Revised Venous Clinical Severity Score: A Facile Measurement of Outcomes in Venous Disease

2012 ◽  
Vol 27 (1_suppl) ◽  
pp. 119-129 ◽  
Author(s):  
M A Vasquez ◽  
C E Munschauer
Keyword(s):  
Severity Score ◽  
Common Ground ◽  
Disease Process ◽  
Assessment Instrument ◽  
Clinical Severity ◽  
Venous Disease ◽  
Assessment Instruments ◽  
Clinical Severity Score ◽  
Venous Clinical Severity Score ◽  
Data Assessment

Outcome assessment is an important criterion for the objective determination of the risks and benefits of a given procedure. The choice of an assessment instrument is critical in order to generate meaningful and relevant data. Assessment instruments are platforms for comparison and stratification of information that provide a common ground and unified language for discussions on disease processes and therapies. Like many complex conditions, venous disease has benefited from the institution of several assessment instruments designed to clarify elements of the disease process. Among these is the venous clinical severity score (VCSS), which has proved to be a valuable tool for evaluating changes in condition over time with or without intervention. The VCSS has recently undergone a revision to increase its sensitivity and value in interpreting the language of venous disease.

scholarly journals Laser-assisted strategy for reflux abolition in a modified CHIVA approach

2015 ◽  
Vol 4 (2) ◽  
Author(s):  
Sergio Gianesini ◽  
Erica Menegatti ◽  
Michele Zuolo ◽  
Mirko Tessari ◽  
Paolo Spath ◽  
...  
Keyword(s):  
Severity Score ◽  
Resistance Index ◽  
Peak Systolic Velocity ◽  
Clinical Severity ◽  
Chronic Venous Disease ◽  
Venous Disease ◽  
Clinical Severity Score ◽  
Diastolic Velocity ◽  
Venous Clinical Severity Score

The aim of this study was to assess feasibility and efficacy of an endovenous laser (EL) assisted saphenous-sparing strategy in chronic venous disease (CVD). Fourteen CVD patients (C2,3,4s Ep As Pr1,2,3) underwent a saphenofemoral junction (SFJ) treatment by EL just from below the superficial epigastric vein downward for a limited tract, together with a flush ligation of the incompetent tributaries of the great saphenous vein (GSV) along the leg. The following GSV parameters were assessed 15 cm below the SFJ: reflux time, caliber, peak systolic velocity (PSV), end diastolic velocity (EDV), resistance index (RI). Venous clinical severity score and the Clinical, Etiological, Anatomical, and Pathophysio logical (CEAP) classification clinical classes were assessed. At 1 year follow up 3 cases were considered failures because of a GSV thrombosis, even if they presented a GSV recanalization with a laminar flow within at the 2 years follow-up. Eleven procedures succeeded because neither minor nor major peri-procedural complications were reported, apart 2 cases of self-healing bruising. In these last 11 cases the procedure led to a GSV reflux suppression (from 3.1±0.4 s to a retrograde laminar draining flow), to a GSV caliber reduction (from 9.4±0.5 to 3.1±0.2 cm, P<0.001), to a PSV reduction (from 50.2±4.6 to 18.4±3.5 cm/s, P<0.001), to a RI reduction (from 0.9±0.2 to 0.51±0.2, P<0.005) and to an oscillatory flow suppression (EDV from -8.9±1.6 to 6.2±2.3 cm/s, P<0.001). Both CEAP and venous clinical severity score improved from 3 to 1 (P<0.001) and from 7±2 to 2±1 (P<0.05), respectively. The GSV flow reappeared below the shrunk tract draining into the re-entry perforator. Sapheno-femoral reflux suppression can be obtained by just a GSV segmental closure. An almost 80% of success rate of the present investigation paves the way for an even wider diffusion of endovenous techniques, moreover erasing the surgical requirements for those who would like to perform a saphenoussparing strategy. In this way new devices could be used inside equally innovative strategies.

