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.

Duplex ultrasound investigation of the veins in chronic venous disease of the lower limbs – UIP Consensus Document. Part II: Anatomy

2006 ◽  
Vol 21 (4) ◽  
pp. 168-179 ◽  
Author(s):  
A Cavezzi ◽  
N Labropoulos ◽  
H Partsch ◽  
S Ricci ◽  
A Caggiati ◽  
...  
Keyword(s):  
Lower Limb ◽  
Duplex Ultrasound ◽  
Lower Limbs ◽  
Chronic Venous Disease ◽  
Specific Reference ◽  
Venous Disease ◽  
Perforating Veins ◽  
Consensus Document ◽  
Wide Range ◽  
Ultrasound Investigation

Objectives: Duplex ultrasound investigation has become the reference standard in assessing the morphology and haemodynamics of the lower limb veins. The project described in this paper was an initiative of the Union Internationale de Phlébologie (UIP). The aim was to obtain a consensus of international experts on the methodology to be used for assessment of the anatomy of superficial and perforating veins in the lower limb by ultrasound imaging. Design: Consensus conference leading to a consensus document. Methods: The authors performed a systematic review of the published literature on duplex anatomy of the superficial and perforating veins of the lower limbs. Afterwards, they invited a group of experts from a wide range of countries to participate in this project. Electronic submissions from the authors and the experts (text and images) were made available to all participants via the UIP website. The authors prepared a draft document for discussion at the UIP Chapter meeting held in San Diego, USA, in August 2003. Following this meeting, a revised manuscript was circulated to all participants and further comments were received by the authors and included in subsequent versions of the manuscript. Eventually, all participants agreed on the final version of the paper. Results: The experts have made detailed recommendations concerning the methods to be used for duplex ultrasound examination as well as the interpretation of images and measurements obtained. This document provides a detailed methodology for complete ultrasound assessment of the anatomy of the superficial and perforating veins in the lower limbs. Conclusions: The authors and a large group of experts have agreed on a methodology for the investigation of the lower limbs venous system, by duplex ultrasonography, with specific reference to the anatomy of the main superficial veins and perforators of the lower limbs in healthy and varicose subjects.

Lower limbs edema among medical students

2019 ◽  
Vol 8 (3) ◽  
pp. 1-5
Author(s):  
Monika Załęcka ◽  
Kacper Lipiński ◽  
Aleksandra Królikowska
Keyword(s):  
Medical Students ◽  
Lower Limb ◽  
High Ambient Temperature ◽  
Lower Limbs ◽  
Chronic Venous Disease ◽  
Venous Disease ◽  
Prolonged Standing ◽  
Limb Edema ◽  
Academic Year ◽  
Exacerbation Of Symptoms

Aim of the study: Chronic venous disease is frequent that affects people of various professions and ages. It consists of a set of symptoms located in the lower limbs, and edema is one of the first and most frequent signs. The aim of this study was to investigate the lifestyle influence on frequency of lower limbs swelling formation among medicine students. Materials and methods: Analysis of questionnaire conducted among 482 students of the academic year 2018/2019 from 12 Polish medicine universities. The survey questions encompass known and possible risk factors of lower limbs edema. CEAP scale was used to assess the severity of chronic venous disease. Results: Lower limb edema occurred in 30% of the respondents, of which 55% stated the exacerbation of symptoms on the days they attended classes. Conclusions: Medical students suffer from edema, it is more common among women. The type of classes affects the manifestation of lower limbs oedema. The factors that have the greatest impact on the formation of edema in students are: prolonged standing or sitting position and high ambient temperature.

