Diagnosis and treatment of venous lymphedema.
Identifieur interne : 004705 ( Ncbi/Merge ); précédent : 004704; suivant : 004706Diagnosis and treatment of venous lymphedema.
Auteurs : Seshadri Raju [États-Unis] ; James Brooke Furrh ; Peter NeglénSource :
- Journal of vascular surgery [ 1097-6809 ] ; 2012.
Descripteurs français
- KwdFr :
- Adolescent, Adulte, Adulte d'âge moyen, Douleur (diagnostic), Douleur (étiologie), Endoprothèses, Enquêtes et questionnaires, Erreurs de diagnostic (), Estimation de Kaplan-Meier, Facteurs temps, Femelle, Humains, Indice de gravité médicale, Jeune adulte, Lymphoedème (), Lymphoedème (diagnostic), Lymphoedème (étiologie), Lymphographie, Maladies vasculaires (), Maladies vasculaires (diagnostic), Maladies vasculaires (physiopathologie), Mesure de la douleur, Mississippi, Mâle, Odds ratio, Perméabilité vasculaire, Phlébographie, Procédures endovasculaires (effets indésirables), Procédures endovasculaires (instrumentation), Qualité de vie, Résultat thérapeutique, Sténose pathologique, Sujet âgé, Sujet âgé de 80 ans ou plus, Valeur prédictive des tests, Veine iliaque commune (imagerie diagnostique), Veine iliaque commune (physiopathologie), Échographie interventionnelle, Études cas-témoins.
- MESH :
- diagnostic : Douleur, Lymphoedème, Maladies vasculaires.
- effets indésirables : Procédures endovasculaires.
- imagerie diagnostique : Veine iliaque commune.
- physiopathologie : Maladies vasculaires, Veine iliaque commune.
- étiologie : Douleur, Lymphoedème, Procédures endovasculaires.
- Adolescent, Adulte, Adulte d'âge moyen, Endoprothèses, Enquêtes et questionnaires, Erreurs de diagnostic, Estimation de Kaplan-Meier, Facteurs temps, Femelle, Humains, Indice de gravité médicale, Jeune adulte, Lymphoedème, Lymphographie, Maladies vasculaires, Mesure de la douleur, Mississippi, Mâle, Odds ratio, Perméabilité vasculaire, Phlébographie, Qualité de vie, Résultat thérapeutique, Sténose pathologique, Sujet âgé, Sujet âgé de 80 ans ou plus, Valeur prédictive des tests, Échographie interventionnelle, Études cas-témoins.
English descriptors
- KwdEn :
- Adolescent, Adult, Aged, Aged, 80 and over, Case-Control Studies, Constriction, Pathologic, Diagnostic Errors (prevention & control), Endovascular Procedures (adverse effects), Endovascular Procedures (instrumentation), Female, Humans, Iliac Vein (diagnostic imaging), Iliac Vein (physiopathology), Kaplan-Meier Estimate, Lymphedema (diagnosis), Lymphedema (etiology), Lymphedema (therapy), Lymphography, Male, Middle Aged, Mississippi, Odds Ratio, Pain (diagnosis), Pain (etiology), Pain Measurement, Phlebography, Predictive Value of Tests, Quality of Life, Severity of Illness Index, Stents, Surveys and Questionnaires, Time Factors, Treatment Outcome, Ultrasonography, Interventional, Vascular Diseases (complications), Vascular Diseases (diagnosis), Vascular Diseases (physiopathology), Vascular Diseases (therapy), Vascular Patency, Young Adult.
- MESH :
- adverse effects : Endovascular Procedures.
- complications : Vascular Diseases.
- diagnosis : Lymphedema, Pain, Vascular Diseases.
- diagnostic imaging : Iliac Vein.
- etiology : Lymphedema, Pain.
- instrumentation : Endovascular Procedures.
- physiopathology : Iliac Vein, Vascular Diseases.
- prevention & control : Diagnostic Errors.
- therapy : Lymphedema, Vascular Diseases.
