scholarly journals AN ALTERNATE MODALITY OF STRIPPING OF VARICOSE VEINS

2021 ◽  
Vol 9 (06) ◽  
pp. 735-738
Author(s):  
Khulem Stellone Singh ◽  
Midhun Chowdary Kothari ◽  
Shilpa Patankar ◽  
Pankaj Bansode
Keyword(s):  
Risk Factors ◽  
Clinical Examination ◽  
Lower Limb ◽  
Clinical Condition ◽  
Varicose Veins ◽  
Systemic Disease ◽  
Abdominal Pressure ◽  
Prolonged Standing ◽  
Below The Knee ◽  
Left Lower Limb

Varicose veins are very common clinical condition characterised by permanently dilated torturous elongated veins in the leg which is due to incompetence of valves. Risk factors being heredity, occupations of prolong standing, immobility, raised intra abdominal pressure, raised progesterone level, altered oestrogen-progesterone ratio etc. A 27 years old patient with no h/o any systemic disease or co morbidities came with complaints of dilated, tortuous veins in the left lower limb extending from mid-thigh to ankle region since 2 months. Since 1 month the patient was having dull aching pain over the left lower limb on walking and prolonged standing. A thorough clinical examination was done with findings of incompetent Sapheno-femoral junction(SFJ) and perforator incompetence of the left lower limb. A venous Doppler of the left lower limb revealed SFJ dilated and incompetent and Incompetent perforators along the GSV 5 cm below the knee. Following all routine preoperative work-ups, patient was posted for surgery. After ligating all the tributarirs of GSV, while checking the metallic stripper, it snapped in between and was not in a useable condition and there was no other metallic stripper in the OT. Decision had to be taken for an alternative the GSV was sucessfully stripped using a 14F Neltons catheter. Thus as an alternative to metallic stripper, a Neltons catheter can also be used for stripping varicose veins.

scholarly journals Saphenous Ladder Formed by Almost Completely Duplicated Great Saphenous Vein

2020 ◽  
Vol 18 (1) ◽  
pp. 99-101
Author(s):  
Vasanthakumar Packiriswamy ◽  
Satheesha B Nayak
Keyword(s):  
Saphenous Vein ◽  
Lower Limb ◽  
Great Saphenous Vein ◽  
Varicose Veins ◽  
Femoral Vein ◽  
Saphenous Veins ◽  
Left Lower Limb ◽  
Male Cadaver ◽  
Complete Duplication ◽  
Femoral Triangle

Knowledge of normal as well as variant great saphenous vein is useful as it is the vein that can get varicosed; the vein that is used in bypass surgeries and the vein that is used for cannulation purpose. We observed almost complete duplication of the great saphenous vein in the left lower limb of an adult male cadaver. Both the great saphenous veins arose from the medial end of the dorsal venous arch and coursed parallel to each other throughout the limb. They united in the femoral triangle to form a short (1 inch long) common great saphenous vein. Common great saphenous vein terminated into the femoral vein. There were four communicating veins connecting the two great saphenous veins in the leg, giving the appearance of a venous ladder. Knowledge of this variation could be extremely useful in treatment of varicose veins of lower limb, in catheterizations and in various surgical procedures of the lower limb.

Photosensitivity During Quinolone Therapy in Diabetic Foot Patients May Falsely Indicate Treatment Failure

2020 ◽  
pp. 153473462095897
Author(s):  
Chariclia V. Loupa ◽  
Evangelia Meimeti ◽  
Eleftherios D. Voyatzoglou ◽  
Andriana Donou ◽  
Sophia Kalantzi ◽  
...  
Keyword(s):  
Treatment Failure ◽  
Clinical Examination ◽  
Lower Limb ◽  
Diabetic Foot ◽  
Sun Exposure ◽  
The Body ◽  
Skin Structure ◽  
Left Limb ◽  
Left Lower Limb

Acute bacterial skin and skin structure infections (ABSSSI), also referred to as skin and soft tissue infections, or skin and skin structure infections, with or without osteomyelitis (OM) in diabetic foot are complications of diabetes. Quinolones are a widely used class of antibiotics in ABSSSI and OM, and photosensitivity is among their adverse reactions. Its appearance may falsely indicate treatment failure. We describe 2 such cases. The first patient is a 49-year-old male with type 2 diabetes mellitus (DM), who presented with left lower limb ulcer with fever (39 °C) over a week. He began treatment with ciprofloxacin, clindamycin, and linezolid. Although his clinical condition and laboratory tests improved, the redness of the left lower limb increased. Clinical examination revealed redness on the face and the parts of the body that had been exposed to sunlight. The patient continued the same antimicrobial therapy and was given instructions to avoid exposure to sunlight. Redness and infection improved, and the patient was discharged. The second case is a 72-year-old male with a history of type 2 DM, admitted to hospital because of an infected ulcer of the first toe of the right limb. The patient received intravenous treatment with levofloxacin and clindamycin. On the fourth hospital day, the patient presented redness (with eczematous plaques) on his left lower limb. Clinical examination revealed that the patient’s bed was placed near a window and his left limb was exposed to direct sunlight. Patient’s bed was changed to avoid sun exposure. Symptoms began to improve over the next few days.

