A topical combination of blackberry, Centella asiatica, sodium hyaluronate, vitamin E and Melilotus to relieve legs symptoms of venous insufficiency

Chronic Venous Insufficiency (CVI) is a clinical condition characterized by several legs symptoms: telangiectasias, reticular veins, varicose veins, edema, pigmentation, eczema, lipodermatosclerosis, white atrophy and ulcers. These symptoms are often associated with tired and heavy legs, leg pain, itching, legs and ankles swelling. This report analyzes the usefulness of a cream based on blackberry, Centella asiatica, sodium hyaluronate, vitamin E and Melilotus (Flavofort 1500® legs cream) to relieve leg symptoms in CVI. A group of 35 subjects (7 men and 28 women) with legs symptoms applied Flavofort 1500® legs cream on the legs, twice a day for 10 days. The symptoms were evaluated with a patient questionnaire at 4 steps: T0 (before cream application), T1 (just after first application), T2 (5 days after first application) and T3 (10 days after first application). A reduction of subjects (%) with legs symptoms was observed both after 5 day and after 10 days.

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Features of postoperative period in patients with chronic venous insufficiency: phlebectomy versus thermal ablation

Hirurg (Surgeon) ◽

10.33920/med-15-2001-05 ◽

2020 ◽

pp. 64-75

Author(s):

E. Burleva ◽

O. Smirnov ◽

S. Tyurin

Keyword(s):

Postoperative Period ◽

Chronic Venous Insufficiency ◽

Thermal Ablation ◽

Venous Insufficiency ◽

Clinical Symptoms ◽

Varicose Veins ◽

Statistical Processing ◽

Group 3 ◽

Group 2 ◽

Group 1

The purpose of the study was to conduct a comparative assessment of the course of the postoperative period after phlebectomy and thermal ablation in patients with varicose veins of the lower extremities in the system of the great saphenous vein (GSV) with class C2 of chronic venous insufficiency (CVI) — CEAP class C2. Materials and methods: 455 patients (455 limbs) with CEAP class C2. Group 1 (n = 154) received stripping + minimally invasive phlebectomy; Group 2 — endovenous laser ablation (EVLA) of GSV trunk + sclerotherapy of varicose veins; 3 group (n = 150) — radiofrequency ablation (RFA) of the GSV + sclerotherapy. All patients were united by a single tactical solution — the elimination of pathological vertical reflux in GSV. In each group, patients were with similar hemodynamic profile were selected (Group 1 = 63; Group 2 = 61; Group 3 = 61). The course of the postoperative period (from 2 days to 2 months) was compared for pain (visual analog scale — VAS), clinical symptoms of chronic venous insufficiency, degree of satisfaction (Darvall questionnaire), and duration of disability. Statistical processing was carried out using Excel programs for Windows XP, MedCalc® (version 11.4.2.0., Mariakerke, Belgium). Results: Postoperative pain is more pronounced (during day 1 for Group 1–4.0, Group 2–3.0, Group 3–2.0) and more prolonged (up to 4 days) after open surgeries (p < 0.05). The dynamics of the clinical symptoms of CVI (including varicose syndrome and use of compression therapy) could not be fully evaluated in connection with the ongoing sclerotherapy procedures for patients of Groups 2 and 3. Satisfaction of patients with aesthetic aspects was higher than expected in all groups. Reliable statistical differences proved decrease in days of disability (Group 1–14; Group 2–4; Group 3–3) and earlier return to physical activities and work in patients after thermal ablation in comparison with phlebectomy. Conclusion: The study shows that all three methods for eliminating vertical reflux in the GSV can be proposed for a large category of patients with CEAP of class C3 and C2. Medical and social rehabilitation of patients using endovascular thermal ablation technologies proceeds faster, which is beneficial both for the patients and for society.

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Pathogenesis of varicose veins and cellular pathophysiology of chronic venous insufficiency

Handbook of Venous and Lymphatic Disorders ◽

10.1201/9781315382449-6 ◽

2017 ◽

pp. 61-72

Author(s):

Deoranie N. Abdel-Naby ◽

Walter N. Duran ◽

Brajesh K. Lal ◽

Frank T. Padberg Jr. ◽

Peter J. Pappas

Keyword(s):

Chronic Venous Insufficiency ◽

Venous Insufficiency ◽

Varicose Veins

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

Journal of Medicine ◽

10.3329/jom.v9i1.1421 ◽

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. Â DOI = 10.3329/jom.v9i1.1421 J MEDICINE 2008; 9 : 20-26

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Chronic venous insufficiency after COVID-19: management of edema and pain syndromes

Ambulatornaya khirurgiya = Ambulatory Surgery (Russia) ◽

10.21518/1995-1477-2021-18-2-151-153 ◽

2021 ◽

Vol 18 (2) ◽

pp. 151-153

Author(s):

