VNET (VENOUS NET)
SOFTWARE OF AIDED DESIGN AND DIAGNOSTIC EVALUATION OF
THE ULTRASOUND VENOUS CARTHOGRAPHY OF LOWER LIMBS
Min. Angiol. 1991; 16:373-4
FAUSTO PASSARIELLO
Società Italiana Operatori C.H.I.V.A. - Sede Napoli 02
Centro Diagnostico AQUARIUS Via Francesco Cilea, 280 - 80127 Napoli tel./Fax. 00390817144110
INTRODUCTION
The ultrasonographic practises of the venous echotomography and doppler allows the study of the venous anatomy, as an essential premise to the formulation of the surgical strategy. These morphological and functional acquisitions can be translated in graphic format in the VENOUS CARTHOGRAPHY.
After a first phase during which the map was traced immediately on a simple paper, at the moment two pre-definied graphic models are currently used: the first is a prospectic/three-dimensional one, used mainly in France by the S.E.M.A.E. for the European protocol, the other is a plane/ bidimensional, used by the S.I.O.C. in the Italian protocol.
Both the methods require some graphic ability of the emodinamist. Furthermore, the maps are literally populated by a lot o technical informations.
That's why, once arrived to a conspicuous volume of work, the problem of the graphic automation is set and the one of the maintenance of the gathered informations, in a format which is useful as for statistic searches as for the graphic report.
THEORETICAL PREMISES TO THE VENOUS CARTHOGRAPHY
The VENOUS NET (RESEAU VEINEUX, RETE VENOSA) can be outlined with KNOTS (VERTEXES, confluence points), BRANCHES (EDGES), PATHS and LOOPS.
This outline has been taken completely from the GRAPH THEORY, broadly used also for the plan of the electric nets.
Each limb in first approximation is analyzed separately and it is not scheduled to the moment the possibility] of unifying the net of an individual. This topic however can be of interest for the anomalies of the ilio-caval veins and for the thromboses and the compensations circles to this level.
The initial configuration of the net for each limb is constituted by 6 knots, 5 branches and 3 paths.
KNOTS: Proximal Terminal Iliac, Saphenous-Femoral Ostium, Saphenous-Popliteal Ostium, Internal Saphenous Root, External Saphenous Root, Deep Circle Root. BRANCHES: External Iliac, Femoral superficial, popliteal-crural Axes, Internal Saphena, External Saphena. VENOUS PATHS: Venous Deep circle, Inside Saphena, External Saphena.
The PERSONALIZED CARTHOGRAPHY
The described configuration constitutes a predefined nucleus of a RELATIONAL DATA BASE, that expands or contracts as the operator likes, through simple operations of immission, deletion, modification, connection of branches and of vertexes, deconnectsion of them, as to make easy the design and to allow the maintenance at the same time of the archive order, which is never seen like an only graphic representation.
The flow direction in each branch can be specified to outline the insufficiencies. Though being available an analytical description of the net, this last one can be queried also in a systematic and not topographical way, which is instead a functional query of the vessel anatomy.
USER INTERFACE
The working environment is that of INTUITION, a Commodore GUI (Graphic User Interface) proprietary format, fully based on screens, windows, icons, that the operator must only point out on the screen using the Mouse, pointer tool which in the last years has almost substituted the intensive use of the keyboard.
The structure of the file is mainly logic, but it could be translated in visual representation, a totally unhooked one from the management, so that it is possible to choose between different graphic configurations of the same carthography in the archives. The operator can insert the carthography, using the scheme that is nearest to him. Currently they are available the two S.E.M.A.E and S.I.O.C. schemes, but the program structure is easily and continously updatedable for the input and output data forms.
PROGRAM GOALS
The main goal is that of providing a help in the carthography design, with the aim to give birth to structures which are not dependent on the individual graphic ability, but of known composition and therefore trasmissible to and comprehensible by also to other operators. The transmission could also be achieved by modem, and the data could be reproduced in graphic form on paper. The use of a standard format will allow in future a ready comparison between data for statistic purposes. It must be noted that the standard is not this or another computer, program or operative system, but a perfectly definite and transmissible format. This is a choice of freedom, that doesn't force the operator to the use of an single computer or program, but leaves an open communication between users of different platforms.
Once having designed the Carthography, it is possible to identify or outline its imperfections and redundances, the anomalies, the different kinds of vascular net, the insufficient segments, the insufficient and reentering perforating veins, the loops, the C.H.I.V.A strategy, the sinuous segments, the terapeutical simulation, the monitoring of the therapy.
Besides, the computer could signal in real time additional diagnostic manoeuvres, to be performed immediately, before the patient goes away.
HARDWARE: Computer AMIGA COMMODORE (500, 1000, 2000, 2500, 3000)
SOFTWARE: VNet 1.0 program, written in C Language and SAS C 5.10 compiled. The program is available in Italian, French, English and German versions.
REFERENCES