Venous Volumetry In The Assessment Of The Post-Thrombotic Limb

1981 ◽  
Author(s):  
C V Ruckley ◽  
H M Crawshaw ◽  
J Seaton
Keyword(s):  
Chronic Venous Insufficiency ◽  
Venous Insufficiency ◽  
Varicose Veins ◽  
Response To Treatment ◽  
Venous Disease ◽  
Clinical Relapse ◽  
Non Invasive ◽  
Coefficients Of Variation ◽  
Primary Varicose Veins

The reproducibility of venous volumetry has been evaluated in 20 normal legs (N), 20 legs with primary varicose veins (W) and 30 with stable post-thrombotic chronic venous insufficiency (CVI).The test has shown significant differences between the groups in mean relative expelled volume (EV rel, ccs): N 1.65 ± SD 0.66; W 1.01 ± 0.40; CVI 0.64 ± 0.39 and in half refilling time (T3 secs): N 23.9 ± 11.5; W 11.8 ± 7.4; CVI 3.6 ± 1.8. The percent coefficients of variation in tests repeated at intervals of up to a month were as follows.The reproducibility of the test confirms its value as a non-invasive means of measuring the severity of postthrombotic venous disease and thus as a means of assessing response to treatment. Serial volumetric tests on 25 patients before and for up to 12 months after Linton operations for chronic venous insufficiency show significant early improvements in expelled volume. But in many of these patients the refilling time tends to remain short indicating residual valvular incompetence and the possibility of clinical relapse in the long term.

The Epidemilogy of Chronic Venous Ulcer: Some Unanswered Questions

2000 ◽  
Vol 15 (3-4) ◽  
pp. 106-109
Author(s):  
C. V. Ruckley
Keyword(s):  
Chronic Venous Insufficiency ◽  
Venous Insufficiency ◽  
Varicose Veins ◽  
Clinical Manifestations ◽  
Epidemiological Studies ◽  
Therapeutic Interventions ◽  
Venous Disease ◽  
Clinical Classification ◽  
Age Related

Objective: To highlight gaps in knowledge concerning the epidemiology of chronic venous insufficiency and to indicate what future studies are required. Methods: Existing classifications are compared. Limitations of epidemiological studies are defined. Data from published series and from the Edinburgh Vein Study are presented. Synthesis: The Basle 1978 classification of chronic venous insufficiency (CVI) is a purely clinical classification in which the earliest grade is corona phlebectatica. The Porter 1988 classification of CVI attempted to correlate clinical grades with sites of venous incompe-tence. However, a consistent relationship does not exist. The CEAP classification separates the clinical grades (which do not include corona phlebectasia) from the anatomical segments. The CEAP clinical classification covers a range of venous manifestations but is not consistent. There is a need for further consideration of classifications. Published selected series of patients show that the frequency of incompetence in both deep and superficial systems increases in proportion to the severity of the clinical manifestations of venous disease. To understand the significance of these data we need to know the patterns of venous incompetence in the general population. Data from 1566 subjects between the ages of 18 and 64 years in the Edinburgh Vein Study, a randomly selected cross-section of members of the Edinburgh population, showed that the prevalence of CVI was age-related and was present in 9.2% of men and 6.6% of women. Men had a significantly higher frequency of reflux in the deep system than women. In order to direct therapeutic interventions where they are most appropriate we need to know which patients with the early stages of varicose veins progress to CVI and which patients with early CVI progress to the serious skin complications. Conclusions: Key information concerning the natural history of venous disease and its evolution in relation to haemodynamic abnormalities awaits the findings of longitudinal-cohort epidemiological studies which include the duplex scanning of large populations.

Duplex Ultrasound Scanning for Chronic Venous Disease: I. Techniques for Examination of the Crural Veins

1994 ◽  
Vol 9 (3) ◽  
pp. 108-113 ◽  
Author(s):  
R. W. Ziegenbein ◽  
K. A. Myers ◽  
P. G. Matthews ◽  
G. H. Zeng
Keyword(s):  
Venous Insufficiency ◽  
Outcome Measure ◽  
Varicose Veins ◽  
Duplex Ultrasound ◽  
Chronic Venous Disease ◽  
Venous Disease ◽  
Ultrasound Scanning ◽  
Diagnostic Laboratory ◽  
Non Invasive ◽  
Anterior Tibial

Objective: To describe a practical technique to reliably find and study crural veins by duplex ultrasound scanning. Design: Prospective scanning of patients referred for evaluation of possible chronic deep venous insufficiency. Setting: A non-invasive vascular diagnostic laboratory in Melbourne, Australia. Patients: A study of 1340 legs in 917 consecutive patients referred with primary or recurrent varicose veins, or for evaluation of possible deep venous disease causing aching or swelling in the legs. Interventions: Examination of the crural veins by duplex ultrasound scanning. Main outcome measure: Identification of all three sets of crural veins. Results: Rates for detecting the posterior tibial, anterior tibial and peroneal veins were 97%, 92% and 91% respectively and all three were observed in 91%. If the last 1227 legs studied by colour-Doppler duplex ultrasound are considered, the rates for detection were 98%, 96% and 96% respectively. Conclusion: Examination of the crural veins can be a part of routine duplex ultrasound scanning in patients referred with suspected venous disease.

