Page 81 - Virtual Vascular Vol 12

VIDEO

Use of Hand-held Doppler machine to examine an

AV-fistula created for haemodialysis

Doppler AVF2.mp4

This is a patient with C6 varicose vein
according to the CEAP classification.

Pigmentation, lipodermatosclerosis, and
ulcer is seen at the ankle “gaiter” area.

Pigmentation is secondary to increased
melanin production due to repeated
trauma, and haemosiderin deposition

due to venous hypertension.

Lipodermatosclerosis is secondary to a

chronic inflammatory process causing
scarring and fibrosis of the skin and
subcutaneous tissues.

Ulcer formation is multifactorial . Venous
hypertension can cause impaired arterial This is a patient with a brachio-cephalic AVF created for HD.
microcirculation. Leakage of

inflammatory factors and oxygen free Pulsation can be heard when the probe is placed on the brachial artery.
radicals damage the tissue. While tissue

edema and fibrosis prevent growth Bruits is heard (thrill is felt on palpation) along the length of the draining vein.
factors from healing the wounds.
Obstruction is suspected at the position where bruits can no longer be heard. It is
replaced by pulsation as the flow of blood hits the obstructed blood vessel wall.
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