scholarly journals Venous leg symptoms in patients with migraine: a potential clue on the pathophysiology of migraine (Vein-Migraine study)

2021 ◽  
Vol 42 (Supplement_1) ◽  
Author(s):  
B Cuglan ◽  
A Onalan ◽  
S Ozturk ◽  
E Altuntas ◽  
A B Demirel ◽  
...  
Keyword(s):  
Lower Extremity ◽  
Varicose Veins ◽  
Clinical Status ◽  
Significant Negative Correlation ◽  
Venous System ◽  
Control Group ◽  
Venous Disease ◽  
Disability Score ◽  
Migraine Group ◽  
Venous Disorders

Abstract Background Chronic venous disorders (CVD) that conventionally refers to disease of lower and upper extremity venous system encompass a large spectrum of abnormalities in the venous system. Recently, various venous disorders such as hemorrhoids, varicocele and lower extremity varicose veins have been gathered under the term of dilating venous disease (DVeD). So, vascular wall pathology itself has been supposed to be the underlying mechanism of DVeD in different vascular systems. Migraine is a neurovascular disorder which cerebral venous congestion might have role in pathogenesis. Both vascular and neurogenic theories have been postulated for the pathophysiology of migraine. We hypothesized that pathophysiology of migraine might related with DVeD due to vascular theory. Purpose The objective was to assess the association between venous disease and migraine by using the Venous Insufficiency Epidemiological and Economic Study-Quality of Life/Symptoms (VEINES-QoL/Sym) questionnaire in migraineurs and non-migraineurs. Methods The study was designed as a non-randomized, prospective cohort study and consisted of patients diagnosed with migraine. The control group included age- and sex-matched healthy subjects. All participants were examined for the presence of CVD. Presence of lower extremity venous system disease and subsequent classification has been assessed and categorized according to clinical component of clinical, etiological, anatomical and pathological (CEAP) classification. VEINES-Sym questionnaire was applied to assess venous symptoms. The Migraine Disability Assessment (MIDAS) questionnaire was used to assess the severity of disease in migraineurs. Results Participants were classified into two groups as migraine (+) group (n=130) and migraine (−) group (n=130) (Figure 1). Migraine patients and control group were comparable in terms of clinical status and demographic parameters. The mean score of night cramps, burnings, itching, tingling and throbbing were found to be lower in migraineurs than those of non-migraineurs. In addition, the presence of venous symptoms, aching legs, night cramps, heat/burning sensation, throbbing and tingling were found to be significantly higher in patients with migraine compared with those without migraine (Figure 2). Also, total VEINES-Sym score was lower in patients with migraine compared to control group (34.4±8.7, 37.6±8.12, p=0.003, respectively). Additionally, there was a significant negative correlation between VEINES-Sym score and total MIDAS disability score (r=−0.33, p<0.001) and MIDAS severity levels (r=−0.266, p=0.003) of the migraineurs. Logistic regression analysis revealed that VEINES-Sym score is an independent and statistically significant associate of migraine (OR: 0.95, 95% CI: 0.92–0.98, p=0.001). Conclusions We have documented an independent association between migraine and VEINES-Sym score indicating possible pathophysiological link between migraine and CVD. FUNDunding Acknowledgement Type of funding sources: None.

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.

Is arteriovenous shunting involved in the development of varicosities? A study of the intraluminal pressure and oxygen content in varicose veins

2008 ◽  
Vol 23 (3) ◽  
pp. 137-141 ◽  
Author(s):  
M A Murphy ◽  
L Hands
Keyword(s):  
Oxygen Content ◽  
Supine Position ◽  
Varicose Veins ◽  
Causative Factor ◽  
Intraluminal Pressure ◽  
Control Group ◽  
Venous Disease ◽  
Control Subjects ◽  
Pulsatile Pressure ◽  
Primary Varicose Veins

