Venous duplex ultrasound

INTRODUCTION: Spontaneous arteriovenous fistulas (AVF), in contrast to iatrogenic or post-traumatic ones, are extremely rare and only sporadically published in the literature. In the absence of exposure risk, the diagnosis of AVF can be challenging, especially if it is an incidental finding. CASE HISTORY: An 80-year-old female patient presented to our vascular consultation because of swelling of the left leg due to varicosis. For years, she had also noticed that the right foot seemed to be cooler...

OBJECTIVES: Polidocanol endovenous microfoam (MFA) is approved by the US Food and Drug Administration for great saphenous vein (GSV) closure, yet there is little published data on the subsequent risk of ablation related thrombus extension (ARTE). Recent societal practice guidelines recommend against routine post-procedure duplex ultrasound (DU) following thermal ablation of the GSV in asymptomatic patients. At present, limited data does not allow this recommendation to extend to MFA. Our aim is to identify characteristics and outcomes associated with ARTE following MFA versus radiofrequency ablation (RFA)...

OBJECTIVES: Third generation lasers with longer wavelengths (>1900 nm) have been introduced, in recent years, for the treatment of varicose veins. The possible advantage of the new generation lasers is that they allow complete damage to the vein wall using a lower Power in Watts (W: J/sec) and a lower linear energy density (LEED: J/cm). The aim of this work is to evaluate the results present in the literature regarding efficacy and safeness of the new generation lasers for the treatment of varicose veins...

Hemodialysis (HD) arteriovenous fistulas commonly present with late vascular access complications, but are rarely in association with internal jugular vein (IJV) reflux. We reported two patients who had severe and mild IJV reflux, respectively. Case 1 was a 48-year-old male with end-stage renal disease (ESRD) who had been treated with HD for 5 years. He presented with persistent headaches, nausea, and vomiting. Combined with all the examinations, it was revealed severe IJV reflux, brachiocephalic vein stenosis, high-flow vascular access, and IJV valve dysfunction...

BACKGROUND: VV ECMO is increasingly used as a rescue strategy for hypercarbic and hypoxic respiratory failure refractory to conventional management, and more than 14,000 patients with COVID-19 related respiratory failure have been supported with VV ECMO to date. One of the known complications of VV ECMO support is the development of cannula-associated deep vein thromboses (CaDVT). The purpose of this study was to identify the incidence of CaDVT in COVID-19 patients supported with VV ECMO as compared to non-COVID-19 patients...

OBJECTIVE: Physician-directed point-of-care ultrasound (PoCUS) is routinely used to identify the etiology of shock and guide therapy in the ICU. We performed a preclinical study to determine what changes are manifested in the femoral vessels during hemorrhagic shock on Duplex imaging and to generate a femoral vessel sonographic profile over the time course of shock. DESIGN & SETTING: A preclinical study in swine was performed using a convenience sample of animals that were being used in a Trauma Surgery training lab...

INTRODUCTION: The primary etiology of Pelvic venous disorder (PeVD) is multifactorial and challengeable in vascular surgery as it mandates multidisciplinary team cooperation for its evaluation and management. METHODS: All patients investigated for (PeVD) in a high-volume, tertiary referral university hospital were identified and analyzed retrospectively during the period (March 2021 and September 2022). Demographic and medical data were scored. Agreement between the non-invasive modalities (CTV or MRV) and diagnostic venography in detecting the refluxing pelvic veins was analyzed...

BACKGROUND: The anatomy of the femoral artery and vein plays an integral role in vascular access. Both technical feasibility and complication rates are associated with femoral vessel diameter and depth. The goal of this study is to establish normative values for common femoral artery (CFA) and vein (CFV) depth and diameter using a large, diverse patient population. METHODS: A retrospective review of all patients undergoing lower extremity venous duplex imaging over a 1 year period were reviewed...

BACKGROUND: The study aims to identify the incidence of symptomatic and asymptomatic venous thromboembolism (VTE) after minimally invasive varicose vein surgery and to assess the predictability of the Caprini risk score (CRS). METHODS: CAPrini Score In Venous Surgery (NCT03041805) is a registry-based prospective study that enrolls patients undergoing minimally invasive open (high ligation, stripping, miniphlebectomy) and endovascular (thermal and non-thermal ablation) surgery on varicose veins...

OBJECTIVES: To assess the trends of VTE occurrence and prevention in varicose vein surgery. METHOD: The registry-based CAPSIVS trial (NCT03041805) analysis includes results in 1878 lower limbs. The primary outcome is a 28-day symptomatic or asymptomatic DVT revealed with duplex ultrasound. RESULTS: Any DVT, including EHIT, was observed in 3.4%, while symptomatic in 0.5%. Prophylactic anticoagulation was administrated in 20.4% with LMWH (13...

