الفهرس 
Anatomy of lower limb veins..Only 14 pages are availabe for public view
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Abstract
Venous ulceration is the most common type of leg ulceration. 60 to 80% of legulcers have a venous component. chronic venous leg ulceration has an estimatedprevalence increases with age. Approximately 1% of the population will sufferfrom leg ulceration at some point in their lives.Chronic venous leg ulcer is defined as an open lesion between the knee and theankle joint that remains unhealed for at least four weeks and occurs in thepresence of venous disease.Venous ulcers arise from venous valve incompetence and calf muscle pumpinsufficiency which leads to venous stasis and hypertension. This results inmicrocirculatory changes and localised tissue ischaemia.The natural history of the disease is of a continuous cycle of healing andbreakdown over decades and chronic venous leg ulcers are associated withconsiderable morbidity and impaired quality of life.Leg ulcers in patients from the most deprived communities take longer to healand are more likely to be recurrent.There are a number of noninvasive and invasive techniques to assist in thediagnosis and management. The most commonly used is the venous Duplexultrasound to confirm the diagnosis and provide anatomic detail.Treatment of venous insufficiency has recently been revolutionized byintroduction of new, less-invasive procedures for saphenous closure asalternatives to surgery. Foam Sclerotherapy by the injection of sclerosentcapable of transforming the walls of veins into fibrotic cords is the mostsimple technique of them The efficacy of UGFS in treating venous ulcers explained by control ofvenous hypertension allows or promotes venous ulcer healing. Venous ulcersare usually located near perforating veins which transmit venous hypertensionaswell as refluxing axial and superficial veins Traditionally, reduction ofmicrocirculatory hypertension has been achieved by superficial vein strippingand/or surgical perforating vein interruption. It is apparent that sclerosant foamachieves both of these objectives and, in addition, reaches the microcirculationdirectly where it obliterates the abnormal tangle of vessels in the ulcer bed.Ultrasound examination during and after treatment shows filling and subsequentocclusion of the tangle of vessels in the base of the ulcer.This method is effective, relatively painless, inexpensive, and safe. Eventually,it may be considered the first-line of treatment for these problems . Comparedwith the costs of other methods for treating chronic venous insufficiencysuch as vein stripping and ligation, or endovenous closure using laser orradio-frequency, UGFS is significantly cheaper. These cost-savings areimportant to all medical economies, but especially in underserved areas. Thisapproach is capable of providing a cost-effective method for the treatment ofchronic venous insufficiency where equipment for laser or radio-frequencyendovenous closure and facilities for surgical intervention are too costlyor unavailable.In conclusion , UGFS is a simple procedure with no hospitalization, noanaesthesia, can be done in outpatient clinic and the patient can return homeafter 45 min and no work off period. The relative freedom from seriouscomplications . also The favourable ulcer healing and acceptaple recurrencerates make UGFS an attractive option in the management of patients ofchronic venous leg ulcers.