The 2023 Society for Vascular Surgery, American Venous Forum, and American Vein and Lymphatic Society clinical practice guidelines for the management of varicose veins of the lower extremities. Part II

Gloviczki, Peter; Lawrence, Peter F.; Wasan, Suman M.; Meissner, Mark H.; Almeida, Jose; Brown, Kellie R.; Bush, Ruth L.; Di Iorio, Michael; Fish, John; Fukaya, Eri; Gloviczki, Monika L.; Hingorani, Anil; Jayaraj, Arjun; Kolluri, Raghu; Murad, M. Hassan; Obi, Andrea T.; Ozsvath, Kathleen J.; Singh, Michael J.; Vayuvegula, Satish; Welch, Harold J.

doi:10.1016/j.jvsv.2023.08.011

Cited by 38 publications

(11 citation statements)

References 270 publications

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“…Fails in prolonged pharmacological prophylaxis with LMWH may be related to compliance, which is lower in comparison with oral medications 38,39 Another interesting finding concerns the use of elastic compression for a mean of 4 weeks, which contradicts current guidelines and evidence, suggesting the only benefit is a slight pain reduction with treatment for 1 week after intervention. 15,17,40 According to the results of the current study, Russian physicians still prefer to prescribe compression stockings for a more extended period. However, such an approach does not protect from asymptomatic deep vein lesions.…”

Section: Duration Of Prophylaxismentioning

confidence: 80%

“…Despite current guidelines and evidence, 60% of all interventions in the present study were not accompanied by tributary removal, which may affect the incidence of postoperative VTE. 17,29 The previous studies reported that miniphlebectomy, in addition to endovenous thermal obliteration, increases the risk of EHIT by 3–3.5-fold. 30,31 In the CAPSIVS trial, isolated truncal ablation was associated with the lowest VTE risk (1.2%; 95% CI, 0.7%–2.0%), while intervention on tributaries increased it six-fold (the primary analysis is under publication elsewhere).…”

Section: Discussionmentioning

confidence: 99%

“…[12][13][14] An individual approach for VTE risk assessment and pharmacological prophylaxis is suggested by current guidelines. [15][16][17] Among all, the Caprini risk score (CRS) is the most validated tool to predict postoperative VTE. [18][19][20] However, it has not yet been validated adequately in minimally invasive VV surgery.…”

Section: Introductionmentioning

confidence: 99%

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The trends in venous thromboembolism occurrence and prevention after minimally invasive varicose vein surgery

Lobastov,

Shaldina,

Matveeva

et al. 2023

Phlebology

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Objectives To assess the trends of VTE occurrence and prevention in varicose vein surgery. Method The registry-based CAPSIVS trial (NCT03041805) analysis includes results in 1878 lower limbs. The primary outcome is a 28-day symptomatic or asymptomatic DVT revealed with duplex ultrasound. Results Any DVT, including EHIT, was observed in 3.4%, while symptomatic in 0.5%. Prophylactic anticoagulation was administrated in 20.4% with LMWH (13.2%) or DOAC (7.1%) for patients with higher VTE risk but did not reduce the events rate. With propensity score matching DOACs were superior to LMWHs (1.5% vs 9.8%). Duration of anticoagulation was essential: the lowest incidence (4.2%) was associated with prophylaxis for up to 7 days, while a single LMWH injection resulted in a DVT rate of 8.8%. With individual VTE history, any anticoagulation duration appeared insufficient. Conclusions Prophylactic anticoagulation after varicose vein surgery should be based on the individual VTE risk and provided for ≥7–30 days.

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Section: Duration Of Prophylaxismentioning

confidence: 80%

Section: Discussionmentioning

confidence: 99%

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The trends in venous thromboembolism occurrence and prevention after minimally invasive varicose vein surgery

Lobastov,

Shaldina,

Matveeva

et al. 2023

Phlebology

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“…10,15 A multi-specialty task force of the Society for Vascular Surgery, American Venous Forum, and American Vein and Lymphatic Society, however, has recommended the term ablation-related thrombus extension (ARTE) that would include EGIT and EHIT and thrombus developing following any type of venous ablation procedure. 16 ARTE after CAC may be like a thread or stick-like shape and is graded according to the glue/thrombus occupied area in the common femoral vein. The assessment of ARTE is done by transverse imaging at the junction level in a standing position (Figure 2).…”

