scholarly journals Pre- and Postoperative Evaluation by Photoplethysmography in Patients Receiving Surgery for Lower-Limb Varicose Veins

2014 ◽  
Vol 2014 ◽  
pp. 1-7 ◽  
Author(s):  
Orlando Adas Saliba Júnior ◽  
Mariangela Giannini ◽  
Ana Paula Mórbio ◽  
Orlando Saliba ◽  
Hamilton Almeida Rollo
Keyword(s):  
Lower Limb ◽  
Varicose Veins ◽  
Lower Limbs ◽  
Varicose Vein Surgery ◽  
Postoperative Evaluation ◽  
Perforating Veins ◽  
Primary Varicose Veins ◽  
Ceap Classification ◽  
The Mean ◽  
Deep Vein

Objective. To evaluate the effectiveness of surgery in treating primary varicose veins in the lower limbs by photoplethysmography (PPG) and duplex mapping (DM).Method. Forty-eight lower limbs were clinically evaluated according to the CEAP classification system and subjected to PPG and DM exams. Each limb had a venous refill time (VRT) of <20 seconds and a normal deep vein system (DVS) by DM.Results. The mean pre- and postoperative VRTs were 13.79 and 26.43 seconds, respectively (P<0.0001). After surgery, 42 limbs (87.50%) had normal results by PPG (VRT > 20 seconds). Four limbs (8.33%) showed improved VRTs, but the VRTs did not reach 20 seconds. In the 2 limbs (4.17%) that maintained their original VRTs, the DM exams showed the presence of insufficient perforating veins.Conclusion. In most cases, PPG allows for a satisfactory evaluation of the outcome of varicose vein surgery.

Expression of the proinflammatory marker CD34 in varicose leg veins

Phlebologie ◽  
2015 ◽  
Vol 44 (01) ◽  
pp. 19-23
Author(s):  
I.V. Samsonava ◽  
M. M. Galishevich ◽  
S. A. Sushkou
Keyword(s):  
Lower Limb ◽  
Varicose Veins ◽  
Control Sample ◽  
Lower Limbs ◽  
Control Group ◽  
Posterior Tibial ◽  
Vena Saphena Magna ◽  
Primary Varicose Veins ◽  
Deep Vein ◽  
Cd34 Expression

Summary Objective: To study the CD34 expression in the leg veins with primary varicose veins. Material and Methods: The study included 18 patients with lower limbs varicose veins and deep vein valves insufficiency of C3 and C4 clinical classes (CEAP). To correct blood flow phlebectomy was accompanied by posterior tibial veins resection. Using immunohistochemistry, we compared the expression of CD34 in resected posterior tibial veins specimens and vena saphena magna distal fragment. Results: Posterior tibial veins wall in patients with lower limb varicosity and deep veins valves insufficiency vary the CD34 degree expression comparing with the control group. Total area of expression was significantly greater than in control sample. CD34 expression area was also significantly greater in vena saphena magna than in control group. CD34 expression comparison in the specimens from patients with varicose veins showed its significantly higher degree in the vena saphena magna than in tibial veins. Conclusion: With primary varicose veins superficial and deep leg veins develop unidirectional increase of CD34 expression, that can be assumed as a pathogenetic factors of further disease progression and involvement of deep vein valves.

Endoscope-assisted management of primary varicose veins of the long saphenous vein and its tributaries

2004 ◽  
Vol 19 (1) ◽  
pp. 35-41 ◽  
Author(s):  
S-D Lin ◽  
Y-L Yang ◽  
S-S Lee ◽  
K-P Chang ◽  
T-M Lin ◽  
...  
Keyword(s):  
Saphenous Vein ◽  
Varicose Veins ◽  
Saphenous Nerve ◽  
Perforating Veins ◽  
Long Saphenous Vein ◽  
Primary Varicose Veins ◽  
The Mean ◽  
Assisted Management ◽  
Incision Wound

