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 The efficacy of Hamamelis 30 in the management of varicose veins and its complications using revised venous clinical severity score tool and peripheral venous Doppler study

2021 ◽  
Vol 4 ◽  
pp. 49-54
Author(s):  
Blany John Lobo
Keyword(s):  
Severity Score ◽  
Varicose Veins ◽  
Clinical Severity ◽  
Rank Test ◽  
Clinical Severity Score ◽  
Doppler Study ◽  
Short Period ◽  
Venous Clinical Severity Score ◽  
Before And After ◽  
Signed Rank Test

Objectives: The homoeopathic remedy, Hamamelis, has been extensively used to treat varicose veins. However, scientific research conclusively proving its utility is lacking. This study was performed to ascertain the remedy’s therapeutic utility and efficacy in treating varicose veins and its complications using the revised venous clinical severity score (VCSS) tool and Doppler studies. Materials and Methods: A prospective uncontrolled experimental study with purposive sampling was performed; the subjects were selected from the outpatient department. A total of 32 cases, fulfilling the inclusion and exclusion criteria were clinically examined. The VCSS and Doppler test before and after treatment with Hamamelis 30 were performed. Results: The Wilcoxon signed-rank test was applied and the change in the median VCSS was found to be statistically significant. P-value of the pre score was 5.53 ± 4.15 and that of the post score was 3.45 ± 2.36 with a mean change of 2.09 ± 2.87 and 37.69% improvement with P-value of 0.000 < 0.01. The Doppler study showed no significant change or improvement. Conclusion: This study revealed that the homoeopathic remedy Hamamelis 30 is effective in the management of varicose veins and its complications by ameliorating symptoms and improving the VCSS. However, the Doppler study reports showed no changes or improvement perhaps due to the short period of treatment.

Endovascular Laser Therapy versus Open Surgery for the Treatment of Primary Varicose Veins of the Lower Limb

QJM ◽  
2021 ◽  
Vol 114 (Supplement_1) ◽  
Author(s):  
Hazem Abd Elsalam Mohamed ◽  
Assist. Prof. Dr. Ramez Mounir Wahba ◽  
Fawzy Salah Fawzy ◽  
Beshoy Maher Yacoub Gebrael
Keyword(s):  
Laser Therapy ◽  
Lower Limb ◽  
Severity Score ◽  
Open Surgery ◽  
Varicose Veins ◽  
Clinical Severity ◽  
Surgery Group ◽  
Clinical Severity Score ◽  
Venous Clinical Severity Score ◽  
Primary Varicose Veins

Abstract Background Venous drainage of the lower extremities is accomplished by a network of superficial veins connected to the deep veins by small perforator veins. Through a variety of pathophysiological mechanisms, weakness develops in the vein wall that results in varicosity over time. Varicosities typically form in the greater and lesser saphenous veins but also develop in branch vessels. Obstruction of the iliac veins or inferior vena cava can result in extensive varicose veins Objective s: The aim of this work is to compare the outcome of endovascular laser therapy versus open surgery in management of primary varicose veins in lower limb. Patients and Methods Type of study is a prospective, randomized, clinical study. This study was conducted on 30 patients with primary varicose veins of the lower limb, 15 patients were subjected to endovascular laser therapy for treatment of varicose veins of the lower limb (EVLA group) and 15 patients were managed by standard open surgery for treatment of varicose veins of the lower limb (surgery group). The patients were randomized selected from surgery clinic in Eldemerdash Hospital. The work was carried out in the period from June 2017 to December 2018. Results Both groups were well matched regarding age(P = 0.352) and sex (P = 0.713), type of vein diseased(P = 0.913), CEAP classification (P = 0.910) and also regarding BMI (P = 0.761). Regarding preoperative venous clinical severity score, the median(IQR) for group A (surgery group) was (5), and for group B (laser group) was (5) without statistical significant differences between both groups (P value =0.524). Many studies have shown that there was some difference in between two methods of treatment of primary varicose veins of the lower limbs open vascular surgery and endovascular laser therapy. Regarding Six weeks post-operative VCSS assessment, the VCSS score in the surgery group was statistically significantly higher (p &lt; 0.001). However, at one and two years after the intervention The VCSS scores converged and the difference between the groups was no longer statistically significant. Conclusion The presented results show that intreatment of varicose veins with both endovascular laser ablation and open surgery there was improvement in the clinical status of the patient occur after both but EVLA was more effective early which was observed by measuring venous clinical severity score. EVLA show distinct advantages over open surgery especially in post operative pain, analgesia use and time needed to return to work.

