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PubMed2005

[Diagnosis of chronic venous insufficiency].

While the importance of clinical criteria for the diagnosis of chronic venous insufficiency remains unchallenged, the equipment-based diagnosis has developed away from pressure measurement, plethysmography and phlebography towards Doppler and color-flow duplex scanning. The CEAP classification of clinical stages is recognized throughout the world. Skin tests, the evaluation of ankle joint mobility and the investigation of the thrombophilia risk continue to be required.

Chronic Disease↗
PubMed1991

[Surgical anatomy of the posterior tibial veins].

An investigation of the posterior tibial vascular plexus has established certain specific features of its structure both in normality and in patients with postthrombotic disease. The alterations found require an individual approach to choice of surgical measures which is finally determined intraoperatively. At the present time surgical interventions on the posterior tibial veins in patients with postthrombotic disease are thought to be of three types: extended resection, extravasal correction and plasty of the posterior tibial veins.

Arteriovenous Anastomosis↗
PubMed1991

[Blood rheological disorders in patients with postthrombotic disease and the means for their correction].

An analysis of results of rheological properties of blood in 45 patients with different forms of postthrombotic disease of lower extremities has shown that 78% of the patients have erythrocytosis and all the patients have hyperviscosity shifts. Correction of the hemorheological changes by the methods of transfusion therapy (plasmapheresis, exfusion of blood, hemodilution) allowed to reduce the microcirculatory disorders in the diseased extremity in this group of patients.

Adult↗
PubMed1991

Factor XIII-deficiency in the blood of venous leg ulcer patients.

Pericapillary fibrin cuffs are probably involved in the pathogenesis of venous leg ulcers. Factor XIII (Fibrin stabilizing factor) is of importance in wound healing. Its activity, which may affect ulceration, was found to be significantly reduced in the blood of venous leg ulcer patients and in post-phlebitic patients, compared with healthy controls.

Chronic Disease↗
PubMed1991

Late complications of asymptomatic deep venous thrombosis.

Forty-one patients who had all participated in studies about prophylaxis of postoperative deep venous thrombosis (DVT) were investigated 5-8 years after operation. Twenty-five had had asymptomatic DVT detected by 125I-fibrinogen uptake test or 99mTc plasmin scintigraphy and verified by phlebography, four of which were bilateral. They received anticoagulant treatment for three months. Sixteen patients had normal screening tests. At the follow up legs in which DVT had previously been diagnosed were compared with normal legs in patients who did not have DVT. There was no significant difference in subjective symptoms between the two groups of legs, although there were more complaints of oedema and restlessness in legs in which DVT had been diagnosed and varicose veins were more common. When the incidence of varicose veins before the operation and at the follow up was compared, more patients who had had a DVT had developed varicose veins. Blood volume and venous refilling time were measured by strain gauge plethysmography, and were significantly lower in those with a history of DVT than in normal legs. The results indicate impaired venous function in patients who previously had had asymptomatic DVT treated with anticoagulants.

Aged↗
PubMed1992

Valvular reflux after deep vein thrombosis: incidence and time of occurrence.

From December 1986 to December 1990, 268 patients with acute deep vein thrombosis were studied in our laboratory. From this group 107 patients (123 legs with deep vein thrombosis) were placed in our long-term follow-up program. The documentation of valvular reflux and its site was demonstrated by duplex scanning. The duplex studies were done at intervals of 1 and 7 days, 1 month, every 3 months for the first year, and then yearly thereafter. The mean follow-up time for these patients was 341 days. In addition, reflux was evaluated in 502 patients with negative duplex study results and no previous history of deep vein thrombosis or chronic venous insufficiency. In the patients with acute deep vein thrombosis, valvular incompetence was noted in 17 limbs (14%) at the time of the initial study. Reflux was absent in 106 limbs (86%). In this last group reflux developed in 17% of the limbs by day 7. By the end of the first month, 37% demonstrated reflux. By the end of the first year, more than two thirds of the involved limbs had developed valvular incompetence. The distribution of reflux at the end of the first year of follow-up was the following: (1) popliteal vein, 58%; (2) superficial femoral vein, 37%; (3) greater saphenous vein, 25%; and (4) posterior tibial vein, 18%. Reflux seems to be more frequent in the segments previously affected with deep vein thrombosis. Among cases where segments were initially affected with thrombi, after 1 year the incidence of reflux was 53%, 44%, 59%, and 33% for the common femoral vein, superficial femoral, popliteal vein, and posterior tibial vein, respectively.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1991

