scholarly journals Extraluminal lipoma with common femoral vein obstruction: A cause of chronic venous insufficiency

2009 ◽  
Vol 49 (2) ◽  
pp. 486-490 ◽  
Author(s):  
Antonios P. Gasparis ◽  
Stylianos Tsintzilonis ◽  
Nicos Labropoulos
Keyword(s):  
Chronic Venous Insufficiency ◽  
Venous Insufficiency ◽  
Femoral Vein ◽  
Common Femoral Vein

Monocusp – novel common femoral vein monocusp surgery uncorrectable chronic venous insufficiency with aplastic/dysplastic valves

2008 ◽  
Vol 23 (4) ◽  
pp. 158-171 ◽  
Author(s):  
J C Opie ◽  
T Izdebski ◽  
D N Payne ◽  
S R Opie
Keyword(s):  
Chronic Venous Insufficiency ◽  
Venous Insufficiency ◽  
Femoral Vein ◽  
Production Capacity ◽  
Full Thickness ◽  
Hormone Production ◽  
Vein Wall ◽  
Common Femoral Vein ◽  
History Of

Objective Previous reparative valvular surgical options directed at reconstructing damaged common femoral vein (CFV) valves associated with pathological chronic venous insufficiency (CVI) have not succeeded in reliably managing CVI. In consequence, venous valvuloplasty is rare and most patients are managed conservatively. As a result, monocusp surgery was identified as an optional surgical solution for this large underserved patient group. Methods Ulcer patients appear at wound clinics and often experience disappointing results. Monocusp valves were constructed utilizing viable vein wall in 14 operations on 11 patients. These patients were observed for four years to see if such an autogenous vein wall valve might control aggressive symptomatic CVI when faced with unusable valves. Results Long-term follow-up showed that the monocusp valves remained competent at four years. Symptomatic failures have not appeared at this time. Pain, swelling, ulcers and leg congestion were reliably reversed. VEnous INsufficiency Epidemiologic and Economic Study (VEINES) classification (see Abenhaim L, Krux X, VIENES Study collaborators. Angiology 1997;48:59 and Kurz X, Kahn SR, Abenhaim L, et al. Int Angiol 1999;18:83–102) improved over four years from 2.7 ± 0.9 to 0 ( P < 0.001); CEAP classifications (see Kistner RL, Eklof B, Masuda EM. Mayo Clin Proc 1996;71:338–45) improved from grade 4–6 to 0–1 (CEAP is not generally a postoperative grading system, but it can be used to develop some form of qualitative analyses as to intervention effectiveness, i.e. what existed preoperatively no longer exists postoperatively. Its postsurgery use is limited by (C5) classification – history of ulcer, which by definition cannot go below that with a history of ulcer even if the ulcer has been cured). Mean venous reflux scores decreased from 3.8 ± 0.4 to 0.3 ± 0.5 ( P < 0.001). Conclusion Monocusp implantation reliably resolved patient symptoms when unusable CFV valves were encountered. Postoperative CFV reflux is usually undetectable. The monocusp valve exhibits minimal thrombogenicity related to its viability with attendant antithrombotic hormone production capacity and has markedly improved the patient's quality of life. Full thickness monocusp surgery could become widespread with the difficult dysplastic/aplastic CVI patient subset because of its simplicity, repeatability, durability, low complication rate, effectiveness, persistent availability and viability providing nitric oxide synthase and thymomodulin hormone production capacity. The full thickness of vein wall has distinct advantages over other partial thickness valve creation methods because of its long-term vitality. Postoperative coumadin is recommended for six months to minimize risks of deep vein thrombosis and/or pulmonary embolism.

scholarly journals An Alternative Therapy for Recurrent Stasis Ulcers in Chronic Venous Insufficiency: Venocuff

2012 ◽  
Vol 2012 ◽  
pp. 1-2 ◽  
Author(s):  
Celal Yavuz ◽  
Sinan Demirtas ◽  
Orkut Guclu ◽  
Oguz Karahan ◽  
Suleyman Yazici ◽  
...  
Keyword(s):  
Chronic Venous Insufficiency ◽  
Venous Insufficiency ◽  
Doppler Sonography ◽  
Femoral Vein ◽  
Alternative Therapy ◽  
Low Molecular Weight ◽  
Drug Usage ◽  
History Of ◽  
Saphenofemoral Junction

Chronic venous insufficiency may cause stasis ulcers that significantly impact on the quality of life. Many methods have been described for preventing or treating these ulcers. However, stasis ulcers often recur as a result of continuing venous insufficiency. Here we report a 30-year-old male patient with chronic venous insufficiency. He was admitted to the hospital owing to recurrent stasis ulcers. He had a history of various flavonoid drug usage and compression therapies over the previous six years. Venous Doppler sonography revealed combined saphenofemoral and deep femoral venous insufficiency. Venocuff was applied to the prejunctional and postjunctional parts of the femoral vein and the saphenofemoral junction. The patient was discharged on the postoperative second day, and a low-molecular-weight heparin dressing composed of calcium alginate was applied to the ulcer wound for one week after the operation. The stasis ulcer wound was totally healed after one month. The patient was followed up six months after the operation, and no postoperative complications or new ulceration was observed. Recurrent stasis ulcers are major reasons for hospitalization in patients with chronic venous insufficiency. Venocuff application for reducing venous insufficiency may be a good option for adjunctive ulcer therapy and for preventing recurrences of the problem.

