Doppler ultrasound venous mapping of the lower limbs

Galeandro, Aldo Innocente; Quistelli, Giovanni; Scicchitano, Pietro; Gesualdo, Michele; Zito, Annapaola; Caputo, Paola; Carbonara, Roberta; Galgano, Giuseppe; Ciciarello, Francesco; Mandolesi, Sandro; Franceschi, C.; Ciccone, Marco Matteo

doi:10.2147/vhrm.s27552

Cited by 14 publications

(11 citation statements)

References 15 publications

(12 reference statements)

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“…These interventions could include diagnostic tests such as imaging techniques and procedures that facilitate diagnosis of VTE so that appropriate intervention can be provided to patients in a timely manner to lower the risk of further complications. 32 , 33 In addition, the advent of new pharmacological options such as the new oral anticoagulants may provide a more convenient alternative to warfarin therapy to reduce the risk of VTE recurrences, along with a lower risk of bleeding complications. 34 – 38 The economic value of these interventions should be evaluated, and those that have been shown to be cost-effective can be incorporated into treatment guidelines to support implementation in clinical practice.…”

Section: Discussionmentioning

confidence: 99%

Review of the cost of venous thromboembolism

Fernandez¹,

Hogue²,

Preblick³

et al. 2015

CEOR

147

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BackgroundVenous thromboembolism (VTE) is the second most common medical complication and a cause of excess length of hospital stay. Its incidence and economic burden are expected to increase as the population ages. We reviewed the recent literature to provide updated cost estimates on VTE management.MethodsLiterature search strategies were performed in PubMed, Embase, Cochrane Collaboration, Health Economic Evaluations Database, EconLit, and International Pharmaceutical Abstracts from 2003–2014. Additional studies were identified through searching bibliographies of related publications.ResultsEighteen studies were identified and are summarized in this review; of these, 13 reported data from the USA, four from Europe, and one from Canada. Three main cost estimations were identified: cost per VTE hospitalization or per VTE readmission; cost for VTE management, usually reported annually or during a specific period; and annual all-cause costs in patients with VTE, which included the treatment of complications and comorbidities. Cost estimates per VTE hospitalization were generally similar across the US studies, with a trend toward an increase over time. Cost per pulmonary embolism hospitalization increased from $5,198–$6,928 in 2000 to $8,764 in 2010. Readmission for recurrent VTE was generally more costly than the initial index event admission. Annual health plan payments for services related to VTE also increased from $10,804–$16,644 during the 1998–2004 period to an estimated average of $15,123 for a VTE event from 2008 to 2011. Lower costs for VTE hospitalizations and annualized all-cause costs were estimated in European countries and Canada.ConclusionCosts for VTE treatment are considerable and increasing faster than general inflation for medical care services, with hospitalization costs being the primary cost driver. Readmissions for VTE are generally more costly than the initial VTE admission. Further studies evaluating the economic impact of new treatment options such as the non-vitamin K antagonist oral anticoagulants on VTE treatment are warranted.

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Section: Discussionmentioning

confidence: 99%

Review of the cost of venous thromboembolism

Fernandez¹,

Hogue²,

Preblick³

et al. 2015

CEOR

147

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“…Venous mapping has been considered a tool able to improve comprehension of venous vascular course, alterations in its morphology, and pathological changes in its function 9,18–20. Venous mapping is a 2D scheme of the venous tree of lower limbs.…”

Section: Discussionmentioning

confidence: 99%

“…Venous mapping is a 2D scheme of the venous tree of lower limbs. The symbols and the overall representation give a frank account of the hemodynamics of the venous tree and allow expert physicians to follow-up chronic venous diseases and to target the appropriate surgical and/or therapeutic intervention 9,18–20. Nevertheless, one of its limitations is the limited comprehension and readability of such a map.…”

Section: Discussionmentioning

confidence: 99%

“…In order to reduce bias, a single expert physician performed all the evaluations by means of a multifrequency 7.5–10 MHz Doppler ultrasound probe (Sonos 1500B; Hewlett Packard, Palo Alto, CA, USA). The ultrasound examinations were performed in a warm room (mean temperature 18°C–22°C) in agreement with our previously standardized ECD protocol 9. In particular, the patients were examined in a standing position in order to detect venous morphology, the presence of venous reflux, or vein thrombosis.…”

