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Stent Recanalization of Chronic Portal Vein Occlusion in a Child
Cwikiel, Wojciech [Department of Diagnostic Radiology, University Hospital, S-221 85 Lund (Sweden); Solvig, Jan [Department of Diagnostic Radiology, University Hospital, Skejby, DK-8200 Aarhus (Denmark); Schroder, Henrik [Department of Pediatric Medicine, University Hospital, Skejby, DK-8200 Aarhus (Denmark)
An 8-year-old boy with a 21/2 year history of portal hypertension and repeated bleedings from esophageal varices, was referred for treatment. The 3.5-cm-long occlusion of the portal vein was passed and the channel created was stabilized with a balloon-expandable stent; a portosystemic stent-shunt was also created. The portosystemic shunt closed spontaneously within 1 month, while the recanalized segment of the portal vein remained open. The pressure gradient between the intrahepatic and extrahepatic portal vein branches dropped from 17 mmHg to 0 mmHg. The pressure in the portal vein dropped from 30 mmHg to 17 mmHg and the bleedings stopped. The next dilation of the stent was performed 12 months later due to an increased pressure gradient; the gastroesophageal varices disappeared completely. Further dilation of the stent was planned after 2, 4, and 6 years.
Laparoscopic umbilical hernia repair in the presence of extensive paraumbilical collateral veins: a case report.
Lases, Seilenna S; Eker, Hasan H; Pierik, Engelbertus G J M; Klitsie, Pieter J; de Goede, Barry; Peeters, Mark P F M Vrancken; Kazemier, Geert; Lange, Johan F
A patient with an umbilical hernia presenting with collateral veins in the abdominal wall and umbilicus is a case that every hernia surgeon has to deal with occasionally. Several underlying diseases have been described to provoke collateral veins in the abdominal wall. However, the treatment strategy should be uniform. We herein report a case of a successful laparoscopic umbilical hernia repair in a patient with collateral veins in the abdominal wall and umbilicus. A 63-year-old man was referred to the surgical outpatient clinic with a large symptomatic umbilical hernia and collateral veins in the abdominal wall, secondary to an occlusion of both common iliac veins. Because of collateral veins in the umbilicus and the size of the hernial defect, he was offered laparoscopic hernia repair without compromising these veins. Because of the extensive abdominal wall collaterals, duplex sonography vein mapping was performed preoperatively to mark a safe collateral-free area for trocar introduction. The defect was repaired by mesh prosthesis. PMID:22146185
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.
Zachariah, Sanoop K; Krishnankutty, Sreejith L; Raja, Nirmalan
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
Laparoscopic management of massive spontaneous external haemorrhage from the umbilical varix due to recanalisation of the paraumbilical vein in a patient with æChild's Class AÆ liver cirrhosis
Zachariah, Sanoop K; Krishnankutty, Sreejith L; Raja, Nirmalan
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
Mid-term follow-up after retrograde recanalization of chronically occluded saphenous vein graft.
Galassi, Alfredo R; Tomasello, Salvatore D; Costanzo, Luca; Tamburino, Corrado
We reported a case of 55-year-old male with an ostial chronically occluded saphenous vein graft which was recanalized by retrograde approach through an epicardial collateral channel with implantation of three drug eluting stents. Six-month coronary angiography showed the patency of graft and distal native vessel diameter enhancement. PMID:20151140
Accessory hepatic vein recanalization for treatment of Budd-Chiari syndrome due to long-segment obstruction of the hepatic vein: initial clinical experience
Fu, Yu-Fei; Xu, Hao; Zhang, Ke; Zhang, Qing-Qiao; Wei, Ning
PURPOSE We aimed to investigate the feasibility and effectiveness of accessory hepatic vein recanalization (balloon dilatation/stent insertion) for patients with Budd-Chiari syndrome (BCS) due to long-segment obstruction of the hepatic vein. METHODS From March 2010 to December 2013, 20 consecutive patients with BCS, due to long-segment obstruction of three hepatic veins, treated with accessory hepatic vein recanalization (11 males, 9 females; mean age, 33.4▒10.9 years; range, 22¢56 years) were included in this retrospective study. Data on technical success, clinical success, and follow-up were collected and analyzed. RESULTS Technical and clinical success was achieved in all patients. Each patient was managed with a single accessory hepatic vein recanalization procedure. No procedure-related complications occurred. The diameter of the accessory hepatic vein was 8.45▒1.47 mm (6¢11 mm) at the stem, and there were many collateral circulations between the hepatic vein and the accessory hepatic vein. The mean pressure of accessory hepatic vein decreased from 47.50▒5.59 cm H2O before treatment to 28.80▒3.47 cm H2O after treatment (P < 0.001). Abnormal levels of total bilirubin, albumin, aspartate aminotransferase, and alanine transaminase improved after the treatment. During the follow-up, three patients experienced restenosis or stenting of the accessory hepatic vein. CONCLUSIONS In BCS due to long-segment obstruction of the hepatic veins, it is important to confirm whether there is a compensatory accessory hepatic vein. For patients with a compensatory but obstructed accessory hepatic vein, recanalization is a simple, safe, and effective treatment option. PMID:25616271
Recanalization of an Occluded Infrainguinal Vein Graft Complicated by Graft Aneurysm
Kakani, Nirmal; Travis, Simon; Hancock, John [Royal Cornwall Hospital, Department of Clinical Imaging (United Kingdom)], E-mail: firstname.lastname@example.com
The technique of subintimal angioplasty has been described for the recanalisation of native vessels after occlusion of infrainguinal vascular bypass grafts. We report a case in which an attempt at such treatment resulted in inadvertent but successful recanalisation of the occluded vein graft instead. This was complicated by graft perforation and subsequent graft aneurysm which was successfully treated with a covered stent.
Time course and the recanalization rate of superficial vein thrombosis treated with low-molecular-weight heparin.
Spirkoska, Ana; Jezovnik, Mateja Kaja; Poredos, Pavel
The aim of this study was to follow the thrombus progression and regression in superficial veins of lower limbs in patients with superficial vein thrombosis (SVT) treated with low-molecular-weight heparin. Patients (n = 68) with a first symptomatic SVT of the lower limbs received 2 different dosages of dalteparin. The primary outcome was a change in the diameter and length of thrombus in the affected veins. The regression of thrombus was not significantly different between the groups (P = .19). The reduction in the length of thrombus as well as thrombus diameter was significantly greater in females. At the end of the observation period, the length of thrombus in the distal part was more reduced than in the proximal segments. It seems that the dosage of anticoagulant drug does not have a significant impact on thrombus resolution. PMID:24807875
Sharp Central Venous Recanalization by Means of a TIPS Needle
Dagmar Honnef; Markus Wingen; Rolf W. G³nther; Patrick Haage
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,
Spontaneous recanalization after vasectomy.
Lucon, Ant¶nio Marmo; Pasqualotto, Fßbio Firmbach; Schneider-Monteiro, Edison Daniel; Saldanha, Luis Balthazar; Danilovic, Alexandre; Danilovic, Alexandre
Vasectomy is the method most commonly used in men for voluntary sterilization purposes. We report two cases of early recanalization following vasectomies performed in 1085 men for sterilization purposes at a tertiary public institution between January 2000 and November 2003. Thus, the risk of 0.2% of failure due to early recanalization should be explained and the fertility implications stressed. Written documentation recording the clarification presented at consultation is essential. PMID:17619703
Massive paraumbilical hernia: not all is as it seems.
Chisholm, J; Dean, N R
We discuss the management of an otherwise healthy obese patient who presented with a massive paraumbilical hernia extending into a large lymphoedematous abdominal apron. After anaesthetic assessment and abdominal computed tomography (CT), the patient underwent an elective operation. The hernia was dissected free of the heavy lymphoedematous apron with the aid of orthopaedic pins and a motorised patient lifter. Despite the size of the hernia, the primary defect was found to be relatively small and easy to reduce. The defect was repaired with a sublay Proceed(«) mesh and skin closure was achieved primarily. The patient had an uneventful post-operative course and gained significant improvement in her mobility. PMID:20221840
Sharp Central Venous Recanalization by Means of a TIPS Needle
Honnef, Dagmar, E-mail: email@example.com; Wingen, Markus; Guenther, Rolf W.; Haage, Patrick [University Hospital, Department of Diagnostic Radiology (Germany)
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.
Power-Pulse Thrombolysis and Stent Recanalization for Acute Post-Liver Transplant Iliocaval Venous Thrombosis
Baccin, Carlos E.; Haskal, Ziv J., E-mail: email@example.com [New York Presbyterian Hospital/Columbia University Medical Center (United States)
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.
Cholecystocutaneous fistula: an unusual complication of a para-umbilical hernia repair.
Dixon, Steven; Sharma, Mitesh; Holtham, Stephen
This case describes a 94-year-old woman who presented 2?years postsutured para-umbilical hernia repair with a painful black lump protruding through her scar with blood stained discharge. This was initially thought to be either ischaemic bowel secondary to strangulated incisional hernia or a large organised haematoma. An urgent CT scan was performed following which the patient passed two large calculi and bile-stained fluid spontaneously through the wound, making the diagnosis somewhat clearer. The scan revealed an incisional hernia containing the gallbladder and two large calculi at the skin surface and an incidental large caecal cancer with surrounding lymphadenopathy. Frail health and the incidental finding of a colon cancer rendered invasive surgical management inappropriate. Therefore, she was managed conservatively with antibiotics. A catheter was inserted into the fistula tract to allow free drainage and alleviate pressure-related symptoms. The patient was discharged following a multidisciplinary team discussion. PMID:24862413
Recanalization of Spontaneous Carotid Artery Dissection
Krassen Nedeltchev; Stefan Bickel; Marcel Arnold; Hakan Sarikaya; Dimitrios Georgiadis; Matthias Sturzenegger; Heinrich P. Mattle; Ralf W. Baumgartner
Background and PurposeŚWe set out to investigate the predictors and time course for recanalization of spontaneous dissection of the cervical internal carotid artery (SICAD). MethodsŚWe prospectively included 249 consecutive patients (mean age, 4511 years) with 268 SICAD. Ultrasound examinations were performed at presentation, during the first month, and then at 3, 6, and 12 months, and clinical follow-ups after 3,
Corsair microcatheter for retrograde coronary chronic total occlusion recanalization: Early experience outside the realm of dedicated recanalization specialists
Joseph, George; Thomson, Viji Samuel; Radhakrishnan, Shanmugasundaram
Objective To determine the extent to which use of the Corsair microcatheter (CM, Asahi Intecc Co., Japan) improves procedural outcomes when an experienced operator who is not a dedicated recanalization specialist attempts retrograde chronic total occlusion (CTO) recanalization through collateral channels during percutaneous coronary intervention. Background The recently introduced CM has improved success rates of retrograde CTO recanalization to nearly 100% in the hands of dedicated coronary recanalization specialists; however, the impact the CM has on the results of non-specialist operators attempting retrograde CTO recanalization is not known. Methods A non-specialist operator attempted CM-assisted recanalization in seven consecutive CTO cases requiring retrograde recanalization. The results obtained were compared with those achieved by the same operator in eleven consecutive retrograde CTO recanalization procedures during the last 2 years before the CM became available. Results CM-assisted retrograde CTO recanalization was successful in 6 of 7 cases (86%), but failed in one case attempted through a tortuous epicardial collateral; there were no complications. In contrast, during the 2 years before the CM became available, retrograde CTO recanalization was successful in only 3 of 11 attempted cases (27%), and was associated with significant morbidity. Lesions in the two groups were comparable in terms of technical difficulty and procedural risk. Conclusions The non-specialist operator's retrograde CTO recanalization results improve significantly when using the CM. Given the effectiveness and safety of CM-assisted retrograde CTO recanalization, operators should be less aggressive with anterograde recanalization attempts, and should switch to the retrograde approach earlier and more often. PMID:22929822
[Selective transcervical tubal recanalization under DSA].
Kelekis, D; Fezoulidis, I; Petsas, T; Tsapalira, A; Kelekis, N
The results of selective transcervical tubal recanalisation by means of a catheter in 20 patients with tubal occlusions are reported and discussed. The advantages of tubal recanalisation under DSA are stressed. In 18 (90%) of the 20 patients treated, it was possible to recanalize at least one tube. Nine of these 18 women (50%) became pregnant during the period of observation, averaging 12 months. Selective transcervical recanalisation of obstructive tubes is a rapid, reliable, cheap and hardly invasive treatment of sterility, when compared with laparoscopy or laparotomy. In the majority of patients it makes surgery unnecessary. PMID:1850148
Two different therapeutic modalities in the treatment of the upper extremity deep vein thrombosis: Preliminary investigation with 20 case reports
Ioannis E. Petrakis; Asterios Katsamouris; Efthimios Kafassis; Mauro D'Anna; Vincenzo Sciacca
Primary or secondary axillary or\\/and subclavian vein thrombosis (ASVT) can produce long-term disability, mostly in young patients, while the final vein recanalization after various therapeutic modalities often fails. Our aim was to compare the results of two different therapeutic modalities: the thrombolytic vs anticoagulant therapy, in primary and secondary ASVT in a retrospective data analysis in terms of efficacy, negative
Korean Guidelines for Interventional Recanalization of Lower Extremity Arteries
Bae, Jae Ik; Jeon, Yong Sun; Kim, Chang Won; Jae, Hwan Jun; Park, Kwang Bo; Cho, Young Kwon; Kim, Man Deuk
Peripheral arterial occlusive disease caused by atherosclerosis can present with intermittent claudication or critical limb ischemia. Proper diagnosis and management is warranted to improve symptoms and salvage limbs. With the introduction of new techniques and dedicated materials, endovascular recanalization is widely performed for the treatment of peripheral arterial occlusive disease because it is less invasive than surgery. However, there are various opinions regarding the appropriate indications and procedure methods for interventional recanalization according to operator and institution in Korea. Therefore, we intend to provide evidence based guidelines for interventional recanalization by multidisciplinary consensus. These guidelines are the result of a close collaboration between physicians from many different areas of expertise including interventional radiology, interventional cardiology, and vascular surgery. The goal of these guidelines is to ensure better treatment, to serve as a guide to the clinician, and consequently, to contribute to public health care.
Portal Vein Thrombosis in Cirrhosis
Raja, Kaiser; Jacob, Mathew; Asthana, Sonal
Portal vein thrombosis (PVT) is being increasingly recognized in patients with advanced cirrhosis and in those undergoing liver transplantation. Reduced flow in the portal vein is probably responsible for clotting in the spleno-porto-mesenteric venous system. There is also increasing evidence that hypercoagulability occurs in advanced liver disease and contributes to the risk of PVT. Ultrasound based studies have reported a prevalence of PVT in 10¢25% of cirrhotic patients without hepatocellular carcinoma. Partial thrombosis of the portal vein is more common and may not have pathophysiological consequences. However, there is high risk of progression of partial PVT to complete PVT that may cause exacerbation of portal hypertension and progression of liver insufficiency. It is thus, essential to accurately diagnose and stage PVT in patients waiting for transplantation and consider anticoagulation therapy. Therapy with low molecular weight heparin and vitamin K antagonists has been shown to achieve complete and partial recanalization in 33¢45% and 15¢35% of cases respectively. There are however, no guidelines to help determine the dose and therapeutic efficacy of anticoagulation in patients with cirrhosis. Anticoagulation therapy related bleeding is the most feared complication but it appears that the risk of variceal bleeding is more likely to be dependent on portal pressure rather than solely related to coagulation status. TIPS has also been reported to restore patency of the portal vein. Patients with complete PVT currently do not form an absolute contraindication for liver transplantation. Thrombectomy or thromboendovenectomy is possible in more than 75% of patients followed by anatomical end-to-end portal anastomosis. When patency of the portal vein and/or superior mesenteric vein is not achieved, only non-anatomical techniques (reno-portal anastomosis or cavo-portal hemitransposition) can be performed. These techniques, which do not fully reverse portal hypertension, are associated with higher morbidity and mortality risks in the short term. PMID:25755579
Portal vein thrombosis with protein C-S deficiency in a non-cirrhotic patient
RodrĒguez-Leal, Gustavo A; Morßn, Segundo; Corona-Cedillo, Roberto; Brom-Valladares, RocĒo
There are several conditions that can lead to portal vein thrombosis (PVT), including including infection, malignancies, and coagulation disorders. Anew condition of interest is protein C and S deficiencies, associated with hypercoagulation and recurrent venous thromboembolism. We report the case of a non-cirrhotic 63-year-old male diagnosed with acute superior mesenteric vein thrombosis and PVT and combined deficiencies in proteins C and S, recanalized by short-term low molecular heparin plus oral warfarin therapy. PMID:25068006
Deep vein thrombosis detection by 99m TC-MDP scanning
Moallem, A.; Lichsztral, R.
A new observation is reported wherein 99m Tc-MDP is incorporated into recanalizing thrombophlebitis. In one patient with subacute disease, inflammatory vascularity is appreciated during the first one to two minutes after injection. Both patients showed evidence of late phosphate uptake in their greater saphenous veins two hours later. Intravenous isotope injections may be given in an arm vein: foot injections are not required.
[Genesis of great saphenous vein obliteration and its clinical manifestations after endovenous laser coagulation combined with crossectomy during the varicose vein treatment].
Vakhitov, M Sh; Ulimbasheva, Z M; Ryzhov, A N; Bykov, M A; Danil'chenko, O V; Tsibin, A Iu; Semenov, D Iu
An analysis of results of the endovenous laser coagulation combined with crossectomy was made in 170 patients with varicose veins of lower extremities (C(VI), C(II)-C(V)). Clinical and ultrasonic data were investigated during a period of 3-5 days (45 lower extremities) and followed up in 1-3 years after operation (194 lower extremities). Three years later the absence of reflux was observed in 95.9% of cases. In 51.1% of cases, 1-2 zones of parietal and segmental hemodynamical insignificant bloodstream were detected. A recanalization of the great saphenous vein along the whole length was revealed in 8 cases out of 194 (4.1%) patients. The bloodstream was provided by affluxes in the area of a shin and a wellhead afflux of the stump of the great suphenous vein. The ultrasonic picture of recanalization was similar to that observed in post-thrombophlebitic occlusion. PMID:23808221
Pull-Through Technique for Recanalization of Occluded Portosystemic Shunts (TIPS): Technical Note and Review of the Literature
Tanaka, Toshihiro, E-mail: firstname.lastname@example.com; Guenther, Rolf W., E-mail: email@example.com; Isfort, Peter, E-mail: firstname.lastname@example.com [RWTH Aachen University, Department of Diagnostic Radiology, Aachen University Hospital (Germany); Kichikawa, Kimihiko, E-mail: firstname.lastname@example.com [Nara Medical University, Department of Radiology (Japan); Mahnken, Andreas H., E-mail: firstname.lastname@example.com [RWTH Aachen University, Department of Diagnostic Radiology, Aachen University Hospital (Germany)
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.
... skin surface ( Figure ). View larger version: In this window In a new window Download as PowerPoint Slide Figure. Types of varicose ... or superficial veins. View this table: In this window In a new window Table 1. Risk Factors ...
Onyx resorbtion with AVM recanalization after complete AVM obliteration.
Bauer, Andrew M; Bain, Mark D; Rasmussen, Peter A
Brain arteriovenous malformations (BAVM) are some of the most complex lesions treated by clinical neuroscientists. The recent publication of the ARUBA trial, showing higher complication rates with treatment compared with the natural history over a short period of follow-up, puts even more pressure on the physician to achieve complete BAVM eradication without complication. These lesions are often treated by multimodality therapy with some combination of endovascular embolization, radiosurgery, and microsurgical resection; however, multimodality therapy involves the additive risk of procedural complication with each procedure. While surgical resection has long been accepted as monotherapy with good cure rates, staged pre-operative endovascular embolization has facilitated microsurgical resection with lower blood loss. Endovascular embolization is more often utilized in conjunction with surgical resection, and often the portions of the AVM and feeders that are completely embolized with Onyx or glue may not be surgically resected since they have been "internally obliterated." We present a case where the AVM was preoperatively embolized with Onyx and subsequently partially surgically resected. Post-operative angiography showed complete obliteration or "cure" of the AVM with no filling of the nidus or early venous drainage. The patient presented 12 months later with seizures and imaging showed volume loss in the residual Onyx cast and recanalization of the AVM nidus. The patient subsequently underwent repeat resection with complete removal of the residual AVM and Onyx cast. To our knowledge this is the first published report of volume loss within the Onyx cast leading to recanalization of the AVM nidus. This suggests that extreme care should be taken with partial resection of the AVM nidus or with embolization for cure, as late recanalization may occur. PMID:26015523
Radiographic fallopian tube recanalization: Absorbed ovarian radiation dose
Hedgpeth, P.L.; Thurmond, A.S.; Fry, R.; Schmidgall, J.R.; Roesch, J. (Department of Diagnostic Radiology, Oregon Health Sciences University, Portland (USA))
Absorbed radiation dose to the ovaries during radiographic fallopian tube recanalization was estimated in 29 patients with use of thermoluminescent dosimeters placed in the vaginal fornix. With an average fluoroscopic time of 8.5 minutes {plus minus} 5.5 and an average of 14 {plus minus} 5 105-mm spot radiographs obtained, the average absorbed dose to the ovaries was 8.5 mGy {plus minus} 5.6 (0.85 rad {plus minus} 0.56). Technical guidelines for keeping patient radiation exposure to a minimum during this new interventional procedure are suggested.
Use of Nitinol Stents Following Recanalization of Central Venous Occlusions in Hemodialysis Patients
Rajan, Dheeraj K., E-mail: firstname.lastname@example.com; Saluja, Jasdeep S. [Toronto General Hospital, University Health Network University of Toronto, Division of Vascular and Interventional Radiology, Department of Medical Imaging (Canada)
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.
Successful Endovascular Treatment of Iliac Vein Compression (May-Thurner) Syndrome in a Pediatric Patient
Oguzkurt, Levent, E-mail: firstname.lastname@example.com; Tercan, Fahri [Baskent University, Adana Teaching and Medical Research Center, Department of Radiology (Turkey); Sener, Mesut [Baskent University, Adana Teaching and Medical Research Center, Department of Anesthesiology and Reanimation (Turkey)
A 10-year-old boy presented to our clinic with left lower extremity swelling present for 1 year with deterioration of symptoms during the prior month. Laboratory investigation for deep vein thrombosis was negative. Venography and computed tomography scan of the pelvis showed compression of the left common iliac vein by the right common iliac artery. A diagnosis of iliac vein compression syndrome was made. After venography, endovascular treatment was planned. The stenosis did not respond to balloon dilatation and a 12 mm Wallstent was placed with successful outcome. The patient's symptoms improved but did not resolve completely, probably due to a chronically occluded left superficial femoral vein that did not respond to endovascular recanalization. To the best of our knowledge, this is the first case of successful endovascular treatment of iliac vein compression syndrome with stent placement in a pediatric patient.
Surgical management of subclavian-vein effort thrombosis as a result of thoracic outlet compression
Anthony Azakie; Doff B. McElhinney; Robert W. Thompson; Raymond B. Raven; Louis M. Messina; Ronald J. Stoney
Background: There is considerable variability and controversy in the current management of subclavian-vein effort thrombosis. The purpose of this study was to determine the long-term effectiveness and the functional outcome of our preferred treatment strategy of early thrombolysis\\/recanalization and prompt extensive supraclavicular decompression. Patients and methods: Thirty-three patients who ranged in age from 15 to 60 years underwent operative decompression
... This causes the veins to swell. Weak vein walls may cause weak valves. Normally, the walls of the veins are elastic (stretchy). If these walls become weak, they lose their normal elasticity. They ...
Deep Vein Thrombosis Deep Vein Thrombosis is like a ticking time bomb Ś knowing the symptoms of DVD can save your life. As temperatures ... a warning about the serious dangers associated with deep vein thrombosis (DVT). This is a condition occurring ...
Endovascular treatment of acute thrombosis of cerebral veins and sinuses.
Yakovlev, Sergey Borisovich; Bocharov, Aleksei Vasilievich; Mikeladze, Ketevan; Gasparian, Sergey Surenovich; Serova, Natalia Konstantinovna; Shakhnovich, Alexander Romanovich
Acute thrombosis of cerebral veins and sinuses (ATCVS) is a multifactorial disease with grave consequences. Because of its rare occurrence there are no proven treatment guidelines. Sixteen patients with ATCVS were treated. The final diagnosis was confirmed by digital subtraction angiography. Sinus catheterization was performed via transfemoral venous access. Treatment included mechanical manipulation of thrombi and thrombolytic therapy. A regression of clinical symptoms with a concomitant decrease of intracranial hypertension was achieved in all patients. Long-term results were studied in eight patients: none presented clinical signs of intracranial hypertension. Endovascular transvenous recanalization is an effective treatment for acute thrombosis of cerebral veins and sinuses. Along with the local thrombolysis, significant potential in the treatment of this complex pathology lies in the transvenous endovascular techniques of mechanical thrombus extraction, especially in patients with intracranial hemorrhage for whom the use of thrombolytic agents is restricted. PMID:25196622
Recanalization Results After Intracranial Stenting of Atherosclerotic Stenoses
Blasel, Stella, E-mail: email@example.com; Yuekzek, Zeynep; Kurre, Wiebke; Berkefeld, Joachim [University of Frankfurt, Institute of Neuroradiology (Germany); Neumann-Haefelin, Tobias [University of Frankfurt, Department of Neurology (Germany); Hattingen, Elke; Mesnil de Rochemont, Richard du [University of Frankfurt, Institute of Neuroradiology (Germany)
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.
Early Magnetic Resonance Imaging Prediction of Arterial Recanalization and Late Infarct Volume in Acute Carotid Artery Stroke
Marc Hermier; Norbert Nighoghossian; Patrice Adeleine; Yves BerthezĶne; Laurent Derex; Hasan Yilmaz; Jean-Franńois Dugor; Pascal Dardel; Franńois Cotton; Frķdķric Philippeau; Paul Trouillas; Jean-Claude Froment
In patients with acute ischemic stroke, early recanalization may save tissue at risk for ischemic infarction, thus resulting in smaller infarcts and better clinical outcome. The hypothesis that clinical and diffusion- and perfusion-weighted imaging (DWI, PWI) parameters may have a predictive value for early recanalization and final infarct size was assessed. Twenty-nine patients were prospectively enrolled and underwent sequential magnetic
Successful Recanalization of a Longstanding Right Common Iliac Artery Occlusion with a Radiofrequency Guidewire
Tapping, C. R.; Uri, I. F.; Dixon, S.; Bratby, M. J.; Anthony, S.; Uberoi, R., E-mail: email@example.com [John Radcliffe Hospital, Department of Radiology (United Kingdom)
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.
Transjugular Intrahepatic Portosystemic Shunt in a Patient with Cavernomatous Portal Vein Occlusion
Kawamata, Hiroshi; Kumazaki, Tatsuo [Department of Radiology, Nippon Medical School, 1-1-5 Sendagi, Bunkyo-ku, Tokyo 113-8603 (Japan); Kanazawa, Hidenori [Third Department of Internal Medicine, Nippon Medical School, 1-1-5 Sendagi, Bunkyo-ku, Tokyo 113-8603 (Japan); Takahashi, Shuji; Tajima, Hiroyuki; Hayashi, Hiromitsu [Department of Radiology, Nippon Medical School, 1-1-5 Sendagi, Bunkyo-ku, Tokyo 113-8603 (Japan)
A 23-year-old woman with liver cirrhosis secondary to primary sclerosing cholangitis was referred to us for the treatment of recurrent bleeding from esophageal varices that had been refractory to endoscopic sclerotherapy. Her portal vein was occluded, associated with cavernous transformation. A transjugular intrahepatic portosystemic shunt (TIPS) was performed after a preprocedural three-dimensional computed tomographic angiography evaluation to determine feasibility. The portal vein system was recanalized and portal blood flow increased markedly after TIPS. Esophageal varices disappeared 3 weeks after TIPS. Re-bleeding and hepatic encephalopathy were absent for 3 years after the procedure. We conclude that with adequate preprocedural evaluation, TIPS can be performed safely even in patients with portal vein occlusion associated with cavernous transformation.
Varicose vein - noninvasive treatment
... vein. The vein will harden and then disappear. Laser treatment can be used on the surface of the ... uses a light under the skin to guide treatment. This may be done along ... energy. During these procedures: Your doctor will puncture ...
Percutaneous Extraluminal (Subintimal) Recanalization of a Brachial Artery Occlusion Following Cardiac Catheterization
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)
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.
Masaki Watanabe
This chapter discusses palm vein authentication, which uses the vascular patterns of the palm as personal identification data.\\u000a Palm vein information is hard to duplicate because veins are internal to the human body. Palm vein authentication technology\\u000a offers a high level of accuracy, and delivers the following results: a false rejection rate (FRR) of 0.01% and a false acceptance\\u000a rate
... in the veins Improving the appearance of your leg Varicose veins that can't be treated with newer procedures ... MP, Guex JJ, Weiss RA. Sclerotherapy: Treatment of Varicose and Telangiectatic Leg Veins . 5th ed. Philadelphia, PA: Elsevier Saunders; 2011.
Pelvic Vein Embolisation in the Management of Varicose Veins
Lakshmi A. Ratnam; Petra Marsh; Judy M. Holdstock; Charmaine S. Harrison; Fuad F. Hussain; Mark S. Whiteley; Anthony Lopez
Pelvic vein incompetence is common in patients with atypical varicose veins, contributing to their recurrence after surgery.\\u000a Therefore, refluxing pelvic veins should be identified and treated. We present our experience with pelvic vein embolisation\\u000a in patients presenting with varicose veins. Patients presenting with varicose veins with a duplex-proven contribution from\\u000a perivulval veins undergo transvaginal duplex sonography (TVUS) to identify refluxing
Trauma, renal vein thrombosis and subsequent nephrotic syndrome.
Laakso, M; Pentikõinen, P J; Lampainen, E; Romppanen, T; Naukkarinen, A; Collan, Y
A case of kidney trauma with local and systemic consequences is given. The patient got a trauma to right kidney region. After a fortnights latency nephrotic syndrome developed. Radiological examinations one month after the trauma revealed a partially recanalized thrombus in the right renal vein. It turned out in renal biopsy that the underlying cause of the nephrotic syndrome was acute proliferative glomerulonephritis with typical humps in electronmicroscopy. In contralateral (non-traumatized) kidney there was in renal biopsy the same type of acute glomerulonephritis as well. The course of the renal lesion was documented by a series of renal biopsies which showed improving proliferative glomerulonephritis. The time course of the events and the bilateral histological changes suggest renal trauma as the cause of acute proliferative glomerulonephritis which is a new aspect. PMID:7137885
Atrial fibrillation as an independent predictor for no early recanalization after IV-t-PA in acute ischemic stroke
Kazumi Kimura; Yasuyuki Iguchi; Shinji Yamashita; Kensaku Shibazaki; Kazuto Kobayashi; Takeshi Inoue
Background and purposeIntravenous administration of tissue plasminogen activator (t-PA) dissolves the clot and can improve clinical outcome in patients with acute ischemic stroke. However, lack of early recanalization frequently does not result in good outcome.
Endovenous Laser Ablation of the Small Saphenous Vein Sparing the Saphenopopliteal Junction
Janne d'Othee, Bertrand, E-mail: firstname.lastname@example.com; 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)
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.
Thrombosis and spontaneous recanalization of a giant intracranial aneurysm: diagnostic and management pearls in a pediatric patient.
Kooshkabadi, Ali; Jankowitz, Brian; Choi, Phillip A; Weiner, Gregory M; Greene, Stephanie
The authors present the case of a boy who was successfully managed through the spontaneous thrombosis of a cavernous internal carotid artery (ICA) aneurysm, the subsequent occlusion of the ICA, its recanalization, and ultimate endovascular sacrifice, using only two angiograms because of the diagnostic capability of CT angiography. Spontaneous recanalization of the ICA following occlusion in the setting of a giant aneurysm has not been previously reported. PMID:25380175
Percutaneous Retrograde Recanalization of the Celiac Artery by Way of the Superior Mesenteric Artery for Chronic Mesenteric Ischemia
Joseph, George, E-mail: email@example.com; Chacko, Sujith Thomas [Christian Medical College, Department of Cardiology (India)] [Christian Medical College, Department of Cardiology (India)
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.
Incompetent Perforating Veins are Associated with Recurrent Varicose Veins
E. E. Rutherford; B. Kianifard; S. J. Cook; J. M. Holdstock; M. S. Whiteley
Aims: we suspected incompetent perforating veins of having a role in the development of recurrent varicose veins in some patients. The aim was to look for an association between perforators and recurrent varicose veins.Methods: a consecutive group of patients presenting with varicose veins were examined using colour duplex ultrasonography by an experienced vascular technologist. Pathological perforating veins were defined as
Radiofrequency Guide Wire Recanalization of Venous Occlusions in Patients with Malignant Superior Vena Cava Syndrome
Davis, Robert M.; David, Elizabeth; Pugash, Robyn A.; Annamalai, Ganesan, E-mail: email@example.com [Sunnybrook Health Sciences Centre, Department of Interventional Radiology (Canada)
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.
Percutaneous recanalization of arteries: Status and prospects of laser angioplasty with modified fibre tips
Cornelius Borst
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
Is the Benefit of Early Recanalization Sustained at 3 Months? A Prospective Cohort Study
Lise A. Labiche; Fahmi Al-Senani; Anne W. Wojner; James C. Grotta; Marc Malkoff; Andrei V. Alexandrov
Background and PurposeŚEarly arterial recanalization can lead to dramatic recovery (DR) during intravenous tissue plasminogen activator (tPA) therapy. However, it remains unclear whether this clinical recovery is sustained 3 months after stroke. MethodsŚWe studied consecutive patients treated with intravenous tPA (0.9 mg\\/kg within 3 hours) who had M1 or proximal M2 middle cerebral artery occlusion on pretreatment transcranial Doppler according
P H Fentem; M Goddard; B A Gooden
A method has been devised to allow reliable comparison of different strengths and constructions of support hosiery. Five garments were evaluated for the compression they exerted on the leg and their ability to limit the distension of a model varicose vein. Stockings and tights which provide modest compression can achieve worthwhile control of vein distension.
Gunnar Plate; Lars Brudin; Bo Ekl÷f; Ragnar Jensen; Per Ohlin
Congenital vein valve aplasia is often misdiagnosed and its symptoms misinterpreted as being caused by previous deep venous thrombosis. The present article reviews the literature providing data on etiology, symptomatology, and phlebographic appearance in congenital vein valve aplasia. A personal experience with 10 cases focuses on the clinico-physiological results with compression therapy and surgical treatment of superficial venous insufficiency. Compressive
Real-Time MRI-Guided Endovascular Recanalization of Chronic Total Arterial Occlusion in a Swine Model
Raval, Amish N.; Karmarkar, Parag V.; Guttman, Michael A.; Ozturk, Cengizhan; Sampath, Smita; DeSilva, Ranil; Aviles, Ronnier J.; Xu, Minnan; Wright, Victor J.; Schenke, William H.; Kocaturk, Ozgur; Dick, Alexander J.; Raman, Venkatesh K.; Atalar, Ergin; McVeigh, Elliot R.; Lederman, Robert J.
Background Endovascular recanalization (guidewire traversal) of peripheral artery chronic total occlusion (CTO) can be challenging. X-Ray angiography resolves CTO poorly. Virtually ōblindö device advancement during X-ray-guided interventions can lead to procedure failure, perforation and hemorrhage. Alternatively, magnetic resonance imaging (MRI) may delineate the artery within the occluded segment to enhance procedural safety and success. We hypothesized that real-time MRI (rtMRI) guided CTO recanalization can be accomplished in an animal model. Methods and Results Carotid artery CTO was created by balloon injury in 19 lipid overfed swine. After 6¢8 weeks, two underwent direct necropsy analysis for histology, three underwent primary X-ray-guided CTO recanalization attempts, and the remaining 14 underwent rtMRI-guided recanalization attempts in a 1.5T interventional MRI system. rtMRI intervention used custom CTO catheters and guidewires that incorporated MRI receiver antennae to enhance device visibility. The mean length of the occluded segments was 13.3 ▒ 1.6cm. rtMRI-guided CTO recanalization was successful in 11/14 swine and only 1/3 swine using X-ray alone. After unsuccessful rtMRI (n = 3), X-ray-guided attempts also were all unsuccessful. Conclusions Recanalization of long CTO is feasible entirely using rtMRI guidance. Low profile clinical-grade devices will be required to translate this experience to humans. Endovascular recanalization of chronic total arterial occlusion (CTO) is challenging under conventional X-ray guidance because devices are advanced almost blindly. MRI can image CTO borders and luminal contents, and could potentially guide these procedures. We test the feasibility of real-time MRI guided wire traversal in a swine model of peripheral artery CTO using custom active MRI catheters. PMID:16490819
Splanchnic vein thrombosis following renal transplantation: a case report
Background Recurrent episodes of venous thrombosis have been closely correlated with JAK2 V617F mutation. Upto date, JAK2 gene mutation has not been defined as a prothrombic risk factor in renal transplant recipients. Herein; we present a case of portosplenic vein thrombosis in a primary renal transplant recipient with JAK2 V617F mutation who had no history of prior venous thromboembolism or thrombophilia. Case presentation A 59Āyear old female caucasian patient with primary kidney transplant admitted with vague abdominal pain at left upper quadrant. Abdominal doppler ultrasound and magnetic resonance imaging angiography demonstrated splanchnic vein thrombosis (SVT). The final diagnosis was SVT due to MPD (essential thrombocytosis, ET) with JAK2 V617F mutation. After 3Āmonths of treatment with warfarin (?5Āmg/day, to keep target INR values of 1.9-2.5), control MRI angiography and doppler USG demonstrated partial (>%50) resolution of thrombosis with recanalization of hepatopedal venous flow. The patient is still on the same treatment protocol without any complication. Conclusion JAK2 V617F mutation analysis should be a routine procedure in the diagnosis and treatment of kidney transplant patients with thrombosis in uncommon sites. PMID:23876158
Recanalization of Acute Intracranial Artery Occlusion Using Temporary Endovascular Bypass Technique
Lee, Kyung-Yul; Seo, Kwon Duk; Lim, Soo Mee; Roh, Hong Gee; Kim, Byung Moon
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. PMID:24024071
... complications of retinal vein occlusion may include: Focal laser treatment, if macular edema is present Injections of anti- ... cause glaucoma. This treatment is still being studied. Laser treatment to prevent the growth of new, abnormal blood ...
Recanalization of Aged Venous Thrombotic Occlusions with the Aid of a Rheolytic System: An Experimental Study
Vicol, Calin; Dalichau, Harald [Clinic for Thoracic and Cardiovascular Surgery, Georg-August-University Goettingen, Robert-Koch-Str. 40, D-37075 Goettingen (Germany)
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.
Spontaneous Recanalization of Superior Mesenteric Artery Occlusion Following Angioplasty and Stenting of Inferior Mesenteric Artery
Akpinar, Erhan, E-mail: email@example.com; 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)
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.
The Outback Catheter: A New Device for True Lumen Re-entry After Dissection During Recanalization of Arterial Occlusions
Hausegger, Klaus A., E-mail: firstname.lastname@example.com; Georgieva, Borjana; Portugaller, Horst; Tauss, Josef [University Hospital Graz, Auenbruggerplatz 9, 8036 Graz, Department of Radiology (Austria); Stark, Gerhard [University Hospital Graz, Graz, Department of Internal Medicine, Angiology (Austria)
To report the initial experience with a new catheter system (The Outback catheter) designed to allow fluoroscopically controlled re-entry of the true arterial lumen after subintimal guidewire passage during recanalization procedures of arterial occlusions. The catheter was used in 10 patients with intermittent claudication caused by chronic segmental occlusions of the superficial femoral or popliteal arteries. In all patients, conventional guidewire recanalization had failed. In 8 patients, successful true lumen re-entry was achieved with the Outback catheter. Percutaneous transluminal angioplasty was successfully performed in these patients without complications. Two technical failures occurred in heavily calcified arteries. The Outback catheter was safe and effective when used in complicated recanalization procedures in the superficial femoral and popliteal artery and the tibial trunk.
Relationships Between Infarct Growth, Clinical Outcome, and Early Recanalization in Diffusion and Perfusion Imaging for Understanding Stroke Evolution (DEFUSE)
Olivot, Jean-Marc; Mlynash, Michael; Thijs, Vincent N.; Kemp, Stephanie; Lansberg, Maarten G.; Wechsler, Lawrence; Schlaug, Gottfried; Bammer, Roland; Marks, Michael P.; Albers, Gregory W.
Background and Purpose The purpose of this study was to determine the relationships between ischemic lesion growth, recanalization, and clinical response in stroke patients with and without a perfusion/diffusion mismatch. Methods DEFUSE is an open label multicenter study in which 74 consecutive acute stroke patients were treated with intravenous tPA 3 to 6 hours after stroke onset. Magnetic resonance imaging (MRI) scans were obtained before, 3 to 6 hours after, and 30 days after treatment. Lesion growth was defined as the difference between the final infarct volume (30 day FLAIR) and the baseline diffusion lesion. Baseline MRI profiles were used to categorize 44 patients into Mismatch versus Absence of Mismatch subgroups. Early recanalization was assessed in 28 patients with an initial vessel lesion on magnetic resonance angiography. Infarct growth was compared based on whether a favorable clinical response (FCR) occurred and whether early recanalization was achieved. Results In the Mismatch subgroup, FCR was associated with less infarct growth P=0.03 and early recanalization was predictive of both FCR (odds ratio: 22, P=0.047) and reduced infarct growth P=0.024. There was no significant relationship between recanalization, infarct growth, and clinical outcome in the Absence of Mismatch subgroup. A threshold of <7 cc of growth had the highest sensitivity and specificity for predicting a FCR in Mismatch patients (odds ratio: 65, P=0.015, sensitivity 82%, specificity 75%). Conclusion In contrast to Absence of Mismatch patients, significant associations between recanalization, reduced infarct growth, and favorable clinical response were documented in patients with a perfusion/diffusion mismatch who were treated with tPA within 3 to 6 hours after stroke onset. These findings support the Mismatch hypothesis but require validation in a larger study. PMID:18566302
Diagnosis of deep vein thrombosis, and prevention of deep vein thrombosis recurrence and the post-thrombotic syndrome in the primary care medicine setting anno 2014.
Michiels, Jan Jacques; Michiels, Janneke Maria; Moossdorff, Wim; Lao, Mildred; Maasland, Hanny; Palareti, Gualtiero
The requirement for a safe diagnostic strategy of deep vein thrombosis (DVT) should be based on an overall objective post incidence of venous thromboembolism (VTE) of less than 1% during 3 mo follow-up. Compression ultrasonography (CUS) of the leg veins has a negative predictive value (NPV) of 97%-98% indicating the need of repeated CUS testing within one week. A negative ELISA VIDAS safely excludes DVT and VTE with a NPV between 99% and 100% at a low clinical score of zero. The combination of low clinical score and a less sensitive D-dimer test (Simplify) is not sensitive enough to exclude DVT and VTE in routine daily practice. From prospective clinical research studies it may be concluded that complete recanalization within 3 mo and no reflux is associated with a low or no risk of PTS obviating the need of MECS 6 mo after DVT. Partial and complete recanalization after 3 to more than 6 mo is usually complicated by reflux due to valve destruction and symptomatic PTS. Reflux seems to be a main determinant for PTS and DVT recurrence, the latter as a main contributing factor in worsening PTS. This hypothesis is supported by the relation between the persistent residual vein thrombosis (RVT = partial recanalization) and the risk of VTE recurrence in prospective studies. Absence of RVT at 3 mo post-DVT and no reflux is predicted to be associated with no recurrence of DVT (1.2%) during follow-up obviating the need of wearing medical elastic stockings and anticoagulation at 6 mo post-DVT. The presence or absence of RVT but with reflux at 3 to 6 mo post-DVT is associated with both symptomatic PTS and an increased risk of VTE recurrence in about one third in the post-DVT period after regular discontinuation of anticoagulant treatment. To test this hypothesis we designed a prospective DVT and postthrombotic syndrome (PTS) Bridging the Gap Study by addressing at least four unanswered questions in the treatment of DVT and PTS. Which DVT patient has a clear indication for long-term compression stocking therapy to prevent PTS after the initial anticoagulant treatment in the acute phase of DVT? Is 3 mo the appropriate point in time to determine candidates at risk to develop DVT recurrence and PTS? Which high risk symptomatic PTS patients need extended anticoagulant treatment? PMID:25685720
Pelvic Vein Embolisation in the Management of Varicose Veins
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: firstname.lastname@example.com [Royal Surrey County Hospital, Department of Radiology (United Kingdom)
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.
Improvement in Deep Vein Haemodynamics Following Surgery for Varicose Veins
P. Ciostek; J. Michalak; W. Noszczyk
Objective. To analyse the effect of superficial and perforating veins surgery on deep vein incompetence.Methods. During a six-month period between 2000 and 2001 24 patients (32 limbs) with chronic venous insufficiency (CVI) were treated. They were selected because they had varicose veins and proximal deep vein incompetence with photoplethysmography (PPG) venous refilling time (VRT) 1.5 s on duplex ultrasound. The
Cerebral and Sinus Vein Thrombosis
... User Name Password Sign In Cardiology Patient Page Cerebral and Sinus Vein Thrombosis Stephan Moll , MD ; Beth Waldron , MA From the ... from the brain is called a sinus or cerebral vein thrombosis. It is an uncommon type of clot, affecting ...
Epidemiology of varicose veins
Robert Beaglehole
The prevalence rate of varicose veins in adults varies from less than 1% in lowland New Guinea women to over 50% in women in south Wales. Within populations the prevalence increases with age, is generally greater in women, is directly related to body mass, has an inconsistent relationship with occupation, and usually increases with increasing parity. None of these factors
Chawla, Yogesh K; Bodh, Vijay
Portal vein thrombosis is an important cause of portal hypertension. PVT occurs in association with cirrhosis or as a result of malignant invasion by hepatocellular carcinoma or even in the absence of associated liver disease. With the current research into its genesis, majority now have an underlying prothrombotic state detectable. Endothelial activation and stagnant portal blood flow also contribute to formation of the thrombus. Acute non-cirrhotic PVT, chronic PVT (EHPVO), and portal vein thrombosis in cirrhosis are the three main variants of portal vein thrombosis with varying etiological factors and variability in presentation and management. Procoagulant state should be actively investigated. Anticoagulation is the mainstay of therapy for acute non-cirrhotic PVT, with supporting evidence for its use in cirrhotic population as well. Chronic PVT (EHPVO) on the other hand requires the management of portal hypertension as such and with role for anticoagulation in the setting of underlying prothrombotic state, however data is awaited in those with no underlying prothrombotic states. TIPS and liver transplant may be feasible even in the setting of PVT however proper selection of candidates and type of surgery is warranted. Thrombolysis and thrombectomy have some role. TARE is a new modality for management of HCC with portal vein invasion. PMID:25941431
Lattice Boltzmann method simulating hemodynamics in the three-dimensional stenosed and recanalized human carotid bifurcations
NASA Astrophysics Data System (ADS)
Kang, XiuYing
By using the lattice Boltzmann method (LBM) pulsatile blood flows were simulated in three-dimensional moderate stenosed and recanalized carotid bifurcations to understand local hemodynamics and its relevance in arterial atherosclerosis formation and progression. The helical flow patterns, secondary flow and wall dynamical pressure spatiotemporal distributions were investigated, which leads to the disturbed shear forces in the carotid artery bifurcations. The wall shear stress distributions indicated by time-averaged wall shear stress (TAWSS), oscillatory shear index (OSI), and the relative residence time (RRT) in a cardiac cycle revealed the regions where atherosclerotic plaques are prone to form, extend or rupture. This study also illustrates the point that locally disturbed flow may be considered as an indicator for early atherosclerosis diagnosis. Additionally the present work demonstrates the robust and highly efficient advantages of the LBM for the hemodynamics study of the human blood vessel system.
Successful pregnancy by direct intraperitoneal insemination in an infertile patient with failure of recanalization of isthmic stenosis after laparoscopic radical trachelectomy
Choi, Sun-Young; Lee, Kyung-Hee; Suk, Hye-Jin; Chae, Hee-Dong; Kang, Byung-Moon
Radical trachelectomy is a promising fertility-sparing treatment for patients with early stage cervical cancer who want to preserve their fertility. However, isthmic stenosis occurs frequently in patients who received radical trachelectomy and it is one of the causes of infertility following radical trachelectomy. Moreover, despite the treatment for recanalization of isthmic stenosis, recanalization can fail or isthmic stenosis can recur. Herein we report a successful pregnancy and birth by direct intraperitoneal insemination in an infertile woman with failure of recanalization of isthmic stenosis after laparoscopic radical trachelectomy. PMID:24596824
[Lower limb vein thrombosis in dynamics of acute impairments of cerebral circulation].
Kuntsevich, G I; Maksimova, M Iu; Popova, L A; Riabinkina, Iu V; Gnedovskaia, E V; Piradov, M A
The present work was aimed at studying the state of the inferior vena cava system according to the findings of duplex scanning in dynamics of acute cerebral circulation impairments (ACCI). Amongst 100 patients with ACCI, lower limb vein deep thrombosis (LLVDT) was revealed in 57% of cases. The incidence of LLVDT in patients with intracerebral haemorrhage was higher than in those with ischaemic stroke, however there were no statistically significant differences between the type of ACCI (p=0.06) and subtypes of ischaemic stroke (atherothrombotic, ceardioembolic) (p = 0.68). The main risk factors for LLVDT are the presence of pronounced motion deficit in the extremities, induced by the underlying disease (p=0.02) and immobilization. In the overwhelming majority of patients (81%) thrombosis localized isolatedly in the crural veins. Ascending thrombosis and the development of a floating thrombus were represented mainly on the side of motility deficit in the extremities. We have confirmed a strong association between positive dynamics in the neurological status of patients and frequency of recanalization of thrombi (p=0.043). Ultrasonographic examination of lower limb veins in dynamics of ACCI is an important component of preventive and therapeutic process. PMID:22929675
Long-term results of vein sparing varicose vein surgery
Peter Raivio; Vesa Perhoniemi; Aarno Lehtola
The aim of this study was to assess the long-term functional outcome of vein sparing varicose vein surgery using handheld\\u000a Doppler ultrasound (HHD). The series consisted of 171 consecutive day-case surgery patients operated on for uncomplicated\\u000a lower limb varicose veins. Venous segments considered competent were spared based on clinical examination and HHD, which was\\u000a performed preoperatively only when deemed necessary
Immediate- and short-term outcome following recanalization of long chronic total occlusions (> 50 mm) of native coronary arteries with the Frontrunner catheter.
Loli, Akil; Liu, Rex; Pershad, Ashish
Thirty percent of diagnostic angiograms have at least 1 chronic total occlusion (CTO). The 10-year survival of patients with a CTO is improved if they have the CTO successfully recanalized. The success of recanalization with conventional wires is 50% and the impact of new technology on recanalization is unknown. This abstract reports a single center experience with one such new device, the Lumend Frontrunner catheter in revascularization of this difficult lesion subset. A consecutive series of 18 patients with CTO's of native coronary arteries were enrolled in this single center, single operator series. The mean age of the CTO was 5.3 years. The indication for attempt at recanalization was ischemia in the territory of the CTO on SPECT imaging. Success was defined as TIMI flow restoration and < 40% residual stenosis. Primary success (defined as TIMI 3 Flow restoration and < 40% residual stenosis) was achieved in 77% of patients. At 30 days and out to 6 months, clinical TVR was 11% (2/18) in this difficult lesion subset. Conventional predictors of failure to recanalize CTOs do not appear to hold true with the use of the Frontrunner catheter. In this small series, dual cusp injections and use of the Microglide catheter appears to correlate with favorable outcomes. Fluoroscopy times and contrast use are high when attempting recanalization of CTOs with this technology. PMID:16775901
Venous Recanalization by Metallic Stents After Failure of Balloon Angioplasty or Surgery: Four-Year Experience
Nazarian, Gwen K.; Austin, William R.; Wegryn, Scott A.; Bjarnason, Haraldur; Stackhouse, Daniel J.; Castaneda-Zuniga, Wilfrido R.; Hunter, David W. [Department of Radiology, University of Minnesota Hospital and Clinic, 420 Delaware Street S.E., Minneapolis, MN 55455-0392 (United States)
Purpose: This retrospective study describes our updated experience in treating venous stenoses and occlusions with metallic endovascular stents. Methods: Gianturco, Palmaz, and Wallstent stents were placed in 55 patients over a 4-year period. Stent sites included the subclavian veins (9), innominate veins (3), superior vena cava (4), inferior vena cava (3), iliac veins (29), femoral veins (5), and portal veins (6). The most common indications for stent placement were malignant stenoses and chronic pelvic venous occlusions. Venoplasty and/or urokinase were used as ancillary therapy. Patients were anticoagulated for 3-6 months. Follow-up included clinical assessment and duplex ultrasound. Results: Lifetable analysis shows 59%, 63%, and 72% primary, primary assisted, and secondary 1-year patency rates, respectively. The 4-year primary patency rates were the same. Duration of patency depended on the venous site. Death was a complication of stent placement in 2 patients and 12 patients died within 6 months after stent placement from primary disease progression. Although early failures were more common in stents placed across occlusions than stenoses, 1-year secondary patency rates were comparable. Primary patency rates were only slightly lower in patients with malignant obstruction than in patients with benign disease. Conclusion: Endovascular stent placement provides a nonsurgical alternative for reestablishment of venous flow and symptomatic relief in patients with benign as well as malignant venous obstruction.
Palm Vein Authentication System: A Review
Ishani Sarkar; Farkhod Alisherov; Tai-hoon Kim; Debnath Bhattacharyya
This paper presents a review on the palm vein authentication device that uses blood vessel patterns as a personal identifying factor. The vein information is hard to duplicate since veins are internal to the human body. The palm vein authentication technology offers a high level of accuracy. Palm vein authentication uses the vascular patterns of an individual's palm as personal
Varicose Veins - Sclerotherapy
NSDL National Science Digital Library
Patient Education Institute
This patient education program explains the benefits and risks of sclerotherapy for varicose veins. It also reviews the anatomy of the cardiovascular system, symptoms, causes, preventive measures, what the procedure involves, and possible complications. This resource is a MedlinePlus Interactive Health Tutorial from the National Library of Medicine, designed and developed by the Patient Education Institute. NOTE: This tutorial requires a special Flash plug-in, version 4 or above. If you do not have Flash, you will be prompted to obtain a free download of the software before you start the tutorial. You will also need an Acrobat Reader, available as a free download, in order to view the Reference Summary.
Sagittal vein thrombosis caused by central vein catheter.
Sabzi, Feridoun; Karim, Hosein; Heydar Pour, Behzad; Faraji, Reza
Cerebral venous thrombosis, including thrombosis of cerebral veins and major dural sinuses, is an uncommon disorder in the general population. However, it has a higher frequency among patients younger than 40 years of age, patients with thrombophilia, pregnant patients or those receiving hormonal contraceptive therapy or has foreign body such as catheter in their veins or arterial system. In this case report, we described clinical and radiological findings in a patient with protein C-S deficiency and malposition of central vein catheter. PMID:25796028
Vein matching using artificial neural network in vein authentication systems
NASA Astrophysics Data System (ADS)
Noori Hoshyar, Azadeh; Sulaiman, Riza
Personal identification technology as security systems is developing rapidly. Traditional authentication modes like key; password; card are not safe enough because they could be stolen or easily forgotten. Biometric as developed technology has been applied to a wide range of systems. According to different researchers, vein biometric is a good candidate among other biometric traits such as fingerprint, hand geometry, voice, DNA and etc for authentication systems. Vein authentication systems can be designed by different methodologies. All the methodologies consist of matching stage which is too important for final verification of the system. Neural Network is an effective methodology for matching and recognizing individuals in authentication systems. Therefore, this paper explains and implements the Neural Network methodology for finger vein authentication system. Neural Network is trained in Matlab to match the vein features of authentication system. The Network simulation shows the quality of matching as 95% which is a good performance for authentication system matching.
