Accuracy of contralateral Villalta score to assess for pre‐existing chronic venous insufficiency in patients with unilateral deep vein thrombosis

2020 ◽  
Vol 18 (12) ◽  
pp. 3309-3315
Author(s):  
Jean‐Philippe Galanaud ◽  
Thierry Ducruet ◽  
Susan R. Kahn ◽  
Keyword(s):  
Deep Vein Thrombosis ◽  
Chronic Venous Insufficiency ◽  
Venous Insufficiency ◽  
Vein Thrombosis ◽  
Deep Vein

scholarly journals Post-thrombotic syndrome in children: current state of affairs

2020 ◽  
Vol 19 (3) ◽  
pp. 139-143
Author(s):  
M. Yu. Zhukov ◽  
N. N. Mitrakov ◽  
P. A. Zharkov
Keyword(s):  
Deep Vein Thrombosis ◽  
Chronic Venous Insufficiency ◽  
Venous Insufficiency ◽  
Published Data ◽  
Vein Thrombosis ◽  
Post Thrombotic Syndrome ◽  
Current State ◽  
Organ Tissue ◽  
State Of Affairs ◽  
Deep Vein

Post-thrombotic syndrome (PTS) is one of the most significant complications that develops in patients after deep vein thrombosis. Patients with PTS have persistent and often worsening chronic venous insufficiency which can lead to permanent impairment of the affected organ, tissue or limb. Despite their importance, the issues of diagnosis and prevention of PTS in children are understudied in Russia. This paper is based on the analysis of recently published data and presents the current state of affairs regarding PTS in pediatrics.

Obesity and lower limb venous disease – The epidemic of phlebesity

2016 ◽  
Vol 32 (4) ◽  
pp. 227-233 ◽  
Author(s):  
Huw OB Davies ◽  
Matthew Popplewell ◽  
Rishi Singhal ◽  
Neil Smith ◽  
Andrew W Bradbury
Keyword(s):  
Deep Vein Thrombosis ◽  
Lower Limb ◽  
Chronic Venous Insufficiency ◽  
Venous Insufficiency ◽  
Varicose Veins ◽  
Venous Disease ◽  
Obese Patients ◽  
Obese People ◽  
Vein Thrombosis ◽  
Deep Vein

Introduction Lower limb venous disease affects up to one half, and obesity up to one quarter, of the adult population. Many people are therefore affected by, and present to health services for the treatment of both conditions. This article reviews the available evidence of pathophysiological and clinical relationship between obesity and varicose veins, chronic venous insufficiency and ulceration and deep vein thrombosis. Methods A literature search of PubMed and Cochrane libraries was performed in accordance with PRISMA statement from 1946 to 2015, with further article identification from following cited references for articles examining the relationship between obesity and venous disease. Search terms included obesity, overweight, thrombosis, varicose veins, CEAP, chronic venous insufficiency, treatment, endovenous, endothermal, sclerotherapy, bariatric surgery and deep vein thrombosis. Results The proportion of the population suffering from lower limb venous disease and obesity is increasing. Obesity is an important risk factor for all types of lower limb venous disease, and obese patients with lower limb venous disease are more likely to be symptomatic as a result of their lower limb venous disease. The clinical diagnosis, investigation, imaging and treatment of lower limb venous disease in obese people present a number of challenges. The evidence base underpinning medical, surgical and endovenous management of lower limb venous disease in obese people is limited and such treatment may be associated with worse outcomes and increased risks when compared to patients with a normal body mass index. Conclusion Lower limb venous disease and obesity are both increasingly common. As such, phlebologists will be treating ever greater numbers of obese patients with lower limb venous disease, and clinicians in many other specialties are going to be treating a wide range of obesity-related health problems in people with or at risk of lower limb venous disease. Unfortunately, obese people have been specifically excluded from many, if not most, of the pivotal studies. As such, many basic questions remain unanswered and there is an urgent need for research in this challenging and increasingly prevalent patient group.

Preventing and treating deep vein thrombosis

1992 ◽  
Vol 30 (3) ◽  
pp. 9-12
Keyword(s):  
Pulmonary Embolism ◽  
Deep Vein Thrombosis ◽  
Chronic Venous Insufficiency ◽  
Venous Insufficiency ◽  
Surgical Patients ◽  
Fatal Pulmonary Embolism ◽  
Venous Ulceration ◽  
Vein Thrombosis ◽  
Hospital Patients ◽  
Deep Vein

Deep vein thrombosis (DVT) is a common event in hospital patients.1 The diagnosis is often missed, and its most serious sequel, fatal pulmonary embolism (PE) is still detected in 10% of hospital autopsies.2–3 DVT also commonly leads to chronic venous insufficiency and venous ulceration, treatment of which costs the NHS about £600 million a year.4 Deep vein thrombosis can be prevented in 60–75% of surgical patients,5 but many different prophylactic regimens are used, and some surgeons still use none.6 We discuss here who should receive prophylaxis, how it should be given, and review the treatment of established venous thrombosis.