Epidemiology of chronic venous disease

2008 ◽  
Vol 23 (3) ◽  
pp. 103-111 ◽  
Author(s):  
L Robertson ◽  
C Evans ◽  
F G R Fowkes
Keyword(s):  
Risk Factors ◽  
Varicose Veins ◽  
Adult Population ◽  
Chronic Venous Disease ◽  
Western World ◽  
Venous Disease ◽  
Venous Ulceration ◽  
Prolonged Standing ◽  
True Incidence ◽  
Disease Definition

Chronic venous disease of the legs occurs commonly in the general population in the Western world. Estimates of the prevalence of varicose veins vary widely from 2–56% in men and from 1–60% in women. These variations reflect differences in variability of study populations including age, race and gender, methods of measurement and disease definition. Definitions of chronic venous disease may rely on reports of varicose veins by study participants, based on self-diagnosis or recall of a diagnosis, or on a standardized physical examination. Venous ulceration is less common, affecting approximately 0.3% of the adult population. Age and pregnancy have been established as risk factors for developing varicose veins. Evidence on other risk factors for venous disease is inconclusive. Prolonged standing has been proposed, but results of studies should be interpreted with caution given the difficulty in measuring levels of posture. Obesity has been suggested as a risk factor in women, but appears to be an aggravating factor rather than a primary cause. Other postulated risk factors include dietary intake and smoking, but evidence is lacking. Longitudinal studies using standardized methods of evaluation are required before the true incidence of chronic venous disease and associated risk factors can be determined.

scholarly journals Childhood Varicose Veins–An Unusual Visceral “May–Thurner” Like Compression

2021 ◽  
Author(s):  
Sreenivasa Narayana Raju ◽  
Rengarajan Rajagopal ◽  
Niraj Nirmal Pandey ◽  
Amarinder Singh ◽  
Sanjeev Kumar
Keyword(s):  
Lower Limb ◽  
Varicose Veins ◽  
Color Doppler ◽  
Left Kidney ◽  
Iliac Vein ◽  
Common Iliac Vein ◽  
Left Common Iliac Vein ◽  
Left Lower Limb ◽  
Limb Edema ◽  
Lateral Decubitus

AbstractWe report the case of 8-year-old girl with left lower limb edema due to superficial venous incompetence and varicosities. Color Doppler demonstrated compression of the left common iliac vein by an ectopic left kidney, which was partly relieved in right lateral decubitus position. CT demonstrated ectopic malrotated pelvic kidney, compressing the left common iliac vein against the L5 vertebra. A “May–Thurner” like syndrome due to visceral compression needs to be suspected in children with unilateral left lower limb varicosities.

scholarly journals Lower limb in the preparticipation examination (PPE)

2019 ◽  
Vol 67 (3) ◽  
Keyword(s):  
Risk Factors ◽  
Lower Extremity ◽  
Musculoskeletal Disorders ◽  
Clinical Examination ◽  
Lower Limb ◽  
Dynamic Testing ◽  
Joint Function

This article described the clinical examination of the lower extremity during a pre-participation screening in regard of sports ability, presence of injuries and musculoskeletal disorders as well as predisposing risk factors for injuries and prevention. It divided into global static and dynamic testing but also isolated analysis of joint function.

scholarly journals A neonate with Klippel–Trénaunay syndrome: a case report 

2021 ◽  
Vol 15 (1) ◽  
Author(s):  
Franck Katembo Sikakulya ◽  
Walufu Ivan Egesa ◽  
Sonye Magugu Kiyaka ◽  
Philip Anyama
Keyword(s):  
Lower Limb ◽  
Varicose Veins ◽  
Color Doppler ◽  
Color Doppler Ultrasound ◽  
Port Wine ◽  
Black African ◽  
Port Wine Stains ◽  
Left Lower Limb ◽  
Clinical Triad ◽  
Klippel Trenaunay Syndrome

