OBJECTIVES: Our retrospective study was designed to examine the efficacy of endovenous laser ablation (ELA) in patients with varicose vein. METHODS: One hundred and twenty-five patients (157 limbs) underwent ELA from June 2008 to June 2011. Age of patients, sex, location of lesions, postoperative complications and recurrence rate were analyzed. Follow up was performed by 1week, 4weeks and 8weeks after operation. RESULTS: The mean age of patients was 51.4 years old and men and women were 73 and 52. The prevalence of minor complications was 14.4% and the recurrence rate was 3.2%. CONCLUSIONS: ELA of the varicose vein is effective and safe methods. ELA is simple to perform, relatively atraumatic and well accepted by patients. In my opinion, ELA can be effectively implemented in surgical practice.
Female ; Follow-Up Studies ; Humans ; Laser Therapy ; Male ; Postoperative Complications ; Prevalence ; Recurrence ; Retrospective Studies ; Varicose Veins

BACKGROUND: Radiofrequency obliteration and endovenous laser therapy of the greater saphenous vein have recently been introduced as alternative, minimally invasive techniques for the treatment of saphenous vein incompetence. The 7 Fr. VNUS ClosureFAST(R) radiofrequency obliteration system was introduced in Gwang-Ju Veterans hospital. The purpose of this study is to evaluate the efficacy and complications of radiofrequency obliteration using the 7 Fr. VNUS ClosureFAST(R) system. MATERIAL AND METHOD: Between May 2, 2007 and May 31, 2008, we performed radiofrequency obliteration on 90 patients. The number of males was 67 and their mean age was 57.9+/-11.0 (range: 23~78) years old. The patients underwent follow up exams at 3 weeks after the procedures and then every 3 months. The effects of treatment and the complications were reviewed. RESULT: The postoperative complications were ecchymosis (94.4%), pain (27.8%), paresthesia (25.6%), bullous formation (8.9%), edema (6.7%) and phlebitis (2.2%). One patient showed good blood flow after 3 weeks and one patient showed good blood flow after 3 months. The one-year success rate of radiofrequency obliteration in varicose veins was 97.6%. CONCLUSION: Our data showed acceptable operative results and short-term clinical results for treating varicose veins with radio frequency obliteration. Long-term follow-up and comparison of radio frequency obliteration with high ligation and stripping, previous radiofrequency ablation and endovenous laser therapy are needed in the future.
Ecchymosis ; Edema ; Follow-Up Studies ; Hospitals, Veterans ; Humans ; Laser Therapy ; Ligation ; Male ; Paresthesia ; Phlebitis ; Postoperative Complications ; Saphenous Vein ; Varicose Veins ; Veins

Aged ; Cholangiopancreatography, Endoscopic Retrograde ; Fibrosis ; drug therapy ; pathology ; surgery ; therapy ; Gallstones ; complications ; Humans ; Middle Aged ; Somatostatin ; therapeutic use ; Varicose Veins ; drug therapy ; pathology ; surgery ; therapy

A 52-yr-old male with alcoholic liver cirrhosis was hospitalized for hematochezia. He had undergone small-bowel resection due to trauma 15 yr previously. Esophagogastroduodenoscopy showed grade 1 esophageal varices without bleeding. No bleeding lesion was seen on colonoscopy, but capsule endoscopy showed suspicious bleeding from angiodysplasia in the small bowel. After 2 weeks of conservative treatment, the hematochezia stopped. However, 1 week later, the patient was re-admitted with hematochezia and a hemoglobin level of 5.5 g/dL. Capsule endoscopy was performed again and showed active bleeding in the mid-jejunum. Abdominal computed tomography revealed a varix in the jejunal branch of the superior mesenteric vein. A direct portogram performed via the transhepatic route showed portosystemic collaterals at the distal jejunum. The patient underwent coil embolization of the superior mesenteric vein just above the portosystemic collaterals and was subsequently discharged without re-bleeding. At 8 months after discharge, his condition has remained stable, without further bleeding episodes.
Embolization, Therapeutic/*methods ; Gastrointestinal Hemorrhage/etiology/therapy ; Humans ; Jejunum/*blood supply ; Liver Cirrhosis, Alcoholic/complications ; Male ; Middle Aged ; Varicose Veins/diagnosis/etiology/*therapy

Ectopic stomal varices are an unusual cause of gastrointestinal hemorrhage. The term "ectopic stomal varices" means abnormally dilated veins that have developed in the stomal mucosa. We describe the 2D reformatted and 3D volume rendered images by MDCT in a patient with an episode of acute bleeding from the colonic stoma. This case indicates that the 2D reformatted and 3D volume rendered images are useful to detect this rare complication of portal hypertension, and they help to tailor adequate treatment for the patients with bleeding from stomal varices.
Varicose Veins/*complications/*radiography/therapy ; Tomography, X-Ray Computed/*methods ; Recurrence ; Male ; Ligation ; Imaging, Three-Dimensional ; Humans ; Gastrointestinal Hemorrhage/*etiology/*radiography/therapy ; *Colostomy ; Aged

