Role of Duplex Imaging in Endovenous Obliteration for Primary Venous Insufficiency

Objective: To evaluate the role of subjective symptoms, grade of disability and axial reflux in superficial veins in different clinical stages of varicose veins (VVs). Methods: A total of 172 legs with primary venous insufficiency from 126 patients were studied. The examination involved evaluation of the CEAP clinical class and clinical disability score (CDS), recording of any symptoms of varicose disease, and a hand-held Doppler (HHD) examination of the superficial veins. Colour-flow duplex imaging (CFDI) was also performed in 22% of the legs. Results: The rate of insufficiency of the great saphenous vein (GSV) was 83% in complicated legs (C4-6), and 68% in uncomplicated legs (C2-3), ( P > 0.05). There was a difference between complicated and uncomplicated legs in the insufficiency of the whole GSV [C4-6: n = 18 (39%) versus C2-3: n = 12 (12%), P < 0.005]. Sensation of pain was noted in 68% of the legs in class C1, 60% of those in class C2-3 and 81% of those in class C4-6. Sensation of oedema was recorded in 70% of the legs in class C1, 65% of those in class C2-3 and 86% of those in class C4-6, respectively. CDS classes 2-3 were significantly more frequent among complicated legs (C4-6: 54% versus C2-3 12%, P < 0.005). Conclusions: Leg symptoms are frequent throughout classes C1-6. Their clinical usefulness is therefore limited. CDS parallels well with the clinical classification. In complicated disease the whole saphenous vein is more frequently insufficient.

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Recurrent varicose veins below the knee after varicose vein surgery

Phlebologie ◽

10.1055/s-0037-1622175 ◽

2007 ◽

Vol 36 (03) ◽

pp. 132-136

Author(s):

M. W. de Haan ◽

J. C. J. M. Veraart ◽

H. A. M. Neumann ◽

P. A. F. A. van Neer

Keyword(s):

Varicose Vein ◽

Varicose Veins ◽

Varicose Vein Surgery ◽

Proximal Point ◽

Perforating Veins ◽

Recurrent Varicose Veins ◽

Below The Knee ◽

Duplex Imaging ◽

Additional Value

SummaryThe objectives of this observational study were to investigate whether varicography has additional value to CFDI in clarifying the nature and source of recurrent varicose veins below the knee after varicose vein surgery and to investigate the possible role of incompetent perforating veins (IPV) in these recurrent varicose veins. Patients, material, methods: 24 limbs (21 patients) were included. All patients were assessed by a preoperative clinical examination and CFDI (colour flow duplex imaging). Re-evaluation (clinical and CFDI) was done two years after surgery and varicography was performed. Primary endpoint of the study was the varicographic pattern of these visible varicose veins. Secondary endpoint was the connection between these varicose veins and incompetent perforating veins. Results: In 18 limbs (75%) the varicose veins were part of a network, in six limbs (25%) the varicose vein appeared to be a solitary vein. In three limbs (12.5%) an incompetent sapheno-femoral junction was found on CFDI and on varicography in the same patients. In 10 limbs (41%) the varicose veins showed a connection with the persistent below knee GSV on varicography. In nine of these 10 limbs CFDI also showed reflux of this below knee GSV. In four limbs (16%) the varicose veins showed a connection with the small saphenous vein (SSV). In three limbs this reflux was dtected with CFDI after surgery. An IPV was found to be the proximal point of the varicose vein in six limbs (25%) and half of these IPV were detected with CFDI as well. Conclusion: Varicography has less value than CFDI in detecting the source of reflux in patients with recurrent varicose veins after surgery, except in a few cases where IPV are suspected to play a role and CFDI is unable to detect these IPV.

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Normal CSF ferritin levels in MS suggest against etiologic role of chronic venous insufficiency

Yearbook of Vascular Surgery ◽

10.1016/j.yvas.2011.07.040 ◽

2011 ◽

Vol 2011 ◽

pp. 272-275

Author(s):

G.L. Moneta

Keyword(s):

Chronic Venous Insufficiency ◽

Venous Insufficiency ◽

Etiologic Role

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Normal CSF ferritin levels in MS suggest against etiologic role of chronic venous insufficiency

Neurology ◽

10.1212/wnl.0b013e318219dcf1 ◽

2011 ◽

Vol 76 (24) ◽

pp. 2130-2132

Author(s):

S. R. Brenner ◽

A. Sena ◽

R. Pedrosa ◽

V. Ferret-Sena ◽

A. Petzold ◽

...

