The role of anti-endothelial cell antibodies in venous insufficiency

Phlebologie ◽  
2009 ◽  
Vol 38 (06) ◽  
pp. 263-266
Author(s):  
T. H. Akay ◽  
B. Bastürk ◽  
S. Özkan ◽  
S. Aslamaci ◽  
E. Aslim
Keyword(s):  
Endothelial Cells ◽  
Endothelial Cell ◽  
Chronic Venous Insufficiency ◽  
Venous Insufficiency ◽  
Varicose Veins ◽  
Duplex Ultrasound ◽  
Inflammatory Cells ◽  
Control Group ◽  
Antibody Complex ◽  
Antigen Antibody

SummaryIt is a hypothesis that autoimmune factors directed against endothelial cells play a role in developing venous insufficiency. We investigated the association between anti-endothelial cell antibodies (AECA) and the development of venous insufficiency and varicose veins. Patients, methods: 44 patients were evaluated with clinical examination and duplex ultrasound for diagnosing chronic venous insufficiency and varicose veins and 120 healthy volunteers were assigned as the control group without evidence of chronic venous insufficiency and varicose veins. All sera samples were analysed by using slides, each containing biochips coated with frozen sections of HUVEC (human umblical vein endothelial cells) and capillary-rich tissue such as skeletal muscle (Euroimmun, FB 1960–1005–2, Germany). If a positive reaction is obtained, specific antibodies of class IgA, IgG, IgM attach to the antigens. In a second step, the bound antibodies are stained with fluorescein labeled antihuman antibodies and visualised by fluorescence microscopy. Results: AECA was positive in 24 out of 44 patients (54.54%) and in 30 out of 120 volunteers (25%). We detected that anti HUVEC antibody occurred significantly more frequent in patients with chronic venous insufficiency or varicose veins: p = 0.0007, OR: 3.60 (1.65 < 7.92). Discussion: The presence of antibodies directed against the endothelial structure causes inflammatory cells of the immune system to move towards the location by both forming antigen-antibody complex and activating the complement system. Tissue damage may occur due to inflammation. In our study we have found a statistically significant relationship between antiendothelial cell antibodies and chronic venous insufficiency. Conclusion: Early diagnosis or prediction of venous insufficiency and/or varicose veins before the occurrence of symptoms may prevent the damage or even help to establish a prophylactic treatment.

Chronic venous insufficiency (CVI)

2018 ◽  
pp. 469-478
Author(s):  
Abdullah Jibawi ◽  
Mohamed Baguneid ◽  
Arnab Bhowmick
Keyword(s):  
Oxygen Transport ◽  
Chronic Venous Insufficiency ◽  
Venous Insufficiency ◽  
Varicose Veins ◽  
Duplex Ultrasound ◽  
Leg Ulcers ◽  
Skin Changes ◽  
Lymphatic Flow ◽  
Compression Bandages ◽  
Ceap Classification

Chronic venous insufficiency (CVI) can result in varicose veins or, if severe, may develop skin changes and leg ulcerations. This chapter details the classification and presentation of varicose veins and venous leg ulcers (CEAP classification). It outlines the recommended investigations for CVI such as handheld Doppler scan and venous duplex ultrasound scans. The management of CVI is to improve the venous and lymphatic flow thereby improving the skin oxygen transport through reducing oedema. This can be performed by graduated compression bandages.

The aetiology and influence of age and gender on the development of advanced chronic venous insufficiency in the population of patients of semi-urban county outpatient vascular clinic in Poland

2010 ◽  
Vol 26 (2) ◽  
pp. 56-61 ◽  
Author(s):  
Ł Dzieciuchowicz ◽  
Z Krasiński ◽  
K Motowidlo ◽  
M Gabriel
Keyword(s):  
Chronic Venous Insufficiency ◽  
Venous Insufficiency ◽  
Varicose Veins ◽  
Severe Trauma ◽  
Control Group ◽  
Age And Gender ◽  
History Of ◽  
Group 2 ◽  
And Gender ◽  
Group 1