scholarly journals Practical experience with adjustable, non-extensible compression bandages in patients with nonhealing trophic ulcers

2021 ◽  
pp. 52-58
Author(s):  
S. P. Zotov ◽  
N. B. Shishmentsev ◽  
V. V. Vladimirskiy ◽  
V. Yu. Bogachev
Keyword(s):  
Deep Vein Thrombosis ◽  
Chronic Venous Insufficiency ◽  
Clinical Case ◽  
Venous Insufficiency ◽  
Compression Bandage ◽  
Working Pressure ◽  
Vein Thrombosis ◽  
Resting Pressure ◽  
The Right ◽  
Deep Vein

Introduction. The adjustable non-extensible compression bandage is a new product recently registered and approved for clinical use in the Russian Federation. The main indications for its use are severe chronic venous insufficiency and lymphedema, which cannot be corrected with traditional bandages and flat knit medical compressions. On the affected limb, an adjustable, non-extensible compression bandage allows high working pressure to be created at low, approaching zero, resting pressure. And depending on the tension of the velcro fastener, the working pressure can be adjusted between 20 and 50 mmHg or more. At the same time, the patient can maintain the actual pressure independently, regardless of the reduction in the volume of the limb. Low resting pressure makes it possible to use this type of bandage all day without the discomfort that is typical for traditional bandages and therapeutic compression knitwear felt by patients during sleep.Clinical case. Patient diagnosed with chronic lymphovenous insufficiency in both lower limbs. CEAP class C5 on the left, CEAP class C5 on the right. After undergoing acute iliofemoral thrombosis on the left, complicated by thromboembolism of small branches of the pulmonary artery, he was treated in a specialized vascular unit, where anticoagulant, antiplatelet and phlebotropic therapy was carried out. After the second episode of deep vein thrombosis, pain in the lower extremities, swelling of the tibia, skin itching and the appearance of small trophic ulcers started to worry, which temporarily closed against the background of increased compression therapy, prescription of phlebotropic drugs and local treatment. Subsequently, large trophic ulcers were formed on the inner surface of both shins above the ankle joint. An adjustable, non-extensible compression bandage was used on the right shin to correct chronic venous insufficiency and heal a trophic ulcer. The use of an adjustable, non-extensible compression bandage within 2 to 4 weeks resulted in the disappearance of chronic swelling, reduction of the pain syndrome, and then 5 months later – led to a reduction in trophic ulcer and the disappearance of infection signs.Conclusions. This clinical case of the successful closure of a large infected trophic ulcer that occurred after deep vein thrombosis against the background of coxarthrosis and which remained unhealed for 7 years clearly illustrates the broad possibilities of an adjustable, nonextensible compression bandage.

Objective Diagnosis Of Recurrent Deep Vein Thrombosis

1981 ◽  
Author(s):  
R W Barnes ◽  
D G Turley ◽  
G D Qureshi ◽  
M J Fratkin
Keyword(s):  
Deep Vein Thrombosis ◽  
Venous Insufficiency ◽  
Leg Pain ◽  
Venous Obstruction ◽  
Vein Thrombosis ◽  
Postphlebitic Syndrome ◽  
Positive Scan ◽  
Recurrent Deep Vein Thrombosis ◽  
Diagnostic Sensitivity And Specificity ◽  
Deep Vein

Recurrent deep vein thrarbosis must be differentiated from other causes of leg pain, swelling and inflammation, including chronic venous insufficiency or the postphlebitic stasis syndrome. Venous obstruction and/or valvular incompetence was evaluated by Dcppler ultrasound in 229 patients with recurrent leg symptoms following one or more prior episodes of clinical deep vein thrombosis. The diagnostic sensitivity and specificity of the Dcppler technique was 96% and 90%, respectively, in 259 consecutive contrast phlebograms. In a subset of 65 patients with abnormal Dcppler examination, I-125 fibrinogen leg scans were performed prior to institution of anticoagulants in order to establish the diagnosis of recurrent active thrarbosis (positive scan) or inactive postphlebitic disease (negative sca.In the 229 symptomatic patients screened, the Dcppler examination was normal in 87 (38.0%). In 65 patients with abnormal deep veins receiving I-125 fibrinogen, leg scans were positive in 25 (38.5%), suggesting active thrarbosis which was treated by anticoagulants. The remaining 40 patients were treated for the postphlebitic syndrome with leg elevation and elastic support and none developed manife stations of venous thrarboerrbolism.This study suggests that many individuals (38%) with suspected recurrent deep vein thrarbosis have normal leg veins and that the majority (62%) of patients with proven venous abnormalities have inactive (postphlebitic) disease which does not require anti coagulation.

