Popliteal Vein Compression, Obesity, and Chronic Venous Disease

Author(s):  
Rebecca N. Millen ◽  
Kate N. Thomas ◽  
Matthew P.T. Versteeg ◽  
Andre M. van Rij
2020 ◽  
Vol 44 (3) ◽  
pp. 157-159
Author(s):  
Viviane Seki Sassaki

Venous aneurysms are rare lesions that have been described within the venous system and may be discovered at any age. The lower extremities are most frequently involved, with the popliteal vein being the most common location. Clinical presentations are often initially classified as subcutaneous masses or alternatively, as an incidental finding during imaging studies for pain or chronic venous disease of the lower limb. They may be asymptomatic and/or initially present as a pulmonary embolism (PE), thrombosis, or vessel rupture with bleeding. Although benign, venous aneurysms have the potential for complications depending on location, size, and type. Here, the author presents two cases of saccular popliteal vein aneurysm that did not receive surgical treatment. Case 1: A 66-year-old male presented with a venous aneurysm without any previously reported symptoms that suggested new onset of claudication. He had an episode of PE in the past. Upon outpatient follow-up for his arterial exam, duplex ultrasound was performed, and a popliteal vein outpouching was visualized. Results: The ultrasound demonstrated a patent arterial bypass graft, with an incidental finding of saccular popliteal vein aneurysm without evidence of thrombus. The patient received no further surgical treatment (considering his comorbidities) and began daily warfarin with close clinical monitoring. Case 2: A 49-year-old male presented with bilateral varicose veins (worse on the left side) with recurrent posterior calf pain. He was referred for a bilateral venous insufficiency ultrasound. The patient had no prior history of deep vein thrombosis or PE. Results: Deep and superficial venous insufficiency was identified bilaterally. In addition, a saccular vein aneurysm without thrombus measuring 3.3 × 2.7 × 2.1 cm was identified in the popliteal vein. The patient received surgical treatment for venous insufficiency and is doing well.


2009 ◽  
Vol 24 (5) ◽  
pp. 201-207 ◽  
Author(s):  
R J Lane ◽  
M L Cuzzilla ◽  
R A Harris ◽  
M N Phillips

Objectives Obesity and venous disease are commonly encountered together. The aetio- logical relationship, however, has not been clear. Popliteal venous compression (PVC) has been encountered both on ultrasound and venographically. In this study, patients with symptoms and/or signs of chronic venous hypertension with PVC were investigated and the relationship to obesity was defined. Methods A total of 89 patients were included in the study, of which 49 limbs were classified as having PVC defined as a greater than 90% reduction in the maximum internal diameter (ID) of the popliteal vein (POPV) with knee locking. Forty consecutive limbs with venous disease with no evidence of PVC were used as controls. The body mass index (BMI) of each group was calculated and the clinical symptoms and signs were documented. After the failure of conservative treatment, 30 of the 49 underwent open popliteal decompression. Results Patients with PVC were found to have a BMI of 34.6 ± 6.2 compared with 25.3 ± 3.0 of the controls. The POPV ID in the PVC group before and after knee locking changed from 11.7 ± 5.0 to 1.0 ± 2.1 mm, respectively. Postoperatively, the POPV ID before and after knee locking changed from 10.2 ± 2.2 to 9.0 ± 1.5 mm, respectively. At 16.2 ± 12.1 months follow-up, all the major clinical parameters improved at a statistically significant level. Conclusions There appears to be a relationship between obesity, chronic venous disease and PVC. POPV compression syndrome may clarify the previously unexplained venous presentations. Surgical decompression provides good results in patients unresponsive to conservative treatment.


VASA ◽  
2014 ◽  
Vol 43 (1) ◽  
pp. 47-54 ◽  
Author(s):  
Weibin Huang ◽  
Weiwei Qin ◽  
Lei Lv ◽  
Haoyv Deng ◽  
Hao Zhang ◽  
...  

