificity of the test. Conclusion: IJV: Peripheral vein ACTH ratio calculated from a single sample from each IJV obtained after hCRH had 83% sensitivity and 100% specificity for diagnosis of CD.

Chittawar, Sachin; Bhattacharya, Saptarshi; Sahoo, Jai Prakash; Prakash, Siva; Bhalla, Ashu Seith; Kandasamy, Devasenathipathy; Arora, Arundeep; Gupta, Nandita; Tandon, Nikhil; Goswami, Ravinder; Khadgawat, Rajesh; Jyotsna, Viveka P.; Karak, Ashish Kumar; Bal, Chandra Sekhar; Pandey, Ravindra Mohan; Kumar, Guresh; Ammini, Ariachery C.



Cephalic vein: Saviour in the microsurgical reconstruction of breast and head and neck cancers  

PubMed Central

Background: Reconstruction with microvascular free flaps is considered the reconstructive option of choice in cancer of the head and neck regions and breast. Rarely, there is paucity of vessels, especially the veins, at the recipient site. The cephalic vein with its good caliber and constant anatomy is a reliable recipient vein available in such situations. Materials and Methods: It is a retrospective study from January 2010 to July 2012 and includes 26 patients in whom cephalic vein was used for free-flap reconstruction in head and neck (3 cases) and breast cancers (23 cases). Results: All flaps in which cephalic vein was used survived completely. Conclusion: Cephalic vein can be considered as a reliable source of venous drainage when there is a non-availability/unusable of veins during free-flap reconstruction in the head and neck region and breast and also when additional source of venous drainage is required in these cases.

Shankhdhar, Vinay K.; Yadav, Prabha S.; Dushyant, Jaiswal; SeethaRaman, Sakthipalan Selva; Chinmay, Wingkar



Superior mesenteric vein thrombosis following laparoscopic Nissen fundoplication.  


This report describes the second case of a superior mesenteric and portal vein thrombosis following an uneventful laparoscopic Nissen fundoplication. The patient presented on postoperative day 10 with acute onset of abdominal pain and inability to tolerate oral food. A computed tomography (CT) scan revealed superior mesenteric and portal venous thrombosis with questionable viability of the proximal small bowel. He was heparinized and taken for emergent exploratory laparotomy. At surgery and at a planned re-exploration the following day, the bowel was viable and no resection was needed. Despite continuation on anticoagulation therapy, he developed a pulmonary embolism. A hypercoagulable workup was normal. After continued anticoagulation therapy and supportive care, a duplex ultrasound 2 months after the event showed normal flow in both the superior mesenteric and portal veins. Possible mechanisms are discussed along with a review of the pertinent literature. PMID:12856849

Steele, Scott R; Martin, Matthew J; Garafalo, Thomas; Ko, Tak-ming; Place, Ronald J


Superior Mesenteric Vein Thrombosis Following Laparoscopic Nissen Fundoplication  

PubMed Central

This report describes the second case of a superior mesenteric and portal vein thrombosis following an uneventful laparoscopic Nissen fundoplication. The patient presented on postoperative day 10 with acute onset of abdominal pain and inability to tolerate oral food. A computed tomography (CT) scan revealed superior mesenteric and portal venous thrombosis with questionable viability of the proximal small bowel. He was heparinized and taken for emergent exploratory laparotomy. At surgery and at a planned re-exploration the following day, the bowel was viable and no resection was needed. Despite continuation on anticoagulation therapy, he developed a pulmonary embolism. A hypercoagulable workup was normal. After continued anticoagulation therapy and supportive care, a duplex ultrasound 2 months after the event showed normal flow in both the superior mesenteric and portal veins. Possible mechanisms are discussed along with a review of the pertinent literature.

Martin, Matthew J.; Garafalo, Thomas; Ko, Tak-ming; Place, Ronald J.



Atypical presentation of lymphangioleiomyomatosis as jugular vein thrombosis  

PubMed Central

Lymphangioleiomyomatosis is a rare disorder of unknown origin that almost exclusively affects women of childbearing age. It is characterised by proliferation of abnormal smooth muscle cells (lymphangioleiomyomatosis cells) in the pulmonary interstitium and along the thoracic and abdominal lymphatics. Lymphangioleiomyomatosis may be associated with tuberous sclerosis complex. The most common manifestations of lymphangioleiomyomatosis are pulmonary symptoms, including progressive dyspnoea, recurrent pneumothoraces and chylous effusions. Extrapulmonary lymphangioleiomyomatosis as the initial presentation of the disease is highly unusual. We describe a patient with extrapulmonary lymphangioleiomyomatosis presenting as jugular vein thrombosis related to lower neck lymphangioleiomyoma. CT study showed bilateral lung cysts with left-sided hydropneumothorax and retroperitoneal lymphadenopathy. A left lower neck cystic lesion was seen with thrombosis of the adjacent left subclavian and internal jugular veins.

Wani, NISAR A; Kosar, T; Gojwari, T



Investigation and significance of short saphenous vein incompetence.  

PubMed Central

In this study, 186 limbs with varicose veins or venous skin changes were examined using duplex ultrasonography. Limbs were classified on the basis of short saphenous or popliteal venous incompetence and the number of limbs with venous ulceration (active or healed) recorded. Short saphenous incompetence did not produce a significant increase in the incidence of ulceration, whereas popliteal reflux produced an increase in the risk of ulceration which was statistically significant when compared with limbs without reflux in these two veins (chi 2 = 4.55, P = 0.003). There was no significant difference in the proportion of limbs with concomitant long saphenous reflux between these two groups. Short saphenous reflux is not important in the pathogenesis of venous ulceration. Popliteal reflux is an important factor in the pathogenesis of venous ulceration. More attention should be paid to the surgical correction of popliteal reflux when present in limbs with venous ulceration that fail to heal by conservative measures.

Payne, S. P.; London, N. J.; Newland, C. J.; Bell, P. R.; Barrie, W. W.



[Ophthalmologic diagnostic procedures and imaging of retinal vein occlusions].  


