Distribution patterns of pathological venous reflux and risk factors in patients with skin changes due to primary venous disease in North India

2020 ◽  
pp. 026835552095719
Author(s):  
Prashant Jain ◽  
Ajay Savlania ◽  
Arunanshu Behera ◽  
Ujjwal Gorsi
Keyword(s):  
Risk Factors ◽  
Lifestyle Modification ◽  
Duplex Ultrasound ◽  
Distribution Patterns ◽  
North India ◽  
Chronic Venous Disease ◽  
Venous Disease ◽  
Venous Reflux ◽  
Skin Changes ◽  
Prolonged Standing

Objectives To determine the distribution patterns of pathological venous reflux and risk factors in patients with skin changes due to primary venous disease. Methods Two hundred limbs belonging to C4, C5 & C6 classes were examined with duplex ultrasound to determine the sites of reflux. We also analyzed the correlation of risk factors with patterns and severity of disease. Results Among 200 limbs, superficial system reflux was found in 163 limbs (81.5%), deep system reflux in 10 limbs (5%) and perforator system reflux in 180 limbs (90%). The most common pattern of abnormality was combined superficial and perforator system reflux. Of all the risk factors, prolonged standing, obesity and in the female history of pregnancy preceding varicose occurrence had the highest prevalence. Conclusions In patients with primary chronic venous disease, lifestyle modification is required to avoid risk associated with obesity and prolonged standing. The higher prevalence of pathological perforator reflux in association with advanced venous disease necessitates careful treatment of this least reported pathology to achieve better treatment results.

Epidemiology of chronic venous disease

2008 ◽  
Vol 23 (3) ◽  
pp. 103-111 ◽  
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.

Valsalva maneuver in phlebologic practice

2017 ◽  
Vol 33 (2) ◽  
pp. 75-83 ◽  
Author(s):  
Stefano Ricci ◽  
Leo Moro ◽  
Girolamo C Minotti ◽  
Raffaele A Incalzi ◽  
Marianne De Maeseneer
Keyword(s):  
Reverse Flow ◽  
Valsalva Maneuver ◽  
Duplex Ultrasound ◽  
Standing Position ◽  
Sample Volume ◽  
Chronic Venous Disease ◽  
Venous Disease ◽  
Forced Expiration ◽  
Venous Reflux ◽  
Saphenofemoral Junction

Forced expiration against an airway obstruction was originally described as a method for inflating the Eustachian tubes and is accredited to Antonio Maria Valsalva (1666–1723). The Valsalva maneuver is commonly applied for different diagnostic purposes. Its use for phlebologic diagnosis is the object this review. Venous reflux is the most frequent pathophysiologic mechanism in chronic venous disease. Reflux is easily visualized by duplex ultrasound when properly elicited, in standing position. A simple way to elicit reflux is the so-called “compression-release maneuver”: by emptying the muscle reservoir, it determines a centrifugal gradient, dependent on hydrostatic pressure, creating an aspiration system from the superficial to the deep system. The same results are obtained with dynamics tests activating calf muscles. The Valsalva maneuver elicits reflux by a different mechanism, increasing the downstream pressure and, thus, highlighting any connection between the source of reflux and the refluxing vessel. The Valsalva maneuver is typically used to investigate the saphenofemoral junction. When the maneuver is performed correctly, it is very useful to analyse several conditions and different hemodynamic behaviours of the valvular system at the saphenofemoral junction. Negative Valsalva maneuver always indicates valvular competence at the saphenofemoral junction. Reverse flow lasting during the whole strain (positive Valsalva maneuver) indicates incompetence or absence of proximal valves. Coupling Valsalva maneuver to compression-release maneuver, with the sample volume in different saphenofemoral junction sections, may reveal different hemodynamic situations at the saphenofemoral junction, which can be analysed in detail.

