Chronic Venous Disease May Delay the Diagnosis of Malignant Ulceration of the Leg

1994 ◽  
Vol 9 (4) ◽  
pp. 167-169 ◽  
Author(s):  
N. R. F. Lagattolla ◽  
K. G. Burnand
Keyword(s):  
Lower Limb ◽  
Squamous Carcinoma ◽  
Descriptive Study ◽  
Punch Biopsy ◽  
Outpatient Department ◽  
Chronic Venous Disease ◽  
Venous Disease ◽  
Cutaneous Malignancy ◽  
Prompt Treatment ◽  
Malignant Ulcer

Objective: To emphasize the association of cutaneous malignancy and chronic venous disease of the lower limb. Design: A descriptive study, reporting six cases, with a discussion of the literature. Setting: St Thomas' Hospital Outpatient Department. Patients: Six outpatients. Conclusions: The development of both squamous carcinoma and basal cell carcinoma may be associated with chronic venous disease of the lower limb. Modest dimensions or a healthy appearance that are out of keeping with a protracted course may be signs of malignancy in a leg ulcer. A punch biopsy under local anaesthesia in the outpatient department provides accurate diagnosis of a malignant ulcer allowing prompt treatment.

Duplex ultrasound investigation of the veins in chronic venous disease of the lower limbs – UIP Consensus Document. Part II: Anatomy

2006 ◽  
Vol 21 (4) ◽  
pp. 168-179 ◽  
Author(s):  
A Cavezzi ◽  
N Labropoulos ◽  
H Partsch ◽  
S Ricci ◽  
A Caggiati ◽  
...  
Keyword(s):  
Lower Limb ◽  
Duplex Ultrasound ◽  
Lower Limbs ◽  
Chronic Venous Disease ◽  
Specific Reference ◽  
Venous Disease ◽  
Perforating Veins ◽  
Consensus Document ◽  
Wide Range ◽  
Ultrasound Investigation

Objectives: Duplex ultrasound investigation has become the reference standard in assessing the morphology and haemodynamics of the lower limb veins. The project described in this paper was an initiative of the Union Internationale de Phlébologie (UIP). The aim was to obtain a consensus of international experts on the methodology to be used for assessment of the anatomy of superficial and perforating veins in the lower limb by ultrasound imaging. Design: Consensus conference leading to a consensus document. Methods: The authors performed a systematic review of the published literature on duplex anatomy of the superficial and perforating veins of the lower limbs. Afterwards, they invited a group of experts from a wide range of countries to participate in this project. Electronic submissions from the authors and the experts (text and images) were made available to all participants via the UIP website. The authors prepared a draft document for discussion at the UIP Chapter meeting held in San Diego, USA, in August 2003. Following this meeting, a revised manuscript was circulated to all participants and further comments were received by the authors and included in subsequent versions of the manuscript. Eventually, all participants agreed on the final version of the paper. Results: The experts have made detailed recommendations concerning the methods to be used for duplex ultrasound examination as well as the interpretation of images and measurements obtained. This document provides a detailed methodology for complete ultrasound assessment of the anatomy of the superficial and perforating veins in the lower limbs. Conclusions: The authors and a large group of experts have agreed on a methodology for the investigation of the lower limbs venous system, by duplex ultrasonography, with specific reference to the anatomy of the main superficial veins and perforators of the lower limbs in healthy and varicose subjects.

scholarly journals Thrombophilia in non‐thrombotic chronic venous disease of the lower limb – a systematic review

2018 ◽  
Vol 183 (5) ◽  
pp. 703-716
Author(s):  
Matthew K. H. Tan ◽  
Sarah Onida ◽  
Michael Laffan ◽  
Alun H. Davies
Keyword(s):  
Systematic Review ◽  
Lower Limb ◽  
Chronic Venous Disease ◽  
Venous Disease

Lower limbs edema among medical students

2019 ◽  
Vol 8 (3) ◽  
pp. 1-5
Author(s):  
Monika Załęcka ◽  
Kacper Lipiński ◽  
Aleksandra Królikowska
Keyword(s):  
Medical Students ◽  
Lower Limb ◽  
High Ambient Temperature ◽  
Lower Limbs ◽  
Chronic Venous Disease ◽  
Venous Disease ◽  
Prolonged Standing ◽  
Limb Edema ◽  
Academic Year ◽  
Exacerbation Of Symptoms

Aim of the study: Chronic venous disease is frequent that affects people of various professions and ages. It consists of a set of symptoms located in the lower limbs, and edema is one of the first and most frequent signs. The aim of this study was to investigate the lifestyle influence on frequency of lower limbs swelling formation among medicine students. Materials and methods: Analysis of questionnaire conducted among 482 students of the academic year 2018/2019 from 12 Polish medicine universities. The survey questions encompass known and possible risk factors of lower limbs edema. CEAP scale was used to assess the severity of chronic venous disease. Results: Lower limb edema occurred in 30% of the respondents, of which 55% stated the exacerbation of symptoms on the days they attended classes. Conclusions: Medical students suffer from edema, it is more common among women. The type of classes affects the manifestation of lower limbs oedema. The factors that have the greatest impact on the formation of edema in students are: prolonged standing or sitting position and high ambient temperature.