Venous Clinical Severity Score and quality-of-life assessment tools: application to vein practice

2008 ◽  
Vol 23 (6) ◽  
pp. 259-275 ◽  
Author(s):  
M A Vasquez ◽  
C E Munschauer
Keyword(s):  
Quality Of Life ◽  
Treatment Outcomes ◽  
Severity Score ◽  
Venous Insufficiency ◽  
Clinical Severity ◽  
Venous Disease ◽  
Clinical Severity Score ◽  
Venous Clinical Severity Score ◽  
Disease Specific

The time is ripe for universal understanding and acceptance of outcome assessment in venous disease. Outcome studies promote understanding of the diseases we treat and the results of treatment. The choice of a valid and reliable assessment tool is crucial. Patient-generated quality-of-life tools include generic instruments and disease-specific instruments. Generic instruments evaluate overall well-being and provide subjective measurements of treatment outcomes in various disease states. The 36-Item Short Form Health Survey and the Nottingham Health Profile are widely used generic surveys. Disease-specific instruments relate to a particular disease state. They are popular in venous disease reporting and have high sensitivity. The Chronic Venous Insufficiency Questionnaire, the Venous Insufficiency Epidemiological and Economic Study, the Aberdeen Varicose Vein Questionnaire and the Charing Cross Venous Ulceration Questionnaire are such devices. Physician-generated measurement tools are used to evaluate and classify the consequences of venous disease. The clinical, aetiology, anatomy, pathophysiology classification (CEAP) is a popular descriptive platform for chronic venous disease. The Venous Severity Scoring (VSS) system was derived from the CEAP classification to provide evaluative capabilities. The three elements of the VSS are the venous disability score, the venous segmental disease score and the venous clinical severity score (VCSS). The VCSS facilitates the follow-up of features of venous disease that change with treatment. Each of these outcomes tools has been validated, and each has strengths and weaknesses. Maintaining the dynamic nature of assessment with periodic review and revision is the way forward to generating universal applicability. Although the choice of instrument is debatable, the most important factor in improving treatment outcomes is the decision to examine results and to share them in a meaningful way.

The relation between clinical scores and quality-of-life in long-term follow-up

2016 ◽  
Vol 31 (1_suppl) ◽  
pp. 99-105 ◽  
Author(s):  
Fabio S Catarinella ◽  
Fred HM Nieman ◽  
Cees HA Wittens
Keyword(s):  
Quality Of Life ◽  
Negative Correlation ◽  
Severity Score ◽  
Clinical Severity ◽  
Venous Disease ◽  
Venous Obstruction ◽  
Clinical Severity Score ◽  
Severity Scores ◽  
Venous Clinical Severity Score

Introduction Quality-of-life and severity scores are both popular measures in medicine. For deep venous obstruction, the VEINES-QOL/Sym and venous clinical severity score (VCSS) are widely used. Combining a patient-reported outcome with a clinical severity score should give a more sensitive outcome for treatment results. To establish and compare their suitability for deep venous disease, we compared the outcomes of both scores in a group of patients who were interventionally treated for deep venous disease. Methods The venous clinical severity scores and VEINES-QOL/Sym scores of a group of patients who had received interventional treatment for deep venous obstruction more than 12 months ago were compared at T0 and T12. Results Both the Spearman’s rho and Pearson’s r show a very weak, negative correlation (statistically significant ( p ≤ 0.05)), between the venous clinical severity score and VEINES-QOL at T12 and between the venous clinical severity score and the VEINES-SYM at both T0 and T12. T0 VCSS-VSYM: rho = −0.219 ( p = 0.052), r = −0.236 ( p = 0.037), T12 VCSS-VQOL: rho = −0.459 ( p = 0.007), r = −0.379 ( p = 0.030), T12 VCSS-VSYM: rho = −0.463 ( p = 0.007), r = −0.432 ( p = 0.012). This negative correlation was not statistically ( p ≥ 0.05) confirmed for T0 VCSS-VSYM. Conclusion The physician-scored venous clinical severity score of patients treated for deep venous obstruction does not correlate well with their self-reported quality-of-life and symptom scores.

