1 the Ultrasound Scanner 1 2 Anatomy of the Superficial Veins 19

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1 the Ultrasound Scanner 1 2 Anatomy of the Superficial Veins 19

1 The Ultrasound Scanner 1 Hans-Peter Weskott, Erika Mendoza, and Christopher R. Lattimer 2 Anatomy of the Superficial Veins 19 Alberto Caggiati, Erika Mendoza, Renate Murena-Schmidt, and Christopher R. Lattimer 3 Pathophysiology of the Superficial Venous System 49 Erika Mendoza, Claude Franceschi, Birgit Kahle, and Christopher R. Lattimer 4 Ultrasound-Based Classifications of Varicose Veins 67 Erika Mendoza and Christopher R. Lattimer 5 Duplex Ultrasound Examination of Superficial Leg Veins.... 93 Erika Mendoza, Nick Morrison, and Christopher R. Lattimer 6 Flow Provocation Manoeuvres for the Diagnosis of Venous Disease Using Duplex Ultrasound 105 Erika Mendoza and Christopher R. Lattimer 7 Examination of the Great Saphenous Vein 119 Erika Mendoza, Nick Morrison, and Christopher R. Lattimer 8 Examination of the Small Saphenous Vein 171 Erika Mendoza and Christopher R. Lattimer 9 Perforating Veins 187 Erika Mendoza and Christopher R. Lattimer 10 Tributaries 201 Erika Mendoza and Christopher R. Lattimer 11 Superficial Vein Thrombosis 217 Erika Mendoza and Christopher R. Lattimer 12 Ultrasound in Varicose Vein Treatment 227 Erika Mendoza, Thomas M. Proebstle, Achim Mumme, Franz Xaver Breu, Nick Morrison, and Christopher R. Lattimer http://d-nb.info/1038119928 xii 13 Ultrasound After Venous Intervention 247 Erika Mendoza,-Achim Mumme, Andreas Hildebrandt, Nick Morrison, and Christopher R. Lattimer 14 Deep Leg Veins 267 Hans-Joachim Kruse, Erika Mendoza, Nick Morrison, and Christopher R. Lattimer 15 Examination of Superficial Veins in the Presence of Deep Venous Disease 279 Erika Mendoza and Christopher R. Lattimer 16 Differential Diagnosis of Leg Oedemas of Venous and Lymphatic Origin 285 Erika Mendoza and Christopher R. Lattimer 17 Incidental Findings During a Venous Examination of the Leg 291 Erika Mendoza, Hans-Peter Weskott, Helmut Kopf, and Christopher R. Lattimer Appendix 1: Further Reading 311 Appendix 2: Literature German Version 313 Appendix 3: Abbreviations Used to Label the Figures 321 Index 323 .

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Surgical Treatment of Varicose Veins with the CHIVA Method
Review Operative Behandlung der Varikose nach der CHIVA-Methode Surgical treatment of varicose veins with the CHIVA method Autoren Erika Mendoza Institut und Spanien durchgesetzt, im Moment hält es seinen Einzug in Venenpraxis, Wunstorf China und in den osteuropäischen Ländern, primär dort, wo der Duplex als Grundlage für die phlebologische Diagnostik zählt Schlüsselwörter und eine kostengünstige Herangehensweise vom Gesundheits- Chronische venöse Insuffizienz, Saphenareflux, Venenerhalt, wesen gefordert wird. CHIVA Das Verfahren kann bei jeder Ausprägung der Varikose und jedem Stadium der chronischen venösen Insuffizienz ange- Key words wendet werden, wobei der Erhalt einer postthrombotisch ver- chronic venous insufficiency, reflux in saphenous vein, änderten Stammvene nicht anstrebenswert erscheint. Eine vein preservation, CHIVA Metaanalyse (Cochrane-Review) bescheinigt CHIVA weniger Rezidive bei gleichwertigem Erstergebnis und weniger Neben- eingereicht 09.11.2018 wirkungen im Vergleich zum Stripping, wobei weitere Studien akzeptiert ohne Revision 14.03.2019 mit höheren Patientenzahlen gefordert werden. Die neuen Techniken, wie endoluminale (Hitze-) Verfahren Bibliografie und schallgesteuerte Schaumverödung haben das Verfahren DOI https://doi.org/10.1055/a-0877-8781 noch minimal-invasiver gemacht, sodass die ohnehin geringe Online Publikation: 02.05.2019 Komplikationsrate und die kurze Arbeitsunfähigkeitszeit noch Phlebologie 2019; 48: 153–160 verkürzt werden kann. © Georg Thieme Verlag KG Stuttgart · New York ISSN 0939-978X ABSTRACT Korrespondenzadresse In 1988, just after the upcoming of duplex ultrasound, the Dr. Erika Mendoza French vascular surgeon and angiologist Claude Franceschi de- Venenpraxis veloped a hemodynamic strategy to treat venous insufficiency Speckenstr. 10 on ambulatory patients. He gave the treatment the name of 31515 Wunstorf the French acronym. CHIVA. E-Mail: [email protected] The strategy is based on the preservation of draining path- ways, specially the saphenous veins.
