Chapter 86
Clinical Application of Objective Testing in Venous Insufficiency
John J. Bergan,
Warner P. Bundens,
John J. Bergan
Search for more papers by this authorWarner P. Bundens
Search for more papers by this authorJohn J. Bergan,
Warner P. Bundens,
John J. Bergan
Search for more papers by this authorWarner P. Bundens
Search for more papers by this authorBook Editor(s):Enrico Ascher,
L. H. Hollier,
D. Eugene Strandness,
Jonathan B. Towne,
Keith Calligaro,
K. Craig Kent,
Gregory L. Moneta,
William H. Pearce,
John J. Ricotta,
Henry Haimovici,
Enrico Ascher
Search for more papers by this authorL. H. Hollier
Search for more papers by this authorD. Eugene Strandness
Search for more papers by this authorJonathan B. Towne
Search for more papers by this authorKeith Calligaro
Search for more papers by this authorK. Craig Kent
Search for more papers by this authorGregory L. Moneta
Search for more papers by this authorWilliam H. Pearce
Search for more papers by this authorJohn J. Ricotta
Search for more papers by this authorHenry Haimovici
Search for more papers by this authorFirst published: 01 January 2004
Summary
This chapter contains section titled:
-
CEAP Classification
-
Diagnostic Approach
-
Duplex Assessment of Venous Reflux
-
Reflux Examination Development
-
Validation of Duplex Testing
-
Duplex Determination of Patterns of Venous Reflux
-
Valve Incompetence in Limbs With Venous Ulceration
-
Correction of Deep Venous Reflux By Superficial Venous Stripping
-
Proximal Reflux Affects Distal Deep Venous Function
-
Hemodynamic Testing
-
Conclusion
-
Pathophysiology
References
- Nicolaides A, Christopoulos D, Vasdekis S. Progress in investigation of chronic venous insufficiency. Ann Vasc Surg 1989; 3: 278–292.
- Pollack AA, Wood EH. Venous pressure in the saphenous vein at the ankle in man during exercise and changes in posture. J Appl Physiol 1949; 1: 649–662.
- Nicolaides AN, Zukowski AJ. The value of dynamic venous pressure measurements. World J Surg 1986; 10: 919–924.
- Yao JST, Flinn WR, et al. The role of noninvasive testing in the evaluation of chronic venous problems. World J Surg 1986; 10: 911–918.
- Abramowitz HB, Queral LA, et al. Use of photoplethysmography in the assessment of venous insufficiency: a comparison with venous pressure measurements. Surgery 1979; 86: 434–439.
- Barnes RW, Collicott RE, et al. Noninvasive quantitation of venous reflux in the postphlebitic syndrome. Surg Gynecol Obstet 1973; 136: 769–776.
- Tibbs DJ, Fletcher EWL. Direction of flow in superficial veins as a guide to venous disorders in lower limbs. Surgery 1983; 93: 758–766.
- Lea Thomas M. Phlebography of the Lower Limb. Scotland: Churchill Livingston, 1982.
- Herman RJ, Neiman HL, Yao JST. Descending venography: a method of evaluating lower limb extremity valvular function. Radiology 1980; 137: 63–69.
- Neuman HAM, Boersma IDS. Light reflection rheography. J Dermatol Surg Oncol 1992; 18: 425–430.
- van Bemmelen PS, van Ramshorst B, Eikelboom BC. Photoplethysmography reexamined: lack of correlation with duplex scanning. Surgery 1992; 112: 544–548.
- Sarin S, Shields DA, et al. Photoplethysmography: a valuable noninvasive tool in the assessment of venous dysfunction? J Vasc Surg 1992; 16: 154–162.
- Beebe WG, Bergan JJ, Bergqvist D, et al. Classification of chronic venous disease of the lower extremities: A consensus statement. Eur J Vasc Endovasc Surg 1996; 12: 487–492.
- Miller SS, Grossman JA, Foote PV. The ultrasonic detection of perforating veins. Br J Surg 1975; 58: 872–874.
- Hoare MC, Royle JP. Doppler ultrasound detection of saphenofemoral and saphenopopliteal incompetence and operative venography to ensure precise saphenopopliteal ligation. Aust NZ J Surg 1984; 54: 49–53.
- Bergan JJ, Moulton SL, et al. Patient selection for surgery of varicose veins using venous reflux quantitation. In: FJ Veith, ed. Current Critical Problems in Vascular Surgery 4. St Louis: Quality Medical Publishers, 1992.
- Rollins DL, Semrow ML, et al. Use of ultrasonic venography in the evaluation of venous valve function. Am J Surg 1987; 154: 189–191.
- Sigel B, Machi S, et al. Red cell aggregation as a cause of blood flow echogenicity. Radiology 1983; 148: 799–806.