scholarly journals The femoral vein diameter and its correlation with sex, age and body mass index – An anatomical parameter with clinical relevance

2018 ◽  
Vol 34 (1) ◽  
pp. 58-69 ◽  
Author(s):  
Jonas Keiler ◽  
Ronald Seidel ◽  
Andreas Wree
Keyword(s):  
Body Mass Index ◽  
Body Mass ◽  
Supine Position ◽  
Chronic Venous Insufficiency ◽  
Venous Insufficiency ◽  
Valsalva Maneuver ◽  
Femoral Vein ◽  
Critical Factor ◽  
Upright Position ◽  
Vein Diameter

Background The femoral vein diameter is a critical factor when assessing endoprosthetic valve size for the treatment of chronic venous insufficiency. To examine the previously stated correlation between body mass index and femoral vein diameter and to re-assess the anatomical and physiological demands for a valve implant for chronic venous insufficiency treatment, we measured the femoral vein diameter in 82 subjects. Method Femoral vein diameters (164 legs) were measured with B-mode sonography both in supine position at rest and in upright position during Valsalva maneuver. Result The mean femoral vein diameter differed significantly between supine position (13.6 ± 3.0 mm) and upright position (16.4 ± 2.6 mm). Males possessed a significant bigger diameter than females. A significant positive correlation between femoral vein diameter and body mass index was observed. Conclusion Assuming an increased femoral vein diameter due to obesity would further impair valve functionality by increasing distance between both valve cusps. For the development of artificial venous valves, it is crucial to consider patient- and condition-dependent vein dilation.

Thrombus Extension into the Common Femoral Vein after Endovenous Ablation of the Greater Saphenous Vein for the Treatment of Venous Insufficiency

2006 ◽  
Vol 30 (3) ◽  
pp. 129-131 ◽  
Author(s):  
Todd L. Berland ◽  
Albert G. Hakaim ◽  
W. Andrew Oldenburg ◽  
Ricardo Paz-Fumagalli ◽  
Naciye Turan ◽  
...  
Keyword(s):  
Saphenous Vein ◽  
Venous Insufficiency ◽  
Femoral Vein ◽  
Common Femoral Vein ◽  
Endovenous Ablation ◽  
The Common

Die Reproduzierbarkeit des veno-arteriellen FlowIndex für die quantitative Erfassung des hämodynamischen Schweregrads von venösen Erkrankungen

VASA ◽  
2003 ◽  
Vol 32 (4) ◽  
pp. 199-203 ◽  
Author(s):  
Kahle ◽  
Hennies ◽  
Bolz ◽  
Pritsch
Keyword(s):  
Standard Deviation ◽  
Healthy Volunteers ◽  
Venous Insufficiency ◽  
Varicose Veins ◽  
Femoral Vein ◽  
Volume Flow ◽  
Postthrombotic Syndrome ◽  
Clinical Grade ◽  
Common Femoral Vein ◽  
The Common

Background: The ratio of volume flow in the common femoral vein and artery denoted as venous-arterial Flowindex (VAFI) is significantly increased in venous insufficiency according the clinical grade of the disease. This study was done to investigate the reliability and reproducibility of VAFI as quantitative pattern. Patients and methods: In 43 patients with varicose veins C4–6 EPAS,D,PPR (PVV), 40 with postthrombotic syndrome C4–6 ESAS,D,PPR,O (PTS) and 48 healthy volunteers volume flow in the common femoral vein (VFV) and artery (VFA) were measured by duplex. Division of VFV by VFA calculated VAFI. VAFI-measurement was repeated 5 times at an interval of ten minutes in 63 subjects (23 PVV, 20 PTS, 20 healthy) and it was performed at three different days in 68 subjects (20 PVV, 20 PTS, 28 healthy). Results: Mean VAFI ± standard deviation was 1.39 ± 0.26 in PVV, 1.42 ± 0.26 in PTS and 0.93 ± 0.13 in healthy veins (p < 0.001). VAFI remained stable and significantly increased (p < 0.001) in PVV and PTS compared to healthy veins during 40 minutes and also within three different days. Conclusion: The venous-arterial flowindex VAFI is a reproducible pattern of the hemodynamic severity in venous insufficiency.

