scholarly journals Clinical and Haemodynamic Sequelae of Deep Venous Thrombosis: Retrospective Evaluation after 7–13 Years

1997 ◽  
Vol 93 (1) ◽  
pp. 7-12 ◽  
Author(s):  
M. C. H. Janssen ◽  
J. H. Haenen ◽  
W. N. J. C. Van Asten ◽  
H. Wollersheim ◽  
F. M. J. Heijstraten ◽  
...  
Keyword(s):  
Venous Thrombosis ◽  
Deep Venous Thrombosis ◽  
Clinical Symptoms ◽  
Clinical Signs ◽  
Signs And Symptoms ◽  
Chronic Venous Disease ◽  
Venous Disease ◽  
International Consensus ◽  
Pump Function ◽  
Patients At Risk

1. In contrast to the extensive documentation on diagnosis and treatment of deep venous thrombosis (DVT), information about long-term complications, clike the post-thrombotic syndrome (PTS), is scarce. Most studies report on clinical examination only, whereas adequate haemodynamic investigation is lacking. Therefore 81 patients with venographically confirmed lower extremity DVT were clinically and haemodynamically reexamined 7–13 years after DVT (mean 10 years) to assess PTS. Interest was focused on the relation between clinical and haemodynamic PTS and the relation between location of the initial DVT and incidence of PTS. 2. Clinical signs and symptoms of PTS were classified according to the latest consensus of the international consensus committee on chronic venous disease. Non-invasive venous vascular laboratory tests were performed to assess the venous outflow resistance and calf muscle pump function (CMP). CMP was determined by the supine venous pump function test (SVPT). 3. Clinically only 20 of 81 patients (25%) were asymptomatic, 34 (42%) had mild PTS (class 1–3), 25 (31%) moderate PTS (class 4) and 2 (2%) severe PTS (class 5–6); 57% had an abnormal CMP. Both the severity of clinical symptoms and the haemodynamic abnormalities were related to the location of the initial thrombus. Of the patients with distal DVT 11% developed moderate clinical PTS and 39% developed an abnormal CMP. CMP and difference in CMP between post-thrombotic and non-thrombotic leg were significantly related to the different classes of PTS. 4. This study indicates that 7–13 years after DVT 31% of the patients had moderate and 2% had severe clinical PTS, while 57% of the patients had abnormal haemodynamic findings (both related to the initial site of the thrombosis). Secondly, it reveals that the risk of PTS after distal DVT is not negligible, which causes concern about not diagnosing and treating patients with distal DVT. Thirdly, we have demonstrated that a functional test, such as the SVPT, is a sensitive test to assess post-thrombotic damage. Therefore its use as a screening tool after a period of DVT should be investigated to select patients at risk of PTS.

Duplex investigations in children: Are clinical signs in children with venous disorders relevant?

2014 ◽  
Vol 30 (10) ◽  
pp. 719-723
Author(s):  
M Birgitte Maessen-Visch ◽  
L Smeets ◽  
C van Vleuten
Keyword(s):  
Venous Thrombosis ◽  
Deep Venous Thrombosis ◽  
Varicose Veins ◽  
Clinical Signs ◽  
Patient Characteristics ◽  
Duplex Sonography ◽  
Chronic Venous Disease ◽  
Ultra Sound ◽  
Venous Disease ◽  
Venous Disorders

Objectives Ultra sound colored duplex sonography is the preferred method in diagnosing chronic venous disease. Data in children on incidence, indications, and results are lacking. Methods From the total of 9180 duplex investigations performed in our hospital from 2009 to 2012, data on indication and results of the investigation as well as patient characteristics were evaluated retrospectively for the proportion of pediatric patients. Results Duplex investigations were performed 49 times in 38 children (6–18 years), with an average of 1.3 times (1–6 times) per child. Forty percent showed abnormalities: 17 times deep venous thrombosis was suspected; deep venous thrombosis was objectified in 18%. In the 21 investigations performed for varicosis-related complaints, varicose veins or venous malformations were objectified in 57%. Edema was never a symptom of chronic venous disease. Conclusions Duplex investigation is not often performed in children. In children with established deep venous thrombosis, a family history with deep venous thrombosis is common. In general, edema was not seen in children with varicose veins and, therefore, does not seem a reliable clinical sign at young age.

scholarly journals Determinants of chronic venous disease after acute deep venous thrombosis

1998 ◽  
Vol 28 (5) ◽  
pp. 826-833 ◽  
Author(s):  
Mark H. Meissner ◽  
Michael T. Caps ◽  
Brenda K. Zierler ◽  
Nayak Polissar ◽  
Robert O. Bergelin ◽  
...  
Keyword(s):  
Venous Thrombosis ◽  
Deep Venous Thrombosis ◽  
Chronic Venous Disease ◽  
Venous Disease

scholarly journals The impact of isolated lesser saphenous vein system incompetence on clinical signs and symptoms of chronic venous disease

