An accurate, functional reconstruction of the subcutaneous venous drainage was accomplished. It was found that telangiectasia was rarely an isolated condition, but was usually associated with incompetence in other elements in the venous drainage of the subcutaneous tissue.
Objective,: To clarify reflux patterns in the saphenofemoral junction in legs with varicose veins that display incompetence in the proximal long saphenous vein on duplex scan examination. Padenls and method: One hundred consecutive extremities were selected for ultrasound studies. Venous reflux was examined in the common femoral vein and long saphenous vein at five selected levels in the vicinity of the sapheno-femoral junction. Results: Duplex ultrasound examination confirmed that in 44 extremities reflux was detectable both in the long saphenous vein and common femoral vein indicating 'true' sapheno-femoral incompetence. In 56 legs reflux was limited to the long saphenous vein, whilst the first saphenous valve remained competent. The ultrasound examination suggested that in these cases the reflux originated from the numerous tributaries of the proximal long saphenous vein.Conclusion: Our findings emphasize the transfascial escape (reflux from the deep veins) is not a necessary precondition of long saphenous vein incompetence and related varicose veins.
Seven volumes from the Cowlishaw Collection were selected for review. The authors highlight the evolution of treatment of venous diseases from the ancient Greek times to the modern day through the writings of Hippocrates, Ambroise Pare, Richard Wiseman and other famous physicians of the past. An important Australian contribution by Jerry Moore is described in detail. Jerry Moore introduced 'high ligation' of the great saphenous vein late in the nineteenth century by modifying Trendelenburg's original procedure. The operation withstood the test of time and it is performed today according to his recommendations.
The variety of pathological processes related to the lower limb veins and the extravascular tissue suggest that routine, "detailed" ultrasound scanning would be indicated in all acutely symptomatic legs with a suspected venous disorder. The important diagnostic information so gained provides guidance to the most appropriate treatment strategy.
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