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In chronic venous insufficiency, sonographic examination is of most benefit; in confirming varicose disease, making an assessment of the hemodynamics, and charting the progression of the disease and its response to treatment. It has become the reference standard for examining the condition and hemodynamics of the lower limb veins.
The most common cause of chronic venous insufficiency is reflux of the venous valves of superficial veins. [2] This may in turn be caused by several conditions: Deep vein thrombosis (DVT), that is, blood clots in the deep veins. Chronic venous insufficiency caused by DVT may be described as postthrombotic syndrome. DVT triggers an inflammatory ...
Still, it is widely used in clinical practice, probably because of its historical role prior to the availability of more reliable diagnostic studies (such as a D-dimer titration or a Doppler ultrasound), as well the ease of eliciting it. [4] An elevated D-dimer in the elderly population has no predictive value for deep venous thrombosis.
Diagnosis can be made using ultrasound or laparoscopy testing. The condition can also be diagnosed with a venogram, CT scan, or an MRI. Ultrasound is the diagnostic tool most commonly used. [8] Some research has suggested that transvaginal duplex ultrasound is the best test for pelvic venous reflux. [11]
Unlike arterial ultrasonography, venous ultrasonography is carried out with the probe in a transversal position, (perpendicular to the vein axis), displaying cross-sections of the veins. [4] All collateral veins are better detected this way, including perforator veins , but of most importance is the detection of venous thrombosis .
Phlebetic lymphedema (or phlebolymphedema) is seen in untreated chronic venous insufficiency and is the most common type of edema (approx. 90%). [14] It is a combination venous/lymphatic disorder that originates in defective "leaky" veins that allows the blood to back flow (venous reflux), slowing the return of the blood to the heart (venous ...
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