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Thrombophlebitis Essig Patent US - Multilayer compression stocking system and method - Google Patents
The present application claims the benefit, under 35 U. The present invention relates to elastic garments or wraps that exert a compressive force when worn. Therapeutic garments and elastic bandages that exert a compressive force are often utilized in the prevention and therapy of lower extremity vascular system disorders, such as edema, emboli, and thrombophlebitis. For example, compressive stockings are utilized to improve vascular circulation and to reduce edema and the possibility of emboli in the legs.
Compression therapy is Thrombophlebitis Essig utilized for the prevention and treatment of conditions caused by chronic venous insufficiency, including stasis ulceration in the leg. Elastic bandages, for example, have traditionally been used for compressive therapy of vascular disorders, including ulcers, of the lower extremities. Therapeutic or compressive stockings are constructed to apply compressive pressure to a wearer's legs, Thrombophlebitis Essig.
Compressive pressure may be greatest Thrombophlebitis Essig the foot and gradually decrease from the foot towards the upper, Thrombophlebitis Essig proximal, part of the leg. Alternatively, compressive pressure may be greatest at the ankle and gradually decrease towards the upper part of the leg. The amount of compressive pressure applied depends on the particular Thrombophlebitis Essig and needs of the wearer.
For example, should a greater amount of compressive pressure be applied higher on the leg than lower on the leg, Thrombophlebitis Essig, blood flow Thrombophlebitis Essig be impaired with a possible tourniquet effect occurring.
Further details on therapeutic compressive stockings, Thrombophlebitis Essig, their use and construction, Thrombophlebitis Essig, may be found in U. The disclosure of each of these patents is hereby incorporated herein by reference.
When elastic bandages are used, the bandages are wrapped onto the Zwiebeln Thrombophlebitis with Thrombophlebitis Essig greatest pressure at the foot or ankle, and compressive pressures are manually reduced as the bandages are wrapped up the leg.
Applying correct pressures at particular locations, and properly graduating pressures, so as to avoid creating a tourniquet effect when wrapping elastic bandages is difficult, Thrombophlebitis Essig. Elastic bandages also come in a variety of styles, with stretch characteristics varying widely from product to product, making proper application of correct compression difficult. The compressive pressure applied by stockings at a particular anatomical location may be determined and measured by various techniques.
As will be recognized in the art, there is no standardized system for testing and measuring compressive pressures. A commonly used system for measuring compressive pressures is a British system, Thrombophlebitis Essig, which may be used with pressure testing equipment made by Instron and by Hatra.
The British system divides compressive pressures into three levels, Thrombophlebitis Essig, each level being referred to as a class, Thrombophlebitis Essig.
In Class I, 14 to 19 mm Hg millimeters of mercury of compressive pressure is provided. In Class II, 18 to 25 mm Hg of compressive pressure is provided. A Class Thrombophlebitis Essig stocking would therefore provide 14 to 19 mm Hg of compressive pressure at the point of greatest compressive pressure.
A Class II stocking would provide 18 to 25 mm Hg of compressive pressure at the point of greatest compressive pressure, and a Class III stocking would provide 24 to 35 mm Hg compressive pressure at the point of greatest compressive pressure, Thrombophlebitis Essig.
Suggested preventative and therapeutic uses for each class of pressure are also defined by the British system. Another system for measuring compressive pressures is a German system, which may be used with testing equipment made by Holenstein, Thrombophlebitis Essig.
There are no recognized standards for testing elastic bandages to accurately determine compressive pressures. Controlling the amount of compressive pressure a bandage will exert when applied requires extensive technical knowledge of bandage stretch characteristics, as well as experience.
Some elastic bandages have incorporated methods to assist a care-giver in proper application. For example, visual indicators may be used to signify the degree of stretch, and thus compressive force, provided by an elastic bandage.
A continuous pattern of geometric shapes may be formed on an elastic bandage by using indicator yams or with print. Either the shape of the geometric design or the spacing between shapes in a pattern may change when tension is applied to the bandage, indicating a change in compressive force.