Abstract Background Klippel–Trénaunay syndrome is a rare congenital capillary–lymphatic–venous condition characterized by the clinical triad of capillary malformations (port wine stains), varicose veins with or without venous malformations, and bony and/or soft-tissue hypertrophy. It has a very low incidence of about 1:100,000. Case presentation We report the case of 21-day-old neonate Black African female (born in Uganda) with Klippel–Trénaunay syndrome who presented with macrodactyly and ectrodactyly on the left foot, as well as numerous port wine stains on the left thoracoabdominal region and anteroposterior left lower limb. Color Doppler ultrasound examination of the left lower limb and abdomen revealed varicose veins without signs of arteriovenous fistula. Conclusion The report presents the case of a neonate with a rare congenital vascular disorder type Klippel–Trénaunay syndrome.

scholarly journals TO EVALUATE THE EFFECTIVENESS OF STRUCTURED TEACHING PROGRAMME ON KNOWLEDGE REGARDING VARICOSE VEINS AND ITS PREVENTION AMONG OT AND ICU STAFF NURSES

2021 ◽  
Vol 8 (3) ◽  
Author(s):  
Mr. Abhimanyu Sharma sharma ◽  
Dr. Rajendra Prasad Sharma sharma ◽  
Dr. Rajendra Prasad Sharma sharma
Keyword(s):  
Risk Factors ◽  
Varicose Veins ◽  
Staff Nurses ◽  
Venous Disease ◽  
Human Beings ◽  
Vein Wall ◽  
Teaching Programme ◽  
Prolonged Standing ◽  
Vein Thrombosis ◽  
Deep Vein

Many factors predispose human beings to a disease of the lower extremities, and this condition affects approximately eighty million Americans. Itsmanifestations may appear to be little more than a cosmetic nuisance, yet it may be an indication of a more serious underlying problem undetected by visual inspection. Venous disease is also capable of producing a plethora of uncomfortable symptoms, and left untreated, may progress to cutaneous pigmentation, dermatitis, ulceration, haemorrhage, or superficial thrombophlebitis. Although uncomplicated cases of the disease are more common, venous disease should not be taken lightly. Steps to retard disease expression and progression should be implemented whenever possible. As blood rushes through our legs the veins send it back to the heart. In case of prolonged standing, due to force of gravity the veins lose their ability to push the blood upwards, causing the blood to settle down in certain areas of the veins. Varicose veins are tortuous, distended and bulging vein s (varicosities) beneath the skin of the legs. They are most often swollen and gnarled veins that most frequently occur in the legs, ankles and feet. Even though the exact cause of varicose veins is unknown, there are some risk factors which contribute to development of this problem. Some of the risk factors are, low physical activity, smoking, family heredity of varicose veins, congenital valve or vein wall defects, valve damage from trauma, obstruction, deep vein thrombosis (DVT) or inflammation, chronic venous distention associated with occupations requiring prolonged standing, obesity or pregnancy, systemic conditions that interfere with venous return and loss of vein wall elasticity with ageing.

scholarly journals Lower limb venous and arterial peripheral diseases and work conditions: systematic review

2020 ◽  
Vol 78 (1) ◽  
pp. 4-14
Author(s):  
Samantha Huo Yung Kai ◽  
Jean Ferrières ◽  
Camille Carles ◽  
Marion Turpin ◽  
François-Xavier Lapébie ◽  
...  
Keyword(s):  
Systematic Review ◽  
Peripheral Arterial Disease ◽  
Lower Limb ◽  
Observational Studies ◽  
Varicose Veins ◽  
Work Conditions ◽  
Arterial Disease ◽  
Prolonged Standing ◽  
Peripheral Arterial

ObjectivesThe individual peripheral vascular disease risk factors are well documented, but the role of work conditions remains equivocal. This systematic review aims to assess relationships between lower limb peripheral venous diseases (lower limb varicose veins (LLVV), venous thromboembolism (VTE) comprising deep vein thrombosis and pulmonary embolism), peripheral arterial disease (intermittent claudication, aortic dissection, aortic aneurysm) and occupational constraints among working adults.MethodsSeveral databases were systematically searched until February 2019 for observational studies and clinical trials. Preferred Reporting Items for Systematic Reviews and Meta-Analyses method was used for article selection. Quality assessment and risk of bias were evaluated using Strengthening the Reporting of Observational Studies in Epidemiology and Newcastle-Ottawa scales.ResultsAmong the 720 screened articles, 37 remained after full-text evaluation. Among the 21 studies on LLVV, prolonged standing was significantly associated to a higher risk of varicose veins with a threshold probably around >3 to 4 hours/day but exposure duration in years was not sufficiently considered. Seated immobility was often observed in workers, with no sufficient evidence to prove that prolonged sitting at work is related to VTE. Carrying heavy loads, stress at work and exposure to high temperatures have emerged more recently notably in relation to varicose veins but need to be better explored. Only three studies discussed the potential role of work on peripheral arterial disease development.ConclusionsAlthough some observational studies showed that prolonged standing can be related to varicose veins and that seated immobility at work could be linked to VTE, very little is known about peripheral arterial disease and occupational constraints. Clinical trials to determine preventive strategies at work are needed.PROSPERO registration numberCRD42019127652.

