Duplex Ultrasound Investigation of the Veins in Chronic Venous Disease of the Lower Limbs—UIP Consensus Document. Part II. Anatomy

University of Vienna, Wien, Vienna, Austria
VASA.: Zeitschrift für Gefässkrankheiten. Journal for vascular diseases (Impact Factor: 1). 03/2007; 36(1):62-71. DOI: 10.1024/0301-1526.36.1.62
Source: PubMed


Duplex ultrasound investigation has become the reference standard in assessing the morphology and haemodynamics of the lower limb veins. The project described in this paper was an initiative of the Union Internationale de Phlébologie (UIP). The aim was to obtain a consensus of international experts on the methodology to be used for assessment of anatomy of superficial and perforating veins in the lower limb by ultrasound imaging.
The authors performed a systematic review of the published literature on duplex anatomy of the superficial and perforating veins of the lower limbs; afterwards they invited a group of experts from a wide range of countries to participate in this project. Electronic submissions from the authors and the experts (text and images) were made available to all participants via the UIP website. The authors prepared a draft document for discussion at the UIP Chapter meeting held in San Diego, USA in August 2003. Following this meeting a revised manuscript was circulated to all participants and further comments were received by the authors and included in subsequent versions of the manuscript. Eventually, all participants agreed the final version of the paper.
The experts have made detailed recommendations concerning the methods to be used for duplex ultrasound examination as well as the interpretation of images and measurements obtained. This document provides a detailed methodology for complete ultrasound assessment of the anatomy of the superficial and perforating veins in the lower limbs.
The authors and a large group of experts have agreed a methodology for the investigation of the lower limbs venous system by duplex ultrasonography, with specific reference to the anatomy of the main superficial veins and perforators of the lower limbs in healthy and varicose subjects.

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Available from: Alberto Caggiati, Apr 11, 2014
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    • "In international use, the accessory veins are called anterior (formerly lateral), superfi cial and posterior (formerly medial) accessory saphenous veins (Caggiati et al. 2002 ). This chapter describes the anatomy of the superfi cial veins (Askar 1963 ; Dodd and Cockett 1976 ; Bergan 1999 ; Caggiati and Mendoza 2004 ; Cavezzi et al. 2006 ; Kubik 1985 in Appendix 2). To avoid duplication, anatomical variants important for diagnosis will be discussed in the relevant chapters. "
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    ABSTRACT: Veins arise from capillaries and transport blood away from the tissues towards the heart. In contrast to arteries which branch, they form a network which merges repeatedly to form larger veins. They are named according to their calibre and position as venous capillaries, venules, tributaries and saphenous trunks.
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    ABSTRACT: Background: The cosmetic treatment of varicose veins is the main activity of most vascular surgeons in Brazil. In order to obtain satisfac- tory cosmetic results, careful planning of varicose vein operations is nec- essary. Objective: Marking (or "mapping") the varicose veins with indeli- ble ink is an essential step in planning cosmetic surgeries for lower limb varicose veins. In the present study, the role of transcutaneous phle- boscopy (TcPh) in planning varicose vein operations is evaluated. Methods: A series of 100 consecutive patients, all female, were evaluated with TcPH as part of their varicose vein operations planning. A total of 171 limbs with varicose veins (71 bilateral and 29 unilateral) were evaluated. The process of marking the varicose veins followed the same protocol in all cases. Firstly, the varicose veins were marked by inspec- tion and palpation, with the patient standing, using an indelible black ink pen. Secondly, with the patients resting in supine and prone positions, the varicose veins detected with TcPh were marked again with red or blue ink. The marks made by the two methods were then compared. Results: In 41 patients, for a total of 80 limbs (46.8%), the marks were altered after use of TcPh. Reasons for such changes were: 1) identi- fication of other varicose veins; 2) identification of reticular veins drain- ing complex telangiectasias; and 3) changes in the position of the marks placed with the patient standing. Conclusions: TcPh has altered the planning of varicose vein sur- geries in 46.8% of all limbs evaluated, especially when the patients had complex telangiectasias, associated with reticular varicose veins.
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