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Veins and Lymphatics 2014; volume 3:1919 Multiple ligation of the Introduction Correspondence: Roberto Delfrate, Figlie di San proximal greater saphenous Camillo Hospital, via Fabio Filzi 56, 26100 vein in the CHIVA treatment The sapheno-femoral junction (SFJ) is a key Cremona, Italy. point for the venous drainage of the lower limb Tel.: +39.0372.421111 – Mobile: +39.334.9089110. of primary varicose veins E-mail: [email protected] from the foot up to the hip and gluteus, the Roberto Delfrate,1 Massimo Bricchi,1 lower abdominal wall and lower genital tract. Key words: saphenous-femoral disconnection, Claude Franceschi,2 Matteo Goldoni3 Moreover, the disconnection of the incompe- saphenous-femoral junction, neovascularization tent SFJ is a fundamental procedure to most recurrences, primary varicose vein surgery. 1 Surgery Unit, Figlie di San Camillo open superficial venous surgery.1-5 2 Hospital, Cremona, Italy; Angiology Unfortunately, most varicose recurrences are Received for publication: 11 September 2013. Consultant, Saint Joseph Hospital, Paris, due to SFJ neovascularization (recurrences) Revision received: 11 February 2014. France; 3Department of Consulting of observed in 25% to 94% of recurrent varicose Accepted for publication: 6 March 2014. Clinical Medicine, Nephrology and Health 6 veins. Conservative saphenous-femoral dis- This work is licensed under a Creative Commons Sciences, University of Parma, Italy connection is a very common surgical practice Attribution 3.0 License (by-nc 3.0). according to the conservative hemodynamic correction of venous insufficiency (CHIVA) ©Copyright R. Delfrate et al., 2014 method.7-12 For more than a decade we have Licensee PAGEPress, Italy Abstract tested a technique that requires a division of Veins and Lymphatics 2014; 3:1919 the SFJ and others that require only peculiar doi:10.4081/vl.2014.1919 Saphenous femoral disconnection is the key ligatures without division of the incompetent point of most surgical techniques in the treat- saphenous femoral tract.
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lli Clinic 015 2 , 16 1st International Haemodynamic Aula Magna of the Mangiaga Symposium on Venous Disorders - Haemodynamic aspects of physiopathology, diagnosis and therapy of the venous disease October 15 and , e Policlinico Hospital of Milan M i l a n Maggior Introduction In recent decades we have Scientific Board witnessed a great revolution in the approach to venous diseases thanks to the increasing understanding of the physiopathologicical mechanisms that cause the typical pathological signs of venous insufficiencies. The introduction of no n-in vasive Prof. Livio Gabrielli diagnostics with the continuous wave Doppler and subsequently with the Echo Color Doppler enabled us to acquire detailed information on the physiological mechanisms of venous circulation and consequently on the physiopathological m echanism s . This allowed for a new close examination of the events and Prof. Claude Franceschi hemodynamic changes that trigger the onset of the clinical abnormalities characteristic of venous insufficiencies. This development has greatly benefitted diagnosis and therapy not only of the superficial venous insufficiencies but also of the deep venous Dott. Roberto Delfrate insufficiencies, which are common in post-thrombosis syndrome. In the last twenty-five years, non -in vas ive hemodynamic ultrasound diagnostics together with technological developments have broade ned therapeutic options. These include conservative hemodynamic therapy and also the progressive development of different forms of m inim ally- invasive therapies which intend to offer alternatives to stripping that are easier to implement. The hemodynamic CH IVA strategy (Conservatrice et Hemodynamique de l'Insuffisance Veineuse en Ambulatoire) codified by Claude Franceschi, a pioneer who played a major role in the development and spreading of the Doppler ultrasound vascular investigation both in the arterial a nd venous districts, appeared in 1988 as an alternative to demolition therapies.
