scholarly journals Repurposing the systemic venous return model for conceptualisation of chronic venous insufficiency and its management

2020 ◽  
Vol 35 (10) ◽  
pp. 749-751
Author(s):  
Pasha Normahani ◽  
Joseph Shalhoub ◽  
Sriram Narayanan
Keyword(s):  
Chronic Venous Insufficiency ◽  
Venous Insufficiency ◽  
Venous Return ◽  
Systemic Venous Return

scholarly journals Fundamental physiologic concepts of venous hemodynamics and systemic venous return

2020 ◽  
Vol 5 (2) ◽  
Author(s):  
Jovan N Markovic
Keyword(s):  
Venous Insufficiency ◽  
Venous Return ◽  
Substantial Improvement ◽  
Venous System ◽  
Venous Anatomy ◽  
Anatomy And Physiology ◽  
Systemic Venous Return ◽  
The Relationship ◽  
Venous Disorders ◽  
Significant Effort

Understanding the nominal venous anatomy and venous hemodynamics is the first and fundamental step in understanding the pathophysiology of venous disorders. Over the last two decades, significant effort has gone into improving the management of chronic venous disorders resulting in substantial improvement in the management of patients affected by venous insufficiency. Given the continuity of the venous system especially pertinent to the relationship between thoracic, abdominal, pelvic, and infrainguinal venous anatomy, combined with the increasing knowledge we gained regarding hemodynamics of the venous system it is imperative that a comprehensive approach to venous disorders is undertaken that evaluates venous system as a continuum rather than an approach that would evaluate only isolated venous territory affected by a specific venous disorder. Understanding of venous anatomy and physiology, as the basic components for venous hemodynamics, is an essential step to gain insights into venous return concepts, initially described by Dr. Guyton. Dr. Guyton's model represents a fundamental and one of the most significant advancements in our understanding of venous return. This manuscript details essential domains of hemodynamics, which can be useful for validation of our current understanding of systemic venous return.

Physical Therapy in Patients with Chronic Venous Insufficiency

Phlebologie ◽  
2000 ◽  
Vol 29 (02) ◽  
pp. 48-53 ◽  
Author(s):  
M. Jünger ◽  
Anke Steins
Keyword(s):  
Physical Therapy ◽  
Chronic Venous Insufficiency ◽  
Venous Insufficiency ◽  
Ulcus Cruris ◽  
Chronisch Venöse Insuffizienz ◽  
Venöse Insuffizienz ◽  
Venöse Stauung ◽  
Venöse Drainage

ZusammenfassungWenn Maßnahmen der physikalischen Therapie wie rezeptpflichtige Kompressionsstrümpfe und ein angeleitetes ambulantes Gefäßtraining in einem frühen Stadium begonnen werden, können die Beschwerden des Patienten gelindert, die Gelenkbeweglichkeit und venöse Drainage verbessert und behindernde Stauungserkrankungen wie die Dermatolipofasziitis und das Ulcus cruris vermieden werden. Hat eine chronische venöse Stauung einmal zu einer Atrophie der Gelenkkapsel, Sprunggelenksversteifung und Muskelatrophie des Unterschenkels geführt, sind teure Therapiemaßnahmen einschließlich einer professionellen Krankengymnastik unumgänglich. Unseren eigenen Erfahrungen nach ist eine krankengymnastische Behandlung am wirksamsten, wenn sie in Kombination mit einer biomechanischen Stimulation erfolgt. Sobald der Steppergang des Patienten behoben wurde, können herkömmliche Gehübungen nach und nach das physiologische Gangbild wiederherstellen. Nach erfolgreicher Physiotherapie tragen ein ambulantes Gefäßtraining und eine optimierte Kompressionsbehandlung bei Patienten mit fortgeschrittener chronisch venöser Insuffizienz entscheidend zum langfristigen Therapieerfolg bei. Vergleichbar dem Koronarsport werden Gefäßtrainingsprogramme von den öffentlichen Kassen übernommen. Zusammen mit einer Kompressionsbehandlung stellen sie eine wirksame und kosteneffektive Basistherapie für die chronisch venöse Insuffizienz dar.

Causes, complications and treatment methods in chronic venous insufficiency

Medic ro ◽  
2018 ◽  
Vol 1 (121) ◽  
pp. 46
Author(s):  
Cristina Vâjâitu ◽  
Teodora Mareş ◽  
Carmen Cristina Drăghici ◽  
Vlad Mihai Voiculescu ◽  
Călin Giurcăneanu
Keyword(s):  
Chronic Venous Insufficiency ◽  
Venous Insufficiency ◽  
Treatment Methods

Features of postoperative period in patients with chronic venous insufficiency: phlebectomy versus thermal ablation

2020 ◽  
pp. 64-75
Author(s):  
E. Burleva ◽  
O. Smirnov ◽  
S. Tyurin
Keyword(s):  
Postoperative Period ◽  
Chronic Venous Insufficiency ◽  
Thermal Ablation ◽  
Venous Insufficiency ◽  
Clinical Symptoms ◽  
Varicose Veins ◽  
Statistical Processing ◽  
Group 3 ◽  
Group 2 ◽  
Group 1

The purpose of the study was to conduct a comparative assessment of the course of the postoperative period after phlebectomy and thermal ablation in patients with varicose veins of the lower extremities in the system of the great saphenous vein (GSV) with class C2 of chronic venous insufficiency (CVI) — CEAP class C2. Materials and methods: 455 patients (455 limbs) with CEAP class C2. Group 1 (n = 154) received stripping + minimally invasive phlebectomy; Group 2 — endovenous laser ablation (EVLA) of GSV trunk + sclerotherapy of varicose veins; 3 group (n = 150) — radiofrequency ablation (RFA) of the GSV + sclerotherapy. All patients were united by a single tactical solution — the elimination of pathological vertical reflux in GSV. In each group, patients were with similar hemodynamic profile were selected (Group 1 = 63; Group 2 = 61; Group 3 = 61). The course of the postoperative period (from 2 days to 2 months) was compared for pain (visual analog scale — VAS), clinical symptoms of chronic venous insufficiency, degree of satisfaction (Darvall questionnaire), and duration of disability. Statistical processing was carried out using Excel programs for Windows XP, MedCalc® (version 11.4.2.0., Mariakerke, Belgium). Results: Postoperative pain is more pronounced (during day 1 for Group 1–4.0, Group 2–3.0, Group 3–2.0) and more prolonged (up to 4 days) after open surgeries (p < 0.05). The dynamics of the clinical symptoms of CVI (including varicose syndrome and use of compression therapy) could not be fully evaluated in connection with the ongoing sclerotherapy procedures for patients of Groups 2 and 3. Satisfaction of patients with aesthetic aspects was higher than expected in all groups. Reliable statistical differences proved decrease in days of disability (Group 1–14; Group 2–4; Group 3–3) and earlier return to physical activities and work in patients after thermal ablation in comparison with phlebectomy. Conclusion: The study shows that all three methods for eliminating vertical reflux in the GSV can be proposed for a large category of patients with CEAP of class C3 and C2. Medical and social rehabilitation of patients using endovascular thermal ablation technologies proceeds faster, which is beneficial both for the patients and for society.

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