Retinal vein occlusions are a common vascular disease of the eye. Ophthalmological diagnostic procedures and imaging are important for the prognosis of the disease, as are the systemic work-up and therapy. Besides routine ophthalmic tests (visual acuity, slit lamp examination, funduscopy) a work-up for glaucoma such as intraocular pressure, visual field or 24 h IOP profile is useful as a diagnostic procedure. Furthermore, new diagnostic and imaging tests such as central corneal thickness and optic nerve head imaging by Heidelberg retina tomography or optical coherence tomography (OCT) should be considered for glaucoma evaluation. Optical coherence tomography also plays a major role in treatment monitoring of macular edema secondary to retinal vein occlusions. Fluorescein angiography is well established and can provide information with regard to size and extent of the occlusion, degree of ischemia, areas of non-perfusion and neovascularization, as well as macular edema. PMID:21331683

Mirshahi, A; Lorenz, K; Kramann, C; Stoffelns, B; Hattenbach, L-O



Dilated episcleral veins with secondary open angle glaucoma  

PubMed Central

We report a case of dilated episcleral vein with secondary open angle glaucoma. A 65-year-old female presented with redness of both the eyes without any prior systemic history. Her ocular examination revealed dilated episcleral veins and a high intraocular pressure (IOP) of 38 mm Hg in the right eye. Systemic examination was negative for carotid cavernous fistula, low-grade dural arteriovenous fistula, dysthyroid ophthalmopathy, and primary pulmonary hypertension. During follow-up, her IOP remained in high thirties despite maximum medications. She underwent right eye trabeculectomy with partial thickness sclerectomy with sclerotomy. In the beginning, the sclerotomy incision was not deepened into the suprachoroidal space. She developed choroidal effusion during surgery and the sclerotomy was deepened into suprachoroidal space and straw color fluid was drained. Postoperatively, she developed choroidal effusion, which resolved with conservative management. This case highlights the importance of sclerotomy in such cases of high episcleral venous pressure.

Parikh, Rajul S; Desai, Savari; Kothari, Kulin



Cytogenetic studies in venous tissue from patients with varicose veins.  


Cytogenetic investigation of primary cell cultures from fragments of varicose veins of seven patients with familial varicosity and seven patients with the sporadic type revealed the presence of metaphases with structural abnormalities, clonal trisomies of chromosomes 7, 12, and 18, and monosomy of chromosome 14 only in cases with the familial type, while the sporadic cases had no similar chromosome aberrations. The immunophenotypical results are consistent with fibroblast lineage of the cultured cells. These results suggest that karyotypic variations in familial varicose vein tissue cultures could in some way be associated either with the genotypic constitution responsible for the familial type or a longer duration of disease on average than those with sporadic varicosities. PMID:8039160

Scappaticci, S; Capra, E; Cortinovis, M; Cortinovis, R; Arbustini, E; Diegoli, M; Fraccaro, M



Subclavian vein aneurysm secondary to a benign vessel wall hamartoma.  


Venous aneurysms are rare clinical entities, particularly in children, and their presentation and natural history often depend on the anatomical location and underlying etiology. We present a single case of a 12-year-old girl who presented with a palpable right supraclavicular mass. Imaging evaluation with CT, conventional venography, MRI and sonography revealed a large fusiform subclavian vein aneurysm with an unusual, mass-like fibrofatty component incorporated into the vessel wall. The girl ultimately required complete resection of the right subclavian vein with placement of a synthetic interposition graft. This case provides a radiology/pathology correlation of an entity that has not previously been described as well as an example of the utility of multiple imaging modalities to aid diagnosis and preoperative planning. PMID:23636539

Warren, Patrick; Spaeth, Maya; Prasad, Vinay; McConnell, Patrick



Splanchnic vein thrombosis: new risk factors and management.  


Splanchnic vein thrombosis (SVT) is a rather heterogeneous disease which involve one or more abdominal veins draining from different organs, including small and large bowel, liver, spleen and pancreas, and it may be associated with a wide spectrum of underlying disorders, either local or systemic. The role of new risk factors for SVT, including the JAK2 V617F mutation and the paroxysmal nocturnal hemoglobinuria clone, has been highlighted in recent years. The clinical presentations of SVT are variable and, not uncommonly, may include the concomitant presence of extensive thrombosis and gastrointestinal bleeding, thus representing a clinical challenge for treatment decisions. High quality evidence on the acute and long-term management is substantially lacking, thus requiring further research on SVT. PMID:22682143

Donadini, Marco P; Dentali, Francesco; Ageno, Walter



Branch Retinal Vein Occlusion: Pathogenesis, Visual Prognosis, and Treatment Modalities  

PubMed Central

In branch retinal vein occlusion (BRVO), abnormal arteriovenous crossing with vein compression, degenerative changes of the vessel wall and abnormal hematological factors constitute the primary mechanism of vessel occlusion. In general, BRVO has a good prognosis: 50–60% of eyes are reported to have a final visual acuity (VA) of 20/40 or better even without treatment. One important prognostic factor for final VA appears to be the initial VA. Grid laser photocoagulation is an established treatment for macular edema in a particular group of patients with BRVO, while promising results for this condition are shown by intravitreal application of steroids or new vascular endothelial growth factor inhibitors. Vitrectomy with or without arteriovenous sheathotomy combined with removal of the internal limiting membrane may improve vision in eyes with macular edema which are unresponsive to or ineligible for laser treatment.

