Epidemiology and classification of venous disease

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.

Programme for detecting chronic venous insufficiency in Belgium

10.1258/026835507781477181 ◽

2007 ◽

Vol 22 (4) ◽

pp. 171-178 ◽

Cited By ~ 4

Author(s):

J-C Schoevaerdts ◽

I Staelens

Keyword(s):

Risk Factors ◽

Venous Insufficiency ◽

Average Duration ◽

Clinical Signs ◽

Epidemiological Data ◽

Maximum Amount ◽

Chronic Venous Disease ◽

Venous Disease ◽

Belgian Population ◽

High Level

Objective: Epidemiological study related to the detection of chronic venous disease (CVD) in a Belgian population and gathering of a maximum amount of epidemiological data on CVD. Method: Survey based on a questionnaire completed by a general practitioner during consultation. Results: In total 3813 files of patients with CVD were completed and analysed. Of these patients suffering from CVD, 70% were women with a mean body mass index of 26.2 and a clinical, aetiological, anatomical and pathological elements classification as follows: C0 = 14; 10%; C1 = 14; 19%; C2 = 14; 29%; C3 = 14; 19%; C4 = 14; 16%; C5 = 14; 4%; C6 = 14; 3%. Risk factors, clinical signs, complications and therapeutic approach are analysed and described. Conclusion: High level of statistically analysable data could be obtained within a reasonable period. The study confirms the socioeconomic importance of CVD. For example, an industrial disablement of an average duration of 23.6 days is found in 6% of patients.

Endocrine mechanisms in the pathogenesis of primary varicosis

Phlebologie ◽

10.12687/phleb2123_1_2013 ◽

2013 ◽

Vol 42 (01) ◽

pp. 13-18 ◽

Cited By ~ 3

Author(s):

S. Schnabl ◽

A. Strölin ◽

Ch. Busch

Keyword(s):

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.

CHRONIC VENOUS INSUFFICIENCY

Polonia University Scientific Journal ◽

10.23856/3217 ◽

2019 ◽

Vol 32 (1) ◽

pp. 131-136

Author(s):

Antoni Stadnicki ◽

Martin Rusnák ◽

Anna Stadnicka

Keyword(s):

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

The Epidemiology of Chronic Venous Diseases

10.1177/026835550001500102 ◽

2000 ◽

Vol 15 (1) ◽

pp. 2-18 ◽

Cited By ~ 14

Author(s):

A. Adhikari ◽

M. H. Criqui ◽

V. Wooll ◽

J. O. Denenberg ◽

A. Fronek ◽

...

Keyword(s):

Risk Factors ◽

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.

Epidemiology of chronic venous disease

10.1258/phleb.2007.007061 ◽

2008 ◽

Vol 23 (3) ◽

pp. 103-111 ◽

Cited By ~ 203

Author(s):

L Robertson ◽

C Evans ◽

F G R Fowkes

Keyword(s):

Risk Factors ◽

Varicose Veins ◽

Adult Population ◽

Chronic Venous Disease ◽

Western World ◽

Venous Disease ◽

Venous Ulceration ◽

Prolonged Standing ◽

True Incidence ◽

Disease Definition

Chronic venous disease of the legs occurs commonly in the general population in the Western world. Estimates of the prevalence of varicose veins vary widely from 2–56% in men and from 1–60% in women. These variations reflect differences in variability of study populations including age, race and gender, methods of measurement and disease definition. Definitions of chronic venous disease may rely on reports of varicose veins by study participants, based on self-diagnosis or recall of a diagnosis, or on a standardized physical examination. Venous ulceration is less common, affecting approximately 0.3% of the adult population. Age and pregnancy have been established as risk factors for developing varicose veins. Evidence on other risk factors for venous disease is inconclusive. Prolonged standing has been proposed, but results of studies should be interpreted with caution given the difficulty in measuring levels of posture. Obesity has been suggested as a risk factor in women, but appears to be an aggravating factor rather than a primary cause. Other postulated risk factors include dietary intake and smoking, but evidence is lacking. Longitudinal studies using standardized methods of evaluation are required before the true incidence of chronic venous disease and associated risk factors can be determined.