Palm vein authentication technology and its applications
Masaki Watanabe; Toshio Endoh; Morito Shiohara; Shigeru Sasaki
This paper discusses the contactless palm vein authentication device that uses blood vessel patterns as a personal identifying factor. The vein information is hard to duplicate since veins are internal to the human body. The palm vein authentication technology offers a high level of accuracy, and delivers the following results: a false rejection rate (FRR) of 0.01%, and a false
Varicose Veins: Endovenous Laser Treatment
Serge R. Mordon; Marc E. Vuylsteke
\\u000a Endovenous laser ablation (EVLA) has been developed as an alternative to surgery of great saphenous vein (GSV) and short saphenous\\u000a vein (SSV) in an attempt to reduce morbidity and improve recovery time. EVLA can be performed in an outpatient special procedure\\u000a room in the hospital. EVLA works by means of thermal destruction of venous tissues. Several wavelengths can be used:
Endovascular Treatment of In-Stent Occlusion: New Technique for Recanalization of Long Superficial Femoral Artery Occlusion (Direct Stent Puncture Technique)
Palena, Luis Mariano, E-mail: email@example.com; Cester, Giacomo; Manzi, Marco [Policlinico Abano Terme, Interventional Radiology Unit (Italy)
In-stent reocclusion is a frequent complication of endovascular treatment and stenting, especially in the superficial femoral artery. Neointimal hyperplasia is the main cause of this problem, but in many cases, it occurs as a result of the presence of stent strut fractures. The two treatment options are endovascular and surgical intervention. The effectiveness of endovascular interventions in patients with critical limb ischemia has been well established, but in some cases, crossing the occluded stent is difficult. We describe a new technique to recanalize long in-stent superficial femoral artery occlusions characterized by direct stent puncture, followed by retrograde-antegrade recanalization after antegrade failures.
Endovascular recanalization of infrapopliteal occlusions in patients with critical limb ischemia
Singh, Gagan D.; Armstrong, Ehrin J.; Yeo, Khung-Keong; Singh, Satinder; Westin, Gregory G.; Pevec, William C.; Dawson, David L.; Laird, John R.
Background Endovascular therapies are increasingly used for treatment of critical limb ischemia (CLI). Infrapopliteal (IP) occlusions are common in CLI, and successful limb salvage may require restoration of arterial flow in the distribution of a chronically occluded vessel. We sought to describe the procedural characteristics and outcomes of patients with IP occlusions who underwent endovascular intervention for treatment of CLI. Methods All patients with IP interventions for treatment of CLI from 2006 to 2012 were included. Angiographic and procedural data were compared between patients who underwent intervention for IP occlusions vs IP stenosis. Restenosis was determined by Doppler ultrasound imaging. Limb salvage was the primary end point of the study. Additional end points included primary patency, primary assisted patency, secondary patency, occlusion crossing success, procedural success, and amputation-free survival. Results A total of 187 patients with CLI underwent interventions for 356 IP lesions, and 77 patients (41%) had interventions for an IP occlusion. Patients with an intervention for IP occlusion were more likely to have zero to one vessel runoff (83% vs 56%; P < .001) compared with interventions for stenosis. Compared with IP stenoses, IP occlusions were longer (118 ▒ 86 vs 73 ▒ 67 mm; P < .001) and had a smaller vessel diameter (2.5 ▒ 0.8 vs 2.7 ▒ 0.5 mm; P =.02). Wire crossing was achieved in 83% of IP occlusions, and the overall procedural success for IP occlusions was 79%. The overall 1-year limb salvage rate was 84%. Limb salvage was highest in the stenosis group, slightly lower in the successful occlusion group, and lowest in the failed occlusion group (92% vs 75% vs 58%, respectively; P = .02). Unsuccessfully treated IP occlusions were associated with a significantly higher likelihood of major amputation (hazard ratio, 5.79; 95% confidence interval, 1.89¢17.7) and major amputation or death (hazard ratio, 2.69; 95% confidence interval, 1.09¢6.63). Conclusions Successful endovascular recanalization of IP occlusions can be achieved with guidewire and support catheter techniques in most patients. In patients selected for an endovascular-first approach for IP occlusions in CLI, this strategy can be successfully implemented with favorable rates of limb salvage. PMID:24393279
Extrahepatic Portal Vein Obstruction and Portal Vein Thrombosis in Special Situations: Need for a New Classification
Wani, Zeeshan A.; Bhat, Riyaz A.; Bhadoria, Ajeet S.; Maiwall, Rakhi
Extrahepatic portal vein obstruction is a vascular disorder of liver, which results in obstruction and cavernomatous transformation of portal vein with or without the involvement of intrahepatic portal vein, splenic vein, or superior mesenteric vein. Portal vein obstruction due to chronic liver disease, neoplasm, or postsurgery is a separate entity and is not the same as extrahepatic portal vein obstruction. Patients with extrahepatic portal vein obstruction are generally young and belong mostly to Asian countries. It is therefore very important to define portal vein thrombosis as acute or chronic from management point of view. Portal vein thrombosis in certain situations such as liver transplant and postsurgical/liver transplant period is an evolving area and needs extensive research. There is a need for a new classification, which includes all areas of the entity. In the current review, the most recent literature of extrahepatic portal vein obstruction is reviewed and summarized. PMID:26021771
Management of superficial vein thrombosis.
Cosmi, B
Superficial vein thrombosis (SVT) is less well studied than deep vein thrombosis (DVT), because it has been considered to be a minor, self-limiting disease that is easily diagnosed on clinical grounds and that requires only symptomatic relief. The most frequently involved sites of the superficial vein system are the lower limbs, especially the saphenous veins, mostly in relation to varicosities. Lower-limb SVT shares the same risk factors as DVT; it can propagate into the deep veins, and have a complicated course with pulmonary embolism. Clinical diagnosis may not be accurate, and ultrasonography is currently indicated for both confirmation and evaluation of SVT extension. Treatment aims are symptom relief and prevention of venous thromboembolism (VTE) in relation to the thrombotic burden. SVT of the long saphenous vein within 3Ācm of the saphenofemoral junction (SFJ) is considered to be equivalent to a DVT, and thus deserving of therapeutic anticoagulation. Less severe forms of lower-limb SVT not involving the SFJ have been included in randomized clinical trials of surgery, compression hosiery, non-steroidal anti-inflammatory drugs, unfractionated heparin, and low molecular weight heparins, with inconclusive results. The largest randomized clinical trial available, on 3004 patients with lower-limb SVT not involving the SFJ, showed that fondaparinux 2.5Āmg once daily for 6Āweeks is more effective than placebo in reducing the risk of the composite of death from any cause and symptomatic VTE (0.9% versus 5.9%). Further studies are needed to define the optimal management strategies for SVT of the lower limbs and other sites, such as the upper limbs. PMID:25903684
Varicose Vein Treatment (Endovenous Ablation of Varicose Veins)
... approximately 1/8 inch in diameter. Laser fibers (fiber optics) or radiofrequency electrodes carry laser or electrical energy from their respective power generators into the body. top of ... vein. A laser fiber or radiofrequency electrode is then inserted through the ...
Pharmacological recanalization therapy in acute ischemic stroke - evolution, current state and perspectives of intravenous and intra-arterial thrombolysis.
Hlavica, Martin; Diepers, Michael; Garcia-Esperon, Carlos; Ineichen, Benjamin Victor; Nedeltchev, Krassen; Kahles, Timo; Remonda, Luca
Stroke ranges third in mortality in industrialized nations and is the leading cause of disability in older people. Ischemic stroke following thrombotic or embolic vessel occlusion accounts for more than 80% of cerebrovascular events. Immediate restoration of cerebral blood flow is crucial in order to salvage brain tissue. Experimental thrombolytic treatment was introduced into the clinical setting in the late 1950s and required more than 30 years of intense research till its breakthrough and subsequent routine clinical use by the presentation of the NINDS trial results in 1995. To date, intravenous thrombolysis with tissue plasminogen activator up to 4.5 h after symptom onset is the only proven reperfusion therapy for acute ischemic stroke. In this review, we summarize the evolution of intravenous and intra-arterial pharmacological recanalization therapies in acute ischemic stroke and present current clinical practice as well as its promising perspectives. PMID:25649921
Combined Retrograde-Antegrade Arterial Recanalization Through Collateral Vessels: Redefinition of the Technique for Below-the-Knee Arteries
Graziani, L., E-mail: firstname.lastname@example.com; Morelli, L. G. [Istituto Clinico Citta di Brescia, Servizio di Emodinamica (Italy)
The effectiveness of below-the-knee PTA to obtain successful revascularization in patients with critical limb ischemia (CLI) has been well established, and many centers have adopted endovascular intervention as the first-line treatment in patients with chronic lower-extremity disease. The well-known complex and multilevel arterial disease in patients with CLI have lead to interventionists to continuously implement different technologies and techniques. The aim of the present study was to standardize and redefine a technique characterized for combined retrograde-antegrade recanalization of a native leg artery through a collateral arterial branch by using a single access. This concept has been well described in coronary arteries and recently in pelvic and tibial arteries.
Recanalization of Acute and Subacute Femoropopliteal Artery Occlusions with the Rotarex Catheter: One Year Follow-up, Single Center Experience
Duc, Sylvain R., E-mail: email@example.com; Schoch, Eric [Kantonsspital Winterthur, Department of Radiology (Switzerland); Pfyffer, Markus; Jenelten, Regula [Section of Angiology, Kantonsspital Winterthur, Department of Internal Medicine (Switzerland); Zollikofer, Christoph L. [Kantonsspital Winterthur, Department of Radiology (Switzerland)
Purpose:To assess the efficacy and safety of a new rotational catheter for percutaneous removal of fresh and organized thrombi in the femoropopliteal artery.Methods:Forty-one limbs in 38 patients (age 56-90 years, mean 75.6 years) with acute, subacute or chronic femoropopliteal occlusions of 1-180 days' duration (mean 31.6 days) were treated with the Rotarex device. The Fontaine stage was mainly IIB (Rutherford 2-3, 22 patients) or III (Rutherford 4, 14 patients). The length of occlusion varied from 2 to 35 cm (mean 13.1 cm). After recanalization percutaneous transluminal angioplasty (PTA) was performed if there was a residual stenosis of >25%. Patients were followed up with color Doppler ultrasound at 48 hr and clinically with Doppler pressures and oscillometry at 3, 6, and 12 months.Results:After an average of two passages with the Rotarex catheter all but two limbs required PTA for residual stenosis >25%. Five patients needed additional stenting. Major complications were one groin hematoma requiring blood transfusion and one arteriovenous fistula spontaneously thrombosing after unsuccessful primary prolonged balloon dilation. Distal embolizations occurred in 10 patients; 6 clinically relevant emboli were aspirated. All occlusions were technically successfully recanalised there were 2 early reocclusions after 1 day and two at 2 weeks. Brachial-ankle indices improved from an average of 0.41 before to 0.93 after recanalization. Primary and secondary patency rates were 62% / 84% after 6 months and 39% / 68% after 1 year. The amputation-free survival at 12 months was 100%.Conclusion:The Rotarex mechanical thrombectomy device is an efficient, quick, easy to handle, and safe tool for the treatment of acute, subacute or even chronic peripheral arterial thromboembolic occlusions. It can be used for short or long occlusions with equal success, provided the obstruction is not heavily calcified and has been safely passed with a guidewire first.
Surgical Access to Jejunal Veins for Local Thrombolysis and Stent Placement in Portal Vein Thrombosis
Schellhammer, Frank, E-mail: email@example.com [University Hospital Duesseldorf, Institute of Diagnostic Radiology (Germany); Esch, Jan Schulte am [University Hospital Duesseldorf, Department of General, Visceral and Pediatric Surgery (Germany); Hammerschlag, Sascha [University Hospital Duesseldorf, Institute of Diagnostic Radiology (Germany); Knoefel, Wolfram Trudo [University Hospital Duesseldorf, Department of General, Visceral and Pediatric Surgery (Germany); Fuerst, Guenter [University Hospital Duesseldorf, Institute of Diagnostic Radiology (Germany)
Portal vein thrombosis is an infrequent entity, which may cause high morbidity and mortality. We report a case of portal vein thrombosis due to benign stenosis following partial pancreatoduodenectomy with segmental replacement of the portal vein by a Gore-tex graft. Using a surgical access to jenunal veins, local thrombolysis, mechanical fragmentation of thrombus, and stent placement were successfully performed.
How Can Varicose Veins Be Prevented?
... tight around your waist, groin (upper thighs), and legs. Tight clothes can make varicose veins worse. Avoid wearing high heels for long periods. ... in the veins and decreases swelling in the legs. Rate This Content: NEXT ... 13, 2014 Varicose Veins Clinical Trials Clinical trials are research studies that ...
Thrombosis of the popliteal vein
Hans-Erich Schmitt; Michael J. Mihatsch
Among 3,307 consecutive patients (3,556 legs) with deep venous thrombosis, 54 (1.5%) showed an isolated thrombus of the popliteal\\u000a vein on phlebography. The majority of those had a history of ōeffortö or long lasting flexion during air or bus travel. Forty-four\\u000a percent suffered from pulmonary embolism as the first sign of deep venous thrombosis. Functional phlebography demonstrated\\u000a the primary site
Occlusion and subsequent re-canalization in early duodenal development of human embryos: integrated organogenesis and histogenesis through a possible epithelial-mesenchymal interaction
Akihiro Matsumoto; Koji Hashimoto; Takafumi Yoshioka; Hiroki Otani
Histogenesis of the duodenum, especially changes in the epithelium in relation to temporal occlusion and re-canalization of\\u000a the lumen, was investigated by light microscopy together with morphometric analysis, as well as by scanning and transmission\\u000a electron microscopy of 133 externally normal human embryos ranging from Carnegie stage 12 to 23. A series of morphogenetic\\u000a events passed the duodenum in a
Portal vein aneurysm in a dog.
Miyawaki, Shingo; Washizu, Makoto; Maeda, Sadatoshi; Shibata, Sanae; Watanabe, Kazuhiro; Yamazoe, Kazuaki
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
MR Venography for the Assessment of Deep Vein Thrombosis in Lower Extremities with Varicose Veins
Nakahara, Hideki
Objective: To assess the performance of magnetic resonance venography (MRV) for pelvis and deep vein thrombosis in the lower extremities before surgical interventions for varicose veins. Materials and Methods: We enrolled 72 patients who underwent MRV and ultrasonography before stripping for varicose veins of lower extremities. All images of the deep venous systems were evaluated by time-of-flight MRV. Results: Forty-six patients (63.9%) of all were female. Mean age was 65.2 ▒ 10.2 years (37¢81 years). There were forty patients (55.6%) with varicose veins in both legs. Two deep vein thrombosis (2.8%) and three iliac vein thrombosis (4.2%) were diagnosed. All patients without deep vein thrombosis underwent the stripping of saphenous veins, and post-thrombotic change was avoided in all cases. Conclusion: MRV, without contrast medium, is considered clinically useful for the lower extremity venous system. PMID:25593625
Remodelling of the Superior Caval Vein After Angioplasty in an Infant with Superior Caval Vein Syndrome
Mert, Murat [Istanbul University, Institute of Cardiology, Department of Cardiovascular Surgery (Turkey)], E-mail: email@example.com; Saltik, Levent [Istanbul University, Cerrahpasa Medical School, Department of Pediatric Cardiology (Turkey); Gunay, Ilhan [Istanbul University, Institute of Cardiology, Department of Cardiovascular Surgery (Turkey)
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.
Improving the management of varicose veins.
Onida, Sarah; Lane, Tristan R A; Davies, Alun H
Up to 30% of the UK population are affected by varicose veins. They are a manifestation of increased venous pressure in the lower limb caused by impaired venous return. Primary varicosities result from poor drainage from the superficial to the deep venous system. Secondary varicosities arise as a result of underlying pathology impeding venous drainage, such as deep venous thrombosis or increased intra-abdominal pressure caused by a mass, pregnancy or obesity. Patients with bleeding varicose veins should be referred to a vascular service immediately. Referral is also indicated in the following cases: symptomatic primary or recurrent varicose veins; lower limb skin changes thought to be caused by chronic venous insufficiency; superficial vein thrombosis and suspected venous incompetence; a venous leg ulcer or healed venous leg ulcer. Imaging is crucial in the assessment of the superficial and deep venous system to enable assessment of venous competence. The gold standard imaging technique is colour duplex ultrasonography. Duplex ultrasound should be used to confirm the diagnosis of varicose veins and the extent of truncal reflux, and to plan treatment for patients with suspected primary or recurrent varicose veins. Superficial vein ligation, phlebectomy and stripping have been the mainstay of treatment. In recent years, new techniques have been developed that are minimally invasive, enabling treatment of superficial venous incompetence with reduced morbidity. NICE recommends that endothermal ablation, in the form of radiofrequency or laser treatment, should be offered as treatment for patients with confirmed varicose veins and truncal reflux. PMID:24555256
Fatal lower extremity varicose vein rupture
Garyfalia Ampanozi; Ulrich Preiss; Gary M. Hatch; Wolf Dieter Zech; Thomas Ketterer; Stephan Bolliger; Michael J. Thali; Thomas D. Ruder
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
Epidemiology of Blackberry yellow vein associated virus
Technology Transfer Automated Retrieval System (TEKTRAN)
Blackberry yellow vein disease is one of the most important diseases of blackberry in the United States. Several viruses are found associated with the symptomology but Blackberry yellow vein associated virus (BYVaV) appears to be the most prevalent of all, leading to the need for a better understand...
Arteries and veins of the zebra fish
NSDL National Science Digital Library
Katie Hale (CSUF; Biological Sciences)
Arteries and veins are blood vessels and are part of the circulatory system. Arteries take oxygenated blood away from the heart and veins bring blood back to the heart after it has circulated through the body. The circulatory system distributes oxygen to the body and also moves around nutrients.
Enhancing the contrast of subcutaneous veins
NASA Astrophysics Data System (ADS)
Zeman, Herbert D.; Lovhoiden, Gunnar
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.
MAPping Out Arteries and Veins
NSDL National Science Digital Library
Ryan E. Lamont (Canada; University of Calgary, Calgary AB REV)
Growing evidence suggests that a genetic program specifies the identity of arteries and veins before the onset of circulation. A signaling cascade involving sonic hedgehog (Shh), vascular endothelial growth factor (VEGF), the VEGF receptor 2 (VEGFR2), homeobox proteins Foxc1 and Foxc2, the Notch receptor, and the downstream transcription factor gridlock is required for expression of arterial markers, whereas only a single transcription factor, COUP-TFII (chicken ovalbumin upstream promoter¢transcription factor II), has previously been implicated in maintaining venous fate. Recent work has now implicated two competing pathways downstream of VEGFR2 in arterial versus venous specification: Activation of the phospholipase C¢? (PLC-?)¢mitogen-activated protein kinase (MAPK) pathway acts in arterial specification, whereas the phosphoinositide 3-kinase (PI3K)¢Akt pathway acts to allow a venous fate by inhibition of the PLC-?¢MAPK pathway. Here, we review this work and discuss how activation of the MAPK signaling cascade could stimulate an arterial fate.
Multi-Modality Image Fusion to Guide Peripheral Artery Chronic Total Arterial Occlusion Recanalization in a Swine Carotid Artery Occlusion Model: Unblinding the Interventionalist!
Klein, Andrew J.; Tomkowiak, Michael T.; Vigen, Karl K.; Hacker, Timothy A.; Speidel, Michael A.; VanLysel, Michael S.; Shah, Nehal; Raval, Amish N.
Objectives To demonstrate the feasibility of magnetic resonance imaging (MRI) to x-ray fluoroscopy (XRF) image fusion to guide peripheral artery chronic total occlusion (CTO) recanalization. Background Endovascular peripheral artery CTO revascularization is minimally invasive, but challenging, because the occlusion is poorly visualized under XRF. Devices may steer out of the artery which can lead to severe perforation. Merging pre-acquired MRI of the CTO to the live XRF display may permit upfront use of aggressive devices and improve procedural outcomes. Methods Swine carotid artery CTOÆs were created using a balloon injury model. Up to 8 weeks later, MRI of the carotid arteries was acquired and segmented to create 3D surface models, which were then registered onto live XRF. CTO recanalization was performed using incrementally aggressive CTO devices (Group A) or an upfront aggressive directed laser approach (Group B). Procedural success was defined as luminal or sub-intimal device position without severe perforation. Results In this swine model, MRI to XRF fusion guidance resulted in a procedural success of 57% in Group A and 100% in Group B, which compared favorably to 33% using XRF alone. Fluoroscopy time was significantly less for Group B (8.5 min ▒ 2.6 min) compared to Group A (48.7 min ▒ 23.9 min), p value<0.01. Contrast dose used was similar between Groups A and B. Conclusions MRI to XRF fusion guided peripheral artery CTO recanalization is feasible. Multi-modality image fusion may permit upfront use of aggressive CTO devices with improved procedural outcomes compared to XRF guided procedures. PMID:23097307
Impact of Laser Fiber Design on Outcome of Endovenous Ablation of Lower-Extremity Varicose Veins: Results from a Single Practice
Prince, Ethan A., E-mail: firstname.lastname@example.com; Soares, Gregory M.; Silva, MaryLou; Taner, Anil; Ahn, SunHo; Dubel, Gregory J.; Jay, Bryan S. [Brown University/Rhode Island Hospital, Warren Alpert School of Medicine (United States)
The design of laser fibers used for endovenous laser ablation (EVLA) in the management of lower-extremity varicose vein disease may affect treatment success. The purpose of this investigation is to report our experience using the gold-tip NeverTouch VenaCure laser fiber (AngioDynamics, Queensbury, NY) and to compare that to our experience with standard bare-tip fibers. A retrospective chart review of 363 consecutive EVLA treatments using the gold-tip laser fiber was performed. Demographic data including patient age, sex, history of previous varicose vein stripping, vein identity, laterality, treatment length, total applied energy in joules (J), use of adjuvant sclerotherapy and ambulatory phlebectomy, treatment-related complications, and treatment failure, which was defined as recanalization of any portion of the treated vein during follow-up as assessed by duplex ultrasound examination-were entered into a spreadsheet. These data were compared with a control group of 471 EVLA treatments performed with a standard bare-tip laser fiber. Data were analyzed using independent-samples Student's t test, chi-square test, and multivariate analysis. Demographic data were similar between the two groups. Treatments with the gold-tip fiber had a failure rate of 11.1%, whereas treatment with a bare-tip fiber had a failure rate of 2.3% during a similar follow-up period. This difference was highly statistically significant (p < 0.0001). Multivariate analysis showed fiber type as the most significant factor associated with treatment failure. We conclude that laser fiber design has a significant effect on treatment success in the performance of EVLA.
Successful Recanalization of Acute Superior Mesenteric Artery Thromboembolic Occlusion by a Combination of Intraarterial Thrombolysis and Mechanical Thrombectomy with a Carotid Filter
Zelenak, Kamil, E-mail: firstname.lastname@example.com [University Hospital, Department of Radiology (Slovakia); Sinak, Igor; Janik, Jan; Mikolajcik, Anton; Mistuna, Dusan [University Hospital, Department of Surgery (Slovakia)
Acute superior mesenteric artery (SMA) occlusion is a life-threatening disease, and acute intestinal ischemia develops from the sudden decrease in perfusion to the intestines. The key to saving the patient's life is early diagnosis, and prompt revascularization of the SMA can prevent intestinal infarction and decrease the risk of bowel segment necrosis. Computed tomographic angiography may be useful for rapid diagnosis. We report recanalization of an SMA occlusion in an 80-year-old man with a combination of intraarterial thrombolysis and mechanical thrombectomy with a carotid filter.
Brain vein disorders in newborn infants.
Raets, Marlou; Dudink, Jeroen; Raybaud, Charles; Ramenghi, Luca; Lequin, Maarten; Govaert, Paul
The brain veins of infants are in a complex phase of remodelling in the perinatal period. Magnetic resonance venography and susceptibility-weighted imaging, together with high-resolution Doppler ultrasound, have provided new tools to aid study of venous developmental anatomy and disease. This review aims to provide a comprehensive background of vein development and perinatal venous lesions in preterm and term-born infants, and to encourage further research in both the fetus and the newborn infant, with the aim of preventing or mitigating parenchymal injury related to diseases involving veins. PMID:25212961
Microstructural evolution of syntaxial veins formed by advective flow
Christoph Hilgers; Karin Dilg-Gruschinski; Janos L. Urai
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
Tectonic fibrous veins: initiation and evolution. Ouachita Orogen, ArkansasĀ
Cervantes, Pablo
, veins are characterized by veinlets (thin veins between 5 and 25 ?m thick) that parallel the vein-host interface and fibers (columns of quartz or calcite) perpendicular to the vein-host interface between 30 and 350 ?m wide. Veinlets are localized...
Deep Vein Thrombosis (DVT) (Beyond the Basics)
... embolism in pregnancy: Treatment Diagnosis of suspected deep vein thrombosis of the lower extremity Etiology, clinical features, and diagnosis of cerebral venous thrombosis Evaluating patients with established venous thromboembolism ...
How Can Deep Vein Thrombosis Be Prevented?
... prevent deep vein thrombosis (DVT) and pulmonary embolism (PE). If you're at risk for these conditions: ... from forming. If you've had DVT or PE before, you can help prevent future blood clots. ...
Primary leiomyosarcoma of the innominate vein.
Illuminati, Giulio; Miraldi, Fabio; Mazzesi, Giuseppe; D'urso, Antonio; Ceccanei, Gianluca; Bezzi, Marcello
Primary venous leiomyosarcoma is rare. We report the case of a primary leiomyosarcoma of the left innominate vein, with neoplastic thrombus extending into the left jugular and subclavian veins. The tumor was curatively resected en bloc with anterior mediastinal and laterocervical lymphatics, through a median sternotomy prolonged into left cervicotomy. Primary venous sarcomas may be associated with prolonged survival in individual cases, with curative resection recommended as the standard treatment, in the absence of distant spread. PMID:17349340
Portal vein thrombosis in liver cirrhosis
Filippo Luca Fimognari; Francesco Violi
Portal vein thrombosis (PVT) is observed in 10¢20% of patients with liver cirrhosis, which is responsible for 20% of all PVT\\u000a cases. The main pathogenic factor of PVT in cirrhosis is the obstacle to portal flow, but acquired and inherited clotting\\u000a abnormalities may play a role. The formation of collateral veins allows many patients to remain asymptomatic and prevents\\u000a the
Veins Improve Fracture Toughness of Insect Wings
Dirks, Jan-Henning; Taylor, David
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 insectÆs 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 materialÆs 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 wingÆs 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 Ąm). This finding directly demonstrates how the biomechanical properties and the morphology of locust wings are functionally correlated in locusts, providing a mechanically æoptimalÆ 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 ævenousÆ 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
Preoperative and intraoperative evaluation of diameter-reflux relationship of calf perforating veins in patients with primary varicose vein
Naoto Yamamoto; Naoki Unno; Hiroshi Mitsuoka; Takaaki Saito; Keita Miki; Kei Ishimaru; Hiroshi Kaneko; Satoshi Nakamura
Objective: Interruption of incompetent perforating veins (PVs) is important for varicose vein surgery. The purpose of this study was to evaluate the preoperative and intraoperative diameter-reflux relationship of PVs and to evaluate the accuracy of preoperative duplex scanning in patients with varicose vein. Methods: Patients with primary varicose veins were retrospectively investigated. Diameters and reflux of PVs were evaluated before
Gonadal vein tumor thrombosis due to renal cell carcinoma.
Haghighatkhah, Hamidreza; Karimi, Mohammad Ali; Taheri, Morteza Sanei
Renal cell carcinoma (RCC) had a tendency to extend into the renal vein and inferior vena cava, while extension into the gonadal vein has been rarely reported. Gonadal vein tumor thrombosis appears as an enhancing filling defect within the dilated gonadal vein anterior to the psoas muscle and shows an enhancement pattern identical to that of the original tumor. The possibility of gonadal vein thrombosis should be kept in mind when looking at an imaging study of patients with RCC. PMID:25624585
Gonadal vein tumor thrombosis due to renal cell carcinoma
Haghighatkhah, Hamidreza; Karimi, Mohammad Ali; Taheri, Morteza Sanei
Renal cell carcinoma (RCC) had a tendency to extend into the renal vein and inferior vena cava, while extension into the gonadal vein has been rarely reported. Gonadal vein tumor thrombosis appears as an enhancing filling defect within the dilated gonadal vein anterior to the psoas muscle and shows an enhancement pattern identical to that of the original tumor. The possibility of gonadal vein thrombosis should be kept in mind when looking at an imaging study of patients with RCC PMID:25624585
Varicose Veins, Deep Vein Thrombosis, and Haemorrhoids: Epidemiology and Suggested Aetiology
Burkitt, Denis P.
Current concepts on the aetiology of varicose veins, deep vein thrombosis, and haemorrhoids have been examined and, in the light of epidemiological evidence, found wanting. It is suggested that the fundamental cause of these disorders is faecal arrest which is the result of a low-residue diet. PMID:5032782
Internal vein texture and vein evolution of the epithermal Shila-Paula district, southern Peru
Paris-Sud XI, Universitķ de
Internal vein texture and vein evolution of the epithermal Shila-Paula district, southern Peru) CEDIMIN S.A.C., Luis N. Saenz 447-449, Jesus Maria, Lima 21, Peru (5) ISTO, CNRS-UMR 6113, University Cordillera (southern Peru). Field studies of the ore bodies reveal a systematic association of a main E
Hepatocellular Carcinoma Invading the Main Portal Vein: Treatment with Transcatheter Arterial Chemoembolization and Portal Vein Stenting
Zhang Xuebin; Wang Jianhua; Yan Zhiping; Qian Sheng; Liu Rong
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
Deep vein thrombosis: a clinical review
Kesieme, Emeka; Kesieme, Chinenye; Jebbin, Nze; Irekpita, Eshiobo; Dongo, Andrew
Background: Deep vein thrombosis (DVT) is the formation of blood clots (thrombi) in the deep veins. It commonly affects the deep leg veins (such as the calf veins, femoral vein, or popliteal vein) or the deep veins of the pelvis. It is a potentially dangerous condition that can lead to preventable morbidity and mortality. Aim: To present an update on the causes and management of DVT. Methods: A review of publications obtained from Medline search, medical libraries, and Google. Results: DVT affects 0.1% of persons per year. It is predominantly a disease of the elderly and has a slight male preponderance. The approach to making a diagnosis currently involves an algorithm combining pretest probability, D-dimer testing, and compression ultrasonography. This will guide further investigations if necessary. Prophylaxis is both mechanical and pharmacological. The goals of treatment are to prevent extension of thrombi, pulmonary embolism, recurrence of thrombi, and the development of complications such as pulmonary hypertension and post-thrombotic syndrome. Conclusion: DVT is a potentially dangerous condition with a myriad of risk factors. Prophylaxis is very important and can be mechanical and pharmacological. The mainstay of treatment is anticoagulant therapy. Low-molecular-weight heparin, unfractionated heparin, and vitamin K antagonists have been the treatment of choice. Currently anticoagulants specifically targeting components of the common pathway have been recommended for prophylaxis. These include fondaparinux, a selective indirect factor Xa inhibitor and the new oral selective direct thrombin inhibitors (dabigatran) and selective factor Xa inhibitors (rivaroxaban and apixaban). Others are currently undergoing trials. Thrombolytics and vena caval filters are very rarely indicated in special circumstances. PMID:22287864
Endovascular Radiofrequency Ablation for Varicose Veins
Executive Summary Objective The objective of the MAS evidence review was to conduct a systematic review of the available evidence on the safety, effectiveness, durability and cost¢effectiveness of endovascular radiofrequency ablation (RFA) for the treatment of primary symptomatic varicose veins. Background The Ontario Health Technology Advisory Committee (OHTAC) met on August 26th, 2010 to review the safety, effectiveness, durability, and cost-effectiveness of RFA for the treatment of primary symptomatic varicose veins based on an evidence-based review by the Medical Advisory Secretariat (MAS). Clinical Condition Varicose veins (VV) are tortuous, twisted, or elongated veins. This can be due to existing (inherited) valve dysfunction or decreased vein elasticity (primary venous reflux) or valve damage from prior thrombotic events (secondary venous reflux). The end result is pooling of blood in the veins, increased venous pressure and subsequent vein enlargement. As a result of high venous pressure, branch vessels balloon out leading to varicosities (varicose veins). Symptoms typically affect the lower extremities and include (but are not limited to): aching, swelling, throbbing, night cramps, restless legs, leg fatigue, itching and burning. Left untreated, venous reflux tends to be progressive, often leading to chronic venous insufficiency (CVI). A number of complications are associated with untreated venous reflux: including superficial thrombophlebitis as well as variceal rupture and haemorrhage. CVI often results in chronic skin changes referred to as stasis dermatitis. Stasis dermatitis is comprised of a spectrum of cutaneous abnormalities including edema, hyperpigmentation, eczema, lipodermatosclerosis and stasis ulceration. Ulceration represents the disease end point for severe CVI. CVI is associated with a reduced quality of life particularly in relation to pain, physical function and mobility. In severe cases, VV with ulcers, QOL has been rated to be as bad or worse as other chronic diseases such as back pain and arthritis. Lower limb VV is a very common disease affecting adults ¢ estimated to be the 7th most common reason for physician referral in the US. There is a very strong familial predisposition to VV. The risk in offspring is 90% if both parents affected, 20% when neither affected and 45% (25% boys, 62% girls) if one parent affected. The prevalence of VV worldwide ranges from 5% to 15% among men and 3% to 29% among women varying by the age, gender and ethnicity of the study population, survey methods and disease definition and measurement. The annual incidence of VV estimated from the Framingham Study was reported to be 2.6% among women and 1.9% among men and did not vary within the age range (40-89 years) studied. Approximately 1% of the adult population has a stasis ulcer of venous origin at any one time with 4% at risk. The majority of leg ulcer patients are elderly with simple superficial vein reflux. Stasis ulcers are often lengthy medical problems and can last for several years and, despite effective compression therapy and multilayer bandaging are associated with high recurrence rates. Recent trials involving surgical treatment of superficial vein reflux have resulted in healing and significantly reduced recurrence rates. Endovascular Radiofrequency Ablation for Varicose Veins RFA is an image-guided minimally invasive treatment alternative to surgical stripping of superficial venous reflux. RFA does not require an operating room or general anaesthesia and has been performed in an outpatient setting by a variety of medical specialties including surgeons and interventional radiologists. Rather than surgically removing the vein, RFA works by destroying or ablating the refluxing vein segment using thermal energy delivered through a radiofrequency catheter. Prior to performing RFA, color-flow Doppler ultrasonography is used to confirm and map all areas of venous reflux to devise a safe and effective treatment plan. The RFA procedure involves the introduction of a guide wire into the target v
Veining Failure and Hydraulic Fracturing in Shales
NASA Astrophysics Data System (ADS)
Mighani, S.; Sondergeld, C. H.; Rai, C. S.
During the hydraulic fracturing, the pressurized fluid creates new fractures and reactivates existing natural fractures forming a highly conductive Stimulated Reservoir Volume (SRV) around the borehole. We extend the previous work on Lyons sandstone and pyrophyllite to anisotropic shale from the Wolfcamp formation. We divide the rock anisotropy into two groups: a) conventional and b) unconventional (shaly) anisotropy. X-ray Computed Tomography (CT), compressional velocity anisotropy, and SEM analysis are used to identify three causes of anisotropy: bedding planes, clay lamination, and calcite veins. Calcite vein is a subsequently filled with calcite bonded weakly to the matrix. Velocity anisotropy and visual observations demonstrate the calcite filled veins to be mostly subparallel to the fabric direction. Brazilian tests are carried out to observe the fracture initiation and propagation under tension. High speed photography (frame rate 300,000 frame/sec) was used to capture the failure. Strain gauges and Acoustic Emission (AE) sensors recorded the deformation leading up to and during failure. SEM imaging and surface profilometry were employed to study the post-failure fracture system and failed surface topology. Fracture permeability was measured as a function of effective stress. Brazilian tests on small disks containing a centered single vein revealed the shear strength of the veins. We interpret the strain data and number, frequency, and amplitude of AE events which are correlated well with the observed fracture process zone, surface roughness, and permeability. The unpropped fracture has enhanced permeability by two orders of magnitude. The observed anisotropic tensile failure seems to have a universal trend with a minimum strength occurring at 15o orientation with respect to the loading axis. The veins at 15o orientation with respect to the loading axis were easily activated at 30% of the original failure load. The measured strength of the vein is as low as 6% of the matrix. Surface roughness measurements show the vein to be as rough as the main tensile fracture in the matrix. The observations suggest that fracking through a deviated well reduces the breakdown pressure significantly and can activate a large number of veins with enhanced conductivity without the need for excessive proppant injection.
[Surgical therapy of primary varicose veins].
Wigger, P
The principle of varicose vein surgery still remains the interruption of all insufficient communications between the deep and the superficial venous system and removal of the varicosities. The basis for differentiated surgical treatment is accurate preoperative assessment. Careful dissection of the saphenofemoral junction through a suprainguinal incision, with division of all the branches and flush tie of the long saphenous vein combined with invaginated stripping of the long saphenous vein to just below the knee, appears to be the method of choice for good clinical results and a low incidence of damage to the saphenous nerve. Oesch recently introduced a new technique of perforate invaginate (PIN) stripping which gives even better cosmetic results. Regarding the short saphenous vein, preoperative localization of the exact level of the saphenopopliteal junction is of major importance in the prevention of recurrence. Simple evulsion or epifascial or subfascial ligation were the most common treatments for incompetent perforating veins for many years. In 1985 Hauer described endoscopic subfascial dissection of perforating veins (ESDP), which reduces delayed wound healing, especially in trophic skin changes. Deprivation of blood supply with a pneumatic tourniquet such as the L÷fqvist roller cuff is necessary. The tributaries are removed by stab evulsion phlebectomy with specially designed hooks. This technique was originally introduced by Muller for ambulatory treatment of varicose veins. The incisions of 1-3 mm guarantee excellent cosmesis and minimal trauma. Adhesive tape is used to close the incisions. A number of alternative techniques such as cryosurgery, laser surgery, paratibial fasciotomy and the CHIVA technique (Conservative Treatment and Haemodynamics in Venous Insufficiency in Outpatient Departments) are briefly described. Complications of varicose vein surgery are rare. Minor complications are skin nerve injuries, haematomas, infections and lymphatic fistulas. Major complications such as injuries to the femoral vein or artery occur in less than 0.05%. But once it has occurred it is of paramount importance to recognize the injury at the time of initial surgery, to avoid limb loss. Provided the preoperative assessment is accurate and the principles of selective surgical treatment are followed, the surgeon is able to perform a curative operation with a low complication rate and excellent cosmetic results. PMID:9854291
Optimization of subcutaneous vein contrast enhancement
NASA Astrophysics Data System (ADS)
Zeman, Herbert D.; Lovhoiden, Gunnar; Deshmukh, Harshal
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.
Anteriorly placed splenic vein: a case report.
Lal, Hira; Boruah, Deb K; Yadav, Ankusha; Samal, Amrita
Splenic vein located anterior to pancreas is a rare congenital anomaly. To date, only one case has been reported in literature. A thorough knowledge of the normal anatomy, most frequent variations, and congenital and acquired anomalies of the spleno-portal axis is of great importance for hepatobiliary and pancreatic surgeons. It is therefore essential for preoperative evaluation of the anatomical details of the spleno-portal venous axis to be made by imaging. We report such a case of anteriorly placed splenic vein in a 40-year-old female prospective renal donor. To the best of our knowledge, this represents the second reported case of an anteriorly placed splenic vein. PMID:25972673
Technical aspects of adrenal vein sampling.
Harsha, Asheesh; Trerotola, Scott O
The most common cause of secondary hypertension is primary aldosteronism, with a prevalence of approximately 30% when screened by specialized hypertension clinics. Adrenal venous sampling is considered the standard for reliably distinguishing between unilateral and bilateral hormone secretion, with unilateral secretion being surgically curable. Success of adrenal vein sampling relies on appropriate patient selection, patient preparation, and recognition and catheterization of both adrenal veins. However, this procedure may prove technically challenging, particularly for inexperienced operators. This video (see Fig; available online at www.jvir.org) is designed to provide the viewer with details on the technical aspects of adrenal vein sampling by using the sequential technique in an immersive format with real-time table-top teaching. Indications, patient preparation, equipment selection, technique, and quality assurance are reviewed in detail, with the goal of providing practitioners an opportunity to successfully incorporate this procedure into their practice. PMID:25645412
How Vein Sealing Boosts Fracture Opening
NASA Astrophysics Data System (ADS)
N³chter, Jens-Alexander
Veins from from cracks. As such, a stage of brittle failure and fracturing is to be set apart from a stage of opening and sealing. The process of fracture opening requires distortion of the host rocks to create space for the evolving vein. To keep a crack arrested and, at the same time, to widen or stabilize the cavity, the stress intensity factor K_I=(P-S3)(?a) must remain below the fracture toughness K_IC of the host rock, and P-S3 >0 (P and S3 denote pore fluid pressure and absolute minimum principal stress, respectively and 'a' refers to the half-length of the fracture). For purely elastic distortion of the host rocks, maximum aperture W0=K_IC (1-?^2)/(E(?/8)^1/2))(2a)^1/2 depends on on K_IC, Poisson's ratio ?, and Young's modulus E of the host rocks. Owing to the low values for rock K_IC typically ranging between 0.1 and 1 MPa m^1/2, veins formed by purely elastic distortion of the host rocks are restricted to high aspect ratios 2a/W. In metamorphic rocks, veins with low aspect ratios are common; inelastic deformation and viscous creep in the host rocks must have contributed to final vein shapes. In the present study, I use finite element models to simulate fracture opening and cavity formation supported by viscous creep distributed in the host rock. Simulations are carried out on 2D plate models containing elliptical fractures. The walls of the fractures are coated by thin layers simulating incipient sealing; a residual cavity prevails in the centre of the model veins. Constant displacement is applied to the plate boundaries oriented normal to the cracks. I run a series of models with various viscosity contrasts between the rocks and the sealing. The results of these models indicate the following. (1) Fracture opening is most effective when the viscosity of the sealing ?s exceeds the viscosity of the host rocks ?r (2) The rate of fracture opening increases with increasing values for ?s/?r . (3) An increase in the thickness of the sealing layer causes an increase in the fracture opening rates. (4) At constant strain rates, the rate of fracture opening increases with increasing strain. These results suggest that vein sealing boosts the rate of fracture opening, and contributes to development of low-aspect ratio veins.
Percutaneous Intraluminal Recanalization of Long, Chronic Superficial Femoral and Popliteal Occlusions Using the Frontrunner XP CTO Device: A Single-Center Experience
Charalambous, Nikolas, E-mail: firstname.lastname@example.com; 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)
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.
Why should we report posterior fossa emissary veins?
Pekńevik, Yeliz; Pekńevik, R?dvan
Posterior fossa emissary veins are valveless veins that pass through cranial apertures. They participate in extracranial venous drainage of the posterior fossa dural sinuses. The mastoid emissary vein, condylar veins, occipital emissary vein, and petrosquamosal sinus are the major posterior fossa emissary veins. We believe that posterior fossa emissary veins can be detected by radiologists before surgery with a thorough understanding of their anatomy. Describing them using temporal bone computed tomography (CT), CT angiography, and cerebral magnetic resonance (MR) venography examinations results in more detailed and accurate preoperative radiological interpretation and has clinical importance. This pictorial essay reviews the anatomy of the major and clinically relevant posterior fossa emissary veins using high-resolution CT, CT angiography, and MR venography images and discusses the clinical importance of reporting these vascular variants. PMID:24047723
What Are the Signs and Symptoms of Varicose Veins?
... around the varicose vein. Signs of telangiectasias are clusters of red veins that you can see just under the surface of your skin. These clusters usually are found on the upper body, including ...
[Constriction of the femoral vein after McVay hernioplasty].
Bj°rgul, K; Forsell, C; Andersen, O K
Constriction of the femoral vein is a well known complication to the Cooper ligament repair of inguinal hernia. This may occur as the transversalis fascia and aponeurosis are sutured to Copper's ligament, either because a suture is passed through the vein or the vein is compressed by tissue. Clinical presentation is usually signs of deep venous thrombosis or pulmonary embolism. Venography verifies the diagnosis by showing a characteristic constriction of the femoral vein. PMID:7940451
Suitability of Varicose Veins for Endovenous Treatments
S. D. Goode; G. Kuhan; N. Altaf; R. Simpson; A. Beech; T. Richards; S. T. MacSweeney; B. D. Braithwaite
The aim of the study was to assess the suitability of radiofrequency ablation (RFA), endovenous laser ablation (EVLA), and foam sclerotherapy (FS) for patients with symptomatic varicose veins (VVs). The study comprised 403 consecutive patients with symptomatic VVs. Data on 577 legs from 403 consecutive patients with symptomatic VVs were collected for the year 2006. Median patient age was 55
A secure cryptosystem from palm vein biometrics
B. Prasanalakshmi; A. Kannammal
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
Portal vein thrombosis complicating endoscopic variceal sclerotherapy
Jacob Korula; Albert Yellin; Gary C. Kanel; Peter Nichols
Summary Portal vein thrombosis occurred in a patient who bled from gastric varices that developed after obliteration of esophageal varices by endoscopic sclerotherapy. This complication was recognized only at surgery when thrombectomy and endovenectomy preceded the successful placement of an end-to-side portocaval shunt. At histopathology, the presence of an amorphous, eosinophilic material staining negatively for fibrin and similar to sclerosant
The Aristotelian account of ōheart and veinsö
Mohammadali M. Shoja; R. Shane Tubbs; Marios Loukas; Mohammad R. Ardalan
The exploration of the cardiovascular (CV) system has a history of at least five millennia. The model of the heart and veins represented by Aristotle (384¢322 B.C.) is one of the earliest and accurate descriptions of the CV system. With his own specific metaphysical approach, Aristotle discussed why there might be a vascular tree composed of two vessels and also
Calcified neonatal renal vein thrombosis demonstration by CT and US
S. Jayogapal; H. L. Cohen; P. W. Brill; P. Winchester; D. Eaton
Two cases of calcified renal vein thrombosis (RVT) were diagnosed, incidentally, within the first weeks of life. The CT images present the virtually diagnostic branching pattern of calcification that has been previously noted on pathology specimen radiographs. The CT and US images show peripheral renal vein, central renal vein and inferior vena cava calcification conforming to the two theoretical origins
An update on the diagnosis and treatment of varicose veins
Richard M. Green
Varicose veins are a common ailment affecting more than 20 million Americans. These veins and the associated venous hypertension are associated with leg swelling, pain, dermatitis, phlebitis, and ulceration. The underlying principle of treatment of any varicosity is the removal or obliteration of pathologically functioning veins and the preservation of those with normal function. Diagnosis is obvious, but deciding whether
Clinical Results of Radiofrequency Endovenous Obliteration for Varicose Veins
Tomohiro Ogawa; Shunichi Hoshino; Hirofumi Midorikawa; Kouichi Sato
Purpose Radiofrequency (RF) endovenous obliteration is performed in the United States and several European countries for the minimally invasive treatment of saphenous-type varicose veins. We evaluated the clinical results of RF endovenous obliteration to treat varicose veins at Fukushima Daiichi Hospital. Methods We performed endovenous obliteration of 25 great saphenous varicose veins in 20 patients, under duplex ultrasound guidance. None
Subclavian vein repair in patients with an ipsilateral arteriovenous fistula.
Gradman, W S; Bressman, P; Sernaque, J D
Management of subclavian vein occlusive disease in persons with an ipsilateral arteriovenous fistula can be challenging. From July 1991 to May 1993, nine patients underwent direct exploration and repair of an obstructed subclavian vein following medial claviculectomy. Eight patients had polytetrafluoroethylene (PTFE) grafts; one patient had a Brescia-Cimino fistula. Intractable arm edema was the major symptom in five of eight. The site of the occlusive disease ranged from the midsubclavian vein to the proximal innominate vein. Pathology varied from a focal occluding web to a long segment of intimal fibroplasia. Five veins were occluded; four were stenotic. Surgical procedures consisted of endovenectomy and vein patch (four), endovenectomy and PTFE patch (one), resection of a focal stricture with end-to-end anastomosis (two), resection with PTFE interposition (one), and end-to-end internal jugular to subclavian vein transposition (one). Postoperative contrast venograms revealed a patent subclavian vein in eight of eight patients. One patient died postoperatively from unrelated causes; two patients died with a functioning fistula 8 and 12 months, respectively, after surgery. Two grafts were removed for infection and one deteriorated graft was abandoned because of repeated thrombosis. Only three of nine original grafts are currently in use, including one in which the ipsilateral subclavian vein rethrombosed. Although stent placement may now be the preferred treatment for subclavian vein stenosis, vein repair may still have a role in the treatment of subclavian vein occlusion, particularly in patients with a Brescia-Cimino fistula. PMID:7865393
Host range comparison of the causal agents of pepper yellow vein and lettuce big vein
A. Th. B. Rast
A number of solanaceous and composite plant species were tested as hosts for the causal agents of pepper yellow vein (PYVA) and lettuce big vein (LBVA), transmitted by a pepper and a lettuce isolate ofOlpidium brassicae, respectively. The agents had the following artificial hosts in common:Lycopersicon esculentum, Solanum melongena, Physalis floridana, Nicandra physaloides, Lactuca sativa, Sonchus oleraceus andL. virosa. Capsicum
Hepatocellular Carcinoma Invading the Main Portal Vein: Treatment with Transcatheter Arterial Chemoembolization and Portal Vein Stenting
Xue-Bin Zhang; Jian-Hua Wang; Zhi-Ping Yan; Sheng Qian; Rong Liu
To retrospectively analyze the therapeutic results of percutaneous transhepatic portal vein stenting (PTPVS) and transcatheter\\u000a arterial chemoembolization (TACE) treatment in 58 patients with hepatocellular carcinoma (HCC) invading the main portal vein\\u000a (MPV). A total of 58 procedures of PTPVS were performed, immediately after which TACE was undertaken to control HCC. The clinical\\u000a effects, complications, digital subtraction angiographic appearance, stent patency
Retinal vein-to-vein anastomoses in Sturge-Weber syndrome documented by ultra-widefield fluorescein angiography.
Quan, Ann V; Moore, Grant H; Tsui, Irena
We report the case of a 6-year-old boy with Sturge-Weber syndrome and unilateral glaucoma in his left eye. He was born with a port wine mark involving his upper left eyelid. On ultra-widefield fluorescein angiography, he was found to have several vein-to-vein anastomoses in his left retina. To our knowledge, this is the first documentation of retinal vein-to-vein anastomoses in Sturge-Weber syndrome. PMID:25944745
Transcutaneous laser treatment of leg veins.
Meesters, Arne A; Pitassi, Luiza H U; Campos, Valeria; Wolkerstorfer, Albert; Dierickx, Christine C
Leg telangiectasias and reticular veins are a common complaint affecting more than 80% of the population to some extent. To date, the gold standard remains sclerotherapy for most patients. However, there may be some specific situations, where sclerotherapy is contraindicated such as needle phobia, allergy to certain sclerosing agents, and the presence of vessels smaller than the diameter of a 30-gauge needle (including telangiectatic matting). In these cases, transcutaneous laser therapy is a valuable alternative. Currently, different laser modalities have been proposed for the management of leg veins. The aim of this article is to present an overview of the basic principles of transcutaneous laser therapy of leg veins and to review the existing literature on this subject, including the most recent developments. The 532-nm potassium titanyl phosphate (KTP) laser, the 585-600-nm pulsed dye laser, the 755-nm alexandrite laser, various 800-983-nm diode lasers, and the 1,064-nm neodymium yttrium-aluminum-garnet (Nd:YAG) laser and various intense pulsed light sources have been investigated for this indication. The KTP and pulsed dye laser are an effective treatment option for small vessels (<1 mm). The side effect profile is usually favorable to that of longer wavelength modalities. For larger veins, the use of a longer wavelength is required. According to the scarce evidence available, the Nd:YAG laser produces better clinical results than the alexandrite and diode laser. Penetration depth is high, whereas absorption by melanin is low, making the Nd:YAG laser suitable for the treatment of larger and deeply located veins and for the treatment of patients with dark skin types. Clinical outcome of Nd:YAG laser therapy approximates that of sclerotherapy, although the latter is associated with less pain. New developments include (1) the use of a nonuniform pulse sequence or a dual-wavelength modality, inducing methemoglobin formation and enhancing the optical absorption properties of the target structure, (2) pulse stacking and multiple pass laser treatment, (3) combination of laser therapy with sclerotherapy or radiofrequency, and (4) indocyanin green enhanced laser therapy. Future studies will have to confirm the role of these developments in the treatment of leg veins. The literature still lacks double-blind controlled clinical trials comparing the different laser modalities with each other and with sclerotherapy. Such trials should be the focus of future research. PMID:24220848
Retrospective Comparison of Clinical Outcomes between Endovenous Laser and Saphenous Vein-sparing Surgery for Treatment of Varicose Veins
Chih-Yang Chan; Tzu-Chun Chen; Yung-Kun Hsieh; Jih-Hsin Huang
BackgroundĀĀThe purpose of the present study was to compare management of varicose veins by endovenous laser ablation (EVL) and a vein-sparing\\u000a procedure (CHIVA: Conservatrice et Hķmodynamique de lÆInsuffisance Veineuse en Ambulatoire) for management of varicose veins.\\u000a \\u000a \\u000a \\u000a \\u000a MethodsĀĀData from 82 consecutive patients with great saphenous vein (GSV) reflux and primary varicose veins presenting to the vascular\\u000a clinic at the Far Eastern
Patterning of Leaf Vein Networks by Convergent Auxin Transport Pathways
Sawchuk, Megan G.; Edgar, Alexander; Scarpella, Enrico
The formation of leaf vein patterns has fascinated biologists for centuries. Transport of the plant signal auxin has long been implicated in vein patterning, but molecular details have remained unclear. Varied evidence suggests a central role for the plasma-membrane (PM)-localized PIN-FORMED1 (PIN1) intercellular auxin transporter of Arabidopsis thaliana in auxin-transport-dependent vein patterning. However, in contrast to the severe vein-pattern defects induced by auxin transport inhibitors, pin1 mutant leaves have only mild vein-pattern defects. These defects have been interpreted as evidence of redundancy between PIN1 and the other four PM-localized PIN proteins in vein patterning, redundancy that underlies many developmental processes. By contrast, we show here that vein patterning in the Arabidopsis leaf is controlled by two distinct and convergent auxin-transport pathways: intercellular auxin transport mediated by PM-localized PIN1 and intracellular auxin transport mediated by the evolutionarily older, endoplasmic-reticulum-localized PIN6, PIN8, and PIN5. PIN6 and PIN8 are expressed, as PIN1 and PIN5, at sites of vein formation. pin6 synthetically enhances pin1 vein-pattern defects, and pin8 quantitatively enhances pin1pin6 vein-pattern defects. Function of PIN6 is necessary, redundantly with that of PIN8, and sufficient to control auxin response levels, PIN1 expression, and vein network formation; and the vein pattern defects induced by ectopic PIN6 expression are mimicked by ectopic PIN8 expression. Finally, vein patterning functions of PIN6 and PIN8 are antagonized by PIN5 function. Our data define a new level of control of vein patterning, one with repercussions on other patterning processes in the plant, and suggest a mechanism to select cell files specialized for vascular function that predates evolution of PM-localized PIN proteins. PMID:23437008
Inadvertent Port: Catheter Placement in Azygos Vein
Harish, K.; Madhu, Y. C.