Section: Methodsmentioning

confidence: 99%

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A three-dimensional electronic report of a venous echo color Doppler of the lower limbs: MEVeC®

Galeandro¹,

Scicchitano²,

Zito³

et al. 2014

VHRM

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BackgroundThe reports of ultrasound evaluation of lower limb veins are difficult to understand by general practitioners (GPs) and physicians who are not specialized. We developed software for a three-dimensional (3D) electronic report of venous hemodynamic mapping (MEVeC®) in order to represent lower limb venous vasculature in a 3D way. The aim of the study is to compare the novel 3D report with the standard report.MethodsThirty subjects (medical students and GPs) evaluated a standard report and a novel 3D report of the lower limb veins of a prespecified patient. The cases were randomly and blindly taken from an archive of 100 cases. GPs and students answered a questionnaire made up of 13 questions that were structured in order to investigate the readability and comprehension of the two reports. A score ranging from 0 to 10 (0= not understandable; 10= full comprehension) was attributed to each report for each question according to the readability of the venous scheme proposed.ResultsThe scores from each question of the questionnaire were compared. The 3D report (MEVeC®) obtained higher scores than those from the evaluation of the standard report (P<0.0001). Each question revealed the superiority of the 3D report (MEVeC®) as compared with the standard report of the ultrasound evaluation of lower limbs. When dividing the scores according to percentiles, the 3D report (MEVeC®) still continued to show more readability than the standard report in a statistically significant way (P<0.0001).ConclusionThe new 3D report (MEVeC®) concerning ultrasound evaluation of lower limb veins is more reproducible than the standard report when evaluated by medical physicians not specialized in the evaluation of the vein tree of lower limbs.

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“…Venous disease of the lower legs can be classified using clinical severity, aetiology, anatomy, and pathophysiology (CEAF classification system). The role of Doppler ultrasound in evaluating venous disease according to the CEAF classification has demonstrated very low intraobserver variability and a high sensitivity and specificity [ 7 ]. Patients with an open venous ulcer are already classified as having the most clinically severe form of venous disease (C6 classification).…”

Section: Introductionmentioning

confidence: 99%

A Comparison of the Efficacy and Cost of Different Venous Leg Ulcer Dressings: A Retrospective Cohort Study

Hussain

2015

International Journal of Vascular Medicine

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Objective. To compare the efficacy and cost-effectiveness of simple nonadherent dressings with other more expensive dressing types in the treatment of venous leg ulcers. Study Design. Retrospective cohort study. Location. The leg ulcer clinic at the University Hospital of South Manchester. Subjects and Methods. The healing rates of twelve leg ulcer patients treated with simple nonadherent dressings (e.g., NA Ultra) were compared with an equal number of patients treated with modern dressings to determine differences in healing rates and cost. Main Outcome Measures. Rate of healing as determined by reduction in ulcer area over a specified period of time and total cost of dressing per patient. Results. Simple nonadherent dressings had a mean healing rate of 0.353 cm2/week (standard deviation ± 0.319) compared with a mean of 0.415 cm2/week (standard deviation ± 0.383) for more expensive dressings. This resulted in a one-tailed p value of 0.251 and a two-tailed p value of 0.508. Multiple regression analysis gave a significance F of 0.8134. Conclusion. The results indicate that the difference in healing rate between simple and modern dressings is not statistically significant. Therefore, the cost of dressing type should be an important factor influencing dressing selection.

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Doppler ultrasound venous mapping of the lower limbs

Cited by 14 publications

References 15 publications

Review of the cost of venous thromboembolism

Review of the cost of venous thromboembolism

A three-dimensional electronic report of a venous echo color Doppler of the lower limbs: MEVeC®

A Comparison of the Efficacy and Cost of Different Venous Leg Ulcer Dressings: A Retrospective Cohort Study

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Doppler ultrasound venous mapping of the lower limbs

Cited by 14 publications

References 15 publications

Review of the cost of venous thromboembolism

Review of the cost of venous thromboembolism

A three-dimensional electronic report of a venous echo color Doppler of the lower limbs: MEVeC&reg;

A Comparison of the Efficacy and Cost of Different Venous Leg Ulcer Dressings: A Retrospective Cohort Study

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A three-dimensional electronic report of a venous echo color Doppler of the lower limbs: MEVeC®