Gail P. Size BS, RPhS, RVS, RVT, FSVU

Laurie Lozanski BS, RVT

EDITED BY:Susan McCormick, PhD

Christopher L. Skelly MD, FACS

VENOUS

The complete guide to venous disease, non-invasive

testing and interpretation

List of Tables

Anatomy

Table 1. Lower Extremity Deep Veins ..................................... 19

Table 2. 1998 and 2011 Terminologia Anatomica for lower extremity deep veins that were deleted, added or had a change in nomenclature. .......................... 25

Table 3. Perforators ................................................................ 26

Table 4. Lower Extremity Superficial Veins ............................. 28

Table 5. 1998 and 2011 Terminologia Anatomica for lower extremity superficial veins.* .................................... 35

Venous Vascular Physiology and Hemodynamics

Table 6. Flow/Pressure/Volume Relationships ....................... 46

Table 7. Pressure and Flow Relationships of Inspiration and Expiration ................................... 48

Table 8. Inspiration/Expiration Flow Changes ........................ 49

Table 9. Calf Muscle Pump Dynamics .................................... 50

Arterial Testing (Lower Extremity)

Table 10. ABI Protocol Summary ............................................ 97

Table 11. Diagnostic Criteria for ABI ..................................... 100

Table 12. University of Chicago Diagnostic ABI Criteria ....... 101

Table 13. ABI Symptoms ....................................................... 101

Arteriovenous Testing (Upper Extremity)

Table 14. Thoracic Outlet Examination Protocol Summary ... 112

Table 15. Diagnostic Criteria for TOS Disease...................... 116

vii

List of Tablesviii

Venous Testing

Table 16. Lower Extremity Venous Protocol Summary ................................... 132

Table 17. Thrombosis Descriptions and Characteristics ....... 137

Table 18. Diagnostic Criteria for Venous Duplex ................................................. 143

Table 19. Risk Factors for Acute Deep Venous Thrombosis (Caprini DVT Risk Score) ...................................... 147

Table 20. IVC and Iliac Venous Duplex Protocol Summary .. 160

Table 21. Thrombosis Descriptions and Characteristics ....... 162

Table 22. Lower Extremity Venous Insufficiency Examination Protocol Summary ............................ 186

Table 23. Diagnostic Criteria for Venous Reflux .................... 189

Table 24. CEAP Classification ............................................. 191

Table 25. CEAP Classification (Advanced) ........................... 192

Table 26. Duplex Imaging for Venous Ablation Protocol Summary (Pre-procedure) .................................... 204

Table 27. Duplex Imaging for Venous Ablation Protocol Summary (Peri-procedure) ................................... 204

Table 28. Duplex Imaging for Venous Ablation Protocol Summary (Post-procedure) ................................... 205

Table 29. Diagnostic Criteria for Post-Venous Ablation Venous Duplex ................... 205

Table 30. Upper Extremity Venous Protocol Summary ......... 217

Table 31. Diagnostic Criteria for Venous Duplex ................... 226

Table 32. Thrombosis Descriptions and Characteristics ....... 247

Table 33. Diagnostic Criteria for Venous Duplex ................... 248

List of Tables

Non-Imaging Venous Testing

Table 34. Photoplethysmography Protocol Summary ........... 258

Table 35. Diagnostic Criteria for PPG ................................... 260

Table 36. APG Protocol Summary ........................................ 270

Table 37. Air Plethysmography Normal Values ..................... 271

Table 38. Diagnostic Criteria for Venous Filling Index ........... 271

Table 39. Diagnostic Criteria for Ejection Fraction (EF) ........ 272

Table 40. Diagnostic Criteria for Residual Volume Fraction (RVF) ......................................... 273

Correlative Testing Modalities

Table 41. D-dimer Criteria ..................................................... 281

Table 42. Risk Factors for Acute Deep Venous Thrombosis (Caprini DVT Risk Score) ...................................... 284

Table 43. Clinical Prediction Criteria for Pulmonary Embolism ....................................... 285

Table 44. Pioped Criteria (Prospective Investigation of Pulmonary Embolism Diagnosis) ............................................ 285

Table 45. Clinical Prediction Criteria for Deep Venous Thrombosis (Wells Criteria) .................................. 286

Cardiac Effects on Spectral Doppler

Table 46. Summary of Cardiac Effect on Spectral Doppler Vascular Waveforms ............................................. 302

Table 47. Effects of Cardiac Diseases on the Spectral Waveform..................................... 317

ix

Vascular Pharmacology

Table 48. Anticoagulants and Thrombolytics for May-Thurner Syndrome ................................... 321

Table 49. Recommendations for Treatment of DVT and PE . 322

Table 50. Anti-inflammatory Agents ..................................... 323

Table 51. Sclerosants and Concentrations for the Treatment of Venous Lesions .................... 324

Measurements

Table 52. Lower Extremity TBI Symptoms ............................ 332

Table 53. Disease Categorization for ABI/TBI ....................... 332

Table 54. Diagnostic Criteria for Venous Reflux .................... 333

Table 55. Venous Refill Time (VRT) ...................................... 334

List of Tablesx

This comprehensive pocket-style text book is well organized with headings and subheadings allowing each section is easy to follow. This text book contains full color images, anatomy drawings, Quick reference tables and helpful hints, physiology, hemodynamics, definitions, rationale, etiology of disease, risk factors, indications, contraindications, mechanism and location of disease, patient history, physical exam, exam protocols, interpretation, differential diagnosis, correlation, medical, surgical and endovascular treatments, “protocol summaries” and points to remember sections.

“What a wonderful resource for anyone involved in the vascular

laboratory. The depth of information and quality of the information is astonishing”

Joseph A. Caprini, MD, MS, FACS, RVT

...a must have for all involved educators, venous and ultrasound professionals, nurses and physicians. This text defines the role of the sonographer in all venous testing and treatment.

Over 300 Illustrations and images, 55 tables, plus:

• Anatomy

• Physiology and Hemodynamics

• Vascular diseases

• Venous Testing and Interpretation

• All Venous Insufficiency testing

• Venous Ablation Duplex

• Vascular Pharmacology including current Sclerosant agents

• Correlative Testing Modalities and Statistics

• Cardiac Effects on the Spectral Doppler

• Measurements

• Testing Optimization

• Glossary of Terms• Full Index• And more9 780974 769486

59999>ISBN 978-0-9747694-8-6

$139.95

Finally a reference guide

dedicated to non-invasive venous

testing and the venous sy

stem!

QR codes can be found throughout this book for viewing pathology videos and duplex findings using your smartphone or tablet.