Correlation of haemodynamics and ankle mobility with clinical classes of clinical, aetiological, anatomical and pathological classification in venous disease

2008 ◽  
Vol 23 (3) ◽  
pp. 120-124 ◽  
Author(s):  
G Cavalheri ◽  
J M P de Godoy ◽  
C E Q Belczak
Keyword(s):  
Volume Fraction ◽  
Lower Limbs ◽  
Clinical State ◽  
P Value ◽  
Venous Disease ◽  
Pathological Classification ◽  
Group I ◽  
Venous Diseases ◽  
Ankle Mobility ◽  
Caucasian Women

Objectives To correlate venous haemodynamic parameters of lower limbs and amplitude of ankle mobility with the clinical, aetiological, anatomical and pathological classification (CEAP) for venous disease. Methods Two hundred and eighty-four lower limbs of 142 Caucasian women were evaluated and distributed in six groups according to the CEAP classification: Group I = C0 and C1 ( n = 24); Group II = C2 ( n = 30); Group III = C3 ( n = 27); Group IV = C4 ( n = 23); Group V = C5 ( n = 20) and Group VI = C6 ( n = 18). Goniometric examinations of ankle joints and air plethysmography (APG) were performed. Analysis of variance and the Bonferroni correction, Kruskal-Wallis' non-parametric and Dunn tests were utilized for statistical analysis with the level of significance being set at 5% ( P value < 0.05). Results There were significant restrictions in ankle mobility seen by goniometry at the C5 stage. In addition, significant changes in the venous-filling index were identified at C2, changes in the ejection fraction at C4 and changes in the residual volume fraction at the C4 stage. Conclusion The evolution of the clinical state of ankles affected by venous diseases is correlated to a reduction of joint mobility and haemodynamic alterations identified using APG.

Association between obesity and the aggravation of limited range of ankle mobility in chronic venous disease

2021 ◽  
pp. 026835552110553
Author(s):  
Sergio Q Belczak ◽  
Rubiana Neves Ramos ◽  
Jose Maria Pereira de Godoy
Keyword(s):  
Varicose Veins ◽  
Limited Range ◽  
Lower Limbs ◽  
Chronic Venous Disease ◽  
Venous Disease ◽  
Limited Joint Mobility ◽  
Group Iii ◽  
Group I ◽  
Significant Difference ◽  
Ankle Mobility

Aim The aim of the present study was to show that an increase in weight leads to the aggravation of limited joint mobility. Method One hundred sixteen patients with varicose veins of the lower limbs and body mass index (BMI) higher than 30 kg/m2 were evaluated at the Belczak Clinic in Maringá, Brazil. All patients were evaluated by the same physician, and the goniometric readings were performed on all patients by a physiotherapist. The participants were then divided into three groups based on BMI: Group I—BMI between 30 and 40. Group II—BMI between 40 and 50, and Group III—BMI > 50. Results There is a significant difference between the groups detected. Conclusion The present findings show that an increased BMI in obese individuals with chronic venous disease is associated with a progressive limitation of ankle mobility.

scholarly journals Contribution of textile technology to the development of modern compression bandages

2007 ◽  
Vol 13 (2) ◽  
pp. 88-102 ◽  
Author(s):  
Svetlana Milosavljevic ◽  
Petar Skundric
Keyword(s):  
Compression Therapy ◽  
Lower Limbs ◽  
Venous Disease ◽  
Clinical Effects ◽  
Textile Materials ◽  
Compression Bandages ◽  
Venous Diseases ◽  
Textile Technology ◽  
Key Factor ◽  
Application Techniques

Although compression therapy is a key factor in the successful treatment of some circulatory problems in lower limbs, this form of therapy includes some risks if used inappropriately. Based on deliberate application of pressure to a lower limb, using a variety of textile materials, elastic or rigid, in order to produce a desired clinical effects, modern compression therapy presents a good sample of successful penetration of textile technology into the phlebology field of medicine. However, although compression therapy has been in use for over 150 years, there exists a low awareness among practitioners and patients on product usage, application techniques and benefits of appropriate selection of bandages for determined types of leg venous diseases. Also, not all manufacturers of compression textile materials seem to be conscious of end - users' needs. Simultaneously, impressive developments in the field of elastan fibers and modern knitting and weaving technologies, offer chances for realization of completely new types of compression bandages, capable of making an important contribution to the management of venous disease. In this review, starting from the brief account of pathogenesis and the presentation of compression therapy principle, an account of the contribution of all sectors in the textile technological chain to a modern compression therapy is given.

