Current practice in treating chronic venous disease by Canadian vascular surgeons

2018 ◽  
Vol 34 (6) ◽  
pp. 414-420
Author(s):  
Gary K Yang ◽  
Jerry C Chen
Keyword(s):  
Full Range ◽  
Perceived Barriers ◽  
Chronic Venous Disease ◽  
Venous Disease ◽  
Compression Stockings ◽  
Web Based ◽  
Endovenous Ablation ◽  
Training Background ◽  
Current Guidelines ◽  
Question Survey

Objective To evaluate the practice patterns and interests of vascular surgeons in Canada in the treatment of chronic venous disorder. Methods A web-based 19-question survey was sent to 155 active members of the Canadian Society for Vascular Surgery. Questions assessed training background, interest in venous disease, practice site, venous treatments offered, and obstacles to therapy. Results A total of 64 responses (41%) were acquired. Respondents were roughly equal from academic (55%) and community (45%) sites with an even distribution of years in practice. Only 43% offered full range of therapy, which includes compression stockings, sclerotherapy, vein surgery, and endovenous ablation. The main challenges hindering venous practice include lack of time due to overwhelming arterial pathologies (67%), equipment cost/office space limitations (53%), and lack of knowledge or skills in contemporary procedures (28%). The majority of surgeons felt that their residency and fellowship did not prepare them for an active venous practice (69%). Fifty-four percent of the respondents perceived barriers in getting venous ultrasound imaging for their patients. Only 19% of the surgeons find venous disease interesting. Characteristics of these interested surgeons were analyzed and found to be very different from surgeons who did not expressed interest. An overwhelming 92% of all respondents believe that vascular surgeons should be leaders in delivering care for venous disease. Conclusion The treatment of chronic venous disorder has advanced over the last few decades but significant obstacles exist for Canadian surgeons to deliver venous therapy in accordance with current guidelines.

European College of Phlebology guideline for truncal ablation

2019 ◽  
Vol 35 (2) ◽  
pp. 73-83 ◽  
Author(s):  
A Kürşat Bozkurt ◽  
Martin Lawaetz ◽  
Gudmundur Danielsson ◽  
Andreas M Lazaris ◽  
Milos Pavlovic ◽  
...  
Keyword(s):  
Relevant Literature ◽  
Chronic Venous Disease ◽  
Current Evidence ◽  
Cochrane Library ◽  
Venous Disease ◽  
Foam Sclerotherapy ◽  
Level Of Evidence ◽  
Grade Scale ◽  
Long Term Follow Up ◽  
Endovenous Ablation

Background The purpose of the guideline was to achieve consensus in the care and treatment of patients with chronic venous disease, based on current evidence. Method A systematic literature search was performed in PubMed, Embase, Cinahl, and the Cochrane library up until 1 February 2019. Additional relevant literature were added through checking of references. Level of evidence was graded through the GRADE scale and recommendations were concluded. Results For the treatment of great and small saphenous vein reflux, endovenous ablation with laser or radiofrequency was recommended in preference to surgery or foam sclerotherapy. If tributaries are to be treated it should be done in the same procedure. Treatment with mecanicochemical ablation and glue can be used but we still need long term follow up results. Conclusion For the treatment of truncal varicosities, endovenous ablation with laser or radiofrequency combined with phlebectomies is recommended before surgery or foam.

scholarly journals CHRONIC VENOUS INSUFFICIENCY

10.23856/3217 ◽  
2019 ◽  
Vol 32 (1) ◽  
pp. 131-136
Author(s):  
Antoni Stadnicki ◽  
Martin Rusnák ◽  
Anna Stadnicka
Keyword(s):  
Chronic Venous Insufficiency ◽  
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

scholarly journals Reduction of Pain and Edema of the Legs by Walking Wearing Elastic Stockings

2015 ◽  
Vol 2015 ◽  
pp. 1-4 ◽  
Author(s):  
Carlos Alberto Carvalho ◽  
Renata Lopes Pinto ◽  
Maria de Fatima Guerreiro Godoy ◽  
Jose Maria Pereira de Godoy
Keyword(s):  
Signs And Symptoms ◽  
Chronic Venous Disease ◽  
Rank Test ◽  
Venous Disease ◽  
Water Displacement ◽  
Compression Stockings ◽  
Signed Rank ◽  
Reduction Of Pain ◽  
Signed Rank Test ◽  
Elastic Stockings

