Anatomy Of The Lower Extremity Veins

Veins The Calf

Thorough knowledge of the fascial compartments of the leg is a prerequisite of understanding the relationship between superficial and deep veins. The fascia surrounding the calf and thigh muscles separates two compartments the superficial compartment, consisting of all tissues between the skin and the fascia, and the deep compartment, which includes all tissues between the fascia and the bones (see Figure 2.6).11 Superficial veins run in the superfical, deep veins in the deep compartments....

The Great Saphenous Vein

Accessory Saphenous Vein

The Great Saphenous vein is scanned from the groin in proximal-to-distal direction. In the thigh, the GSV lies within the saphenous compartment (see Figure 18.5).19 The superficial fascia and the muscular fascia define the saphenous compartment and provide the typical ultrasound image of an Asian eye (see Figure 18.5c).25 Anterior and posterior accessory veins are often identified in the thigh (see Figure 18.6). These veins are often incompetent and receive reflux from the saphenous vein.19...

Clinical Aspects Of Iliocaval Obstruction

Rash Abacavir

The clinical presentation of inferior vena cava occlusion comprises a wide spectrum of signs and symptoms of venous hypertension. The recruitment of collateral pathways may be adequate, as well as occult, and some individuals will remain symptom free. Symptomatic individuals present with edema and a variety of signs and symptoms of venous hypertension. The severity of symptoms implies inadequate collateral inflow in the face of poorly recanalized, multisegmental obstruction. Although not as...

Varicose Veins Quality Of Life Questionnaire

Patients completed the SF-36, the Aberdeen questionnaire, and a set of 25 questions focussing on the symptoms and concerns. The conclusion was that the AVVQ was a valid measure of quality of life for patients pre- and postsurgery. Patients were found to have a significantly improved quality of life six weeks postsurgery. Two studies emerged in 2002 where the AVVQ was used. In a prospective study of 203 unselected patients with CEAP 2-6 who underwent saphenous vein...

Postsclerotherapy Hyperpigmentation

Varicose Veins Spots

Cutaneous pigmentation to some degree is a relatively common occurrence after sclerotherapy with any sclerosing solution. It has been reported in 11 to 80 1-3 of patients. The true incidence of hyperpigmentation is a result of many factors, including treatment technique, sclerosing solution, and concentration, as well as how the authors define pigmentation. The definition of pigmentation should be, any brown-black staining of the skin occurring after sclerotherapy, with persistent pigmentation...

Pulsed Lasers And Light Sources

Laser Depth Penetration Graph

For small telangiectatic leg veins in fair-skinned patients, the pulsed KTP laser has become the treatment of choice. The Versapulse KTP laser (Lumenis, Santa Clara, California, U.S.) uses the following parameters a spot size of 3 5 mm, pulse duration of10-15 ms, and fluences of 14-20 J cm2, which have proven to be effective. A 4 C chilled tip provides epidermal protection. Side effects include transient erythema, crusting superficially, and purpura. When administering the pulsed KTP laser,...

Conclusion Of Varicose Vein

Ambulatory phlebectomy is elegant by its mere simplicity. It is effective and safe with acceptable cosmetic results (see Figure 27.4). AP is a perfect complement to endovenous thermal ablation of the saphenous veins. With this combination, patients can expect all varicose veins to vanish following a one-hour procedure that employed only local anesthesia, in the comfort of a physician's office. 1. Celsus AC. Medicinae Libri Octo, Patavii. Typis Seminarii Apud Joannem Manfre, Liber Septimus....

Side Effects Of Sclerofoam

Sclerofoam sclerotherapy shares most of its (rare) side effects with usual sclerotherapy but some complications are more specific. Visual disturbances are frequently quoted as one of the main inconveniences of foam, but there is evidence16 that they are more related to big bubbles than to microbubbles. When visual troubles were observed with liquid, it was mainly associated with the use of the air block technique. After sessions using only Sclerofoam, we observed less than 0.25 visual adverse...

Preulcerative Cutaneous Changes

Inflammation dominates the early skin changes that precede venous ulceration. Increased leukocyte activation and an increased expression of soluble adhesion molecules have been demonstrated. There is a perivascular infiltration of the papillary plexus capillaries. Granulation tissue composed of lymphocytes, plasma cells, macrophages, histiocytes, and fibroblasts invades the subepithelial layer. This granulation tissue is responsible for the deposition of collagen fibers.13 Collagen fibers...

Previous Classifications Of

The most commonly used classification, particularly in Europe, was Widmer's classification from 19781 of chronic venous insufficiency Stage I Edema and dilated subcutaneous veins with corona phlebectatica Stage II Trophic lesions of the skin with hyper- or depig- mented areas Stage III Healed or active ulcer The criticism against this clinical classification was the non-specificity of Stage I, and the absence of differentiation between trophic changes in Stage II. In 19792 Hach suggested a...

Telangiectatic Matting

The new appearance of previously unnoticed, fine red telangiectasia occurs in a number of patients. The reported incidence varies from 5 to 75 . Reasons for the development of TM are multiple. Recovery from an ischemic injury such as closing blood vessels with sclerotherapy may produce a hypoxia-induced neovascularization. In addition, injury to endothelial cells may stimulate the release of a variety of growth factors. These responses are probably a fundamental feedback response, acting to...

Complications Of Heparin Therapy

The main adverse effects of heparin therapy include bleeding, thrombocytopenia, and osteoporosis. Patients at particular risk of bleeding are those who have had recent surgery or trauma, or who have other clinical factors which predispose to bleeding on heparin, such as peptic ulcer, occult malignancy, liver disease, hemostatic defects, age > 65 years, and female gender. The management of bleeding on heparin will depend on the location and severity of bleeding, the risk of recurrent VTE and...

Deep Venous Thrombosis Examination by Plethysmography

The four plethysmographs just described have been used for the identification and monitoring of DVT. For purposes of this text a generic procedure for DVT will be described. Deep venous thrombosis is a life-threatening disease for that reason alone accurate diagnosis and therapy are essential. The deep venous system is not only a conduit for returning blood to the right side of the heart it is also a storage or capacitant system. This means its volume changes rapidly as pressure within the deep...