Angioscopy: Direct visualization of chronic venous occlusion, May-Thurner syndrome, and other applications in phlebology.
Adult
Aged
Aged, 80 and over
Angioscopy
Chronic Disease
Constriction, Pathologic
Endovascular Procedures
Female
Fibrosis
Humans
Male
May-Thurner Syndrome
/ diagnostic imaging
Patient Positioning
Pilot Projects
Postthrombotic Syndrome
/ diagnostic imaging
Predictive Value of Tests
Retrospective Studies
Veins
/ abnormalities
Venous Thrombosis
/ diagnostic imaging
Young Adult
Angioscopy
Chronic venous thrombosis
Endovenous laser ablation
May-Thurner syndrome
Post-thrombotic syndrome
Journal
Journal of vascular surgery. Venous and lymphatic disorders
ISSN: 2213-3348
Titre abrégé: J Vasc Surg Venous Lymphat Disord
Pays: United States
ID NLM: 101607771
Informations de publication
Date de publication:
11 2019
11 2019
Historique:
received:
15
01
2019
accepted:
03
05
2019
pubmed:
25
8
2019
medline:
14
7
2020
entrez:
25
8
2019
Statut:
ppublish
Résumé
Angioscopy has been widely used in the diagnosis and management of vascular disorders and in particular in coronary artery disease. However, few applications have been developed in the diagnosis or management of venous disease. Endovenous angioscopy was performed to explore applications of this modality in phlebology. Procedures were performed in a sterile setting. Access was obtained by ultrasound guidance and a 9F introducer sheath. An 8.5F videoscope was used to visualize target veins. Continuous saline irrigation was used to displace blood and to clear the visual field. Fifteen procedures were performed. We describe diagnostic or interventional applications of endovenous angioscopy that include diagnosis and characterization of chronic venous occlusion, deployment of venous stents, angioscopy-guided thrombectomy, foam sclerotherapy, and endovenous laser ablation. Chronic venous occlusion was observed to be fibrotic rather than thrombotic. Endoscopic imaging of the venous system has great potential to improve access and to guide endovenous interventions. Chronic venous occlusion in post-thrombotic syndrome is a fibrotic process, and chronic venous fibrosis is a better description of the type of occlusion and should replace chronic venous thrombosis.
Sections du résumé
BACKGROUND
Angioscopy has been widely used in the diagnosis and management of vascular disorders and in particular in coronary artery disease. However, few applications have been developed in the diagnosis or management of venous disease.
METHODS
Endovenous angioscopy was performed to explore applications of this modality in phlebology. Procedures were performed in a sterile setting. Access was obtained by ultrasound guidance and a 9F introducer sheath. An 8.5F videoscope was used to visualize target veins. Continuous saline irrigation was used to displace blood and to clear the visual field.
RESULTS
Fifteen procedures were performed. We describe diagnostic or interventional applications of endovenous angioscopy that include diagnosis and characterization of chronic venous occlusion, deployment of venous stents, angioscopy-guided thrombectomy, foam sclerotherapy, and endovenous laser ablation. Chronic venous occlusion was observed to be fibrotic rather than thrombotic.
CONCLUSIONS
Endoscopic imaging of the venous system has great potential to improve access and to guide endovenous interventions. Chronic venous occlusion in post-thrombotic syndrome is a fibrotic process, and chronic venous fibrosis is a better description of the type of occlusion and should replace chronic venous thrombosis.
Identifiants
pubmed: 31444090
pii: S2213-333X(19)30349-X
doi: 10.1016/j.jvsv.2019.05.008
pii:
doi:
Types de publication
Journal Article
Review
Video-Audio Media
Langues
eng
Sous-ensembles de citation
IM
Pagination
870-881Informations de copyright
Copyright © 2019 Society for Vascular Surgery. Published by Elsevier Inc. All rights reserved.