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Conclusion The candy-plug technique using an Ex-cuff may be a feasible option; however, it takes time to achieve complete AVP embolization. Therefore, using additional embolic materials should be considered when we use it for the rupture case. (This is a translation of Jpn J Endovasc Interv 2018; 19 29-35.).Objectives As per standard guidelines, the recommended order of arteriovenous fistula (AVF) creation for hemodialysis (HD) access is radiocephalic (RC), followed by proximal elbow fistulas and arteriovenous graft. Although ulnar-basilic (UB) fistula has been an alternative to RC-AVF, still this procedure searches clear recommendations. We present here our experience on UB-AVF as the preferred "second procedure" instead of proximal fistula after the RC-AVF. Methods Forty-two UB-AVF were created in nonfeasible and failed RC-AVF cases between 2016 and 2018. They were reviewed retrospectively and outcomes were compared with 480 RC-AVF constructed within the same period. Results The primary patency at 18 months was 73.8%, 69.6% and mean maturation time was 33.7±6.6 days, 32.1±4.7 days for UB-AVF and RC-AVF respectively (p>0.05). Conclusion Our altered order of preference enabled us to create all the first-time fistula in the distal forearm, providing all the advantages of distal fistula like RC-AVF and avoiding proximal fistula, improved patient convenience and short-term benefit. In an inference that may be used for references and needs support from a larger sample and longer duration study from other centers, UB-AVF may be considered as the second option after RC-AVF depending on the clinical scenario.Objective To investigate the optimal duration of compression therapy after endovenous laser ablation (EVLA) using a 1470-nm diode dual-ring radial laser fiber for great saphenous vein (GSV) insufficiency. Methods Patients undergoing EVLA of GSV for varicose vein disease were divided into two groups based on the duration of subsequent compression after the procedure short duration group (S group; 0-2 days) and long duration group (L group; 1-4 weeks). see more Patient-reported outcomes (pain and quality of life [QOL]) were set as the primary outcomes, and objective findings (venous clinical severity score [VCSS], leg circumference, and duplex ultrasound [DUS] findings) were set as the secondary outcomes. A follow-up examination was performed at 1 week and 1 and 6 months. Each variable between the groups was compared after a propensity score matching using the age, sex, Clinical-Etiological-Anatomical-Pathophysiological (CEAP) clinical class, job type, and target variable as covariates. A per-protocol analysis was performed. Results The S and L groups included 98 and 99 patients, respectively. A propensity score matching analysis showed no significant differences between the groups in any outcomes at any follow-up intervals. Conclusion Long-term compression showed little benefit; therefore, the prescription of compression stocking beyond 2 days after EVLA is unnecessary.Objective To measure the pattern and severity of chronic venous insufficiency (CVI) in patients presenting to a vascular surgery clinic in Pakistan. Materials and Methods This cross-sectional study has examined patients presenting with CVI for the first time. Patients were assessed for severity of the disease using clinical, etiological, anatomical and pathological (CEAP) score and venous clinical severity score (VCSS). Patients were then divided into two groups depending on the severity of the disease 'mild/moderate' CVI if the CEAP classification was ≤C3 or VCSS was 3 or VCSS was ≥5. Both groups were then compared to determine the factors associated with the more 'severe' form of CVI. Results During the study duration, 121 patients presented with CVI with mean age of 47.83±12.02 years; 74 (61.2%) were female. Mean body mass index of the patients was 32.49±18.3 kg/m2. Mean VCSS was 5.49±3.84, indicating most patients presented with the severe form of CVI. Field workers were determined to be three to five times more likely to present with severe CVI compared to housewives and office workers. Conclusion Majority of the patients who presented to a tertiary care facility had the severe form of CVI. Thus, there is a need to raise awareness on this disease at community level.Background As a standard treatment for the varicose vein of the great saphenous vein (GSV) type, endovenous ablation (EVA) is the main approach. However, as a background to this, in Europe and the United States, neovascularization (Neo) following high ligation (HL) of the saphenofemoral junction (SFJ) at the time of GSV stripping has been emphasized as one of the reasons for the high rate of recurrence. However, in Japan, almost no similar mid- or long-term results of GSV stripping have been reported. Patients and Methods From September 2011 to March 2014 when EVA was not my surgical option, 413 consecutive legs of patients underwent GSV stripping by myself using the same procedure. The patients were contacted by phone 5 years later, and recurrent varices after surgery (REVAS) and reoperation (REDO) were investigated. A total of 270 legs of the 391 living cases (69%) underwent venous ultrasonography (VUS). HL of the SFJ was performed via central flash ligation with towing and pulling out of the peripheral sidResults Of the 391 legs of patients who could be contacted, REDO was performed in 23 (6%), including 15 limbs, immediately after this investigation, and symptomatic REVAS were observed in 29 (7%). In 270 legs examined by VUS, REVAS were diagnosed as follows 29 legs with Level 1 lesion, 40 legs with Level 2 lesion, and 27 legs with Level 3 lesion. Level 1 REVAS that occurred at the SFJ were observed only in 3 legs (1.1%), Level 1 REVAS due to incompetent perforating veins (IPVs) were observed in 14 legs (5%), and Level 1 solitary tributary varices were observed in 9 legs (3%). Conclusion In this study, REVAS at the SFJ were significantly less than those in the past reports. It has been shown that REVAS due to IPVs or solitary tributary varices were more important than those at the SFJ. (This is a translation of Jpn J Phlebol 2019; 30(3) 259-265.).
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