Objectives Arteriovenous (AV) shunting has been postulated as the underlying cause of varicose veins. The aim of this study was to analyse pressure and oxygen content in primary varicose veins in order to determine evidence of arterial shunting. Methods Thirty-nine patients with varicose veins underwent cannulation of varicosities. The pressure and the blood oxygen content within varicosities were measured in different positions and during exercise. Similar measurements were made in the long saphenous veins of 10 control subjects without venous disease. Results Mean pressure in varicose veins in the supine position was 12.3 mmHg (Standard deviation [SD] 3.6 mmHg). Control subjects had similar pressures measured in the long saphenous vein. No pulsatile pressure tracings were obtained. Varicosity pressures in the erect position averaged 66 mmHg (SD 9 mmHg). In all cases, the pressure correlated with the distance of the varicosity from the heart. Pressure reduction in varicosities after exercise was significantly less than that in control subjects. Recovery time (RT 90) was also significantly shorter than in the control group. Mean venous pO2 in varicosities was 4.5 kPa (SD 1.0) in the supine position dropping to 3.9 kPa (SD 0.9) on standing; these values were not significantly different to samples from control subjects. Conclusions AV shunting is unlikely to be a causative factor in the development of primary varicose veins.

A Novel Scoring System for Lower-extremity Venous Pathology Analysed Using Magnetic Resonance Venography and Duplex Ultrasound

2012 ◽  
Vol 27 (1_suppl) ◽  
pp. 163-170 ◽  
Author(s):  
C W K P Arnoldussen ◽  
I Toonder ◽  
C H A Wittens
Keyword(s):  
Magnetic Resonance ◽  
Lower Extremity ◽  
Scoring System ◽  
Imaging Techniques ◽  
Vena Cava ◽  
Duplex Ultrasound ◽  
Venous System ◽  
Magnetic Resonance Venography ◽  
Chronic Venous Disease ◽  
Venous Disease

Objectives: To present a novel scoring system for lower-extremity venous pathology (the LOVE score) and our experiences using it in our clinical practice to identify venous pathology with duplex ultrasound (DUS) and magnetic resonance venography (MRV). Method: A total of 40 patients, 30 suspected of chronic venous disease and 10 with acute deep vein thrombosis (DVT) were examined from the inferior vena cava (IVC) to the popliteal vein using DUS and MRV. The image findings were reported using the LOVE score. Results The majority of deep veins (368 out of 378 segments) were completely visualized by both our imaging techniques and could be analysed using the LOVE score. Both imaging techniques reported comparable findings with regard to the visualization of thrombus, obstruction, collaterals, trabeculations, anatomic variations and central venous compression (e.g. May–Thurner). Conclusions: The LOVE score can be used to expand and standardize the documentation of imaging the deep venous system beyond thrombosis, to help identify (optimal) treatment options in patients with venous disease, in both the clinical and research setting. This first assessment shows that both DUS and MRV are capable of systematically identifying a multitude of changes in the venous system.

Graduated compression stockings effects on chronic venous disease signs and symptoms during pregnancy

2019 ◽  
Vol 35 (1) ◽  
pp. 46-55 ◽  
Author(s):  
Orlando Adas Saliba Júnior ◽  
Hamilton Almeida Rollo ◽  
Orlando Saliba ◽  
Marcone Lima Sobreira
Keyword(s):  
Pregnant Women ◽  
Saphenous Vein ◽  
Great Saphenous Vein ◽  
Varicose Veins ◽  
Intervention Group ◽  
Signs And Symptoms ◽  
Lower Limbs ◽  
Control Group ◽  
Venous Disease ◽  
Compression Stockings

Objectives To evaluate the effectiveness of compression stockings in controlling the varicose veins in pregnant women. Method A prospective controlled randomized clinical trial was performed, including 60 women: intervention group (n = 30), who used compression stockings, and control group (n = 30). Diameters of the great saphenous vein and small saphenous vein in the lower limbs of pregnant women in an orthostatic position were analyzed using Duplex-ultrasound. The symptomatology and CEAP were evaluated. Results Great saphenous vein diameters in the intervention group were 0.37 cm initial and 0.32 cm final (p < 0.0001) in the right leg and 0.28 cm and 0.38 cm (p < 0.0001) in the control group. CEAP classification presented worsening in the control group (p < 0.0001). The signs and symptoms in the control vs. intervention group: pain (86.67% vs. 23.33%; p < 0.0001), edema (70.00% vs. 33.33%; p = 0.0045), and leg heaviness (93.33% vs. 13.33%; p < 0.0001). Conclusions Compression stockings were effective in controlling the varicose veins related to pregnancy.

scholarly journals Experience of application of mechanochemical scleroobliteration in treatment for recurrence of lower extremity varicose vein disease

