International angiology : a journal of the International Union of Angiology
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The purpose of the following research was to provide a systematic survey on the use of additive manufacturing in vascular surgery. The survey focuses on applications of 3D printing in endovascular surgery like endovascular aneurysm repair (EVAR), a quite unexplored application domain. 3D printing is an additive production process of three-dimensional objects starting from a three-dimensional digital model. This kind of manufacturing process is getting great attention in the medical field and new applications have emerged in recent years especially thanks to the combination of additive printing with 3D imaging techniques. The purpose of the study is to reflect on additive manufacturing and its potential as an inclusive manufacturing practice which can provide benefits at economic and societal level. ⋯ Different applications of the use of 3D printing and digital imaging in vascular surgery have been experimented with a different maturity level. Whilst the technology has increased its potential in the latest years, the number of studies documented in the literature is still quite narrow. Further research is necessary to fully test the potential of 3D printing, also in combination with other technologies (e.g. 3D imaging and CNC cutting). Early experimentations show that these technologies have the potential to radically change the vascular surgery practice in the near future, in particular in treatment like EVAR, to improve the planning and therefore the success of the surgery.
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Review
Understanding lower leg volume measurements used in clinical studies focused on venous leg edema.
The aim of this review was to discuss the different techniques of leg edema measurement that have been used in clinical trials to help determine the most appropriate method of assessment and quantification for use in future research. Venoactive drugs such as micronized purified flavonoid fraction (MPFF) are established agents for the treatment of venous leg edema, but results from randomized-controlled trials vary depending on the method of edema assessment. The medical literature was searched for published articles using the terms "venous lower limb edema" and "method of edema assessment." Clinical trials performed with MPFF used leg circumference and optometry for leg edema assessment. ⋯ Patient heterogeneity and method of edema assessment impact clinical trial results. In particular, there are a number of error sources with several methods of assessment that can lead to variability in trial results. Consequently, pilot studies are required to validate new methods of edema assessment using innovative technologies.
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The use of a venoactive drug is considered an important component of medical treatment of chronic venous disease (CVD), although the efficacy of certain venoactive drugs (VADs) on one or more individual leg symptoms or signs may have not been extensively studied to justify a strong recommendation in guidelines on CVD. The aim of this systematic review and meta-analysis was to study the effectiveness of the micronized purified flavonoid fraction (MPFF, Daflon®) across the spectrum of defined venous symptoms, signs, quality of life (QoL) and treatment assessment by the physician. ⋯ Based on high quality evidence, MPFF is highly effective in improving leg symptoms, edema and quality of life in patients with CVD.
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The use of a venoactive drug is considered an important component of medical treatment of chronic venous disease (CVD), although the efficacy of certain venoactive drugs (VADs) on one or more individual leg symptoms or signs may have not been extensively studied to justify a strong recommendation in guidelines on CVD. The aim of this systematic review and meta-analysis was to study the effectiveness of the micronized purified flavonoid fraction (MPFF, Daflon®) across the spectrum of defined venous symptoms, signs, quality of life (QoL) and treatment assessment by the physician. ⋯ Based on high quality evidence, MPFF is highly effective in improving leg symptoms, edema and quality of life in patients with CVD.