Such designs in elastic bandages have been used to indicate compressive pressures as high as 40 to 50 mm Hg. Compressive stockings, due to the compressive pressures they apply, are generally more difficult to place on the leg than conventional dress hosiery. To be most effective, the area or areas of the stockings having the highest compressive pressure, Thrombophlebitis Essig, and thus the most difficult to apply, should be located at the feet or more distal portions of the leg, such as the ankle.
Consequently, Thrombophlebitis Essig, compressive stockings are often especially difficult for the elderly or persons with compromised mobility to apply to their legs. In addition, Thrombophlebitis Essig, higher compressive pressures are indicated for the prevention and treatment of leg ulcerations.
As a result, compressive stockings that use higher compressive pressures, such as for leg ulcerations, may be even more difficult to apply. It has been generally found that most persons can place, or apply, Class I stockings with minimal or no assistance. However, many patients are unable to apply or remove stockings with Class II or Class III pressures without assistance by a care-giver or medical personnel.
Thrombophlebitis Essig stockings may also be difficult for the care-giver to apply, Thrombophlebitis Essig. As discussed above, compression therapy is often utilized for the prevention and treatment of ulcers, for which Class II or Class III compressive pressures may be beneficial, Thrombophlebitis Essig.
Often, patients suffering from leg ulcers have difficulty applying stockings with Class II or Class III compressive pressures due to age or disability, Thrombophlebitis Essig, such as compromised mobility. Such patients may also have difficulty removing such stockings, particularly if they are applied by a care-giver, Thrombophlebitis Essig. It may also be difficult for a care-giver to remove such stockings due to the compressive pressures involved.
For compressive therapy to be most effective, higher pressures may be required. The very high pressures that may be required for both prevention Tod Thrombophlebitis therapy may preclude use of a stocking, as construction of a stocking having such higher compressive force may cause the stocking to be too tight to apply over the heel of a person's foot, Thrombophlebitis Essig.
As an alternative, high pressure elastic bandages which can be applied directly to a leg, without placement over the foot as with compressive stockings, may be used.
Pressures higher than those supplied by a stocking can be applied by an elastic bandage. Using a high pressure elastic bandage, a leg is generally wrapped by a care-giver, rather than by a patient, as applying desired pressures with proper pressure graduation up the leg requires training and experience. Because of the difficulty of properly applying elastic bandages, they may be left on a patient for longer periods than a compressive stocking, Thrombophlebitis Essig.
Higher compressive pressures and a wider range of pressures can be obtained by utilizing multiple stockings in layers. The layering of compressive pressures will produce a Thrombophlebitis Essig pressure effect. Layering a stocking that provides 10 mm Hg pressure with a Class Thrombophlebitis Essig stocking would produce a stocking with Class II pressure.
Layering of stockings allows the use of higher compressive pressures indicated for certain medical conditions. Since compression stockings are constructed having specific compressive pressures, layering of stockings to achieve specific higher, cumulative, Thrombophlebitis Essig, compressive pressures eliminates the uncertainty of pressures resulting from application of elastic bandages.
In addition, using multiple layers of compression stockings, patients and care-givers can apply a wide variety of accurate pressures, Thrombophlebitis Essig.
However, there are many problems associated with layering multiple stockings. One problem is that it is difficult to coordinate the compressive pressures applied by each stocking to Thrombophlebitis Essig a desired increased pressure at particular anatomical locations on the Thrombophlebitis Essig extremities. Should the areas of compressive pressure not align correctly, it is possible that the area of highest pressure may be on a more proximal, and thus undesired, area of the leg, and a Thrombophlebitis Essig effect may result.
When elastic bandages are used, Thrombophlebitis Essig, the bandages overlap when applied, or may overlap more as they are worn, and create a localized pressure point that may cause skin irritation, breakdown, and ulceration.
Accordingly, there remains a need for compression stockings that are able to accurately achieve Class Wolfsburg Lieferung Varison, Class III, or greater compressive pressures at particular anatomical locations with proper pressure gradations and a smooth surface against the skin, while being easier to apply, Thrombophlebitis Essig, than compression stockings and elastic compression bandages currently available.
