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Chronic venous insufficiency(CVI)

Kotaro Suehiro, Noriyasu Morikage, Osamu Yamashita, Takasuke Harada, Makoto Samura, Yuriko Takeuchi, Takahiro Mizoguchi, Kimikazu Hamano
Purpose: To clarify the risk factors for venous stasis-related skin lesions in the legs in patients without major abnormalities on duplex ultrasonography (DUS). Methods: Fifty patients (nine males and 41 females, age 27-93 years) with symptoms of C4 or greater according to the Clinical, Etiological, Anatomical, Pathological (CEAP) classification, but having no abnormalities on DUS were reviewed for known risk factors for chronic venous insufficiency (CVI) such as older age (>70 years), obesity (body mass index [BMI] >30 kg/m(2)), short walking distance (<200 m/day), reduced ankle range of motion (<20°), and occupation requiring prolonged standing (>8h per day)...
2016: Annals of Vascular Diseases
A V Pokrovskiĭ, I M Ignat'ev, M Iu Volodiukhin, E G Gradusov
The present study was aimed at assessing initial results of hybrid operations in obstructive lesions of the iliac-femoral veins in patients with post-thrombotic disease (PTD). Hybrid operations [open endovenectomy from the common femoral vein (CFV) with creation of an arteriovenous fistula + stenting of iliac veins] were performed carried out in a total of eleven patients with PTD. Of these, there were 7 men and 4 women aged from 34 to 52 years (mean age - 42.8±7 years). All patients had severe-degree chronic venous insufficiency (CVI)...
2016: Angiologii︠a︡ i Sosudistai︠a︡ Khirurgii︠a︡, Angiology and Vascular Surgery
Jan Shepherd
Venous leg ulceration (VLU) is a chronic condition associated with chronic venous insufficiency (CVI), where the most frequent complication is recurrence of ulceration after healing. Traditionally, graduated compression therapy has been shown to increase healing rates and also to reduce recurrence of VLU. Graduated compression occurs because the circumference of the limb is narrower at the ankle, thereby producing a higher pressure than at the calf, which is wider, creating a lower pressure. This phenomenon is explained by the principle known as Laplace's Law...
September 2016: British Journal of Community Nursing
Özlem Cinar Özdemir, Serkan Sevim, Elif Duygu, Alper Tuğral, Yesim Bakar
[Purpose] This study was aimed to analyse the effects of short-term use of compression stockings (CS) on symptoms and QoL in patients with Chronic Venous Insufficiency (CVI). [Subjects and Methods] Based on the CEAP classification C2 and C3, 117 patients with CVI were enrolled in this study. The participants were divided into two groups. The control group refused to use CS, however, was advised to do exercises and take skin care whereas the CS group used CS and performed exercise. The data were collected by using Nottingham Health Profile (NHP), Venous Insufficiency Epidemiological and Economic Study (VEINES-QoL/Sym) and Beck Depression Inventory (BDI) at baseline and after four weeks of treatment and compared within and in between groups...
July 2016: Journal of Physical Therapy Science
K Kroeger, M Storck, P Kujath, E Rabe, J Dissemond
Venous leg ulcer (VLU) counts among the most common chronic wounds in Europe. Treatment is lengthy, cumbersome and costly, and there is a high rate of recurrence. This review shows the measures that should be offered to every patient with healed VLU to permanently prevent recurrence. To prevent VLU in case of varicose veins, the progression of chronic venous insufficiency (CVI) has to be stopped. There is convincing evidence that the effective treatment of varicose veins reduces the recurrence rate in patients with VLU...
August 8, 2016: Zentralblatt Für Chirurgie
Raghu Kolluri
Minimally invasive endothermal treatments have replaced surgical ligation and stripping in the management of chronic venous insufficiency (CVI) and are now considered the standard of care. Newer techniques have emerged in the last few years in an attempt to further minimize the procedural discomfort associated with endothermal procedures. These new techniques are designed to avoid tumescent anesthesia (TA). These new non-thermal, tumescentless techniques are well tolerated and are shown to result in equivalent outcomes when compared to the thermal ablations...
July 2016: Current Treatment Options in Cardiovascular Medicine
Tao Ma, Weiguo Fu, Jie Ma
OBJECTIVE: Axial deep venous reflux causes skin changes or ulcers in patients with chronic venous insufficiency (CVI). The study aimed to review the results of correcting axial deep venous reflux using the novel valve-free popliteal vein external banding (PVEB) technique in patients with severe CVI. METHODS: We retrospectively reviewed 1252 patients (1252 limbs) who underwent PVEB for treatment of severe CVI from 2000 to 2015. The number and position of popliteal vein valves (PVVs) and gastrocnemius vein entries were analyzed...
