Chap 57-58 CVI Treatment Flashcards Preview

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Flashcards in Chap 57-58 CVI Treatment Deck (13):
1

What are compression indications?

symptomatic VV (20-30)
healing ulcers
against as primary for VV for those who are candidates for SV ablation

2

What is recommendation for surgery?

EVLT > surgery

3

What are recommendation for treatment of incompetent GSV?

high ligation and inversion stripping to level of knee

4

What perforators are the most important? what are they?

medial perforators

medial thigh
posteromedial
popliteal fossa
medial gastroc
post tib
medial ankle
medial foot
parartibial

5

What are surgical techniques for reflux?

high ligation of the GSV
divide tributaries
resect 5-10cm portion of gsv

GSV stripping

6

Name the six tributaries of the saphenofemoral junction.

inferior epigastric
superficial circumflex
lateral accessory saphenous
deep external pudendal
superficial external pudendal
medial accessory saphenous

7

What are adjuncts for stripping?

US guidance
Tumescent anesthesia
compressive dressing and elevation
leg elevation before and after
proximal tourniquet (massive varices)

8

What were the results of the ESCHAR trial?

RCT C5-6
No difference in healing, recurrence reduce with sx at one year 12 vs 28
Sx better QoL (LT no diff)
EVLT less peri-procedural morbidity

9

When to consider Sx >EVLT in environment where EVLT is recommended over sx?

sperficial saphenous tributary
GSV dilation/aneurysm
Chrinic thrombophleb
excessive tortuosity
acute superficial thrombosis
economic

10

How does sclerotherapy work?

sclerosants destroy endothelium
veins transformed into fibrous cord

11

What are different sclerosants?

Hypertonic salin
Sclerodex
Chromated glycerin
Nonchromated glycerin
Polidocanol
Sodium tetradecyl sulfate

12

What are indications for EVLT?

saphenous
VV
perforating veins
reticular VV
telangiectasia
residual

13

What are CI for EVLT?

known allergy
acute DVT/PE
local infection
r-l shunt for sclerosant

relative
pregnancy
breast feeding
severe PAD