scholarly journals The efficacy of Hamamelis 30 in the management of varicose veins and its complications using revised venous clinical severity score tool and peripheral venous Doppler study

2021 ◽  
Vol 4 ◽  
pp. 49-54
Author(s):  
Blany John Lobo
Keyword(s):  
Severity Score ◽  
Varicose Veins ◽  
Clinical Severity ◽  
Rank Test ◽  
Clinical Severity Score ◽  
Doppler Study ◽  
Short Period ◽  
Venous Clinical Severity Score ◽  
Before And After ◽  
Signed Rank Test

Objectives: The homoeopathic remedy, Hamamelis, has been extensively used to treat varicose veins. However, scientific research conclusively proving its utility is lacking. This study was performed to ascertain the remedy’s therapeutic utility and efficacy in treating varicose veins and its complications using the revised venous clinical severity score (VCSS) tool and Doppler studies. Materials and Methods: A prospective uncontrolled experimental study with purposive sampling was performed; the subjects were selected from the outpatient department. A total of 32 cases, fulfilling the inclusion and exclusion criteria were clinically examined. The VCSS and Doppler test before and after treatment with Hamamelis 30 were performed. Results: The Wilcoxon signed-rank test was applied and the change in the median VCSS was found to be statistically significant. P-value of the pre score was 5.53 ± 4.15 and that of the post score was 3.45 ± 2.36 with a mean change of 2.09 ± 2.87 and 37.69% improvement with P-value of 0.000 < 0.01. The Doppler study showed no significant change or improvement. Conclusion: This study revealed that the homoeopathic remedy Hamamelis 30 is effective in the management of varicose veins and its complications by ameliorating symptoms and improving the VCSS. However, the Doppler study reports showed no changes or improvement perhaps due to the short period of treatment.

scholarly journals Evaluation of liquid or foam sclerotherapy in small varicose veins (ceap c1) with venous clinical severity score

2018 ◽  
Vol 64 (12) ◽  
pp. 1117-1121 ◽  
Author(s):  
Mehmet Ali Kaygin ◽  
Umit Halici
Keyword(s):  
Severity Score ◽  
Skin Necrosis ◽  
Varicose Veins ◽  
Clinical Severity ◽  
Foam Sclerotherapy ◽  
Clinical Severity Score ◽  
Severity Scores ◽  
Study Results ◽  
Venous Clinical Severity Score ◽  
The Mean

SUMMARY OBJECTIVE: We aimed to evaluate the efficacy of liquid or foam sclerotherapy of varicose veins using venous clinical severity scores and possible complications. METHODS: A total of 318 patients (268 females, 50 males) who were treated with liquid or foam sclerotherapy between January 2012 and December 2012 were included in this study. RESULTS: Skin necrosis was observed in only 6 patients (1. 8%), thrombophlebitis in 10 patients (3. 1%), and hyperpigmentation in 18 patients (5. 6%) in this study group. The mean venous clinical severity score was calculated as: pain score, 1. 23 ± 0.88; varicose vein score,1.85 ± 0. 8; edema score, 0.64 ± 0.77). Pain and edema decreased at the control examination, 1 month after completion of sclerotherapy sessions. Varicose veins completely disappeared after sclerotherapy. While the decrease in edema in the foam sclerotherapy group was significantly less (P<0.001), the decline in pain showed an increasing trend (P=0.069). While skin necrosis did not develop after foam sclerotherapy, rates of pigmentation and local thrombophlebitis were similar (P>0.05). CONCLUSION: In conclusion, we observed that both sclerotherapy methods are effective with a low rate of complications, alleviating the complaints of patients with small varicose veins, and providing considerable improvement in venous clinical severity scores.

