The value of hemodynamic measurements by air plethysmography in diagnosing venous obstruction of the lower limb

2016 ◽  
Vol 4 (3) ◽  
pp. 313-319 ◽  
Author(s):  
Ralph L.M. Kurstjens ◽  
Mark A.F. de Wolf ◽  
Sarah A. Alsadah ◽  
Carsten W.K.P. Arnoldussen ◽  
Rob H.W. Strijkers ◽  
...  
Keyword(s):  
Lower Limb ◽  
Venous Obstruction ◽  
Air Plethysmography ◽  
Hemodynamic Measurements

Iliac Venous Obstruction: Surgical Reconstruction

2000 ◽  
Vol 15 (3-4) ◽  
pp. 144-148
Author(s):  
F. Mercier ◽  
F. Cormier ◽  
J. M. Fichelle ◽  
F. Duarte ◽  
J. M. Cormier
Keyword(s):  
Iliac Artery ◽  
Lower Limb ◽  
Iliac Vein ◽  
Lower Limbs ◽  
Surgical Reconstruction ◽  
Invasive Technique ◽  
Venous Obstruction ◽  
Long Term Outcome ◽  
First Choice

Aim: To review the investigation and treatment of iliac vein obstruction. Method: A review of current literature in the field of management of iliac venous obstruction has been conducted. Synthesis: Iliac venous obstruction results in chronic or acute symptoms in the lower limb presenting as pain, swelling, oedema and discomfort of the lower limb. Intrinsic or extrinsic obstruction of the iliac veins may be the cause. Cockett syndrome is the classic aetiology for chronic intermittent or fixed left inferior limb venous obstruction. Other causes include tumours, vascular grafts or lymph node compression and retroperitoneal fibrosis. Duplex ultrasound imaging is now the first-choice investigation. CT scanning is useful where external vein compression is suspected. Phlebography is used when an endovascular procedure is to be done. The surgical treatment of Cockett syndrome described by Cormier is transposition of the common right iliac artery in the left internal iliac artery. This is being replaced by endovascular balloon venoplasty completed by stenting of the left iliac vein. We reviewed the experience of surgical correction of Cockett syndrome with Cormier's technique in 70 patients operated on between 1976 and 1990; 55 patients had a follow-up of 12-177 months. Anatomical and functional results were perfect for all patients except when endoluminal synechiae or iliac venous thrombosis were associated with postural compression. In this case a 50% success rate was achieved. The endovascular revolution offers a less invasive technique for treatment of chronic iliac venous obstruction. Follow-up is short at present in the few publications found in the literature. Conclusions: Iliac vein obstruction results in symptoms of swelling in the lower limbs. These may be managed conservatively. Where there is an indication for venous reconstruction, investigation by duplex ultrasonography is the first step. Endovascular procedures including stenting offer significant benefit. The long-term outcome of these interventions has yet to be established.

scholarly journals The inability of venous occlusion air plethysmography to identify patients who will benefit from stenting of deep venous obstruction

2017 ◽  
Vol 33 (7) ◽  
pp. 483-491 ◽  
Author(s):  
Ralph LM Kurstjens ◽  
Fabio S Catarinella ◽  
Yee Lai Lam ◽  
Mark AF de Wolf ◽  
Irwin M Toonder ◽  
...  
Keyword(s):  
Magnetic Resonance ◽  
Successful Treatment ◽  
Clinical Success ◽  
Duplex Ultrasound ◽  
Venous Occlusion ◽  
Venous Occlusion Plethysmography ◽  
Venous Obstruction ◽  
Venous Volume ◽  
Air Plethysmography ◽  
One Year

Background The aim of this study was to assess whether venous occlusion plethysmography can be used to identify venous obstruction and predict clinical success of stenting. Method Receiver operated characteristic curves were used to determine the ability of venous occlusion plethysmography to discriminate between the presence and absence of obstruction, measured by duplex ultrasound and magnetic resonance venography, and to discriminate between successful and non-successful stenting, measured by VEINES-QOL/Sym. Result Two hundred thirty-seven limbs in 196 patients were included. Areas under the curve for post-thrombotic obstruction were one-second outflow volume 0.71, total venous volume 0.69 and outflow fraction 0.59. Stenting was performed in 45 limbs of 39 patients. Areas under the curve for identifying patients with successful treatment at one year after stenting were 0.57, 0.54 and 0.63, respectively. Conclusion Venous occlusion plethysmography cannot be used to identify venous obstruction proximal to the femoral confluence or to distinguish which patients will benefit from treatment.

scholarly journals Automated Measurements of Ankle-Brachial Index: A Narrative Review

2021 ◽  
Vol 10 (21) ◽  
pp. 5161
Author(s):  
Aleksandra Danieluk ◽  
Sławomir Chlabicz
Keyword(s):  
Lower Limb ◽  
Reliable Method ◽  
Ankle Brachial Index ◽  
Diagnostic Tools ◽  
Peripheral Artery ◽  
Asymptomatic Patients ◽  
Pubmed Database ◽  
Automated Measurements ◽  
Air Plethysmography ◽  
Artery Disease

Peripheral artery disease (PAD) is an atherosclerotic disease that causes obstruction in lower limb arteries. It increases cardiovascular risk even in asymptomatic patients. Accurate diagnostic tools for identification of affected individuals are needed. Recently, there have been attempts to establish a reliable method of automated ankle-brachial index (ABI) identification. A search of PubMed database to identify studies assessing automatic ABI measurements in agreement with standard PAD diagnosis methods was conducted in December 2020. A total of 57 studies were analyzed in the review. The majority of analyzed studies found ABI measured by automatic oscillometric devices to be potentially feasible for use. Some note that, even though the Doppler and oscillometric methods are not fully interchangeable, the oscillometric devices could be used in screening. Significantly fewer publications are available on automatic plethysmographic devices. For photoplethysmography, most studies reported either good or moderate agreement with reference standards. For air plethysmography, poorer agreement with Doppler ABI is suggested. It is noted that pulse volume recording (PVR) function may improve the diagnostic accuracy of the devices.

