By Peter F. Lawrence, Christine E. Gazak (auth.), Jeffrey L. Ballard MD, FACS, John J. Bergan MD FACS (eds.)
Chronic venous insufficiency, manifesting as disabling open leg ulcers, lipodermatosclerosis and serious cutaneous hyperpigmentation is assumed to impact 5 percentage of the inhabitants over age eighty and an important percentage, most likely more than one percentage, of Western populations below age sixty five. to this point little has been identified approximately easy methods to deal with this cost-effectively past supportive and palliative care. therefore, an important characteristic of ChronicVenous Insufficiency is that it describes the interventions which markedly ameliorate, and every so often treatment, the situation. The authoritative textual content has been skilfully illustrated to teach how new equipment of endovascular and endoscopic interventions should be built-in with radiologic strategies to right absolutely the abnormalities which produce continual venous insufficiency. Taken as an entire this quantity will permit basic surgeons, vascular surgeons, dermatologists and interventional radiologists to regard a that was once, till lately, considered untreatable.
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Additional info for Chronic Venous Insufficiency: Diagnosis and Treatment
Cut . branches of femoral n. Greater saphenous v. Hunter's perforator Dodd's perforator Deep peroneal n. Dorsal venous arch Ant . ),w~HIl Proximal paratibial perforators Posterior arch Y. 2. Anatomy of th e superficial and perforating veins of the foot. Greater saphenous Y. Superf. peroneal n. arch vein. The anterior tributary ascends from the dorsum of the foot and joins the greater saphenous vein at the knee. 9 The posterior arch vein, or Leonardo's vein (presumably first depicted on Leonardo da Vinci's drawings),10 is a relatively constant tributary.
In: Gloviczki P, Bergan JJ (eds) Atlas of endoscopic perforator vein surgery. Springer-Verlag, London, 1998: 17-28 43. Fischer R. Insufficient perforating vein on the antero-medial surface of the tibia (in German). VASA 1985; 14:168-9 44. Patrick JG. Blood vessels. ) Histology for pathologist. Raven Press, New York, 1992: 195-213 45. Parum DV. Histochemistry and immunochemistry of vascular disease. In: Stehbens WE and Lie JT (eds) Vascular pathology. Chapman & Hall, London, 1995: 313-27 46. Thomson H.
2. Suggested work-up for chronic venous insufficiency, based on the maximal severity of symptoms Clinical Class (C) of CEAP. Note: in patients with more than one class, use the class with the highest level of work-up Clinical class Asymptomatic (CO-2) Symptomatic o No signs 1 Telangiectasia or reticular veins 2 Varicose veins 3 Edema 4 Skin Changes 5 Ulcer healed 6 Ulcer active level I Clinical exam level II Non-invasive test level III Invasive test Continuous wave Doppler Duplex scanning Plethysmography Venography Vein pressures x x X· X· X X X X X X X X X X X X· X· X· X X': Proceed with this level of diagnostic testing if treatment requires a higher level of testing.