Aim. The objective of the current study was to evaluate the reduction of edema and pain with the use of elastic stockings.Method. The effect of walking on a treadmill for 50 minutes in the evening wearing elastic compression stockings on pain and edema was evaluated in a prospective randomized crossover clinical trial. In Assessment 1, the legs of participants were measured by volumetry at 7:00 a.m. and they were asked to perform their normal daily activities and to return at 4:00 p.m. Forty-two legs of 21 female patients with ages of the participants ranged from 32 to 72 years with signs and symptoms of chronic venous disease. The sizes of the legs of all patients were evaluated by water displacement volumetry and a visual analog scale was used to assess pain.Results. After walking for 50 minutes on the treadmill, the volume reduced (pairedt-test:pvalue < 0.03). In relation to pain, there was a reduction in pain after the treadmill session using the elastic stocking (Wilcoxon signed rank test:pvalue < 0.007).Conclusion. The reduction of edema and pain of the legs during the course of the day can be accomplished with the use of elastic stockings, as well as walking.

Frequency of use of elastic compression stockings in patients with chronic venous disease of the lower extremities

2019 ◽  
Vol 34 (7) ◽  
pp. 481-485
Author(s):  
Marco Antonio Ayala-García ◽  
Jorge Sanchéz Reyes ◽  
Norberto Muñoz Montes ◽  
Eduardo Guaní-Guerra
Keyword(s):  
Analytical Study ◽  
Lower Extremities ◽  
Chronic Venous Disease ◽  
Sufficient Evidence ◽  
Medical Attention ◽  
Venous Disease ◽  
Compression Stocking ◽  
Compression Stockings ◽  
Elastic Compression ◽  
Frequency Of Use

Objective To determine the frequency of use of elastic compression stockings in patients with lower extremity chronic venous disease. Methods An explorational, prospective, transversal, observational, descriptive, analytical study including 168 patients was performed. We identified the proportion of patients using elastic compression stockings. The odds ratio (OR) was used to determine the relation between elastic compression stocking use and previous medical attention for chronic venous disease. Results Only 59 patients (35.1%) were using elastic compression stockings at the time of the study. We determined that the patients who had received previous medical attention to manage chronic venous disease in their lower extremities were >3 times more likely to use elastic compression stockings than patients who had not received previous medical attention (OR = 3.3, p < 0.0001). Conclusions Although there is sufficient evidence of the effectiveness of elastic compression stockings for treating chronic venous disease in the lower extremities, their use is relatively infrequent (35.1%).

Long-Term Prevention of Sequelae of Chronic Venous Disease with Graduated-Compression Stockings

1997 ◽  
Vol 31 (4) ◽  
pp. 451-455 ◽  
Author(s):  
Terrance P. Hanley ◽  
Jonathan Kiev ◽  
Janet C. Rice ◽  
Morris D. Kerstein
Keyword(s):  
Chronic Venous Disease ◽  
Venous Disease ◽  
Compression Stockings ◽  
Graduated Compression Stockings

Anatomical and clinical factors favoring the performance of saphenous ablation and microphlebectomy or sclerotherapy as a single-stage procedure

2014 ◽  
Vol 30 (9) ◽  
pp. 627-631 ◽  
Author(s):  
AA Kokkosis ◽  
H Schanzer
Keyword(s):  
Saphenous Vein ◽  
Great Saphenous Vein ◽  
Varicose Veins ◽  
Class I ◽  
Chronic Venous Disease ◽  
Venous Disease ◽  
Class Iii ◽  
Endovenous Ablation ◽  
Secondary Procedures ◽  
Extensive Class

Objective To identify the anatomical and clinical parameters that predict lack of regression of superficial varicosities after ablation of the great saphenous vein. Methods Symptomatic patients treated with endovenous ablation from August 2006 to July 2013, by a single surgeon, were included. Recorded parameters included age, sex, size, and extent of varicosities (class I–IV) (patient standing), and diameter and length (patient supine) of treated great saphenous vein. Varicose vein classification was defined as: class I ≤6 mm and localized to thigh or leg, class II ≤6 mm and present in the thigh and leg (extensive), class III >6 mm and localized to the thigh or leg, and class IV >6 mm and extensive. “Excellent” results were defined as complete resolution of varicosities, “good” results as incomplete resolution, and “poor” results as no improvement. Results A total of 267 patients and 302 consecutive limbs were included in the study. There were 175 females (65.5%), and the mean age was 54 years old (22–92). The CEAP classification was as follows: C2 (81.5%), C3 (6.3%), C4 (7.9%), C5 (2.0%), and C6 (2.3%). Great saphenous vein diameters was significantly larger in patients with C3–C6 (proximal 0.84 ± 0.25 versus 0.65 ± 0.21, p = < 0.0001, distal 0.58 ± 0.18 versus 0.44 ± 0.13, p < 0.0001) or class III–IV varicose veins (proximal 0.85 ± 0.25 versus 0.75 ± 0.27, p = 0.012, distal 0.62 ± 0.62 versus 0.50 ± 0.17, p < 0.0001). Class III–IV limbs had a “good/poor” result 69.8% of the time, as compared to 51.9% of the limbs class I–II varicose veins (p = 0.002). Conclusions Advanced chronic venous disease (C3–C6) patients have larger diameter great saphenous veins, reflecting the progressive nature of the disease. Patients with more severe varicosities regardless of CEAP class were more likely to require a secondary procedure. The severity of the varicosities may not correlate with the degree of venous disease, but it is an indication of which patients should undergo secondary procedures, possibly with a one-stage approach.

