Diagnostic yield of intravascular ultrasound in patients with clinical signs and symptoms of lower extremity venous disease.

Background: Intravascular ultrasound (IVUS) examination has a higher sensitivity compared with venography in the assessment of obstructive venous disease. However, at most venous centers, both modalities continue to be used concomitantly. This study evaluated the diagnostic clinical yield of IVUS examination as a singular intraoperative investigative modality in patients in whom clinical signs and symptoms of venous disease were severe enough to merit such an examination and in whom a venogram was not performed simultaneously.

A systematic review of the efficacy and limitations of venous intervention in stasis ulceration.

Background: Surgical techniques to address various components of chronic venous disease are rapidly evolving. Their efficacy and generally good results in treating superficial venous reflux (SVR) have been documented and compared in patients presenting with pain and swelling. A growing amount of literature is now available suggesting their efficacy in patients with venous leg ulcer (VLU).

Optimal sizing of iliac vein stents.

Background Iliac vein stenting has emerged as a therapeutic option in chronic venous disease. The optimal stent size is unknown but should match normal caliber at a minimum. Methods Teleology: The iliac-femoral outflow caliber was measured by Duplex in healthy volunteers to determine normal caliber.

Deep venous thrombosis associated with caval extension of iliac stents.

Background: It is generally difficult to place an iliac vein stent precisely at the iliocaval junction with venographic control or even with intravascular ultrasound guidance. Furthermore, mechanical properties of the Wallstent (Boston Scientific, Marlborough, Mass) can predispose precisely placed stents to distal displacement or stent collapse. Our center has thus advocated extending Wallstents 3 to 5 cm into the inferior vena cava to prevent complications of missed proximal lesions or stent migration.