Non-Invasive Methods of Measuring Venous Compliance

1992 ◽  
Vol 7 (2) ◽  
pp. 78-81 ◽  
Author(s):  
A. H. Davies ◽  
T. R. Magee ◽  
J. Hayward ◽  
R. Harris ◽  
R. N. Baird ◽  
...  
Keyword(s):  
Saphenous Vein ◽  
Duplex Ultrasound ◽  
Venous Occlusion ◽  
Qualitative Assessment ◽  
Venous Compliance ◽  
Non Invasive ◽  
Long Saphenous Vein ◽  
Saphenous Veins ◽  
Transit Times ◽  
The Mean

Objective: To compare two non-invasive methods of qualitative assessment of the long saphenous vein in terms of venous compliance. Design: Thirty-five long saphenous veins were examined. Compliance measurements have been calculated using: Method A in which an AV Impulse machine (Novamedix, UK) is used to generate a pulse wave in the long saphenous vein and the measurement of transit times are performed. Method B involves duplex ultrasound and venous occlusion of the long saphenous vein. Occlusive pressure measurements are used in both methods. Results: The mean vein compliance ratio measured in 35 long saphenous veins with the different methods was 0.23 (0.18–0.28) and 0.26 (0.22–0.30) using method A and B respectively. (Mean and (95% confidence interval)). The results show that a good correlation r = 0.91 and this was confirmed using methods of agreement. Conclusion: Both techniques give comparable results, however, the method involving Duplex is easier to perform. The research and clinical implications of these techniques remain to be assessed.

Does a Double Long Saphenous Vein Exist?

1999 ◽  
Vol 14 (2) ◽  
pp. 59-64 ◽  
Author(s):  
S. Ricci ◽  
A. Caggiati
Keyword(s):  
Saphenous Vein ◽  
Lower Limb ◽  
Healthy Subjects ◽  
Varicose Veins ◽  
Duplex Ultrasound ◽  
Clear Definition ◽  
Arterial Grafts ◽  
Long Saphenous Vein ◽  
Saphenous Veins ◽  
Definition Of

Background: The incidence of reduplication of the long saphenous vein (LSV) reported in the literature is highly variable, perhaps due to the lack of a clear definition. Objective: To use ultrasonography to re-evaluate the incidence of LSV reduplication in healthy subjects and Patients with varicose veins on the basis of a new definition of this anatomical aspect. Methods: The presence of two parallel superficial venous channels in the lower limb was sought in a series of 610 duplex ultrasound examinations. The LSV was identified, by the ‘eye’ sign, running deeply in the hypodermis, closely ensheathed by two hyperechogenic laminae (the saphenous compartment). Tributary veins were identified by their more superficial course, lying outside the compartment. True LSV reduplication was considered to be present when two venous channels were Present within the saphenous compartment. Results: True reduplication of the LSV is extremely rare (1%) and only affects a segment of vein. Large tributaries running parallel to the LSV do not comprise true reduplication, but may act as a ‘functional double vein’. Better understanding of the anatomy of the LSV may improve operative treatment for varicose veins and improve the use of saphenous veins as arterial grafts.

Echoanatomical Patterns of the Long Saphenous Vein in Patients with Primary Varices and in Healthy Subjects

1999 ◽  
Vol 14 (2) ◽  
pp. 54-58 ◽  
Author(s):  
S. Ricci ◽  
A. Caggiati
Keyword(s):  
Saphenous Vein ◽  
Healthy Subjects ◽  
Duplex Ultrasound ◽  
Normal Subjects ◽  
Predisposing Factor ◽  
Long Saphenous Vein ◽  
Saphenous Veins ◽  
Ultrasound Evaluation ◽  
Congenital Origin

Objective: To evaluate the pathway of reflux in incompetent long saphenous veins (LSVs), paying particular attention to the role of longitudinal saphenous tributaries in the thigh (accessory saphenous veins, ASVs). Design: Prospective study in a group of patients with primary varices. Comparison with the anatomical patterns in a group of normal subjects. Setting: Private phlebology practice. Patients: Sixty-seven patients with primary varices (100 limbs) and 66 subjects without varices and with competent saphenous veins (120 limbs). Methods: Duplex ultrasound evaluation of the saphenous system in the thigh of patients and healthy subjects. The ‘eye’ ultrasonographic sign was used as the marker to distinguish the LSV from the longitudinal tributary veins of the thigh. Results: In 57% of limbs in patients with varices, reflux followed the saphenous vein, while in 43% the reflux spilled outside the LSV into an ASV (h or S types). When reflux followed the saphenous vein, no large calibre ASVs could be observed. In 30% of limbs in control subjects a parallel tributary vein with a similar calibre was found joining the LSV. Conclusion: Clinically visible varices in the thigh rarely comprise the LSV itself, but are usually dilated ASVs, the reflux stream passing from the proximal LSV into a more superficial ASV. The distal LSV running parallel beneath is often competent. In subjects with healthy LSVs, a large competent tributary vein is already present in the thigh in 30% of cases. This suggests that superficial deviation of reflux flow into an ASV in patients with varices may not arise from haemodynamically acquired changes, but could have a congenital origin. This could even be a predisposing factor in the development of varices.