Σύγκριση της αποτελεσματικότητας της χειρουργικής επέμβασης της σαφηνεκτομής και τοπικών εκριζώσεων στην αντιμετώπιση των συμπτωμάτων σε ασθενείς με χρόνια φλεβική νόσο

2021 ◽  
Author(s):  
Χρυσάνθη Παπαγεωργοπούλου
Keyword(s):  
Severity Score ◽  
Clinical Severity ◽  
Cronbach’S Alpha ◽  
Cronbach's Alpha ◽  
Clinical Severity Score ◽  
Venous Clinical Severity Score

Στόχος: Ο στόχος της μελέτης είναι η επικύρωση του 3D εργαλείου βαθμολόγησης – αξιολόγησης για τη χρόνια φλεβική νόσο, όπως προτάθηκε στο SYM VEIN consensus. Μέθοδος: Η παρούσα κλινική μελέτη είναι μία προοπτική μελέτη κοόρτης που περιλαμβάνει συνολικά τριάντα πέντε (35) ασθενείς, κατόπιν συναίνεσης, με χρόνια φλεβική νόσο. Οι ασθενείς αυτοί που θα υποβάλλονταν σε σαφηνεκτομή εκτιμήθηκαν με το αναθεωρημένο Venous Clinical Severity Sore (r-VCSS), με το CIVIQ-20 ερωτηματολόγιο για την ποιότητα ζωής και με το 3D σύστημα βαθμονόμησης του SYM VEIN consensus, προεγχειρητικά και τέσσερεις εβδομάδες μετά την επέμβαση. Το συνολικό αποτελέσματα του 3D εργαλείου αξιολόγησης ελέγχθηκε για την ανταπόκρισή του, για την αξιοπιστία του και για τη δομική του εγκυρότητα.Αποτελέσματα: Το συνολικό αποτέλεσμα του 3D εργαλείου αξιολόγησης αποδείχθηκε καλής αξιοπιστίας και εσωτερικής συνοχής (Cronbach’s alpha 0,85). Η πρωταρχική ανάλυση των καταληκτικών σημείων ταυτοποίησε τρεις ομάδες συμπτωμάτων (παραισθησία, καυστικό άλγος, κνησμός vs αίσθημα βάρους, αίσθημα οιδήματος, κνησμός vs σύνδρομο ανήσυχων ποδιών, πάλλων πόνος) αποδεικνύοντας μία υψηλή συσχέτιση των συμπτωμάτων που περιλαμβάνονται στην ίδια ομάδα και πιθανώς μοιράζονται κοινή παθοφυσιολογία, ενδεικτικό της επαρκούς δομικής εγκυρότητας του εργαλείου αξιολόγησης. Το συνολικό αποτέλεσμα του 3D εργαλείου αξιολόγησης είχε σημαντική συσχέτιση με το r-VCSS και το αποτέλεσμα του CIVIQ-20 (rho 0,46, p = 0,005 and rho 0,65, p < 0,001, αντίστοιχα), ενδεικτικό της επαρκούς συγκλίνουσας εγκυρότητας. Μετά τη σαφηνεκτομή, παρατηρήθηκαν στατιστικώς σημαντικές μειώσεις (p < 0,001) του συνολικού αποτελέσματος του 3D εργαλείου αξιολόγησης, αλλά και των επιμέρους αποτελεσμάτων του 3D εργαλείου για όλα τα φλεβικά συμπτώματα εκτός από δύο, ενδεικτικό της εξαιρετικής ανταπόκρισης του εργαλείου στη θεραπεία. Η διάμεση τιμή της συνολικής βαθμολογίας του 3D εργαλείου αξιολόγησης μειώθηκε από το 31 στο 6 (83,8% μείωση, p < 0,001), η διάμεση τιμή του r-VCSS μειώθηκε από το 6 στο 0 (100% μείωση, p < 0,001), και η μέση τιμή της βαθμολογίας του CIVIQ-20 μειώθηκε από το 24 στο 14 (40% μείωση, p < 0,001). Η διαφορά της ποσοστιαίας αλλαγής της διάμεσης τιμής των αποτελεσμάτων μεταξύ των r-VCSS και του CIVIQ-20 σε σύγκριση με τη συνολική βαθμολογία του 3D εργαλείου αξιολόγησης ήταν στατιστικώς σημαντική (p = 0,005 and p < 0,001, αντίστοιχα).Συμπέρασμα: Το συνολικό αποτέλεσμα του 3D SYM VEIN εργαλείου αξιολόγησης έχει καλή αξιοπιστία, δομική εγκυρότητα και εξαιρετική ανταπόκριση στη θεραπεία, παρά του ότι είναι λιγότερο επιρρεπές στην αλλαγή μετά τη σαφηνεκτομή, σε σύγκριση με την αναθεωρημένη μορφή του Venous Clinical Severity Score (r-VCSS).

