Sign and symptoms of chronic venous disorders

NewsBot · Aug 28, 2007

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Chronic venous disorders: correlation between visible signs, symptoms, and presence of functional disease.
Chiesa R, Marone EM, Limoni C, Volontè M, Petrini O.
J Vasc Surg. 2007 Aug;46(2):322-30. Epub 2007 Jun 27

BACKGROUND: The aim of this study was to investigate the frequency of chronic venous disorders (CVD) in different demographic groups in Italy and to provide correlations between patterns of valve incompetence and clinical feature of disease severity.

METHODS: Advertisements in television and newspapers in 53 Italian cities were used to solicit 16,251 subjects (13,826 women, mean age 50.4 years; 2,425 men, mean age 59.1 years). They underwent a clinical examination of the lower limbs, including presence and severity of visible signs (CEAP classification), and assessment of functional disease by color-coded duplex ultrasound imaging.

RESULTS: Varicose veins and telangiectases were the most common objective signs in both men and women. Older people were more severely affected. Telangiectases were more frequent in women, and men had a higher incidence of trunk varices, trophic changes, and venous reflux. Frequency of both visible and functional venous disease increased with family history and body mass index. Presence of reflux correlated positively with increasing CEAP grade of visible disease (Pfor trend < .0001 for all superficial venous segments). A large number of subjects, especially women, complained of subjective symptoms in the legs, and the presence of symptoms correlated almost always positively with both worsening of visible findings (P for trend < .001) and presence of hemodynamic change in both genders.

CONCLUSIONS: The frequency of reflux increased with the severity of visible signs of disease as described by the CEAP classification. In men, the occurrence of subjective symptoms was mostly correlated with functional disorders.
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NewsBot · Aug 28, 2007

Risk factors for chronic venous disease: the San Diego Population Study.
Criqui MH, Denenberg JO, Bergan J, Langer RD, Fronek A.
J Vasc Surg. 2007 Aug;46(2):331-7. Epub 2007 Jun 27

BACKGROUND: The etiology of chronic venous disease in the lower limbs is unclear, and very limited data are available on potential risk factors from representative population studies.

METHODS: Participants in the San Diego Population Study, a free-living adult population randomly selected from age, sex, and ethnic strata, were systematically assessed for risk factors for venous disease. Categorization of normal, moderate, and severe disease was determined hierarchically through clinical examination and ultrasonography imaging by trained vascular technologists, who also performed anthropometric measures. An interviewer administered a questionnaire and an examination assessed potential risk factors for venous disease suggested by previous reports.

RESULTS: In multivariable models, moderate venous disease was independently related to age, a family history of venous disease, previous hernia surgery, and normotension in both sexes. In men, current walking, the absence of cardiovascular disease, and not moving after sitting were also predictive. Additional predictors in women were weight, number of births, oophorectomy, flat feet, and not sitting. For severe disease, age, family history of venous disease, waist circumference, and flat feet were predictive in both sexes. In men, occupation as a laborer, cigarette smoking, and normotension were also independently associated with severe venous disease. Additional significant and independent predictors in women were hours standing, history of leg injury, number of births, and cardiovascular disease, but African American ethnicity was protective. Multiple other postulated risk factors for venous disease were not significant in multivariable analysis in this population.

CONCLUSIONS: Although some risk factors for venous disease such as age, family history of venous disease, and findings suggestive of ligamentous laxity (hernia surgery, flat feet) are immutable, others can be modified, such as weight, physical activity, and cigarette smoking. Overall, these data provide modest support for the potential of behavioral risk-factor modification to prevent chronic venous disease.
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Admin2 · Aug 28, 2007

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NewsBot · Dec 17, 2008

Measuring venous insufficiency objectively in the clinical setting.
Kelechi TJ, Bonham PA.
J Vasc Nurs. 2008 Sep;26(3):67-73.

The purpose of this article is to propose a screening procedure to assess venous insufficiency with a hand-held photoplethysmography (PPG) instrument in the clinical setting. PPG is noninvasive technology that is used as part of venous assessment of the lower extremities. Although duplex ultrasound remains the industry gold standard for assessment, there are many situations in which access or expertise is not available. The measurement of venous refill time with PPG, one measure of venous insufficiency, is becoming increasingly more prevalent in research settings; however, PPG is underused in clinical settings. Rapid venous refill time </= 20 seconds is associated with chronic venous disorders, and its measurement in clinical settings as a screening mechanism may provide useful data to augment diagnostic and therapeutic decision making. Future research is needed to establish a best-practice guideline for venous assessment in clinical settings to validate using PPG.
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NewsBot · Dec 30, 2008

