The Relevance of the Natural History of Varicose Veins and Refunded Care

2012 ◽  
Vol 27 (1_suppl) ◽  
pp. 23-26 ◽  
Author(s):  
F Pannier ◽  
E Rabe
Keyword(s):  
General Population ◽  
Natural History ◽  
Clinical Symptoms ◽  
Negative Impact ◽  
Varicose Veins ◽  
Chronic Venous Disease ◽  
Venous Disease ◽  
Progression Rate ◽  
Venous Ulcers ◽  
History Of

Chronic venous disease (CVD) is one of the most common diseases in our population. Aside from venous symptoms like heaviness and pain, which are present in about 50% of the general population, signs of CVD include varicose veins (VVs), oedema, eczema, venous eczema, hyperpigmentation, white atrophy, lipodermatosclerosis and venous ulcers. The aim of this paper is to review current literature for the relevance of natural history of VVs in refunded care. Available papers on VVs, progression of the disease and complications were reviewed. Prevalence of VVs is high with more than 20% in the general population. Information on progression of uncomplicated VV to chronic venous insufficiency (CVI) is rare. However, most venous ulcers have a primary venous origin. The progression rate of VV to higher clinical stages reaches 4% per year. Among the risk factors are obesity and higher age. Quality of life (QOL) is also reduced in uncomplicated VV in C2 patients. In conclusion, there is evidence from the literature that a high proportion of patients with uncomplicated VVs in the clinical, aetiological, anatomical and pathophysiological classification (CEAP Clinical Class 2) will progress to CVI if untreated. VVs have a negative impact on QOL and clinical symptoms. VV patients with CVI (C3–C6) as well as those C2 patients with severe clinical symptoms and impaired QOL due to CVD should be treated with ablation of the VVs in a refunded care system.

Prevalence, risk and aggravating factors of chronic venous disease: an epidemiological survey of the general population of Greece

2012 ◽  
Vol 28 (4) ◽  
pp. 184-190 ◽  
Author(s):  
E Dimakakos ◽  
K Syrigos ◽  
E Scliros ◽  
I Karaitianos
Keyword(s):  
General Population ◽  
Western Europe ◽  
Varicose Veins ◽  
Epidemiological Survey ◽  
Chronic Venous Disease ◽  
Venous Disease ◽  
Common Disease ◽  
Mediterranean Country ◽  
Prolonged Standing ◽  
Of Greece

Introduction Chronic venous disease (CVD) is a common disease all over the world, mainly in Western Europe and the USA. Aim To evaluate the prevalence of CVD in the Greek general population and the characteristics of CVD. Materials and methods The study sample included 1500 individuals, 15–64 years of age, who were citizens of Athens, Thessaloniki, or one of five Greek cities with more than 10,000 in the population. The sample was selected by a stratified, multistage, random sampling procedure based on the Greek Census 2001. Questionnaires were completed for each individual by personal interview. Results From 1500 individuals, 224 (14.9%) had symptoms and/or signs of CVD, 9.6% were men and 20.1% were women. The highest percentage of presenting CVD symptoms was among 45–54-year-olds (23.4%) and 55–64-year-olds (27%). The symptoms that were mostly mentioned among sufferers were 58% achy legs, 37.4% swollen legs and 25.3% heavy legs, whereas the frequent signs were broken capillaries – telangiectasia (19.2%) and varicose veins (14.8%). About 62.9% with CVD had an obese body mass index (BMI > 25). The prevalence of CVD in patients with prolonged standing hours at work (4+ hours) was 20.8%. The symptoms of CVD were worse during the summer period only in 26.8% of the patients whereas in 50.8% during all the year. Regarding quality of life, more than 40% of the patients had either health or cosmetic problems. Sufferers mentioned that they took first advice from physicians (28%), or from friends and relatives (27%) or from pharmacists (26%). Conclusion This is a real whole-population study of Greece – a Mediterranean country that provides important and remarkable data on the epidemiology of CVD and highlights that we need improvement of relations within the triangle constituted by physicians, patients and disease.

