scholarly journals Using Non-Contrast MRA to Discriminate between Obstructive and Nonobstructive Venous Diseases of the Legs

Diagnostics ◽  
2021 ◽  
Vol 11 (8) ◽  
pp. 1392
Author(s):  
Chien-Wei Chen ◽  
Yuan-Hsi Tseng ◽  
Min Yi Wong ◽  
Yu-Hui Lin ◽  
Teng-Yao Yang ◽  
...  
Keyword(s):  
Great Saphenous Vein ◽  
Femoral Vein ◽  
Area Under The Curve ◽  
Iliac Vein ◽  
Venous Disease ◽  
Flow Volume ◽  
Mean Velocity ◽  
P Values ◽  
Venous Diseases ◽  
Venous Interventions

Background: Venous interventions of the legs are less predictable owing to a lock of objective tools. Methods: One hundred and twenty patients with lower extremity venous disease were evaluated anatomically using TRANCE MRI. Then, a QFlow analysis was performed in 53 patients with only one leg affected for hemodynamic evaluation. Those patients with complete QFlow were classified into obstructive and nonobstructive. Results: The QFlow—namely, stroke volume, forward flow volume, mean flux, stroke distance (SD), and mean velocity (MV) in the external iliac vein (EIV), femoral vein (FV), popliteal vein (PV), and great saphenous vein (GSV). The obstructed group had a shorter SD and lower MV in the EIV, EIV/FV, and GSV/PV (SD: p-values of 0.025, 0.05, and 0.043, respectively; MV: p-values of 0.02, 0.05, and 0.048, respectively). A good performance in discriminating obstructive venous disease was reported for SD in the EIV (area under the curve (AUC) = 67.9%, 95% confidence interval (CI) = 53.2–82.7%), EIV/FV (AUC = 72.4%, 95% CI = 58.2–86.5%), and GSV/PV (AUC = 67.9%, 95% CI = 51.7–84.1%). The SD in the EIV, EIV/FV, and GSV/PV had the ability to discriminate between obstructive and nonobstructive diseases (p-values of 0.025, 0.005, and 0.043). The MV in the EIV, EIV/FV, and GSV/PV had ability to discriminate between obstructive and nonobstructive venous diseases (p-values of 0.02, 0.005, and 0.048). Conclusions: The SD and MV were lower for obstructive than nonobstructive disease in the EIV.

scholarly journals Discriminating Reflux from Non-Reflux Diseases of Superficial Veins in Legs by Novel Non-Contrast MR with QFlow Technique

2021 ◽  
Vol 11 (4) ◽  
pp. 242
Author(s):  
Yuan-Hsi Tseng ◽  
Chien-Wei Chen ◽  
Min Yi Wong ◽  
Teng-Yao Yang ◽  
Bor-Shyh Lin ◽  
...  
Keyword(s):  
Stroke Volume ◽  
Saphenous Vein ◽  
Great Saphenous Vein ◽  
Flow Volume ◽  
Mean Velocity ◽  
Forward Flow ◽  
Saphenous Veins ◽  
Venous Diseases ◽  
The Status ◽  
Stroke Distance

Objectives: To find an objective diagnostic tool for the superficial veins in legs. Methods: This study included 137 patients who underwent TRANCE-MRI from 2017 to 2020 (IRB: 202001570B0). Among them, 53 with unilateral leg venous diseases underwent a QFlow scan and were classified into the reflux and non-reflux groups according to the status of the great saphenous veins. Results: The QFlow, namely stroke volume (SV), forward flow volume (FFV), mean flux (MF), stroke distance (SD), and mean velocity (MV) measured in the external iliac, femoral, popliteal, and great saphenous vein (GSV). The SV, FFV, SD, MF, SD, and MV in the GSV (morbid/non-morbid limbs) demonstrated a favorable ability to discriminate reflux from non-reflux in the ROC curve. The SD in the GSV and GSV/PV ratio (p = 0.049 and 0.047/cutoff = 86 and 117.1) and the MV in the EIV/FV ratio, GSV, and GSV/PV ratio (p = 0.035, 0.034, and 0.025/cutoff = 100.9, 86.1, and 122.9) exhibited the ability to discriminate between reflux and non-reflux group. The SD, MV, and FFV have better ability to discriminate a reflux from non-reflux group than the SV and MF. Conclusions: QFlow may be used to verify the reflux of superficial veins in the legs. An increasing GSV/PV ratio is a hallmark of reflux of superficial veins in the legs.

