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Objective To study the influence of body mass index on ambulatory venous pressure of chronic venous insufficiency of lower extremity.Methods One hundred and two consecutive patients with chronic venous insufficiency of lower extremity were enrolled in this study.Ambulatory venous pressure and body mass index were assessed and compared.Normal body weight group had 28 cases,over weight group had 43 cases,obesity group had 31 cases.Resets The complication of pigmentation,eczema,skin sclerosis and ulcer were more in obesity group and over weight group than those in normal body weight group.The resting pressure (P0) in obesity group,over weight group and normal body weight group were (118.0 ± 11.5),(113.0 ± 9.7),(101.0 ± 10.6) mm Hg (1 mm Hg =0.133 kPa),the pressure after unclamp 4 s (4SP)were (75.00 ± 2.99),(71.00 ± 3.01),(65.00 ± 2.17) mm Hg,the percentage of decreased pressure(pd)were (35.0 ± 5.4)％,(39.0 ± 4.3)％,(43.0 ± 5.1)％,the time of P0 recovered 50％ (RT50) were(7 ± 1),(9 ± 2),(12 ± 3) s.The P0 and 4SP in obesity group,over weight group were significantly higher than those in normal body weight group (P ＜0.05).The Pd,RT50 in obesity group,over weight group were significantly lower than those in normal body weight group (P＜0.05).Conclusion With the increasing of body mass index,the chronic venous insufficiency of lower extremity is more severity.
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Objective To evaluate the preliminary mechanisms of endovenous laser treatment (EVLT) for lower extremity varicose vein.Methods Laser energy was endovenously administered to observe its biological effects on greater saphenous vein (GSV) segments with different conditions.Some great saphenous vein that was surgically removed after EVLT was examined by means of histopathology.Cruor status was tested after EVLT.Results Histopathologic examination found the vein wall treated by EVLT showed reddening,carbonization,or even perforation,denudation of the intima,loss of cellular contours,and fibrin deposition.Additionally,some areas showed marked vacuolization of cells or even spongiosis,swelling and waxy homogenization of collagen,focal coagulation necrosis within the intima.In saline-filled veins,EVLT-induced vessel wall injury was confined to the site of direct laser impact.In contrast,blood-filled veins exhibited thermal damage in more remote areas including the vein wall opposite to the laser impact.D-dimer was significantly changed after EVLT.Conclusions EVLT laser induced indirect local heat injury of the inner vein wall by steam bubbles originating from boiling blood is proposed as the pathophysiological mechanism of action of EVLT.Intravascular blood plays a key role for homogeneously distributed thermal damage of the inner vein wall during EVLT.No significant difference could be detected between the two laser wavelengths.Continuous emission mode is better than pulse emission mode.
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Retrievable vena cava filters can be used to prevent pulmonary embolism. The advantage of the retrievable vena cava filters is that they can either be removed or be remained in the vena cava permanently if needed. This article describes the current status of retrievable vena cava filters including indications, outcomes, patient management, time of filter removal, and the management of thrombus in the filter.