scholarly journals Demographic examination of lymphedema seen in the lower extremities

2021 ◽  
Vol 8 (6) ◽  
pp. 1682
Author(s):  
Ibrahim Demir ◽  
Dogan Yetut ◽  
Metin Onur Beyaz
Keyword(s):  
Lower Extremity ◽  
Venous Insufficiency ◽  
Blood Groups ◽  
Venous Disease ◽  
Lower Extremity Edema ◽  
Secondary Lymphedema ◽  
Patient Profile ◽  
The Mean ◽  
The Relationship ◽  
Perforating Vein

Background: We aimed to indicate the frequency of this disease according to blood groups, other disease types, age, weight and other demographic characteristics.Methods: We examined total of 236 patients who applied to our clinic because of lower extremity edema within 5 years. All patients had a diagnosis of lymphedema. Patients with a diagnosis of congenital lymphedema or a diagnosis secondary to cancer were excluded. Obesity, presence of venous disease, diabetes mellitus and hypertension which are considered as causes of secondary lymphedema were included in the study. Also the relationship between lymphedema patients and blood groups were evaluated.Results: 81% (n:193) of patients were women. The mean age of the patients was 50.71 (±10.28). All patients had diagnosis of lymphedema. Most of patients (n:189) had bilateral lower extremity edema. Body mass index was above 25 in 149 (63.1%) patients. Deep venous insufficiency accompanied in 75 (31.8%) patients. Perforator vein incompetance was observed with lymphedema in 96 (40.7%) patients. The number of diabetic and hypertensive patients was 64 (27.1%) and 67 (28.4%), respectively. Patients with B type blood group constituted the largest patient profile with a rate of 41.9% (n:99).Conclusions: In our study, demographic characteristics were not statistically corolated to lymphedema development, however, the rate of lymphedema in patients with perforating vein insufficiency was statistically significant (p<0.05, P=0.002). The most important point to be considered here is whether lymphedema plays a role in the development of additional pathology or do additional pathologies trigger the development of lymphedema?

Evaluation and Management of Patients with Leg Swelling: Therapeutic Options for Venous Disease and Lymphedema

2021 ◽  
Vol 38 (02) ◽  
pp. 189-193
Author(s):  
Kimberly Scherer ◽  
Neil Khilnani
Keyword(s):  
Lower Extremity ◽  
Interstitial Fluid ◽  
Therapeutic Options ◽  
Venous Disease ◽  
Lower Extremity Edema ◽  
Common Condition ◽  
Common Causes ◽  
Subcutaneous Tissues ◽  
Venous Disorders

AbstractLower extremity swelling is a common condition which has a variety of etiologies and can be challenging to diagnose and manage. Swelling is usually the result of the accumulation of interstitial fluid in the subcutaneous tissues. Common etiologies include systemic, superficial, and deep venous, and lymphatic disorders. Leg swelling can occur bilaterally or unilaterally, with venous disorders being one of the most common causes of unilateral lower extremity edema.

Use of Noncontact Low-Frequency Ultrasound in the Treatment of Chronic Foot and Leg Ulcerations

2007 ◽  
Vol 97 (2) ◽  
pp. 95-101 ◽  
Author(s):  
Steven J. Kavros ◽  
Erik C. Schenck
Keyword(s):  
Lower Extremity ◽  
Control Period ◽  
Low Frequency ◽  
Standard Of Care ◽  
Volume Reduction ◽  
Venous Disease ◽  
Ultrasound Therapy ◽  
Low Frequency Ultrasound ◽  
The Mean ◽  
Frequency Ultrasound

