scholarly journals Chronic Venous Insufficiency (CVI) - A Study of 100 Cases

1970 ◽  
Vol 9 (1) ◽  
pp. 20-26
Author(s):  
MM Shahin-Ul-Islam ◽  
Md Zahirul Haque ◽  
Saki Md Jakiul Alam ◽  
Mesbahuddin Noman ◽  
FM Siddiqui
Keyword(s):  
Chronic Venous Insufficiency ◽  
Venous Insufficiency ◽  
Leg Pain ◽  
Advanced Stage ◽  
College Hospital ◽  
Prolonged Standing ◽  
Burning Pain ◽  
Significant Difference ◽  
Ceap Classification ◽  
Relationship Of

This study was carried out in the out patient department of Dhaka Medical College Hospital. 100 patients presented with chronic venous insufficiency during the period of January 2005 to June 2005 were studied to find out the various modes of presentation, risk factors and relationship of symptoms with age, sex and Body Mass Index of the patients. It was found that, maximum patients presented with heaviness in the leg (87%), followed by aching leg pain (75%), leg swelling (70%), cramping leg pain (68%), tiredness (48%), burning pain (43%), engorged leg vein (39%), restless leg at night (21%), throbbing leg pain (18%), itching (13%), various skin changes without active ulceration (7%) and active leg ulceration only 3% of cases. Increasing age of the patients, obesity, increasing number of pregnancy, prolonged standing and sitting position at work were found to be positively correlated with CVI. Advanced age is associated with more advanced stage of CVI according to clinical CEAP classification. There is almost equal sex distribution among the stages of CVI except in advanced stage, in stage C4, C5 and C6 there is 10 patients out of them 9 are male and only 1 is female. Relationship of symptoms with BMI of the patients were also sort out and found that, in C3 group of CEAP classification out of 61 patients 46 are obese according to BMI, of which 32 are female and 14 are male and only 17 patients have BMI within normal range, but in other group there is no significant difference in incidence between two groups.   DOI = 10.3329/jom.v9i1.1421 J MEDICINE 2008; 9 : 20-26

scholarly journals Pattern of Presentation of Chronic Venous Insufficiency in CVI Clinic of CMCH

2018 ◽  
Vol 30 (1) ◽  
pp. 26-29
Author(s):  
Md Salim ◽  
GM Zakir Hossain ◽  
Mahmudur Rahman ◽  
Md Monirul Alam ◽  
Muallem Al Farukh Khan ◽  
...  
Keyword(s):  
Chronic Venous Insufficiency ◽  
Prospective Observational Study ◽  
Venous Insufficiency ◽  
Medical College ◽  
Advanced Stages ◽  
Ceap Classification ◽  
Male Patients ◽  
Common Sign ◽  
The Impact ◽  
Chronic Ulceration

Chronic venous insufficiency (CVI) is a common but often ignored problem in primary health care, sign and symptoms may ranges from mild leg heaviness or aching, dilated or unsightly veins, or troublesome odema to fibroses subcutaneous panniculitis associated with recurrent cellulitis and chronic ulceration. The prospective observational study was carried out department of surgery, Chittagong Medical College & Hospital, Chittagong. The primary purpose of the present study was to evaluate the impact of the diagnostic approach on patient of chronic venous insufficiency, varicose vein to difference primary and secondary venous insufficiency. Most common sign flebedema found in 56 (65.12%) patients was followed by dermo-hypodermatitis in 15(17.44) patients, stasis eczema in 09(10.47) patients and thrombophlebitis in 06(6.98) patients. Most frequent lower leg symptoms are heaviness 82 (95.35%) & the lowest is Throbbing 55(63.95%). The others are according to order of frequency cramps 66 (70.0%), Itching (73.26%), burning 61(70.93%), tiredness (80.23%), restless leg (82.55%), pain aching 76 (88.37%). CVI (chronic venous insufficiency) studied 04 (4.65%) were in C1, 54(62.79%) were in C2, 03(3.49%) were in C3, 11(12.79%) were in C4, 6 (6.98%) were in C5 and 8(9.30%) were in C6 according to clinical CEAP classification. Majority of patients presented with the complains of heaviness of leg and unexplained leg swelling, sex predilection is almost same for male and female but advanced stages are more common in male patients. Increasing age is associated with more advanced stage of the disease.Medicine Today 2018 Vol.30(1): 26-29

