Venous Stasis Disease

2019 ◽  
Author(s):  
Allyson R Alfonso ◽  
Daniel Cuzzone ◽  
Ernest S Chiu
Keyword(s):  
Venous Insufficiency ◽  
Compression Therapy ◽  
Venous Ulcer ◽  
Clinical Severity ◽  
Chronic Venous Disease ◽  
Venous Stasis ◽  
Venous Disease ◽  
Venous Ulceration ◽  
Disease Etiology ◽  
Venous Clinical Severity Score

Chronic venous disease (CVD) is a chronic and morbid condition with a wide pathologic spectrum. The common denominator is either impaired venous outflow or anomalous (retrograde) venous inflow most often related to a failure of the valvular system. Diagnosis is made with a thorough history, physical examination, and imaging such as duplex ultrasonography. The disease can then be classified using the Clinical, Etiology, Anatomic, Pathophysiology classification system and Venous Clinical Severity Score. Management is based on disease etiology and symptomatic presentation. It is important to first identify the presence or absence of venous ulceration. In venous ulceration, compression therapy with contact dressings is standard therapy, but surgical wound debridement and skin or fat grafting can be necessary for wound closure. Additional operative treatment for those with CVD can include conservative hemodynamic correction of venous insufficiency, vein stripping, and endovenous thermal ablation. With multiple etiologies and subsequent treatment options, CVD requires patient and vigilant care on part of the patient and the treating clinician. Although much is known about CVD, our ability to predict, prevent, and treat is limited by aspects of the disease in need of further study.   This review contains 8 figures, 6 tables, and 51 references. Key Words: chronic venous disease, chronic venous insufficiency, venous ulcer, wound healing, venous physiology, venous ulcer management, compression therapy, wound contact dressings, surgical management 

The efficiency of exercise training in patients with venous insufficiency: A double blinded, randomized controlled trial

2021 ◽  
pp. 026835552098575
Author(s):  
Saliha Gürdal Karakelle ◽  
Yeldan Ipek ◽  
Ozalhas Tulin ◽  
İbrahim Ufuk Alpagut
Keyword(s):  
Exercise Training ◽  
Venous Insufficiency ◽  
Short Form ◽  
Clinical Severity ◽  
Chronic Venous Disease ◽  
Control Group ◽  
Venous Disease ◽  
Life Questionnaire ◽  
Walking Test ◽  
Venous Clinical Severity Score

Background Exercise training (ET) is current treatment method for venous insufficiency (VI). The comprehensive effect of ET in addition to compression therapy (CT) in VI is not clear. Method Twenty-four patients with VI were randomly divided into exercise group (EG) and control group (CG). While CG received only CT, EG was applied ET consisting of aerobic, strengthening and stretching exercises in addition to CT for 2 days/week, 6 weeks at hospital under the supervision of physiotherapist. All the patients were assessed with Chronic Venous Disease Quality Of Life Questionnaire-20, Short Form-36, Duplex Doppler Ultrasonography, Venous Clinical Severity Score, hand-held dynamometer, Visual Analogue Scale, circumference measurements, 6 minute-walking test, and 10-meter-walking test before and after the treatment. Result Except of hemodynamic status and edema (p > 0.05), all parameters were significantly different in favor of EG (p < 0.05). Conclusion ET in addition to CT was more effective and safe treatment in VI.

scholarly journals Circaid adjustable inelastic compression wraps for the treatment of lower limb edema in the venous system pathology

2019 ◽  
pp. 12-16
Author(s):  
A. Yu. Semenov ◽  
A. M. Malakhov
Keyword(s):  
Chronic Venous Insufficiency ◽  
Western Europe ◽  
Venous Insufficiency ◽  
Medical Science ◽  
Compression Therapy ◽  
European Population ◽  
Chronic Venous Disease ◽  
Venous Disease ◽  
Compression Garments ◽  
The Usa

Symptoms of chronic venous insufficiency have been known since antiquity. The prevalence of chronic venous insufficiency in Western Europe and the USA has been reported within the range from from 1 to 40% in women and from 1 to 17% in men [1]. As reported by the European authors, the average prevalence of chronic venous insufficiency with class C2-C6 (according to the CEAP classification) among the European population reaches 30% [2]. Edema syndrome remains one of the leading manifestations of chronic venous disease. Compression therapy is one of the main ways to combat edema. The arsenal of devices for the treatment of edematous syndrome is steadily expanding with the development of medical science. Today, in addition to inelastic compression wrap and elastic compression garments, brand-new compression products, circaid adjustable inelastic compression wraps are available.

