Chronic Venous Insufficiency

Eberhardt, Robert T.; Raffetto, Joseph D.

doi:10.1161/circulationaha.113.006898

Cited by 524 publications

(550 citation statements)

References 109 publications

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“…From a practical, therapeutic point of view, despite the absence of effect of elastic compression stockings (ECS) to prevent PTS as reported in the SOX trial, 20 patients with PVI should be advised to wear ECS with the purpose of reducing worsening of their venous insufficiency. 21 Thus, the AHA states that application of ECS is reasonable to reduce swelling in patients with a diagnosis of DVT (grade A). 5 Older age.…”

Section: Nonmodifiable Risk Factorsmentioning

confidence: 99%

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Predictors of the post-thrombotic syndrome and their effect on the therapeutic management of deep vein thrombosis

Galanaud¹,

Monréal²,

Kahn³

2016

Journal of Vascular Surgery: Venous and Lymphatic Disorders

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Section: Nonmodifiable Risk Factorsmentioning

confidence: 99%

“…19 It is unknown if weight loss would have an effect on the development of PTS. However, because obesity is known to worsen PVI, 21 it is likely that weight loss, by decreasing central venous pressure, could improve PTS symptoms.…”

Section: Modifiable Risk Factorsmentioning

confidence: 99%

Predictors of the post-thrombotic syndrome and their effect on the therapeutic management of deep vein thrombosis

Galanaud¹,

Monréal²,

Kahn³

2016

Journal of Vascular Surgery: Venous and Lymphatic Disorders

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“…Although the lymphatic contribution to VLU formation and healing has long been recognized, recent authoritative reviews on CVI management do not define the lymphatic role in the outcomes to surgical treatment. 6 …”

Section: Introductionmentioning

confidence: 99%

Lymphatic transport in patients with chronic venous insufficiency and venous leg ulcers following sequential pneumatic compression

Rasmussen

Aldrich

Tan

et al. 2016

Journal of Vascular Surgery: Venous and Lymphatic Disorders

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Objective To assess lymphatics in subjects with venous leg ulcers using near-infrared fluorescence lymphatic imaging (NIRFLI) and to assess lymphatic impact of a single session of sequential pneumatic compression (SPC). Background Recent advancements in NIRFLI technology provide opportunities for non-invasive, real-time assessment of lymphatic contribution in the etiology and treatment of ulcers. Methods Following intradermal microdoses of indocyanine green (ICG) as a lymphatic contrast agent, NIRFLI was used in a pilot study to image the lymphatics of 12 subjects with active venous leg ulcers (CEAP C6). The lymphatics were imaged before and after a single session of SPC to assess impact on lymphatic function. Results Baseline imaging showed impaired lymphatic function and bilateral dermal backflow in all subjects with chronic venous insufficiency, even those without ulcer formation in the contralateral limb (C0 and C4 disease). SPC therapy caused proximal movement of ICG away from the active wound in 9 of 12 subjects, as indicated by newly recruited functional lymphatic vessels, emptying of distal lymphatic vessels, or proximal movement of extravascular fluid. Subjects with the longest duration of active ulcers had few visible lymphatic vessels and proximal movement of ICG was not detected after SPC therapy. Conclusions This study provides visible confirmation of lymphatic dysfunction at an early stage in the etiology of venous ulcer formation and demonstrates the potential therapeutic mechanism of SPC therapy in removing excess fluid. The ability of SPC therapy to restore fluid balance through proximal movement of lymph and interstitial fluid may explain its value in hastening venous ulcer healing. Anatomical differences between the lymphatics of longstanding and more recent venous ulcers may have important therapeutic implications.

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“…A dysfunction of one of these mechanisms results in a disturbance of the venous outfl ow, which in turn causes a venous hypertension, particularly with standing and ambulation. Unabated venous hypertension may result in tissue oedema, skin hyperpigmentation, subcutaneous tissue fi brosis called "lipodermatosclerosis", eczematous dermatitis, atrophie blanche, and eventual venous ulceration [13]. Varicose veins with venous valve failure and blood refl ux account for the majority of cases of venous hypertension and the pattern of clinical fi ndings depends on which valves fail.…”

Section: Physiologic and Pathogenetic Considerationsmentioning

confidence: 99%

Clinical and duplex ultrasound evaluation of lower extremities varicose veins – a practical guideline

Spinedi

Brož

Engelberger

et al. 2017

Vasa

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Summary:Lower extremities varicose veins are among the most frequent diseases in the general population. They can cause complaints with a deterioration of the quality of life and are associated with potentially threatening clinical conditions such as chronic venous ulceration, haemorrhage from ruptured varicose veins, and venous thromboembolism. An accurate diagnostic work-up is crucial to confi rm the presence and the extension of the venous problem, in order to obtain an optimal management of the condition. In the past years, great efforts have been made to reach an international consensus on the terminology, the symptomatology, the classifi cation, and the duplex ultrasound examination of lower extremities varicose veins. Mainly guided by these consensus documents, the present article describes the diagnostic work-up of lower extremities varicose veins, based on a careful medical history, physical examination, and duplex ultrasound examination.

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Chronic Venous Insufficiency

Cited by 524 publications

References 109 publications

Predictors of the post-thrombotic syndrome and their effect on the therapeutic management of deep vein thrombosis

Predictors of the post-thrombotic syndrome and their effect on the therapeutic management of deep vein thrombosis

Lymphatic transport in patients with chronic venous insufficiency and venous leg ulcers following sequential pneumatic compression

Clinical and duplex ultrasound evaluation of lower extremities varicose veins – a practical guideline

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