| Preoperative duplex venous mapping: a comparison of positional techniques in patients with and without atherosclerosis. | |
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MedLine Citation:
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PMID: 8040946 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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PURPOSE: Preoperative duplex venous mapping is the preferred modality to measure the diameter of the greater saphenous vein and its suitability as an arterial conduit for infrainguinal bypass. We wanted to determine the optimal mapping technique and maximal venous diameter in patients with and without atherosclerosis. METHODS: Three groups of patients were prospectively studied: younger control subjects (n = 20), preoperative atherosclerotic patients (n = 10), and older control subjects (n = 10). All patients underwent greater saphenous vein duplex mapping in a standardized manner. Maximal internal vein diameters were measured with the subjects in the supine position in bed, in the 20 degree reversed Trendelenburg position, sitting on the edge of the bed, standing, and in the supine position with a high-thigh, low-pressure tourniquet. Measurements were taken just beyond the saphenofemoral junction, in the distal thigh, below the knee, at midcalf, and superior to the medial malleolus. RESULTS: In younger control subjects an increasingly more erect position resulted in progressively larger measured vein diameters at all levels along the length of the leg. Both patients with atherosclerosis and older control subjects had no such increase in venous diameter with any positional change from the supine position to standing. Patients with atherosclerosis also had significantly smaller measured veins than either younger or older control subjects. A high-thigh tourniquet significantly increased vein diameters in the atherosclerotic group to the size of vein diameters in the older control group, although the absolute size differences were not large. CONCLUSIONS: The optimal position for venous mapping is with the patient in a supine position. If the internal vein diameter is below an acceptable minimum size, a high-thigh tourniquet will maximally distend the vein in patients with atherosclerosis. Vein diameter decreases with age and is less distended in patients with atherosclerosis compared with older patients without atherosclerosis. |
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Authors:
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J Blebea; W R Schomaker; G Hod; R J Fowl; R F Kempczinski |
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Publication Detail:
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Type: Comparative Study; Journal Article |
Journal Detail:
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Title: Journal of vascular surgery Volume: 20 ISSN: 0741-5214 ISO Abbreviation: J. Vasc. Surg. Publication Date: 1994 Aug |
Date Detail:
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Created Date: 1994-08-25 Completed Date: 1994-08-25 Revised Date: 2012-10-03 |
Medline Journal Info:
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Nlm Unique ID: 8407742 Medline TA: J Vasc Surg Country: UNITED STATES |
Other Details:
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Languages: eng Pagination: 226-33; discussion 233-4 Citation Subset: IM |
Affiliation:
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Division of Vascular Surgery, University of Cincinnati Medical Center, OH 45267-0558. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Adult Aged Analysis of Variance Arteriosclerosis / surgery, ultrasonography* Female Humans Male Middle Aged Posture Preoperative Care Reference Values Saphenous Vein / surgery, ultrasonography* Ultrasonography / methods |
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