There is also a need for higher pressure compression stockings that are easier to correctly apply and that can be made efficiently and economically. The present invention provides compression garments and bandages that overcome the disadvantages of currently available compression garments Thrombophlebitis Essig elastic compression bandages and provide advantages to the wearer and care-giver. One aspect of the present invention is a multilayer compression stocking system for use on a person's lower extremities.
The compression stocking system comprises a plurality of layers including an underlayer and at least one overlayer.
The underlayer may be worn next to the skin or over another stocking, bandage or garment and includes predetermined amounts of compressive pressure at discrete locations. The underlayer further includes alignment markings to assist a wearer in positioning the underlayer on their leg.
The alignment markings may Thrombophlebitis Essig located at the locations of compressive pressure or at different Thrombophlebitis Essig on the underlayer. As discussed below with reference to other aspects and embodiments of the present invention, one or more of the overlayers may include alignment markings that may or may not correspond to the alignment markings on the underlayer.
Thrombophlebitis Essig an embodiment of the present invention, the overlayer is aligned simply by aligning the toe and heel portions of the underlayer and the overlayer. In alternative embodiments, Thrombophlebitis Essig, as discussed below, Thrombophlebitis Essig, alignment markings are utilized to align the overlayer and underlayer.
The overlayer may or may not include areas of compressive Thrombophlebitis Essig depending Thrombophlebitis Essig the application. Further details of possible embodiments of the underlayer and the overlayer are set forth below with reference to additional embodiments of the present invention. Another aspect of the present invention is a multilayer compression stocking system comprising: More than one overlayer may be utilized to produce the compressive pressures desired.
For example, an underlayer and additional overlayers may be layered to provide a total compressive pressure in a Class I range, Thrombophlebitis Essig. As another example, an underlayer and two additional layers, each providing Class I compressive pressures, may be utilized to achieve Class III compressive pressures, Thrombophlebitis Essig.
Thus, at the point of greatest compressive pressure, a Class I stocking would provide 14 to 19 mm Hg of compressive pressure, a Class II stocking would provide 18 to 25 mm Hg of compressive pressure, and a Class III stocking would provide 24 to 35 mm Hg compressive pressure. A multilayer compression stocking system of the present invention may further comprise a final outer layer without medically therapeutic compressive pressures.
In use, an underlayer may be applied first to a wearer's leg and then an overlayer applied up and over the underlayer. Alignment markings on each layer may then be aligned to create the desired areas and amounts of compressive pressure and to ensure that the pressures are properly graduated, for example, in decreasing amounts up the leg.
A final outer layer, if utilized, may then be applied up and over the compressive underlayer and overlayer. A multilayer compression stocking of the present invention may be produced utilizing a circular knitting machine, Thrombophlebitis Essig.
Suitable yams and knitting techniques include those set forth in the patents referred to above and incorporated herein by reference. It is generally preferable to construct the stocking without seams. Seamless construction provides the advantage of avoiding ridges or wrinkles, which may lead to deterioration of the skin.
The multilayer compression stocking may be produced in different sizes, both in length and circumference, for use by a wide variety of people. Pressures graduations along the length of each layer would preferably be constructed the same so that the pressures are matched at the same location on each layer, ensuring the proper cumulative pressure effect and the proper pressure gradation when applied to a leg.
The multilayer compression stocking may be any size, style, or length. For example, the multilayer compression stocking may be of knee length, or may extend above the knee in mid-thigh length, full-thigh length, or may be pantyhose. The underlayer could also be of a different length than the outer layer or layers. For example, the underlayer could be of knee length with the outer layer or layers thigh length. A further aspect of the present Thrombophlebitis Essig is a multilayer compression bandage system.
The bandage system comprises a plurality of layers including als detraleks mit Krampfadern ersetzen underlayer and at least one overlayer. The underlayer may be worn next to the skin or over another bandage or garment and includes predetermined amounts of compressive pressure at discrete locations. The underlayer further includes alignment markings to assist a wearer Thrombophlebitis Essig positioning the underlayer on their body.
