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VARICOSE VEINS and CVM
UPPER EXTREMITY
Case report
Claude Franceschi, Roerto Delfrate, Massimo Bricchi
Paris, Cremona
Hand : angioma + extra
truncular venous
malformation + varicose
veins.
Forearm: Varicose veins
+ Heaviness, sweating ,
uln...
Venous Mapping+ Marking: Disconnection ( 2 cm
vein excision under local anesthesia) of refluxing
veins flux the competent ...
Hand : faded
angioma color,
collapsed
varicose veins
Forearm:
collapsed
Varicose veins
Heaviness,
sweating
Dramatically
re...
Shunts: closed shunt ( 1 escape point disconnection) and
open deviated shunts ( 2,3,4,5,6 escape points
disconnection) ove...
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Cvm upper extremity

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CHIVA managment of Upper extremity varicose veins and venous malformation

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Cvm upper extremity

  1. 1. VARICOSE VEINS and CVM UPPER EXTREMITY Case report Claude Franceschi, Roerto Delfrate, Massimo Bricchi Paris, Cremona
  2. 2. Hand : angioma + extra truncular venous malformation + varicose veins. Forearm: Varicose veins + Heaviness, sweating , ulnar neuralgia
  3. 3. Venous Mapping+ Marking: Disconnection ( 2 cm vein excision under local anesthesia) of refluxing veins flux the competent veins (shunts escape points ). NO phlebectomy no Laser, no Sclerosant. 1st step: 1,2,3,4,5 . 2nd step ( 5 months) 6,7.12 3 6 7 12 3 4 5 6 7
  4. 4. Hand : faded angioma color, collapsed varicose veins Forearm: collapsed Varicose veins Heaviness, sweating Dramatically relieved Ulnar neuralgia: Cured
  5. 5. Shunts: closed shunt ( 1 escape point disconnection) and open deviated shunts ( 2,3,4,5,6 escape points disconnection) overload the hand extra-truncular venous malformation and angioma and harms the ulnar nerve. Their disconnection relieves signs and symptoms. Random disconnections and/or ablation could be inefficient or aggravate the disease ( excess of residual pressure and impaired drainage° Why 2 steps? Excessive disconnections would hamper the physiological drainage of the hand as well as the angioma would . Thus, progressive disconnection.

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