2020 ◽  
Vol 28 (1) ◽  
pp. 57-66
Author(s):  
Alidzhon D. Gaibov ◽  
Okildzhon Ne’matzoda ◽  
Shakhnoza M. Burieva ◽  
Egan L. Kalmykov
Keyword(s):  
Lower Extremity ◽  
Saphenous Vein ◽  
Varicose Veins ◽  
Invasive Procedure ◽  
Sulfate Solution ◽  
Chronic Venous Disease ◽  
Long Term Results ◽  
Venous Disease ◽  
Mechanochemical Ablation ◽  
Complete Obliteration

Aim. Evaluation of the effectiveness of mechanochemical scleroobliteration in treatment for recurrent lower extremity varicose veins (VVD). Materials and Methods. A retrospective analysis of the results of examination and treatment of 19 patients (17 women and 2 men, average age 36.34.5 years) with recurrences of VVD, in whom mechanochemical sclerotherapy as the main method of treatment was used. In all cases, mechanochemical ablation of the superficial venous trunks was performed using Phlebogriph catheter. As a hardener, 3% sodium tetradecyl sulfate solution (fibro-vein) was used in the volume not more than 10 ml per procedure. Results. According to the CEAP classification, 15 patients had C2 and 4 patients had C3 class. Recurrence of VVD in one lower extremity was diagnosed in 17 (89.5%) patients, and bilateral in 2 (10.5%). In 6 (31.6%) cases, recurrence occurred in 5 or more years after the first operation, in 8 (42.1%) patients after 3-5 years, in 5 (26.3%) after 1-3 years. The diameter of varicose veins before treatment according to color duplex scanning (CDR) was 7.90.8 mm. The duration of the detected saphenofemoral reflux (n=10) with the trunk of the great saphenous vein (GSV) left on the hip was 5.71.4 s, with the length 31.231.4 mm. With the preserved зtrunk of the GSV, crossectomy was performed in combination with mechanochemical scleroobliteration. Crossectomy was also performed in two patients with repeated dilation of the trunk of the small saphenous vein (SSV) followed by mechanochemical scleroobliteration. In two cases, insufficient shin perforants were ligated from mini-incisions, and in two more cases, foam scleroobliteration of them was performed. Within 3 weeks after the procedure, a good result was recorded in 94.7% of cases in the form of complete occlusion of sclerotized veins with the absence of reflux in them. Only in one observation incomplete occlusion of the sclerotized vein on the hip was noted, which required a repeated procedure. Long-term results were studied in 19 patients, in 94.7% of who complete obliteration of sclerotized veins and improvement of the clinical course of chronic venous disease were recorded. Conclusion. Mechanochemical scleroobliteration has proven to be an effective method of treatment for lower extremity VVD being a minimally invasive procedure.

Evaluation and Management of Patients with Leg Swelling: Therapeutic Options for Venous Disease and Lymphedema

2021 ◽  
Vol 38 (02) ◽  
pp. 189-193
Author(s):  
Kimberly Scherer ◽  
Neil Khilnani
Keyword(s):  
Lower Extremity ◽  
Interstitial Fluid ◽  
Therapeutic Options ◽  
Venous Disease ◽  
Lower Extremity Edema ◽  
Common Condition ◽  
Common Causes ◽  
Subcutaneous Tissues ◽  
Venous Disorders

AbstractLower extremity swelling is a common condition which has a variety of etiologies and can be challenging to diagnose and manage. Swelling is usually the result of the accumulation of interstitial fluid in the subcutaneous tissues. Common etiologies include systemic, superficial, and deep venous, and lymphatic disorders. Leg swelling can occur bilaterally or unilaterally, with venous disorders being one of the most common causes of unilateral lower extremity edema.

Diagnostic and prognostic potential of the use of ultrasound and three-dimensional endo-visualization in women with pelvic varicose veins

GYNECOLOGY ◽  
2019 ◽  
Vol 21 (5) ◽  
pp. 59-64
Author(s):  
Aleksandr I Gus ◽  
Dmitrii A Stupin ◽  
Andrei A Semendiaev ◽  
Mariia A Cherepanova ◽  
Natalia V Akudovich
Keyword(s):  
Varicose Veins ◽  
Three Dimensional ◽  
Pathological Process ◽  
Venous System ◽  
Control Group ◽  
Lower Abdomen ◽  
History Of ◽  
The Right ◽  
Selection Of ◽  
Significant Factors

