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At least 667 records · Page 37Linked to original sources
PubMed1988

[Reconstructive venous surgery. Principles and technical prerequisites].

The main prerequisites for successful reconstructive venous surgery include (1) critical selection of patients according to morphological and functional diagnostic aspects; (2) optimal surgical techniques; (3) the routine use of intraoperative lumen control in all disobliterative procedures (vascular endoscopy, phlebography); and (4) selective use of protective measures (temporary a.v. fistula, anticoagulans). Expanded PTFE-prostheses with increased microporosity and external ring support are the most suitable substitutes for big veins. Antireflux surgery, such as valvuloplasty, transposition technique and free valvular transfer, is a new approach for the repair of deep venous insufficiency.

Abdominal Neoplasms↗
PubMed1988

[Venous thrombectomy: indications, technic and results].

Venous thrombectomy is a promising approach to treating acute iliofemoral thrombosis with comparable results to those of thrombolysis. It is the treatment of choice in cases of thrombosis caused by pregnancy, delivery, surgery (early postoperative period) and trauma. The success depends on the age of the thrombus, skilled surgical techniques with atraumatic preparation and intra-operative endoscopic control. Creation of an adjunctive av-fistula is mandatory to protect against reocclusion. Followup includes X-ray and checkups. Reininterventions are possible.

Humans↗
PubMedDate not supplied

Evaluation of the effects of elastic compression in patients with postphlebitic limbs by laser-Doppler flowmetry.

Laser-Doppler flowmetry has been used to study the skin microcirculation in 20 normal limbs and 80 limbs of patients with venous hypertension and leg ulceration due to deep venous reflux. It was found that limbs with venous hypertension had a high skin resting blood flow (BRF) and an impaired veno-arteriolar reflex (VR). There was a marked improvement in both BRF and VR after elastic compression for three weeks and an association between this improvement and the rate of healing of the leg ulcers. The results indicate that elastic compression may affect the microcirculation even though it does not alter the venous pressure measurements when the elastic stockings are removed.

Adult↗
PubMedDate not supplied

Evaluation of capillary permeability and microcirculation in patients with chronic venous hypertension treated with venoruton by the vacuum suction chamber (VSC) device and laser-Doppler flowmetry.

A new system to study capillary permeability, the VSC (vacuum suction chamber) device has been developed to evaluate the variations of capillary permeability in postphlebitic limbs. The VSC device produces by negative pressure [obtained in a plastic chamber applied to the skin at the perimalleolar region] a wheal which disappears in normals in less than one hour. In twelve patients with moderate [superficial] venous hypertension and in twelve patients with postphlebitic limbs the time of disappearance of the wheals was significantly longer in comparison with ten normal limbs. There was also a significantly increased time of disappearance of the wheals in postphlebitic legs in comparison with those with superficial incompetence. The validation of the VSC technique with venous occlusion plethysmography (VOP) showed that the increase of time of disappearance of the wheals is well correlated with the increase of capillary permeability demonstrated by VOP. After 2 weeks treatment with Venoruton (at the dosage of 1000 mg t.i.d.) the time of disappearance of the wheal was significantly reduced in both groups of patients (while it was unchanged in normals). Laser-Doppler parameters used together with the VSC device to evaluate the microcirculatory changes associated with an altered capillary permeability also showed a significant improvement of the laser-Doppler parameters after treatment. In conclusion there is evidence by the VSC device that capillary permeability [which is abnormally increased] in chronic venous hypertension is improved [decreased] after treatment for two weeks with Venoruton. This study demonstrated also the efficacy of the VSC device to study capillary permeability and the effects of drugs active on capillary permeability.

Adult↗
PubMed1988

[Peripheral hemodynamics at various stages of deep vein thrombosis of the legs].

A study of 46 patients at different stages of deep-vein thrombosis of the legs, using venous-occlusion plethysmography, doppler ultrasonic flowmetry and radiopaque phlebography, has identified structural and functional mechanisms compensating venous outflow for clinically inapparent nonocclusive thrombosis, acute occlusion of a major venous trunk and post-thrombotic disease.

Acute Disease↗
PubMed1988

[Venous diseases of the extremities--surgery and demands on radiology].

Surgery in the low-pressure system primarily means surgical treatment of varicosis. Reconstructive treatment is rather rare. That is the reason why for the radiologist phlebography is the most important method of examination in venous affections. The assessment of valve failures and the differing anatomy in the orifices of the major and minor saphenous vein show the high ranking of this examination from the surgeons point of view. No vascular surgeon would like to do without it.

Humans↗
PubMed1988

[The combination of phlebography and invasive measurement of venous pressure].

