scholarly journals SELECTION OF SURGICAL TACTICS FOR TREATMENT OF NON-APHENIC VARICOSIS ON THE RESULTS OF US-DIAGNOSTICS OF THE VENES OF THE LOWER LIMBS

2021 ◽  
pp. 18-21
Author(s):  
A. Novikova ◽  
I. B. Babinkina ◽  
G. P. Babinkina ◽  
L. V. Provar ◽  
О. A. Golovina
Keyword(s):  
Doppler Ultrasound ◽  
Venous Insufficiency ◽  
Varicose Veins ◽  
Treatment Protocol ◽  
Venous System ◽  
Lower Limbs ◽  
Ultrasound Doppler ◽  
Surgical Tactics ◽  
Selection Of

Purpose of research. Determination of variants of the anatomical structure of non-saaphenic veins and pathological anastomoses in varicose enlargement of atypical venous basins with ultrasound Doppler of the veins of the lower extremities, including as sources of pathological venous reflux, as well as the importance of insolvent veins — perforants and non-saaphenic veins — in the formation of venous insufficiency to clarify the treatment protocol. Materials and methods. The venous system was studied in 2348 pa tients, including both patients with various pathologies of the venous system, including those with varicose veins, and those in whom the pathology of the veins was not detected by Doppler ultrasound. Research results and discussion. Surgical treatment for non-safenic varicose veins includes phlebectomy, sclerotherapy and Muller-Vara di minifblektomy, depending on the diameter of the affected nonsafenic vein. Conclusions. The specialists’ understanding of the variants of nonsafenic varicose veins, as well as adherence to the full research protocol for ultrasound Doppler ultrasound of the veins, allows us to provide detailed information in order to determine the most effective treatment tactics and prevention of relapses and complications of the disease.

scholarly journals Klippel–Trénaunay Syndrome – A Very Rare and Interesting Syndrome

2015 ◽  
Vol 9 ◽  
pp. CCRPM.S21645 ◽  
Author(s):  
Deepak Sharma ◽  
Sachin Lamba ◽  
Aakash Pandita ◽  
Sweta Shastri
Keyword(s):  
Soft Tissue ◽  
Vascular Malformation ◽  
Chronic Venous Insufficiency ◽  
Venous Insufficiency ◽  
Varicose Veins ◽  
Lower Limbs ◽  
Port Wine ◽  
Bone Deformity ◽  
Klippel Trenaunay Syndrome

Klippel–Trénaunay syndrome (KTS or KT) is an infrequently seen dermatological syndrome, which is often viewed as a triad of vascular malformation (capillary malformations or port-wine brands), venous varicosity, and soft tissue and/or bony hypertrophy. We report a case of a 12-year-old male who presented to us with the symptoms of varicose plaques over both lower limbs and was diagnosed as a case of KTS. Management is normally conservative and includes stockings for compression of the branches to reduce edema because of chronic venous insufficiency; modern devices that cause on and off pneumatic compression; and rarely, surgical correction of varicose veins with lifelong follow-up. The orthopedic abnormalities are treated with epiphysiodesis in order to prevent (stop) overgrowing of limb and correction of bone deformity.

scholarly journals Elastic compression treatment of chronic superficial venous insufficiency of the lower limbs based on Doppler venous pressure index measurements

2015 ◽  
Vol 4 (1) ◽  
Author(s):  
Leonardo Corcos ◽  
Daniele Pontello ◽  
Tommaso Spina
Keyword(s):  
Venous Insufficiency ◽  
Varicose Veins ◽  
Venous Pressure ◽  
Lower Limbs ◽  
Compression Stockings ◽  
Elastic Compression ◽  
Pressure Index ◽  
Counter Pressure ◽  
The Difference ◽  
Compression Treatment

