scholarly journals Elastic compression treatment of chronic superficial venous insufficiency of the lower limbs based on Doppler venous pressure index measurements

2015 ◽  
Vol 4 (1) ◽  
Author(s):  
Leonardo Corcos ◽  
Daniele Pontello ◽  
Tommaso Spina
Keyword(s):  
Venous Insufficiency ◽  
Varicose Veins ◽  
Venous Pressure ◽  
Lower Limbs ◽  
Compression Stockings ◽  
Elastic Compression ◽  
Pressure Index ◽  
Counter Pressure ◽  
The Difference ◽  
Compression Treatment

Ineffectiveness or discomfort from graduated elastic compression stockings (GES) in patients with chronic venous insufficiency (CVI) and/or varicose veins of the lower limbs (VVLL) can depend of inappropriate counter pressure applied. Counter pressure was calculated by Doppler venous pressure index (VPI). The aim of this study was to verify the value VPI in the choice of GES. A total of 1212 LL of 606 patients subjected to VPI measurements VPI correlated with the various sites of reflux (R) and C of Clinical-Etiology-Anatomy-Pathophysiology (CEAP) classification. The difference between standing VPI the and normal values=counter pressure to be applied by GES. Questionnaire to 96 patients with CVI/VVLL wearing GES. Mean VPI values: greater saphenous (GSV)>smaller saphenous; GSV with isolated venous reflux (R) at the leg>GSV at the thigh; additional R in perforators increases VPI in all the districts; superficial R increases VPI in PT. Relation between VPI/C of CEAP: P<0.05-0.0001; 81/83/96 (97.5%) patients improved; 0 complained. R in GSV at the leg and in perforators increases VPI in deep veins. Few discrepancies VPI/CEAP can be expected. Standing VPI is highly predictive. The best choice of GES can be based on the VPI measurement.

Compression therapy and pressure in the deep venous system

2003 ◽  
Vol 18 (4) ◽  
pp. 192-197 ◽  
Author(s):  
J C J M Veraart ◽  
T K Oei ◽  
H A M Neumann
Keyword(s):  
Venous Insufficiency ◽  
Venous Pressure ◽  
Venous System ◽  
Rank Test ◽  
Class Iii ◽  
Compression Stockings ◽  
Elastic Compression ◽  
Deep Venous System ◽  
Strong Compression ◽  
Elastic Stockings

Objectives: To evaluate the effect of five different elastic compression stockings on the venous pressure in the deep venous system in the supine and standing positions. Methods: Setting: Departments of Dermatology and Radiology, University Hospital Maastricht, The Netherlands. Patients: A total of eight limbs of seven subjects (five patients and two healthy volunteers) with a mean age of 53 years (range 33-79) were measured. The patients were known to have severe venous insufficiency and recurrent leg ulceration. A catheter connected to an external pressure transducer was placed in one of the deep veins of the lower leg after puncturing the popliteal vein. The position of the catheter was established with contrast medium. Venous pressure recordings were made in the supine and standing positions while wearing an anti-embolism stocking and while wearing four different compression stockings (class II and III). Results: All stockings worn in the supine position caused a significant increase in pressure when compared with no compression at all ( P <0.05; Wilcoxon rank test). Only the strong compression class III stockings caused a significant and clinically relevant pressure increase, compared with the other four elastic compression stockings ( P <0.05; Wilcoxon rank test). In the standing position no differences in pressure were found between the elastic stockings, or when any stocking was compared with the use of no stocking at all. Conclusions: The results demonstrate that only strong compression class III stockings (>40 mmHg at the ankle) increase the pressure in the deep venous system in the supine position. Because of this, these elastic stockings may be the only stockings that have a positive influence on the pathologic deep venous system in patients with deep venous insufficiency, such as after deep venous thrombosis. The study confirms earlier clinical observations that in the treatment of patients with post-thrombotic symptoms and deep venous insufficiency only strong elastic compression stockings are effective.

