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Application of the ankle pump method in a sitting position to evaluate calf perforating veins by color Doppler ultrasound.
- Source :
-
Journal of vascular surgery. Venous and lymphatic disorders [J Vasc Surg Venous Lymphat Disord] 2024 Jul; Vol. 12 (4), pp. 101897. Date of Electronic Publication: 2024 Apr 26. - Publication Year :
- 2024
-
Abstract
- Objective: We investigated the feasibility and efficacy of assessing calf perforating veins (PVs) using the ankle pump in a sitting position (AP-sit) method by color Doppler ultrasound.<br />Methods: We performed a multicenter prospective clinical trial between November 2022 and October 2023. Eligible patients with chronic venous disease and healthy controls were enrolled. The calf PVs were assessed using three different methods: manual compression in a standing position, manual compression in a sitting position, and AP-sit method. The reflux durations and detection rate of incompetent PVs (IPVs) were compared among the three methods. The number and diameter of calf PVs and distribution of IPVs were analyzed.<br />Results: A total of 50 patients with chronic venous disease and 50 healthy controls were included. There were 173 calves analyzed, including 97 healthy calves and 76 calves with chronic venous disease. The number of PVs per calf was higher in the diseased calves (median, 7.0; interquartile range [IQR], 6.0-8.0) than in the healthy calves (median, 5.0; IQR, 3.0-6.0; P < .001). The diameter of IPVs (median, 2.3 mm; IQR, 2.0-3.1 mm) was larger than that of competent PVs (median, 1.4 mm; IQR, 1.2-1.7 mm). Most of the IPVs (78.8%) were located in the medial and posterior middle of the calf. The reflux duration induced by the AP-sit method was greater than that induced by the manual compression methods (P < .001). Although the AP-sit method had a higher detection rate (92.0%) of IPVs than the manual compression methods (71.7% and 74.3% for standing and sitting, respectively; P < .001), especially in the distal lower leg, the manual compression methods found IPVs not found using the AP-sit method.<br />Conclusions: Diseased calves with chronic venous disease have more PVs than do healthy calves. IPVs are commonly larger than competent PVs, with most IPVs located in the medial and posterior middle of the calf. Most importantly, the AP-sit method provides a convenient and effective approach for assessing the calf PVs, especially those located in the distal calf, as an alternative or complementary method to traditional manual compression, which is valuable in the daily practice of sonographers.<br />Competing Interests: Disclosures None.<br /> (Copyright © 2024 The Author(s). Published by Elsevier Inc. All rights reserved.)
- Subjects :
- Prospective Studies
Humans
Female
Male
Middle Aged
Chronic Disease
Predictive Value of Tests
Adult
Aged
Patient Positioning
Case-Control Studies
Leg blood supply
Leg diagnostic imaging
Veins diagnostic imaging
Regional Blood Flow
Ultrasonography, Doppler, Color
Venous Insufficiency diagnostic imaging
Venous Insufficiency physiopathology
Feasibility Studies
Sitting Position
Subjects
Details
- Language :
- English
- ISSN :
- 2213-3348
- Volume :
- 12
- Issue :
- 4
- Database :
- MEDLINE
- Journal :
- Journal of vascular surgery. Venous and lymphatic disorders
- Publication Type :
- Academic Journal
- Accession number :
- 38679143
- Full Text :
- https://doi.org/10.1016/j.jvsv.2024.101897