Duplex ultrasound investigation of the veins in chronic venous disease of the lower limbs-UIP consensus document. Part I. Basic principles

VASA ◽  
2007 ◽  
Vol 36 (1) ◽  
pp. 53-61 ◽  
Author(s):  
Coleridge-Smith ◽  
Labropoulos ◽  
Partsch ◽  
Myers ◽  
Nicolaides ◽  
...  
Keyword(s):  
Lower Limb ◽  
Duplex Ultrasound ◽  
Lower Limbs ◽  
Chronic Venous Disease ◽  
Venous Disease ◽  
Consensus Document ◽  
Wide Range ◽  
International Experts ◽  
Training Of Personnel ◽  
Ultrasound Investigation

Background: Duplex ultrasound investigation has become the reference standard in assessing the morphology and haemodynamics of the lower limb veins. The project described in this paper was an initiative of the Union Internationale de Phlébologie (UIP). The aim was to obtain a consensus of international experts on the methodology to be used for assessment of veins in the lower limb by ultrasound imaging. Methods: The authors invited a group of experts from a wide range of countries to participate in this project. Electronic submissions from the experts were made available to all participants via the UIP website. The authors prepared a draft document for discussion at an UIP Chapter meeting held in San Diego, USA in August 2003. Following this meeting a revised manuscript was circulated to all participants and further comments were received by the authors and included in subsequent versions of the manuscript. Eventually all participants agreed the final version of the paper. Results: The experts have made detailed recommendations concerning the methods to be used for duplex ultrasound examination as well as the interpretation of images and measurements obtained. This document suggests a methodology for complete assessment of the superficial and perforating veins of the lower limbs, including recommendations on reporting results and training of personnel involved in these investigations. Conclusions: The authors and a large group of experts have agreed a methodology for the investigation of the lower limbs venous system by duplex ultrasonography.

Duplex ultrasound investigation of the veins in chronic venous disease of the lower limbs – UIP Consensus Document. Part I: Basic principles

2006 ◽  
Vol 21 (4) ◽  
pp. 158-167 ◽  
Author(s):  
P Coleridge-Smith ◽  
N Labropoulos ◽  
H Partsch ◽  
K Myers ◽  
A Nicolaides ◽  
...  
Keyword(s):  
Lower Limb ◽  
Duplex Ultrasound ◽  
Consensus Conference ◽  
Lower Limbs ◽  
Chronic Venous Disease ◽  
Venous Disease ◽  
Consensus Document ◽  
Wide Range ◽  
International Experts ◽  
Ultrasound Investigation

Objectives: Duplex ultrasound investigation has become the reference standard in assessing the morphology and haemodynamics of the lower limb veins. The project described in this paper was an initiative of the Union Internationale de Phlébologie (UIP). The aim was to obtain a consensus of international experts on the methodology to be used for assessment of veins in the lower limb by ultrasound imaging. Design: Consensus conference leading to a consensus document. Methods: The authors invited a group of experts from a wide range of countries to participate in this project. Electronic submissions from the experts were made available to all participants via the UIP website. The authors prepared a draft document for discussion at a UIP Chapter meeting held in San Diego, USA, in August 2003. Following this meeting, a revised manuscript was circulated to all participants, and further comments were received by the authors and included in subsequent versions of the manuscript. Eventually, all participants agreed on a final version of the paper. Results: The experts have made detailed recommendations concerning the methods to be used for duplex ultrasound examination, as well as the interpretation of images and measurements obtained. This document suggests a methodology for complete assessment of the superficial and perforating veins of the lower limbs, including recommendations on reporting results and training of personnel involved in these investigations. Conclusions: The authors and a large group of experts have agreed a methodology for the investigation of the lower limbs venous system by duplex ultrasonography.

D-dimer levels in combination with residual venous obstruction and the risk of recurrence after anticoagulation withdrawal for a first idiopathic deep vein thrombosis

2005 ◽  
Vol 94 (11) ◽  
pp. 969-974 ◽  
Author(s):  
Cristina Legnani ◽  
Michela Cini ◽  
Giuliana Guazzaloca ◽  
Gualtiero Palareti ◽  
Benilde Cosmi
Keyword(s):  
Deep Vein Thrombosis ◽  
Recurrence Rate ◽  
Oral Anticoagulant Therapy ◽  
Lower Limbs ◽  
First Episode ◽  
Venous Obstruction ◽  
Risk Of Recurrence ◽  
Vein Thrombosis ◽  
Deep Vein ◽  
D Dimer