Background: A feasibility study was conducted to characterize the effects of noncontact low-frequency ultrasound therapy for chronic, recalcitrant lower-leg and foot ulcerations.Methods: The study was an open-label, nonrandomized, baseline-controlled clinical case series. Patients were initially treated with the Mayo Clinic standard of care before the addition of or the switch to noncontact low-frequency ultrasound therapy. We analyzed the medical records of 51 patients (median ± SD age, 72 ± 15 years) with one or more of the following conditions: diabetes mellitus, neuropathy, limb ischemia, chronic renal insufficiency, venous disease, and inflammatory connective tissue disease. All of the patients had lower-extremity ulcers, 20% had a history of amputation, and 65% had diabetes. Of all the wounds, 63% had a multifactorial etiology, and 65% had associated transcutaneous oximetry levels below 30 mm Hg.Results: The mean ± SD treatment time of wounds during the baseline standard of care control period versus the noncontact low-frequency ultrasound therapy period was 9.8 ± 5.5 weeks versus 5.5 ± 2.8 weeks (P &lt; .0001). Initial and end measurements were recorded, and percent volume reduction of the wound was calculated. The mean ± SD percent volume reduction in the baseline standard of care control period versus the noncontact low-frequency ultrasound therapy period was 37.3% ± 18.6% versus 94.9% ± 9.8% (P &lt; .0001).Conclusions: Using noncontact low-frequency ultrasound improved the rate of healing and closure in recalcitrant lower-extremity ulcerations. (J Am Podiatr Med Assoc 97(2): 95–101, 2007)

scholarly journals IS FLAT FOOT A PREVENTABLE FACTOR IN CHRONIC VENOUS INSUFFICIENCY?

2021 ◽  
Vol 9 (02) ◽  
pp. 1000-1003
Author(s):  
Srinivasan a ◽  
Prathap Kumar ◽  
Velladuraichi a ◽  
Ilaya Kumar ◽  
Sritharan b
Keyword(s):  
Risk Factors ◽  
Varicose Vein ◽  
Venous Insufficiency ◽  
Lower Limbs ◽  
Venous Disease ◽  
Flat Foot ◽  
Anatomy And Physiology ◽  
Effective Interventions ◽  
Relationship Of ◽  
The Relationship

The presence of a venous pumping mechanism in the foot may be significant for venous return in the lower extremities. The anatomy and physiology of venous foot pump {VFP} is essential of effective interventions for prevention, treatment, and management of venous disease in the lower limbs. Though many studies have identified the risk factors for prevalence of venous disease, only few have investigated for risk factors for venous disease progression. Therefore, the aim of this study was to investigate the relationship of flatfoot and varicose vein and the progression of venous disease. We did a pilot study on 12 patients with bilateral varicose vein with bilateral pes planus where we presume the cause of CVI is secondary to VFP dysfunction.

scholarly journals The Relationship Between ABO Blood Groups and Retinal Venous Occlusion

2021 ◽  
Author(s):  
Pinar Kaya ◽  
Mehmet Murat Uzel ◽  
Ömer Can Kayıkçıoğlu ◽  
Cenap Güler
Keyword(s):  
Regression Analysis ◽  
Retinal Vein Occlusion ◽  
Blood Group ◽  
Venous Occlusion ◽  
Blood Groups ◽  
Blood Type ◽  
Vein Occlusion ◽  
The Mean ◽  
And Gender ◽  
The Relationship

Abstract Purpose The aim of this study is to investigate the relationship between retinal vein occlusions (RVO) and blood groups.Methods Detailed ophthalmological examinations, systemic diseases and blood groups of patients who applied to Balıkesir University Faculty of Medicine, Ophthalmology Outpatient Clinic between February 2019 and May 2020 with retinal vein occlusion were retrospectively analyzed. The blood groups of the patients were divided into 2 groups as O and non-O. The results were compared with a normal group matched in terms of age and gender. Regression analysis was performed to determine the relationship between blood group types and vein occlusions.Results A total of 116 people were included in the study. The mean age of 38 patients with vein occlusion was 61.8 ± 11.3, while the mean age of 78 patients without vein occlusion was 62.6 ± 11.1 (p=0.696). In the RVO patients group, 14 (36.8%) were female, 30 (78.9%) had non-O blood group, 20 (52.6%) had hypertension (HT), 19 (50%) had diabetes mellitus (DM). According to the results of simple logistic regression analysis, non-O blood group and HT have statistically significant effects on RVO formation (Simple Regression Analysis results: OR 2.47, 95% CI 1.00-6.09, p=0.049; OR 2.22, 95% CI 1.00-4.90, p=0.048 ; respectively). Non-O blood group and HT significance remained limited as a result of multiple regression analysis (OR 2.47,95% CI 0.97-6.06, p=0.057; OR 2.18, 95% CI 0.97-4.88, p=0.057, respectively).Conclusion Non-0 blood type can be considered as a risk factor for retinal vein occlusion.