scholarly journals Evaluation of liquid or foam sclerotherapy in small varicose veins (ceap c1) with venous clinical severity score

2018 ◽  
Vol 64 (12) ◽  
pp. 1117-1121 ◽  
Author(s):  
Mehmet Ali Kaygin ◽  
Umit Halici
Keyword(s):  
Severity Score ◽  
Skin Necrosis ◽  
Varicose Veins ◽  
Clinical Severity ◽  
Foam Sclerotherapy ◽  
Clinical Severity Score ◽  
Severity Scores ◽  
Study Results ◽  
Venous Clinical Severity Score ◽  
The Mean

SUMMARY OBJECTIVE: We aimed to evaluate the efficacy of liquid or foam sclerotherapy of varicose veins using venous clinical severity scores and possible complications. METHODS: A total of 318 patients (268 females, 50 males) who were treated with liquid or foam sclerotherapy between January 2012 and December 2012 were included in this study. RESULTS: Skin necrosis was observed in only 6 patients (1. 8%), thrombophlebitis in 10 patients (3. 1%), and hyperpigmentation in 18 patients (5. 6%) in this study group. The mean venous clinical severity score was calculated as: pain score, 1. 23 ± 0.88; varicose vein score,1.85 ± 0. 8; edema score, 0.64 ± 0.77). Pain and edema decreased at the control examination, 1 month after completion of sclerotherapy sessions. Varicose veins completely disappeared after sclerotherapy. While the decrease in edema in the foam sclerotherapy group was significantly less (P<0.001), the decline in pain showed an increasing trend (P=0.069). While skin necrosis did not develop after foam sclerotherapy, rates of pigmentation and local thrombophlebitis were similar (P>0.05). CONCLUSION: In conclusion, we observed that both sclerotherapy methods are effective with a low rate of complications, alleviating the complaints of patients with small varicose veins, and providing considerable improvement in venous clinical severity scores.

scholarly journals Performance characteristics of the venous clinical severity score

2002 ◽  
Vol 36 (5) ◽  
pp. 889-895 ◽  
Author(s):  
Mark H. Meissner ◽  
Cynthia Natiello ◽  
Stephen C. Nicholls
Keyword(s):  
Severity Score ◽  
Performance Characteristics ◽  
Clinical Severity ◽  
Clinical Severity Score ◽  
Venous Clinical Severity Score

scholarly journals Impacto da escleroterapia com espuma de polidocanol guiada por ultrassom em pacientes com úlcera venosa

2017 ◽  
Vol 16 (3) ◽  
pp. 239-243 ◽  
Author(s):  
Melissa Andreia de Moraes Silva ◽  
Álefy Zanelato Pereira Araujo ◽  
Jéssica Funchal do Amaral ◽  
Seleno Glauber de Jesus-Silva ◽  
Rodolfo Souza Cardoso ◽  
...  
Keyword(s):  
Severity Score ◽  
Clinical Severity ◽  
Clinical Severity Score ◽  
Venous Clinical Severity Score

Resumo Contexto A escleroterapia com espuma de polidocanol guiada por ultrassom tem sido utilizada no tratamento de pacientes com úlceras venosas. É um procedimento minimamente invasivo e de fácil execução, porém apresenta taxas de recidiva elevadas. Objetivos Relatar a evolução a curto e médio prazo de pacientes com úlcera venosa tratados com escleroterapia com espuma de polidocanol guiada por ultrassom. Métodos Foram reavaliados 19 pacientes submetidos ao tratamento de escleroterapia com espuma de polidocanol guiada por ultrassom no período de janeiro de 2013 a dezembro de 2014. Foram analisados tempo de cicatrização da úlcera, melhora de sintomas clínicos, recanalização das veias tratadas, recidiva dos sintomas e da úlcera venosa. Resultados Foram analisados 15 pacientes do sexo feminino (78,9%) e quatro do sexo masculino (21,1%). A média geral de idade foi de 53 anos. O tempo de seguimento dos pacientes variou de 448 dias a 1.276 dias (média de 791 dias). O tempo médio de presença das úlceras foi de 53 meses. Na avaliação pós-procedimento, foram observadas recanalização total em 15,7%, recanalização parcial em 21% e oclusão em 47,3% das veias tratadas. Apenas em um caso foi observada recidiva da úlcera. Pela avaliação das médias do Venous Clinical Severity Score (VCSS), houve diferença significativa antes e após o procedimento, com variação entre os grupos de 11,2 (p < 0,01). Conclusões A escleroterapia por espuma guiada por ultrassom apresenta altas taxas de sucesso terapêutico, com índices de cicatrização de úlceras venosas elevados.

