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Venous hemodynamic abnormalities in patients with leg ulceration.
Am J Surg 1995; 169(6):572-4AJ

Abstract

PURPOSE

Venous ulceration in the leg has been predominantly associated with deep venous insufficiency, although a few reports have implicated the superficial veins. The aim of this study was to identify the distribution of valvular incompetence in patients with active leg ulceration.

PATIENTS AND METHODS

Color flow duplex imaging (CFDI) ultrasonography was used to evaluate the entire venous system--superficial, perforator and deep--from groin to ankle in 112 limbs of 94 patients with venous leg ulcers.

RESULTS

Seventy two limbs (64%) had multisystem incompetence and 36 (32%) had one system involved only, whereas in 4 limbs (4%) there was no venous incompetence. Deep venous reflux exclusively was present in 7 limbs (6%) and the perforator system alone was involved only in 3 limbs (3%). However, isolated superficial incompetence was seen in 26 extremities (23%) and combination of superficial with perforator system alone in 23 (21%). In addition, reflux overall in the superficial system (alone and in combination with perforator and deep systems) was seen in 94 limbs (84%). The most common pattern (28%) of abnormality was reflux in all systems, superficial, perforator, and deep.

CONCLUSIONS

The results of this study show that variable combined patterns account for over two thirds of patients with ulceration. No comprehensive surgical policy for alleviating ulceration can be justified; we suggest that a complete evaluation of all venous systems from groin to ankle with CFDI ultrasonography in patients with venous ulceration is practical on a routine basis and will be particularly valuable before surgery in order to target intervention at specific incompetent sites.

Authors+Show Affiliations

Irvine Laboratory for Cardiovascular Investigation and Research, St. Mary's Hospital Medical School, Imperial College of Science Technology and Medicine, London, United Kingdom.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

7771618

Citation

Labropoulos, N, et al. "Venous Hemodynamic Abnormalities in Patients With Leg Ulceration." American Journal of Surgery, vol. 169, no. 6, 1995, pp. 572-4.
Labropoulos N, Leon M, Geroulakos G, et al. Venous hemodynamic abnormalities in patients with leg ulceration. Am J Surg. 1995;169(6):572-4.
Labropoulos, N., Leon, M., Geroulakos, G., Volteas, N., Chan, P., & Nicolaides, A. N. (1995). Venous hemodynamic abnormalities in patients with leg ulceration. American Journal of Surgery, 169(6), pp. 572-4.
Labropoulos N, et al. Venous Hemodynamic Abnormalities in Patients With Leg Ulceration. Am J Surg. 1995;169(6):572-4. PubMed PMID: 7771618.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Venous hemodynamic abnormalities in patients with leg ulceration. AU - Labropoulos,N, AU - Leon,M, AU - Geroulakos,G, AU - Volteas,N, AU - Chan,P, AU - Nicolaides,A N, PY - 1995/6/1/pubmed PY - 1995/6/1/medline PY - 1995/6/1/entrez SP - 572 EP - 4 JF - American journal of surgery JO - Am. J. Surg. VL - 169 IS - 6 N2 - PURPOSE: Venous ulceration in the leg has been predominantly associated with deep venous insufficiency, although a few reports have implicated the superficial veins. The aim of this study was to identify the distribution of valvular incompetence in patients with active leg ulceration. PATIENTS AND METHODS: Color flow duplex imaging (CFDI) ultrasonography was used to evaluate the entire venous system--superficial, perforator and deep--from groin to ankle in 112 limbs of 94 patients with venous leg ulcers. RESULTS: Seventy two limbs (64%) had multisystem incompetence and 36 (32%) had one system involved only, whereas in 4 limbs (4%) there was no venous incompetence. Deep venous reflux exclusively was present in 7 limbs (6%) and the perforator system alone was involved only in 3 limbs (3%). However, isolated superficial incompetence was seen in 26 extremities (23%) and combination of superficial with perforator system alone in 23 (21%). In addition, reflux overall in the superficial system (alone and in combination with perforator and deep systems) was seen in 94 limbs (84%). The most common pattern (28%) of abnormality was reflux in all systems, superficial, perforator, and deep. CONCLUSIONS: The results of this study show that variable combined patterns account for over two thirds of patients with ulceration. No comprehensive surgical policy for alleviating ulceration can be justified; we suggest that a complete evaluation of all venous systems from groin to ankle with CFDI ultrasonography in patients with venous ulceration is practical on a routine basis and will be particularly valuable before surgery in order to target intervention at specific incompetent sites. SN - 0002-9610 UR - https://www.unboundmedicine.com/medline/citation/7771618/Venous_hemodynamic_abnormalities_in_patients_with_leg_ulceration_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0002961099802232 DB - PRIME DP - Unbound Medicine ER -