Peter Gillette

Chronische venöse Insuffizienz in einer Minderzahl von Patienten mit Ulcus cruris infolge einer Sichelzellanämie

Background: Chronic or recurrent leg ulceration occurs in 25% of sickle cell anemia patients, but not in the remaining 75%. Doppler studies of venous function were normal in 16 sickle cell anemia patients with leg ulcers. Patients and methods: Venous Duplex Ultrasound was used to study 33 sickle cell anemia patients with chronic leg ulcers. Results: Six of the 33 patients had venous reflux in at least one leg. Conclusions: Venous insufficiency may contribute to the development of leg ulcers in a minority of sickle cell anemia patients. A minority of sickle cell anemia patients with chronic leg ulcers can be shown to have leg venous reflux by duplex ultrasound imaging.BACKGROUND Chronic or recurrent leg ulceration occurs in 25% of sickle cell anemia patients, but not in the remaining 75%. Doppler studies of venous function were normal in 16 sickle cell anemia patients with leg ulcers. PATIENTS AND METHODS Venous Duplex Ultrasound was used to study 33 sickle cell anemia patients with chronic leg ulcers. RESULTS Six of the 33 patients had venous reflux in at least one leg. CONCLUSIONS Venous insufficiency may contribute to the development of leg ulcers in a minority of sickle cell anemia patients. A minority of sickle cell anemia patients with chronic leg ulcers can be shown to have leg venous reflux by duplex ultrasound imaging.

Perforator and Axial Venous Insufficiency in Sickle Cell Disease Patients with and without Leg Ulceration

Chronic or recurrent leg ulceration occurs in at least 25% of patients with sickle cell disease (SSD). Conflicting data exist concerning the association between SSD leg ulcers and axial venous insufficiency. To determine whether the incidence of perforator vein insufficiency (PVI) is greater in the ulcerated legs of SSD patients than in those without ulcers, the legs of 46 SSD patients, 25 of whom had chronic ulceration and of 19 normal young adult volunteers, were investigated with color-flow venous duplex Doppler sonography. PVI was found in 25 of 37 ulcerated legs and in 14 of 55 nonulcerated legs of SSD patients. The difference was significant (odds ratio 6.2). PVI may contribute to leg ulceration in SSD disease.