Three Tests of Microcirculatory Function in the Evaluation of Treatment for Chronic Venous Insufficiency

1990 ◽  
Vol 5 (3) ◽  
pp. 165-172 ◽  
Author(s):  
T. R. Cheatle ◽  
G. M. McMullin ◽  
J. Farrah ◽  
P. D. Coleridge Smith ◽  
J. H. Scurr
Keyword(s):  
Chronic Venous Insufficiency ◽  
Venous Insufficiency ◽  
Subcutaneous Fat ◽  
Intermittent Pneumatic Compression ◽  
Laser Doppler ◽  
Response To Treatment ◽  
Venous Disease ◽  
Doppler Flowmetry ◽  
Xenon Clearance ◽  
Microcirculatory Function

No investigation exists which has been shown to detect accurately microcirculatory improvement following treatment for chronic venous insufficiency. This study examines three possible techniques for doing so. Fourteen patients with chronic venous insufficiency and fourteen controls underwent measurement of transcutaneous PO2, 133xenon clearance from the skin and subcutaneous tissues and laser–Doppler flowmetry in the gaiter region. Patients with venous disease then followed a regime of intermittent pneumatic compression for 4 h each day for 4 weeks. The same measurements were then repeated. Xenon clearance from subcutaneous fat and the time taken to reach maximal laser–Doppler flow after release of a tourniquet showed a significant improvement after compression treatment. These tests may be useful as parameters in the objective monitoring of response to treatment in patients with liposclerotic skin.

Epidemiology of Chronic Venous Insufficiency

1996 ◽  
Vol 11 (1) ◽  
pp. 2-5 ◽  
Author(s):  
F. G. R. Fowkes
Keyword(s):  
General Population ◽  
Chronic Venous Insufficiency ◽  
Venous Insufficiency ◽  
Varicose Veins ◽  
Venous Disease ◽  
Skin Changes ◽  
Medline Search ◽  
Study Selection ◽  
Varicose Ulcer ◽  
Definition Of

Objective: To determine the prevalence of chronic venous insufficiency in the general population and its association with varicose veins. Data sources: MEDLINE search 1980–94 plus scanning of reference lists in articles obtained. Study selection: Studies on venous disease in subjects not attending health services. Data synthesis: A formal systematic review of metaanalysis was not carried out because of the heterogeneity of the few available studies. Skin changes were found to occur in over 3% of adults, more so in women than men. The prevalence was higher in subjects with varicose veins and depended on the definition of skin changes and the severity of varicose veins. Approximately 0.3% of adults had an open varicose ulcer, and around 1% had an open or healed ulcer. Prevalence was higher in women and increased with age. Conclusions: The prevalence of chronic venous insufficiency was found to be common in the general population, but more studies of distribution and aetiology are required.

Endocrine mechanisms in the pathogenesis of primary varicosis

Phlebologie ◽  
2013 ◽  
Vol 42 (01) ◽  
pp. 13-18 ◽  
Author(s):  
S. Schnabl ◽  
A. Strölin ◽  
Ch. Busch
Keyword(s):  
Chronic Venous Insufficiency ◽  
Regulatory Networks ◽  
Venous Insufficiency ◽  
Varicose Veins ◽  
Chronic Venous Disease ◽  
Venous Disease ◽  
Extensive Literature ◽  
Vein Wall ◽  
Extensive Literature Search ◽  
Relaxin 2

SummaryIntroduction: Varicose veins affect up to 40 % of men and up to 51 % of women. The patho-physiology of primary varicosis (chronic venous insufficiency, CVI) is poorly understood. Here, the available data on possible endocrine mechanisms in healthy and varicose veins are reviewed.Methods: An extensive literature search was conducted in PubMed using the following key words: Chronic venous insufficiency, CVI, chronic venous disease, CVD, varicosis, saphenous vein, pathogenesis, hormone.Results: Several theories ranging from incompetence of the valves to functional, biological or morphologic changes in different layers of the vein wall have been proposed. However, an increasing body of evidence suggests that endocrine mechanisms might be involved in the pathogenesis of primary varicosis. In this respect a growing number of hormones (e.g. estrogen, progesterone, relaxin-2, and oxytocin) and their receptors have been linked to primary varicosis in experimental, pharmacological and histological studies.Conclusion: In summary, endocrine-based mechanisms seem to play a role in the pathogenesis of primary varicosis. This opens up the perspective for pharmacological treatments targeting the various described endocrine regulatory networks.

