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Venous anatomy
Published in Joseph A. Zygmunt, Venous Ultrasound, 2020
The posterior tibial veins drain the medial aspect of the foot and travel upward posteromedially beneath the medial edge of the tibia. The two posterior tibial veins unite to form the common tibial trunk. The tibial veins are densely packed with valves, whereas the popliteal vein only has one or two valves, the femoral vein has between three and five valves, and the major perforating veins have between one and three valves [14].
Venous Thrombosis
Published in Hau C. Kwaan, Meyer M. Samama, Clinical Thrombosis, 2019
Gary E. Raskob, Russell D. Hull
A Doppler examination that is falsely negative for the presence of proximal vein thrombosis may be obtained if the observer fails to include the posterior tibial vein examination site.147 Inclusion of the posterior tibial vein site in the Doppler ultrasound examination greatly improves the sensitivity for proximal venous thrombosis, but at the expense of specificity.147 Thus, a Doppler ultrasound examination that is positive only at the posterior tibial vein site requires confirmation by venography.
Anatomy of veins and lymphatics
Published in Ken Myers, Paul Hannah, Marcus Cremonese, Lourens Bester, Phil Bekhor, Attilio Cavezzi, Marianne de Maeseneer, Greg Goodman, David Jenkins, Herman Lee, Adrian Lim, David Mitchell, Nick Morrison, Andrew Nicolaides, Hugo Partsch, Tony Penington, Neil Piller, Stefania Roberts, Greg Seeley, Paul Thibault, Steve Yelland, Manual of Venous and Lymphatic Diseases, 2017
Ken Myers, Paul Hannah, Marcus Cremonese, Lourens Bester, Phil Bekhor, Attilio Cavezzi, Marianne de Maeseneer, Greg Goodman, David Jenkins, Herman Lee, Adrian Lim, David Mitchell, Nick Morrison, Andrew Nicolaides, Hugo Partsch, Tony Penington, Neil Piller, Stefania Roberts, Greg Seeley, Paul Thibault, Steve Yelland
The posterior tibial veins arise from the medial and lateral plantar veins and drain the posterior compartment of the leg and plantar surface of the foot. Peroneal veins drain the deep compartment. Anterior tibial veins arise from dorsal veins of the foot and pass along the anterior compartment of the leg and through the proximal interosseous membrane below the knee.
Central Venous Catheter as a Novel Approach to Postoperative Thrombolysis in Patients with Acute Iliofemoral Deep Venous Thrombosis
Published in Clinical and Experimental Hypertension, 2023
Biyun Teng, Fenghe Li, Xuehu Wang, Hao Tian, Yu Zhao, Qiu Zeng
All venous access was established in the vessels below the knee (BTK), including in the proximal posterior tibial vein (PPTV), anterior tibial vein (ATV), distal posterior tibial vein (DPTV), and peroneal vein (PeV), to sufficiently facilitate thrombi removal during the procedures and maintain patient comfort and ambulatory care after the procedures (Figure 1). Venous access was obtained through four approaches: ultrasound-guided puncture, crossover guidewire- or roadmap-guided puncture, great saphenous vein roadmap-guided puncture, or fluoroscopic image of tibial bone-guided puncture. Twenty-one gauge microneedles with associated microwires and introducers (COOK, USA) were used in all punctures. A 10 French vascular sheath (Cordis, USA) was introduced to accommodate the aspiration catheter, and stents with different sizes were placed to manage iliac vein compression.
Myocardial infarction and factor VIII elevation in a 36-year-old man
Published in Baylor University Medical Center Proceedings, 2022
Amit Alam, Harsh Doshi, Divya N. Patel, Keval Patel, Dreamy James, Jesus Almendral
A year later, he developed pump thrombosis in the setting of Neisseria bacteremia and was treated with antibiotics and LVAD exchange. Aspirin was increased to 325 mg daily and his international normalized ratio goal was increased to 2.5 to 3.5. After 6 months, he had a second episode of pump thrombosis without an associated infection. Chest computed tomography showed no evidence of cannula malposition or obstruction. He underwent another LVAD exchange. Dipyridamole was added to his full-dose aspirin and warfarin. Four years later, he underwent a combined heart-kidney transplant and was discharged on aspirin 81 mg daily. Six weeks posttransplant he developed acute left lower extremity swelling and developed deep vein thrombosis of the left common femoral, femoral, popliteal, and posterior tibial veins requiring thrombolysis with thrombectomy.
Surgical and non-surgical approaches in the management of lower limb post-thrombotic syndrome
Published in Expert Review of Cardiovascular Therapy, 2021
M Machin, S Salim, M Tan, S Onida, AH Davies, J Shalhoub
Surgical thrombectomy has fallen out of practice with the advancement in catheter-directed therapies, with numbers at rock-bottom in the UK since the early 2000s with as few as 26–45 procedures performed annually [15]; it is likely that even these few open thrombectomy procedures are not exclusively related to primary DVT and include cases for restoring flow within venous bypass grafts. Although no longer routinely practiced, some centers in Europe still undertake surgical thrombectomy; hence, it will be briefly mentioned here. The usual technique is to perform a surgical cut down to the common femoral vein as a minimum, with addition of access to the crural veins such as the posterior tibial vein if required [24]. If there is involvement of the inferior vena cava, a proximal filter is usually placed to avoid pulmonary embolization during thrombectomy. Intra-operative venography is used to visualize the obstruction and aid passage of the Fogarty catheter. The catheter is passed to a cephalad point prior to balloon inflation and thrombectomy undertaken. Intra-operative injection thrombolysis and stenting procedures can also be undertaken as an adjunct to open surgical thrombectomy. A surgical arteriovenous fistula can be created at the femoral vessels to improve venous patency.