Objective To determine the aetiology and influence of age and gender on the development of advanced chronic venous insufficiency in patients of semi-urban county outpatient vascular clinic. Methods One hundred and fourteen patients with venous ulcers were divided, based on the ultrasound examination, into group 1 or group 2, with or without post-thrombotic lesions in the deep venous system, respectively. The control group consisted of 352 patients with varicose veins and without leg ulceration. The demographic data and thrombotic risk factors were compared between the groups. Results Group 1 patients ( n = 109) were older than group 2 patients ( n = 5) and control group patients, 64.7 versus 47.2 years ( P = 0.016) and versus 53.8 years ( P < 0.001), respectively. The percentage of women did not differ between group 1 and the control group, but was lower in group 2 ( P = 0.01). The history of lower limb fracture or severe trauma increased the risk of post-thrombotic syndrome (PTS) in patients with venous ulcer. Conclusion In the population studied, the venous leg ulcer develops mainly due to primary varicose veins and its risk increases with age and is equal for both sexes. PTS should be suspected in younger patients with a history of severe trauma or leg fracture.

Registry to investigate the efficacy and safety of the VenaBlock© VeIn SEaling system for VaRicose veins in SingApore – Six months results of the RIVIERA trial

2021 ◽  
pp. 026835552110251
Author(s):  
YL Linn ◽  
CJQ Yap ◽  
SXY Soon ◽  
SL Chan ◽  
VBX Khoo ◽  
...  
Keyword(s):  
Saphenous Vein ◽  
Chronic Venous Insufficiency ◽  
Venous Insufficiency ◽  
Varicose Veins ◽  
Duplex Ultrasound ◽  
Venous Occlusion ◽  
Clinical Severity ◽  
Puncture Site ◽  
Venous Clinical Severity Score

Background The Venablock© Venous Closure System (Invamed, Ankara, Turkey) is a novel cyanoacrylate-based non-thermal non-tumescent embolization device to block refluxing truncal veins for chronic venous insufficiency and varicose veins. The aim was to prospectively evaluate the safety and 6 months efficacy of Venablock© for the treatment of primary great saphenous vein (GSV) and small saphenous vein (SSV) incompetency in a multi-ethnic cohort from Singapore. Methods This was a single arm, single investigator prospective study of 29 patients (39 limbs, 39 truncal veins) recruited over a 5-month period (August 2019 to February 2020), who were treated with the Venablock© device at a tertiary vascular unit in Singapore. Patients with symptomatic varicose veins (C2–6) and had truncal reflux > 0.5 second on venous Duplex ultrasound were included. Follow-up occurred at 2 weeks, 3 and 6 months with dedicated quality of life questionnaires and a targeted Duplex ultrasound performed to check for continued venous occlusion. Result Mean age was 61.4 (±11.0) years and mean BMI was 26.2 (±5.7) kg/m2. 11/29 (37.9%) were males. Most common CEAP class treated was 2 (12/29, 41.3%). Mean diameter of treated GSV was 5.7 (±2.0) mm, 4.8 (±1.7) mm and 4.2 (±1.3) mm for the proximal, mid and distal above knee segments respectively. Mean time from access puncture to sheath removal was 23.4 (±10.0) mins. Vein occlusion at 2 weeks, 3 and 6 months was 39/39 (100%), 39/39 (100%) and 36/37 (97.2%) respectively. 5/29 (17.2%) developed puncture site infections, of which 3/29 (7.7%) required formal surgical drainage. 3/29 (7.7%) developed phlebitis. At 6 months, revised Venous Clinical Severity Score improved from 5.2 (±3.5) to 2.1 (±2.9; p < .001); EuroQol-5 Dimension score, from 7.4 (±2.1) to 5.7 (±1.4; p < .001); Aberdeen Varicose Vein Questionnaire score, from 18.1 (±15.5) to 7.9 (±8.9; p = .007); and Chronic Venous Insufficiency Questionnaire, from 18.6 (±16.2) to 4.5 (±6.3; p < .001). Conclusion Venablock© is a safe and efficacious option of treating truncal venous insufficiency in a multi-ethnic Asian cohort from Singapore in the short term. There is a significant improvement in QoL. Longer follow-up is required to assess the durability of this technique, in particular the higher puncture site infection rates observed compared to other glue-based therapies.