The standing heel-rise test: relation to chronic venous disorders and balance, gait, and walk time in injection drug users.
Pieper B, Templin TN, Birk TJ, Kirsner RS.
Ostomy Wound Manage. 2008 Sep;54(9):18-22, 24, 26-30

Injection drug use can impair mobility. When mobility is impaired in combination with other potential pathologic changes to the veins, muscles, and joints of the lower legs, chronic venous disorders can develop. The heel-rise test, an assessment of eccentric-concentric muscle action of calf muscle function with regard to plantar flexion, can be used to measure ankle mobility. To examine the test-retest reliability and construct validity of the heel-rise test in relation to chronic venous disorders in persons with a history of injection drug use (N = 104), a test-retest study (M = 45.9+/-12.9 days from first to second test) was conducted. Participants were assessed for chronic venous disorders of the legs and walk time; they also completed the heel-rise and Tinetti Balance and Gait tests. Test-retest reliability was found to be good for full heel rise of right and left legs (ICC = .66 and .67, respectively). Heel-rise performance was positively correlated with balance (r = .38 to .47) and gait (r = .38 to .45) and negatively related to walk time (r = -.30 to -.35) (P <0.01). Participants who injected in the groin, legs, or feet performed fewer heel rises than those who injected in the arms and upper body only or those who did not inject drugs. Chronic venous disorders accounted for 7% to 17% of the variance in heel rise. The heel-rise test as a measure of calf muscle function is supported by these results, implicating the role of mobility restriction in the etiology of venous disease. Although more research is needed regarding its performance, the heel-rise test may be a low-cost, noninvasive screening or assessment tool in a variety of outpatient settings.
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NewsBot · Feb 12, 2013

Analysis of the physical and functional parameters of older adults with chronic venous disease.
de Moura RM, Gomes Hde A, da Silva SL, Britto RR, Dias RC.
Arch Gerontol Geriatr. 2012 Nov-Dec;55(3):696-701.

The chronic venous disease (CVD) results from a situation of venous hypertension which occurs when there is a dysfunction of the calf pump musculature. Such alteration contributes to the worsening of the disease and may generate physical and functional limitations among older adults, carriers of CVD. In the present study, we aimed to compare the performance of the plantar flexor, the range of motion (ROM) of the ankle, gait speed and functional capacity among older adults with and without CVD. This is a cross-sectional study, with a convenience sample of 30 older adults with CVD and 30 without the disease. Gait speed was assessed by the GAITrite system, version 3.9; the dorsiflexion (DF) and plantar flexion (PF) ROMs, by goniometry, and the function of the plantar flexors by the isokinetic dynamometry. Functional capacity was evaluated by Katz and Lawton scales and by the assessment of the activities of social nature. The CVD group presented lesser ROM of DF and PF, peak torque and power of plantar flexors, gait speed and social restriction when compared to the control group (p<0.05). We concluded that older adults with CVD present important limitations of ROM and strength, mobility and social restriction confirming findings of previous studies. Such results might guide professionals in their approaches both for determining the relevance of parameters to be assessed and of their therapeutic approaches.
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NewsBot · Oct 26, 2023

Early-stage chronic venous disorder as a cause of leg pain overlooked for lumbar spinal disease
Dong-Hoon Yang et al
Sci Rep. 2023 Oct 25;13(1):18303

Leg pain can be caused by both lumbar spinal disease and chronic venous disorder (CVD) of leg veins, but their clinical differences have not been thoroughly investigated. This study aimed to determine the incidence of CVD among patients visiting a spine center for leg pain. A total of 196 cases underwent ultrasound examination with a diagnosis rate were 85.7% (168 cases). CVD-diagnosed cases were divided into two groups based on the severity of lumbar spinal disease. The Clinical grades, symptom areas, and symptom types were compared. The differences in symptom improvements with vasoactive medication were also assessed. The most common symptom area was calf then the foot in CVD, while calf then thigh in lumbar spinal disease. Tingling-paresthesia was the most common symptom type for both, with pain and cramping similarly common in CVD and pain more common than cramping in lumbar spinal disease. Considering that the majority of CVD cases (78.6%) had minor cutaneous changes and almost half of cases (41.7%) had refluxes only in tributaries, significant differences in symptom improvement in CVD-dominant group suggested that early-stage venous reflux is a symptomatic disease and a possible cause of leg pain and other symptoms.
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NewsBot The Admin that posts the news.

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