Static foot disorders: a major risk factor for chronic venous disease?

2011 ◽  
Vol 27 (1) ◽  
pp. 13-18 ◽  
Author(s):  
J-F Uhl ◽  
M Chahim ◽  
F-A Allaert
Keyword(s):  
Risk Factor ◽  
Daily Practice ◽  
Chronic Venous Disease ◽  
Venous Stasis ◽  
Venous Disease ◽  
Prolonged Standing ◽  
Flat Feet ◽  
Study Population ◽  
Ceap Classification ◽  
Standardized Measurement

Objective To study the relationship between the static foot disorders (SFDs) and chronic venous disease (CVD). Material and methods A retrospective study of 824 feet in unselected 412 patients seen by one phlebologist using a standardized record form. A complete clinical, aetiological, anatomical and pathological elements (CEAP) classification was determined. Alleged venous symptoms were recorded using a 10-point visual analogue scale and scored using a customized questionnaire. A standardized measurement of the Djian-Annonier angle was used to quantify and identify the presence of any static disorder of the foot. Results There were 156 men (37.8%) and 256 women (62.2%) who were included in this study. A majority of patients (59.3%) had a CEAP classification of C3 or greater. Static disorders of the feet were found to be very common in the study population: 137 feet were hollow feet (16.6%) and 120 flat feet (14.5%). Thus, 31% of all of the feet had some form of SFD. A significant correlation was found between the incidence of SFD and body mass index ( P < 0.01), the presence of symptoms ( P<0.001) and prolonged standing during the day (>5 hours, P < 0.05). The severity of the CVD, represented by the CEAP clinical classes, was also found to be very significantly related to the SFD ( P < 0.001). This correlation was found to be independent of age. Conclusion Static disorders of the foot can be considered as an important risk factor that negatively affects CVD. In daily practice, it is often underestimated. This emphasizes the crucial importance of the detection of SFD during the clinical exam of all CVD patients. Correction of static disorders of the feet will improve symptoms due to the SFD, as well as those related to venous stasis. These results can easily be explained by improvement of foot pump efficacy during walking.

Prevalence and Risk Factors of Chronic Venous Insufficiency

Angiology ◽  
2001 ◽  
Vol 52 (1_suppl) ◽  
pp. S5-S15 ◽  
Author(s):  
F.G.R. Fowkes ◽  
C.J. Evans ◽  
A.J. Lee
Keyword(s):  
Risk Factor ◽  
General Population ◽  
Venous Insufficiency ◽  
Varicose Veins ◽  
Adult Population ◽  
Adult Life ◽  
Chronic Venous Disease ◽  
Bowel Habit ◽  
Venous Disease ◽  
Prolonged Standing

Venous disease in the legs occurs very commonly in the general population in Western countries. Around one third of women have trunk varices. A lower prevalence has been observed in men but some recent surveys have suggested that the occurrence in men may be comparable to that in women. The prevalence increases with age but the incidence of new cases appears to be constant throughout adult life. Open venous ulcers occur in about 0.3% of the adult population and a history of open or healed ulceration occurs in around 1%. The etiology of chronic venous disease in the legs is unknown. A genetic predisposition may be present but evidence for this and for a mode of inheritance is lacking. There is some suggestion that prolonged standing may be a risk factor but studies are open to considerable bias. In women, obesity and previous pregnancy has been associated with the presence of varicose veins but the evidence is inconsistent. There have been few well-conducted studies examining diet and bowel habit as a risk factor. The risk of ulceration is related to the severity of varicosities and venous insufficiency, and is increased following deep vein thrombosis. Much further research is required to investigate the cause of this common condition in the general population.

Lower limbs edema among medical students

2019 ◽  
Vol 8 (3) ◽  
pp. 1-5
Author(s):  
Monika Załęcka ◽  
Kacper Lipiński ◽  
Aleksandra Królikowska
Keyword(s):  
Medical Students ◽  
Lower Limb ◽  
High Ambient Temperature ◽  
Lower Limbs ◽  
Chronic Venous Disease ◽  
Venous Disease ◽  
Prolonged Standing ◽  
Limb Edema ◽  
Academic Year ◽  
Exacerbation Of Symptoms

Aim of the study: Chronic venous disease is frequent that affects people of various professions and ages. It consists of a set of symptoms located in the lower limbs, and edema is one of the first and most frequent signs. The aim of this study was to investigate the lifestyle influence on frequency of lower limbs swelling formation among medicine students. Materials and methods: Analysis of questionnaire conducted among 482 students of the academic year 2018/2019 from 12 Polish medicine universities. The survey questions encompass known and possible risk factors of lower limbs edema. CEAP scale was used to assess the severity of chronic venous disease. Results: Lower limb edema occurred in 30% of the respondents, of which 55% stated the exacerbation of symptoms on the days they attended classes. Conclusions: Medical students suffer from edema, it is more common among women. The type of classes affects the manifestation of lower limbs oedema. The factors that have the greatest impact on the formation of edema in students are: prolonged standing or sitting position and high ambient temperature.

