CEAP-classes and symptoms in people with varicose veins

Phlebologie ◽  
2005 ◽  
Vol 34 (06) ◽  
pp. 305-309
Author(s):  
C. Ose ◽  
G. Rudofsky ◽  
J. Roesener ◽  
H. Hirche ◽  
K. Kroeger
Keyword(s):  
Odds Ratio ◽  
Varicose Veins ◽  
Clinical Signs ◽  
Clinical Findings ◽  
Venous Disease ◽  
Muscle Cramps ◽  
Restless Legs ◽  
Class 1 ◽  
Ceap Classification ◽  
Reticular Veins

SummaryIndividual symptoms of patients with varicose veins are not considered in the CEAP-classification. Method: We analysed how far people with CEAP class 1 and 2 differ in their symptoms from people without varicose veins in the Duesseldorf/ Essen civil servants study recruiting 9935 employees. All volunteers were asked to fill out a questionnaire and were clinically examined. Primarily the clinical findings were documented adapted to the Basel Study and later modified according to the CEAP classification: 64% class 0 (no visible or palpable clinical signs of venous disease), 27% class 1 (small cutaneous veins and/or reticular veins) and 9 class 2 (varicose veins). Results: Leg swelling and muscle cramps during night were the most frequent symptoms in both classes. Statistically the frequency of symptoms in volunteers classified as CEAP class 1 respectively 2 were different from volunteers showing CEAP class 0 but were not different from each other. Grouping the symptoms restless legs, itching and cramps and calculating odds ratios for none of these showed significant results. Especially in women suffering from CEAP class 2 a significant small odds ratio of 0.5 (95%CI: 0.4–0.6) indicated that women rid of all these three symptoms had less frequently a varicosis disease. Conclusion: It can be assumed that the clinical differentiation into CEAP classes also differentiates groups of people with different symptoms.

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.

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.

Early morning oedema in patients with primary varicose veins without trophic changes

VASA ◽  
2016 ◽  
Vol 45 (6) ◽  
pp. 491-495 ◽  
Author(s):  
Didier Rastel ◽  
François-André Allaert
Keyword(s):  
Varicose Veins ◽  
Clinical Signs ◽  
Time Lapse ◽  
Early Morning ◽  
Epidemiological Studies ◽  
Control Group ◽  
Trophic Changes ◽  
Primary Varicose Veins ◽  
Ceap Classification ◽  
Consultation Time

Abstract. Background: Chronic lower limb oedema is one of the complications of superficial or deep chronic venous disorders. It is ranked as “C3”on the CEAP classification. In epidemiological studies, the recognition of oedema is mainly based on clinical signs, and oedema is more easily detected in the second part of the day when it becomes evident. We addressed the question whether oedema is already present in the morning in patients suffering of primary varicose veins without trophic changes. Patients and methods: In total, 101 patients with primary varicose veins (C2 and/or C3 stage of the CEAP classification) and 122 controls were enrolled as they appeared in our centre. The consultation time was no later than 6 hours after the patient had woken up. Oedema was detected by pitting test and ultrasound. Results: The mean consultation time lapse was 3.7 ± 1.2 hours after waking-up. Oedema was more frequent in the group of primary varicose veins without trophic changes (36 % compared to 14 % in the control group; p < 0.01). Oedema was mainly detected by ultrasound and far less so by the pitting test. Conclusions: Patients with varicose veins have morning oedema more frequently than patients without varicosis and at a higher rate than in epidemiological studies.

Ambulatory Phlebectomy and Sclerotherapy as Tools for the Treatment of Varicose Veins and Telangiectasias

2021 ◽  
Vol 38 (02) ◽  
pp. 160-166
Author(s):  
R. Hampton Andrews ◽  
Robert G. Dixon
Keyword(s):  
Varicose Veins ◽  
Chronic Venous Disease ◽  
Venous Disease ◽  
Reticular Veins

AbstractTreatment of chronic venous disease is a fascinating and rewarding undertaking. Once the truncal reflux is addressed, several options are available that can be used to treat the associated ulcers, varicosities, reticular veins, and telangiectasias. This review will focus on two widely employed procedures: ambulatory phlebectomy and sclerotherapy.

