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Ola Bjorgell - One of the best experts on this subject based on the ideXlab platform.
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scoring systems for grading deep Leg Vein thrombosis
Acta Radiologica, 2002Co-Authors: Ola Bjorgell, Fredrik RobertsonAbstract:A scoring system could be used in all situations where grading of deep Leg Vein thrombosis (DVT), including mapping of its distribution, is needed. It should also be used in epidemiological studies of DVT in further analysis of different risk groups suffering from DVT. Several scoring systems have been developed during the last three decades but have resulted in various complex and impractical systems. A scoring system should be easy to follow without any risk of misunderstanding and misinterpretation. All Vein segments of importance should be defined and be possible to be included. This review describes and compares the scoring systems according to Marder et al., Arnesen et al., a subcommittee of venous disease and Bjorgell et al.
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isolated nonfilling of contrast in deep Leg Vein segments seen on phlebography and a comparison with color doppler ultrasound to assess the incidence of deep Leg Vein thrombosis
Angiology, 2000Co-Authors: Ola Bjorgell, Paul E Nilsson, Hartmut JarenrosAbstract:Nonfilling of contrast in deep Veins on phlebography is claimed to be an indirect sign of deep Vein thrombosis (DVT) by some authors but rejected by others. The aim of this study was to prospectively assess, with color Doppler ultrasound (CDU), the occurrence and distribution of DVT in isolated, nonfilling, deep Vein segments seen on a phlebogram. One hundred consecutive patients with clinical signs of acute DVT, in whom phlebography displayed nonfilling of the posterior tibial Veins and/or the deep calf muscle Veins, were examined with CDU on the same occasion. Ultrasound confirmed a DVT in 31 (31%) patients; in another 38 (38%) patients other pathology, without concomitantly detected DVT, such as edema, bleedings, ligament and muscle ruptures, Baker cysts, or superficial thrombophlebitis were found instead; and in the remaining 31 (31%) patients no pathology that could explain the nonfilling was identified. Isolated, nonfilling of the posterior tibial and/or deep muscle Veins of the calf found by phlebography may be an indirect sign of DVT but is equally commonly caused by other pathological conditions or arises without any detectable explanation. When the thrombotic burden is to be scored, and to facilitate the establishment of the correct diagnosis, additional CDU is recommended when isolated nonfilling is present.
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a new scoring system for the detailed description of the distribution and thrombotic burden in deep Leg Vein thrombosis
Angiology, 1999Co-Authors: Ola Bjorgell, Paul E Nilsson, Peter Svensson, David BergqvistAbstract:A new scoring system for the detailed description of the distribution andthrombotic burden in deep Leg Vein thrombosis.
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a new scoring system for the detailed description of the distribution and thrombotic burden in deep Leg Vein thrombosis
Angiology, 1999Co-Authors: Ola Bjorgell, Paul E Nilsson, Peter Svensson, David BergqvistAbstract:The scoring system most commonly used to date to describe the thrombotic burden of deep Vein thrombosis (DVT) excludes several deep Vein segments and is thereby of limited use in research. The aim of this prospective, comparative study was to develop a new scoring and distribution system that would include all major deep Veins of the Leg and pelvis. In total, 247 consecutive patients were included, of whom 105 had a positive phlebography. The positive phlebographies were registered in the new system and the result was compared with that obtained by the Marder system. In 72% (76/105) of the patients the DVT distribution was not completely described and the thrombotic burden was significantly underestimated by the Marder system. Of these, 12% (13/105) were not scored at all, thus representing false-negative investigations. It was possible to score all DVTs and important Vein segments of these patients with the new system. The scoring system previously used excludes several deep Vein segments. A description of the important Vein segments, where DVT is shown to originate and propagate, is mandatory in a scoring system designed for the purpose of research of DVT and later detected deep Vein insufficiency. The new system meets this demand.
David Bergqvist - One of the best experts on this subject based on the ideXlab platform.
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a new scoring system for the detailed description of the distribution and thrombotic burden in deep Leg Vein thrombosis
Angiology, 1999Co-Authors: Ola Bjorgell, Paul E Nilsson, Peter Svensson, David BergqvistAbstract:A new scoring system for the detailed description of the distribution andthrombotic burden in deep Leg Vein thrombosis.