Duplex ultrasound investigation of the veins in chronic venous disease of the lower limbs-UIP consensus document. Part I. Basic principles

VASA ◽  
2007 ◽  
Vol 36 (1) ◽  
pp. 53-61 ◽  
Author(s):  
Coleridge-Smith ◽  
Labropoulos ◽  
Partsch ◽  
Myers ◽  
Nicolaides ◽  
...  
Keyword(s):  
Lower Limb ◽  
Duplex Ultrasound ◽  
Lower Limbs ◽  
Chronic Venous Disease ◽  
Venous Disease ◽  
Consensus Document ◽  
Wide Range ◽  
International Experts ◽  
Training Of Personnel ◽  
Ultrasound Investigation

Background: Duplex ultrasound investigation has become the reference standard in assessing the morphology and haemodynamics of the lower limb veins. The project described in this paper was an initiative of the Union Internationale de Phlébologie (UIP). The aim was to obtain a consensus of international experts on the methodology to be used for assessment of veins in the lower limb by ultrasound imaging. Methods: The authors invited a group of experts from a wide range of countries to participate in this project. Electronic submissions from the experts were made available to all participants via the UIP website. The authors prepared a draft document for discussion at an UIP Chapter meeting held in San Diego, USA in August 2003. Following this meeting a revised manuscript was circulated to all participants and further comments were received by the authors and included in subsequent versions of the manuscript. Eventually all participants agreed the final version of the paper. Results: The experts have made detailed recommendations concerning the methods to be used for duplex ultrasound examination as well as the interpretation of images and measurements obtained. This document suggests a methodology for complete assessment of the superficial and perforating veins of the lower limbs, including recommendations on reporting results and training of personnel involved in these investigations. Conclusions: The authors and a large group of experts have agreed a methodology for the investigation of the lower limbs venous system by duplex ultrasonography.

scholarly journals Damage to Cranial Extension of the Small Saphenous Vein and Vein of Giacomini in Lower Limb Varicose Vein Disease

2016 ◽  
Vol 23 (3) ◽  
Author(s):  
Rostyslav Vasyliovych Sabadosh
Keyword(s):  
Saphenous Vein ◽  
Lower Limb ◽  
Great Saphenous Vein ◽  
Subsequent Development ◽  
Chronic Venous Disease ◽  
Venous Disease ◽  
Results Of Treatment ◽  
Surgical Tactics ◽  
Primary Chronic Venous Disease ◽  
Antegrade Flow

Abstract. The vein of Giacomini is often identified with the cranial extension of the small saphenous vein despite the fact that according to the international interdisciplinary anatomical nomenclature they are distinguished from one another.The objective of the research was to improve the results of treatment of patients with lower limb primary chronic venous disease disease studying the variation in anatomy and pathology of the vein of Giacomini and the cranial extension of the small saphenous vein with subsequent development of differential surgical tactics.Materials and methods. 502 patients with primary chronic venous disease on 605 legs were examined and treated. Each patient underwent preoperative ultrasonographic triplex scanning of the lower limb venous system.Results. Varicose dilatation of the vein of Giacomini was observed in 3.8% of patients (95% CI 2.4-5.6 %), and the pathology of the cranial extension of the small saphenous vein was detected in 1.7% of patients (95% CI 0.8-3.0%). When the arch of the small saphenous vein was present the following variations in the pathology of the vein of Giacomini were observed: 1) the spread of reflux from the great saphenous vein to the vein of Giacomini; 2) reflux from the terminal valve of the small saphenous vein intensified the antegrade flow of blood within the vein of Giacomini resulting in reflux in the great saphenous vein distal to the point where the vein of Giacomini drained into the great saphenous vein. The causes of failure of the valves in the trunk of the cranial extension of the small saphenous vein included: 1) reflux from the ostium of the cranial extension of the small saphenous vein; 2) perforating vein reflux; 3) reflux from the terminal valve of the small saphenous vein.Conclusions.  The pathology of the vein of Giacomini and the cranial extension of the small saphenous vein is not homogeneous; therefore, surgical tactics in every patient has to be hemodynamically justified and differentiated depending on the pathways of pathological reflux spreading. 