Manual lymphatic drainage in chronic venous disease: A duplex ultrasound study

2013 ◽  
Vol 29 (10) ◽  
pp. 667-676 ◽  
Author(s):  
Rute Sofia dos Santos Crisóstomo ◽  
Miguel Sandu Candeias ◽  
Ana Margarida Martins Ribeiro ◽  
Catarina da Luz Belo Martins ◽  
Paulo AS Armada-da-Silva
Keyword(s):  
Blood Flow ◽  
Saphenous Vein ◽  
Great Saphenous Vein ◽  
Femoral Vein ◽  
Lymphatic Drainage ◽  
Chronic Venous Disease ◽  
Venous Disease ◽  
Flow Volume ◽  
Manual Lymphatic Drainage ◽  
Venous Flow

Objectives To compare the effect of call-up and reabsorption maneuvers of manual lymphatic drainage on blood flow in femoral vein and great saphenous vein in patients with chronic venous disease and healthy controls. Methods Forty-one subjects participated in this study (mean age: 42.68(15.23)), 23 with chronic venous disease (chronic venous disease group) with clinical classification C1–5 of clinical-etiological-anatomical-pathological (CEAP) and 18 healthy subjects (control group). Call-up and reabsorption maneuvers were randomly applied in the medial aspect of the thigh. The cross-sectional areas, as well as the peak and the mean blood flow velocity at femoral vein and great saphenous vein, were assessed by Duplex ultrasound at the baseline and during maneuvers. The venous flow volume changes were calculated. Results The venous flow volume in femoral vein and great saphenous vein increased during both manual lymphatic drainage maneuvers and in both groups ( P < 0.05). The two maneuvers had a similar effect on femoral vein and great saphenous vein hemodynamics, and in both the chronic venous disease and control groups. As a result of the call-up maneuver, the flow volume augmentations, as a result of call-up maneuver, decreased with the severity of chronic venous disease in those patients measured by the clinical classification of CEAP ( r = −0.64; P = 0.03). Conclusions Manual lymphatic drainage increases the venous blood flow in the lower extremity with a magnitude that is independent from the specific maneuver employed or the presence of chronic venous disease. Therefore, manual lymphatic drainage may be an alternative strategy for the treatment and prevention of venous stasis complications in chronic venous disease.

Anatomy of the lymph node venous networks of the groin and their investigation by ultrasonography

2015 ◽  
Vol 31 (5) ◽  
pp. 334-343 ◽  
Author(s):  
Jean Francois Uhl ◽  
Miguel Lo Vuolo ◽  
Nicos Labropoulos
Keyword(s):  
Lymph Node ◽  
Saphenous Vein ◽  
Great Saphenous Vein ◽  
Varicose Veins ◽  
Femoral Vein ◽  
Normal Subjects ◽  
Chronic Venous Disease ◽  
Venous Disease ◽  
Anatomical Dissection ◽  
Anatomical Finding