- Adolescent, Adult, Aged, Aged, 80 and over, Case-Control Studies, Constriction, Pathologic, Female, Humans, Kaplan-Meier Estimate, Lymphography, Male, Middle Aged, Mississippi, Odds Ratio, Pain Measurement, Phlebography, Predictive Value of Tests, Quality of Life, Severity of Illness Index, Stents, Surveys and Questionnaires, Time Factors, Treatment Outcome, Ultrasonography, Interventional, Vascular Patency, Young Adult.
Abstract
Chronic venous disease (CVD) is a common cause of secondary lymphedema. Venous lymphedema is sometimes misdiagnosed as primary lymphedema and does not receive optimal treatment. We have routinely used intravascular ultrasound (IVUS) imaging in all cases of limb swelling. The aim of this study is to show that (1) routine use of IVUS can detect venous obstruction missed by traditional venous testing, and (2) iliac-caval venous stenting can yield satisfactory clinical relief and can sometimes reverse abnormal lymphangiographic findings.
DOI: 10.1016/j.jvs.2011.07.078
PubMed: 21958566
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pubmed:21958566Le document en format XML
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cas-témoins</term></keywords></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">Chronic venous disease (CVD) is a common cause of secondary lymphedema. Venous lymphedema is sometimes misdiagnosed as primary lymphedema and does not receive optimal treatment. We have routinely used intravascular ultrasound (IVUS) imaging in all cases of limb swelling. The aim of this study is to show that (1) routine use of IVUS can detect venous obstruction missed by traditional venous testing, and (2) iliac-caval venous stenting can yield satisfactory clinical relief and can sometimes reverse abnormal lymphangiographic findings.</div></front></TEI><pubmed><MedlineCitation Status="MEDLINE" Owner="NLM"><PMID Version="1">21958566</PMID><DateCreated><Year>2011</Year><Month>12</Month><Day>20</Day></DateCreated><DateCompleted><Year>2012</Year><Month>02</Month><Day>02</Day></DateCompleted><DateRevised><Year>2016</Year><Month>11</Month><Day>25</Day></DateRevised><Article PubModel="Print-Electronic"><Journal><ISSN IssnType="Electronic">1097-6809</ISSN><JournalIssue CitedMedium="Internet"><Volume>55</Volume><Issue>1</Issue><PubDate><Year>2012</Year><Month>Jan</Month></PubDate></JournalIssue><Title>Journal of vascular surgery</Title><ISOAbbreviation>J. Vasc. Surg.</ISOAbbreviation></Journal><ArticleTitle>Diagnosis and treatment of venous lymphedema.</ArticleTitle><Pagination><MedlinePgn>141-9</MedlinePgn></Pagination><ELocationID EIdType="doi" ValidYN="Y">10.1016/j.jvs.2011.07.078</ELocationID><Abstract><AbstractText Label="BACKGROUND" NlmCategory="BACKGROUND">Chronic venous disease (CVD) is a common cause of secondary lymphedema. Venous lymphedema is sometimes misdiagnosed as primary lymphedema and does not receive optimal treatment. We have routinely used intravascular ultrasound (IVUS) imaging in all cases of limb swelling. The aim of this study is to show that (1) routine use of IVUS can detect venous obstruction missed by traditional venous testing, and (2) iliac-caval venous stenting can yield satisfactory clinical relief and can sometimes reverse abnormal lymphangiographic findings.</AbstractText><AbstractText Label="METHODS" NlmCategory="METHODS">The study comprised CVD patients who underwent iliac vein stenting. Lymphangiography was abnormal in 72 of 443 CEAP C(3) limbs, with leg swelling as the primary complaint (abnormal lymphangiography group). Clinical features and stent outcome were compared with a control group of 205 of 443 with normal lymphangiography (normal lymphangiographic group).