Effects of Kinesio Taping and compression stockings on pain, edema, functional capacity and quality of life in patients with chronic venous disease: a randomized controlled trial

2020 ◽  
Vol 34 (6) ◽  
pp. 783-793
Author(s):  
Baha Naci ◽  
Semiramis Ozyilmaz ◽  
Nadir Aygutalp ◽  
Rengin Demir ◽  
Gul Baltaci ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Functional Capacity ◽  
Short Form ◽  
Chronic Venous Disease ◽  
Control Group ◽  
Venous Disease ◽  
Compression Stockings ◽  
Kinesio Taping ◽  
Experimental Group

Objective: The aim of this study was to compare the effects of Kinesio Taping and compression stockings on pain, edema, functional capacity and quality of life in patients with chronic venous disease (CVD). Design: This is a prospective, randomized, controlled, single-blind clinical trial. Setting: The study was conducted in a physiotherapy and rehabilitation unit of a university hospital. Subjects: A total of 62 patients with early-stage CVD were allocated to either an experimental group or a control group. Interventions: Experimental group ( n = 29) received Kinesio Taping intervention once a week for four weeks, while control group ( n = 29) received compression stockings for four weeks. All patients additionally undertook an exercise training programme including calf muscle pump exercises, flexibility exercises and diaphragmatic breathing. Main measures: Visual analogue scale, lower limb circumference measurements, 6-minute walk test and Short Form 36 questionnaire were applied before and after four weeks of treatment. Results: Control group showed statistically significant improvements in pain ( P < 0.001), ankle circumferences (right, P = 0.002; left, P = 0.037), calf circumferences (right, P = 0.020; left, P = 0.022), knee circumference (left, P = 0.039) and thigh circumferences (right, P = 0.029; left, P = 0.002) compared with experimental group. There were no significant differences between groups with respect to functional capacity and quality of life ( P > 0.05). Both groups significantly improved 6-minute walk distance ( P < 0.001) and Short Form 36 physical component summary (experimental group, P = 0.002; control group, P = 0.006). Conclusion: This study demonstrated that Kinesio Taping and compression stockings revealed similar improvements of functional capacity and quality of life in patients with CVD. The symptoms of pain and edema caused by CVD can be decreased more efficiently with compression stockings than Kinesio Taping intervention.

scholarly journals Therapeutic approach in patients with chronic venous insufficiency

2017 ◽  
Vol 12 (2) ◽  
pp. 28-32
Author(s):  
Marilena SPIRIDON ◽  
◽  
Dana CORDUNEANU ◽  
Keyword(s):  
Chronic Venous Insufficiency ◽  
Venous Insufficiency ◽  
Thrombus Formation ◽  
Venous Pressure ◽  
External Pressure ◽  
Chronic Venous Disease ◽  
Venous Disease ◽  
Compression Stockings ◽  
Venous Valve ◽  
Severe Stage

Chronic venous insufficiency (CVI), frequent cause of lower limb edema, represents a severe consequence of the dysfunction of the venous valve, which results from the venous hypertension together with the degenerative processes at this level. CVI defines only the severe stages of the chronic venous disease (CVD), accompanied by morphological and functional damage, with significant alteration in quality of life. The treatment of CVI involves, depending on the severity of the case, a combination of general nonpharmacologic, pharmacologic, and surgical measures. Non-pharmacologic measures involve the use of a continuous and controlled external pressure represented by compression stockings which can significantly improve the venous return and lead to a major symptoms improvement. Pharmacologic treatment aims on one hand to alleviate hemodinamics by lowering blood viscosity, decreasing venous pressure and preventing intravascular thrombus formation and, on the other hand, restoring thevascular glycocalyx/endothelium, reducing parietal inflammation and increasing the venous wall tone. Within this pathology, sulodexide represents an innovative biological product with polypharmacological actions targeting more sites involved in the pathogenesis of CVD/CVI that alleviate hemodynamics and restore vascular structure which lead to a significant symptoms improvement and a slow disease progression. Surgery remains the procedure of choice in patients initially treated conservatively in whom symptoms persist or worsen, but also in case of those who already come to doctor in a severe stage of the disease.

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