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a new scoring system for the detailed description of the distribution and thrombotic burden in deep Leg Vein thrombosis
Angiology, 1999Co-Authors: Ola Bjorgell, Paul E Nilsson, Peter Svensson, David BergqvistAbstract:The scoring system most commonly used to date to describe the thrombotic burden of deep Vein thrombosis (DVT) excludes several deep Vein segments and is thereby of limited use in research. The aim of this prospective, comparative study was to develop a new scoring and distribution system that would include all major deep Veins of the Leg and pelvis. In total, 247 consecutive patients were included, of whom 105 had a positive phlebography. The positive phlebographies were registered in the new system and the result was compared with that obtained by the Marder system. In 72% (76/105) of the patients the DVT distribution was not completely described and the thrombotic burden was significantly underestimated by the Marder system. Of these, 12% (13/105) were not scored at all, thus representing false-negative investigations. It was possible to score all DVTs and important Vein segments of these patients with the new system. The scoring system previously used excludes several deep Vein segments. A description of the important Vein segments, where DVT is shown to originate and propagate, is mandatory in a scoring system designed for the purpose of research of DVT and later detected deep Vein insufficiency. The new system meets this demand.
Paul E Nilsson - One of the best experts on this subject based on the ideXlab platform.
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isolated nonfilling of contrast in deep Leg Vein segments seen on phlebography and a comparison with color doppler ultrasound to assess the incidence of deep Leg Vein thrombosis
Angiology, 2000Co-Authors: Ola Bjorgell, Paul E Nilsson, Hartmut JarenrosAbstract:Nonfilling of contrast in deep Veins on phlebography is claimed to be an indirect sign of deep Vein thrombosis (DVT) by some authors but rejected by others. The aim of this study was to prospectively assess, with color Doppler ultrasound (CDU), the occurrence and distribution of DVT in isolated, nonfilling, deep Vein segments seen on a phlebogram. One hundred consecutive patients with clinical signs of acute DVT, in whom phlebography displayed nonfilling of the posterior tibial Veins and/or the deep calf muscle Veins, were examined with CDU on the same occasion. Ultrasound confirmed a DVT in 31 (31%) patients; in another 38 (38%) patients other pathology, without concomitantly detected DVT, such as edema, bleedings, ligament and muscle ruptures, Baker cysts, or superficial thrombophlebitis were found instead; and in the remaining 31 (31%) patients no pathology that could explain the nonfilling was identified. Isolated, nonfilling of the posterior tibial and/or deep muscle Veins of the calf found by phlebography may be an indirect sign of DVT but is equally commonly caused by other pathological conditions or arises without any detectable explanation. When the thrombotic burden is to be scored, and to facilitate the establishment of the correct diagnosis, additional CDU is recommended when isolated nonfilling is present.
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a new scoring system for the detailed description of the distribution and thrombotic burden in deep Leg Vein thrombosis
Angiology, 1999Co-Authors: Ola Bjorgell, Paul E Nilsson, Peter Svensson, David BergqvistAbstract:A new scoring system for the detailed description of the distribution andthrombotic burden in deep Leg Vein thrombosis.
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a new scoring system for the detailed description of the distribution and thrombotic burden in deep Leg Vein thrombosis
Angiology, 1999Co-Authors: Ola Bjorgell, Paul E Nilsson, Peter Svensson, David BergqvistAbstract:The scoring system most commonly used to date to describe the thrombotic burden of deep Vein thrombosis (DVT) excludes several deep Vein segments and is thereby of limited use in research. The aim of this prospective, comparative study was to develop a new scoring and distribution system that would include all major deep Veins of the Leg and pelvis. In total, 247 consecutive patients were included, of whom 105 had a positive phlebography. The positive phlebographies were registered in the new system and the result was compared with that obtained by the Marder system. In 72% (76/105) of the patients the DVT distribution was not completely described and the thrombotic burden was significantly underestimated by the Marder system. Of these, 12% (13/105) were not scored at all, thus representing false-negative investigations. It was possible to score all DVTs and important Vein segments of these patients with the new system. The scoring system previously used excludes several deep Vein segments. A description of the important Vein segments, where DVT is shown to originate and propagate, is mandatory in a scoring system designed for the purpose of research of DVT and later detected deep Vein insufficiency. The new system meets this demand.