Objective: Primary varicose veins of the long saphenous vein and its tributaries were managed in 104 limbs of 101 patients with the assistance of endoscopic surgery. Methods: Patients were divided into four clinico-anatomical types according to normal veins involved in the varicosities. With good illumination and magnified monitor viewing by means of a surgical endoscope, the varicositic trunk, varicositic tributaries, incompetent perforating veins and healthy veins could be clearly visualized and identified. Through two or more access incisions (2.5-3.0 cm in length), the varicose veins were completely dissected, divided and removed. The incompetent perforating veins were clipped and divided. In all cases, the mean number of incisions in each limb was 3.0. Results: The most common cause of morbidity was maceration of the incision wound. Transient numbness may have presented at the dissected area, but there were no signs of injury to the saphenous nerve. Conclusions: There was very little possibility of recurrence, because no residual varicosities or incompetent perforating veins remained after this operation. Recurrence presented in only one case at follow up, three months postoperatively. Patients were satisfied with the minimal surgical scarring and complete absence of disfiguring varicosities in the limb.

Endoscope-assisted management of primary varicose veins below the knee

2005 ◽  
Vol 20 (4) ◽  
pp. 163-169 ◽  
Author(s):  
S-D Lin ◽  
T-M Lin ◽  
S-S Lee ◽  
Y-L Yang ◽  
I-F Sun ◽  
...  
Keyword(s):  
Endoscopic Surgery ◽  
Varicose Veins ◽  
Good Alternative ◽  
Perforating Veins ◽  
Long Saphenous Vein ◽  
Below The Knee ◽  
Primary Varicose Veins ◽  
The Mean ◽  
Assisted Management

Objective: Primary varicose veins below the knee were managed with the assistance of endoscopic surgery in 240 limbs (235 cases). Methods: Patients were classified into five clinico-anatomic types according to associated normal veins involved in the varicosities. All procedures were limited to below the knee. With the superior illumination and magnified monitor view offered by the endoscope, all the varicosities and the incompetent perforating veins were dissected, clipped, divided and removed through one or more access incisions (2.5–3.0 cm in length). However, the normal veins were preserved, including the long saphenous vein. Results: The mean number of incisions in each limb of all patients was 1.86. As there were no residual varicosities or incompetent perforating veins, there was little possibility of recurrence. In the follow-up of 218 limbs, recurrence occurred in only two limbs. Conclusion: Endoscope-assisted surgery is a good alternative for management of primary varicose veins below the knee, resulting in low recurrence and aesthetically acceptable surgical scarring.

scholarly journals Homeostatic feelings – a novel explanation of vein symptoms derived from an experimental patient study

VASA ◽  
2019 ◽  
Vol 48 (6) ◽  
pp. 492-501
Author(s):  
Werner Blättler ◽  
Erika Mendoza ◽  
Christine Zollmann ◽  
John Bendix ◽  
Felix Amsler
Keyword(s):  
Rating Scale ◽  
Varicose Veins ◽  
Stress Test ◽  
Numeric Rating Scale ◽  
Lower Limbs ◽  
Venous Disease ◽  
Scale Range ◽  
Patient Groups ◽  
Primary Varicose Veins ◽  
Ceap Classification

Summary. Background: Vein symptoms (VS) entail diffuse leg discomfort and pain coinciding with a perception of weighty or swollen legs. Their traditional classification as a form of venous disease may be inaccurate as they occur in patients with no or any venous disorder. We hypothesized that VS would emerge from a primordially standing associated perturbation in the lower limbs which is not necessarily connected with a venous disorder. Patients and methods: Patients were sorted into groups according to the CEAP classification, VS only (C0s), primary varicose veins (C2p), varicose veins plus oedema (C2p and C3), and venous dermatopathy (C4). Patients completed questionnaires before and one week after they were exposed to a test of stationary standing. Results: Patients (N = 127) in the four groups differed by sex, age and body weight. The VS experienced in the preceding week scored the same in all groups at 3.1 on a numeric rating scale (range 0–10; SD 1.6). During standing, lower leg volume increased and symptoms emerged to the same extent across patient groups and were reduced similarly by compression (volume by 1.7 %, symptoms by 41.7 %). The emergence of symptoms was neither correlated with leg volume increase per se, nor with limiting this increase by compression. Symptoms recorded at baseline correlated with the symptoms provoked by the stress test with bare legs while the symptoms reported at follow-up, when stockings were worn regularly, correlated with the stress test with compression. Conclusions: VS, in terms of neuropsychology, reflect a homeostatic disturbance experienced in the presence and absence of venous disease. Thus, VS are not distinctive for the presence of venous disease insofar as they may reflect dynamic homeostatic feelings resulting from a standing-related disequilibrium in the legs’ internal environment.