scholarly journals Pressure dynamics in chronic venous disease

2019 ◽  
Vol 4 (2) ◽  
Author(s):  
Taimur Saleem ◽  
Seshadri Raju
Keyword(s):  
Ex Vivo ◽  
Venous Pressure ◽  
Venous Hypertension ◽  
Chronic Venous Disease ◽  
Abdominal Pressure ◽  
Venous Disease ◽  
Venous Obstruction ◽  
Resting Pressure ◽  
Air Plethysmography ◽  
Focal Stenosis

Peripheral venous pressure is regulated by central and peripheral mechanisms. Peripheral venous hypertension is an important pathologic component of chronic venous disease and is present in about two-third of patients with chronic venous disease. It can result from reflux, obstructive lesions or high arterial inflow. The dominant influence in patients with peripheral venous hypertension appears to be obstruction rather than reflux. Reflux can be superficial or deep or both. In about 70% of patients with reflux, valvular incompetence is present in the superficial, deep and perforator systems in some combination. In an ex vivo experimental model, conduit pressure increased with smaller native or functional caliber, focal stenosis and increased post-capillary inflow. Venous pressure in the lower limb can be measured in a variety of ways: supine resting pressure, erect resting pressure and ambulatory venous pressure. These measurements are affected by factors such as intra-abdominal pressure, intra-thoracic pressure, gravity, venoarteriolar reflux, valve reflux and venous obstruction. Venous obstruction is associated with elevated supine pressures while reflux is associated with elevated erect resting and ambulatory venous pressures. Ambulatory venous pressure reflects venous hypertension in patients with advanced venous disease. However, our investigation has shown that ambulatory venous pressure hypertension is rarely present if air plethysmography testing is negative. Consideration maybe given to the omission of the ambulatory venous pressure testing if air plethysmography testing is normal.

Underlying deep venous abnormalities in patients with unilateral chronic venous disease

2013 ◽  
Vol 28 (8) ◽  
pp. 426-431 ◽  
Author(s):  
A S Gaweesh ◽  
M H Kayed ◽  
T Y Gaweesh ◽  
J Shalhoub ◽  
A H Davies ◽  
...  
Keyword(s):  
Lower Limb ◽  
Lower Limbs ◽  
Chronic Venous Disease ◽  
Venous Disease ◽  
Venous Obstruction ◽  
Cross Sectional ◽  
Vein Thrombosis ◽  
Clinically Significant ◽  
Deep Vein ◽  
Computed Tomography Venography

Objectives To report our initial experience using direct multidetector computed tomography venography (MDCT-V) for imaging lower limb deep veins. CT findings in limbs with chronic venous disease (CVD) were compared with contralateral healthy limbs. Methods MDCT-V with bilateral direct pedal injection of contrast was used to image the deep veins in both lower limbs. Eight patients with unilateral lower limb CVD of varying severity (according to the Clinico-Etiological-Anatomical and Pathological classification [CEAP] class 2-6) were studied. Five patients had primary CVD, while three patients had CVD secondary to previous deep vein thrombosis. Results Deep venous obstruction (>50%) or occlusion was identified in all CVD limbs and was not seen in contralateral healthy limbs. These lesions were not only iliac, were not exclusively present in advanced CVD and were independent of the presence or absence of deep venous reflux. Conclusion Morphologically significant lesions could be underlying in patients with clinically significant CVD. Direct MDCT-V provides clear reconstructable cross-sectional images of the whole deep venous tree, including infrainguinal areas, beyond the reach of intravascular ultrasound. Utilization of new venous imaging modalities may uncover previously undiagnosed and potentially treatable venous pathology in patients with CVD.

Iliocaval Venous Obstruction in Pergolide-Induced Retroperitoneal Fibrosis

1999 ◽  
Vol 14 (3) ◽  
pp. 126-127
Author(s):  
M. S. Simms ◽  
M. H. Simms
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Case Report ◽  
Lower Limb ◽  
Retroperitoneal Fibrosis ◽  
Past History ◽  
Rare Complication ◽  
Iliac Vein ◽  
Venous Obstruction

Design: Case report. Setting: BMI Priory Hospital, Birmingham, UK. Patient: A 67-year-old man presenting with unilateral lower limb oedema. Past history included ipsilateral lower limb melanoma and Parkinson's disease, treated by pergolide. Intervention: Laparotomy to confirm a diagnosis of retroperitoneal fibrosis (RPF) causing iliac vein obstruction. Conclusion: RPF is a rare complication of pergolide therapy for Parkinson's disease. Previous reports have also described iliocaval obstruction and there may be an association between pergolide-induced RPF and venous complications.

Metallosis-induced Iliopsoas Bursal Cyst Causing Venous Obstruction and Lower-limb Swelling After Metal-on-metal THA

Orthopedics ◽  
2012 ◽  
Vol 35 (12) ◽  
pp. e1811-e1814 ◽  
Author(s):  
Abdulrahman D. Algarni ◽  
Olga L. Huk ◽  
Manuela Pelmus
Keyword(s):  
Lower Limb ◽  
Venous Obstruction ◽  
Metal On Metal
Sign in / Sign up

Export Citation Format

Share Document