scholarly journals Interrelation of venous and osteoarticular pathology in patients with Giacomini's vein

2021 ◽  
Author(s):  
G. V. Yarovenko ◽  
A. I. Zhdanova
Keyword(s):  
Soft Tissues ◽  
Lower Extremities ◽  
Chronic Venous Disease ◽  
Venous Stasis ◽  
Venous Disease ◽  
Pearson Criterion ◽  
The Third ◽  
Group I ◽  
Venous Diseases ◽  
The Relationship

Objective: To establish a possible relationship between the Giacomini vein and osteoarticular pathology of the lower extremities in chronic venous diseases (CVD).Materials and methods. In 115 examined patients (out of 321), we identified the Giacomini vein (92 women, 23 men). The average age of men was 44.82 ± 1.62 years; women – 45.36 ± 3.31 years. All patients were divided into 3 groups by anatomical randomization. The first group was without pathology, the second group of patients had only CVD, and the third group included patients with CVD and osteoarticular pathology. The criteria for inclusion in the groups were: the presence of Giacomini vein in patients, chronic venous disease and osteoarticular pathology on one or both lower extremities. Exclusion criteria: age of patients less than 18 years, the presence of CVD C5-C6 according to the CEAP classification, post-traumatic changes in the osteoarticular system, post-thrombotic transformation of the veins of the lower extremities. Using triplex angioscanning, the anatomical features of the structure of the venous system of the lower extremities were assessed. The study of the condition of the foot was carried out using the Friedland method.Results. Group I with an absolute norm of the venous and osteoarticular systems included 30 people (26 %). The second group consisted of 45 patients (39.22 %) with CVD C0-C4 according to CEAP, and the third group consisted of 40 patients (34.78 %) who, in addition to venous, osteoarticular pathology. Chronic venous diseases in patients of groups II and III were distributed as follows: C0 – 25.6 %; C1 – 16.4 %; C2 – 49.4 %; C3 – 4.3 %; C4 – 4.3 % on the CEAP scale. Among the osteoarticular pathology, the most numerous group consisted of changes in the configuration of the foot, non-traumatic deformities – 32 (27.81 %) cases. To confirm the relationship between venous and osteoarticular pathology, we used the Pearson criterion. We found a significant correlation in the presence of nontraumatic deformities of the foot in the group of patients with CVD (Pearson's criterion 0.749642; p < 0.22). A strong correlation was established between the age of patients and changes in the venous and osteoarticular systems of the lower extremities (Pearson's criterion 0.7677696; p < 0.22), which confirms the relationship between the development of nontraumatic changes in the foot and CVD in patients with Giacomini vein with age.Conclusion. It was found that the presence of an altered Giacomini vein leads to an aggravation of venous stasis in the lower extremities, which in turn increases the likelihood of developing venous pathology. Chronic diseases of the veins of the lower extremities contribute to dystrophic changes in soft tissues, most pronounced in the distal part of the extremity and, as a consequence, predispose to the development of osteoarticular pathology. 

Primary and secondary lymphoedema in male patients with oedema in lower limbs

2006 ◽  
Vol 21 (3) ◽  
pp. 127-131 ◽  
Author(s):  
C Bolcal ◽  
H Iyem ◽  
M Sargin ◽  
I Mataraci ◽  
S Doganci ◽  
...  
Keyword(s):  
Age Distribution ◽  
Young Male ◽  
Lower Extremities ◽  
Diagnostic Techniques ◽  
Lower Limbs ◽  
Venous Disease ◽  
Concomitant Disease ◽  
Venous Diseases ◽  
Male Patients ◽  
Klippel Trenaunay Syndrome

Objective: The purpose of this prospective study was to evaluate patients with clinically diagnosed lymphoedema of the lower extremities. The proportions of primary and secondary lymphoedema, the possible aetiologic factors and the concomitance of chronic venous diseases and lymphoedema were focused on. Method: The male patients who attended our outpatient clinic during 2000 and 2004 were evaluated. In all, 160 male patients with 5 cm circumference difference at calf level between two lower extremities or with clinically diagnosed bilateral leg oedema were enrolled. All patients underwent duplex venous ultrasonography and lymphoscintigraphy. Venography was performed in 12 patients with normal lymphoscintigraphy and ultrasonography. Results: The age distribution was between 20 and 54 years (mean ± SD; 22.9 ± 4.3). Among 160 patients, 70.0% had lymphoedema, while 7.5% had chronic venous insufficiency, 3.75% chronic deep venous thrombosis, 7.5% concomitant venous disease and lymphatic obstruction, and 7.5% idiopathic oedema. In the last 3.75% the pathology was Klippel–Trenaunay syndrome. Of the primary lymphoedema patients (16.25%), 18 were praecox, six tarda and two were congenital types. Conclusion: In young male patients, the causes of secondary lymphoedema are lymphadenectomy, neoplastic metastasis, cellulitis, lymphangitis, etc. Further techniques confirmed the clinical diagnosis of lymphoedema in 77.5% (sum of lymphoedema and concomitant disease) of all patients. With these findings lymphoedema can be diagnosed clinically, and further diagnostic techniques can be reserved unless treatment is effective.