EPIDEMIOLOGY OF PRIMARY VARICOSE VEINS OF LOWER LIMB IN A TERTIARY CARE HOSPITAL.

2021 ◽  
pp. 30-32
Author(s):  
Praveen Kumar Nookala ◽  
Sandeep Mahapatra ◽  
Anusha Arumalla ◽  
Muneer Ahmad Para ◽  
Venu Gopal Mustyala ◽  
...  
Keyword(s):  
Vascular Surgery ◽  
Lower Limb ◽  
Varicose Veins ◽  
Tertiary Care ◽  
Clinical Manifestations ◽  
Lower Limbs ◽  
Venous Disease ◽  
Care Hospital ◽  
Study Results ◽  
Primary Varicose Veins

Introduction: Epidemiological studies plays an important role in providing information on the spectrum and frequency of venous disease distribution in a population. In India, study encompassing the clinical evaluation and surgical management of varicose veins on the conventional lines seems a necessity to improve the quality care with the available resources. We have undertaken an epidemiological study on inuence of age, sex, body mass index, posture on clinical manifestations and complications of varicose veins of lower limbs in patients attending the Department of Vascular Surgery . Materials and Methods: A prospective observational study was conducted in Department of vascular surgery on patients with primary varicose veins of lower limb. Patients with secondary varicose veins, recurrent varicose veins, patients less than 18 years, deep vein thrombosis& peripheral arterial disease were excluded from the study. Results: In the present study 88.89% of ulcer patients had combined saphenofemoral(SFJ) and perforator incompetence, while 11.11% of ulcer patients had combined saphenofemoral, saphenopopliteal (SPJ)and perforator incompetence.14% patients present with combined SFJ, SPJ and perforator incompetence. The patients with higher CEAP classication had combined SFJ and SPJ valvular incompetence. Most commonly, the disease affected the males in the age group of 40-50 years. Conclusion: The present study shows that prolonged standing , obesity ,increasing age are the common risk factors for development of varicose veins.

scholarly journals Clinical study of asymptomatic deep vein thrombosis in patients with varicose veins of lower extremities

2019 ◽  
Vol 6 (10) ◽  
pp. 3548
Author(s):  
Basavarajappa M. ◽  
Anantharaju G. S. ◽  
Deepak G.
Keyword(s):  
Deep Vein Thrombosis ◽  
Varicose Veins ◽  
Strong Association ◽  
Medical Science ◽  
Clinical Signs ◽  
Lower Limbs ◽  
Research Centre ◽  
Vein Thrombosis ◽  
Ceap Classification ◽  
Deep Vein

Background: The main aim is to study the association between asymptomatic deep vein thrombosis (DVT) in patients with varicose veins in different gender and age groups. Secondly, to study the risk of developing DVT in patients having superficial venous thrombophlebitis (SVT) with varicose veins and finally to study the clinical correlation of clinical, etiological, anatomical and pathological (CEAP) classification with DVT in patients with varicose veins.Methods: Patients presenting to department of General surgery at SS Institute of Medical Science and Research Centre during the period from June 2017 to June 2019 with varicose veins of lower limbs and without clinical signs of DVT were included in this study. Patients were categorised according to CEAP classification. All patients were subjected to duplex scanning of lower limbs to look for presence of SVT and DVT.Results: In our study, 73% patients were males and 27% patients were females. Maximum patients were in age group of 40-60 years.16 patients had DVT, 38 patients had SVT, 166 patients belonged to C2 and 56 patients belonged to CEAP class C3 and beyond.Conclusions: There is a strong association between varicose veins and asymptomatic DVT .The presence of SVT is not a risk factor for concomitant DVT in varicose vein patients. Clinical presentation with C3 or more CEAP grade is one of the potential risk factors for concomitant DVT in vari­cose vein patients.