F. Kh. Nizamov

Keyword(s):

Chronic Diseases ◽

Chronic Venous Insufficiency ◽

Venous Insufficiency ◽

Clinical Symptoms ◽

Varicose Veins ◽

Clinical Manifestations ◽

Pain Syndrome ◽

Venous Stasis ◽

Vein Wall ◽

Vas Scores

Introduction. COVID-19 infection raises many questions regarding the health condition of patients after they have had COVID-19. The aim of this study is to examine the characteristic symptoms of chronic venous insufficiency in the postcovid period.Materials and methods. The materials that were used for work included the results of studying the medical aid appealability, characteristic symptoms, diagnosis and treatment of symptoms of chronic venous insufficiency in persons who have had the coronavirus infection. 47 patients presented with complaints about deterioration of their condition after they had had COVID-19 over March to September 2021 period. Methods: general clinical examiniation, ultrasound angioscanning of veins of the lower extremities, laboratory coagulation tests.Results and discussion. Before deterioration, calf circumference was measured 22–24 cm at a typical measurement site in most patients (89%), after covid infection it reached 26–27 cm. Varicose veins remained soft, without intravascular formations, edema was often bilateral, asymmetric, pain was described as constant (5–6 VAS scores), patients had prominent signs of lymphostasis. 35 out of 47 people received diosmin-based venotonic drug of Russian manufacture at a dose of 1000 mg/day (one tablet twice a day), the course of treatment lasted one to two months. After that period, the edema subsided in 85% of patients, the severity of pain syndrome significantly reduced (up to 2–3 VAS scores). With regard to chronic venous insufficiency in patients with chronic diseases of lower extremity veins (mostly varicose and post-thrombotic diseases), the significant progress of disease was observed in almost 94% of follow-up cases. Diosmin is the main drug that is prescribed to treat chronic venous insufficiency. The drug has an angioprotective and venotonic effect, reduces the vein wall elasticity, increases venous tone, and decreases venous stasis, reduces capillary permeability and fragility, and increases their resistance, improves microcirculation and lymphatic drainage.Сonclusions. In the postcovid period, clinical symptoms of some chronic diseases occur/worsen, including clinical manifestations of chronic venous insufficiency. The use of Russian diosmin-based drug for the management of edema and pain syndrome is very promising.

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Klippel–Trénaunay Syndrome – A Very Rare and Interesting Syndrome

Clinical Medicine Insights Circulatory Respiratory and Pulmonary Medicine ◽

10.4137/ccrpm.s21645 ◽

2015 ◽

Vol 9 ◽

pp. CCRPM.S21645 ◽

Cited By ~ 11

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.

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Surgical Treatment of the Superficial and Perforating Veins

Phlebology The Journal of Venous Disease ◽

10.1177/026835550001500309 ◽

2000 ◽

Vol 15 (3-4) ◽

pp. 131-136 ◽

Cited By ~ 2

Author(s):

P. Gloviczki

Keyword(s):

Surgical Treatment ◽

Chronic Venous Insufficiency ◽

Venous Insufficiency ◽

Varicose Veins ◽

High Ligation ◽

Ulcer Recurrence ◽

Perforating Veins ◽

Post Thrombotic Syndrome ◽

Venous Ulcers ◽

Ulcer Surgery

Objective: To review the techniques and results of surgical treatment of the superficial and perforating veins in patients with chronic venous insufficiency. Methods: The current techniques used at the Mayo Clinic for treatment of simple varicose veins and venous ulcers are presented. Results of subfascial endoscopic perforator vein surgery (SEPS) are discussed and data from large centres are tabulated. Results are compared with those reported following non-operative management. Synthesis: High ligation and invagination stripping of the incompetent segment of the saphenous vein, with stab avulsion of branch varicosities, is the optimal surgical technique to ablate superficial venous incompetence. SEPS is safer than open perforator vein ligation and is the technique of choice to interrupt incompetent perforating veins. A review of 12 series on SEPS, that included 361 limbs, found an ulcer recurrence rate of 10% in those 211 patients who underwent ablation of superficial reflux together with SEPS. One hundred and fifty limbs had SEPS alone, without saphenous stripping: ulcer recurrence in this group at a mean of 23 months was 12%. Results in primary valvular incompetence were significantly better than in post-thrombotic syndrome. Conclusions: Ablation of superficial reflux remains the main surgical treatment of all forms of chronic venous insufficiency. SEPS is safe and effective to interrupt medial calf perforators and results in rapid ulcer healing and low recurrence in patients with primary valvular incompetence. The treatment of post-thrombotic syndrome remains a challenge. Results of the North American Venous Ulcer Surgery (NAVUS) trial, a prospective, randomised, multicentre study, will be required to provide level 1 evidence of the effectiveness of surgical treatment over medical therapy in the treatment of venous ulcers.

