Prevalence and factors associated with chronic venous insufficiency, leg ulceration and deep‐vein thrombosis among people who inject drugs in London, UK

2021 ◽  
Author(s):  
Jason Doran ◽  
Vivian Hope ◽  
Talen Wright ◽  
Jenny Scott ◽  
Daniel Ciccarone ◽  
...  
2020 ◽  
Vol 19 (3) ◽  
pp. 139-143
Author(s):  
M. Yu. Zhukov ◽  
N. N. Mitrakov ◽  
P. A. Zharkov

Post-thrombotic syndrome (PTS) is one of the most significant complications that develops in patients after deep vein thrombosis. Patients with PTS have persistent and often worsening chronic venous insufficiency which can lead to permanent impairment of the affected organ, tissue or limb. Despite their importance, the issues of diagnosis and prevention of PTS in children are understudied in Russia. This paper is based on the analysis of recently published data and presents the current state of affairs regarding PTS in pediatrics.


2016 ◽  
Vol 32 (4) ◽  
pp. 227-233 ◽  
Author(s):  
Huw OB Davies ◽  
Matthew Popplewell ◽  
Rishi Singhal ◽  
Neil Smith ◽  
Andrew W Bradbury

Introduction Lower limb venous disease affects up to one half, and obesity up to one quarter, of the adult population. Many people are therefore affected by, and present to health services for the treatment of both conditions. This article reviews the available evidence of pathophysiological and clinical relationship between obesity and varicose veins, chronic venous insufficiency and ulceration and deep vein thrombosis. Methods A literature search of PubMed and Cochrane libraries was performed in accordance with PRISMA statement from 1946 to 2015, with further article identification from following cited references for articles examining the relationship between obesity and venous disease. Search terms included obesity, overweight, thrombosis, varicose veins, CEAP, chronic venous insufficiency, treatment, endovenous, endothermal, sclerotherapy, bariatric surgery and deep vein thrombosis. Results The proportion of the population suffering from lower limb venous disease and obesity is increasing. Obesity is an important risk factor for all types of lower limb venous disease, and obese patients with lower limb venous disease are more likely to be symptomatic as a result of their lower limb venous disease. The clinical diagnosis, investigation, imaging and treatment of lower limb venous disease in obese people present a number of challenges. The evidence base underpinning medical, surgical and endovenous management of lower limb venous disease in obese people is limited and such treatment may be associated with worse outcomes and increased risks when compared to patients with a normal body mass index. Conclusion Lower limb venous disease and obesity are both increasingly common. As such, phlebologists will be treating ever greater numbers of obese patients with lower limb venous disease, and clinicians in many other specialties are going to be treating a wide range of obesity-related health problems in people with or at risk of lower limb venous disease. Unfortunately, obese people have been specifically excluded from many, if not most, of the pivotal studies. As such, many basic questions remain unanswered and there is an urgent need for research in this challenging and increasingly prevalent patient group.


1992 ◽  
Vol 30 (3) ◽  
pp. 9-12

Deep vein thrombosis (DVT) is a common event in hospital patients.1 The diagnosis is often missed, and its most serious sequel, fatal pulmonary embolism (PE) is still detected in 10% of hospital autopsies.2–3 DVT also commonly leads to chronic venous insufficiency and venous ulceration, treatment of which costs the NHS about £600 million a year.4 Deep vein thrombosis can be prevented in 60–75% of surgical patients,5 but many different prophylactic regimens are used, and some surgeons still use none.6 We discuss here who should receive prophylaxis, how it should be given, and review the treatment of established venous thrombosis.