An Epidemiological Survey of Venous Disease Among General Practitioner Attendees in Different Geographical Regions on the Globe: The Final Results of the Vein Consult Program

Angiology ◽  
2018 ◽  
Vol 69 (9) ◽  
pp. 779-785 ◽  
Author(s):  
Marc E. Vuylsteke ◽  
Roos Colman ◽  
Sarah Thomis ◽  
Geneviève Guillaume ◽  
Damien Van Quickenborne ◽  
...  
Keyword(s):  
Risk Factors ◽  
Western Europe ◽  
Positive Family History ◽  
Patient Characteristics ◽  
Epidemiological Survey ◽  
Chronic Venous Disease ◽  
Venous Disease ◽  
Prolonged Standing ◽  
Geographical Regions ◽  
Birth Control Pills

This study measured the prevalence of chronic venous disease (CVD, C1-C6), chronic venous insufficiency (C3-C6) in 23 countries. The possible influence of risk factors was assessed. Patient recruitment was carried out by general practitioners. Patient characteristics, prevalence of risk factors, and C-classification were recorded. We assessed differences in prevalence and risk factors between Asia (A), Eastern Europe (EE), Latin America (LA), and Western Europe (WE). A total of 99 359 patients were included. The prevalence of CVD (51.9% A, 70.18% EE, 68.11% LA, and 61.65% WE) was significantly ( P < .001) lower in A. Risk factors such as age, obesity, smoking, having regular exercise, use of birth control pills, prolonged standing and sitting, and having a positive family history differ significantly between regions. After model-based probabilities corrected for risk factors, significant differences in the probability of having CVD were only found in the older age-group (>65 years). The lowest prevalence was noted in A. Chronic venous disease is very common and the prevalence varies between different geographical areas. After correcting for risk factors, these differences diminished.

Duplex ultrasound investigation of the veins in chronic venous disease of the lower limbs – UIP Consensus Document. Part II: Anatomy

2006 ◽  
Vol 21 (4) ◽  
pp. 168-179 ◽  
Author(s):  
A Cavezzi ◽  
N Labropoulos ◽  
H Partsch ◽  
S Ricci ◽  
A Caggiati ◽  
...  
Keyword(s):  
Lower Limb ◽  
Duplex Ultrasound ◽  
Lower Limbs ◽  
Chronic Venous Disease ◽  
Specific Reference ◽  
Venous Disease ◽  
Perforating Veins ◽  
Consensus Document ◽  
Wide Range ◽  
Ultrasound Investigation

Objectives: Duplex ultrasound investigation has become the reference standard in assessing the morphology and haemodynamics of the lower limb veins. The project described in this paper was an initiative of the Union Internationale de Phlébologie (UIP). The aim was to obtain a consensus of international experts on the methodology to be used for assessment of the anatomy of superficial and perforating veins in the lower limb by ultrasound imaging. Design: Consensus conference leading to a consensus document. Methods: The authors performed a systematic review of the published literature on duplex anatomy of the superficial and perforating veins of the lower limbs. Afterwards, they invited a group of experts from a wide range of countries to participate in this project. Electronic submissions from the authors and the experts (text and images) were made available to all participants via the UIP website. The authors prepared a draft document for discussion at the UIP Chapter meeting held in San Diego, USA, in August 2003. Following this meeting, a revised manuscript was circulated to all participants and further comments were received by the authors and included in subsequent versions of the manuscript. Eventually, all participants agreed on the final version of the paper. Results: The experts have made detailed recommendations concerning the methods to be used for duplex ultrasound examination as well as the interpretation of images and measurements obtained. This document provides a detailed methodology for complete ultrasound assessment of the anatomy of the superficial and perforating veins in the lower limbs. Conclusions: The authors and a large group of experts have agreed on a methodology for the investigation of the lower limbs venous system, by duplex ultrasonography, with specific reference to the anatomy of the main superficial veins and perforators of the lower limbs in healthy and varicose subjects.

