Advertisement

Duplex Ultrasound of Superficial Leg Veins in the Context of Saphenous Vein Sparing Surgery

  • Erika Mendoza
  • Erica Menegatti
Chapter

Abstract

Duplex ultrasound is the foundation to understanding venous haemodynamics as described in this book. That is the reason why the examination has to be mastered by at least one person in the team treating patients with varicose veins. In this chapter the identification of the different reflux sources, alone or in combination, refluxing pathways and re-entry points are described. Special attention will be given to the discrimination between the different shunt types after Franceschi. The typical outcome images after surgery, in case of failure as well as success, are discussed.

Literature

  1. 1.
    Trendelenburg F. Ueber die Unterbindung der Vena saphena magna bei Unterschenkelvaricen. Bruns Beitr Klein Chir. 1891;7(1):195–210.Google Scholar
  2. 2.
    Cavezzi A, Labropoulos N, Partsch H, Ricci S, Caggiati A, Myers K, Nicolaides A, Smith PC. Duplex ultrasound investigation of the veins in chronic venous disease of the lower limbs—UIP consensus document. Part II. Anatomy. Eur J Vasc Endovasc Surg. 2006;31:288–99.CrossRefPubMedGoogle Scholar
  3. 3.
    Coleridge-Smith P, Labropoulos N, Partsch H, Myers K, Nicolaides A, Cavezzi A. 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. 2006;31(1):83–92.CrossRefPubMedGoogle Scholar
  4. 4.
    De Maeseneer M, Pichot O, Cavezzi A, Earnshaw J, van Rij A, Lurie F, Smith PC. Duplex ultrasound investigation of the veins of the lower limbs after treatment for varicose veins e UIP consensus document. EJVS. 2011;42(1):89–102.Google Scholar
  5. 5.
    Mendoza E, Lattimer CR, Morrison N. Duplex ultrasound of superficial leg veins. New York: Springer; 2014.CrossRefGoogle Scholar
  6. 6.
    Lattimer C, Azzam M, Papaconstandinou JA, Villasin M, Ash S, Kalodiki E. Neuromuscular electrical stimulation reduces sludge in the popliteal vein. J Vasc Surg Venous Lymphat Disord. 2017. pii: S2213–333X(17)30448–1.  https://doi:10.1016/j.jvsv.2017.09.008. [Epub ahead of print].CrossRefPubMedGoogle Scholar
  7. 7.
    Lattimer CR, Franceschi C, Kalodiki E. Optimizing calf muscle pump function. Phlebology. 2017:268355517709410.  https://doi.org/10.1177/0268355517709410. [Epub ahead of print]. PMID: 28530489.
  8. 8.
    Weskott HP, Mendoza E, Lattimer CR. The ultrasound scanner. In: Mendoza E, Lattimer CR, Morrison N, editors. Duplex ultrasound of superficial leg veins. New York: Springer; 2014.Google Scholar
  9. 9.
    Labropoulos N, Tiongson J, Pryor L, Tassiopoulos AK, Kang SS, Mansour A, Baker WH. Definition of venous reflux in lower-extremity veins. J Vasc Surg. 2003;38:793–8.CrossRefPubMedGoogle Scholar
  10. 10.
    Habenicht M, Rabe E, Amsler F, Mendoza E. Toe elevation manoeuvre to assess venous reflux in comparison to manual calf compression and release. Vasa. 2016;45(4):299–304.CrossRefPubMedGoogle Scholar
  11. 11.
    Jeanneret C, Labs KH, Aschwanden M, Bollinger A, et al. Physiological reflux and venous diameter change in the proximal lower limb veins during a standardised Valsalva manoeuvre. Eur J Vasc Endovasc Surg. 1999;17:398–403.CrossRefPubMedGoogle Scholar
  12. 12.
    Lattimer CR, Azzam M, Kalodiki E, Geroulakos G. Quantifying saphenous recirculation in patients with primary lower extremity venous reflux. J Vasc Surg Venous Lymphat Disord. 2016;4(2):179–86.  https://doi.org/10.1016/j.jvsv.2015.09.006. Epub 2015 Nov 24. PMID: 26993865.CrossRefPubMedGoogle Scholar
  13. 13.
    Franceschi C. Mésures et interprétation des flux veineux lors des manœvres de stimulation. Compressions manuelles et manœvre de Paraná Indice dynamique de reflux IDR et indice de Psatakis. J Mal Vasc. 1997;22(2):1–5.Google Scholar
  14. 14.
    Mendoza E. Diameter reduction of the great saphenous vein and the common femoral vein after CHIVA long-term results. Phlebologie. 2013;42:65–9.CrossRefGoogle Scholar
  15. 15.
    Mendoza E. Popliteal reflux in incompetent small saphenous veins. Phlebologie. 2013;42:37–41.CrossRefGoogle Scholar
  16. 16.
    Lattimer CR, Mendoza E. Superficial venous reflux duration and cessation with two concurrent duplex probes. J Vasc Surg Venous Lymphat Disord. 2015;3(2):154–60.CrossRefPubMedGoogle Scholar
  17. 17.
    Lattimer CR, Azzam M, Kalodiki E, Geroulakos G. Venous filling time using air-plethysmography correlates highly with great saphenous vein reflux time using duplex. Phlebology. 2014;29(2):90–7.  https://doi.org/10.1258/phleb.2012.012042. Epub 2013 May 6. PMID: 23035010.CrossRefPubMedGoogle Scholar
  18. 18.
    Mendoza E. The sapheno-femoral junction in ultrasound. Phlebologie. 2014;43:42–5.CrossRefGoogle Scholar
  19. 19.
    Zollmann P, Zollmann C, Zollmann P, Veltman J, Kerzig D, Doerler M, Stücker M. Determining the origin of superficial venous reflux in the groin with duplex ultrasound and implications for varicose vein surgery. J Vasc Surg Venous Lymphat Disord. 2017;5(1):82–6.CrossRefPubMedGoogle Scholar
  20. 20.
    Stücker M, Moritz R, Altmeyer P, Reich-Schupke S. New concept: different types of insufficiency of the saphenofemoral junction identified by duplex as a chance for a more differentiated therapy of the great saphenous vein. Phlebology. 2013;28:268–74.CrossRefPubMedGoogle Scholar
  21. 21.
    Mendoza E, Stücker M. Duplex-ultrasound assessment of the saphenofemoral junction (Review). Phlebological Review. 2015;23(3):1–8.Google Scholar
  22. 22.
    Mendoza E. Handbuch CHIVA, Arrien GmbH; 2002.Google Scholar
  23. 23.
    Mendoza E, Amsler F. CHIVA with endoluminal procedures: LASER versus VNUS—treatment of the saphenofemoral junction. Phlebologie. 2017;46:5–12.CrossRefGoogle Scholar
  24. 24.
    Dwerryhouse S, Davies B, Harradine K, Earnshaw JJ. Stripping the long saphenous vein reduces the rate of reoperation for recurrent varicose vein: five-year results of a randomized trial. J Vasc Surg. 1999;29(4):589–92.CrossRefPubMedGoogle Scholar

Copyright information

© Springer International Publishing AG, part of Springer Nature 2018

Authors and Affiliations

  1. 1.VenenpraxisWunstorfGermany
  2. 2.Vascular Diseases CenterUniversity of FerraraFerraraItaly

Personalised recommendations