Endovascular Laser Therapy versus Open Surgery for the Treatment of Primary Varicose Veins of the Lower Limb

QJM ◽  
2021 ◽  
Vol 114 (Supplement_1) ◽  
Author(s):  
Hazem Abd Elsalam Mohamed ◽  
Assist. Prof. Dr. Ramez Mounir Wahba ◽  
Fawzy Salah Fawzy ◽  
Beshoy Maher Yacoub Gebrael
Keyword(s):  
Laser Therapy ◽  
Lower Limb ◽  
Severity Score ◽  
Open Surgery ◽  
Varicose Veins ◽  
Clinical Severity ◽  
Surgery Group ◽  
Clinical Severity Score ◽  
Venous Clinical Severity Score ◽  
Primary Varicose Veins

Abstract Background Venous drainage of the lower extremities is accomplished by a network of superficial veins connected to the deep veins by small perforator veins. Through a variety of pathophysiological mechanisms, weakness develops in the vein wall that results in varicosity over time. Varicosities typically form in the greater and lesser saphenous veins but also develop in branch vessels. Obstruction of the iliac veins or inferior vena cava can result in extensive varicose veins Objective s: The aim of this work is to compare the outcome of endovascular laser therapy versus open surgery in management of primary varicose veins in lower limb. Patients and Methods Type of study is a prospective, randomized, clinical study. This study was conducted on 30 patients with primary varicose veins of the lower limb, 15 patients were subjected to endovascular laser therapy for treatment of varicose veins of the lower limb (EVLA group) and 15 patients were managed by standard open surgery for treatment of varicose veins of the lower limb (surgery group). The patients were randomized selected from surgery clinic in Eldemerdash Hospital. The work was carried out in the period from June 2017 to December 2018. Results Both groups were well matched regarding age(P = 0.352) and sex (P = 0.713), type of vein diseased(P = 0.913), CEAP classification (P = 0.910) and also regarding BMI (P = 0.761). Regarding preoperative venous clinical severity score, the median(IQR) for group A (surgery group) was (5), and for group B (laser group) was (5) without statistical significant differences between both groups (P value =0.524). Many studies have shown that there was some difference in between two methods of treatment of primary varicose veins of the lower limbs open vascular surgery and endovascular laser therapy. Regarding Six weeks post-operative VCSS assessment, the VCSS score in the surgery group was statistically significantly higher (p &lt; 0.001). However, at one and two years after the intervention The VCSS scores converged and the difference between the groups was no longer statistically significant. Conclusion The presented results show that intreatment of varicose veins with both endovascular laser ablation and open surgery there was improvement in the clinical status of the patient occur after both but EVLA was more effective early which was observed by measuring venous clinical severity score. EVLA show distinct advantages over open surgery especially in post operative pain, analgesia use and time needed to return to work.

scholarly journals PC206. Correlation of Age With Patient Reported Symptoms and Venous Clinical Severity Score for Patients With Varicose Veins

2018 ◽  
Vol 67 (6) ◽  
pp. e229 ◽  
Author(s):  
Shravan Leonard-Murali ◽  
Dylan McLaughlin ◽  
Loay Kabbani ◽  
Mitchell R. Weaver ◽  
Nicole Kennedy ◽  
...  
Keyword(s):  
Severity Score ◽  
Varicose Veins ◽  
Clinical Severity ◽  
Clinical Severity Score ◽  
Venous Clinical Severity Score ◽  
Patient Reported

scholarly journals Evaluation and usefulness of venous clinical severity score (VCSS) in patients of varicose veins, undergoing surgery in a tertiary care hospital

2021 ◽  
Vol 5 (4) ◽  
pp. 209-211
Author(s):  
Dr. Raghuveer Chakravarthy Gogineni ◽  
Dr. Ratta Reddy Bommareddy ◽  
Dr. Tejaswi Chandana ◽  
Dr. Mounika Nadakuditi ◽  
Dr. Sai Sanath Kandula
Keyword(s):  
Severity Score ◽  
Tertiary Care Hospital ◽  
Varicose Veins ◽  
Tertiary Care ◽  
Clinical Severity ◽  
Care Hospital ◽  
Clinical Severity Score ◽  
Venous Clinical Severity Score

Σύγκριση της αποτελεσματικότητας της χειρουργικής επέμβασης της σαφηνεκτομής και τοπικών εκριζώσεων στην αντιμετώπιση των συμπτωμάτων σε ασθενείς με χρόνια φλεβική νόσο