2000 ◽  
Vol 32 (5) ◽  
pp. 954-960 ◽  
Author(s):  
Nicos Labropoulos ◽  
Athanasios D. Giannoukas ◽  
Kostas Delis ◽  
Steven S. Kang ◽  
M.Ashraf Mansour ◽  
...  
Keyword(s):  
Saphenous Vein ◽  
Clinical Signs ◽  
Signs And Symptoms ◽  
Chronic Venous Disease ◽  
Venous Disease ◽  
Vein System ◽  
Clinical Signs And Symptoms ◽  
The Impact

Abstract 331: Restless Leg Syndrome and Its Association with Iliofemoral Venous Disease

2016 ◽  
Vol 36 (suppl_1) ◽  
Author(s):  
Navya Reddy
Keyword(s):  
Large Population ◽  
Clinical Signs ◽  
Signs And Symptoms ◽  
Strong Relationship ◽  
Current Treatment ◽  
Chronic Venous Disease ◽  
Venous Disease ◽  
Restless Leg Syndrome ◽  
External Compression ◽  
Venous Compression

Background: Restless leg syndrome (RLS) is one of the most common sleep disorders, affecting between 5% and 10% of the U.S. population.1 However, it has an unclear etiology, and is often over-medicated without a resulting qualitative improvement in lifestyle. It has not been determined whether iliofemoral or iliocaval venous disease resulting from either thrombotic lesions or external compression, has any association with RLS. Methods: A total of 510 patients treated for iliofemoral venous compression syndrome (IVCS) with angioplasty and stenting were documented to have concomitant RLS per NIH screening criteria,2 prior to endovenous revascularization. 367 of the following patients were selected for retrospective research analysis based on pre-procedural selection criteria which included: IVCS with > 60% luminal stenosis, confirmed RLS > 1 year with or without current treatment, diminished quality of life, and clinical signs and symptoms of chronic venous disease. Patients with Diabetes, End stage renal disease, current pregnancy, and Rheumatic disease were excluded from this study. Patients with thrombotic lesions of the iliofemoral veins were also excluded. Following revascularization, patients were followed at 6 weeks, 3 months, and 6 months with doppler evaluation and asked to rate the severity of their RLS using a scale developed by the International Restless Leg Syndrome study group.3 Results: Of the 367 patients studied, 52% of patients had improvement of their RLS symptoms at 3 months, 90% reported significant relief with cessation of medication(s) within 6 months, and 10% did not have any statistically significant improvement by 6 months (p < 0.001). Conclusion: This study demonstrates a strong relationship between deep vein outflow obstruction, with either iliocaval or iliofemoral stenosis, and RLS. It is suspected that a large population suffers from iliofemoral venous disease, and including this subset of patients in the differential diagnosis for RLS can allow for earlier treatment of IVCS and prevention of RLS.

Predicted burden of venous disease

2016 ◽  
Vol 31 (1_suppl) ◽  
pp. 74-79 ◽  
Author(s):  
Sarah Onida ◽  
Alun Huw Davies
Keyword(s):  
Varicose Veins ◽  
Clinical Signs ◽  
Signs And Symptoms ◽  
Chronic Venous Disease ◽  
Venous Disease ◽  
Venous Ulceration ◽  
Increased Risk ◽  
Future Burden ◽  
Clinical Signs And Symptoms

Chronic venous disease is a common condition with clinical signs and symptoms ranging from spider veins, to varicose veins, to active venous ulceration. Both superficial and deep venous dysfunction may be implicated in the development of this disease. Socio-economic factors are shaping our population, with increasing age and body mass index resulting in significant pressure on healthcare systems worldwide. These risk factors also lead to an increased risk of developing superficial and/or deep venous insufficiency, increasing disease prevalence and morbidity. In this chapter, the authors review the current and future burden of chronic venous disease from an epidemiological, quality of life and economic perspective.