Totally implantable ports are safe and effective means of venous access for administration of chemotherapy. One of the usual vessels accessed, through which the port is placed, is the subclavian. Herein, we report a case where the central access was obtained through the left subclavian vein. But the catheter when it was placed was found to be in the azygos vein. This was confirmed with dye study. This is the first report of such an occurrence with subclavian access. The catheter was later withdrawn and repositioned in the superior vena cava. We recommend that the entire procedure of catheter placement must be done under fluoroscopy guidance to ensure safe and error-free positioning. PMID:23730139
Finger Vein Recognition with Personalized Feature Selection
Xi, Xiaoming; Yang, Gongping; Yin, Yilong; Meng, Xianjing
Finger veins are a promising biometric pattern for personalized identification in terms of their advantages over existing biometrics. Based on the spatial pyramid representation and the combination of more effective information such as gray, texture and shape, this paper proposes a simple but powerful feature, called Pyramid Histograms of Gray, Texture and Orientation Gradients (PHGTOG). For a finger vein image, PHGTOG can reflect the global spatial layout and local details of gray, texture and shape. To further improve the recognition performance and reduce the computational complexity, we select a personalized subset of features from PHGTOG for each subject by using the sparse weight vector, which is trained by using LASSO and called PFS-PHGTOG. We conduct extensive experiments to demonstrate the promise of the PHGTOG and PFS-PHGTOG, experimental results on our databases show that PHGTOG outperforms the other existing features. Moreover, PFS-PHGTOG can further boost the performance in comparison with PHGTOG. PMID:23974154
Suitability of Varicose Veins for Endovenous Treatments
S. D. Goode; G. Kuhan; N. Altaf; R. Simpson; A. Beech; T. Richards; S. T. MacSweeney; B. D. Braithwaite
The aim of the study was to assess the suitability of radiofrequency ablation (RFA), endovenous laser ablation (EVLA), and\\u000a foam sclerotherapy (FS) for patients with symptomatic varicose veins (VVs). The study comprised 403 consecutive patients with\\u000a symptomatic VVs. Data on 577 legs from 403 consecutive patients with symptomatic VVs were collected for the year 2006. Median\\u000a patient age was 55Āyears
Brain Single-photon Emission CT Studies Using 99mTc-HMPAO and 99mTc-ECD Early after Recanalization by Local Intraarterial Thrombolysis in Patients with Acute Embolic Middle Cerebral Artery Occlusion
Kuniaki Ogasawara; Akira Ogawa; Masayuki Ezura; Hiromu Konno; Michiyasu Suzuki; Takashi Yoshimoto
BACKGROUND AND PURPOSE: The brain distribution of 99mTc-hexamethylpropyleneam- ine oxime (HMPAO) correlates with regional brain perfusion, whereas 99mTc-ethyl cysteinate dimer (ECD) reflects not only perfusion but also the metabolic status of brain tissue. We compared 99mTc-ECD single-photon emission CT (SPECT) with 99mTc-HMPAO SPECT early after recanalization by local intraarterial thrombolysis (LIT) in patients with acute embolic middle cerebral artery occlusion.
Nitroxidergic nerve stimulation relaxes human uterine vein.
Toda, N; Kimura, T; Okamura, T
The predominant action of nitroglycerin, a nitric oxide (NO) donor, on veins over arterioles is well recognized. This study was carried out to determine whether endogenous NO derived from vasodilator nerve regulates the tone of human uterine venous strips. The isolated vein partially contracted with prostaglandin F2 alpha responded to nicotine with a contraction or a relaxation; the contraction was reversed to a relaxation by prazosin, and the relaxation was potentiated by the alpha 1-adrenoceptor antagonist. In prazosin-treated strips, nicotine-induced relaxations were not affected by timolol, atropine and indomethacin but were abolished by oxyhemoglobin and NG-nitro-L-arginine (L-NA), a NO synthase inhibitor. The D-enantiomer was without effect. The inhibition by L-NA was reversed by L-arginine. The NO-induced relaxation was not influenced by L-NA but was abolished by oxyhemoglobin. It may be concluded that the human uterine vein is innervated by vasodilator nerves from which NO is liberated as a vasodilator neurotransmitter. Norepinephrine from adrenergic nerves contracts venous smooth muscle possibly via stimulation of alpha 1-adrenoceptors. PMID:8801269
Quantitative modeling of quartz vein sealing
NASA Astrophysics Data System (ADS)
Wendler, Frank; Okamoto, Atsushi; Schwarz, Jens-Oliver; Enzmann, Frieder; Blum, Philipp
Mineral precipitation significantly effects many aspects of fluid-rock interaction across all length scales, as the dynamical change of permeability, of mechanical interaction and redistribution of dissolved material. The hydrothermal growth of quartz establishes one of the most important mineralization processes in fractures. Tectonically caused fracturing, deformation and fluid transport leaves clear detectable traces in the microstructure of the mineralized veins. As these patterns give hints on the deformation history and the fluid pathways through former fracture networks, accurate spatio-temporal modeling of vein mineralization is of special interest, and the objective of this study. Due to the intricate polycrystalline geometries involved, the underlying physical processes like diffusion, advection and crystal growth have to be captured at the grain scale. To this end, we adapt a thermodynamically consistent phase-field model (PFM), which combines a kinetic growth law and mass transport equations with irreversible thermodynamics of interfaces and bulk phases. Each grain in the simulation domain is captured by a phase field with individual orientation given by three Euler angles. The model evolves in discrete time steps using a finite difference algorithm on a regular grid, optimized for large grain assemblies. The underlying processes are highly nonlinear, and for geological samples, boundary conditions as well as many of the physical parameters are not precisely known. One motivation in this study is to validate the adequately parameterized model vs. hydrothermal experiments under defined (p,T,c) conditions. Different from former approaches in vein growth simulation, the PFM is configured using thermodynamic data from established geochemical models. Previously conducted batch flow experiments of hydrothermal quartz growth were analyzed with electron backscatter diffraction (EBSD) and used to calibrate the unknown kinetic anisotropy parameters. In the simulations, we study the sealing of syntaxial veins of 300 microns aperture by epitaxial overgrowth of preexisting grains from the rock surface. Results from 3D simulations conducted in the limit of low Damk÷hler numbers explain the observed transition regime in competitive crystal growth for blocky-elongate veins. The initial formation of quartz crystal bridges, especially pronounced in the regime of low supersaturation, is observed. The morphological evolution of micro-ensembles of grain neighbourhoods from the rock sample compares well to that of the simulations. To juxtapose larger polycrystal domains, the variation of grain number, texture and porosity as function of scaled distance from the initial wall is calculated. Velocity profiles from solutions of the isothermal incompressible Navier-Stokes equation are used to record permeability evolution and to evaluate deviations from the cubic law. Both, the geometry of the microstructure and the permeability of the flow pathway, are used as upscaling parameters for larger scale (fracture scale) simulations.
Variations of Gonadal Veins: Embryological Prospective and Clinical Significance
Gupta, Raman; Aggarwal, Navita
Introduction: An adequate knowledge of anomalies of gonadal veins will help the radiologists and surgeons in recognition and protection of these veins which play major roles in thermo-regulation that is essential for the efficient functioning of testis on which the survival of the human species depends. Aim: The aim of this work is to present an analysis of the anatomical variations of gonadal veins. An effort has also been made to explicate the possible embryological model of development of such variants and to present the variable clinical aspects concerning them. Materials and Methods: Gonadal veins in 60 dissection room cadavers were examined for variations from the classic anatomic description. Result: In the present study, out of 60 cases, male: female ratio was 2:1(40:20) in which no variation was found in ovarian veins. In the 18 (45%) cases, testicular veins showed variations which consist of duplication and atypical drainage. Discussion: Variations of drainage of gonadal vein are due to error of embryological development in venous shift and alteration in anastomotic channel of post-cardinal, supra-cardinal and sub cardinal veins. Conclusion: The gonadal veins present numeric variations as well as variations in its site of drainage, which attributed to the various pathological conditions as varicocele and pelvic congestion syndrome, leading to infertility in patients. Hence, in -depth knowledge of these developmental anomalies of gonadal veins is important. PMID:25859438
Development of HIFU Therapy System for Lower Extremity Varicose Veins
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)
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.
From the Veins to the Heart: A Rare Cause of Varicose Veins
Dalla Vestra, Michele; Grolla, Elisabetta; Bonanni, Luca; Dorrucci, Vittorio; Presotto, Fabio; Rigo, Fausto
The presence of pulsating varicous veins is an uncommon finding, generically attributed to right heart failure. The precise causes of this phenomenon have been poorly defined in the literature. The finding of this infrequent condition is important because it may be a sign of major diseases, often not known. Here we described a 75-year-old woman presented to the Angiology Unit for the presence of bilateral pulsatile swelling in her groin and along both lower limbs. A bedside ultrasound examination showed an arterial like pulsating flow both in the superficial and in the deep veins of the lower limbs due to a severe tricuspid regurgitation not previously known. PMID:26090263
A Novel Device for True Lumen Re-Entry After Subintimal Recanalization of Superficial Femoral Arteries: First-in-Man Experience and Technical Description
Airoldi, Flavio, E-mail: email@example.com; Faglia, Ezio, E-mail: email@example.com; Losa, Sergio, E-mail: email@example.com; Tavano, Davide, E-mail: email@example.com [Multimedica IRCCS, Cardiovascular Department (Italy); Latib, Azeem, E-mail: email@example.com [University of Cape Town, Division of Cardiology (South Africa); Mantero, Manuela, E-mail: firstname.lastname@example.com; Lanza, Gaetano, E-mail: email@example.com; Clerici, Giacomo, E-mail: email@example.com [Multimedica IRCCS, Cardiovascular Department (Italy)
Subintimal angioplasty (SAP) is frequently performed for the treatment of critical limb ischemia (CLI) and has been recognized as an effective technique for these patients. Nevertheless, this approach is limited by the lack of controlled re-entry into the true lumen of the target vessel. We describe a novel device for true lumen re-entry after subintimal recanalization of superficial femoral arteries (SFA). We report our experience with six patients treated between April 2009 and January 2010 with a novel system designed to facilitate true lumen re-entry. The device was advanced by ipsilateral antegrade approach through a 6-French sheath. Successful reaccess into the true lumen was obtained in five of six patients without complications. The patient in whom the reaccess to the true lumen was not possible underwent successful bypass surgery. At 30 days follow-up, the SFA was patent in all patients according to echo-Doppler examination. Our preliminary experience indicates that this novel re-entry device increases the success rate of percutaneous revascularization of chronically occluded SFA.
Kinematics of crystal growth in syntectonic fibrous veins
J. L. Urai; P. F. Williams; H VANROERMUND
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
Can vein patterns be used to estimate rock permeabilities?
NASA Astrophysics Data System (ADS)
Koehn, Daniel; Vass, Anna; Ghani, Irfan; Toussaint, Renaud; Bons, Paul; Gomez-Rivas, Enrique; Urai, Janos L.; Arndt, Max; Virgo, Simon; Wendler, Frank; Blum, Philipp; Schwarz, Jens-Oliver
Fracturing of rocks due to tectonic stresses or local high fluid pressures and the formation of fluid pathways is important for a whole range of industrially relevant processes in the Earth's upper crust reaching from groundwater transport, hydrocarbon migration to geothermal systems. Fracturing and the opening of fluid pathways become especially important in tight rocks where fluid migration through the rock matrix is restricted. In addition observations show that fractures are often partly or completely sealed and occur as veins in geological systems. How can we interpret the permeability of these vein systems? The internal structure of veins often indicates that they are formed by several cracking and sealing events. In addition some geological systems contain partly sealed veins that have a preserved porosity and may add to the overall permeability of the system. We are comparing field areas that contain different vein patterns with hydrodynamic numerical models where fractures develop as a function of gravity, extension and fluid pressure gradients. In addition fractures seal where the developing veins can have variable properties in terms of elasticity, breaking strength and porosity. Results indicate that permeability in such systems is not a constant but may vary strongly over time. In an active system the amount of veins and number of open fractures depends not only on the timing of sealing but also on the breaking strength of the veins. Strong veins can clog the system whereas weak veins tend to lead to possible connected fracture networks. In addition one cannot link veins directly to fluid flow, intense veining does not mean that the system has or had a high permeability. We will present a first attempt to classify different fracturing and sealing systems based on field observations and numerical models.
Multiple Abdominal Veins Thrombosis Secondary to Protein S Deficiency - A Case Report
Kodali, Venkata Umakant; Borra, Seshulakshmi; Mandarapu, Surendra Babu; Sanda, Mallikarjuna Rao
Abdominal venous thrombosis may present either as Budd-Chiari syndrome (BCS) caused by hepatic vein or proximal inferior vena cava (IVC) obstruction or as an extra hepatic portal obstruction (EHPVO) caused by Portal vein thrombosis or mesenteric vein thrombosis, but a mixed involvement is uncommon. Multiple abdominal venous obstructions presenting with thrombosis of hepatic vein, IVC, portal vein and renal vein are very rarely seen . We are reporting a rare case with thrombosis of IVC, hepatic vein, portal vein and renal vein, with protein S and protein C deficiencies, which was managed by giving anticoagulant therapy. PMID:25121018
Late failure of reversed vein bypass grafts.
Berkowitz, H D; Greenstein, S; Barker, C F; Perloff, L J
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. PMID:2589891
[Catheter-based treatment for acute deep vein thrombosis].
Engelberger, Rolf P; Alatri, Adriano; Qanadli, Salah D; Calanca, Luca; Mazzolai, Lucia
Nearly half of patients with acute lower limb deep vein thrombosis (DVT) develop a post-thrombotic syndrome (PTS). This risk is particularly high in case of proximal DVT of the common femoral and iliac vein, the major lower limbs venous outflow vessel. Several studies have demonstrated that PTS incidence can be reduced with early vein recanalisation. Currently, catheter-based recanalisation therapies can be offered to selected patients with acute ilio-femoral deep vein thrombosis. Aim of the present article is to summarize current knowledge on these catheter-based recanalisation therapies. PMID:25854044
Finger-vein verification based on multi-features fusion.
Qin, Huafeng; Qin, Lan; Xue, Lian; He, Xiping; Yu, Chengbo; Liang, Xinyuan
This paper presents a new scheme to improve the performance of finger-vein identification systems. Firstly, a vein pattern extraction method to extract the finger-vein shape and orientation features is proposed. Secondly, to accommodate the potential local and global variations at the same time, a region-based matching scheme is investigated by employing the Scale Invariant Feature Transform (SIFT) matching method. Finally, the finger-vein shape, orientation and SIFT features are combined to further enhance the performance. The experimental results on databases of 426 and 170 fingers demonstrate the consistent superiority of the proposed approach. PMID:24196433
Absence of the superior petrosal veins and sinus: Surgical considerations
Matsushima, Ken; Ribas, Eduardo Santamaria Carvalhal; Kiyosue, Hiro; Komune, Noritaka; Miki, Koichi; Rhoton, Albert L.
Background: The superior petrosal vein, one of the most constant and largest drainage pathways in the posterior fossa, may result in complications if occluded. This study calls attention to a unique variant in which the superior petrosal veins and sinus were absent unilaterally, and the venous drainage was through the galenic and tentorial drainage groups. Methods: This study examines one venogram and another anatomic specimen in which the superior petrosal vein and sinus were absent. Results: The superior petrosal veins, described as 1¢3 bridging veins, emptying into the superior petrosal sinus, are the major drainage pathways of the petrosal group of posterior fossa veins. In the cases presented, the superior petrosal vein and sinus were absent and venous drainage was through the galenic and tentorial groups, including the lateral mesencephalic or bridging vein on the tentorial cerebellar surface. Conclusions: In cases in which the superior petrosal sinus and veins are absent, care should be directed to preserving the collateral drainage through the galenic and tentorial tributaries. Although surgical strategies for intraoperative management and preservation of venous structures are still controversial, knowledge of the possible anatomical variations is considered to be essential to improve surgical outcomes. PMID:25745589
Deep Vein Thrombosis - Multiple Languages: MedlinePlus
Pediatric aneurysms and vein of Galen malformations
Rao, V. R. K.; Mathuriya, S. N.
Pediatric aneurysms are different from adult aneurysms ¢ they are more rare, are giant and in the posterior circulation more frequently than in adults and may be associated with congenital disorders. Infectious and traumatic aneursyms are also seen more frequently. Vein of Galen malformations are even rarer entities. They may be of choroidal or mural type. Based on the degree of AV shunting they may present with failure to thrive, with hydrocephalus or in severe cases with heart failure. The only possible treatment is by endovascular techniques ¢ both transarterial and transvenous routes are employed. Rarely transtorcular approach is needed. These cases should be managed by an experienced neurointerventionist. PMID:22069420
Medical treatment of retinal vein occlusions.
Parodi, Maurizio Battaglia
The medical treatment of retinal vein occlusion (RVO) is comprised of three main stages: identification and therapy of the detectable risk factors, specific treatment aimed at the occlusive form and treatment of RVO complications. Even though the possible medical management of RVO includes several treatments, the most interesting approaches have been: anticoagulant/antiaggregating agents, troxerutin, corticosteroid, fibrinolytic/thrombolytic agents, and hemodilution. Overall, the medical approach to RVO is still awkward and unsatisfactory. Randomized clinical trials are needed to assess the degree of efficacy of the medical treatment of the specific forms of RVO. PMID:15590533
Lymphangioma: surrounding the ovarian vein and ovary
Gonen, Korcan Aysun; Abali, Remzi; Oznur, Meltem; Erdogan, Cuneyt
Lymphangiomas are usually benign lesions seen in the head and neck region in children. Intra-abdominal localisation is rare and the majority of these cases are in early childhood. Retroperitoneal lymphangiomas constitute approximately 1% of all lymphangiomas. They are generally diagnosed incidentally, may be asymptomatic or may present with a palpable abdominal mass. A limited number of cases of ovarian lymphangiomas have been reported in women, whereas there are no reported cases of paraovarian localisation. We present a rare case of lymphangioma located in bilateral paraovarian region and along the left ovarian vein with radiological findings. PMID:23814093
Endovenous saphenous vein ablation in patients with acute isolated superficial-vein thrombosis
Objective: The possible benefits of endovenous saphenous ablation (EVSA) as initial treatment in patients presenting with isolated superficial-vein thrombosis (SVT) and saphenous vein reflux include: (1) definitive treatment of the underlying pathology and (2) elimination of the saphenous vein as a path for pulmonary emboli, which (3) may eliminate the need for anticoagulation. Methods: In a ten-year review of 115 limbs presenting with acute isolated SVT, 72 limbs (71 patients) with saphenous reflux were given a choice of two treatments following an explanation of the risks and benefits of each. Group I limbs (n?=?41) were treated with office EVSA using radiofrequency or laser with or without thrombophlebectomy if performed within 45 days of diagnosis. Post-treatment anticoagulants were not given. Group II limbs (n?=?31) were treated with compression hose and repeat Duplex within one week, with added anticoagulants if SVT extended into the thigh. Results: In group I, mean interval from diagnosis to treatment was 13.7 days. One calf deep vein thrombosis was noted. In group II no complications were noted. In late follow-up of group II patients, 12/29 underwent EVSA more than 45 days after initial presentation. Conclusions: The safety and efficacy of EVSA and thrombophlebectomy appear indistinguishable from conservative measures and may be offered as initial treatment to patients presenting with SVT and saphenous reflux. PMID:24307241
Distribution of saphenous vein valves and its pratical importance
Portugal, Isabella Batista Martins; Ribeiro, Igor de Lima; de Sousa-Rodrigues, Cķlio Fernando; Monte-Bispo, Rodrigo Freitas; da Rocha, Amauri Clemente
Objective Among the veins used as a graft in myocardial revascularizations and ends, great saphenous vein is the most used. Knowing the presence and location of valves has great importance when evaluating the surgical anatomy of the great saphenous vein. Despite major surgical application and many works involving great saphenous vein, the number of valves present in it from the saphenous hiatus to the medial epicondyle of the femur is still described inaccurately. The objective of this study is to quantify the valves of the great saphenous vein from the saphenous hiatus to the medial epicondyle of the femur to determine the best portion of the great saphenous vein to perform revascularization surgeries. Methods This is a crosssectional observational study in which it was analyzed great saphenous vein extracted from 30 cadavers. It was measured the length of the veins; (diameter) at its proximal, middle and distal, quantifying the number of valves in each one and the total number of valves at the great saphenous vein. Results The frequency of valves in the great saphenous vein taken from the medial epicondyle of the femur to the saphenous hiatus was 4.82, ranging between 2 and 9. Moreover, there is a significant difference in the number of valves in the proximal and distal relative to the average. Conclusion the median and distal portions of the saphenous vein in the thigh, are the best options for the realization of bridges due to the fact that these portions have fewer valves which therefore would tend to decrease the risk of complications connected with the valves in these grafts. PMID:25714210
Plasma Endothelin1 Release in Normal and Varicose Saphenous Veins
Roberto Antonio Mangiafico; Lorenzo Salvatore Malatino; Maurizio Santonocito; Rosario Sebastiano Spada; Francesco Antonio Benedetto
The aim of the study was to investigate the release of endothelin-1 (ET-1) in normal and varicose saphenous veins at baseline and after venous stasis test. Ten patients (eight women and two men, mean age 43 ▒4) with primarily varicose great saphenous veins and ten controls (eight women and two men, mean age 42 ▒6) were recruited. After 30 minutes
Neurovascular Compression of the Common Peroneal Nerve by Varicose Veins
N Yamamoto; K Koyano
Compression of the common peroneal nerve occurs sometimes, but compression caused by varicose veins has not been reported before. We report a case of common peroneal nerve compression syndrome which was confirmed and treated surgically. A 63-year-old woman complained of parµsthesia on the lateral aspect of the right leg, which was worse in the evening. A primary varicose vein arising
Design and implementation of a contactless palm vein recognition system
Goh Kah Ong Michael; Tee Connie; Lau Siong Hoe; Andrew Teoh Beng Jin
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
Persistence of a single pulmonary vein in a child.
Mainard, L; Hoeffel, J C; Worms, A M; Marcon, F
Persistence of a single pulmonary vein with normal pulmonary venous return is a rape and unusual radiographic finding. We report such a case with the venous opacity partially visible on the right border of the heart on a plain frontal chest film. MRI showed beautifully the pulmonary vein and can now replace angiocardiography. PMID:1603604
Endoscopic vein harvesting with the aid of carbon dioxide insufflation
Malcolm J. R Dalrymple-Hay; Aiman Alzetani; Robert Costa; Sunil K Ohri
Endoscopic harvesting of the long saphenous vein has been introduced to decrease the morbidity of obtaining venous conduit for coronary artery bypass grafting. Herein is described an endoscopic method using carbon dioxide insufflation into the tissues around the vein. This has several advantages; improved vision, no physical retraction required, easier development of tissue planes, and improved hemostasis.
Exercise-Induced Deep Vein Thrombosis of the Upper Extremity
Leonardo R. BrandŃo; Suzan Williams; Walter H. A. Kahr; Clodagh Ryan; Michael Temple; Anthony K.C. Chan
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
Tissue Fibrinolytic Activity in Different Types of Varicose Veins
Viola Hach; Monika Fink; Norbert Blees; Inge Scharrer
The fibrinolytic activity of the venous wall was investigated by using Todd's technique 1 in 92 patients with different types of varicosis.A control group consisted of 19 patients with apparently normal superficial veins who had had a saphenectomy prior to an aortocoronary bypass operation. Fibrinolytic activity was mainly localized in the adventitia of varicose and nor mal veins. It significantly
Green Veining: Landscape Determinants of Biodiversity in European Agricultural Landscapes
Carla J. Grashof-Bokdam; Frank van Langevelde
Many semi-natural landscape elements, the so-called green veining, are disappearing from the intensively used agricultural landscapes of Europe. In order to develop or restore biodiversity in these networks, it is necessary to quantify the relation between biodiversity and amount, spatial arrangement and management intensity of green veining elements. In this review, we investigate whether biodiversity increases with the amount of
Fossil evidence for Cretaceous escalation in angiosperm leaf vein evolution
Bermingham, Eldredge
Fossil evidence for Cretaceous escalation in angiosperm leaf vein evolution Taylor S. Feilda,1 plants that dominate modern vegetation possess leaf gas exchange potentials that far exceed those of all. Using vein density (DV) measurements of fossil angiosperm leaves, we show that the leaf hydraulic
Subclavian vein repair in patients with an ipsilateral arteriovenous fistula
Wayne S. Gradman; Paul Bressrnan; J. David Sernaque
Management of subclavian vein occlusive disease in persons with an ipsilateral arteriovenous fistula can be challenging. From July 1991 to May 1993, nine patients underwent direct exploration and repair of an obstructed subclavian vein following medial claviculectomy. Eight patients had polytetrafluoroethylene (PTFE) grafts; one patient had a Brescia-Cimino fistula. Intractable arm edema was the major symptom in five of eight.
Cross-Database Evaluation Using an Open Finger Vein Sensor
recognition is a recent biometric ap- plication, which relies on the use of human finger vein pat- terns the vein patterns inside a person's finger [1]. Compared to other biometric modalities such as fingerprint made available in 2002 and logical access for ATMs in 2005 [2]. Nowadays this technology is widely used
Spontaneous rupture of the left common iliac vein.
Gaschignard, N; Le Paul, Y; Maouni, T; Le Priol, P D
We report a case of spontaneous rupture of the left common iliac vein in a 58-year-old woman. Because of hemorrhagic shock, the intervention had to be performed under emergency circumstances, precluding repair of the external iliac vein, which was ligated. The postoperative course was uneventful. We also review the 17 prior cases found in the literature. PMID:10990565
Endoscopic and traditional saphenous vein harvest: a histologic comparison
Gary L. Griffith; Keith B. Allen; Bruce F. Waller; David A. Heimansohn; Robert J. Robison; John J. Schier; Carl J. Shaar
Background. Vein trauma after saphenectomy by endoscopic or longitudinal techniques may influence the progression of medial and intimal hyperplasia and ultimately affect graft patency. This study compared the histologic characteristics of saphenous veins after endoscopic and longitudinal harvest.Methods. One hundred seventy patients who underwent elective coronary artery bypass grafting had saphenectomy performed endoscopically (n = 88) or by a longitudinal
Endoscopic versus traditional saphenous vein harvesting: a prospective, randomized trial
Keith B Allen; Gary L Griffith; David A Heimansohn; Robert J Robison; Robert G Matheny; John J Schier; Edward B Fitzgerald; Carl J Shaar
Background. Saphenous vein harvested with a traditional longitudinal technique often results in leg wound complications. An alternative endoscopic harvest technique may decrease these complications.Methods. One hundred twelve patients scheduled for elective coronary artery bypass grafting were prospectively randomized to have vein harvested using either an endoscopic (group A, n = 54) or traditional technique (group B, n = 58). Groups
Sphincters of the pulmonary veins in man, and their significance
L. L. Kapuller; M. Lo Shik
Pressure curves in the pulmonary vein and in the left auricle were recorded in patients with stenosis of the left atrioventricular valve before and after mitral valvotomy. The curves showed that the sphincters of the pulmonary veins may fail when the mean pressure in the left auricle exceeds 20 mm Hg. Normally, by blocking the reverse flow, the sphincters protect
The relationship of Olpidium brassicae (Wor.) Dang. to the big-vein disease of lettuce
P. R. Fry
Inoculation of lettuce with tobacco-necrosis virus isolated from big-vein plants did not cause big-vein symptoms.Olpidium brassicae was always found in roots of lettuce grown in big-vein-infected soil but not in two gardens where big vein did not occur.Olpidium resting spores were sedimented from big-vein root sap by low-speed centrifuging. Inoculation of lettuce with resuspended sediment produced big-vein symptoms while inoculation
Design of a clinical vein contrast enhancing projector
NASA Astrophysics Data System (ADS)
Zeman, Herbert D.; Lovhoiden, Gunnar; Deshmukh, Harshal
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.
Balloon-Occluded Retrograde Transvenous Obliteration of Gastric Varix Draining via the Left Inferior Phrenic Vein into the Left Hepatic Vein
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)
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.
[Effort thrombosis of the right subclavian vein].
Tamar, Michael; Farah, Raymond
This case report illustrates a primary upper extremity DVT of the right subclavian vein in an otherwise healthy young male. The pathogenesis of primary upper extremity DVT may be anatomical, such as thoracic outlet syndrome, vascular microtrauma e.g. effort thrombosis, or both. After examining the patient's clinical presentation and imaging results, a diagnosis of effort thrombosis, or "Paget-Schroetter syndrome" was made. Due to the clear insulting factor, the mild clinical presentation, and the fast response to anti-coagulant treatment, a conservative treatment was followed, which included anti-coagulation and close follow-up, as advised by the American College of Chest Physician's evidence-based clinical practice guidelines. PMID:23367728
NET impact on deep vein thrombosis
Fuchs, Tobias A.; Brill, Alexander; Wagner, Denisa D.
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. PMID:22652600
Repair of peripheral nerve with vein wrapping*
Objective The post¢traumatic neuro-anastomosis must be protected from the surrounding environment. This barrier must be biologically inert, biodegradable, not compressing but protecting the nerve. Formation of painful neuroma is one of the major issues with neuro-anastomosis; currently there is no consensus on post-repair neuroma prevention. Aim of this study is to evaluate the efficacy of neuroanastomosis performed with venous sheath to reduce painful neuromas formation, improve the electrical conductivity of the repaired nerve, and reduce the discrepancies of the sectioned nerve stumps. Patients and methods From a trauma population of 320 patients treated in a single centre between January 2008 and December 2011, twenty-six patients were identified as having an injury to at least one of the peripheral nerves of the arm and enrolled in the study. Patients were divided into two groups. In the group A (16 patients) the end-to-end nerve suture was wrapped in a vein sheath and compared with the group B (10 patients) in which a simple end-to-end neurorrhaphy was performed. The venous segment used to cover the nerve micro-suture was harvested from the superficial veins of the forearm. The parameters analyzed were: functional recovery of motor nerves, sensitivity and pain. Results Average follow-up was 14 months (range: 12¢24 months). The group A showed a more rapid motor and sensory recovery and a reduction of the painful symptoms compared to the control group (B). Conclusions The Authors demonstrated that, in their experience, the venous sheath provides a valid solution to avoid the dispersion of the nerve fibres, to prevent adherent scars and painful neuromas formation. Moreover it can compensate the different size of two nerve stumps, allowing, thereby, a more rapid functional and sensitive recovery without expensive devices. PMID:24841688
Central retinal vein occlusion and pseudoexfoliation syndrome
Karagiannis, Dimitrios; Kontadakis, Georgios A; Klados, Nektarios E; Tsoumpris, Ioannis; Kandarakis, Artemios S; Parikakis, Efstratios A; Georgalas, Ilias; Tsilimbaris, Miltiadis K
Purpose The purpose of this study was to investigate the existence of pseudoexfoliation syndrome (PXF) as a risk factor for the development of central retinal vein occlusion (CRVO). Methods This was a retrospective, comparative study of the prevalence of pseudoexfoliation in three groups of patients: 48 patients with CRVO, 164 patients with branch retinal vein occlusion (BRVO), and 70 control patients (70 eyes). All patients were phakic and had no previous diagnosis of glaucoma. Patients were matched in terms of age and systemic hypertension. All patients had normal intraocular pressure (IOP) at presentation (defined as less than or equal to 21 mmHg). Results In the CRVO group, 14 out of 48 patients were diagnosed as having PXF (29.17%). In the BRVO group, 14 out of 164 patients had PXF (8.5%), and in the control group, six out of 70 patients had PXF (8.6%). Differences of percentage between groups were statistically significant (P<0.001, ?2 test). When comparing patient subgroup with ischemic CRVO with subgroup with non-ischemic CRVO, we found that in the ischemic CRVO group, 13 out of 27 patients were diagnosed as having PXF (48.15%), and in the non-ischemic CRVO group, one out of 21 patients was diagnosed as having PXF (4.7%; P<0.001, ?2 test). The relative odds of having CRVO in patients with PXF versus patients without PXF were 4.406 (confidence interval [CI], 2.03¢9.54). Conclusion PXF and CRVO, especially ischemic, are strongly associated in our study. Our results indicate that PXF might be an independent factor for CRVO, as it is related with CRVO independently from glaucoma.
Influence of vein fabric on strain distribution and fold kinematics
NASA Astrophysics Data System (ADS)
Torremans, Koen; Muchez, Philippe; Sintubin, Manuel
Abundant pre-folding, bedding-parallel fibrous dolomite veins in shale are found associated with the Nkana-Mindola stratiform Cu-Co deposit in the Central African Copperbelt, Zambia. These monomineralic veins extend for several meters along strike, with a fibrous infill orthogonal to low-tortuosity vein walls. Growth morphologies vary from antitaxial with a pronounced median surface to asymmetric syntaxial, always with small but quantifiable growth competition. Subsequently, these veins were folded. In this study, we aim to constrain the kinematic fold mechanism by which strain is accommodated in these veins, estimate paleorheology at time of deformation and investigate the influence of vein fabric on deformation during folding. Finally, the influence of the deformation on known metallogenetic stages is assessed. Various deformation styles are observed, ultimately related to vein attitude across tight to close lower-order, hectometre-scale folds. In fold hinges, at low to average dips, veins are (poly-)harmonically to disharmonically folded as parasitic folds in single or multilayer systems. With increasing distance from the fold hinge, parasitic fold amplitude decreases and asymmetry increases. At high dips in the limbs, low-displacement duplication thrusts of veins at low angles to bedding are abundant. Slickenfibres and slickenlines are sub-perpendicular to fold hinges and shallow-dipping slickenfibre-step lineations are parallel to local fold hinge lines. A dip isogon analysis of reconstructed fold geometries prior to homogeneous shortening reveals type 1B parallel folds for the veins and type 1C for the matrix. Two main deformation mechanisms are identified in folded veins. Firstly, undulatory extinction, subgrains and fluid inclusions planes parallel the fibre long axis, with deformation intensity increasing away from the fold hinges, indicate intracrystalline strain accumulation. Secondly, intergranular deformation through bookshelf rotation of fibres, via collective parallel rotation of fibres and shearing along fibre grain boundaries, is clearly observed under cathodoluminescence. We analysed the internal strain distribution by quantifying simple shear strain caused by deflection of the initially orthogonal fibres relative to layer inclination at a given position across the fold. Shear angle, and thus shear strain, steadily increases towards the limbs away from the fold hinge. Comparison of observed shear strain to theoretical distribution for kinematic mechanisms, amongst other lines of evidence, clearly points to pure flexural flow followed by homogeneous shortening. As flexural flow is not the expected kinematic folding mechanism for competent layers in an incompetent shale matrix, our analysis shows that the internal vein fabric in these dolomite veins can exhibit a first-order influence on folding mechanisms. In addition, quantitative analysis shows that these veins acted as rigid objects with high viscosity contrast relative to the incompetent carbonaceous shale, rather than as semi-passive markers. Later folding-related syn-orogenic veins, intensely mineralised with Cu-Co sulphides, are strongly related to deformation of these pre-folding veins. The high viscosity contrast created by the pre-folding fibrous dolomite veins was therefore essential in creating transient permeability for subsequent mineralising stages in the veining history.
Angiosperm leaf vein evolution was physiologically and environmentally transformative
Boyce, C. Kevin; Brodribb, Tim J.; Feild, Taylor S.; Zwieniecki, Maciej A.
The veins that irrigate leaves during photosynthesis are demonstrated to be strikingly more abundant in flowering plants than in any other vascular plant lineage. Angiosperm vein densities average 8?mm of vein per mm2 of leaf area and can reach 25?mm?mm?2, whereas such high densities are absent from all other plants, living or extinct. Leaves of non-angiosperms have consistently averaged close to 2?mm?mm?2 throughout 380 million years of evolution despite a complex history that has involved four or more independent origins of laminate leaves with many veins and dramatic changes in climate and atmospheric composition. We further demonstrate that the high leaf vein densities unique to the angiosperms enable unparalleled transpiration rates, extending previous work indicating a strong correlation between vein density and assimilation rates. Because vein density is directly measurable in fossils, these correlations provide new access to the physiology of extinct plants and how they may have impacted their environments. First, the high assimilation rates currently confined to the angiosperms among living plants are likely to have been unique throughout evolutionary history. Second, the transpiration-driven recycling of water that is important for bolstering precipitation in modern tropical rainforests might have been significantly less in a world before the angiosperms. PMID:19324775
[Reconstructive surgery of the large intrathoracic veins, four cases report].
Abreu, Rodolfo; Valentim, Hugo; Martelo, Fernando; Rodrigues, Hugo; Bravio, Ivan; Gonńalves, Frederico; Ferreira, Maria E; Castro, JoŃo A; Fragata, J; CapitŃo, L Mota; Castro, JoŃo M
The resection and reconstruction of the large venous vessels of the chest is a procedure intended to treat the symptoms of venous hypertension caused by the Superior Vena Cava Syndrome and to allow resection of mediastinal tumors that invade the superior vena cava (SVC) and the left and right innominate veins. We report four clinical cases of mediastinal tumors involving the large intrathoracic venous vessels, submitted to surgery between 2010 and 2013. In all cases our purpose was to completely resect the tumor. We intended to evaluate the surgical results in terms of improvement of symptoms, complications of the procedures, permeability of the bypasses in the short and medium term and mortality rates. We used ringed ePTFE grafts to perform the following vascular reconstructions: - Y configuration bypass from the left subclavian vein and the left internal jugular vein to the left inominate vein; - two bypasses from the top of the left innominate vein to the right atrial appendage; - bypass from the left innominate vein to the right atrial appendage and a bypass from the right innominate vein to the SVC. All patients were discharged, and all the bypasses were patent at discharge and after 30 days . There were two cases of late thrombosis, but patients remained asymptomatic. Our series shows the feasibility of these technically complex surgeries, which are an excellent example of the benefits of multidisciplinary collaboration between vascular and thoracic surgeons. PMID:24730017
Dynamic multiplanar real time ultrasound guided infraclavicular subclavian vein catheterization.
Zhong, Xin; Hamill, Mark; Collier, Bryan; Bradburn, Eric; Ferrara, John
Ultrasound guided vascular access has been well-characterized as a safe and effective technique for internal jugular and femoral vein catheterization. However, there is limited experience with the use of ultrasound to access the infraclavicular subclavian vein. Multiple ultrasound techniques do exist to identify the subclavian vein, but real time access is limited by vessel identification in a single planar view. To overcome this limitation, a novel technique of ultrasound guided infraclavicular subclavian vein catheterization using a real time multiplanar approach has been developed. The initial experience with this approach is described. A single surgeon used combined oblique, transverse, and longitudinal views along with Doppler color flow images to both define the infraclavicular anatomy and to obtain subclavian vein access in 42 adult patients (20 M/22 F and 22 L/20 R) with a mean body mass index of 29.2 (range = 18.9-55.4). Chest x-ray was obtained to confirm position and to rule out pneumothorax. Subclavian vein cannulation was achieved in 100 per cent of patients; subsequent catheterization was successful in 92.9 per cent. The number of attempts required for cannulation averaged 1.3 (range = 1-5), and decreased after a five patient learning curve. No patient developed a pneumothorax, hematoma, or cannula malposition. Ultrasound guided multiplanar infraclavicular subclavian vein access appears to be a safe and effective adjunct for central line placement. PMID:26031277
Spontaneous intrahepatic portosystemic shunt managed by laparoscopic hepatic vein closure
Kwon, Jung-Nam; Jeon, Yong Sun; Cho, Soon-Gu; Lee, Keon-Young; Hong, Kee Chun
Intrahepatic portosystemic shunt (IPSS) is uncommon and usually follows trauma or iatrogenic injury, but spontaneous shunts may also occur, in patients without the evidence of chronic liver disease. Although interventional endovascular management of the shunts is the treatment of choice, a surgical approach can be used when the percutaneous approach fails. We report here a case of symptomatic spontaneous IPSS between the posteroinferior branch of right portal vein and the right inferior hepatic vein, which was successfully managed with laparoscopic closure of the hepatic vein. To the best of our knowledge, this is the first case report of laparoscopic management of spontaneous IPSS. PMID:25336823
Duodenal obstruction due to a preduodenal portal vein.
Vilakazi, Mnc; Ismail, F; Swanepoel, H M; Muller, E W; Lockhat, Z I
An infant presented with clinical signs and symptoms suggestive of a pyloric stenosis. On abdominal ultrasound, pyloric stenosis was excluded, and other causes for proximal duodenal obstruction, such as a duodenal web or annular pancreas, were suspected. At surgery, the cause was found to be due to an anterior portal vein or preduodenal portal vein, compressing the duodenum. There were no associated findings such as midgut malrotation, duodenal web and congenital anomalies. The treatment was a diamond-shaped duodeno-duodenostomy anterior to the portal vein. The patient improved after surgery. PMID:25323190
Thymic Cavernous Hemangioma With a Left Innominate Vein Aneurysm.
Nakada, Takeo; Akiba, Tadashi; Inagaki, Takuya; Morikawa, Toshiaki; Ohki, Takao
Here we report a case of thymic cavernous haemangioma with the left innominate vein aneurysm. A 43-year-old man presented with chest pain. Enhanced chest computed tomography revealed an anterior mediastinal tumor measuring 60Āū 52Āū 38 mm with multiple venous lakes and focal specks of calcification, composed of a low-density soft tissue mass along with a left innominate vein aneurysm. We preoperatively diagnosed the mass asĀa thymic hemangioma and subsequently performed surgical resection. Pathologic diagnosis was a thymic cavernous hemangioma with a left innominate vein aneurysm, which is very rare. PMID:26140781
Upper extremity deep vein thrombosis with tourniquet use
Desai, Karan; Dinh, Trish P.; Chung, Susan; Pierpont, Yvonne N.; Naidu, Deepak K.; Payne, Wyatt G.
INTRODUCTION Upper extremity deep vein thrombosis is an increasingly important clinical finding with significant morbidity and mortality. The condition may be under-diagnosed in trauma and surgery settings. PRESENTATION OF CASE We present a case of upper extremity thrombosis with venous congestive symptoms secondary to the use of an operative tourniquet. A literature review and discussion of the causes of upper extremity deep vein thrombosis and the pathophysiological disturbances seen with tourniquet use are presented. DISCUSSION Upper extremity deep venous thrombosis is uncommon. In this case the likely cause was operative tourniquet use. CONCLUSION Operative tourniquet may be a risk factor in upper extremity deep vein thrombosis. PMID:25524302
Endovenous radiofrequency ablation for the treatment of varicose veins
Kayssi, Ahmed; Pope, Marc; Vucemilo, Ivica; Werneck, Christiane
Summary Varicose veins are a common condition that can be treated surgically. Available operative modalities include saphenous venous ligation and stripping, phlebectomy, endovenous laser therapy and radiofrequency ablation. Radiofrequency ablation is the newest of these technologies, and to our knowledge our group was the first to use it in Canada. Our experience suggests that it is a safe and effective treatment for varicose veins, with high levels of patient satisfaction reported at short-term follow-up. More studies are needed to assess long-term effectiveness and compare the various available treatment options for varicose veins. PMID:25799244
Bridging veins and autopsy findings in abusive head trauma.
Rambaud, Caroline
Bridging veins are crucial for the venous drainage of the brain. They run as short and straight bridges between the brain surface and the superior sagittal sinus in the subdural compartment. Subdural bleeding is a marker for a traumatic mechanism (i.e., acceleration/deceleration, rotational and shearing forces due to violent shaking) causing rupture of the bridging veins. Demonstration of bridging vein rupture allows the unequivocal diagnosis of a traumatic mechanism and should therefore be a routine part of the postmortem in cases of subdural hemorrhage. PMID:25698365
Videothoracoscopic management of a perforated central vein and pleura after ultrasound-guided internal jugular vein cannulation: a case report
Kim, Jeong-Eun; Jeon, Joon-Pyo; Kim, Yongsuk; Jeong, Su Ah
A 23-year-old male underwent a left internal jugular vein catheterization during extended surgery for treatment of multiple fractures due to a traffic accident. Although the catheterization was performed under ultrasound (US) guidance, iatrogenic perforation of the central vein and pleura occurred. The catheter was removed, and the perforated site was addressed under thoracoscopy rather than an open thoracotomy. This case suggests that using US does not completely guarantee a complication-free outcome, and that catheter placement should be carefully confirmed. In addition, this case suggests that thoracoscopy may be an ideal method of resolving a perforation of the central vein and pleura. PMID:24851167
Endoscopic subfascial sectioning of incompetent perforating veins in treatment of primary varicosis
M. Jugenheimer; Th. Junginger
Subfascial elimination of incompetent perforating veins is the most effective therapeutic principle in the treatment of trophic skin disorders associated with varicosis. A recently developed endoscopic technique allows accurate sectioning of perforating veins with direct observation of the veins and minor trauma. From November 1986 to July 1991 endoscopic sectioning of perforating veins was performed in 72 patients (103 legs).
Correlation of contractile activity and of streaming direction between branching veins of Physarum polycephalum plasmodium
A. Grebecki; M. Moczo?
Summary Pulsation curves recorded in a lateral vein and in the main vein behind and ahead of junction demonstrate the existence of a common contraction-relaxation rhythm. Correlation of contraction periods is very strong in the major vein on both sides of the junction and strong between the major vein and its lateral branch. Correlation of streaming periodicities is also very
Diagnosis and Management of a Vein of Galen Malformation in a Neonate
Stacy L. French
Vein of Galen arterial malformation (VGAM) is an arteriovenous malformation between cerebral vessels of the circle of Willis and the vein of Galen. VGAM is a direct communication between an artery and a vein resulting in increased cardiac output due to arterial blood flowing directly into a vein and returning directly to the heart, without traversing the full vascular system.
Finger vein recognition based on local directional code.
Meng, Xianjing; Yang, Gongping; Yin, Yilong; Xiao, Rongyang
Finger vein patterns are considered as one of the most promising biometric authentication methods for its security and convenience. Most of the current available finger vein recognition methods utilize features from a segmented blood vessel network. As an improperly segmented network may degrade the recognition accuracy, binary pattern based methods are proposed, such as Local Binary Pattern (LBP), Local Derivative PatternĀ(LDP) and Local Line Binary Pattern (LLBP). However, the rich directional information hidden in the finger vein pattern has not been fully exploited by the existing local patterns. Inspired by the Webber Local Descriptor (WLD), this paper represents a new direction based local descriptor called Local Directional Code (LDC) and applies it to finger vein recognition. In LDC, the local gradient orientation information is coded as an octonary decimal number. Experimental results show that the proposed method using LDC achieves better performance than methods using LLBP. PMID:23202194
Left renal vein transposition is effective for posterior nutcracker syndrome
Chen, Yuedong; Xing, Jinchun; Liu, Fei
An 8-year-old girl was enrolled in hospital with intermittent gross hematuria in a period of 3 years. Bloody efflux from the left ureteral orifice was diagnosed in this patient with urethrocystoscopy. A retroaortic left renal vein appeared to be compressed by the aorta as detected by computerized tomography. The left renal vein was compressed between the aorta and the spine. A groove in the anterior surface of the left renal vein was detected. A transposition surgery of the left renal vein to a site in front of the aorta was performed for the patient. The patient was discharged after recovery and the hematuria symptom was not found during the 15-month follow-up investigation. PMID:25664135
Posttransplant Complex Inferior Venacava Balloon Dilatation After Hepatic Vein Stenting
Kohli, Vikas, E-mail: email@example.com [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)
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.
Travelers' Health: Deep Vein Thrombosis and Pulmonary Embolism
... gov . Home Destinations Travel Notices Find a Clinic Yellow Fever Vaccinations Clinics FAQ Disease Directory Information Centers For Travelers Common Travel Health Topics Adopting a Child from Another Country Adventure ... Yellow Book Contents Chapter 2 (19) Deep Vein Thrombosis & ...
Duplication of the right internal jugular vein: A case report.
Bathala, Srinivasalu; Makura, Zvoru G
We present a case of duplication of the right internal jugular vein (IJV) in a patient who underwent neck dissection as part of the management of carcinoma of the larynx. The patient was a 63-year-old man who presented to the otolaryngology department with a 7-month history of hoarseness and a 3-week history of noisy breathing. Flexible endoscopy detected a transglottic tumor that had extended beyond the vocal folds. The patient underwent a total laryngectomy and bilateral selective neck dissection at levels II-VI. Intraoperatively, the right IJV was noted to be duplicated. The duplicate segment was approximately 10 cm in length, and it rejoined the normal vein before the normal vein joined the subclavian vein. PMID:26053982
Mars Opportunity rover finds gypsum veins
NASA Astrophysics Data System (ADS)
Showstack, Randy
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. ōTo me, this is the single most powerful piece of evidence for liquid water on Mars that has been discovered by the Opportunity rover,ö said Steve Squyres, a geoscientist at Cornell University in Ithaca, N. Y., and principal investigator for NASA Mars Exploration Rovers Opportunity and Spirit. ōWe 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.ö
Subclavian artery- internal jugular vein fistula and heart failure: complication of internal jugular vein catheterization.
Prakash, Jai; Takhellambam, Brojen; Ghosh, Biplab; Choudhury, Tauhidul Alam; Singh, Shivendra; Sharma, Om Prakash
Hemodialysis in patients with end-stage renal disease (ESRD) requires vascular access which can be either temporary or permanent. However, these procedures are not without complications. Arterial puncture is the most common immediate complication and pseudoaneurysm formation is the most common late sequel of internal jugular venous catheterization (IJVC). However, arterio-venous fistula (AVF) formatiorn following IJVC is rare. We are reporting a case of AVF formation between subclavian artery (SCA) and internal jugular vein (IJV) following IJVC which later on leads to the development of cardiac failure. PMID:24471256
Recurrent Varicose Veins: Incidence, Risk Factors and Groin Anatomy
L. Blomgren; G. Johansson; A. Dahlberg-┼kerman; A. Norķn; C. Brundin; E. Nordstr÷m; D. Bergqvist
Objectives. To investigate the recurrence rate after sapheno-femoral junction (SFJ) ligation and great saphenous vein (GSV) stripping for varicose veins (VV), to evaluate risk factors for recurrence and to classify the anatomy of the recurrence in the groin.Design. Clinical follow-up study.Methods. Eighty-nine consecutive patients with 100 operated legs were re-examined clinically and with duplex after 6¢10 years. Fourteen groins were
Neovascularization is not a major cause of varicose vein recurrence
Patrick M. Moreau
Neovascularization is often seen as an important cause of varicose vein recurrence. Is this a convenient expression to explain some bad results in surgery? This clinical retrospective study (from 1\\/1\\/94 to 12\\/31\\/98) included 1880 patients (1348 females: 71.7%, 532 males: 28.3%, with the median age of 52) who received limb varicose vein operations. 2455 legs were operated on (575 bilateral).
Management of Varicose Veins From Chronic Venous Insufficiency
John B. Chang; Theodore A. Stein
ĀĀChronic venous insufficiency is a progressive disease, which may require surgical intervention to prevent complications. This\\u000a study was done to determine the usefulness of a high ligation with sclerotherapy to prevent the return of symptoms. Duplex\\u000a scanning was used to locate incompetent veins. There was no evidence of incompetent perforating or deep veins in the 322 patients\\u000a who had 483
The persistent embryonic vein in Klippel-Trenaunay syndrome.
Oduber, CharlĶne E U; Young-Afat, Danny A; van der Wal, Allard C; van Steensel, Maurice A M; Hennekam, Raoul C M; van der Horst, Chantal M A M
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
Vein formation in the C1 carbonaceous chondrites
NASA Technical Reports Server (NTRS)
Richardson, S. M.
Veins in the C1 chondrites Orgueil, Alais, and Ivuna have been deposited during an extended period of impact brecciation and leaching. At least three generations of mineralization, dominated successively by carbonates, calcium sulfate, and magnesium sulfate, can be recognized. Vein minerals are derived locally by closed-system reactions between matrix phyllosilicates and an aqueous fluid, with the result that few, if any, primitive mineral phases still exist in the C1s.
Endovascular Treatment of a Portal Vein Tear During TIPSS
Owen, Richard J.T.; Rose, John D.G. [Department of Clinical Radiology, Freeman Hospital, Newcastle upon Tyne, NE7 7DN (United Kingdom)
During a transjugular portosystemic stent-shunt (TIPSS) procedure a portal vein laceration occurred with subsequent intraperitoneal hemorrhage. A PTFE-covered nitinol stent was successfully placed eliminating the leak and creating a functioning portosystemic shunt. This case demonstrates both the importance of portal vein puncture more than 1 cm from the bifurcation and the necessity of maintaining a stock of available stent-grafts.
An Ophiovirus isolated from lettuce with big-vein symptoms
P. Roggero; M. Ciuffo; A. M. Vaira; G. P. Accotto; V. Masenga; R. G. Milne
Summary.ĀĀ?Big-vein is a widespread and damaging disease of lettuce, transmitted through soil by the chytrid fungus Olpidium brassicae, and generally supposed to be caused by Lettuce big-vein virus (LBVV; genus Varicosavirus). This virus is reported to have rigid rod-shaped particles, a divided double-stranded RNA genome, and one capsid protein\\u000a of 48?kD, but has not been isolated or rigorously shown to
Branch retinal vein occlusion treated by intravitreal triamcinolone acetonide
J B Jonas; I Akkoyun; B Kamppeter; I Kreissig; R F Degenring
PurposeTo evaluate the effect of intravitreal triamcinolone acetonide on visual acuity in branch retinal vein occlusion.MethodsThe prospective comparative nonrandomized clinical interventional study included 28 patients (28 eyes) with branch retinal vein occlusion. The study group consisting of 10 consecutive patients received an intravitreal injection of 20¢25 mg of triamcinolone acetonide. The control group including 18 patients did not receive an
Vascular Neural Network: the Importance of Vein Drainage in Stroke
Li, Qian; Khatibi, Nikan; Zhang, John H.
This perspective commentary summarized the stroke pathophysiology evolution, especially the focus in the past on neuroprotection and neurovascular protection and highlighted the newer term for stroke pathophysiology: vascular neural network. Emphasize is on the role of venules and veins after an acute stroke and as potential treatment targets. Vein drainage may contribute to the acute phase of brain edema and the outcomes of stroke patients. PMID:24563018
Pain evoked by polymodal stimulation of hand veins in humans.
Arndt, J O; Klement, W
1. To explore the function of the sensory innervation of veins in humans we used a psychophysical approach to study painful and non-painful sensations by applying polymodal stimuli (electrical, stretch, cold/heat and osmotic) inside vascularly isolated hand vein segments before and after blockade of either venous or cutaneous afferents. 2. All modes of stimulation elicited pain, which showed only slight adaptation during 10 min of maintained stimulation. Pain increased monotonically with stimulus intensity between threshold and the maximally tolerable pain. 3. The exponents of the power functions of the pain magnitude-stimulus strength relations for five stimulus modes ranged between 2.5 and 3.3 but did not significantly differ from one another (P = 0.3). 4. Pain evoked by all stimuli was reported to be of similar quality, i.e. sharp, aching and unpleasant; it was accompanied by non-painful sensations (skin movements on stretching, warm and cold sensation with intravenous thermal stimulation) unless the skin above the stimulated vein segment was numbed with benzocaine ointment. 5. Pain could no longer be evoked in the presence of 0.4-0.8% procaine within the stimulated vein segment. 6. These observations are consistent with the view that veins are invested with polymodal nociceptors only, which in all likelihood are connected with thinly myelinated afferents of the A delta group. 7. The vascularly isolated vein segment may open a new avenue for pain research in humans. PMID:1804973
Thrombosis of the portal vein in eleven dogs.
Van Winkle, T J; Bruce, E
Case records from the small animal necropsy service of the University of Pennsylvania (Philadelphia, PA) from January 1981 through August 1990 were searched for reports of animals with grossly visible portal vein thrombi. Eleven dogs identified from their case materials as having portal vein thrombosis were used for this study. The age of the dogs ranged from 2 to 13 years, and there were five spayed females and six males--four intact and two castrated. Seven breeds were represented (Lhasa Apso, German Wire haired Pointer, Shetland Sheepdog, Dalmatian, Irish Wolfhound, Old English Sheepdog, and Siberian Husky), and the remaining four cases were identified as mixed breeds. The weight of the dogs ranged from 7.7 to 50 kg, and most of them were considered overweight. Dogs with microthrombi and tumor emboli in the portal vein were excluded. No age, sex, or breed predisposition was found. Thrombi were also detected in the pulmonary arteries in five of the dogs and both the pulmonary arteries and aorta in one dog. The portal thrombi extended into the mesenteric veins in three dogs, resulting in infarction of the jejunum. One of these dogs and two other dogs had chronic occlusion of the portal vein, with the formation of secondary portosystemic shunts. Conditions also present in dogs with portal vein thrombi included pancreatic necrosis (four dogs), peritonitis (two dogs), distant neoplasia (three dogs), and therapy with steroids (ten dogs). PMID:8442325
[A case of portal vein stenting for portal vein stenosis due to pancreatic cancer recurrence after pancreatoduodenectomy].