</AbstractText><AbstractText Label="RESULTS" NlmCategory="RESULTS">Clinical features were a poor guide to the diagnosis of lymphedema. Isotope lymphangiography was not helpful in differentiating primary from secondary lymphedema. Venography had 61% sensitivity to the diagnosis of venous obstruction. IVUS had a sensitivity of 88% for significant (≥50% area stenosis) venous obstruction. At 40 months, cumulative secondary stent patency was similar for the abnormal (100%) and normal lymphangiographic (95%) groups. Swelling improved significantly after stent placement in the abnormal lymphangiographic group (mean [standard deviation] swelling grade improvement 0.8 ± 1.1) but was less (P < .004) than in the control group (1.4 ± 1.3). Complete swelling relief was 16% and 44% (P < .001) and partial improvement (≥1 grade of swelling) was 45% and 66% (P < .01) in the abnormal and normal lymphangiographic groups, respectively. Associated pain was present in 50% and 36% of the swollen limbs in the abnormal and normal lymphangiographic groups. Pain relief (≥3 visual analog scale) at 40 months was 87% and 83%, respectively (P = .3), with 65% and 71%, experiencing complete pain relief. Quality of life criteria improved after stent placement in both groups but to a better extent in the normal lymphangiographic group. Abnormal lymphangiography improved or normalized in 9 of 36 (25%) of those tested after stent correction.</AbstractText><AbstractText Label="CONCLUSIONS" NlmCategory="CONCLUSIONS">Prevailing practice patterns and diagnostic deficiencies probably result in the misdiagnosis of many cases of venous lymphedema as "primary" lymphedema. IVUS is recommended to rule out venous obstruction as the associated or initiating cause of lymphedema. Iliac venous stenting to correct the obstruction has excellent long-term patency and good clinical outcome, although results are not as good as in those with normal lymphatic function.</AbstractText><CopyrightInformation>Copyright © 2012 Society for Vascular Surgery. Published by Mosby, Inc. All rights reserved.</CopyrightInformation></Abstract><AuthorList CompleteYN="Y"><Author ValidYN="Y"><LastName>Raju</LastName><ForeName>Seshadri</ForeName><Initials>S</Initials><AffiliationInfo><Affiliation>The Rane Center, Flowood, MS. USA. rajumd@earthlink.net</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Furrh</LastName><ForeName>James Brooke</ForeName><Initials>JB</Initials><Suffix>4th</Suffix></Author><Author ValidYN="Y"><LastName>Neglén</LastName><ForeName>Peter</ForeName><Initials>P</Initials></Author></AuthorList><Language>eng</Language><PublicationTypeList><PublicationType UI="D016428">Journal Article</PublicationType></PublicationTypeList><ArticleDate DateType="Electronic"><Year>2011</Year><Month>09</Month><Day>29</Day></ArticleDate></Article><MedlineJournalInfo><Country>United States</Country><MedlineTA>J Vasc Surg</MedlineTA><NlmUniqueID>8407742</NlmUniqueID><ISSNLinking>0741-5214</ISSNLinking></MedlineJournalInfo><CitationSubset>IM</CitationSubset><MeshHeadingList><MeshHeading><DescriptorName UI="D000293" MajorTopicYN="N">Adolescent</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D000328" MajorTopicYN="N">Adult</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D000368" MajorTopicYN="N">Aged</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D000369" MajorTopicYN="N">Aged, 80 and over</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D016022" MajorTopicYN="N">Case-Control Studies</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D003251" MajorTopicYN="N">Constriction, Pathologic</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D003951" MajorTopicYN="N">Diagnostic Errors</DescriptorName><QualifierName UI="Q000517" MajorTopicYN="N">prevention & control</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D057510" MajorTopicYN="Y">Endovascular Procedures</DescriptorName><QualifierName UI="Q000009" MajorTopicYN="N">adverse effects</QualifierName><QualifierName UI="Q000295" MajorTopicYN="N">instrumentation</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D005260" MajorTopicYN="N">Female</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D006801" MajorTopicYN="N">Humans</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D007084" MajorTopicYN="N">Iliac Vein</DescriptorName><QualifierName UI="Q000000981" MajorTopicYN="Y">diagnostic imaging</QualifierName><QualifierName UI="Q000503" MajorTopicYN="N">physiopathology</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D053208" MajorTopicYN="N">Kaplan-Meier Estimate</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D008209" MajorTopicYN="N">Lymphedema</DescriptorName><QualifierName