Does a Varicose Saphenous Vein Exist?

1997 ◽  
Vol 12 (2) ◽  
pp. 74-77 ◽  
Author(s):  
P. Zamboni ◽  
M. Cappelli ◽  
M. G. Marcellino ◽  
A. P. Murgia ◽  
L. Pisano ◽  
...  
Keyword(s):  
Saphenous Vein ◽  
Varicose Veins ◽  
Duplex Ultrasound ◽  
Longitudinal Vein ◽  
Medial Aspect ◽  
Long Saphenous Vein ◽  
Saphenous Veins ◽  
Ultrasound Evaluation ◽  
Primary Varicose Veins ◽  
High Resolution Ultrasonography

Objective: Duplex ultrasound evaluation of the clinically diagnosed varicose long saphenous vein (LSV). Design: Prospective, single patient group study. Setting: Department of Surgery, University of Ferrara, Italy (teaching hospital). Patients: 378 patients, 509 limbs with primary varicose veins; 94 patients, 103 limbs with a visible, superficial varicose vein trunk on the medial aspect of the thigh. Main outcome measure: Duplex ultrasound detection of a varicose saphenous vein and/or segmental saphenous dilatation and their relationship to saphenous reflux. Results: In 98% of cases the varicose trunk visible in the thigh was demonstrated to be a tributary of the saphenous vein; 34% of the observed saphenous veins exhibited segmental dilatations in the thigh. This finding was related in every case to saphenous vein reflux with high velocity and turbulence ( p < 0.0001). Conclusions: High-resolution ultrasonography demonstrated that when a dilated varicose longitudinal vein trunk is visible and palpable on the medial aspect of the thigh it is most likely to be a tributary rather than the LSV. In addition, a varicose saphenous vein along its entire length essentially does not exist. However, when a dilated saphenous segment occurs, it seems to be related to high diastolic flow velocity and turbulence.

Capillary Filtration Rate, before and after Stripping of the Greater Saphenous Vein, Measured with Air-Plethysmography

1998 ◽  
Vol 13 (2) ◽  
pp. 50-52 ◽  
Author(s):  
A. J. van Geest ◽  
J. C. J. M. Veraart ◽  
P. J. E. H. M. Kitslaar ◽  
H. A. M. Neumann
Keyword(s):  
Saphenous Vein ◽  
Filtration Rate ◽  
Duplex Ultrasound ◽  
Lower Limbs ◽  
Academic Hospital ◽  
Capillary Filtration ◽  
Before And After ◽  
The Mean ◽  
Air Plethysmography ◽  
Level Of Significance

Objective: To investigate whether there is a decrease in the capillary filtration rate after stripping of the greater saphenous vein, measured by air-plethysmography. Design: Prospective study. Setting: Academic Hospital Maastricht, The Netherlands. Patients: Fourteen lower limbs of 10 patients in which duplex ultrasound demonstrated insufficiency of the sapheno-femoral junction and of the greater saphenous vein, before operation. Interventions: Stripping of the greater saphenous vein. Main outcome measures: Capillary filtration rate before and 6 weeks after stripping of the greater saphenous vein, measured by air-plethysmography. Results: The capillary filtration rate after stripping of the greater saphenous vein had decreased in 12 legs and increased in two legs. The mean capillary filtration rate before operation was 6.58 ml/min (SD 1.97). Six weeks after stripping of the greater saphenous vein the mean capillary filtration rate was 5.54 ml/min (SD 1.22). These values have a level of significance of p < 0.01. Conclusion: The significant decrease of the capillary filtration rate, 6 weeks after stripping of the greater saphenous vein, measured with air-plethysmography, signifies an improvement in the microcirculation, related to the filtration function of the capillaries.