Sawatsubashi, Takahiro; Morioka, Nobuhiro; Shimizu, Takao; Nakatsuka, Hideki
We report a case of portal vein stenosis due to pancreatic cancer recurrence that was successfully treated with intravenous stent implantation. The patient was a 70-year-old man who had undergone a subtotal stomach-preserving pancreatoduodenectomy with the modified Child method for pancreatic cancer. He was readmitted due to melena, dorsal pain, and severe ascites 8 months after the operation. Computed tomography (CT) findings revealed that pancreatic cancer recurrence had narrowed the portal vein. Neither gastrointestinal nor colon endoscopy could locate the source of gastrointestinal bleeding. Bleeding from the varices increased, and a hepatopetal collateral was considered to be the cause. We therefore placed an intravenous stent at the site of portal vein stenosis, by the transileocolic portal vein. After the stent placement, no further gastrointestinal hemorrhagic episodes occurred. PMID:25731472
Transradial Approach for Transcatheter Selective Superior Mesenteric Artery Urokinase Infusion Therapy in Patients with Acute Extensive Portal and Superior Mesenteric Vein Thrombosis
Wang Maoqiang, E-mail: firstname.lastname@example.com; Guo Liping; Lin Hanying; Liu Fengyong; Duan Feng; Wang Zhijun [Chinese PLA General Hospital, Department of Interventional Radiology (China)
The purpose of this investigation was to assess the feasibility and effectiveness of transradial approach for transcatheter superior mesenteric artery (SMA) urokinase infusion therapy in patients with acute extensive portal and superior mesenteric venous thrombosis. During a period of 7 years, 16 patients with acute extensive thrombosis of the portal (PV) and superior mesenteric veins (SMV) were treated by transcatheter selective SMA urokinase infusion therapy by way of the radial artery. The mean age of the patients was 39.5 years. Through the radial sheath, a 5F Cobra catheter was inserted into the SMA, and continuous infusion of urokinase was performed for 5-11 days (7.1 {+-} 2.5 days). Adequate anticoagulation was given during treatment, throughout hospitalization, and after discharge. Technical success was achieved in all 16 patients. Substantial clinical improvement was seen in these 16 patients after the procedure. Minor complications at the radial puncture site were observed in 5 patients, but trans-SMA infusion therapy was not interrupted. Follow-up computed tomography scan before discharge demonstrated nearly complete disappearance of PV-SMV thrombosis in 9 patients and partial recanalization of PV-SMV thrombosis in 7 patients. The 16 patients were discharged 9-19 days (12 {+-} 6.0 days) after admission. Mean duration of follow-up after hospital discharge was 44 {+-} 18.5 months, and no recurrent episodes of PV-SMV thrombosis developed during that time period. Transradial approach for transcatheter selective SMA urokinase infusion therapy in addition to anticoagulation is a safe and effective therapy for the management of patients with acute extensive PV-SMV thrombosis.
Should All Patients Undergo Postoperative Duplex Imaging to Detect a Deep Vein Thrombosis After Varicose Vein Surgery?
R. H. Bhogal; I. K. Nyamekye
ObjectivesĀĀDeep vein thrombosis (DVT) is a serious complication of varicose vein surgery, with attendant risks of pulmonary embolization.\\u000a Prospective duplex screening identifies DVT in 5% of patients compared to clinical incidence of approximately 1%. Universal\\u000a duplex screening is costly, and the benefits of diagnosing subclinical DVT are unproven. This study evaluates whether a policy\\u000a of using clinical indications (leg swelling)
Persistence of multiple emissary veins of posterior fossa with unusual origin of left petrosquamosal sinus from mastoid emissary
Narvir Singh Chauhan; Yash Paul Sharma; Tilak Bhagra; Bindu Sud
Emissary veins are valveless veins which pass through the cranial apertures and connect the dural venous sinuses and the extracranial\\u000a veins. The clinical importance of emissary veins is increasingly being appreciated. Some emissary veins like the petrosquamosal\\u000a sinus and mastoid emissary vein may cause significant bleeding during middle ear and skull base surgeries. A dilated mastoid\\u000a emissary vein or condylar
Construction and evaluation of a multidimensional score to assess varicose vein severity - the Homburg Varicose Vein Severity Score (HVVSS).
Rass, Knuth; Daschzeren, M÷nchzezeg; Grõber, Stefan; Vogt, Thomas; Tilgen, Wolfgang; Frings, Norbert
To evaluate a novel score (HVVSS) for varicose vein patients combining subjective symptoms, clinical findings and functional data of venous insufficiency. 91 patients (118 legs) with primary varicose veins of the great, small or accessory anterior saphenous vein were treated with conventional surgery. HVVSS was assessed pre- and 3 months postoperatively. The data were compared with established clinical and disease-related life quality scores (VCSS, AVVQ, CIVIQ). Test responsiveness, validity and reliability were determined using correlations with CEAP stage and venous refilling time as hemodynamic parameter, and inter-observer variability was assessed. All scores were highly responsive to varicose vein surgery (p<0.001). HVVSS(0-100) decreased from 34.1 ▒ 13.0 to 9.6 ▒ 6.9 postoperatively. The relative score change of HVVSS was superior to VCSS (69.5% vs. 58.8%, p=0.005). HVVSS revealed highly significant correlations with the clinical CEAP stage and was exclusively able to differentiate mild from severe disease as defined by venous refilling time (p=0.009). Inter-observer reliability of HVVSS was confirmed by correlation coefficients of 0.977 and 0.950 pre- and postoperatively (p<0.001). HVVSS is a suitable and reliable tool to assess disease severity in varicose vein patients and to quantify therapeutic effects of varicose vein treatment. PMID:21680286
Stripping the long saphenous vein reduces the rate of reoperation for recurrent varicose veins: Five-year results of a randomized trial
Simon Dwerryhouse; Birgit Davies; Kate Harradine; Jonathan J. Earnshaw
Objective: The purpose of this study was to investigate the possible long-term clinical advantages of stripping the long saphenous vein during routine primary varicose vein surgery. Methods: The study was designed as a 5-year, clinical and duplex scan follow-up examination of a group of patients who were randomized to stripping of the long saphenous vein during varicose vein surgery versus
Dual Balloon-Occluded Retrograde Transvenous Obliteration of Gastric Varix Draining into the Left Adrenal Vein and Left Inferior Phrenic Vein
Nishida, Norifumi, E-mail: firstname.lastname@example.com; Ninoi, Teruhisa; Kitayama, Toshiaki; Yamamoto, Akira; Sakai, Yukimasa; Sato, Kimihiko; Hamuro, Masao; Nakamura, Kenji; Inoue, Yuichi; Yamada, Ryusaku [Osaka City University Medical School 1-4-3, Asahi-machi, Department of Radiology (Japan)
A 66-year-old woman with a gastric varix, draining into a dilated left adrenal vein and a left inferior phrenic vein, was treated with dual balloon-occluded retrograde transvenous obliteration (B-RTO). Under balloon occlusion of the left adrenal vein and the left inferior phrenic vein, retrograde injection of a sclerosant (5% ethanolamine oleate) into the gastric varix was performed. Two weeks later, disappearance of flow in the gastric varix was confirmed on endoscopic ultrasound examination.
Fluid overpressure estimates from the aspect ratios of mineral veins
NASA Astrophysics Data System (ADS)
Philipp, Sonja L.
Several hundred calcite veins and (mostly) normal faults were studied in limestone and shale layers of a Mesozoic sedimentary basin next to the village of Kilve at the Bristol Channel (SW-England). The veins strike mostly E-W (239 measurements), that is, parallel with the associated normal faults. The mean vein dip is 73░N (44 measurements). Field observations indicate that these faults transported the fluids up into the limestone layers. The vein outcrop (trace) length (0.025-10.3 m) and thickness (0.1-28 mm) size distributions are log-normal. Taking the thickness as the dependent variable and the outcrop length as the independent variable, linear regression gives a coefficient of determination (goodness of fit) of R2 = 0.74 (significant with 99% confidence), but natural logarithmic transformation of the thickness-length data increases the coefficient of determination to R2 = 0.98, indicating that nearly all the variation in thickness can be explained in terms of variation in trace length. The geometric mean of the aspect (length/thickness) ratio, 451, gives the best representation of the data set. With 95% confidence, the true geometric mean of the aspect ratios of the veins lies in the interval 409-497. Using elastic crack theory, appropriate elastic properties of the host rock, and the mean aspect ratio, the fluid overpressure (that is, the total fluid pressure minus the normal stress on the fracture plane) at the time of vein formation is estimated at around 18 MPa. From these results, and using the average host rock and water densities, the depth to the sources of the fluids (below the present exposures) forming the veins is estimated at between around 300 m and 1200 m. These results are in agreement to those obtained by independent isotopic studies and indicate that the fluids were of rather local origin, probably injected from sill-like sources (water sills) inside the sedimentary basin.
Huebnerite veins near Round Mountain, Nye County, Nevada
Shawe, D.R.; Foord, E.E.; Conklin, N.M.
Small huebnerite-bearing quartz veins occur in and near Cretaceous (about 95 m.y. old) granite east and south of Round Mountain. The veins are short, lenticular, and strike mostly northeast and northwest in several narrow east-trending belts. The quartz veins were formed about 80 m.y. ago near the end of an episode of doming and metamorphism of the granite and emplacement of aplite and pegmatite dikes in and near the granite. An initial hydrothermal stage involved deposition of muscovite, quartz, huebnerite, fluorite, and barite in the veins. Veins were then sheared, broken, and recrystallized. A second hydrothermal stage, possibly associated with emplacement of a rhyolite dike swarm and granodiorite stock about 35 m.y. ago, saw deposition of more muscovite, quartz, fluorite, and barite, and addition of scheelite, tetrahedrite-tennantite, several sulfide minerals, and chalcedony. Finally, as a result of near-surface weathering, secondary sulfide and numerous oxide, tungstate, carbonate, sulfate, phosphate, and silicate minerals formed in the veins. Depth of burial at the time of formation of the veins, based on geologic reconstruction, was about 3-3.5 km. The initial hydrothermal stage ended with deposition of quartz at a temperature of about 210/sup 0/C and pressures of about 240 to 280 bars from fluids with salinity of about 5 wt % sodium chloride. Fluorite then was deposited at about 250/sup 0/ to 280/sup 0/C from solutions of similar salinity and containing a small amount of carbon dioxide. During shearing that followed initial mineralization, quartz was recrystallized at a temperature of 270/sup 0/ to 290/sup 0/C and in association with fluids of about 5 wt % sodium chloride equivalent and containing carbon dioxide. Late-stage fluorite was deposited from fluids with similar salinity but devoid of carbon dioxide at a temperature of about 210/sup 0/C. 76 refs., 38 figs., 8 tabs.
Safety of withholding anticoagulation in pregnant women with suspected deep vein thrombosis following negative serial compression ultrasound and iliac vein imaging
Chan, Wee-Shian; Spencer, Frederick A.; Lee, Agnes Y. Y.; Chunilal, Sanjeev; Douketis, James D.; Rodger, Marc; Ginsberg, Jeffrey S.
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. PMID:23318405
Small arterial reconstruction using modified cadaveric saphenous veins.
Sheil, A G; Stephen, M S; Boulas, J; Johnson, D S; Loewenthal, J
Human saphenous veins removed from cadaver donors were subjected to proteolytic enzymatic digestion, cross bonding, and heparin bonding. They were tested as small arterial substitutes in dogs. Eight of eleven were successful, persisting without development of stenosis or aneurysm, the longest for eighteen months. In humans, similarly prepared veins were used as arterial bypasses to revascularize ischemic limbs in eleven patients and aneurysmal degeneration of an earlier unmodified allograft bypass in one patient. Distal arterial anastomoses were to the tibial and peroneal arteries. Nine patients who had not undergone previous reconstructive surgery involving the vessel used for distal anastomosis were treated successfully; all remain with healed limbs between three and twelve months after surgery, eight with functioning bypasses. In three patients who had undergone previous operations on the same artery used for distal anastomosis, long bypasses failed, although amputation was avoided in one patient by additional bypass with modified vein to the profunda femoris artery. We conclude that modified saphenous vein allografts are suitable small arterial substitutes. It remains to be seen whether veins will maintain patency for long periods without development of complications. PMID:920887
Stent Compression in Iliac Vein Compression Syndrome Associated with Acute Ilio-Femoral Deep Vein Thrombosis
Cho, Hun; Kim, Jin Woo; Hong, You Sun; Lim, Sang Hyun
Objective This study was conducted to evaluate stent compression in iliac vein compression syndrome (IVCS) and to identify its association with stent patency. Materials and Methods Between May 2005 and June 2014, after stent placement for the treatment of IVCS with acute ilio-femoral deep vein thrombosis, follow-up CT venography was performed in 48 patients (35 women, 13 men; age range 23-87 years; median age 56 years). Using follow-up CT venography, the degree of the stent compression was calculated and used to divide patients into two groups. Possible factors associated with stent compression and patency were evaluated. The cumulative degree of stent compression and patency rate were analyzed. Results All of the stents used were laser-cut nitinol stents. The proportion of limbs showing significant stent compression was 33%. Fifty-six percent of limbs in the significant stent compression group developed stent occlusion. On the other hand, only 9% of limbs in the insignificant stent compression group developed stent occlusion. Significant stent compression was inversely correlated with stent patency (p < 0.001). The median patency period evaluated with Kaplan-Meier analysis was 20.0 months for patients with significant stent compression. Other factors including gender, age, and type of stent were not correlated with stent patency. Significant stent compression occurred most frequently (87.5%) at the upper end of the stent (ilio-caval junction). Conclusion Significant compression of nitinol stents placed in IVCS highly affects stent patency. Therefore, in order to prevent stent compression in IVCS, nitinol stents with higher radial resistive force may be required.
Retrograde mechanochemical ablation of the small saphenous vein for the treatment of a venous ulcer.
Moore, Hayley M; Lane, Tristan Ra; Franklin, Ian J; Davies, Alun H
We present the first case of retrograde ablation of the small saphenous vein to treat active venous ulceration. A 73-year-old gentleman with complicated varicose veins of the left leg and a non-healing venous ulcer despite previous successful endovenous treatment to his left great saphenous vein underwent mechanochemical ablation of his small saphenous vein with the ClariVein« system, under local anaesthetic, using a retrograde cannulation technique. Post-operatively the patient had improved symptomatically and the ulcer size had reduced. This report highlights that patients with small saphenous vein incompetence and active ulceration can be treated successfully with retrograde mechanochemical ablation. PMID:24347131
Gelfoam scaffold for vein prolapse during brain tumor surgery.
Hervey-Jumper, Shawn L; Breshears, Jonathan; Berger, Mitchel S
When resecting gliomas, extra-axial tumors, or their overlying cortex, cortical veins may become suspended over the resection cavity and ultimately prolapse and kink into the cavity, promoting venous thrombosis. To prevent this, we describe a technique to secure a Gelfoam scaffold beneath the cortical vein at the edge of the resection cavity to prevent kinking and possible thrombosis from taking place after tumor removal. Depending on the diameter of the resection cavity, this can be done at 1 or both edges of the resection cavity to prevent prolapse of the vein into the cavity. In our experience with this technique, during the past 10 years, there have been no cases of venous thrombosis after tumor removal on postoperative imaging or clinical examination. PMID:25118058
The epidemiology of varicose veins. A survey in western Jerusalem.
Abramson, J H; Hopp, C; Epstein, L M
The prevalence and correlates of varicose veins were investigated in a community survey in a neighbourhood of western Jerusalem in 1969-71. The prevalence was 10% among men and 29% among women aged 15 and over; it rose with age in each sex. In both sexes, significant associations were found with standing at work and with region of birth. Among women, varicose veins were associated with weight, the wearing of corsets, and having ever been pregnant. Among men, there was an association with inguinal hernia. The findings support the aetiological role of prolonged standing and raised intra-abdominal pressure. Varicose veins were relatively uncommon among North African-born men and women aged 45 and over. This finding, which was not accounted for by the other observed associations, is consistent with the possible aetiological role of experiences before immigration, such as behavioural patterns laid down in early life. PMID:7328382
The epidemiology of varicose veins. A survey in western Jerusalem.
Abramson, J H; Hopp, C; Epstein, L M
The prevalence and correlates of varicose veins were investigated in a community survey in a neighbourhood of western Jerusalem in 1969-71. The prevalence was 10% among men and 29% among women aged 15 and over; it rose with age in each sex. In both sexes, significant associations were found with standing at work and with region of birth. Among women, varicose veins were associated with weight, the wearing of corsets, and having ever been pregnant. Among men, there was an association with inguinal hernia. The findings support the aetiological role of prolonged standing and raised intra-abdominal pressure. Varicose veins were relatively uncommon among North African-born men and women aged 45 and over. This finding, which was not accounted for by the other observed associations, is consistent with the possible aetiological role of experiences before immigration, such as behavioural patterns laid down in early life. PMID:7328382
SWI enhances vein detection using gadolinium in multiple sclerosis.
Maggi, Pietro; Mazzoni, Lorenzo N; Moretti, Marco; Grammatico, Matteo; Chiti, Stefano; Massacesi, Luca
Susceptibility weighted imaging (SWI) combined with the FLAIR sequence provides the ability to depict inĀvivo the perivenous location of inflammatory demyelinating lesions - one of the most specific pathologic features of multiple sclerosis (MS). In addition, in MS white matter (WM) lesions, gadolinium-based contrast media (CM) can increase vein signal loss on SWI. This report focuses on two cases of WM inflammatory lesions enhancing on SWI images after CM injection. In these lesions in fact the CM increased the contrast between the parenchyma and the central vein allowing as well, in one of the two cases, the detection of a vein not visible on the same SWI sequence acquired before CM injection. PMID:25815209
Hemodynamically Driven Vein Graft Remodeling: A Systems Biology Approach
Berceli, Scott A.; Tran-Son-Tay, Roger; Garbey, Marc; Jiang, Zhihua
Despite intense investigation over several decades to understand the mechanisms of vein graft failure, few therapeutic modalities have emerged. Emphasis using standard reductionist approaches has been focused on cataloging the components involved in the early events following vein graft implantation, but limited insight has been gained in understanding the dynamic interaction of these components. We propose that the application of systems theory offers the opportunity for significant advances in this area. Focused on modeling the dynamic relationships that define living organisms, systems biology provides the necessary tools to further our understanding of the complex series of overlapping biologic events on surgical implantation of the vein graft. Through the use of ordinary differential equation and agent-based modeling techniques, we present our ongoing efforts to define the nonlinear interactions between hemodynamics and vascular adaptation. PMID:19426605
Superficial vein thrombosis: a current approach to management.
Scott, Gemma; Mahdi, Ali Jassem; Alikhan, Raza
Superficial vein thrombosis (SVT) was considered to be a benign and self-limiting condition. However, it is now appreciated that a significant proportion of those presenting with SVT will have concomitant deep vein thrombosis or pulmonary embolism, or are at significant risk of developing deep venous thromboembolism. Potential therapeutic options include topical preparations, compression therapy (stockings, bandages), medication such as non-steroidal anti-inflammatory drugs (NSAIDs) or anticoagulants (therapeutic or prophylactic doses) and surgery, ligation or stripping, of superficial veins. The treatment of choice is therapeutic/intermediate dose low molecular weight heparin or prophylactic dose fondaparinux administered for 4-6 weeks. The cost-effectiveness of treatment is a concern and more targeted therapy is required. PMID:25521017
Branch portal vein pyaemia secondary to amoebic liver abscess.
Kenny, Conor; Sohan, Oliver; Murray, Lois; Fox, Thomas Peter
We describe a case of a young returning traveller who contracted amoebic dysentery while visiting India. She presented to a major London Hospital several months later with features suggestive of amoebic liver abscesses, a known sequelae of amoebiasis. MRI with intravenous contrast demonstrated an area of likely occlusion of the portal vein. The patient was treated with intravenous metronidazole for 10?days followed by diloxanide furoate, an intraluminal agent. The largest abscess was drained acutely under ultrasound guidance. The portal vein occlusion was treated medically without the use of anticoagulation. A repeat ultrasound at 6?weeks post-treatment confirmed patency of the portal vein indicating spontaneous recanalisation with antimicrobial therapy alone. PMID:26055593
Lack of significant difference between internal spermatic vein and brachial vein ischemia modified albumin levels in patients with varicocele.
Aliyazicioglu, Yuksel; Ozbek, Emin; Ozcan, Levent; Cakir, S Sami; Dursun, Murat
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
Vasorelaxant Effect of 17?-Ethynylestradiol on Human Saphenous Vein
Jodati, Ahmad Reza; Babaei, Hossein; Azarmi, Yadollah; Fallah, Sahar; Gharebageri, Afsaneh; Fadaei Fouladi, Danial; Safaei, Naser
Purpose: A protective effect for estrogens against cardiovascular problems has long been known. The aim of this study was to investigate the vasorelaxant effect of 17?-Ethynylestradiol (17?-EE) on human saphenous vein. Methods: The veins were suspended horizontally between two triangular stainless steel hooks for the measurement of isometric tension in individual organ baths containing 10ml Krebs solution, at 37░C and gassed with carbogen under 3gr optimum tension. The effect of different concentrations of 17?-EE (2-40 ?M) on vascular tone was investigated in veins precontracted with PGF2?. Relaxation was measured after 40min and expressed as the percent decrease of initial contraction. To determine the involvement of potassium channels, endothelium, nitric oxide synthase, guanylylcyclase and prostaglandins in the vasorelaxant effect of estrogen, the veins were incubated with tetraethyl ammonium, N-nitro-L-arginine methyl ester, methylene blue or indomethacin, respectively for 20min prior to experimentation. Responses to 17?-EE were directly compared to those obtained in the same tissues in the absence of the inhibitors. Results: The mean relaxations induced by 17?-EE with concentrations of 2, 5, 10, 20 and 40?M in tissues precontracted with PGF2? were 19.8 ▒5.5%, 26.1▒10.8%, 32.2▒7.4%, 48.6▒10.8%and56▒7.6%, respectively. The results of the inhibition of potassium channels, nitric oxide synthase, guanylylcyclase, cyclooxygenase and removing endothelium in relaxation induced by 17?-EE on precontracted veins with PGF2? proved no significant differences. Conclusion: This study showed that 17?-EE has significant vasorelaxant effect on human saphenous vein in a concentration-dependent manner. This effect is probably independent of potassium channels, nitric oxide synthase, guanylylcyclase, prostaglandin synthesis and endothelium functions. PMID:25789224
Interictal regional delta slowing in cerebral sinus vein thrombosis.
Aharoni, Sharon; Goldberg-Stern, Hadassa; Kornreich, Liora; Shuper, Avinoam
The electroencephalographic finding of regional delta activity should alert to the possibility of an underlying structural abnormality of the brain as a cause. A 5-year-old boy, who presented with severe headache and focal seizures, had normal neurological examination and brain CT findings. The initial electroencephalograph showed focal delta activity. An emergent brain MRI disclosed a thrombosis of the left sigmoid sinus and jugular vein, but no parenchymal lesions. The regional delta activity can presumably serve as a marker for brain tissue damage in cerebral sinus vein thrombosis, and sometimes, even to add information to that gained from imaging studies. PMID:25692516
Recurrent bilateral varicose veins secondary to tricuspid regurgitation
S. A. Badger; R. R. Makar; E. W. Chew; B. Lee
BackgroundĀĀVaricose veins are a common condition. We present a case of recurrent veins due to tricuspid regurgitation.\\u000a \\u000a \\u000a \\u000a Case historyĀĀA 55-year-old female presented with large bilateral varicosities. On examination these were extensive and pulsatile in nature\\u000a over both legs. Three and 5Āyears previously she presented with similar signs and had undergone bilateral venous surgery including\\u000a Trendelenburg procedure. Past medical history included
Superior mesenteric vein thrombosis after laparoscopic sleeve gastrectomy.
Pineda, Lucas; Sarhan, Mohammad; Ahmed, Leaque
Laparoscopic procedures for morbid obesity are becoming standard of care which, in experienced hands, has a very low mortality and morbidity. Superior mesenteric vein thrombosis has been reported in the literature after different bariatric and nonbariatric laparoscopic procedures. Laparoscopic sleeve gastrectomy is a relatively new procedure in the treatment of morbid obesity; its complications being well-known including staple line leak, bleeding, and stricture among others. We present a case of superior mesenteric vein thrombosis after laparoscopic sleeve gastrectomy successfully managed conservatively with therapeutic anticoagulation, and propose a different hypothesis for the development of such a complication. PMID:23917607
The distinct morphological and petrological features of shock melt veins in the Suizhou L6 chondrite
NASA Astrophysics Data System (ADS)
Xie, Xiande; Sun, Zhenya; Chen, Ming
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 1900-02000 ░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.
The Distant Morphological and Petrological Features of Shock Melt Veins in the Suizhou L6 Condrite
X Xie; Z Sun; M Chen
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.
Geometry and texture of quartz veins in Wadi Atalla area, Central Eastern Desert, Egypt
NASA Astrophysics Data System (ADS)
Akawy, Ahmed
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.
The Investigation on Fibrous Veins and Their Host from Mt. Ida, Ouachita Mountains, ArkansasĀ
Chung, Jae Won
I have studied syntectonic veins from shales and coarse calcareous sands of the Ordovician Womble Shale, Benton uplift, Arkansas. All veins are composed of calcite with minor quartz and trace feldspar and dolomite or high-Mg ...
Hepatocellular Carcinoma Invading the Main Portal Vein: Treatment with Transcatheter Arterial Chemoembolization and Portal Vein Stenting
Zhang Xuebin, E-mail: firstname.lastname@example.com; Wang Jianhua, E-mail: email@example.com; Yan Zhiping, E-mail: firstname.lastname@example.com; Qian Sheng, E-mail: firstname.lastname@example.com; Liu Rong, E-mail: email@example.com [Fudan University, Department of Radiology, Zhong Shan Hospital (China)
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.
Hepatocellular carcinoma invading the main portal vein: treatment with transcatheter arterial chemoembolization and portal vein stenting.
Zhang, Xue-Bin; Wang, Jian-Hua; Yan, Zhi-Ping; Qian, Sheng; Liu, Rong
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(2)O to 37.19 +/- 7.89 cmH(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. PMID:18931871
Identification and Partial Characterisation of Lettuce big-vein associated virus and Mirafiori lettuce big-vein virus in Common Weeds Found Amongst Spanish Lettuce Crops and their Role in Lettuce Big-vein Disease Transmission
Jose A. Navarro; Francisco Botella; Antonio Marhuenda; Pedro Sastre; M. Amelia Sßnchez-Pina; Vicente Pallas
The potential role of 10 frequently occurring weed species found amongst Spanish lettuce crops as host plants for the two\\u000a viruses associated with the lettuce big-vein disease, Lettuce big-vein associated virus (LBVaV) and Mirafiori lettuce big-vein virus (MLBVV), was studied. The results showed that both viruses can infect naturally growing Sonchus oleraceus (common sowthistle) plants, the unique susceptible species detected
Technical procedure of two-port system subfascial endoscopic perforator vein surgery (TPS-SEPS)
Naoki Haruta; Toshimasa Asahara; Seiji Marubayashi; Keizou Sugino; Yosio Miura; Hideki Nakahara
It has long been noted that incompetent perforating veins contribute to the development of chronic venous insufficiency and\\u000a recurrent varicose veins that are complicated by skin ulcerations or liposcleroderma. For these conditions, severing of incompetent\\u000a perforating veins is an effective surgical treatment. However, severing of incompetent perforating veins by a direct approach\\u000a has become less commonly performed because of the
Subclavian Vein Cannulation Success Rate in Neonates and Children
Aminnejad, Reza; Razavi, Seyed Sajjad; Mohajerani, Seyed Amir; Mahdavi, Seyed Alireza
Background: Central vein cannulation allows the administration of large volumes of fluids in short times and at high osmolarities for rehydration, volume replacement, chemotherapy, and parenteral nutrition. Percutaneous central venous line insertion has replaced peripheral venous cut-down as the primary mode of short-term venous access in children. Objectives: The aim of our study was to delineate some aspects of this procedure as well as its success rate and relative risk in pediatrics. Patients and Methods: Totally, 3264 subclavian vein cannulations in neonates and children were analyzed regarding successful catheterization attempts and early complication rates after the procedure retrospectively in Mofid Hospital (Tehran, Iran). Results: There were 1340 newborn patients (first 28 days of life) in our study population. In these newborns, only 55 cannulations failed; one patient was complicated with pneumothorax; guide wires malfunctioned in 21 cases; and first- attempt cannulation success was reported in only 981 cases. In the remaining 1924 patients, between one month and 8 years old, only 14 attempts at the cannulation of the subclavian vein failed and 1655 cases had first-attempt cannulation success. Conclusions: The cannulation of the central vein in neonates and children in a skilled hand would be performed with great success rate and low complications.
Venous Hypoxia: A Poorly Studied Etiological Factor of Varicose Veins
C. S. Lim; M. S. Gohel; A. C. Shepherd; E. Paleolog; A. H. Davies
Venous hypoxia has long been postulated as a potential cause of varicosity formation. This article aimed to review the development of this hypothesis, including evidence supporting and controversies surrounding it. Vein wall oxygenation is achieved by oxygen diffusing from luminal blood and vasa vasorum. The whole media of varicosities is oxygenated by vasa vasorum as compared to only the outer
Minimally invasive vein harvesting significantly reduces pain and wound morbidity
Edward A. Black; R. N. Karen Campbell; Keith M. Channon; Chandi Ratnatunga; Ravi Pillai
Objectives: Minimally invasive saphenous vein harvesting is advocated to reduce wound morbidity. Our early experience with minimally invasive techniques, however, suggested that increased tissue traction and trauma might follow. We aimed to test the hypothesis that minimally invasive harvesting reduces post-operative pain and inflammation. A secondary objective was to determine if minimally invasive harvesting could be performed efficiently. Methods: Forty
Minimally invasive vein harvesting significantly reduces pain and wound morbidity
Edward A Black; R. N Karen Campbell; Keith M Channon; Chandi Ratnatunga; Ravi Pillai
Objectives: Minimally invasive saphenous vein harvesting is advocated to reduce wound morbidity. Our early experience with minimally invasive techniques, however, suggested that increased tissue traction and trauma might follow. We aimed to test the hypothesis that minimally invasive harvesting reduces post-operative pain and inflammation. A secondary objective was to determine if minimally invasive harvesting could be performed efficiently. Methods: Forty
Bilateral renal vein thrombosis due to inapparent polycythaemia.
Rapur, Ram; Gudithi, Swarnalatha; Adiraju, Krishna Prasad; Vangipurapu Rangacharlu, Srinivasasan; Venkata, Dakshinamurty Kaligotla
Thromboses at unusual sites are characteristic of polycythaemia. We present a patient of bilateral renal vein thromboses due to polycythaemia that was inapparent. The diagnosis was confirmed by trilineage hyperplasia in bone marrow and JAK 2 V617F mutation in blood. PMID:25949491
Transluminal extraction atherectomy for aortosaphenous vein graft stent restenosis.
Patel, J J; Meadaa, R; Cohen, M; Adiraju, R; Kussmaul, W G
The optimal strategy to manage in-stent saphenous vein graft (SVG) restenosis has not been studied. We present two cases in which transluminal extraction atherectomy (TEC) was used successfully for the treatment of SVG stent restenosis. TEC atherectomy may provide an alternative to conventional balloon angioplasty for such patients. PMID:8804772
CT mapping of the vertebral level of right adrenal vein
Degenhart, Christoph; Strube, Hanna; Betz, Matthias J.; Pallauf, Anna; Bidlingmaier, Martin; Fischer, Evelyn; Reincke, Martin; Reiser, Maximilian F.; Wirth, Stefan
PURPOSE We aimed to evaluate the accuracy of multidetector computed tomography (MDCT) venous mapping for the localization of the right adrenal veins (RAV) in patients suffering from primary aldosteronism. METHODS MDCT scans of 75 patients with primary aldosteronism between March 2008 and November 2011 were evaluated by two readers (a junior [R1] and a senior [R2] radiologist) according to the following criteria: quality of RAV depiction (scale, 1¢5), localization of the RAV confluence with regard to the inferior vena cava, and depiction of anatomical variants. Results were compared with RAV venograms obtained during adrenal vein sampling and corroborated by laboratory testing of cortisol in selective RAV blood samples. Kappa statistics were calculated for interobserver agreement and for concordance of MDCT mapping with the gold standard. RESULTS Successful RAV sampling was achieved in 69 of 75 patients (92%). Using MDCT mapping, adrenal veins could be visualized in 78% (R1, 54/69) and 77% (R2, 53/69) of patients. MDCT mapping led to correct identification of RAV in 70% (R1, 48/69) and 88% (R2, 61/69) of patients. Venograms revealed five cases of anatomical variants, which were correctly identified in 60% (R1, R2). MDCT-based localizations were false or misleading in 16% (R1, 11/69) and 7% (R2, 5/69) of cases. CONCLUSION Preinterventional MDCT mapping may facilitate successful catheterization in adrenal vein sampling. PMID:25430527
Arteries and veins: making a difference with zebrafish
Nathan D. Lawson; Brant M. Weinstein
Arteries and veins are structurally different and have long been functionally defined by the direction of blood flow that they carry. However, a growing body of evidence indicates that the identity of the endothelial cells that line these vessels is determined in the developing embryo, before circulation begins. Recent work on the zebrafish has led to the identification of signals
Drosophila Smad2 Opposes Mad Signaling during Wing Vein Development
De Robertis, Eddy M.
Drosophila Smad2 Opposes Mad Signaling during Wing Vein Development Veronika Sander, Edward Eivers In the vertebrates, the BMP/Smad1 and TGF-b/Smad2 signaling pathways execute antagonistic functions in different Smad1 and high Smad2 signaling. In Drosophila, Mad regulates tissue determination and growth
Mathematical Modeling of Radiofrequency Ablation for Varicose Veins
Choi, Sun Young; Kwak, Byung Kook
We present a three-dimensional mathematical model for the study of radiofrequency ablation (RFA) with blood flow for varicose vein. The model designed to analyze temperature distribution heated by radiofrequency energy and cooled by blood flow includes a cylindrically symmetric blood vessel with a homogeneous vein wall. The simulated blood velocity conditions are U = 0, 1, 2.5, 5, 10, 20, and 40?mm/s. The lower the blood velocity, the higher the temperature in the vein wall and the greater the tissue damage. The region that is influenced by temperature in the case of the stagnant flow occupies approximately 28.5% of the whole geometry, while the region that is influenced by temperature in the case of continuously moving electrode against the flow direction is about 50%. The generated RF energy induces a temperature rise of the blood in the lumen and leads to an occlusion of the blood vessel. The result of the study demonstrated that higher blood velocity led to smaller thermal region and lower ablation efficiency. Since the peak temperature along the venous wall depends on the blood velocity and pullback velocity, the temperature distribution in the model influences ablation efficiency. The vein wall absorbs more energy in the low pullback velocity than in the high one. PMID:25587351
Recognizing misplacement of a dialysis catheter in the azygos vein.
Calvi±o, Jes·s; Bravo, Juan; MartĒnez, LucĒa; Millßn, Beatriz; Pulpeiro, Josķ R
Uneventful central venous catheterization for hemodialysis patients may not always result in a correct tip position. A case of inadvertent cannulation of the azygos vein is described. Radiographic features for its early recognition are emphasized and mechanisms related with azygos unintended catheterization are discussed. PMID:23113923
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...
Design of a Vein Based Personal Identification System
Madhumita Kathuria
A wide variety of real world systems require reliable personal recognition schemes to either confirm or determine the identity of an individual requesting their services. Biometric recognition scheme refers to the automatic recognition\\/identification of individuals based on their physiological and\\/or behavioral characteristics. We have proposed a Vein Based Personal Identification System (VBPIS), which overcomes the deficiencies usually found in commercially
Effect of twist on flow and patency of vein grafts.
Endean, E D; DeJong, S; Dobrin, P B
This article examines the effect of twist on flow through reversed vein segments in vitro and its effect on graft patency in vivo. Excised canine superficial femoral veins were perfused in vitro with normal saline solution or canine blood. Perfusion was carried out at five pressures and against three outflow resistances. Increasing increments of twist were applied to the outflow end of the vein. Flow was measured at each level of twist. With both saline solution and blood, flow was unaltered until twist reached 140 to 180 degrees. Flow then decreased sharply, stopping completely at 175 to 200 degrees of twist. In vivo experiments were then performed in 13 dogs. Reversed superficial femoral veins were used as end-to-end grafts to bypass the iliac arteries. Each graft was deliberately twisted 0, 45, 90, 135, or 200 degrees. All grafts were harvested 6 months after surgery. Eighteen of 20 grafts twisted 135 degrees or less remained patent. However, all five grafts twisted 200 degrees were thrombosed within 4 hours of surgery (p less than 0.05). These data suggest that in patients a slight amount of graft twist probably does not reduce flow; however, more than 135 degrees of twist will greatly reduce flow, leading to early graft thrombosis. PMID:2724454
Bassam Nawaiseh; Ahmed Shobaki; Ahmad Hassouneh; Issam Bataineh; Mohamed Al-Jaar
This is a report of a 31-year old male patient who presented with poor vision of his left eye of one-week duration after the use of two tablets of Sildenafil citrate (Viagra) approximately 24 hours before and 48 hours after the onset of ocular symptoms. Ocular examination was consistent with the diagnosis of central retinal vein occlusion. There was no
Recovery from bilateral renal vein thrombosis on supportive management alone
Ashok Kumar; Deepika Chaudhary; V. Bhargava
Renal vein thrombosis (RVT) may be fatal, particularly when it occurs bilaterally. We report a neonate who recovered from bilateral RVT on supportive management alone. A 2450 g male infant was born at term gestation to a non-diabetic mother. The anmiotic fluid contained particulate mecoilium. The Apgar scores were 1 and 3 at 1 and 5 minutes, respecfivelyl Postnatal course
Duplex ultrasound, clinical score, thrombotic risk, and D-dimer testing for evidence based diagnosis and management of deep vein thrombosis and alternative diagnoses in the primary care setting and outpatient ward.
Michiels, J J; Moosdorff, W; Maasland, H; Michiels, J M; Lao, M U; Neumann, H A; Dulicek, P; Stvrtinova, V; Barth, J; Palareti, G
Deep vein thrombosis (DVT) has an annual incidence of 0.2% in the urban population. First episodes of calf vein thrombosis (CVT) and proximal DVT are frequently elicited by risk factors, including varicose veins, cancer, pregnancy/postpartum, oral contraceptives below the age of 50 years, immobility or surgery. Leg pain and tenderness in the calf and popliteal fossa on physical examination may result from other conditions than DVT labeled as alternative diagnosis (AD) Congenital venous thrombophilia is present in every third first DVT, increased FVIII in every fourth first DVT, and FV Leiden/FII mutation in 40% of women on oral anticonceptive pill before reaching the menopause. Routine thrombophilia testing for FV Leiden/prothrombin mutation and FVIII as main risk factor for venous thrombosis is recommended. Primary superficial venous thrombosis (SVT) and DVT patients with a autosomal dominant family history of DVT are candidates for thrombophilia testing for congenital AT, PC and PS deficiency. The requirement for a safe diagnostic strategy of CVT and DVT should be based on an objective post-test incidence of venous thromboembolism (VTE) of less than 0.1% with a negative predictive value for exclusion of DVT of 99.9% during 3 months follow-up. Modification of the Wells score by elimination of the "minus 2 points" for AD is mandatory and will improve the diagnostic accuracy of CVT/DVT suspicion in the primary care setting and outpatient ward. The sequential use of complete DUS, ELISA D-dimer testing and modified clinical Wells' score assessment is safe and effective for the exclusion and diagnosis of CVT, DVT and AD. About 10% to 20% of patients with DVT develop overt post-thrombotic syndrome (PTS) at one year post-DVT, and both PTS and DVT recurrences further increase to about 30% during long-term follow-up. Objective risk stratification of PTS complications using DUS for recanalization and reflux and D-dimer testing will become an integral part in routine clinical practice to assess the optimal duration of wearing medical elastic stockings and anticoagulation for the prevention DVT recurrence as the best option to reduce the incidence and costs of suffering from irreversible PTS. PMID:24452081
Responsiveness of human varicose saphenous veins to vasoactive agents
Brunner, Friedrich; Hoffmann, Christine; Schuller-Petrovic, Sanja
Aims To test in vitro the constrictor and relaxation responsiveness of variously diseased segments of human saphenous vein from patients with varicose vein disease. Methods The vein segments were derived (i) from the inguinal saphenous vein (valvularly incompetent and slightly dilated; tissue A); (ii) from the distal end of the lower leg just above the medial ankle (competent; tissue B); (iii) from a tributary to the long saphenous vein just below the knee (dilated, incompetent and overtly varicose; tissue C). The contractile responses were tested with phenylephrine (an ?-adrenergic receptor agonist) and aescin, a clinically used phlebotonic drug derived from horse chestnut extract. Relaxant responses were tested with acetylcholine and sodium nitroprusside. Results Both contractile agents contracted vein segments from the inguinal and ankle area with similar potency and efficacy, but were virtually without effect in the overtly varicose segments from the calf. EC50 values (molar concentration of the agonist that produces 50% of the maximum effect) in tissues A and B were 2.9 ▒ 0.3 and 2.5 ▒ 0.5 Ąmol l?1 (phenylephrine) and 9.4 ▒ 1.0 and 15.9 ▒ 2.5 Ąmol l?1 (aescin); the corresponding maximum effects (maximum effect, percent of KCl-induced contraction) were 76 ▒ 3 and 70 ▒ 4% (phenylephrine) and 70 ▒ 2 and 71 ▒ 3% (aescin) (P = NS in both cases for A vs B). In tissue C, the maximum effects were 5 ▒ 5% (phenylephrine) and 10 ▒ 7% (aescin) of KCl-induced contraction (not significantly different from zero). Acetylcholine-induced relaxation was similar for vein segments from locations A and B, whereas sodium nitroprusside was more effective in tissue B than A. Conclusions These findings support the notion that abnormalities within the venous wall affect venous smooth muscle contractility. Since competent and incompetent clinically normal vessels show normal contractile responses, whereas varicose vessels are not responsive to vasoactive drugs, it is likely that pharmacological treatment regimens are effective in early, but not in late stages of the disease. PMID:11298067
Varicose Veins in Women Cotton Workers. An Epidemiological Study in England and Egypt
Siza Mekky; R. S. F. Schilling; Joan Walford
The prevalence of varicose veins was studied in 504 women cotton workers in England and 467 in Egypt, by a standardized questionary and a specially developed method of examination. The English mill population showed a much higher prevalence of varicose veins than the Egyptian, probably owing to environmental rather than ethnic reasons.Among the European women the prevalence of varicose veins
Axillary vein thrombosis in a female backpacker: Paget-Schroetter syndrome.
Kolodinsky, S D; Brandschwei, F H
In 1875 Sir James Paget reported the first case of primary axillary vein thrombosis. Since then numerous reports of axillary vein thrombosis have appeared citing various initiating events and possible causes. We report here a patient with axillary vein thrombosis. The thrombosis appears to have been provoked by carrying a backpack. PMID:2766025
Finite Element simulation of buckling-induced vein tortuosity and influence of the wall constitutive
Paris-Sud XI, Universitķ de
-induced changes in the varicose vein wall. Based on a 3D model of the leg and in vivo identification of varicose veins may precede the mechanical aspects of the disease. To test the hypothesis of tortuosity of the material properties of varicose veins, a clinical validation of these findings is being developed. hal
Control of distension of varicose veins achieved by leg bandages, as used after injection sclerotherapy
P H Fentem; M Goddard; B A Gooden; C K Yeung
A study was performed to determine whether the pressures routinely produced by bandaging for compression sclerotherapy of varicose veins are adequate to maintain the superfical veins almost empty of blood. The results suggest that well-applied bandages can provide sufficient support to combat the high distending pressures found in varicose veins. The large variation among different surgeons, however, indicates that any
Effect of Hydroxyethylrutosides on Blood Oxygen Levels and Venous Insufficiency Symptoms in Varicose Veins
Andrew J. McEwan; Colin S. McArdle
Oxygen levels (tension, saturation, and content) in blood from varicose leg veins were found to be significantly lower than those in blood from normal leg veins at the same site on the limb under the same laboratory conditions. Treatment with hydroxyethylrutosides significantly increased the oxygen levels in blood from varicose veins, and this was associated with an improvement in leg
Design and implementation of a contactless palm print and palm vein sensor
Michael Goh Kah Ong; Connie Tee; Andrew Teoh Beng Jin
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
Biochemical Assay of Collagen and Elastin in the Normal and Varicose Vein Wall
Marco Venturi; Luigi Bonavina; Federico Annoni; Laura Colombo; Caterina Butera; Alberto Peracchia; Emilio Mussini
Alterations of the connective tissue in the varicose vein wall have been noted by several investigators; however, the cause of the vein dilatation has still not been established. The aim of this study was to find a biochemical explanation to the development of varices by evaluating sensitive biochemical markers of collagen and elastin in the varicose vein wall. 4-L-Hydroxyproline (HYP),
Efficacy of pulmonary vein isolation for the elimination of chronic atrial fibrillation in cardiac valvular surgery
Taijiro Sueda; Katsuhiko Imai; Osamu Ishii; Kazumasa Orihashi; Masanobu Watari; Kenji Okada
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,
Selected contribution: Effects of sex and ovariectomy on responses to platelets in porcine femoral veins.
Lewis, D A; Bracamonte, M P; Rud, K S; Miller, V M
Estrogen replacement increases risk of venous thrombosis. In this study, we determined responses in vitro to platelets and platelet products in veins from adult male and intact and ovariectomized female pigs. When contracted with prostaglandin F(2alpha), platelets (25,000 platelets/microl) caused relaxation in veins with endothelium. Higher numbers of platelets caused contraction in veins with and without endothelium. In veins without endothelium, contractions were greater in veins from male than in veins from female pigs, and contractions in intact female pig veins were greater than in ovariectomized females pig veins. Platelet products 5-hydroxytryptamine and thromboxane (analog U-46619) caused comparable contractions in all veins; contractions to prostacyclin were less in veins from intact female pigs. ADP caused comparable endothelium-dependent relaxations in all groups. These relaxations were increased by indomethacin in veins from intact males and females; with inhibition of nitric oxide, relaxations were comparable in all groups. These results suggest that venous responses to platelets vary with sex and presence of ovaries in female pigs. These variations reflect differences in type and quantity of substances released from platelets as well as the sensitivity of the smooth muscle to some vasoactive substances. In addition, products of cyclooxygenase may reduce endothelium-dependent relaxations in veins. PMID:11717251
Reviewing models of auxin canalization in the context of leaf vein pattern formation in Arabidopsis
Prusinkiewicz, Przemyslaw
fol- lowed by the loops of secondary veins (Candela et al., 1999). Finally, higher-order veins (Avsian-Kretchmer et al., 2002; Mattsson et al., 1999; Sieburth, 1999). The concept of canalization). This assumption made it possible, in particular, to simulate the formation of vein loops. Recent evidence usi
Stent-graft treatment for extrahepatic portal vein hemorrhage after pancreaticoduodenectomy
Igami, Tsuyoshi; Komada, Tomohiro; Mori, Yoshine; Yokoyama, Yukihiro; Ebata, Tomoki; Naganawa, Shinji; Nagino, Masato
We report a case of intraperitoneal hemorrhage from the extrahepatic portal vein after pancreaticoduodenectomy for distal bile duct carcinoma. A stent-graft was deployed from the superior mesenteric vein to the main portal vein using a transhepatic approach. After the procedure, the patient remained free of intraperitoneal hemorrhage and was discharged 2 months later. PMID:26137314
Subclavian vein thrombosis following IVF and ovarian hyperstimulation: a case report
Anjali K. Rao; Usha Chitkara; Amin A. Milki
Thromboembolic phenomena are a serious consequence of assisted reproductive technology. We present a case of upper extremity deep vein thrombosis (DVT) at 7 weeks gestation following ovarian hyperstimulation syndrome (OHSS) and IVF. Three weeks after recovering from OHSS, the patient presented with left neck pain and swelling. Ultrasound revealed a thrombus in the left jugular vein and left subclavian vein.
Automatic determination of the artery vein ratio in retinal images
NASA Astrophysics Data System (ADS)
Niemeijer, Meindert; van Ginneken, Bram; AbrÓmoff, Michael D.
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.
Local SIFT analysis for hand vein pattern verification
NASA Astrophysics Data System (ADS)
Wang, Yunxin; Wang, Dayong; Liu, Tiegen; Li, Xiuyan
The newly emerging hand vein recognition technology has attracted remarkable attention for its uniqueness, noninvasion, friendliness and high reliability. It is unavoidable to produce small location deviation of human hand in the practical application; however, the existing recognition methods are sensitive to the hand shift or rotation. The test sample is matched with a series of registered images after affine transformation including the shift or rotation by most of researches, this affine transform method can remedy the location deviation to some extent, but the limited range for hand shift and rotation brings users much inconvenience and the computational cost also increases greatly. Aiming at this issue, a hand vein recognition algorithm based on local SIFT (Scale Invariant Feature Transform) analysis is developed in this contribution, which has practical significance due to its translation and rotation invariance. First, the hand vein image is preprocessed to remove the background and reduce image noises, and then SIFT features are extracted to describe the gradient information of hand vein. Many one-to-more matching pairs are produced by the common matching method of SIFT features, thus the matching rule is improved by appending a constrained condition to ensure the one-to-one matching, which is achieved by selecting feature point with the nearest distance as the optimal match. Finally the match ratio of features between the registered and test images is calculated as the similarity measurement to verify the personal identification. The experiment results show that FRR (False Rejection Rate) is only 0.93% when FAR (False Acceptance Rate) is 0.002%, and EER (Equal Error Rate) is low to 0.12%, which demonstrate the proposed approach is valid and effective for hand vein authentication.
Female Pelvic Vein Embolization: Indications, Techniques, and Outcomes.
Lopez, Anthony James
Until recently, the main indication for pelvic vein embolization (PVE) in women was to treat pelvic venous congestion syndrome (PVC) but increasingly, patients with refluxing pelvic veins associated with leg varicosities are also being treated. A more unusual reason for PVE is to treat pelvic venous malformations, although such lesions may be treated with sclerotherapy alone. Embolotherapy for treating PVC has been performed for many years with several published studies included in this review, whilst an emerging indication for PVE is to treat lower limb varicosities associated with pelvic vein reflux. Neither group, however, has been subjected to an adequate randomized, controlled trial. Consequently, some of the information presented in this review should be considered anecdotal (level III evidence) at this stage, and a satisfactory 'proof' of clinical efficacy remains deficient until higher-level evidence is presented. Furthermore, a wide range of techniques not accepted by all are used, and some standardization will be required based on future mandatory prospective studies. Large studies have also clearly shown an unacceptably high recurrence rate of leg varicose veins following venous surgery. Furthermore, minimally or non-invasive imaging is now revealing that there is a refluxing pelvic venous source in a significant percentage of women with de novo leg varicose veins, and many more with recurrent varicosities. Considering that just over half the world's population is female and a significant number of women not only have pelvic venous reflux, but also have associated leg varicosities, minimally invasive treatment of pelvic venous incompetence will become a common procedure. PMID:25804635
Occurrence and Partial Characterization of Lettuce big vein associated virus and Mirafiori lettuce big vein virus in Lettuce in Iran.
Alemzadeh, E; Izadpanah, K
Mirafiori lettuce big vein virus (MiLBVV) and lettuce big vein associated virus (LBVaV) were found in association with big vein disease of lettuce in Iran. Analysis of part of the coat protein (CP) gene of Iranian isolates of LBVaV showed 97.1-100Ā% nucleotide sequence identity with other LBVaV isolates. Iranian isolates of MiLBVV belonged to subgroup A and showed 88.6-98.8Ā% nucleotide sequence identity with other isolates of this virus when amplified by PCR primer pair MiLV VP. The occurrence of both viruses in lettuce crop was associated with the presence of resting spores and zoosporangia of the fungus Olpidium brassicae in lettuce roots under field and greenhouse conditions. Two months after sowing lettuce seed in soil collected from a lettuce field with big vein affected plants, all seedlings were positive for LBVaV and MiLBVV, indicating soil transmission of both viruses. PMID:24293824
Accelerated intimal hyperplasia in aortocoronary internal mammary vein grafts in minipigs
Popov, Aron Frederik; Dorge, Hilmar; Hinz, Jose; Schmitto, Jan Dieter; Stojanovic, Tomislav; Seipelt, Ralf; Didilis, Vassilios; Schoendube, Friedrich Albert
Background More than 50% of aortocoronary saphenous vein grafts are occluded 10 years after surgery. Intimal hyperplasia is the initial critical step in the progression toward occlusion. Internal mammary veins, which are physiologically prone to less hydrostatic pressure, may undergo an accelerated progression to intimal hyperplasia and thus be suitable for investigation of the mechanisms of aortocoronary vein graft disease. Methods Six minipigs underwent aortocoronary bypass grafting using standard cardiopulmonary bypass and cardioplegic arrest. Mammary vein were grafted in a reversed manner from ascending aorta to left anterior descending coronary artery (LAD). The proximal LAD was ligated, rendering the anterior left ventricle vein graft-dependent. Minipigs were killed after 4 weeks, and vein grafts were harvested. Histological and immunohistological investigation were performed with respect to morphometric analysis, endothelial damage/dysfunction (v-Willebrand-factor (vWF)), smooth muscle cells (?-smooth actin) and proliferation rate (proliferation marker Ki 67). Results Mean intimal area of vein grafts was increased compared to ungrafted mammary veins. Intimal hyperplasia in vein grafts was characterized by massive accumulation of smooth muscle cells with a high proliferation rate and endothelial perturbation. Significant (p = 0.001) intimal hyperplasia of the grafted mammary vein compared to the ungrafted mammary vein was found. These changes were absent in ungrafted mammary veins. Conclusion The present study demonstrates a pig model of aortocoronary vein graft intimal hyperplasia which is characterized by an accelerated progression within internal mammary veins. The model is suitable to investigate the pathophysiology of aortocoronary vein graft intimal hyperplasia as well as therapeutic approaches. PMID:18445288
Palliative Portal Vein Stent Placement in Malignant and Symptomatic Extrinsic Portal Vein Stenosis or Occlusion
Novellas, Sebastien [Hopital Archet, Department of Radiology and Interventional Radiology (France); Denys, Alban, E-mail: firstname.lastname@example.com; Bize, Pierre, E-mail: firstname.lastname@example.com [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)
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.
Outcome of Endovenous Laser Ablation of Varicose Veins
Rustempasic, Nedzad; Cvorak, Alemko; Agincic, Alija
ABSTRACT Introduction: In Bosnia and Herzegovina according to available data, treatment of incompetent superficial lower extremity varicose veins by endovenous laser ablation (EVLA) has been introduced two years ago and so far no paper has been published regarding results of EVLA treatment of patients from our country. We wanted to present our results with EVLA treatment. Aim of study: to evaluate and compare primary posttreatment outcomes of endovenous laser ablation (EVLA) with classical surgical method of varicose vein treatment. Patients and methods: The study was clinical and prospective. It was carried out at Clinic for vascular surgery in Sarajevo where fifty-eight (58) patients received surgical treatment for varicose veins and in Aesthetic Surgery Center ōNasa mala klinikaö in Sarajevo were sixty-one (61) patients with varicose veins were treated by endovenous laser ablation. Total 119 patients (limbs) with pathologic reflux only in great saphenous vein were evaluated between 1st of January 2013 and 31st of April 2014. Following primary outcome endpoints were evaluated smean day of return to normal everyday activities, patient subjective quantification of pain during first seven days after intervention, incidence of deep venous thrombosis (DVT), incidence of wound bleeding requiring surgical intervention, incidence of peri-saphenous vein hematoma and infection rate. Results: Mean of return to normal activities (expressed in days after intervention); EVLA vs. stripping (surgery) =1.21vs12.24, T test 13,619; p=0, 000, p<0,05. T test was used for comparing Mean value of visual pain analog scale for the first 7 days between groups, for all seven days pain was significantly higher in surgical group of patients as compared to EVLA group; p<0,05. Incidence of hematoma greater than 1% of total body surface area was significantly higher in patients receiving surgical treatment; Pearson Chi Square=23,830, p<0,05; odds ratio:10,453. Incidences of infection, deep venous thrombosis and posttreatment bleeding were not statistically different between analyzed groups; EVLA vs Surgery (Pearson Chi Square =3,237; p>0,05; Pearson Chi Square=2,139, p>0,05, Pearson Chi Square=2,139, p>0,05, respectively.) Conclusion: EVLA offers better patient recovery in terms of significantly lower post treatment pain, faster return to everyday activities and lower incidence of bruising (hematomas). PMID:25568583
Cranial dural arteriovenous shunts. Part 1. Anatomy and embryology of the bridging and emissary veins.