scholarly journals VENOUS INSUFFICIENCY AND THROMBOEMBOLIC DISEASE IN BARIATRIC SURGERY PATIENTS

2013 ◽  
Vol 50 (3) ◽  
pp. 191-195 ◽  
Author(s):  
Bonno van BELLEN ◽  
Ivan de Barros GODOY ◽  
Andrea Almeida REIS ◽  
Pedro BERTEVELLO
Keyword(s):  
Bariatric Surgery ◽  
Morbid Obesity ◽  
Venous Thrombosis ◽  
Chronic Venous Insufficiency ◽  
Venous Insufficiency ◽  
Thromboembolic Disease ◽  
Lower Limbs ◽  
Abdominal Circumference ◽  
Morbidly Obese ◽  
Ceap Classification

Context Morbid obesity is associated with various co-morbidities, including chronic venous insufficiency. Bariatric surgery is the only effective treatment for morbid obesity, but with potential risks and possible complications, including venous thromboembolism. Objective To determine the prevalence of clinical and ultrasonographic signs of chronic venous insufficiency in morbid obese patients in preparation for bariatric surgery and the incidence of post-operative venous thromboembolic disease. Methods Patients on work-up for bariatric surgery of Centro Terapêutico Especializado em Fígado (CETEFI) and Pro-Gastro surgical teams of the Hospital Beneficência Portuguesa de São Paulo were included. The analysed data were pre-operative findings for venous insufficiency (CEAP - clinical, etiological, anatomical, physiopathologic - classification and venous ultrassonographic findings), type of surgery (open or laparoscopic), abdominal circumference, body mass index (BMI) and post-operative ultrassonography search for venous insufficiency and deep venous thrombosis. Results Between March 2007 and December 2009, 95 patients candidates for bariatric surgery had clinical and duplex scan evaluation of the lower limbs venous system. Of the 95 patients, 53 were submitted to the surgical procedure. There was a predominance of women (77.9%), the average age was 38.5 years, average preoperative weight 124.6 kg and average BMI of 45.5 kg/m2. Regarding obesity, 16.8% were obese, and 83.1% were morbidly obese. In relation to the venous findings, 86.3% of the patients did fit CEAP classification less than 3 and 13.7% greater than or equal to 3. Among the post-operative complications, there were four cases of wound infection. Three patients developed post-operative distal venous thrombosis (7.5%), but no one had clinically manifested pulmonary embolism. Conclusion No relation between BMI, CEAP classification and venous ultrassonographic findings were found. Although prophylaxis was used in all patients, the incidence of post-operative distal venous thrombosis was considerably high.

scholarly journals Pattern of Presentation of Chronic Venous Insufficiency in CVI Clinic of Chittagong Medical College Hospital

2018 ◽  
Vol 16 (2) ◽  
pp. 51-55
Author(s):  
Md Salim ◽  
GM Zakir Hossain ◽  
Mahmudur Rahman ◽  
Md Monirul Alam ◽  
Muallem Al Farukh Khan
Keyword(s):  
Chronic Venous Insufficiency ◽  
Prospective Observational Study ◽  
Venous Insufficiency ◽  
Medical College Hospital ◽  
College Hospital ◽  
Medical College ◽  
Advanced Stages ◽  
Male Patients ◽  
Common Sign ◽  
The Impact