Two-year follow-up of first human use of cyanoacrylate adhesive for treatment of saphenous vein incompetence

2014 ◽  
Vol 30 (6) ◽  
pp. 397-404 ◽  
Author(s):  
Jose I Almeida ◽  
Julian J Javier ◽  
Edward G Mackay ◽  
Claudia Bautista ◽  
Daniel J Cher ◽  
...  
Keyword(s):  
Saphenous Vein ◽  
Duplex Ultrasound ◽  
Clinical Severity ◽  
Leg Pain ◽  
Compression Stockings ◽  
Saphenous Veins ◽  
Kaplan Meier ◽  
Venous Clinical Severity Score ◽  
Human Use

Objectives To evaluate the safety and effectiveness of endovenous cyanoacrylate-based embolization of incompetent great saphenous veins. Methods Incompetent great saphenous veins in 38 patients were embolized by cyanoacrylate bolus injections under ultrasound guidance without the use of perivenous tumescent anesthesia or graduated compression stockings. Follow-up was performed over a period of 24 months. Result Of 38 enrolled patients, 36 were available at 12 months and 24 were available at 24 months follow-up. Complete occlusion of the treated great saphenous vein was confirmed by duplex ultrasound in all patients except for one complete and two partial recanalizations observed at, 1, 3 and 6 months of follow-up, respectively. Kaplan-Meier analysis yielded an occlusion rate of 92.0% (95% CI 0.836–1.0) at 24 months follow-up. Venous Clinical Severity Score improved in all patients from a mean of 6.1 ± 2.7 at baseline to 1.3 ± 1.1, 1.5 ± 1.4 and 2.7 ± 2.5 at 6, 12 and 24 months, respectively ( p < .0001). Edema improved in 89% of legs (n = 34) at 48 hours follow-up. At baseline, only 13% were free from pain. At 6, 12 and 24 months, 84%, 78% and 64% were free from leg pain, respectively. Conclusions The first human use of endovenous cyanoacrylate for closure of insufficient great saphenous veins proved to be feasible, safe and effective. Clinical efficacy was maintained over a period of 24 months.

Endoscope-assisted management of primary varicose veins of the long saphenous vein and its tributaries

2004 ◽  
Vol 19 (1) ◽  
pp. 35-41 ◽  
Author(s):  
S-D Lin ◽  
Y-L Yang ◽  
S-S Lee ◽  
K-P Chang ◽  
T-M Lin ◽  
...  
Keyword(s):  
Saphenous Vein ◽  
Varicose Veins ◽  
Saphenous Nerve ◽  
Perforating Veins ◽  
Long Saphenous Vein ◽  
Primary Varicose Veins ◽  
The Mean ◽  
Assisted Management ◽  
Incision Wound

Objective: Primary varicose veins of the long saphenous vein and its tributaries were managed in 104 limbs of 101 patients with the assistance of endoscopic surgery. Methods: Patients were divided into four clinico-anatomical types according to normal veins involved in the varicosities. With good illumination and magnified monitor viewing by means of a surgical endoscope, the varicositic trunk, varicositic tributaries, incompetent perforating veins and healthy veins could be clearly visualized and identified. Through two or more access incisions (2.5-3.0 cm in length), the varicose veins were completely dissected, divided and removed. The incompetent perforating veins were clipped and divided. In all cases, the mean number of incisions in each limb was 3.0. Results: The most common cause of morbidity was maceration of the incision wound. Transient numbness may have presented at the dissected area, but there were no signs of injury to the saphenous nerve. Conclusions: There was very little possibility of recurrence, because no residual varicosities or incompetent perforating veins remained after this operation. Recurrence presented in only one case at follow up, three months postoperatively. Patients were satisfied with the minimal surgical scarring and complete absence of disfiguring varicosities in the limb.

The morphology of the varicose short saphenous system

2006 ◽  
Vol 21 (2) ◽  
pp. 55-59 ◽  
Author(s):  
L A Fowkes ◽  
S G Darke
Keyword(s):  
Saphenous Vein ◽  
Continuous Wave ◽  
Duplex Ultrasound ◽  
Entire System ◽  
Recurrence Rates ◽  
Female Ratio ◽  
Long Saphenous Vein ◽  
Continuous Wave Doppler ◽  
Short Saphenous Vein ◽  
Male To Female

