Cancer is one of the conditions associated with a raised level of D-dimer. This causes the specificity of the D-dimer test for suspected venous thrombo-embolism (VTE) to be reduced. This is well known and documented. However, less is known about the prognostic value of an elevated D-dimer. This was investigated by the RIETE group using… Read More »
Factor V is part of the normal coagulation cascade which promotes the production of a fibrin thrombus. Its action is inactivated by activated protein C (APC), thereby preventing thrombosis. This is the normal situation in health. Factor V Leiden (FVL) is a mutation. It is an autosomal dominant condition with incomplete penetrance. Patients with an… Read More »
MOCA is an abbreviation for mechano-chemical ablation. It is the combination of a rotating metal filament used to denude the venous endothelium and put the vein into spasm. Concomitant instillation of liquid sclerosant ensures venous destruction. The application device is inserted percutaneously, under ultrasound control, into the vein awaiting ablation and advanced proximally. The saphenous… Read More »
The use of glue in the ablation of refluxing saphenous trunks is gaining popularity. The main advantage is that tumescence is not required. This is of benefit to the patient because the perivenous injection of fluid is uncomfortable and the procedure time is shortened. Bilateral treatments are facilitated. In common with all endovenous treatments, patient… Read More »
The venous filling index (VFI) of air-plethysmography (APG) is recorded in mL/s. It quantifies filling and is the most useful parameter in the quantification of reflux since the early pioneers like J C Allan et al, in 1964. The VFI represents the rate of increase in calf volume following an elevation to dependency manoeuvre. The… Read More »
Vein dilatation is considered the primary event in patients with varicose veins, with valve incompetence as a consequence. The great saphenous vein (GSV) is usually affected. The resulting reflux can pressurise tributaries which drain into the GSV. This leads to dilatation and tortuosity detectable clinically as varicose veins. The treatment approach by most phlebologists is… Read More »