Prevalence of Venous Insufficiency in French Adults of the SUVIMAX Cohort

2000 ◽  
Vol 15 (3-4) ◽  
pp. 98-98
Author(s):  
P. Preziosi ◽  
P. Galan ◽  
M. Aissa ◽  
S. Hercberg ◽  
H. Boccalon ◽  
...  
Keyword(s):  
Venous Insufficiency ◽  
Varicose Veins ◽  
Lower Limbs ◽  
Common Disease ◽  
Compression Stockings ◽  
Functional Symptoms ◽  
Nocturnal Cramps ◽  
Age Range ◽  
Organic Disorder

Background: The symptoms of venous insufficiency of the lower limbs (VILL) include a feeling of heaviness in the legs, pain, and nocturnal cramps, which may be combined with organic disorder (varicose veins). The objective of this study was to determine the prevalence of VTLL in terms of both varicose veins and functional symptoms in the participants of the SUVIMAX cohort, which is representative of the French population for the age range under consideration (women: 35–60; men: 45–60). Methods: Information on the venous status of 3065 subjects in SUVIMAX cohort were collected from three different sources: yearly systematic clinical (1994-1996), monthly follow-up by a telematic network (1994–1998) and non-specific questionnaire (1997). Two mutually exclusive populations were thus denned on medically diagnosed varicose and venous insufficiency. Results: Venous insufficiency was medically diagnosed in 192 men (14.6%) and 584 women (33.6%), and varicose veins were diagnosed in 143 men (74.5%) and 317 women (54.2%) from this group. Prevalence reported symptoms of venous insufficiency and of varicose veins was 13.6% and 7.4% respectively in men and 28.2% and 12.4% in women. Sex, age, body mass index and number of pregnancies were found to be correlated with the risk of venous insufficiency. Conclusions: VILL is a very common disease in French adults both as varicose veins and as functional symptoms. Venotonics were the main type of treatment but not enough use is made of elastic compression stockings. [Int Angiol 1999;18.171–5]

Invasive therapeutic options in truncal varicosity of the great saphenous vein

VASA ◽  
2006 ◽  
Vol 35 (3) ◽  
pp. 157-166 ◽  
Author(s):  
Hach-Wunderle ◽  
Hach
Keyword(s):  
Minimally Invasive ◽  
Saphenous Vein ◽  
Venous Insufficiency ◽  
Great Saphenous Vein ◽  
Varicose Veins ◽  
Venous Pressure ◽  
Stage Iii ◽  
High Ligation ◽  
Surgical Trauma ◽  
Disease Stages

It is known from current pathophysiology that disease stages I and II of truncal varicosity of the great saphenous vein do not cause changes in venous pressure on dynamic phlebodynamometry. This is possibly also the case for mild cases of the disease in stage III. In pronounced cases of stage III and all cases of stage IV, however, venous hypertension occurs which triggers the symptoms of secondary deep venous insufficiency and all the complications of chronic venous insufficiency. From these facts the therapeutic consequence is inferred that in stages I and II and perhaps also in very mild cases of stage III disease, it is enough "merely" to remove varicose veins without expecting there to be any other serious complications in the patient’s further life caused by the varicosity. Recurrence rates are not included in this analysis. In marked cases of disease stages III and IV of the great saphenous vein, however, secondary deep venous insufficiency is to be expected sooner or later. The classical operation with saphenofemoral high ligation ("crossectomy") and stripping strictly adheres to the recognized pathophysiologic principles. It also takes into account in the greatest detail aspects of minimally invasive surgery and esthetics. In the past few years, developments have been advanced to further minimize surgical trauma and to replace the stripping maneuver using occlusion of the trunk vein which is left in place. Obliteration of the vessel is subsequently performed via transmission of energy through an inserted catheter. This includes the techniques of radiofrequency ablation and endovenous laser treatment. High ligation is not performed as a matter of principle. In a similar way, sclerotherapy using microfoam is minimally invasive in character. All these procedures may be indicated for disease stages I and II, and with reservations also in mild forms of stage III disease. Perhaps high ligation previously constituted overtreatment in some cases. Targeted studies are still needed to prove whether secondary deep venous insufficiency can be avoided in advanced stages of varicose vein disease without high ligation and thus without exclusion of the whole recirculation circuit.

