The hemodynamics and diagnosis of venous disease

Mark H. Meissner, Gregory (Greg) Moneta, Kevin Burnand, Peter Gloviczki, Joann M. Lohr, Fedor Lurie, Mark A. Mattos, Robert Mclafferty, Geza Mozes, Robert B. Rutherford, Frank Padberg, David S. Sumner

    Research output: Contribution to journalArticle

    181 Citations (Scopus)

    Abstract

    The venous system is, in many respects, more complex than the arterial system and a thorough understanding of venous anatomy, pathophysiology, and available diagnostic tests is required in the management of acute and chronic venous disorders. The venous system develops through several stages, which may be associated with a number of development anomalies. A thorough knowledge of lower extremity venous anatomy, anatomic variants, and the recently updated nomenclature is required of all venous practitioners. Effective venous return from the lower extremities requires the interaction of the heart, a pressure gradient, the peripheral muscle pumps of the leg, and competent venous valves. In the absence of pathology, this system functions to reduce venous pressure from approximately 100 mm Hg to a mean of 22 mm Hg within a few steps. The severe manifestations of chronic venous insufficiency result from ambulatory venous hypertension, or a failure to reduce venous pressure with exercise. Although the precise mechanism remains unclear, venous hypertension is thought to induce the associated skin changes through a number of inflammatory mechanisms. Several diagnostic tests are available for the evaluation of acute and chronic venous disease. Although venous duplex ultrasonography has become the standard for detection of acute deep venous thrombosis, adjuvant modalities such as contrast, computed tomographic, and magnetic resonance venography have an increasing role. Duplex ultrasonography is also the most useful test for detecting and localizing chronic venous obstruction and valvular incompetence. However, it provides relatively little quantitative hemodynamic information and is often combined with measurements of hemodynamic severity determined by a number of plethysmographic methods. Finally, critical assessment of venous treatment modalities requires an understanding of the objective clinical outcome and quality of life instruments available.

    Original languageEnglish (US)
    JournalJournal of Vascular Surgery
    Volume46
    Issue number6 SUPPL.
    DOIs
    StatePublished - Dec 2007

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    Venous Pressure
    Routine Diagnostic Tests
    Lower Extremity
    Ultrasonography
    Anatomy
    Hemodynamics
    Venous Valves
    Hypertension
    Venous Insufficiency
    Phlebography
    Terminology
    Venous Thrombosis
    Leg
    Chronic Disease
    Magnetic Resonance Spectroscopy
    Quality of Life
    Pathology
    Pressure
    Muscles
    Skin

    ASJC Scopus subject areas

    • Cardiology and Cardiovascular Medicine
    • Surgery

    Cite this

    Meissner, M. H., Moneta, G. G., Burnand, K., Gloviczki, P., Lohr, J. M., Lurie, F., ... Sumner, D. S. (2007). The hemodynamics and diagnosis of venous disease. Journal of Vascular Surgery, 46(6 SUPPL.). https://doi.org/10.1016/j.jvs.2007.09.043

    The hemodynamics and diagnosis of venous disease. / Meissner, Mark H.; Moneta, Gregory (Greg); Burnand, Kevin; Gloviczki, Peter; Lohr, Joann M.; Lurie, Fedor; Mattos, Mark A.; Mclafferty, Robert; Mozes, Geza; Rutherford, Robert B.; Padberg, Frank; Sumner, David S.

    In: Journal of Vascular Surgery, Vol. 46, No. 6 SUPPL., 12.2007.

    Research output: Contribution to journalArticle

    Meissner, MH, Moneta, GG, Burnand, K, Gloviczki, P, Lohr, JM, Lurie, F, Mattos, MA, Mclafferty, R, Mozes, G, Rutherford, RB, Padberg, F & Sumner, DS 2007, 'The hemodynamics and diagnosis of venous disease', Journal of Vascular Surgery, vol. 46, no. 6 SUPPL.. https://doi.org/10.1016/j.jvs.2007.09.043
    Meissner MH, Moneta GG, Burnand K, Gloviczki P, Lohr JM, Lurie F et al. The hemodynamics and diagnosis of venous disease. Journal of Vascular Surgery. 2007 Dec;46(6 SUPPL.). https://doi.org/10.1016/j.jvs.2007.09.043
    Meissner, Mark H. ; Moneta, Gregory (Greg) ; Burnand, Kevin ; Gloviczki, Peter ; Lohr, Joann M. ; Lurie, Fedor ; Mattos, Mark A. ; Mclafferty, Robert ; Mozes, Geza ; Rutherford, Robert B. ; Padberg, Frank ; Sumner, David S. / The hemodynamics and diagnosis of venous disease. In: Journal of Vascular Surgery. 2007 ; Vol. 46, No. 6 SUPPL.
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