Rehak, Jiri; Rehak, Matus



The Role of Urokinase Plasminogen Activator and Plasmin Activator Inhibitor-1 on Vein Wall Remodeling in Experimental Deep Vein Thrombosis  

PubMed Central

OBJECTIVE Deep vein thrombosis (DVT) resolution instigates an inflammatory response, resulting in vessel wall damage and scarring. Urokinase-plasminogen activator (uPA) and its inhibitor, plasminogen activator inhibitor-1 (PAI-1), are integral components of the fibrinolytic system, essential for VT resolution. This study determined the vein wall response when exposed to increased and decreased plasmin activity. Methods A mouse inferior vena cava (IVC) ligation model in uPA ?/? or PAI-1 ?/? and their genetic wild types (B6/SvEv and C57/BL6, respectively) was used to create stasis thrombi, with tissue harvest at either 8 or 21d. Tissue analysis included gene expression of vascular smooth muscle cells (alpha SMA [?SMA], SM22) and endothelial marker (CD31), by real time PCR, ELISA, matrix metalloproteinase (MMP) -2 and 9 activity by zymography and vein wall collagen by picrosirius red histological analysis. A P < .05 was considered significant. RESULTS Thrombi were significantly larger in both 8d and 21d uPA ?/? as compared to WT, and were significantly smaller in both 8 and 21d PAI-1 ?/? as compared to WT. Correspondingly, 8d plasmin levels were reduced in half in uPA ?/? and increased 3 fold in PAI-1 ?/? when compared to respective WT thrombi (P < .05, N = 5 – 6). The endothelial marker CD31 was elevated 2 fold in PAI-1 ?/? mice at 8d, but reduced 2.5 fold at 21d in uPA ?/? as compared with WT (P = .02, N = 5 – 6), suggesting less endothelial preservation. Vein wall VSMC gene expression showed that 8d and 21d PAI-1 ?/? mice had 2.3 and 3.8 fold more SM22 and 1.8 and 2.3 fold more ?SMA expression than respective WT (P < .05, N = 5 – 7), as well as 1.8 fold increased ?SMA (+) cells (N = 3 – 5, P ? .05). No significant difference in MMP2 or 9 activity was found in the PAI-1 ?/? mice compared with WT, while 5.4 fold more MMP9 was present in 21d WT than 21d uPA ?/? (P = .03, N = 5). Lastly, collagen was ~2 fold greater at 8d in PAI-1 ?/? IVC as compared to WT (P = .03, N = 6) with no differences observed in uPA ?/? mice. CONCLUSIONS In stasis DVT, plasmin activity is critical for thrombus resolution. Divergent vein wall responses occur with gain or loss of plasmin activity, and despite smaller VT, greater vein wall fibrosis was associated with lack of PAI-1.

Baldwin, Joe F.; Sood, Vikram; Elfline, Megan A.; Luke, Cathy E.; Dewyer, Nicholas A.; Diaz, Jose A.; Myers, Dan D.; Wakefield, Thomas; Henke, Peter K.



A rare complication of acute appendicitis: Superior mesenteric vein thrombosis  

PubMed Central

Introduction Very few cases of superior mesenteric vein thrombosis have been reported as a complication of appendicitis. In these handful of cases, the thrombosis was identified early with computerised tomography scan and patients have been managed conservatively with antibiotics and anticoagulation. Presentation of case A 45-year-old gentleman presented to the emergency department with a 13-day history of right lower quadrant abdominal pain and rigors. CT scan of the abdomen revealed an appendicular mass and superior mesenteric vein thrombosis. The patient was initially managed by anticoagulation and antibiotics for two weeks and was discharged after satisfactory clinical improvement. He represented after discharge for increased severity of his abdominal pain and abnormal inflammatory markers. Emergency open appendicectomy for complicated appendicitis was performed and his postoperative course was unremarkable. He was discharged on the 7th postoperative day with anticoagulation. Outpatient review at two months was unremarkable. Discussion Acute appendicitis is a common surgical presentation where history and examination is key in clinching the diagnosis. Inflammatory markers and imaging modalities such as a CT scan can be helpful. Although surgical intervention is the mainstay of treatment, conservative management with antibiotics is an option if the diagnosis of appendicitis is equivocal. Recent evidence has revealed that elective appendicectomy is not necessary upon successful conservative management. Acute appendicitis can lead to local perforations and abscesses. Complications such as thrombosis in the superior mesenteric vein are rare and can be managed successfully with anticoagulants. Conclusion Although this is a rare complication of appendicitis, the case was managed successfully with a conservative approach. This is inline with the general consensus which is to treat superior mesenteric vein thrombosis secondary to appendicitis conservatively unless the patient deteriorates.

Bakti, N.; Hussain, A.; El-Hasani, S.



A Prague isolate of wisteria vein mosaic virus  

Microsoft Academic Search

An isolate of wisteria vein mosaic virus (WVMV) obtained fromWisteria sinensis in Prague resembled in its properties WVMV isolates described in Italy and Holland.Nicotiana megalosiphon is reported as a new host of WVMV. Other known host plants showed reactions similar to those described formerly. The incubation\\u000a period extended in some hosts up to two or four weeks. Pea plants showed

J. Br?ák



Presumed bilateral branch retinal vein occlusions secondary to antiepileptic agents  

PubMed Central

A 61-year-old man presented to the ophthalmology department having developed bilateral branch retinal vein occlusions. Baseline blood tests revealed no abnormality; however, subsequent investigations showed a raised plasma homocysteine (HC) level. The patient has been treated for refractory epilepsy for a number of years. Although antiepileptic medications have been shown to reduce folate levels and result in a raised HC level, this has not previously been shown to be to a level causing a retinal vascular event.