Prevalence and Risk Factors of Chronic Venous Insufficiency

Angiology ◽

10.1177/0003319701052001s02 ◽

2001 ◽

Vol 52 (1_suppl) ◽

pp. S5-S15 ◽

Cited By ~ 95

Author(s):

F.G.R. Fowkes ◽

C.J. Evans ◽

A.J. Lee

Keyword(s):

Risk Factor ◽

General Population ◽

Venous Insufficiency ◽

Varicose Veins ◽

Adult Population ◽

Adult Life ◽

Chronic Venous Disease ◽

Bowel Habit ◽

Venous Disease ◽

Prolonged Standing

Venous disease in the legs occurs very commonly in the general population in Western countries. Around one third of women have trunk varices. A lower prevalence has been observed in men but some recent surveys have suggested that the occurrence in men may be comparable to that in women. The prevalence increases with age but the incidence of new cases appears to be constant throughout adult life. Open venous ulcers occur in about 0.3% of the adult population and a history of open or healed ulceration occurs in around 1%. The etiology of chronic venous disease in the legs is unknown. A genetic predisposition may be present but evidence for this and for a mode of inheritance is lacking. There is some suggestion that prolonged standing may be a risk factor but studies are open to considerable bias. In women, obesity and previous pregnancy has been associated with the presence of varicose veins but the evidence is inconsistent. There have been few well-conducted studies examining diet and bowel habit as a risk factor. The risk of ulceration is related to the severity of varicosities and venous insufficiency, and is increased following deep vein thrombosis. Much further research is required to investigate the cause of this common condition in the general population.

Progression in venous pathology

10.1177/0268355514568847 ◽

2015 ◽

Vol 30 (1_suppl) ◽

pp. 95-97 ◽

Cited By ~ 18

Author(s):

F Pannier ◽

E Rabe

Keyword(s):

Varicose Vein ◽

Venous Insufficiency ◽

Varicose Veins ◽

Chronic Venous Disease ◽

Venous Disease ◽

Leg Ulcers ◽

Skin Changes ◽

Venous Leg Ulcers

Aim To review epidemiologic data on progression of venous pathology in varicose veins and from varicose veins towards chronic venous insufficiency. Methods We searched Medline and PubMed for epidemiologic studies concerning progression of venous pathology. Results The data suggest that reflux progression may develop from segmental to multisegmental superficial reflux. In younger age, reflux in tributaries and non-saphenous veins is more frequent. In older age, more saphenous reflux develops and more proximal sites seem to be affected. A high proportion of uncomplicated varicose vein (C2) develops skin changes and chronic venous insufficiency (C3–C6). Significant risk factors for the progression of varicose vein towards venous leg ulcers are skin changes, corona phlebectatica, higher body mass index and popliteal vein reflux. During a 13.4-year follow-up period, 57.8% (4.3%/year) of all chronic venous disease patients showed progression of the disease. Summary Studies on the progression of venous pathology show a high progression rate of chronic venous disease. More follow-up studies are still needed to get better information about the risk of varicose vein patients for progression to venous leg ulcers and to answer the question which patients may benefit from early varicose vein interventions.