Background: Duffy antigen / receptor for chemokines (DARC) possesses high affinity for several chemokine subgroups of CC and CXC. Although DARC has been shown to play a role in many inflammatory diseases, its effect on chronic venous disease (CVD) remains unidentified. We explored whether the expression of DARC in skin tissue was activated under venous hypertension as well as the relationships between DARC and inflammation. Materials and methods: The inflammation in a rat model of venous hypertension caused by a femoral arterial-venous fistula (AVF) was studied. At specified intervals the pressure in the femoral veins was recorded within 42 days. Hindlimb skin specimens were harvested at different time points. The expressions of DARC, interleukin-8 (IL-8), and monocyte chemotactic protein-1 (MCP-1) in skin tissue were examined. Mononuclear cells infiltrated in skin tissue were detected. Results: Femoral venous pressures in AVF groups increased significantly at different time points (P < 0.01). DARC was expressed in skin tissue and its expression level increased significantly in AVF groups from the 7nd day on and was enhanced in a time-dependent manner within 42 days (P < 0.05). Meanwhile, both MCP-1 and IL-8 had higher levels, accompanied by increased mononuclear cells infiltrating into skin tissue (P < 0.05). Conclusions: A rat AVF model which can maintain venous hypertension for at least 42 days is competent for researching the pathogenesis of CVD. DARC, which plays a role in the inflammation of skin tissue under venous hypertension, may become a new molecular target for diagnosis and treatment of CVD at a very early stage.


Author(s):  
Mohamed A. Taha ◽  
Tristan Lane ◽  
Joseph Shalhoub ◽  
Alun H. Davies

2019 ◽  
Vol 20 (1) ◽  
Author(s):  
Rino Albrigo ◽  
Cinzia Andreoni ◽  
Gaetano Anello ◽  
Maria G. Barboni ◽  
Elena Barzaghi ◽  
...  

2016 ◽  
Vol 1 (1) ◽  
pp. 51-58 ◽  
Author(s):  
Jean François Uhl ◽  
Maxime Chahim ◽  
François Cros ◽  
Amina Ouchene ◽  
◽  
...  

The 3D modeling of the vascular system could be achieved in different ways: In the venous location, the morphological modeling by MSCT venography is used to image the venous system: this morphological modeling tool accurately investigates the 3D morphology of the venous network of our patients with chronic venous disease. It is also a fine educational tool for students who learn venous anatomy, the most complex of the human body. Another kind of modeling (mathematical modeling) is used to simulate the venous functions, and virtually tests the efficacy of any proposed treatments. To image the arterial system, the aim of 3D modeling is to precisely assess and quantify the arterial morphology. The use of augmented reality before an endovascular procedure allows pre-treatment simulation, assisting in pre-operative planning as well as surgical training. In the special field of liver surgery, several 3D modeling software products are available for computer simulations and training purposes and augmented reality.


2020 ◽  
Vol 62 (1) ◽  
pp. 12-16
Author(s):  
Oksana K. Melekhovets ◽  
Tetyana O. Kharchenko ◽  
Victor F. Orlovskiy ◽  
Iuirii V. Melekhovets ◽  
Alevtina S. Radko ◽  
...  

Introduction: Trophic ulcers of the lower extremities are an unresolved problem of modern medicine. The treatment of this pathology requires new methods that optimize care regimens and improve patients’ quality of life. Aim: The study to improve efficacy of treatment of the patients with trophic ulcers of the lower limbs with consideration to pathogenesis. M aterials and Methods: The study included 32 patients with chronic venous disease C6 (1st group) and 31 with diabetes mellitus type 2, moderate severity, compensation stage with diabetic foot syndrome II stage according to Wagner’s classification (2nd group). In addition to basic therapy in both groups photodynamic therapy was added at the first stage of the study, and at the second stage plasma rich in growth factors was prescribed. Results: At baseline evaluating of the chronic venous disease demonstrates that a total score in patient of the 1st group was 20,9 points on a modified VCSS scale; after two weeks – 15,71 points (improvement by 24.83%), and 6 weeks after–9,72 points (improvement by 53.49%). In patients with DM (2nd group) at the baseline a total score average was 13,91 points according to S(AD)SAD-1 scale; after 2 weeks – 12,29 (improvement by 11,65%), after 6 weeks – 6,39 points (improvement by 54,06%). Conclusions: The inclusion of photodynamic therapy and plasmatherapy in complex therapy in both groups led to a significant improvement of the healing process and helps to reduce the depth and area of the wound surface. However, the wound healing in patients in group 2 was slower.


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