tailieunhanh - Ebook Phlebology, vein surgery and ultrasonography: Part 2

(BQ) Part 2 book "Phlebology, vein surgery and ultrasonography" presents the following contents: Perforator veins, upper deep vein disease, lower deep vein disease, ultrasound for thrombosis, superficial venous thrombophlebitis, deep vein thrombosis, venous leg ulcers, vein anesthesia,. | Part IV Non-Superficial Veins Perforator Veins 14 Elna M. Masuda and Darcy M. Kessler Contents Introduction. 191 History. 192 Anatomy. 192 Pathophysiology. 194 Evidence in Favor of Importance of PVs. . 194 Evidence Against the Importance of IPVs. . 196 Fate of IPVs After Surgery. 197 Diagnosis. 197 Treatment Options and Techniques. 198 SEPS. . 198 Percutaneous Ablation. 198 Thermal Ablation Techniques. 199 Ultrasound-Guided Sclerotherapy Techniques. 200 Influence of Postthrombotic Syndrome on Outcomes. 203 Suggested Indications for PV Treatment . 203 References . 203 . Masuda MD . Kessler RVT Division of Vascular Surgery Straub Clinic and Hospital John A. Burns School of Medicine Honolulu HI USA e-mail emasuda@ dkessler@ Abstract Perforator veins PVs are one of three major venous systems in the leg directly linked to serious manifestations of chronic venous disease CVD including venous ulceration. Although its anatomical details are clearly defined the physiology and clinical importance of PVs continue to remain less explicit. This chapter will review the evidence to support the diagnosis indication for treatment noninvasive and invasive options for management of PVs. Introduction Nearly 100 years ago Homans presented a comprehensive description of the relationship between perforator veins and leg ulceration 1 . Despite its long history and the fact that perforator veins are frequently identified in the gaiter area beneath ulcers and areas of venous stasis dermatitis controversy still prevails over its clinical significance and role in producing the pathologic state. Additionally choices for treatment are highly variable and range from invasive eradication by long calf incisions to simple ablation by direct injections. This chapter will attempt to clarify the role of PVs in CVI and discuss the optimal diagnostic and therapeutic strategies. E. .