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

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.

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

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.

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

2000 ◽  
Vol 32 (5) ◽  
pp. 954-960 ◽  
Author(s):  
Nicos Labropoulos ◽  
Athanasios D. Giannoukas ◽  
Kostas Delis ◽  
Steven S. Kang ◽  
M.Ashraf Mansour ◽  
...  
Keyword(s):  
Saphenous Vein ◽  
Clinical Signs ◽  
Signs And Symptoms ◽  
Chronic Venous Disease ◽  
Venous Disease ◽  
Vein System ◽  
Clinical Signs And Symptoms ◽  
The Impact

Predicted burden of venous disease

2016 ◽  
Vol 31 (1_suppl) ◽  
pp. 74-79 ◽  
Author(s):  
Sarah Onida ◽  
Alun Huw Davies
Keyword(s):  
Varicose Veins ◽  
Clinical Signs ◽  
Signs And Symptoms ◽  
Chronic Venous Disease ◽  
Venous Disease ◽  
Venous Ulceration ◽  
Increased Risk ◽  
Future Burden ◽  
Clinical Signs And Symptoms

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.

scholarly journals Clinical and Haemodynamic Sequelae of Deep Venous Thrombosis: Retrospective Evaluation after 7–13 Years

1997 ◽  
Vol 93 (1) ◽  
pp. 7-12 ◽  
Author(s):  
M. C. H. Janssen ◽  
J. H. Haenen ◽  
W. N. J. C. Van Asten ◽  
H. Wollersheim ◽  
F. M. J. Heijstraten ◽  
...  
Keyword(s):  
Venous Thrombosis ◽  
Deep Venous Thrombosis ◽  
Clinical Symptoms ◽  
Clinical Signs ◽  
Signs And Symptoms ◽  
Chronic Venous Disease ◽  
Venous Disease ◽  
International Consensus ◽  
Pump Function ◽  
Patients At Risk

1. In contrast to the extensive documentation on diagnosis and treatment of deep venous thrombosis (DVT), information about long-term complications, clike the post-thrombotic syndrome (PTS), is scarce. Most studies report on clinical examination only, whereas adequate haemodynamic investigation is lacking. Therefore 81 patients with venographically confirmed lower extremity DVT were clinically and haemodynamically reexamined 7–13 years after DVT (mean 10 years) to assess PTS. Interest was focused on the relation between clinical and haemodynamic PTS and the relation between location of the initial DVT and incidence of PTS. 2. Clinical signs and symptoms of PTS were classified according to the latest consensus of the international consensus committee on chronic venous disease. Non-invasive venous vascular laboratory tests were performed to assess the venous outflow resistance and calf muscle pump function (CMP). CMP was determined by the supine venous pump function test (SVPT). 3. Clinically only 20 of 81 patients (25%) were asymptomatic, 34 (42%) had mild PTS (class 1–3), 25 (31%) moderate PTS (class 4) and 2 (2%) severe PTS (class 5–6); 57% had an abnormal CMP. Both the severity of clinical symptoms and the haemodynamic abnormalities were related to the location of the initial thrombus. Of the patients with distal DVT 11% developed moderate clinical PTS and 39% developed an abnormal CMP. CMP and difference in CMP between post-thrombotic and non-thrombotic leg were significantly related to the different classes of PTS. 4. This study indicates that 7–13 years after DVT 31% of the patients had moderate and 2% had severe clinical PTS, while 57% of the patients had abnormal haemodynamic findings (both related to the initial site of the thrombosis). Secondly, it reveals that the risk of PTS after distal DVT is not negligible, which causes concern about not diagnosing and treating patients with distal DVT. Thirdly, we have demonstrated that a functional test, such as the SVPT, is a sensitive test to assess post-thrombotic damage. Therefore its use as a screening tool after a period of DVT should be investigated to select patients at risk of PTS.

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

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.

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.

Endovenous management of varicose veins

2004 ◽  
Vol 19 (4) ◽  
pp. 163-169 ◽  
Author(s):  
S Soumian ◽  
A H Davies
Keyword(s):  
Varicose Veins ◽  
Signs And Symptoms ◽  
Venous Hypertension ◽  
Chronic Venous Disease ◽  
Venous Disease ◽  
Foam Sclerotherapy ◽  
High Prevalence ◽  
Promising Treatment ◽  
Developed World

Objective: Chronic venous disease has made a considerable socio-economical impact in the developed world due to its high prevalence and cost of management. Venous hypertension gives rise to significant signs and symptoms that are indications for treatment. Though the mainstay of treatment currently is surgery, it may not be the ideal choice in some cases considering the heterogeneous spectrum of venous disease. Recent alternative endovenous treatments have shown a lot of promise in successfully treating this condition. The aim of this review was to assess the long-term effectiveness of these treatments. Methods: A Medline-based review of literature was carried out. Results: Foam sclerotherapy seems to be a very promising treatment for venous disease, as short-term results have shown good results in terms of outcomes, low morbidity and cost. New endovenous techniques such as radiofrequency and laser ablation are attractive considering the absence of groin scar and subsequent neovascularization, as well as very little bruising and discomfort. Conclusions: There is no clear evidence yet regarding the long-term effectiveness of these relatively new endovenous techniques.