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. 

scholarly journals Plasma levels of leucocyte elastase-generated cross linked fibrin degradation products (E-XDP) are elevated in chronic venous disease

PLoS ONE ◽  
2021 ◽  
Vol 16 (12) ◽  
pp. e0261073
Author(s):  
Helen Sinabulya ◽  
Angela Silveira ◽  
Lena Blomgren ◽  
Joy Roy
Keyword(s):  
Reference Group ◽  
Degradation Products ◽  
Chronic Venous Disease ◽  
Enzyme Linked Immunosorbent Assay ◽  
Venous Disease ◽  
Fibrin Degradation Products ◽  
Leucocyte Elastase ◽  
History Of ◽  
Ceap Classification ◽  
Independent Association

Patients with chronic venous disease (CVD) have elevated levels of leucocyte elastase (LE) released from the activation of leucocytes. In acute deep venous thrombosis (DVT), LE can degrade fibrin from the thrombus resulting in cross-linked fibrin degradation products (E-XDP) being released into the bloodstream. In patients with CVD the levels and significance of circulating E-XDP are unknown. We aimed to investigate the association between plasma E-XDP concentration and severity of CVD. Levels of E-XDP were quantified with a specific enzyme-linked immunosorbent assay (ELISA) in plasma from 142 consecutively recruited CVD patients (mean age 64 years, (range 23–89), 81 were females and 61 males). Patients were also divided into three groups based on CVD severity using the C-class of the Clinical-Etiological-Anatomical-Pathophysiological (CEAP) classification, with C 0–1 class as the reference group, C 2–3 as the second group and C 4–6 as the third group with the most severely affected patients. We found significantly elevated levels of E-XDP in patients with C 4–6 compared with patients with C 0–1 (p = 0.007) and increased with increasing disease severity across the groups (p = 0.02). Significant independent association was observed between levels of E-XDP and the classes C 4–6 after adjustment for age and sex (p < 0.05), but the association was no longer significant after further adjustment for use of statins, use of anticoagulants and history of DVT (p = 0.247). This exploratory study shows that E-XDP levels are elevated in patients with CVD, encouraging further studies on the role of E-XDP in CVD.

Prevalence and presentation of chronic venous disease in Pakistan: a multicentre study

2013 ◽  
Vol 28 (2) ◽  
pp. 74-79 ◽  
Author(s):  
A F A Khan ◽  
R Chaudhri ◽  
M A Ashraf ◽  
M S Mazaffar ◽  
S Zawar-ul-Imam ◽  
...  
Keyword(s):  
Risk Factors ◽  
Primary Care Physicians ◽  
Significant Risk ◽  
Cross Sectional Study ◽  
Chronic Venous Disease ◽  
Venous Disease ◽  
Cross Sectional ◽  
Blood Clots ◽  
History Of ◽  
Study Population

Our objective was to study the prevalence and clinical pattern of chronic venous disease (CVD) in the Pakistani population. This was a multicentre cross-sectional study in which 100 primary care physicians examined 3000 subjects. The study population was aged 18–95 years (mean ± SD = 39 ± 13.2) comprised 47.4% women and 52.6% men. The prevalence of CVD was 34.8%, being significantly higher ( P < 0.04) among men (36.4%) than women (33.0%). The maximum prevalence was of C3 (36.7%), followed by C2 (15.8%). The most frequent symptom was pain in the legs (59.2%) followed by heavy legs (42.7%) and night cramps (34.4%). The prevalence of symptoms increased with age but was similarly distributed between men and women. Family history of CVD, blood clots in veins and lack of exercise were significant risk factors. The roles of age or gender as risk factors could not be established. In conclusion, the prevalence and presentation of CVD in Pakistan is similar to most other countries.

Can we predict and prevent the postthrombotic syndrome?

