Trans-vaginal ultrasound (TVU) is a way of assessing the pelvic veins. It should be performed in women when a reflux source is suspected arising from above the sapheno-femoral junction. Approximately a sixth of women have a refluxive saphenous vein fed from above. Accurate evaluation of all reflux sources is essential to direct durable treatment options.… Read More »
Endovenous steam ablation is an emerging technique for the treatment of saphenous trunks and large varicose tributaries. It acts by denaturing the collagen and proteins in the vein wall which cause it to shrink. Each pulse of steam releases only 0.08 cc of water equivalent making the amount of haemolysis insignificant. The first 2 pulses… Read More »
Skin necrosis, telangiectatic matting and post-inflammatory hyperpigmentation (PIH) are side effects which may occur in susceptible patients following sclerotherapy. Their appearance may be preventable in some patients using careful injection techniques. Patients should be warned of these potential complications, which vary between practitioners, when deciding on whether to undergo treatment. PHILIP COLERIDGE-SMITH Telangiectatic matting is… Read More »
Conflict injuries often result in the division of major arteries supplying a limb. Surgical treatment is focussed on the repair of the arterial injury with less consideration of the venous drainage. This is often a forgotten factor in limb salvage. The importance of concurrent venous repair cannot be overestimated and may be the determining factor… Read More »
These are ulcers situated around the gaiter area in patients with a reduced arterial inflow, quantified by a reduced ankle-brachial pressure index (ABPI). This results in 2 different treatment philosophies: 1) Treat the arterial inflow problem with angioplasty or bypass so that compression can be applied to heal the ulcer. This is sound advice but… Read More »
This is short for corona phlebectatica paraplantaris and was first recognised by van der Molen in 1960. Unrelenting venous pressure over time will cause susceptible cutaneous venules to dilate. This is most likely to occur around the ankle which is the region of the highest hydrostatic pressure. This is below a failing calf muscle pump… Read More »