Internal Perivenous Compression for venous insufficiency at the Saphenofemoral Junction: Early and Midterm Results and Operative Pain

2021 ◽  
pp. 026835552110519
Author(s):  
Hakan Parlar ◽  
Ali Ahmet Arıkan
Keyword(s):  
Postoperative Pain ◽  
Venous Insufficiency ◽  
Area Under The Curve ◽  
Compression Therapy ◽  
Clinical Severity ◽  
Patient Comfort ◽  
Midterm Results ◽  
Doppler Ultrasound Imaging ◽  
Venous Clinical Severity Score ◽  
Saphenofemoral Junction

Objectives To assess the postoperative pain and midterm results of patients undergoing internal perivenous compression with internal compression therapy (ICT) for venous insufficiency at the saphenofemoral junction (SFJ) Materials and Methods Patients managed with ICT between April and October 2019 for grade 4 venous reflux at the SFJ were retrospectively evaluated. The venous clinical severity score (VCSS) was calculated preoperatively and 1, 3, and 6 months postoperatively. Postoperative pain was assessed with the visual analog scale (VAS). Control Doppler ultrasound imaging was performed 6 months postoperatively. Results Forty-five patients [14 (31%) males and 31 (69%) females; mean age, 47 ± 13 years] were included. The median preoperative VCSS was 7 (5–8.5). The median VCSS at 1, 3, and 6 months postoperatively was 6 (4–7.5), 4 (3–5.5), and 3 (2–4), respectively, and these values were significantly lower than the preoperative score (p = 0,001, p < 0.001, and p < 0.001, respectively). The postoperative VAS score was 0 in 6 patients (13%), 1 in 17 patients (38%), 2 in 6 patients (13%), 3 in 15 patients (33%), and 4 in 1 patient (2%). At 6 months, reflux was absent in 9 (20%), grade 1 in 20 (44%), and grade 2 in 16 (36%) patients. A vena saphena magna diameter of >6.7 mm predicted grade >1 reflux at 6 months [87.5%, with an area under the curve of 0.78 (p < 0.001)]. No complications occurred. Conclusion ICT alleviated symptoms and reduced reflux grade in patients with venous insufficiency at the SFJ. This therapy can be applied with satisfactory patient comfort.

Segmental saphenous ablation for chronic venous disease treatment

2020 ◽  
pp. 026835552094623
Author(s):  
Sergio Gianesini ◽  
Erica Menegatti ◽  
Savino Occhionorelli ◽  
Maria Grazia Sibilla ◽  
Marianna Mucignat ◽  
...  
Keyword(s):  
Clinical Severity ◽  
Chronic Venous Disease ◽  
Procedural Pain ◽  
Venous Disease ◽  
Disease Treatment ◽  
Endovenous Laser Ablation ◽  
Venous Clinical Severity Score ◽  
Endovenous Thermal Ablation ◽  
Occlusion Rate ◽  
Reflux Recurrence

Background Endovenous thermal ablation for chronic venous disease treatment is recommended over traditional surgery. The present investigation compares endovenous laser ablation (EVLA) with radiofrequency (RF) for segmental endovenous sapheno–femoral junction ablation. Methods This is a retrospective study in which 79 patients underwent a 6 cm great saphenous vein ablation by RF or by EVLA. Primary outcome was occlusion rate. Secondary outcomes included Venous Clinical Severity Score (VCSS), Aberdeen Varicose Vein Questionnaire (AVVQ) score, peri-procedural pain, aesthetic satisfaction. Results At 12 ± 1 months recanalization of shrunk tract was recorded in 5/85 (5.8%) cases (2 RF, 3 EVLA) [OR: 1.6; 95%CI: 0.2–10.4; P = 0.6689]. Two cases (1/44 RF group and 1/38 EVLA group) also showed reflux recurrence [OR: 1.0; 95%CI: 0.06–17.8; P = 1.0000]. No significant differences between groups were found in AVVQ, VCSS, peri-procedural pain, or aesthetic satisfaction. Conclusion Saphenous sparing is feasible and effective by means of both EVLA and RF, representing a possible alternative to surgery.