Evaluation of physical activity level and exercise capacity in patients with varicose veins and chronic venous insufficiency

2021 ◽  
pp. 026835552110023
Author(s):  
Elif Sakızlı Erdal ◽  
Arzu Demirgüç ◽  
Mehmet Kabalcı ◽  
Hüseyin Demirtaş
Keyword(s):  
Physical Activity ◽  
Exercise Capacity ◽  
Chronic Venous Insufficiency ◽  
Physical Activity Level ◽  
Venous Insufficiency ◽  
Varicose Veins ◽  
Activity Level ◽  
Clinical Indication ◽  
Control Group ◽  
Study Group

Objective The clinical indication of chronic venous insufficiency (CVI) is related to functional performance and the benefits of physical activity in patients with CVI are known. Despite its importance, the literature is limited in this regard. This study aimed to determine exercise capacity and physical activity level in patients with varicose veins and CVI. Methods Volunteers who came to the polyclinic with leg pain complaints were enrolled in the study. Individual sociodemographic and clinical information was recorded. Individuals' pain severity was assessed by the visual analog scale (VAS) and exercise capacity was assessed by 6-minute walk test (6MWT). International Physical Activity Questionnaire (IPAQ) was used to assess the level of physical activity. Results The study group consisted of 51 individuals who were diagnosed with varicose veins and CVI. The control group consisted of 51 individuals without varicose veins and CVI diagnosis. In the study group, the VAS during activity was significantly higher compared to the control group. The 6MWT distance, distance %, IPAQ total score and IPAQ walking score of the control group were significantly higher in comparison with the study group (p<0.05). Conclusions We believe that our findings will lead the planning of interventions to increase the level of physical activity in CVI patients.

Features of postoperative period in patients with chronic venous insufficiency: phlebectomy versus thermal ablation

2020 ◽  
pp. 64-75
Author(s):  
E. Burleva ◽  
O. Smirnov ◽  
S. Tyurin
Keyword(s):  
Postoperative Period ◽  
Chronic Venous Insufficiency ◽  
Thermal Ablation ◽  
Venous Insufficiency ◽  
Clinical Symptoms ◽  
Varicose Veins ◽  
Statistical Processing ◽  
Group 3 ◽  
Group 2 ◽  
Group 1

The purpose of the study was to conduct a comparative assessment of the course of the postoperative period after phlebectomy and thermal ablation in patients with varicose veins of the lower extremities in the system of the great saphenous vein (GSV) with class C2 of chronic venous insufficiency (CVI) — CEAP class C2. Materials and methods: 455 patients (455 limbs) with CEAP class C2. Group 1 (n = 154) received stripping + minimally invasive phlebectomy; Group 2 — endovenous laser ablation (EVLA) of GSV trunk + sclerotherapy of varicose veins; 3 group (n = 150) — radiofrequency ablation (RFA) of the GSV + sclerotherapy. All patients were united by a single tactical solution — the elimination of pathological vertical reflux in GSV. In each group, patients were with similar hemodynamic profile were selected (Group 1 = 63; Group 2 = 61; Group 3 = 61). The course of the postoperative period (from 2 days to 2 months) was compared for pain (visual analog scale — VAS), clinical symptoms of chronic venous insufficiency, degree of satisfaction (Darvall questionnaire), and duration of disability. Statistical processing was carried out using Excel programs for Windows XP, MedCalc® (version 11.4.2.0., Mariakerke, Belgium). Results: Postoperative pain is more pronounced (during day 1 for Group 1–4.0, Group 2–3.0, Group 3–2.0) and more prolonged (up to 4 days) after open surgeries (p < 0.05). The dynamics of the clinical symptoms of CVI (including varicose syndrome and use of compression therapy) could not be fully evaluated in connection with the ongoing sclerotherapy procedures for patients of Groups 2 and 3. Satisfaction of patients with aesthetic aspects was higher than expected in all groups. Reliable statistical differences proved decrease in days of disability (Group 1–14; Group 2–4; Group 3–3) and earlier return to physical activities and work in patients after thermal ablation in comparison with phlebectomy. Conclusion: The study shows that all three methods for eliminating vertical reflux in the GSV can be proposed for a large category of patients with CEAP of class C3 and C2. Medical and social rehabilitation of patients using endovascular thermal ablation technologies proceeds faster, which is beneficial both for the patients and for society.