scholarly journals Klippel–Trénaunay Syndrome – A Very Rare and Interesting Syndrome

2015 ◽  
Vol 9 ◽  
pp. CCRPM.S21645 ◽  
Author(s):  
Deepak Sharma ◽  
Sachin Lamba ◽  
Aakash Pandita ◽  
Sweta Shastri
Keyword(s):  
Soft Tissue ◽  
Vascular Malformation ◽  
Chronic Venous Insufficiency ◽  
Venous Insufficiency ◽  
Varicose Veins ◽  
Lower Limbs ◽  
Port Wine ◽  
Bone Deformity ◽  
Klippel Trenaunay Syndrome

Klippel–Trénaunay syndrome (KTS or KT) is an infrequently seen dermatological syndrome, which is often viewed as a triad of vascular malformation (capillary malformations or port-wine brands), venous varicosity, and soft tissue and/or bony hypertrophy. We report a case of a 12-year-old male who presented to us with the symptoms of varicose plaques over both lower limbs and was diagnosed as a case of KTS. Management is normally conservative and includes stockings for compression of the branches to reduce edema because of chronic venous insufficiency; modern devices that cause on and off pneumatic compression; and rarely, surgical correction of varicose veins with lifelong follow-up. The orthopedic abnormalities are treated with epiphysiodesis in order to prevent (stop) overgrowing of limb and correction of bone deformity.

scholarly journals LivRelief varicose veins cream in the treatment of chronic venous insufficiency of the lower limbs: A 6-week single arm pilot study

PLoS ONE ◽  
2018 ◽  
Vol 13 (12) ◽  
pp. e0208954
Author(s):  
Heather C. Dwyer ◽  
David C. Baranowski ◽  
Perry V. Mayer ◽  
Simona Gabriele
Keyword(s):  
Pilot Study ◽  
Chronic Venous Insufficiency ◽  
Venous Insufficiency ◽  
Varicose Veins ◽  
Lower Limbs

scholarly journals Reasons for patient non-compliance with compression stockings as a treatment for varicose veins in the lower limbs: A qualitative study

PLoS ONE ◽  
2020 ◽  
Vol 15 (4) ◽  
pp. e0231218
Author(s):  
Jian-Mei Gong ◽  
Jian-Shi Du ◽  
Dong-Mei Han ◽  
Xin-Yu Wang ◽  
Shao-Long Qi
Keyword(s):  
Qualitative Study ◽  
Varicose Veins ◽  
Lower Limbs ◽  
Compression Stockings

Anatomical Patterns in Varicose Vein Disease: A Duplex Scanning Study

1995 ◽  
Vol 10 (3) ◽  
pp. 94-97 ◽  
Author(s):  
J. J. Guex ◽  
B. Hiltbrand ◽  
J. M. Bayon ◽  
F. Henri ◽  
F. A. Allaert ◽  
...  
Keyword(s):  
Saphenous Vein ◽  
Venous Insufficiency ◽  
Varicose Veins ◽  
Previous Treatment ◽  
Lower Limbs ◽  
Duplex Scanning ◽  
Consecutive Series ◽  
Yield Data ◽  
Varicose Disease ◽  
Vein Disease