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The Epidemilogy of Chronic Venous Ulcer: Some Unanswered Questions

Phlebology The Journal of Venous Disease ◽

10.1177/026835550001500304 ◽

2000 ◽

Vol 15 (3-4) ◽

pp. 106-109

Author(s):

C. V. Ruckley

Keyword(s):

Chronic Venous Insufficiency ◽

Venous Insufficiency ◽

Varicose Veins ◽

Clinical Manifestations ◽

Epidemiological Studies ◽

Therapeutic Interventions ◽

Venous Disease ◽

Clinical Classification ◽

Age Related

Objective: To highlight gaps in knowledge concerning the epidemiology of chronic venous insufficiency and to indicate what future studies are required. Methods: Existing classifications are compared. Limitations of epidemiological studies are defined. Data from published series and from the Edinburgh Vein Study are presented. Synthesis: The Basle 1978 classification of chronic venous insufficiency (CVI) is a purely clinical classification in which the earliest grade is corona phlebectatica. The Porter 1988 classification of CVI attempted to correlate clinical grades with sites of venous incompe-tence. However, a consistent relationship does not exist. The CEAP classification separates the clinical grades (which do not include corona phlebectasia) from the anatomical segments. The CEAP clinical classification covers a range of venous manifestations but is not consistent. There is a need for further consideration of classifications. Published selected series of patients show that the frequency of incompetence in both deep and superficial systems increases in proportion to the severity of the clinical manifestations of venous disease. To understand the significance of these data we need to know the patterns of venous incompetence in the general population. Data from 1566 subjects between the ages of 18 and 64 years in the Edinburgh Vein Study, a randomly selected cross-section of members of the Edinburgh population, showed that the prevalence of CVI was age-related and was present in 9.2% of men and 6.6% of women. Men had a significantly higher frequency of reflux in the deep system than women. In order to direct therapeutic interventions where they are most appropriate we need to know which patients with the early stages of varicose veins progress to CVI and which patients with early CVI progress to the serious skin complications. Conclusions: Key information concerning the natural history of venous disease and its evolution in relation to haemodynamic abnormalities awaits the findings of longitudinal-cohort epidemiological studies which include the duplex scanning of large populations.

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Chapter-49 Varicose Veins and Chronic Venous Insufficiency

Arriving at a Surgical Diagnosis ◽

10.5005/jp/books/11859_49 ◽

2013 ◽

pp. 694-702

Author(s):

Pramod Bapat

Keyword(s):

Chronic Venous Insufficiency ◽

Venous Insufficiency ◽

Varicose Veins

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Effect of TGF-beta1 on MMP/TIMP and TGF-beta1 receptors in great saphenous veins and its significance on chronic venous insufficiency

Phlebology The Journal of Venous Disease ◽

10.1177/0268355516655067 ◽

2016 ◽

Vol 32 (5) ◽

pp. 334-341 ◽

Cited By ~ 11

Author(s):

Pedro Serralheiro ◽

Elisa Cairrão ◽

Cláudio J Maia ◽

Marina João ◽

Carlos M Costa Almeida ◽

...

Keyword(s):

Gene Expression ◽

Chronic Venous Insufficiency ◽

Venous Insufficiency ◽

Transforming Growth Factor ◽

Varicose Veins ◽

Bypass Graft ◽

Tissue Inhibitor Of Metalloproteinase ◽

Wall Structure ◽

Vein Wall ◽

Tgf Β1

Objectives Transforming growth factor-beta1 (TGF-β1) may participate in local chronic inflammatory processes in varicose veins and in venous wall structure modifications through regulation of matrix metalloproteinases (MMP) and their inhibitors (tissue inhibitor of metalloproteinase (TIMP)). The aim of this study was to analyze the effect of TGF-β1 in the vein wall, namely on the gene expression of selected MMP, TIMP and TGF-β1 receptors. Methods Healthy vein samples were harvested from eight subjects who underwent coronary bypass graft surgery with great saphenous vein. Each vein sample was divided into two segments, which were cultivated separately in vitro (one of the segments had TGF-β1 added) and then submitted to gene expression analysis. Results In the TGF-β1 supplemented group, there was a general increase in the mean gene expression. Specifically, expression of MMP9, MMP12, TIMP1 and TIMP2 were statistically significant. Conclusion The results of this study demonstrate that the gene expression of MMP9, MMP12, TIMP1 and TIMP2 was influenced by the addition of TGF-β1. These results may be translated to chronic venous insufficiency framework and suggest involvement of TGF-β1 in the vein wall pathology.

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