A 50-year-old woman was referred to the noninvasive vascular laboratory for carotid artery evaluation because of a bruit in the neck. Color Doppler ultrasound examination demonstrated absence of the right common carotid artery and parallel internal and external carotid arteries originating at the brachiocephalic trunk. Computed tomography angiography further described anomalous anatomy, demonstrating a common origin of the innominate artery and left common carotid artery.
View Article and Find Full Text PDFBackground: Accreditation in peripheral venous testing can be obtained based on femoropopliteal (FP) duplex ultrasound evaluation, and many laboratories limit their examination to this segment only. This simplified protocol detects acute FP deep venous thrombosis (DVT) but misses calf vein DVT, superficial venous thrombosis, chronic DVT, venous reflux, and other nonvenous findings potentially responsible for the patients' presenting conditions. A protocol limited to the FP segment results in additional unnecessary testing and can create patient dissatisfaction.
View Article and Find Full Text PDFAim: The aim of the current study was to evaluate fluid mobilization during the intensive treatment of leg lymphedema.
Methods: The mobilization of intracellular and extracellular fluids in the lower and upper extremities and trunk was evaluated with the intensive treatment of leg lymphedema in a prospective study. Mobilization of fluids was assessed by bioelectrical impedance using the InBody S10 device in ten patients with leg lymphedema, regardless of the cause.
Aim: Ultrasound tissue characterization (USTC) is a precursor of ultrasound virtual histology (USVH), already applied to B-mode images of coronary, carotid, and peripheral arteries, as well as venous thrombosis. Elevated echogenicity has been described for a rejected transplanted kidney. We analyzed data from healthy young adults as reference for further renal USTC.
View Article and Find Full Text PDFBackground: Venous ultrasonography identifies reflux patterns of the great and small saphenous veins (GSV, SSV), allowing evaluation of lower extremities for treatment planning and patient follow-up.
Objective: To determine progression of saphenous vein reflux patterns in women with primary venous valvular insufficiency.
Methods: Venous ultrasonography was performed in the extremities of 92 women, 43 ± 12 (23-77) years old, CEAP (clinical, aetiological, anatomical and pathological elements) clinical classes C1-C2.
Aim: This study aimed to determine whether grayscale median (GSM) ultrasound (US) analysis could differentiate acute from subacute femoropopliteal deep venous thrombosis (DVT) classified based on (a) the time of symptoms onset and (b) sonographers' evaluation of US images.
Methods: Patients who had US because of suspected DVT were included. Patients with history of previous DVT, with normal US results or US with findings of isolated calf thrombosis were excluded.
Aim: To determine if gray-scale median (GSM) analysis could differentiate acute and recent deep venous thrombosis (DVT).
Methods: Patients submitted to vascular ultrasound examination of lower extremities due to suspected DVT were evaluated. Patients with acute or recent femoropopliteal DVT were included, whereas those without DVT, with chronic or isolated calf DVT were excluded.
Objectives: Impact of pregnancies on great saphenous vein (GSV) reflux patterns deserves clarification. Which GSV segment is most affected? Is the saphenofemoral junction (SFJ) involved?
Methods: Colour-flow duplex ultrasonography was performed in 583 women extremities with primary varicose veins (clinical, aetiological, anatomical and pathological elements [CEAP C2]), without oedema, skin changes or ulcer. Women with previous thrombosis or varicose surgery were excluded.
Eur J Vasc Endovasc Surg
September 2010
Objectives: To determine the incidence of side effects following treatment of varicose veins with carbon dioxide-oxygen (CO(2)/O(2)) foam sclerotherapy, and to compare results with historical controls using CO(2)- or air-based foams.
Design: Cohort study with prospective data collection, private clinic setting.
Patients: The patient population consisted of one hundred patients, 95% women, age 52 SD 13 years-old, CEAP class C(2)EpAsPr.
Objective: This clinical study evaluated prospectively adverse events immediately following ultrasound-guided foam sclerotherapy (UGFS) for the treatment of lower extremity venous valvular insufficiency. Incidence of side effects associated with carbon dioxide (CO(2)) foam was compared with a historical control using air-based foam. The literature on the subject was reviewed.
View Article and Find Full Text PDFBackground: Telangiectasias have been treated with sclerotherapy without concomitant assessment or treatment of saphenous veins.
Objective: To clarify if ultrasound (US) mapping of saphenous veins is justifiable, this investigation determined prevalence of specific patterns of saphenous vein reflux in women with telangiectasias.
Methods: US mapping of the great and small saphenous veins (GSV, SSV) was performed in 1,740 extremities of 910 consecutive patients, mostly women (86%).
Owing to the overall poor medical health of patients with end-stage renal disease, we have sought alternatives to the use of general anesthesia for access procedures. Furthermore, since local anesthesia (1) does not offer the motor block that is sometimes desired and (2) can be difficult to maintain when a large amount of vein needs to be transposed, we examined whether regional blocks can be useful for the creation of new arteriovenous fistulae (AVF). From August 2002 to January 2005, 41 patients scheduled for AVF placement underwent a regional block with the use of a lidocaine and ropivacaine mixture using a nerve stimulator.