SummaryWe assessed the predictive value of D-dimer levels in combination with residual venous obstruction (RVO) for recurrent venous thromboembolism (VTE) in a prospective cohort of outpatients after oral anticoagulant therapy (OAT) suspension for a first episode of idiopathic proximal deep vein thrombosis of the lower limbs during a 2-year follow-up. Patients (n=400) were enrolled on the day of OAT suspension when RVO was determined by compression ultrasonography (present in 48.6% of patients). D-dimer (cut-off value: 500 ng/mL) was measured 30±10 days afterwards (abnormal in 56.4% of patients). The overall recurrence rate was 16.7% (67/400; 95% confidence intervals - CI -:13–21%). The multivariate hazard ratio (HR) for recurrence was 3.32 (95% CI:1.78–6.75; p > 0.0001) for abnormal D-dimer compared to normal D-dimer and 1.2 (95% CI:0.72–2.07; p>0.05) for RVO compared to absent RVO. The recurrence rate was 5.7% (95% CI:2–13%) and 10.4% (95% CI:6–18%), respectively, for normal D-dimer either without or with RVO, 22.9% (95% CI:14–33%) and 25.9% (95% CI: 18–35%), respectively, for abnormal D-dimer, either without or with RVO. When compared with normal D-dimer without RVO, the multivariate HR for recurrence was similar for abnormal D-dimer either with RVO (4.76 – 95% CI:1.78–12.8) or without RVO (4.3–95%:1.56–11.88). Abnormal D-dimer at one month after OAT withdrawal is an independent risk factor for recurrent VTE, while RVO at the time of OAT withdrawal, either with normal or abnormal D-dimer after one month, does not influence the risk of recurrence.

Duplex ultrasound investigation of the veins in chronic venous disease of the lower limbs-UIP consensus document. Part II. Anatomy

VASA ◽  
2007 ◽  
Vol 36 (1) ◽  
pp. 62-71 ◽  
Author(s):  
Cavezzi ◽  
Labropoulos ◽  
Partsch ◽  
Ricci ◽  
Caggiati ◽  
...  
Keyword(s):  
Lower Limb ◽  
Duplex Ultrasound ◽  
Lower Limbs ◽  
Chronic Venous Disease ◽  
Specific Reference ◽  
Venous Disease ◽  
Perforating Veins ◽  
Consensus Document ◽  
Wide Range ◽  
Ultrasound Investigation

Background: Duplex ultrasound investigation has become the reference standard in assessing the morphology and haemodynamics of the lower limb veins. The project described in this paper was an initiative of the Union Internationale de Phlébologie (UIP). The aim was to obtain a consensus of international experts on the methodology to be used for assessment of anatomy of superficial and perforating veins in the lower limb by ultrasound imaging. Methods: The authors performed a systematic review of the published literature on duplex anatomy of the superficial and perforating veins of the lower limbs; afterwards they invited a group of experts from a wide range of countries to participate in this project. Electronic submissions from the authors and the experts (text and images) were made available to all participants via the UIP website. The authors prepared a draft document for discussion at the UIP Chapter meeting held in San Diego, USA in August 2003. Following this meeting a revised manuscript was circulated to all participants and further comments were received by the authors and included in subsequent versions of the manuscript. Eventually, all participants agreed the final version of the paper. Results: The experts have made detailed recommendations concerning the methods to be used for duplex ultrasound examination as well as the interpretation of images and measurements obtained. This document provides a detailed methodology for complete ultrasound assessment of the anatomy of the superficial and perforating veins in the lower limbs. Conclusions: The authors and a large group of experts have agreed a methodology for the investigation of the lower limbs venous system by duplex ultrasonography, with specific reference to the anatomy of the main superficial veins and perforators of the lower limbs in healthy and varicose subjects.

scholarly journals The role of inflammatory reaction in chronic venous disease of the lower limb

2019 ◽  
Vol 6 (5) ◽  
pp. 1835
Author(s):  
Ketan Vagholkar ◽  
Shivangi Garima ◽  
Yash Kripalani
Keyword(s):  
Lower Limb ◽  
Lower Limbs ◽  
Chronic Venous Disease ◽  
Venous Disease ◽  
Vascular Disorder ◽  
Disease Awareness ◽  
Prolonged Sitting ◽  
Inflammatory Mechanism ◽  
Prevention And Treatment

