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  • 1
    Online Resource
    Online Resource
    SAGE Publications ; 2018
    In:  Phlebology: The Journal of Venous Disease Vol. 33, No. 6 ( 2018-07), p. 367-378
    In: Phlebology: The Journal of Venous Disease, SAGE Publications, Vol. 33, No. 6 ( 2018-07), p. 367-378
    Abstract: Venous thromboembolism, encompassing deep vein thrombosis and pulmonary embolism, is a significant cause of morbidity and mortality, affecting one in 1000 adults per year. Neuromuscular electrical stimulation is the transcutaneous application of electrical impulses to elicit muscle contraction, preventing venous stasis. This review aims to investigate the evidence underlying the use of neuromuscular electrical stimulation in thromboprophylaxis. Methods The Medline and Embase databases were systematically searched, adhering to PRISMA guidelines, for articles relating to electrical stimulation and thromboprophylaxis. Articles were screened according to a priori inclusion and exclusion criteria. Results The search strategy identified 10 randomised controlled trials, which were used in three separate meta-analyses: five trials compared neuromuscular electrical stimulation to control, favouring neuromuscular electrical stimulation (odds ratio of deep vein thrombosis 0.29, 95% confidence interval 0.13–0.65; P = .003); three trials compared neuromuscular electrical stimulation to heparin, favouring heparin (odds ratio of deep vein thrombosis 2.00, 95% confidence interval 1.13–3.52; P = .02); three trials compared neuromuscular electrical stimulation as an adjunct to heparin versus heparin only, demonstrating no significant difference (odds ratio of deep vein thrombosis 0.33, 95% confidence interval 0.10–1.14; P = .08). Conclusion Neuromuscular electrical stimulation significantly reduces the risk of deep vein thrombosis compared to no prophylaxis. It is inferior to heparin in preventing deep vein thrombosis and there is no evidence for its use as an adjunct to heparin.
    Type of Medium: Online Resource
    ISSN: 0268-3555 , 1758-1125
    Language: English
    Publisher: SAGE Publications
    Publication Date: 2018
    detail.hit.zdb_id: 1463018-7
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  • 2
    Online Resource
    Online Resource
    SAGE Publications ; 2020
    In:  Phlebology: The Journal of Venous Disease Vol. 35, No. 7 ( 2020-08), p. 520-523
    In: Phlebology: The Journal of Venous Disease, SAGE Publications, Vol. 35, No. 7 ( 2020-08), p. 520-523
    Abstract: Non-thermal non-tumescent methods for varicose vein treatment have rapidly gained popularity in recent years due to clinical efficacy comparable to other endovenous methods, but with a superior safety and tolerability profile. Cyanoacrylate is an adhesive that rapidly polymerises during endovenous treatment to cause rapid occlusion of veins and initiate vein fibrosis. Method Cyanoacrylate glue treatment is known to cause complications such as phlebitis, cellulitis and deep vein thrombosis in rare instances. We present the first reported case of cyanoacrylate extravasation with chronic foreign body reaction in a patient nine months after initial treatment. Results We discuss the aetiology of this complication, its treatment, patient outcome and its significance to both clinicians and patients. Conclusion Cyanoacrylate glue embolisation can, in rare instances, lead to extravasation and chronic foreign body reaction, necessitating surgical intervention. The relative novelty of cyanoacrylate glue embolisation in the treatment of varicose veins requires clinicians to monitor for rare complications during its use in clinical practice. Patients should be aware of the rare risk of glue extravasation and foreign body reaction for fully informed consent prior to treatment.
    Type of Medium: Online Resource
    ISSN: 0268-3555 , 1758-1125
    Language: English
    Publisher: SAGE Publications
    Publication Date: 2020
    detail.hit.zdb_id: 1463018-7
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  • 3
    Online Resource
    Online Resource
    SAGE Publications ; 2016
    In:  Phlebology: The Journal of Venous Disease Vol. 31, No. 1 ( 2016-02), p. 5-14
    In: Phlebology: The Journal of Venous Disease, SAGE Publications, Vol. 31, No. 1 ( 2016-02), p. 5-14
    Abstract: Varicose veins are common and their management has undergone a number of changes over the years. Surgery has been the traditional treatment option, but towards the 21st century, new endovenous thermal ablation techniques, namely, radiofrequency ablation and endovenous laser ablation, were introduced which have revolutionised the way varicose veins are treated. These minimally invasive techniques are associated with earlier return to normal activity and less pain, as well as enabling procedures to be carried out as day cases. They are, however, also known to cause a number of side-effects and involve infiltration of tumescent fluid which can cause discomfort. Non-thermal, non-tumescent methods are believed to be the answer to these unwelcome effects. Ultrasound-guided foam sclerotherapy is one such non-thermal, non-tumescent method and, despite a possible lower occlusion, has been shown to improve the quality of life of patients. The early results of two recently launched non-thermal, non-tumescent methods, mechanochemical ablation and cyanoacrylate glue, are promising and are discussed.
