Underlying deep venous abnormalities in patients with unilateral chronic venous disease

Gaweesh, Ahmed S.; Kayed, Mohamed Hamdy; Gaweesh, T.Y.; Shalhoub, Joseph; Davies, Alun H.; Khamis, H M

doi:10.1258/phleb.2012.012028

Cited by 12 publications

(9 citation statements)

References 12 publications

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“…CT is generally more readily available and less expensive compared to MR. Recent development of CT including dual-energy acquisition and dedicated protocols for CTV may also improve the results, as have been shown for example using pedal cannulation and contrast injection 20 For clinically relevant doses, the price/examination is approximately 25% lower for Gadofosveset compared to Gadobutrol (based on the official prices provided by the manufacturers for the doses used in our patient material).…”

Section: Discussionmentioning

confidence: 96%

Gadofosveset-enhanced magnetic resonance venography in patients with venous pathology of the lower limbs – Comparison of diagnostic image quality and inter-rater variability with gadobutrol venography and computed tomography venography

et al. 2016

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Gadofosveset-enhanced magnetic resonance venography in patients with venous pathology of the lower limbs -Comparison of diagnostic image quality and inter-rater variability with gadobutrol venography and computed tomography venography.Åkesson, Michael; Lehti, Leena; Höglund, Peter; Åkeson, Per; Wasselius, Johan General rights Copyright and moral rights for the publications made accessible in the public portal are retained by the authors and/or other copyright owners and it is a condition of accessing publications that users recognise and abide by the legal requirements associated with these rights.• Users may download and print one copy of any publication from the public portal for the purpose of private study or research.• You may not further distribute the material or use it for any profit-making activity or commercial gain • You may freely distribute the URL identifying the publication in the public portal Abstract PurposeThis study was performed to compare the diagnostic quality of Gadofosveset-enhanced MR venography (MRV) with Gadobutrol-enhanced MRV and CT venography for the deep veins of the lower extremities in patients with iliocaval venous pathology. Materials and MethodsDiagnostic capability and image quality was assessed by two independent readers. Inter-reader variability was analyzed by unweighted and quadratic weighted Cohen's kappa values. ResultsThe diagnostic capability was equal to or higher in the Gadofosveset group for all examined vessel segments compared with both control groups. The image quality score was significantly higher for the Gadofosveset group compared to both control groups.Inter-reader variability, expressed by quadratic weighted Cohen's kappa value (k) showed less variability in the Gadofosveset group compared to the control groups. ConclusionOur results show that Gadofosveset enhanced MRV is a reliable technique in clinical routine practice, with image quality superior to both Gadobutrol enhanced MRV and CT venography.

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Section: Discussionmentioning

confidence: 96%

Gadofosveset-enhanced magnetic resonance venography in patients with venous pathology of the lower limbs – Comparison of diagnostic image quality and inter-rater variability with gadobutrol venography and computed tomography venography

et al. 2016

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“…Сегодня для анализа состояния глубокой венозной системы в основном применяется непрямая СКТ-венография путем инъекции контрастного препарата через кубитальную вену [7]. Однако прямая СКТ-венография с инъекцией разведенного препарата через дистальные вены нижней конечности может обеспечить лучшее заполнение венозного русла, предоставляя, соответственно, лучшее качество изображений [4,7].…”

Section: Adherence To Ethical Standardsunclassified

“…Следует отметить, что за последнее время обструкции илиофеморального и/или илиокавального сегментов были идентифицированы как важная составляющая прогрессирования клинической картины хронической венозной недостаточности, а их качественная визуализация расширила возможности лечения за счет интервенционных методик реканализации и стентирования [4,12,13]. В нашей выборке в тех случаях, когда имелись клинические признаки поражения вен выше паховой складки с или без регистрации косвенных ультразвуковых признаков при оценке кровотока по общей бедренной вене, таких как монофазный кровоток и/или выраженная асимметрия гемодинамических показателей на контрлатеральной конечности, СКТ-венография предоставляла необходимую информацию для принятия дальнейших решений по выбору оптимальной лечебной тактики.…”