Ineffectiveness or discomfort from graduated elastic compression stockings (GES) in patients with chronic venous insufficiency (CVI) and/or varicose veins of the lower limbs (VVLL) can depend of inappropriate counter pressure applied. Counter pressure was calculated by Doppler venous pressure index (VPI). The aim of this study was to verify the value VPI in the choice of GES. A total of 1212 LL of 606 patients subjected to VPI measurements VPI correlated with the various sites of reflux (R) and C of Clinical-Etiology-Anatomy-Pathophysiology (CEAP) classification. The difference between standing VPI the and normal values=counter pressure to be applied by GES. Questionnaire to 96 patients with CVI/VVLL wearing GES. Mean VPI values: greater saphenous (GSV)>smaller saphenous; GSV with isolated venous reflux (R) at the leg>GSV at the thigh; additional R in perforators increases VPI in all the districts; superficial R increases VPI in PT. Relation between VPI/C of CEAP: P<0.05-0.0001; 81/83/96 (97.5%) patients improved; 0 complained. R in GSV at the leg and in perforators increases VPI in deep veins. Few discrepancies VPI/CEAP can be expected. Standing VPI is highly predictive. The best choice of GES can be based on the VPI measurement.

scholarly journals LivRelief varicose veins cream in the treatment of chronic venous insufficiency of the lower limbs: A 6-week single arm pilot study

PLoS ONE ◽  
2018 ◽  
Vol 13 (12) ◽  
pp. e0208954
Author(s):  
Heather C. Dwyer ◽  
David C. Baranowski ◽  
Perry V. Mayer ◽  
Simona Gabriele
Keyword(s):  
Pilot Study ◽  
Chronic Venous Insufficiency ◽  
Venous Insufficiency ◽  
Varicose Veins ◽  
Lower Limbs

Anatomical Patterns in Varicose Vein Disease: A Duplex Scanning Study

1995 ◽  
Vol 10 (3) ◽  
pp. 94-97 ◽  
Author(s):  
J. J. Guex ◽  
B. Hiltbrand ◽  
J. M. Bayon ◽  
F. Henri ◽  
F. A. Allaert ◽  
...  
Keyword(s):  
Saphenous Vein ◽  
Venous Insufficiency ◽  
Varicose Veins ◽  
Previous Treatment ◽  
Lower Limbs ◽  
Duplex Scanning ◽  
Consecutive Series ◽  
Yield Data ◽  
Varicose Disease ◽  
Vein Disease

Objectives: To determine symptomatology, clinical class, and topographic patterns of varicose veins in a consecutive series of patients with venous complaints. Methods: We performed clinical examination and duplex scanning of 498 lower limbs in 317 patients with obvious varicose veins for whom no previous treatment had been undertaken. Results: Classes of chronic venous insufficiency (CVI) in 498 legs: grade 0: 117 (23.5%); gr 1: 310 (62.2%); gr 2: 47 (9.4%); gr 3: 24 (4.8%). Duplex-detected venous reflux was found in the greater saphenous vein territory (junction or trunk or related perforator or main tributary) in 423 limbs (85.3%) the sapheno-femoral junction was incompetent in only 342 legs (68.7%). Reflux was found in the lesser saphenous vein territory in 100 limbs (20.1%) and in sapheno-popliteal junction in 92 (18.5%). Strictly non saphenous origin of varicosities was found in 31 limbs (6.2%). Deep venous incompetence was found in 48 legs (9.6%). Conclusions: These findings yield data on the distribution and occurence of lower limbs venous lesions in patients with varicose disease.

scholarly journals CHOICE OF TACTICS OF SURGICAL TREATMENT OF VARICOSE DISEASE DEPENDING ON THE VARIANT OF THE ANATOMICAL STRUCTURE OF SAPHENO-POPLITEAL ANASTOMOSIS IN DOPPLEROMETRY OF THE VENES OF THE LOWER LIMBS

2020 ◽  
pp. 31-35
Author(s):  
I. B. Babinkina ◽  
G. A. Novikova ◽  
G. P. Babinkina
Keyword(s):  
Saphenous Vein ◽  
Surgical Intervention ◽  
Varicose Veins ◽  
Disease Recurrence ◽  
Anatomical Structure ◽  
Venous System ◽  
Lower Limbs ◽  
Laser Coagulation ◽  
Perforating Veins ◽  
Below The Knee

