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

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.

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Groin-to-Knee Downward Stripping of the Long Saphenous Vein

Phlebology The Journal of Venous Disease ◽

10.1177/026835559200700105 ◽

1992 ◽

Vol 7 (1) ◽

pp. 20-22 ◽

Cited By ~ 11

Author(s):

P. Conrad

Keyword(s):

Saphenous Vein ◽

Varicose Veins ◽

Neurological Complication ◽

Clinical Signs ◽

Signs And Symptoms ◽

Long Saphenous Vein ◽

Aesthetic Results ◽

Clinical Signs And Symptoms ◽

Neurological Disturbance ◽

Sydney Australia

Objective: To demonstrate the safety and efficacy of downward stripping of the long saphenous vein. Design: Retrospective study in a series of patients treated surgically by the author. Setting: Department of Surgery, Nepean Hospital, Sydney, Australia. Patients: Patients presenting with clinical signs and symptoms of varicose veins attributable to sapheno-femoral incompetence. Interventions: Patients underwent flush sapheno-femoral ligation with stripping of the long saphenous vein using a downward stripping of the long saphenous vein between the groin and knee. Main outcome measures: Cosmetic appearance of the limb and presence or absence of neurological disturbance suggestive of injury to the saphenous nerve. Results: Satisfactory healing of all wounds was found. Good aesthetic results and no neurological complication was encountered. Conclusion: Groin to knee downward stripping of the long saphenous vein provides a safe and effective method for managing varices of the long saphenous vein.

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

Arteriosclerosis Thrombosis and Vascular Biology ◽

10.1161/atvb.36.suppl_1.331 ◽

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.

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Endovenous laser ablation is an effective treatment for great saphenous vein incompetence in teenagers

Phlebology The Journal of Venous Disease ◽

10.1177/0268355515585436 ◽

2015 ◽

Vol 31 (3) ◽

pp. 198-202

Author(s):

Piotr Terlecki ◽

Stanislaw Przywara ◽

Marek Iłżecki ◽

Karol Terlecki ◽

Piotr Kawecki ◽

...

Keyword(s):

Laser Ablation ◽

Saphenous Vein ◽

Great Saphenous Vein ◽

Current Knowledge ◽

Varicose Veins ◽

Signs And Symptoms ◽

Chronic Venous Disease ◽

Venous Disease ◽

Invasive Treatment ◽

Endovenous Laser Ablation

Objectives The current knowledge of chronic venous disease in teenagers and its treatment is very limited. The aim of the study is to present our experience and the available literature data on the treatment of varicose veins in teenagers with endovenous laser ablation of the great saphenous vein. Methods Five patients, aged 15–17 years, were qualified for surgery, based on typical signs and symptoms of chronic venous disease. Minimally invasive treatment with endovenous laser ablation of the great saphenous vein was applied. Results The technical success of surgery was achieved in all patients. Over a 2-year follow-up we did not observe any case of recanalisation of the great saphenous vein, recurrence of varicose veins, or serious complications, such as deep vein thrombosis or pulmonary embolism. One patient presented with resolving of post-operative bruising, and two cases of local numbness were transient. Conclusions Endovenous laser ablation of the great saphenous vein in the treatment of chronic venous disease in teenagers is effective and safe. The method provides excellent cosmetic effects, very short recovery time and high levels of patient satisfaction.

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Pendidikan Kesehatan tentang Anemia pada Remaja Putri di SMA N 12 Kabupaten Merangin

Jurnal Abdimas Kesehatan (JAK) ◽

10.36565/jak.v3i1.148 ◽

2021 ◽

Vol 3 (1) ◽

pp. 41

Author(s):

Dini Junita ◽

Arnati Wulansari

Keyword(s):

Health Workers ◽

Clinical Signs ◽

Signs And Symptoms ◽

Nutritional Anemia ◽

Post Test ◽

Service Activity ◽

Implementation Method ◽

Clinical Signs And Symptoms ◽

Indicators Of Success ◽

The Impact

Anemia is the impact of nutritional problems on teenager girl. Nutritional anemia is caused by a lack of nutrients that play a role in the formation of hemoglobin, it can be due to lack of consumption or absorption disorders. Only 62% of anemia mothers have received iron supplemented tablets in the working area of Puskesmas Simpang Limbur, while the iron supplemented tablet program for teenager girls in high school has not been implemented. The purpose of this community service activity is to provide information and motivation to teenagers to prevent anemia. Providing information in the form of health education regarding the definition, signs, clinical signs and symptoms and the impact of anemia. The implementation method is in the form of counseling, discussion, practice simulation and pre-post test evaluation. Monitoring evaluation is carried out by looking at the indicators of success in the aspect of target attendance attending every meeting in service and practice activities to the target, reflections and feedback from the participants. The results of the activity show that school support is very good, students' knowledge of anemia is more than 80%. The material still needs to be improved regarding the risk factors for anemia in adolescents. Collaboration with health workers is needed to gain new knowledge on a regular basis, as well as empowering students as youth cadres.

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

Circulation Research ◽

10.1161/res.119.suppl_1.232 ◽

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.