Objective To describe the anatomy of the lymph node venous networks of the groin and their assessment by ultrasonography. Material and methods Anatomical dissection of 400 limbs in 200 fresh cadavers following latex injection as well as analysis of 100 CT venograms. Routine ultrasound examinations were done in patients with chronic venous disease. Results Lymph node venous networks were found in either normal subjects or chronic venous disease patients with no history of operation. These networks have three main characteristics: they cross the nodes, are connected to the femoral vein by direct perforators, and join the great saphenous vein and/or anterior accessory great saphenous vein. After groin surgery, lymph node venous networks are commonly seen as a dilated and refluxing network with a dystrophic aspect. We found dilated lymph node venous networks in about 15% of the dissected cadavers. Conclusion It is likely that lymph node venous networks represent remodeling and dystrophic changes of a normal pre-existing network rather than neovessels related to angiogenic factors that occur as a result of an inflammatory response to surgery. The so-called neovascularization after surgery could, in a number of cases, actually be the onset of dystrophic lymph node venous networks. Lymph node venous networks are an ever-present anatomical finding in the groin area. Their dilatation as well as the presence of reflux should be ruled out by US examination of the venous system as they represent a contraindication to a groin approach, particularly in recurrent varicose veins after surgery patients. A refluxing lymph node venous network should be treated by echo-guided foam injection.

scholarly journals Novel Compliant Scaffold with Specific Design for Venous System: Results of a Porcine Model Study

2018 ◽  
Vol 2018 ◽  
pp. 1-8
Author(s):  
Pierfrancesco Veroux ◽  
Alessia Giaquinta ◽  
Carla Virgilio ◽  
Davide Danilo Zani ◽  
Giuliano Ravasio ◽  
...  
Keyword(s):  
Porcine Model ◽  
Femoral Vein ◽  
Primary Patency ◽  
Venous Disease ◽  
Jugular Veins ◽  
Safety And Efficacy ◽  
Model Study ◽  
Venous Diseases ◽  
Brachiocephalic Trunk ◽  
Efficacy Profile

Background. Stenting has become the first-line treatment of obstructive venous disease because of poor results of balloon angioplasty. This preclinical study aimed to investigate the safety and efficacy profile of a novel compliant venous scaffold (CVS) denominated Petalo CVS, specifically designed for venous diseases. Materials and Methods. Twelve healthy pigs weighing 90 kg were used to test Petalo CVS. The devices were implanted into the internal jugular veins (IJVs) using a femoral vein percutaneous approach. The safety profile including the success rate of device releasing, anchoring, and positioning was evaluated immediately. Fracture, migration, primary patency, and endothelial response were assessed at 1, 2, 3, and 6 months after the study procedure. Results. A total of 32 devices were successfully released in both IJVs. No procedure- or device-related complications were reported, and all pigs successfully completed the different scheduled follow-up periods. The primary patency rate was 100%, and no fracture or migration of the device into the brachiocephalic trunk was reported. Histological examination revealed only minimal lesions with minimal or absent inflammatory reaction surrounding the incorporated metallic rods. Conclusions. This porcine model study showed a promising safety and efficacy profile of Petalo CVS, a novel endovenous device based on specific concepts.

scholarly journals A rare case of anatomical variation of the femoral artery and vein

2020 ◽  
Vol 9 (2) ◽  
pp. 1826-1830
Author(s):  
B. Ba ◽  
T. Touré ◽  
A. Kanté ◽  
M. Koné ◽  
K.D. Kouamenou ◽  
...  
Keyword(s):  
Femoral Artery ◽  
Rare Case ◽  
Great Saphenous Vein ◽  
Anatomical Variation ◽  
Femoral Vein ◽  
Iliac Vein ◽  
External Iliac Vein ◽  
Medial Side ◽  
Femoral Vessels ◽  
The Right

During a dissection of the two femoral trigons in a female corpse, about 14 years old, we discovered on the right side, the deep artery of the thigh arising from the medial side of the femoral artery and passed in front of the femoral vein above the mouth of the great saphenous vein; on both sides, there was the presence of a collateral canal which communicated the external iliac vein with the femoral vein on the right, on the left, it communicated the external iliac vein with the quadricipital vein. The lower part of the femoral vein was duplicated on both sides, but on the right, there was an interconnecting channel between the two trunks of the duplication. Variations of the femoral vessels are very frequent and can be responsible for an incident during the practice of certain gestures at the level of the femoral trigon such as: catheterization of the femoral artery or vein, the treatment of femoral hernias. Key words: Deep thigh artery, collateral venous canal, external iliac vein, anatomic variations.

