Antibiotic dressings, however, have shown no benefit. Adjuncts such as topical dressings to control wound exudate and maintain moisture as well as skin protectants are also important [6,21]. Variant 5: Suspected pelvic-origin lower extremity varicose veins in females. Initial diagnosis. Catheter Venography Pelvis Catheter-directed venography of the iliac veins has been described as the next step in diagnosis after US of the iliac veins, ovarian veins, renal veins, and IVC, CTV/MRV has characterized an occlusion or stenosis [9]. Venographic findings can be grouped into normal, stenosis, and occlusion [8]. Pelvic varices can sometimes be demonstrated with direct catheterization plus or minus balloon occlusion. CTV Abdomen and Pelvis There is no relevant literature regarding the use of CTV abdomen and pelvis in the evaluation of pelvic-derived lower extremity varicose veins in women. This examination can be useful in evaluating the anatomy of dilated ovarian veins and nutcracker phenomenon, which can explain connections to pelvic-origin lower extremity varicose veins. CTV of the abdomen and pelvis has been suggested in the literature in cases with signs of iliac or IVC involvement [9]. Further anatomic characterization before therapy can ensure appropriate and effective treatment thus reducing the frequency for reintervention [10-13]. Understanding the anatomy could aid in the selection of an appropriate treatment modality and reduce recurrence and complication rates. US Intravascular Iliac Veins IVUS has been cited as the most sensitive and specific imaging modality for detecting deep vein obstructive disease. Compared to multiplanar venography, IVUS has been found to be more sensitive for detecting significant stenosis. One study found that in 26.3% of patients, significant lesions were detected with IVUS not initially seen with 3- view venography [42].
Lower Extremity Chronic Venous Disease. Antibiotic dressings, however, have shown no benefit. Adjuncts such as topical dressings to control wound exudate and maintain moisture as well as skin protectants are also important [6,21]. Variant 5: Suspected pelvic-origin lower extremity varicose veins in females. Initial diagnosis. Catheter Venography Pelvis Catheter-directed venography of the iliac veins has been described as the next step in diagnosis after US of the iliac veins, ovarian veins, renal veins, and IVC, CTV/MRV has characterized an occlusion or stenosis [9]. Venographic findings can be grouped into normal, stenosis, and occlusion [8]. Pelvic varices can sometimes be demonstrated with direct catheterization plus or minus balloon occlusion. CTV Abdomen and Pelvis There is no relevant literature regarding the use of CTV abdomen and pelvis in the evaluation of pelvic-derived lower extremity varicose veins in women. This examination can be useful in evaluating the anatomy of dilated ovarian veins and nutcracker phenomenon, which can explain connections to pelvic-origin lower extremity varicose veins. CTV of the abdomen and pelvis has been suggested in the literature in cases with signs of iliac or IVC involvement [9]. Further anatomic characterization before therapy can ensure appropriate and effective treatment thus reducing the frequency for reintervention [10-13]. Understanding the anatomy could aid in the selection of an appropriate treatment modality and reduce recurrence and complication rates. US Intravascular Iliac Veins IVUS has been cited as the most sensitive and specific imaging modality for detecting deep vein obstructive disease. Compared to multiplanar venography, IVUS has been found to be more sensitive for detecting significant stenosis. One study found that in 26.3% of patients, significant lesions were detected with IVUS not initially seen with 3- view venography [42].