Hussain, Rumana N; Banerjee, Somnath



Intravitreal Ranibizumab for Macular Edema Secondary to Retinal Vein Occlusion  

Microsoft Academic Search

Background\\/Aims: To investigate the effects of intravitreal ranibizumab treatment for macular edema (ME) secondary to retinal vein occlusion (RVO) and the relationship between spectral-domain optical coherence tomography (SD-OCT) findings and visual outcome after successful resolution of ME. Methods: Forty consecutive eyes with ME secondary to branch RVO (BRVO; 29 eyes of 29 patients) or central RVO (CRVO; 11 eyes of

Moosang Kim; Seung-Young Yu; Eung-Suk Kim; So Hyun Bae; Jung Hyun Park; Hyeong Gon Yu; Hyung-Woo Kwak



Diodia vein chlorosis virus is a group-1 crinivirus  

Microsoft Academic Search

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\\u000a whitefly-transmitted closterovirus. Given the presence of the primary host for the virus in major agricultural production\\u000a areas in the United States, we characterized the virus at the molecular level, demonstrating that it belongs

Ioannis E. TzanetakisWilliam; William M. Wintermantel; Bindu Poudel; Jing Zhou


Endovenous Laser and Radiofrequency Treatment of Leg Veins  

Microsoft Academic Search

\\u000a Superficial varicosity is a common medical condition that is symptomatic in 20-30% of the US population. Classic symptoms\\u000a of venous insufficiency are ankle edema, leg fatigue, aching, discomfort, and muscle cramps. Some patients develop associated\\u000a complications, including stasis dermatitis, lipodermatosclerosis, skin atrophy, superficial thrombophlebitis, and venous ulcers.\\u000a The treatment of varicose veins reduces symptoms and complications of chronic venous insufficiency

Marisa Pongprutthipan; Jeffrey T. S. Hsu


Origin of pegmatitic segregation veins within flood basalts  

SciTech Connect

Subhorizontal veins and lenses of coarse-grained rock composed of plagioclase, augite, and Fe-Ti oxides in a glassy and vesicular mesostasis occur within several thick subaerial basalt flows in the Columbia River Basalt province of Washington and in the eastern North American Mesozoic basalt province. The veins and lenses, referred to as pegmatitic segregation veins, are typically 1-10 cm thick and are enriched in Fe, Ti, K, P, Cu, Zr, Ba, and REE by a factor of about 1.1 to 3 over the host basalt; Al, Ca, Sr, Mg, Ni, and Cr are lower, and Si and Na are typically unchanged. We interpret the pegmatitic segregation veins as the product of residual melt carried in vapor bubbles from the lower crystallization front of partially crystallized flows to the crystal mush within the upper crystallization front. Movement through the elevated temperatures of flow interiors fused any crystal nuclei in the segregation melt. Diminished nucleation density during crystallization may partially account for coarse grain sizes. In addition, diffusion of ions to large, rapidly growing skeletal crystals was probably enhanced by the viscosity-reduction effect of water enrichment. The water content of accumulated segregation melt may have increased whenever the escape of volatiles from partially crystallized flows was temporarily sealed off under a rigid barrier of solidified basalt. Rupture of the barrier by downward propagation of columnar joints would allow the resumption of effervescence and any remaining partially crystallized segregation melt-phase would be degassed and quenched into a glassy and vesicular mesostasis. 59 refs., 8 figs., 2 tabs.

Puffer, J.H.; Horter, D.L. (Rutgers Univ., Newark, NJ (United States))



Vein of Galen malformations: epidemiology, clinical presentations, management.  


The vein of Galen aneurysmal malformation is a congenital vascular malformation that comprises 30% of the pediatric vascular and 1% of all pediatric congenital anomalies. Treatment is dependent on the timing of presentation and clinical manifestations. With the development of endovascular techniques, treatment paradigms have changed and clinical outcomes have significantly improved. In this article, the developmental embryology, clinical features and pathophysiology, diagnostic workup, and management strategies are reviewed. PMID:22107867

Recinos, Pablo F; Rahmathulla, Gazanfar; Pearl, Monica; Recinos, Violette Renard; Jallo, George I; Gailloud, Philippe; Ahn, Edward S



Phenotypic heterogeneity in the endothelium of the human vortex vein system.  


The vortex vein system is the drainage pathway for the choroidal circulation and serves an important function in the effective drainage of the exceptionally high blood flow from the choroidal circulation. As there are only 4-6 vortex veins, a large volume of blood must be drained from many choroidal veins into each individual vortex vein. The vortex vein system must also cope with passing through tissues of different rigidity and significant pressure gradient as it transverses from the intrao-cular to the extra-ocular compartments. However, little is known about how the vortex vein system works under such complex situations in both physiological and pathological condition. Endothelial cells play a vital role in other vascular systems, but they have not been studied in detail in the vortex vein system. The purpose of this study is to characterise the intracellular structures and morphology in both the intra-and extra-ocular regions of the human vortex vein system. We hypothesise the presence of endothelial phenotypic heterogeneity through the vortex vein system. The inferior temporal vortex vein system from human donor eyes were obtained and studied histologically using confocal microscopy. The f-actin cytoskeleton and nuclei were labelled using Alexa Fluor conjugated Phalloidin and YO-PRO-1. Eight regions of the vortex vein system were examined with the venous endothelium studied in detail with quantitative data obtained for endothelial cell and nuclei size and shape. Significant endothelial phenotypic heterogeneity was found throughout the vortex vein system with the most obvious differences observed between the ampulla and its downstream regions. Variation in the distribution pattern of smooth muscle cells, in particular the absence of smooth muscle cells around the ampulla, was noted. Our results suggest the presence of significantly different haemodynamic forces in different regions of the vortex vein system and indicate that the vortex vein system may play important roles in regulation of the choroidal circulation. PMID:23872432

Yu, Paula K; Tan, Priscilla E Z; Cringle, Stephen J; McAllister, Ian L; Yu, Dao-Yi



Influence of dexamethasone on intimal thickening in experimental vein graft.  