Objectives: To determine symptomatology, clinical class, and topographic patterns of varicose veins in a consecutive series of patients with venous complaints. Methods: We performed clinical examination and duplex scanning of 498 lower limbs in 317 patients with obvious varicose veins for whom no previous treatment had been undertaken. Results: Classes of chronic venous insufficiency (CVI) in 498 legs: grade 0: 117 (23.5%); gr 1: 310 (62.2%); gr 2: 47 (9.4%); gr 3: 24 (4.8%). Duplex-detected venous reflux was found in the greater saphenous vein territory (junction or trunk or related perforator or main tributary) in 423 limbs (85.3%) the sapheno-femoral junction was incompetent in only 342 legs (68.7%). Reflux was found in the lesser saphenous vein territory in 100 limbs (20.1%) and in sapheno-popliteal junction in 92 (18.5%). Strictly non saphenous origin of varicosities was found in 31 limbs (6.2%). Deep venous incompetence was found in 48 legs (9.6%). Conclusions: These findings yield data on the distribution and occurence of lower limbs venous lesions in patients with varicose disease.

scholarly journals Dynamic Fractioning of the Gravitational Hydrostatic Pressure: A hemodynamic model for the venous pressure control by the valvo-muscular pump

2020 ◽  
Vol 5 (2) ◽  
Author(s):  
Claude Franceschi ◽  
Massimo Cappelli ◽  
José Maria Escribano ◽  
Erika Mendoza
Keyword(s):  
Hydrostatic Pressure ◽  
Fluid Mechanics ◽  
Venous Insufficiency ◽  
Venous Pressure ◽  
Clinical Signs ◽  
Lower Limbs ◽  
Instrumental Data ◽  
Basic Fluid ◽  
Hemodynamic Model ◽  
Muscular Pump

Dynamic Fractioning of the Gravitational Hydrostatic Pressure (DFGHSP) is a pillar of a hemodynamic model of the venous pathophysiology. It describes how the valvo-muscular pump varies the distal venous pressure in the lower limbs. It results from an inductive reasoning based on clinical signs and instrumental data at rest and during the action of the valvo-muscular pump of the calf. It does not claim to be the final truth, but a new "as if" model that improved the diagnosis and the treatment of the venous insufficiency (CHIVA, French acronym for Cure Conservatrice et Hémodynamique de l’Insuffisance Veineuse en Ambulatoire) according to several randomized studies and meta-analyses. That approach overturns the classic diagnosis and treatment of venous insufficiency because it is conservative and opposes the widely spread destructive based view. It needs a minimal study of basic fluid mechanics which can explain venous hemodynamics, the core of venous pathophysiology. The proposed DFGHSP fluid mechanics model is compared with the hemodynamic clinical and instrumental data in order to assess its pathophysiologic relevance.

scholarly journals CHRONIC VENOUS INSUFFICIENCY

10.23856/3217 ◽  
2019 ◽  
Vol 32 (1) ◽  
pp. 131-136
Author(s):  
Antoni Stadnicki ◽  
Martin Rusnák ◽  
Anna Stadnicka
Keyword(s):  
Chronic Venous Insufficiency ◽  
Venous Insufficiency ◽  
Varicose Veins ◽  
Chronic Venous Disease ◽  
Postthrombotic Syndrome ◽  
Venous Disease ◽  
Compression Stockings ◽  
Venous Leg Ulcer ◽  
Color Flow ◽  
Clinical Disorder

Chronic venous insufficiency (CVI) is a common, but underdiagnozed clinical disorder associated with a variety of signs and symptoms. The presence of leg edema in association  with varicose veins, and venous leg ulcer in later disease stages defines the disease. The pathogenesis of chronic venous disease  is based on venous reflux, obstruction, or a combination thereof.  Prior postthrombotic syndrome   is one of risk factor for CVI which may explain observed  prevalence of thrombophilia in CVI. Color flow duplex ultrasound is the gold standard for nearly all diagnostic issues related to chronic venous disease. Compression stockings are the mainstay for conservative management. Earlier use of venous ablation therapy should be considered in symptomatic patients with superficial tortuous vein

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