Chronic venous disease is the problem which is assuming alarming proportions in subjects whose occupation involves prolonged sitting or standing. The exact mechanism by which the venous system gets damaged continues to be a subject of endless research. The role of inflammation is a significant factor in the evolution of chronic venous disease. Awareness of this mechanism can help in both prevention and treatment of this complex vascular disorder. The paper reviews inflammatory mechanism underlying the pathogenesis of chronic venous disease in lower limbs.

scholarly journals Prevention of subclinical deep vein thrombosis in abdominal surgeries

2018 ◽  
Vol 5 (7) ◽  
pp. 2475
Author(s):  
Tazeem M. D. ◽  
Wasim M. D. ◽  
Sabia Amin ◽  
Tahmida Ali
Keyword(s):  
Molecular Weight ◽  
Deep Vein Thrombosis ◽  
Lower Limb ◽  
Low Molecular Weight Heparin ◽  
Lower Limbs ◽  
Low Molecular Weight ◽  
Vein Thrombosis ◽  
Group I ◽  
Deep Vein ◽  
D Dimer

Background: Deep vein thrombosis (DVT) is a common but elusive illness that can result in disability and death if not recognized and treated effectively. The reported incidence has not changed much over past couple of decades. The aim of this study was to identify the risk of deep vein thrombosis related to the number of days of immobility and the role of low molecular weight heparin in the prevention of deep vein thrombosis.Methods: A total of hundred (n=100) patients undergoing laparotomy were studied in the post-operative period between January 2014 and December 2016. Patients were divided into two groups alternatively; Group I patients did not receive any DVT prophylaxis and Group II patients were given low molecular weight heparin once a day till mobilization. From 3rdPOD, all the patients were evaluated with detailed history and lower limb examination. D-dimer study was done in all the patients and if positive then followed by Color Venous Doppler. Regular follow-ups were done weekly once for a month, every two weeks for next month and once a month thereafter, minimum for 6 months.Results: A total of hundred (n=100) patients, including 65 men and 35 women, with median age of 40 years underwent laparotomies in 2 years by a single unit. The incidence of Lower Limb DVT in Group I was 8%. The risk factors associated with DVT were sex, BMI, smoking and Malignancy. The signs and symptoms associated with DVT were swelling of lower limbs, pain and tenderness, fever and Homan’s and Moses signs. The D-dimer test results were positive in 9 patients. Color Venous Doppler identified DVT in 8 patients. On regular follow- ups, remissions of clinical symptoms were recorded and repeat Doppler scans showed recanalization in all the patients after 6 months.Conclusions: Deep Vein Thrombosis is multifactorial, and post-operative patients account for majority of cases. Early mobilization and Prophylactic Low Molecular Heparin prevents DVT in abdominal surgeries.

scholarly journals Recanalization after acute deep vein thrombosis

2013 ◽  
Vol 12 (4) ◽  
pp. 296-302 ◽  
Author(s):  
Gustavo Mucoucah Sampaio Brandao ◽  
Marcone Lima Sobreira ◽  
Hamilton Almeida Rollo
Keyword(s):  
Deep Vein Thrombosis ◽  
Vessel Wall ◽  
Lower Limbs ◽  
Venous Disease ◽  
Natural Evolution ◽  
Vein Thrombosis ◽  
Complex Process ◽  
History Of ◽  
Acute Deep Vein Thrombosis ◽  
Deep Vein

The process of recanalization of the veins of the lower limbs after an episode of acute deep venous thrombosis is part of the natural evolution of the remodeling of the venous thrombus in patients on anticoagulation with heparin and vitamin K inhibitors. This remodeling involves the complex process of adhesion of thrombus to the wall of the vein, the inflammatory response of the vessel wall leading to organization and subsequent contraction of the thrombus, neovascularization and spontaneous lysis of areas within the thrombus. The occurrence of spontaneous arterial flow in recanalized thrombosed veins has been described as secondary to neovascularization and is characterized by the development of flow patterns characteristic of arteriovenous fistulae that can be identified by color duplex scanning. In this review, we discuss some controversial aspects of the natural history of deep vein thrombosis to provide a better understanding of its course and its impact on venous disease.

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