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Venous diseases are highly prevalent, mostly caused by valve incompetence and/or obstruction of the vein lumen. Signs and symptoms are diverse and unspecific. Careful clinical assessment and imaging interpretation are crucial to diagnosis. Duplex ultrasound is the first choice and often the gold standard imaging technique for this purpose, providing information on the anatomy and function of the veins. This article describes the sonographic anatomic and hemodynamic criteria used for the diagnosis of venous reflux, venous obstruction, and the most frequent complications after interventions in the superficial, perforating, and deep venous systems., (Copyright © 2017 Elsevier Inc. All rights reserved.)

Background: The management of patients with isolated deep venous thrombosis (DVT) is controversial, leading to overtreatment and undertreatment with several complications and increased cost. The aim of this study was to describe the management of isolated calf DVT (ICDVT) in a university hospital., Methods: Data on patients with acute DVT in our hospital are prospectively entered in a database through our venous thromboembolism team. All patients had an objective diagnosis with duplex ultrasound (DU) in our accredited vascular laboratory. A retrospective analysis was performed on patients with ICDVT from July 2015 to June 2016. Patients with proximal DVT were excluded. The management of the patients was assessed for use of different types of anticoagulation, use of sequential compression devices, serial follow-up with ultrasound, or any combination. Patients' demographic information, risk factors, calf DVT anatomic location, DVT extension into calf deep veins, DVT propagation to proximal deep veins, and pulmonary embolism were collected as well., Results: There were 159 patients diagnosed with ICDVT in 1 year, of whom 52% were female with a mean age of 59 years. Nearly half of the patients were smokers (48%), 62% had limited or no mobility, 36% had surgery within the past 30 days, and 23% were considered readmissions. Anticoagulation was given to 121 patients who received seven different types of treatment varying from prophylactic dosing to thrombin inhibitors. In the rest of the 38 patients, 28 had a contraindication to anticoagulation and two had an inferior vena cava filter placed. Eighty-six patients had one DU follow-up study, 39 patients had two follow-up studies, and 21 had three follow-up studies. In the 86 patients with one DU study, seven propagated within the calf (8.1%) and two to the proximal veins (2.3%). Two patients developed nonfatal pulmonary embolism (1.2%). Sequential compression devices were applied in 75 patients despite that the majority were receiving anticoagulation and having serial DU examinations., Conclusions: Significant variation in the management of ICDVT was found on the basis of the physician's preference. The type of treatment overall did not follow a plan based on the patient's risk. Such an approach may increase the cost in the management of these patients without ensuring benefit., (Copyright © 2017 Society for Vascular Surgery. Published by Elsevier Inc. All rights reserved.)

Ovarian vein thrombosis (OVT) is a rare medical disorder most often diagnosed in the peripartum period and maybe associated with other risk factors for thrombosis. Rarely, OVT is considered idiopathic. It occurs in the right ovarian vein alone in two-thirds of patients. In this report, we present a case of idiopathic and bilateral OVT in a 35-year-old woman who presented with 2-day history of left flank pain. Duplex ultrasound imaging and computed tomography confirmed the diagnosis. Oral anticoagulation achieved a favorable outcome., (Copyright © 2017 Society for Vascular Surgery. Published by Elsevier Inc. All rights reserved.)