Platelet distribution width in young patients with chronic venous insufficiency

Vascular ◽  
2021 ◽  
pp. 170853812110296
Author(s):  
Mustafa Aldemir ◽  
Ahmet Yuksel ◽  
Mehmet Inanir ◽  
Salih Metin ◽  
Yusuf Velioglu ◽  
...  
Keyword(s):  
Lower Extremity ◽  
Clinical Features ◽  
Chronic Venous Insufficiency ◽  
Venous Insufficiency ◽  
Young Patients ◽  
Control Group ◽  
Platelet Distribution Width ◽  
Distribution Width ◽  
Research Hospital ◽  
Lymphocyte Ratio

Objective Platelet distribution width (PDW) has been reported in a wide range of pathological settings. In this study, we aimed to investigate the relationship between PDW and lower extremity chronic venous insufficiency (CVI) by comparing the levels of PDW and other parameters derived from complete blood count (CBC) tests in young individuals with or without lower extremity CVI. Methods This prospective clinical study was conducted between January 2020 and December 2020. A total of 108 patients, 72 patients with lower extremity CVI (study group) and 36 healthy volunteers (control group) were enrolled from the Bursa Yuksek Ihtısas Educatıon Research Hospıtal and the Bolu Abant Izzet Baysal University Training and Research Hospital. The age range of the participants was between 18 and 50 years old. Participants’ baseline clinical features and CBC parameters including PDW, white blood cell, hemoglobin, hematocrit, mean corpuscular volume, red cell distribution width, neutrophil, lymphocyte, platelet count, mean platelet volume, plateletcrit, neutrophil-to-lymphocyte ratio, and platelet-to-lymphocyte ratio were compared between the two groups. Results The groups were statistically similar in terms of baseline clinical features. The median PDW value was significantly higher for the CVI patients relative to the control group (17.6 vs 16.8; p < 0.001). In terms of other CBC parameters, there were no significant differences between the groups. According to ROC analysis, area under the curve of PDW was 0.749 (95% confidence interval: 0.653–0.846 and p < 0.001). If the value of PDW was accepted as 17, it could predict CVI with 76% sensitivity and 59% specificity, whereas a PDW value of 17.5 could predict CVI with 51% sensitivity and 81% specificity. Conclusion Platelet distribution width might be a useful marker to determine an increased inflammatory response and thrombotic status in young patients with CVI.

scholarly journals Effect of aminaphtone on in vitro vascular permeability and capillary-like maintenance

2017 ◽  
Vol 33 (9) ◽  
pp. 592-599 ◽  
Author(s):  
Francesca Felice ◽  
Ester Belardinelli ◽  
Alessandro Frullini ◽  
Tatiana Santoni ◽  
Egidio Imbalzano ◽  
...  
Keyword(s):  
Endothelial Cells ◽  
Chronic Venous Insufficiency ◽  
Venous Insufficiency ◽  
Umbilical Vein ◽  
Three Dimensional ◽  
Endothelial Permeability ◽  
Human Umbilical Vein ◽  
Pre Treatment ◽  
Umbilical Vein Endothelial Cells

Objectives Aminaphtone, a naphtohydrochinone used in the treatment of capillary disorders, may affect oedema in chronic venous insufficiency. Aim of study is to investigate the effect of aminaphtone on vascular endothelial permeability in vitro and its effects on three-dimensional capillary-like structures formed by human umbilical vein endothelial cells. Method Human umbilical vein endothelial cells were treated with 50 ng/ml VEGF for 2 h and aminaphtone for 6 h. Permeability assay, VE-cadherin expression and Matrigel assay were performed. Results VEGF-induced permeability was significantly decreased by aminaphtone in a range concentration of 1–20 µg/ml. Aminaphtone restored VE-cadherin expression. Finally, 6 h pre-treatment with aminaphtone significantly preserved capillary-like structures formed by human umbilical vein endothelial cells on Matrigel up to 48 h compared to untreated cells. Conclusions Aminaphtone significantly protects endothelium permeability and stabilises endothelial cells organised in capillary-like structures, modulating VE-cadherin expression. These data might explain the clinical benefit of aminaphtone on chronic venous insufficiency.