Baltsavias, Gerasimos; Parthasarathi, Venkatraman; Aydin, Emre; Al Schameri, Rahman A; Roth, Peter; Valavanis, Anton
We reviewed the anatomy and embryology of the bridging and emissary veins aiming to elucidate aspects related to the cranial dural arteriovenous fistulae. Data from relevant articles on the anatomy and embryology of the bridging and emissary veins were identified using one electronic database, supplemented by data from selected reference texts. Persisting fetal pial-arachnoidal veins correspond to the adult bridging veins. Relevant embryologic descriptions are based on the classic scheme of five divisions of the brain (telencephalon, diencephalon, mesencephalon, metencephalon, myelencephalon). Variation in their exact position and the number of bridging veins is the rule and certain locations, particularly that of the anterior cranial fossa and lower posterior cranial fossa are often neglected in prior descriptions. The distal segment of a bridging vein is part of the dural system and can be primarily involved in cranial dural arteriovenous lesions by constituting the actual site of the shunt. The veins in the lamina cribriformis exhibit a bridging-emissary vein pattern similar to the spinal configuration. The emissary veins connect the dural venous system with the extracranial venous system and are often involved in dural arteriovenous lesions. Cranial dural shunts may develop in three distinct areas of the cranial venous system: the dural sinuses and their interfaces with bridging veins and emissary veins. The exact site of the lesion may dictate the arterial feeders and original venous drainage pattern. PMID:25468011
Fetal umbilical vein transplantation for the repair of middle cerebral artery injury
Hou, Xuhui; Yuan, Yi; Yin, Jian; Yang, Songbai; Xie, Lili; Wang, Shiji
It is necessary to investigate the longitudinal tensile mechanical characteristics of the middle cerebral artery and the fetal umbilical vein prior to applying fetal umbilical vein transplantation for repair of injured middle cerebral artery. Fifteen fresh fetal umbilical vein specimens and 15 normal human fresh cadaver middle cerebral artery specimens were collected for longitudinal tensile testing at the speed of 0.5 mm/min and at normal human temperature. The results showed that under 16.0 kPa physiological stress, the strain value of fetal umbilical vein specimens was larger, while the maximal stress and elastic modulus values were less than those of middle cerebral artery specimens. Our findings indicate that fetal umbilical vein has good elastic properties and the stress-strain curve of the fetal umbilical vein is similar to that of the middle cerebral artery. Fetal umbilical vein transplantation can, therefore, potentially repair the injured middle cerebral artery. PMID:25206646
The clinical anatomy of the cephalic vein in the deltopectoral triangle.
Loukas, M; Myers, C S; Wartmann, Ch T; Tubbs, R S; Judge, T; Curry, B; Jordan, R
Identification and recognition of the cephalic vein in the deltopectoral triangle is of critical importance when considering emergency catheterization procedures. The aim of our study was to conduct a cadaveric study to access data regarding the topography and the distribution patterns of the cephalic vein as it relates to the deltopectoral triangle. One hundred formalin fixed cadavers were examined. The cephalic vein was found in 95% (190 right and left) specimens, while in the remaining 5% (10) the cephalic vein was absent. In 80% (152) of cases the cephalic vein was found emerging superficially in the lateral portion of the deltopectoral triangle. In 30% (52) of these 152 cases the cephalic vein received one tributary within the deltopectoral triangle, while in 70% (100) of the specimens it received two. In the remaining 20% (38) of cases the cephalic vein was located deep to the deltopectoral fascia and fat and did not emerge through the deltopectoral triangle but was identified medially to the coracobrachialis and inferior to the medial border of the deltoid. In addition, in 4 (0.2%) of the specimens the cephalic vein, after crossing the deltopectoral triangle, ascended anterior and superior to the clavicle to drain into the subclavian vein. In these specimens a collateral branch was observed to communicate between the cephalic and external jugular veins. In 65.2% (124) of the cases the cephalic vein traveled with the deltoid branch of the thoracoacromial trunk. The length of the cephalic vein within the deltopectoral triangle ranged from 3.5 cm to 8.2 cm with a mean of 4.8+/-0.7 cm. The morphometric analysis revealed a mean cephalic vein diameter of 0.8+/-0.1 cm with a range of 0.1 cm to 1.2 cm. The cephalic vein is relatively large and constant, usually allowing for easy cannulation. PMID:18335417
Inferior Vena Cava Anomaly: A Risk for Deep Vein Thrombosis
Sitwala, Puja S; Ladia, Vatsal M; Brahmbhatt, Parag B; Jain, Vinay; Bajaj, Kailash
Context: Inferior vena cava (IVC) anomalies have a 0.5% incidence rate and could be associated with other congenital abnormalities. In later stage of the disease, trophic ulcers with or without deep vein thrombosis (DVT) is consistent finding. Case Report: A 29-year-old male patient presented with recurrent lower extremity ulcers. Further workup revealed an absent infrahepatic inferior vena cava, prominently dilated azygos and hemiazygos veins with enlarged retroperitoneal collaterals without DVT. Conclusion: IVC anomaly should be suspected in a young patient presenting with unexplained venous thrombosis and recurrent ulcers of a lower extremity. IVC anomaly would inherently lead to blood flow stasis and endothelial injury. Thus per Virchow's triad, other risk factors for hypercoagulability such as physical inactivity, smoking tobacco, oral contraceptive pills should be avoided and when hereditary thrombophilias or other irreversible risk factors are present, lifelong anticoagulation should be considered. PMID:25535612
Cirrhosis of liver and portal vein thrombosis - a review article.
Debnath, C R; Debnath, M R; Alam, M M; Moshwan, M M; Alam, M J; Rana, M S; Biswas, D; Mahmuduzzaman, M; Tarafder, A J
Cirrhosis is characterized by diffuse hepatic fibrosis and nodule formation which can occur at any age with significant morbidity and is an important cause of premature death. Occlusive portal vein thrombosis (PVT) is common complication of chronic liver disease with prevalence ranging from 1% to 16% of population. The occurrence of portal vein thrombosis is influenced by local factors (cirrhosis with associated liver architectural changes and increased resistance effects), systemic factors (inherited and acquired abnormalities leading to hyper coagulability) and development of hepatocellular carcinoma. The majority of patients with cirrhosis PVT are diagnosed on radiographic studies although in some patients PVT may present with decompensated chronic liver disease but the natural history of PVT in patients with cirrhosis is largely unknown. However patients with cirrhosis and PVT have been shown to have inferior survival in comparison with patients without PVT. PMID:25178622
[Isolated cortical vein thrombosis: report of two cases].
Miranda V, Hķctor; Mellado T, Patricio; Sandoval R, Patricio; Huete L, Isidro
Isolated cortical vein thrombosis is an uncommon presentation of central venous thrombosis. We report two females, aged 29 and 40 years, with isolated cortical vein thrombosis. Both presented with a focal neurological deficit and focal seizures that became generalized. The diagnosis was made with magnetic resonance imaging. Both had a history of oral contraceptive use. Both had a rapid response to unfractionated heparin. One patient had an antiphospholipid syndrome as a possible etiology. The most common manifestations of this disease are a transient or recurrent neurological deficit, visual disturbances and focal or generalized seizures, usually without intracanial hypertension. Neuroimages show ischemic abnormalities that do not follow an arterial vascular territory, often with an early hemorrhagic component. There is a good clinical response to heparin. PMID:18180839
Branch Retinal Vein Occlusion: Pathogenesis, Visual Prognosis, and Treatment Modalities
Rehak, Jiri; Rehak, Matus
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. PMID:18293182
[Ophthalmologic diagnostic procedures and imaging of retinal vein occlusions].
Mirshahi, A; Lorenz, K; Kramann, C; Stoffelns, B; Hattenbach, L-O
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
Varicose Vein Trauma: A Risk for Pulmonary Embolism
Marak, Creticus P; Ponea, Anna M; Guddati, Achuta K
Pulmonary embolism (PE) is a deceptive condition which is often incorrectly diagnosed leading to high morbidity and mortality. We present a case where symptoms were localised to different areas of the body starting with post-traumatic pain over lower extremity varicosities that migrated sequentially over a month to the knee, hip, back, abdomen and chest finally presenting as syncope. Despite a low pre-test clinical probability, a very high index of suspicion led to a timely diagnosis of a massive bilateral PE that eventually caused a troponin leak. The aetiology is highly suspicious of a thrombus which originated in the veins of the leg due to trauma over varicose veins.The case described here exemplifies the importance of considering trauma to varicosities as a risk factor for embolism when the clinical picture is concerning but other signs and symptoms of PE are not apparent. PMID:25478387
Varicose vein trauma: a risk for pulmonary embolism.
Joy, Parijat S; Marak, Creticus P; Ponea, Anna M; Guddati, Achuta K
Pulmonary embolism (PE) is a deceptive condition which is often incorrectly diagnosed leading to high morbidity and mortality. We present a case where symptoms were localised to different areas of the body starting with post-traumatic pain over lower extremity varicosities that migrated sequentially over a month to the knee, hip, back, abdomen and chest finally presenting as syncope. Despite a low pre-test clinical probability, a very high index of suspicion led to a timely diagnosis of a massive bilateral PE that eventually caused a troponin leak. The aetiology is highly suspicious of a thrombus which originated in the veins of the leg due to trauma over varicose veins.The case described here exemplifies the importance of considering trauma to varicosities as a risk factor for embolism when the clinical picture is concerning but other signs and symptoms of PE are not apparent. PMID:25478387
Randomized clinical trial comparing endovenous laser ablation with surgery for the treatment of primary great saphenous varicose veins
R. J. Darwood; N. Theivacumar; D. Dellagrammaticas; A. I. D. Mavor; M. J. Gough
Background: Endovenous laser ablation (EVLA) is a minimally invasive technique for treating varicose veins due to truncal vein incompetence. This randomized trial compared EVLA with conventional surgery in patients with primary saphenofemoral and great saphenous vein (GSV) reflux. Methods: Consecutive consenting patients with symptomatic varicose veins were randomized to EVLA 1 (stepwise laser withdrawal), EVLA 2 (continuous laser withdrawal) or
Lipoma causing upper extremity deep vein thrombosis: A case report
Balavani Palamari; Jerome F. Breen; Waldemar E. Wysokinski
We report a case of lipoma in the right infraclavicular and axillary area compressing subclavian vein there by presenting\\u000a with upper extremity deep venous thrombosis (UEDVT) and persistent symptoms of venous congestion. Patient was also found to\\u000a be a heterozygous carrier of prothrombin 20210 gene mutation. Surgical excision of lipomatous tissue performed after 6Āmonths\\u000a of anticoagulation resulted in a complete
Postpartum Ovarian Vein and Inferior Vena Cava Thrombosis
Ada, Sibel; Ūelik, Sebahattin; Topta?, Tayfur
Postpartum ovarian vein thrombosis (POVT), which generally occurs 2¢15 days postpartum, is a rare complication. It can be confused with acute appendicitis, pelvic infection, ovarian torsion, tubo-ovarian abscess, and pyelonephritis. It is associated with morbidity and mortality. Here, we present a patient with postpartum OVT and IVC diagnosed by US and CT findings. She was treated successfully with no further need for any interventional procedures. PMID:25114685
Characterization of cassava vein mosaic virus: a distinct plant pararetrovirus
Lee A. Calvert; Manuel D. Ospina; Robert J. Shepherd
Cassava vein mosaic virus (CVMV) was found to be widespread throughout the north-eastern region of Brazil. The complete sequence of CVMV was de- termined, and the genome was 8158 bp in size. A cytosolic initiator methionine tRNA (tRNAn~t.0-binding site that probably acts as a primer for minus-strand synthesis was present. The genome contained five open reading frames that potentially encode
Potential Risk Factors for Varicose Veins with Superficial Venous Reflux
Uzun Kulao?lu, T³lin; Fen, Turgay; Kap?s?z, Hasan Fahri
The objective of the study is to evaluate a range of potential risk factors in the etiology of varicose veins with superficial venous reflux. Forty-nine patients attending a cardiovascular surgery clinic for the management of varicose disease between 2009 and 2010 were enrolled for the study. The age range of the patient group was 44,04 ▒ 15,05 years and female/male (F/M) ratio was 30/19. Twenty-six normal, healthy volunteers with the age of 40,94 ▒ 13,60 years and with the female/male ratio of 15/11 acted as control subjects. We investigated several parameters including body mass index, age, birth number > 1, standing for a long time (standing for 8 or more hours without taking a break), systemic diseases, family history, venous Doppler f?ndings, the levels of homocysteine, ferritin, vitamin B12, and hemoglobin, sedimentation rate, mean corpuscular volume, low density lipoprotein, and rheumatoid factor of the patient group and the control group. We also determined the contribution of the methylene tetrahydrofolate reductase 677 C>T and 1298 A>C gene polymorphisms and FV Leiden in both groups. In this small study, there appears to be no association between varicose veins and body mass index, smoking, type 2 DM, hypertension, family history, and birth number. A history of increased standing duration period (>8 hours) and rheumatoid factor positivity have association with varicose veins with superficial venous reflux. PMID:25302121
Splanchnic Vein Thrombosis in the Mediterranean Area in Children
El-Karaksy, Hanaa; El-Raziky, Mona
Abdominal venous thrombosis may present as splanchnic venous thrombosis (SVT) (occlusion of portal, splenic, superior or inferior mesenteric veins) or Budd- Chiari Syndrome (BCS) (thrombosis of inferior vena cava and/or hepatic veins). The aim of this review is to report the scanty data available for SVT in the South Mediterranean area. In one Egyptian study, the possible circumstantial risk factors for portal vein thrombosis (PVT) were found in 30% of cases: 19% neonatal sepsis, 8.7% umbilical catheterization, 6% severe gastroenteritis and dehydration. Another Egyptian study concluded that hereditary thrombophilia was common in children with PVT (62.5%), the commonest being factor V Leiden mutation (FVL) (30%). Concurrence of more than one hereditary thrombophilia was not uncommon (12.5%). The first international publication on hepatic veno-occlusive disease (VOD) in Egypt was in 1965 in children who rapidly develop abdominal distention with ascites and hepatomegaly. This disease was more frequent in malnourished children coming from rural areas; infusions given at home may contain noxious substances that were hepatotoxic and infections might play a role. VOD of childhood is rarely seen nowadays. Data from South Mediterranean area are deficient and this may be attributable to reporting in local medical journals that are difficult to access. Medical societies concerned with this topic could help distribute this information. PMID:21869913
Splanchnic vein thrombosis in the mediterranean area in children.
El-Karaksy, Hanaa; El-Raziky, Mona
Abdominal venous thrombosis may present as splanchnic venous thrombosis (SVT) (occlusion of portal, splenic, superior or inferior mesenteric veins) or Budd- Chiari Syndrome (BCS) (thrombosis of inferior vena cava and/or hepatic veins). The aim of this review is to report the scanty data available for SVT in the South Mediterranean area. In one Egyptian study, the possible circumstantial risk factors for portal vein thrombosis (PVT) were found in 30% of cases: 19% neonatal sepsis, 8.7% umbilical catheterization, 6% severe gastroenteritis and dehydration. Another Egyptian study concluded that hereditary thrombophilia was common in children with PVT (62.5%), the commonest being factor V Leiden mutation (FVL) (30%). Concurrence of more than one hereditary thrombophilia was not uncommon (12.5%). The first international publication on hepatic veno-occlusive disease (VOD) in Egypt was in 1965 in children who rapidly develop abdominal distention with ascites and hepatomegaly. This disease was more frequent in malnourished children coming from rural areas; infusions given at home may contain noxious substances that were hepatotoxic and infections might play a role. VOD of childhood is rarely seen nowadays. Data from South Mediterranean area are deficient and this may be attributable to reporting in local medical journals that are difficult to access. Medical societies concerned with this topic could help distribute this information. PMID:21869913
Blood vessel classification into arteries and veins in retinal images
NASA Astrophysics Data System (ADS)
Kondermann, Claudia; Kondermann, Daniel; Yan, Michelle
The prevalence of diabetes is expected to increase dramatically in coming years; already today it accounts for a major proportion of the health care budget in many countries. Diabetic Retinopathy (DR), a micro vascular complication very often seen in diabetes patients, is the most common cause of visual loss in working age population of developed countries today. Since the possibility of slowing or even stopping the progress of this disease depends on the early detection of DR, an automatic analysis of fundus images would be of great help to the ophthalmologist due to the small size of the symptoms and the large number of patients. An important symptom for DR are abnormally wide veins leading to an unusually low ratio of the average diameter of arteries to veins (AVR). There are also other diseases like high blood pressure or diseases of the pancreas with one symptom being an abnormal AVR value. To determine it, a classification of vessels as arteries or veins is indispensable. As to our knowledge despite the importance there have only been two approaches to vessel classification yet. Therefore we propose an improved method. We compare two feature extraction methods and two classification methods based on support vector machines and neural networks. Given a hand-segmentation of vessels our approach achieves 95.32% correctly classified vessel pixels. This value decreases by 10% on average, if the result of a segmentation algorithm is used as basis for the classification.
Varicose Veins Possess Greater Quantities of MMP-1 Than Normal Veins and Demonstrate Regional Variation in MMP-1 and MMP-13
D. L. Gillespie; A. Patel; B. Fileta; A. Chang; S. Barnes; A. Flagg; M. Kidwell; J. L. Villavicencio; N. M. Rich
Background. Studies have reported that structural proteins such as elastin and collagen are decreased in varicose veins compared to normal controls. We hypothesized that the changes observed in varicose vein wall composition may be related to alterations in extracellular matrix remodeling proteins, such as the matrix metalloproteases and serine proteases. In addition we hypothesized that there may be regional variation
Bioaccumulation of ergovaline in bovine lateral saphenous veins in vitro.
Klotz, J L; Kirch, B H; Aiken, G E; Bush, L P; Strickland, J R
Ergot alkaloids have been associated with vasoconstriction in grazing livestock affected by the fescue toxicosis syndrome. Previous in vitro investigations studying how ergot alkaloids caused vasoconstriction have shown that ergovaline has a distinct receptor affinity and sustained contractile response. A similar contractile response has not been noted for lysergic acid. The objectives of this study were to determine if repetitive in vitro exposure of bovine lateral saphenous vein to lysergic acid or ergovaline would result in an increasing contractile response and if a measurable bioaccumulation of the alkaloids in the vascular tissue occurs over time. Segments of vein were surgically biopsied from healthy, Angus x Brangus cross-bred, fescue-na've yearling heifers (n = 16) or collected from healthy mixed breed and sex cattle immediately after slaughter (n = 12) at a local abattoir. Veins were trimmed of excess fat and connective tissue, sliced into cross-sections, and suspended in a myograph chamber containing 5 mL of oxygenated Krebs-Henseleit buffer (95% O(2)/5% CO(2); pH = 7.4; 37 degrees C). Contractile responses to repetitive additions of ergovaline (1 x 10(-9) and 1 x 10(-7) M) and lysergic acid (1 x 10(-5) and 1 x 10(-4) M) were evaluated using the biopsied veins. For the bioaccumulation experiments, veins collected at the abattoir underwent repetitive additions of 1 x 10(-7) M ergovaline and 1 x 10(-5) M lysergic acid and the segments were removed after every 2 additions and media rinses for alkaloid quantification via HPLC/mass spectrometry. Contractile data were normalized as a percentage of contractile response induced by a reference dose of norepinephrine (1 x 10(-4) M). Repetitive additions of 1 x 10(-9) M ergovaline and 1 x 10(-5) and 1 x 10(-4) M lysergic acid resulted in contractile response with a negative slope (P < 0.02). In contrast, repetitive addition of 1 x 10(-7) M ergovaline resulted in a contractile response that increased with each addition (P < 0.01). Lysergic acid and ergovaline were detected at all 4 exposure levels (2x to 8x), but only the 1 x 10(-7) M ergovaline treatment resulted in increased tissue content as the number of exposures increased (P < 0.05). These data indicate that ergovaline, but not lysergic acid, bioaccumulates with repetitive exposure in vitro. These results suggest that ergovaline may have a greater potential for inducing toxicosis in grazing animals than lysergic acid because of its potential to bioaccumulate at the cellular site of action. PMID:19286813
Computer-assisted diagnostic tool to quantify the pulmonary veins in sickle cell associated pulmonary hypertension
NASA Astrophysics Data System (ADS)
Jajamovich, Guido H.; Pamulapati, Vivek; Alam, Shoaib; Mehari, Alem; Kato, Gregory J.; Wood, Bradford J.; Linguraru, Marius George
Pulmonary hypertension is a common cause of death among patients with sickle cell disease. This study investigates the use of pulmonary vein analysis to assist the diagnosis of pulmonary hypertension non-invasively with CT-Angiography images. The characterization of the pulmonary veins from CT presents two main challenges. Firstly, the number of pulmonary veins is unknown a priori and secondly, the contrast material is degraded when reaching the pulmonary veins, making the edges of these vessels to appear faint. Each image is first denoised and a fast marching approach is used to segment the left atrium and pulmonary veins. Afterward, a geodesic active contour is employed to isolate the left atrium. A thinning technique is then used to extract the skeleton of the atrium and the veins. The locations of the pulmonary veins ostia are determined by the intersection of the skeleton and the contour of the atrium. The diameters of the pulmonary veins are measured in each vein at fixed distances from the corresponding ostium, and for each distance, the sum of the diameters of all the veins is computed. These indicators are shown to be significantly larger in sickle-cell patients with pulmonary hypertension as compared to controls (p-values < 0.01).
Targeted endovenous treatment of Giacomini vein insufficiency-associated varicose disease: considering the reflux patterns
Atasoy, Mehmet Mahir; G³m³?, Burńak; Caymaz, ?smail; O?uzkurt, Levent
PURPOSE We aimed to assess the technical feasibility of targeted endovenous treatment of Giacomini vein insufficiency (GVI)-associated varicose disease and report our early results. METHODS We retrospectively screened 335 patients with varicose disease who underwent endovenous laser ablation from September 2011 to January 2013, and determined 17 patients who underwent Giacomini vein ablation. Using a targeted endovenous treatment approach considering the reflux pattern, all healthy great saphenous veins (GSV) or vein segments were preserved while all insufficient veins (Giacomini vein, perforator veins, small saphenous vein, anterior accessory GSV, major tributary veins, or incompetent segments of the GSV) were ablated. Treatment success was analysed using Doppler findings and clinical assessment scores before and after treatment. RESULTS Targeted endovenous treatment was technically successful in all cases. Seven GSVs were preserved totally and three GSVs were preserved partially (10/17, 58%), with no major complications. Clinical assessment scores and Doppler findings were improved in all cases. CONCLUSION Targeted endovenous treatment of GVI-associated varicose disease is safe and effective. In majority of GVI cases saphenous vein can be preserved using this approach. PMID:25205026
Portalsystemic hemodynamic changes in chronic severe hepatitis B: An ultrasonographic study
Zhong-Zhen Su; Hong Shan; Wei-Min Ke; Bing-Jun He; Rong-Qin Zheng
AIM: To evaluate portalsystemic hemodynamic changes in chronic severe hepatitis B. METHODS: Hemodynamic parameters included portal vein diameter (PVD), portal vein peak velocity (PVPV), portal vein volume (PVV), spleen length (SPL), spleen vein diameter (SPVD), spleen vein volume (SPVV) and umbilical vein recanalization. They were measured by Color Doppler ultrasonography in 36 patients with chronic severe hepatitis B, compared with
[Portal vein thrombosis with sepsis caused by inflammation at colonic stent insertion site].
Choi, Su Jin; Min, Ji Won; Yun, Jong Min; Ahn, Hye Shin; Han, Deok Jae; Lee, Hyeon Jeong; Kim, Young Ok
Portal vein thrombosis is an uncommon but an important cause of portal hypertension. The most common etiological factors of portal vein thrombosis are liver cirrhosis and malignancy. Albeit rare, portal vein thrombosis can also occur in the presence of local infection and inflammation such as pancreatitis or cholecystitis. A 52-year-old male was admitted because of general weakness and poor oral intake. He had an operation for colon cancer 18 months ago. However, colonic stent had to be inserted afterwards because stricture developed at anastomosis site. Computed tomography taken at admission revealed portal vein thrombosis and inflammation at colonic stent insertion site. Blood culture was positive for Escherichia coli. After antibiotic therapy, portal vein thrombosis resolved. Herein, we report a case of portal vein thrombosis with sepsis caused by inflammation at colonic stent insertion site which was successfully treated with antibiotics. PMID:25998979
Fluid immiscibility in late-Alpine gold-bearing veins, Eastern and Northwestern European Alps
D. Craw; D. A. H. Teagle; R. Belocky
Gold-bearing quartz veins fill late-Alpine brittle structures in Pennine nappes of Austria (in the Tauern window) and in northern Italy. The veins formed in the latter stages of uplift of the Alps. Fluid inclusions in veins sampled from B÷ckstein, Austria, and Valle Anzasca, Italy have a wide variety of compositions, ranging from aqueous brine (about 5 wt% NaCl equiv.) to
Mineralogical and fluid inclusion studies of low-sulfidation epithermal veins at Osilo (Sardinia), Italy
R. Simeone; S. F. Simmons
Several precious metal-bearing, low sulfidation epithermal veins occur in the rolling topography of the Osilo area, northern\\u000a Sardinia. The Sa Pala de Sa Fae and the Sa Pedra Bianca veins were subject to intense diamond drilling exploration in the\\u000a mid 1990?s. The veins extend for 1¢3 km, dip steeply, and range from 1 to 10?m in width. High K-calc-alkaline volcanic
Sclerotherapy for varicose veins of the lower legs in patients with dysplasminogenemia
Masataka Ikeda; Tomio Kawasaki; Jun-ichi Kambayashi; Shin-ichi Iwamoto; Nobutoshi Shinoki; Takashi Nakamura; Takashi Shibuya; Morito Monden
Sclerotherapy combined with ligation has become a widely accepted treatment for varicose veins; however, it is associated\\u000a with some risk of the serous complications of deep vein thrombosis (DVT). We investigated the incidence of thrombophilia in\\u000a 164 consecutive patients undergoing treatment for varicose veins and determined the activities of antithrombin-III, protein\\u000a C, and plasminogen. Of the 164 patients, 10 were
Percutaneous Management of a Long Saphenous Vein Graft Aneurysm: A Case Report and Review of Literature
Panetta, Carmelo J.; Schneider, Williaim; Boller, Max A.
Aneurysms of saphenous vein grafts are rare but can result in complications such as myocardial infarction or death. Percutaneous treatment has included a variety of approaches, including covered stents. Long aneurysms in saphenous vein grafts pose an additional challenge due to the lack of coronary covered stents with sufficient length. We present successful treatment of a long saphenous vein graft aneurysm with use of peripheral covered stents over two coronary guidewires, a 55-centimeter 8-French sheath and no guide catheter. PMID:19946630
Effect of Hydroxyethylrutosides on Blood Oxygen Levels and Venous Insufficiency Symptoms in Varicose Veins
McEwan, Andrew J.; McArdle, Colin S.
Oxygen levels (tension, saturation, and content) in blood from varicose leg veins were found to be significantly lower than those in blood from normal leg veins at the same site on the limb under the same laboratory conditions. Treatment with hydroxyethylrutosides significantly increased the oxygen levels in blood from varicose veins, and this was associated with an improvement in leg symptoms attributable to venous insufficiency. Hydroxyethylrutosides have been shown to have a beneficial effect on capillary dysfunction in venous stasis. PMID:5581491
The Role of Surgical Therapy for Pulmonary Vein Atresia in Childhood
J. Shuhaiber; M. Rehman; K. Jenkins; F. Fynn-Thompson; E. Bacha
The outcome for children with pulmonary vein atresia has been historically poor. This report describes clinical outcomes after\\u000a surgical treatment of primary and secondary pulmonary vein atresia. All patients undergoing surgery for pulmonary vein atresia\\u000a at ChildrenÆs Hospital Boston from 1 January 2005 to 1 January 2009 were identified. The data available for analysis included\\u000a demographic characteristics, findings based on
Rule-based model of vein graft remodeling.
Hwang, Minki; Garbey, Marc; Berceli, Scott A; Wu, Rongling; Jiang, Zhihua; Tran-Son-Tay, Roger
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
External Jugular Vein Aneurysm with Thrombus Presenting as Painful Neck Mass: A Case Report
Verma, Roshan Kumar; Kaushal, Darwin; Panda, Naresh K.
External jugular vein aneurysm with thrombosis presenting as neck swelling is a rare clinical entity and rarely encountered in routine clinical practice. We present a case of a 45-year-old female with external jugular vein aneurysm presenting as a painful lump in the neck. Ultrasound of the neck and CT angiography showed saccular dilation of the lower end of the external jugular vein with thrombosis within the aneurysm. Saccular aneurysm of the external jugular vein is very uncommon and can lead to thrombotic complications with serious consequence. PMID:23904923
Approach to the confluence of the subclavian and internal jugular veins without claviculectomy.
Molina, J E
A new technique is described to approach the confluence of the subclavian vein and the internal jugular, as well as to expose the innominate vein from its origin to the superior vena cava. The operation accomplishes decompression of the subclavian vein and allows direct approach of the subclavian and the innominate veins. It avoids dividing the clavicle or disarticulating the sternal-clavicular joint. It also has the advantage of accomplishing the procedure without entering the pleural cavity. Its reconstruction is explained in detail and achieves solid stability of the sternum and of the shoulder girdle. This approach also prevents deformity that other operations proposed in the past may cause. PMID:10743884
[Minimally invasive saphenous vein harvesting for coronary artery bypass grafting. Use of Vega system].
Simek, M; Nemec, P
The authors present their first experience with minimally invasive saphenous vein harvesting for coronary artery bypass grafting (CABG). From February 2004 to June 2004 33 patients undergoing CABG were scheduled for minimally vein harvest with the use of Vega system (B/Braun-Aesculap, Tuttlingen, Germany). We evaluated wound and neurological complications associated with the vein harvest at the time of discharge and at the 3-month follow-up. The limited experience suggests that minimally invasive vein harvesting offers improved patient outcome in term of wound healing. PMID:16045115
[Puerperal thrombophlebitis of the ovarian vein revealed by renal colic].
Sappey, O; Mollier, S; Skowron, O; Equy, V; Ranchoup, Y; Descotes, J L; Boillot, B; Rambeaud, J J
The authors report the clinical case of a young woman with thrombophlebitis of the right ovarian vein following delivery by caesarean section, initially presenting in the form of renal colic. In the light of a review of the literature, they recall the pathophysiological mechanisms of ovarian thrombophlebitis and the various features observed on imaging examinations. The most frequent clinical features are also described. The authors emphasize the potential, but rare severity of this disease, characterized by the risk of pulmonary embolism, and its treatment, which is usually medical. PMID:10370958
A hand vein recognition system based on DSP and CPLD
NASA Astrophysics Data System (ADS)
Kang, Wen-Xiong; Chen, Zi-Yi; Yang, Qing-Qiang
The hand vein recognition system based on digital signal processing (DSP) and complex programmable logic device (CPLD) is designed according to the requirements for equipment volume, accuracy and reaction speed. The overall structure and detailed implementation of the system hardware architecture are discussed in this paper. Moreover, the design philosophy and specific realization of system software as well as core algorithms are explored. The recognition system owns many good characteristics, such as high-degree integration, simple structure, flexible programming, convenient application and so on, which make it suitable for circumstances with high requirements for personal identification.
[Treatment of deep vein thrombosis in the leg and pelvis].
Hach-Wunderle, Viola
The most important step for the treatment of deep vein thrombosis in the leg and pelvis is the immediate and sufficient anticoagulation by subcutaneous application of low-molecular-weight heparins or fondaparinux. Prevention of a relapse can be achieved by subsequent oral anticoagulation with vitamin K antagonists, whereas treatment duration is based on localisation of the thrombus and underlying risk factors. Immediate mobilisation of the patient is a fundamental step. Treatment with a compression bandage and subsequent use of compression stockings is a further effective step in reducing pain and swelling, preventing pulmonary embolism and a postthrombotic syndrome (PTS). PMID:19205133
Novel Balloon Catheter Technologies for Pulmonary Vein\\/Antrum Isolation
Hiroshi Nakagawa; Katsuaki Yokoyama; Hiroshi Aoyama; Sara Foresti; Jan V. Pitha; Ralph Lazzara; Andrea Natale; Warren M. Jackman
\\u000a We describe novel balloon catheter technologies for pulmonary vein (PV)\\/antrum isolation using three different energy sources\\u000a (high-intensity focused ultrasound, laser energy and cryothermia). 1) A High-intensity focused ultrasound (HIFU) balloon catheter\\u000a is designed to focus HIFU energy circumferentially outside the PV (PV antrum). The catheter has two non-compliant balloons\\u000a and a 9MHz ultrasound crystal is located with the distal bal
Lķiomyosarcome de la veine cave infķrieure: un cas clinique
Hammoune, Nabil; El Guendouz, Faycal; Elhaddad, Siham; Latib, Rachida; Chami, Imane; Boujida, Najib; Hommadi, Abdelaziz
Le lķiomyosarcome de la veine cave infķrieure est une tumeur maligne rare dķveloppķe aux dķpens des cellules musculaires lisses de la paroi vasculaire. L'imagerie radiologique par tomodensitomķtrie ou rķsonance magnķtique nuclķaire est un ķlķment important au diagnostic et au bilan d'extension tumorale. Le traitement est chirurgical. Nous illustrons l'apport de l'imagerie Ó travers un cas de lķiomyosarcome rķvķlķ par des ķpigastralgies paroxystiques, dont le diagnostique ķtait orientķ par la TDM, et confirmķ par lÆķtude histologique. LÆķvolution ķtait favorable. AprĶs 2 ans de recul, la patiente ķtait indemne de toute rķcidive tumorale.
Vein and stratabound gold deposits of northern Zaire
NASA Astrophysics Data System (ADS)
Lavreau, J.
Seventy years of gold mining in the North Zaire region resulted in a total output of ca. 350 t of metal, half of this amount coming from recent placer deposits. All deposits are linked to volcano-sedimentary series and associated granitoid bodies constituting the granite-green-stone terrane of northern Zaire. The actual metallotects are tectonic shear structures cutting across various rock types and giving rise either to quartz veins or to quartz-free tabular deposits, thereby obscuring the original stratabound (or rock-type bound) character of the subeconomic mineralization. Both the Archaean magmatic activity and the late Precambrian tectonics have played a role in gold concentration.
Alteration and vein mineralization, Schwartzwalder uranium deposit, Front Range, Colorado
Wallace, Alan R.
The Schwartzwalder uranium deposit, in the Front Range west of Denver, Colorado, is the largest vein-type uranium deposit in the United States. The deposit is situated in a steeply dipping fault system that cuts Proterozoic metamorphic rocks. The host rocks represent a submarine volcanic system with associated chert and iron- and sulfide-rich pelitic rocks. Where faulted, the more competent garnetiferous and quartzitic units behaved brittlely and created a deep, narrow conduit. The ores formed 70-72 m.y. ago beneath 3 km of Phanerozoic sedimentary rocks. Mineralization included two episodes of alteration and three stages of vein-mineralization. Early carbonate-sericite alteration pseudomorphically replaced mafic minerals, whereas the ensuing hematite-adularia episode replaced only the earlier alteration assemblage. Early vein mineralization produced a minor sulfide-adularia-carbonate assemblage. Later vein mineralization generated the uranium ores in two successive stages. Carbonates, sulfides, and adularia filled the remaining voids. Clastic dikes composed of fault gouge and, locally, ore were injected into new and existing fractures. Geologic and chemical evidence suggest that virtually all components of the deposit were derived from major hornblende gneiss units and related rocks. The initial fluids were evolved connate/metamorphic water that infiltrated and resided along the extensive fault zones. Complex fault movements in the frontal zone of the eastern Front Range caused the fluids to migrate to the most permeable segments of the fault zones. Heat was supplied by increased crustal heat flow related to igneous activity in the nearby Colorado mineral belt. Temperatures decreased from 225?C to 125?C during later mineralization, and the pressure episodically dropped from 1000 bars. The CO2 fugacity was initially near 100 bars, and uranium was carried as a dicarbonate complex. Sudden decreases in confining pressure during fault movement caused evolution of CO2 and a consequent increase in pH. Uranium was released with destruction of the uranyl complexes; it was subsequently reduced by aqueous sulfur species, thereby leading to the precipitation of pitchblende.
Association of a distinct strain of hollyhock yellow vein mosaic virus and Ludwigia leaf distortion betasatellite with yellow vein mosaic disease of hollyhock (Alcea rosea) in India.
Srivastava, A; Kumar, S; Raj, S K; Pande, S S
A distinct strain of hollyhock yellow vein mosaic virus (HoYVMV) and Ludwigia leaf distortion betasatellite (LuLDB) were associated with yellow vein mosaic of hollyhock. The viral DNA genome (JQ911766) and betasatellite (JQ408216) shared highest nucleotide sequence identity (89.2 %) with HoYVMV (the only available sequence in GenBank) and 92 % identity with LuLDB. Agroinfiltration of HoYVMV and LuLDB induced yellow vein mosaic symptoms on hollyhock, thereby demonstrating causality of the disease. PMID:24810100
Peripheral nerve regeneration with conduits: use of vein tubes
Sabongi, Rodrigo Guerra; Fernandes, Marcela; dos Santos, JoŃo Baptista Gomes
Treatment of peripheral nerve injuries remains a challenge to modern medicine due to the complexity of the neurobiological nerve regenerating process. There is a greater challenge when the transected nerve ends are not amenable to primary end-to-end tensionless neurorraphy. When facing a segmental nerve defect, great effort has been made to develop an alternative to the autologous nerve graft in order to circumvent morbidity at donor site, such as neuroma formation, scarring and permanent loss of function. Tubolization techniques have been developed to bridge nerve gaps and have been extensively studied in numerous experimental and clinical trials. The use of a conduit intends to act as a vehicle for moderation and modulation of the cellular and molecular ambience for nerve regeneration. Among several conduits, vein tubes were validated for clinical application with improving outcomes over the years. This article aims to address the investigation and treatment of segmental nerve injury and draw the current panorama on the use of vein tubes as an autogenous nerve conduit. PMID:26170802
Kyste hydatique du foie rompu dans la veine cave infķrieure
Laalim, Said Ait; Ibn Majdoub Hassani, Karim; Toughai, Imane; Oussaden, Abdelmalek; Kamaoui, Imane; Mazaz, Khalid; Taleb, Khalid Ait
La rupture du kyste hydatique dans la veine cave infķrieure est une complication rare et grave des kystes hydatiques hķpatique. La manifestation la plus frķquente est l'embolie pulmonaire. L'hķmorragie aigue intra-kystique survienne surtout en per-opķratoire et elle est dÆķvolution dramatique. Le diagnostic est basķ sur le scanner. Le traitement est chirurgical. Nous rapportons un cas clinique rare chez un patient de 38 ans, opķrķ en urgence pour un sepsis sur un kyste hydatique du foie comprimant la veine cave infķrieur (VCI) avec thrombose partielle de cette derniĶre. AprĶs ķvacuation du kyste, une fistulisation spontanķ per opķratoire s'est produite dans la VCI ayant causķ le dķcĶs du patient. La rupture du kyste hydatique du foie dans la VCI doit toujours Ļtre redoutķe devant un kyste hydatique des segments postķrieurs du foie droit (VII et VIII), comprimant la VCI avec prķsence en son sein d'une thrombose ou des vķsicules filles. Le traitement chirurgical doit Ļtre rķalisķ avec prudence et toujours sous contr¶le vasculaire. PMID:22355421
Refinement of blood sampling from the sublingual vein of rats.
Zeller, W; Weber, H; Panoussis, B; B³rge, T; Bergmann, R
A refined method of repeated blood sampling is described: the tongue of the anaesthetized rat is pulled forward with the fingers and the sublingual vein is punctured with a 23 gauge hypodermic needle. Based on the requirement of a pharmacokinetic study, 0.5 or 1 ml of blood was collected 7 times at 0, 0.5, 1, 2, 4, 8 and 24 h. The degree of suffering was judged by determining the body weight and food and water consumption. All animals showed an increase in body weight already after 24 h and, therefore, the method of collecting blood from the sublingual vein can be recommended for repeated blood sampling. The haematological evaluation of groups of animals with differing body weight showed that sample volumes of up to 15% of the total blood volume lead to haematocrit values of approximately 40%. A remarkable initial drop in white blood cell counts followed by a marked rise 2 h after first sampling to values partly above the pre-test could not be directly related to the extracted blood volume. PMID:9807750
Partial portal vein arterialization in acute liver failure.
Cavallari, Giuseppe; Bonaiuto, Elisabetta; Tsivian, Matvey; Vaccarisi, Sebastiano; Nardo, Bruno
Experimental studies have shown that increasing the oxygen supply to the liver through partial portal vein arterialization (PPVA) enhances liver regeneration after extensive liver resection or drug intoxication. In the last two decades, several PPVA procedures were performed in humans with the aim to prevent or treat acute liver failure (ALF) following major hepatobiliary surgery or other etiology. The aim of this review was to analyze literature data on PPVA and report our experimental and clinical experience of this procedure. In this setting, we report our positive experience in the realization and clinical application of an extracorporeal device able to increase the oxygenated blood delivered to the liver through the umbilical vein and to support liver function in a man subjected to an extended liver resection. PPVA procedure has shown promising results in the treatment of ALF following major hepatobiliary surgery or from other etiology. Moreover, less invasive approaches to PPVA demonstrated to be safe and efficacy. It is clear that further investigations must be done to fully understand the potentiality of PPVA as a strategy to treat ALF. PMID:24101216
Venotonic activity of escin on the human saphenous vein.
Annoni, F; Mauri, A; Marincola, F; Resele, L F
The venotonic effects of escin on the human saphenous vein have been evaluated in vitro on histologically normal venous segments obtained during surgical saphenectomy procedures. It is necessary to use the human preparations because of the great variability in the responses of the veins of different species. By using a standard stimulus and fitting the experimental data to the logistic function, we were able to compare the activity of escin with those of the commonly used venotonic agents. Stimulation with escin always induced an increase in venous tone which was constant for a given dose and stable for some time, and maintained for as long as an hour after removal of the substance from the bath. The maximum contraction obtained with escin was similar to those obtained with serotonin and dihydroergotamine, significantly greater than that obtained with acetylcholine or vasopressin. However, the affinity of escin was found to be lower than those of the other substances studied. An increase in venous tone, and therefore a decrease in the volume of the venous district, would be considered a very favorable result to be obtained with a drug which, like escin, is indicated for treatment of venous diseases leading to irreversible dilation. PMID:582766
Arteries are formed by vein-derived endothelial tip cells
Xu, Cong; Hasan, Sana S.; Schmidt, Inga; Rocha, Susana F.; Pitulescu, Mara E.; Bussmann, Jeroen; Meyen, Dana; Raz, Erez; Adams, Ralf H.; Siekmann, Arndt F.
Tissue vascularization entails the formation of a blood vessel plexus, which remodels into arteries and veins. Here we show, by using time-lapse imaging of zebrafish fin regeneration and genetic lineage tracing of endothelial cells in the mouse retina, that vein-derived endothelial tip cells contribute to emerging arteries. Our movies uncover that arterial-fated tip cells change migration direction and migrate backwards within the expanding vascular plexus. This behaviour critically depends on chemokine receptor cxcr4a function. We show that the relevant Cxcr4a ligand Cxcl12a selectively accumulates in newly forming bone tissue even when ubiquitously overexpressed, pointing towards a tissue-intrinsic mode of chemokine gradient formation. Furthermore, we find that cxcr4a mutant cells can contribute to developing arteries when in association with wild-type cells, suggesting collective migration of endothelial cells. Together, our findings reveal specific cell migratory behaviours in the developing blood vessel plexus and uncover a conserved mode of artery formation. PMID:25502622
Uranium-series age determination of calcite veins, VC-1 drill core, Valles Caldera, New Mexico
NASA Astrophysics Data System (ADS)
Sturchio, Neil C.; Binz, Carl M.
Uranium-series analysis (238U-234U-230Th) of 13 calcite veins from the hydrothermally altered Madera Limestone in the VC-1 drill core was performed to determine the ages of the veins and their relation to the Valles hydrothermal system. Thermal water from VC-1 and two hot springs in San Diego Canyon was analyzed for U and (234U/238U) to help evaluate the constancy of initial (234U/238U). The (230Th/234U) age of one of the veins is ś95 kyr, and those of two other veins are ś230 and ś250 kyr. Five of the veins have near equilibrium (230Th/234U) and are probably older than ś0.3 m.y. Uranium concentrations in the remaining veins are too low for analysis by the ?-spectrometry techniques employed in this study. Of the five veins near (230Th/234U) equilibrium, four are also near (234U/238U) equilibrium, suggesting ages greater than ś1.0 m.y., but one has (234U/238U) = 1.15, suggesting an age between ś0.3 and ś1.0 m.y. Calculated initial (234U/238U) of the veins yielding relatively young ages are neither equal to each other nor to (234U/238U) in thermal water from VC-1, indicating inconstancy of initial (234U/238U) that may be related to variations in groundwater mixing proportions. Three of the four veins that yield relatively young ages consist of coarse, sparry, vuggy calcite, suggesting that this may be the type of calcite vein which forms under conditions resembling those encountered presently in VC-1. The analytical data are consistent with closed-system behavior of U and Th in the VC-1 calcite veins.
Hepatic Vein Segmentation in CT Images using Fast Marching Method Driven by Gaussian Mixture Models
Leow, Wee Kheng
Hepatic Vein Segmentation in CT Images using Fast Marching Method Driven by Gaussian Mixture Models SONG ZHIYUAN (B.Sc., ZHEJIANG UNIVERSITY, 2003) A THESIS SUBMITTED FOR THE DEGREE OF MASTER OF SCIENCE . . . . . . . . . . . . . . . . . 36 4.2 Hepatic Vein Segmentation Algorithm . . . . . . . . . . . . . . 38 4.2.1 Noise Removal
Using the Boazul Cuff to Reduce Blood Loss in Varicose Vein Surgery
J Robinson; J Macierewicz; JD Beard
Objective: this study was designed to assess if the use of a sterile exsanguination tourniquet (Boazul cuff) reduced blood loss from the groin and avulsion wounds during varicose vein surgery, (saphenofemoral disconnection, stripping to knee and multiple avulsions). Design: prospective, parallel cohort study. Materials: thirty-eight patients undergoing primary varicose vein surgery. Methods: the blood loss and number of avulsion wounds
Unattended fatal haemorrhage due to spontaneous peripheral varicose vein ruptureŚTwo case reports
E. Doberentz; L. Hagemeier; C. Veit; B. Madea
Venous haemorrhage is a rare complication of varicose veins of the legs. Varicosis is found in 15¢50% of the population. Haemorrhage from ruptured varicose veins of the legs can occur spontaneously or after a minor trauma. More frequent complications of varicosis include peripheral oedema of the ankles, skin pigmentation and skin ulcers. In case of venous haemorrhage simple possibilities of
Ultrasound-guided foam sclerotherapy for the treatment of varicose veins
S. G. Darke; S. J. A. Baker
Background: The aim was to assess the early efficacy and complications of ultrasound-guided foam sclerotherapy (UGFS) in a cohort of patients with varicose veins. Methods: Of 192 consecutive patients referred with varicose veins over 15 months, only 11 chose surgery; the rest underwent UGFS treatment. Polidocanol was foamed 1:3 with air. Under ultrasound control via butterfly or Seldinger cannulation, 1
Surgical management of major varicose veins of the lower limb using a pneumatic tourniquet
Roland Streichenberger; Hanna Barjoud; Maciej Konieczny; Walid Elias
A technique to facilitate ablation of varicose veins is described. We have tested this technique in 25 patients. A pneumatic tourniquet is place on the lower limb during operation for a maximum of 90 minutes. This technique allows the operative field to remain dry and clean, and the resulting bloodless field makes the operation easier and faster. Because the veins
Viscoelastic evaluation of fetal umbilical vein for reconstruction of middle cerebral artery.
Li, Dongyuan; Xu, Donghui; Li, Peng; Wei, Jun; Yang, Kun; Zhao, Conghai
The transplantation of artificial blood vessels with < 6 mm inner diameter as substitutes for human arterioles or veins has not achieved satisfactory results. Umbilical vein has been substituted for ar-tery in vascular transplantation, but it remains unclear whether the stress relaxation and creep tween these vessels are consistent. In this study, we used the fetal umbilical vein and middle cere-bral artery from adult male cadavers to make specimens 15 mm in length, 0.196-0.268 mm in nica media thickness, and 2.82-2.96 mm in outer diameter. The results demonstrated that the stress decrease at 7 200 seconds was similar between the middle cerebral artery and fetal umbilical vein specimens, regardless of initial stress of 18.7 kPa or 22.5 kPa. However, the strain increase at 7 200 seconds of fetal umbilical veins was larger than that of middle cerebral arteries. Moreover, the stress relaxation experiment showed that the stress decrease at 7 200 seconds of the fetal umbilical vein and middle cerebral artery specimens under 22.5 kPa initial stress was less than the decrease in these specimens under 18.7 kPa initial stress. These results indicate that the fetal umbilical vein has appropriate stress relaxation and creep properties for transplantation. These properties are advantageous for vascular reconstruction, indicating that the fetal umbilical vein can be transplanted to repair middle cerebral artery injury. PMID:25206626
Viscoelastic evaluation of fetal umbilical vein for reconstruction of middle cerebral artery
Li, Dongyuan; Xu, Donghui; Li, Peng; Wei, Jun; Yang, Kun; Zhao, Conghai
The transplantation of artificial blood vessels with < 6 mm inner diameter as substitutes for human arterioles or veins has not achieved satisfactory results. Umbilical vein has been substituted for ar-tery in vascular transplantation, but it remains unclear whether the stress relaxation and creep tween these vessels are consistent. In this study, we used the fetal umbilical vein and middle cere-bral artery from adult male cadavers to make specimens 15 mm in length, 0.196¢0.268 mm in nica media thickness, and 2.82¢2.96 mm in outer diameter. The results demonstrated that the stress decrease at 7 200 seconds was similar between the middle cerebral artery and fetal umbilical vein specimens, regardless of initial stress of 18.7 kPa or 22.5 kPa. However, the strain increase at 7 200 seconds of fetal umbilical veins was larger than that of middle cerebral arteries. Moreover, the stress relaxation experiment showed that the stress decrease at 7 200 seconds of the fetal umbilical vein and middle cerebral artery specimens under 22.5 kPa initial stress was less than the decrease in these specimens under 18.7 kPa initial stress. These results indicate that the fetal umbilical vein has appropriate stress relaxation and creep properties for transplantation. These properties are advantageous for vascular reconstruction, indicating that the fetal umbilical vein can be transplanted to repair middle cerebral artery injury. PMID:25206626
Early Effects of Arterial Hemodynamic Conditions on Human Saphenous Veins Perfused Ex Vivo
Chesler, Naomi C.
and vascular cell proliferation12Ł14 as well as intimal hyperplasia.15 The role of MMPs in pathological graft of saphenous vein grafts. Using matched pairs of freshly isolated human saphenous vein, we analyzed the early effects of ex vivo hemodynamic conditions mimicking the venous (native) compared with arterial (graft
IL10 Regulates Thrombus-Induced Vein Wall Inflammation and Thrombosis1,2
L. Joseph Downing; Robert M. Strieter; Amy M. Kadell; Carol A. Wilke; John C. Austin; Bradley D. Hare; Marie D. Burdick; Lazar J. Greenfield; Thomas W. Wakefield
Vein wall inflammation associated with venous thrombosis is mediated by an imbalance in proinflammatory as compared with antiinflammatory molecules. We hypothesize that IL-10 is an important antiinflammatory cytokine that influences vein wall inflammation and thrombus propagation during venous thrombosis. To test this hypothesis a model of inferior vena caval throm- bosis was used. Studies were performed at sacrifice 2 days
Brachial plexus compression due to subclavian pseudoaneurysm from cannulation of jugular vein hemodialysis catheter
DC Tarng; TP Huang; KP Lin
Jugular venous cannulation is generally safer than subclavian cannulation. The traumatic complications associated with jugular vein hemodialysis catheters are rare. A jugular vein, therefore, has become the preferred site for hemodialysis catheter insertion. We describe the first case of brachial plexus compression attributable to delayed recognition of a right subclavian pseudoaneurysm as a complication of jugular venous cannulation of hemodialysis
Prepancreatic postduodenal portal vein: a rare vascular variant detected on imaging.
Jain, Vishal Kumar; Rajesh, S; Bhatnagar, Shorav; Dev, Ankur; Mukund, Amar; Arora, Ankur
Anomalous preduodenal portal vein is a rare abdominal vascular variant; even rarer is the prepancreatic postduodenal position. We report an anomalous portal vein positioned in between duodenum and pancreatic head detected on contrast enhanced computed tomography. Awareness and accurate radiological interpretation of this unique and rare vascular pattern can prevent inadvertent injury during surgical and radiological interventions. PMID:23392551
An Extremely Rare Complication of Varicose Vein Surgery: Retained Foreign Body
F?nd?k, Orhan; Ayd?n, Ufuk; D³zyol, Ūa?r?; Bar??, ųzg³r; Końo?ullar?, Cevdet U?ur
Foreign body is among complications of surgery. But as a complication of varicose vein surgery it was reported extremely rarely and, to our knowledge, there is only one paper in the literature. A case with retained sponge which was detected five months after varicose vein surgery was presented. PMID:25431729
Vein Graft-Coated Vascular Stents: A Feasibility Study in a Canine Model
Schellhammer, Frank [Department of Radiology, University of Cologne, Joseph-Stelzmann Strasse 9, D-50931 Cologne (Germany); Haberstroh, Joerg [Department of Surgical Research, University of Freiburg, Breisacher Strasse 64, D-79108 Freiburg (Germany); Wakhloo, Ajay K. [Department of Neurosurgery, State University of New York at Buffalo, School of Medicine and Biomedical Science, 3 Gates Circle, Buffalo, NY 14209 (United States); Gottschalk, Eva; Schumacher, Martin [Department of Neuroradiology, University of Freiburg, Breisacher Strasse 64, D-79108 Freiburg (Germany)
Purpose: To evaluate different vein grafts for luminal coating of endovascular stents in normal canine arteries. Methods: Twenty-four tantalum Strecker stents were coated with either autologous (n= 10), denatured heterologous (n= 11), or denatured homologous vein grafts (n= 3). The carotid artery (n= 11) and the iliac artery (n= 13) were stented using a transfemoral approach. Angiograms were performed at days 0, 7, and 21, and months 3, 6, and 9. All grafts underwent histological examination. Results: Eight of 10 autologous vein grafts showed patency during the whole observation period of 9 months, without histological signs of inflammation. Denatured heterologous vein grafts revealed acute (n= 3), subacute (n= 5), or delayed (n= 3) vessel occlusion. Hyaloid transformation of the vein graft and lympho-plasmacellular formations were seen. Denatured homologous vein grafts showed acute vessel occlusion. Although significant inflammatory tissue response was seen, no host-versus-graft reaction was present. Conclusion: Autologous vein graft-coated stents showed good biocompatibility in canine arteries. Preparation was cumbersome and required surgical venae-sectio. Denatured vein grafts, however, were limited by inflammatory reactions.