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Patterns of short saphenous vein incompetence

Phlebology The Journal of Venous Disease ◽

10.1177/0268355513477064 ◽

2013 ◽

Vol 28 (1_suppl) ◽

pp. 47-50 ◽

Cited By ~ 4

Author(s):

M I Qureshi ◽

T R A Lane ◽

H M Moore ◽

I J Franklin ◽

A H Davies

Keyword(s):

Saphenous Vein ◽

Venous Insufficiency ◽

Recurrent Disease ◽

Chronic Venous Disease ◽

Venous Disease ◽

Venous Ulceration ◽

Complex Anatomy ◽

History Of ◽

Short Saphenous Vein ◽

The Impact

The significance of short saphenous vein (SSV) reflux is an under-explored territory in chronic venous disease (CVD). We have examined the origin and significance of SSV reflux in primary and secondary CVD. While the natural history of SSV incompetence remains uncertain, its prevalence has been shown to approximate 3.5%, rising with progressing clinical venous insufficiency, and bears an association with lateral malleolar venous ulceration. The most common pattern of reflux extends throughout the SSV Patterns of incompetence in recurrent disease are highly variable, but SSV reflux may itself pose a risk for recurrence, in part due to the complex anatomy of the saphenopopliteal system. Further studies are required to delineate the impact of SSV reflux in secondary venous disease and deep venous incompetence.

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Role of Clinical Pharmacist in a Heart Failure Clinic

Hospital Pharmacy ◽

10.1177/001857870504001008 ◽

2005 ◽

Vol 40 (10) ◽

pp. 890-896 ◽

Cited By ~ 1

Author(s):

Devada Singh-Franco ◽

Leanne Li ◽

Stan Hannah ◽

Morton Diamond

Keyword(s):

Heart Failure ◽

Clinical Pharmacist ◽

Hospital Admissions ◽

Care Service ◽

Clinical Signs ◽

Signs And Symptoms ◽

Medical Insurance ◽

Post Intervention ◽

Clinical Signs And Symptoms ◽

The Impact

Purpose To determine if the inclusion of a clinical pharmacist (CP) in a heart failure (HF) multidisciplinary team could lead to a reduction in the number of hospital admissions and additionally decrease the clinical signs and symptoms of HF patients with either Medicaid or no medical insurance. Methods Longitudinal study to determine the impact of a pharmaceutical-care service program to HF patients by comparing the 9-month period before (pre-intervention) and the 9-month period after (post-intervention) implementation of the program. The intervention of the CP was directed in two complementary functions. The first was direct patient contact and the second was to provide drug information to the medical clinicians. Results Twenty-nine outpatients completed the study. Over 9 months, the CP made a total of 216 interventions and had three in-person, follow-up contacts and three telephone contacts per patient. At post-intervention, there was a statistically significant reduction in the total number of hospitalizations (50 vs 23; P < 0.018) and length of stay (LOS) (263 days vs 108 days; P < 0.03). However, there was an insignificant reduction in HF hospitalizations, LOS, and total number of HF signs and symptoms. Conclusions Addition of a CP to an outpatient HF clinic can lead to fewer hospital admissions and a reduction in the LOS in patients with either Medicaid or no medical insurance.

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Diagnostic yield of intravascular ultrasound in patients with clinical signs and symptoms of lower extremity venous disease

Journal of Vascular Surgery Venous and Lymphatic Disorders ◽

10.1016/j.jvsv.2019.10.021 ◽

2020 ◽

Vol 8 (4) ◽

pp. 634-639 ◽

Cited By ~ 1

Author(s):

Taimur Saleem ◽

Alexander Knight ◽

Seshadri Raju

Keyword(s):

Lower Extremity ◽

Intravascular Ultrasound ◽

Diagnostic Yield ◽

Clinical Signs ◽

Signs And Symptoms ◽

Venous Disease ◽

Clinical Signs And Symptoms

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Abstract TP226: Predictors and Impact of Paramedic Recognition of Hemorrhagic Stroke

Stroke ◽

10.1161/str.48.suppl_1.tp226 ◽

2017 ◽

Vol 48 (suppl_1) ◽

Author(s):

John A Oostema ◽

Christian Negronrolon ◽

Mathew J Reeves

Keyword(s):

Hemorrhagic Stroke ◽

Prehospital Care ◽

Clinical Signs ◽

Signs And Symptoms ◽

Hospital Data ◽

Discharge Disposition ◽

Transportation Times ◽

Clinical Signs And Symptoms ◽

Department Evaluation ◽

The Impact

Introduction: Utilization of EMS is associated with faster emergency department evaluation and treatment of patients with stroke, especially among EMS-recognized patients. However, most research focuses on patients with ischemic stroke. We sought to identify factors associated with prehospital recognition of hemorrhagic stroke and the impact of recognition on prehospital and in-hospital care. Methods: A cohort of hospital-confirmed hemorrhagic stroke cases transported by EMS to 2 primary stroke centers in Kent County, Michigan over a 12-month time period was assembled. Data regarding prehospital care (Cincinnati stroke screen [CPSS] documentation, GCS, clinical signs and symptoms, transportation times, and paramedic impression) were linked to in-hospital data on door-to-CT (DTCT) times, mortality, and discharge disposition. We examined the relationships between clinical factors and stroke recognition by paramedics as well as between recognition and in-hospital outcomes. Results: Over 12 months, 73 confirmed hemorrhagic stroke patients arrived by EMS. Forty-seven (64.4%) were correctly identified by EMS as stroke; 26 (35.6%) were missed. EMS recognition was associated with greater likelihood CPSS documentation, intracerebral hemorrhage, dispatch impression of stroke, absence of seizure, and higher systolic blood pressure (Table). Multiple logistic regression confirmed a strong independent relationship between CPSS documentation and stroke recognition (OR 40.3 [5.0 to 323.5]). EMS recognized cases had shorter on-scene times (17 vs. 21 minutes, p=0.004), total transport times (33 vs. 43 minutes, p=0.003), and DTCT times (30 vs. 48 minutes, p=0.004). Recognition was not associated with mortality or discharge disposition. Conclusion: CPSS documentation is strongly associated with hemorrhagic stroke recognition by EMS providers. EMS recognition is associated with more efficient transportation and faster DTCT times upon hospital arrival.

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