View Article and Find Full Text PDFPrevious research has suggested that arterial aneurysm might result from a systemic tendency to dilatation. This systemic effect would involve both arterial and venous dilatation. The authors investigated whether venous grafts implanted to bypass popliteal artery aneurysms (PAA) had larger diameters than those implanted to treat peripheral arterial occlusive disease (PAOD).
View Article and Find Full Text PDFChronic venous insufficiency (CVI) with the resultant clinical sequelae significantly reduces quality of life. Most elderly patients with CVI are treated nonoperatively owing to concerns of increased operative risk and therefore suffer more advanced disease. Radiofrequency ablation (RFA) has emerged as a minimally invasive procedure to treat patients with superficial venous insufficiency (SVI) due to great saphenous vein (GSV) incompetence.
View Article and Find Full Text PDFVasc Endovascular Surg
August 2006
The authors have noted a significant incidence of pulmonary embolism and mortality associated with upper extremity deep venous thrombosis (UEDVT). Since there is an association between the site of lower extremity DVT (LEDVT) and pulmonary embolism, they hypothesized that there might also be a correlation between the site of UEDVT and the incidence of pulmonary embolism (PE) and associated mortality. To further elucidate this hypothesis, they analyzed the mortality rate and incidence of PE diagnosed with subclavian/axillary or internal jugular vein thrombosis during a 5-year period at their institution.
View Article and Find Full Text PDFAlthough ultrasonography (US) advantageously portrays lumen and wall thickness, velocity criteria have been used primarily to interpret carotid artery stenosis. The relationship of US and velocity measurements was investigated. Peak-systolic and end-diastolic velocities (PSV, EDV) increase exponentially as the lumen of the internal carotid artery narrows and the percent stenosis (%S) increases.
View Article and Find Full Text PDFObjective: Varicose veins have been linked to great saphenous vein (GSV) reflux and in particular, with reflux at the saphenofemoral junction (SFJ). Early stages of disease, however, may be associated with limited, localized reflux in segments of the GSV and/or small saphenous vein (SSV). Ultrasound mapping of saphenous veins was performed to determine patterns of GSV and SSV reflux in women with simple, primary varicose veins.
View Article and Find Full Text PDFObjective: As an emerging endovascular alternative to ligation and stripping of the incompetent greater saphenous vein (GSV), radiofrequency ablation was monitored with ultrasound scanning to evaluate anatomic results. Neovascularization and inflammation are potential consequences that lead to the appearance of small vessels. The natural history of the below-knee untreated GSV segment may be important in our understanding of ongoing chronic venous disease.
View Article and Find Full Text PDFThe duplex exam is widely used in the diagnosis of peripheral arterial occlusive disease. It presents some drawbacks, however, such as calcified plaques, sequential stenosis, and time-consuming examinations. A type of waveform analysis, referred to in this study as segmental analysis, was conducted to try to find solutions to these problems.
View Article and Find Full Text PDFThe clinical significance of lower extremity deep vein thrombus (DVT) propagation in the setting of anticoagulation therapy remains unclear. The purpose of this study is to compare results of thrombus outcome found with repeat duplex ultrasonography to the incidence of pulmonary embolism and mortality. During a recent 18-month period, 457 patients were diagnosed with lower extremity DVT with duplex ultrasonography and their data were retrospectively analyzed.
View Article and Find Full Text PDFObjectives: Carotid duplex scanning is the standard test for documenting carotid disease. Carotid endarterectomy effectively reduces stroke in selected patients with carotid artery disease. Data from large national randomized trials suggest that the benefits of CEA may be gender dependent.
View Article and Find Full Text PDFVenography is rarely available for comparison with ultrasonography (US) as a means for quality assurance (QA) in the detection of lower extremity venous thrombosis. New QA methods must be implemented. We compared results of multiple serial studies performed in the same extremity as a QA indicator.
View Article and Find Full Text PDFRadio-frequency ablation (RFA) of the great saphenous vein (GSV) is an endovascular alternative to stripping. To determine long-term effectiveness, the fate of GSV treated for valvular insufficiency with RFA was evaluated in detail with ultrasound imaging (US). One hundred lower extremities were examined with high-resolution color flow US, an average of 8 months after RFA treatment of an incompetent GSV.
View Article and Find Full Text PDFLittle attention has been given to superficial thrombophlebitis and particularly to lesser saphenous vein thrombophlebitis (LSVT) by vascular surgeons. A prospective nonrandomized study was conducted to assess LSVT's potential association with deep venous thrombosis (DVT) as well as its natural history. Between January 1994 and December 1995, the authors reviewed 33 cases of LSVT detected by duplex scanning in 32 patients at their institution's vascular laboratory.
View Article and Find Full Text PDFObjective: Endovascular placement of prosthetic valves is currently in clinical trials as treatment for lower extremity venous hypertension caused by valvular insufficiency. Femoropopliteal vein sizing is a critical factor in treatment planning. A wide diameter range could influence selection of an endoprosthesis.
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