Prevalence and management of ovarian venous insufficiency in the presence of leg venous insufficiency

2007 ◽  
Vol 22 (1) ◽  
pp. 29-33 ◽  
Author(s):  
R Sutaria ◽  
A Subramanian ◽  
B Burns ◽  
H Hafez
Keyword(s):  
Lower Extremity ◽  
Lower Limb ◽  
Venous Insufficiency ◽  
Varicose Veins ◽  
Vena Cava ◽  
Vascular Surgeon ◽  
Venous Surgery ◽  
Magnetic Resonance Imaging Mri ◽  
The Right ◽  
Superficial Venous Insufficiency

Objective: The correlation between ovarian venous insufficiency and lower limb venous insufficiency remains poorly understood. Clinically, incompetent ovarian veins in association with lower extremity varicose veins are suspected when leg varicose veins are found in atypical distributions. Such distributions include upper lateral or posterior thigh, on the buttocks, crossing the inguinal ligament, and also in the vulval or perineal regions. The aim of this study was to determine the prevalence of ovarian venous insufficiency in those with clinically suspicious varicose veins, and to assess the effectiveness of ovarian venous embolization/ligation in treating this condition. Methods: Between June 2001 and December 2004, 424 female patients with lower limb superficial venous insufficiency were seen by a single vascular surgeon. These patients were clinically assessed, and those with atypical varicose veins were investigated with venous duplex examination and magnetic resonance imaging (MRI) venography. Patients with proven ovarian venous insufficiency were offered venography with a view to embolization or laparoscopic ligation. Results: A total of seven patients were clinically suspected of having ovarian venous insufficiency, of which three had recurrent varicose veins (42.9%). Of these, six were confirmed on MRI venography with the left side being more affected than the right; one of them had an occluded vena cava, three were treated by embolization, and two had laparoscopic ligation. Discussion: The prevalence of clinically detectable ovarian venous insufficiency in association with lower extremity varicose veins is in the region of 1.65%. Compared with the estimated prevalence of incidental ovarian venous insufficiency of 10–47%, this suggests that only a minority of incompetent ovarian veins will present with clinically detectable lower limb venous insufficiency. In our opinion, patients with signs suggestive of ovarian venous insufficiency in association with lower limb venous insufficiency should have their ovarian insufficiency controlled prior to embarking on limb venous surgery.

scholarly journals Use of a Novel Device in Reconstructive Venous Surgery: Preliminary Results

2020 ◽  
Vol 29 (04) ◽  
pp. 245-249
Author(s):  
Daniele Camilli ◽  
Alessandro Platone ◽  
Massimo Ruggeri ◽  
Sergio Furgiuele
Keyword(s):  
Venous Thrombosis ◽  
Venous Insufficiency ◽  
Varicose Veins ◽  
External Support ◽  
Long Term Results ◽  
Novel Device ◽  
Venous Surgery ◽  
Varicose Disease ◽  
Superficial Venous Insufficiency ◽  
External Valvuloplasty

AbstractEvaluation of the outcomes of OSES (oval-shaped external support), a novel device for external valvuloplasty of the great saphenous vein (GSV) for the conservative treatment of superficial venous insufficiency. Between 2012 and 2015, 30 patients underwent external valvuloplasty of the GSV for a total of 32 limbs. Patients were subjected to clinical and instrumental follow-up by a half-year ultrasound for a minimum of 36 months. The main endpoints were the recurrence of varicose disease, persistent or recurrent venous reflux, and venous thrombosis. Varicose recurrence was verified in six limbs on 32 (18.75%). Four limbs (12.5%) presented a recurrence of the reflux even in the absence of varicose veins. Two limbs (6.25%) underwent saphenectomy after the valvuloplasty intervention at 12 and 18 months, respectively, because of the presence of saphenofemoral reflux and varicose recurrences. No case of venous thrombosis of the saphenous trunk was observed. The external valvuloplasty of the GSV is a well-known technique that used to treat the superficial venous insufficiency. The newly introduced OSES device seems to show better midterm results, due to a better alignment of the valve flaps. In our experience, the use of this device gives better long-term results and allowed to extend the indication to patients with saphenic diameters that were considered not eligible for repair. In conclusion, although our data needs further confirmation, OSES device might represents a new interesting opportunity for reconstructive venous surgery.