scholarly journals Relapse of varicose veins of lower extremities

2018 ◽  
Vol 11 (3) ◽  
pp. 183-185
Author(s):  
Galina Viktorovna Yarovenko ◽  
Alexey Vitalievich Fesun
Keyword(s):  
Varicose Veins ◽  
Statistical Significance ◽  
Young Patients ◽  
Lower Extremities ◽  
Chronic Venous Disease ◽  
Venous Disease ◽  
Group I ◽  
Venous Diseases ◽  
Varicose Disease ◽  
Group Ii

According to modern data, there are no signs of chronic venous disease in only 15.9% of people. Observing the clinical data of recent years, there is a tendency to increase the number of people with venous diseases and, unfortunately, the number of young patients is increasing (there are data that schoolchildren of the senior classes have signs of varicose transformation in 10-15%). Polymorphism of matrix metalloproteinase-12 is a key link in the pathogenesis of varicose veins.We conducted surveys of 50 patients. The average age is 43.7 ± 15.9 years, of them women 32, men 18 people. All patients with the class C2-C6 varicose veins (CEAP-classifier) ​​were divided into two groups by the method of serial sampling: group I (n = 20) - with relapse of varicose veins; Group II (n = 30) - patients treated with varicose disease for the first time. The only exception was patients with deferred vein thrombosis. Ultrasound diagnosis of the main veins of the lower extremities and genomic analysis of blood samples of patients was used.The obtained results confirm that in patients of the I group the MMP-12 gene occurs in 80% of cases (homo- and heterozygous variation), whereas in group II only in 33.3% of cases. The Pearson consensus criterion is 10.4 (the critical value of the criterion is 6.63). The significance level of this relationship corresponds to p <0.01. The statistical significance of the frequency of recurrence of varicose disease and the MMP-12 gene was established using the Spearman rank correlation coefficient, which is equal to 1,000 (criterion value is 0.398). Dependence of signs is statistically significant, with p <0.05

scholarly journals Rehabilitation of patients with venous diseases of the lower limbs: State of the art

2018 ◽  
Vol 33 (10) ◽  
pp. 663-671 ◽  
Author(s):  
Alberto Caggiati ◽  
Marianne De Maeseneer ◽  
Attilio Cavezzi ◽  
Giovanni Mosti ◽  
Nick Morrison
Keyword(s):  
Lower Limbs ◽  
Chronic Venous Disease ◽  
Motor Deficits ◽  
Venous Disease ◽  
Complex Issue ◽  
Surgical Interventions ◽  
Venous Diseases ◽  
Psychosocial Conditions ◽  
Venous Disorders

Background To date, no document comprehensively focused on the complex issue of the rehabilitation of chronic venous diseases of the lower limbs. Method This article overviews and summarizes current strategies concerning venous rehabilitation of lower limbs. Results Venous rehabilitation is based on four main strategies: (1) lifestyle adaptations and occupational therapies; (2) physical therapies; (3) adapted physical activities; (4) psychological and social support. Rehabilitative protocols must be tailored to the specific needs of each patient, depending on the severity of chronic venous disease and on the location and pattern of venous lesion(s), but also on age, motor deficits, co-morbidities and psychosocial conditions. Conclusions Venous rehabilitation consists of non-pharmacologic and non-surgical interventions aiming at prevention of venous disease progression and complications, reduction of symptoms and improvement of quality of life. Well-designed clinical trials are required to evaluate the efficacy of the described rehabilitative protocols in influencing the evolution of venous disorders.

scholarly journals Some features of compression therapy for early forms of chronic venous diseases of the lower limbs

2019 ◽  
pp. 89-94 ◽  
Author(s):  
V. Yu. Bogachev ◽  
B. V. Boldin ◽  
N. R. Arkadan ◽  
V. N. Lobanov
Keyword(s):  
Class Ii ◽  
Calf Muscle ◽  
Lower Limbs ◽  
Class I ◽  
Venous Disease ◽  
Compression Garments ◽  
Pump Function ◽  
Muscle Pump ◽  
Calf Muscle Pump ◽  
Venous Diseases