2021 ◽  
Author(s):  
Χρυσάνθη Παπαγεωργοπούλου
Keyword(s):  
Severity Score ◽  
Clinical Severity ◽  
Cronbach’S Alpha ◽  
Cronbach's Alpha ◽  
Clinical Severity Score ◽  
Venous Clinical Severity Score

Στόχος: Ο στόχος της μελέτης είναι η επικύρωση του 3D εργαλείου βαθμολόγησης – αξιολόγησης για τη χρόνια φλεβική νόσο, όπως προτάθηκε στο SYM VEIN consensus. Μέθοδος: Η παρούσα κλινική μελέτη είναι μία προοπτική μελέτη κοόρτης που περιλαμβάνει συνολικά τριάντα πέντε (35) ασθενείς, κατόπιν συναίνεσης, με χρόνια φλεβική νόσο. Οι ασθενείς αυτοί που θα υποβάλλονταν σε σαφηνεκτομή εκτιμήθηκαν με το αναθεωρημένο Venous Clinical Severity Sore (r-VCSS), με το CIVIQ-20 ερωτηματολόγιο για την ποιότητα ζωής και με το 3D σύστημα βαθμονόμησης του SYM VEIN consensus, προεγχειρητικά και τέσσερεις εβδομάδες μετά την επέμβαση. Το συνολικό αποτελέσματα του 3D εργαλείου αξιολόγησης ελέγχθηκε για την ανταπόκρισή του, για την αξιοπιστία του και για τη δομική του εγκυρότητα.Αποτελέσματα: Το συνολικό αποτέλεσμα του 3D εργαλείου αξιολόγησης αποδείχθηκε καλής αξιοπιστίας και εσωτερικής συνοχής (Cronbach’s alpha 0,85). Η πρωταρχική ανάλυση των καταληκτικών σημείων ταυτοποίησε τρεις ομάδες συμπτωμάτων (παραισθησία, καυστικό άλγος, κνησμός vs αίσθημα βάρους, αίσθημα οιδήματος, κνησμός vs σύνδρομο ανήσυχων ποδιών, πάλλων πόνος) αποδεικνύοντας μία υψηλή συσχέτιση των συμπτωμάτων που περιλαμβάνονται στην ίδια ομάδα και πιθανώς μοιράζονται κοινή παθοφυσιολογία, ενδεικτικό της επαρκούς δομικής εγκυρότητας του εργαλείου αξιολόγησης. Το συνολικό αποτέλεσμα του 3D εργαλείου αξιολόγησης είχε σημαντική συσχέτιση με το r-VCSS και το αποτέλεσμα του CIVIQ-20 (rho 0,46, p = 0,005 and rho 0,65, p < 0,001, αντίστοιχα), ενδεικτικό της επαρκούς συγκλίνουσας εγκυρότητας. Μετά τη σαφηνεκτομή, παρατηρήθηκαν στατιστικώς σημαντικές μειώσεις (p < 0,001) του συνολικού αποτελέσματος του 3D εργαλείου αξιολόγησης, αλλά και των επιμέρους αποτελεσμάτων του 3D εργαλείου για όλα τα φλεβικά συμπτώματα εκτός από δύο, ενδεικτικό της εξαιρετικής ανταπόκρισης του εργαλείου στη θεραπεία. Η διάμεση τιμή της συνολικής βαθμολογίας του 3D εργαλείου αξιολόγησης μειώθηκε από το 31 στο 6 (83,8% μείωση, p < 0,001), η διάμεση τιμή του r-VCSS μειώθηκε από το 6 στο 0 (100% μείωση, p < 0,001), και η μέση τιμή της βαθμολογίας του CIVIQ-20 μειώθηκε από το 24 στο 14 (40% μείωση, p < 0,001). Η διαφορά της ποσοστιαίας αλλαγής της διάμεσης τιμής των αποτελεσμάτων μεταξύ των r-VCSS και του CIVIQ-20 σε σύγκριση με τη συνολική βαθμολογία του 3D εργαλείου αξιολόγησης ήταν στατιστικώς σημαντική (p = 0,005 and p < 0,001, αντίστοιχα).Συμπέρασμα: Το συνολικό αποτέλεσμα του 3D SYM VEIN εργαλείου αξιολόγησης έχει καλή αξιοπιστία, δομική εγκυρότητα και εξαιρετική ανταπόκριση στη θεραπεία, παρά του ότι είναι λιγότερο επιρρεπές στην αλλαγή μετά τη σαφηνεκτομή, σε σύγκριση με την αναθεωρημένη μορφή του Venous Clinical Severity Score (r-VCSS).

