Dialogue on venous hemodynamics

Oscar MALETI,1 MD: Fedor LURIE,2 MD, PhD; Giorgio BERGAMO,3 BSc; Sara GUERZONI,4 BSc; Marzia LUGLI,1 MD 1Vascular Surgery, Hesperia Hospital, Modena, Italy 2Jobst Vascular Institute and the Division of Vascular Surgery at the University of Michigan, Ann Arbor, Michigan, USA 3Microlab Elettronica Sas. Padova, Italy 4Fleboxan Vein Clinic, Modena, Italy Abstract Hemodynamics of the venous system of the lower limbs is very complex, its explanation typically evoking formulas and concepts that can be daunting for those new to the subject. Here, we approach the task from a more conversational angle, introducing a dialogue between expert and student as they discuss…

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The transosseous perforator veins of the knee

Jean-François UHL,1 MD; Marios VALSAMIS,2 MD; Claude GILLOT,3 MD 1Research Director, UNESCO Chair of Digital Anatomy – Paris University, Paris, France 2Phlebologist & Surgeon (private practice), Athens, Greece 3Laboratory of Anatomy – Paris University, Paris, France Abstract The perforator veins (PVs) of the knee can be responsible for reticular veins, telangiectases, and varicosities around the knee, but they are frequently underdiagnosed and missed by the phlebologists and the sonographers because of their tiny size. These PVs are frequently located around the patella and connected with transosseous perforators, well-demonstrated in the anatomical part of this work. This could explain why sclerotherapy…

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Duplex ultrasound as first-line imaging for morphology and hemodynamics in the upper limb venous system

Niels BÆKGAARD,1 MD; Charlotte STRANDBERG,2 MD 1Vascular Department, Gentofte Hospital and Rigshospitalet, University of Copenhagen, Denmark; 2Department of Radiology, Gentofte and Herlev Hospital, Copenhagen, Denmark Abstract This review describes venous anatomy and hemodynamic characteristics for venous return in the upper limb, including main differences in comparison with venous drainage in the lower limb. Duplex ultrasound (DUS) is the first-line imaging modality even it seems less standardized than other investigation approaches for veins in the lower limb. This article presents useful instructions to assess veins from the peripheral to the thoracic outlet via the costoscalene hiatus. Without basic understanding, it is…

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