Gross hematuria secondary to vesical varices is an unusual presentation. We report such a case recurrent gross hematuria in a male patient who had a history of bladder substitution with ileal segments that had been treated by balloon-occluded percutaneous transhepatic obliteration of vesical varices.
Balloon Occlusion/*adverse effects ; Contrast Media/diagnostic use ; Embolization, Therapeutic/*methods ; Hematuria/*etiology ; Humans ; Male ; Middle Aged ; Phlebography ; Recurrence ; Tomography, X-Ray Computed ; Varicose Veins/*complications/*therapy

No abstract available.
Adult ; Angiography ; Balloon Occlusion ; Capsule Endoscopy ; Gastrointestinal Hemorrhage/*complications/therapy ; Humans ; Jejunal Diseases/*diagnosis/etiology ; Jejunum/*blood supply ; Male ; Recurrence ; Tomography, X-Ray Computed ; Varicose Veins/*diagnosis/etiology

To compare the effect of cold or room temperature of tumescence anesthesia solution on pain perception during and after endovenous laser ablation (EVLA) for varicose veins of lower limb.
 Methods: A total of 51 patients with lower extremity varicose vein were treated by EVLA with tumescence anesthesia solution. All patients were used for local anesthesia and randomly divided into 2 groups according to the temperature of tumescence anesthesia solution: Group A (n=26) with room temperature (24 ℃) of tumescence anesthesia solution and Group B (n=25) with cold (4 ℃) tumescence anesthesia solution. Number rating scale (NRS) was recorded immediately after the procedure and postoperative 1, 2, 3 day. Patients were asked to register pain scores during the week.
 Results: The mean linear endovenous energy density (LEED) in the 2 groups was not significantly different (P>0.05). The ratio of patients without pain during the operation in the Group A was lower than that in the Group B (30.8% vs 64%, P<0.05). On the day of operation and postoperative day 1, 2, 3, the average number rating scale (NRS) scores in the Group A were greater than those in the Group B (P<0.05). Postoperative day 1, only 30.8% of the patients in the Group A resumed daily activities, which was lower than that (68% of the patients) in the Group B.
 Conclusion: In the process of EVLA for varicose veins of lower limb, there is less pain during operation and post-operation using cold tumescence anesthesia solution comparing room temperature tumescence anesthesia solution.
Anesthesia ; methods ; Cold Temperature ; Humans ; Intraoperative Complications ; physiopathology ; Laser Therapy ; Lower Extremity ; Pain Measurement ; Pain Perception ; physiology ; Pain, Postoperative ; physiopathology ; Treatment Outcome ; Varicose Veins ; physiopathology ; surgery

Duodenal varices result from retroperitoneal portosystemic shunts that usually come from the pancreaticoduodenal vein and drain into the inferior vena cava. Because they are a rare but fatal cause of gastrointestinal bleeding, a prompt hemostatic intervention is mandatory. A 62-year-old man who had a history of excessive alcohol consumption presented with massive hematemesis and melena. Emergent endoscopy revealed ruptured varices with an adhering whitish fibrin clot on the postbulbar portion of the duodenum. Abdominal computed tomography demonstrated a cirrhotic liver with venous collaterals around the duodenum and extravasated contrast in the second and third portions. The collaterals originated from the main portal vein and drained via the right renal vein into the inferior vena cava. Endoscopic injection sclerotherapy with cyanoacrylate was successful in achieving hemostasis, and resulted in the near eradication of duodenal varices at a 6-month follow-up.
Cyanoacrylates/therapeutic use ; Duodenal Diseases/diagnosis/etiology/*therapy ; Duodenum/*blood supply ; Endoscopy, Gastrointestinal ; Gastrointestinal Hemorrhage/etiology/*therapy ; Humans ; Male ; Middle Aged ; Portal Vein ; Rupture ; Sclerosing Solutions/therapeutic use ; *Sclerotherapy ; Tomography, X-Ray Computed ; Varicose Veins/complications/*therapy

Klippel - Trenaunay syndrome (KTS) is characterized by a cutaneous vascular nevus of the involved extremity, bone and soft tissue hypertrophy of the extremity and venous malformations. We present a case of KTS with splenic hemangiomas and rectal varices. A 29-year-old woman was referred for intermittent hematochezia for several years. She had history with a number of operations for cutaneous and soft tissue hamangiomas since the age of one year old and for increased circumference of her left thigh during the last few months. Abdominal CT revealed multiple hemangiomas in the spleen, fusiform aneurysmal dilatation of the deep veins and soft tissue hemangiomas. There was no evidence of hepatosplenomegaly or liver cirrhosis. Colonoscopy revealed hemangiomatous involvement in the rectum. There were rectal varices without evidence of active bleeding. Upon venography of the left leg, we also found infiltrative dilated superficial veins in the subcutaneous tissue and aneurysmal dilatation of the deep veins. The patient was finally diagnosed with KTS, and treated with oral iron supplementation only, which has been tolerable to date. Intervention or surgery is not required. When gastrointestinal varices or hemangiomatous mucosal changes are detected in a young patient without definite underlying cause, KTS should be considered.
Adult ; Colonoscopy ; Female ; Hemangioma/*complications ; Humans ; Iron, Dietary/therapeutic use ; Klippel-Trenaunay-Weber Syndrome/complications/*diagnosis/drug therapy ; Rectum/blood supply ; Spleen/blood supply ; Tomography, X-Ray Computed ; *Varicose Veins