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162 NEWS IN ANGIOLOGY • ChrONIC vENOuS dISEASES nTheon-invasive mem-neT programdiagnosis 12 for chronicof cerebro-spinalchronic venous venous disorders insufficiency 43 color flow dopplerP.l. antignani imaging assessmenT s . Mandolesi, a. d’alessandro Chronic venous insufficiency (CVI) is the con- of investigation is the color Doppler ultrasound dition in which one or more veins become unable imaging (CDUI)). For more proximal vessels such to fulfill their three specific functions:1 as those of the pelvis magnetic resonance imaging – drainage from the tissues of toxic substances; (MRI) is very reliable for the detection of throm- – filling of the heart cavities; bosis. – thermoregulation of tissues; In 1988 with the birth of the conservative he- in any physical activity or position of the subject. modynamic ambulatory treatment of varicose What is the event that causes the CVI? veins, Claude Franceschi has realized the first Any condition that poses an obstacle to the cartographic maps of venous hemodynamics of drainage of one or more veins it is the cause that the lower limbs.1 In 1992, the authors showed for in time will determine the appearance of clinical the first time the venous compression syndrome disorders manifested as CVI. (VCS) of the lower limbs 2 and in 2011 that of the The CVI has been studied mainly for its effects veins draining cerebral spinal flow.3 The VCS has on the circulation of the lower limbs. Specifically, widened the field of interest of the phlebologists lower limb varicose veins are characterized first by and lead to static and dynamic biomechanic stud- the dilation of the veins and gradually, over the ies.
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Veins and Lymphatics 2018; volume 7:7199 Who knows the rationale of the According to Cestmir Recek’s the strain refilling time measured by gauge measurements improved the plethys- Correspondence: Claude Franceschi, Centre mographic parameters as follows: de soins Marie Thérèse, Paris, France. plethysmography? After great saphenous vein (GSV) E-mail: [email protected] crossectomy, the mean of 30 measurements Key words: Plethysmography; venous patho- Claude Franceschi was: refill time t-90 by 24.5 s; t-50 by 10.6 physiology; chronic venous insufficiency; Centre de soins Marie Thérèse, Paris, s; refill volume by 0.94 mL/100 mL (a mean CHIVA; saphenous ablation; lower limb of 30 measurements).1 France drainage. After crossectomy and stripping, the mean of 18 measurements was: refill time t- This work is licensed under a Creative 90 by 26.2 s; t-50 by 10.8 s; refill volume by Commons Attribution 4.0 License (by-nc 4.0). Abstract 1.1 mL/100 mL.² The Recek’s conclusion was: the differ- ©Copyright C. Franceschi, 2018 This mini-review analyzes the patho- Licensee PAGEPress, Italy ences were minimal and the postoperative Veins and Lymphatics 2018; 7:7199 physiology significance of the refilling time results both after high ligation and after doi:10.4081/vl.2018.7199 (RT) assessed in limbs after exercise by the high ligation plus stripping were well in the means of plethysmographic techniques. range of normal values. Based on such a rationale the Author offers The hemodynamic analysis of these an interpretation of RT following suppres- results shows limitations and sometimes gery does not take into account all the sion of reflux points respectively achieved misinterpretations of the data.
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Anno: 2016 Lavoro: 3580-ANGY Mese: February titolo breve: CHIVA: hemodynamic concept, strategy and results Volume: 35 primo autore: FRANCESCHI No: 1 pagine: 8-30 Rivista: INTERNATIONAL ANGIOLOGY Cod Rivista: International Angiology , Copyright © 2016 @EDIZIONI MINERVA MEDICA International Angiology 2016 February;35 (1):8-30 ORIGINAL ARTICLE CHIVA: hemodynamic concept, strategy and results Claude FRANCESCHI 1, Massimo CAPPELLI 2, Stefano ERMINI 3, Sergio GIANESINI 4* Erika MENDOZA 5, Fausto PASSARIELLO 6, Paolo ZAMBONI 4 1Centre Marie Therese Hopital Saint Joseph, Paris, France; 2Private Practitioner, Florence, Italy; 3Private Practitioner, Grassina, Flor- ence, Italy; 4Vascular Diseases Center, University of Ferrara, Italy; 5Venenpraxis, Wunstorf, Germany; 6Diagnostic Centre Aquarius, Napoli, Italy *Corresponding author: Sergio Gianesini, Vascular Disease Center, University of Ferrara Italy, Via Aldo Moro 8, 44124 Loc Cona, Ferrara, Italy. E-mail: [email protected] ABSTRACT The first part of this review article provides the physiologic background that sustained the CHIVA principles development. Then the venous networks anatomy and flow patterns are described with pertinent sonographic interpretations, leading to the shunt concept description and to the consequent CHIVA strategy application. An in depth explanation into the hemodynamic conservative cure approach follows, together with pertinent review of the relevant literature. (Cite this article as: Franceschi C, Cappelli M, Ermini S, Gianesini S, Mendoza E, Passariello F et al. CHIVA: hemodynamic concept, strategy and results. Int Angiol 2016;35:8-30) Key words: Venous insufficiency - Hemodynamics - Saphenous Vein - Ultrasonography, Doppler, Duplex. HIVA is a French acronym for “Cure conservatrice sequently suppressing the pressure overload by tar- Cet Hemodynamique de l’Insuffisance Veineuse en geted ligations that are customized on each specific Ambulatoire” (Conservative and Hemodynamic treat- reflux pattern.