Phlebographic visualisation offers the highest spatial resolution of all imaging methods both in respect of veins of the leg and pelvis and of the abdomen. Phlebography offers optimal conditions for assessing morphological changes at the veins and in their direct neighbourhood. No quantitative information is available via phlebography if haemodynamics are disturbed; qualitative information is yielded merely to a restricted extent (by assessing flow velocity and collaterals). Direct sanguinous measurement of venous blood pressure is particularly suitable for the quantitative and qualitative assessment of disturbed haemodynamic conditions; in this respect it stands out among the function tests based on the employment of apparatures. If it is combined with phlebography, it is possible not only to optimise the diagnostic yield in the hands of one investigator, but also to reduce the invasiveness of both methods to one single puncture, since the puncture needle is at the same time also an instrument to measure the pressure. The article points out the possibilities and limitations of combining a) ascending phlebography of the leg and pelvis with peripheral venous pressure measurement (phlebodynamometry) and b) visualisation of the veins of the pelvis and vena cava inferior with central sanguinous venous pressure measurement (CP). Indicatious and technical execution are described.

Adult↗
PubMed1988

[Endoscopic dissection of perforating veins].

The eradication of incompetent perforating veins in combination with fasciotomy is an effective way of treating advanced postphlebitic leg ulcers. Our newly developed endoscopic instrument can be used with both techniques. First the superficial fasciae of the leg are split, and then the perforating veins at different levels are located, injected with anticoagulant and severed. Preliminary clinical studies have reported very encouraging results: leg ulcers healed in all cases and the venous function was improved.

Endoscopes↗
PubMed1988

[Reconstruction of unilateral iliac vein occlusion].

From 1 July 1971 through 6 June 1987, 46 of 10,644 reconstructive vascular interventions were Palma-operations. The morphological operability was ascertained by ascending phlebography and the functional indication by phlebodynamometry. The autologous contralateral saphenous vein was used in 19 patients as a transplant, whereas 27 patients received a spiral-wrap polytetrafluoraethylene (PTFE) prosthesis. All patients were given a temporary av-fistula. Followup was possible in 15 of the 19 autologous operations and in 25 of the 27 PTFE operations. Ten vein transplants and 21 PTFE transplants were still patent.

Adult↗
PubMedDate not supplied

[Practical reflections on Linton's operation. Apropos of 110 operations].

Appropriate surgery on venous ulcers (Linton's operation) is an efficient therapeutic method. In 110 of these operations, rapid healing of the ulcer was achieved in 90% of cases, with 10% affected by necrosis and infection of the cutaneous incision. The result held without relapse for three years for 85% of the 52 patients who were able to be reviewed after this length of time. The operative technique has to adhere to two imperatives: a long incision up to the ulcer, and very exact skin closure. Ulcerous relapse, and ulcers failing to respond to routine treatment are the prime indications of surgery; indications can be extended to certain pre-ulcerous conditions.

Humans↗
PubMed1988

Relationship of venous reflux to the site of venous valvular incompetence: implications for venous reconstructive surgery.

To evaluate the relationship of the site of venous valvular incompetence to the severity of venous reflux, legs of 71 patients with suspected chronic venous insufficiency were evaluated with Doppler ultrasonography and photoplethysmography. A venous recovery time (VRT) of less than 20 seconds after calf muscle exercise was considered indicative of significant reflux. Average VRTs were brief in 15 legs with stasis changes (10 +/- 7 seconds), longer in 42 legs with edema (26 +/- 23 seconds), and normal in 64 asymptomatic legs (37 +/- 24 seconds) and 16 legs with pain (53 +/- 19 seconds). Average VRTs in limbs with incompetent saphenous veins were abnormal. In limbs with competent superficial veins, only those with incompetent distal deep veins (popliteal and posterior tibial) had abnormal VRTs (14 +/- 10 seconds). VRTs in limbs with no detectable valvular incompetence and in those with incompetence limited to the proximal deep veins (common and superficial femoral) were normal (47 +/- 23 and 42 +/- 27 seconds, respectively). When superficial veins were incompetent, an ankle tourniquet normalized VRTs in 63% of legs with proximal deep venous incompetence and in only 33% of legs with distal deep venous incompetence. It is concluded that venous reflux is largely determined by saphenous and distal deep valvular function and that competence of the proximal valves has little effect. Decreased venous reflux would not be expected after proximal valvular reconstruction.

Female↗
PubMed1988

[Rational diagnosis in phlebologic practice].

Venous diseases are of extraordinary sociomedical and socioeconomic relevance. They are a daily problem in general practice and require careful diagnostic clarification and exact definition with regard to differential diagnosis. In the diagnosis of important venous diseases Doppler sonography must always be carried out after the case history has been taken and a physical examination has been performed. It allows a relatively fast, functionally orientated and differentiated assessment of all venous diseases of the lower and upper extremities and does not involve any risk. At present, it cannot be replaced by any other method either in general or in clinical practice, and also serves as an indication for phlebography for example. Duplex sonography can supplement Doppler ultrasonography significantly, but this examination is still very expensive. There are fundamental sources of error in photoplethysmography and this technique has considerable limitations. It never can replace Doppler ultrasonography. Its only well-founded application - besides a general determination of a more pronounced venous transport disturbance - is to test the haemodynamic effect of eliminating important venous insufficiency points as preparation for invasive forms of therapy. The kind of examination shown here offers the best prerequisites for rational diagnosis in phlebological practice.

Humans↗