Type:
Educational Exhibit
Keywords:
Varices, Oedema, Embolism / Thrombosis, Diagnostic procedure, Cost-effectiveness, Ultrasound-Spectral Doppler, Ultrasound-Colour Doppler, Ultrasound, Veins / Vena cava, Vascular, Extremities
Authors:
A. Fuentealba1, D. Ramirez2, J. P. Durán1, G. P. Zamboni1, D. I. Herquinigo1; 1Santiago/CL, 2Santiago, METROPOLITANA/CL
DOI:
10.1594/ecr2018/C-3166
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 and Pathophysiological) classification.
Higher c-classification corresponds to more advanced CVD.
The revised Venous Clinical Scoring System (VCSS) is another venous assessment tool utilized to categorize the overall severity of venous
disease.
Unlike CEAP,
VCSS scale is a dynamic tool that provides descriptions of the signs and symptoms of CVD and should be used to assess treatment outcome.
It is necessary to know the nomenclature that is used to describe the deep and superficial territory an how it relates to venous disease,
the distribution of the venous system in relation to the deep fascia,
if there is communication between the different territories (Deep,
Superficial or Perforators) and evidence of the main variants and their relation to main venous trunks which can influence the treatment.
Considering the extent of the territory to be evaluated,
it is important to Remain in the Desirable Path and systematically report:
- Determine if there is Retrograde flow (R)
- Diameters of the deep and superficial veins (D)
- Permeability of the venous system (P)