Objective: Surgery for the varicose short saphenous vein (SSV) remains unsatisfactory. Specific problems include locating the saphenopopliteal junction (SPJ) and whether the trunk should be stripped. Recurrence rates are high. The objective was to review the morphology of varicose SSV and to address these aspects. Methods: Retrospective study of consecutive patients scheduled for SSV surgery based on initial continuous wave Doppler assessment. Detailed analysis of preoperative duplex ultrasound examinations with quantified reflux. Results: A total of 56 limbs (unilateral) were studied, male to female ratio was 18:38 and mean age was 51 years. SPJ: severe reflux in 47, mean diameter 8.1 mm (all above the skin crease [mean 2.7 cm]). Reflux was 'focal', being confined to the peri-junctional area with normal sized and competent distal short saphenous trunks in 29. In the remainder, incompetence was 'complete' with dilatation and reflux of the entire system. In only one limb did varicosities arise distally from a proximally competent system. Long saphenous vein ( LSV): coexistent reflux in 17, with communications with the SSV in 11. Deep reflux: at least one segment of deep reflux was found in 24 limbs. In this small study, no significant association with other morphology was found apart from 'complete' SSV reflux. Conclusion: The SPJ is usually severely incompetent, enlarged and sited above the skin crease. The morphology of the varicose SSV exhibits important differences from the LSV. In over half, incompetence is 'focal', confined to the peri-junctional vein and the distal trunk is competent suggesting a case for selective trunk stripping. Varicosities arising from a distally incompetent short saphenous trunk are uncommon.

A Non-Invasive γ-Camera Technique for the Measurement of Intrarenal Flow Distribution in Man

1981 ◽  
Vol 61 (4) ◽  
pp. 385-389 ◽  
Author(s):  
S. M. Gruenewald ◽  
C. C. Nimmon ◽  
M. K. Nawaz ◽  
K. E. Britton
Keyword(s):  
Flow Distribution ◽  
Region Of Interest ◽  
Human Kidney ◽  
Normal Subjects ◽  
Hypertensive Patients ◽  
Renal Autoregulation ◽  
Non Invasive ◽  
Transit Times ◽  
Left And Right ◽  
The Mean

1. A new method, based on the transit time of o-iodohippurate sodium (Hippuran) through the kidney, is proposed as an accurate non-invasive means of measuring the intrarenal flow distribution in man. 2. Data from [123I]Hippuran γ-camera renography are utilized in this method which employs region of interest selection, deconvolution, cross-correlation and curve subtraction to obtain the spectrum of transit times through the cortical and juxtamedullary nephrons. 3. In 12 normal subjects the mean percentage cortical flow was 83.9% (sem 0.7%) which is approximately the anatomical proportion of cortical nephrons in the human kidney. 4. Cortical flow as a percentage of total was significantly reduced in 21 hypertensive patients, all of whom had no evidence of primary renal disease (mean 74.6%, sem 1.5%). 5. In both the normotensive and hypertensive groups there was a good correlation between the results obtained from the left and right kidneys of the same patient showing the parallel physiological response of the two kidneys (mean difference 4%, P < 0.001). 6. Reduction in the distribution of flow to the cortical nephrons in the essential hypertensive patients supports the hypothesis that renal autoregulation is important in this syndrome.

Venous Reflux at the Sapheno-Femoral Junction

1995 ◽  
Vol 10 (4) ◽  
pp. 132-135 ◽  
Author(s):  
G. M. Somjen ◽  
J. Donlan ◽  
J. Hurse ◽  
J. Bartholomew ◽  
A. H. Johnston ◽  
...  
Keyword(s):  
Saphenous Vein ◽  
Ultrasound Examination ◽  
Varicose Veins ◽  
Femoral Vein ◽  
Duplex Ultrasound ◽  
Venous Reflux ◽  
Duplex Scan ◽  
Common Femoral Vein ◽  
Long Saphenous Vein ◽  
The Common

Objectives: To clarify reflux patterns in the sapheno-femoral junction in legs with varicose veins that display incompetence in the proximal long saphenous vein on duplex scan examination. Patients and method: One hundred consecutive extremities were selected for ultrasound studies. Venous reflux was examined in the common femoral vein and long saphenous vein at five selected levels in the vicinity of the sapheno-femoral junction. Results: Duplex ultrasound examination confirmed that in 44 extremities reflux was detectable both in the long saphenous vein and common femoral vein indicating ‘true’ sapheno-femoral incompetence. In 56 legs reflux was limited to the long saphenous vein, whilst the first saphenous valve remained competent. The ultrasound examination suggested that in these cases the reflux originated from the numerous tributaries of the proximal long saphenous vein. Conclusion: Our findings emphasize the transfascial escape (reflux from the deep veins) is not a necessary precondition of long saphenous vein incompetence and related varicose veins.

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