title: Investigation of venous ulcers.
abstract: The evaluation of patients with venous ulceration primarily includes noninvasive methods to elucidate the distribution and extent of pathology. Duplex ultrasound is the first line of investigation, as it provides assessment of both reflux and obstruction conditions. In patients with iliofemoral pathology, axial imaging with computed tomography scan or magnetic resonance imaging should be performed. If the treatment of iliofemoral vein obstruction is warranted, then invasive assessment using venography and/or intravascular ultrasound should be used to guide the interventional procedure. Venous valve reflux can be identified and accurately characterized by duplex ultrasound, whereas the ultrasound assessment of functional abnormality associated with obstruction is less reliable. In patients with ulceration, the evaluation for and treatment of proximal venous obstruction has resulted in improved ulcer healing.
authors.affiliation: Division of Vascular Surgery, Stony Brook University Medical Center, HSC T19-090, Stony Brook, NY 11794. Electronic address: angela.kokkosis@stonybrookmedicine.edu.
authors.forename: Angela A
authors.initials: AA
authors.lastname: Kokkosis
authors.affiliation: Division of Vascular Surgery, Stony Brook University Medical Center, HSC T19-090, Stony Brook, NY 11794.
authors.forename: Nicos
authors.initials: N
authors.lastname: Labropoulos
authors.affiliation: Division of Vascular Surgery, Stony Brook University Medical Center, HSC T19-090, Stony Brook, NY 11794.
authors.forename: Antonios P
authors.initials: AP
authors.lastname: Gasparis
mesh_terms: D017130:Angioplasty / Q000379:methods; D005260:Female; D006801:Humans; D035002:Lower Extremity; D018810:Magnetic Resonance Angiography / Q000379:methods*; D008297:Male; D064847:Multimodal Imaging / Q000379:methods*; D010690:Phlebography / Q000379:methods; D010991:Plethysmography / Q000379:methods; D012501:Saphenous Vein / Q000000981:diagnostic imaging / Q000473:pathology; D012680:Sensitivity and Specificity; D014057:Tomography, X-Ray Computed / Q000379:methods; D018616:Ultrasonography, Doppler, Duplex / Q000379:methods*; D018084:Ultrasonography, Interventional / Q000379:methods*; D014647:Varicose Ulcer / Q000175:diagnosis* / Q000628:therapy; D014689:Venous Insufficiency / Q000175:diagnosis / Q000628:therapy