VASA ◽  
2021 ◽  
Vol 50 (1) ◽  
pp. 11-21
Author(s):  
Tomasz Urbanek ◽  
Nicos Labropoulos
Keyword(s):  
Risk Factor ◽  
Prediction Models ◽  
Late Complications ◽  
Current Approach ◽  
Chronic Venous Disease ◽  
Postthrombotic Syndrome ◽  
Venous Disease ◽  
Risk Factor Modification ◽  
Vein Thrombosis ◽  
Prediction And Prevention

Summary: Postthrombotic syndrome (PTS) remains one of the major late complications of deep vein thrombosis (DVT) with a reported prevalence from 10 to 50%. Many factors were found to be related with the development and severity of PTS such as ipsilateral recurrent DVT, advanced age, obesity, ilio-femoral DVT and primary chronic venous disease presence. Some PTS prediction models have been proposed based on risk factor weight. However, it is still difficult to predict which patient with DVT will develop PTS and thus, the clinical application of these models remains limited. Among the identified problems the heterogeneity of the DVT patient population together with the variety of PTS clinical presentations and difficulties concerning PTS severity assessment should be mentioned. Difficulties on the implementation of the specific and objective PTS identification method have also the significant influence on the research focusing on PTS prevention modalities including risk factor modification, compression treatment, anticoagulation and invasive DVT treatment. In this review, the current approach and knowledge on PTS prediction and prevention are presented, including the conservative and invasive DVT treatment possibilities.

Effects of epidural-and-general anesthesia combined versus general anesthesia alone on the venous hemodynamics of the lower limb

2004 ◽  
Vol 92 (11) ◽  
pp. 1003-1011 ◽  
Author(s):  
Alison Knaggs ◽  
Peter Mason ◽  
Ken Macleod ◽  
Konstantinos Delis
Keyword(s):  
Abdominal Surgery ◽  
General Anesthesia ◽  
Epidural Anesthesia ◽  
Lower Limb ◽  
Chronic Venous Disease ◽  
Venous Stasis ◽  
Controlled Study ◽  
Point Estimate ◽  
Venous Disease ◽  
Post Induction

SummaryOur hypothesis was that, due to its sympatholytic action, epidural anesthesia (EA) administered as part of anesthesia in abdominal surgery would generate a marked venous leg flow enhancement, thus aiding in the prevention of peroperative venous stasis. We studied, and comprehensively quantified the venous haemodynamic changes in the lower limb during and immediately after abdominal surgery performed under EA and general (GA) anesthesia combined, in comparison to GA alone. This is a prospective, randomized, controlled study, stratified for hypertension and smoking, comprising ASA 1-2 patients undergoing elective total abdominal hysterectomy. Those with peripheral vascular or chronic venous disease, prior DVT or BMI>35 were excluded. Eligible recruits received either GA (Group GA) (n = 10; age 36-65, median 50) alone or epidural anesthesia (EA) and GA combined (Group EA/GA) (n = 9; age 32-58, median 46). EA (L1-2) was administered using lignocaine 2%. Both groups had GA induced with fentanyl and propofol, maintained with N2O and isoflurane; larygoscopy was facilitated with vecuronium; analgesia was provided either with morphine (Group GA) or epidurally with 2% lignocaine boli (Group EA/GA). Hemodynamics were determined at the popliteal vein in the horizontal supine position at baseline (resting prior to anesthesia), post epidural (20 min after delivery of EA), post induction (15 min after laryngeal intubation), surgery (upon uterus removal) and recovery (30 min after extubation). There was no difference in the mean velocity[Vmean] between the 2 groups at baseline (p = 0.35[Mann-Whitney]), and post induction (p = 0.5[Mann-Whitney]). However Vmean was significantly higher in Group EA/GA than Group GA, both at surgery (point estimate[PE]: 1.8 cm/s; 95% CI: 0.01, 6.3 cm/s; p <0.05[Mann-Whitney]) and recovery (PE: 2.6 cm/s; 95% CI: 0.4, 5.1 cm/s; p = 0.02[Mann-Whitney]). Volume flow[VQ] was similar in the 2 groups at baseline and post induction (both, p >0.1[Mann-Whitney]), but was significantly higher in Group EA/GA at surgery (PE: 54 ml/min; 95% CI: 18, 159 ml/min; p = 0.045[Mann-Whitney]) and recovery (PE: 49 ml/min; 95% CI: 16, 129 ml/min; p=0.0037[Mann-Whitney]). Peak velocity, Vmean and VQ increased significantly post epidural in Group EA/GA. Contrary to the venous leg flow attenuation in elective abdominal surgery under GA and upon its recovery, EA administered as part of GA is associated with a significant enhancement of both Vmean and VQ. This beneficial hemodynamic effect of EA at the vulnerable stage of recovery may be critically essential in light of enhanced blood viscosity, fibrinolytic shutdown, endothelial/platelet activation and immobility, acting in synergy with putative cardiorespiratory protection. The results of this study lend support to the preferential selection of combined EA/GA in subjects at high risk for venous thromboembolism, particularly when optimal DVT prophylaxis is practically unattainable due to limitations pertaining to the nature of surgery.

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.

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