scholarly journals A Case of Successful Iliofemoral Vein Stenting from Great Saphenous Vein Access

2018 ◽  
Vol 21 (6) ◽  
pp. E472-E475
Author(s):  
Hae Won Jung ◽  
Chul-Min Ahn ◽  
Young-Guk Ko
Keyword(s):  
Clinical Significance ◽  
Treatment Option ◽  
Saphenous Vein ◽  
Great Saphenous Vein ◽  
Good Alternative ◽  
Iliac Vein ◽  
Chronic Venous Disease ◽  
Venous Disease ◽  
Vein Access ◽  
Successful Case

Chronic venous disease is strongly associated with morbidity and leads to considerable medical costs. Therefore, its clinical significance is very important. Currently, iliac vein stenting is the first treatment option for chronic venous disease due to iliac vein obstruction. For iliac vein stenting, ipsilateral femoral or popliteal vein access is common. However, great saphenous vein access may be a good alternative if there is obstruction in the ipsilateral femoropopliteal vein. Until now, there has been no reported case of successful iliac vein stenting using great saphenous vein access. We report the first successful case of iliofemoral vein stenting from great saphenous vein access.

The role of circumflex femoral veins in the saphenofemoral junction incompetence: a case report

2011 ◽  
Vol 26 (3) ◽  
pp. 121-124
Author(s):  
F Passariello
Keyword(s):  
Great Saphenous Vein ◽  
Femoral Vein ◽  
Anatomical Variations ◽  
Iliac Vein ◽  
Lower Limbs ◽  
Valsalva Manoeuvre ◽  
External Iliac Vein ◽  
The Common ◽  
Saphenofemoral Junction

A 31 year-old female patient, an opera singer, came for a consultation, mainly for aesthetic problems of the lower limbs. An asymptomatic bilateral P-point pelvic shunt was demonstrated by the EchoDoppler, while no nutcracker syndrome was detected. The examination demonstrated a medial circumflex femoral vein (MCFV), going into the common femoral vein and then into the great saphenous vein (GSV). The Valsalva manoeuvre showed the GSV terminal valve incompetence. A dilated MCFV vein at the level of the saphenofemoral junction was the source of the reflux through the GSV, while the external iliac vein was competent. GSV reflux with Valsalva was present only in the lying position. Flow in the MCFV was directed toward the CFV during and after the Valsalva. The examination shows clearly that a GSV reflux can sometimes occur in absence of iliac reflux. Circumflex femoral veins (medial and lateral) are anatomical variations, but common findings during ordinary EchoColourDoppler investigations of the venous system of the lower limbs.

Frequency of refluxive tributaries of the junction region in the groin in patients with recurrent varicose veins of the thigh

Phlebologie ◽  
2016 ◽  
Vol 45 (03) ◽  
pp. 149-153 ◽  
Author(s):  
E. Mendoza ◽  
M. Dörler ◽  
M. Stücker ◽  
S. Reich-Schupke
Keyword(s):  
Great Saphenous Vein ◽  
Varicose Veins ◽  
Femoral Vein ◽  
Iliac Vein ◽  
Junction Region ◽  
Duplex Scan ◽  
Recurrent Varicose Veins ◽  
History Of ◽  
Saphenofemoral Junction ◽  
Thigh Region

