Epidemiology of Chronic Venous Insufficiency

1996 ◽  
Vol 11 (1) ◽  
pp. 2-5 ◽  
Author(s):  
F. G. R. Fowkes

Objective: To determine the prevalence of chronic venous insufficiency in the general population and its association with varicose veins. Data sources: MEDLINE search 1980–94 plus scanning of reference lists in articles obtained. Study selection: Studies on venous disease in subjects not attending health services. Data synthesis: A formal systematic review of metaanalysis was not carried out because of the heterogeneity of the few available studies. Skin changes were found to occur in over 3% of adults, more so in women than men. The prevalence was higher in subjects with varicose veins and depended on the definition of skin changes and the severity of varicose veins. Approximately 0.3% of adults had an open varicose ulcer, and around 1% had an open or healed ulcer. Prevalence was higher in women and increased with age. Conclusions: The prevalence of chronic venous insufficiency was found to be common in the general population, but more studies of distribution and aetiology are required.

2015 ◽  
Vol 30 (1_suppl) ◽  
pp. 95-97 ◽  
Author(s):  
F Pannier ◽  
E Rabe

Aim To review epidemiologic data on progression of venous pathology in varicose veins and from varicose veins towards chronic venous insufficiency. Methods We searched Medline and PubMed for epidemiologic studies concerning progression of venous pathology. Results The data suggest that reflux progression may develop from segmental to multisegmental superficial reflux. In younger age, reflux in tributaries and non-saphenous veins is more frequent. In older age, more saphenous reflux develops and more proximal sites seem to be affected. A high proportion of uncomplicated varicose vein (C2) develops skin changes and chronic venous insufficiency (C3–C6). Significant risk factors for the progression of varicose vein towards venous leg ulcers are skin changes, corona phlebectatica, higher body mass index and popliteal vein reflux. During a 13.4-year follow-up period, 57.8% (4.3%/year) of all chronic venous disease patients showed progression of the disease. Summary Studies on the progression of venous pathology show a high progression rate of chronic venous disease. More follow-up studies are still needed to get better information about the risk of varicose vein patients for progression to venous leg ulcers and to answer the question which patients may benefit from early varicose vein interventions.


2000 ◽  
Vol 15 (3-4) ◽  
pp. 106-109
Author(s):  
C. V. Ruckley

Objective: To highlight gaps in knowledge concerning the epidemiology of chronic venous insufficiency and to indicate what future studies are required. Methods: Existing classifications are compared. Limitations of epidemiological studies are defined. Data from published series and from the Edinburgh Vein Study are presented. Synthesis: The Basle 1978 classification of chronic venous insufficiency (CVI) is a purely clinical classification in which the earliest grade is corona phlebectatica. The Porter 1988 classification of CVI attempted to correlate clinical grades with sites of venous incompe-tence. However, a consistent relationship does not exist. The CEAP classification separates the clinical grades (which do not include corona phlebectasia) from the anatomical segments. The CEAP clinical classification covers a range of venous manifestations but is not consistent. There is a need for further consideration of classifications. Published selected series of patients show that the frequency of incompetence in both deep and superficial systems increases in proportion to the severity of the clinical manifestations of venous disease. To understand the significance of these data we need to know the patterns of venous incompetence in the general population. Data from 1566 subjects between the ages of 18 and 64 years in the Edinburgh Vein Study, a randomly selected cross-section of members of the Edinburgh population, showed that the prevalence of CVI was age-related and was present in 9.2% of men and 6.6% of women. Men had a significantly higher frequency of reflux in the deep system than women. In order to direct therapeutic interventions where they are most appropriate we need to know which patients with the early stages of varicose veins progress to CVI and which patients with early CVI progress to the serious skin complications. Conclusions: Key information concerning the natural history of venous disease and its evolution in relation to haemodynamic abnormalities awaits the findings of longitudinal-cohort epidemiological studies which include the duplex scanning of large populations.


Author(s):  
Amanda J. Lee ◽  
Lindsay A. Robertson ◽  
Sheila M. Boghossian ◽  
Paul L. Allan ◽  
C. Vaughan Ruckley ◽  
...  