Incidence and distribution of lower extremity reflux in patients with pelvic venous insufficiency

2019 ◽  
Vol 35 (1) ◽  
pp. 10-17 ◽  
Author(s):  
Nicholas Scotti ◽  
Karl Pappas ◽  
Sanjiv Lakhanpal ◽  
Candace Gunnarsson ◽  
Peter J Pappas
Keyword(s):  
Lower Extremity ◽  
Saphenous Vein ◽  
Venous Insufficiency ◽  
Clinical Severity ◽  
Venous Disease ◽  
Entire Cohort ◽  
Venous Clinical Severity Score ◽  
Venous Disorders ◽  
Pelvic Venous Insufficiency ◽  
Extremity Veins

Introduction Women with pelvic venous insufficiency often present with lower extremity symptoms and manifestations of chronic venous disorders. The purpose of this investigation was to determine the incidence of lower extremity chronic venous disorders and the types and distribution of lower extremity veins involved in patients with a known diagnosis of pelvic venous insufficiency. Methods Between January 2012 and December 2015, we retrospectively reviewed the charts of 227 women with pelvic venous insufficiency as well as their lower extremity venous duplex investigations. Presenting symptoms, Clinical, Etiology, Anatomy, Pathophysiology (CEAP) class, initial revised Venous Clinical Severity Score (rVCSS) and the types of lower extremity veins with reflux and their locations were noted. Patients were also subcategorized according to their primary pelvic disorder as follows: Entire cohort (PVI), Ovarian vein reflux (OVR), Iliac vein stenosis (IVS) or both (OVR + IVS). Results The study group consisted of 227 women (454 limbs) with documented pelvic venous insufficiency. The average age was 44.71 ± 10.2 years. In decreasing order, patients presented with the following lower extremity symptoms: pain (66%), swelling (32%), heaviness (26%), limb fatigue (13%), itching (13%), leg cramps (10%), skin changes or Superficial Venous Thrombosis (SVT) (2%) and ulceration or bleeding (0.08%). Table 1 outlines the CEAP class for 215 of the 227 patients. For the entire cohort, 48% of right and 50% of left limbs demonstrated C0 or C1 disease. The incidence and type of symptomatic lower extremity veins were as follows: any axial vein, 32%; great saphenous vein (GSV), 21%; small saphenous vein (SSV), 11%; GSV and SSV, 5%; non-saphenous tributaries, 15%; saphenous tributaries, 12%; posterior or postero-lateral thigh distribution, 5%; vulvar distribution, 4%; perforators, 4%; deep veins, 2%; and anterior accessory saphenous veins, 1%. For the GSV and SSV, the following patterns of reflux were observed: entire GSV, 4%; entire above knee GSV, 2%; entire below knee GSV, 2%; above knee segmental GSV, 20%; below knee segmental GSV, 21%; above and below knee GSV segmental disease, 1%; entire SSV, 4%; and SSV segmental disease, 12%. The incidence of reflux in any axial vein, the GSV and anterior accessory GSV was greater in the OVR group compared to IVS or OVR + IVS (p ≤ 0.03). In addition, 64 of 227 (28%) patients had a history of prior lower extremity venous ablations: OVR (10/39, 26%), IVS (15/50, 30%) and OVR + IVS (39/127, 9%). The number of ablations per patient was as follows—OVR: 1.48 ± 0.5, IVS: 1.7 ± 0.7 and OVR + IVS: 1.65 ± 0.7. Conclusion At least 50% of patients with pelvic venous insufficiency present with lower extremity venous disease. The incidence of reflux in any axial vein is greatest in the OVR group suggesting a correlation with hormonal fluctuations and pregnancy. The majority of symptomatic patients present with segmental axial GSV or SSV disease. Although vulvar and gluteal escape veins are highly associated with pelvic venous insufficiency, they are infrequently observed. In patients who experience residual or persistent symptoms after treatment for chronic venous disorders, a pelvic venous ultrasound should be performed to assess the presence of pelvic venous insufficiency.