Background: Chronic Venous Insufficiency (CVI) is a common but often ignored problem in primary health care, sign and symptoms may ranges from mild leg heaviness or aching, dilated or unsightly veins, or troublesome odema to fibroses subcutaneous panniculitis associated with recurrent cellulitis and chronic ulceration.Methods: The prospective observational study was carried out Depaertment of Surgery, Chittagong Medical College Hospital, Chittagong. The primary purpose of the present study was to evaluate the impact of the diagnostic approach on patient of chronic venous insufficiency, varicose vein to difference primary and secondary venous insufficiency.Results: Most common sign flebedema found in 56 (65.12%) patients was followed by dermo-hypodermatitis in 15(17.44) patients, stasis eczema in 09(10.47) patients and thrombophlebitis in 06(6.98) patients. Most frequent lower leg symptoms are heaviness 82 (95.35%) & the lowest is throbbing 55(63.95%). The others are according to order of Frequency cramps 66 (70.0%) Itching 63 (73.26%) Burning 61(70.93%) Tiredness 69 (80.23%) Restless leg 71 (82.55%) Pain aching 76 (88.37%). CVI (Chronic Venous Insufficiency) studied 04 (4.65%) were in C1, 54(62.79%) were in C2, 03(3.49%) were in C3, 11(12.79%) were in C4, 6 (6.98%) were in C5 and 8(9.30%) were in C6 according to clinical CEAP classification.Conclusion: Majority of patients presented with the complains of heaviness of leg and unexplained leg swelling, sex predilection is almost same for male and female but advanced stages are more common in male patients. Increasing age is associated with more advanced stage of the disease.Chatt Maa Shi Hosp Med Coll J; Vol.16 (2); July 2017; Page 51-55

Chronic venous insufficiency (CVI)

2018 ◽  
pp. 469-478
Author(s):  
Abdullah Jibawi ◽  
Mohamed Baguneid ◽  
Arnab Bhowmick
Keyword(s):  
Oxygen Transport ◽  
Chronic Venous Insufficiency ◽  
Venous Insufficiency ◽  
Varicose Veins ◽  
Duplex Ultrasound ◽  
Leg Ulcers ◽  
Skin Changes ◽  
Lymphatic Flow ◽  
Compression Bandages ◽  
Ceap Classification

Chronic venous insufficiency (CVI) can result in varicose veins or, if severe, may develop skin changes and leg ulcerations. This chapter details the classification and presentation of varicose veins and venous leg ulcers (CEAP classification). It outlines the recommended investigations for CVI such as handheld Doppler scan and venous duplex ultrasound scans. The management of CVI is to improve the venous and lymphatic flow thereby improving the skin oxygen transport through reducing oedema. This can be performed by graduated compression bandages.

An evaluation of the lower extremity muscle strength of patients with chronic venous insufficiency

2015 ◽  
Vol 31 (3) ◽  
pp. 203-208 ◽  
Author(s):  
Cem Cetin ◽  
Mustafa O Serbest ◽  
Sabriye Ercan ◽  
Turhan Yavuz ◽  
Ali Erdogan
Keyword(s):  
Muscle Strength ◽  
Lower Extremity ◽  
Visual Analog Scale ◽  
Chronic Venous Insufficiency ◽  
Venous Insufficiency ◽  
Plantar Flexion ◽  
Lower Extremities ◽  
Analog Scale ◽  
Lower Extremity Muscle ◽  
Significant Difference

Objective In this study, the aim was to evaluate the lower extremity muscle strength in patients with chronic venous insufficiency using an isokinetic dynamometer. Methods The study comprised a group of 36 lower extremities of 23 patients diagnosed with chronic venous insufficiency and a control group of 40 lower extremities of 20 patients who did not have chronic venous insufficiency. In the diagnosis and evaluation of chronic venous insufficiency, photoplethysmography was used to evaluate the venous return circulation time. Visual Analog Scale scoring was applied to define the level of pain of the patients. Muscle strength measurements were made in all the lower extremities by using an isokinetic dynamometer. Results A statistically significant difference was detected between the groups in terms of the muscle strength parameters in the ankle plantar flexion, and knee flexor and extensor muscles. However, no statistically significant difference was found between the groups in the ankle dorsiflexion muscle strength parameters. A significant difference was determined in the ratio of ankle dorsiflexion/plantar flexion muscle strength between the mild, moderate and severe venous insufficiency groups. A statistically considerable negative correlation was found between the Visual Analog Scale scores and the photoplethysmography results. According to the Visual Analog Scale results, as the degree of venous insufficiency increased, so did the level of pain. Conclusion Impaired lower extremity muscle strength was observed in chronic venous insufficiency patients. Although the current study was consistent with literature in respect of impaired calf muscle strength, this finding was also seen in the thigh muscles. Furthermore, we concluded that if venous insufficiency becomes more severe, impaired calf muscle strength becomes more evident.