Impact of graduated compression stockings on the prevention of post-thrombotic syndrome - results of a randomized controlled trial

2014 ◽  
Vol 30 (8) ◽  
pp. 541-548 ◽  
Author(s):  
Arjun Jayaraj ◽  
Mark Meissner
Keyword(s):  
Venous Thrombosis ◽  
Deep Venous Thrombosis ◽  
Severity Score ◽  
Scoring Systems ◽  
Clinical Severity ◽  
Compression Stockings ◽  
Post Thrombotic Syndrome ◽  
Clinical Severity Score ◽  
Venous Clinical Severity Score ◽  
Graduated Compression Stockings

Objective Post-thrombotic syndrome is a chronic complication of acute deep venous thrombosis in the lower extremity. The role of graduated compression stockings in the prevention of post-thrombotic syndrome has been studied with opinion being divided on the beneficial effects. We aim to answer this question with a randomized controlled study that uses multiple scoring instruments to assess post-thrombotic syndrome. Methods Sixty-nine consecutive patients with acute deep venous thrombosis diagnosed by duplex ultrasonography were randomized to treatment with graduated compression stockings or no graduated compression stockings. Venous Clinical Severity Score and Villalta-Prandoni Score, commonly used scoring systems, were used to appraise post-thrombotic syndrome at 3, 6, 12, 18, and 24 months following diagnosis of deep venous thrombosis. In both scoring systems, the individual either had post-thrombotic syndrome or no post-thrombotic syndrome. Cumulative incidence was computed using Kaplan–Meier analysis. Relative risk was assessed for age, obesity, varicose veins, and iliofemoral deep venous thrombosis. Results As measured by both Villalta-Prandoni Score and Venous Clinical Severity Score instruments, the graduated compression stockings group had a lower incidence of post-thrombotic syndrome compared to the control group, but only when one month was used as cut off time for the first diagnosis of post-thrombotic syndrome. When 6 or 12 months were used, there was no difference in the incidence of post-thrombotic syndrome between the two groups. The burden of post-thrombotic syndrome was significantly more when the Villalta-Prandoni Score instrument (∼75%) was used as compared to the Venous Clinical Severity Score instrument (∼30%) at 24 months’ follow-up. Obesity was the only statistically significant predictor for the development of post-thrombotic syndrome. Conclusion As assessed by both Villalta-Prandoni Score and Venous Clinical Severity Score instruments, use of graduated compression stockings does not reduce the incidence of post-thrombotic syndrome. There is a significant difference in the incidence post-thrombotic syndrome as detected by Villalta-Prandoni Score and Venous Clinical Severity Score instruments with incidence of post-thrombotic syndrome dependent on instrument and cut off time interval used to assess post-thrombotic syndrome. However, larger prospective studies are required to confirm these differences.

scholarly journals Resultados do tratamento do refluxo de veias safenas com endolaser 1.470 nm e correlação com o grau de insuficiência venosa

2021 ◽  
Vol 20 ◽  
Author(s):  
Ana Paula Pires Silva ◽  
Daniel Mendes Pinto ◽  
Vanessa Aline Miranda Vieira Milagres ◽  
Leonardo Ghizoni Bez ◽  
Júlio César Arantes Maciel ◽  
...  
Keyword(s):  
Severity Score ◽  
Hazard Ratio ◽  
Clinical Severity ◽  
Clinical Severity Score ◽  
Kaplan Meier ◽  
Venous Clinical Severity Score