scholarly journals Using radiofrequency ablation for the treatment of lower limb varicose veins

2020 ◽  
Vol 28 ◽  
pp. 82-91
Author(s):  
Nguyen Van Viet Thanh ◽  
Nguyen Hoai Nam
Keyword(s):  
Radiofrequency Ablation ◽  
Lower Limb ◽  
Chronic Venous Insufficiency ◽  
Venous Insufficiency ◽  
Varicose Veins ◽  
Treatment Options ◽  
Lower Extremities ◽  
Endovascular Interventions ◽  
Medication Intervention ◽  
Superficial Venous Insufficiency

Lower limb chronic venous insufficiency is a commonly seen disease which accounted for 40.5% of people over the age of 50 years old with females having 4.25 higher prevalence compared with males [23]. The lesions could be observed in superficial, perforating, deep veins or all three venous systems in the lower extremities [2]. Superficial veins in particular could be classified in 3 groups: chronic venous insufficiency, varicose veins, and thrombophlebitis. The treatment options of lower limb chronic venous insufficiency in general and chronic venous insufficiency – varicose veins are grouped in two major categories: medication/intervention and surgery. Since 1980s-1990s, endovascular interventions for the treatment of superficial venous insufficiency – varicose veins were introduced and were the new advancement in the treatment of lower limb venous insufficiency disorders [3, 7, 11, 12, 16] .

Experience of Using Shear Wave Elastography Imaging in Superficial Venous Insufficiency of the Lower Extremity

2018 ◽  
pp. 1
Author(s):  
Mehmet Sedat Durmaz ◽  
Serdar Arslan ◽  
Ahmet Nihat Baysal ◽  
Funda Gökgöz Durmaz ◽  
Mesut Sivri ◽  
...  
Keyword(s):  
Lower Extremity ◽  
Shear Wave ◽  
Venous Insufficiency ◽  
Shear Wave Elastography ◽  
Superficial Venous Insufficiency

scholarly journals Superficial venous insufficiency from the infernal to the endothermal

2014 ◽  
Vol 96 (1) ◽  
pp. 5-10 ◽  
Author(s):  
D Carradice
Keyword(s):  
Gold Standard ◽  
Venous Insufficiency ◽  
Varicose Veins ◽  
Treatment Options ◽  
Resource Limitation ◽  
Skin Damage ◽  
The Common ◽  
Modern Treatment ◽  
The Cost ◽  
Superficial Venous Insufficiency

This review presents the common diseases associated with superficial venous insufficiency of the leg. These include varicose veins, swelling, skin damage and ulceration. The benefits and rationale behind treatment are discussed, followed by the historical advances from ancient mortality and prayer to the modern endovenous revolution. Finally, an overview of modern treatment options will discuss the evidence supporting the gold standard of endothermal ablation and the cost effectiveness of treatment at this time of challenging resource limitation.

scholarly journals An oral combined contraceptive user with elevated D-dimer post COVID-19: a case report

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Nada A. Alyousefi
Keyword(s):  
Emergency Room ◽  
Lower Limb ◽  
Varicose Veins ◽  
Hormonal Contraception ◽  
Oral Contraception ◽  
Contraceptive User ◽  
Lower Limb Pain ◽  
The Right ◽  
D Dimer ◽  
Ethinyl Oestradiol

