Skip to Main Content

Chapter 37. Veins & Lymphatics

Which statement regarding the treatment of varicose and perforator veins is true?

A. Surgical and chemical ablation are preferred compared to thermal ablation of the greater saphenous vein (GSV).

B. Selective treatment of incompetent perforator veins is recommended in patients with simple varicose veins.

C. Thermal ablation is an effective approach to the treatment of saphenous veins.

D. Foam sclerotherapy is associated with improved ablation outcomes compared to all other therapies.

The correct answer is C. Thermal ablation is an effective approach to the treatment of saphenous veins. The 2011 consensus opinion recommends thermal ablation to surgical or chemical ablation for GSVs. Selective treatment of incompetent perforating veins is not recommended in patients with simple varicose veins, though is an option for pathologic perforating veins. Vein absorption occurs over the course of months.

A limited duration of 3 months of anticoagulation is recommended for which of the following?

A. In patients with pulmonary embolism (PE) or isolated distal deep vein thrombosis (DVT) of the leg provoked by surgery

B. In patients with PE or proximal DVT of the leg provoked by a nonsurgical transient risk factor

C. All patients with unprovoked DVT

D. A and B

The correct answer is D. A and B. Three months of anticoagulation are similarly recommended in patients with PE or proximal DVT of the leg provoked by a nonsurgical transient risk factor and in patients with PE or an isolated distal DVT of the leg provoked by surgery or by a nonsurgical transient risk factor. This is recommended over a longer or shorter duration of anticoagulation. Patients with unprovoked DVT should be considered for an extended duration therapy.

Which imaging study is an appropriate initial evaluation in patients with suspected axillary-subclavian vein thrombosis?

A. Computed tomography (CT) angiogram

B. CT venogram

C. Chest x-ray

D. Upper extremity venous duplex ultrasound

The correct answer is D. Upper extremity venous duplex ultrasound. Upper extremity venous duplex ultrasound is both sensitive and reliable in the diagnosis of axillary-subclavian vein thrombosis. A chest x-ray is obtained to exclude the presence of cervical ribs which can contribute to the compression of the subclavian vein, but cannot be used solely in diagnosis. A CT venogram ...

Pop-up div Successfully Displayed

This div only appears when the trigger link is hovered over. Otherwise it is hidden from view.