scholarly journals Status of clinical profile and management of varicose veins in a tertiary care teaching hospital

2021 ◽  
Vol 8 (10) ◽  
pp. 3093
Author(s):  
Atul Tandon
Keyword(s):  
Lower Limb ◽  
Medical Condition ◽  
Varicose Veins ◽  
Tertiary Care ◽  
Lower Limbs ◽  
Venous Flow ◽  
Male Predominance ◽  
Vein Thrombosis ◽  
Left Limb ◽  
Deep Vein

Background: Varicose veins are a widespread medical condition found in at least 10 percent of the general population. Symptoms of varicose veins range from asymptomatic varicose veins to more extreme symptoms such as ulceration and bleeding.Methods: Fifty-six cases of varicose veins of lower limb were evaluated by taking detailed history and by carrying out thorough clinical examination. Patients with features of varicose veins and its complications were included in the study while patients with secondary varicose veins due to deep vein thrombosis, recurrent varicose veins, pregnancy, and venous flow obstruction were excluded from the study.Results: It was more common in left lower limb then compared to right one, 26 (46.4%) patients developed in left and 23 (41.1%) patients in right lower limb. In the present study, right limb involvement of 41.1% and left limb involvement of 46.4%. In the present study bilateral involvement is seen in four patients (12.5%).Conclusions: Distributions of varicose veins of lower limbs is greater common in center age organization of 30 to 50 years (58.9%) with male predominance, career and own family history are the opposite contributory factors.

scholarly journals Management and outcome of lower limb varicose veins: a hospital based follow up study

2019 ◽  
Vol 6 (7) ◽  
pp. 2538
Author(s):  
G. V. Ramana Reddy ◽  
V. Abhilash ◽  
Y. Harshavardhan ◽  
B. Ravikiran
Keyword(s):  
Clinical Examination ◽  
Varicose Veins ◽  
Signs And Symptoms ◽  
Lower Limbs ◽  
Vein Thrombosis ◽  
Follow Up Study ◽  
Predominant Symptom ◽  
The Mean ◽  
Deep Vein

Background: Disorders of veins which are chronic in nature and very common are the varicose veins. Surgery is required at any one stage of the disease. There have been considerable advances that took place in the diagnostics of the varicose veins, but the treatment outcomes may not be good in many cases. To study the management and outcome of lower limbs varicose veins.Methods: This was a hospital based follow up study. Patients who presented with varicose veins signs and symptoms were included. During the study period it was possible to include 40 patients who were willing to get included in the present study. Various presentations, complications and treatments were noted and finally followed up for minimum of 3 months.Results: Most commonly affected age group was 36-45 years. Males were four times more affected than females. Most commonly affected limb was left side in 48%. Long saphenous system was involved in 55%. The predominant symptom was dilated and tortuous veins (32%) followed by pain (25%). 65 incompetent perforators identified by clinical examination and 130 by Doppler with above ankle being the commonest incompetent perforator. With the mean follow up of six months, no serious complications were noted. It was found that the sensitivity of the clinical examination was 82% when doppler scan was taken as gold standard. On follow up no one developed deep vein thrombosis. Incompetence recurrence rate at SFJ was 8% and at SPJ was 18%.Conclusions: We conclude that surgery is the first line of management and if done accurately, complications are minimal.