Pain in chronic venous insufficiency (including venous claudication)

Phlebologie ◽  
2014 ◽  
Vol 43 (06) ◽  
pp. 287-289 ◽  
Author(s):  
M. Dörler ◽  
M. Stücker
Keyword(s):  
Chronic Venous Insufficiency ◽  
Venous Insufficiency ◽  
Physical Exertion ◽  
Wound Dressings ◽  
Leg Pain ◽  
Warning Sign ◽  
Leg Ulcers ◽  
Venous Leg Ulcers ◽  
Peripheral Arterial ◽  
Venous Claudication

SummaryPain in chronic venous insufficiency can indicate an acute complication in the form of superficial thrombosis or deep venous thrombosis of the leg or chronic symptoms associated with venous leg ulcers or venous claudication. Up to 80 % of patients with venous leg ulcers report pain. This pain is a principal cause of the reduced quality of life of such patients. A distinction must be made between the acute pain arising from dressing changes, wound cleaning and debridement and pain occurring between these procedures. The pain should be evaluated systematically using visual analogue scales, as any increase in pain can be a warning sign of wound infections, irritation or allergic reactions to the wound dressings or exacerbation of a vascular disorder (e.g. additional peripheral arterial occlusive disease). Venous claudication occurs in the form of leg pain with a sensation of constriction on physical exertion, which subsides with rest. In the majority of cases, it is a symptom of reduced iliofemoral venous outflow. It occurs in up to 43.6 % of patients after iliofemoral thromboses.

Non-linear analysis of skin blood flow in patients suffering from chronic venous leg ulcers

Phlebologie ◽  
2009 ◽  
Vol 38 (02) ◽  
pp. 64-70
Author(s):  
K. Bräuer ◽  
C. Radke ◽  
A. Strölin ◽  
H.-M. Häfner
Keyword(s):  
Time Series ◽  
Blood Flow ◽  
Wavelet Analysis ◽  
Chronic Venous Insufficiency ◽  
Healthy Subjects ◽  
Venous Insufficiency ◽  
Laser Doppler ◽  
Healthy Controls ◽  
Laser Doppler Fluxmetry ◽  
Significant Difference

SummaryThe elevated ambulatory pressure in the peripheral venous system in patients suffering from chronic venous insufficiency manifests itself not only in the form of disturbed macrocirculation but also and particularly in microangiopathic changes. Laser Doppler fluxmetry is a well established method to measure cutaneous blood flow. Aim of the study was to investigate the cutaneous vasomotion at the inner ankle in patients suffering from chronic venous insufficiency in the clinical stadium C6 compared to healthy subjects. Patients, methods: In 38 patients suffering from venous ulcer and in 33 healthy subjects continous time series of Laser Doppler fluxmetry (LDF) data were recorded with a sampling frequency of 50 Hz over a period of 15 min. The patients were supine and LDF was measured at the inner ankle. Time series were analyzed using newly developed methods (wavelet analysis and biorthogenal decomposition). Results: There was a statistically significant difference in mean LDF between patients and healthy controls (94 SD 65 AU [C6] vs. 28 SD 13 AU (C0), p < 0.001). There also were statistically significant differences in the scaling levels using wavelet analysis corresponding to sympathetic activity, corresponding to myogenic activity in the vessel wall and corresponding to the heart beat. Conclusion: There are changes in vasomotion between patients with venous ulcers and healthy controls. We found a vasale neuropathy and a high degree in dysregulating skin perfusion. The new innovative strategies are suited for describing microcirculation and controlling therapies.