April 27, 2016: Journal of Vascular Surgery
Giulia Salazar, Chiara Bellocchi, Katia Todoerti, Federica Saporiti, Luca Piacentini, Raffaella Scorza, Gualtiero I Colombo
Aminaphtone, a drug used in the treatment of chronic venous insufficiency (CVI), showed a remarkable role in the modulation of several vasoactive factors, like endothelin-1 and adhesion molecules. We analysed in vitro the effects of Aminaphtone on whole-genome gene expression and production of different inflammatory proteins. ECV-304 endothelial cells were stimulated with IL-1β 100U/ml in the presence or absence of Aminaphtone 6μg/ml. Gene expression profiles were compared at 1, 3, and 6h after stimulation by microarray...
July 5, 2016: European Journal of Pharmacology
R S S Crisóstomo, M S Candeias, P A S Armada-da-Silva
OBJECTIVES: To evaluate the effect of manual lymphatic drainage (MLD) on venous flow when applied to the medial and lateral aspects of the thigh and leg in patients with chronic venous insufficiency (CVI) and healthy subjects. DESIGN: Cross-sectional study. SETTING: Participants were assessed in a school-based health community attendant service. PARTICIPANTS: Fifty-seven subjects participated in this study {mean age: 43 [standard deviation (SD) 14] years, 38 women and 19 men}...
February 1, 2016: Physiotherapy
Maria José Martinez-Zapata, Robin W M Vernooij, Sonia Maria Uriona Tuma, Airton T Stein, Rosa M Moreno, Emilio Vargas, Dolors Capellà, Xavier Bonfill Cosp
BACKGROUND: Chronic venous insufficiency (CVI) is a common condition caused by valvular dysfunction with or without associated obstruction, usually in the lower limbs. It might result in considerable discomfort with symptoms such as pain, itchiness and tiredness in the legs. Patients with CVI may also experience swelling and ulcers. Phlebotonics are a class of drugs often used to treat CVI. This is an update of a review first published in 2005. OBJECTIVES: To assess the efficacy and safety of phlebotonics administered both orally and topically for treatment of signs and symptoms of lower extremity CVI...
2016: Cochrane Database of Systematic Reviews
Lindsay Robertson, Amanda J Lee, Christine J Evans, Sheila Boghossian, Paul L Allan, C Vaughan Ruckley, F G R Fowkes
BACKGROUND: Epidemiologic research in chronic venous disease has focused on prevalence and associated risk factors. Evidence on the risks and incidence that this condition will develop is limited. The aim of this study was to measure the incidence of new varicose veins and chronic venous insufficiency (CVI) in an adult population and to investigate risk factors associated with the development of these conditions. METHODS: The Edinburgh Vein Study is a cohort study of a random sample of the general population...
January 2013: Journal of Vascular Surgery. Venous and Lymphatic Disorders
Henry Y Chen, Zachary C Berwick, Arika Kemp, Joshua Krieger, Sean Chambers, Fedor Lurie, Ghassan S Kassab
BACKGROUND: There is significant interest in a venous prosthesis to replace insufficient valves. The aim of the current study was to select the patients with hemodynamic conditions most likely to benefit from a valve implant. The hypothesis is that the venous valve prosthesis is most suitable for patients with significant reflux, such as in chronic venous insufficiency (CVI), right heart hypertrophy (RHH), and right heart failure (RHF). Conversely, a prosthetic valve is likely to be of least benefit for deep venous thrombosis (DVT) patients with low flow...
January 2015: Journal of Vascular Surgery. Venous and Lymphatic Disorders
Amanda J Lee, Lindsay A Robertson, Sheila M Boghossian, Paul L Allan, C Vaughan Ruckley, F Gerald R Fowkes, Christine J Evans
OBJECTIVE: The natural history in the general population of chronic venous disease in the legs is not well understood. This has limited our ability to predict which patients will deteriorate and to assign clinical priorities. The aims of this study were to describe the progression of trunk varicose veins and chronic venous insufficiency (CVI) in the general population, to identify important lifestyle and clinical prognostic factors, and to determine the relationship between venous reflux and progression...
January 2015: Journal of Vascular Surgery. Venous and Lymphatic Disorders
Sandrine Mestre, Florent Veye, Antonia Perez-Martin, Thomas Behar, Jean Triboulet, Nicolas Berron, Christophe Demattei, Isabelle Quéré
BACKGROUND: Measurement of limb volume is helpful for the evaluation and follow-up of edema, especially in patients with chronic venous insufficiency (CVI) or lymphedema. Water displacement (WD) is the reference method for limb volumetry but is not really suitable for clinical routine. Indirect volumetry based on circumference measurements as well as the more expansive but automatic optoelectronic techniques do not allow detailed measurement at the extremity of the limb. METHODS: We used a self-positioning laser scanner with dynamic referencing for acquisition and real-time three-dimensional (3D) reconstruction of the lower limb volume in 30 patients with CVI, 30 patients with lymphedema, and 30 healthy controls...