[The current diagnostic procedure in chronic pathology of the veins of the lower extremities].

Stepwise (out- and inpatient) examination forms the basis of diagnostic examination tactics in chronic abnormalities of the veins. Noninvasive ultrasonic methods of studying the venous system are preferred. With the gradual formation of groups of patients with an affection of the veins, invasive isotope and angiographic methods are supplemented. The authors emphasize that such examination of patients in stages raises the efficacy and the quality of diagnosis in individuals with chronic venous abnormalities.

Diagnosis, Differential↗
PubMed1991

[Combined ultrasonic methods in the diagnosis and treatment of patients with chronic venous insufficiency].

The use of combined ultrasonic methods in chronic venous insufficiency of the lower extremities is of high diagnostic value. A colored doppler image demonstrates most vividly the vascular blood flow. Quantitative values of arterial and venous hemodynamics obtained by means of the image in real time and dopplerography allow correct choice of the tactics of treatment. With the use of ultrasonic methods in reconstructive operations all necessary corrections can be introduced into the treatment in time.

Chronic Disease↗
PubMed1991

Laser Doppler vasomotion among patients with post-thrombotic venous insufficiency: effect of intermittent pneumatic compression.

Laser Doppler fluxmetry (LDF) was used to measure skin blood flux and its vasomotion, i.e. rhythmical variations in nineteen patients with post-thrombotic venous insufficiency, and in eight healthy control subjects before and after a single intermittent pneumatic compression treatment session. Following the compression treatment session skin blood flux increased and vasomotion was seen in all the patients. The transcutaneous oxygen tension also increased slightly, but significantly, from 25.4 (range 3-56) mmHg to 30.8 (range 7-61) mmHg (p less than 0.01). It is suggested that IPC treatment decreases venous distention and venous pressure thereby decreasing vasocontrictor stimulus. This seems to restore normal skin blood flow including vasomotion.

Adult↗
PubMed1991

[Therapy and the natural course of axillary vein thrombosis--review of 765 patients and analysis of our personal patient sample].

UNLABELLED: Thrombosis of the axillary vein is a rare event. The incidence of 0.5, -1.5% of all venous thromboses makes comparative studies concerning therapy in a single center impossible. 15 own patients and 750 patients with axillary vein thrombosis collected from literature were studied, to compare the different therapeutic modalities. 36% received no therapy (NV), 15% anticoagulation (AG: heparin, warfarin, coumarins), 18% thrombolytic therapy (TL streptokinase, urokinase, locally and systemic) and 31% were treated by surgery (OP). Mean follow up was 32 months in NV, AG: 16, 3, TL: 35, OP: 38 months. RESULTS: NV; No complaints: 12%, PTS I: 29%, PTS II: 25%, PTS III: 33%. CONCLUSION: Untreated axillary vein thrombosis leads to functional disability of the affected extremity in one third. AG reduces this rate to 25%. After surgery and thrombolytic therapy a severe PTS is found only in 12% and 13.7% respectively. Loss of extremity was found in 5 cases (0.6%). A mechanic factor seems to be important in thrombogenesis. Rapid restitution of venous backflow and promotion of collateralisation is important to avoid disability of the patient. The low difference between AG and OP is pointed out indicating that invasive surgery should be restricted to special cases.

Adult↗