- van Bemmelen PS, Bedford G, et al. Quantitative segmental evaluation of venous valvular reflux with ultrasound scanning. J Vasc Surg 1989; 10: 425–431.
- Vasdekis SN, Clarke GH, Nicolaides AN. Quantification of venous reflux by means of duplex scanning. J Vasc Surg 1989; 10: 670–677.
- Browse NL, Burnand KG, Lea Thomas M. Diseases of the Veins: Pathology, Diagnosis, and Treatment. Great Britain: Edward Arnold Publishers, 1988: 478.
- Thomson H. The surgical anatomy of the superficial and perforating veins of the lower limb. Ann R Coll Surg Engl 1979; 61: 198–203.
- Zamboni, P. La chirurgia conservativa del sistema venoso superficiale. Faenza: Gruppo Editoriale Faenza Editrice 1996; 3–9.
- Caggiati A. Fascial relationship of the long saphenous vein. Circulation 1999; 100: 2547–2549.
- Caggiati A. The saphenous compartments. Surg Radiol Anat 1999; 21: 29–34.
- Szendro G, Nicolaides AN, et al. Duplex scanning in the assessment of deep venous incompetence. J Vasc Surg 1986; 4: 237–242.
- Sarin S, Sommerville K, et al. Duplex ultrasonography for assessment of venous valvular function of the lower limb. Br J Surg 1994; 81: 1591–1595.
- Araki CT, Back TL, et al. Refinements in the ultrasonic detection of popliteal vein reflux. J Vasc Surg 1993; 18: 742–748.
- Pichot O, Sessa C, et al. Role of duplex imaging in endovenous obliteration for primary venous insufficiency. J Endovasc Ther 2000; 7: 451–459.
- Mekenas L, Bergan JJ. Venous reflux examination: technique using miniaturized ultrasound scanning. J Vasc Tech 2002; 26: 139–146.
- Payne SPK, London NJM, et al. Investigation and significance of short saphenous vein incompetence. Ann Royal Coll Surg 1993; 75: 354–357.
- Delis KT, Ibeguna V, et al. Prevalence and distribution of incompetent perforating veins in chronic venous insufficiency. J Vasc Surg 1998; 28: 815–825.
- Grouden MC, Stanley ST, et al. Triplex imaging of the saphenofemoral junction is the test of choice in patients with primary varicose veins. J Vasc Tech 1993; 17: 131–133.
- Masuda EM, Kistner RL. Prospective comparison of duplex scanning and descending venography in the assessment of venous insufficiency. Am J Surg 1992; 164: 254–259.
- Kistner RL, Ferris EB, et al. A method of performing descending phlebography. J Vasc Surg 1986; 4: 464–468.
- Rosfors S. A methodological study of venous valvular insufficiency and musculovenous pump function of the lower leg. Phlebology 1992; 7: 12–19.
- Neglen P, Raju S. A comparison between descending phlebography and duplex doppler investigations in the evaluation of reflux in chronic venous insufficiency: a challenge to phlebography as the “gold standard. ” J Vasc Surg 1992; 16: 687–693.
- Lees TA, Lambert D. Patterns of venous reflux in limbs with skin changes associated with chronic venous insufficiency. Br J Surg 1993; 80: 725–728.
- Hanrahan LM, Araki CT, et al. Distribution of valvular incompetence in patients with venous stasis ulceration. J Vasc Surg 1991; 13: 805–812.
- Walsh JC, Bergan JJ, et al. Femoral venous reflux is abolished by greater saphenous stripping. Ann Vasc Surg 1993; 1994; 8: 566–570.
- Fischer H, Siebrecht H. Das Kaliber der tiefen Unter-schenkelvenen bei der primaren Varicose und beim post-thrombotischen Syndrome (Eine phlebographische Studie). Der Hautarzt 1970; 5: 205–211.
- Hach W, Schirmers U, Becker L. Veranderungen der tiefen Lietvenen bei einer Stammverikose der V. saphena magna. In: H Muller-Wiefel, ed. Mikrozirkulation and Blutrheologic. Baden Baden: Witzstock, 1980.
- Walsh JC, Bergan JJ, et al. Proximal reflux adversely affects distal venous function. Vasc Surg 1996; 30: 89–96.
- Neglen P, Raju S. Detection of outflow in chronic venous insufficiency. J Vasc Surg 1993; 17: 583–589.
- McDaniel HB, Marston WA, et al. Recurrence of chronic venous ulcers on the basis of clinical, etiologic, anatomic, and pathophysiologic criteria and air plethysmography. J Vasc Surg 2002; 35: 723–728.
- Marston WA. PPG, APG, duplex: Which noninvasive tests are most appropriate for the management of patients with chronic venous insufficiency? Semin Vasc Surg 2002; 15: 13–20.