Method for the Localization of Incompetent Ankle Perforating Veins

Chilvers, A. S.; Thomas, Manfred

doi:10.1136/bmj.2.5709.577

Cited by 18 publications

(4 citation statements)

References 13 publications

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“…FRα has previously been targeted for folate conjugated chemotherapies and immunotherapies . A fluorescein dye was chosen due to a long history of data demonstrating its safety …”

Section: Preclinical Studies Of Fluorescent Dyes For Ifimentioning

confidence: 99%

Intraoperative fluorescence imaging in thoracic surgery

Newton

Predina

Nie

et al. 2018

Journal of Surgical Oncology

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Intraoperative fluorescence imaging (IFI) can improve real-time identification of cancer cells during an operation. Phase I clinical trials in thoracic surgery have demonstrated that IFI with second window indocyanine green (TumorGlow ) can identify subcentimeter pulmonary nodules, anterior mediastinal masses, and mesothelioma, while the use of a folate receptor-targeted near-infrared agent, OTL38, can improve the specificity for diagnosing tumors with folate receptor expression. Here, we review the existing preclinical and clinical data on IFI in thoracic surgery.

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“…FRα has previously been targeted for folate conjugated chemotherapies and immunotherapies . A fluorescein dye was chosen due to a long history of data demonstrating its safety …”

Section: Preclinical Studies Of Fluorescent Dyes For Ifimentioning

confidence: 99%

Intraoperative fluorescence imaging in thoracic surgery

Newton

Predina

Nie

et al. 2018

Journal of Surgical Oncology

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“…In the cases with multiple incompetent perforating veins causing calf pump dysfunction, oedema is common and fascia1 defects difficult to detect. Many other methods of detection have been tried, including venography (Townsend et al, 1967), thermography (Beesley andFegan, 1970;Patil et al, 1970), fluorescein injection with ultraviolet light scanning (Chilvers and Thomas, 1970), but no single method has been found to give results which are very much better than simple clinical examination, and it is debatable, therefor:, whether their attendant disadvantages of cost, risk or discomfort to the patient and time involved are justifiable.…”

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confidence: 99%

The ultrasonic detection of incompetent perforating veins

Miller

Foote

1974

Journal of British Surgery

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Of the methods of detecting incompetent perforators in current use, only two, clinical and ultrasouna: are easily performed and lend themselves to routine use in the ward or outpatients' department. The ultrasound method has a higher degree of accuracy than the clinical method, requires little in the way of additimal equipment or training and provides a very useful method of pre-and postoperative assessment of the varicose leg as well as a method for the study of the natural history of the disease. In a pilot study of 100 limbs 28 incompetcntperforators were discovered in 36 'normal' limbs. A detection rate of 82 per cent in 165 marked sites was noted in limbs with varicose veins. Greater numbers of verforators were jound in association with skin changes and previous operation than in uncomplicated varices. I n 15of 64 limbs with varicose veins no incompetent leg perforators were detected.

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“…Many studies have proven that careful clinical evaluation can give a correct localization of incompetent veins. 2 But recent literature state that clinical methods are unreliable in assessment of varicose veins and doppler ultrasound is of greater accuracy in identifying the sites of reflux. 3 With continuing advances in methods of evaluating venous anatomy and hemodynamics, it is essential to bring out the accuracy of various diagnostic methods of varicose veins, so that early intervention can be achieved and complications can be prevented.…”

Section: Introductionmentioning

confidence: 99%

Accuracy of clinical methods and doppler ultrasound in detection of incompetency of sapheno-femoral junction and perforators compared with operative results

Prabhu

Mohanty

2017

Int Surg J

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Background: Varicose veins, though a common condition, many time remains asymptomatic. The accurate diagnosis of varicose veins is of great importance in planning effective treatment. It is essential to bring out the accuracy of various diagnostic methods of varicose veins, so that early intervention can be achieved and recurrence can be prevented. The objective of this study was to our study was done with the intention of assessing the accuracy of Clinical evaluation of incompetence of Sapheno-Femoral Junction (SFJ) and perforators over doppler ultrasound evaluation and its Intra-operative confirmation, and also to assess the sensitivity, specificity, positive and negative predictive values and significance of both clinical as well as doppler ultrasound evaluation of varicose veins. Methods: The study was conducted in the in-patients of General Surgery Department from September 2011 to August 2013. Patients presented with dilated tortuous veins in lower limb(s) and operated were included in the study. Patients who had recurrent varicose veins and who were unfit for surgery were excluded from the study. The patients were first evaluated clinically using Brodie -Trendelenburg Test I and II, Tourniquet Test, Schwartz Test, Pratt's Test, Morrissey's Cough Impulse Test and Fegan's Method. Following this, patients were evaluated by Ultrasound Doppler study of Venous system of the Lower limb(s) and sites of perforator incompetence were marked. Intraoperative confirmation of incompetence was done by Turner Warwick's Bleed back sign. The accuracy of clinical methods and doppler ultrasound evaluation compared with operative findings were assessed. Results: Accuracy of clinical methods in detecting SFJ incompetence was checked with intra-operative findings. The sensitivity was 100%, specificity 100%, PPV 100% and NPV 100%. Similar results were obtained when checking the accuracy of doppler with intra-operative findings. Accuracy of clinical methods in detecting perforator incompetence was checked with intra-operative findings. The sensitivity was 82.93%, specificity 22.22%, PPV 90.67% and NPV 12.5%. Accuracy of doppler evaluation in detecting perforator incompetence was checked with Intra-operative findings. The sensitivity was 97.56%, specificity 12.5%, PPV 91.95% and NPV 33.33%. Conclusions: Diagnosis of varicose veins is essential for planning of treatment if needed. Clinical methods predict the diagnosis of incompetent SFJ and perforators for which patient need not spend money, and are easy to perform. But doppler ultrasound evaluation has been proved to be more reliable, non-invasive and compatible in detecting venous incompetence. Hence, we conclude that doppler ultrasound evaluation is more accurate than clinical methods in detecting incompetent veins.

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Method for the Localization of Incompetent Ankle Perforating Veins

Cited by 18 publications

References 13 publications

Intraoperative fluorescence imaging in thoracic surgery

Intraoperative fluorescence imaging in thoracic surgery

The ultrasonic detection of incompetent perforating veins

Accuracy of clinical methods and doppler ultrasound in detection of incompetency of sapheno-femoral junction and perforators compared with operative results

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