Chronic Venous Insufficiency of the Upper Limb Due to Outflow Obstruction of Venous Access

1988 ◽  
Vol 3 (4) ◽  
pp. 265-270
Author(s):  
A. Halevy ◽  
A. Zelikovski ◽  
D. Modai ◽  
Y. Swissgarten ◽  
R. Orda
Keyword(s):  
Upper Limb ◽  
Chronic Venous Insufficiency ◽  
Venous Insufficiency ◽  
Clinical Signs ◽  
Venous Access ◽  
Lower Limbs ◽  
Vein Thrombosis ◽  
Short Period ◽  
Cubital Fossa ◽  
Deep Vein

Two patients with angio-access for haemodialysis in whom the main venous outflow tract was thrombosed, developed severe chronic venous insufficiency (CVI) of the upper limb after a short period; one case developing a stasis ulcer of the cubital fossa. The angio-accesses were still functioning when the diagnosis was made. Treatment by surgery resulted in a dramatic regression of clinical signs of chronic venous insufficiency. CVI of the upper limb has not previously been described. CVI is a frequent and known complication after deep vein thrombosis (DVT) of the lower limbs, but never appears after DVT of the upper limbs. We describe two cases of upper limb CVI which developed as a complication of angio-access for haemodialysis treatment, and their successful treatment by surgery.

Venous Insufficiency 4 Years after an Episode of Deep Vein Thrombosis: A Clinical and Plethysmographic Investigation

1998 ◽  
Vol 13 (2) ◽  
pp. 53-58
Author(s):  
M. Nordström ◽  
B. Lindblad ◽  
H. Åkesson ◽  
D. Bergqvist ◽  
T. Kjellström
Keyword(s):  
Deep Vein Thrombosis ◽  
Venous Insufficiency ◽  
Outcome Measure ◽  
Clinical Symptoms ◽  
University Hospital ◽  
Vein Thrombosis ◽  
Venous Function ◽  
Deep Vein ◽  
Symptoms And Signs

Objective: To evaluate the frequency of venous insufficiency following deep vein thrombosis (DVT). Design: Follow-up 4 years after a verified DVT. Setting: University hospital in Malmö. Patients: Eighty-seven subjects with venographically verified DVT. Main outcome measure: To compare venous function in legs, with and without previous DVT, by venous straingauge plethysmography and its correlation with clinical symptoms and signs. Results: Fifty-two per cent of patients described general discomfort from the thrombotic leg at follow-up. Active leg ulcers were found in three patients (3%); there were no signs of venous insufficiency in 33% at clinical examination. Thirty-seven patients (75%) with ≥ 1 cm difference in calf circumference between the thrombotic and contralateral leg had suffered a proximal DVT. The refilling time T90 was pathological in 67% and the muscle pump function (RV) in 55%. In the nonthrombotic leg the corresponding figures were 53% and 40%. Nevertheless a positive correlation was found between RV of the thrombotic leg and the contralateral leg ( r = 0.33) but an even stronger correlation was found for T90 ( r = 0.74). Conclusion: Venous insufficiency was found in 60% of legs 4 years after DVT but was also found in 14% of legs without previous thrombosis. This may be caused not only by effects of the thrombosis but also by the ageing process.

Anatomical Distribution of Chronic Venous Insufficiency in a Chinese Population

1999 ◽  
Vol 14 (1) ◽  
pp. 29-32 ◽  
Author(s):  
A. C. W. Ting ◽  
S. W. K. Cheng ◽  
L. L. H. Wu ◽  
G. C. Y. Cheung
Keyword(s):  
Chronic Venous Insufficiency ◽  
Chinese Population ◽  
Venous Insufficiency ◽  
Duplex Scanning ◽  
Venous Reflux ◽  
Anatomical Distribution ◽  
Group Iii ◽  
Vein Thrombosis ◽  
Group I ◽  
Deep Vein

Objective: To study the anatomical distribution of chronic venous insufficiency (CVI) in a Chinese population by means of duplex scanning. Procedures: A total of 582 limbs in 291 patients with primary venous insufficiency were classified clinically into three different groups according to SVS/ISCVS criteria and evaluated prospectively with duplex scanning. Results: One hundred and thirty-one limbs were classified into group I (CEAP clinical class 0), 291 into group II (CEAP clinical classes 1 and 2) and 160 into group III (CEAP clinical classes 3–6). Mixed deep and superficial venous incompetence was found in 70% and 83% of limbs in groups II and III, respectively. Reflux was also demonstrated in 73% of group I limbs. Conclusions: Most of our patients had mixed deep and superficial venous incompetence. The prevalence of deep venous incompetence in this population, in which deep vein thrombosis is rare, suggests a pattern of venous incompetence other than postphlebitic deep vein valvular dysfunction. The prevalence of reflux in the asymptomatic contralateral limbs implies a bilateral predisposition to venous reflux and thus a possible developmental origin of CVI.

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