From: Steven Knight <[log in to unmask]>
To: [log in to unmask]
Sent: Tuesday, October 23, 2012 9:03 AM
Subject: Re: eliciting venous reflux
We discussed this at our chapter meeting on Saturday and I had a similar circumstance today with a patient with DVT. I didn’t want to use auto inflator. In cases of gross insufficiency the veins become maximally dilated with little or no capacitance for regurgitant flow. You cannot put more water into a bucket that is already full to the brim. Ergo you will have trouble showing reverse flow.I’m not saying that is what happened in your case but if you suspect that in the future you might try DECREASING hydrostatic pressure (have patient lay in moderate footdownberg) so that you can squeeze enough volume out of the veins to allow space for them to refill with retrograde flow.Eager for others to chime in on this.Hi SteveWe normally use a rapid cuff inflator, but didn't on this case. Do you think that makes a big difference?
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On Oct 23, 2012, at 6:32 AM, Steven Knight <[log in to unmask]> wrote:Karen, do you use a rapid cuff inflator doing your studies or do you squeeze the leg manually?~SI saw a patient today with very large veins, >8mm GSV( at the ankle), with multiple ropey tributaries but was not able to elicit reflux in the standing position. She had an ulcer at the medial malleolus, hemosiderin staining in the gaitor area and edematous ankles. The perforator at the ulcer was incompetent. I am having a very difficult time believing that this patient does not have an incompetent GSV. Have any of you ever seen this before? Could this patient have reflux even though I couldn't demonstrate it?KarenTo unsubscribe or search other topics on UVM Flownet link to: http://list.uvm.edu/archives/uvmflownet.htmlTo unsubscribe or search other topics on UVM Flownet link to: http://list.uvm.edu/archives/uvmflownet.html
To unsubscribe or search other topics on UVM Flownet link to: http://list.uvm.edu/archives/uvmflownet.html