scholarly journals PC206. Correlation of Age With Patient Reported Symptoms and Venous Clinical Severity Score for Patients With Varicose Veins

2018 ◽  
Vol 67 (6) ◽  
pp. e229 ◽  
Author(s):  
Shravan Leonard-Murali ◽  
Dylan McLaughlin ◽  
Loay Kabbani ◽  
Mitchell R. Weaver ◽  
Nicole Kennedy ◽  
...  
Keyword(s):  
Severity Score ◽  
Varicose Veins ◽  
Clinical Severity ◽  
Clinical Severity Score ◽  
Venous Clinical Severity Score ◽  
Patient Reported

Outcomes associated with ablation compared to combined ablation and transilluminated powered phlebectomy in the treatment of venous varicosities

2016 ◽  
Vol 31 (9) ◽  
pp. 618-624 ◽  
Author(s):  
Andrea T Obi ◽  
Bradley N Reames ◽  
Trent J Rook ◽  
Sandford O Mouch ◽  
Arya Zarinsefat ◽  
...  
Keyword(s):  
Radiofrequency Ablation ◽  
Severity Score ◽  
Venous Insufficiency ◽  
Varicose Veins ◽  
Clinical Severity ◽  
Severity Scores ◽  
Venous Clinical Severity Score ◽  
Operative Complications ◽  
Thrombotic Complications ◽  
Procedure Type

Background Patients with painful varicose veins and venous insufficiency can be treated by eliminating axial reflux only or by eliminating axial reflux plus phlebectomy with transilluminated powered phlebectomy. This study was undertaken with the aim of determining and improving signs and symptoms of venous disease (measured by venous clinical severity score) and complications (by routine surveillance ultrasound and long-term post-operative follow up) for each treatment strategy. Methods We performed a retrospective evaluation of prospectively collected data from 979 limbs undergoing procedures for significant varicose veins and venous insufficiency from March 2008 until June 2014 performed at a single tertiary referral hospital. Patient demographics, Clinical Etiology Anatomy and Pathophysiology classification, venous clinical severity scores pre- and post-procedure, treatment chosen, and peri-operative complications were collected; descriptive statistics were calculated and unadjusted surgical outcomes for patients stratified by the procedure performed. Multivariable logistic regression was used to evaluate the relationship between procedure type and thrombotic complications after adjusting for patient characteristics, severity of disease, pre-operative anticoagulation, and post-operative compression. Result Venous clinical severity scores improved more with radiofrequency ablation + transilluminated powered phlebectomy as compared to radiofrequency ablation alone (3.8 ± 3.4 vs. 3.2 ± 3.1, p = 0.018). Regarding deep venous thrombosis, there was no significant difference between radiofrequency ablation + transilluminated powered phlebectomy vs. radiofrequency ablation alone. There was no statistical difference in asymptomatic endovenous heat-induced thrombosis or infection, although there were slightly more hematomas and cases of asymptomatic superficial thrombophlebitis with combined therapy. On multivariable analysis, only procedure type predicted thrombotic complications. Conclusion Ablation of axial reflux plus transilluminated powered phlebectomy produces improved outcomes as measured by venous clinical severity score, with slight increases in minor post-operative complications and should be strongly considered as initial therapy when patients present with significant symptomatic varicose veins and superficial venous insufficiency. Implementation of a standardized thromboprophylaxis protocol with individual risk assessment results in few significant thrombotic complications amongst high-risk patients, thus potentially obviating the need for routine post-operative duplex.