Abstract Background This case discusses the challenges created by COVID-19 (coronavirus disease 2019) in the area of hormonal contraception, highlighting the contraception knowledge gap for women in their post COVID-19 period, especially if they had high D-dimer levels. Case presentation This case involves a thirty-eight-year-old woman taking combined oral contraception (desogestrel/ethinyl oestradiol tablets) with a history of varicose veins. She recovered from a COVID-19 infection in November 2020. She presented to the emergency room with right lower-limb pain below the knee and progressive swelling for five days in February 2021. Physical examination of the lower limb showed mild swelling and tenderness of the right leg compared to the left leg. D-Dimer was elevated (1.06 mcg/mL FEU). COVID-19 screening was negative. A Doppler scan to exclude DVT was performed considering the clinical picture and high D-dimer level. There was no evidence of DVT in the right limb. She was reassured and discharged with instructions on when to visit the emergency room. The D-dimer had decreased to 0.53 mcg/mL FEU in March 2021. She booked an appointment with family medicine clinics because she was concerned about the continuation of combined oral contraception (desogestrel/ethinyl oestradiol tablets) with high D-dimer and risk of thrombosis. The follow-up D-dimer level in May 2021 was normal (0.4 mcg/mL FEU). The patient preferred to continue taking oral contraception. Conclusion An evidence-based consensus is needed to guide clinicians in providing contraception counselling for such patients.

Lower Limb Deep Venous Incompetence is Rare in Patients Undergoing Obesity Surgery

2000 ◽  
Vol 15 (1) ◽  
pp. 30-32 ◽  
Author(s):  
A. Westling ◽  
A. Boström ◽  
S. Gustavsson ◽  
S. Karacagil ◽  
D. Bergqvist
Keyword(s):  
Lower Limb ◽  
Venous Insufficiency ◽  
Varicose Veins ◽  
Femoral Vein ◽  
Clinical Signs ◽  
Duplex Ultrasound ◽  
Morbidly Obese ◽  
Obese Patients ◽  
Saphenous Veins ◽  
The Common

Objective: To investigate the incidence of lower limb venous insufficiency in morbidly obese patients. Patients and methods: The study group comprised 125 patients (109 women, 16 men). The median (range) age and body mass index were 35 (19–59) years and 42 (32–68) kg/m2 respectively. Eleven patients had clinical signs of varicose veins or had previously undergone varicose vein surgery. Patients were investigated with duplex ultrasound scanning on the day before surgery. Iliac, femoral, popliteal, and long and short saphenous veins in both legs were studied. Results: A total of 33 patients had abnormal reflux in the superficial veins (>0.5 s). In the deep veins 2 patients had valvular incompetence in the common femoral vein with reflux times of 2 and 0.7 s respectively. At reinvestigation 18 and 24 months after surgery the reflux times were normalised. Conclusion: In this study the incidence of deep venous incompetence in the lower limb in morbidly obese patients is low.

scholarly journals Fatal bleeding caused by a ruptured varicose vein

2020 ◽  
Vol 88 (1) ◽  
pp. 41-44
Author(s):  
Serenella Serinelli ◽  
Luigi Bonaccorso ◽  
Lorenzo Gitto
Keyword(s):  
Varicose Vein ◽  
Venous Insufficiency ◽  
Varicose Veins ◽  
Hypovolemic Shock ◽  
Massive Bleeding ◽  
The Body ◽  
Medical Emergency ◽  
Medial Aspect ◽  
Fatal Bleeding ◽  
The Right

Chronic venous insufficiency is generally not lethal, but massive bleeding from ruptured varicose veins can be fatal. A 79-year-old woman was found dead in her apartment in Rome. Pools of blood and contact pattern bloodstains were observed around the body. She lived alone and suffered from vascular dementia. On the medial aspect of the right leg, a circular ulcer communicating with the lumen of a varicose vein was noted. Death was attributed to hypovolemic shock caused by bleeding from the rupture of the varicose vein. Our case confirms that varicose veins rupture is a potentially fatal medical emergency. Conditions such as dementia may lead to failure to understand the gravity of the bleeding and to seek help. Recognition of this issue is important especially when the care of people suffering from mental illness is involved.

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