UI="Q000175" MajorTopicYN="Y">diagnosis</QualifierName><QualifierName UI="Q000209" MajorTopicYN="N">etiology</QualifierName><QualifierName UI="Q000628" MajorTopicYN="Y">therapy</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D008220" MajorTopicYN="N">Lymphography</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D008297" MajorTopicYN="N">Male</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D008875" MajorTopicYN="N">Middle Aged</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D008922" MajorTopicYN="N">Mississippi</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D016017" MajorTopicYN="N">Odds Ratio</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D010146" MajorTopicYN="N">Pain</DescriptorName><QualifierName UI="Q000175" MajorTopicYN="N">diagnosis</QualifierName><QualifierName UI="Q000209" MajorTopicYN="N">etiology</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D010147" MajorTopicYN="N">Pain Measurement</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D010690" MajorTopicYN="N">Phlebography</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D011237" MajorTopicYN="N">Predictive Value of Tests</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D011788" MajorTopicYN="N">Quality of Life</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D012720" MajorTopicYN="N">Severity of Illness Index</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D015607" MajorTopicYN="N">Stents</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D011795" MajorTopicYN="N">Surveys and Questionnaires</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D013997" MajorTopicYN="N">Time Factors</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D016896" MajorTopicYN="N">Treatment Outcome</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D018084" MajorTopicYN="Y">Ultrasonography, Interventional</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D014652" MajorTopicYN="N">Vascular Diseases</DescriptorName><QualifierName UI="Q000150" MajorTopicYN="N">complications</QualifierName><QualifierName UI="Q000175" MajorTopicYN="Y">diagnosis</QualifierName><QualifierName UI="Q000503" MajorTopicYN="N">physiopathology</QualifierName><QualifierName UI="Q000628" MajorTopicYN="Y">therapy</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D014654" MajorTopicYN="N">Vascular Patency</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D055815" MajorTopicYN="N">Young Adult</DescriptorName></MeshHeading></MeshHeadingList></MedlineCitation><PubmedData><History><PubMedPubDate PubStatus="received"><Year>2011</Year><Month>05</Month><Day>04</Day></PubMedPubDate><PubMedPubDate PubStatus="revised"><Year>2011</Year><Month>07</Month><Day>18</Day></PubMedPubDate><PubMedPubDate PubStatus="accepted"><Year>2011</Year><Month>07</Month><Day>19</Day></PubMedPubDate><PubMedPubDate PubStatus="entrez"><Year>2011</Year><Month>10</Month><Day>1</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate><PubMedPubDate PubStatus="pubmed"><Year>2011</Year><Month>10</Month><Day>1</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate><PubMedPubDate PubStatus="medline"><Year>2012</Year><Month>2</Month><Day>3</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate></History><PublicationStatus>ppublish</PublicationStatus><ArticleIdList><ArticleId IdType="pubmed">21958566</ArticleId><ArticleId IdType="pii">S0741-5214(11)01833-7</ArticleId><ArticleId IdType="doi">10.1016/j.jvs.2011.07.078</ArticleId></ArticleIdList></PubmedData></pubmed><affiliations><list><country><li>États-Unis</li></country><region><li>État du Mississippi</li></region></list><tree><noCountry><name sortKey="Furrh, James Brooke" sort="Furrh, James Brooke" uniqKey="Furrh J" first="James Brooke" last="Furrh">James Brooke Furrh</name><name sortKey="Neglen, Peter" sort="Neglen, Peter" uniqKey="Neglen P" first="Peter" last="Neglén">Peter Neglén</name></noCountry><country name="États-Unis"><region name="État du Mississippi"><name sortKey="Raju, Seshadri" sort="Raju, Seshadri" uniqKey="Raju S" first="Seshadri" last="Raju">Seshadri 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