Negative impact of deep venous thrombosis on chronic venous disease

2013 ◽  
Vol 131 (4) ◽  
pp. e123-e126 ◽  
Author(s):  
Francisco S. Lozano Sánchez ◽  
José Ramón González-Porras ◽  
Santiago Díaz Sánchez ◽  
Josep Marinel.lo Roura ◽  
Ignacio Sánchez Nevarez ◽  
...  
Keyword(s):  
Venous Thrombosis ◽  
Deep Venous Thrombosis ◽  
Negative Impact ◽  
Chronic Venous Disease ◽  
Venous Disease

Abstract 232: Restless Leg Syndrome and its Association with Iliofemoral Venous Disease

2016 ◽  
Vol 119 (suppl_1) ◽  
Author(s):  
Navya Reddy ◽  
Nagender Reddy
Keyword(s):  
Large Population ◽  
Clinical Signs ◽  
Signs And Symptoms ◽  
Strong Relationship ◽  
Current Treatment ◽  
Chronic Venous Disease ◽  
Venous Disease ◽  
Restless Leg Syndrome ◽  
External Compression ◽  
Venous Compression

Background: Restless leg syndrome (RLS) is one of the most common sleep disorders, affecting between 5% and 10% of the U.S. population (1). However it has an unclear etiology, and is often over-medicated without a resulting qualitative improvement in lifestyle. It has not been determined whether iliofemoral or iliocaval venous disease, resulting from either thrombotic lesions or external compression, has an association with RLS. Methods: A total of 510 patients treated for iliofemoral venous compression syndrome (IVCS) with angioplasty and stenting were documented to have concomitant RLS per NIH screening criteria,2 prior to endovenous revascularization. 367 of the following patients were selected for retrospective research analysis based on pre-procedural selection criteria which included: IVCS with > 60% luminal stenosis, confirmed RLS > 1 year with or without current treatment, diminished quality of life, and clinical signs and symptoms of chronic venous disease. Patients with Diabetes, End stage renal disease, current pregnancy, and Rheumatic disease were excluded from this study. Patients with thrombotic lesions of the iliofemoral veins were also excluded. Following revascularization, patients were followed at 6 weeks, 3 months, and 6 months with doppler evaluation and asked to rate the severity of their RLS using a scale developed by the International Restless Leg Syndrome study group (3). Results: Of the 367 patients studied, 52% of patients had improvement of their RLS symptoms at 3 months, 90% reported significant relief with cessation of medication(s) within 6 months, and 10% did not have any statistically significant improvement by 6 months (p < 0.001). Conclusion: This study demonstrates a strong relationship between deep vein outflow obstruction, with either iliocaval or iliofemoral stenosis, and RLS. It is suspected that a large population suffers from iliofemoral venous disease, and including this subset of patients in the differential diagnosis for RLS can allow for earlier treatment of IVCS and prevention of RLS.

Deep Venous Thrombosis: A Prospective 3-Month Follow-up Using Duplex Scanning and Strain-Gauge Plethysmography

1998 ◽  
Vol 94 (6) ◽  
pp. 651-656 ◽  
Author(s):  
M. C. H. Janssen ◽  
H. Wollersheim ◽  
J. H. Haenen ◽  
W. N. J. C. van Asten ◽  
TH. Thien
Keyword(s):  
Venous Thrombosis ◽  
Deep Venous Thrombosis ◽  
Clinical Symptoms ◽  
Calf Muscle ◽  
Duplex Scanning ◽  
Pump Function ◽  
Muscle Pump ◽  
Calf Muscle Pump ◽  
Function Test

1. The purpose of the study was to evaluate the degree of thrombus regression, development of valvular insufficiency, impaired calf muscle pump function and clinical symptoms after a period of acute deep venous thrombosis. 2. Seventy patients with acute deep venous thrombosis, diagnosed by duplex scanning or venography, received treatment with heparin and oral coumarin derivatives according to a standard protocol. All patients wore graduated compression stockings during the whole study period. Duplex scanning was performed at diagnosis and 1 and 3 months later to measure thrombus mass and reflux. The supine venous pump function test was used to assess calf muscle pump function. 3. Three months follow-up was completed in 60 patients. In total 218 (28%) out of 780 vein segments were initially thrombosed and 134 (17%) could not be traced. A statistically significant reduction of thrombus mass was recorded throughout the study period. Total resolution of thrombosis in all vein segments occurred in 25% of the patients within 1 month and in 40% in 3 months. There was no difference in regression between the various proximal vein segments. Distal segments showed more regression than proximal segments. Reflux occurred in 27% of the initially thrombosed veins and in 15% of the patent veins. Patients who showed total resolution after 1 month had a significantly higher calf muscle pump function than patients without total resolution (70%pf vs 61%pf, P < 0.05). Patients with reflux in two or more segments had a significantly lower calf muscle pump function than patients with reflux in less than two segments (58%pf vs 69%pf, P < 0.05). 4. Using duplex scanning and the supine venous pump function test 3 months after an acute deep venous thrombosis, overall haemodynamic abnormalities and local site of valve incompetence could readily be identified. Patients with haemodynamic abnormalities might be at risk to develop the post-thrombotic syndrome. There was no difference in thrombus regression between the various proximal vein segments. Reflux was significantly more often seen in initially thrombosed veins. Thirty-five percent of the patients developed an abnormal calf muscle pump function after 3 months. Patients with early resolution of thrombus had a higher calf muscle pump function after 3 months.