A retrospective study of a new n-butyl-2-cyanoacrylate glue ablation catheter incorporated with application guiding light for the treatment of venous insufficiency: Twelve-month results

Vascular ◽  
2018 ◽  
Vol 26 (5) ◽  
pp. 547-555 ◽  
Author(s):  
Turhan Yavuz ◽  
Altay Nihat Acar ◽  
Huseyin Aydın ◽  
Evren Ekingen
Keyword(s):  
Saphenous Vein ◽  
Varicose Vein ◽  
Severity Score ◽  
Great Saphenous Vein ◽  
Clinical Severity ◽  
The Third ◽  
Clinical Severity Score ◽  
Venous Clinical Severity Score ◽  
The Mean

Objective This study aims to present the early results of a retrospective study of the use of novel n-butyl-2-cyanoacrylate (VenaBlock)-based nontumescent endovenous ablation with a guiding light for the treatment of patients with varicose veins. Methods Patients with lower limb venous insufficiency were treated with n-butyl-2-cyanoacrylate (VenaBlock Venous Closure System) between April 2016 and July 2016. The study enrolled adults aged 21–70 years with symptomatic moderate to severe varicosities (C2–C4b) and great saphenous vein reflux lasting longer than 0.5 s with great saphenous vein diameter between 5.5 and 15 mm assessed in the standing position. No compression stockings were used after the procedure. Duplex ultrasound imaging and clinical follow-up were performed on the third day, first month, sixth month, and 12th month. Clinical, etiological, anatomical, pathophysiological classification; venous clinical severity score; and completed Aberdeen varicose vein questionnaire were recorded. Results Five hundred thirty-eight patients with great saphenous vein incompetency underwent n-butyl-2-cyanoacrylate ablation. The mean ablation length was 25.69 ± 4.8 cm, and the average amount of n-butyl-2-cyanoacrylate delivered was 0.87 ± 0.15 ml. The mean procedure time was 11.7 ± 4.9 min. Procedural success was 100%, and complete occlusion was observed after treatment and at the third-day follow-up. We observed ecchymosis in five patients (1.00%) at the entry site at the third-day follow-up. Phlebitis was encountered with six (1.20%) patients. No skin pigmentation, hematoma, paresthesia, deep vein thrombosis, or pulmonary embolism was observed. Kaplan–Meier analysis yielded an occlusion rate of 99.4% at the 12-month follow-up. All patients had significant improvement in venous clinical severity score and Aberdeen varicose vein questionnaire scores postoperatively ( p <0.0001). Venous clinical severity score scores decreased from 5.43 ± 0.87 to 0.6 ± 0.75. Aberdeen varicose vein questionnaire scores decreased from 18.32 ± 5.24 to 4.61 ± 1.42. Conclusions The procedure appears to be feasible, safe, and efficient in treating the great majority of incompetent great saphenous veins with this technique.

scholarly journals Evaluation and usefulness of venous clinical severity score (VCSS) in patients of varicose veins, undergoing surgery in a tertiary care hospital

2021 ◽  
Vol 5 (4) ◽  
pp. 209-211
Author(s):  
Dr. Raghuveer Chakravarthy Gogineni ◽  
Dr. Ratta Reddy Bommareddy ◽  
Dr. Tejaswi Chandana ◽  
Dr. Mounika Nadakuditi ◽  
Dr. Sai Sanath Kandula
Keyword(s):  
Severity Score ◽  
Tertiary Care Hospital ◽  
Varicose Veins ◽  
Tertiary Care ◽  
Clinical Severity ◽  
Care Hospital ◽  
Clinical Severity Score ◽  
Venous Clinical Severity Score

Two-year follow-up of a n-butyl-2-cyanoacrylate glue ablation for the treatment of saphenous vein insufficiency with a novel application catheter with guiding light

Vascular ◽  
2019 ◽  
Vol 27 (4) ◽  
pp. 352-358
Author(s):  
Atilla Sarac
Keyword(s):  
Saphenous Vein ◽  
Severity Score ◽  
Venous Insufficiency ◽  
Great Saphenous Vein ◽  
Clinical Severity ◽  
The Third ◽  
Clinical Severity Score ◽  
Venous Clinical Severity Score ◽  
The Mean

