medigraphic.com
Órgano Oficial de la Sociedad Mexicana de Angiología y Cirugía Vascular

2006, Number 3

<< Back Next >>

Rev Mex Angiol 2006; 34 (3)

Chronic venous disease, clinic and ultrasonic relationship

Huerta HH, Serrano LJ, Cossío ZA, Sánchez NN, Rodríguez AE, Cal y Mayor TI, González HR, Anaya AB, Cisneros TMA

Language: Spanish
References: 38
Page: 91-97
PDF size: 72.32 Kb.


ABSTRACT

Objective: To estimate the percentage of patients with chronic venous disease (CVD) who have patterns of venous reflux in one or more segments of the superficial and deep venous system.
Methods: We performed a prospective, observational and transversal study in the hospital Lic. Adolfo López Mateos ISSSTE from April 1st to July 31st 2004. Including patients older than 18 and younger than 65 years old; excluding patients with arterial disease and neuropathy. All the patients were ranked in a scale of Venous Severity Clinical Score (VSCS). We performed a doppler duplex ultrasound to all the patients, in which eight different venous segments were evaluated for the presence of reflux. All the variables were analyzed with the χ2 test.
Results: We evaluated a total of 47 patients and 51 legs by doppler duplex ultrasound. The pain was considered severe only in 19.6% (10 patients) and mild in 39.2% (20 patients). Varicous veins were considered moderate in 51% and severe in 31.4%. The analysis proved a significant relationship for the group of patients with grade III varicous veins and reflux at the venous segments of the saphenous vein in its upper and lower segments with a value of p = 0.029 and 0.006 respectively.
Discusion: The ultrasonic evaluation of patients with CVD in order to proof the presence of reflux is a great tool for an optimal medical and surgical care of our patients.


REFERENCES

  1. Nelzen O. Leg ulcers: economic aspects. Phlebology 2000; 15: 110-4.

  2. Laing W. Chronic venous diseases of the leg. London: Office of Health Economics; 1992.

  3. Bobek K, Cajzl L, Cepelak V, Slaisova V, Opatzny K, Barcal R. Etude de la frequence des Maladies phlebologiques et de l’influence de quelques facteurs etiologiques. Phlebologie 1966; 19: 217-30.

  4. Widmer LK. Peripheral venous disorders Basle III. Bern: Hans Huber; 1978.

  5. Coon WW, Willis PW, Keller JB. Venous thromboembolism and other venous disease-the Tecumseh Community Health Study. Circulation 1973; 48: 839-46.

  6. Callam MJ, Ruckely CV, Harper DR, Dale JJ. Chronic ulceration of the leg-extent of the problem and provision of care. Br Med J 1985; 290: 1855-6.

  7. Cornwall JV, Dore CJ, Lewis JD. Leg ulcers: epidemiology and etiology. Br J Surg 1986; 73: 693-6.

  8. Henry M. Incidence of varicose ulcers in Ireland. Irish Med J 1986; 79: 65-7.

  9. Maffei FHA. Varicose veins and chronic venous insufficiency in Brazil: prevalence among 1755 inhabitants of a county town. Int J Epidemiol 1986; 15: 210-7.

  10. Nelzen O, Bergqvist D, Lindhagen A, Halbook T. Chronic leg ulcers: an underestimated problem in the primary health care among elderly patients. J Epidemiol Comm Health 1991; 45: 184-7.

  11. Baker SR, Stacey MC, Jop-Mackay AG, Hoskins SE, Thompson PJ. Epidemiology of chronic venous ulcers. Br Med J 1991; 78: 864-7.

  12. Van Bemmelan PS, Bedfoprd G, Beach K, Strandness DE. Status of the valves in the superficial and deep venous system in chronic venous disease. Surgery 1990; 109: 730-4.

  13. Hanrahan LM, Araki CT, Rodriguez AA, Kechejian GJ, LaMorte WW, Menzoian JO. Distribution of valvular incompetence in patients with venous stasis ulceration. J Vasc Surg 1991; 13: 805-12.

  14. Weingarten MS, Branas CC, Czeredarczik M, Schmidt TD, Wolferth CC. Distribution and quantification of venous reflux in lower extremity chronic venous disease with duplex scanning. J Vasc Surg 1993; 18: 753-9.

  15. Schami SK, Sarin S, Cheatle TR, Scurr JH, Coleridge Smith PD. Venous ulcers and the superficial venous system. J Vasc Surg 1993; 17: 487-90.

  16. Lees TA, Lambert D. Patterns of venous reflux in limbs with skin changes associated with chronic venous insufficiency. Br J Surg 1993; 80: 725-8.

  17. Myers KA, Ziegebein RW, Zeng GH, Matthews PG. Duplex ultrasonography scanning for chronic venous disease: patterns of reflux. J Vasc Surg 1995; 21: 605-12.