The current compression garment selection guide is targeted at the earliest clinical stages of chronic venous disease (CVD) and assumes a priori that application of a higher class of compression improves the calf muscle pump function, which is the major mechanism promoting venous return from the lower limb to the heart.Objective of the study: to evaluate the calf muscle pump function in patients with the early forms of CVD using different classes of compression garments.Material and methods: A total of 30 patients (45 lower limbs) with Class 1 CVD (CEAP classification) were enrolled in the study. The calf muscle pump function was evaluated during wearing compression garments using remote cableless photoplethysmography of Bodytronic measurement system (Bauerfeind, Germany) with automatic data processing. The investigators measured venous refilling time (T0) and pump capacity (V0) in patients without compression garments and also in those wearing classes 0, I and II compression garments (RAL standard, Venotrain micro, Bauerfiend socks). All indicators were measured three times with an interval of 30 minutes. The final values of T0 and V0 were calculated as average.Results and discussion: when the indicators were measured without compression and with zero compression, T0 was 26.7 ± 1.2 sec and 25.4 ± 1.1 sec (p = 0.56); V0 - 8.6 ± 0.7% and 8.0 ± 0.4% (p = 0.47). When the calf muscle pump function indicators were measured using class I compression garments, its performance was improved. Thus, T0 and V0 (p <0.01) increased significantly to 38.9 ± 2.1 sec and 12.9 ± 1.4%, respectively. When the calf muscle pump function indicators were measured using class II compression garments, T0 and V0 were 38.1 ± 1.6 sec and 8.1 ± 0.6%. Thus, the use of class I compression garments significantly improved the calf muscle pump function in patients with early manifestations of CVD. The higher level of compression (class II) did not improve T0 and worsened V0. This fact can be explained by excessive compression of the muscular venous sinuses caused by wearing class 2 compression garments, which, apparently, worsened the propulsive ability of the calf pump.Conclusion: the use of class I compression garments is optimal for the management of hemodynamic disorders in patients with early forms of chronic venous diseases (C1 according to CEAP). The higher class of compression does not improve the hemodynamic parameters of the calf muscle pump.

scholarly journals Generation of reactive oxygen species by a sufficient, insufficient and varicose vein wall.

2011 ◽  
Vol 58 (1) ◽  
Author(s):  
Wirginia Krzyściak ◽  
Mariusz Kózka
Keyword(s):  
Reactive Oxygen Species ◽  
Free Radicals ◽  
Varicose Veins ◽  
Reactive Oxygen ◽  
Chronic Venous Disease ◽  
Clinical State ◽  
Venous Disease ◽  
Oxygen Species ◽  
Vein Wall ◽  
Venous Diseases

Despite numerous theories, the etiology and pathogenesis of primary varicose veins remain unclear. The etiology of chronic venous diseases (CVDs) known as chronic venous insufficiency (CVI) is related to leukocyte trapping. Leukocyte trapping involves trapping of white cells in vessel walls followed by their activation and translocation outside the vessel. Release of reactive oxygen species (ROS) from trapped white cells has been documented. Superoxide dismutase (SOD) directly inhibits the generation of free radicals and compounds that are produced during oxidation by ROS, such as malonyldialdehyde (MDA). The aim of this study was to determine the involvement of free radicals in the etiology of venous changes. The following material was used for the study: fragments of sufficient or insufficient venous system and varices from 31 patients diagnosed with chronic venous disease in the 2nd or 3rd degree, according to clinical state, etiology, anatomy and pathophysiology (CEAP), which were qualified for surgical procedure. The levels of oxidative stress markers strongly correlated with lesions observed by USG in insufficient and varicose veins. In both a higher concentration of MDA was observed, which is a sign of lipid peroxidation. Antioxidative mechanisms, SOD activity and total antioxidative power expressed as FRAP were inversely proportional to MDA concentration. In insufficient and varicose veins both FRAP and SOD activities were significantly lower than in normal veins. The severity of clinical changes was inversely dependent on the efficiency of scavenging of ROS, which additionally proves the participation of free radicals in pathogenesis of CVDs.

scholarly journals Comparative assessment of the clinical efficacy of first-generation phlebotonics in the complex treatment of patients with chronic venous diseases of the lower limbs