Summary. The aim of the study is to determine the variants of the anatomical structure of the saphenopliteal anastomosis in ultrasound Doppler of the veins of the lower extremities, including as sources of pathological blood reflux in varicose veins of the small saphenous vein basin, and the importance of insolvent veins in the formation of insufficiency in the small saphenous vein basin to clarify the further protocol treatment. Materials and methods. The venous system of 2348 patients was studied, including both patients with various pathologies of the venous system, including those with varicose veins, and those in whom the pathology of the veins was not detected by USDG. Results and discussion. In patients with USDG, various anatomical variants of the structure of the sapheno-popliteal anastomosis were found. The anastomosis may look like a perforating vein and have a fairly sharp angle of deviation from the trunk. In these cases, it is recommended to conduct an open surgical intervention, namely: crossectomy — ligation and transection of the small saphenous vein, striping — removal of the trunk of the small saphenous vein, ligation of insolvent communicative veins, miniflebectomy - removal of varicose nodes through punctures. The smooth course of the sapheno-popliteal anastomosis was found in 58.0 % of the subjects and did not depend on the level of the anastomosis. In such cases, the option of choice for surgical intervention was minimally invasive technologies: laser coagulation, radiofrequency ablation, as well as combined phlebectomy, which includes the following stages - removal of varicose inflows of the small saphenous vein and elimination of incompetent perforating veins. Indirect variants of the anastomosis turned out to be frequent, for example, through the sural or nonsaphenic vein with the presence of additional venous vessels (up to 18.0 % of those studied). In these cases, the level of the anastomosis was also formed below the knee joint gap. According to the USDG data, the anatomical absence of the sapheno-popliteal anastomosis was found only in 142 patients, which is less than 1.0 %. In such patients, a search and elimination of pathological reflux is performed, which leads to the development of varicose veins in the system of the small saphenous vein. Its varicose inflows are removed and insolvent perforating veins are eliminated. Conclusion. The specialists’ understanding of the variants of the structure of the saphenopliteal anastomosis in normal and pathological conditions, as well as the observance of the full examination protocol for venous ultrasonography, allows providing detailed information in order to determine the most effective treatment tactics and prevention of disease recurrence.

scholarly journals Study to compare open surgery, endovenous thermal ablation and ultrasound guided foam sclerotherapy for treatment of varicose veins

2016 ◽  
Vol 18 (3) ◽  
pp. 58
Author(s):  
Sandeep Raj Pandey
Keyword(s):  
Clinical Outcome ◽  
Thermal Ablation ◽  
Open Surgery ◽  
Venous Insufficiency ◽  
Varicose Veins ◽  
Venous System ◽  
Ultrasound Guided ◽  
Foam Sclerotherapy ◽  
Same Day Discharge ◽  
Endovenous Thermal Ablation

Introduction and Objective: To compare open surgery, Endovenous thermal ablation(EVTA) and ultrasound(USG) guided foam sclerotherapy for primary superficial venous insufficiency(PVI) with respect to obliteration of superficial venous system at 3 months, clinical outcome and cost.Materials and Methods: Between January 2015 to January 2016, all patients with symptomatic PVI of lower limbs who were willing for definitive management were randomized to open surgery (n=20), EVTA (n=40) or ultrasound guided foam sclerotherapy (n=20). In foam sclerotherapy group, review USG was done at 1 week and if necessary re-injection was done. The patients in all the groups underwent review USG at 3 months. Obliteration of superficial venous system, clinical outcome and costs were registered.Results: 5 patients in foam sclerotherapy group required re-injection at 1 week. Superficial venous system was obliterated in all the patients of all the groups at 3 months. Improvement in clinical score was similar in all groups. The foam sclerotherapy group had less frequent analgesia intake, earlier return to normal activity and lower cost. Local complication rate was slightly higher in foam sclerotherapy group.Conclusion: Foam sclerotherapy is a cheaper alternative to open surgery & EVTA for PVI with respective to early measures of clinical outcome. USG guided sclerotherapy demonstrated to be a safe and effective procedure for the treatment of chronic venous insufficiency. The observed complications were minimal and most of the patients reported satisfaction with the treatment outcomes. If patient have no cost issue, endovenous thermal ablation of varicose veins is better than open surgery & foam sclera in context of minimally invasive, cosmetic, less pain, no incisions, early ambulation & same day discharge.