Duplex ultrasound investigation of the veins in chronic venous disease of the lower limbs – UIP Consensus Document. Part I: Basic principles

2006 ◽  
Vol 21 (4) ◽  
pp. 158-167 ◽  
Author(s):  
P Coleridge-Smith ◽  
N Labropoulos ◽  
H Partsch ◽  
K Myers ◽  
A Nicolaides ◽  
...  
Keyword(s):  
Lower Limb ◽  
Duplex Ultrasound ◽  
Consensus Conference ◽  
Lower Limbs ◽  
Chronic Venous Disease ◽  
Venous Disease ◽  
Consensus Document ◽  
Wide Range ◽  
International Experts ◽  
Ultrasound Investigation

Objectives: Duplex ultrasound investigation has become the reference standard in assessing the morphology and haemodynamics of the lower limb veins. The project described in this paper was an initiative of the Union Internationale de Phlébologie (UIP). The aim was to obtain a consensus of international experts on the methodology to be used for assessment of veins in the lower limb by ultrasound imaging. Design: Consensus conference leading to a consensus document. Methods: The authors invited a group of experts from a wide range of countries to participate in this project. Electronic submissions from the experts were made available to all participants via the UIP website. The authors prepared a draft document for discussion at a UIP Chapter meeting held in San Diego, USA, in August 2003. Following this meeting, a revised manuscript was circulated to all participants, and further comments were received by the authors and included in subsequent versions of the manuscript. Eventually, all participants agreed on a final version of the paper. Results: The experts have made detailed recommendations concerning the methods to be used for duplex ultrasound examination, as well as the interpretation of images and measurements obtained. This document suggests a methodology for complete assessment of the superficial and perforating veins of the lower limbs, including recommendations on reporting results and training of personnel involved in these investigations. Conclusions: The authors and a large group of experts have agreed a methodology for the investigation of the lower limbs venous system by duplex ultrasonography.

Effects of epidural-and-general anesthesia combined versus general anesthesia alone on the venous hemodynamics of the lower limb

2004 ◽  
Vol 92 (11) ◽  
pp. 1003-1011 ◽  
Author(s):  
Alison Knaggs ◽  
Peter Mason ◽  
Ken Macleod ◽  
Konstantinos Delis
Keyword(s):  
Abdominal Surgery ◽  
General Anesthesia ◽  
Epidural Anesthesia ◽  
Lower Limb ◽  
Chronic Venous Disease ◽  
Venous Stasis ◽  
Controlled Study ◽  
Point Estimate ◽  
Venous Disease ◽  
Post Induction

SummaryOur hypothesis was that, due to its sympatholytic action, epidural anesthesia (EA) administered as part of anesthesia in abdominal surgery would generate a marked venous leg flow enhancement, thus aiding in the prevention of peroperative venous stasis. We studied, and comprehensively quantified the venous haemodynamic changes in the lower limb during and immediately after abdominal surgery performed under EA and general (GA) anesthesia combined, in comparison to GA alone. This is a prospective, randomized, controlled study, stratified for hypertension and smoking, comprising ASA 1-2 patients undergoing elective total abdominal hysterectomy. Those with peripheral vascular or chronic venous disease, prior DVT or BMI>35 were excluded. Eligible recruits received either GA (Group GA) (n = 10; age 36-65, median 50) alone or epidural anesthesia (EA) and GA combined (Group EA/GA) (n = 9; age 32-58, median 46). EA (L1-2) was administered using lignocaine 2%. Both groups had GA induced with fentanyl and propofol, maintained with N2O and isoflurane; larygoscopy was facilitated with vecuronium; analgesia was provided either with morphine (Group GA) or epidurally with 2% lignocaine boli (Group EA/GA). Hemodynamics were determined at the popliteal vein in the horizontal supine position at baseline (resting prior to anesthesia), post epidural (20 min after delivery of EA), post induction (15 min after laryngeal intubation), surgery (upon uterus removal) and recovery (30 min after extubation). There was no difference in the mean velocity[Vmean] between the 2 groups at baseline (p = 0.35[Mann-Whitney]), and post induction (p = 0.5[Mann-Whitney]). However Vmean was significantly higher in Group EA/GA than Group GA, both at surgery (point estimate[PE]: 1.8 cm/s; 95% CI: 0.01, 6.3 cm/s; p <0.05[Mann-Whitney]) and recovery (PE: 2.6 cm/s; 95% CI: 0.4, 5.1 cm/s; p = 0.02[Mann-Whitney]). Volume flow[VQ] was similar in the 2 groups at baseline and post induction (both, p >0.1[Mann-Whitney]), but was significantly higher in Group EA/GA at surgery (PE: 54 ml/min; 95% CI: 18, 159 ml/min; p = 0.045[Mann-Whitney]) and recovery (PE: 49 ml/min; 95% CI: 16, 129 ml/min; p=0.0037[Mann-Whitney]). Peak velocity, Vmean and VQ increased significantly post epidural in Group EA/GA. Contrary to the venous leg flow attenuation in elective abdominal surgery under GA and upon its recovery, EA administered as part of GA is associated with a significant enhancement of both Vmean and VQ. This beneficial hemodynamic effect of EA at the vulnerable stage of recovery may be critically essential in light of enhanced blood viscosity, fibrinolytic shutdown, endothelial/platelet activation and immobility, acting in synergy with putative cardiorespiratory protection. The results of this study lend support to the preferential selection of combined EA/GA in subjects at high risk for venous thromboembolism, particularly when optimal DVT prophylaxis is practically unattainable due to limitations pertaining to the nature of surgery.

