Inflammatory biomarkers are molecules detected within the blood or tissues of the patient in response to an insult or injury. In chronic venous disease (CVD) this is an elevated venous pressure from gravitational force. These biomarkers become expressed in inflammation and many are believed to be responsible for the symptoms, pain and skin changes characteristic… Read More »
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 (SFJ). Approximately a sixth of women have saphenous vein reflux fed from above. Source points of pelvic venous reflux (PVR) or incompetence (PVI) include the internal… Read More »
This is the examination of the microcirculation using a microscope at a magnification in the order of 50 X. It has the potential to detect the cutaneous manifestations of chronic venous insufficiency (CVI) before overt skin changes are seen clinically. The technique has been described as a microscopic C of CEAP in the assessment of… Read More »
The clinical part of the CEAP (Clinical, Etiological, Anatomical, Pathological) classification is the most popular classification system for venous disorders. Its purpose originally in 1994 was to standardise reporting by defining the study groups in clinical trials and manuscripts submitted to journals. However, the C of CEAP is not a perfect system and there have… Read More »
The importance of the ankle region in venous disease and treatment cannot be overestimated. It bears the skin changes of pigmentation, eczema, fibrosis, lipodermatosclerosis, atrophie blanche and ulceration that defines the later stages of venous disease. It is believed that a sustained venous pressure elevation in the ankle region from venous insufficiency is the primary… Read More »
A common clinical dilemma is the management of patients with symptomatic varicose veins who have had a past deep vein thrombosis (DVT). In these cases it is unclear as to whether symptoms result from the post-thrombotic syndrome (PTS) or from superficial venous reflux/insufficiency (SVI), or a combination of both. If a DVT history is extracted… Read More »