Resumo Contexto Pacientes com doença venosa crônica avançada são mais propensos a exigir outros procedimentos para recidiva de veias varicosas. Ainda não está estabelecido se a gravidade da insuficiência venosa é um fator que influencia a taxa de oclusão de veias safenas tratadas por endolaser. Objetivos Analisar a taxa de oclusão dos segmentos venosos tratados com endolaser e correlacionar com o Venous Clinical Severity Score (VCSS) e a classificação Clínica-Etiológica-Anatômica-Patológica (CEAP) dos pacientes. Métodos Análise retrospectiva de coorte de pacientes operados com endolaser 1.470 nm entre novembro/2012 a março/2020. Foram realizadas estatística descritiva e curva de sobrevida de Kaplan-Meier com regressão de Cox para grupos de VCSS e CEAP. Resultados Foram analisados 170 pacientes e 180 segmentos venosos; a idade média foi de 44,3 ± 9,2, sendo a maioria do sexo feminino (71%). A densidade de energia média utilizada na veia safena magna foi 49,2 ± 8,3 J/cm. As principais complicações foram dor no trajeto da safena (12,2%) e parestesias após 6 meses (17,2%). Não houve diferença na taxa de oclusão venosa entre grupos com VCSS ≤ 7 e VCSS > 7 (p = 0,067). O grupo de pacientes com CEAP agrupada C4-C5-C6 teve taxa de oclusão menor em relação ao grupo C2-C3 [hazard ratio (HR) = 3,22; intervalo de confiança (IC) 1,85, 5,61; p = 0,001]. Conclusões As taxas de oclusão de segmentos venosos tratados com endolaser foram menores na presença de classificações CEAP avançadas. Nesses pacientes, provavelmente deve-se despender mais energia para o tratamento eficaz das safenas.

scholarly journals Vai trò của hội chứng May – Thurner trong bệnh lý huyết khối tĩnh mạch sâu chi dưới

2020 ◽  
Vol 21 ◽  
pp. 32-37
Author(s):  
Lê Phi Long ◽  
Nguyễn Hoài Nam
Keyword(s):  
Ct Scan ◽  
Severity Score ◽  
Clinical Severity ◽  
Ct Venography ◽  
Clinical Severity Score ◽  
Venous Clinical Severity Score

Nhóm I: Hồi cứu hồ sơ và khảo sát lại CT Scan, chúng tôi ghi nhận 30 trường hợp huyết khối tĩnh mạch sâu chi dưới (HKTMSCD) được can thiệp lấy huyết khối bằng Fogarty, trong đó có 9/30 trường hợp được xác định HC May – Thurner. Tuổi trung bình là 44,4, tỷ lệ nam/nữ là 1/8. Tỷ lệ tái huyết khối sớm cao là 89% và điểm số VCSS (Venous Clinical Severity Score) trung bình là 7,625. Can thiệp sửa chữa tổn thương giải phẫu của HC May-Thurner chỉ thành công về mặt kỹ thuật ở 01 trường hợp. Nhóm II: Can thiệp điều trị lấy huyết khối cho 60 trường hợp, chụp khảo sát trong mổ kết hợp với hình ảnh CT cản quang thì tĩnh mạch, ghi nhận được 37/60 (61,6%) trường hợp có HC May-Thurner. Can thiệp sửa chữa tổn thương bằng nong bóng – stent thành công về mặt kỹ thuật là 35/37 (94,6%). Tỷ lệ tái huyết khối sớm cải thiện hơn rõ so với nhóm I 21,6% (8/37) và điểm số VCSS trung bình cũng cải thiện hơn là 5,025. HKTMSCD do HC May-Thurner là bệnh cảnh thường gặp trên lâm sàng. Cần lưu ý hướng đến chẩn đoán này khi người bệnh có biểu hiện sưng phù 1 bên chân Trái. Phương tiện chẩn đoán xác định dựa vào hình ảnh học với vai trò của chụp CT Venography. Điều trị theo phác đồ hiện nay là lấy huyết khối với tiêu sợi huyết tại chỗ và sửa chữa thương tổn giải phẫu bằng nong bóng và stent

Sign in / Sign up

Export Citation Format

Share Document