Telangiectases in Venous Insufficiency: Point of Reflux and Treatment Strategy

2000 ◽  
Vol 15 (1) ◽  
pp. 38-42 ◽  
Author(s):  
F. Mariani ◽  
V. Bianchi ◽  
S. Mancini ◽  
S. Mancini
Keyword(s):  
Venous Insufficiency ◽  
Duplex Ultrasound ◽  
Average Diameter ◽  
Venous System ◽  
Lower Limbs ◽  
Perforating Veins ◽  
Ceap Classification

Objective: To verify the role of sources of non-saphenous reflux in the appearance of reticular varices and telangiectases in areas other than the lateral venous system of Albanese. Setting: Institute of General Surgery and Surgical Specialisations, Interdepartmental Centre of Research, Treatment and Phlebolymphological Rehabilitation, University of Siena. Patients and methods: The study was carried out on 106 women aged 18–65 years who were affected by chronic venous insufficiency (CVI) at the Cla-s Ep Asl stage, according to the CEAP classification. The patients had telangiectases (200 telangiectactic areas) and reticular varices of the lower limbs of type II and III of the classification of Weiss, with competent saphenous trunks and a normal deep venous system. Sclerotherapy was therefore performed, after clinical and duplex ultrasound examination. The records of 185 telangiectactic area treated 3 years earlier were reviewed. Results: In all cases reticular varices was found together with the telangiectases. In 73.5% (147/200 areas) one or more incompetent perforating veins was found (average diameter 1.6 mm) and in 83.6% (123/147 areas) it was possible to establish that the main source of reflux was in the base of the telangiectasia. Complete elimination of microvarices was achieved in 88% of cases (176/200 areas; average sessions: 3.5). The complications were haemosiderin pigmentation (1.5%, 3/200 areas) and matting (1%, 2/200 areas). In 24 areas resistant to the therapy it was not possible to demonstrate the presence of reflux, while in 24.5% of cases (49/200 areas, average surface 15.4 cm2) two sessions of sclerotherapy were sufficient eventually to obtain (about 4 weeks later) the disappearance of the micro-varices. Follow-up after 3 years revealed the appearance of new telangiectases in 58.9% of cases (109/185 check-ups). Of these 95.4% (104/109) arose in areas other than those treated and therefore only 4.6% (5/109) recurred in the area where the sclerosing treatment had been carried out. Conclusion: In CVI all telangiectases are accompanied by reticular varices, even when not visible on clinical examination; in most cases the sources of reflux are distinguishable as incompetent perforating veins and are situated beneath telangiectactic efflorescences.

Considerations of the Anatomical Variations in the Venous System of the Lower Limbs in Varicose Disease

1989 ◽  
Vol 4 (4) ◽  
pp. 259-270 ◽  
Author(s):  
L. Corcos ◽  
G.P. Peruzzi ◽  
V. Romeo ◽  
C. Fiori
Keyword(s):  
Surgical Treatment ◽  
Varicose Veins ◽  
Anatomical Variations ◽  
Venous System ◽  
Lower Limbs ◽  
Intraoperative Diagnosis ◽  
Varicose Disease

The Authors experience in the surgical treatment of varicose veins of the lower limbs in the last 15 years, performed on 1500 cases, show that varicose recurrence may be nearly always attributed to unrecognised anatomical variations in the venous system. Methods of preoperative and intraoperative diagnosis are described and the most frequent variants observed are presented and their significance are discussed.

