Prova di Trendelenburg
La prova di Trendelenburg si utilizza per valutare l’insufficienza valvolare delle vene perforanti e dell’arco della safena interna nello sbocco della femorale. Si esegue svuotando le vene superficiali (collocandole in posizione più elevata rispetto al corpo, con il passaggio del sangue dalle vene superficiali a quelle profonde) e applicando un manicotto a pressione alla regione superiore della coscia. Quando il paziente assume la posizione eretta possono verificarsi diverse situazioni:
Se si riempiono rapidamente le varici (superficiali) significa che il sangue sarà passato per le perforanti, che saranno insufficienti:
- Trendelenburg negativo;
Se non si riempiono rapidamente, però con l’eliminazione della compressione si riempiono rapidamente in forma discendente, si tratterà di un’insufficienza dell’arco della safena interna, mentre le perforanti sono sane:
- Trendelenburg positivo;
Se si riempiono rapidamente e ancora di più quando si elimina la compressione, si avrà insufficienza venosa di entrambe (vene perforanti e safena interna):
- Trendelenburg doppio;
Se non si riempiono con rapidità, ma lentamente, in mezzo minuto, è fisiologico, il sangue viene dalla periferia:
- Trendelenburg nullo.
Ti potrebbero interessare:
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