scholarly journals Venous function after pharmacomechanical thrombolysis for extensive iliofemoral deep vein thrombosis

2017 ◽  
Vol 21 (1) ◽  
Author(s):  
Wim Greeff ◽  
Ali Reza Dehghan-Dehnavi ◽  
Jacobus Van Marle
Keyword(s):  
Venous Thrombosis ◽  
Deep Venous Thrombosis ◽  
Chronic Venous Insufficiency ◽  
Venous Insufficiency ◽  
Clinical Signs ◽  
Venous Disease ◽  
Long Term Outcome ◽  
Ceap Classification ◽  
Venous Function ◽  
The Mean

Background: Chronic venous insufficiency is an important complication following iliofemoral deep venous thrombosis. Early thrombus removal may preserve venous function and prevent this complication. This study represents the largest reported South African series of pharmacomechanical thrombolysis for iliofemoral deep venous thrombosis to date.Objective: To evaluate the long-term outcome following pharmacomechanical thrombolysis for proximal and extensive deep venous thrombosis in a private, specialist vascular unit.Methods: All patients who underwent pharmacomechanical thrombolysis for iliofemoral deep venous thrombosis between August 2009 and January 2016 were invited to return for clinical assessment and venous ultrasound. Clinical findings were recorded according to the Villalta score and clinical, etiology, anatomic and pathology (CEAP) classification. The quality of life (QoL) was assessed utilising the VEINES-QoL/Sym questionnaire, providing two scores per patient, one describing the QoL and the other symptom severity (Sym).Results: Thirty two patients (35 legs) were evaluated. There were 25 females and 7 males, with a mean age of 33.5 years (±14 years). The mean follow-up period was 31 months (range 3 months – 80 months). Results of the CEAP classification were C0 = 24 (75%), C1 = 1 (4%), C2 = 2 (6%), C3 = 2 (6%) and C4 = 3 (9%). Thirty-one (97%) patients had Villalta scores from 0 to 4, indicating no or mild evidence of venous disease. One patient (3%) had a Villalta score of 6, indicating post-thrombotic syndrome. The mean QoL score was 87% (±12) and the mean Sym score was 86% (±14). Twenty-four (75%) patients had no abnormality on ultrasound, with fibrosis the most observed abnormality.Conclusion: Most patients who had undergone pharmacomechanical thrombolysis for extensive iliofemoral deep venous thrombosis showed few significant clinical signs of chronic venous insufficiency, had excellent function on venous ultrasound and reported excellent QoL.

scholarly journals Understanding Chronic Venous Disease: A Critical Overview of Its Pathophysiology and Medical Management

2021 ◽  
Vol 10 (15) ◽  
pp. 3239
Author(s):  
Miguel A. Ortega ◽  
Oscar Fraile-Martínez ◽  
Cielo García-Montero ◽  
Miguel A. Álvarez-Mon ◽  
Chen Chaowen ◽  
...  
Keyword(s):  
Inflammatory Responses ◽  
Current Knowledge ◽  
Varicose Veins ◽  
Clinical Signs ◽  
Clinical Manifestations ◽  
Significant Loss ◽  
Venous Hypertension ◽  
Chronic Venous Disease ◽  
Venous Disease ◽  
Environmental Agents

Chronic venous disease (CVD) is a multifactorial condition affecting an important percentage of the global population. It ranges from mild clinical signs, such as telangiectasias or reticular veins, to severe manifestations, such as venous ulcerations. However, varicose veins (VVs) are the most common manifestation of CVD. The explicit mechanisms of the disease are not well-understood. It seems that genetics and a plethora of environmental agents play an important role in the development and progression of CVD. The exposure to these factors leads to altered hemodynamics of the venous system, described as ambulatory venous hypertension, therefore promoting microcirculatory changes, inflammatory responses, hypoxia, venous wall remodeling, and epigenetic variations, even with important systemic implications. Thus, a proper clinical management of patients with CVD is essential to prevent potential harms of the disease, which also entails a significant loss of the quality of life in these individuals. Hence, the aim of the present review is to collect the current knowledge of CVD, including its epidemiology, etiology, and risk factors, but emphasizing the pathophysiology and medical care of these patients, including clinical manifestations, diagnosis, and treatments. Furthermore, future directions will also be covered in this work in order to provide potential fields to explore in the context of CVD.

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