The Significance of Pain in Chronic Venous Disease and its Medical Treatment

2019 ◽  
Vol 17 (3) ◽  
pp. 291-297
Author(s):  
Djordje Radak ◽  
Igor Atanasijević ◽  
Mihailo Nešković ◽  
Esma Isenovic
Keyword(s):  
Varicose Veins ◽  
Compression Therapy ◽  
Interventional Therapy ◽  
Lifestyle Changes ◽  
Chronic Venous Disease ◽  
Venous Disease ◽  
Venous Ulcers ◽  
Venoactive Drugs ◽  
Micronized Purified Flavonoid Fraction ◽  
Flavonoid Fraction

Chronic venous disease (CVeD) is a highly prevalent condition in the general population, and it has a significant impact on quality of life. While it is usually manifested by obvious signs, such as varicose veins and venous ulcers, other symptoms of the disease are less specific. Among the other symptoms, which include heaviness, swelling, muscle cramps and restless legs, pain is the symptom that most frequently compels CVeD patients to seek medical aid. However, there is a substantial discrepancy between pain severity and clinically detectable signs of CVeD, questioned by several opposing studies. Further evaluation is needed to clarify this subject, and to analyse whether pain development predicts objective CVeD progression. </P><P> General management of CVeD starts with advising lifestyle changes, such as lowering body mass index and treating comorbidities. However, the mainstay of treatment is compression therapy, with the additional use of pharmacological substances. Venoactive drugs proved to be the drugs of choice for symptom alleviation and slowing the progression of CVeD, with micronized purified flavonoid fraction being the most effective one. Interventional therapy is reserved for advanced stages of the disease.

Venous haemodynamics: What we know and don't know

2009 ◽  
Vol 24 (1) ◽  
pp. 3-7 ◽  
Author(s):  
F Lurie
Keyword(s):  
Blood Flow ◽  
Natural History ◽  
Clinical Manifestations ◽  
Treatment Strategies ◽  
Chronic Venous Disease ◽  
Simplified Model ◽  
Venous Disease ◽  
Simplified Approach ◽  
Current State ◽  
History Of

The presence of haemodynamic abnormalities in chronic venous disease (CVD) has been well established. The relationships between these abnormalities and clinical manifestations, or natural history of CVD, are complex and remain to be investigated. Flow-mediated processes and mechanisms unrelated to blood flow may play an important role in the pathophysiology of CVD. Current state of knowledge makes questionable a possibility of building treatment strategies based on a single simplified model of the disease. As an example of such simplified approach, CHIVA introduces an opportunity to critically assess the gaps in knowledge in venous pathophysiology.

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.

Superficial Venous Disease

2018 ◽  
pp. 287-298
Author(s):  
Ronald S. Winokur ◽  
Geraldine Abbey-Mensah ◽  
Neil M. Khilnani
Keyword(s):  
Venous Insufficiency ◽  
Varicose Veins ◽  
Treatment Options ◽  
Duplex Ultrasound ◽  
Chronic Venous Disease ◽  
Venous Disease ◽  
Venous Ulcers ◽  
Patient Morbidity ◽  
And Performance ◽  
Superficial Venous Insufficiency

Superficial venous insufficiency (SVI) is an extremely common condition affecting up to 39% of Americans, which results in significant patient morbidity and high healthcare costs (up to $3 billion per year for treatment). In addition to patients with asymptomatic spider veins and painful varicose veins, over 2 million adults have advanced chronic venous disease (CVD), and at least 20,000 individuals develop new venous ulcers each year. Patients suffering from venous insufficiency can benefit greatly from office-based, minimally invasive treatments. Successful treatment depends on understanding of superficial venous anatomy and pathophysiology, how to conduct a targeted history and physical exam, and performance and interpretation of Duplex ultrasound (DUS), as well as knowledge and application of the available treatment options.

Differential diagnosis of leg ulcers

2013 ◽  
Vol 28 (1_suppl) ◽  
pp. 55-60 ◽  
Author(s):  
F Pannier ◽  
E Rabe
Keyword(s):  
Differential Diagnosis ◽  
Varicose Veins ◽  
Correct Diagnosis ◽  
Duplex Ultrasound ◽  
Underlying Disease ◽  
Chronic Venous Disease ◽  
Venous Disease ◽  
Leg Ulcers ◽  
Swedish Population ◽  
Venous Ulcers

