scholarly journals Fundamental physiologic concepts of venous hemodynamics and systemic venous return

2020 ◽  
Vol 5 (2) ◽  
Author(s):  
Jovan N Markovic
Keyword(s):  
Venous Insufficiency ◽  
Venous Return ◽  
Substantial Improvement ◽  
Venous System ◽  
Venous Anatomy ◽  
Anatomy And Physiology ◽  
Systemic Venous Return ◽  
The Relationship ◽  
Venous Disorders ◽  
Significant Effort

Understanding the nominal venous anatomy and venous hemodynamics is the first and fundamental step in understanding the pathophysiology of venous disorders. Over the last two decades, significant effort has gone into improving the management of chronic venous disorders resulting in substantial improvement in the management of patients affected by venous insufficiency. Given the continuity of the venous system especially pertinent to the relationship between thoracic, abdominal, pelvic, and infrainguinal venous anatomy, combined with the increasing knowledge we gained regarding hemodynamics of the venous system it is imperative that a comprehensive approach to venous disorders is undertaken that evaluates venous system as a continuum rather than an approach that would evaluate only isolated venous territory affected by a specific venous disorder. Understanding of venous anatomy and physiology, as the basic components for venous hemodynamics, is an essential step to gain insights into venous return concepts, initially described by Dr. Guyton. Dr. Guyton's model represents a fundamental and one of the most significant advancements in our understanding of venous return. This manuscript details essential domains of hemodynamics, which can be useful for validation of our current understanding of systemic venous return.

Varicose veins and chronic venous insufficiency

VASA ◽  
2009 ◽  
Vol 38 (4) ◽  
pp. 293-301 ◽  
Author(s):  
Partsch
Keyword(s):  
Chronic Venous Insufficiency ◽  
Venous Insufficiency ◽  
Varicose Veins ◽  
Single Case ◽  
Clinical Stage ◽  
Clinical Signs ◽  
Venous System ◽  
High Recurrence Rate ◽  
Therapeutic Concepts ◽  
Venous Disorders

Varicose veins are a very frequent disorder with prevalence in our adult population between 14 % for large varices and 59 % for small teleangiectasias. Subjective symptoms may be very non-specific. The term “chronic venous insufficiency (CVI)” defines functional abnormalities of the venous system producing advanced symptoms like oedema, skin changes or leg ulcers. Both entities, varicose veins and CVI, may be summarized under the term “chronic venous disorders” which includes the full spectrum of morphological and functional abnormalities of the venous system. A classification system to describe chronic venous disorders regarding clinical appearance, etiology, anatomical distribution and pathophysiology has been proposed under the acronym of CEAP. The revised version of the CEAP classification contains also definitions of clinical signs and suggests three levels of apparative investigations adjusted to the clinical stage. Concerning the etiology of venous disorders controversial theories exist leading to different therapeutic concepts. As a matter of fact there is a vicious circle between structural changes in valves and venous wall and hemodynamic forces leading to reflux and venous hypertension. Different methods for treating varicose veins are available producing satisfactory early outcome in most cases, but followed by a high recurrence rate after years. Chronic venous insufficiency requires “chronic management”. Compression therapy by bandages for initial treatment of severe stages and maintenance therapy using medical compression stockings is essential. In addition correction of venous refluxes by surgery or endovenous procedures including echo-guided foam sclerotherapy should be considered in every single case.

scholarly journals IS FLAT FOOT A PREVENTABLE FACTOR IN CHRONIC VENOUS INSUFFICIENCY?

2021 ◽  
Vol 9 (02) ◽  
pp. 1000-1003
Author(s):  
Srinivasan a ◽  
Prathap Kumar ◽  
Velladuraichi a ◽  
Ilaya Kumar ◽  
Sritharan b
Keyword(s):  
Risk Factors ◽  
Varicose Vein ◽  
Venous Insufficiency ◽  
Lower Limbs ◽  
Venous Disease ◽  
Flat Foot ◽  
Anatomy And Physiology ◽  
Effective Interventions ◽  
Relationship Of ◽  
The Relationship

The presence of a venous pumping mechanism in the foot may be significant for venous return in the lower extremities. The anatomy and physiology of venous foot pump {VFP} is essential of effective interventions for prevention, treatment, and management of venous disease in the lower limbs. Though many studies have identified the risk factors for prevalence of venous disease, only few have investigated for risk factors for venous disease progression. Therefore, the aim of this study was to investigate the relationship of flatfoot and varicose vein and the progression of venous disease. We did a pilot study on 12 patients with bilateral varicose vein with bilateral pes planus where we presume the cause of CVI is secondary to VFP dysfunction.