    Type of Medium: Online Resource
    ISSN: 0268-3555 , 1758-1125
    Language: English
    Publisher: SAGE Publications
    Publication Date: 2016
    detail.hit.zdb_id: 1463018-7
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  • 4
    Online Resource
    Online Resource
    Springer Science and Business Media LLC ; 2008
    In:  Cases Journal Vol. 1, No. 1 ( 2008-12)
    In: Cases Journal, Springer Science and Business Media LLC, Vol. 1, No. 1 ( 2008-12)
    Type of Medium: Online Resource
    ISSN: 1757-1626
    Language: English
    Publisher: Springer Science and Business Media LLC
    Publication Date: 2008
    detail.hit.zdb_id: 2431132-7
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  • 5
    Online Resource
    Online Resource
    Royal College of Surgeons of England ; 2010
    In:  The Annals of The Royal College of Surgeons of England Vol. 92, No. 6 ( 2010-09), p. 533-533
    In: The Annals of The Royal College of Surgeons of England, Royal College of Surgeons of England, Vol. 92, No. 6 ( 2010-09), p. 533-533
    Type of Medium: Online Resource
    ISSN: 0035-8843 , 1478-7083
    Language: English
    Publisher: Royal College of Surgeons of England
    Publication Date: 2010
    detail.hit.zdb_id: 2100560-6
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  • 6
    Online Resource
    Online Resource
    SAGE Publications ; 2014
    In:  Vascular Vol. 22, No. 5 ( 2014-10), p. 375-377
    In: Vascular, SAGE Publications, Vol. 22, No. 5 ( 2014-10), p. 375-377
    Abstract: 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.
    Type of Medium: Online Resource
    ISSN: 1708-5381 , 1708-539X
    Language: English
    Publisher: SAGE Publications
    Publication Date: 2014
    detail.hit.zdb_id: 2143006-8
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  • 7
    Online Resource
    Online Resource
    SAGE Publications ; 2020
    In:  Phlebology: The Journal of Venous Disease Vol. 35, No. 9 ( 2020-10), p. 644-646
    In: Phlebology: The Journal of Venous Disease, SAGE Publications, Vol. 35, No. 9 ( 2020-10), p. 644-646
    Type of Medium: Online Resource
    ISSN: 0268-3555 , 1758-1125
    Language: English
    Publisher: SAGE Publications
    Publication Date: 2020
    detail.hit.zdb_id: 1463018-7
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  • 8
    Online Resource
    Online Resource
    SAGE Publications ; 2014
    In:  Phlebology: The Journal of Venous Disease Vol. 29, No. 1_suppl ( 2014-05), p. 181-185
    In: Phlebology: The Journal of Venous Disease, SAGE Publications, Vol. 29, No. 1_suppl ( 2014-05), p. 181-185
    Abstract: Worldwide superficial and deep venous diseases are common and associated with significant individual and socioeconomic morbidity. Increasing burden of venous disease requires Phlebology to define itself as an independent specialty representing not only patients but the multidisciplinary physicians involved in venous care. Methods & Results In this article the scope of venous disease in Europe and subsequent future governance for treatment in the region is discussed. Superficial venous disease is common with 26.9-68.6% of European populations reported to have C2-C6 disease according to the CEAP (Clinical severity, Aetiology, Anatomy and Pathophysiology) scoring system. However, a significant disparity is observed in the treatment of superficial venous disease across Europe. Post thrombotic syndrome (PTS) after deep vein thrombosis (DVT) contributes to the increasing burden of deep venous disease. Aggressive thrombus removal for acute ileofemoral DVT provides a cost-effective 14.4% risk reduction in the development of PTS. Additionally, deep venous lesions requiring endovascular intervention are being increasingly performed to prevent recurrent thrombosis. The European College of Phlebology (ECoP) has been formed to provide a responsible body for the care of the European patient with venous disease. The role of the ECoP includes unifying European member states through standardised guideline production, identification of research strategy and provision of training and accreditation of physicians. Conclusion Creation of a European venous disease specific speciality will provide a patient centred approach through understanding of the impact of disease in the region and delivery of high quality diagnostics and treatment from an appropriately certified Phlebologist.