Recurrent varicose veins below the knee after varicose vein surgery

Phlebologie ◽  
2007 ◽  
Vol 36 (03) ◽  
pp. 132-136
Author(s):  
M. W. de Haan ◽  
J. C. J. M. Veraart ◽  
H. A. M. Neumann ◽  
P. A. F. A. van Neer
Keyword(s):  
Varicose Vein ◽  
Varicose Veins ◽  
Varicose Vein Surgery ◽  
Proximal Point ◽  
Perforating Veins ◽  
Recurrent Varicose Veins ◽  
Below The Knee ◽  
Duplex Imaging ◽  
Additional Value

SummaryThe objectives of this observational study were to investigate whether varicography has additional value to CFDI in clarifying the nature and source of recurrent varicose veins below the knee after varicose vein surgery and to investigate the possible role of incompetent perforating veins (IPV) in these recurrent varicose veins. Patients, material, methods: 24 limbs (21 patients) were included. All patients were assessed by a preoperative clinical examination and CFDI (colour flow duplex imaging). Re-evaluation (clinical and CFDI) was done two years after surgery and varicography was performed. Primary endpoint of the study was the varicographic pattern of these visible varicose veins. Secondary endpoint was the connection between these varicose veins and incompetent perforating veins. Results: In 18 limbs (75%) the varicose veins were part of a network, in six limbs (25%) the varicose vein appeared to be a solitary vein. In three limbs (12.5%) an incompetent sapheno-femoral junction was found on CFDI and on varicography in the same patients. In 10 limbs (41%) the varicose veins showed a connection with the persistent below knee GSV on varicography. In nine of these 10 limbs CFDI also showed reflux of this below knee GSV. In four limbs (16%) the varicose veins showed a connection with the small saphenous vein (SSV). In three limbs this reflux was dtected with CFDI after surgery. An IPV was found to be the proximal point of the varicose vein in six limbs (25%) and half of these IPV were detected with CFDI as well. Conclusion: Varicography has less value than CFDI in detecting the source of reflux in patients with recurrent varicose veins after surgery, except in a few cases where IPV are suspected to play a role and CFDI is unable to detect these IPV.

Duplex ultrasound investigation of the veins in chronic venous disease of the lower limbs – UIP Consensus Document. Part II: Anatomy

2006 ◽  
Vol 21 (4) ◽  
pp. 168-179 ◽  
Author(s):  
A Cavezzi ◽  
N Labropoulos ◽  
H Partsch ◽  
S Ricci ◽  
A Caggiati ◽  
...  
Keyword(s):  
Lower Limb ◽  
Duplex Ultrasound ◽  
Lower Limbs ◽  
Chronic Venous Disease ◽  
Specific Reference ◽  
Venous Disease ◽  
Perforating Veins ◽  
Consensus Document ◽  
Wide Range ◽  
Ultrasound Investigation

Objectives: Duplex ultrasound investigation has become the reference standard in assessing the morphology and haemodynamics of the lower limb veins. The project described in this paper was an initiative of the Union Internationale de Phlébologie (UIP). The aim was to obtain a consensus of international experts on the methodology to be used for assessment of the anatomy of superficial and perforating veins in the lower limb by ultrasound imaging. Design: Consensus conference leading to a consensus document. Methods: The authors performed a systematic review of the published literature on duplex anatomy of the superficial and perforating veins of the lower limbs. Afterwards, they invited a group of experts from a wide range of countries to participate in this project. Electronic submissions from the authors and the experts (text and images) were made available to all participants via the UIP website. The authors prepared a draft document for discussion at the UIP Chapter meeting held in San Diego, USA, in August 2003. Following this meeting, a revised manuscript was circulated to all participants and further comments were received by the authors and included in subsequent versions of the manuscript. Eventually, all participants agreed on the final version of the paper. Results: The experts have made detailed recommendations concerning the methods to be used for duplex ultrasound examination as well as the interpretation of images and measurements obtained. This document provides a detailed methodology for complete ultrasound assessment of the anatomy of the superficial and perforating veins in the lower limbs. Conclusions: The authors and a large group of experts have agreed on a methodology for the investigation of the lower limbs venous system, by duplex ultrasonography, with specific reference to the anatomy of the main superficial veins and perforators of the lower limbs in healthy and varicose subjects.

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