Dr. Griffin Maura
Role of Duplex Ultrasound in the Diagnosis of Chronic Venous Disease – CVD
AUTHOR: Maura Griffin
Chronic venous disease (CVD) is a common and often underdiagnosed problem, that presents with a wide range of signs and symptoms. They can vary from straightforward cosmetic issues to the more serious skin ulceration with tissue loss, the latter resulting in a marked loss of quality of life. This in turn impacts on a significant proportion of health care resources.
For both the wellbeing of patients and the wise use of financial resources, it is imperative that the practicing clinician have a sound understanding of the pathophysiology and pertinent venous anatomy.
Here is where duplex ultrasound, with its skilful application, plays a pivotal role. Its non-invasive assessment of the venous system allows the practitioner to accurately assess anatomy and classify CVD, ultimately providing guidance for the appropriate treatment pathways which maybe surgical or non-surgical.
Additionally, duplex ultrasound is used to guide endovenous procedures such as endovenous laser therapy (EVLT), foam sclerotherapy or radiofrequency ablation (RFA). It also lends itself easily to follow-up visits if deemed necessary.
As ultrasound technology has developed and more training is now readily available, there has been a greater understanding of the venous system which has resulted in the development of two distinct examination protocols, one for deep venous thrombosis and one for chronic venous insufficiency. The presentation will endeavour to present both concepts.
My main role has always been to instigate and support clinical and scientific research in the field of diagnostic vascular ultrasound
I began working within this area over 24 years ago as a Research Fellow with Professor Andrew N Nicolaides at Imperial College and St Mary’s Hospital London and obtained the MSc in Vascular Technology and Medicine with Distinction. My PhD focused on work in the field of ultrasound and cardiovascular disease.
My publications include several papers and book chapters relating to the field vascular ultrasound. I have also participated in several research trials. One area of major research work involved the British Regional Heart Study (BRHS) in conjunction with the Royal Free Hospital and University College Hospital (UCH) London exploring low and high risk areas for the prevalence of heart disease in the UK. Other areas included The Asymptomatic Carotid Stenosis and Risk of Stroke multicentre study (ACSRS) a world-wide trial, The Imaging in Carotid Angioplasty and Risk of Stroke (ICAROS) trial, Intermittent compression devices for the prevention of deep vein thrombosis (DVT), the role of angioplasty in the treatment of lower limb arterial disease and The Cyprus Epidemiology Study. Currently I am working in collaboration with the Rheumatology Department at UCH into the investigation of factors affecting cardiovascular disease in patients with systemic lupus erythematosus (SLE).