January 2014: Journal of Vascular Surgery. Venous and Lymphatic Disorders
Harold J Welch, Thomas F O'Donnell, Mark D Iafrati, Daniel R Gorin, Michael Merport
Many health insurance plan (HIP) policies toward the treatment of chronic venous insufficiency (CVI) are outdated, formulated by administrators with the advice of physicians unfamiliar with CVI, and are not evidence-based. Denial of appropriate care by the HIP is frustrating to both the patient and provider, leading to delays in care and much time and effort in the appeals process. This led to meeting with the HIPs outlining the problems with their CVI policies. Through education of the HIP medical staff and reviewers, the specialists were then asked to review the policies and recommend changes...
October 2013: Journal of Vascular Surgery. Venous and Lymphatic Disorders
Dalibor Musil, Marketa Kaletova, Jiri Herman
BACKGROUND: Primary chronic venous disease (CVD) is associated with an increased risk of superficial vein thrombosis (SVT). While CVD is a predominant factor in SVT, there is a range of additional predisposing factors. The objective was to investigate the association between age, gender, BMI, smoking, oestrogen hormone therapy, family history of venous thromboembolism (VTE) and CEAP clinical classification in patients with CVD and a history of SVT. PATIENTS AND METHODS: In a retrospective observational study on consecutive patients with primary CVD, 641 outpatients were enrolled (152 men, 23...
January 2016: VASA. Zeitschrift Für Gefässkrankheiten
Patrick Bastos Metzger, Fabio Henrique Rossi, Antônio Massamitsu Kambara, Nilo Mitsuru Izukawa, Mohamed Hassan Saleh, Ibraim M F Pinto, Jorge Eduardo Amorim, Patricia E Thorpe
OBJECTIVE: The purpose of this study was to determine the sonographic criteria for diagnosis of iliac venous outflow obstruction by assessing the correlation of this method with intravascular ultrasound (IVUS) in patients with advanced chronic venous insufficiency (CVI). METHODS: The evaluation included 15 patients (30 limbs; age, 49.4 ± 10.7 years; 1 man) with initial CVI symptoms (Clinical class, Etiology, Anatomy, and Pathophysiology [CEAP] classification, CEAP1-2) in group I (GI) and 51 patients (102 limbs; age, 50...
January 2016: Journal of Vascular Surgery. Venous and Lymphatic Disorders
Ying Huang, Peter Gloviczki
OBJECTIVE: Relationships between duplex findings and data on health-related quality of life (QoL) to assess long-term results of treatment of varicose veins and chronic venous insufficiency (CVI) are not well known. The goal of this review was to correlate duplex findings and QoL assessments in clinical studies with long-term follow-up. METHODS: A review of the English language literature on PUBMED revealed 17 clinical studies, including 9 randomized controlled trials (RCTs), 6 prospective, and 2 retrospective studies that included patients with at least 5-year follow-up after endovenous laser ablation (EVLA), radiofrequency ablation (RFA), ultrasound-guided foam sclerotherapy (UGFS), and traditional superficial venous surgery...
March 2016: Phlebology
Paulo Eduardo de Oliveira Carvalho, Natiara G Magolbo, Rebeca F De Aquino, Carolina D Weller
BACKGROUND: Venous leg ulcers (VLUs) or varicose ulcers are the final stage of chronic venous insufficiency (CVI), and are the most common type of leg ulcer. The development of VLUs on ankles and lower legs can occur spontaneously or after minor trauma. The ulcers are often painful and exudative, healing is often protracted and recurrence is common. This cycle of healing and recurrence has a considerable impact on the health and quality of life of individuals, and healthcare and socioeconomic costs...
2016: Cochrane Database of Systematic Reviews
Milan Matic, Aleksandra Matic, Verica Djuran, Zorica Gajinov, Sonja Prcic, Zoran Golusin
BACKGROUND: It is estimated that about 15% (10% - 30% in most of the studies) of the total adult population has some aspects of the Chronic Venous Insufficiency (CVI). Frequency of the Peripheral Arterial Disease (PAD) in the adult population is 3% - 4%. Studies dealing with etiopathogenesis of leg ulcers show that between 10% and 18% of all ulcers are of mixed, arterial-venous origin. OBJECTIVES: The purpose of this study was to find out if there is a higher frequency of PAD among CVI patients in comparison with the control group, as well as to discover some common risk factors for CVI and PAD...
January 2016: Iranian Red Crescent Medical Journal
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