Area-pressure relationship of lower limb main veins in man

VASA ◽  
2006 ◽  
Vol 35 (2) ◽  
pp. 59-66 ◽  
Author(s):  
Chauveau ◽  
Bassez ◽  
Tra ◽  
Scherrer
Keyword(s):  
Mechanical Properties ◽  
Cross Section ◽  
Saphenous Vein ◽  
Lower Limb ◽  
Chronic Venous Insufficiency ◽  
Venous Insufficiency ◽  
Great Saphenous Vein ◽  
Femoral Vein ◽  
Posterior Tibial ◽  
Relationship Of

Background: The mechanical properties of human veins remain incompletely known. However they play an important part in number of physiological and pathological situations, as hemodynamic adjustment to orthostasis, deep venous thrombosis (DVP) and chronic venous insufficiency (CVI). The aim of the study was to describe the pressure/volume (area) relationship of some important conduit veins of the human’s lower limb. Probands and methods: We investigated the area/pressure relationship of the femoral vein (FV) at mid thigh, the great saphenous vein (GSV) at lower third of the leg, and a deep leg vein (DLV), either the peroneal or posterior tibial vein, in fifteen healthy young men. The cross section areas were measured with B-mode ultrasound while various positive and negative venous pressures were generated by body’s tilting. Results: Over the range of pressures investigated, the area/pressure relationship was roughly linear, the classical sigmoid relation did not emerge from our data. The relative compliance of FV, GSV and DLV was 0.0312, 0.0118, and 0.0147 mmHg-1, respectively. Conclusions: The relative compliance of FV is more than two times higher than the relative compliance of both the DLV and the GSV.

Venous Reflux Localization: Comparative Study of Venography and Duplex Scanning

1993 ◽  
Vol 8 (3) ◽  
pp. 124-127 ◽  
Author(s):  
L. I. Valentín ◽  
W. H. Valentín ◽  
S. Mercado ◽  
C. J. Rosado
Keyword(s):  
Ultrasound Imaging ◽  
Chronic Venous Insufficiency ◽  
Venous Insufficiency ◽  
Femoral Vein ◽  
Duplex Ultrasound ◽  
Duplex Scanning ◽  
Venous Disease ◽  
Superficial Femoral Vein ◽  
Saphenous Veins ◽  
Prospective Comparison

Objective: To compare the results obtained by duplex ultrasound imaging and ascending and descending phlebography in patients with chronic venous insufficiency. Design: Prospective comparison between venography and duplex ultrasound imaging in a single patient group with chronic venous insufficiency. Setting: Private vascular clinic in Puerto Rico. Patients: Twenty-one patients presenting with clinical evidence of venous disease of the lower limb. Main outcome measures: Presence of valvular incompetence in deep and superficial veins as indicated by duplex ultrasound imaging and ascending and descending phlebography. Results: Duplex ultrasound imaging showed twice as many patients with popliteal vein incompetence (eight veins compared with four veins) and twice as many incompetent long saphenous veins (14 detected by duplex, eight detected by venography). In the proximal venous system, 13 common femoral veins were thought incompetent on venography, but only seven on duplex scanning; in the superficial femoral vein, 11 were incompetent on venography and three on duplex scanning. Conclusion: Duplex ultrasound scanning provides greater sensitivity for detection of valvular incompetence in distal veins compared with venography. Descending phlebography is poor in demonstrating distal venous valvular incompetence.

Physical Therapy in Patients with Chronic Venous Insufficiency

Phlebologie ◽  
2000 ◽  
Vol 29 (02) ◽  
pp. 48-53 ◽  
Author(s):  
M. Jünger ◽  
Anke Steins
Keyword(s):  
Physical Therapy ◽  
Chronic Venous Insufficiency ◽  
Venous Insufficiency ◽  
Ulcus Cruris ◽  
Chronisch Venöse Insuffizienz ◽  
Venöse Insuffizienz ◽  
Venöse Stauung ◽  
Venöse Drainage

ZusammenfassungWenn Maßnahmen der physikalischen Therapie wie rezeptpflichtige Kompressionsstrümpfe und ein angeleitetes ambulantes Gefäßtraining in einem frühen Stadium begonnen werden, können die Beschwerden des Patienten gelindert, die Gelenkbeweglichkeit und venöse Drainage verbessert und behindernde Stauungserkrankungen wie die Dermatolipofasziitis und das Ulcus cruris vermieden werden. Hat eine chronische venöse Stauung einmal zu einer Atrophie der Gelenkkapsel, Sprunggelenksversteifung und Muskelatrophie des Unterschenkels geführt, sind teure Therapiemaßnahmen einschließlich einer professionellen Krankengymnastik unumgänglich. Unseren eigenen Erfahrungen nach ist eine krankengymnastische Behandlung am wirksamsten, wenn sie in Kombination mit einer biomechanischen Stimulation erfolgt. Sobald der Steppergang des Patienten behoben wurde, können herkömmliche Gehübungen nach und nach das physiologische Gangbild wiederherstellen. Nach erfolgreicher Physiotherapie tragen ein ambulantes Gefäßtraining und eine optimierte Kompressionsbehandlung bei Patienten mit fortgeschrittener chronisch venöser Insuffizienz entscheidend zum langfristigen Therapieerfolg bei. Vergleichbar dem Koronarsport werden Gefäßtrainingsprogramme von den öffentlichen Kassen übernommen. Zusammen mit einer Kompressionsbehandlung stellen sie eine wirksame und kosteneffektive Basistherapie für die chronisch venöse Insuffizienz dar.

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