Monday, January 2, 2012

Incompetent perforators and varicose veins: part-2

This is the same patient as in the previous blog. Here one of the perforators of the lower third of the right leg is seen between the right posterior tibial veins (paired) and the distended great saphenous vein.
To get this video, I passed the probe along the leg from below (ankle level) upwards, sweeping in the transverse plane until the perforator was seen clearly.
Color Doppler ultrasound Video 1:

Video-2: Another display of the same perforator:

The transverse axis of the great saphenous vein (GSV) is ideally suited to display the perforator emerging from the GSV and reaching deeper towards the posterior tibial veins (seen here as paired veins on either side of the posterior tibial artery).

Ultrasound video sapheno-femoral incompetence: part-1:

This patient of right lower limb varicose veins presented a strange display of the incompetent valves flailing helplessly in the to and fro flow of blood from and to the right great saphenous vein across the right saphenofemoral junction.
The spectral Doppler trace of this junction proves the point with moderately severe incompetence seen as reflux across the valve lasting almost 2 seconds. (see image below):

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