The influence of dexamethasone on vein graft intimal hyperplasia was studied in a rat model. The iliolumbar vein was grafted to the common iliac artery in 42 rats. Twenty animals were treated with dexamethasone 0.1 mg/kg per day by injection for 3 weeks; 22 control animals received saline injections. Grafts were harvested at 3 weeks and longitudinal sections prepared. Five deaths and considerable morbidity was seen in the dexamethasone-treated animals. All grafts in the surviving animals in both groups were patent at 3 weeks. Intimal thickening, measured in the proximal, mid and distal graft, was found to be maximal in the proximal graft and least in the mid-portion of the graft. Dexamethasone reduced intimal thickening throughout the graft; the median thickness of the proximal graft was 30 microns (control 50 microns), in the mid-graft 10 microns (control 30 microns) and in the distal graft 20 microns (control 30 microns). This reduction was statistically significant in the mid-graft only (P < 0.05; Mann-Whitney U test). The small effect on anastomotic intimal thickening suggests that dexamethasone is of limited use in the prevention of vein graft intimal hyperplasia in clinical practice. PMID:8076131

Norman, P E; House, A K



Testicular Vein Syndrome and Its Treatment with a Laparoscopic Approach  

PubMed Central

Background and Objectives: Testicular vein syndrome (TVS) is a rare cause of ureteral obstruction. Only 5 previous cases are on record in the literature, and no review exists on this topic to date. Laparoscopic treatment has never been mentioned in the management of TVS. Materials and Methods: We reviewed the literature related to this unusual entity to clarify the preoperative evaluation and the management of TVS. For this purpose, the data related to all the 5 cases previously reported so far in the English literature have been reviewed. Also, we report the sixth case of TVS, and the first patient to be successfully treated with the laparoscopic approach. This was a 37-year-old male with a 6-month history of left loin pain. Preoperative diagnosis was confirmed by CT-Urography. Results: Our patient underwent laparoscopic excision of the left testicular vein followed by ureteroureterostomy in a single sitting. The laparoscopic transperitoneal approach was used. Histopathological examination of the vein showed normal venous tissue. This is the sixth reported case of TVS and the first to be successfully treated with a laparoscopic technique. Conclusions: A laparoscopic approach is safe and effective for treating patients with TVS with the common advantages of minimal invasiveness and better visualization of the complex anatomy of the retroperitoneum. Thus, it should be the treatment of choice for TVS.

Arvind, Nand Kishore; Gupta, Shilpi Singh



A dynamical system that describes vein graft adaptation and failure.  


Adaptation of vein bypass grafts to the mechanical stresses imposed by the arterial circulation is thought to be the primary determinant for lesion development, yet an understanding of how the various forces dictate local wall remodeling is lacking. We develop a dynamical system that summarizes the complex interplay between the mechanical environment and cell/matrix kinetics, ultimately dictating changes in the vein graft architecture. Based on a systematic mapping of the parameter space, three general remodeling response patterns are observed: (1) shear stabilized intimal thickening, (2) tension induced wall thinning and lumen expansion, and (3) tension stabilized wall thickening. Notable is our observation that the integration of multiple feedback mechanisms leads to a variety of non-linear responses that would be unanticipated by an analysis of each system component independently. This dynamic analysis supports the clinical observation that the majority of vein grafts proceed along an adaptive trajectory, where grafts dilate and mildly thicken in response to the increased tension and shear, but a small portion of the grafts demonstrate a maladaptive phenotype, where progressive inward remodeling and accentuated wall thickening lead to graft failure. PMID:23871714

Garbey, Marc; Berceli, Scott A



Portal vein thrombosis after laparoscopy-assisted splenectomy and cholecystectomy.  


A 12-year-old girl underwent laparoscopy-assisted splenectomy and cholecystectomy with removal of her spleen through a small Pfannenstiel incision. She had an unremarkable postoperative course but returned 16 days later because of increasing right-sided abdominal pain. The pain was constant, sharp, and stabbing without radiation. Abdominal examination showed diffuse right upper quadrant and epigastric tenderness without peritoneal irritation. Laboratory test results included white blood cell count, 14.4 x 10(9)/mm3; hemoglobin, 8.5 g/dL; platelets, 1,483,000; and normal values for lipase, amylase, aspartate transaminase, and alanine transaminase. Evaluation with ultrasonography and vessel Doppler studies showed an occlusive thrombus throughout the portal and splenic veins. The patient underwent intravenous heparin anticoagulation therapy. Her symptoms resolved completely over the next 2 days. The patient is currently receiving warfarin and anagrelide as an outpatient (international normalized ratio, 2). There were no long-term complications caused by portal vein thrombosis. This is the first reported case of portal vein thrombosis after laparoscopic splenectomy in the pediatric population. PMID:12677588

Brink, Jeromy S; Brown, Amanda K; Palmer, Brian A; Moir, Christopher; Rodeberg, David R



Risk factors associated with postpartum ovarian vein thrombosis.  


Thrombosis of the ovarian vein is a remarkable process occuring within a few days of labor in 1:500-1:2000 women. Its presentation is characterized by fever, abdominal pain and occasionally by a palpable abdominal mass that in earlier years sometimes lead to explorative laparotomy. With the advent of modern imaging techniques the diagnosis can be made relatively easily. The pathogenesis has been attributed to an infectious process expanding from the uterus to the right ovarian vein and stasis. A predisposition towards thrombosis has not been so far explored. In this study we retrospectively analysed the clinical features, diagnosis and treatment of 22 patients with objective documentation of post partum ovarian vein thrombosis (POVT) and assessed potential risk factors. In 11 of the 22 patients (50%) inherited prothrombotic risk factors were detected as follows: 4 were heterozygous for factor V G1691A, 2 had protein S deficiency, one had protein S deficiency and was heterozygous for factor V G1691A, and 4 were homozygous for MTHFR C677T. Eight of the 11 patients who bore a prothrombotic predisposition underwent cesarean section. Taken together, the data suggest that POVT may result from the combined effect of an infection, cesarean section and a prothrombotic tendency. PMID:10494756

Salomon, O; Apter, S; Shaham, D; Hiller, N; Bar-Ziv, J; Itzchak, Y; Gitel, S; Rosenberg, N; Strauss, S; Kaufman, N; Seligsohn, U



A unique virus complex causes Ageratum yellow vein disease  

PubMed Central

Ageratum conyzoides L., a weed species widely distributed throughout southeast Asia, frequently exhibits striking yellow vein symptoms associated with infection by Ageratum yellow vein virus (AYVV), a member of the Geminiviridae (genus Begomovirus). Most begomoviruses have bipartite genomes (DNAs A and B), but only a DNA A has been identified for AYVV. We demonstrate that yellow vein disease of A. conyzoides results from co-infection by AYVV DNA A (2,741 nt) and a circular DNA that is approximately half its size (1,347 nt) that we designate DNA ?. Apart from the sequence TAATATTAC, common to all geminiviruses and containing the initiation site of rolling circle replication, DNA ? shows negligible sequence homology either to AYVV DNA A or to DNA B associated with bipartite begomoviruses. DNA ? depends on DNA A for replication and is encapsidated by DNA A-encoded coat protein and so has characteristics of a DNA satellite. However, systemic infection of A. conyzoides by DNA A alone is sporadic and asymptomatic, and DNA A accumulation is reduced to 5% or less of its accumulation in the presence of DNA ?. Therefore, DNA A and DNA ? together form a previously unrecognized disease-inducing complex. Our data also demonstrate that the nanovirus-like DNA 1 component associated with infected A. conyzoides plays no essential role in the disease and represents a satellite-like DNA. Furthermore, the satellite DNA previously found associated with tomato leaf curl virus is probably a defective DNA ? homologue.