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Messages 4144-4221
Digest Pagina 1 di 65 Messages in vasculab group. Page 1 of 1. Group: vasculab Message: 4144 From: Waldemar L. Olszewski Date: 06/02/2011 Subject: Re: MEVc Course Group: vasculab Message: 4145 From: MUDr. Andrej Džupina Date: 06/02/2011 Subject: Re: MEVc Course Group: vasculab Message: 4147 From: Dr.D.Eckert Date: 07/02/2011 Subject: Re: MEVc Course Group: vasculab Message: 4150 From: Giancarlo Bracale Date: 09/02/2011 Subject: Re: MEVc Course Group: vasculab Message: 4153 From: bblee Date: 10/02/2011 Subject: Re: MEVc Course Group: vasculab Message: 4157 From: Nada Theivacumar Date: 10/02/2011 Subject: Re: MEVc Course Group: vasculab Message: 4158 From: Dr.D.Eckert Date: 10/02/2011 Subject: Re: MEVc Course Group: vasculab Message: 4159 From: Nick Morrison Date: 10/02/2011 Subject: Re: Lymphatic Group: vasculab Message: 4160 From: bblee Date: 10/02/2011 Subject: Re: Lymphatic Group: vasculab Message: 4161 From: [email protected] Date: 11/02/2011 Subject: Re: Lymphatic Group: vasculab Message: 4162 From: Albert Adrien RAMELET Date: 11/02/2011 Subject: Re: Lymphatic Group: vasculab Message: 4163 From: Pier Luigi Antignani Date: 11/02/2011 Subject: R: [vasculab] Lymphatic Group: vasculab Message: 4164 From: Dr.D.Eckert Date: 11/02/2011 Subject: Re: Lymphatic Group: vasculab Message: 4165 From: bblee Date: 11/02/2011 file:///H:/xsl -fo/fop -2.0/jtavr/jtavr01/jtavr012/JTAVR000017 -PassarielloF/Phlebolymphedema%20Feb%206 -20,%202011%20 -%20 ©%2 ... 30/ 04/ 2017 Digest Pagina 2 di 65 Subject: Re: Lymphatic Group: vasculab Message: 4166 From:
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Veins and Lymphatics 2019; volume 8:8020 The overtreatment of illusory pletely mirrored by the modern IVUS, May Thurner syndrome which currently may nicely depict truncular Correspondence: Paolo Zamboni, Chair venous malformations (Figure 3). It is Center for Veins and Lymphatics Diseases mandatory to improve preoperative diag- Regione Emilia Romagna, University 1 2 Paolo Zamboni, Claude Franceschi, nostics to avoid useless and harmful Hospital of Ferrara, Via Aldo Moro 8, 44124 3 Roberto Del Frate overtreatment to arrive at correct surgical Cona (FE), Italy. E-mail: [email protected] 1Center for Veins and Lymphatics indications. It is clear that illusory MTS Diseases Regione Emilia Romagna, occurs whenever the compression is Key words: May Thurner syndrome; editorial. University Hospital of Ferrara, Cona reversible. The ultrasound manoeuver here- 2 in described could become an initial screen- (FE), Italy; Groupe Hospitalier Paris Received for publication: 2 January 2019. ing useful also to avoid more invasive or Revision received: 3 January 2019. Saint-Joseph, Paris, France; 3Casa di expensive diagnostic steps, demonstrating Accepted for publication: 4 January 2019. Cura Figlie di San Camillo, Cremona, rapidly the presence of illusory MTS. To the Italy contrary, the real MTS is related to not This work is licensed under a Creative reversible compression and/or to associated Commons Attribution 4.0 License (by-nc 4.0). intraluminal defects. ©Copyright P. Zamboni et al., 2019 Introduction Licensee PAGEPress, Italy Veins and Lymphatics 2019; 8:8020 Recently, an excellent article of van doi:10.4081/vl.2019.8020 Vuuren et al. described in healthy volun- teers an impressive prevalence of angio- graphic signs usually indicative of May Turner syndrome (MTS).1 In 80% of participants, at least two signs indicative of May-Thurner compres- sion were seen.
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