Thermography by Specialty
James Stewart Campbell, M. Nathaniel Mead in Human Medical Thermography, 2023
“Varicose” veins are superficial veins that have enlarged and elongated, producing ropy, convoluted venous masses in the subdermal fat layer just under the skin surface, usually in the lower extremities. The saphenous veins are often implicated in forming complex varicosities. Hemorrhoids, scrotal varicoceles, and venous masses forming in the female labia can also be considered varicosities; varicosities may occasionally form over any part of the body. Insufficiency (reverse leakage) of venous valves is a frequent cause of leg varicosities. Varicose veins are usually patent, with blood flow bringing deep body warmth to the skin surface. Leg varicosities without thrombophlebitis may appear warm when engorged, but should flatten and have a reduced thermal appearance if the limb is raised above heart level. If clots form in a varicose vein, the resulting thrombophlebitis releases NO, causing the skin over the affected vein to appear warmer. Clotting in varicose veins may be induced therapeutically by intravenous injection of sclerosing agents; if successful, the vein no longer carries warm venous blood, becoming cooler. Because of their superficial location, thermography provides an excellent way to find, evaluate, map, and monitor treatment of varicose veins.
Applied Surgical Anatomy
Tjun Tang, Elizabeth O'Riordan, Stewart Walsh in Cracking the Intercollegiate General Surgery FRCS Viva, 2020
What are the current recommendations for managing symptomatic varicose veins?The current NICE guidelines/American Venous Forum recommends the following for patients with varicose veins and truncal reflux: Endovenous thermal ablation (laser or RFA) is suitableIf EVA unsuitable, offer ultrasound-guided foam sclerotherapyIf UGFS unsuitable, offer conventional high tie strip and avulsionsCompression hosiery is only used if interventional treatment is unsuitableThe newer non-thermal non-tumescent technologies such as cyanoacrylate glue ablation (VenaSeal™) or mechano-chemical ablation (ClariVein™) have yet to be defined in this workflow pattern but have similar ablation rates to EVA but are less painful for the patient. Furthermore, they can ablate total GSV reflux to the ankle without the concern of damaging the saphenous nerve.
Combined methods
Suzanne Everett in Handbook of Contraception and Sexual Health, 2020
This research highlights the importance of selecting the right women for combined methods. No woman with a medical history of VTE should be prescribed the combined pill; this is an absolute contraindication. When assessing a woman’s suitability for the pill, you should screen women for the following risk factors for VTE: Family history of VTE under the age of 45.Prominent varicose veins.Obesity (this is considered if the BMI is over 30 kg m2).Immobility, e.g. wheelchair bound.
Comprehensive overview of the venous disorder known as pelvic congestion syndrome
Published in Annals of Medicine, 2022
Kamil Bałabuszek, Michał Toborek, Radosław Pietura
Pelvic Venous Disorders manifests in many clinical presentations. Pelvic Congestion Syndrome is a common condition occurring worldwide, in which a significant proportion of cases remain undiagnosed and symptoms reported by women are often underestimated, due to poor knowledge of the condition. It is an important cause of chronic pelvic pain in female patients. It can also present with superficial varicose veins as the only symptom as well as in combination with pain. Symptoms can be non-specific and difficult to distinguish from other diseases. Certain diagnosis of the PCS is very challenging, due to its multiformity. Determining which patients suffer from symptoms associated with PCS is hard, but also extremely important to implement appropriate and targeted treatment. Future randomised trials on embolisation management are needed. A common treatment algorithm for trials based on an understanding of the mechanisms leading to symptoms would be particularly helpful in objectively evaluating outcomes.
Analysis of the vein wall destruction under endovenous laser ablation in an ex vivo model
Published in Journal of Cosmetic and Laser Therapy, 2021
Natalia Ignatieva, Olga Zakharkina, Alexander Kurkov, Maxim Molchanov, Konstantin Mazayshvili
By histological analysis, control saphenous vein was characterized by three subsystems (tunica intima, tunica media, and tunica adventitia), and also their finer structure (Figure 1) The intima consisted of endothelium and a very thin subendothelial layer of a loose fibrous connective tissue. The media consisted of 2 layers of smooth muscle cells embedded in an extracellular matrix. The adventitia consisted of irregularly oriented bundles of loose connective tissue (Figure 1b,e). Vasa vasorum were traced from the adventitia through the outer part of the media to the inner part of the media. The extracellular matrix of connective tissue in the three subsystems of the vein wall was composed of collagen and elastic fibers mainly. Under polarized light, collagen exhibited birefringence (Figure 1c,f) resulting from both the anisotropy of molecules and the anisotropy inherent in the orderly arrangement of collagen fibers. Varicose vein demonstrated regional variability in wall thickness. As compared with the control specimen, some decrease in the amount of smooth muscle cells and thinning and loosening of collagen fibers were observed in the media; fibrosis was noted in the intima (Figure 1d). The amount of the elastic fibers decreased (Figure 1e).
Vein wall shrinkage induced by thermal coagulation with high-intensity-focused ultrasound: numerical modeling and in vivo experiments in sheep
Published in International Journal of Hyperthermia, 2020
Nesrine Barnat, Anthony Grisey, Bjoern Gerold, Sylvain Yon, Jérémie Anquez, Jean-François Aubry
Varicose veins are a common pathology that can lead to many different health complications if left untreated, including blood clots, skin hyperpigmentation, or even ulcers; thus, they significantly affect the quality of life of patients. Several treatment modalities are currently available to reduce symptoms and prevent complications, including surgery, sclerotherapy, and endovenous thermotherapies such as radiofrequency ablation (RFA) or endovenous laser ablation. During endovenous thermotherapy, a catheter or an optic fiber is inserted into the vein and generates a high temperature (>70 °C) to damage the vein wall thermally [1,2]. These methods can be technically challenging since catheter insertion into and maneuvering in a tortuous vein may be arduous [3]. In this context, high-intensity focused ultrasound (HIFU) is a promising alternative means of treating varicose veins as it can induce tissue coagulation noninvasively and reduce operator dependence. In particular, a previous study (described in a companion paper [4]) demonstrated that the temperatures induced at the vein wall during HIFU ablation are similar to those induced by RFA in clinics.
Related Knowledge Centers
- Obesity
- Quality of Life
- Superficial Thrombophlebitis
- Superficial Vein
- Varices
- Varicocele
- Vein
- Hemorrhoid
- Scrotum
- Anus
- Quality of Life