Saunders, Keith; Bedford, Ian D.; Briddon, Rob W.; Markham, Peter G.; Wong, Sek Man; Stanley, John



Splanchnic Vein Thrombosis in the Mediterranean Area in Children  

PubMed Central

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.

El-Karaksy, Hanaa; El-Raziky, Mona



Intraoperative assessment of hepatic venous congestion with direct clamping of the hepatic vein trunk for living donor liver transplantation  

Microsoft Academic Search

We devised a hepatic vein clamping method to assess the amount of hepatic venous congestion (HVC) before liver transection. From February 2003 to May 2003, this method was applied to 5 of 58 living donor livers especially to assess donor safety. The left portal vein and proper hepatic artery as well as the middle hepatic vein (MHV)–left hepatic vein (LHV)

S Hwang; S. G Lee; K. H Kim; K. M Park; Y. J Lee; C. S Ahn; D. B Moon; T. Y Ha; S. H Cho; K. B Oh



Pulmonary vein isolation under direct visual identification of the left atrium—pulmonary vein junction using intra-cardiac echography  

Microsoft Academic Search

Introduction: Intra-cardiac echocardiography (ICE) which has some benefits, can be used to obtain detailed anatomy of the heart chambers\\u000a or large vessels, and the catheter positions, and it has been considered useful for improving the outcome of the ablation.\\u000a In the present study, we performed pulmonary vein isolation (PVI) under real time monitoring of ICE imaging utilizing an ICE\\u000a catheter

Y. Higashi; H. Shimojima; D. Wakatsuki; K. Wakabayashi; F. Asano; Y. Honda; K. Kawachi; K. Oota; T. Sato; M. Ebato; T. Hashimoto; T. Takeshi; Y. Takeyama




Microsoft Academic Search

Purpose: To compare intravitreous bevacizumab to other current treatments of branch retinal vein occlusion (BRVO) and hemisphere retinal vein occlusion (HRVO) with consideration to visual outcome, cost, convenience, and risk of treatment. Methods: This is a retrospective chart review from a large referral retina practice. The data comprise 56 patients with BRVO and HRVO treated by intravitreous bevacizumab, with and

Gary Edd


A case with dextrocardia, ventricular septal defect, persistent left superior vena cava and drainage of the great cardiac vein into the left internal thoracic vein  

Microsoft Academic Search

A 17-month-old female patient was operated on for ventricular septal defect and pulmonary stenosis. During the operation several cardiac anomalies were observed these were dextrocardia, ventricular septal defect, persistent left superior vena cava, drainage of the great cardiac vein into the left internal thoracic vein and a pericardial pouch. These anomalies have not previously been reported together.

N. Yener; H. S. Sürücü; R. Dogan; M. M. Aldur



Effect of surgical preparation and arterialization on vasomotion of human saphenous vein.  


To gain an insight into venous physiologic adaptation to arterialization, this study examined the effects of thromboxane, 5-hydroxytryptamine, endothelin, leukotriene C4, and norepinephrine on isolated segments of native and distended human saphenous vein, short-term (up to 1 year) grafts, and long-term (1 to 10 year) grafts. The mean maximum constrictor responses, expressed as percentage of maximum potassium depolarization, were as follows: thromboxane analog U46619: native vein 147.0% +/- 10.5%, distended vein 251.2% +/- 29.1%, short-term graft 174.6% +/- 33.8%, long-term graft 220.9% +/- 21.7%; 5-hydroxytryptamine: native vein 115.6% +/- 6.1%, distended vein 129.9% +/- 13.3%, short-term graft 80.0% +/- 15.0%, long-term graft 95.1% +/- 12.1%; endothelin-1: native vein 126.5% +/- 22.1%, distended vein 138.1% +/- 24.7%, short-term graft 120.7% +/- 43.3%, long-term graft 171.4% +/- 26.0%; leukotriene C4: native vein 49.9% +/- 8.7%, distended vein 78.9% +/- 11.8%, short-term graft 90.8% +/- 39.1%, long-term graft 7.4% +/- 5.0%; and norepinephrine: native vein 127.0% +/- 9.3%, distended vein 155.0% +/- 17.8%, short-term graft 61.6% +/- 11.3%, long-term graft 80.1% +/- 7.7%. The vasoconstriction elicited by each agonist, in absolute terms (in millinewtons), diminished with age of graft. We conclude that surgical treatment of saphenous vein immediately renders it more responsive to U46619, norepinephrine, and leukotriene C4. An agonist-specific profile of response was evident up to 10 years after operation, which may affect myocardial blood supply when luminal bore is diminished by vein graft disease. PMID:8127099

O'Neil, G S; Chester, A H; Schyns, C J; Tadjkarimi, S; Borland, J A; Yacoub, M H



Development of an image acquisition system for hand vein based on an embedded system  

NASA Astrophysics Data System (ADS)

