Learning objectives
After reviewing this educational exhibit you will be able to :
Describe the most important classifications of chronic venous disease (CVD) in clinical and vascular surgery; and learn the correct nomenclature used
Remember the main anatomical landmarks and their more frequent variants
Propose a systematic and efficient scanning protocol
Background
Doppler ultrasound is probably the most frequent used exam to evaluate the venous system for management of chronic venous disease (CVD).
However,
there is no systematic consensus agreement from the different medical societies on how the Doppler ultrasound in CVD is best performed.
Classification
Different classifications and scores have been developed to characterize CVD(VEIN-TERM,
CEAP,
VCSS,
VDS).
CVD is an spectrum of chronic morphologic and functional venous abnormalities manifested by clinical signs and / or symptoms that can be classified according CEAP (Clinical,
Etiological,
Anatomical...
Findings and procedure details
Anatomy
Great Saphenous Vein (GSV)
The GSV commences its course anterior to the medialmalleolus and passes upwards along the tibial edge ofthe medial calf to cross the knee and then along themedial thigh to the Saphenous Femoral Junction (SFJ).
The GSV has a constantterminal valve 1–2 mm distal to the SFJ,
which is usually easily identified on ultrasound (US).Thereis often another pre-terminal valve a further 2 cmdistal,
which marks the distal limit of the SFJ area.
The most important tributaries join the GSVbetween the two...
Conclusion
The study of CVD of lower extremities can be long and tedious,
even for experienced sonographers,
so it is important to have a systematic approach to the study and analysis of different veins.
In order to achieve an adequate evaluation we must maintain an order and keep in mind toRemain in the Desirablepath and always evaluate:
Determine if there is Retrograde flow (R)
Diameters of the deep and superficial veins (D)
Permeability of the venous system (P)
References
P.
Coleridge-Smith,1* N.
Labropoulos,2 H.
Partsch,3 K.
Myers,4 A.
Nicolaides5and A.
Cavezzi6.Duplex Ultrasound Investigation of the Veins in Chronic
Venous Disease of the Lower Limbs—UIP Consensus
Document.
Part I.
Basic Principles.Eur J Vasc Endovasc Surg Vol 31,
1 2006
A.
Cavezzi,1* N.
Labropoulos,2 H.
Partsch,3 S.
Ricci,4 A.
Caggiati,4 K.
Myers,5
A.
Nicolaides6 and P.C.
Smith7Duplex Ultrasound Investigation of the Veins in Chronic
Venous Disease of the Lower Limbs—UIP Consensus
Document.
Part II.
Anatomy.Eur J Vasc Endovasc Surg 31,
288–299 (2006)
Bo Eklof,
MD,
PhD,a...