Duplex Ultrasound Scanning for Chronic Venous Disease: I. Techniques for Examination of the Crural Veins

1994 ◽  
Vol 9 (3) ◽  
pp. 108-113 ◽  
Author(s):  
R. W. Ziegenbein ◽  
K. A. Myers ◽  
P. G. Matthews ◽  
G. H. Zeng
Keyword(s):  
Venous Insufficiency ◽  
Outcome Measure ◽  
Varicose Veins ◽  
Duplex Ultrasound ◽  
Chronic Venous Disease ◽  
Venous Disease ◽  
Ultrasound Scanning ◽  
Diagnostic Laboratory ◽  
Non Invasive ◽  
Anterior Tibial

Objective: To describe a practical technique to reliably find and study crural veins by duplex ultrasound scanning. Design: Prospective scanning of patients referred for evaluation of possible chronic deep venous insufficiency. Setting: A non-invasive vascular diagnostic laboratory in Melbourne, Australia. Patients: A study of 1340 legs in 917 consecutive patients referred with primary or recurrent varicose veins, or for evaluation of possible deep venous disease causing aching or swelling in the legs. Interventions: Examination of the crural veins by duplex ultrasound scanning. Main outcome measure: Identification of all three sets of crural veins. Results: Rates for detecting the posterior tibial, anterior tibial and peroneal veins were 97%, 92% and 91% respectively and all three were observed in 91%. If the last 1227 legs studied by colour-Doppler duplex ultrasound are considered, the rates for detection were 98%, 96% and 96% respectively. Conclusion: Examination of the crural veins can be a part of routine duplex ultrasound scanning in patients referred with suspected venous disease.

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.

Major risk factors for chronic venous disease development in women: is childbirth among them?

2019 ◽  
Vol 59 (10) ◽  
pp. 1118-1127
Author(s):  
Milan Matić ◽  
Aleksandra Matić ◽  
Zorica Gajinov ◽  
Zoran Golušin ◽  
Sonja Prćić ◽  
...  
Keyword(s):  
Risk Factors ◽  
Chronic Venous Disease ◽  
Venous Disease ◽  
Disease Development

scholarly journals Duplex ultrasonography scanning for chronic venous disease: Patterns of venous reflux

1995 ◽  
Vol 21 (4) ◽  
pp. 605-612 ◽  
Author(s):  
Kenneth A. Myers ◽  
Robert W. Ziegenbein ◽  
Ge Hua Zeng ◽  
P.Geoffrey Matthews
Keyword(s):  
Chronic Venous Disease ◽  
Duplex Ultrasonography ◽  
Venous Disease ◽  
Venous Reflux ◽  
Disease Patterns

Gravitational Reflux Does Not Correlate with Clinical Status of Venous Stasis

1993 ◽  
Vol 8 (1) ◽  
pp. 2-6 ◽  
Author(s):  
S. Moulton ◽  
J. J. Bergan ◽  
S. Beeman ◽  
R. Poppiti
Keyword(s):  
Clinical Status ◽  
Tertiary Care ◽  
Duplex Ultrasound ◽  
Clinical Severity ◽  
Venous Stasis ◽  
Venous Disease ◽  
Venous Reflux ◽  
Ultrasound Technique ◽  
Cross Sectional ◽  
A Prospective Study

Objective: To quantify venous reflux by a standard duplex ultrasound technique and correlate the data obtained with clinical grades of severity of venous disease. Design: A prospective study in a single group of patients with venous insufficiency. Setting: Private practice in secondary and tertiary care. Patients: 133 inpatients undergoing investigation for venous disease. Patients with known venous obstruction, arterio-venous malformations or lymphoedema were excluded from the study. Main outcome measures: Duplex ultrasound scanning was performed to measure the cross-sectional area, severity and duration of venous reflux following calf compression using a standardized technique. Results: Clinical classification assigned to each limb correlated with the presence of venous reflux, but not the quantity, velocity or duration of reflux in the veins studied. Presence of reflux and diameter of the vein studied correlated ( p<0.001) in all the veins except the popliteal vein ( p > 0.03). Conclusion: Quantification of venous reflux obtained by cuff deflation does not correlate with clinical severity of venous stasis, but does detect reflux accurately. This allowed greater saphenous sparing in nine limbs in 41 patients but proved the need for saphenous removal in seven limbs not previously suspected clinically of requiring this procedure.

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