Effect of venous hypertension on canine hind limb lymph

Leach, R D; Browse, N L

doi:10.1002/bjs.1800720409

Cited by 17 publications

(7 citation statements)

References 16 publications

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“…10,33 Sustained hypertension at the capillary level is associated with many morphologic changes including elongation and dilation of the capillary bed, increased surface area of the endothelium, increased type IV collagen in the basement membrane, and the formation of a pericapillary fibrin cuff. 12,[34][35][36][37] These abnormal capillaries are more permeable to large molecules, including fibrinogen, 38 and it has been hypothesized that leaked fibrinogen is converted to fibrin in the pericapillary space. 37,38 Other studies have shown that the fibrinolytic activity of blood and tissues is deficient in patients with lipodermatosclerosis, resulting in a decreased clearance of fibrin.…”

Section: Pathophysiologymentioning

confidence: 99%

“…12,[34][35][36][37] These abnormal capillaries are more permeable to large molecules, including fibrinogen, 38 and it has been hypothesized that leaked fibrinogen is converted to fibrin in the pericapillary space. 37,38 Other studies have shown that the fibrinolytic activity of blood and tissues is deficient in patients with lipodermatosclerosis, resulting in a decreased clearance of fibrin. [38][39][40] Although the functional significance of pericapillary fibrin is debated, studies in patients with lipodermatosclerosis have documented diminished cutaneous oxygenation, 34,41,42 which improves with the administration of oxygen, 43 suggesting that a diffusion barrier, rather than deficient transport, is responsible for low oxygen tissue pressure.…”

Section: Pathophysiologymentioning

confidence: 99%

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Chronic Venous Insufficiency and Venous Ulceration

Alguire

Mathes

1997

J Gen Intern Med

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OBJECTIVE:To review and summarize the literature on the normal venous circulation of the leg, and the epidemiology, pathophysiology, and treatment of chronic venous insufficiency (CVI).DATA SOURCES: English-language articles identified through a MEDLINE search using the terms venous insufficiency or varicose ulcer and epidemiology, pathophysiology, diagnosis, and clinical trial (pt), and selected cross-references. STUDY SELECTION:Articles on epidemiology, pathophysiology, and treatment of CVI. Randomized, controlled studies were specifically sought for treatment efficacy. DATA EXTRACTION:Data were manually extracted from selected studies and reviews; emphasis was placed on information relevant to the general internist. pproximately 5 million people in the United States exhibit some evidence of chronic venous insufficiency (CVI) and between 400,000 and 500,000 of these individuals have or will develop a venous leg ulcer. 1-3 The signs of CVI include engorgement of the cutaneous veins and dependent edema in mildly affected patients to pigmentation, dermatitis, and ulceration in the more severe cases. Although most patients are asymptomatic, others have leg heaviness and aching or recurrent and recalcitrant leg ulcers punctuated by bouts of cellulitis. These more severe cases are associated with recurrent hospitalization, high health-care costs, and disability. 4,5 Venous insufficiency with trophic skin changes or ulceration is a frustrating problem, which many physicians approach with a sense of ennui. This may be due to the chronic and remitting nature of the problem, the need for lifestyle modification, inconvenient therapies, and contradictory information regarding medical and surgical management. Nevertheless, CVI, including ulceration, is a manageable problem. The purpose of this review is to present the normal anatomy and physiology of the venous circulation and to summarize the epidemiology, pathophysiology, and treatment of CVI. DATA SYNTHESIS: METHODSA MEDLINE search for relevant English-language articles published between 1966 and 1996 was completed using the following MeSH terms: venous insufficiency or varicose ulcer and epidemiology, pathophysiology, diagnosis, and clinical trial (pt). When selecting articles on treatment, randomized, controlled trials were reviewed whenever possible. Emphasis was placed on reviewing articles with clinical relevance for internal medicine physicians. ANATOMY AND NORMAL PHYSIOLOGYVenous blood from the skin and subcutaneous fat is collected in a system of superficial venules and veins that drain toward the deep venous system underneath the fascia via three major pathways: (1) through the long or short saphenous veins, which join the deep system at the saphenofemoral and saphenopopliteal junctions; (2) through the perforating veins originating from the long or short saphenous veins or their branches; or (3) directly into the deep venous system or bypass the deep system entirely and enter the pelvis. 6 Deep veins are categorized as either intramuscular or intermuscular; o...