Anatomy of the foot venous pump: physiology and influence on chronic venous disease

2012 ◽  
Vol 27 (5) ◽  
pp. 219-230 ◽  
Author(s):  
J-F Uhl ◽  
C Gillot
Keyword(s):  
Venous Insufficiency ◽  
Venous Return ◽  
Functional Unit ◽  
Anatomical Study ◽  
Venous System ◽  
Chronic Venous Disease ◽  
Venous Disease ◽  
Posterior Tibial ◽  
True Blood ◽  
Foot Disorder

The aim of this paper is to demonstrate the location of the venous foot pump using an anatomical study. Four hundred cadaveric feet were injected with green neoprene latex followed by a dissection. A coloured segmentation of the venous system was achieved. The Lejars’ concept of the venous sole of the foot is incorrect: the true blood venous reservoir of the foot is located deeply in the plantar veins, between the plantar muscles. The medial and mostly lateral plantar veins converge into the plexus shaped calcaneal crossroad, where the blood is ejected upwards into the two posterior tibial veins. In addition, the several medial perforators of the foot directly connect the deep system (medial plantar veins) to the superficial venous system (medial marginal vein). This forms a true ‘medial functional unit’ which is unique in the limb given its directional flow is from deep to superficial. In conclusion, the plantar veins play an important role in the physiology of the venous return since a venous reservoir of 25 mL of blood is mobilized upwards with each step during walking. Therefore, the impairment of the foot pump by a static foot disorder should be considered as an important risk factor for chronic venous disease, and should be evaluated and corrected in any patient with venous insufficiency.

Chronic cerebrospinal venous insufficiency is not associated with chronic venous disorders: A case–control study

2014 ◽  
Vol 30 (10) ◽  
pp. 736-738
Author(s):  
Maurizio A Leone ◽  
Olga Raymkulova ◽  
Piergiorgio Lochner ◽  
Laura Bolamperti ◽  
Gianandrea Rivadossi ◽  
...  
Keyword(s):  
Family History ◽  
Venous Insufficiency ◽  
Ad Hoc ◽  
Varicose Veins ◽  
Color Doppler ◽  
Chronic Cerebrospinal Venous Insufficiency ◽  
History Of ◽  
The Relationship ◽  
Venous Disorders ◽  
Control Study

Objectives To evaluate the relationship between chronic cerebrospinal venous insufficiency (CCSVI) and the presence of a Chronic Venous Disorder (CVD). Method We included 55 subjects with CCSVI aged >18 years, and 186 controls without CCSVI. Each subject was evaluated with color Doppler sonography in accordance with Zamboni’s five criteria, examined by two neurologists and interviewed with an ad-hoc designed form. The neurologists and the sonographers were mutually blinded. CVD were classified according to CEAP. Results Mean age was 42 years (SD = 9) in cases and 43 years (10) in controls ( p = ns). The odds ratios in subjects CCSVI were 0.6 (0.2–2.2) for CEAP 1, 0.9 (0.2–4.5) for CEAP 2, and 1.0 (0.6–1.9) for family history of varicose veins. The prevalence of CVD and, family history of varicose veins, was similar between cases and controls for each Zamboni criterion. Conclusions We found no association of CCSVI with the presence of CVD or family history of varicose veins.

scholarly journals Physical Examination and Ultrasound Evaluation of Patients with Superficial Venous Disease

2021 ◽  
Vol 38 (02) ◽  
pp. 167-175
Author(s):  
Leigh C. Casadaban ◽  
John M. Moriarty ◽  
Cheryl H. Hoffman
Keyword(s):  
Physical Examination ◽  
Venous Insufficiency ◽  
Duplex Ultrasonography ◽  
Venous Disease ◽  
Venous Anatomy ◽  
Ultrasound Evaluation ◽  
Clinical Presentations ◽  
Ultrasound Assessment ◽  
Anatomic Variants ◽  
Tools And Techniques

AbstractSystematic and standardized evaluation of superficial venous disease, guided by knowledge of the various clinical presentations, venous anatomy, and pathophysiology of reflux, is essential for appropriate diagnosis and optimal treatment. Duplex ultrasonography is the standard for delineating venous anatomy, detecting anatomic variants, and identifying the origin of venous insufficiency. This article reviews tools and techniques essential for physical examination and ultrasound assessment of patients with superficial venous disease.

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