Superficial venous reflux is commonly the cause of symptomatic venous disease, but proximal venous obstruction may also play a role. A duplex ultrasound evaluating bilateral common femoral veins can detect differences in phasicity, which may be due to pelvic venous obstruction. We report a case of a patient with recurrent symptomatic varicose veins after treatment of superficial venous reflux. Based the duplex ultrasound results of damped respiratory phasicity, the patient was diagnosed with deep venous obstruction which was confirmed on MRV.
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References
1.
KistnerR.L., EklofB., MasudaE.M.Diagnosis of chronic venous disease of the lower extremities: the CEAP classification. Mayo Clin Proc1996; 71: 338–345.
2.
van BemmelenP.S., BerganJ.J.Quantitative Measurement of Venous Incompetence.Austin, TX: R.G. Landes Company, 1992.
JohnsonB.F., ManzoR.A., BergelinR.O., StrandnessD.E.Jr.. Relationship between changes in the deep venous system and the development of the postthrombotic syndrome after an acute episode of lower limb deep vein thrombosis: A one- to six-year follow-up. J Vasc Surg1995; 21: 307–312.
5.
NicolaidesA.N., HusseinM.K., SzendroG., ChristopoulosD., VasdekisS., ClarkeH.The relation of venous ulceration with ambulatory venous pressure measurements. J Vasc Surg1993; 17: 414–419.
6.
NeglénP., ThrasherT.L., OlivierJ., RajuS.Venous outflow obstruction: An underestimated contributor to chronic venous disease. J Vasc Surg2003; 38: 879–885.
7.
NeglénP., HollisK.C., OlivierJ., RajuS.Stenting of the venous outflow in chronic venous disease: Long-term stent-related outcome, clinical, and hemodynamic result. J Vasc Surg2007; 46: 979–990.
8.
LabroupoulosN., BorgeM., PierceK., PappasP.J.Criteria for defining significant central vein stenosis with duplex ultrasound. J Vasc Surg2007; 46: 101–107.