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Varicose Veins/Incompetent Perforator
Simon S. M. Ho, MBBS, FRCR
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KEY FACTS

  • Terminology

    • Imaging

      • Top Differential Diagnoses

        • Clinical Issues

          TERMINOLOGY

          • Abbreviations

            • Varicose veins (VVs)
          • Definitions

            • Chronic venous insufficiency: Venous valvular incompetence in superficial, deep, or perforating veins
            • Venous reflux that persists for longer than 1 sec in common femoral vein (CFV), femoral vein (FV), or popliteal vein (PV), or 0.5 sec at any other level considered clinically significant
            • "Proximal" and "distal" in venous system applies to position of vein segment in relation to position of heart (rather than flow direction of blood)
            • VVs defined as subcutaneous, usually tortuous veins measuring 3-4 mm or larger

          IMAGING

          • Ultrasonographic Findings

            • Imaging Recommendations

              DIFFERENTIAL DIAGNOSIS

                PATHOLOGY

                • General Features

                  CLINICAL ISSUES

                  • Presentation

                    • Demographics

                      • Treatment

                        DIAGNOSTIC CHECKLIST

                        • Image Interpretation Pearls

                          Selected References

                          1. Attaran RR: Latest innovations in the treatment of venous disease. J Clin Med. 7(4), 2018
                          2. Garcia R et al: Duplex ultrasound for the diagnosis of acute and chronic venous diseases. Surg Clin North Am. 98(2):201-218, 2018
                          3. Spinedi L et al: Clinical and duplex ultrasound evaluation of lower extremities varicose veins - a practical guideline. Vasa. 46(5):325-336, 2017
                          4. Merchant RF et al: Long-term outcomes of endovenous radiofrequency obliteration of saphenous reflux as a treatment for superficial venous insufficiency. J Vasc Surg. 42(3):502-9; discussion 509, 2005
                          5. Neumyer MM: Ultrasound diagnosis of venous insufficiency. In Zwiebel et al: Introduction to Vascular Sonography, 5th ed. Philadelphia, Elsevier Saunders. 479-510, 2005
                          6. Perala J et al: Radiofrequency endovenous obliteration versus stripping of the long saphenous vein in the management of primary varicose veins: 3-year outcome of a randomized study. Ann Vasc Surg, 2005
                          7. Min RJ et al: Endovenous laser treatment of saphenous vein reflux: long-term results. J Vasc Interv Radiol. 14(8):991-6, 2003
                          Related Anatomy
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                          Related Differential Diagnoses
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                          References
                          Tables

                          Tables

                          KEY FACTS

                          • Terminology

                            • Imaging

                              • Top Differential Diagnoses

                                • Clinical Issues

                                  TERMINOLOGY

                                  • Abbreviations

                                    • Varicose veins (VVs)
                                  • Definitions

                                    • Chronic venous insufficiency: Venous valvular incompetence in superficial, deep, or perforating veins
                                    • Venous reflux that persists for longer than 1 sec in common femoral vein (CFV), femoral vein (FV), or popliteal vein (PV), or 0.5 sec at any other level considered clinically significant
                                    • "Proximal" and "distal" in venous system applies to position of vein segment in relation to position of heart (rather than flow direction of blood)
                                    • VVs defined as subcutaneous, usually tortuous veins measuring 3-4 mm or larger

                                  IMAGING

                                  • Ultrasonographic Findings

                                    • Imaging Recommendations

                                      DIFFERENTIAL DIAGNOSIS

                                        PATHOLOGY

                                        • General Features

                                          CLINICAL ISSUES

                                          • Presentation

                                            • Demographics

                                              • Treatment

                                                DIAGNOSTIC CHECKLIST

                                                • Image Interpretation Pearls

                                                  Selected References

                                                  1. Attaran RR: Latest innovations in the treatment of venous disease. J Clin Med. 7(4), 2018
                                                  2. Garcia R et al: Duplex ultrasound for the diagnosis of acute and chronic venous diseases. Surg Clin North Am. 98(2):201-218, 2018
                                                  3. Spinedi L et al: Clinical and duplex ultrasound evaluation of lower extremities varicose veins - a practical guideline. Vasa. 46(5):325-336, 2017
                                                  4. Merchant RF et al: Long-term outcomes of endovenous radiofrequency obliteration of saphenous reflux as a treatment for superficial venous insufficiency. J Vasc Surg. 42(3):502-9; discussion 509, 2005
                                                  5. Neumyer MM: Ultrasound diagnosis of venous insufficiency. In Zwiebel et al: Introduction to Vascular Sonography, 5th ed. Philadelphia, Elsevier Saunders. 479-510, 2005
                                                  6. Perala J et al: Radiofrequency endovenous obliteration versus stripping of the long saphenous vein in the management of primary varicose veins: 3-year outcome of a randomized study. Ann Vasc Surg, 2005
                                                  7. Min RJ et al: Endovenous laser treatment of saphenous vein reflux: long-term results. J Vasc Interv Radiol. 14(8):991-6, 2003