Disease of the venous system
Disease of the venous system
Chronicvenousinsufficiency of lowerextremityStatueofAncientRome
Statue of Ancient Rome Chronic venous insufficiency of lower extremity
anatomyVenous systemof the legs is composed bytwoparallelandconnectedsystems,thedeep and superficialvenous.Thesetwosystemswas connected byperforatingvenoussystem交通静脉PerforatingVein皮肤←Skin深静脉DeepVein浅静脉SuperficialVein
anatomy Venous system of the legs is composed by two parallel and connected systems, the deep and superficial venous. These two systems was connected by perforating venous system
primary venous insufficiencyetiological factor1.Valvularincompetence→bloodrefluxhighpressure invenousvenousdilatation2.Weakvesselwall→dilatationvalvularincompetenceProximalDistalveinveinSubcutaneouslayerSubfasciallayerPerioratingPerforatingveinvein
primary venous insufficiency etiological factor 1. Valvular incompetence →blood reflux→high pressure in venous→venous dilatation 2.Weak vessel wall→ dilatation→valvular incompetence
clinical manifestationSimple varicose venousvaricose ofsuperficial vein,no complicationcomplications-dystrophic complication in skins（eczemaulcer）rupturetohemorrhageperforatorvenous insufficiencyankle edemadystrophic complication ofankle skins
clinical manifestation Simple varicose venous—varicose of superficial vein , no complication complications— dystrophic complication in skins（eczema、ulcer） rupture to hemorrhage perforator venous insufficiency —ankle edema， dystrophic complication of ankle skins
Superficia varicose veinsvenous ulcerH141175ShortSingular branchLong图6、静脉曲张致溃场saphenousveinssaphenous veins
Superficia varicose veins venous ulcer
diagnosisclinicalmanifestationimagingdetection:phlebographycolorDopple
diagnosis clinical manifestation imaging detection： phlebography color Dopple
HSurfacezhouwen RuanEx48933SUBEIPEOP HOS5109M6930037142Se:3DoB:Sep20 194Ex:May16201RenderingNo cutWolumeDFOV109.1cmSTND No Filter350VOINo100KV220nARot0.80s/HE+20.6mm/rot.2mm0.516:1/1.2spTilt:.0.005:22:29PM=220L60
Diagnostic studiesVenographyForcedValsalvalightregionundervalvulamaneuverlightregiondisappearingunder valvulaValvula incompetenceNormalvalvuila
Diagnostic studies Venography Forced Valsalva maneuver light region under valvula Normal valvula light region disappearing under valvula Valvula incompetence
treatmentConservativetreatment:CompressionStockings orpressure bandages and lowerextremityelevationFoamsclerotherapySurgical treatment: high ligation and stripping ofgreat (small) saphenous vein+varicose veinstripping deligation of perforating venous!
treatment Conservative treatment： Compression Stockings or pressure bandages and lower extremity elevation Foam sclerotherapy Surgical treatment：high ligation and stripping of great (small) saphenous vein＋varicose vein stripping deligation of perforating venous!