Treating great and small saphenous vein insufficiency with histoacryl in patients with symptomatic varicose veins and increased risk of surgery

VASA ◽  
2018 ◽  
Vol 47 (5) ◽  
pp. 416-424 ◽  
Author(s):  
Karel Novotný ◽  
Míla Roček ◽  
Radek Pádr ◽  
Radim Pavlík ◽  
Michal Polovinčák ◽  
...  
Keyword(s):  
Saphenous Vein ◽  
Venous Insufficiency ◽  
Varicose Veins ◽  
Clinical Severity ◽  
Cyanoacrylate Glue ◽  
Venous Ulceration ◽  
Increased Risk ◽  
Venous Clinical Severity Score ◽  
Vein Insufficiency

Abstract. Background: Treating great and small saphenous vein trunk insufficiency with cyanoacrylate glue is the least taxing treatment method of all available techniques. Due to long-term unavailability of commercial kits with n-butyl-2-cyanoacrylate (histoacryl) in the Czech Republic, we used a modified technique. Patients and methods: Fifty-six limbs in 49 patients suffering from great saphenous vein or small saphenous vein insufficiency in combination with symptomatic chronic venous insufficiency and complicating comorbidities were treated with a modified endovascular cyanoacrylate glue application technique. Results: The immediate success rate of the treatment was 98 %. In follow-up intervals of six weeks, six months, one year, and two years, the anatomical success rates of embolization (recanalization of no more than 5 cm of the junction) were 98, 96, 94, and 94 %, respectively. At identical intervals the venous insufficiency was scored according to the Aberdeen Varicose Vein Questionnaire and the American Venous Clinical Severity Score. In both cases, improvement was demonstrated over the two-year follow-up, with a 0.5 % significance level. Specific clinical signs of venous insufficiency were also evaluated, such as pain, oedema, clearance of varicose veins, and healing of venous ulceration. One severe complication – a pulmonary embolism – was reported, without consequences. Conclusions: We demonstrated that treating insufficient saphenous veins with modified histoacryl application brought a relief from symptoms of venous insufficiency and that the efficiency of this technique is comparable to commonly used methods.

Reflux time estimation on air-plethysmography may stratify patients with early superficial venous insufficiency

2013 ◽  
Vol 28 (2) ◽  
pp. 101-108 ◽  
Author(s):  
C R Lattimer ◽  
E Kalodiki ◽  
M Azzam ◽  
G Geroulakos
Keyword(s):  
Venous Insufficiency ◽  
Time Estimation ◽  
Clinical Severity ◽  
Venous Disease ◽  
Exact Test ◽  
Venous Clinical Severity Score ◽  
Venous Filling ◽  
Venous Volume ◽  
Air Plethysmography ◽  
Superficial Venous Insufficiency

Objectives It has been suggested that quantification of haemodynamic parameters of venous disease may complement clinical assessment and may help identify a group of patients with severe venous disease or alternatively patients with early venous disease. However, there has been very little work to prove this hypothesis. The venous filling index (VFI) of air-plethysmography (APG) can quantify severity and treatment effect but has limited discriminatory value. However, the components of the VFI, total venous volume (VV) and time to reach 90% of VV (VFT90), have never been fully studied. The aim was to investigate the contribution of VV and VFT90 to an elevated VFI and determine their relationship to great saphenous vein (GSV) diameter and clinical severity scoring. Method Ninety-three consecutive patients/legs (22–78 years) with primary GSV reflux (>0.5 seconds) awaiting endovenous treatment were recruited. CEAP (clinical, aetiological, anatomical and pathological elements) assessments were: 33 (35.5%) C2, 14 (15.0%) C3, 29 (31.2%) C4a, 5 (5.4%) C4b, 7 (7.5%) C5 and 5 (5.4%) C6. The median venous clinical severity score (VCSS) was 6 (2–20) and the averaged GSV diameter at three sites was 7.5 mm (4–12). The VFI, VV and VFT90 were recorded using APG. Results There was no correlation between the VV and the VFT90 ( r = −0.103, P = 0.324). The VFI, VV and VFT90 significantly correlated ( P < 0.0005, Spearman) with the GSV diameter: r = 0.623, r = 0.567, r = −0.432, respectively, and the C of CEAP ( P < 0.05): r = 0.4, r = 0.225, r = −0.343, respectively. None of the 25 (26.9%) patients with a VFT90 > 25 seconds were among the 17 (18.3%) patients in categories C4b–6 or with a VCSS > 9 ( P = 0.005, Fisher's exact test, corrected odds ratio: 17.3). Conclusions The VFT90 complements the VFI as a marker of severe superficial venous insufficiency. However, in contrast to the VFI, it may have discriminatory value in stratifying patients with early disease into two groups based on the severity of haemodynamic impairment.

