{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,19]],"date-time":"2026-10-19T18:40:43Z","timestamp":1792435243481,"version":"4.5.0"},"reference-count":26,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2026,10,17]],"date-time":"2026-10-17T00:00:00Z","timestamp":1792195200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Vasc Med"],"abstract":"<jats:sec>\n                    <jats:title>Introduction:<\/jats:title>\n                    <jats:p>Chronic venous insufficiency (CVI) significantly increases the risk of developing secondary lymphedema and related infections. This study tested the hypothesis that lower-extremity venous procedures can reduce the 5-year incidence of lymphedema in adults with CVI.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>A multicenter retrospective cohort study was conducted using the TriNetX Research Network. Adults (\u2a7e 18 years) diagnosed with CVI between Jan 1, 2005, and Jan 1, 2020, were identified and followed for at least 5 years. Patients were stratified into those undergoing venous procedures, including saphenous vein ligation, phlebectomy, sclerotherapy, and endovenous ablation, and matched controls managed without intervention. Propensity score matching was performed 1:1 on demographics, comorbidities, and infection-related variables. The primary outcome was new-onset lymphedema, assessed using Cox proportional hazards models and Kaplan\u2013Meier analysis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>After matching, 17,703 patients were included in each cohort. At 5 years, new-onset lymphedema occurred in 5.1% of controls versus 4.0% of patients who underwent venous procedures (hazard ratio [HR] 1.26, 95% CI 1.14\u20131.40). Phlebectomy showed the strongest association with risk reduction (4.0% vs 1.5%; HR 2.60, 95% CI 1.33\u20135.06), followed by varicose vein sclerotherapy (5.3% vs 3.6%; HR 1.49, 95% CI 1.02\u20132.16).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>Venous interventions may reduce the risk of developing lymphedema in patients with chronic venous insufficiency.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/1358863x261472418","type":"journal-article","created":{"date-parts":[[2026,10,17]],"date-time":"2026-10-17T18:25:21Z","timestamp":1792261521000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Venous interventions reduce the risk of lymphedema in chronic venous insufficiency"],"prefix":"10.1177","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3196-5879","authenticated-orcid":false,"given":"John Yuxuan","family":"Ha","sequence":"first","affiliation":[{"name":"Department of Plastic Surgery, Cleveland Clinic, Cleveland, OH, USA"},{"name":"School of Medicine, Case Western Reserve University, Cleveland, OH, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Berk B","family":"Ozmen","sequence":"additional","affiliation":[{"name":"Department of Plastic Surgery, Cleveland Clinic, Cleveland, OH, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Douglas","family":"Joseph","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine, Section of Vascular Medicine, Heart Vascular and Thoracic Institute, Cleveland Clinic, Cleveland, OH, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9616-1540","authenticated-orcid":false,"given":"Scott","family":"Cameron","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine, Section of Vascular Medicine, Heart Vascular and Thoracic Institute, Cleveland Clinic, Cleveland, OH, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jennifer","family":"Murphy","sequence":"additional","affiliation":[{"name":"Center for Clinical Research, University Hospitals Cleveland Medical Center, Cleveland, OH, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Graham","family":"Schwarz","sequence":"additional","affiliation":[{"name":"Department of Plastic Surgery, Cleveland Clinic, Cleveland, OH, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,10,17]]},"reference":[{"key":"e_1_3_3_2_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.annepidem.2004.05.015"},{"key":"e_1_3_3_3_2","doi-asserted-by":"publisher","DOI":"10.1053\/j.semvascsurg.2021.02.007"},{"key":"e_1_3_3_4_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.113.006898"},{"key":"e_1_3_3_5_2","article-title":"Degradation of lymphatic anatomy and function in early venous insufficiency","volume":"9","author":"Rasmussen JC","year":"2021","unstructured":"Rasmussen JC, Zhu B, Morrow JR, et al. Degradation of lymphatic anatomy and function in early venous insufficiency. J Vasc Surg Venous Lymphat Disord 2021; 9: 720\u2013730.e2.","journal-title":"J Vasc Surg Venous Lymphat Disord"},{"key":"e_1_3_3_6_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jvs.2009.06.003"},{"key":"e_1_3_3_7_2","doi-asserted-by":"publisher","DOI":"10.1177\/1358863X231215329"},{"key":"e_1_3_3_8_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jvsv.2015.06.001"},{"key":"e_1_3_3_9_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jvsv.2019.11.014"},{"key":"e_1_3_3_10_2","doi-asserted-by":"publisher","DOI":"10.1002\/j.2040-4603.2019.tb00063.x"},{"key":"e_1_3_3_11_2","doi-asserted-by":"publisher","DOI":"10.3390\/biology10040261"},{"key":"e_1_3_3_12_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.avsg.2007.07.014"},{"key":"e_1_3_3_13_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0741-5214(96)70002-2"},{"key":"e_1_3_3_14_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jvsv.2023.06.015"},{"key":"e_1_3_3_15_2","doi-asserted-by":"publisher","DOI":"10.1177\/153857440604000206"},{"key":"e_1_3_3_16_2","doi-asserted-by":"publisher","DOI":"10.3233\/CH-211239"},{"key":"e_1_3_3_17_2","doi-asserted-by":"publisher","DOI":"10.1177\/17085381241236927"},{"key":"e_1_3_3_18_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.avsg.2024.01.009"},{"key":"e_1_3_3_19_2","doi-asserted-by":"publisher","DOI":"10.1161\/01.CIR.102.20.e126"},{"key":"e_1_3_3_20_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcws.2010.04.004"},{"key":"e_1_3_3_21_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.mpaic.2019.01.009"},{"key":"e_1_3_3_22_2","doi-asserted-by":"publisher","DOI":"10.1093\/cvr\/cvq062"},{"key":"e_1_3_3_23_2","doi-asserted-by":"publisher","DOI":"10.1172\/JCI71608"},{"key":"e_1_3_3_24_2","doi-asserted-by":"publisher","DOI":"10.1258\/phleb.2009.009003"},{"key":"e_1_3_3_25_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jvsv.2020.05.016"},{"key":"e_1_3_3_26_2","doi-asserted-by":"publisher","DOI":"10.1055\/s-2005-921955"},{"key":"e_1_3_3_27_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejvs.2010.03.031"}],"container-title":["Vascular Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/1358863X261472418","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/1358863X261472418","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/1358863X261472418","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,10,19]],"date-time":"2026-10-19T18:17:59Z","timestamp":1792433879000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/1358863X261472418"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,10,17]]},"references-count":26,"alternative-id":["10.1177\/1358863X261472418"],"URL":"https:\/\/doi.org\/10.1177\/1358863x261472418","relation":{},"ISSN":["1358-863X","1477-0377"],"issn-type":[{"value":"1358-863X","type":"print"},{"value":"1477-0377","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,10,17]]},"article-number":"1358863X261472418"}}