Author(s):  
S. P. Zotov ◽  
N. B. Shishmentsev ◽  
V. V. Vladimirskiy ◽  
V. Yu. Bogachev

Introduction. The adjustable non-extensible compression bandage is a new product recently registered and approved for clinical use in the Russian Federation. The main indications for its use are severe chronic venous insufficiency and lymphedema, which cannot be corrected with traditional bandages and flat knit medical compressions. On the affected limb, an adjustable, non-extensible compression bandage allows high working pressure to be created at low, approaching zero, resting pressure. And depending on the tension of the velcro fastener, the working pressure can be adjusted between 20 and 50 mmHg or more. At the same time, the patient can maintain the actual pressure independently, regardless of the reduction in the volume of the limb. Low resting pressure makes it possible to use this type of bandage all day without the discomfort that is typical for traditional bandages and therapeutic compression knitwear felt by patients during sleep.Clinical case. Patient diagnosed with chronic lymphovenous insufficiency in both lower limbs. CEAP class C5 on the left, CEAP class C5 on the right. After undergoing acute iliofemoral thrombosis on the left, complicated by thromboembolism of small branches of the pulmonary artery, he was treated in a specialized vascular unit, where anticoagulant, antiplatelet and phlebotropic therapy was carried out. After the second episode of deep vein thrombosis, pain in the lower extremities, swelling of the tibia, skin itching and the appearance of small trophic ulcers started to worry, which temporarily closed against the background of increased compression therapy, prescription of phlebotropic drugs and local treatment. Subsequently, large trophic ulcers were formed on the inner surface of both shins above the ankle joint. An adjustable, non-extensible compression bandage was used on the right shin to correct chronic venous insufficiency and heal a trophic ulcer. The use of an adjustable, non-extensible compression bandage within 2 to 4 weeks resulted in the disappearance of chronic swelling, reduction of the pain syndrome, and then 5 months later – led to a reduction in trophic ulcer and the disappearance of infection signs.Conclusions. This clinical case of the successful closure of a large infected trophic ulcer that occurred after deep vein thrombosis against the background of coxarthrosis and which remained unhealed for 7 years clearly illustrates the broad possibilities of an adjustable, nonextensible compression bandage.


MedComm ◽  
2021 ◽  
Author(s):  
Bin Wang ◽  
Li Zhang ◽  
Shanye Yin ◽  
Wenjun Deng ◽  
Mingxing Xie

1981 ◽  
Author(s):  
R W Barnes ◽  
D G Turley ◽  
G D Qureshi ◽  
M J Fratkin

Recurrent deep vein thrarbosis must be differentiated from other causes of leg pain, swelling and inflammation, including chronic venous insufficiency or the postphlebitic stasis syndrome. Venous obstruction and/or valvular incompetence was evaluated by Dcppler ultrasound in 229 patients with recurrent leg symptoms following one or more prior episodes of clinical deep vein thrombosis. The diagnostic sensitivity and specificity of the Dcppler technique was 96% and 90%, respectively, in 259 consecutive contrast phlebograms. In a subset of 65 patients with abnormal Dcppler examination, I-125 fibrinogen leg scans were performed prior to institution of anticoagulants in order to establish the diagnosis of recurrent active thrarbosis (positive scan) or inactive postphlebitic disease (negative sca.In the 229 symptomatic patients screened, the Dcppler examination was normal in 87 (38.0%). In 65 patients with abnormal deep veins receiving I-125 fibrinogen, leg scans were positive in 25 (38.5%), suggesting active thrarbosis which was treated by anticoagulants. The remaining 40 patients were treated for the postphlebitic syndrome with leg elevation and elastic support and none developed manife stations of venous thrarboerrbolism.This study suggests that many individuals (38%) with suspected recurrent deep vein thrarbosis have normal leg veins and that the majority (62%) of patients with proven venous abnormalities have inactive (postphlebitic) disease which does not require anti coagulation.


1988 ◽  
Vol 3 (4) ◽  
pp. 265-270
Author(s):  
A. Halevy ◽  
A. Zelikovski ◽  
D. Modai ◽  
Y. Swissgarten ◽  
R. Orda

Two patients with angio-access for haemodialysis in whom the main venous outflow tract was thrombosed, developed severe chronic venous insufficiency (CVI) of the upper limb after a short period; one case developing a stasis ulcer of the cubital fossa. The angio-accesses were still functioning when the diagnosis was made. Treatment by surgery resulted in a dramatic regression of clinical signs of chronic venous insufficiency. CVI of the upper limb has not previously been described. CVI is a frequent and known complication after deep vein thrombosis (DVT) of the lower limbs, but never appears after DVT of the upper limbs. We describe two cases of upper limb CVI which developed as a complication of angio-access for haemodialysis treatment, and their successful treatment by surgery.


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