[Management of patients with varicose veins presenting with a history of deep venous thrombosis].

The notion of a history of deep venous thrombosis in patients with varicose veins has often been at the origin of a contemplative attitude toward this pathology. What used to be an act of vigilance has now become plain negligence, if not a therapeutic error. Indeed, the difficulty in diagnosing an acute episode explains the many false positive results obtained; moreover, the variability of the evolution of true venous thrombosis should no longer cause one to adopt a monolithic attitude.

[Diagnosis of varicocele by Doppler effect].

Varicoceles, which may produce oligo-astherospermia are a curable cause of subfertility in the male. Doppler velocimetry of the anterior spermatic venous plexus or pampiniform plexus allows the diagnosis of clinical and infraclinical varicoceles to be confirmed. It can also assess and quantify the spontaneous increase in flow due to venous distension and Valsalva reflux related to valvular incompetence.

[Scanner and carotid artery surgery].

The utility of CT scan imaging in patients with hemispheric cerebrovascular accidents suspected of being of carotid artery origin was investigated by analysis of case reports of 57 patients treated recently. A low density image was found in 38.5% of cases, superficial and deep localizations being of equal number.

[Non-invasive exploration of the deep veins. Therapeutic implications in varicose patients].

The functional investigation of patients with varicose veins allows essential varicose veins to be distinguished from secondary varicose veins, so that appropriate therapy can be instituted. These investigations include global evaluation of the venous function, plethysmography and segmental ultrasonography. The authors propose a protocol combining Doppler with photoplethysmography: - if the deep channels are normal on the Doppler examination and the filling time of the PPG is normal after a venous tourniquet has been applied, the varicose veins are essential; - if the deep channels are abnormal: in the case of an obstructive or restrictive syndrome, the PPG can determine whether the varices act as collaterals and should be left intact or whether saphenous incontinence is partially or totally responsible for the disorders, in the case of reflux diagnosed on the Doppler, the PPG can decide whether or not this deep reflux is pathological.