Duplex ultrasound investigation of the veins in chronic venous disease of the lower limbs-UIP consensus document. Part II. Anatomy

VASA ◽  
2007 ◽  
Vol 36 (1) ◽  
pp. 62-71 ◽  
Author(s):  
Cavezzi ◽  
Labropoulos ◽  
Partsch ◽  
Ricci ◽  
Caggiati ◽  
...  
Keyword(s):  
Lower Limb ◽  
Duplex Ultrasound ◽  
Lower Limbs ◽  
Chronic Venous Disease ◽  
Specific Reference ◽  
Venous Disease ◽  
Perforating Veins ◽  
Consensus Document ◽  
Wide Range ◽  
Ultrasound Investigation

Background: Duplex ultrasound investigation has become the reference standard in assessing the morphology and haemodynamics of the lower limb veins. The project described in this paper was an initiative of the Union Internationale de Phlébologie (UIP). The aim was to obtain a consensus of international experts on the methodology to be used for assessment of anatomy of superficial and perforating veins in the lower limb by ultrasound imaging. Methods: The authors performed a systematic review of the published literature on duplex anatomy of the superficial and perforating veins of the lower limbs; afterwards they invited a group of experts from a wide range of countries to participate in this project. Electronic submissions from the authors and the experts (text and images) were made available to all participants via the UIP website. The authors prepared a draft document for discussion at the UIP Chapter meeting held in San Diego, USA in August 2003. Following this meeting a revised manuscript was circulated to all participants and further comments were received by the authors and included in subsequent versions of the manuscript. Eventually, all participants agreed the final version of the paper. Results: The experts have made detailed recommendations concerning the methods to be used for duplex ultrasound examination as well as the interpretation of images and measurements obtained. This document provides a detailed methodology for complete ultrasound assessment of the anatomy of the superficial and perforating veins in the lower limbs. Conclusions: The authors and a large group of experts have agreed a methodology for the investigation of the lower limbs venous system by duplex ultrasonography, with specific reference to the anatomy of the main superficial veins and perforators of the lower limbs in healthy and varicose subjects.

scholarly journals The role of inflammatory reaction in chronic venous disease of the lower limb

2019 ◽  
Vol 6 (5) ◽  
pp. 1835
Author(s):  
Ketan Vagholkar ◽  
Shivangi Garima ◽  
Yash Kripalani
Keyword(s):  
Lower Limb ◽  
Lower Limbs ◽  
Chronic Venous Disease ◽  
Venous Disease ◽  
Vascular Disorder ◽  
Disease Awareness ◽  
Prolonged Sitting ◽  
Inflammatory Mechanism ◽  
Prevention And Treatment

Chronic venous disease is the problem which is assuming alarming proportions in subjects whose occupation involves prolonged sitting or standing. The exact mechanism by which the venous system gets damaged continues to be a subject of endless research. The role of inflammation is a significant factor in the evolution of chronic venous disease. Awareness of this mechanism can help in both prevention and treatment of this complex vascular disorder. The paper reviews inflammatory mechanism underlying the pathogenesis of chronic venous disease in lower limbs.

scholarly journals Chronic venous disease as a clinical manifestation of tibial osteochondroma

2013 ◽  
Vol 12 (2) ◽  
pp. 163-169
Author(s):  
Marcelo Fernandes Lima ◽  
Ilidio Almeida Lima ◽  
Sergio Luiz Bizerra Oliveira ◽  
Vanessa Heinrich Barbosa de Oliveira Lima ◽  
Carlos Alexandre de Souza Rocha
Keyword(s):  
Lower Limb ◽  
Benign Tumor ◽  
Vascular Complications ◽  
Common Type ◽  
Chronic Venous Disease ◽  
Long Bone ◽  
Venous Disease ◽  
Distal Extremity ◽  
Pseudoaneurysm Formation ◽  
Left Lower Limb

Osteochondromas are the most common type of benign tumor of the skeleton. They most frequently affect the distal extremity of the femur, with the tibia being the second most commonly affected long bone. Vascular complications of these lesions are rare, but pseudoaneurysm formation is the most frequently reported of them. In this case report, we describe a case of compression of the popliteal neurovascular bundle by a tibial osteochondroma in a diabetic patient who had been admitted to hospital to treat an infected lesion on his left foot and complained of edema and paresthesia of the left lower limb.

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