In Thrombophlebitis Essig embodiment of the present invention, the overlayer is aligned simply by aligning the top and bottom portions of the underlayer and the overlayer. A further aspect of the present invention Thrombophlebitis Essig a multilayer compressive bandage system comprising:
Background Thrombophlebitis Essig Even after extensive evaluation, the etiology of ischemic stroke remains undefined in a considerable proportion of cases, suggesting that causes of stroke may exist that have not yet been established. We tested the hypothesis that pulmonary venous thrombosis PVT is a potential source of brain embolism in patients with cryptogenic stroke. Summary of Report — Within 7 days after mild to moderately severe ischemic stroke or transient ischemic attack, 18 patients Thrombophlebitis Essig women, 9 men; mean age, Thrombophlebitis Essig, 48 years were studied in whom the etiology remained undefined despite complete workup.
All patients received high-resolution pulmonary venography with the use of multiple-bolus, multiphase, 3-dimensional, gadolinium-enhanced MR angiography MRA. Overall quality of the MRA was good in 14 and insufficient in 4 patients, mainly as a result of breathing artifacts.
Visualization of the main and segmental veins and evaluability of Thrombophlebitis Essig patency were good for most right pulmonary veins but often inadequate for left pulmonary veins, particularly for those in the left lower lobe, Thrombophlebitis Essig. There was no evidence for PVT in any of the sufficiently visualized pulmonary veins.
Conclusions — The results do not support the hypothesis of PVT as a contributor to the etiology Thrombophlebitis Essig ischemic stroke. However, the study was limited regarding scan volume, spatial discrimination, patient selection, and delay between ischemia and MRA.
Therefore, further investigations, including postmortem studies, are needed to resolve the question of whether PVT may contribute to ischemic stroke. Besides the heart Varizen ist eine genetische Erkrankung large extracranial arteries, pulmonary venous thrombosis PVT could be an additional origin of cerebral emboli.
Pulmonary arteriovenous malformations and thrombosis at venous anastomoses after lung transplantation can cause ischemic stroke, indicating that emboli from pulmonary vessels can reach the brain. Gadolinium-enhanced MR angiography MRA was shown to possess high sensitivity and specificity for the diagnosis of pulmonary embolism. Patients were eligible for the study if the following conditions were fulfilled: We investigated 18 Thrombophlebitis Essig 9 women, 9 men; mean age, 48 years; range, 31 to 61 years.
Pulmonary Thrombophlebitis Essig was performed on average 4, Thrombophlebitis Essig. The protocol of this study was approved by the local ethics committee. All patients gave informed consent. The MRA technique was specially developed for this study and successfully tested in healthy volunteers, as described in detail recently.
A standard 4-element phased-array body coil was centered on the chest. Within this volume, 90 phase-encoding and 30 partition-encoding steps were performed, resulting in a voxel size of 1. In a single breath hold of approximately 25 seconds, a total of 4 consecutive acquisitions were performed. To improve separation of arteries and veins, we exploited the intrinsic enhancement kinetics of the pulmonary system using 2 contrast medium boluses each 0.
The Thrombophlebitis Essig was asked to hold the breath as long as possible, preferably for the whole period of 25 seconds, Thrombophlebitis Essig. All veins summarized in the Table were systematically evaluated. Vessel visibility was defined by a semiquantitative score Table. Distal interruptions of vessels close to the margins of the 3-dimensional slab or inhomogeneities in veins with poor visibility were not taken into account.
The 3-dimensional, gadolinium-enhanced MRA could be performed in all patients who had given informed consent. Overall quality of the examinations was good or sufficient grade 1 to 2 in 14 patients, including all 4 patients with Thrombophlebitis Essig infection Figure 1.
The Table depicts the evaluability of all veins assessed. Visibility was substantially better for right than left pulmonary veins. Because of cardiac motion artifacts and superimposition of the left ventricle, which possesses the same enhancement kinetic as pulmonary veins, lower lobe veins mostly showed poorer visibility than upper lobe veins, Thrombophlebitis Essig.
A year-old female patient with acute ischemic stroke. Note good visualization of all veins without evidence of PVT top, anterior-posterior view; bottom, rotated oblique view. Note poor visualization of pulmonary veins, mainly due Thrombophlebitis Essig severe motion artifacts top, anterior-posterior view; bottom, rotated oblique view. None of the pulmonary veins that revealed sufficient diagnostic vessel visibility mode score 5 showed signs of partial or complete vessel obstruction indicative of venous thrombosis.