  18. Welch HJ, Young CM, Semegran AB, Lafrati MD, Mackey WC, O’Donnel TF. Duplex assessment of venous reflux and chronic venous insufficiency: the significance of deep venous reflux. J Vasc Surg 1996; 24: 755-62.

  19. Labropoulos N, Leon M, Nicolaides AN, Giannoukas AD, Ramasawami G, Volteas N. The role of the distribution and anatomical extent in the development of signs and symptoms in chronic venous insufficiency. J Vasc Surg 1996; 23: 504-10.

  20. Scriven JM, Hartshorne T, Bell PFR, Naylor AR, London NJM. Single visit venous ulcer clinic: the first year. Br J Surg 1997; 84: 334-6.

  21. Ruckely CV, Stuart WP. What are the indications for endoscopic perforator surgery? In: Indications for vascular and endovascular surgery. RM Greenhalgh, editor. London: WB Saunders; 1998. p. 423-3.

  22. Evans CJ, Fowkes FGR, Ruckely CV, Allan PL, Carson MN, Kerracher EMG, et al. Edinburgh Vein Study: methods and response in a survey of venous disease in the general population. Phlebology 1997; 12: 127-35.

  23. Evans CJ, Fowkes FGR, Ruckely CV, Lee AJ. Prevalence of varicose veins and chronic venous insufficiency in men and women in the general population: Edinburgh Vein Study. J Epidemiol Community Health 1999; 53: 149-53.

  24. Evans CJ, Allan PL, Lee AJ, Bradbury AW, Ruckley CV, Fowkes FGR. Prevalence of venous reflux in the general population on duplex scanning: the Edinburgh Vein Study. J Vasc Surg 1998; 28: 767-76.

  25. Allan PL, Bradbury AW, Evans CJ, Lee AJ, Ruckely CV, Fowkes FGR. Patterns of reflux and severity of varicose veins in the general population-Edinburgh Vein Study. Eur J Vasc Endovasc Surg 2000; 20: 470-7.

  26. Bradbury A, Evans C, Allan P, Lee A, Ruckely CV, Fowkes FGR. What are the symptoms of varicose veins? Edinburgh Vein Study cross sectional population survey. BMJ 1999; 318: 353-6.

  27. Beebe HG, Bergan JJ, Bergqvist D, Eklof B, Eriksson I, Goldman MP, et al. Classification of chronic venous disease of the lower limbs: a consensus statement. Eur J Vasc Surg 1996; 12: 487-92.

  28. Darke SG, Penfold C. Venous ulceration and saphenous ligation. Eur J Vasc Surg 1992; 6: 4-9.

  29. Burnand KG, Lea Thomas M, O’Donnell TF, Browse NL, The relationship between post-phlebitic changes in the deep veins and results of surgical treatment of venous ulcers. Lancet 1976; 1: 936-8.

  30. Bradbury AW, Ruckley CV. Foot volumetry can predict recurrent ulceration after subfascial ligation of perforators and saphenous ligation. J Vasc Surg 1993; 18: 789-95.

  31. Callam MJ. Leg ulcer and chronic venous disease in the community. In: Venous disease: epidemiology, management and delivery of care. Ruckley CV, Fowkes FGR, Bradbury AW, editors. London: Springer-Verlag; 1999. p. 15-25.

  32. Schultz-Ehrenberg U, Weindorf N, Von Uslar D, Hirche H. Prospective epidemiological investigations on early and pre-clinical stages of varicosis. In: Phlebology ’89, Davy A, Stemmer R, editors. 33. Cockett FB, Elgan Jones D. The ankle blow out syndrome. Lancet 1953; 1: 17-9.

  33. Bjordal RI. Circulation patterns in incompetent perforating veins on the calf and in the saphenous system in primary varicose veins. Acta Chir Scand 1972; 138: 252-61.

  34. Sytchev GG. Classification of chronic venous disorders of the lower extremities and pelvis. Int Angiol 1985; 4: 203-6.

  35. Pierchalia P, Tronnier H. Diagnosis and classification of venous insufficiency of the leg. Dtsch Med Wochenschr 1985; 110: 1700-2.

  36. Parsch H. “Betterable” and “nonbetterable” chronic venous insufficiency: a proposal for a practice orientated classification. Vasa 1980; 9: 165-7.

  37. Jesús Sánchez B. Aportaciones del ecodoppler color en la valoración anatómica de los cayados safenos y en la elección de la estrategia terapéutica. Rev Mex Angiología 2003; 2: 24-8.

  38. Porter JM. Rutherford RB, Clagett CP, Cranley JJ, O’Donnel TF, Raju S, et al. Reporting standards in venous disease. Prepared by the Sub-committee on Reporting Standards in Venous Disease, Ad Hoc Committee on Reporting Standards, Society for Vascular Surgery/North American Chapter, International Society for Cardiovascular Surgery. J Vasc Surg 1988; 8: 172-81.




2020     |     www.medigraphic.com