Section: Adverse Eventsmentioning

confidence: 99%

Current practice of cyanoacrylate endovenous ablation: American vein and lymphatic society position statement

Vasquez,

Di Iorio,

Worthington-Kirsch

et al. 2023

Phlebology

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Background Cyanoacrylate endovenous ablation and closure of incompetent saphenous veins have become increasingly utilized since its approval for use in the United States in 2015. This increase in usage necessitates a societal update to guide treatment and ensure optimal and consistent patient outcomes. Method The American Vein and Lymphatic Society convened an expert panel to write an updated Position Statement with explanations and recommendations for the appropriate use of cyanoacrylate endovenous ablation for patients with venous insufficiency. Result A Position Statement was produced by the expert panel with recommendations for appropriate use, treatment technique, outcomes review, and potential adverse events. Their recommendations were reviewed, edited, and approved by the Guidelines Committee of the Society. Conclusion This societal Position Statement provides a useful document for reference for physicians and venous specialists to assist in the appropriate use of cyanoacrylate endovenous ablation in the treatment of patients with venous insufficiency.

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“…The potential of phytochemicals in the treatment of chronic venous disease (CVD) was confirmed by clinical practice guidelines [12][13][14], which highlighted flavonoids as the principal pharmacological treatment (recommendation class IIa, level A). Flavonoids proved to be effective for CVD [15], due to their multiple mechanisms to counteract vascular damage (antioxidant, anti-inflammatory, enhances capillary resistance, and inhibits matrix metalloproteinases [16][17][18]).…”

Section: Introductionmentioning

confidence: 98%

Preparation and Preliminary Analysis of Several Nanoformulations Based on Plant Extracts and Biodegradable Polymers as a Possible Application for Chronic Venous Disease Therapy

Ungureanu,

Ozon,

Musuc

et al. 2024

Polymers

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Nanotechnology is one of the newest directions for plant-based therapies. Chronic venous disease often predisposes to long-term and invasive treatment. This research focused on the inclusion of vegetal extracts from Sophorae flos (SE), Calendulae flos (CE), and Ginkgo bilobae folium (GE) in formulations with PHB and PLGA polymers and their physicochemical characterization as a preliminary stage for possible use in the development of a complex therapeutic product. The samples were prepared by an oil–water emulsification and solvent evaporation technique, resulting in suspensions with high spreadability and a pH of 5.5. ATR-FTIR analysis revealed bands for stretching vibrations (O-H, C=O, and C-H in symmetric and asymmetric methyl and methylene) in the same regions as the base components, but switched to high or low wavenumbers and absorbance, highlighting the formation of adducts/complexes between the extracts and polymers. The obtained formulations were in the amorphous phase, as confirmed by XRD analysis. AFM analysis emphasized the morphological peculiarities of the extract–polymer nanoformulations. It could be noticed that, in the case of SE-based formulations, the dominant characteristics for SE-PHB and SE-PLGA composition were the formation of random large (SE-PHB) and smaller uniform (SE-PLGA) particles; further on, these particles tended to aggregate in the case of SE-PHB-PLGA. For the CE- and GE-based formulations, the dominant surface morphology was their porosity, generally with small pores, but larger cavities were observed in some cases (CE- and GE-PHB). The highest roughness values at the (8 µm × 8 μm) scale were found for the following samples and succession: CE-PHB < SE-PLGA < SE-PHB-PLGA. In addition, by thermogravimetric analysis, impregnation in the matrix of compression stockings was evaluated, which varied in the following order: CE-polymer > SE-polymer > GE-polymer. In conclusion, nine vegetal extract–polymer nanoformulations were prepared and preliminarily characterized (by advanced physicochemical methods) as a starting point for further optimization, stability studies, and possible use in complex pharmaceutical products.

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The 2023 Society for Vascular Surgery, American Venous Forum, and American Vein and Lymphatic Society clinical practice guidelines for the management of varicose veins of the lower extremities. Part II

Cited by 38 publications

References 270 publications

The trends in venous thromboembolism occurrence and prevention after minimally invasive varicose vein surgery

The trends in venous thromboembolism occurrence and prevention after minimally invasive varicose vein surgery

Current practice of cyanoacrylate endovenous ablation: American vein and lymphatic society position statement

Preparation and Preliminary Analysis of Several Nanoformulations Based on Plant Extracts and Biodegradable Polymers as a Possible Application for Chronic Venous Disease Therapy

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