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  • Review ArticleDecember 31, 2022

    0 199 321

    Image Optimization in Venous Ultrasound Examination

    Hyangkyoung Kim, M.D., Ph.D. and Nicos Labropoulos, Ph.D.

    Ann Phlebology 2022; 20(2): 64-67
    Abstract
    Ultrasound is a diagnostic tool of choice for venous disease. As treatment is based on ultrasound results, accurate examination is essential and image optimization is necessary to provide objective information. Understanding the physical properties and knobology of ultrasound helps to obtain good images. To begin with, comfortable placement of the ultrasound for the examiner to use and the appropriate positioning of the patient is also important. The next step for an optimal ultrasound image is to attain good resolution to a given depth. It is also essential to appropriately utilize the provocation maneuvers when diagnosing a suspected disease, especially for the chronic venous disease.
  • Review ArticleDecember 31, 2023

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    Proper Preparations for the Ultrasonographic Evaluation of Varicose Veins of the Lower Extremities - The 2023 Korean Society for Phlebology Clinical Practice Guidelines

    Wooshik Kim, M.D., Tae Sik Kim, M.D., Sangchul Yun, M.D., Heangjin Ohe, M.D., Seung Chul Lee, M.D., Sung Ho Lee, M.D. and Sang Seob Yun, M.D.

    Ann Phlebology 2023; 21(2): 60-62
    Abstract
    In the diagnosis of varicose veins, duplex ultrasound scanning is recommended as the diagnostic test of choice. Both superficial and deep veins must be tested accurately and consistently in a standardized manner. Ultrasonography, while effective, is highly dependent on the examiner and requires standardization. To ensure reliable results, it is crucial to obtain high-quality images of superficial veins using a high-frequency linear array transducer during ultrasound examinations of the lower extremities. Image optimization techniques should be employed to minimize artificial images and enhance diagnostic quality. When conducting ultrasound examinations of the lower extremities, specifically for varicose veins, performing the venous reflux test in a standing position is essential. This positioning allows for testing under conditions more similar to physiological ones, ensuring a more accurate assessment of pathological reflux influence.
  • Review ArticleDecember 31, 2023

    0 120 170

    What are the Standard Recommendations for Ultrasound Documentation of Varicose Veins? - The 2023 Korean Society for Phlebology Clinical Practice Guidelines

    Seung Chul Lee, M.D., Tae Sik Kim, M.D., Sangchul Yun, M.D., Wooshik Kim, M.D., Heangjin Ohe, M.D., Sang Seob Yun, M.D. and Sung Ho Lee, M.D.

    Ann Phlebology 2023; 21(2): 70-73
    Abstract
    In diagnosing varicose veins, accurate ultrasound examinations and meticulous recording of findings are crucial, as they play a significant role in determining treatment methods. Therefore, the Korean Society of Phlebology, in collaboration with related societies, has developed guidelines for the ultrasound diagnosis of varicose veins, including standard recommendations for documenting examination records. After examining varicose veins, it is mandatory to record in writing the name of the blood vessel that was measured. For penetrating veins, it is also necessary to precisely record both the size and location. Additionally, during a provocation test involving compression, the augmented waveform and the regurgitation waveform must be documented so that they are distinctly visible in opposite directions around the baseline. Lastly, the reflux time should be specified in seconds or milliseconds.
  • Original ArticleJune 30, 2024

    0 43 11

    Early Midterm Results of Laser Assisted Sclerotherapy

    Jin Won Jun, M.D., Ji Ran Jang, M.D., Yong Beom Bak, M.D., Seung Jae Byun, M.D., Ph.D.

    Ann Phlebology 2024; 22(1): 27-31
    Abstract
    Objective This study aims to evaluate the effect of treatment for great saphenous vein incompetence with a fourth-generation 1940 nm laser with radial fiber and catheter directed foam sclerotherapy (CDFS) without a tumescent simultaneously. The procedure was termed laser assisted sclerotherapy (LAST). It is a kind of thermochemical ablation.
    Methods From January 1 to June 30, 2023, 86 GSV cases from 50 patients who underwent LAST at Cheongmac hospital were enrolled in this retrospective study. Endogenous laser ablation (EVLA) was performed in the order of accessary vein, tributaries and truncal vein and then followed by CDFS which was performed with a 3% sodium tetradecyl sulfate (STS) mixed with CO2 gas at a ratio of 1:4. The degree of pain was measured after procedure at 2 hours after the procedure. Follow-up was conducted at 1 week, 1 month, and 6 months.
    Results Three of the 86 GSV observed for >6 months showed mild reflux. According to size and number of ablated vessels, various energy level was needed. Three percent STS was used 4.5±0.4 cc and operation time per GSV was about 8±2 minutes. The VAS score was 2.5±0.6 at 2 hours after surgery. The closure rate was 100% at 6 months. Symptoms improved after 6 months in all patients (6.2±1.2 to 0.9±0.2).
    Conclusion LAST showed a good closure rate in the early midterm follow up period. Ablation was possible with less energy compared with EVLA and the pain index was lower at the second hour after procedure.
AP
Vol.22 No.1 Jun 30, 2024, pp. 1~38

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