Programme for detecting chronic venous insufficiency in Belgium

2007 ◽  
Vol 22 (4) ◽  
pp. 171-178 ◽  
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.

scholarly journals Triage of patients with venous and lymphatic diseases during the COVID-19 pandemic – The Venous and Lymphatic Triage and Acuity Scale (VELTAS)

2020 ◽  
Vol 35 (8) ◽  
pp. 550-555
Author(s):  
Kurosh Parsi ◽  
Andre M van Rij ◽  
Mark H Meissner ◽  
Alun H Davies ◽  
Marianne De Maeseneer ◽  
...  
Keyword(s):  
Massive Pulmonary Embolism ◽  
Vascular Anomalies ◽  
Chronic Venous Disease ◽  
Venous Disease ◽  
International Consensus ◽  
Vein Thrombosis ◽  
Venous Compression ◽  
Global Pandemic ◽  
Lymphatic Diseases ◽  
Clinical Conditions

The coronavirus disease 2019 (COVID-19) global pandemic has resulted in diversion of healthcare resources to the management of patients infected with SARS-CoV-2 virus. Elective interventions and surgical procedures in most countries have been postponed and operating room resources have been diverted to manage the pandemic. The Venous and Lymphatic Triage and Acuity Scale was developed to provide an international standard to rationalise and harmonise the management of patients with venous and lymphatic disorders or vascular anomalies. Triage urgency was determined based on clinical assessment of urgency with which a patient would require medical treatment or surgical intervention. Clinical conditions were classified into six categories of: (1) venous thromboembolism (VTE), (2) chronic venous disease, (3) vascular anomalies, (4) venous trauma, (5) venous compression and (6) lymphatic disease. Triage urgency was categorised into four groups and individual conditions were allocated to each class of triage. These included (1) medical emergencies (requiring immediate attendance), example massive pulmonary embolism; (2) urgent (to be seen as soon as possible), example deep vein thrombosis; (3) semi-urgent (to be attended to within 30–90 days), example highly symptomatic chronic venous disease, and (4) discretionary/non-urgent- (to be seen within 6–12 months), example chronic lymphoedema. Venous and Lymphatic Triage and Acuity Scale aims to standardise the triage of patients with venous and lymphatic disease or vascular anomalies by providing an international consensus-based classification of clinical categories and triage urgency. The scale may be used during pandemics such as the current COVID-19 crisis but may also be used as a general framework to classify urgency of the listed conditions.

Chronic venous disease: Correlation between ultrasound findings and the clinical, etiologic, anatomic and pathophysiologic classification

2013 ◽  
Vol 29 (8) ◽  
pp. 522-527 ◽  
Author(s):  
Predrag A Matić ◽  
Hristina D Vlajinac ◽  
Jelena M Marinković ◽  
Miloš Ž Maksimović ◽  
Đorđe J Radak
Keyword(s):  
Clinical Signs ◽  
Duplex Ultrasound ◽  
Cross Sectional Study ◽  
Chronic Venous Disease ◽  
Venous Disease ◽  
Strongly Correlated ◽  
Cross Sectional ◽  
Venous Ulcers ◽  
Final Study ◽  
Color Duplex Ultrasound

Objective The aim of the study was to investigate association between clinical manifestation of chronic venous disease and the presence and severity of functional venous disease. Method A cross-sectional study was conducted in 14 towns in Serbia. All men and women aged >18 years, consecutively coming to venous specialists (47 specialists) were included in the study. Patients who were previously treated for chronic venous disease were excluded. Patients were classified according to the clinical category of clinical, etiologic, anatomic and pathophysiologic classification for chronic venous disease. Reflux and/or obstruction were determined by using a color duplex ultrasound. Results The study included 1679 chronic venous disease patients. Color duplex ultrasound was performed in 1029 (61.3%) of them who formed the final study group. Reflux was found in 76.8% of patients – 53.1% had reflux in superficial, 7.2% in deep and 16.1% in perforator veins. Obstruction was found in 31.9% of patients – superficial in 14.8% of patients and deep in 16.9%. Deep obstruction was even found in clinical, etiologic, anatomic and pathophysiologic C0s-C1 categories. Reflux and obstruction combined were revealed in 19.1% of patients. Reflux in deep and perforator veins and reflux and obstruction combined were significantly associated with clinical, etiologic, anatomic and pathophysiologic clinical categories being the most frequent in patients with venous ulcers. Conclusion Clinical, etiologic, anatomic and pathophysiologic clinical categories of chronic venous disease are strongly correlated with functional disease especially with reflux in deep and perforator veins, and reflux and obstruction combined. The presence of deep obstruction in patients with chronic venous disease belonging to clinical, etiologic, anatomic and pathophysiologic C0s-C1 category could justify recommendation for color duplex ultrasonography in all patients with symptoms of chronic venous disease but without clear clinical signs.

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