Page 196 - Libro vascular I

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ANATOMY OF THE LOWER LIMB VENOUS SYSTEM AND ASSESSMENT OF VENOUS INSUFFICIENCY
KTS, to detect any deep venous abnormalities, before treating any large superficial varicosities by surgery (Eifert et al 2000).
Venous hemangioma
Venous malformations can occur anywhere in the body and consist of an abnormal network of veins. Venous hemangiomas vary in size and can be very extensive. They can occur in the superficial tissues, muscles or organs. They can cause pain and swelling and may be disfiguring when they are superficial. Duplex scanning can be useful for imaging venous malformations to exclude evidence of arteriovenous fistulas, but it can be difficult to define the full extent of the lesion, especially if it is deep or involves joints. When imaging very superficial lesions, it is important not to apply too much pressure with the transducer, as this may occlude the veins. Other imaging techniques, such as MRI, are often used to
References
Abu-Own A, Scurr J H, Coleridge Smith P D 1994 Saphenous vein reflux without incompetence at the saphenofemoral junction. British Journal of Surgery 81(10):1452–1454
Browse N, Burnand K G, Irvine A T, et al 1999 Diseases of the veins, 2nd edn. Arnold, London, pp 191–248
Caggiati A, Bergan J J, Gloviczki P, et al 2002 Nomenclature of the veins of the lower limbs: an international interdisciplinary consensus statement. Journal of Vascular Surgery 36(2):416–422
Callam M J 1994 Epidemiology of varicose veins. British Journal of Surgery 81(2):167–173
Eifert S, Villavicencio J L, Kao T C, et al 2000 Prevalence of deep venous anomalies in congenital vascular malformations of venous predominance. Journal of Vascular Surgery 31(3):462–471
Evans C J, Allan P L, Lee A J, et al 1998 Prevalence of venous reflux in the general population on duplex scanning: the Edinburgh Vein Study. Journal of Vascular Surgery 28(5):767–776
Evans C J, Fowkes F G, Ruckley C V, et al 1999 Prevalence of varicose veins and chronic venous insufficiency in men and women in the general population: Edinburgh Vein Study. Journal of Epidemiology and Community Health 53(3):149–153
Georgiev M, Myers K A, Belcaro G 2003 The thigh extension of the lesser saphenous vein: from Giacomini’s
investigate the extent of the malformation, especially if it is diffusely distributed in muscles.
REPORTING
Duplex assessment of varicose veins is a dynamic technique, and it can be difficult to demonstrate this quality on hard copy, although recordings of reflux patterns, as seen on the spectral Doppler display, may be useful. It is therefore easier to provide a functional map of the venous system, as shown in Figure 12.33. The superficial veins can be drawn onto the diagram, and black arrows pointing toward the heart indicate normal competent veins. Red arrows pointing toward the feet indicate venous reflux. This diagram can be accompanied by a brief report outlining any limita- tions of the scan. This type of report is easy for the surgeon to interpret in a busy outpatient clinic and is also useful to show to the patient, as it provides a clear explanation of the problem.
observations to ultrasound scan imaging. Journal of
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Neovascularisation is the principal cause of varicose vein recurrence: results of a randomised trial of stripping the long saphenous vein. European Journal of Vascular and Endovascular Surgery 12(4):442–445
Lambourne L A, Moffatt C J, Jones A C, et al 1996 Clinical audit and effective change in leg ulcer services. Journal of Wound Care 5(8):348–351
Magnusson M B, Nelzen O, Risberg B, et al 2001 A colour Doppler ultrasound study of venous reflux in patients with chronic leg ulcers. European Journal of Vascular and Endovascular Surgery 21(4):353–360
Porter J M, Moneta G L 1995 Reporting standards on venous disease: an update. An international consensus committee on chronic venous disease. Journal of Vascular Surgery 21(4):635–645
Ruckley C V, Evans C J, Allan P L, et al 2002 Chronic venous insufficiency: clinical and duplex correlations. The Edinburgh Vein Study of venous disorders in the general population. Journal of Vascular Surgery 36(3):520–525
Sarin S, Sommerville K, Farrah J, et al 1994 Duplex ultrasonography for assessment of venous valvular function of the lower limb. British Journal of Surgery 81(11):1591–1595
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