Keyword(s):

Chronic Venous Insufficiency ◽

Venous Insufficiency ◽

Etiologic Role

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Contact allergy in patients with chronic venous leg ulcers - possible role of chronic venous insufficiency

Contact Dermatitis ◽

10.1111/j.0105-1873.2006.00777.x ◽

2006 ◽

Vol 54 (2) ◽

pp. 100-105 ◽

Cited By ~ 21

Author(s):

Maria Zmudzinska ◽

Magdalena Czarnecka-Operacz ◽

Wojciech Silny ◽

Lucyna Kramer

Keyword(s):

Chronic Venous Insufficiency ◽

Venous Insufficiency ◽

Contact Allergy ◽

Leg Ulcers ◽

Venous Leg Ulcers

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So It's Not a DVT: Duplex Imaging of Venous Insufficiency

Journal of Vascular and Interventional Radiology ◽

10.1016/s1051-0443(03)70216-4 ◽

2003 ◽

Vol 14 (2) ◽

pp. P260-P261

Author(s):

Robert J. Min

Keyword(s):

Venous Insufficiency ◽

Duplex Imaging

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Chronic cerebrovascular disease: the role of venous disorders and the possibility of pathogenetic correction

Russian Medical Inquiry ◽

10.32364/2587-6821-2020-4-9-544-551 ◽

2020 ◽

Vol 4 (9) ◽

pp. 544-551

Author(s):

I.A. Schukin ◽

◽

M.S. Fidler ◽

I.A. Koltsov ◽

◽

...

Keyword(s):

Cerebral Ischemia ◽

Cerebrovascular Disease ◽

Venous Insufficiency ◽

Main Group ◽

Duplex Scanning ◽

Control Group ◽

Chronic Cerebral Ischemia ◽

Venous Disorders ◽

Tinetti Test

Aim: to evaluate the efficacy and safety of the L-lysine escinate venotropic drug in the treatment of cephalgic, atactic and asthenic syndromes in patients with chronic cerebral ischemia, mainly caused by venous disorders. Patients and Methods: the study involved 60 patients with a diagnosis of chronic cerebral ischemia with signs of chronic venous insufficiency. All patients were randomly divided into two groups consisting of 30 people. Patients in the main group received L-lysine escinate, and the control group received Vinpocetine. The drugs were administered by intravenous drip for 10 days. A dynamic assessment was performed using a modified subjective scale of asthenia evaluation (MFI-20), 100 mm long visual analogue scale (VAS) for headache, subjective neurological impairment scale (SNIS), and Tinetti test. An ophthalmic examination with an assessment of the fundus vessels and an ultrasound duplex scanning of head vessels (veins) were also conducted. Results: it was shown that L-lysine escinate therapy showed a statistically more significant reduction in the severity of headache (according to VAS) and an improved stability measured by Tinetti test versus during Vinpocetine treatment. There were no significant differences in the level of asthenia (MFI-20), the severity of emotional disorders, and the SNIS score. Also, the number of patients with dilated fundus veins significantly decreased during treatment in the main group (p<0.05), which was not the case in the control group. According to ultrasound duplex scanning data, the venous flow velocity through the veins of Rosenthal and angular veins during L-lysine escinate therapy was significantly higher (p<0.05) than in patients receiving Vinpocetine. Conclusion: the inclusion of vasotropic drugs (in particular, the L-lysine escinate venotonic drug) in the treatment regimen of patients with chronic brain ischemia seems appropriate, especially if there are signs of venous insufficiency. KEYWORDS: systemic venous insufficiency, chronic cerebrovascular disease, venous dyscirculation, glymphatic system, L-lysine escinate, Vinpocetine. FOR CITATION: Schukin I.A., Fidler M.S., Koltsov I.A. Chronic cerebrovascular disease: the role of venous disorders and the possibility of pathogenetic correction. Russian Medical Inquiry. 2020;4(9):544–551. DOI: 10.32364/2587-6821-2020-4-9-544-551.

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