Electric currents along earthquake faults and the magnetization of pseudotachylite veins
Friedemann Freund; Manuel A. Salgueiro da Silva; Bobby W. S. Lau; Akihiro Takeuchi; Hollis H. Jones
Pseudotachylites occur in the form of thin glassy veins quenched from frictional melts along the fault planes of major earthquakes. They contain finely grained magnetite and often exhibit a high natural remanent magnetization (NRM). High NRM values imply strong local electric currents. These currents must persist for some time, while the pseudotachylite veins cool through the Curie temperature of magnetite
True and apparent geometric variability of en-ķchelon vein arrays
John V. Smith
The wide range of vein-array angles reported for en-ķchelon vein arrays can be attributed to both true and apparent geometric effects. A survey of published figures supports a continuum of orientations rather than distinct populations related to different fracture mechanisms. The results of the survey indicate a modal veinarray angle of less than 45 ░ which indicates area increase as
Hydrothermal Alteration and Mineralization Zoning in Iron-Oxide(-Cu-Au) Vein Deposits, near Copiap, Chile
Barton, Mark D.
as a function of structural levels. Two vein systems hosted in La Brea diorite phase of the Copiap¾ batholith vein formed near the upper contact of the host La Brea diorite. Few IOCG systems have well documented and Sollner, 2006; M.D. Barton et al., unpubl. data). The plutons are broadly dioritic in composition
Three Dimensional Petrography of Kernouvķ: A Story of Vein Formation, Compaction, and Metamorphism
NASA Astrophysics Data System (ADS)
Friedrich, J. M.; Ruzicka, A.; Ebel, D. S.; Thostenson, J.; Rudolph, R. A.; Rivers, M. L.; Macke, R. J.; Britt, D. T.
We use the 3D technique X-ray microtomography to investigate the structures of metallic veins in the Kernouvķ H chondrite. The striking complexity of shape of these large (>1 cm) vein structures indicates a pre-metamorphic impact origin.
Biomechanical response of varicose veins to2 elastic compression: a numerical study3
Paris-Sud XI, Universitķ de
1 1 Biomechanical response of varicose veins to2 elastic compression: a numerical study3 4 Rohan C,version1-15Mar2013 Author manuscript, published in "Journal of Biomechanics 46, 3 (2013) 599-603" DOI : 10 the biomechanical response of varicose veins28 to compression treatment. The aim is to investigate the relationship
An uncommonly encountered perirenal mass: Robotic resection of renal vein leiomyosarcoma
Saltzman, Amanda F.; Brown, Elizabeth T.; Halat, Shams K.; Hedgepeth, Ryan C.
Primary leiomyosarcoma (LMS) of the renal vein is a rare tumour and poorly described in the literature. Surgical resection, using open and laparoscopic approaches, is the mainstay of treatment. In this report, we describe a patient with left renal vein LMS, report the first robotic laparoscopic resection for this tumor, and review the typical presentation, imaging, pathology and treatment for this rare clinical entity.
Geometric Analysis of Vein Fracture Networks From the Awibengkok Core, Indonesia
NASA Astrophysics Data System (ADS)
Khatwa, A.; Bruhn, R. L.; Brown, S. R.
Fracture network systems within rocks are important features for the transportation and remediation of hazardous waste, oil and gas production, geothermal energy extraction and the formation of vein fillings and ore deposits. A variety of methods, including computational and laboratory modeling have been employed to further understand the dynamic nature of fractures and fracture systems (e.g. Ebel and Brown, this session). To substantiate these studies, it is also necessary to analyze the characteristics and morphology of naturally occurring vein systems. The Awibengkok core from a geothermal system in West Java, Indonesia provided an excellent opportunity to study geometric and petrologic characteristics of vein systems in volcanic rock. Vein minerals included chlorite, calcite, quartz, zeolites and sulphides. To obtain geometric data on the veins, we employed a neural net image processing technique to analyze high-resolution digital photography of the veins. We trained a neural net processor to map the extent of the vein using RGB pixel training classes. The resulting classification image was then converted to a binary image file and processed through a MatLab program that we designed to calculate vein geometric statistics, including aperture and roughness. We also performed detailed petrographic and microscopic geometric analysis on the veins to determine the history of mineralization and fracturing. We found that multi-phase mineralization due to chemical dissolution and re-precipitation as well as mechanical fracturing was a common feature in many of the veins and that it had a significant role for interpreting vein tortuosity and history of permeability. We used our micro- and macro-scale observations to construct four hypothetical permeability models that compliment the numerical and laboratory modeled data reported by Ebel and Brown. In each model, permeability changes, and in most cases fluctuates, differently over time as the tortuosity and aperture of veins are affected by the precipitation, dissolution, and re-precipitation of minerals, and also by mechanical fracturing. In all of our cases we interpret a first-phase mineral dissolution stage where permeability gradually declines as the vein is blocked by inward growing minerals. Hereafter, permeability may briefly increase with the onset of internal fracturing within the vein or by a phase of mineral dissolution opening up new pathways for fluid flow. Eventually we infer that permeability will decline again as second stage minerals are deposited in the fluid flow pathways.
Minimally invasive cardiac surgery for removal of the greater saphenous vein
Cusimano, Robert J.; Dale, Laura; Butany, Jagdish W.
Objective To determine if saphenous vein required for coronary bypass could be quickly, easily and safely removed with a minimally invasive technique. Design A consecutive series. Setting A university centre. Material and Methods In cadavers, a standard mediastinoscope was used to remove segments of the greater saphenous vein. Thigh segments, superior leg segments and ankle segments were removed. Fifteen minutes were allowed for removal of a segment. Results Segments of vein 15 to 17 cm long could be removed. One segment could not be removed within 15 minutes. Thigh segments were easy to remove, calf segments were the most difficult. There were no avulsed side branches. All incisions were less than 5 cm long. Conclusions Saphenous vein can be harvested quickly and safely by a minimally invasive method. Lower extremity complications may be reduced and long-term patency improved with this in-situ technique of vein removal. PMID:8857986
[Cockett's syndrome, May-Thurner syndrome, or iliac vein compression syndrome].
Gil MartĒn, A R; Carreras Aja, M; Arrieta Ardieta, I; Labayen Azparren, I
Iliac vein compression syndrome (also known as May-Thurner syndrome or Cockett's syndrome) is a rare clinical entity in which the left common iliac vein is compressed when it passes between the right common iliac artery and the spine. The sustained compression and trauma caused by the pulsatile force of the artery on the vein damage the intima and lead to the formation of membranes or bands in the vascular lumen that hinder or obstruct the flow of blood in the vein, favoring thrombus formation. The current treatment strategy of choice is endovascular vein patch angioplasty and stenting with the aim of improving the caliber of the lumen and enabling normal venous drainage. We present two cases of May-Thurner syndrome and review the clinical and CT findings. PMID:22621823
Congenital Agenesis of the Internal Jugular Vein: An Extremely Rare Anomaly
Kayiran, Oguz; Calli, Caglar; Emre, Abdulkadir; Soy, Fatih Kemal
Vascular anomalies of major venous vessels are rarely seen. Moreover, congenital absence of internal jugular vein is extremely uncommon. In our case, a female patient presented with primary unknown left cervical mass. Cervical ultrasonography demonstrated absence of right internal jugular vein. In addition, computed tomography and dynamic magnetic resonance imaging scans confirmed this diagnosis. Compensatory left internal jugular vein enlargement mimicked sort of cervical mass. Venous magnetic resonance imaging images revealed the absence of right internal jugular vein with compensatory left internal jugular vein dominance. In the literature, the agenesis of IJV was mentioned in a case with concomitant multiple problems. Here, an asymptomatic case is reported with an incident diagnosis. No interventions were planned upon the patient's request. It should be kept in mind that any kind of anomalies can be seen during venous access and neck surgery. PMID:25821625
[Crossectomy--exhairesis--stripping--laser therapy. How even refractory varicose veins respond to treatment].
Welter, H F; Mosa, T; Kettmann, R
Chronic venous insufficiency affects more than 50% of the German population. Major factors involved in its development are age, family disposition, female sex and an occupation involving much standing. Together with the clinical presentation, Doppler and duplex ultrasonography in particular enable a reliable pre-operative diagnosis, and deep venous thrombosis can also be definitively excluded. Indications for surgical treatment are in particular varicosis of the greater and lesser saphenous vein and perforating vein insufficiency. Commonly used procedures are crossectomy, restrictive stripping of pathological vein segments, resection of varicose side branches, and the endoscopic discission of perforating veins. Recent developments are deep-freezing and extraction of the vein and endovenous laser treatment (EVLT), requiring only tiny incisions. In most cases, these interventions can be performed on an outpatient basis. PMID:12577743
Renal failure due to renal vein thrombosis in a fetus with growth restriction and thrombophilia.
Has, Recep; Corbacioglu Esmer, Aytul; Kalelioglu, Ibrahim H; Yumru, Harika; Y³ksel, Atil; Ziylan, Orhan
We report a case of renal vein thrombosis diagnosed at 27 weeks of gestation in a dichorionic twin pregnancy. The left kidney of one fetus was hyperechoic and enlarged with echoic streaks following the direction of interlobular veins and the loss of corticomedullary differentiation. In the following weeks, left kidney became smaller and echoic, and Doppler examination showed no flow in both artery and vein. The right kidney had totally normal appearance in the beginning, but it became enlarged and hyperechoic, and progressed into a small echoic kidney with no flow in artery and vein. In the postnatal ultrasound examination, both kidneys appeared hyperechoic with no vascularization in the hilum region. There was thrombosis in arteries and veins of both kidneys, as well as in the inferior vena cava. The investigation for thrombophilia resulted with the combined presence of heterozygote mutation in factor V Leiden and prothrombin 20210 genes. PMID:24612313
Percutaneous implantation of (125)iodine seeds for treatment of portal vein tumor thrombosis in hepatocellular carcinoma.
Liu, Yan; Liu, Ruibao; Wang, Ping; Li, Shijie; Shen, Haiyang
The aim of the study is to evaluate the practicability and therapeutic efficacy of (125)iodine seeds implantation percutaneously for portal vein tumor thrombosis (PVTT) in patients with hepatocellular carcinoma (HCC). Nineteen patients with HCC accompanied with PVTT received ultrasound-guided implantation of 8-30 (125)iodine seeds, 8Āmm apart within the portal vein tumor thrombi. The patients were followed up postoperatively for a period of 3-22Āmonths. The successful rates of the procedure, postoperative changes of liver and renal function, hemogram, complications and therapeutic response were monitored. (125)I seeds were successfully implanted in the portal veins in all patients without serious complications. During the follow-up period, the portal vein tumor thrombi all shrunk obviously. Percutaneous implantation of (125)iodine seeds into the portal vein is an effective and safe treatment for PVTT accompanying HCC. PMID:26152896
Fresh vein allograft survival in dogs after cyclosporine treatment.
Mingoli, A; Edwards, J D; Feldhaus, R J; Hunter, W J; Naspetti, R; Cavallari, N; Sapienza, P; Kretchmar, D H; Cavallaro, A
Synthetic grafts are widely used for peripheral arterial reconstructions when autologous veins are not available, but their results have not been satisfactory. Venous allograft may be used as an alternative to synthetic prostheses. The aim of the study was to explore the immunosuppressive efficacy of Cyclosporine A (CyA) as a means of preventing venous allograft failures and rejection. We utilized 56 mongrel dogs. Immunological incompatibility was checked with the skin graft method. Donor inferior vena cava was transplanted into the infrarenal abdominal aorta of recipient animals. One group (group 1, 10 dogs) served as a control and three groups received CyA treatment regimens. Group 2 (10 dogs) received postoperative oral CyA treatment for 30 days. Group 3 (12 dogs) received a vein graft pretreated with a CyA solution without postoperative immunosuppressive therapy. Group 4 (9 dogs) received a vein graft pretreated with a CyA solution and postoperative CyA treatment for 30 days. Allografts were examined at 30 days for patency, aneurysmal dilatation, gross structural changes, inflammatory response, and lymphocytic infiltration. Sex chromatine assessment determined the origin (donor or recipient) of the endothelial cells. The allografts from groups 1 and 3 showed significant aneurysmal dilatation and perivenous inflammation when compared to dogs treated with oral CyA therapy (P < 0.0002). Moreover allografts treated with CyA therapy had a better-developed venous neointima (P < 0.009) with less fibrin (P < 0.02) and thinner medial (P < 0.0009) with less fibrin (P < 0.02), and thinner medial (P < 0.0009) and adventitial layers (P < 0.02). No significant differences were observed in neointimal thickness among the four groups. Lymphocytic infiltration was greater in the group of animals who did not receive oral CyA therapy (P < 0.0004). Barr bodies status showed significant differences between oral CyA treated groups and nontreated groups (P < 0.0003). Oral CyA therapy reduced aneurysmal dilatation and immunological response, promoted the development of a neoendothelium, and preserved the structure of the venous layers. Graft pretreatment with CyA flushing did not have a significant immunosuppressive effect. PMID:8606518
A new design concept for knitted external vein-graft support mesh.
Singh, Charanpreet; Wang, Xungai
Autologous vein-graft failure significantly limits the long-term efficacy of coronary artery bypass procedures. The major cause behind this complication is biomechanical mismatch between the vein and coronary artery. The implanted vein experiences a sudden increase (10-12 fold) in luminal pressures. The resulting vein over-distension or 'ballooning' initiates wall thickening phenomenon and ultimate occlusion. Therefore, a primary goal in improving the longevity of a coronary bypass procedure is to inhibit vein over-distension using mechanical constriction. The idea of using an external vein-graft support mesh has demonstrated sustained benefits and wide acceptance in experimental studies. Nitinol based knitted structures have offered more promising mechanical features than other mesh designs owing to their unique loosely looped construction. However, the conventional plain knit construction still exhibits limitations (radial compliance, deployment ease, flexibility, and bending stresses) which limit this design from proving its real clinical advantage. The new knitted mesh design presented in this study is based on the concept of composite knitting utilising high modulus (nitinol and polyester) and low modulus (polyurethane) material components. The experimental comparison of the new design with a plain knit design demonstrated significant improvement in biomechanical (compliance, flexibility, extensibility, viscoelasticity) and procedural (deployment limit) parameters. The results are indicative of the promising role of new mesh in restoring the lost compliance and pulsatility of vein-graft at high arterial pressures. This way it can assist in controlled vein-graft remodelling and stepwise restoration of vein mechanical homoeostasis. Also, improvement in deployment limit parameter offers more flexibility for a surgeon to use a wide range of vein diameters, which may otherwise be rendered unusable for a plain knit mesh. PMID:25916819
The Transition from Open to Endoscopic Saphenous Vein Harvesting and Its Clinical Impact
Lai, Tianjie; Babb, Yarrow; Ning, Qian; Reyes, Luz; Dao, Thanh; Lee, Vei-Vei; Mitchell, Laurie; Gentry, Layne O.; Reul, Ross M.; Ott, David A.
Open saphenous vein harvesting can be associated with wound complications, incision pain, prolonged convalescence, and poor cosmetic results. Endoscopic vein harvesting has been widely used for prevention of these problems. We compared outcomes of open and endoscopic vein harvesting for coronary artery bypass grafting at the Texas Heart Institute. We retrospectively analyzed data from 1,573 consecutive coronary artery bypass procedures performed at our institution during a 20-month period. Each procedure included saphenectomy by endoscopic vein harvesting (n=588) performed by physician assistants, or by traditional open vein harvesting (n=985) performed by physicians or physician assistants. The primary outcome variable was the incidence of postoperative leg infections. Both groups were similar in terms of preoperative risk factors. After surgery, leg wound infections were significantly less frequent in the endoscopic vein harvesting group (3/588, 0.5%) than in the open vein harvesting group (27/985, 2.7%; P <0.002). The most common organism involved in leg infections was Staphylococcus (20/30, 66%): S. aureus was present in 14 of 30 infections (47%). Open vein harvesting was the only significant independent risk factor for leg infection. We conclude that endoscopic vein harvesting reduces leg wound infections, is safe and reliable, and should be the standard of care when venous conduits are required for coronary artery bypass grafting and vascular procedures. Although the transition from open to endoscopic vein harvesting can be challenging in institutions, it can be successful if operators receive adequate training in endoscopic technique and are supported by surgeons and staff. PMID:17041688
The use of mesh-tube-constricted dilated or varicose veins as arterial bypass conduit.
Moritz, A; Raderer, F; Magometschnigg, H; Trubel, W; Ullrich, R; Laufer, G; Staudacher, M
In general, dilated and varicose veins are not used as arterial bypass grafts despite their physiological endothelial lining. A uniform small diameter may be achieved by inserting such veins into mesh tubes. To test the degree to which dilated veins can be constricted without forming folds, in-vitro and experimental investigations were performed before such composites were used for clinical reconstructive surgery. Ovine jugular veins with a diameter of 15 mm were inserted into 6 mm tubes. After casting in paraffin wax none of the specimens showed folds on the flow surface. In 12 sheep pairs of mesh-constricted jugular veins and native femoral veins were implanted as femoropopliteal bypass grafts. Six animals were killed at 6 months and 6 at one year. All bypasses remained patent and none showed signs of obstruction caused by folds or anastomotic hyperplasia at angiographic control. Intimal hyperplasia was significantly reduced from 416 +/- 143 microns in the midportion of native vein grafts to 231 +/- 76 microns (p = 0.0001 paired t-test) in constricted veins as well as at the anastomoses (358 +/- 256 microns vs. 180 +/- 73 microns; p = 0.008). Partially or totally mesh-tube-constricted varicose veins were used for infrainguinal reconstructions in 19 patients and for coronary revascularization in 3. All grafts showed an even calibration at control angiography. As constriction does not lead to internal folds, varicose or dilated veins may be used successfully as bypass grafts after insertion into mesh tubes. The external reinforcement reduces the intimal hyperplasia within the graft and also reduces anastomotic hyperplasia. PMID:1290183
Percutaneous Antegrade Varicocele Embolization Via the Testicular Vein in a Patient with Recurrent Varicocele After Surgical Repair.
Guevara, Carlos J; El-Hilal, Alexander H; Darcy, Michael D
This is a case report of an adolescent male who underwent surgical ligation for a left-sided varicocele that recurred 2Āyears later. Standard retrograde embolization via the left renal vein was not possible, because there was no connection from the renal vein to the gonadal vein following surgical ligation. The patient was treated via antegrade access of the spermatic vein at the inguinal level with subsequent coil embolization. PMID:25192950
Misleading findings of subclavian artery and vein transection.
Kotsis, T; Moulakakis, K; Pavlidis, P; Boudouris, I; Pomoni, M; Georgakis, P
Trauma involving the subclavian and axillary arteries is relatively infrequent. However, it can result in devastating functional disability of the upper limb due to significant and permanent associated neurologic deficits. Uncertainty exists in relation to certain aspects of therapeutical management of patients with trauma of the upper limb. Although decision pathway and algorithms have been proposed by several authors, the indications for surgery remain uncertain and not established. Two main points seem to be the most important determinants of the therapeutical strategy; first the viability of the limb and second the accurate determination of the vascular and nerve damage. We present a patient with a traumatic disruption of the subclavian artery and vein and concomitant brachial plexus injury following a road traffic accident. We highlight the role of accurate diagnosis to avoid life and limb-threatening complications from missed diagnosis. Also we review the recent literature emphasizing the therapeutical strategy and the role of conventional surgical repair and endovascular treatment. PMID:18019282
How metalliferous brines line Mexican epithermal veins with silver
Wilkinson, Jamie J.; Simmons, Stuart F.; Stoffell, Barry
We determined the composition of ~30-m.y.-old solutions extracted from fluid inclusions in one of the world's largest and richest silver ore deposits at Fresnillo, Mexico. Silver concentrations average 14 ppm and have a maximum of 27 ppm. The highest silver, lead and zinc concentrations correlate with salinity, consistent with transport by chloro-complexes and confirming the importance of brines in ore formation. The temporal distribution of these fluids within the veins suggests mineralization occurred episodically when they were injected into a fracture system dominated by low salinity, metal-poor fluids. Mass balance shows that a modest volume of brine, most likely of magmatic origin, is sufficient to supply the metal found in large Mexican silver deposits. The results suggest that ancient epithermal ore-forming events may involve fluid packets not captured in modern geothermal sampling and that giant ore deposits can form rapidly from small volumes of metal-rich fluid. PMID:23792776
Subclavian vein thrombosis after application of body cast.
Badlani, Neil; Korenblit, Allen; Hammerberg, Kim
Mehta-Cotrel body casting is a well-recognized and effective technique for the treatment of progressive infantile scoliosis. The treatment can be challenging to execute given the commitment required by the patient's family and treatment team, and is not without complications. In this report, we detail the occurrence of a subclavian vein thrombosis after the placement of a Mehta-Cotrel cast for the treatment of progressive infantile kyphoscoliosis. To date, this is a previously unreported complication after body casting. Expeditious and accurate diagnosis of this complication leads to effective treatment without further morbidity. Therefore, clinicians using body casting for the treatment of scoliosis should be aware of the possibility of this complication and know how to quickly diagnose and treat it. PMID:23232388
[A case of upper extremity deep vein thrombosis].
Aguilar Shea, A L; Gallardo Mayo, C
The case is presented of a 41 year-old women with a personal history of smoking and treated with oral contraceptives, who began taking analgesics and muscle relaxants due to a right cervical pain. As her clinical condition did not improve she was seen again. During the physical examination an increase of soft tissue in the right supraclavicular area was observed. The ultrasound revealed thrombosis of the internal jugular, subclavian, brachycephalic, axillar and humeral veins. We believe that upper-extremity deep venous thrombosis is a rare condition that must be considered in patients with oedema of the upper limbs. The key to a prompt diagnosis is to know the risk factors. Ultrasound is the standard approach. PMID:23452538
Changing paradigms in the management of deep vein thrombosis.
Lang, Kathryn J; Saha, Prakash; Roberts, Lara N; Arya, Roopen
In adults diagnosed with deep vein thrombosis (DVT), challenges remain in the management of the acute event whilst remaining alert to long-term morbidity. The addition of non-vitamin K antagonist oral anticoagulants (NOACs) to the pharmacopoeia represents the first of a number of recent advancements in the management of DVT. Worldwide, uptake of these agents has been avid, although drug selection, reversal and chronic treatment effects continue to be controversial areas. Multi-centre studies to evaluate the impact of NOACs on long-term outcomes, including thrombosis recurrence and post-thrombotic syndrome (PTS), are ongoing. Validation of tools capable of predicting PTS would enable patient selection for early aggressive intervention, such as local thrombolysis. Such interventional strategies are gaining momentum as initial approaches and would benefit from large randomized controlled trials. PMID:25892324
Indexing of yellow vein mosaic disease of mesta (Hibiscus cannabinus).
Chatterjee, Arpita
The assessment of severity with chronological development of disease of mesta (Hibiscus cannabinus, cv. HC-583) on a particular diseased plant was studied. Based on the symptomatology and intensity of diseases caused by Begomovirus an empirical formula was developed. A methodology for assessing the disease intensity of yellow vein mosaic disease of mesta grown under natural field condition was proposed and it was validated by comparing with infected plants grown under field as well as glasshouse conditions. Quantitative assessment of the disease indicated that the disease index value at different stages of pathogenesis varied from 1.82 to 49.44 under field condition whereas the same varied from 2.78 to 50.83 under glasshouse condition. Mortality of infected leaves was noticed when the index value reached maximum. With the present methodology scoring of gradual development of disease has become possible for a particular plant and even for an individual leaf of a particular cultivar. PMID:24498814
Facial vein thrombophlebitis: an uncommon complication of sinusitis.
Cotes, Claudia; Riascos, Roy; Swischuk, Leonard E
Facial vein thrombophlebitis is an uncommon complication of sinusitis. In cases where periorbital swelling complicating sinusitis is diagnosed, clinical findings of swelling and erythema extending beyond the orbital region into the cheek should alert the physician about this unusual complication and the need for further contrast-enhanced imaging and venography. The radiologist must be particularly careful in the evaluation of vascular structures of the face and neck in these children. CT and MRI with contrast material and MR venography are studies that clearly demonstrate the vascular anatomy and possible complications. However, MR venography confirms flow abnormalities within the venous system with the advantage of avoiding radiation exposure to the pediatric patient. PMID:25636529
Superior mesenteric vein thrombosis accompanied with severe appendicitis
Lee, Kyo Won
Superior mesenteric vein (SMV) thrombosis caused by acute appendicitis is a very rare entity nowadays. We report a successfully treated case of a 21-year-old man with SMV thrombosis associated with severe acute appendicitis. Intravenous heparin was administered, and it was later substituted with warfarin. Systemic antibiotic therapy was continued for 1 week, and it was substituted with oral antibiotics, which were administered for 3 weeks. On the 45th postoperative day, follow-up computed tomography scan demonstrated dissolution of SMV thrombosis. Anticoagulation therapy was maintained for 3 months. He was discharged without any complications. SMV thrombosis can be treated successfully with emergency appendectomy, broad-spectrum antibiotics, and anticoagulation therapy.
Idiopathic Myointimal Hyperplasia of the Mesenteric Veins Diagnosed Preoperatively.
Wangensteen, Kirk J; Fogt, Franz; Kann, Brian R; Osterman, Mark T
Idiopathic myointimal hyperplasia of the mesenteric veins (IMHMV) of the colon is a very rare disease that in previously reported cases was often mistaken for inflammatory bowel disease because of similar clinical characteristics. In our review of the literature, we found a total of 15 cases described, generally featuring sigmoid and rectal colitis and symptoms of abdominal pain, diarrhea, and hematochezia refractory to treatment with immunosuppressants. In all previously reported cases, the diagnosis was achieved only after surgical resection of the affected area. Herein, we report a case of IMHMV that was diagnosed preoperatively based on clinical information and endoscopy with biopsies. This led to the withdrawal of immunosuppression before a carefully planned surgical resection, with confirmation of the diagnosis in the resected tissue. To our knowledge, our case of IMHMV is the first to be diagnosed preoperatively. PMID:25626629
The history and historical treatments of deep vein thrombosis.
Galanaud, J-P; Laroche, J-P; Righini, M
Deep vein thrombosis (DVT) is a common disease. However, unlike that of varicose veins, which have been depicted since antiquity in art and literature, its description was more recent in the history of medicine. The first well-documented case of DVT was reported during the Middle Ages: in 1271, Raoul developed a unilateral edema in the ankle, which then extended to the leg. The number of reported DVT cases steadily increased thereafter, particularly in pregnant and postpartum women. During the first half of the 20th century, well before the discovery of anticoagulants, many therapeutic approaches were used, and arose from the pathologic hypotheses that prevailed at their time. Despite the development of anticoagulants, and the fact that they were thought to dramatically decrease DVT mortality, numerous complementary treatments have also been developed during the last 50 years: they include vena cava clips and surgical thrombectomy, and are intended to decrease mortality or to prevent late complications. Most of these treatments have now been abandoned, or even forgotten. In this review, we recall also the discovery and the use of vitamin K antagonists and heparin, which have constituted the mainstay of treatment for decades. We also bring some perspective to historical aspects of this disease and its treatment, notably regarding elastic compression and early mobilization, but also abandoned and complementary treatments. In these times of change regarding DVT treatment, mainly marked by the arrival of new oral anticoagulants, efforts of physicians through the ages to treat this common disease provide a beautiful example of the history of knowledge. PMID:23297815
Host Resistance to Mirafiori Lettuce Big-vein Virus and Virus Sequence Diversity in the Western United States.
Technology Transfer Automated Retrieval System (TEKTRAN)
Big vein is an economically damaging disease of lettuce (Lactuca sativa) caused by the Olpidium brassicae vectored Mirafiori lettuce big-vein virus (MLBVV). Although big vein is a perennial problem in the US, the extent of MLBVV infection and diversity was unknown. Lettuce cultivars partially resist...
Local Transdermal Glyceryl Trinitrate Has an Antiinflammatory Action on Thrombophlebitis Induced by Sclerosis of Leg Varicose Veins
J. R. Berrazueta; M. Fleitas; E. Salas; J. A. Amado; J. J. Poveda; A. Ochoteco; M. J. Sßnchez de Vega; G. Ruiz de Celis
To test the antiinflammatory and analgesic effects of transdermal glyceryl trinitrate (GTN) the authors carried out a double-blind, randomized, controlled clinical study in 21 patients with mild to moderate leg varicose veins who underwent vein sclerotherapy in both legs. GTN or placebo ointment was applied in a blinded protocol along the surface of the sclerosed vein every eight hours until
Relationship between prolonged standing and symptoms of varicose veins and nocturnal leg cramps among women and men
Jin Wook Bahk; Hyunjoo Kim; Kyunghee Jung-Choi; Myung-Chul Jung; Inseok Lee
The relationships between occupational characteristics and symptoms of varicose veins and nocturnal leg cramps and their gender differences were explored in a Korean population. The study population was 2165 workers from various occupations (55.6% female). Multiple logistic regression analyses were conducted to reveal factors related to symptoms of varicose veins and nocturnal leg cramps. The prevalence of varicose veins and
Relationship between prolonged standing and symptoms of varicose veins and nocturnal leg cramps among women and men
Jin Wook Bahk; Hyunjoo Kim; Kyunghee Jung-Choi; Myung-Chul Jung; Inseok Lee
The relationships between occupational characteristics and symptoms of varicose veins and nocturnal leg cramps and their gender differences were explored in a Korean population. The study population was 2165 workers from various occupations (55.6% female). Multiple logistic regression analyses were conducted to reveal factors related to symptoms of varicose veins and nocturnal leg cramps. The prevalence of varicose veins and
Early electrical remodeling in rabbit pulmonary vein results from trafficking of intracellular SK2 channels to membrane sites
Nazira ųzgen; Wen Dun; Eugene A. Sosunov; Evgeny P. Anyukhovsky; Masanori Hirose; Heather S. Duffy; Penelope A. Boyden; Michael R. Rosen
Objective: Atrial fibrillation is often initiated by bursts of ectopic activity arising in the pulmonary veins. We have previously shown that a 3- h intermittent burst pacing protocol (BPP), mimicking ectopic pulmonary vein foci, shortens action potential duration (APD) locally at the pulmonary vein-atrial interface (PV) while having no effect elsewhere in rabbit atrium. This shortening is Ca2+ dependent and
Blood Vessel Classification into Arteries and Veins in Retinal Claudia Kondermann and Daniel Kondermanna and Michelle Yanb
Cremers, Daniel
Blood Vessel Classification into Arteries and Veins in Retinal Images Claudia Kondermann and Daniel for DR are abnormally wide veins leading to an unusually low ratio of the average diameter of arteries symptom being an abnormal AVR value. To determine it, a classification of vessels as arteries or veins
Embryologicalic collateral venous channel on radionuclide liver/spleen study
Wilkinson, R.H. Jr.; Johnson, D.G.
Obstruction of normal venous portal blood flow generally results in collateral circulation. The obstruction may be intrinsic t the vasculature (e.g., hepatic vein thrombosis, vascular anomalies) or it may be extravascular (e.g., cirrhosis, hepatic masses) and may effect blood flow by deforming and compressing the intrahepatic or splenoportal axis vessels. A technetium-99m sulfur colloid liver/spleen study demonstrates what is thought to be a functional paraumbilical or umbilical vein in a cirrhotic patient with portal hypertension.
Doppler study of hepatic vein in cirrhotic patients: Correlation with liver dysfunction and hepatic hemodynamics
Sudhamshu, KC; Matsutani, Shoiichi; Maruyama, Hitoshi; Akiike, Taro; Saisho, Hiromitsu
AIM: To elucidate the significance of Doppler measurements of hepatic vein in cirrhotic patients and to correlate with liver dysfunction and hepatic hemodynamics. METHODS: One hundred patients with liver cirrhosis and 60 non-cirrhotic controls were studied. Doppler waveforms were obtained from right hepatic vein and flow velocity measured during quiet respiration. Doppler measurements were also obtained from portal trunk, right portal vein and proper hepatic artery. RESULTS: Hepatic vein waveforms were classified into three classical patterns. Flat waveform was uncommon. Mean hepatic vein velocity was significantly higher in cirrhotic patients (12.7 ▒ 6.4 vs 5.1 ▒ 2.1 and 6.2 ▒ 3.2 cm/s; P < 0.0001). The poorer the grade of cirrhosis, the higher was the mean velocity. Maximum forward velocity was never greater than 40 cm/s in controls. Degree of ascites was found to be highly correlated with mean velocity. ōVery highö group (? 20 cm/s) presented clinically with moderate to massive ascites. Correlations between right portal flow and mean velocity was significant (P < 0.0001, r = 0.687). CONCLUSION: Doppler waveforms of hepatic vein, which is independent of liver dysfunction, should be obtained during normal respiration. Mean hepatic vein velocity reflects the change in hepatic circulation associated with progression of liver cirrhosis. It can be used as a new parameter in the assessment of liver cirrhosis. PMID:17007052
Internal Jugular Vein Blood Flow in Multiple Sclerosis Patients and Matched Controls
Mancini, Marcello; Lanzillo, Roberta; Liuzzi, Raffaele; Di Donato, Orlando; Ragucci, Monica; Monti, Serena; Salvatore, Elena; Morra, Vincenzo Brescia; Salvatore, Marco
The aim of the study was to investigate the Internal Jugular Veins dynamics using contrast enhanced ultrasonography in Multiple Sclerosis patients, clinically isolated syndrome patients and healthy controls. Contrast enhanced ultrasonography imaging of the Internal Jugular Vein was performed in fifty-eight patients with Multiple Sclerosis, seven clinically isolated syndrome patients and in thirteen healthy controls. Time-intensity curves were quantified using a semi-automated method and compared with clinical disease outcomes. Wash-out parameters were calculated and six Time-intensity curves shapes were created. Significantly reduction of wash-out rate in Internal Jugular Veins was detected in Multiple Sclerosis patients compared to healthy controls [22.2% (2.7%¢65.9%) vs. 33.4% (16.2%¢76.8%); P<0.005]. Internal Jugular Vein enhancement was heterogeneous in patients with Multiple Sclerosis and consisted of slow wash-out Time-intensity curves shapes, compared with almost only one type of Time-intensity curves shape in control subjects that correspond to fast enhancement and fast wash-out. The vein wash-in parameters were similar in Multiple Sclerosis group compared with controls. A significant correlation was found between Internal Jugular Vein wash-out and level of disability (R?=??0.402, p<0.05). Contrast enhanced ultrasonography of the Internal Jugular Vein with time intensity curve analysis revealed alterations of cerebral venous outflow in Multiple Sclerosis patients, however mechanisms that determine this condition remains unclear. PMID:24675965
Prevalence of clinically important posterior fossa emissary veins on CT angiography
Pekcevik, Yeliz; Sahin, Hilal; Pekcevik, Ridvan
Purpose: We assessed the prevalence of the clinically important posterior fossa emissary veins detected on computed tomography (CT) angiography. Materials and Methods: A total of 182 consecutive patients who underwent 64-slice CT angiography were retrospectively reviewed to determine the clinically important posterior fossa emissary veins. Results: Of 166 patients, the mastoid emissary vein (MEV) was not identified in 37 (22.3%) patients. It was found bilaterally in 82 (49.4%) and unilaterally in 47 (28.3%) patients. Only six patients had more than one MEV that were very small (<2 mm), and only five patients had very large (>5 mm) veins. The posterior condylar vein (PCV) was not identified in 39 (23.5%) patients. It was found bilaterally in 97 (58.4%) and unilaterally in 30 (18.1%) patients. Only 15 patients had a very large (>5 mm) PCV. The petrosquamosal sinus (PSS) was identified only in one patient (0.6%) on the left side. The occipital sinus was found in two patients (1.2%). Conclusions: The presence of the clinically important posterior fossa emissary veins is not rare. Posterior fossa emissary veins should be identified and systematically reported, especially prior to surgeries involving the posterior fossa and mastoid region. PMID:24966550
Blood Flows in Tributaries of the Portal Vein: Anatomical and Angiographic Studies in Normal Beagle Dogs.
Mogicato, G; Vautravers, G; Meynaud-Collard, P; Deviers, A; Sautet, J
Liver anatomy, particularly its vascularization, has been investigated in many studies in dogs. Knowledge of blood flow from the main tributaries of the portal vein (PV) is necessary to explain the preferential sites of secondary lesions within the liver based on the site of the initial malignant lesion. How these flows come together was established in an earlier ex vivo study. Here, we highlight in vivo the blood flows from the main PV tributaries and their distribution in the liver of normal dogs. Portographs of the main PV tributaries were obtained in seven dogs after injection of an angiographic contrast medium. After euthanasia, the livers and their portal vascularization (PV and tributaries) were extracted for a comparative corrosion cast study. Flows were demonstrated in the cranial mesenteric vein, caudal mesenteric vein and splenic vein. However, no proper flow could be distinguished for the gastroduodenal and ileocolic veins. All these tributaries primarily supply the lateral liver lobes (right or left). Most of our observations indicate that the cranial mesenteric, caudal mesenteric and splenic veins primarily supply the right lateral lobe and the caudate process of the caudate lobe and secondarily the left lateral lobe, left medial lobe and the quadrate lobe. The two other tributaries (gastroduodenal and ileocolic veins) primarily supply the right lateral lobe and the caudate process of the caudate lobe. PMID:25376527
Vasopressin decreases portal vein pressure and flow in the native liver during liver transplantation.
Wagener, Gebhard; Gubitosa, Gina; Renz, John; Kinkhabwala, Milan; Brentjens, Tricia; Guarrera, James V; Emond, Jean; Lee, H Thomas; Landry, Donald
Vasodilation due to impaired vascular tone is common in liver failure. Vasoconstrictor drugs are almost always required during the anhepatic phase of a liver transplant to maintain blood pressure unless venovenous bypass is employed. Arginine-vasopressin can be used as a vasoconstrictor instead of or in addition to norepinephrine for this purpose, but the effect of vasopressin on the portal vein pressure and flow in this setting is unknown. Portal vein pressure, portal vein blood flow, hemodynamic variables, and plasma vasopressin levels were measured in 16 patients during liver transplantation after ligation of the hepatic artery before and after a vasopressin infusion of 3.8 +/- 1.1 units/hour. Measurements were performed on the native liver prior to caval clamping. After vasopressin infusion, the portal vein pressure decreased significantly from 24.0 +/- 6.5 to 21.5 +/- 7.4 mm Hg [mean +/- standard deviation (SD), P = 0.006]. The portal vein blood flow also decreased (from 1.01 +/- 0.53 to 0.76 +/- 0.53 L/minute, mean +/- SD, P < 0.0001), as did the portal vein blood flow to cardiac output ratio (from 0.14 +/- 0.06 to 0.10 +/- 0.07, mean +/- SD, P < 0.0001). In conclusion, vasopressin significantly decreased portal vein pressure and flow of the native liver without decreasing cardiac output or intestinal perfusion in patients undergoing liver transplantations. PMID:18975276
Contact-free palm-vein recognition based on local invariant features.
Kang, Wenxiong; Liu, Yang; Wu, Qiuxia; Yue, Xishun
Contact-free palm-vein recognition is one of the most challenging and promising areas in hand biometrics. In view of the existing problems in contact-free palm-vein imaging, including projection transformation, uneven illumination and difficulty in extracting exact ROIs, this paper presents a novel recognition approach for contact-free palm-vein recognition that performs feature extraction and matching on all vein textures distributed over the palm surface, including finger veins and palm veins, to minimize the loss of feature information. First, a hierarchical enhancement algorithm, which combines a DOG filter and histogram equalization, is adopted to alleviate uneven illumination and to highlight vein textures. Second, RootSIFT, a more stable local invariant feature extraction method in comparison to SIFT, is adopted to overcome the projection transformation in contact-free mode. Subsequently, a novel hierarchical mismatching removal algorithm based on neighborhood searching and LBP histograms is adopted to improve the accuracy of feature matching. Finally, we rigorously evaluated the proposed approach using two different databases and obtained 0.996% and 3.112% Equal Error Rates (EERs), respectively, which demonstrate the effectiveness of the proposed approach. PMID:24866176
Intraosseous Venography with Carbon Dioxide in Percutaneous Vertebroplasty: Carbon Dioxide Retention in Renal Veins
Komemushi, Atsushi, E-mail: email@example.com; Tanigawa, Noboru; Kariya, Shuji; Kojima, Hiroyuki; Shomura, Yuzo; Tokuda, Takanori; Nomura, Motoo; Terada, Jiro; Kamata, Minoru; Sawada, Satoshi [Kansai Medical University, Department of Radiology (Japan)
The objective of the present study was to determine the frequency of gas retention in the renal vein following carbon dioxide intraosseous venography in the prone position and, while citing references, to examine its onset mechanisms. All percutaneous vertebroplasties performed at our hospital from January to December 2005 were registered and retrospectively analyzed. Of 43 registered procedures treating 79 vertebrae, 28 procedures treating 54 vertebrae were analyzed. Vertebral intraosseous venography was performed using carbon dioxide as a contrast agent in all percutaneous vertebroplasty procedures. In preoperative and postoperative vertebral CT, gas retention in the renal vein and other areas was assessed. Preoperative CT did not show gas retention (0/28 procedures; 0%). Postoperative CT confirmed gas retention in the renal vein in 10 of the 28 procedures (35.7%). Gas retention was seen in the right renal vein in 8 procedures (28.6%), in the left renal vein in 5 procedures (17.9%), in the left and right renal veins in 3 procedures (10.7%), in vertebrae in 22 procedures (78.6%), in the soft tissue around vertebrae in 14 procedures (50.0%), in the spinal canal in 12 procedures (42.9%), and in the subcutaneous tissue in 5 procedures (17.9%). In conclusion, in our study, carbon dioxide gas injected into the vertebra frequently reached and remained in the renal vein.
Simultaneous kissing stent in a patient with severe bifurcation pulmonary vein stenosis.
Cubeddu, Roberto J; Gulati, Vishal K
Pulmonary vein stenosis (PVS) is a late and rare complication of pulmonary vein isolation for the treatment of atrial fibrillation. The ideal approach to the management of PVS has not yet been established, however, corrective procedures may include both surgical and percutaneous techniques. We describe the case of a complex bifurcation lesion involving the left superior pulmonary vein. The condition required percutaneous intervention using a modified kissing stent technique with bare metal stents that resulted in an excellent post-operative course, sustained symptomatic relief, and uncomplicated 1-year follow-up. ® 2014 Wiley Periodicals, Inc. PMID:24905444
Detection of Reflux in Jugular and Vertebral Veins Through Directional Multigate Quality Doppler Profiles
NASA Astrophysics Data System (ADS)
Forzoni, Leonardo; Morovic, Sandra; Semplici, Paolo; Corsi, Massino; Ricci, Stefano; Tortoli, Piero
Chronic Cerebro-Spinal Venous Insufficiency (CCSVI) is a medical condition where deoxygenated blood flows from the veins surrounding the brain and spine is slowed down or blocked in its return to the heart. The diagnosis and severity of CCSVI can be assessed by investigating the possible presence and the extent of such reflux and/or blockage in neck veins and intracranial veins, with the patient in both sitting and supine positions. During such examinations, B-Mode and Color Doppler ultrasound are not always capable of accurately detect the flow behavior in all subjects.
Saphenous vein interposition as a salvage technique for complex vascular situations during renal transplantation.
Oertl, A J; Jonas, D; Oremek, G M; Jones, J
The shortage of donor organs for renal transplantation leads to the necessity of accepting organs with vascular disadvantages, such as venous difficulties (eg, shortness, disrupted vein after explantation) or arterial problems (eg, iatrogenic vascular accidents, arterial plaques, hemodynamically relevant polar arteries) and horseshoe kidneys. Consequently, such organs may not be considered for transplantation. Surgeons still have the ability to use such organs by saphenous vein interposition. This study focused on the frequency of vascular difficulties in 100 randomly selected kidney transplantations and their outcomes after arterial or venous saphenous vein interposition. PMID:17275492
Hepatic Veins and Inferior Vena Cava Thrombosis in a Child Treated by Transjugular Intrahepatic Portosystemic Shunt
Carnevale, Francisco Cesar, E-mail: firstname.lastname@example.com; Santos, Aline Cristine Barbosa [Sao Paulo University Medical School, Interventional Radiology Unit, Radiology Institute, Hospital das Clinicas (Brazil); Tannuri, Uenis [Sao Paulo University Medical School, Liver Transplantation Unit, Children's Institute, Hospital das Clinicas (Brazil); Cerri, Giovanni Guido [Sao Paulo University Medical School, Interventional Radiology Unit, Radiology Institute, Hospital das Clinicas (Brazil)
We report the case of a 9-year-old boy with portal hypertension, due to Budd-Chiari syndrome, and retrohepatic inferior vena cava thrombosis, submitted to a transjugular intrahepatic portosystemic shunt (TIPS) by connecting the suprahepatic segment of the inferior vena cava directly to the portal vein. After 3 months, the withdrawal of anticoagulants promoted the thrombosis of the TIPS. At TIPS revision, thrombosis of the TIPS and the main portal vein and clots at the splenic and the superior mesenteric veins were found. Successful angiography treatment was performed by thrombolysis and balloon angioplasty of a severe stenosis at the distal edge of the stent.
Iatrogenic graft to vein fistula (GVF) formation associated with synthetic arteriovenous grafts.
Haddad, Nabil J; Vachharajani, Tushar J; Van Cleef, Sheri; Agarwal, Anil K
The prevalence of fistulous connection between arteriovenous graft (AVG) and an adjacent vein resulting in graft-vein fistula (GVF) formation is not established. AVG venous outflow stenosis along with repeated and traumatic cannulation is likely major contributing factor of this complication. Detection and resolution of venous outflow stenosis may be the only needed intervention. We report a series of eight cases with GVF formation between AVG and adjacent veins. Awareness of this complication and intervention to relieve stenotic lesions may result in improved AVG survival. PMID:21175839
Congenital internal jugular vein aneurysm in an infant: A rare entity.
Awasthy, Neeraj; Khandelwal, Nidhi; Iyer, Krishna S
A 1-month old baby boy presented with a mass at the root of the neck. On investigation, a saccular aneurysm arising from the internal jugular vein was diagnosed. The aneurysm was excised after ligating the patent internal jugular vein above and below the origin of the aneurysm. Histopathology confirmed the diagnosis of a vascular malformation. Vascular malformation of the internal jugular vein, presenting as neck mass, is extremely rare with no case described in neonates. We present one such interesting case. PMID:25425716
[Spontaneous splenic vein rupture complicating liver cirrhosis: an autopsy case report].
Okubo, Satoshi; Kiriyama, Kazuo; Usui, Takeo; Takemura, Tadaharu; Ikeda, Kouichiro; Kanayama, Yoshio
A 70-year-old woman, who had hepatitis-C related liver cirrhosis died suddenly. Autopsy showed a massive retroperitoneal hematoma and ruptured splenic vein, as well as densely bloody ascites. This suggested that chronic and unnoticed retroperitoneal leak from the ruptured vein preceded the acute and fatal outcome of the intra-abdominal bleeding. Spontaneous rupture of the splenic vein is rarely reported in liver cirrhosis despite the presence of portal hypertension. This rare association is discussed with a literature review. PMID:23459537
Atypical abnormal pulmonary vein drainage with atrial septal defect: surgical treatment.
Szychta, Wojciech; Cerin, Gheorghe; Popa, Bogdan Adrian; Felice, Armienti; Lanzillo, Guido; Diena, Marco; Opolski, Grzegorz
Sinus venosus atrial septal defect (SV-ASD) usually coexists with partial anomalous pulmonary vein connection (PAPVC). It is a difficult diagnosis in transthoracic echocardiography (TTE) due to eccentric position of defects. We present a rare case of atypical anatomical variation in PAPVC, which was never described before. Two right pulmonary veins drained into superior vena cava, which overrode SV-ASD and interatrial septum, a third pulmonary vein into the right atrium. Complete diagnosis could not be set after TTE, nor transesophageal echocardiography, whereas angio-CT was finally conclusive. This diagnostic approach allowed the surgical planning. PMID:25604753
A Proposed Anatomic Typing of the Right Internal Spermatic Vein: Importance for Percutaneous Sclerotherapy of Varicocele
Siegel, Yoel [Rabin Medical Center Beilinson Campus, Sackler Medical School Tel Aviv University, Department of Radiology (Israel)], E-mail: firstname.lastname@example.com; Gat, Yigal [Rabin Medical Center Beilinson Campus, Sackler Medical School Tel Aviv University, Andrology Unit, Department of Obstetrics and Gynecology (Israel); Bacher, Gil N.; Gornish, Michael [Rabin Medical Center Beilinson Campus, Sackler Medical School Tel Aviv University, Department of Radiology (Israel)
Purpose. To classify the anatomic types of the right internal spermatic vein (ISV). Methods. We evaluated venograms obtained in 150 consecutive patients with idiopathic varicocele referred for transfemoral sclerotherapy .Results. Six anatomic types of the right internal spermatic vein (ISV) were recognized. These were classified by the location of their orifices and the tributary venous patterns. In roughly half the patients (53%), the ISV appeared as a simple vein with no remarkable retroperitoneal interconnections. In the remainder, complex retroperitoneal anastomoses were encountered. Conclusion. By understanding these anatomic variations, the angiographer can approach treatment of right-sided varicocele with foreknowledge of the nature of these types and the presence of valves and collaterals.
Double suicide genes selectively kill human umbilical vein endothelial cells
Background To construct a recombinant adenovirus containing CDglyTK double suicide genes and evaluate the killing effect of the double suicide genes driven by kinase domain insert containing receptor (KDR) promoter on human umbilical vein endothelial cells. Methods Human KDR promoter, Escherichia coli (E. coli) cytosine deaminase (CD) gene and the herpes simplex virus-thymidine kinase (TK) gene were cloned using polymerase chain reaction (PCR). Plasmid pKDR-CDglyTK was constructed with the KDR promoter and CDglyTK genes. A recombinant adenoviral plasmid AdKDR-CDglyTK was then constructed and transfected into 293 packaging cells to grow and harvest adenoviruses. KDR-expressing human umbilical vein endothelial cells (ECV304) and KDR-negative liver cancer cell line (HepG2) were infected with the recombinant adenoviruses at different multiplicity of infection (MOI). The infection rate was measured by green fluorescent protein (GFP) expression. The infected cells were cultured in culture media containing different concentrations of prodrugs ganciclovir (GCV) and/or 5-fluorocytosine (5-FC). The killing effects were measured using two different methods, i.e. annexin V-FITC staining and terminal transferase-mediated dUTP nick end-labeling (TUNEL) staining. Results Recombinant adenoviruses AdKDR-CDglyTK were successfully constructed and they infected ECV304 and HepG2 cells efficiently. The infection rate was dependent on MOI of recombinant adenoviruses. ECV304 cells infected with AdKDR-CDglyTK were highly sensitive to GCV and 5-FC. The cell survival rate was dependent on both the concentration of the prodrugs and the MOI of recombinant adenoviruses. In contrast, there were no killing effects in the HepG2 cells. The combination of two prodrugs was much more effective in killing ECV304 cells than GCV or 5-FC alone. The growth of transgenic ECV304 cells was suppressed in the presence of prodrugs. Conclusion AdKDR-CDglyTK/double prodrog system may be a useful method for suppressing tumor angiogenesis. PMID:21333030
O eco-Doppler colorido na avaliańŃo das varizes recidivadas Color-flow duplex scanning in the assessment of recurrent varicose veins
Graciliano Josķ Franńa; Jorge Rufino Ribas Timi; Enrique Ant¶nio Vidal; Aguinaldo de Oliveira; Fßbio Secchi; Marcio Miyamotto
Objective: The aim of the present study is to use color-flow duplex scanning to determine the prevalence of reflex in the greater saphenous vein stump in patients with recurrent varicose veins after saphenous vein stripping. All other possible causes of recurrence were also evaluated. Method: Over a 3-year period, 469 patients with recurrent varicose veins were prospectively assessed. The cohort
Prevention or Reversal of Deep Venous Insufficiency and Treatment: Why Are Spider Veins of the Legs a Serious and A Dangerous Medical Condition?
Waheed Ahmad
Spider veins (also known as spider hemangiomas) unlike varicose veins (dilated pre-existing veins) are acquired lesions caused by venous hypertension leading to proliferation of blood vessels in the skin and subcutaneous tissues due to the release of endothelial growth factors causing vascular neogenesis. More than 60% of the patients with spider veins of the legs have significant symptoms including pain,
A Primary Primitive Neuroectodermal Tumor Arising from Left Subclavian Vein and Extending along Left Brachiocephalic Vein and Superior Vena Cava into Right Atrium.
Wang, Jian; Wang, Weici; Li, Yiqing; Jin, Bi; Yu, Miao; Liu, Wenqi; Yao, Shaohua; Liao, Yonggui; Ouyang, Chenxi
Primitive neuroectodermal tumor (PNET) is an extremely rare malignancy thought to be derived from fetal neuroectodermal precursor cells. It usually occurs in central and peripheral nervous system or soft tissue and bone, while intravenous or intracavitary PNET is considered as an extremely rare tumor. We reported a case of a 44-year-old woman who presented with the left unilateral facial and neck swelling. Magnetic resonance imaging revealed a tape-shaped solid mass within left subclavian vein, left brachiocephalic vein, superior vena cava, and right atrium; the proximal end proportion occupied almost the entire right atrium with a pedicle flip protruded into the right ventricle. Ultrasonography revealed an irregular hypoechnoic mass arising from the left subclavian vein, which extended along the left brachiocephalic vein and superior vena cava into the right atrium and up to the right ventricle. Positron emission tomography-computed tomography revealed several hypermetabolic thyroid nodules with no evidence of intravenous hyperactive lesion. The patient underwent tumor resection under cardiopulmonary bypass. At 15Ādays postoperatively, total thyroidectomy and resection of the left subclavian vein were simultaneously performed. The patient received chemotherapy and radiotherapy later. Histologically, the neoplasm displayed small, round, blue cells with hyperchromatic nuclei and scant cytoplasm. The neoplastic cells showed a strong immunopositivity for CD99, synaptophysin, CD56, CD57, and friend leukemia integration 1, thus confirming a diagnosis of the PNET. Histopathological examination of the thyroid showed papillary carcinoma. Thus, this PNET had no definitive organ or tissue of origin, which primarily originated from the left subclavian vein with tumor extension along the superior vena cava to the right ventricle. PMID:25725277
Absence of infra-renal segment of inferior vena cava with anomalous right renal vein.
Ajay-Chandrasekar, Vs; Kaliyaperumal, V; Alfred, D
Various anomalies of the inferior venacava (IVC) have been reported in the past. Amongst, the absence of IVC is one of the less frequently reported anomalies. The absence can be complete or partial, confined to the hepatic, supra-renal or infra-renal segment of IVC. It is still a controversy, whether these conditions are true embryonic anomalies or the result of perinatal IVC thrombosis. A man in his mid 30's presented with absence of the infra-renal IVC and both common iliac veins. The right renal vein is replaced by a long tortuous vessel, similar to the appearance of collateral vessel. He presented with extensive varicose veins on the anterior abdominal wall, severe varices of right leg with ulcer. A coronal multiplanar reconstruction CT imaging was used to document the anomaly. Prior knowledge of this anomaly is vital, especially if these individuals are subjected to undergo cardiac procedures via femoral vein access. PMID:24960739
[The method of miniinvasive operation for varicosely-changed veins of gastric fundus].
Grubnik, V Iu; Vorotyntseva, K O; Grubnik, V V
The laparoscopic operation method was elaborated for prophylaxis arrest of hemorrhage, originated from varicosely-changed (VCH) veins of gastric fundus. Dissection and clipping of a. gastri-ca sinistra is performed and VCH gastric vein is transsected. After gastric fundus mobilization a laparoscopic suturing apparatus is applied on him and the fundus became resected. Additionally the sutures made of nonabsorbable threads are applied above the mechanical sutures line. The method was applied in 2 patients, suffering VCH gastroesophageal veins. Application of the proposed operative intervention method have permitted to reduce significantly the occurrence rate of purulent-septic complications. While follow-up prolong 24 - 30 months the hemorrhage recurrence was not revealed. Application of modem videoendoscopic methods of operation for VCH gastric veins permits to improve significantly the operation results and safety, to reduce the patients stationary treatment time. PMID:23705480
Dynamics of the ectoplasmic walls during pulsation of plasmodial veins of Physarum polycephalum
A. Gr?becki; M. Cie?lawska
Summary The thickness of ectoplasmic walls decreases at the contraction phase and increases at the expansion phase of each pulsation cycle. In average, 29% of material forming the walls of expanded veins is evacuated during contraction with the endoplasm streaming.