Epidemiology and classification of venous disease

ESC CardioMed ◽  
2018 ◽  
pp. 2805-2806
Author(s):  
Eberhard Rabe ◽  
Felizitas Pannier
Keyword(s):  
Risk Factors ◽  
Chronic Venous Insufficiency ◽  
Venous Insufficiency ◽  
Varicose Veins ◽  
Adult Population ◽  
Clinical Signs ◽  
Advanced Age ◽  
Chronic Venous Disease ◽  
Venous Disease ◽  
General Adult Population

Chronic venous diseases are frequent pathologies in the general population. The most common chronic venous pathologies are varicose veins and chronic venous insufficiency including post-thrombotic syndrome. In the general adult population, varicose veins are present in up to 25% of people with an increasing prevalence with age. Risk factors include advanced age, genetic predisposition, female sex, and multiparity. The term chronic venous insufficiency summarizes the clinical signs of chronic venous disease with oedema, skin changes, or venous ulcers. More than 15% of the population is affected by chronic venous insufficiency. Risk factors include advanced age, obesity, and prolonged sitting.

Clinical, Aetiological, Anatomical and Pathological Classification (Ceap): Gold Standard and Limits

2012 ◽  
Vol 27 (1_suppl) ◽  
pp. 114-118 ◽  
Author(s):  
E Rabe ◽  
F Pannier
Keyword(s):  
Gold Standard ◽  
Varicose Veins ◽  
Clinical Signs ◽  
Consensus Conference ◽  
Scientific Publications ◽  
Consensus Document ◽  
Venous Diseases ◽  
Ceap Classification ◽  
Definition Of

The first CEAP (clinical, aetiological, anatomical and pathological elements) consensus document was published after a consensus conference of the American Venous Forum, held at the sixth annual meeting of the AVF in February 1994 in Maui, Hawaii. In the following years the CEAP classification was published in many international journals and books which has led to widespread international use of the CEAP classification since 1995. The aim of this paper is to review the benefits and limits of CEAP from the available literature. In an actual Medline analysis with the keywords ‘CEAP’ and ‘venous insufficiency’, 266 publications using the CEAP classification in venous diseases are available. The CEAP classification was accepted in the venous community and used in scientific publications, but in most of the cases only the clinical classification was used. Limitations of the first version including a lack of clear definition of clinical signs led to a revised version. The CEAP classification is the gold standard of classification of chronic venous disorders today. Nevertheless for proper use some facts have to be taken into account: the CEAP classification is not a severity classification, C2 summarizes all kinds of varicose veins, in C3 it may be difficult to separate venous and other reasons for oedema, and corona phlebectatica is not included in the classification. Further revisions of the CEAP classification may help to overcome the still-existing deficits.

scholarly journals Homeostatic feelings – a novel explanation of vein symptoms derived from an experimental patient study

VASA ◽  
2019 ◽  
Vol 48 (6) ◽  
pp. 492-501
Author(s):  
Werner Blättler ◽  
Erika Mendoza ◽  
Christine Zollmann ◽  
John Bendix ◽  
Felix Amsler
Keyword(s):  
Rating Scale ◽  
Varicose Veins ◽  
Stress Test ◽  
Numeric Rating Scale ◽  
Lower Limbs ◽  
Venous Disease ◽  
Scale Range ◽  
Patient Groups ◽  
Primary Varicose Veins ◽  
Ceap Classification

Summary. Background: Vein symptoms (VS) entail diffuse leg discomfort and pain coinciding with a perception of weighty or swollen legs. Their traditional classification as a form of venous disease may be inaccurate as they occur in patients with no or any venous disorder. We hypothesized that VS would emerge from a primordially standing associated perturbation in the lower limbs which is not necessarily connected with a venous disorder. Patients and methods: Patients were sorted into groups according to the CEAP classification, VS only (C0s), primary varicose veins (C2p), varicose veins plus oedema (C2p and C3), and venous dermatopathy (C4). Patients completed questionnaires before and one week after they were exposed to a test of stationary standing. Results: Patients (N = 127) in the four groups differed by sex, age and body weight. The VS experienced in the preceding week scored the same in all groups at 3.1 on a numeric rating scale (range 0–10; SD 1.6). During standing, lower leg volume increased and symptoms emerged to the same extent across patient groups and were reduced similarly by compression (volume by 1.7 %, symptoms by 41.7 %). The emergence of symptoms was neither correlated with leg volume increase per se, nor with limiting this increase by compression. Symptoms recorded at baseline correlated with the symptoms provoked by the stress test with bare legs while the symptoms reported at follow-up, when stockings were worn regularly, correlated with the stress test with compression. Conclusions: VS, in terms of neuropsychology, reflect a homeostatic disturbance experienced in the presence and absence of venous disease. Thus, VS are not distinctive for the presence of venous disease insofar as they may reflect dynamic homeostatic feelings resulting from a standing-related disequilibrium in the legs’ internal environment.

