Preoperative and intraoperative evaluation of diameter-reflux relationship of calf perforating veins in patients with primary varicose vein

Yamamoto, Naoto; Unno, Naoki; Mitsuoka, Hiroshi; Saito, Takaaki; Kushima, Miki; Ishimaru, Kei; Kaneko, Hiroshi; Nakamura, Satoshi

doi:10.1067/mva.2002.128941

Cited by 29 publications

(15 citation statements)

References 18 publications

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“…Similar limitations were found by Yamamoto et al,17 who compared ultrasound evaluation of the lower limb veins with intraoperative evaluation and found a poor result for ultrasound in offering a reliable comparison with data from intraoperative evaluation of veins.…”

Section: Discussionsupporting

confidence: 71%

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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Section: Discussionsupporting

confidence: 71%

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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“…Moreover, Labropoulos et al [7] 5 indicated that diameters larger than 3.9 mm on US were reliably predictive of reflux in patients with skin change and ulcers. Yamamoto et al [8] 5…”

Section: Discussionmentioning

confidence: 98%

Endoscopic anatomy of perforating veins in chronic venous insufficiency of the legs: “Solitary” incompetent perforating veins are often actually multiple vessels

et al. 2011

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We have already reported on the effectiveness of subfascial, endoscopic, perforating-veins surgery for chronic venous insufficiency of the legs. The incompetent perforating vein (IPV) often appears to be a single vessel, when it is actually two or more vessels. Accordingly we examined the anatomy and features of IPVS. The features of perforating veins were assessed in 173 limbs of 152 patients. In the recent 50 limbs, 1128 IPVs were subjected to complete dissection of the adventitia to confirm the number of vessels. Ninety-seven out of 110 IPVs (88.2%) had a concomitant artery. On endoscopy 128 IPVs could be classified into seven types (type N, type O, type I, type II, type III, type IV, and type V) according to the combination of arteries and veins which were presented. Type N means a normal perforator consisting of a single artery with a pair of normal veins running alongside it. Type O has the same anatomy as type N but shows reverse flow. Type I has an incompetent vein with thick walls and reverse flow, which is not accompanied by an artery. Type II is an artery associated with an incompetent vein. Type III is composed of an artery, a normal vein, and an incompetent vein. Type IV is an artery with two incompetent veins and type V contains multiple incompetent veins. When the anatomy of 128 IPVs was confirmed, 1 the number of each type was as follows: 7 type O (5%), 32 type I (25%), 1 type II (1%), 48 type III (38%), 39 type IV (30%), and 1 2 type V (1%). This is the first report on all the components of IPVs directly visualized in vivo. It has been almost impossible to predict the postoperative reversibility of IPVs after surgical ablation of superficial veins. By using our classification of IPVs, it will be possible to treat only the irreversible (true) incompetent veins and to avoid operating on arteries, normal veins, and reversibly incompetent veins. In the future, it will be necessary to devise the operative strategy according to the type of IPVs as assessed by endoscopic examination.

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“…Reflux was defined as flow in the reverse direction of the physiologic flow of duration Ͼ0.5 seconds after a provocation maneuver. 8 All VV patients had retrograde flow in the saphenofemoral junction; the control patients had no reflux in the GSV. We analyzed the GSV tissue that was in close to the saphenofemoral junction, excluding the terminal valve.…”

Section: Methodsmentioning

confidence: 99%

Loss of lymphatic vessels and regional lipid accumulation is associated with great saphenous vein incompetence

Tanaka

Zaima

Sasaki

et al. 2012

Journal of Vascular Surgery

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Preoperative and intraoperative evaluation of diameter-reflux relationship of calf perforating veins in patients with primary varicose vein

Cited by 29 publications

References 18 publications

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

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

Endoscopic anatomy of perforating veins in chronic venous insufficiency of the legs: “Solitary” incompetent perforating veins are often actually multiple vessels

Loss of lymphatic vessels and regional lipid accumulation is associated with great saphenous vein incompetence

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Preoperative and intraoperative evaluation of diameter-reflux relationship of calf perforating veins in patients with primary varicose vein

Cited by 29 publications

References 18 publications

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

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

Endoscopic anatomy of perforating veins in chronic venous insufficiency of the legs: “Solitary” incompetent perforating veins are often actually multiple vessels

Loss of lymphatic vessels and regional lipid accumulation is associated with great saphenous vein incompetence

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

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