Flashcards in Misc Venous Deck (19)
What is the gold standard for venous testing?
the number of venograms has decreased due to the accuracy of duplex scanning
Ascending venography is used to evaluate what?
acute DVT, congenital venous disease and/or anomalies, chronic venous thrombosis
Descending venography is used primarily to detect and quantify what?
reversed flow from incompetent venous valves
What are limitation of contrast venography?
-highly technical in technique and interpretation
-allergic reactions or extravasation of contrast media
What is the process of ascending venography?
- radio-opaque contrast media injected into vein on dorsum of the foot
- serial x-rays taken as media passes through venis identifying filling defects, anatomic variations, development of collateral channels
What is the process of descending venography?
- radio-opaque contrast media injected in common femoral vein
- serial x-rays taken as material passes through veins to detect and quantify reversed flow and location of incompetent valves
What are different ways to decrease venous stasis?
- limit long periods of inactivity
- wear support hose
- elevate legs
- intermittent pneumatic calf compression during and after surgery
What is the meaning of prophylaxis?
the preventing of disease
What does low-doses of heparin do?
-interferes with formation of blood clots
-does not lyse an existing thrombus
What pharmaceuticals are used to treat acute DVT and/or PE?
-heparin: loading dose followed by continuous intravenous infusion for 5-10 days
- coumadin: prescribed for three to six months
- lytic therapy: breaks down thrombus
What is used to prevent PE in patients who cannot be anticoagulated and using fluoroscopy is placed in the IVC via jugular or femoral vein?
vena cava interruption devices
- an external caval clip may also be placed around the IVC during abdominal surgery to decrease risk of PE
When is iliofemoral venous thrombectomy preformed?
for impending limb loss (phlegmasia cerulea dolens) if thrombolytic therapy (streptokinase or urokinase) does not dissolve clot
What surgical treatments can be done for chronic venous insufficiency?
- vein ligation of incompetent perforators preformed
- valvular reconstruction or valve transplantation procedures infrequent
Surgical treatment of varicose veins?
-saphenous vein removal or local excision (phlebectomy) of varicosities
How are do endovenous procedures treat varicose veins?
treat from the inside using heat energy that causes the vein to shrink and slowly disappear
- major ablation types are radio frequency ablation and laser ablation
- duplex scanning utilized to confirm patency of veins; size and depth; used to follow catheter during procedure and confirm ablation and absence of thrombosis post procedure
The process of sclerotherapy being used to treat small varicosities?
seals them of with sodium tetradecyl sulfate, injected into varix and compression dressing applied
What surgical treatment creates a shunt between the portal and hepatic veins to treat portal hypertension?
transjugular intrahepatic portosystemuc shunt (TIPSS)
- usual approach is rt IJV to IVC into rt hepatic vein
- bridge created to portal vein
- tract stented with metallic endoprosthesis
What are high level disinfects?