2019 ◽  
pp. 96-103
Author(s):  
S. E. Katorkin ◽  
P. N. Myshentsev ◽  
O. E. Lisin ◽  
A. A. Rozanova
Keyword(s):  
Clinical Efficacy ◽  
First Generation ◽  
Clinical Symptoms ◽  
Pain Syndrome ◽  
Comparative Assessment ◽  
Lower Limbs ◽  
Complex Treatment ◽  
Group I ◽  
Venous Diseases ◽  
Group Ii

Target. Comparative assessment of the clinical efficacy of Aescusan I generation phlebotonics application in the complex treatment of patients with CVD.Material and methods. Analysis of treatment of 380 patients who applied for a phlebological appointment at the polyclinic department of SamSMU Clinics for the period from September 2017 to March 2019 was conducted. Group I (n = 104) included patients with even outpatient card numbers who were prescribed Troxevasin as a first-generation phlebotonic according to the scheme recommended by manufacturers Group II (n = 276) included patients with odd outpatient card numbers who were prescribed Aescusan (an extract of horse chestnut seeds Aesculus hippocastanum, active ingredient of which is aescin) as phlebotonics of the first generation according to the scheme recommended by the manufacturers. All patients were examined by a phlebologist before and after 1 course of treatment. Clinical efficacy of the therapy was assessed by the severity of the pain syndrome, feeling of heaviness, swelling and seizures using visual analogue scale (VAS). In addition, the effectiveness of conservative therapy was assessed through interviews and questionnaires. For a comparative assessment of the severity of edema syndrome, the lower limb circumference was measured at ankle level using a graduated tape.Results. No side effects were detected during clinical observation of the use of drugs. After the course of treatment, most of the observations showed positive dynamics. Changes in clinical symptoms (pain, seizures, heavy legs) in Group I were statistically unreliable (p>0.05). In the second group there was a decrease of pain syndrome intensity by 73,2%, a decrease of convulsions - by 63,5%, a decreaseof heaviness feeling – by 73,7%. In the course of the survey, 272 patients (98.5%) of Group II evaluated the treatment results as good, 4 patients (1.5%) did not notice any treatment results.In the course of repeated examination after the treatment 96,5% of doctors noted the result in Group II as good, 3,5% - as satisfactory. Conclusion. Thus, the results of complex treatment of patients with CVD showed that the use of 1st generation phlebotonics should be considered not only as pathogenetically justified, but also effective from the clinical point of view. Application of Aescusan drug leads to statistically significant reduction of clinical symptoms (subjective and objective) of lower limbs CVD. 

Treatment Peculiarity of the Chronic Trophic Ulcers with Different Pathogenic Mechanism

2020 ◽  
Vol 62 (1) ◽  
pp. 12-16
Author(s):  
Oksana K. Melekhovets ◽  
Tetyana O. Kharchenko ◽  
Victor F. Orlovskiy ◽  
Iuirii V. Melekhovets ◽  
Alevtina S. Radko ◽  
...  
Keyword(s):  
Photodynamic Therapy ◽  
Healing Process ◽  
Modern Medicine ◽  
Lower Limbs ◽  
Chronic Venous Disease ◽  
Venous Disease ◽  
Second Stage ◽  
Group 2

Introduction: Trophic ulcers of the lower extremities are an unresolved problem of modern medicine. The treatment of this pathology requires new methods that optimize care regimens and improve patients’ quality of life. Aim: The study to improve efficacy of treatment of the patients with trophic ulcers of the lower limbs with consideration to pathogenesis. M aterials and Methods: The study included 32 patients with chronic venous disease C6 (1st group) and 31 with diabetes mellitus type 2, moderate severity, compensation stage with diabetic foot syndrome II stage according to Wagner’s classification (2nd group). In addition to basic therapy in both groups photodynamic therapy was added at the first stage of the study, and at the second stage plasma rich in growth factors was prescribed. Results: At baseline evaluating of the chronic venous disease demonstrates that a total score in patient of the 1st group was 20,9 points on a modified VCSS scale; after two weeks – 15,71 points (improvement by 24.83%), and 6 weeks after–9,72 points (improvement by 53.49%). In patients with DM (2nd group) at the baseline a total score average was 13,91 points according to S(AD)SAD-1 scale; after 2 weeks – 12,29 (improvement by 11,65%), after 6 weeks – 6,39 points (improvement by 54,06%). Conclusions: The inclusion of photodynamic therapy and plasmatherapy in complex therapy in both groups led to a significant improvement of the healing process and helps to reduce the depth and area of the wound surface. However, the wound healing in patients in group 2 was slower.

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