Change in perception of sclerotherapy results after exposure to pre–post intervention photographs

2017 ◽  
Vol 33 (4) ◽  
pp. 282-287 ◽  
Author(s):  
Fabricio R Santiago ◽  
Mario Piscoya ◽  
Yung-Wei Chi
Keyword(s):  
Varicose Veins ◽  
Statistical Significance ◽  
Wilcoxon Test ◽  
Clinical Severity ◽  
Post Intervention ◽  
Chi Square ◽  
Severity Scores ◽  
Venous Clinical Severity Score ◽  
Before And After ◽  
Chi Square Test

Objective To evaluate patients’ self-perception of cosmetic improvement before and after they were presented with pre- and postprocedure photographs after sclerotherapy with 75% dextrose. Methods Treatments included sclerotherapy of reticular and varicose veins using 75% dextrose. All treated limbs were photographed and classified according to Clinical, Etiology, Anatomy, and Pathology classification and Venous Clinical Severity Score pre- and posttreatment. The patients were queried before and after viewing the photos during these visits and indicated if they were very unsatisfied, dissatisfied, satisfied, or very satisfied. Nonparametric kappa correlation coefficient and a Chi square test were used to measure associations among agreement (p < 0.05 indicated statistical significance). The paired Wilcoxon test was used to compare statistical differences in mean Venous Clinical Severity Scores measured at different times (p < 0.05 indicated statistical significance). Data were analyzed using STATA software (version 12). Results Individuals were more satisfied with the results of sclerotherapy after exposure to images portraying their limbs two months after the procedure (p = 0.0028). This effect was maintained six months after sclerotherapy (p = 0.0027). Conclusion Patient exposure to pre- and postsurgical photographs is a simple intervention with the potential of improving patient satisfaction up to six months after treatment with sclerotherapy.

scholarly journals Performance characteristics of the venous clinical severity score

2002 ◽  
Vol 36 (5) ◽  
pp. 889-895 ◽  
Author(s):  
Mark H. Meissner ◽  
Cynthia Natiello ◽  
Stephen C. Nicholls
Keyword(s):  
Severity Score ◽  
Performance Characteristics ◽  
Clinical Severity ◽  
Clinical Severity Score ◽  
Venous Clinical Severity Score

scholarly journals Impacto da escleroterapia com espuma de polidocanol guiada por ultrassom em pacientes com úlcera venosa

2017 ◽  
Vol 16 (3) ◽  
pp. 239-243 ◽  
Author(s):  
Melissa Andreia de Moraes Silva ◽  
Álefy Zanelato Pereira Araujo ◽  
Jéssica Funchal do Amaral ◽  
Seleno Glauber de Jesus-Silva ◽  
Rodolfo Souza Cardoso ◽  
...  
Keyword(s):  
Severity Score ◽  
Clinical Severity ◽  
Clinical Severity Score ◽  
Venous Clinical Severity Score