Section: острые тромбозы глубоких венunclassified

“…Вышеупомянутые ограничения могут вызывать определенные трудности при принятии решений о выборе наиболее предпочтительной тактики лечения у некоторых категорий пациентов на амбулаторном приеме. В таких случаях мультиспиральная компьютерная томография-венография (СКТ-венография), являясь также амбулаторной методикой, не требующей госпитализации, позволяет в короткие сроки добиться хорошей, высокого разрешения, трехмерной объемной визуализации анатомии венозной системы живота, таза и нижних конечностей, а также окружающих их тканей [3][4][5][6]. Точная локация поражения и понимание анатомических соотношений расширяют возможности лечения подобных пациентов.…”

Section: Introductionunclassified

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Multidetector spiral computed tomography–venography in outpatient phlebological practice

Фокин

Борсук²,

Шкаредных

et al. 2020

SMJ

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Duplex ultrasound scanning (DUS) and magnetic resonance imaging are sometimes insufficient to meet our clinical needs due to specifics of given pathology and intrinsic technical limitations of these methods. This study aims to assess the need for multispiral computed tomography–venography (CT-venography) and to evaluate its diagnostic capabilities for various disorders in primary ambulatory patients in phlebology practice.Material and Methods. From January, 2017 to December,2019, a total of 10,112 patients sought initial consultation of a phlebologist. Upon examination, the physician assigned patients to one of the proposed categories using dedicated software. Analysis of these categories demonstrated the following pattern of morbidity: 2,167 patients (21.4%) had chronic venous disorders of class С0S-1 (CEAP classification); 4,460 patients (44.1%) had varicose veins of class C2-3 (CEAP classification); 351 patients (3.5%) had varicose veins of class C4-6; 570 patients (5.6%) had other diseases including post-thrombotic syndrome, acute thrombosis, thrombophlebitis, and venous malformations; and 2,564 patients (25.4%) were suffering from non-venous disorders. DUS was performed in all cases.Results. The study demonstrated that 260 patients required CT-venography constituting 2.6% of the total number of patients who came to the clinic in the indicated period. The direct venography with contrast medium injection through the peripheral veins was used in 156 cases (60%). Patients did not have any significant complications, such as acute kidney injury or worsening of chronic renal failure, severe allergic reactions to the contrast agent, or problems with the puncture site of peripheral veins.Conclusions: 1) CT-venography allowed to achieve the accurate three-dimensional imaging of the venous system, providing, in some cases, the necessary information for finding solutions on optimal management. 2) The need for CT-venography may occur in 2.6% of patients in ambulatory phlebology practice. 3) CT-venography is useful for diagnosing angiodysplasias, postthrombotic and non-thrombotic lesions, complicated varicose veins, especially in recurrence, and in some cases of acute deep vein thrombosis. 4) DUS is mandatory for hemodynamic assessment in all patients before CT-venography.

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“…The high incidence of proximal lesions and their treatment has led to the suggestion that a degree of impeded venous drainage may be a factor in the development of superficial venous reflux and varicose veins. [5][6][7][8] This hypothesis assumes that impeded proximal venous drainage is the primary venous abnormality with vein dilatation and reflux as secondary events. This is intuitive and analogous to most biological tubes which dilate in response to obstruction.…”

Section: Introductionmentioning

confidence: 99%

Gravitational venous drainage is significantly faster in patients with varicose veins

Lattimer

Kalodiki

Mendoza³

2016

Phlebology

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Underlying deep venous abnormalities in patients with unilateral chronic venous disease

Cited by 12 publications

References 12 publications

Gadofosveset-enhanced magnetic resonance venography in patients with venous pathology of the lower limbs – Comparison of diagnostic image quality and inter-rater variability with gadobutrol venography and computed tomography venography

Gadofosveset-enhanced magnetic resonance venography in patients with venous pathology of the lower limbs – Comparison of diagnostic image quality and inter-rater variability with gadobutrol venography and computed tomography venography

Multidetector spiral computed tomography–venography in outpatient phlebological practice

Gravitational venous drainage is significantly faster in patients with varicose veins

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