Objectives This study aims to present the early results of a prospective study of the use of novel n-butyl-2 cyanoacrylate (VenaBlock)-based nontumescent endovenous ablation with a guiding light for the treatment of patients with varicose veins. Methods Five hundred and seventy-three patients with lower-limb venous insufficiency were treated within in the previous four years. The study enrolled adults aged 21–70 years with symptomatic moderate to severe varicosities (C2–C6 patients clinical, etiological, anatomical, and pathophysiological classification) and great saphenous vein reflux lasting longer than 0.5 s with great saphenous vein diameter ≥ 5.5 mm assessed in the standing position. Duplex ultrasound imaging and clinical follow-up were performed on the third day, first month, and sixth month. Clinical, etiological, anatomical, pathophysiological classification; venous clinical severity score; and completed Aberdeen varicose vein questionnaire were recorded. Results Five hundred and seventy-three patients aged 21–70 years with lower-extremity venous insufficiency treated with n-butyl-2. The mean treatment length was 30.6 ± 5.3 cm and the average n-butyl-2 delivered was 1.2 ± 0.3 ml. The mean procedure time was 10.8 ± 4.7 min. There was no deep venous thrombosis, pulmonary embolism, or paresthesia. We observed ecchymosis in eight patients (1.4%) at the entry site at the third day follow-up. Phlebitis was encountered with 10 (1.8%) patients. No skin pigmentation, hematoma, paresthesia, deep-vein thrombosis, or pulmonary embolism was observed. Procedural success was 100%, and complete occlusion was observed after treatment, at the third day follow-up and at first month. Kaplan–Meier analysis yielded with overall clinical recurrence-free rate after a mean follow-up of 23.96 months was 99.38%. All patients had significant improvement in venous clinical severity score and quality-of-life scores postoperatively ( p < 0.0001). Venous clinical severity score scores at preintervention and 24th month were 5.8 ± 1.0 (range 4–8) and 0.6 ± 0.6 (range 0–4), respectively ( p < 0.0001). Aberdeen varicose vein questionnaire scores at preintervention and 24th month were 19.7 ± 6.4 (range 9–30) and 4.4 ± 1.1 (range 1–9), respectively ( p < 0.0001). Conclusions The procedure appears to be feasible, safe, and efficient in treating the great majority of incompetent great saphenous veins with this technique.

Responsiveness of individual questions from the venous clinical severity score and the Aberdeen varicose vein questionnaire

2012 ◽  
Vol 29 (1) ◽  
pp. 43-51 ◽  
Author(s):  
C R Lattimer ◽  
E Kalodiki ◽  
M Azzam ◽  
G Geroulakos
Keyword(s):  
Varicose Vein ◽  
Severity Score ◽  
Poor Response ◽  
Clinical Severity ◽  
Foam Sclerotherapy ◽  
Endovenous Laser Ablation ◽  
Clinical Severity Score ◽  
Venous Clinical Severity Score ◽  
Pre Treatment ◽  
The Individual

Objectives The venous clinical severity score (VCSS) and the Aberdeen varicose vein questionnaire (AVVQ) improve after treating chronic venous insufficiency (CVI). The aim was to examine how and why they improve by evaluating the change in each individual question. Methods This was an analysis on prospectively collected data from a clinical study on 100 patients (58% female) with CVI (C2 = 34, C3 = 14, C4a = 29, C4b = 9, C5 = 7, C6 = 7) who were randomized to endovenous laser ablation ( n = 50) or foam sclerotherapy ( n = 50). The change scores (performance) of each question of the VCSS (questions 1–10) and the AVVQ (questions 1–13) were calculated by subtracting the score at three weeks, and three months, from the pre-treatment score. Results Both the median, interquartile range (IQR), VCSS and the AVVQ scores improved from 6 (4) and 21.4 (15.1) at baseline to 3 (4) and 18.6 (12.1) at three weeks ( P < 0.0005, P = 0.031) to 2 (3) and 8.8 (13.6) at three months, ( P < 0.0005, P < 0.0005), respectively. The performance of the first three questions of the VCSS (pain, extent of varicosities, oedema) were the most contributory to the overall score. Questions 5, 7, 8, 9 on ulceration improved the most individually but did not contribute significantly to the overall score. Questions 5, 9 of the AVVQ on stocking use and ulceration failed to contribute statistically to the overall improvement at three months. Conclusion The majority of the individual questions of the VCSS and AVVQ responded to change. However, the cause of a poor response was multifactorial with statistical dilution playing a significant role. Stratification of patients according to ulceration may allow better comparisons.

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