Mario A Trelles - One of the best experts on this subject based on the ideXlab platform.
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1064 nm nd yag long pulse laser after polidocanol microfoam injection dramatically improves the result of Leg Vein treatment a randomized controlled trial on 517 Legs with a three year follow up
Phlebology, 2014Co-Authors: Javier Morenomoraga, Adriana Smarandache, Mihail L Pascu, Josefina Royo, Mario A TrellesAbstract:ObjectiveTo assess the efficacy and safety of a new method of clearing varicose Veins in the long term. It consists of applying the long-pulsed Nd:YAG laser following the injection of polidocanol microfoam, in two consecutive sessions, treating both Legs in full in each session.MethodRandomized, Polidocanol-controlled, blind evaluation clinical trial comparing the results between 79 Legs treated with Polidocanol and 517 treated with Polidocanol + Laser. Photographs were taken preoperatively and at three months, two years and three years after treatment, as well as patient self-assessments.ResultsPolidocanol + Laser is much more effective than polidocanol microfoam in clearing venulectasias with a diameter under 4 mm (p < 0.001). After three years, clearing percentages of 89% (Class I Veins), 94% (Class II Veins) and 95% (Class III Veins) are observed, in comparison to 15%, 18% and 17%, respectively when only polidocanol was applied. No unexpected adverse effects were found and 86% of patients stated they ...
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Treatment of Leg Veins with combined pulsed dye and Nd:YAG lasers: 60 patients assessed at 6 months
Lasers in Surgery and Medicine, 2010Co-Authors: Mario A Trelles, Robert A. Weiss, Javier Moreno‐moragas, Carmen Romero, Mariano Vélez, Xavier ÁlvarezAbstract:Introduction Leg telangiectasias have been reported to have been treated with a variety of lasers. This study was designed to measure response to treatment of Leg telangiectasias with a unique coupled 585 nm and 1064 nm pulse. Methods Sixty female patients (24–62 y.o., skin types II–IV) with Leg Vein varicosities were treated with pulses of a combined 585 nm long pulsed dye (LPDL) and 1064 nm Nd:YAG lasers, which were delivered sequentially using a novel dual laser device. Pulses were placed along the entire length of the targeted Veins. A beam diameter of 7 mm with pulses of 10 ms and 9J/cm2 of fluence for LPDL, and pulses of 30 ms and 80 J/cm2 for the 106 nm Nd:YAG were utilized and these remained uniform. Time delays between sequential LPDL and Nd:YAG pulses were 125 ms, 250 ms and 500 ms depending on Vein diameter of 4, 3 and 2 mm respectively. One or two treatments were given at 2 month intervals, with post-treatment assessments at 6 months following the final treatment. Patients subjectively assessed the treatment and their results were used to draw up a satisfaction index (SI). Objective assessment was based on clinical photography and computer-generated data using a Vein clearance detection computer program. Results The overall patient satisfaction rate was 47 of 60 patients and the objective assessments, based on blinded evaluation of clinical photography as well as computer assessment, demonstrated good to very good improvement in 47 by photograph evaluation and 49 of 60 patients by computer edge detection data. Conclusions The combination of LPDL and Nd:YAG laser pulses offered efficient treatment of Leg Veins irrespective of skin type. Results were better on blue and vessels larger than 1 mm. Side effects were minimal and transient. Lasers Surg. Med. 42:769–774, 2010 © 2010 Wiley-Liss, Inc.