Pathogenesis of varicose veins and cellular pathophysiology of chronic venous insufficiency

2017 ◽  
pp. 61-72
Author(s):  
Deoranie N. Abdel-Naby ◽  
Walter N. Duran ◽  
Brajesh K. Lal ◽  
Frank T. Padberg Jr. ◽  
Peter J. Pappas
Keyword(s):  
Chronic Venous Insufficiency ◽  
Venous Insufficiency ◽  
Varicose Veins

scholarly journals Chronic venous insufficiency after COVID-19: management of edema and pain syndromes

2021 ◽  
Vol 18 (2) ◽  
pp. 151-153
Author(s):  
F. Kh. Nizamov
Keyword(s):  
Chronic Diseases ◽  
Chronic Venous Insufficiency ◽  
Venous Insufficiency ◽  
Clinical Symptoms ◽  
Varicose Veins ◽  
Clinical Manifestations ◽  
Pain Syndrome ◽  
Venous Stasis ◽  
Vein Wall ◽  
Vas Scores

Introduction. COVID-19 infection raises many questions regarding the health condition of patients after they have had COVID-19. The aim of this study is to examine the characteristic symptoms of chronic venous insufficiency in the postcovid period.Materials and methods. The materials that were used for work included the results of studying the medical aid appealability, characteristic symptoms, diagnosis and treatment of symptoms of chronic venous insufficiency in persons who have had the coronavirus infection. 47 patients presented with complaints about deterioration of their condition after they had had COVID-19 over March to September 2021 period. Methods: general clinical examiniation, ultrasound angioscanning of veins of the lower extremities, laboratory coagulation tests.Results and discussion. Before deterioration, calf circumference was measured 22–24 cm at a typical measurement site in most patients (89%), after covid infection it reached 26–27 cm. Varicose veins remained soft, without intravascular formations, edema was often bilateral, asymmetric, pain was described as constant (5–6 VAS scores), patients had prominent signs of lymphostasis. 35 out of 47 people received diosmin-based venotonic drug of Russian manufacture at a dose of 1000 mg/day (one tablet twice a day), the course of treatment lasted one to two months. After that period, the edema subsided in 85% of patients, the severity of pain syndrome significantly reduced (up to 2–3 VAS scores). With regard to chronic venous insufficiency in patients with chronic diseases of lower extremity veins (mostly varicose and post-thrombotic diseases), the significant progress of disease was observed in almost 94% of follow-up cases. Diosmin is the main drug that is prescribed to treat chronic venous insufficiency. The drug has an angioprotective and venotonic effect, reduces the vein wall elasticity, increases venous tone, and decreases venous stasis, reduces capillary permeability and fragility, and increases their resistance, improves microcirculation and lymphatic drainage.Сonclusions. In the postcovid period, clinical symptoms of some chronic diseases occur/worsen, including clinical manifestations of chronic venous insufficiency. The use of Russian diosmin-based drug for the management of edema and pain syndrome is very promising.

scholarly journals Klippel–Trénaunay Syndrome – A Very Rare and Interesting Syndrome

2015 ◽  
Vol 9 ◽  
pp. CCRPM.S21645 ◽  
Author(s):  
Deepak Sharma ◽  
Sachin Lamba ◽  
Aakash Pandita ◽  
Sweta Shastri
Keyword(s):  
Soft Tissue ◽  
Vascular Malformation ◽  
Chronic Venous Insufficiency ◽  
Venous Insufficiency ◽  
Varicose Veins ◽  
Lower Limbs ◽  
Port Wine ◽  
Bone Deformity ◽  
Klippel Trenaunay Syndrome

Klippel–Trénaunay syndrome (KTS or KT) is an infrequently seen dermatological syndrome, which is often viewed as a triad of vascular malformation (capillary malformations or port-wine brands), venous varicosity, and soft tissue and/or bony hypertrophy. We report a case of a 12-year-old male who presented to us with the symptoms of varicose plaques over both lower limbs and was diagnosed as a case of KTS. Management is normally conservative and includes stockings for compression of the branches to reduce edema because of chronic venous insufficiency; modern devices that cause on and off pneumatic compression; and rarely, surgical correction of varicose veins with lifelong follow-up. The orthopedic abnormalities are treated with epiphysiodesis in order to prevent (stop) overgrowing of limb and correction of bone deformity.

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