Management of the Marginal Vein: Current Issues

The marginal vein, an abnormal superficial vein of the lateral lower limb, is a remnant of primitive embryonic vessels that have failed to regress. According to the extent, topography and sites of connection with the deep veins, five types have been distinguished by Weber. The marginal vein is valveless and may create venous stasis. Limb–length discrepancy and nevus may coexist. Diagnosis is made by duplex scan examination and phlebography; angio computerized tomography or magnetic resonance effectively demonstrates the vein but yield less haemodynamic data. The best treatment is complete surgical resection of the vein. Resection should be avoided in the rare cases when aplasia of the deep veins exists. A careful skeletonization can be performed if arterio-venous fistulas converge into the vein.

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Predicting composition of leg sections with anthropometry and bioelectrical impedance analysis, using magnetic resonance imaging as reference

Clinical Science ◽

10.1042/cs0960647 ◽

1999 ◽

Vol 96 (6) ◽

pp. 647-657 ◽

Cited By ~ 38

Author(s):

N. J. FULLER ◽

C. R. HARDINGHAM ◽

M. GRAVES ◽

N. SCREATON ◽

A. K. DIXON ◽

...

Keyword(s):

Magnetic Resonance Imaging ◽

Adipose Tissue ◽

Magnetic Resonance ◽

Coefficient Of Variation ◽

Lower Limb ◽

Bioelectrical Impedance Analysis ◽

Bioelectrical Impedance ◽

Impedance Analysis ◽

Tissue Composition ◽

Resonance Imaging

Magnetic resonance imaging (MRI) was used to evaluate and compare with anthropometry a fundamental bioelectrical impedance analysis (BIA) method for predicting muscle and adipose tissue composition in the lower limb. Healthy volunteers (eight men and eight women), aged 41 to 62 years, with mean (S.D.) body mass indices of 28.6 (5.4) kg/m2 and 25.1 (5.4) kg/m2 respectively, were subjected to MRI leg scans, from which 20-cm sections of thigh and 10-cm sections of lower leg (calf) were analysed for muscle and adipose tissue content, using specifically developed software. Muscle and adipose tissue were also predicted from anthropometric measurements of circumferences and skinfold thicknesses, and by use of fundamental BIA equations involving section impedance at 50 kHz and tissue-specific resistivities. Anthropometric assessments of circumferences, cross-sectional areas and volumes for total constituent tissues matched closely MRI estimates. Muscle volume was substantially overestimated (bias: thigh, -40%; calf, -18%) and adipose tissue underestimated (bias: thigh, 43%; calf, 8%) by anthropometry, in contrast to generally better predictions by the fundamental BIA approach for muscle (bias: thigh, -12%; calf, 5%) and adipose tissue (bias: thigh, 17%; calf, -28%). However, both methods demonstrated considerable individual variability (95% limits of agreement 20–77%). In general, there was similar reproducibility for anthropometric and fundamental BIA methods in the thigh (inter-observer residual coefficient of variation for muscle 3.5% versus 3.8%), but the latter was better in the calf (inter-observer residual coefficient of variation for muscle 8.2% versus 4.5%). This study suggests that the fundamental BIA method has advantages over anthropometry for measuring lower limb tissue composition in healthy individuals.

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Relationship between Flow-mediated Vasodilation and Lower Limb Venous Stasis: A Prospective Pilot Study

The Journal of Japanese College of Angiology ◽

10.7133/jca.19-00001 ◽

2019 ◽

Vol 59 (5) ◽

pp. 29-32

Author(s):

Eisaku Ito ◽

Naoki Toya ◽

Ryosuke Nishie ◽

Yuri Murakami ◽

Soichiro Fukushima ◽

...

Keyword(s):

Pilot Study ◽

Lower Limb ◽

Venous Stasis ◽

Prospective Pilot Study ◽

Flow Mediated Vasodilation

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Concomitant testicular infection by Zika virus and Schistosoma mansoni in a Brazilian young boy

Revista da Associação Médica Brasileira ◽

10.1590/1806-9282.63.06.500 ◽

2017 ◽

Vol 63 (6) ◽

pp. 500-503 ◽

Cited By ~ 4

Author(s):

Leonardo Souza Alves ◽

Cesar Estanislau ◽

Lucio Barreto ◽

Francisco Batista ◽

Nivaldo Toppa

Keyword(s):

Magnetic Resonance Imaging ◽

Magnetic Resonance ◽

Schistosoma Mansoni ◽

Zika Virus ◽

Testicular Biopsy ◽

Resonance Imaging ◽

Duplex Scan ◽

Magnetic Resonance Imaging Mri ◽

High Possibility ◽

Rule Out

Sumary The identification of a escrotal mass without pain or report of trauma should be investigated to rule out scrotal cancer. We report the case of a young Brazilian boy who underwent orchiectomy after magnetic resonance imaging (MRI) and duplex scan (DS) indicating a high possibility of cancer. Blood exams ruled out the possibility of cancer. Testicular biopsy was not indicated. After surgery the diagnostic was extensive orchiepididymitis by Schistosoma. In endemic areas orchiepididymis by Schistosoma should be investigate to avoid unnecessary surgeries. This patient was also infected with Zika virus.