scholarly journals May–Thurner syndrome, a diagnosis to consider in young males with no risk factors: a case report and review of the literature

2021 ◽  
Vol 15 (1) ◽  
Author(s):  
Joel Zhen Khang Hng ◽  
Shu Su ◽  
Noel Atkinson
Keyword(s):  
Risk Factors ◽  
Deep Vein Thrombosis ◽  
Endovascular Treatment ◽  
Computer Tomography ◽  
Lower Limb ◽  
Iliac Vein ◽  
Common Iliac Vein ◽  
Vein Thrombosis ◽  
Left Lower Limb ◽  
Deep Vein

Abstract Background May–Thurner syndrome is an anatomical condition characterized by compression of the left common iliac vein by the right common iliac artery, causing venous outflow obstruction. It is an uncommon cause of deep vein thrombosis and is more prevalent among women. This paper highlights the importance of considering May–Thurner syndrome in young males without risk factors presenting with left lower limb pain, as endovascular treatment may be required. Case presentation A 23 year-old Caucasian male presented with a 1-week history of left lower limb pain, edema, and pallor. He was found to have an unprovoked deep vein thrombosis on Doppler ultrasound involving the left fibular, soleus, gastrocnemius, popliteal, femoral, common femoral, and external iliac veins. A heparin infusion was commenced as the initial treatment for deep vein thrombosis. Further investigation with computer tomography pulmonary angiogram and computer tomography venography of the abdomen and pelvis showed bilateral pulmonary emboli and left common iliac vein compression with left common, internal, and external iliac vein thrombosis. He was diagnosed with May–Thurner syndrome despite having no risk factors. A retrievable Cook Celect Platinum inferior vena cava filter was placed, and thrombus of the left common femoral, external, and common iliac veins was treated successfully with AngioJet thrombectomy, thrombolysis using 200,000 units of urokinase, angioplasty and stenting using two Cook Zilver Vena venous self-expanding stents. Therapeutic enoxaparin was commenced on discharge. His filter was removed after 10 weeks. Hematological follow-up 4 months later showed an overall negative thrombophilia screen, and anticoagulation was switched to apixaban. He has had no recurrent thrombosis. Conclusions Clinicians should have a low threshold to investigate for May-Thurner syndrome in patients with left lower limb venous thrombotic events regardless of risk factors, as endovascular treatment may be required to minimize the long-term sequelae of deep vein thrombosis. Duplex ultrasound can be used initially for diagnosis, and computer tomography venography used subsequently if the common iliac vein is not visualized on ultrasound. Endovascular treatment is preferred over anticoagulation alone, especially in otherwise fit patients presenting early, the aim being to reduce the chances of chronic venous hypertension in the lower limb.

Pathogenesis of varicose veins - lessons from biomechanics

VASA ◽  
2014 ◽  
Vol 43 (2) ◽  
pp. 88-99 ◽  
Author(s):  
Larissa Pfisterer ◽  
Gerd König ◽  
Markus Hecker ◽  
Thomas Korff
Keyword(s):  
Risk Factors ◽  
Venous Insufficiency ◽  
Varicose Veins ◽  
Wall Stress ◽  
Filling Pressure ◽  
Venous Hypertension ◽  
Venous Disease ◽  
Prolonged Standing ◽  
Venous Filling ◽  
Venous Wall

The development of varicose veins or chronic venous insufficiency is preceded by and associated with the pathophysiological remodelling of the venous wall. Recent work suggests that an increase in venous filling pressure is sufficient to promote varicose remodelling of veins by augmenting wall stress and activating venous endothelial and smooth muscle cells. In line with this, known risk factors such as prolonged standing or an obesity-induced increase in venous filling pressure may contribute to varicosis. This review focuses on biomechanically mediated mechanisms such as an increase in wall stress caused by venous hypertension or alterations in blood flow, which may be involved in the onset of varicose vein development. Finally, possible therapeutic options to counteract or delay the progress of this venous disease are discussed.

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