As one kind of the latest forms of biometrics, the human hand vein recognition utilizes a state-of-the-art recognition algorithm based on unique veins and capillaries found on human dorsal hand, which possesses the advantages such as well anti-falsification and high noise immunity. For the hand vein recognition, the most important premise is acquiring the high quality hand vein image. According to the special effect of human hand vein on the near infrared (NIR), when a hand is scanned by an image sensor, the vein pattern appears darker than its surroundings. Depending on this characteristic, the NIR light source was utilized to illuminate the image acquisition system for hand vein. And the optimal parameters of light source were chosen and the light source with high uniformity illuminance was manufactured to acquire the more clear hand vein image. Simultaneously, for the purpose of system miniaturization and design flexibility, the embedded image acquisition system for hand vein was designed based on the technology of system on programmable chip (SOPC). FPGA and CMOS image sensor were taken as the core components in the system, and the hardware of acquisition module is realized by configuring NiosII soft-core CPU and some corresponding interface modules on a FPGA. The software was developed by using the NiosII IDE to realize the initialization control to CMOS image sensor and collection, storage and transmission for the image data gathered from CMOS. Then the collected hand vein image was simply preprocessed, which further improved the image quality. Through experiments, the results indicated that this system could obtain the hand vein image with high performance, and it supplied the embedded development platform for hand vein recognition simultaneously. It was significant to develop the hand vein recognition system with small size and high speed.

Li, Xiuyan; Liu, Tiegen; Wang, Yunxin; Yuan, Chenhu; Deng, Shichao



Myocardial Perfusion Grade (MPG) After Late Infarct Artery Recanalization is Associated With Global and Regional LV Function at One Year; Analysis From the Total Occlusion Study of Canada-2  

PubMed Central

Background Whether myocardial perfusion grade (MPG) following late recanalization of infarct-related arteries (IRA) predicts left ventricular (LV) function recovery beyond the acute phase of myocardial infarction (MI) is unknown. Methods and Results The Total Occlusion Study of Canada-2 (TOSCA-2) enrolled stable patients with persistently occluded IRA beyond 24 h and up to 28 days post-MI. We studied the relationship between the initial MPG and changes in LV function and volume, and the change in MPG from immediate post-PCI to one year in 139 PCI patients with TIMI 3 epicardial flow post PCI and with paired values, grouped into impaired or good MPG groups (MPG 0/1 or MPG 2/3). MPG 0/1 patients were more likely to have received thrombolytic therapy and to have a LAD IRA. They had lower blood pressure and LV ejection fraction (LVEF), and a higher heart rate and systolic sphericity index at baseline. Changes in the MPG 0/1 and MPG 2/3 groups from baseline to 1 year were: LVEF 3.3±9.0 and 4.8±8.9 percent (p=0.42), LV end-systolic volume index (LVESVI) -1.1±9.2 and -4.7±12.3 ml/m2 (p=0.25), LV end-diastolic volume index (LVEDVI) 0.08±19.1 and -2.4±22.2 ml/m2 (p=0.67), and standard deviations /chord for infarct zone wall motion index (WMI)) 0.38±0.70 and 0.84±1.11 (p=0.01). By covariate-adjusted analysis, post-PCI MPG 0/1 predicted lower WMI (p<0.001), lower LVEF (p<0.001) and higher LVESVI (p<0.01), but not LVEDVI at one year. Of the MPG 0/1 patients, 60% were MPG 2 or 3 at one year. Conclusions Preserved MPG is present in a high proportion of patients following late PCI of occluded IRAs post-MI. Poor MPG post-PCI frequently improves MPG over 1 year. MPG graded after IRA recanalization undertaken days to weeks post MI is associated with LV recovery indicating that MPG determined in the subacute post-MI period remains a marker of viability.

Steigen, Terje K.; Buller, Christopher E.; John Mancini, G. B.; Jorapur, Vinod; Cantor, Warren J.; Rankin, James M.; Thomas, Boban; Webb, John G.; Kronsberg, Shari S.; Atchison, Deborah J.; Lamas, Gervasio A.; Hochman, Judith S.; Dzavik, Vladimir



Management of pulmonary vein rupture after percutaneous intervention: utility of a hybrid approach.  


Percutaneous intervention of subtotally occluded pulmonary veins can be difficult owing to the cicatrized nature of the stenotic vein tissue. A 55-year-old man with complete left superior and left inferior pulmonary vein occlusions 4 years after repeated atrial fibrillation radiofrequency ablations for symptomatic paroxysmal atrial fibrillation underwent sequential angioplasty, during which an uncovered stent was placed and expanded 2 mm from the pulmonary vein ostium. Hemodynamics rapidly deteriorated, and intracardiac echocardiogram confirmed pericardial tamponade. Median sternotomy was rapidly performed, and a tear encompassing approximately one-third of the circumference of the fibrotic and scarred left upper pulmonary vein was identified. The patient was supported on cardiopulmonary bypass, the heart was arrested, the left atrium was opened, and a covered 10-mm × 10-cm Viabahn covered stent was inserted. Additional external repair of pulmonary vein/epicardial tissue was performed to completely seal the perforation. PMID:23706441

Suri, Rakesh M; Valles, Alfred G; Asirvatham, Samuel J; McKellar, Stephen H; Sandhu, Gurpreet S; Wigle, Dennis; Holmes, David R



Clay veins: their occurrence, characteristics, and support. Report of Investigations/1987  

SciTech Connect

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.

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



Asymptomatic Deep Vein Thrombosis in a Patient with Major Depressive Disorder  

PubMed Central

Pulmonary embolism is a serious, life-threatening condition and most commonly derives from deep vein thrombosis of the lower extremities. Once deep vein thrombosis (DVT) reaches a proximal vein (i.e., popliteal vein or higher), pulmonary embolism reportedly occurs in up to 50% of patients. Case Presentation. We report on an inpatient with major depressive disorder in a catatonic state in whom an asymptomatic proximal deep vein thrombosis of 11 × 70?mm was detected through routine screening, using doppler ultrasound scanning. Anticoagulant therapy was immediately started and continued for three months, which resulted in resolution of the deep vein thrombosis. Discussion. To our knowledge, this is the first description of asymptomatic proximal DVT that was detected in a psychiatric inpatient setting. In light of the reported causal relationship between DVT and pulmonary embolism, screening for DVT can be of high clinical value in patients with psychiatric disorders, especially when their physical activity is highly compromised.