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Section: Pathophysiologymentioning

confidence: 99%

Section: Pathophysiologymentioning

confidence: 99%

Chronic Venous Insufficiency and Venous Ulceration

Alguire

Mathes

1997

J Gen Intern Med

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“…Venous hypertension caused by venous insufficiency, including varicose veins, triples the flow of lymph and doubles its concentration of fibrinogen, thereby increasing net transport of fibrinogen across the interstitial space by 600%. 17 However, there is no significant change in the fibrinolytic activity of lymph. The quantity of fibrinogen passing across the interstitial space increases, but fibrinolysis does not increase.…”

Section: Discussionmentioning

confidence: 97%

Lymphatic flow restoration after stripping surgery for varicose veins: A case report

Yoshida

Koshima

Imai

et al. 2019

SAGE Open Medical Case Reports

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It has been suggested that the dynamics of the venous and lymphatic systems interact as a mutually dependent dual outflow system and that derangement of lymph flow could be reversed by surgical treatment of venous incompetence. In this report, we describe a patient in whom lymphatic function was restored after stripping of the great saphenous vein for varicosity. The patient was a 79-year-old woman who had varicose veins along the medial side of an edematous left leg. Lymphatic function was investigated using indocyanine green imaging to evaluate for the presence of lymphedema. Based on the findings, we made a diagnosis of bilateral varicosity of the great saphenous vein with left-sided lymphedema. The great saphenous vein was stripped between the groin and ankle on both sides. At 3 months after the stripping procedure, lymphatic flow was observed immediately after injection of indocyanine green in both legs along the medial side from the foot to the groin. We therefore determined that lymphatic flow had been restored after the stripping surgery. The functions of the venous and lymphatic systems are thought to be closely related, and that, if the function of one declines, the other will also be affected. Treatment of venous system, including stripping, may help to break the vicious cycle of lymphatic stasis and venous insufficiency.

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“…[4] Exact pathology for the cause of venous ulcer is uncertain, some of the postulates being these like fibrin cuff theory, [5] leucocyte trapping theory, tissue damage by free radicals, inflammatory theory, [6] growth factor depletion and lipodermato sclerosis. [7] At present ambulatory venous hypertension [8] is the only cause for venous hypertension. Other factors may contribute individually or culminatingly in the nonhealing of a venous ulcer.…”

Section: Introductionmentioning

confidence: 99%

Management of a Venous Ulcer with Virechana Karma and internal medications - A Case Report

Prashantha

2018

JAIMS

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Venous Ulcer is a very common disease encountered in surgical practice. There are many modality of treatment in contemporary science, yet it takes very long time for healing of the ulcer. Objective - This is a single case study depicting the effect of Virechana Karma along with internal medications in a case of chronic venous ulcer. Materials and Methods - In this study a male patient of 52 years presenting with a non healing ulcer on the right lower leg was diagnosed as venous ulcer. He was treated with Virechana Karma and internal medications along with Kashaya Parisheka to the ulcer. Result - After discharge, follow up of patient was done. Complete healing of wound was noted in 45 days. The changes in wound healing were documented during the stay in the hospital and during follow up. Conclusion - After Virechana a significant reduction in many of symptoms was noted. This treatment protocol has shown encouraging results in terms of early healing of the ulcer with low cost of the treatment when compared to conventional treatment methods.

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Effect of venous hypertension on canine hind limb lymph

Cited by 17 publications

References 16 publications

Chronic Venous Insufficiency and Venous Ulceration

Chronic Venous Insufficiency and Venous Ulceration

Lymphatic flow restoration after stripping surgery for varicose veins: A case report

Management of a Venous Ulcer with Virechana Karma and internal medications - A Case Report

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