Aim. To study the diagnostic and prognostic potential of the complex use of ultrasound and 3D laparoscopy in women with pelvic varicose veins (PVV). Outcomes and methods. The study included 100 women who were divided into two groups: the main group (39 patients with various severity PVV) and the control group (61 women with no venous system disorders). All patients had a complete clinical examination with the selection of pairs that had the most significant factors for the disease prognosis: average age over 35 years, history of varicose veins, pain in the lower abdomen, dysmenorrhea and dyspareunia. Examination of the small pelvis venous system included duplex angioscanning and retrograde endoscopic functional test controlled by the three-dimensional image. Multivariate analysis (logistic regression) was used to identify normative phlebological parameters. Results. Predictors of early PVV are the following rations: Vmax in the cava-ovarian segment / Vmax in the right ovary portal ≥ 8.3 and Vmax in the reno-ovarian segment /Vmax in the left ovarian portal ≥ 8. The severity of PVV is determined by a progression of alterations in hemodynamic parameters in the main ovarian veins and a spreading venous congestion in the small pelvis plexuses. Conclusions. Criteria of small pelvis phlebohemodynamics make it possible to predict a development of PVV and a severity of the pathological process. Ovarian varicose veins are characteristic of early PVV and venous plethora of all pelvis venous plexuses is characteristic of late PVV.

Varicose veins and chronic venous insufficiency

VASA ◽  
2009 ◽  
Vol 38 (4) ◽  
pp. 293-301 ◽  
Author(s):  
Partsch
Keyword(s):  
Chronic Venous Insufficiency ◽  
Venous Insufficiency ◽  
Varicose Veins ◽  
Single Case ◽  
Clinical Stage ◽  
Clinical Signs ◽  
Venous System ◽  
High Recurrence Rate ◽  
Therapeutic Concepts ◽  
Venous Disorders

Varicose veins are a very frequent disorder with prevalence in our adult population between 14 % for large varices and 59 % for small teleangiectasias. Subjective symptoms may be very non-specific. The term “chronic venous insufficiency (CVI)” defines functional abnormalities of the venous system producing advanced symptoms like oedema, skin changes or leg ulcers. Both entities, varicose veins and CVI, may be summarized under the term “chronic venous disorders” which includes the full spectrum of morphological and functional abnormalities of the venous system. A classification system to describe chronic venous disorders regarding clinical appearance, etiology, anatomical distribution and pathophysiology has been proposed under the acronym of CEAP. The revised version of the CEAP classification contains also definitions of clinical signs and suggests three levels of apparative investigations adjusted to the clinical stage. Concerning the etiology of venous disorders controversial theories exist leading to different therapeutic concepts. As a matter of fact there is a vicious circle between structural changes in valves and venous wall and hemodynamic forces leading to reflux and venous hypertension. Different methods for treating varicose veins are available producing satisfactory early outcome in most cases, but followed by a high recurrence rate after years. Chronic venous insufficiency requires “chronic management”. Compression therapy by bandages for initial treatment of severe stages and maintenance therapy using medical compression stockings is essential. In addition correction of venous refluxes by surgery or endovenous procedures including echo-guided foam sclerotherapy should be considered in every single case.

Outcome assessment after varicose veins treatment

Phlebologie ◽  
2008 ◽  
Vol 37 (04) ◽  
pp. 205-209 ◽  
Author(s):  
J.-J. Guex
Keyword(s):  
Patient Reported Outcomes ◽  
Varicose Veins ◽  
Clinical Status ◽  
Simple Manner ◽  
Instrumental Assessment ◽  
Patient Reported ◽  
History Of ◽  
Severity Of The Disease ◽  
Venous Disorders

SummaryIt is a general problem in chronic venous disorders (CVD) that there are very few solid outcomes, and that there is no simple manner to evaluate the severity of the disease. Many items must be taken into account: clinical status, anatomy, haemodynamics, prevention of complications, risk of recurrence, patients’ preferences, cost effectiveness, and most of all, patients’ main concerns relief.Assessment through physician reported outcomes has been the most common for decades but a fundamental progress has been made when patient reported outcomes have been described, validated and used. We consider that evaluation–not only of results, but also of the natural history of CVD–cannot be done by a single, physician driven, tool, and that it must include: clinical assessment, instrumental assessment and most of all patient reported outcomes such as quality of life scales. The SQOR-V, developed and validated by our team, serves specifically this latter goal. Use of such an instrument, specifically designed for CVD reduces biases in clinical studies and improves the value of evidences.

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