Ishida, Takuto; Katagiri, Takeshi; Uchida, Hiroyuki; Suzuki, Takefumi; Watanabe, Koichiro; Mimura, Masaru



Plateletcrit : A platelet marker associated with saphenous vein graft disease.  


BACKGROUND: Saphenous vein graft disease (SVGD) after by-pass surgery is an important cause of morbidity and mortality for patients with coronary artery disease. Comprehensive evaluation of biochemical and hematological parameters associated with this problem is limited. Plateletcrit (PCT) provides complete information on total platelet mass, but it has not been previously studied. In this study, we examined the relationship between SVGD and platelet parameters such as PCT, mean platelet volume, platelet count, and platelet distribution. METHODS: We retrospectively analyzed 14,398 patients who underwent coronary angiography between February 2006 and August 2012. Records from 893 patients with previous coronary artery by-pass graft operation were re-evaluated. A total of 251 cases were divided into two groups (127 patients receiving a saphenous vein graft; 124 patients diagnosed with SVGD) and hematological and biochemical parameters were compared. RESULTS: There were no significant differences in clinical characteristics between the two groups except that the SVGD group had a higher median time from surgery to coronary angiography than the patent saphenous vein graft group [7 years (2-16) vs. 5 years (2-15), p?

Akpinar, I; Sayin, M R; Gursoy, Y C; Karabag, T; Kucuk, E; Buyukuysal, M C; Aydin, M; Haznedaroglu, I C



Absorption of carbon dioxide during endoscopic vein harvest  

PubMed Central

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 10 min during the endoscopic step (T1) and end after 10 min 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 (44.5 ± 7.9 vs 39.7 ± 7.9 mmHg) 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.

Zingaro, Carlo; Pierri, Michele Danilo; Massi, Francesco; Matteucci, Marco Luciano Sacha; Capestro, Filippo; D'Alfonso, Alessandro; Aratari, Carlo; Torracca, Lucia



Rule-based model of vein graft remodeling.  


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

Hwang, Minki; Garbey, Marc; Berceli, Scott A; Wu, Rongling; Jiang, Zhihua; Tran-Son-Tay, Roger



Portal vein parameters in Egyptian patients with spontaneous bacterial peritonitis.  


Spontaneous bacterial peritonitis (SBP) is a severe complication of cirrhosis and the role of portal hypertension in the development of SBP has been suggested. This study assessed the portal vein (PV) haemodynamic changes in patients with SBP. The study was conducted on 20 ascitic patients with SBP (GI), 20 ascitic patients without SBP (GII), 20 cirrhotic patients without ascites (GIII) and 20 healthy cross-matched controls (GIV). All groups were subjected to complete clinical assessment and routine laboratory investigations. Portal vein diameter, velocity and congestion index (CI) were assessed by Doppler ultrasound. The results showed no significant difference between SBP patients and ascitic patients without SBP as regard PV diameter, velocity or CI. Portal vein diameter was significantly wider in patients with SBP (14.9 +/- 2.08 mm) and cirrhotic ascites (14.15 +/- 2.3) than normal persons (10.55 +/- 2.24 mm) or cirrhotic compensated patients (13.15 +/- 1.6 mm). The mean velocity of PV was significantly lower in patients with SBP (10.4 +/- 2.11) and ascites (10.7 +/- 2.22) than normal persons (15.35 +/- 2.08) or cirrhotic compensated patients (14 +/- 2.6), with no significant difference between controls and cirrhotic compensated patients. The CI of PV was significantly higher in patients with SBP (0.1825 +/- 0.036) and ascites (0.1743 +/- 0.051) than controls (0.05 +/- 0.050) or cirrhotic compensated patients (0.0955 +/- 0.091). Cirrhotic compensated patients showed significantly wider PV (13.15 +/- 1.6) and higher congestion index (0.0955 +/- 0.091) than normal persons (10.55 +/- 2.24 and 0.05 +/- 0.050 respectively). PMID:21268541

Allam, Mohamed A; Elmetwaly, Mohamed Toulba; Elwan, Hamed Abdelhafiz; Alteby, Diaa Mohamed; Soliman, Gamal Mohamed; Abu-Alfotuh, Atef



[The insertion of permanent pacemaker leads via the retro-pectoral veins (author's transl)].  


When it is not possible to use the cephalic vein for the insertion of a permanent pacemaker wire, the veins situated below the clavicular head of the pectoralis major, close to the lateral border of its upper part, can be used. This is possible in 87.6% of cases. The use of this approach is associated with a lower reoperation rate than the cephalic vein way. PMID:493082

Camous, J P; Guarino, L; Bracco, J; Guiran, J B



Results of bevacizumab as the primary treatment for retinal vein occlusions  

Microsoft Academic Search

BackgroundThe purpose of this study is to evaluate the efficacy of intravitreal bevacizumab as the primary treatment of macular oedema due to retinal vein occlusions.MethodsPatients diagnosed as having central retinal vein occlusion (CRVO) or branch retinal vein occlusion (BRVO) with visual acuity of less than 20\\/40 and macular oedema with more than 300 ?m central retinal thickness were recruited. Patients

M. S. Figueroa; I. Contreras; S. Noval; C. Arruabarrena



Hepatocellular Carcinoma Presenting as an Incidental Isolated Malignant Portal Vein Thrombosis  

Microsoft Academic Search

Introduction  Portal vein thrombosis is frequently associated with hepatocellular carcinoma (HCC). Tumor invasion into the portal vein by\\u000a direct venous extension or metastasis occurs in up to 70% of HCC patients (Cedrone et al., Liver 16:94–8, 1996). However, presentation as an isolated malignant portal vein thrombosis without any evidence of obvious hepatoma-like lesions\\u000a in the liver by imaging studies is extremely

Nishant Poddar; Boris Avezbakiyev; Zili He; Ming Jiang; Arash Gohari; Jen Chen Wang