Deep vein thrombosis after spine operation in prone position with subclavian venous catheterization: a case report.
Cho, Jae Kyung; Han, Jin Hee; Park, Sung Wook; Kim, Keon Sik
We experienced a case of deep vein thrombosis after spine surgery in the prone position with a central venous catheter (CVC). Posterior lumbar interbody fusion was performed on a 73-year-old female patient who was diagnosed with spinal stenosis. Accordingly, in the operation room under general anesthesia, two-lumen CVC were inserted into the left subclavian vein. The surgery was performed in the prone position with a Wilson frame. On the next day, there was a sudden occurrence of severe edema in the patient's left arm. By ultrasonography and computed tomography scanning, extensive deep vein thrombosis was observed in the left subclavian vein. The existence of a factor affecting blood flow such as the prone position may increase the risk of thrombus formation. Therefore, careful perioperative evaluation should be implemented. PMID:25097742
Circular mapping and ablation of thepulmonary vein for treatment of atrial fibrillation
Nassir F Marrouche; Thomas Dresing; Christopher Cole; Dianna Bash; Eduardo Saad; Krzysztof Balaban; Stephen V Pavia; Robert Schweikert; Walid Saliba; Ahmed Abdul-Karim; Ennio Pisano; Raffaele Fanelli; Patrick Tchou; Andrea Natale
ObjectivesWe conducted this study to compare the efficacy and safety of different catheter ablation technologies and of distal versus ostial pulmonary veins (PV) isolation using the circular mapping technique.
A microstructural study of a "crack-seal" type serpentine vein using SEM and TEM techniques
is well understood. Factors concerning vein for- mation that need to be addressed include i) cause in an incremental opening fol- lowed by complete sealing (Ramsay, 1980) of small succes- sive cracks. Hundreds
Portacaval shunt with arterialization of the portal vein by means of a low flow arteriovenous fistula.
Adamons, R J; Butt, K; Iyer, S; DeRose, J; Dennis, C R; Kinkhabwala, M; Gordon, D; Martin, E
A new operative technique was designed combining an end-to-side portacaval shunt with arterialization of the intrahepatic portal vein by means of a saphenous vein graft between the right gastroepiploic artery and the stump of the portal vein. The objective of this operation is to perfuse the hepatic portion of the portal vein with a low volume of arterial blood to ameliorate the adverse metabolic consequences of portosystemic decompression. The procedure was performed upon 18 patients with one operative mortality. The mean follow-up period is 15.4 months. The benefits of this operation are evident in the prevention of hepatic decompensation and avoidance of encephalophy, thus permiting unrestricted protein intake. The operation is well tolerated, and the operative mortality appears to be less than that following conventional shunting procedures. PMID:653559
Renal Infarction in a Patient with Pulmonary Vein Thrombosis after Left Upper Lobectomy
Manabe, Shun; Oshima, Yasuko; Nakano, Marie; Fujii, Teruhiro; Maehara, Takamitsu; Nitta, Kosaku; Hatano, Michiyasu
A 43-year-old male experienced renal infarction (RI) following left upper lobectomy for lung cancer. The patient complained of acute-onset severe left flank pain on the 14th postoperative day. A contrast-enhanced computed tomography (CT) of the abdomen revealed RI by a large wedge-shaped defect in the left kidney. A chest CT scan located the thrombus in the stump (a blind-ended vessel) of the left superior pulmonary vein. Therefore, thromboembolic RI caused by pulmonary vein thrombosis was suspected. Anticoagulation therapy was initiated with heparin and warfarin to treat RI and to prevent further embolic episodes. Two months later, pulmonary vein thrombosis had resolved without the appearance of additional peripheral infarction. This case emphasizes the need to consider thrombus in the stump of the pulmonary vein as a cause of RI. PMID:24987406
Extensive Thrombosis of the Inferior Vena Cava and Left Renal Vein in a Neonate
Kdous, Moez; Khlifi, Oussema; Brahem, Marwene; Khrouf, Mohamed; Amari, Sarah; Ferchiou, Monia; Zhioua, Fethi
Antenatal renal vein thrombosis is a rarely described diagnostic finding, with variable consequences on kidney function. We present the case of an affected fetus, born at 35-week gestation, with intrauterine oligohydramnios and two small kidneys. A renal ultrasound carried out after birth confirmed the presence of prenatal abnormalities. Renal vein thrombosis was not diagnosed at the time. The baby died 20 days later of kidney failure, metabolic acidosis, and polypnea with severe hypotrophy. Autopsy revealed atrophied kidneys and adrenal glands. The vena cava had thrombosis occupying most of its length. The right renal vein was normal, while the left renal vein was threadlike and not permeable. Histologically, there was necrosis of the left adrenal gland with asymmetrical bilateral renal impairment and signs of ischemic and hemorrhagic lesions. A review of thrombophilia was carried out and a heterozygous mutation in Factor V was found in both the mother and the child.
Pre- and Postoperative Evaluation by Photoplethysmography in Patients Receiving Surgery for Lower-Limb Varicose Veins
Saliba J·nior, Orlando Adas; Giannini, Mariangela; M¾rbio, Ana Paula; Saliba, Orlando; Rollo, Hamilton Almeida
Objective. To evaluate the effectiveness of surgery in treating primary varicose veins in the lower limbs by photoplethysmography (PPG) and duplex mapping (DM). Method. Forty-eight lower limbs were clinically evaluated according to the CEAP classification system and subjected to PPG and DM exams. Each limb had a venous refill time (VRT) of <20 seconds and a normal deep vein system (DVS) by DM. Results. The mean pre- and postoperative VRTs were 13.79 and 26.43 seconds, respectively (P < 0.0001). After surgery, 42 limbs (87.50%) had normal results by PPG (VRT > 20 seconds). Four limbs (8.33%) showed improved VRTs, but the VRTs did not reach 20 seconds. In the 2 limbs (4.17%) that maintained their original VRTs, the DM exams showed the presence of insufficient perforating veins. Conclusion. In most cases, PPG allows for a satisfactory evaluation of the outcome of varicose vein surgery. PMID:24696783
Occurrence of a Begomovirus with yellow vein mosaic disease of mesta ( Hibiscus cannabinus and Hibiscus sabdariffa )
A. Chatterjee; A. Roy; K. V. Padmalatha; V. G. Malathi; S. K. Ghosh
A whitefly transmitted Begomovirus (Geminiviridae: Begomovirus) with a satellite (?-DNA associated with yellow vein mosaic disease of mesta (Hibiscus cannabinus and Hibiscus sabdariffa) has been detected for the first time in mesta growing regions of India.
Long-term patency of vein grafts preserved in liquid nitrogen in dimethyl sulfoxide.
Weber, T R; Lindenauer, S M; Dent, T L; Allen, E; Salles, C A; Weatherbee, L
Autogenous canine jugular veins were stored in 15% dimethyl sulfoxide (DMSO) in liquid nitrogen vapor for one to 28 days and then implanted in the carotid artery as autografts. The patency rate at one year was 62.5-87.5%. The patency rate of fresh jugular vein autografts placed in the carotid artery for one year was 75%. Similar autografts stored in liquid nitrogen vapor for one to 28 days without the cryopreservative DMSO exhibited a zero to 12.5% patency rate at one year. Scanning electron microscope studies revealed preservation of theendothelium in DMSO protected veins and a damaged or sloughed endothelium in veins frozen without DMSO cryopreservation. Images Figs. 1a and b. Figs. 2a and b. Figs. 3a and b. PMID:999347
Constitutive modeling of human saphenous veins at overloading pressures.
Vesel², J; Horn², L; Chlup, H; Adßmek, T; KrajĒ?ek, M; Äitn², R
In the present study, inflation tests with free axial extension of 15 human vena saphena magna were conducted ex vivo to obtain data suitable for multi-axial constitutive modeling at overloading conditions (pressures up to approximately 15kPa). Subsequently the data were fitted with a hyperelastic, nonlinear and anisotropic constitutive model based on the theory of the closed thick-walled tube. It was observed that initial highly deformable behavior (up to approximately 2.5kPa) in the pressure-circumferential stretch response is followed by progressive large strain stiffening. Contrary to that, samples were much stiffer in longitudinal direction, where the observed stretches were in the range 0.98-1.03 during the entire pressurization in most cases. The effect of possible residual stress was evaluated in a simulation of the intramural stress distribution with the opening angle prescribed to 0░, 10░, 20░, 30░, 40░, and 50░. The result suggests that the optimal opening angle making the stress distribution through the wall thickness uniform is about 40░. The material parameters presented here are suitable for use in mechanobiological simulations describing the adaptation of the autologous vein wall after bypass surgery. PMID:25700260
Postthrombotic syndrome following upper extremity deep vein thrombosis in children.
Avila, Maria L; Duan, Lucy; Cipolla, Amanda; Kim, Ashley; Kahr, Walter H A; Williams, Suzan; BrandŃo, Leonardo R
Despite its relatively estimated high occurrence, the characterization of pediatric upper extremity deep vein thrombosis (UE-DVT) and of UE postthrombotic syndrome (PTS) is still lacking. We investigated the occurrence, characteristics, and predictors of UE-PTS in a cohort of children with objectively confirmed UE-DVT. Patients were analyzed in 3 groups according to DVT pathogenesis and neonatal status: primary (G1), secondary neonates (G2neonates), and non-neonates (G2non-neonates). A total of 158 children (23 G1, 25 G2neonates, and 110 G2non-neonates) were included. The most common triggering factors were effort-related (87%) in G1 and central lines in G2neonates (100%) and in G2non-neonates (92%). PTS scores ?1, as per the Modified Villalta Scale, were identified in 87% of primary patients, 16% of G2neonates, and 49% of G2non-neonates. Survival analysis showed that the time to PTS score ?1 significantly differed among group (log-rank test P < .0001). A multivariable logistic regression showed that DVT pathogenesis and imaging-determined degree of thrombus resolution at the end of therapy were independent predictors of a PTS score ?2. In conclusion, pediatric UE-PTS frequency and severity depend on UE-DVT pathogenesis (primary/secondary) and, within the secondary group, on patient's age. Line-related UE-PTS has a more benign course, particularly in neonates. PMID:24957144
Optimal vein density in artificial and real leaves
Noblin, X.; Mahadevan, L.; Coomaraswamy, I. A.; Weitz, D. A.; Holbrook, N. M.; Zwieniecki, M. A.
The long evolution of vascular plants has resulted in a tremendous variety of natural networks responsible for the evaporatively driven transport of water. Nevertheless, little is known about the physical principles that constrain vascular architecture. Inspired by plant leaves, we used microfluidic devices consisting of simple parallel channel networks in a polymeric material layer, permeable to water, to study the mechanisms of and the limits to evaporation-driven flow. We show that the flow rate through our biomimetic leaves increases linearly with channel density (1/d) until the distance between channels (d) is comparable with the thickness of the polymer layer (?), above which the flow rate saturates. A comparison with the plant vascular networks shows that the same optimization criterion can be used to describe the placement of veins in leaves. These scaling relations for evaporatively driven flow through simple networks reveal basic design principles for the engineering of evaporation¢permeation-driven devices, and highlight the role of physical constraints on the biological design of leaves. PMID:18599446
[Management of catheter-related upper extremity deep vein thrombosis].
Linnemann, B; Lindhoff-Last, E
Central venous catheters (CVCs) are important tools in the care of patients with acute or chronic diseases, but catheter-related thrombosis and thrombotic occlusions are frequent complications, especially if CVCs are implanted for long-term use. In this review we focus on the management of these complications. Risk factors for catheter-related thrombosis include dislocation of the catheter tip, the presence of malignant disease and hypercoagulability. Catheter-related thrombosis is associated with catheter infection, pulmonary embolism and post-thrombotic syndrome. Catheter-related thromboses which most frequently involve the subclavian vein are usually diagnosed by duplex ultrasound examination and treated with anticoagulation therapy for a minimum of three months or longer if the catheter is left in place. Prevention of catheter-related thrombotic complications includes proper positioning of the CVC with the catheter tip lying in the proximal superior vena cava and regular flushing of the catheter with saline solution or unfractionated heparin. The use of anticoagulants for primary prevention is currently not recommended. PMID:23575524
[Management of mesenteric ischemia and mesenteric vein thrombosis].
Hoffmann, M; Keck, T
Acute mesenteric ischemia is secondary to acute embolic disease or thrombosis of the superior mesenteric artery. Further pathologies that manifest themselves with the same clinical presentation are thrombosis of the superior mesenteric vein and non-occlusive disease. The patients are admitted to the emergency room with an acute abdomen. Most patients are more than 70 years old. Known risk factors for mesenteric ischemia are cardiac diseases as atrial fibrillation, aneurysms of the aorta and the visceral arteries, occlusive arterial diseases, tumorigenic compression of the vessel and several diseases that result in a reduction of the flow and intravascular volume in the superior mesenteric artery. The golden standard in the diagnosis of acute mesenteric ischemia is CT-angiography of the abdominal vessels with 3?D reconstruction. The therapy is different and dependent from the underlying pathology. A statistically significantly elevated mortality of more than 95% is associated with a delay of surgical or interventional therapy of more than 12 hours after the initial symptoms and non-occlusive mesenteric ischemia. Because of the advanced age of the patients and the co-morbidities a non-surgical interventional re-canalisation of the superior mesenteric vessels is recommended. A laparotomy is necessary in all patients with peritonitis and/or bowel necrosis or perforation. PMID:25072864
Diagnosis of deep vein thrombosis and pulmonary embolism in pregnancy.
Chan, Wee-Shian; Ginsberg, Jeffrey S
Venous thromboembolism (VTE) is a major cause of maternal morbidity and mortality. Because unrecognized and untreated pulmonary embolism (PE) can result in maternal mortality, physician vigilance for this disease should remain high. The diagnosis of both PE and deep vein thrombosis (DVT) in the pregnant patient, as in the nonpregnant patient, requires the use of accurate objective imaging. However, unlike the nonpregnant population, there is a paucity of trials evaluating the safety and accuracy of objective testing for PE or DVT diagnosis in pregnant patients--likely because of concerns surrounding the use of ionizing radiation associated with diagnostic tests during pregnancy. Regardless of extrapolating results from studies in the nonpregnant population, the use of compression leg ultrasound and ventilation-perfusion (VQ) scanning during pregnancy is central to the diagnosis of DVT and PE, respectively. Data on the utility of structured clinical models or D-dimer testing for the diagnosis of DVT or PE during pregnancy is currently unavailable. Future research is urgently needed to validate the use of current approaches and perhaps define safer and more accurate strategies to reduce maternal morbidity from this disease. PMID:12431472
The nucleotide sequence of tobacco vein mottling virus RNA.
Domier, L L; Franklin, K M; Shahabuddin, M; Hellmann, G M; Overmeyer, J H; Hiremath, S T; Siaw, M F; Lomonossoff, G P; Shaw, J G; Rhoads, R E
The nucleotide sequence of the RNA of tobacco vein mottling virus, a member of the potyvirus group, was determined. The RNA was found to be 9471 residues in length, excluding a 3'-terminal poly(A) tail. The first three AUG codons from the 5'-terminus were followed by in-frame termination codons. The fourth, at position 206, was the beginning of an open reading frame of 9015 residues which could encode a polyprotein of 340 kDa. No other long open reading frames were present in the sequence or its complement. This AUG was present in the sequence AGGCCAUG, which is similar to the consensus initiation sequence shared by most eukaryotic mRNAs. The chemically-determined amino acid compositions of the helper component and coat proteins were similar to those predicted from the nucleotide sequence. Amino acid sequencing of coat protein from which an amino-terminal peptide had been removed allowed exact location of the coat protein cistron. A consensus sequence of V-(R or K)-F-Q was found on the N-terminal sides of proposed cleavage sites for proteolytic processing of the polyprotein. Images PMID:3737407
Portal vein thrombosis in cirrhosis: Controversies and latest developments.
Harding, Damian J; Perera, M Thamara Pr; Chen, Frederick; Olliff, Simon; Tripathi, Dhiraj
Portal vein thrombosis (PVT) is encountered in liver cirrhosis, particularly in advanced disease. It has been a feared complication of cirrhosis, attributed to significant worsening of liver disease, poorer clinical outcomes and potential inoperability at liver transplantation; also catastrophic events such as acute intestinal ischaemia. Optimal management of PVT has not yet been addressed in any consensus publication. We review current literature on PVT in cirrhosis; its prevalence, pathophysiology, diagnosis, impact on the natural history of cirrhosis and liver transplantation, and management. Studies were identified by a search strategy using MEDLINE and Google Scholar. The incidence of PVT increases with increasing severity of liver disease: less than 1% in well-compensated cirrhosis, 7.4%-16% in advanced cirrhosis. Prevalence in patients undergoing liver transplantation is 5%-16%. PVT frequently regresses instead of uniform thrombus progression. PVT is not associated with increased risk of mortality. Optimal management has not been addressed in any consensus publication. We propose areas for future research to address unresolved clinical questions. PMID:26078553
Portal vein thrombosis in cirrhosis: Controversies and latest developments
Harding, Damian J; Perera, M Thamara PR; Chen, Frederick; Olliff, Simon; Tripathi, Dhiraj
Portal vein thrombosis (PVT) is encountered in liver cirrhosis, particularly in advanced disease. It has been a feared complication of cirrhosis, attributed to significant worsening of liver disease, poorer clinical outcomes and potential inoperability at liver transplantation; also catastrophic events such as acute intestinal ischaemia. Optimal management of PVT has not yet been addressed in any consensus publication. We review current literature on PVT in cirrhosis; its prevalence, pathophysiology, diagnosis, impact on the natural history of cirrhosis and liver transplantation, and management. Studies were identified by a search strategy using MEDLINE and Google Scholar. The incidence of PVT increases with increasing severity of liver disease: less than 1% in well-compensated cirrhosis, 7.4%-16% in advanced cirrhosis. Prevalence in patients undergoing liver transplantation is 5%-16%. PVT frequently regresses instead of uniform thrombus progression. PVT is not associated with increased risk of mortality. Optimal management has not been addressed in any consensus publication. We propose areas for future research to address unresolved clinical questions. PMID:26078553
Quartz-molybdenite veins in the Priestly Lake granodiorite, north-central Maine
Ayuso, Robert A.; Shank, Stephen G.
Quartz-molybdenite veins up to 15 cm in width occur in fine to medium-grained porphyritic biotite-hornblende granodiorite at Priestly Lake north-central Maine. An area of about 150 m x 150 m contains quartz-molybdenite veins; a larger area is characterized by barren quartz veins. Quartz-molybdenite veins are concentrated within the most felsic variants of the intrusion as suggested by lower mafic mineral contents. The pluton has a narrow range in SiO2 (67-70 wt.%), major oxides, and in trace-element compositions. Molybdenite occurs as coarse grained clusters in pockets within the quartz veins, and fills fractures in the quartz veins and host rocks. Disseminated molybdenite in the granodiorite is relatively rare and occurs only in the area characterized by a high density of quartz veins (up to 50 veins per square meter). Alteration envelopes along the quartz veins are very thin or absent, although in some areas the granodiorite appears to be selectively and pervasively altered. Sericite, chlorite, epidote, calcite, pyrite, and quartz are concentrated near the quartz-molybdenite veins. Many of the field and geochemical characteristics of the Priestly Lake pluton are unlike those of major molybdenum-producing areas (Climax, Henderson, Urad). For example, the area of alteration seems to be of limited extent, the host rock is not intensely altered hydrothermally at the surface, the density of fractures is rather low in the mineralized area, and the amount of disseminated molybdenite appears to be small. However, the Priestly Lake pluton may be a small fraction of a concealed batholith as suggested by geophysical data. It is conceivable that the type of mineralization at the surface might be the expression of more extensive molybdenite mineralization at depth. The quartz-molybdenite veins in the Priestly Lake pluton are significant because they indicate that potential molybdenum sources for producing mineralized granites were available at depth. Future studies should be aimed at delineating the area of quartz-molybdenite mineralization, documenting hydrothermal alteration and zonation, determining fracture density, and evaluating the sulfide assemblage.
Repeated Seismic Slips Recorded in Fluidized ultracataclastic Veins within Shallow Seismogenic Fault Zones
NASA Astrophysics Data System (ADS)
Lin, A.
It is well known that direct evidence of earthquakes within fault zones is limited to the presence of pseudotachylyte. In addition to pseudotachylyte, previous studies have shown that the meso- and microstructural features of cataclastic veins that lack the primary cohesion of the host rocks, including crush-origin pseudotachylyte, fault breccia, may represent primary evidence of brittle deformation caused by recurrent seismic slip within shallow seismogenic fault zones (e.g., Lin, 1996, 2008). In this presentation, we report on the structural mode of typical ultracataclastic veins including pseudotachylyte and fault gouge veins that formed repeatedly as simple veins and complex networks at shallow depth within two main active fault zones along the Arima-Takatsuki Tectonic Line (ATTL) and the Itoigawa-Shizuoka Tectonic Line (ISTL), Japan. Multistage veinlet cataclastic rocks, composed of aphanitic veins typical of pseudotachylyte and unconsolidated fault gouge, breccias, as complex networks along the main active fault zones. Early veins are generally fractured and overprinted by younger veins, indicating that vein-forming events occurred repeatedly within the same fault shear zone. Microstructurally, both the pseudotachylyte and fault gouge veins are characterized by a superfine- to fine-grained matrix and angular-subangular fragments ranging in size from submicron scale to several centimeters. Based on the meso- and microstructural features of veinlet ultracataclastic rocks and the results of powder X-ray diffraction analyses, we conclude that (i) the pseudotachylyte veins were generated mainly by crushing rather than melting at shallow fault zones, and (ii) multistage veinlet fault gouge and pseudotachylyte formed repeatedly within the fault-fracture zone via the rapid fluidization and injection of superfine- to fine-grained materials derived from the host rocks during large-magnitude earthquakes that occurred along the active fault zones within the ATTL and ISTL. Our results show that the fluidized ultracataclastic veins record paleoseismic faulting events that occurred at shallow seismogenic fault zones; consequently, these features are a type of earthquake fossil, as is melt-origin pseudotachylyte.
Subclavian vein to right atrial appendage bypass without sternotomy to maintain arteriovenous access in patients with complete central vein occlusion, a new approach.
Glass, Carolyn; Maevsky, Victor; Massey, Todd; Illig, Karl
Given the increasing numbers of patients requiring long-term hemodialysis, there is an inevitably increasing population of patients with occluded central venous inflow (subclavian, innominate, and caval) despite access or access possibilities in the arm. In an effort to avoid sternotomy, we have attempted to treat these patients with a substernally tunneled subclavian to right atrial bypass. Patients treated in this fashion have an existing fistula with symptomatic venous hypertension or good fistula options but complete central vein obstruction, a patent subclavian/axillary vein to the costoclavicular junction, and no other options in the contralateral arm. Claviculectomy is performed and the subclavian vein isolated. Through a third intercostal space "minipericardiotomy," the right atrial appendage is exposed. A retrosternal tunnel is fashioned, and bypass is performed from the subclavian vein to atrial appendage. Eleven patients aged 20-70 (mean 46) years underwent surgery at our institution between February 2004 and March 2007. Three bypasses were performed with autogenous vein (two femoral and one saphenous), while eight were performed with polytetrafluoroethylene in an effort to preserve the superficial femoral vein for later leg bypass. There was one early mortality due to sepsis, and early morbidity was limited to one patient with a symptomatic pericardial effusion. Mean follow-up was 16 (range 3-43) months. Sixty-seven percent and 33% of arteriovenous fistulas remained functional at 6 and 10 months, respectively; and one patient's fistula remained functional at 21 months. Four patients (36%) developed central bypass stenosis or occlusion, one requiring a redo bypass and three angioplasty. Infection occurred in two patients (18%), with removal of autogenous vein graft in one. While a significant number of these bypasses fail, upper extremity access is maintained in a reasonable number of patients (67% at 6 months) who are not candidates for local repair or stenting and would thus have no other upper extremity access options. This technique offers an alternative to sternotomy and brachiocephalic vein reconstruction, although the superiority of one method over the other will require direct comparison. PMID:19359137
Endovascular Coil Embolization in a Postnephrostomy Renal Vein to Renal Pelvis Fistula
Anil, Gopinathan, E-mail: firstname.lastname@example.com; Taneja, Manish [Singapore General Hospital, Department of Radiology (Singapore)
We report the case of a 74-year-old man with post-percutaneous-nephrostomy venous hemorrhage from an iatrogenic fistula between the renal pelvis and a large tributary of the renal vein. Conservative management failed to contain the hemorrhage. Hence the fistula was occluded by coil embolization through the renal vein. This endovascular approach enabled rapid and effective stoppage of the venous bleed.There was no recurrence of the bleed or any pertinent complication at 3-month follow-up.
A Comparative Study Between Crepe Bandage, Tensopress, and Panelast Following Varicose Vein Operations
Nasser M. Amer; Mike Walker
This study was conducted in a district general hospital to compare the effect of three types of bandages applied following\\u000a standard varicose vein operations. The three bandages studied were Crpe bandage, Tensopress, and Panelast. The study included\\u000a 60 patients and took place over a period of a year. All patients coming for a varicose veins operation were included in the
Accuracy of Hand-held Doppler in Planning the Operation for Primary Varicose Veins
T. Rautio; J. Perõlõ; F. Biancari; H. Wiik; P. Ohtonen; K. Haukipuro; T. Juvonen
Objective: to evaluate whether hand-held Doppler (HHD) examination is an adequate screening test in planning surgical treatment for primary varicose vein.Design: prospective study.Materials:one hundred and eleven consecutive patients (142 legs) with primary, uncomplicated varicose veins.Methods: legs were examined clinically, with HHD and duplex ultrasonography on the same day at the outpatient clinic. The plan for the subsequent treatment was recorded
Matrix Metalloproteinases as Potential Targets in the Venous Dilation Associated with Varicose Veins
Kucukguven, Arda; Khalil, Raouf A.
Varicose veins (VVs) are a common venous disease of the lower extremity characterized by incompetent valves, venous reflux, and dilated and tortuous veins. If untreated, VVs could lead to venous thrombosis, thrombophlebitis and chronic venous leg ulcers. Various genetic, hormonal and environmental factors may lead to structural changes in the vein valves and make them incompetent, leading to venous reflux, increased venous pressure and vein wall dilation. Prolonged increases in venous pressure and vein wall tension are thought to increase the expression/activity of matrix metalloproteinases (MMPs). Members of the MMPs family include collagenases, gelatinases, stromelysins, matrilysins, membrane-type MMPs and others. MMPs are known to degrade various components of the extracellular matrix (ECM). MMPs may also affect the endothelium and vascular smooth muscle, causing changes in the vein relaxation and contraction mechanisms. ECs injury also triggers leukocyte infiltration, activation and inflammation, which lead to further vein wall damage. The vein wall dilation and valve dysfunction, and the MMP activation and superimposed inflammation and fibrosis would lead to progressive venous dilation and VVs formation. Surgical ablation is an effective treatment for VVs, but may be associated with high recurrence rate, and other less invasive approaches that target the cause of the disease are needed. MMP inhibitors including endogenous tissue inhibitors (TIMPs) and pharmacological inhibitors such as zinc chelators, doxycycline, batimastat and marimastat, have been used as diagnostic and therapeutic tools in cancer, autoimmune and cardiovascular disease. However, MMP inhibitors may have side effects especially on the musculoskeletal system. With the advent of new genetic and pharmacological tools, specific MMP inhibitors with fewer undesirable effects could be useful to retard the progression and prevent the recurrence of VVs. PMID:23316963
Adaptation of the Main Peripheral Artery and Vein to Long Term Confinement (MARS 500)
Arbeille, Philippe; Provost, Romain; Vincent, Nicole; Aubert, Andre
Purpose The objective was to check if 520 days in confinement (MARS 500), may affect the main peripheral arterial diameter and wall thickness and the main vein size. Method Common carotid (CC) femoral artery (FA) portal vein (PV), jugular (JG), femoral vein (FV) and tibial vein were assessed during MARS 500 by echography, performed by the subjects. A hand free volumic echographic capture method and a delayed 3D reconstruction software developed by our lab were used for collecting and measuring the vascular parameters. Results During the MARS 500 experiment the subjects performed 6 sessions among which 80% of the echographic data were of sufficient quality to be processed. No significant change was found for the Common carotid, Jugular vein, femoral artery, femoral vein, portal vein, and tibial vein diameter. CC and FA IMT (intima media thickness) were found significantly increased (14% to 28% P<0.05) in all the 6 subjects, during the confinement period and also at +2 days after the confinement period, but there was no significant difference 6 month later compare to pre MARS 500. Conclusion The experiment confirmed that even untrained to performing echography the subjects were able to capture enough echographic data to reconstruct the vessel image from which the parameters were measured. The increase in both CC and FA IMT should be in relation with the stress generated by the confined environment or absence of solar radiation, as there was no change in gravity, temperature and air in the MARS 500 module, and minor changes in physical exercise and nutrition. PMID:24475025
Brittle-viscous deformation of vein quartz under fluid-rich lower greenschist facies conditions
NASA Astrophysics Data System (ADS)
Kj°ll, H. J.; Viola, G.; Menegon, L.; S°rensen, B. E.
We studied by Electron BackScatter Diffraction (EBSD) and optical microscopy a coarse-grained (ca. 0.5-6 mm) quartz vein embedded in a phyllonitic matrix to gain insights into the recrystallization mechanisms and the processes of strain localization in quartz deformed under lower greenschist facies conditions, broadly coincident with the brittle-viscous transition. The vein deformed during faulting along a phyllonitic thrust of Caledonian age within the Porsa Imbricate Stack in the Paleoproterozoic Repparfjord Tectonic Window in northern Norway. The phyllonite hosting the vein formed at the expense of a metabasaltic protolith through feldspar breakdown to form interconnected layers of fine, synkinematic phyllosilicates. In the mechanically weak framework of the phyllonite, the quartz vein acted as a relatively rigid body. Viscous deformation in the vein was initially accommodated by quartz basal slip. Under the prevailing deformation conditions, however, dislocation glide- and possibly creep-accommodated deformation of quartz was inefficient, and this resulted in localized strain hardening. In response to the (1) hardening, (2) progressive and cyclic increase of the fluid pressure, and (3) increasing competence contrast between the vein and the weakly foliated host phyllonite, vein quartz crystals began to deform by brittle processes along specific, suitably oriented lattice planes, creating microgouges along microfractures. Nucleated new grains rapidly sealed these fractures as fluids penetrated the actively deforming system. The grains grew initially by solution precipitation and later by grain boundary migration. We suggest that the different initial orientation of the vein crystals led to strain accommodation by different mechanisms in the individual crystals, generating remarkably different microstructures. Crystals suitably oriented for basal slip, for example, accommodated strain mainly viscously and experienced only minor fracturing. Instead, crystals misoriented for basal slip hardened and deformed predominantly by domainal fracturing. This study indicates the importance of considering shear zones as dynamic systems wherein the activated deformation mechanisms may vary through time in response to the complex temporal and spatial evolution of the shear zone, often in a cyclic fashion.
Slower Onset of Low Shear Stress Leads to Less Neointimal Thickening in Experimental Vein Grafts
Zachary K. Baldwin; Amito Chandiwal; Wendy Huang; James E. Vosicky; Viji Balasubramanian; Michael A. Curi; Lewis B. Schwartz
Vein grafts respond to low flow and shear stress (?w) by generating thicker walls and smaller lumens through the processes of neointimal hyperplasia and remodeling. Clinically,\\u000a however, vein grafts with obviously low ?w, such as those distal to high-grade proximal obstructions, are not infrequently found to be widely patent and pliable. One\\u000a possible explanation for this phenomenon may be that
Molecular analysis of the complete genomic sequences of four isolates of Gooseberry vein banding associated virus
Donglin Xu; Ray Mock; Gary Kinard; Ruhui Li
The presence of Gooseberry vein banding associated virus (GVBaV), a badnavirus in the family Caulimoviridae, is strongly correlated with gooseberry vein banding disease in Ribes spp. In this study, full-length genomic sequences of four GVBaV isolates from different hosts and geographic regions were\\u000a determined to be 7649¢7663 nucleotides. These isolates share identities of 96.4¢97.3% for the complete genomic sequence, indicating
Pulmonary veins in the normal lung and pulmonary hypertension due to left heart disease
Hunt, James M.; Bethea, Brian; Liu, Xiang; Gandjeva, Aneta; Mammen, Pradeep P. A.; Stacher, Elvira; Gandjeva, Marina R.; Parish, Elisabeth; Perez, Mario; Smith, Lynelle; Graham, Brian B.; Kuebler, Wolfgang M.
Despite the importance of pulmonary veins in normal lung physiology and the pathobiology of pulmonary hypertension with left heart disease (PH-LHD), pulmonary veins remain largely understudied. Difficult to identify histologically, lung venous endothelium or smooth muscle cells display no unique characteristic functional and structural markers that distinguish them from pulmonary arteries. To address these challenges, we undertook a search for unique molecular markers in pulmonary veins. In addition, we addressed the expression pattern of a candidate molecular marker and analyzed the structural pattern of vascular remodeling of pulmonary veins in a rodent model of PH-LHD and in lung tissue of patients with PH-LHD obtained at time of placement on a left ventricular assist device. We detected urokinase plasminogen activator receptor (uPAR) expression preferentially in normal pulmonary veins of mice, rats, and human lungs. Expression of uPAR remained elevated in pulmonary veins of rats with PH-LHD; however, we also detected induction of uPAR expression in remodeled pulmonary arteries. These findings were validated in lungs of patients with PH-LHD. In selected patients with sequential lung biopsy at the time of removal of the left ventricular assist device, we present early data suggesting improvement in pulmonary hemodynamics and venous remodeling, indicating potential regression of venous remodeling in response to assist device treatment. Our data indicate that remodeling of pulmonary veins is an integral part of PH-LHD and that pulmonary veins share some key features present in remodeled yet not normotensive pulmonary arteries. PMID:24039255
Deep vein and intracardiac thrombosis during the post-partum period in BehńetÆs disease
Prashant Hiwarkar; Roberto Stasi; George Sutherland; Muriel Shannon
A 22-year-old woman presented on the 10th post-partum day with deep vein thrombosis involving the right ilio-femoral and popliteal\\u000a veins. This thrombosis was refractory to conventional anticoagulation and subsequently over a period of 6Āweeks progressed\\u000a to involve inferior vena cava and right ventricle. A diagnosis of BehńetÆs disease was made on the clinical grounds of fever,\\u000a night sweats, and recurrent
Effect of Image Processing of a Leaf Photograph on the Calculated Fractal Dimension of Leaf Veins
Yun Kong; Shaohui Wang; Chengwei Ma; Baoming Li; Yuncong Yao
Digital photography is a promised method for estimating the fractal characteristics of leaf veins. In this study, the effects\\u000a of different threshold levels and image processing methods using Adobe Photoshop software on the fractal dimension values\\u000a were examined from a digital photo of nectarine leaf. The results showed that the nectarine leaf vein has typical fractal\\u000a characteristics and its fractal
The Mathematical Treatment of Leaf Venation: the Variation in Secondary Vein Length along the Midrib
d Background and Aims In some dicotyledonous leaves and leaflets, the secondary veins run more-or-less straight to the margins and have well-defined lengths. For a given half-lamina of length L, an equation, previously pro- posed, relates the lengths of these veins, p, to the distances, l, between the leaf tip and their insertions on the midrib: p=B 2 x+ylx(L -
Percutaneous Stent Placement as Treatment of Renal Vein Obstruction Due to Inferior Vena Caval Thrombosis
Stecker, Michael S., E-mail: email@example.com; Casciani, Thomas [Indiana University School of Medicine, Department of Radiology, Vascular and Interventional Radiology Section (United States); Kwo, Paul Y. [Indiana University School of Medicine, Department of Medicine, Division of Gastroenterology/Hepatology (United States); Lalka, Stephen G. [Indiana University School of Medicine, Department of Surgery, Division of Vascular Surgery (United States)
A patient who had undergone his third orthotopic liver transplantation nearly 9 years prior to presentation developed worsening hepatic and renal function, as well as severe bilateral lower extremity edema. Magnetic resonance imaging demonstrated vena caval thrombosis from the suprahepatic venous anastomosis to the infrarenal inferior vena cava, obstructing the renal veins. This was treated by percutaneous placement of metallic stents from the renal veins to the right atrium. At 16 months clinical follow-up, the patient continues to do well.
Endovascular Treatment of Acute Portal Vein Thrombosis After Liver Transplantation in a Child
Carnevale, Francisco Cesar, E-mail: email@example.com; Borges, Marcus Vinicius [University of Sao Paulo, Division of Interventional Radiology, Radiology Institute, Hospital das Clinicas (Brazil); Moreira, Airton Mota [University of Sao Paulo, Division of Interventional Radiology, Children's Institute, Hospital das Clinicas (Brazil); Cerri, Giovanni Guido [University of Sao Paulo, Radiology Institute, Hospital das Clinicas (Brazil); Maksoud, Joao Gilberto [Hospital das Clinicas, University of Sao Paulo, Division of Pediatric Surgery, Children's Institute (Brazil)
Although operative techniques in hepatic transplantation have reduced the time and mortality on waiting lists, the rate of vascular complications associated with these techniques has increased. Stenosis or thrombosis of the portal vein is an infrequent complication, and if present, surgical treatment is considered the traditional management. This article describes a case of acute portal vein thrombosis after liver transplantation from a living donor to a child managed by percutaneous techniques.
Transvenous approach to carotid-cavernous fistula via facial vein cut down.
Thiex, Ruth; Gross, Bradley A; Gupta, Rishi; Wyers, Mark C; Frerichs, Kai U; Thomas, Ajith J
Endovascular access to carotid-cavernous sinus fistulae (CCF) can be obtained through a transfemoral approach to the inferior petrosal sinus (IPS) or superior ophthalmic vein (SOV). If the transfemoral approach cannot be utilized, direct surgical exposure of the SOV can provide access to the CCF. The authors present an alternate approach to a CCF in a 66-year-old woman in whom the IPS was thrombosed and the facial vein so tortuous at its origin that it could not be passed with a wire. The facial vein was exposed surgically at the angle of the mandible after percutaneous attempts failed. After localization of the anterior facial vein with ultrasound, a 1 cm skin incision was made over the margin of the mandible. The dissected vein was cannulated using a micropuncture technique and a 0.018 inch wire. A four French short access sheath was inserted and sutured to the vein. Subsequent venogram allowed navigation of an SL-10 microcatheter over a Synchro soft microwire (both Boston Scientific, Natick, MA, USA) via the SOV into the cavernous sinus, and coil embolization was performed with angiographic cure of the fistula. No complications were encountered and the cosmetic result of the small incision of the mandibular region was excellent and less conspicuous than it would have been on the eyelid. This technical note illustrates that facial vein cut down is an attractive and safe alternate approach to endovascular management of CCF via a transvenous route in patients with a focally narrowed and tortuous IPS and common facial vein. PMID:24387933
Intravitreal triamcinolone acetonide as treatment of macular edema in central retinal vein occlusion
Jost B. Jonas; Ingrid Kreissig; Robert F. Degenring
Purpose. To report the clinical outcome of a patient receiving an intravitreal injection of triamcinolone acetonide as treatment of bilateral, long-standing, cystoid macular edema due to central retinal vein occlusion. Methods. A 70-years-old patient suffering from bilateral central retinal vein occlusion for 2 years and 1.5 years, respectively, received transconjunctivally an intravitreal injection of 25 mg of crystalline triamcinolone acetonide
Effects of green tea polyphenol on preservation of human saphenous vein
Dong-Wook Han; Young Hwan Park; Jeong Koo Kim; Kwon-Yong Lee; Suong-Hyu Hyon; Hwal Suh; Jong-Chul Park
The potential role of green tea polyphenol (GtPP) in preserving the human saphenous vein was investigated under physiological conditions. The vein segments were incubated for 1, 3, 5, 7 and 14 days, either after 4h of treatment with 1.0mg\\/ml GtPP or in the presence of GtPP at the same concentration. After incubation, the endothelial cell viability, endothelial nitric oxide synthase
TGF-? signaling mediates endothelial to mesenchymal transition (EndMT) during vein graft remodeling
Yang, Dan; Hilaire, Cynthia St.; Negro, Alejandra; Fang, Fang; Chen, Guibin; San, Hong; Walts, Avram D.; Schwartzbeck, Robin L.; Taylor, Brandi; Lanzer, Jan D.; Wragg, Andrew; Elagha, Abdalla; Beltran, Leilani E.; Berry, Colin; Feil, Robert; Virmani, Renu; Ladich, Elena; Kovacic, Jason C.; Boehm, Manfred
Veins grafted into an arterial environment undergo a complex vascular remodeling process. Pathologic vascular remodeling often results in stenosed or occluded conduit grafts. Understanding this complex process is important for improving the outcome of patients with coronary and peripheral artery disease undergoing surgical revascularization. Using in vivo murine cell lineage-tracing models, we show that endothelial-derived cells contribute to neointimal formation through endothelial to mesenchymal transition (EndMT), which is dependent upon early activation of the Smad2/3-Slug signaling pathway. Antagonism of TGF-? signaling by TGF-? neutralizing antibody, shRNA-mediated Smad3 or Smad2 knockdown, Smad3 haploinsufficiency, or endothelial cell-specific Smad2 deletion resulted in decreased EndMT and less neointimal formation compared to controls. Histological examination of postmortem human vein graft tissue corroborated the changes observed in our mouse vein graft model, suggesting that EndMT is operative during human vein graft remodeling. These data establish that EndMT is an important mechanism underlying neointimal formation in interpositional vein grafts, and identifies the TGF-?/Smad2/3-Slug signaling pathway as a potential therapeutic target to prevent clinical vein graft restenosis. PMID:24622514
TGF-? signaling mediates endothelial-to-mesenchymal transition (EndMT) during vein graft remodeling.
Cooley, Brian C; Nevado, Jose; Mellad, Jason; Yang, Dan; St Hilaire, Cynthia; Negro, Alejandra; Fang, Fang; Chen, Guibin; San, Hong; Walts, Avram D; Schwartzbeck, Robin L; Taylor, Brandi; Lanzer, Jan D; Wragg, Andrew; Elagha, Abdalla; Beltran, Leilani E; Berry, Colin; Feil, Robert; Virmani, Renu; Ladich, Elena; Kovacic, Jason C; Boehm, Manfred
Veins grafted into an arterial environment undergo a complex vascular remodeling process. Pathologic vascular remodeling often results in stenosed or occluded conduit grafts. Understanding this complex process is important for improving the outcome of patients with coronary and peripheral artery disease undergoing surgical revascularization. Using in vivo murine cell lineage-tracing models, we show that endothelial-derived cells contribute to neointimal formation through endothelial-to-mesenchymal transition (EndMT), which is dependent on early activation of the Smad2/3-Slug signaling pathway. Antagonism of transforming growth factor-? (TGF-?) signaling by TGF-? neutralizing antibody, short hairpin RNA-mediated Smad3 or Smad2 knockdown, Smad3 haploinsufficiency, or endothelial cell-specific Smad2 deletion resulted in decreased EndMT and less neointimal formation compared to controls. Histological examination of postmortem human vein graft tissue corroborated the changes observed in our mouse vein graft model, suggesting that EndMT is operative during human vein graft remodeling. These data establish that EndMT is an important mechanism underlying neointimal formation in interpositional vein grafts, and identifies the TGF-?-Smad2/3-Slug signaling pathway as a potential therapeutic target to prevent clinical vein graft stenosis. PMID:24622514
Discomfort during Periorbital and Lateral Temporal Laser Vein Treatment: A Double-blind Randomized Controlled Trial
Ellis, David E.
Background: Treatments for cosmetically unpleasing periocular and lateral temporal veins are limited. The purpose of this study was to test the hypothesis that the application of topical lidocaine before the cosmetic treatment of periorbital and lateral temporal veins with a neodymium-doped yttrium aluminum garnet (ND:YAG) laser will result in a significant reduction in subjective pain compared with placebo as assessed using a visual analogue scale. Methods: Twenty patients who required bilateral treatment of facial veins were randomly assigned to receive either placebo or 30% lidocaine gel applied topically over the veins, a split-body design. Both the investigator and the patient were blinded to the treatment. An ND:YAG laser was used to treat the veins. Patients completed a visual analogue scale to assess the pain on each side of the face. Data were analyzed using nonparametric data testing. Results: There was a 64.0% reduction in pain on the treatment side compared with the placebo side (P < 0.001). There was no significant difference in patient-assessed subjective efficacy between sides (P = 0.2). Complications were minimal and mild. Conclusions: Patients undergoing periorbital and temporal vein ablation using ND:YAG laser should be offered topical lidocaine as the pain levels are moderate. The use of topical 30% lidocaine results in a significant reduction in pain levels. PMID:25289352
A Computational Model of Optimal Vein Graft Adaptation in an Arterial Environment
NASA Astrophysics Data System (ADS)
Ramachandra, Abhay B.; Sankaran, Sethuraman; Humphrey, Jay; Marsden, Alison
In coronary artery disease, surgical revascularization using venous bypass grafts is performed to relieve symptoms and prolong life. Coronary bypass graft surgery is performed on approximately 500,000 people every year in the United States, with graft failure rates as high as 50% within 5 years. When a vein graft is implanted in the arterial system it adapts to the high flow rate and high pressure of the arterial environment by changing composition and geometry, and thus stiffness. Hemodynamic loads, resulting in altered wall shear and intramural stresses, are major factors impacting vein graft remodeling. Here, a constrained mixture theory of growth and remodeling for arteries is extended to model the evolution of a vein graft subjected to arterial flow and pressure conditions. A derivative-free optimization method is used to estimate the optimal set of constitutive parameters that best match passive biaxial mouse inferior vena cava data from experiments. Optimization is performed using surrogate management framework, a pattern search method with established convergence theory. The resulting parameter set is used to predict optimal vein adaptation in an arterial environment for two illustrative cases: a) Step change b) Gradual change in loading. Results are compared against vein graft data from the literature and a possible set of mechanisms for sub-optimal vein graft remodeling is suggested.
Enoxaparin Treatment of Spontaneous Deep Vein Thrombosis in a Chronically Catheterized Rhesus Macaque (Macaca mulatta)
Wathen, Asheley B; Myers, Daniel D; Zajkowski, Paul; Flory, Graham; Hankenson, F Claire
A chronically catheterized 14-y-old male rhesus macaque (Macaca mulatta) was reported for recurrent scrotal swelling. The scrotum was enlarged and warm to touch, and associated skin was noted to be lichenified on physical examination. The penis could not be extruded due to preputial swelling. Results from the following diagnostic tests were all unremarkable or within normal limits: scrotal aspirate, hematology, serum biochemistries, urinalysis, and radiography of the thorax, scrotum, and abdomen. Ultrasonography of lower extremities identified thrombi in bilateral iliac veins and left femoral vein. Collateral circulation surrounding the left femoral vein permitted some compensatory venous return. The left femoral vein of this animal had been catheterized approximately 2 mo before initial presentation. A coagulation panel revealed a positive D-dimer test, indicative of elevated levels of fibrin degradation products due to active thrombus breakdown. Enoxaparin sodium, a low-molecular-weight heparin for human use, was administered at 20 mg subcutaneously once daily for 10 d to treat occlusive venous thrombi. After enoxaparin treatment, the edema was greatly decreased. To achieve complete resolution, a second course of enoxaparin was administered 2 months after the first. Ultrasonography of the pelvic vasculature 6 mo after completion of therapy showed marked thrombus resolution, allowing for bilateral patency in the iliac and femoral veins. Follow-up evaluation revealed that D-dimer values were negative as well. This case demonstrates the novel application of the human medication enoxaparin to treat clinical signs of deep vein thrombosis in a chronically catheterized rhesus macaque. PMID:19807974
Analysis of factors associated with portal vein thrombosis in pediatric living donor liver transplant recipients.
Neto, Joao Seda; Fonseca, Eduardo A; Feier, Flßvia H; Pugliese, Renata; Candido, Helry L; Benavides, Marcel R; Porta, Gilda; Miura, Irene K; Danesi, Vera B; Guimaraes, Teresa; Porta, Adriana; Borges, Cristian; Godoy, Andre; Kondo, Mario; Chapchap, Paulo
The technique of vascular reconstruction plays a major role in the outcome of living donor liver transplantation (LDLT). An increased use of vascular grafts (VGs) as replacements for sclerotic portal veins has become a standard technique for our group. The aim of this study was to analyze the factors associated with portal vein thrombosis (PVT) in pediatric LDLT. We performed a retrospective analysis of 486 primary pediatric LDLT procedures performed between October 1995 and May 2013. VGs used for portal reconstruction included living donor inferior mesenteric veins, living donor ovarian veins, recipient internal jugular veins, deceased donor iliac arteries, and deceased donor iliac veins. Thirty-four patients (7.0%) developed PVT. The incidence of PVT dropped from 10.1% to 2%; the overall utilization of VGs increased from 3.5% to 37.1%. In a multivariate analysis, only the use of VGs remained an independent risk factor for the occurrence of PVT (hazard ratio?=?7.2, 95% confidence interval?=?2.8-18.7, P?0.001). There was no difference in survival rates between patients with PVT and patients without PVT. No patient with PVT underwent retransplantation. In conclusion, the use of VGs was independently associated with the development of PVT. Over time, there was a reduction in the incidence of early PVT in this cohort, and there was a trend toward a reduction in total PVT. The occurrence of isolated PVT in this study was not associated with decreased patient or graft survival. PMID:24954288
[Study and treatment of varicose veins. Truths and counter-truths].
Priollet, P; Franceschi, C; Lazareth, I; Laurian, C
Varicose veins are not the only symptomatology of chronic venous insufficiency of the lower limbs, which has other clinical manifestations: purely symptomatic problems, varicosities, edema and trophic skin lesions. The management of varicose veins is base upon thorough clinical examination. Doppler and ultrasonography are useful in cases of varicose veins in which radical treatment is envisaged. Ultrasound investigation is essential in the presence of cutaneous ulceration in order to avoid mistaking a trophic lesion due to incompetence of deep veins, most often of post-thrombotic origin, for a varicose ulcer. The treatment of varicose veins varies according to the precise nature of the preoccupations of the patient concerned. Elastic support is useful regardless of the clinical form of the disease. Vasculoprotective and venotonic drugs can be used when venous insufficiency is symptomatic. Radical treatment of varicose veins, whether by sclerosing injections or surgery, depends upon the anatomical nature of lesions, the degree of venous incompetence and the extent of signs, but also the wishes of the patient, properly informed of the advantages and limitations of each technique. PMID:8074422
Decreased PGE2 Content Reduces MMP-1 Activity and Consequently Increases Collagen Density in Human Varicose Vein
Gomez, Ingrid; Benyahia, Chabha; Louedec, Liliane; Lesķche, Guy; Jacob, Marie-Paule; Longrois, Dan; Norel, Xavier
Varicose veins are elongated and dilated saphenous veins. Despite the high prevalence of this disease, its pathogenesis remains unclear. Aims In this study, we investigated the control of matrix metalloproteinases (MMPs) expression by prostaglandin (PG)E2 during the vascular wall remodeling of human varicose veins. Methods and Results Varicose (small (SDv) and large diameter (LDv)) and healthy saphenous veins (SV) were obtained after surgery. Microsomal and cytosolic PGE-synthases (mPGES and cPGES) protein and mRNA responsible for PGE2 metabolism were analyzed in all veins. cPGES protein was absent while its mRNA was weakly expressed. mPGES-2 expression was similar in the different saphenous veins. mPGES-1 mRNA and protein were detected in healthy veins and a significant decrease was found in LDv. Additionally, 15-hydroxyprostaglandin dehydrogenase (15-PGDH), responsible for PGE2 degradation, was over-expressed in varicose veins. These variations in mPGES-1 and 15-PGDH density account for the decreased PGE2 level observed in varicose veins. Furthermore, a significant decrease in PGE2 receptor (EP4) levels was also found in SDv and LDv. Active MMP-1 and total MMP-2 concentrations were significantly decreased in varicose veins while the tissue inhibitors of metalloproteinases (TIMP -1 and -2), were significantly increased, probably explaining the increased collagen content found in LDv. Finally, the MMP/TIMP ratio is restored by exogenous PGE2 in varicose veins and reduced in presence of an EP4 receptor antagonist in healthy veins. Conclusions In conclusion, PGE2 could be responsible for the vascular wall thickening in human varicose veins. This mechanism could be protective, strengthening the vascular wall in order to counteract venous stasis. PMID:24505358
Estimating Shock Pressures in Chondrites From High-Pressure Minerals in Shock-induced Melt Veins
NASA Astrophysics Data System (ADS)
Xie, Z.; Sharp, T. G.
High-pressure minerals are common in highly shocked (S6) L6 chondrites, occurring within or adjacent to shock-induced melt veins and melt pockets. They provide natural examples of high-pressure minerals that make up the Earth's transition zone (410 to 660 km depth) and lower mantle, as well as a record of high-pressure and temperature conditions during impact events on chondrite parent bodies. The high-pressure minerals that crystallize in melt veins and pockets can be used as an alternative means of investigating shock pressure. We used transmission electron microscopy (TEM) to characterize the shock-vein mineralogy in seven L6 chondrites ranging from shock stage S6 to S3: Tenham (S6), Umbarger (S6), Roy (S3-5), Ramsdorf (S4), Kunashak (S4), Nakhon Pathon (S4) and La Lande (S4). Tenham contains assemblages that reflect variable cooling rates during crystallization. Majorite plus magnesiow\\x81stite occur in the center of melt veins, whereas ringwoodite, akimotoite and round amorphous grains (probably vitrified MgSiO3-pervoskite) occur along melt-vein edges. In addition, a symplectitic intergrowth of majorite and an amorphous phase has been observed, which probably represents clinopyroxene that has disassociated into majorite plus CaSiO3-pervoskite. High pressure minerals in the Umbarger melt veins include: ringwoodite, akimotoite ((Mg,Fe)SiO3-ilmenite), augite, and hollandite-structured plagioclase. In addition, Fe2SiO4-spinel (new mineral) and stishovite occur in SiO2-FeO rich melt. High-pressure minerals in the Roy melt veins include ringwoodite and majorite. Melt veins in Ramsdorf, Kunashak, Nakhon Pathon and La lande contain fine-grained olivines and pyroxenes that are defect free and interpreted as having crystallized from the melt. Crystallization pressures can be inferred from the mineral assemblages in the melt veins and available phase equilibrium data. Melt veins in Tenham crystallized at pressure of approximately 25 GPa; Umbarger at pressure between 18 to 25 GPa; Roy at pressure between 14 to 22 GPa; Ramsdort, Kunashak, Nakhon Pathon and La lande at pressure up to to15 GPa.
Thrombophilic factor analysis in cirrhotic patients with portal vein thrombosis.
Saugel, Bernd; Lee, Marcel; Feichtinger, Stephanie; Hapfelmeier, Alexander; Schmid, Roland M; Siveke, Jens T
Liver cirrhosis, myeloproliferative disorders (MPDs) and prothrombotic mutations are aetiologic factors for portal vein thrombosis (PVT). The role and frequency of thrombophilic genetic risk factors in cirrhotic patients is not well established. In this case-control study, we investigated the frequency of Janus kinase 2 (JAK2) (JAK2 V617F), Factor V Leiden (FVL G1691A), and Prothrombin (G20210A) mutations in cirrhotic patients with PVT (LCi+/PVT+ group, nĀ=Ā21) in comparison with two control collectives (cirrhotic patients without PVT, LCi+/PVT- group, nĀ=Ā43; PVT patients without liver cirrhosis, LCi-/PVT+ group, nĀ=Ā29). In the LCi+/PVT+ group, JAK2 V617F was present in 2/21 patients (10Ā%; pĀ=Ā0.104 compared to LCi+/PVT-; pĀ=Ā0.092 compared to LCi-/PVT+), whereas 0/43 LCi+/PVT- patients (0Ā%; pĀ<Ā0.001 compared to LCi-/PVT+) and 9/29 LCi-/PVT+ patients (31Ā%) harboured this mutation. The FVL G1691A mutation was identified in 1/21 patients (5Ā%) in the LCi+/PVT+ group, in 5/43 patients (12Ā%) in the LCi+/PVT- group, and in 2/29 patients (7Ā%) in the LCi-/PVT+ group. The Prothrombin G20210A mutation was present in 0/21 LCi+/PVT+ patients (0Ā%), in 1/43 LCi+/PVT- patients (2Ā%), and in 4/29 patients (14Ā%) in the LCi-/PVT+ group. This study provides evidence that a relevant proportion of cirrhotic patients with PVT harbours a JAK2 V617F mutation. PMID:25115839
Portal vein thrombosis after laparoscopic splenectomy during childhood.
