Estudio de la insuficiencia venosa crónica mediante ecografía Doppler y realización de cartografía venosa / Doppler ultrasound study and venous mapping in chronic venous insufficiency

La insuficiencia venosa crónica (IVC) de las extremidades inferiores es una enfermedad muy prevalente. La ecografía Doppler se ha establecido en las últimas décadas como el método de elección en el estudio de esta patología, por lo que resulta imprescindible ante una eventual indicación quirúrgica. El objetivo de este trabajo es establecer una metodología en la exploración, incluyendo la realización de cartografía y el marcaje prequirúrgico. Para ello revisaremos la anatomía venosa de los miembros inferiores y la fisiopatología de la IVC explicando los conceptos hemodinámicos básicos y la terminología necesarios para la realización de un informe radiológico que permita una adecuada planificación terapéutica y comunicación con otros especialistas. Explicaremos brevemente la estrategia CHIVA (cura hemodinámica de la insuficiencia venosa ambulatoria), método quirúrgico mínimamente invasivo que tiene como objetivo restaurar la hemodinámica venosa sin extirpar la vena safena (AU)

Chronic venous insufficiency of the lower limbs is very prevalent. In recent decades, Doppler ultrasound has become the method of choice to study this condition, and it is considered essential when surgery is indicated. This article aims to establish a method for the examination, including venous mapping and preoperative marking. To this end, we review the venous anatomy of the lower limbs and the pathophysiology of chronic venous insufficiency and explain the basic hemodynamic concepts and the terminology required to elaborate a radiological report that will enable appropriate treatment planning and communication with other specialists. We briefly explain the CHIVA (the acronym for the French term "cure conservatrice et hémodynamique de l'insuffisance veineuse en ambulatoire" = conservative hemodynamic treatment for chronic venous insufficiency) strategy, a minimally invasive surgical strategy that aims to restore correct venous hemodynamics without resecting the saphenous vein (AU)

Duplex-guided thrombin injection for the treatment of iatrogenic pseudoaneurysms.

This study compares duplex-guided thrombin injection (DGTI) with duplex-guided compression (DGC) for the treatment of iatrogenic pseudoaneurysms. A nonrandomized prospective study, approved by the institutional review board, was performed to evaluate the success rate in DGTI versus DGC (with the use of historical data) in patients who arrive at the vascular surgery service for the treatment of iatrogenic pseudoaneurysm as identified by ultrasound examination. DGTI has been shown to have major advantages over DGC, such as improved patient and operator acceptance, shorter pseudoaneurysm thrombosis times, broader patient applications, and higher success rate.

Review of duplex and colour Doppler imaging of lower-limb arteries and veins.

Ultrasonic imaging provides a non-invasive assessment of the arterial and venous circulation in the lower limb and is accepted as a valuable diagnostic technique. Grey-scale images identify plaque and thrombus, duplex assessment provides a measurement of blood velocity through a vessel, and colour Doppler imaging enables the rapid localization of arterial stenoses and occlusions and the identification of incompetent veins. This article outlines the principles of the different techniques and presents normal images. Procedures for investigating arterial stenoses, superficial venous incompetence and deep venous thrombosis are described, abnormal images presented and the limitations discussed. It is hoped to provide an insight into the strengths and limitations of ultrasonic vascular investigations for those involved in tissue viability and ulcer management.