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treatment effects of combined radio frequency current and a 900 nm diode laser on Leg blood vessels
Lasers in Surgery and Medicine, 2006Co-Authors: Mario A Trelles, Manuel Martinvazquez, Oswaldo Trelles, Serge MordonAbstract:Background and Objectives: Effective laser treatment of Leg Veins remains a major challenge. The present study examined the safety and efficacy of a new technology for Leg Vein treatment combining 900 nm diode laser with radiofrequency (RF) current. Study Design/Materials and Methods: Forty patients, skin types II–IV, received a maximum of three treatments on 1–4 mm Leg Veins at 2-week intervals with a 900 nm diode laser (250 millisecond exposure time, average fluence 60 J/cm 2 ) and RF (energy 100 J/cm 3 ). Results were assessed after each treatment and at 2 and 6 months after the final session. Patients rated their satisfaction with the clinical outcome on a five-item scale. Clinician and computer analysis of the clinical photography was also performed, in addition to histological assessment. Results: One or two sessions were required in the majority of patients. Shortly after treatment, histology revealed contracted vessels with perivascular edema. Side effects were extremely rare. The clinician 2- and 6-month assessments showed that 70% and 82.5% of subjects, respectively, achieved over 50% clearance, with patient and computer assessments lower and slightly higher, respectively. Treatments showed greater efficacy on thicker vessels and in the darker skin types. Conclusions: The success of the treatment, minimal side effects, and patient comfort suggest that this combination is an effective, safe technique for Leg Vein treatment. When compared to previous studies using diode laser alone, the very low fluence needed to achieve vessel clearance emphasizes the role of RF energy. Lasers Surg. Med. 38:185–195, 2006. 2006 Wiley-Liss, Inc.
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a clinical histological and computer based assessment of the polaris lv combination diode and radiofrequency system for Leg Vein treatment
Lasers in Surgery and Medicine, 2005Co-Authors: Neil S Sadick, Mario A TrellesAbstract:Background and Objectives Electro-optical synergy (ELOS™) is a novel technology that combines radiofrequency (RF) with optical energy. This study investigated the safety and effectiveness of the Polaris LV™ system, which is based on combined RF and diode laser (915 nm), for the treatment of Leg Veins. Study Design/Materials and Methods Fifty women (Fitzpatrick II–IV) with red or blue Leg Veins (1–4 mm in diameter) were treated with the Polaris LV, using a fluence of 60–80 J/cm2 and conducted RF energy of 100 J/cm3. Patients received up to three treatment sessions at 2- to 4-week intervals. Both patients and an independent physician graded the level of vessel clearance at 2 months following the last treatment, using pre- and post-treatment photographs. Also, a computer-generated assessment of vessel clearance was done in 40 patients. Twenty patients provided biopsy specimens for histologic assessment. Results Approximately three-quarters of patients demonstrated ≥ 50% vessel clearance, and about 30% had 75%–100% vessel clearance. Computer-generated scores correlated closely with physician scores. Histologic assessment showed signs of coagulation and prominent endothelial degeneration in all treated vessels, but the epidermis remained normal. There were minimal complications. Conclusions The Polaris LV is effective and safe in treating red and blue Leg Veins up to 4 mm in diameter. © 2005 Wiley-Liss, Inc.
Patti Romero - One of the best experts on this subject based on the ideXlab platform.
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clinical comparison of sclerotherapy versus long pulsed nd yag laser treatment for lower extremity telangiectases
Dermatologic Surgery, 2002Co-Authors: Joanne R. Lupton, Tina S Alster, Patti RomeroAbstract:background. Sclerotherapy has traditionally been considered the gold standard of treatment for Leg Veins, but patient fear of multiple needle injections and side effects of treatment have fueled investigation into other treatment alternatives. As a result, vascular-specific laser and light sources have been developed in an effort to treat these vessels with minimal morbidity and improved efficacy. objective. To compare the clinical efficacy of Leg telangiectasia treatment with sodium tetradecyl sulfate sclerotherapy to long-pulsed 1064 nm Nd:YAG laser irradiation. methods. A series of 20 patients with size-matched superficial telangiectases of the lower extremities were randomly assigned to receive two consecutive monthly treatments with injectable sodium tetradecyl sulfate on one Leg and long-pulsed 1064 nm Nd:YAG laser irradiation on the other. Patients were evaluated by two masked assessors at each treatment visit and at 1 and 3 months after treatment to assess clinical improvement within matched sites. results. Leg telangiectases responded best to sclerotherapy in fewer treatment sessions than to long-pulsed 1064 nm Nd:YAG laser irradiation. The incidence of adverse sequelae was minimal and equivocal in both treatment groups. conclusion. Despite recent advances in laser technology for treatment of lower extremity telangiectases, sclerotherapy continues to offer superior clinical effect in the majority of cases. Laser Leg Vein treatment appears to be most beneficial in patients with telangiectatic matting, needle phobia, or sclerosant allergy.