Semin intervent Radiol 2021; 38(02): 189-193
DOI: 10.1055/s-0041-1727162
Review Article

Evaluation and Management of Patients with Leg Swelling: Therapeutic Options for Venous Disease and Lymphedema

Kimberly Scherer
1   Division of Interventional Radiology, Department of Radiology, Weill Cornell Medical College, New York, New York
,
Neil Khilnani
1   Division of Interventional Radiology, Department of Radiology, Weill Cornell Medical College, New York, New York
› Author Affiliations

Abstract

Lower extremity swelling is a common condition which has a variety of etiologies and can be challenging to diagnose and manage. Swelling is usually the result of the accumulation of interstitial fluid in the subcutaneous tissues. Common etiologies include systemic, superficial, and deep venous, and lymphatic disorders. Leg swelling can occur bilaterally or unilaterally, with venous disorders being one of the most common causes of unilateral lower extremity edema.



Publication History

Article published online:
03 June 2021

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  • References

  • 1 Adamson RH, Lenz JF, Zhang X, Adamson GN, Weinbaum S, Curry FE. Oncotic pressures opposing filtration across non-fenestrated rat microvessels. J Physiol 2004; 557 (Pt 3): 889-907
  • 2 Levick JR. Revision of the Starling principle: new views of tissue fluid balance. J Physiol 2004; 557 (Pt 3): 704-704
  • 3 Gasparis AP, Kim PS, Dean SM, Khilnani NM, Labropoulos N. Diagnostic approach to lower limb edema. Phlebology 2020; 35 (09) 650-655
  • 4 Dean SM, Valenti E, Hock K, Leffler J, Compston A, Abraham WT. The clinical characteristics of lower extremity lymphedema in 440 patients. J Vasc Surg Venous Lymphat Disord 2020; 8 (05) 851-859
  • 5 Trayes KP, Studdiford JS, Pickle S, Tully AS. Edema: diagnosis and management. Am Fam Physician 2013; 88 (02) 102-110
  • 6 Willenberg T, Clemens R, Haegeli LM, Amann-Vesti B, Baumgartner I, Husmann M. The influence of abdominal pressure on lower extremity venous pressure and hemodynamics: a human in-vivo model simulating the effect of abdominal obesity. Eur J Vasc Endovasc Surg 2011; 41 (06) 849-855
  • 7 Suehiro K, Morikage N, Murakami M. et al. A study of leg edema in immobile patients. Circ J 2014; 78 (07) 1733-1739
  • 8 Lee B-B, Bergan JJ, Rockson SG. eds. Lymphedema: A Concise Compendium of Theory and Practice. Springer; 2011
  • 9 Labropoulos N, Borge M, Pierce K, Pappas PJ. Criteria for defining significant central vein stenosis with duplex ultrasound. J Vasc Surg 2007; 46 (01) 101-107
  • 10 O'Donnell Jr TF, Rasmussen JC, Sevick-Muraca EM. New diagnostic modalities in the evaluation of lymphedema. J Vasc Surg Venous Lymphat Disord 2017; 5 (02) 261-273
  • 11 Saleem T, Knight A, Raju S. Diagnostic yield of intravascular ultrasound in patients with clinical signs and symptoms of lower extremity venous disease. J Vasc Surg Venous Lymphat Disord 2020; 8 (04) 634-639
  • 12 Gagne PJ, Tahara RW, Fastabend CP. et al. Venography versus intravascular ultrasound for diagnosing and treating iliofemoral vein obstruction. J Vasc Surg Venous Lymphat Disord 2017; 5 (05) 678-687
  • 13 Raju S. Best management options for chronic iliac vein stenosis and occlusion. J Vasc Surg 2013; 57 (04) 1163-1169
  • 14 Kibbe MR, Ujiki M, Goodwin AL, Eskandari M, Yao J, Matsumura J. Iliac vein compression in an asymptomatic patient population. J Vasc Surg 2004; 39 (05) 937-943
  • 15 Beidler SK, Douillet CD, Berndt DF, Keagy BA, Rich PB, Marston WA. Inflammatory cytokine levels in chronic venous insufficiency ulcer tissue before and after compression therapy. J Vasc Surg 2009; 49 (04) 1013-1020
  • 16 Rossi FH, Kambara AM, Izukawa NM. et al. Randomized double-blinded study comparing medical treatment versus iliac vein stenting in chronic venous disease. J Vasc Surg Venous Lymphat Disord 2018; 6 (02) 183-191
  • 17 Shutze W, Shutze R, Dhot P, Ogola GO. Patient-reported outcomes of endovenous superficial venous ablation for lower extremity swelling. Phlebology 2019; 34 (06) 391-398
  • 18 Mosti G, Cavezzi A. Compression therapy in lymphedema: between past and recent scientific data. Phlebology 2019; 34 (08) 515-522
  • 19 Blumberg SN, Berland T, Rockman C. et al. Pneumatic compression improves quality of life in patients with lower-extremity lymphedema. Ann Vasc Surg 2016; 30: 40-44
  • 20 Deol ZK, Lakhanpal S, Franzon G, Pappas PJ. Effect of obesity on chronic venous insufficiency treatment outcomes. J Vasc Surg Venous Lymphat Disord 2020; 8 (04) 617-628.e1