Passive hyperthermia causes cerebral hypoperfusion primarily from heat-induced respiratory alkalosis. However, despite the cerebral hypoperfusion, it is possible that the mild alkalosis might help to attenuate cerebral inflammation. In this study, the cerebral exchange of extracellular vesicles (microvesicles), which are known to elicit pro-inflammatory responses when released in conditions of stress, were examined in hyperthermia with and without respiratory alkalosis. Ten healthy male adults were heated passively, using a warm water-perfused suit, up to core temperature + 2°C...

PURPOSE: Venous thromboembolism (VTE) is a potential major complication in patients undergoing total hip arthroplasty (THA). However, the incidence of VTE following THA using anterolateral supine approach (ALS) has not been reported. The purpose of this study was to investigate the incidence of perioperative VTE and the distribution and characteristics of deep vein thrombosis (DVT) following ALS THA. PATIENTS AND METHODS: This retrospective single-arm study analyzed the 182 consecutive hips of 164 patients who underwent primary ALS THA...

The suggestion that bidirectional flow is a normal feature seen in venous perforators of the lower leg has been a longstanding debate. Newer published evidence has changed the perspective on normal perforator flow and is presented here to resolve the misunderstandings and different viewpoints previously held.

No abstract text is available yet for this article.

BACKGROUND: Ethanol has been a commonly used sclerosant for low flow vascular malformations, but it carries a high risk of complications. Bleomycin has been recently introduced as a potentially effective treatment. OBJECTIVE: The aim of this study was to evaluate the safety and efficacy of bleomycin intralesional injection for the treatment of low flow vascular malformations and determine the different factors affecting the outcome. PATIENTS AND METHODS: A total of fifty patients with low flow vascular malformations were enrolled in the study between April 2020 and March 2022...

With an increasing number of interventional and noninterventional treatment options available for venous disorders, it is important that patients undergo a thorough and systematic evaluation. Clinical evaluation should include a personal and family history of venous thromboembolism (VTE), varicose veins, and thrombophilia as these factors affect response and recurrence of disease. Patient should undergo diagnostic and quality of life assessment using validated tools to monitor response to treatment. Duplex ultrasound, both deep and superficial veins, documenting both obstruction and reflux is initial imaging with CT and MRI indicated to document pelvic, iliac vein, and IVC patency and pathology...

Guidelines based on randomized controlled data recommend patients with newly diagnosed venous leg ulcers (VLUs) undergo venous reflux duplex ultrasound (VRDUS) and be considered for treatment with pentoxifylline to accelerate ulcer healing. A retrospective review was conducted of 2,061 patients with VLU, diagnosed between 2011 and 2020 in a rural healthcare system, to identify factors associated with increased or decreased likelihood of being prescribed VRDUS and pentoxifylline. VRDUS (16%) and pentoxifylline (0...

OBJECTIVE: The aim of this study was to assess the role of treatment of superficial venous reflux in patients with combined deep segmental venous reflux as regards clinical symptoms as well as reflux improvement of the deep veins. SETTING AND DESIGN: We reviewed eighty patients, retrospectively selected on the inclusion criteria and having combined superficial venous reflux and segmental deep venous reflux who underwent superficial venous reflux ablation. The contralateral limb of 44 patients was used as a control group, asked to wear compression stockings for three months during day time with no surgical intervention...

OBJECTIVE: Compression ultrasonography of the leg is established for triaging proximal lower extremity deep venous thrombosis (DVT). AutoDVT, a machine-learning software, provides a tool for non-specialists in acquiring compression sequences to be reviewed by an expert for patient triage. The purpose of this study was to test image acquisition and remote triaging in a clinical setting. MATERIALS AND METHODS: Patients with a suspected DVT were recruited at two centers in Germany and Greece...

BACKGROUND: The aim of this study was to evaluate the clinical efficacy of a modified surgical procedure for the treatment of varicose veins. METHODS: This retrospective analysis was conducted on lower extremities with symptomatic great saphenous vein (GSV) incompetence that underwent stripping from the groin to the knee, with preservation of the superficial epigastric vein (SEV), between January 2015 and April 2022. Follow-up assessments were performed using Doppler ultrasound, Venous Clinical Severity Score (VCSS), and the Aberdeen Varicose Vein Questionnaire (AVVQ) at 6 and 12 months after surgery...