    Type of Medium: Online Resource
    ISSN: 0268-3555 , 1758-1125
    Language: English
    Publisher: SAGE Publications
    Publication Date: 2014
    detail.hit.zdb_id: 1463018-7
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  • 9
    Online Resource
    Online Resource
    SAGE Publications ; 2015
    In:  Phlebology: The Journal of Venous Disease Vol. 30, No. 3 ( 2015-04), p. 172-179
    In: Phlebology: The Journal of Venous Disease, SAGE Publications, Vol. 30, No. 3 ( 2015-04), p. 172-179
    Abstract: Superficial venous thrombosis is common and traditionally considered a benign condition requiring only symptomatic treatment. Recent evidence, however, advocates more aggressive management. Extensive guidance is available but actual practice is unknown. This study aimed to assess the management of superficial venous thrombosis by general practitioners (primary care physicians) and vascular surgeons. Methods A 19-question validated electronic survey was created and circulated by e-mail to general practitioners and vascular surgeons in the United Kingdom. The survey evaluated presentation, investigation and treatment of superficial venous thrombosis. Results Three hundred sixty-nine surveys were returned from 197 vascular surgeons and 172 general practitioners. Most clinicians saw less than 20 cases a year, with 40% of clinicians not performing any investigations. Venous duplex was the investigation of choice in over 55%. Treatment with anti-inflammatory drugs was widespread, but anticoagulation and compression were seldom prescribed. Follow-up and treatment duration were disparate. Discussion The management of superficial venous thrombosis varies widely despite good levels of evidence and guidance. Investigation and treatment of superficial venous thrombosis show marked differences both between and within groups. Improvements in education are required to optimise the treatment pathway and advance patient care.
    Type of Medium: Online Resource
    ISSN: 0268-3555 , 1758-1125
    Language: English
    Publisher: SAGE Publications
    Publication Date: 2015
    detail.hit.zdb_id: 1463018-7
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  • 10
    Online Resource
    Online Resource
    SAGE Publications ; 2014
    In:  Phlebology: The Journal of Venous Disease Vol. 29, No. 10 ( 2014-12), p. 648-653
    In: Phlebology: The Journal of Venous Disease, SAGE Publications, Vol. 29, No. 10 ( 2014-12), p. 648-653
    Abstract: This work was presented as a poster in the American Venous Forum 25th Annual Meeting; 28 February 2013; Phoenix, Arizona, USA. Quality of life (QoL) is an important outcome measure in the treatment for chronic venous disease. The Aberdeen Varicose Vein Questionnaire (AVVQ) and the ChronIc Venous Insufficiency quality of life Questionnaire (CIVIQ-14) are two validated disease-specific QoL questionnaires in current use. The aim of this study is to evaluate the relationship between the AVVQ and the CIVIQ-14 to enable better comparison between studies and to compare these disease-specific QoL tools with generic QoL and clinician-driven tools. Methods Adults attending our institution for management of their varicose veins completed the AVVQ, CIVIQ-14 and EuroQol-5D (EQ-5D). Clinical data, CEAP classification and the Venous Clinical Severity Score (VCSS) were collected. The relationship between the AVVQ and CIVIQ-14 scores was analysed using Spearman’s correlation. The AVVQ and CIVIQ-14 scores were also analysed with a generic QoL tool (EQ-5D) and a clinician-driven tool, the VCSS. Results One hundred patients, mean age 57.5 (44 males; 56 females), participated in the study. The median AVVQ score was 21.9 (range 0–74) and the median CIVIQ-14 score was 30 (range 0–89). A strong correlation was demonstrated between the AVVQ and CIVIQ-14 scores ( r = 0.8; p  〈  0.0001). Strong correlation was maintained for patients with C1-3 disease ( r = 0.7; p  〈  0.0001) and C4-6 disease ( r = 0.8; p  〈  0.0001). The VCSS correlated strongly with the AVVQ and CIVIQ-14 scores ( r = 0.7; p  〈  0.0001 and r = 0.7; p  〈  0.0001, respectively). Both the AVVQ and CIVIQ-14 scores correlated well with the EQ-5D score ( r = −0.5; p  〈  0.0001 and r = −0.7; p  〈  0.0001, respectively). Conclusions This study demonstrates that there is good correlation between two widely used varicose vein specific QoL tools (AVVQ and CIVIQ-14) across the whole spectrum of disease severity. Strong correlation exists between these disease-specific QoL tools and generic and clinician-driven tools. Our findings confirm valid comparisons between studies using either disease-specific QoL tool.
    Type of Medium: Online Resource
    ISSN: 0268-3555 , 1758-1125
    Language: English
    Publisher: SAGE Publications
    Publication Date: 2014
    detail.hit.zdb_id: 1463018-7
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