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.

scholarly journals Correlation between the hemodynamic gain obtained after operation of primary varicose veins and chronic venous disease classification

2011 ◽  
Vol 26 (suppl 2) ◽  
pp. 115-119 ◽  
Author(s):  
Nei Rodrigues Alves Dezotti ◽  
Edwaldo Edner Joviliano ◽  
Takachi Moriya ◽  
Carlos Eli Piccinato
Keyword(s):  
Surgical Treatment ◽  
Varicose Veins ◽  
Disease Classification ◽  
Clinical Severity ◽  
University Hospital ◽  
Chronic Venous Disease ◽  
Venous Disease ◽  
Severe Group ◽  
Primary Varicose Veins ◽  
Ceap Classification

CONTEXT: Previous studies have demonstrated improvement of venous hemodynamics after surgical treatment of primary varicose veins of the lower extremities using air plethysmography (APG). PURPOSE: To correlate the venous hemodynamics obtained by APG with the CEAP classification after surgical treatment of primary varicose veins. METHODS: We studied 63 limbs of 39 patients (35 women and 4 men) aged on average 46.3 years, operated upon at the University Hospital, Faculty of Medicine of Ribeirão Preto, University of São Paulo, during the period from January 2001 to December 2004. The 63 limbs were divided into the three following groups according to CEAP classification: group C2 + C3 (38 limbs), group C4 (15 limbs) and group C5 + C6 (10 limbs). The patients were evaluated clinically before and 30 to 40 days after surgery by preoperative duplex ultrasonography and pre- and postoperative APG. RESULTS: There was an apparent hemodynamic improvement after surgical treatment of the varicose veins in the two groups of lower severity, but the improvement was significant in the most severe group based on venous filling index. CONCLUSION : Surgical treatment was beneficial for all three groups, but the greatest hemodynamic gain was observed in the group of highest clinical severity (group C5 + C6).

The effect of endovenous laser ablation on restless legs syndrome

2008 ◽  
Vol 23 (3) ◽  
pp. 112-117 ◽  
Author(s):  
C A Hayes ◽  
J R Kingsley ◽  
K R Hamby ◽  
J Carlow
Keyword(s):  
Laser Ablation ◽  
Restless Legs Syndrome ◽  
Rating Scale ◽  
Varicose Veins ◽  
Complete Relief ◽  
Venous Disease ◽  
Endovenous Laser Ablation ◽  
Restless Legs ◽  
Irls Score

Objectives Venous disease was proposed as a cause of restless legs syndrome (RLS) by Dr Karl A Ekbom in 1944, but has since remained largely unexplored. This study examines the effect of endovenous laser ablation (ELA) in patients with concurrent RLS and duplex-proven superficial venous insufficiency (SVI). Methods Thirty-five patients with moderate to very severe RLS (as defined by the 2003 National Institute of Health (NIH) RLS criteria) and duplex-proven SVI completed an international RLS rating scale questionnaire (IRLS) and underwent standard duplex examination to objectively measure the baseline severity of their conditions. They were separated into non-operative and operative cohorts. The operative cohort underwent ELA of refluxing superficial axial veins using the CoolTouch CTEV 1320 nm laser and ultrasound-guided sclerotherapy of the associated varicose veins with foamed sodium tetradecyl sulphate (STS). All patients then completed a follow-up IRLS questionnaire. Baseline and follow-up IRLS scores were compared. Results Operative correction of the SVI decreased the mean IRLS score by 21.4 points from 26.9 to 5.5, corresponding to an average of 80% improvement in symptoms. A total of 89% of patients enjoyed a decrease in their score of ≥15 points. Fifty-three percent of patients had a follow-up score of ≤5, indicating their symptoms had been largely alleviated and 31% had a follow-up score of zero, indicating a complete relief of RLS symptoms. Conclusions ELA of refluxing axial veins with the CTEV 1320 nm laser and foamed STS sclerotherapy of associated varicosities alleviates RLS symptoms in patients with SVI and moderate to very severe RLS. Recommendations SVI should be ruled-out in all patients with RLS before initiation or continuation of drug therapy.

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