Duplex Ultrasound for the Diagnosis of Acute and Chronic Venous Diseases

Garcia, Raudel; Labropoulos, Nicos

doi:10.1016/j.suc.2017.11.007

Cited by 26 publications

(23 citation statements)

References 48 publications

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“…The previous study reported that the compression ultrasound is the highly accurate test for detection of deep vein thrombosis. 27 Another study added that thrombosis and/or complete obstruction of the subclavian vein occur in 35% (15%-50%) and of the internal jugular vein in 3% of patients with hemodialysis. 28 There are a few limitations of this study.…”

Section: Discussionmentioning

confidence: 99%

Inter-observer agreement of color duplex ultrasound of central vein stenosis in hemodialysis patients

et al. 2019

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Purpose To assess the inter-observer agreement of color duplex ultrasound of central vein stenosis in hemodialysis patients. Patients and methods This prospective study was conducted on 35 hemodialysis patients with suspected central vein stenosis. All patients underwent color flow duplex examination of the subclavian, internal jugular and brachiocephalic veins in hemodialysis patients. Image analysis was performed by two reviewers for diameter reduction, peak venous velocity ratio, post-stenotic turbulent flow, waveform changes, and thrombus formation. Results There was no significant difference between both observers for diameter reduction ( p = 0.105) and for the mean peak systolic velocity ratio ( p = 0.515). The overall inter-observer agreement of color duplex ultrasound of central vein stenosis was excellent ( k = 0.84, percent agreement = 89.7%, P = 0.001). There was excellent inter-observer agreement of both reviewers for diameter reduction ( k = 0.928, percent agreement = 97.14%), peak venous velocity ratio ( k = 0.7, percent agreement = 85.7%), waveform changes ( k = 0.62, percent agreement = 77.14%), post-stenotic turbulent flow ( k = 0.866, percent agreement = 88.6%), thrombus formation ( k = 1, percent agreement = 100%). Conclusion We concluded that color duplex ultrasound is a reliable and reproducible method for diagnosis of central vein stenosis in hemodialysis patients.

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Section: Discussionmentioning

confidence: 99%

Inter-observer agreement of color duplex ultrasound of central vein stenosis in hemodialysis patients

et al. 2019

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“…With sensitivity and specificity rate >90% for DVT, venous reflux, and non-vascular etiologies, swelling can be readily and robustly evaluated. 10,11 DUS can also assess the venous anatomy in the abdomen and pelvis to look for thrombosis or compression by adjacent arteries or masses. Visualization of pelvic anatomy may be difficult for less experienced operators, or because of gas-filled intestinal loops, or obesity.…”

Section: Diagnostic Testingmentioning

confidence: 99%

“…With sensitivity and specificity rate >90% for DVT, venous reflux, and non-vascular etiologies, swelling can be readily and robustly evaluated. 10 , 11 …”

Section: Diagnostic Testingmentioning

confidence: 99%

“…Visualization of pelvic anatomy may be difficult for less experienced operators, or because of gas-filled intestinal loops, or obesity. 10,11 If additional imaging of the abdomen or pelvis is necessary after DUS, contrast-enhanced venous phase computed tomography (CT) or magnetic resonance (MR) imaging are alternatives. Mass effect by tumor or enlarged lymph nodes, iliocaval compression/obstruction, and general venous anatomy can be easily visualized.…”

Section: Diagnostic Testingmentioning

confidence: 99%

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Diagnostic approach to lower limb edema

Gasparis

Kim²,

Dean

et al. 2020

Phlebology

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Patients with lower limb edema are frequently referred to vascular specialists for evaluation. Multiple etiologies must be considered and often more than one cause may be present. Notably, the role of lymphatic system regardless of the underlying pathology has been underestimated. A thorough history and physical examination and a carefully considered laboratory and imaging evaluation are critical in differentiating causes. In this opinion article, we propose a diagnostic algorithm that incorporates a systematic approach to the patient with leg swelling and provides an efficient pathway for the differential diagnosis for this problem.

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“…3 Thus, the disease manifests with a variety of signs and symptoms that are caused by valve incompetence or reflux. 4 The CVI can result in varicose veins, edema, eczema, lipodermatosclerosis, or venous ulceration, the most advanced clinical manifestation of the disease, which is strongly associated with reflux. 5 Most hospital admissions in the United States are due to venous ulcers, occurring in approximately 20 550 patients each year, which generate a treatment cost of US$3 billion/year.…”

Section: Introductionmentioning

confidence: 99%

Evaluation of the Use of Compressive Stockings Impregnated With Hesperetin-Based Nanocapsules in the Healing of Venous Ulcers: A Case Report

Menezes

Gomes

Carvalho

et al. 2019

Clin Med Insights Case Rep

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Venous ulcers are a more severe complication of chronic venous insufficiency, significantly compromising patient quality of life (QoL). Compressive stockings are still the gold standard treatment method with alternative therapies currently being evaluated. In this perspective, we investigate the influence of compressive stockings impregnated with hesperetin-based nanocapsules in the healing process of venous ulcers. Compressive stockings impregnated with hesperetin-based nanocapsules were applied to a consenting patient for 6 months following all relevant ethical principles for patient studies. The patient was evaluated at baseline (T0), 3 months (T3), and 6 months (T6), using photographic register (healing) probes to measure skin melanin, erythema and hydration parameters, and venous diameters, followed by questionnaires regarding QoL and pain perception. Healing was observed at the 3-month time point and with 91.6% and 93.1% of retraction area in larger ulcers of the right leg and lateral portion of the left leg, respectively. The deepest ulcer in a medial portion of the left leg healed 47.3%. A reduction of all measured skin parameters was observed, indicating a possible hesperetin effect. The scores of QoL and pain were, respectively, in the ranges of 91.6 to 31.2 and 7 to 0. Reduction in venous diameters also indicates healing function. These preliminary findings suggest that compressive stockings impregnated with hesperetin nanocapsules enhance venous ulcer healing. Further clinical trial controlled by placebo, involving a greater number of patients, is required to confirm the findings of this case report.

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Duplex Ultrasound for the Diagnosis of Acute and Chronic Venous Diseases

Cited by 26 publications

References 48 publications

Inter-observer agreement of color duplex ultrasound of central vein stenosis in hemodialysis patients

Inter-observer agreement of color duplex ultrasound of central vein stenosis in hemodialysis patients

Diagnostic approach to lower limb edema

Evaluation of the Use of Compressive Stockings Impregnated With Hesperetin-Based Nanocapsules in the Healing of Venous Ulcers: A Case Report

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