Resumo Contexto A escleroterapia com espuma de polidocanol guiada por ultrassom tem sido utilizada no tratamento de pacientes com úlceras venosas. É um procedimento minimamente invasivo e de fácil execução, porém apresenta taxas de recidiva elevadas. Objetivos Relatar a evolução a curto e médio prazo de pacientes com úlcera venosa tratados com escleroterapia com espuma de polidocanol guiada por ultrassom. Métodos Foram reavaliados 19 pacientes submetidos ao tratamento de escleroterapia com espuma de polidocanol guiada por ultrassom no período de janeiro de 2013 a dezembro de 2014. Foram analisados tempo de cicatrização da úlcera, melhora de sintomas clínicos, recanalização das veias tratadas, recidiva dos sintomas e da úlcera venosa. Resultados Foram analisados 15 pacientes do sexo feminino (78,9%) e quatro do sexo masculino (21,1%). A média geral de idade foi de 53 anos. O tempo de seguimento dos pacientes variou de 448 dias a 1.276 dias (média de 791 dias). O tempo médio de presença das úlceras foi de 53 meses. Na avaliação pós-procedimento, foram observadas recanalização total em 15,7%, recanalização parcial em 21% e oclusão em 47,3% das veias tratadas. Apenas em um caso foi observada recidiva da úlcera. Pela avaliação das médias do Venous Clinical Severity Score (VCSS), houve diferença significativa antes e após o procedimento, com variação entre os grupos de 11,2 (p < 0,01). Conclusões A escleroterapia por espuma guiada por ultrassom apresenta altas taxas de sucesso terapêutico, com índices de cicatrização de úlceras venosas elevados.

Impact of graduated compression stockings on the prevention of post-thrombotic syndrome - results of a randomized controlled trial

2014 ◽  
Vol 30 (8) ◽  
pp. 541-548 ◽  
Author(s):  
Arjun Jayaraj ◽  
Mark Meissner
Keyword(s):  
Venous Thrombosis ◽  
Deep Venous Thrombosis ◽  
Severity Score ◽  
Scoring Systems ◽  
Clinical Severity ◽  
Compression Stockings ◽  
Post Thrombotic Syndrome ◽  
Clinical Severity Score ◽  
Venous Clinical Severity Score ◽  
Graduated Compression Stockings

Objective Post-thrombotic syndrome is a chronic complication of acute deep venous thrombosis in the lower extremity. The role of graduated compression stockings in the prevention of post-thrombotic syndrome has been studied with opinion being divided on the beneficial effects. We aim to answer this question with a randomized controlled study that uses multiple scoring instruments to assess post-thrombotic syndrome. Methods Sixty-nine consecutive patients with acute deep venous thrombosis diagnosed by duplex ultrasonography were randomized to treatment with graduated compression stockings or no graduated compression stockings. Venous Clinical Severity Score and Villalta-Prandoni Score, commonly used scoring systems, were used to appraise post-thrombotic syndrome at 3, 6, 12, 18, and 24 months following diagnosis of deep venous thrombosis. In both scoring systems, the individual either had post-thrombotic syndrome or no post-thrombotic syndrome. Cumulative incidence was computed using Kaplan–Meier analysis. Relative risk was assessed for age, obesity, varicose veins, and iliofemoral deep venous thrombosis. Results As measured by both Villalta-Prandoni Score and Venous Clinical Severity Score instruments, the graduated compression stockings group had a lower incidence of post-thrombotic syndrome compared to the control group, but only when one month was used as cut off time for the first diagnosis of post-thrombotic syndrome. When 6 or 12 months were used, there was no difference in the incidence of post-thrombotic syndrome between the two groups. The burden of post-thrombotic syndrome was significantly more when the Villalta-Prandoni Score instrument (∼75%) was used as compared to the Venous Clinical Severity Score instrument (∼30%) at 24 months’ follow-up. Obesity was the only statistically significant predictor for the development of post-thrombotic syndrome. Conclusion As assessed by both Villalta-Prandoni Score and Venous Clinical Severity Score instruments, use of graduated compression stockings does not reduce the incidence of post-thrombotic syndrome. There is a significant difference in the incidence post-thrombotic syndrome as detected by Villalta-Prandoni Score and Venous Clinical Severity Score instruments with incidence of post-thrombotic syndrome dependent on instrument and cut off time interval used to assess post-thrombotic syndrome. However, larger prospective studies are required to confirm these differences.

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