Venous Pressure Gradients in Patients with Chronic Venous Disease

1986 ◽  
Vol 1 (1) ◽  
pp. 47-50 ◽  
Author(s):  
Einer Stranden ◽  
Per Øgreid ◽  
Egil Seem
Keyword(s):  
Chronic Venous Insufficiency ◽  
Venous Insufficiency ◽  
Venous Pressure ◽  
Chronic Venous Disease ◽  
Venous Disease ◽  
Pressure Gradients ◽  
Venous Valves ◽  
The Mean ◽  
The Difference ◽  
Pressure Changes

Venous pressure was measured simultaneously in a vein of the calf and the foot in five healthy controls and 10 patients with superficial chronic venous insufficiency (CVI). In both groups ambulatory venous pressure decreased more in the foot veins than in the calf veins. In patients with CVI the mean difference in foot and calf ambulatory venous pressure reduction (AVPR) was 25.5 mmHg, as was found in the controls (24.6 mmHg). During compression of superficial veins the difference in AVPR was reduced in patients but not in controls (11.6 vs 27.0 mmHg, respectively). About 50% of this difference in AVPR could be ascribed to the difference in cannulation height (except for the meaurement with superficial compression in patients where the whole difference in AVPR could be ascribed to the difference in cannulation height). Pressure changes during ambulation in the dorsal foot vein and calf veins may differ considerably, dependent on the existance of a specific foot vein pump and sufficiency of venous valves at the level of the ankle. Therefore, veins proximal to the ankle should be used for pressure recordings in the evaluation of chronic venous insufficiency in the calf.

scholarly journals Venous function after pharmacomechanical thrombolysis for extensive iliofemoral deep vein thrombosis

2017 ◽  
Vol 21 (1) ◽  
Author(s):  
Wim Greeff ◽  
Ali Reza Dehghan-Dehnavi ◽  
Jacobus Van Marle
Keyword(s):  
Venous Thrombosis ◽  
Deep Venous Thrombosis ◽  
Chronic Venous Insufficiency ◽  
Venous Insufficiency ◽  
Clinical Signs ◽  
Venous Disease ◽  
Long Term Outcome ◽  
Ceap Classification ◽  
Venous Function ◽  
The Mean

Background: Chronic venous insufficiency is an important complication following iliofemoral deep venous thrombosis. Early thrombus removal may preserve venous function and prevent this complication. This study represents the largest reported South African series of pharmacomechanical thrombolysis for iliofemoral deep venous thrombosis to date.Objective: To evaluate the long-term outcome following pharmacomechanical thrombolysis for proximal and extensive deep venous thrombosis in a private, specialist vascular unit.Methods: All patients who underwent pharmacomechanical thrombolysis for iliofemoral deep venous thrombosis between August 2009 and January 2016 were invited to return for clinical assessment and venous ultrasound. Clinical findings were recorded according to the Villalta score and clinical, etiology, anatomic and pathology (CEAP) classification. The quality of life (QoL) was assessed utilising the VEINES-QoL/Sym questionnaire, providing two scores per patient, one describing the QoL and the other symptom severity (Sym).Results: Thirty two patients (35 legs) were evaluated. There were 25 females and 7 males, with a mean age of 33.5 years (±14 years). The mean follow-up period was 31 months (range 3 months – 80 months). Results of the CEAP classification were C0 = 24 (75%), C1 = 1 (4%), C2 = 2 (6%), C3 = 2 (6%) and C4 = 3 (9%). Thirty-one (97%) patients had Villalta scores from 0 to 4, indicating no or mild evidence of venous disease. One patient (3%) had a Villalta score of 6, indicating post-thrombotic syndrome. The mean QoL score was 87% (±12) and the mean Sym score was 86% (±14). Twenty-four (75%) patients had no abnormality on ultrasound, with fibrosis the most observed abnormality.Conclusion: Most patients who had undergone pharmacomechanical thrombolysis for extensive iliofemoral deep venous thrombosis showed few significant clinical signs of chronic venous insufficiency, had excellent function on venous ultrasound and reported excellent QoL.