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Comparison of the Hemodynamic Performance of Two Neuromuscular Electrical Stimulation Devices Applied to the Lower Limb

Journal of Personalized Medicine ◽

10.3390/jpm10020036 ◽

2020 ◽

Vol 10 (2) ◽

pp. 36

Author(s):

Sahar Avazzadeh ◽

Andrea O’Farrell ◽

Kate Flaherty ◽

Sandra O’Connell ◽

Gearóid ÓLaighin ◽

...

Keyword(s):

Electrical Stimulation ◽

Lower Limb ◽

Chronic Venous Insufficiency ◽

Venous Insufficiency ◽

Neuromuscular Electrical Stimulation ◽

Venous Stasis ◽

Western World ◽

Neuromuscular Stimulation ◽

Mean Velocity ◽

Compression Bandages

Currently, 1% of the population of the Western world suffers from venous leg ulcers as a result of chronic venous insufficiency. Current treatment involves the use of moist wound healing, compression bandages, and intermittent pneumatic compression. Neuromuscular electrical stimulation is a novel potential new therapeutic method for the promotion of increased lower limb hemodynamics. The aim of this study was to measure the hemodynamic changes in the lower limb with the use of two neuromuscular electrical stimulation devices. Twelve healthy volunteers received two neuromuscular stimulation device interventions. The GekoTM and National University of Ireland (NUI) Galway neuromuscular electrical stimulation devices were randomized between dominant and non-dominant legs. Hemodynamic measurements of peak venous velocity (cm/s), the time average mean velocity (TAMEAN) (cm/s), and ejected volume (mL) of blood were recorded. Peak venous velocity was significantly increased by the GekoTM and the NUI Galway device compared to baseline blood flow (p < 0.0001), while only the voluntary contraction produced significant increases in TAMEAN and ejected volume (both p < 0.05). Neuromuscular muscular electrical stimulation can produce adequate increases in lower limb hemodynamics sufficient to prevent venous stasis. Greater use of neuromuscular stimulation devices could be considered in the treatment of conditions related to chronic venous insufficiency but requires further research.

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The risk of lower-limb superficial vein thrombosis relative to lower-limb venous thrombotic events is not increased in winter months

Phlebology The Journal of Venous Disease ◽

10.1177/0268355519896729 ◽

2020 ◽

Vol 35 (7) ◽

pp. 533-537

Author(s):

Samir Henni ◽

Pierre Ramondou ◽

Guillaume Duval ◽

Jean Picquet ◽

Georges Leftheriotis ◽

...

Keyword(s):

Venous Thrombosis ◽

Deep Venous Thrombosis ◽

Lower Limb ◽

Homogeneous Distribution ◽

Superficial Vein ◽

Chi Square ◽

Venous Flow ◽

Vein Thrombosis ◽

Superficial Vein Thrombosis ◽

Chi Square Test

Objectives Ambient temperature (that impacts differently venous flow in superficial and deep veins) could have a different effect on the risk of superficial and deep venous thrombosis. We searched for a trimestral variation of the risk of superficial venous thrombosis among all lower-limb thrombotic events (lower-limb thrombotic events = superficial venous thrombosis + deep venous thrombosis). Methods We retrospectively analyzed the results of venous ultrasound investigations performed among 11,739 patients (aged 67 ± 19 years old, 56.1% males) referred for suspected lower-limb thrombotic events over a 12-year period. Chi-square test was used to compare the superficial venous thrombosis/lower-limb thrombotic events ratio observed by trimesters to a homogeneous distribution. Results The proportion of lower-limb thrombotic events were 30.7%, 28.8%, 31.1%, and 31.4% (Chi2: 0.133; p = 0.987) of total investigations, while that of superficial venous thrombosis among all lower-limb venous thrombotic events were 27.2%, 30.0%, 31.4%, and 31.0%, for the first, second, third, and fourth trimesters respectively (Chi2: 0.357; p: 0.949). Conclusion No trimestral variation of the superficial venous thrombosis/lower-limb venous thrombotic events ratio was observed.

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