scholarly journals CHRONIC VENOUS INSUFFICIENCY

10.23856/3217 ◽  
2019 ◽  
Vol 32 (1) ◽  
pp. 131-136
Author(s):  
Antoni Stadnicki ◽  
Martin Rusnák ◽  
Anna Stadnicka
Keyword(s):  
Chronic Venous Insufficiency ◽  
Venous Insufficiency ◽  
Varicose Veins ◽  
Chronic Venous Disease ◽  
Postthrombotic Syndrome ◽  
Venous Disease ◽  
Compression Stockings ◽  
Venous Leg Ulcer ◽  
Color Flow ◽  
Clinical Disorder

Chronic venous insufficiency (CVI) is a common, but underdiagnozed clinical disorder associated with a variety of signs and symptoms. The presence of leg edema in association  with varicose veins, and venous leg ulcer in later disease stages defines the disease. The pathogenesis of chronic venous disease  is based on venous reflux, obstruction, or a combination thereof.  Prior postthrombotic syndrome   is one of risk factor for CVI which may explain observed  prevalence of thrombophilia in CVI. Color flow duplex ultrasound is the gold standard for nearly all diagnostic issues related to chronic venous disease. Compression stockings are the mainstay for conservative management. Earlier use of venous ablation therapy should be considered in symptomatic patients with superficial tortuous vein

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.

Expression of adhesion molecules on leukocytes of patients with chronic venous insufficiency

Phlebologie ◽  
2002 ◽  
Vol 31 (03) ◽  
pp. 63-68
Author(s):  
E. Jahnová ◽  
P. Labasˇ ◽  
S. Weissová ◽  
M. Horváthová ◽  
M. Ferencík ◽  
...  
Keyword(s):  
Adhesion Molecules ◽  
Chronic Venous Insufficiency ◽  
Venous Insufficiency ◽  
Varicose Veins ◽  
Ulcus Cruris ◽  
Lower Limbs ◽  
Hla Dr ◽  
Activated T Lymphocytes ◽  
Primary Varicose Veins ◽  
Monocytes And Lymphocytes

SummaryAim: We studied if the expression and release of adhesion molecules is changed in peripheral lymphocytes obtained from patients with chronic venous insufficiency (CVI) of the lower limbs. Methods: 26 patients with CVI (19 primary varicose veins, 7 ulcus cruris) and 39 clinically healthy persons were included in our study. The expression of adhesion molecules on granulocytes, monocytes, and lymphocytes was analysed by flow cytometry. In serum soluble sCD31 and sCD54 was assayed by ELISA, the CD profile was estimated on lymphocytes. Results: In patients suffering from CVI the increased expression of CD11b, CD18, CD54, and CD49d on granulocytes and lymphocytes, of CD62L and CD49d on granulocytes and monocytes, and of CD15 on monocytes and lymphocytes was demonstrated. The highest difference in the expression of adhesion molecules between patients and controls were found on lymphocytes. In patients with CVI lower mean counts of cytotoxic (CD8+) lymphocytes and higher counts of NK cells (CD16+ + CD56+) were seen. The concentration of activated T lymphocytes (CD3 HLA-DR+) and of sCD54 was much higher in the circulation of patients with ulcus cruris than in those with varicose veins or in the controls. Conclusion: Lymphocytes and leukocytes of patients with CVI express elevated concentrations of various adhesion molecules, especially in patients with ulcus cruris. Additionally, significant changes in their CD profile were observed.

The Epidemiology of Chronic Venous Diseases

2000 ◽  
Vol 15 (1) ◽  
pp. 2-18 ◽  
Author(s):  
A. Adhikari ◽  
M. H. Criqui ◽  
V. Wooll ◽  
J. O. Denenberg ◽  
A. Fronek ◽  
...  
Keyword(s):  
Risk Factors ◽  
Chronic Venous Insufficiency ◽  
World Literature ◽  
Venous Insufficiency ◽  
Varicose Veins ◽  
Female Gender ◽  
Venous Disease ◽  
Leg Ulcers ◽  
Venous Leg Ulcers ◽  
Venous Diseases

Objective: To review the prevalence of and risk factors for varicose veins, chronic venous insufficiency (CVI) and venous leg ulcers. Data sources: MEDLINE was searched for the terms prevalence and varicose veins, chronic venous insufficiency, or venous leg ulcers. Study selection: The extant world literature (1966–1999) with a minimum of an available English abstract was collected. Ninety-nine studies were reviewed. Data extraction: Data were extracted on prevalence of diseases of the veins in the lower limb, age and gender of the subject populations, and other risk factors for those diseases examined by the original researchers. Data synthesis: The two most prominent risk factors for venous disease are increasing age and female gender. Additional risk factors for venous disease with at least some documentation in the literature include dietary patterns, obesity, physical activity, standing occupations, constrictive clothing, connective tissue laxity, and hormonal differences, including pregnancy. Family history is also a prominent risk factor, suggesting a genetic component. Conclusions: Varicose veins are found more commonly in women, and with increased age. The increase with age is linear, suggesting a constant incidence and cumulative prevalence. CVI is also more common in women and increases with age, but data are limited. Venous leg ulcers are much less common than varicose veins or CVI and show less of a female preponderance, but increase exponentially with age, suggesting a true increasing incidence with age.

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