Expression of adhesion molecules on leukocytes of patients with chronic venous insufficiency

Phlebologie ◽  
2002 ◽  
Vol 31 (03) ◽  
pp. 63-68
Author(s):  
E. Jahnová ◽  
P. Labasˇ ◽  
S. Weissová ◽  
M. Horváthová ◽  
M. Ferencík ◽  
...  
Keyword(s):  
Adhesion Molecules ◽  
Chronic Venous Insufficiency ◽  
Venous Insufficiency ◽  
Varicose Veins ◽  
Ulcus Cruris ◽  
Lower Limbs ◽  
Hla Dr ◽  
Activated T Lymphocytes ◽  
Primary Varicose Veins ◽  
Monocytes And Lymphocytes

SummaryAim: We studied if the expression and release of adhesion molecules is changed in peripheral lymphocytes obtained from patients with chronic venous insufficiency (CVI) of the lower limbs. Methods: 26 patients with CVI (19 primary varicose veins, 7 ulcus cruris) and 39 clinically healthy persons were included in our study. The expression of adhesion molecules on granulocytes, monocytes, and lymphocytes was analysed by flow cytometry. In serum soluble sCD31 and sCD54 was assayed by ELISA, the CD profile was estimated on lymphocytes. Results: In patients suffering from CVI the increased expression of CD11b, CD18, CD54, and CD49d on granulocytes and lymphocytes, of CD62L and CD49d on granulocytes and monocytes, and of CD15 on monocytes and lymphocytes was demonstrated. The highest difference in the expression of adhesion molecules between patients and controls were found on lymphocytes. In patients with CVI lower mean counts of cytotoxic (CD8+) lymphocytes and higher counts of NK cells (CD16+ + CD56+) were seen. The concentration of activated T lymphocytes (CD3 HLA-DR+) and of sCD54 was much higher in the circulation of patients with ulcus cruris than in those with varicose veins or in the controls. Conclusion: Lymphocytes and leukocytes of patients with CVI express elevated concentrations of various adhesion molecules, especially in patients with ulcus cruris. Additionally, significant changes in their CD profile were observed.

Venous Insufficiency of the Lower Limbs and Working Conditions

1998 ◽  
Vol 13 (4) ◽  
pp. 133-141 ◽  
Author(s):  
A. Sobaszek ◽  
P. Frimat ◽  
A. Tiberguent ◽  
A. Domont ◽  
H. Chevalier ◽  
...  
Keyword(s):  
Discriminant Analysis ◽  
Family History ◽  
Working Conditions ◽  
Venous Insufficiency ◽  
Varicose Veins ◽  
Lower Limbs ◽  
Venous Disease ◽  
Personal Factors ◽  
Cross Sectional ◽  
Occupational Factors

Objectives: To determine the prevalence of venous insufficiency (VI) in a population of women working in the health and social sectors. In a second stage, we assessed the relative contributions of the different occupational and personal risk factors for venous disease. Design: Descriptive, randomized, multicentre, cross-sectional study during January to September 1995. Study group: One thousand eight hundred and twenty-three women working in four health sectors: operating rooms, hospital laundries, day-nurseries and offices. Methods: The study was based on a physical examination and a medical questionnaire (personal and family history of VI, symptoms, use of medical care). Working conditions, temperature and humidity recordings were studied for each activity. A typological analysis and a discriminant analysis were carried out to determine the contribution of personal and occupational factors to the course of VI. Findings: VI is highly prevalent: 76% of subjects and up to 84% in the surgical room and laundry population. Functional symptoms and the presence of varicosities (small varicose veins of the ankle and medial plantar arch) and large varicose veins are more frequent, with the highest prevalence among operating room staff (respectively, 68% and 41%). Seniority is the first and main factor to explain the severity of the disease, independently of age. The number of pregnancies is also an important factor for the severity of VI, while a family history is not. Occupational factors such as high temperature and load-carrying have a significant direct influence. Conclusion: We observed a strong relationship between occupational factors and severity of VI. Occupational factors and personal factors could be quantified on the basis of scores identified in the discriminant analysis.

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