Gelas, Thomas; Scalabre, Aurķlien; Hameury, Frķdķric; Dubois, Rķmi; Grosos, Cķline; Mouriquand, Pierre D; Mure, Pierre-Yves
Portal vein thrombosis (PVT) is a rare but potentially life-threatening complication of laparoscopic splenectomy (LS) and can lead to bowel ischemia or portal hypertension. In childhood, this complication is reported in 5-10Ā% of the cases whereas it can be up to 50Ā% in adult population. Our aim was to evaluate PVT incidence after LS and associated risks factors. A retrospective chart review identified 37 children who underwent elective LS from 2005 to 2013. The main indications were spherocytosis or sickle cell disease. Median age and weight were respectively 7.4Āyears and 25.1Ākg. Thromboembolic prophylaxis was not routinely given. Duration of surgery was 129Āmin and hospital length of stay 4Ādays. Doppler ultrasound scan (USS) was performed post-operatively in 26 cases. Post-operative course was uneventful in all but one patient. She was a 17Āyear-old girl previously operated for an ovarian tumor with hyperandrogenism. Histopathology revealed a splenic lymphoma. At day 4, a systematic USS showed a PVT extending in the portal branches. Therapeutic low molecular weight heparin was used and then transitioned to fluindione for 3Āmonths. Follow-up USS performed at 1 and 4Āmonths demonstrated complete resolution of the PVT. PVT after pediatric LS is a rare event in our series. Clinician should be cautious in oncologic cases and if very large spleen or if thrombocythemia >650.10(9)/L is present. If detected early, PVT can be treated efficiently. We therefore recommend a systematic USS during the first postoperative week. PMID:24338249
Milrinone Relaxes Pulmonary Veins in Guinea Pigs and Humans
Rieg, Annette D.; Suleiman, Said; Perez-Bouza, Alberto; Braunschweig, Till; Spillner, Jan W.; Schr÷der, Thomas; Verjans, Eva; Schõlte, Gereon; Rossaint, Rolf; Uhlig, Stefan; Martin, Christian
Introduction The phosphodiesterase-III inhibitor milrinone improves ventricular contractility, relaxes pulmonary arteries and reduces right ventricular afterload. Thus, it is used to treat heart failure and pulmonary hypertension (PH). However, its action on pulmonary veins (PVs) is not defined, although particularly PH due to left heart disease primarily affects the pulmonary venous bed. We examined milrinone-induced relaxation in PVs from guinea pigs (GPs) and humans. Material and Methods Precision-cut lung slices (PCLS) were prepared from GPs or from patients undergoing lobectomy. Milrinone-induced relaxation was studied by videomicroscopy in na've PVs and in PVs pre-constricted with the ETA-receptor agonist BP0104. Baseline luminal area was defined as 100%. Intracellular cAMP was measured by ELISA and milrinone-induced changes of segmental vascular resistances were studied in the GP isolated perfused lung (IPL). Results In the IPL (GP), milrinone (10 ĄM) lowered the postcapillary resistance of pre-constricted vessels. In PCLS (GP), milrinone relaxed na've and pre-constricted PVs (120%) and this relaxation was attenuated by inhibition of protein kinase G (KT 5823), adenyl cyclase (SQ 22536) and protein kinase A (KT 5720), but not by inhibition of NO-synthesis (L-NAME). In addition, milrinone-induced relaxation was dependent on the activation of KATP-, BKCa2+- and Kv-channels. Human PVs also relaxed to milrinone (121%), however only if pre-constricted. Discussion Milrinone relaxes PVs from GPs and humans. In GPs, milrinone-induced relaxation is based on KATP-, BKCa2+- and Kv-channel-activation and on cAMP/PKA/PKG. The relaxant properties of milrinone on PVs lead to reduced postcapillary resistance and hydrostatic pressures. Hence they alleviate pulmonary edema and suggest beneficial effects of milrinone in PH due to left heart disease. PMID:24498166
Combined Hepatic Vein, Umbilicoportal Vein, and Superior Mesenteric Artery Catheterization in Portal Hypertension: Estimation of the Portal Fraction of Total Hepatic Blood Flow in Cirrhotic Patients 1
Huet, P. M.; Lavoie, P.; Legare, A.; Viallet, A.
Hemodynamic data were obtained in 13 cirrhotic patients with severe portal hypertension, undergoing combined hepatic vein, umbilicoportal vein, and superior mesenteric artery catheterization. The relative clearance of indocyanine green, the portohepatic gradient (difference between the free portal venous pressure and the free hepatic venous pressure), and the estimated hepatic blood flow were measured. The portal fraction (PF) of total hepatic blood flow was calculated in all patients using indicator dilution curves obtained from the portal bifurcation, a right hepatic vein, and when possible a left hepatic vein (six cases) after injection of 51Cr-labeled red blood cells (51Cr RBC) into the superior mesenteric artery. Flows were overestimated because of loss of indicator through spontaneous portosystemic shunts; however, the ratio between hepatic and portal indicator dilution curves can be used to calculate the portal fraction of total hepatic blood flow since no extrahepatic shunts existed after the bifurcation of the portal vein (as shown on portography). In 10 patients, 15 series of curves were calculable and the PF varied between 30.1 and 100% (mean ▒ SE: 71.1 ▒ 6.2%). In the three other patients, only delayed activity from recirculation was detected from portal and hepatic vein samples and PF was 0%; in these three cases, portography and arteriography revealed spontaneous portacaval shunting with reverse and/or stagnant circulation in the portal vein. In the 13 patients, no correlation existed between PF and the relative clearance of indocyanine green or the portohepatic gradient, parameters generally used as indices of severity in cirrhosis. In 10 patients, no correlation was found between PF and the estimated hepatic blood flow. These data indicate that 51Cr RBC dilution curves can be used for the estimation of the portal fraction of total hepatic blood flow in conscious cirrhotic patients before portacaval shunts. Using this methodology, it could be assessed whether any critical level of portal fraction exists above which poor clinical results occur after portacaval shunting. This measurement could eventually be helpful in determining the appropriate surgical procedure to be applied in individual cases. ImagesFIG. 4FIG. 5aFIG. 5bFIG. 5c PMID:1130101
Recurrent varicose veins of the legs. Analysis of a social problem.
Cardia, G; Catalano, G; Rosafio, I; Granatiero, M; De Fazio, M
The present study was aimed at assessing the experience of a single referral center with recurrent varicose veins of the legs (RVL) over the period 1993-2008. Among a total of 846 procedures for Leg Varices (LV), 74 procedures were for RVL (8.7%). The causes of recurrence were classified as classic: insufficient crossectomy (13); incompetent perforating veins (13); reticular phlebectasia (22); small saphenous vein insufficiency (9); accessory saphenous veins (4); and particular: post-hemodynamic treatment (5); incomplete stripping (1); Sapheno-Femoral Junction (SFJ) vascularization (5); post-thermal ablation (2). For the "classic" RVL the treatment consisted essentially of completing the previous treatment, both if the problem was linked to an insufficient earlier treatment and if it was due to a later onset. The most common cause in our series was reticular phlebectasia; when the simple sclerosing injections are not sufficient, this was treated by phlebectomy according to Mueller. The "particular" cases classified as 1, 2 and 4 were also treated by completing the traditional stripping procedure (+ crossectomy if this had not been done previously), considered to be the gold standard. In the presence of a SFJ neo-vascularization, with or without cavernoma, approximately 5 cm of femoral vein were explored, the afferent vessels ligated and, if cavernoma was present, it was removed. Although inguinal neo-angiogenesis is a possible mechanism, some doubt can be raised as to its importance as a primary factor in causing recurrent varicose veins, rather than their being due to a preexisting vein left in situ because it was ignored, regarded as insignificant, or poorly evident. In conclusion, we stress that LV is a progressive disease, so the treatment is unlikely to be confined to a single procedure. It is important to plan adequate monitoring during follow-up, and to be ready to reoperate when new problems present that, if left, could lead the patient to doubt the validity and efficacy of the original treatment. PMID:23140935
18O Spatial Patterns of Vein Xylem Water, Leaf Water, and Dry Matter in Cotton Leaves
Gan, Kim Suan; Wong, Suan Chin; Yong, Jean Wan Hong; Farquhar, Graham Douglas
Three leaf water models (two-pool model, Pķclet effect, and string-of-lakes) were assessed for their robustness in predicting leaf water enrichment and its spatial heterogeneity. This was achieved by studying the 18O spatial patterns of vein xylem water, leaf water, and dry matter in cotton (Gossypium hirsutum) leaves grown at different humidities using new experimental approaches. Vein xylem water was collected from intact transpiring cotton leaves by pressurizing the roots in a pressure chamber, whereas the isotopic content of leaf water was determined without extracting it from fresh leaves with the aid of a purpose-designed leaf punch. Our results indicate that veins have a significant degree of lateral exchange with highly enriched leaf water. Vein xylem water is thus slightly, but progressively enriched in the direction of water flow. Leaf water enrichment is dependent on the relative distances from major veins, with water from the marginal and intercostal regions more enriched and that next to veins and near the leaf base more depleted than the Craig-Gordon modeled enrichment of water at the sites of evaporation. The spatial pattern of leaf water enrichment varies with humidity, as expected from the string-of-lakes model. This pattern is also reflected in leaf dry matter. All three models are realistic, but none could fully account for all of the facets of leaf water enrichment. Our findings acknowledge the presence of capacitance in the ground tissues of vein ribs and highlight the essential need to incorporate Pķclet effects into the string-of-lakes model when applying it to leaves. PMID:12376664
(18)O spatial patterns of vein xylem water, leaf water, and dry matter in cotton leaves.
Gan, Kim Suan; Wong, Suan Chin; Yong, Jean Wan Hong; Farquhar, Graham Douglas
Three leaf water models (two-pool model, Pķclet effect, and string-of-lakes) were assessed for their robustness in predicting leaf water enrichment and its spatial heterogeneity. This was achieved by studying the (18)O spatial patterns of vein xylem water, leaf water, and dry matter in cotton (Gossypium hirsutum) leaves grown at different humidities using new experimental approaches. Vein xylem water was collected from intact transpiring cotton leaves by pressurizing the roots in a pressure chamber, whereas the isotopic content of leaf water was determined without extracting it from fresh leaves with the aid of a purpose-designed leaf punch. Our results indicate that veins have a significant degree of lateral exchange with highly enriched leaf water. Vein xylem water is thus slightly, but progressively enriched in the direction of water flow. Leaf water enrichment is dependent on the relative distances from major veins, with water from the marginal and intercostal regions more enriched and that next to veins and near the leaf base more depleted than the Craig-Gordon modeled enrichment of water at the sites of evaporation. The spatial pattern of leaf water enrichment varies with humidity, as expected from the string-of-lakes model. This pattern is also reflected in leaf dry matter. All three models are realistic, but none could fully account for all of the facets of leaf water enrichment. Our findings acknowledge the presence of capacitance in the ground tissues of vein ribs and highlight the essential need to incorporate Pķclet effects into the string-of-lakes model when applying it to leaves. PMID:12376664
MR Quantification of Flow in Children with Vein of Galen Malformations
Poskitt, K.J.; Marotta, T.; Culham, G.; Xiang, S.
Summary Vein of Galen vascular malformations are either Vein of Galen Aneurysmal malformations (VGAMs) or Vein of Galen Aneurysmal Dilatations (VGADs). VGAMs may be of the choroidal or mural type and are fistulas associated with the precursor of the vein of Galen. The treatment of VGAMs is aimed at controlling the size of the vascular shunt since it is believed that the shunt is responsible for venous hypertension, cardiac stress, delayed development and may be so large as to damage the brain. In VGAMs as noted by Berenstein and Lasjaunias. Absolute measures of flow may contribute to our understanding of CNS disease and permit objective measures of the success or failure of therapeutic interventions 5. MR phase contrast cine angiographic techniques can be employed to measure bulk flow in intracranial vessels. Vein of Galen vascular malformations are an ideal model to measure venous flow as the draining vein is large and angiographic evaluation is limited. Thus our goal was to develop an objective non-invasive method of measuring vascular flow in VGAMs and VGADs 6. Herein we report our experience using this technique in a group of patients with Vein of Galen vascular malformations. We also hypothesized that the degree of shunting would correlate to the degree of cardiac stress and be an indicator of optimal timing for intervention. We believe that we have succeeded in our goal to develop an objective, non-invasive method of shunt quantification using velocity encoded MR sequences. This promises new insight into the hemodynamics, natural history and treatment response of vascular malformations. PMID:20663350
Prolonged lobar hypoxia in vivo enhances the responsivity of isolated pulmonary veins to hypoxia
NASA Technical Reports Server (NTRS)
Sheehan, D. W.; Farhi, L. E.; Russell, J. A.
The hypoxic response of pulmonary vessels isolated from eight sheep whose right apical lobes (RAL) had inspired 100% N2 for 20 h was studied. The RAL of these conscious sheep inspired hypoxic gas and the remainder of the lung inspired air. During hypoxia, RAL perfusion was 33 +/- 3% of its air value, carotid arterial PO2 averaged 86 +/- 3 mm Hg and pulmonary perfusion pressure was not significantly different from the initial control period when the RAL inspired air. At the end of the hypoxic exposure, the sheep were killed, and pulmonary artery and vein rings (0.5 to 2 mm inner diameter) were isolated from both the RAL and the right cardiac lobe, which served as the control lobe (CL). Arteries from the RAL and CL did not contract in response to 6% O2/6% CO2/88% N2 (hypoxia). In contrast, RAL veins did contract vigorously in response to hypoxia, whereas CL veins did not contract or contracted only minimally. Rubbing of the endothelium or prior incubation of RAL veins with catalase (1,200 units/ml), indomethacin (10(-5) M), or the thromboxane A2/prostaglandin H2 (TxA2/PGH2) receptor antagonist, SQ 29,548 (3 X 10(-6) M) each significantly reduced the response to hypoxia. RAL veins were also found to be more reactive than CL veins to the prostaglandin endoperoxide analogue U46619. We conclude that prolonged lobar hypoxia in vivo increases the responsivity of isolated pulmonary veins to hypoxia. These contractions may result from an increase in reactive O2 species, which in turn modify production of, metabolism of, and/or tissue responsivity to TxA2/PGH2.
Differential effect of propofol on sympathetic neurotransmission in isolated human omental arteries and veins
Wallerstedt, Susanna M; Bodelsson, Mikael
The present study was undertaken to elucidate the effect of propofol on sympathetic neurotransmission in isolated human omental vessels.Segments of both arteries and veins were exposed to 0, 10?7, 10?6, 10?5 or 10?4?M propofol, and studied in vitro to determine effects on: (i) isometric tension after electrical field stimulation (EFS) or after exogenous administration of noradrenaline (NA); (ii) EFS-stimulated release of [3H]-NA from vessel segments preincubated with [3H]-NA; (iii) uptake of [3H]-NA.Propofol at 10?6?M enhanced EFS-induced contraction in artery segments, 10?7 and 10?5?M had no effect, and 10?4?M propofol depressed EFS-induced contraction in both artery and vein segments.Propofol did not affect the response to exogenous NA in artery and vein segments.EFS-stimulated release of [3H]-NA was depressed by 10?5 and 10?4?M propofol in artery segments, and by 10?4?M in vein segments.Uptake of [3H]-NA was depressed by 10?6¢10?4?M propofol in artery but not in vein segments.The results suggest that sympathetic neurotransmission is enhanced at clinical concentrations (10?6?M) of propofol in human omental arteries, but not veins. This may be due to an increased availability of NA in the neuromuscular junction resulting from a reduced presynaptic reuptake. Propofol at probably supraclinical concentrations (10?5¢10?4?M) impairs the sympathetic neurotransmission in both human omental arteries and veins, probably due to an inhibitory effect on the NA release from the sympathetic nerves. PMID:9776351
Critical appraisal of the clinical utility of the dexamethasone intravitreal implant (Ozurdex«) for the treatment of macular edema related to branch retinal vein occlusion or central retinal vein occlusion
Chan, Annie; Leung, Loh-Shan; Blumenkranz, Mark S
Macular edema is a common cause of visual loss in patients with retinal vein occlusions. Ozurdex«, a dexamethasone intravitreal implant, has been shown in randomized controlled trials to reduce macular edema and improve visual acuity in patients with either branch retinal vein occlusions or central retinal vein occlusions. It was approved in the United States in 2009. Since then, new therapeutic agents and clinical data have emerged. The purpose of this review is to critically evaluate the clinical utility of Ozurdex« in the current treatment strategy of macular edema related to retinal vein occlusion. PMID:21845032
The Influence of Branch Order on Optimal Leaf Vein Geometries: MurrayÆs Law and Area Preserving Branching
Price, Charles A.; Knox, Sarah-Jane C.; Brodribb, Tim J.
Models that predict the form of hierarchical branching networks typically invoke optimization based on biomechanical similitude, the minimization of impedance to fluid flow, or construction costs. Unfortunately, due to the small size and high number of vein segments found in real biological networks, complete descriptions of networks needed to evaluate such models are rare. To help address this we report results from the analysis of the branching geometry of 349 leaf vein networks comprising over 1.5 million individual vein segments. In addition to measuring the diameters of individual veins before and after vein bifurcations, we also assign vein orders using the Horton-Strahler ordering algorithm adopted from the study of river networks. Our results demonstrate that across all leaves, both radius tapering and the ratio of daughter to parent branch areas for leaf veins are in strong agreement with the expectation from MurrayÆs law. However, as veins become larger, area ratios shift systematically toward values expected under area-preserving branching. Our work supports the idea that leaf vein networks differentiate roles of leaf support and hydraulic supply between hierarchical orders. PMID:24392008
Effect of adrenocorticotropic hormone stimulation during adrenal vein sampling in primary aldosteronism.
Monticone, Silvia; Satoh, Fumitoshi; Giacchetti, Gilberta; Viola, Andrea; Morimoto, Ryo; Kudo, Masataka; Iwakura, Yoshitsugu; Ono, Yoshikiyo; Turchi, Federica; Paci, Enrico; Veglio, Franco; Boscaro, Marco; Rainey, William; Ito, Sadayoshi; Mulatero, Paolo
Adrenal vein sampling (AVS) is fundamental for subtype diagnosis in patients with primary aldosteronism. AVS protocols vary between centers, especially for diagnostic indices and for use of adrenocorticotropic hormone (ACTH) stimulation. We investigated the role of both continuous ACTH infusion and bolus on the performance and interpretation of AVS in a sample of 76 patients with confirmed primary aldosteronism. In 36 primary aldosteronism patients, AVS was performed both under basal conditions and after continuous ACTH infusion, and in 40 primary aldosteronism patients, AVS was performed both under basal conditions and after ACTH IV bolus. Both ACTH protocols determined an increase in the rate of successful cannulation of the adrenal veins. Both ACTH infusion and bolus determined a significant increase in selectivity index for the right adrenal vein and ACTH bolus for the left adrenal vein. Lateralization index was not significantly different after continuous ACTH infusion and IV bolus. In 88% and 78% of the patients, the diagnosis obtained was the same before and after ACTH infusion and IV bolus, respectively. However, the reproducibility of the diagnosis was reduced using less stringent criteria for successful cannulation of the adrenal veins. This study shows that ACTH use during AVS may be of help for centers with lower success rates, because a successful adrenal cannulation is more easily obtained with this protocol; moreover, this technique performs at least as well as the unstimulated strategy and in some cases may be even better. Stringent criteria for cannulation should be used to have a high consistency of the diagnosis. PMID:22331382
Effects of spaceflight and ground recovery on mesenteric artery and vein constrictor properties in mice
Behnke, Bradley J.; Stabley, John N.; McCullough, Danielle J.; Davis, Robert T.; Dominguez, James M.; Muller-Delp, Judy M.; Delp, Michael D.
Following exposure to microgravity, there is a reduced ability of astronauts to augment peripheral vascular resistance, often resulting in orthostatic hypotension. The purpose of this study was to test the hypothesis that mesenteric arteries and veins will exhibit diminished vasoconstrictor responses after spaceflight. Mesenteric arteries and veins from female mice flown on the Space Transportation System (STS)-131 (n=11), STS-133 (n=6), and STS-135 (n=3) shuttle missions and respective ground-based control mice (n=30) were isolated for in vitro experimentation. Vasoconstrictor responses were evoked in arteries via norepinephrine (NE), potassium chloride (KCl), and caffeine, and in veins through NE across a range of intraluminal pressures (2¢12 cmH2O). Vasoconstriction to NE was also determined in mesenteric arteries at 1, 5, and 7 d postlanding. In arteries, maximal constriction to NE, KCl, and caffeine were reduced immediately following spaceflight and 1 d postflight. Spaceflight also reduced arterial ryanodine receptor-3 mRNA levels. In mesenteric veins, there was diminished constriction to NE after flight. The results indicate that the impaired vasoconstriction following spaceflight occurs through the ryanodine receptor-mediated intracellular Ca2+ release mechanism. Such vascular changes in astronauts could compromise the maintenance of arterial pressure during orthostatic stress.ŚBehnke, B. J., Stabley, J. N., McCullough, D. J., Davis, R. T., III, Dominguez, J. M., II, Muller-Delp, J. M., Delp, M. D. Effects of spaceflight and ground recovery on mesenteric artery and vein constrictor properties in mice. PMID:23099650
Effect of fluid shear stress on portal vein remodeling in a rat model of portal hypertension.
Wen, Bin; Liang, Jian; Deng, Xin; Chen, Ran; Peng, Peichun
Aims. To explore the effects and mechanisms of fluid shear stress on portal vein remodeling in a rat model of portal hypertension. Methods. Subcutaneous injections of CCl4 were given to establish a rat model of liver cirrhosis and portal hypertension. Biomechanical technology was adopted to determine the dynamic changes of haemodynamic indices and fluid shear stress. Nitric oxide (NO), synthase (NOS), and endothelin-1 (ET-1) of the portal vein blood were measured. Changes in geometric structure and ultrastructure of the portal vein were observed using optical and electron microscopy. Results. After the CC14 injections, rat haemodynamics were notably altered. From week 4 onwards, PVP, PVF, and PVR gradually and significantly increased (P < 0.05 versus baseline). The fluid shear stress declined from week 4 onwards (P < 0.01 versus control group). NO, NOS, and ET-1 increased after repeated CCI4 injections. Hematoxylin and eosin staining showed thickened portal vein walls, with increased inside and outside diameters. Electron microscopy revealed different degrees of endothelial cell degeneration, destruction of basement membrane integrity, proliferating, and hypertrophic smooth muscle cells. Conclusions. Fluid shear stress not only influenced the biomechanical environment of the portal vein but also participated in vascular remodeling. PMID:25892988
Acclimation to humidity modifies the link between leaf size and the density of veins and stomata.
Carins Murphy, Madeline R; Jordan, Gregory J; Brodribb, Timothy J
The coordination of veins and stomata during leaf acclimation to sun and shade can be facilitated by differential epidermal cell expansion so large leaves with low vein and stomatal densities grow in shade, effectively balancing liquid- and vapour-phase conductances. As the difference in vapour pressure between leaf and atmosphere (VPD) determines transpiration at any given stomatal density, we predict that plants grown under high VPD will modify the balance between veins and stomata to accommodate greater maximum transpiration. Thus, we examined the developmental responses of these traits to contrasting VPD in a woody angiosperm (Toona ciliata M. Roem.) and tested whether the relationship between them was altered. High VPD leaves were one-third the size of low VPD leaves with only marginally greater vein and stomatal density. Transpirational homeostasis was thus maintained by reducing stomatal conductance. VPD acclimation changed leaf size by modifying cell number. Hence, plasticity in vein and stomatal density appears to be generated by plasticity in cell size rather than cell number. Thus, VPD affects cell number and leaf size without changing the relationship between liquid- and vapour-phase conductances. This results in inefficient acclimation to VPD as stomata remain partially closed under high VPD. PMID:23682831
Plaque Rupture Complications in Murine Atherosclerotic Vein Grafts Can Be Prevented by TIMP-1 Overexpression
de Vries, Margreet R.; Niessen, Hans W. M.; L÷wik, Clemens W. G. M.; Hamming, Jaap F.; Jukema, J. Wouter; Quax, Paul H. A.
The current study describes the incidence and phenotype of plaque rupture complications in murine vein grafts. Since matrix metalloproteinases (MMPs) are highly involved in atherosclerotic plaque vulnerability and plaque rupture, we hypothesized that this model can be validated by overexpression of the MMP inhibitor TIMP-1. First we studied 47 vein grafts in hypercholesterolemic ApoE3*Leiden mice for the incidence of plaque complications. In 79% of these grafts, extensive lesions with plaque rupture complications like dissections, intraplaque hemorrhages or erosions with intramural thrombi were found. Next, in vivo Near-InfraRed-Fluorescence imaging demonstrated that electroporation mediated TIMP-1-overexpression reduced local MMP activity in vein grafts by 73% (p<0.01). This led to a 40% reduction in lesion-size after 28d (p?=?0.01) and a more stable lesion phenotype with significant more smooth muscle cells (135%), collagen (47%) and significant less macrophages (44%) and fibrin (55%) than controls. More importantly, lesions in the TIMP-1 group showed a 90% reduction of plaque complications (10/18 of control mice showed plaque complications versus 1/18 in TIMP-1 treated mice). Murine vein grafts are a relevant spontaneous model to study plaque stability and subsequent hemorrhagic complications, resulting in plaque instability. Moreover, inhibition of MMPs by TIMP-1-overexpression resulted in decreased plaque progression, increased stabilization and decreased plaque rupture complications in murine vein grafts. PMID:23071737
Ultrasonographic Visualization of Accessory Hepatic Veins and Their Lesions in Budd-Chiari Syndrome.
Cai, Shi-Feng; Gai, Yong-Hao; Ma, Shuang; Liang, Bo; Wang, Guang-Chuan; Liu, Qing-Wei
The aim of this study was to investigate the ultrasonographic features of accessory hepatic veins (AHVs) and their lesions in Budd-Chiari syndrome (BCS). Three hundred patients with BCS were examined by ultrasonography with multifrequency (3-6ĀMHz) convex transducers. Sonography was performed 1 to 2Āwk before digital subtraction angiography and computed tomography angiography or magnetic resonance imaging. Using sonograms, we evaluated the number, course, diameter, orifice, lesions and hemodynamics of patent and obstructed AHVs. Ultrasonography was superior to digital subtraction angiography, computed tomography angiography and magnetic resonance imaging in revealing AHV lesions and hemodynamics. Dilated AHVs were detected in 227 patients. There were 239 caudate lobe veins in 167 patients and 168 inferior right hepatic veins in 151 patients. Both caudate lobe veins and inferior right hepatic veins were found in 91 of the 227 patients. The inlets to AHVs were located mainly on the right lateral or right anterior wall of the inferior vena cava, and the remnant, on the left lateral wall. AHV lesions comprised mainly septal obstruction and segmental stenosis. The hemodynamics of AHVs varied with the condition of inferior vena cava and AHVs. Ultrasonic examination can reveal AHVs and their lesions in patients with BCS and is helpful in choosing and planning therapeutic approaches. PMID:25952161
Soluble Jagged-1 inhibits restenosis of vein graft by attenuating Notch signaling.
Zhou, Xinming; Xiao, Yongguang; Mao, Zhifu; Huang, Jie; Geng, Qing; Wang, Wei; Dong, Ping
The excessive proliferation of vascular smooth muscle cells was key factor in the restenosis of vein graft. And the Notch signaling was demonstrated to regulate vSMC proliferation and differentiation. Soluble Jagged-1 (sJag1) can inhibit Notch signaling in vitro and in vivo; however, its capacity to suppress restenosis of vein graft remains unknown. Under the microscope, the left jugular vein of these rats was interposed into the left common carotid artery, followed without any treatment (control), or with Ad-Jag1 (treatment) or placebo (DMSO) post operation. We showed that Ad-Jag1 can attenuate restenosis of vein graft by inducing decreased proliferation and increased apoptosis in vivo. Notch1-Hey2 signaling is critical for the development of intima thickening by controlling vSMC-fate determination. By blocking Notch signaling, Ad-Jag1 can significantly inhibit intima thickening. These studies identify that Ad-Jag1 can restore the vSMC phenotype and inhibit the vSMC proliferation by suppression of Notch1 signaling, and thus open a new avenue for the treatment of restenosis in vein graft. PMID:25660475
Complicated emergent endovascular repair of a life-threatening bilateral internal jugular vein occlusion.
Kwei, S; Ohki, T; Beitler, J; Veith, F J
A 62-year-old woman had painful facial swelling that progressed to extensive periorbital and perioral edema with loss of vision, hearing, and consciousness. Her past surgical history was significant for right radical neck dissection including internal jugular vein (IJV) resection, laryngectomy, partial esophagectomy, tracheoesophageal fistula repair, and tracheostomy for squamous cell carcinoma of the oropharynx. In addition, the patient had received radiation therapy to the neck. A venogram revealed occlusion of the left IJV. A guidewire from the femoral vein was passed through the occluded segment; however, attempts to introduce an angioplasty balloon failed. A percutaneous basilic vein approach allowed passage of a dilator sheath over a guidewire, thereby enabling Wallstent deployment across the IJV occlusion. A second Wallstent was inserted across a stenosis in the brachiocephalic vein; however, this second stent reoccluded the IJV. Surgical removal of the second Wallstent was required through a segmental claviculectomy and venotomy. Patency was restored in the IJV and the brachiocephalic vein with the return of baseline neurologic function. This case demonstrates a complicated emergent endovascular repair of a life-threatening IJV occlusion that required surgical salvage. PMID:10918002
Massively calcified intravascular cast after removal of a tunneled central vein catheter for hemodialysis.
Capitanini, Alessandro; Ricci, Enrico; Frosini, Pierfrancesco; Cupisti, Adamasco
Vascular calcifications usually affect the arteries, while central vein calcifications are rare. A 45-year-old hemodialysis patient underwent a chest CT scan before central vein catheterization required for arteriovenous access thrombosis, in July 2011. He was on hemodialysis since 1995 and from 2005 on warfarin treatment because of repeated thrombosis and dysfunction of arteriovenous fistula and central vein catheters (CVC). A previous tunneled CVC placed in the left external jugular vein was removed in December 2010. Eight months later a chest CT scan showed a 79-mm irregular, linear, tubular radiopaque density in the superior vena cava and left brachiocephalic vein. The possibility of a retained catheter fragment was considered, but the final diagnosis was: calcified "cast" adherent to the vessel wall. This is the first report of an intravenous calcified "cast" (originating from peri-catheter calcification) retained after removal of a tunneled dialysis CVC. This finding is significant because it mimics a retained catheter fragment possibly leading to misdiagnosis and exposing patients to additional risk for unnecessary retrieving interventions. Catheter removal or over the wire substitution in the presence of a calcified cast could also be considered a risky procedure. Retained calcified cast should be included among the long-term complications of hemodialysis CVCs. At the time of publication, the patient is alive without any complication related to the pathology reported. PMID:23147749
Saphenous Vein Graft Wrapping by Nitinol Mesh: A Word of Caution.
Rescigno, Giuseppe; Aratari, Carlo; Matteucci, Sacha Marco; Parisi, Rosario; Gironi, Giulia; Schicchi, Niccol"; D'Alfonso, Alessandro; Cola, Valentina; Torracca, Lucia
Background?Saphenous vein conduits are still used in a large proportion of coronary artery bypass graft (CABG) operations. A recently commercialized nitinol mesh seems to improve venous graft patency. The aim of this study was to control nitinol mesh vein graft patency in a series of isolated CABG patients by computed tomographic (CT) scan. Methods?In 25 patients (mean age: 61.0?▒?9.65 years), operated for isolated CABG, the eSVS nitinol mesh (Kips Bay Medical Inc., Minneapolis, Minnesota, United States) was used to wrap one vein graft in each patient. Nitinol mesh vein graft was used to revascularize the right coronary (4 patients; 16%), the posterior descending (18 patients; 72%), and the obtuse marginal (3 patients; 12%) arteries. CT scans were performed at 1, 6, and 12 months postoperatively. Results?The procedure was uneventful in all patients. CT controls showed an overall patency rate of 86.9, 42.7, and 34.1% at 1, 6, and 12 months, respectively. The 4?mm mesh had a significantly higher patency rate at 12 months (83.33%) than the 3.5?mm one which showed quite unsatisfactory results (20%) (p?=?0.02). Patients with graft occlusion underwent stress testing which was mildly positive in two cases. One of them underwent a percutaneous revascularization. Conclusion?Despite promising early results, use of nitinol mesh for saphenous veins was disappointing in our experience. Further refinements are probably needed. PMID:25361016
Endovascular treatment of post-laparoscopic pancreatectomy splenic arteriovenous fistula with splenic vein aneurysm
Ueda, Tatsuo; Murata, Satoru; Yamamoto, Akira; Tamai, Jin; Kobayashi, Yuko; Hiranuma, Chiaki; Yoshida, Hiroshi; Kumita, Shin-ichiro
Splenic arteriovenous fistulas (SAVFs) with splenic vein aneurysms are extremely rare entities. There have been no prior reports of SAVFs developing after laparoscopic pancreatectomy. Here, we report the first case. A 40-year-old man underwent a laparoscopic, spleen-preserving, distal pancreatectomy for an endocrine neoplasm of the pancreatic tail. Three months after surgery, a computed tomography (CT) scan demonstrated an SAVF with a dilated splenic vein. The SAVF, together with the splenic vein aneurysm, was successfully treated using percutaneous transarterial coil embolization of the splenic artery, including the SAVF and drainage vein. After the endovascular treatment, the patientÆs recovery was uneventful. He was discharged on postoperative day 6 and continues to be well 3 mo after discharge. An abdominal CT scan performed at his 3-mo follow-up demonstrated complete thrombosis of the splenic vein aneurysm, which had decreased to a 40 mm diameter. This is the first reported case of SAVF following a laparoscopic pancreatectomy and demonstrates the usefulness of endovascular treatment for this type of complication.
Chicken primordial germ cells use the anterior vitelline veins to enter the embryonic circulation
De Melo Bernardo, Ana; Sprenkels, Kaylee; Rodrigues, Gabriela; Noce, Toshiaki; Chuva De Sousa Lopes, Susana M.
Summary During gastrulation, chicken primordial germ cells (PGCs) are present in an extraembryonic region of the embryo from where they migrate towards the genital ridges. This is also observed in mammals, but in chicken the vehicle used by the migratory PGCs is the vascular system. We have analysed the migratory pathway of chicken PGCs, focusing on the period of transition from the extraembryonic region to the intraembryonic vascular system. Our findings show that at Hamburger and Hamilton developmental stage HH12¢HH14 the majority of PGCs concentrate axially in the sinus terminalis and favour transport axially via the anterior vitelline veins into the embryonic circulation. Moreover, directly blocking the blood flow through the anterior vitelline veins resulted in an accumulation of PGCs in the anterior region and a decreased number of PGCs in the genital ridges. We further confirmed the key role for the anterior vitelline veins in the correct migration of PGCs using an ex ovo culture method that resulted in defective morphogenetic development of the anterior vitelline veins. We propose a novel model for the migratory pathway of chicken PGCs whereby the anterior vitelline veins play a central role at the extraembryonic and embryonic interface. The chicken model of PGC migration through the vasculature may be a powerful tool to study the process of homing (inflammation and metastasis) due to the striking similarities in regulatory signaling pathways (SDF1¢CXCR4) and the transient role of the vasculature. PMID:23213395
Femoral vein blood flow during a total hip arthroplasty using a modified heuter approach.
Mednick, Rachel E; Alvi, Hasham M; Morgan, Courtney E; Stover, Michael D; Manning, David W
Several modifications to traditional surgical approaches for total hip arthroplasty (THA) have been introduced in an attempt to improve upon minimally invasive approaches and enhance short-term recovery. However, minimally invasive approaches are not without risk, including that of postoperative venous thromboembolism (VTE). There has been no published literature evaluating the femoral vein during an anterior approach. We aimed to study femoral vein blood flow using duplex ultrasonography during THA performed through a modified Heuter approach. Peek flow and vessel cross-sectional area were affected by limb position as well as acetabular and femoral retractor placement. No VTE was observed, but there was observed femoral vein compression, which may represent a risk of postoperative VTE similar to that seen in standard surgical approaches for THA. PMID:25660612
Effect of starvation on vein preference of whitefly (Bemisia tabaci) on chilli as host plant
NASA Astrophysics Data System (ADS)
Siti Sakinah, A.; Mohamad Roff M., N.; Idris, A. B.
The whitefly, Bemisia tabaci (Gennadius), is a cosmopolitan pest of horticultural crops. It caused serious damaged to the plants by feeding on plant saps as direct damage and transmit virus as indirect damage. Vein preferences of both female and male whitefly (WF) on chilli plant were recorded using Dinolite, a portable microscope, under laboratory conditions. WF adults of both sexes were starved for 2 and 4 hours before used for observation while no starvation for control individual (treatment). Results showed that both female and male preferred to feed on secondary veins rather than lamina, midrib and vein. From the result of whitefly preferred target site, hopefully this information will help to improve control tactics in WF management.
[MR angiography of pelvic veins and the inferior vena cava using 0.5 tesla].
Haubold-Reuter, B; Nicolas, V
The pelvic veins and/or the inferior vena cava were examined in 15 patients with pelvic vein thrombosis or retroperitoneal tumours, using phlebography or cavography and MR angiography. The latter was carried out using 0.5 Tesla with an inflow technique TR/TE 30/8 ms, flip angle 70 degrees). 3-D projection angiograms were obtained from the 2-D angiograms in the coronary plane. Image quality was generally satisfactory and the veins up to the internal iliac could be demonstrated in all cases; below this, the examination was unreliable. Comparison of the methods with reference to information of therapeutic relevance has shown that in two-thirds of all examinations (8/13) MR angiography and phlebography were of equal diagnostic value. In the presence of a renal cell carcinoma, MR angiography was unable to distinguish between thrombosis and infiltration of the vena cava. PMID:7948977
Oxygen-sensitive chemoreceptors in the branchio-cardiac veins of the crayfish, Astacus leptodactylus.
Ishii, K; Ishii, K; Massabuau, J C; Dejours, P
Oxygen-sensitive activity was recorded from the branchial nerve of the crayfish Astacus leptodactylus in vitro. After the podobranchial and arthrobranchial nerves branch off to the gill, the branchial nerve terminates in the branchio-cardiac vein wall and its surroundings. When the former 2 branches were cut, irregular spontaneous activity could be recorded from a few fiber preparations innervating the branchio-cardiac vein. The branchio-cardiac vein was superfused or perfused with hypoxic or hyperoxic Ringer solution. Impulse frequency increased in response to hypoxia and decreased in hyperoxia. NaCN and almitrine strongly stimulated nerve activity. Baroreceptor activity was also observed. These response characteristics demonstrate that these receptors are Heymans-type chemoreceptors. PMID:2813989
Diagnosis of deep vein thrombosis using autologous indium-III-labelled platelets.
Fenech, A; Hussey, J K; Smith, F W; Dendy, P P; Bennett, B; Douglas, A S
Forty-eight patients who had undergone surgical reduction of a fractured neck of femur or in whom deep vein thrombosis was suspected clinically were studied by ascending phlebography and imaging after injection of autologous indium-111-labelled platelets to assess the accuracy and value of the radioisotopic technique in diagnosing deep vein thrombosis. Imaging was performed with a wide-field gammacamera linked with data display facilities. Phlebography showed thrombi in 26 out of 54 limbs examined and a thrombus in the inferior vena cava of one patient; imaging the labelled platelets showed the thrombi in 24 of the 26 limbs and the thrombus in the inferior vena cava. The accumulation of indium-111 at sites corresponding to those at which venous thrombi have been shown phlebographically indicates that this radioisotopic technique is a useful addition to methods already available for the detection of deep vein thrombosis. Images FIGS 1-2 FIG 3 PMID:6783228
Effect of a venotonic agent on the main arteries and veins during a 5 day HDT
NASA Astrophysics Data System (ADS)
Roumy, Jerome; Herault, Stephane; Tobal, Nathalie; Besnard, Stephane; Arbeille, Philippe
Objective: To evaluate the cardiac, arterial and venous effect of a venotonic drug (Cirkan ½ Ck Õ) administrated orally daily to 6 subjects in HDT position during 5 days. These subjects underwent a second 5d HDT without Ck treatment one month later. Pre and post HDT the subjects were submitted to a stand test. Method: The cardiovascular parameters were measured by echography and Doppler. Results and discussion: The Cirkan treatment contributed to reduce the increase in cerebral resistance, and to maintain the lower limb resistance at a higher level than on controls. It reduces the vein section at the extremities (Jugular, femoral) and in the central vein system connected to the right heart (sub hepatics). On the other hand it increases the portal vein section which means that the blood stagnation at the splanchnic level is increased. Despite these arterial and venous significant modifications the clinical and ECG and Blood pressure response to the Stand test was similar in both groups.
Percutaneous Vein Occlusion with Small Intestinal Submucosa: An Experimental Pilot Study in Swine and Sheep
Kim, Man Deuk; Hoppe, Hanno; Pavcnik, Dusan, E-mail: firstname.lastname@example.com; Kaufman, John A.; Uchida, Barry T.; Correa, Luiz O.; Timmermans, Hans A.; Park, Won Kyu; Corless, Christopher L.; Keller, Frederick S.; Roesch, Josef [Oregon Health and Sciences University, Dotter Interventional Institute (United States)
Purpose. The objective of this study was to investigate the feasibility, outcomes, and amount of small intestinal submucosa (SIS) material needed for embolization of jugular vein (JV) in a swine and sheep model. Our hypothesis was that SIS would cause vein occlusion. Materials and Methods. The external JVs (EJV) in swine (n = 6) and JVs in sheep (n = 6) were occluded with SIS fan-folded compressed strips. After percutaneous puncture of the peripheral portion of the EJV or JV, a TIPS set was used to exit their lumen centrally through the skin. The SIS strips were delivered into the isolated venous segment with a pull-through technique via a 10-Fr sheath. Follow-up venograms were done immediately after placement and at the time of sacrifice at 1 or 3 months. Gross examinations focused on the EJV or JV and their surrounding structures. Specimens were evaluated by histology. Results. SIS strip(s) placement was successful in all cases, with immediate vein occlusion seen in 23 of 24 veins (95.8%). All EJVs treated with two strips and all JVs treated with three or four strips remained closed on 1- and 3-month follow-up venograms. Two EJVs treated with one strip and one JV treated with two strips were partially patent on venograms at 1 and 3 months. There has been one skin inflammatory reaction. Necropsies revealed excluded EJV or JV segments with SIS incorporation into the vein wall. Histology demonstrated various stages of SIS remodeling with fibrocytes, fibroblasts, endothelial cells, capillaries, and inflammatory cells. Conclusion. We conclude that EJV and JV ablation with SIS strips using percutaneous exit catheterization is feasible and effective in animal models. Further exploration of SIS as vein ablation material is recommended.
Three Dimensional Petrography of Kernouve: A Story of Vein Formation, Compaction, and Metamorphism
Friedrich, J.M.; Ruzicka, A.; Ebel, D.S.; Thostenson, J.; Rudolph, R.A.; Rivers, M.L.; Macke, R.J.; Britt, D.T. (Central Florida); (AMNH); (Portland SU); (UC); (Fordham)
Metallic veins in ordinary chondrites, like those found in Kernouve (H5, S1), have been attributed to impact or shock processes on the parent body. However, Kernouve is widely known to exhibit few traditional signs of shock loading and has a very old {sup 39}Ar-{sup 40}Ar age (4.46 Ga), making the significance of vein formation in Kernouve unclear. One possibility is early vein formation followed by partial obliteration due to thermal metamorphism. We examine this scenario here. The metal vein in Kernouve can be explained as a pre-metamorphic shock-induced structure, given the evidence for current weak compaction and low shock stage. However, it is not clear how one explains high porosity and low shock stage if the meteorite experienced early shock sufficiently strong to mobilize metal into a vein-like structure. Some combination of unusual conditions during shock (e.g. high temperatures) or mobility of metal during metamorphism may be needed. One possible mechanism occurring early on the H chondrite parent body follows: blocks of slightly indurated but porous material were disturbed by an impact which caused a physical concentration of metallic phases akin to slickensides. Shearing of these materials caused the warm, ductile metal grains to be concentrated on rock surfaces. This process would have imparted the rocks with indicators cited by as shock induced. This event happened early in the history of the chondrite otherwise shearing forces would have imparted a preferred orientation upon the metal grains. Subsequent annealing due to radiogenic heating erased any preferential orientation and further coalesced the vein metal. The final compaction of the material occurred yielding the porosity seen in the samples today. The material escaped other major shock episodes.
Automated characterization of blood vessels as arteries and veins in retinal images.
Mirsharif, Qazaleh; Tajeripour, Farshad; Pourreza, Hamidreza
In recent years researchers have found that alternations in arterial or venular tree of the retinal vasculature are associated with several public health problems such as diabetic retinopathy which is also the leading cause of blindness in the world. A prerequisite for automated assessment of subtle changes in arteries and veins, is to accurately separate those vessels from each other. This is a difficult task due to high similarity between arteries and veins in addition to variation of color and non-uniform illumination inter and intra retinal images. In this paper a novel structural and automated method is presented for artery/vein classification of blood vessels in retinal images. The proposed method consists of three main steps. In the first step, several image enhancement techniques are employed to improve the images. Then a specific feature extraction process is applied to separate major arteries from veins. Indeed, vessels are divided to smaller segments and feature extraction and vessel classification are applied to each small vessel segment instead of each vessel point. Finally, a post processing step is added to improve the results obtained from the previous step using structural characteristics of the retinal vascular network. In the last stage, vessel features at intersection and bifurcation points are processed for detection of arterial and venular sub trees. Ultimately vessel labels are revised by publishing the dominant label through each identified connected tree of arteries or veins. Evaluation of the proposed approach against two different datasets of retinal images including DRIVE database demonstrates the good performance and robustness of the method. The proposed method may be used for determination of arteriolar to venular diameter ratio in retinal images. Also the proposed method potentially allows for further investigation of labels of thinner arteries and veins which might be found by tracing them back to the major vessels. PMID:23849699
Ultrasound guided foam sclerotherapy for varicose veins using two needle technique Ś A case series
Ashley C. Solomon; Dilip Kumar Maurya
IntroductionĀĀVaricose veins are one of the most common vascular problems encountered. Ultrasound guided foam sclerotherapy is one such\\u000a option it was introduced in 2001. We present our two needle technique of ultrasound guided foam sclerotherapy along with our\\u000a short term results.\\u000a \\u000a \\u000a \\u000a \\u000a Materials and methodsĀĀPatients presenting us between January 2009 to October 2009 with symptomatic primary varicose veins were selected for
Calcium Sulfate Vein Observations at Yellowknife Bay using ChemCam on the Curiosity Rover
NASA Astrophysics Data System (ADS)
Clegg, S. M.; Mangold, N.; Nachon, M.; Le Mouelic, S.; Ollila, A.; Vaniman, D. T.; Kah, L. C.; Dromart, G.; Bridges, J.; Rice, M. S.; Wellington, D. F.; Bell, J. F.; Anderson, R. B.; Clark, B. C.; Cousin, A.; Forni, O.; Lasue, J.; Schr÷der, S.; Meslin, P.; Dyar, M. D.; Blaney, D. L.; Maurice, S.; Wiens, R. C.; Team, M.
The Mars Science Laboratory Curiosity rover completed its traverse from the Bradbury landing site into Yellowknife Bay (YKB) on sol 125, where it spent ~175 sols. The YKB region is characterized as a fluvio-lacustrine depositional environment. The entire Curiosity payload was used to thoroughly investigate parts of YKB from which significant geochemical observations were made, including the identification of anhydrite and hydrated calcium sulfate. The Curiosity ChemCam package consists of a remote Laser-Induced Breakdown Spectrometer (LIBS) and a Remote Micro-Imager (RMI). LIBS is essentially an elemental analysis micro-probe capable of 300 - 550 ?m spatial resolution from 1.5 - 7.0 m standoff distance from the Curiosity mast. The RMI records context images that have a resolution of 40 ?rad, which corresponds to 120 ?m at 3 meters. The ChemCam instrument recorded many calcium rich geochemical features as it descended ~18 m into YKB. Many light-toned veins became apparent with the ChemCam RMI and Mastcam once Curiosity entered YKB. The ChemCam LIBS instrument is uniquely capable of distinctly probing the elemental composition of these vein structures separately from the host rock. LIBS demonstrated that the white vein material was dominated by CaSO4, while the host rock had relatively low SO3 compositions. The ChemCam instrument can also qualitatively detect H, presumably due to H2O, in many samples. While some of these veins contained no H signature beyond the ubiquitous small amount of H on rock surfaces and in soils, some of the veins contained various amounts of H as a function of depth indicating that some of the samples were either bassanite or gypsum. Mastcam spectral hydration surveys detect evidence of hydration that is consistent with (but not a unique indicator of) the presence of gypsum in some, but not all, of the veins. The CheMin X-ray diffraction instrument identified both anhydrite and bassanite in the matrix of a mudstone unit but did not detect gypsum. Stoichiometric analysis of the ChemCam data currently suggests that the hydrated vein samples analyzed by LIBS are bassanite. This paper will summarize the vein observations and describe some of the more likely formation mechanisms.
Compartment Syndrome following Open Femoral Fracture with an Isolated Femoral Vein Injury Treated with Acute Repair
Walmsley, David; Axelrod, Terry; Rodriguez-Elizalde, Sebastian
Acute compartment syndrome is a surgical emergency and its diagnosis is more difficult in obtunded or insensate patients. We present the case of a 34-year-old woman who sustained a Gustilo-Anderson grade III open midshaft femur fracture with an isolated femoral vein injury treated with direct repair. She developed lower leg compartment syndrome at 48 hours postoperatively, necessitating fasciotomies. She was subsequently found to have a DVT in her femoral vein at the level of the repair and was started on therapeutic anticoagulation. This case highlights the importance of recognition of isolated venous injuries in a trauma setting as a risk factor for developing compartment syndrome. PMID:25587476
Unilateral Axillary Arch and Variations in the Axillary Vein and Intercostal Nerves: A Case Report
Ramanadham, Sharada; Kalthur, Sneha Guruprasad; Pai, Shakunthala R
Knowledge of muscular, vascular, and neural variations in the axilla is of great clinical importance, especially in mastectomies, breast reconstruction, and axillary bypass operations. In the present paper, we report unilateral variations observed in the axillary region of a male cadaver. A fibromuscular axillary arch was observed on the right side. On the same side, there was a bifurcated axillary vein; a medial cutaneous nerve of the arm passed through and later ran beneath this axillary vein. In addition, the intercostobrachial nerve was absent on the right side. The clinical significance of the variations observed and their embryological basis are discussed in this paper. PMID:22135576
A physical sign of coital rupture of superficial dorsal vein of penis
Usman, Farooq; Kyriacos, Alexandrou
A 39-year-old man presented with penile swelling, pain and hematoma associated with sexual intercourse. On exploration, he was found to have ruptured the superficial dorsal vein of penis, which was ligated. He had an uneventful postoperative recovery and has resumed normal sexual life. A rectangular-shaped suprapubic and distal penile hematoma with sparing of the proximal penile skin was observed. We believe that this physical sign could aid clinical diagnosis of a ruptured superficial dorsal vein of penis. PMID:24578872
Anti-neutrophil cytoplasmic antibody vasculitis presenting with bilateral renal vein thrombosis
Robson, Michael Gregory
We report a case of anti-neutrophil cytoplasmic antibody (ANCA)-associated necrotizing crescentic glomerulonephritis presenting with bilateral renal vein thrombosis and pulmonary emboli in a patient who also had a lupus anticoagulant and anti-cardiolipin antibodies. Although the link between venous thrombosis and ANCA vasculitis is well established, the coexistence of renal vein thrombosis is unusual. Furthermore, despite the positive ANCA, he was initially negative for antibodies to myeloperoxidase (MPO) and proteinase-3 (PR3), illustrating that a positive ANCA may be significant despite a negative test for antibodies to MPO and PR3.
Transhepatic Preoperative Portal Vein Embolization Using the Amplatzer Vascular Plug: Report of Four Cases
Ringe, Kristina I., E-mail: email@example.com; Weidemann, Juergen; Rosenthal, Herbert; Keberle, Marc [Medizinische Hochschule Hannover, Abteilung Diagnostische Radiologie (Germany); Chavan, Ajay [Institut fuer Radiologie, Klinikum Oldenburg GmbH (Germany); Baus, Stefan; Galanski, Michael [Medizinische Hochschule Hannover, Abteilung Diagnostische Radiologie (Germany)
The Amplatzer Vascular Plug (AVP) is a device originally intended for arterial and venous embolization in peripheral vessels. From December 2004 to March 2007 we implanted a total of 8 AVPs in the portal venous system in our institution for preoperative portal vein embolization in 4 patients (55-71 years) prior to right hemihepatectomy. AVP implantation was successful in all patients. Total occlusion of the embolized portal vein branches was achieved in all patients. There were no major complications associated with the embolization.
Aberrant drainage of the umbilical vein into the coronary sinus without ductus venosus agenesis.
Ben Brahim, Foued; Hazelzet, Tristan; Cohen, Laurence; Durand, Isabelle; Blanc, Julie; Barre, Elise; Daudruy, Marie Brasseur; David, Nadine
We describe a case series of 4 fetuses with ectopic connections of the ductus venosus to the coronary sinus detected prospectively between August 2011 and February 2012 in 2 congenital cardiologic centers. An enlarged coronary sinus alerted the sonographer. Fetal echocardiography showed ectopic connection of the ductus venosus in an enlarged coronary sinus in all 4 cases. To our knowledge, this anatomic form of ectopic umbilical vein drainage has not previously been reported. The infants were doing well. This venous variant should be considered in cases of isolated coronary sinus dilatation after elimination of a left superior vena cava and a totally anomalous pulmonary vein connection. PMID:24567466
Single site pacing through the anterior interventricular vein in a patient with a mechanic tricuspid valve
Anselmino, Matteo; Marocco, Maria Cristina; Jorfida, Marcella; Massa, Riccardo
Transvenous endocardial pacing through classical implantation of a pace/sensing lead in the right ventricle is strictly contraindicated in patients with a mechanical tricuspid valve. Usually permanent pacing is achieved by an epimyocardial surgical approach. We hereby describe the implantation of a single site left ventricle pacing lead in the anterior interventricular vein in a 60 year-old woman with symptomatic bradycardia, permanent atrial fibrillation, and mechanical tricuspid valve. The described use of left ventricle pacing through a coronary vein lead, in a patient with favorable venous anatomy, provided (through a minimal invasive approach) effective with a low and stable threshold. PMID:19471596
Single site pacing through the anterior interventricular vein in a patient with a mechanic tricuspid valve.
Anselmino, Matteo; Marocco, Maria Cristina; Jorfida, Marcella; Massa, Riccardo
Transvenous endocardial pacing through classical implantation of a pace/sensing lead in the right ventricle is strictly contraindicated in patients with a mechanical tricuspid valve. Usually permanent pacing is achieved by an epimyocardial surgical approach. We hereby describe the implantation of a single site left ventricle pacing lead in the anterior interventricular vein in a 60 year-old woman with symptomatic bradycardia, permanent atrial fibrillation, and mechanical tricuspid valve. The described use of left ventricle pacing through a coronary vein lead, in a patient with favorable venous anatomy, provided (through a minimal invasive approach) effective with a low and stable threshold. PMID:19471596