Endovenous laser treatment of groin and popliteal varicose veins recurrence

2017 ◽  
Vol 33 (3) ◽  
pp. 195-205 ◽  
Author(s):  
Alvise Cavallini ◽  
Daniela Marcer ◽  
Salvatore Ferrari Ruffino
Keyword(s):  
Laser Treatment ◽  
Diode Laser ◽  
Varicose Veins ◽  
Clinical Severity ◽  
Chronic Venous Disease ◽  
Venous Disease ◽  
Recurrent Varicose Veins ◽  
Venous Clinical Severity Score ◽  
Effective Option ◽  
One Year

Objectives Recurrent varicose veins following surgery is a common, complex and costly problem in vascular surgery. Treatment for RVV is technically more difficult to perform and patient satisfaction is poorer than after primary interventions. Nevertheless, traditional vein surgery has largely been replaced by percutaneous office-based procedures, and the patients with recurrent varicose veins have not benefited from the same advantages. In this paper, we propose an endovascular laser treatment that allows reducing the invasiveness and complications in case of SFJ and SPJ reflux after ligation and stripping of the great and small saphenous vein. Methods 8 SFJ and 1 SPJ stumps were treated by endovascular laser treatment in out-patient clinic. Endovascular laser treatment was performed with a 1470 nm diode laser and a 400 µc radial slim™ fiber. Intraoperative ultrasoud was used to guide the fiber position and the delivery of tumescent anesthesia. The gravity of chronic venous disease was determined according to the CEAP classification and the severity of symptoms was scored according to the revised Venous Clinical Severity Score (VCSS). Results The average linear endovenous energy density was 237 J/cm. Patients return to daily activities after a mean of 1.9 days after. The VCSS improved drastically from a mean of 8 pre-interventional to 1 at day 30 and until one year. During the follow-up period (mean 8 months, range: 5–17 months), all the stumps except one were occluded. All patients were very satisfied or satisfied with the method. No severe complications occurred. Conclusions Office-based endovascular laser treatment of groin and popliteal recurrent varicose veins with 1470 nm diode laser and radial-slim fiber is a safe and highly effective option, with a high success rate in the early post-operative period.

Compression therapy for venous disease

2016 ◽  
Vol 32 (2) ◽  
pp. 81-88 ◽  
Author(s):  
Robert R Attaran ◽  
Cassius I Ochoa Chaar
Keyword(s):  
Lower Extremities ◽  
Compression Therapy ◽  
Venous Ulcer ◽  
Venous Disease ◽  
Post Intervention ◽  
Venous Ulceration ◽  
Ulcer Disease ◽  
Post Thrombotic Syndrome ◽  
Compression Data

For centuries, compression therapy has been utilized to treat venous disease. To date it remains the mainstay of therapy, particularly in more severe forms such as venous ulceration. In addition to mechanisms of benefit, we discuss the evidence behind compression therapy, particularly hosiery, in various forms of venous disease of the lower extremities. We review compression data for stand-alone therapy, post-intervention, as DVT prevention, post-thrombotic syndrome and venous ulcer disease. We also review the data comparing compression modalities as well as the use of compression in mixed arteriovenous disease.

scholarly journals A randomised controlled trial of neuromuscular stimulation in non-operative venous disease improves clinical and symptomatic status

2020 ◽  
pp. 026835552096864
Author(s):  
Raveena Ravikumar ◽  
Tristan RA Lane ◽  
Adarsh Babber ◽  
Sarah Onida ◽  
Alun H Davies
Keyword(s):  
Randomised Controlled Trial ◽  
Controlled Trial ◽  
Clinical Severity ◽  
Percentage Change ◽  
Chronic Venous Disease ◽  
Venous Disease ◽  
Severity Scores ◽  
Venous Clinical Severity Score ◽  
Group A ◽  
Randomised Controlled

Background This randomised controlled trial investigates the dosing effect of neuromuscular electrical stimulation (NMES) in patients with chronic venous disease (CVD). Methods Seventy-six patients with CEAP C3-C5 were randomised to Group A (no NMES), B (30 minutes of NMES daily) or C (60 minutes of NMES daily). Primary outcome was percentage change in Femoral Vein Time Averaged Mean Velocity (TAMV) at 6 weeks. Clinical severity scores, disease-specific and generic quality of life (QoL) were assessed. Results Seventy-six patients were recruited - mean age 60.8 (SD14.4) and 47:29 male. Six patients lost to follow-up. Percentage change in TAMV (p<0.001) was significantly increased in Groups B and C. Aberdeen Varicose Veins Questionnaire Score (-6.9, p=0.029) and Venous Clinical Severity Score (-4, p-0.003) improved in Group C, and worsened in Group A (+1, p=0.025). Conclusions Daily NMES usage increases flow parameters, with twice daily usage improving QoL and clinical severity at 6 weeks in CVD patients.

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