Classification of Chronic Venous Insufficiency: A Review

Angiology ◽  
2001 ◽  
Vol 52 (1_suppl) ◽  
pp. S17-S26 ◽  
Author(s):  
Pier Luigi Antignani
Keyword(s):  
Chronic Venous Insufficiency ◽  
Clinical Studies ◽  
Venous Insufficiency ◽  
Clinical Settings ◽  
European Working ◽  
Current Therapies ◽  
Ceap Classification ◽  
Set Up ◽  
Classi Fication

Chronic venous insufficiency (CVI) is a very variable and complex entity that has stimulated different attempts at classification. Several proposals have been made in recent years, based on objective and anatomical criteria, most of them incomplete and unsatisfactory. Finally the CEAP classification was presented in 1994. This certainly is the most nearly complete classi fication, since it takes into consideration not only the main aspects of CVI: Clinical, Etiological, Anatomical, and Pathophysiological, but also the degrees of severity, reported in the form of scores. It is now accepted internationally although it still has some flaws (such as the absence of the corona phlebectactica sign) and inaccuracies (above all in the clinical part and the scoring). Recently, some members of the Promoting Committee proposed a substantial modi fication of the part on scores, coming closest to the clinical reality, instrumental diagnosis, and current therapies. The characteristics of CEAP enable us to affirm that this represents the most original and useful classification, not only for clinical studies, but also in the assessment of therapeutic results and in patient follow-up. Like all classifications, CEAP also needs to be validated by means of clinical studies in order to demonstrate its applicability. For this purpose, a European Working Group was set up in 1997. The first interesting results of 872 dossiers collected by means of a computerized program (European Phlebological File) were presented at several international congresses and concentrated on the consistency and reproducibility of the clinical part of the CEAP classification in different clinical settings.

scholarly journals Association of great saphenous vein diameter and clinical severity score after treatment of severe chronic venous insufficiency with foam sclerotherapy

2021 ◽  
Vol 11 (4) ◽  
pp. 102-107
Author(s):  
Melissa Andreia De Moraes Silva ◽  
Luiz Henrique Silva de Sordi ◽  
Lara Camargo Rezende Grillo ◽  
Elisa de Paula Garcia ◽  
Luisa Resende Silva ◽  
...  
Keyword(s):  
Saphenous Vein ◽  
Ulcer Healing ◽  
Chronic Venous Insufficiency ◽  
Venous Insufficiency ◽  
Healing Rate ◽  
Clinical Severity ◽  
Foam Sclerotherapy ◽  
Ulcer Healing Rate ◽  
Ceap Classification

Objectives: to evaluate the association of the greater saphenous vein (GSV) diameter in the treatment of patients with severe chronic venous insufficiency (C6 CEAP classification) with ultrasound-guided polidocanol foam sclerotherapy (UGFS).  Methods: A prospective, descriptive and analytical study of 28 patients (30 limbs) that underwent UGFS. Patients were divided into 2 subgroups by GSV diameter (< 8 mm and ≥ 8 mm). Variables analyzed were ulcer healing, clinical intercurrences, clinical CEAP classification, Venous Clinical Severity Score (VCSS), diameter of the treated vein and presence of occlusion or recanalization by Doppler ultrasound. Patients were analyzed at the 1st, 3rd, and 6th months post-treatment. Results: The average age was 68.7 ± 10.5 years, 23 (82,1%) were women, and the average body mass index was 29.2 kg/m2. Although an improvement in VCSS score was observed during follow-up, no significant intergroup difference was noted. Seventeen (56%) limbs presented occlusion of the treated vein at the 1st month, 11 (36%) at the 3rd month, and 9 (30%) at the 6th month of follow-up. The ulcer healing rate was 56,6%. The average ulcer healing time was 90 days. Three (10%) patients presented with ulcer recurrence at the 6th month.  Survival analysis showed no significant difference in ulcer healing rate between subgroups after one year of follow-up (log-rank, p = 0,178). Conclusion: There was no difference between the subgroups of large and small VSM diameter in terms of symptom severity. However, significant reduction of VCSS and pain relief was observed after foam sclerotherapy.

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