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DVT423-TH1

USIDMS LE Venous Insufficiency

QuestionAnswer
What are the two types of venous insufficiency and describe the difference between the two? Primary venous insufficiency comes from the absence or malformation of valves while secondary venous insufficiency comes from DVT and/or venous outflow obstruction.
What are the symptoms of venous insufficiency? heaviness, tension, aching, restless legs, muscle cramps, varicosities, recurrent swelling, stasis dermatitis, ulcerations, etc.
Where do you normally see stasis dermatitis, varicosities, and venous ulcerations? Medial calf, aka gaiter zone
What is an EVLT and what is the landmark for an EVLT on the GSV? EVLT= ablation of veins, the landmark for an EVLT of the GSV is the inferior epigastric vein
How many valves are found in the perforators? One
Between spectral and color Doppler, which is qualitative and which is quantitative? Spectral Doppler= quantitative, Color Doppler= qualitative
The Valsalva maneuver is equivalent to proximal or distal compression? Proximal
During distal compression/augmentation of a vein you should see.....? Flow = normal
After distal compression/augmentation of a vein you should see.....? No Flow = normal
During proximal compression / Valsava of a vein you should see....? No Flow = normal
After proximal compression / Valsalva of a vein you should see....? Flow = normal
What are the two axes of a histogram? Distance(y or vertical) and time(x or horizontal)
Can Color Doppler tell how severe venous insufficiency is? No, color Doppler is qualitative, not quantitative.
Name the perforators down the leg. Thigh= Dodd's. Knee= Boyd's. Medial calf= Cockett's
How does Radiofrequency (VNUS) ablation work? Catheter is placed and energy heats electrodes which contracts vessel wall.
What is sclerosing foam injection used for? spider veins
How does PPG test venous insufficiency? Uses infrared light to measure amount of blood subcutaneously. Measures venous refill time (VRT) which should be >20 seconds.
If PPG test is abnormal what should you do? Apply tourniquet around thigh and do again, if normal GSV is incompetent. Do again if abnormal and apply tourniquet around calf, if normal GSV in calf and SSV are incompetent. If STILL abnormal, deep system is incompetent.
Does PPG or APG quantitate venous reflux? APG
Describe the difference between PPG and APG? PPG measures how quick calf fills back up with blood. APG measures how well the calf muscle pump works.
What can cause pulsatile venous flow in the lower extremity veins? Congestive Heart Failure (CHF)
What is considered the "gold standard" for venous insufficiency? Contrast Venography
Description of Arterial Ulcers On bony prominences, round, deep, very painful, little bleeding, legs will be shiny, scaly , hairless
Description of Venous Ulcers Found in gaiter zone, irregular shape, barely painful, oozes yellow, stasis dermatitis, varicosities,
Created by: thollander