SummaryBackground A long stump and neovascularisation are commonly discussed reasons for recurrence of varicosis in the groin after “disconnection” of the saphenofemoral junction (SFJ) and stripping of the great saphenous vein (GSV). A third possible reason for recurrence with non femoral reflux emerging from tributaries of the junction region, is often underrated. The aim of the study was to report on the source of reflux for recurrent varicose veins of the thigh in patients who already had a history of disconnection of the SFJ and stripping of the GSV.Methods In this two-centre study, consecutive patients with a history of disconnection of the SFJ, stripping of the GSV and visible or palpable varicose veins of the thigh region were included. Their data and venous diagnostics (DPPG, duplex scan) were recorded and evaluated by a standardised protocol.Results 101 legs were included. In 58.4 % there was a long stump of the GSV as a source for variose veins of the thigh. In the other legs (42,6 %) the source for the reflux was not a long stump with contact to the femoral vein but residual tributaries of the SFJ, e.g. the superficial epigastric vein or the superficial circumflex iliac vein.Conclusions Residual refluxive tributaries of the SFJ seem to be an important source for recurrent varicose veins of the thigh. Further prospective studies should focus on suitable therapeutic options.

scholarly journals Diosmin Alleviates Venous Injury and Muscle Damage in a Mouse Model of Iliac Vein Stenosis

2022 ◽  
Vol 8 ◽  
Author(s):  
Zhiye Guo ◽  
Xiaolong Du ◽  
Yihua Zhang ◽  
Chunwan Su ◽  
Feng Ran ◽  
...  
Keyword(s):  
Mouse Model ◽  
Therapeutic Effect ◽  
Iliac Vein ◽  
Chronic Venous Disease ◽  
Venous Disease ◽  
Sequencing Analysis ◽  
Venous Injury ◽  
Venous Diseases ◽  
Vein Stenosis ◽  
Dose Dependent

Chronic venous disease (CVD) is a progressive inflammatory disease that increases in prevalence with age. Elucidating the underlying molecular mechanism of CVD development is essential for disease prevention and treatment. This study constructed a mouse model of iliac vein stenosis to explore the mechanism of the CVD disease progression, and diosmin was administered as a positive control (as recommended by clinical practice). The mouse model was established successfully with iliac vein stenosis, leading to the expansion of the intercellular space and venous leakage. Conversely, micronized diosmin showed a dose-dependent therapeutic effect for these manifestations. Concerning the mechanism, iliac vein stenosis caused an inflammatory response in veins, while diosmin suppressed this increase. Furthermore, RNA sequencing analysis indicated that diosmin significantly improved muscle function through actin filament organization and muscle contraction. These results indicated that the mouse model of iliac vein stenosis is a reliable model to study venous diseases. Furthermore, the dose-dependent therapeutic effect of diosmin on stenosis (without toxic side-effects) suggests greater protection against venous diseases at higher doses of diosmin.

Optimal sizing of iliac vein stents

2017 ◽  
Vol 33 (7) ◽  
pp. 451-457 ◽  
Author(s):  
Seshadri Raju ◽  
William J Buck ◽  
William Crim ◽  
Arjun Jayaraj
Keyword(s):  
Therapeutic Option ◽  
Femoral Vein ◽  
Iliac Vein ◽  
Chronic Venous Disease ◽  
Venous Disease ◽  
Initial Procedure ◽  
The Common ◽  
The Right ◽  
Vein Stenosis ◽  
Scaling Rule

Background Iliac vein stenting has emerged as a therapeutic option in chronic venous disease. The optimal stent size is unknown but should match normal caliber at a minimum. Methods Teleology: The iliac-femoral outflow caliber was measured by Duplex in healthy volunteers to determine normal caliber. Patient IVUS data: The distribution curve of IVUS planimetry data in 345 chronic venous disease limbs was analyzed: values at the right tail end of the curve should approach normal values according to distribution theory. The optimal stent size was also projected using Poiseuille equation and Young’s scaling rule. Results The optimal stent sizes in the common iliac, external iliac, and common femoral vein segments are: 16, 14, and 12 mm diameters, respectively. Conclusion Stent correction of iliac vein stenosis should aim to restore the lumen to the minimum recommended caliber during the initial procedure and later re-interventions.

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