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Surgical and pharmaceutical treatment of superficial vein thrombosis of the lower limbs: what has changed over the last 5 years?

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Papageorgopoulou C., Nikolakopoulos K., Papageorgopoulou A., Seretis C.
Polish Journal of Surgery
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2022
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vol. 95
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issue 6
62-67
EN
Introduction: Superficial vein thrombosis of the lower limbs is a common condition encountered by a wide spectrum of clinical specialties. In contrast to deep vein thrombosis of the lower limbs though, there is significant variability in terms of its treatment with respect to the type and duration of pharmacotherapy, as well as regarding the potential role of operative management. Materials and methods: Systematic review of the literature in a best evidence topic manner, including only prospective and randomized controlled studies on the treatment of lower limb SVT, focusing on the emerged data over the last 5 years. Results: A total of 17 prospective observational and randomized clinical studies met our set criteria. Despite the major differences in study designs, outcomes and intervention types, upfront pharmaceutical treatment with fondaparinux or intermediate dose of low molecular weight heparins, combined with regular clinical and radiological follow-up, seem to be effective and safe as first-line approaches. Upfront surgical treatment of lower limb SVT can also be safely performed in selected cases in the presence of clinical expertise. Conclusion: Our review revealed the presence of considerable variability in the therapeutic options of the lower limb superficial venous thrombosis, highlighting the need for further randomized controlled trials in the field in order to establish and standardize its optimal treatment.
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Zabiegi uzupełniające w obrębie tętnicy biodrowej w kontekście wewnątrznaczyniowego leczenia tętniaka aorty: na co należy zwrócić uwagę w formularzu zgody?

100%
Seretis C., Papageorgopoulou C., Nikolakopoulos K.
Polish Journal of Surgery
|
2022
|
vol. 95
|
issue 1
60-63
PL
Zabiegi uzupełniające w obrębie tętnicy biodrowej wewnętrznej, takie jak embolizacja przedoperacyjna lub pokrycie przedłużeniami gałęzi biodrowych, nie są rzadkie w kontekście wewnątrznaczyniowej naprawy tętniaków aorty brzusznej. Co więcej, w wielu przypadkach zabiegi te wykonuje się w kilku etapach z udziałem radiologów interwencyjnych przed głównym zabiegiem. Gdy rewaskularyzacja początkowo nie zostanie uznana za konieczną, z potencjalnymi powikłaniami niedrożności tętnicy biodrowej wewnętrznej wiążą się różne problemy od odpowiedniej konsultacji pacjenta aż po zagadnienia prawne. W niniejszym artykule staramy się przedstawić strategię dotyczącą uzyskania świadomej zgody chorego, podkreślając potrzebę wielodyscyplinarnego podejścia do tej grupy pacjentów.
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Adjunct internal iliac artery procedures in the context of endovascular abdominal aortic aneurysm repair: anything to stress on the consent form?

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Seretis C., Papageorgopoulou C., Nikolakopoulos K.
Polish Journal of Surgery
|
2022
|
vol. 95
|
issue 1
60-63
EN
Adjunct internal iliac artery (IIA) procedures, such as preoperative embolisation or coverage with iliac branch extensions, are not infrequent in the context of endovascular repair of abdominal aortic aneurysms. Moreover, on many occasions, these procedures are performed in a multi-stage approach by interventional radiologists prior to the main operation. Bearing in mind the potential complications of IIA occlusion when revascularization is not initially deemed necessary, various issues arise spanning from appropriate patient counselling to medicolegal consequences. Herein, we aim to provide a roadmap regarding appropriate patient consenting, highlighting the need for multidisciplinary approach of these patients.
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