Leg and foot ulcers are symptoms of very different diseases. The aim of this paper is to demonstrate the differential diagnosis of leg ulcers. The majority of leg ulcers occur in the lower leg or foot. In non-venous ulcers the localization in the foot area is more frequent. The most frequent underlying disease is chronic venous disease. In 354 leg ulcers, Koerber found 75.25% venous leg ulcers, 3.66% arterial leg ulcers, 14.66% ulcers of mixed venous and arterial origin and 13.5% vasculitic ulcers. In the Swedish population of Skaraborg, Nelzen found a venous origin in 54% of the ulcer patients. Each leg ulcer needs a clinical and anamnestic evaluation. Duplex ultrasound is the basic diagnostic tool to exclude vascular anomalies especially chronic venous and arterial occlusive disease. Skin biopsies help to find a correct diagnosis in unclear or non-healing cases. In conclusion, chronic venous disease is the most frequent cause of leg ulcerations. Because 25% of the population have varicose veins or other chronic venous disease the coincidence of pathological venous findings and ulceration is very frequent even in non-venous ulcerations. Leg ulcers without the symptoms of chronic venous disease should be considered as non-venous.

Association of polymorphisms near the FOXC2 gene with the risk of varicose veins in ethnic Russians

2016 ◽  
Vol 31 (9) ◽  
pp. 640-648 ◽  
Author(s):  
Alexandra S Shadrina ◽  
Mariya A Smetanina ◽  
Ekaterina A Sokolova ◽  
Kseniya S Sevost’ianova ◽  
Andrey I Shevela ◽  
...  
Keyword(s):  
Multiple Testing ◽  
Haplotype Analysis ◽  
Varicose Veins ◽  
Chronic Venous Disease ◽  
Control Group ◽  
Venous Disease ◽  
Increased Risk ◽  
Haplotype Frequencies ◽  
History Of ◽  
Primary Varicose Veins

Objective To investigate the association of polymorphisms located near the FOXC2 gene with the risk of varicose veins in ethnic Russians. Methods Allele, genotype, and haplotype frequencies were determined in the sample of 474 patients with primary varicose veins and in the control group of 478 individuals without a history of chronic venous disease. Results Polymorphisms rs7189489, rs4633732, and rs1035550 showed the association with the increased risk of varicose veins, but none of the observed associations remained significant after correction for multiple testing. Haplotype analysis revealed the association of haplotype rs7189489 C–rs4633732 T–rs34221221 C–rs1035550 C–rs34152738 T–rs12711457 G with the increased risk of varicose veins (OR = 2.67, P = 0.01). Conclusions Our results provide evidence that the studied polymorphisms do not play a major role in susceptibility to varicose veins development in the Russian population.

scholarly journals Dysregulations of MicroRNA and Gene Expression in Chronic Venous Disease

2020 ◽  
Vol 9 (5) ◽  
pp. 1251 ◽  
Author(s):  
Daniel P. Zalewski ◽  
Karol P. Ruszel ◽  
Andrzej Stępniewski ◽  
Dariusz Gałkowski ◽  
Jacek Bogucki ◽  
...  
Keyword(s):  
Gene Expression ◽  
Mononuclear Cells ◽  
Varicose Veins ◽  
Expression Profiles ◽  
Lower Limbs ◽  
Chronic Venous Disease ◽  
Venous Disease ◽  
Operating Characteristics ◽  
Potential Biomarker ◽  
Pathologic Features

Chronic venous disease (CVD) is a vascular disease of lower limbs with high prevalence worldwide. Pathologic features include varicose veins, venous valves dysfunction and skin ulceration resulting from dysfunction of cell proliferation, apoptosis and angiogenesis. These processes are partly regulated by microRNA (miRNA)-dependent modulation of gene expression, pointing to miRNA as a potentially important target in diagnosis and therapy of CVD progression. The aim of the study was to analyze alterations of miRNA and gene expression in CVD, as well as to identify miRNA-mediated changes in gene expression and their potential link to CVD development. Using next generation sequencing, miRNA and gene expression profiles in peripheral blood mononuclear cells of subjects with CVD in relation to healthy controls were studied. Thirty-one miRNAs and 62 genes were recognized as potential biomarkers of CVD using DESeq2, Uninformative Variable Elimination by Partial Least Squares (UVE-PLS) and ROC (Receiver Operating Characteristics) methods. Regulatory interactions between potential biomarker miRNAs and genes were projected. Functional analysis of microRNA-regulated genes revealed terms closely related to cardiovascular diseases and risk factors. The study shed new light on miRNA-dependent regulatory mechanisms involved in the pathology of CVD. MicroRNAs and genes proposed as CVD biomarkers may be used to develop new diagnostic and therapeutic methods.

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