Phlebologie ◽  
2013 ◽  
Vol 42 (01) ◽  
pp. 13-18 ◽  
Author(s):  
S. Schnabl ◽  
A. Strölin ◽  
Ch. Busch

SummaryIntroduction: Varicose veins affect up to 40 % of men and up to 51 % of women. The patho-physiology of primary varicosis (chronic venous insufficiency, CVI) is poorly understood. Here, the available data on possible endocrine mechanisms in healthy and varicose veins are reviewed.Methods: An extensive literature search was conducted in PubMed using the following key words: Chronic venous insufficiency, CVI, chronic venous disease, CVD, varicosis, saphenous vein, pathogenesis, hormone.Results: Several theories ranging from incompetence of the valves to functional, biological or morphologic changes in different layers of the vein wall have been proposed. However, an increasing body of evidence suggests that endocrine mechanisms might be involved in the pathogenesis of primary varicosis. In this respect a growing number of hormones (e.g. estrogen, progesterone, relaxin-2, and oxytocin) and their receptors have been linked to primary varicosis in experimental, pharmacological and histological studies.Conclusion: In summary, endocrine-based mechanisms seem to play a role in the pathogenesis of primary varicosis. This opens up the perspective for pharmacological treatments targeting the various described endocrine regulatory networks.


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

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


1981 ◽  
Author(s):  
C V Ruckley ◽  
H M Crawshaw ◽  
J Seaton

The reproducibility of venous volumetry has been evaluated in 20 normal legs (N), 20 legs with primary varicose veins (W) and 30 with stable post-thrombotic chronic venous insufficiency (CVI).The test has shown significant differences between the groups in mean relative expelled volume (EV rel, ccs): N 1.65 ± SD 0.66; W 1.01 ± 0.40; CVI 0.64 ± 0.39 and in half refilling time (T3 secs): N 23.9 ± 11.5; W 11.8 ± 7.4; CVI 3.6 ± 1.8. The percent coefficients of variation in tests repeated at intervals of up to a month were as follows.The reproducibility of the test confirms its value as a non-invasive means of measuring the severity of postthrombotic venous disease and thus as a means of assessing response to treatment. Serial volumetric tests on 25 patients before and for up to 12 months after Linton operations for chronic venous insufficiency show significant early improvements in expelled volume. But in many of these patients the refilling time tends to remain short indicating residual valvular incompetence and the possibility of clinical relapse in the long term.


2018 ◽  
pp. 469-478
Author(s):  
Abdullah Jibawi ◽  
Mohamed Baguneid ◽  
Arnab Bhowmick

Chronic venous insufficiency (CVI) can result in varicose veins or, if severe, may develop skin changes and leg ulcerations. This chapter details the classification and presentation of varicose veins and venous leg ulcers (CEAP classification). It outlines the recommended investigations for CVI such as handheld Doppler scan and venous duplex ultrasound scans. The management of CVI is to improve the venous and lymphatic flow thereby improving the skin oxygen transport through reducing oedema. This can be performed by graduated compression bandages.


ESC CardioMed ◽  
2018 ◽  
pp. 2805-2806
Author(s):  
Eberhard Rabe ◽  
Felizitas Pannier

Chronic venous diseases are frequent pathologies in the general population. The most common chronic venous pathologies are varicose veins and chronic venous insufficiency including post-thrombotic syndrome. In the general adult population, varicose veins are present in up to 25% of people with an increasing prevalence with age. Risk factors include advanced age, genetic predisposition, female sex, and multiparity. The term chronic venous insufficiency summarizes the clinical signs of chronic venous disease with oedema, skin changes, or venous ulcers. More than 15% of the population is affected by chronic venous insufficiency. Risk factors include advanced age, obesity, and prolonged sitting.


2000 ◽  
Vol 15 (1) ◽  
pp. 2-18 ◽  
Author(s):  
A. Adhikari ◽  
M. H. Criqui ◽  
V. Wooll ◽  
J. O. Denenberg ◽  
A. Fronek ◽  
...  

Objective: To review the prevalence of and risk factors for varicose veins, chronic venous insufficiency (CVI) and venous leg ulcers. Data sources: MEDLINE was searched for the terms prevalence and varicose veins, chronic venous insufficiency, or venous leg ulcers. Study selection: The extant world literature (1966–1999) with a minimum of an available English abstract was collected. Ninety-nine studies were reviewed. Data extraction: Data were extracted on prevalence of diseases of the veins in the lower limb, age and gender of the subject populations, and other risk factors for those diseases examined by the original researchers. Data synthesis: The two most prominent risk factors for venous disease are increasing age and female gender. Additional risk factors for venous disease with at least some documentation in the literature include dietary patterns, obesity, physical activity, standing occupations, constrictive clothing, connective tissue laxity, and hormonal differences, including pregnancy. Family history is also a prominent risk factor, suggesting a genetic component. Conclusions: Varicose veins are found more commonly in women, and with increased age. The increase with age is linear, suggesting a constant incidence and cumulative prevalence. CVI is also more common in women and increases with age, but data are limited. Venous leg ulcers are much less common than varicose veins or CVI and show less of a female preponderance, but increase exponentially with age, suggesting a true increasing incidence with age.


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