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.

Duplex investigations in children: Are clinical signs in children with venous disorders relevant?

2014 ◽  
Vol 30 (10) ◽  
pp. 719-723
Author(s):  
M Birgitte Maessen-Visch ◽  
L Smeets ◽  
C van Vleuten
Keyword(s):  
Venous Thrombosis ◽  
Deep Venous Thrombosis ◽  
Varicose Veins ◽  
Clinical Signs ◽  
Patient Characteristics ◽  
Duplex Sonography ◽  
Chronic Venous Disease ◽  
Ultra Sound ◽  
Venous Disease ◽  
Venous Disorders

Objectives Ultra sound colored duplex sonography is the preferred method in diagnosing chronic venous disease. Data in children on incidence, indications, and results are lacking. Methods From the total of 9180 duplex investigations performed in our hospital from 2009 to 2012, data on indication and results of the investigation as well as patient characteristics were evaluated retrospectively for the proportion of pediatric patients. Results Duplex investigations were performed 49 times in 38 children (6–18 years), with an average of 1.3 times (1–6 times) per child. Forty percent showed abnormalities: 17 times deep venous thrombosis was suspected; deep venous thrombosis was objectified in 18%. In the 21 investigations performed for varicosis-related complaints, varicose veins or venous malformations were objectified in 57%. Edema was never a symptom of chronic venous disease. Conclusions Duplex investigation is not often performed in children. In children with established deep venous thrombosis, a family history with deep venous thrombosis is common. In general, edema was not seen in children with varicose veins and, therefore, does not seem a reliable clinical sign at young age.

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.

Chronic venous insufficiency and post-thrombotic syndrome

ESC CardioMed ◽  
2018 ◽  
pp. 2817-2822
Author(s):  
Robert T. Eberhardt ◽  
Joseph D. Raffetto
Keyword(s):  
Chronic Venous Insufficiency ◽  
Venous Insufficiency ◽  
Surgical Techniques ◽  
Duplex Ultrasound ◽  
Venous Hypertension ◽  
Chronic Venous Disease ◽  
Venous Disease ◽  
Severity Of Disease ◽  
Venous Valves ◽  
Venous Function

Chronic venous disease is a common problem with a significant impact upon both afflicted individuals and the healthcare system. Normal venous function requires patency of the axial veins with a series of venous valves, and muscle pumps. Dysfunction of any of the normal structures may lead to venous hypertension and development of chronic venous insufficiency. There is a spectrum of manifestations of chronic venous insufficiency including skin changes and venous leg ulcers. Venous duplex ultrasound may be used to confirm the diagnosis and provide anatomical detail. The treatment of chronic venous insufficiency will be based on the severity of disease and guided by anatomical and pathophysiological considerations. Compressive garments have been a mainstay in treatment. Interventional methods have replaced many traditional surgical techniques but are still typically reserved for unsatisfactory response to conservative measures.

Epidemiology and classification of venous disease

ESC CardioMed ◽  
2018 ◽  
pp. 2805-2806
Author(s):  
Eberhard Rabe ◽  
Felizitas Pannier
Keyword(s):  
Risk Factors ◽  
Chronic Venous Insufficiency ◽  
Venous Insufficiency ◽  
Varicose Veins ◽  
Adult Population ◽  
Clinical Signs ◽  
Advanced Age ◽  
Chronic Venous Disease ◽  
Venous Disease ◽  
General Adult Population

Chronic venous diseases are frequent pathologies in the general population. The most common chronic venous pathologies are varicose veins and chronic venous insufficiency including post-thrombotic syndrome. In the general adult population, varicose veins are present in up to 25% of people with an increasing prevalence with age. Risk factors include advanced age, genetic predisposition, female sex, and multiparity. The term chronic venous insufficiency summarizes the clinical signs of chronic venous disease with oedema, skin changes, or venous ulcers. More than 15% of the population is affected by chronic venous insufficiency. Risk factors include advanced age, obesity, and prolonged sitting.

Popliteal vein entrapment presenting as deep venous thrombosis and chronic venous insufficiency

1993 ◽  
Vol 18 (5) ◽  
pp. 760-766 ◽  
Author(s):  
Charles C. Wolferth ◽  
Todd M. Gerkin ◽  
Hugh G. Beebe ◽  
David M. Williams ◽  
Jess R. Bloom
Keyword(s):  
Venous Thrombosis ◽  
Deep Venous Thrombosis ◽  
Chronic Venous Insufficiency ◽  
Venous Insufficiency ◽  
Popliteal Vein

Popliteal vein entrapment presenting as deep venous thrombosis and chronic venous insufficiency

1993 ◽  
Vol 18 (5) ◽  
pp. 760-766 ◽  
Author(s):  
Todd M. Gerkin ◽  
Hugh G. Beebe ◽  
David M. Williams ◽  
Jess R. Bloom ◽  
Thomas W. Wakefield
Keyword(s):  
Venous Thrombosis ◽  
Deep Venous Thrombosis ◽  
Chronic Venous Insufficiency ◽  
Venous Insufficiency ◽  
Popliteal Vein

Thrombotic Potential of a Prosthetic Vein Valve

2007 ◽  
Author(s):  
Laura-Lee Farrell ◽  
Deepak Nair ◽  
Ross Milner ◽  
David Ku
Keyword(s):  
Surgical Treatment ◽  
Venous Thrombosis ◽  
Deep Venous Thrombosis ◽  
Chronic Venous Insufficiency ◽  
Venous Insufficiency ◽  
Vein Wall ◽  
Skin Breakdown ◽  
Leg Edema

Over seven million Americans suffer from chronic venous insufficiency, secondary to valvular dysfunction, with few effective clinical therapies. Chronic Venous Insufficiency (CVI) is a painful and debilitating disease that affects the superficial and deep veins of the legs. After deep venous thrombosis, the vein valves leaflets become adherent, fold over, or are absorbed into the vein wall. Incompetent valves allow reflux and subsequent pooling of blood in the legs. The resultant CVI causes severe leg edema, skin breakdown, and possible gangrene. Current clinical therapies are only modestly effective and include vein stripping and ligation, valvuloplasty, vein valve transposition, and vein valve transplantation. Valvuloplasty is the most definitive of CVI treatment, though this surgical treatment is rarely performed due to its difficulty. The quest for a better solution continues.

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