High tolerance of progressive elastic compression in peripheral arterial disease

VASA ◽  
2019 ◽  
Vol 48 (5) ◽  
pp. 413-417 ◽  
Author(s):  
Serge Couzan ◽  
Jean-François Pouget ◽  
Claire Le Hello ◽  
Céline Chapelle ◽  
Silvy Laporte ◽  
...  
Keyword(s):  
Venous Insufficiency ◽  
Ankle Brachial Index ◽  
Arterial Disease ◽  
Return Flow ◽  
High Tolerance ◽  
Compression Stockings ◽  
Short Term ◽  
Poor Tolerance ◽  
The Mean ◽  
Peripheral Arterial

Summary. Background: Theoretically progressive compression stockings, which produce a higher compression at the calf than at the ankle level, improve venous return flow without exacerbating peripheral arterial insufficiency (PAD). We aimed to evaluate the short-term tolerance of elastic progressive compression stockings on peripheral arterial vascularisation in patients with symptomatic PAD and associated mild venous insufficiency. Patients and methods: Monocentric, prospective, open pilot study of 18 patients (acceptability study, 6 x 6 plan) evaluating the short-term tolerance of progressive compression stockings (18 ± 2 mmHg at calf and 8 ± 2 mmHg at ankle level) in patients with PAD (ankle brachial index ABI > 0.60 < 0.75) and chronic venous insufficiency (C1s–C4 stages of the CEAP classification). Day 15 tolerance was evaluated by a composite primary criteria comprising: no decrease > 15 % of ABI on each side, no decrease > 15 % of toe brachial index (TBI) on each side and no decrease > 25 % of the number of active plantar flexions performed while standing. Results: The proportion of men was 77.8 %, mean age was 77.3 ± 7.5 years and no patient were diabetic. At inclusion, the mean low ABI was 0.60 ± 0.04 and the mean high ABI was 0.77 ± 0.18. The mean low TBI was 0.32 ± 0.09 and the mean high TBI 0.46 ± 0.15. The mean number of active standing plantar flexions was 33.0 ± 5.0. The majority of the patients were classified in CEAP C2s and C3 classes (class 2: 16.7 %, class C2s: 27.8 %, class C3: 44.4 %, class C4: 5.6 % and class C4s: 5.6 %). Poor tolerance occurred in no patient. By day 30, no patient had worsening of their arterial and venous symptoms. No adverse events occurred during the study. Conclusions: These results suggest a high tolerance of progressive elastic stockings (18 ± 2 mmHg at calf and 8 ± 2 mmHg at ankle level) in symptomatic PAD.

Multi-Center Calibration of the Second Reference Material for Thromboplastin, Rabbit, Plain, Coded CRM 149R

1991 ◽  
Vol 65 (03) ◽  
pp. 263-267 ◽  
Author(s):  
A M H P van den Besselaar ◽  
R M Bertina
Keyword(s):  
Reference Material ◽  
Standard Error ◽  
Standard Errors ◽  
Sensitivity Index ◽  
Long Term Stability ◽  
Significant Bias ◽  
The Mean ◽  
The Relationship ◽  
International Sensitivity Index

SummaryIn a collaborative trial of eleven laboratories which was performed mainly within the framework of the European Community Bureau of Reference (BCR), a second reference material for thromboplastin, rabbit, plain, was calibrated against its predecessor RBT/79. This second reference material (coded CRM 149R) has a mean International Sensitivity Index (ISI) of 1.343 with a standard error of the mean of 0.035. The standard error of the ISI was determined by combination of the standard errors of the ISI of RBT/79 and the slope of the calibration line in this trial.The BCR reference material for thromboplastin, human, plain (coded BCT/099) was also included in this trial for assessment of the long-term stability of the relationship with RBT/79. The results indicated that this relationship has not changed over a period of 8 years. The interlaboratory variation of the slope of the relationship between CRM 149R and RBT/79 was significantly lower than the variation of the slope of the relationship between BCT/099 and RBT/79. In addition to the manual technique, a semi-automatic coagulometer according to Schnitger & Gross was used to determine prothrombin times with CRM 149R. The mean ISI of CRM 149R was not affected by replacement of the manual technique by this particular coagulometer.Two lyophilized plasmas were included in this trial. The mean slope of relationship between RBT/79 and CRM 149R based on the two lyophilized plasmas was the same as the corresponding slope based on fresh plasmas. Tlowever, the mean slope of relationship between RBT/79 and BCT/099 based on the two lyophilized plasmas was 4.9% higher than the mean slope based on fresh plasmas. Thus, the use of these lyophilized plasmas induced a small but significant bias in the slope of relationship between these thromboplastins of different species.

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