Pulmonary veins are the most distant of the various upstream sources of arterial emboli. However, this potential source of ischemic stroke has rarely been considered.
One report described a patient who was hospitalized for bronchopneumonia and died from basilar artery occlusion. As Thrombophlebitis Essig only potential source of embolism, autopsy revealed thrombophlebitis in the periphery of the left lung in an area of severe pneumonia, including a small abscess. We developed an MRA method to test the hypothesis that PVT may be an etiology of embolism in otherwise cryptogenic Thrombophlebitis Essig. We failed to detect evidence of PVT among Thrombophlebitis Essig younger patients.
However, there are several limitations inherent to our study. We could investigate only cooperative patients with mild to moderately severe stroke. If emboli from PVT should cause severe stroke, this would not be assessable with our method. Postmortem studies would then be helpful; however, a very low autopsy rate in our country made such approach impossible.
Furthermore, spontaneous thrombolysis could have occurred between ischemia and examination. Although 3-dimensional, gadolinium-enhanced MRA has improved and is a reliable technique to detect pulmonary embolism, 13 conventional angiography is still the gold standard to investigate pulmonary vessels, Thrombophlebitis Essig.
However, periprocedural risk, radiation exposure, and nephrotoxic contrast media hindered our use of conventional angiography or CT angiography. Transesophageal echocardiography allows evaluation of only proximal parts of main pulmonary veins and was unremarkable in our patients. Given the aforementioned methodical limitations, our negative results do not exclude that PVT contributes to the pathogenesis of stroke.
In the future, Thrombophlebitis Essig, further technical refinements and postmortem examinations will be required to study this issue. We only request your email address so that the person you are recommending the page to knows that you wanted them to see it, and that it is not junk mail. We do not capture any email Thrombophlebitis Essig. Skip to main content.
GrauStefan O. Abstract Background — Even after extensive evaluation, Thrombophlebitis Essig, the etiology of ischemic stroke remains undefined in Thrombophlebitis Essig considerable proportion of cases, suggesting that causes Thrombophlebitis Essig stroke may exist that have not yet been established. Subjects and Methods Patients were eligible for the study if the following conditions were fulfilled: MR Angiography The MRA technique was specially developed for this study and successfully tested in healthy volunteers, as described in detail recently.
View inline View popup. Evaluability of Pulmonary Veins. Results The 3-dimensional, gadolinium-enhanced MRA could be performed in all patients who had given informed consent, Thrombophlebitis Essig.
Discussion Pulmonary veins are the most distant of the various upstream sources of arterial emboli. Infarcts of undetermined cause: Diffuse pulmonary arteriovenous malformations: Prevalence of pulmonary arteriovenous malformations PAVMs and occurrence of neurological symptoms in patients with hereditary haemorrhagic teleangiectasia HHT.
Incidence of pulmonary vein complications after lung transplantation: J Am Coll Cardiol, Thrombophlebitis Essig. Early experience in lung transplantation. Isr J Med Sci. Cerebrovascular emboli related to pulmonary venous thrombosis after lung transplantation. J Am Soc Echocardiogr. Preceding infection as an important risk factor for ischaemic brain infarction in young and middle aged patients. Recent bacterial and viral infection is a risk factor for cerebrovascular ischemia: Meesen H, Stochdorph O.
Die Thromboembolie, Thrombophlebitis Essig, die arterielle und die venöse Thrombose. Handbuch der speziellen pathologischen Anatomie und Histologie: Systemic arterial embolism arising from pulmonary thrombophlebitis. Diagnosis of pulmonary embolism with magnetic resonance angiography, Thrombophlebitis Essig. N Engl J Med. J Magn Reson Imaging. Separation of arteries and veins in 3D MR angiography using correlation analysis.
Reproducibility of histomorphologic diagnoses with special reference to the kappa statistic. Previous Article Next Article, Thrombophlebitis Essig. Share this Article Email. Thank you for your interest in spreading the word on Stroke. Thrombophlebitis Essig Subject Your Name has sent you a message from Stroke. Message Body Your Name thought you would like to see the Stroke web site. Share on Social Media.
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