How specific are venous symptoms for diagnosis of chronic venous disease?

Van der Velden S, Shadid N, Nelemans P, Sommer A. Phlebology. 2014 Jan 3. (Epub ahead of print). Reviewed by: Djordje Radak and Srdjan Babic Belgrade, Serbia Are the symptoms of venous disease specific for chronic venous disease (CVD)? Is the pain or swelling the most important venous symptoms? Does the presence of pain predicti CVD progression? What is the best medical treatment to prevent development of CVD? When should we start with medical treatment, to be more efficient in prevention of CVD progression? Those are the question that should be answer by large prospective multicentric international studies including patients…

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The “C0s” patient: worldwide results from the Vein Consult Program

  Jean-Jérôme GUEX1, Eberhard RABE2, Sanchez Ignacio ESCOTTO3, José-Román ESCUDERO4, Angelo SCUDERI5, Hendro Sudjono YUWONO6, and the Vein Consult Program coordinators7 1. 32, Boulevard Dubouchage, Nice, France 2. Department of Dermatology, University of Bonn, Germany 3. National Autonomous University of Mexico, Mexico City, Mexico 4. Hospital de la Santa Creu i Sant Pau, Barcelona, Spain 5. Instituto Sorocabano de Pesquisa de Molestias Circulatorios (INSPEMOC), São Paulo, Brazil 6. Hasan Sadikin General Hospital, Bandung, Indonesia 7. National coordinators of the Vein Consult Program (VCP): Alberti T, Venezuela; Andercou A, Giurcaneanu C, and Puskas A, Romania; Dinh Thi Thu H and Le…

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The natural progression of chronic venous disorders: An overview of available information from longitudinal studies

Amanda C. SHEPHERD, Tristan R. LANE, Alun H. DAVIES Academic Section of Vascular Surgery Imperial College School of Medicine Charing Cross Hospital, Fulham Palace Road, London, W6 8RF ABSTRACT Chronic venous disorders remain a common problem worldwide; however, despite increasing research into novel endovenous therapies for the treatment of superficial venous disease, the natural history of primary venous disorders remains poorly understood. The following article provides a review of the longitudinal studies evaluating the progression of chronic venous disorders in the published literature. This includes a summary of the rate of development of venous disease in asymptomatic limbs and the…

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Venous Clinical Severity Score and quality-of-life assessment tools: application to vein practice

Michael A. VASQUEZ and Carolyn E. MUNSCHAUER SUNY Buffalo Surgery, The Venous Institute of Buffalo, New York, USA However beautiful the strategy, you should occasionally look at the results. Sir Winston Churchill Outcome assessment is a term that dominates the global landscape of vascular interventions and has become a catchphrase for determination of the acceptable standard. Its tools allow us to stratify disease and therapy. In his 1996 presidential address to the Society of Vascular Surgery, Rutherford stated: “The results of therapy for vascular diseases have little meaning if presented in isolation, no matter how uniform and valid the criteria…

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Results from detection surveys on chronic venous disease in Eastern Europe

Françoise PITSCH ervier Interntational Suresnes, France INTRODUCTION Chronic venous disease (CVD) is common among general populations.1 Both general practitioners and specialist doctors have to deal with this pathology, which is often mild in presentation but potentially progressive. Despite this, it is acknowledged that CVD is usually overlooked both by doctors who underdiagnose the condition and by patients themselves who rarely consult spontaneously for venous leg problems except in the advanced stages.2 As a consequence, CVD is undertreated, particularly in the early stages. CVD may be associated with a wide range of lower limb symptoms, which may be present from the…

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Investigations in postthrombotic syndrome according to clinical status

Michel PERRIN Vascular Surgery, France INTRODUCTION Many angiologists and vascular surgeons consider that postthrombotic syndrome (PTS) should only be managed noninterventional treatment. Unaware of the real possibilities provided by operational treatment, they limit investigation to color duplex scanning (CDS), which in this perspective is logical and reasonable. Compression, drugs, and lifestyle recommendations do not call for level III investigation according to the CEAP classification.1 Conservative treatment as far as etiology is concerned relies mainly on the signs and symptoms, independently of the location, extension of anatomical lesions, and pathophysiological abnormality. Conversely, when surgical or endovenous treatment is considered, the CEAP…

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Subjective venous symptoms: review and presentation of a pilot study

Michael KENDLER1 Eva HAAS2 1. University of Leipzig Dep. Dermatology Leipzig, Germany 2. Laufen, Germany SUMMARY In phlebology practice, the symptoms of heavy legs, feeling of swelling, fatigue, and the sensation of tension in the leg (heavy leg syndrome) are often found without an organic cause. These patients frequently suffer from psychic disturbances accompanied by a reduced quality of life. The discrepancy between symptoms and lack of objective findings leads to an ineffective therapy. In this article we discuss the problem of leg symptoms without varicose veins and present a survey of heavy leg syndrome and quality of life in…

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Premenstrual symptoms in lower limbs and Duplex scan investigations

Jerry G. NINIA Clinical Associate Professor SUNY – Stony Brook School of Medicine ABSTRACT Objectives: Approximately 40% of menstruating women experience luteal phase symptoms that are bothersome. Although the distinguishing characteristic is irritability, symptoms typically are a mix of cognitive and physical disturbances. Leg swelling and discomfort are one such physical symptom. The goal of the study is to define the clinical entity of a late luteal phase vasodilation syndrome in symptomatic patients. Methods: Duplex venous scans were performed in the standing position on 12 premenopausal women (age range 19-46 years) who described premenstrual symptoms of bilateral leg swelling, pressure,…

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Pelviperineal venous insufficiency and varicose veins of the lower limbs

Edgar BALIAN, Jean-Louis LASRY, Gérard COPPÉ, Hervé BORIE, Agnès LEROUX, Dominique BRYON, Stéphane KOVARSKY Private Hospital, Antony, France. Dept. of Cardiology and Interventional Radiology Investigation and treatment of pelvic venous insufficiency (PVI) in women to date has primarily involved its most familiar clinical presentation, ie, pelvic congestion syndrome (PCS) accurately described by Hobbs.1 For the last few years,2 more attention has focused on involvement of PVI in the pathogenesis of primary varicose veins or recurring varicosities of the lower limbs. This finding has been confirmed by a national epidemiologic survey that evaluated the potential incidence of pelvic pain of venous…

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The white book of venous disease in Spain

Marc CAIROLS1 Josep MARINEL.LO I ROURA2 1. Department of Angiology and Vascular Surgery, Bellvitge Hospital L´Hospitalet de Llobregat, Spain 2. Department of Angiology and Vascular Surgery, Mataró Hospital Mataró, Spain Chronic venous disease (CVD) is extremely important in Western countries because of its high prevalence, chronic nature, repercussions on quality of life, and complications.1-3 In Spain, there is a high incidence of CVD both in primary care and in vascular surgical departments. Consequently, CVD consumes a high percentage of available resources4 and a large part of the public health budget. A first step towards improving care for patients with CVD…

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