Diagnosis and treatment of varicose veins and chronic venous insufficiency

Journal of Korean Medical Association ◽

10.5124/jkma.2020.63.12.756 ◽

2020 ◽

Vol 63 (12) ◽

pp. 756-763

Author(s):

Shin-Seok Yang

Keyword(s):

Surgical Treatment ◽

Varicose Vein ◽

Venous Insufficiency ◽

Varicose Veins ◽

Symptom Relief ◽

Venous Pressure ◽

Chronic Venous Disease ◽

High Ligation ◽

Venous Disease

This study aimed to review the pathophysiology of varicose veins and chronic venous insufficiency and the recent surgical treatment trend. Varicose veins are tortuous, twisted, or lengthened veins in the lower extremities. It is part of the spectrum of chronic venous disease. Primary pathogenesis is increased chronic venous hypertension caused by valvular insufficiency, venous outflow obstruction, and calf muscle pump failure. Some patients complain of no symptoms, except report cosmetic concerns. If the varicose vein progresses to chronic venous insufficiency, it may cause edema of the lower limb. The skin lesion can present as hyperpigmentation of the median part of the ankle, congestive dermatitis, and even a skin ulcer. The varicose vein can be diagnosed easily by visual inspection after identifying the skin lesions. For non-surgical treatment, elastic stocking, Unna boots, and pneumatic compression devices are recommended to reduce venous pressure. High ligation with stripping has been the standard treatment for varicose veins to achieve symptom relief and improve cosmetic effects. Endovenous laser ablation, radiofrequency ablation, mechanochemical ablation, and the VenaSeal closure system have been introduced as surgical treatment methods. Recently, endovenous thermal/non-thermal ablations are recommended for treatment because both are less invasive techniques. The appropriate therapy should be selected after considering the patients’ symptoms and signs, anatomical structure, and economic burden of the treatment.

Understanding Chronic Venous Disease: A Critical Overview of Its Pathophysiology and Medical Management

Journal of Clinical Medicine ◽

10.3390/jcm10153239 ◽

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.

Evaluation of Arterial Stiffness Using Pulse Wave Velocity and Augmentation Index in Patients with Chronic Venous Insufficiency

International Journal of Vascular Medicine ◽

10.1155/2018/5437678 ◽

2018 ◽

Vol 2018 ◽

pp. 1-5

Author(s):

Mustafa Dogdus ◽

Onur Akhan ◽

Mehmet Ozyasar ◽

Ahmet Yilmaz ◽

Mehmet Sait Altintas

Keyword(s):

Arterial Stiffness ◽

Pulse Wave Velocity ◽

Wave Velocity ◽

Venous Insufficiency ◽

Pulse Wave ◽

Augmentation Index ◽

Chronic Venous Disease ◽

Venous Disease ◽

High Morbidity

Background and Objectives. Chronic venous insufficiency (CVI) is a common pathology of the circulatory system and is associated with a high morbidity for the patients and causes high costs for the healthcare systems. Arterial stiffness has been shown to be a predictor of cardiovascular events and mortality. The relationship between CVI and arterial stiffness using pulse wave velocity (PWV) and augmentation index (Aix) was evaluated in this study. Methods. Sixty-two patients with the stage of C3-C5 chronic venous disease (CVD) and 48 healthy subjects were enrolled in the study. To assess arterial stiffness, all cases were evaluated with I.E.M. Mobil-O-Graph brand ambulatory blood pressure monitor device. PWV and Aix were used to assess arterial stiffness in this study. Results. The mean age was 61.9±11.05 years and 54 % of the patient population was females. PWV and Aix were significantly higher in CVI patients than controls (8.92±1.65 vs. 8.03±1.43, p=0.001; 25.51±8.14 vs. 20.15±9.49, p=0.003, respectively) and also positive linear correlation was observed between CVI and all measured arterial stiffness parameters (r=0.675 for CVI and PWV, r=0.659 for CVI and Aix, respectively). A PWV value of > 9.2 has 88.9 % sensitivity and 71.4 % specificity to predict the presence of CVI. Conclusions. PWV and Aix are the most commonly used, easy, reproducible, reliable methods in the clinic to assess arterial stiffness. Logistic regression analysis showed that PWV and Aix were the independent predictors of CVI. PWV has the sensitivity of 88.9 % and specificity of 71.4 % to detect the presence of CVI.