Phlebosclerosis in lower extremities veins

Labropoulos, Nicos; Tzogias, Leonidas; Malgor, Rafael D.; Antoniou, George Α.; Giannoukas, Athanasios D.

doi:10.1258/phleb.2012.012113

Cited by 8 publications

(9 citation statements)

References 14 publications

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“…The prevalence of phlebosclerosis for intense wall brightness, wall calcification, and increased wall thickness was 2.1 %, 1.5 %, and 6.1 % respectively. The prevalence for the intense wall brightness and wall calcification was 3.6 % which rose to 9.7 % when the increased wall thickness was included (Table III) [8]. However, there was some inconsistency between radiological and histological prevalence.…”

Section: Epidemiologymentioning

confidence: 96%

“…The appraisal of the epidemiology of phlebosclerosis was based on 7 cohort studies (2.619 participants, mean age 58.8 years, 57.7 % men, and 42.3 % women) (Table II). The incidence of ultrasound detected phlebosclerosis was 1.5-9.7 % depending on the radiological findings [8]. On the contrary, the incidence of the great saphenous vein phlebosclerosis estimated histologically during the great saphenous vein mapping prior to coronary and infragenicular bypass surgery varied between 26.9-91 % [10,[11][12][13][14][15].…”

Section: Epidemiologymentioning

confidence: 97%

“…The small saphenous vein was predominantly affected followed by great saphenous vein, accessory veins, tributaries, and non-saphenous veins. The mean length of phlebosclerotic changes was 2 cm (range 1-7) [8].…”

Section: Epidemiologymentioning

confidence: 99%

“…In terms of the clinical significance of phlebosclerosis in lower extremities veins, superficial vein phlebosclerosis has very few clinical effects, whereas deep vein phlebosclerosis may lead to thrombosis. Preexisting phlebosclerotic great saphenous vein seems to play a key role in the development of vein graft stenosis when it is used as a conduit in coronary artery bypass graft surgery and infrainguinal bypass surgery [8].…”

Section: Introductionmentioning

confidence: 99%

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Phlebosclerosis in lower extremities veins – a systematic review

Tepelenis

Παπαθανάκος

Barbouti

et al. 2020

Vasa

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Summary. Phlebosclerosis is a venous wall degenerative disease which has gained little popularity in the literature due to its uncertain clinical significance. The objective of this review is to evaluate the epidemiology, etiology and clinical significance of phlebosclerosis in lower extremities veins, particularly the effect of preexisting phlebosclerosis of the great saphenous vein on vein graft patency. Medline was searched from inception until November 1, 2019. Reference lists of included studies were scanned. Only articles published after 1949 were included. Two reviewers independently screened titles/abstracts and full-text papers for any study design in relation to phlebosclerosis in lower extremities veins and abstracted data. A total of 16 Cohort studies and one case-control study (3708 participants, mean age 61.8 years, 59.3 % men, and 40.7 % women) were included after screening 317 titles and abstracts, and 80 full-text articles. The incidence of phlebosclerosis ranged from 1.5–9.7 % depending on the radiological features. On the contrary, the incidence of the phlebosclerotic great saphenous vein prior to its use as a vein graft was 26.9–91 % on histological examination. The small saphenous vein was the most common location of phlebosclerosis followed by the great saphenous vein. There is a link between phlebosclerosis and age, venous insufficiency and haemodialysis. As for the vein graft patency seven studies demonstrated a correlation between preexisting phlebosclerosis and vein graft stenosis, whereas three studies failed to prove any association. In conclusion, the radiological incidence of phlebosclerosis depended on the ultrasound findings. Its presence in the great saphenous vein prior to its use as a vein graft is established on histological examination. The small saphenous vein is mainly affected. Risk factors included age, haemodialysis, and venous insufficiency. Preexisting wall thickness of the great saphenous vein graft seemed to affect negatively its patency in bypass surgery.

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Section: Epidemiologymentioning

confidence: 96%

Section: Epidemiologymentioning

confidence: 97%

Section: Epidemiologymentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Phlebosclerosis in lower extremities veins – a systematic review

Tepelenis

Παπαθανάκος

Barbouti

et al. 2020

Vasa

View full text Add to dashboard Cite

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“…First, in the present study the internal diameter of the GSV was measured, but the thickness of the vein wall has not been considered. According to recent investigations, thickening of the vein wall and phlebosclerosis may indicate more advanced disease, 30 hence this may warrant a more aggressive approach (TA, NTNT) to obtain a good result. This should be further studied in trials including measurement of vein wall thickness in addition to simple diameter measurement.…”

Section: Limitationsmentioning

confidence: 99%

Great Saphenous Vein Diameters in Phlebological Practice in France: A Report of the DIAGRAVES Study by the French Society of Phlebology

Hamel-Desnos

Maeseneer

Josnin

et al. 2019

European Journal of Vascular and Endovascular Surgery

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WHAT THIS PAPER ADDS In routine phlebological practice, only a small minority of patients with venous symptoms and/or clinical signs of chronic venous disorders present with large diameter (>8 mm) incompetent great saphenous veins (GSVs). More than half of the incompetent GSVs are small (<6 mm). This knowledge should influence management strategies in daily practice, with a view to reducing the global cost of treating patients with chronic venous disorders. Objective: The aim was to evaluate the distribution of the diameter of the great saphenous vein (GSV) at midthigh level and to investigate its association with clinical class, symptoms, and proximal extent of reflux. Methods: Vascular physicians, members of the French Society of Phlebology, were invited to participate in a consecutive observational study in patients presenting with symptoms and/or signs of uni-or bilateral chronic venous disorders (CVDs) in previously untreated limbs (clinical class of the CEAP classification C0s e C6). Patients were included between January and March 2015. They completed a specially designed venous symptoms questionnaire. Duplex ultrasound of the included limbs was performed with the patient standing to detect reflux in the GSV and to measure the GSV inner diameter at mid-thigh. Results: Between January and March 2015, 35 physicians examined 1245 patients (2450 limbs after excluding 40 limbs): 77% were female, mean age 52 AE 14; 69% of the patients had venous symptoms in one or both legs. The most frequent symptoms were feeling of heaviness, feeling of swelling and aching. Predominant CEAP clinical classes were C2 (38% of limbs) and C1 (35%). In case of GSV reflux (40% of limbs), the average diameter was 5.6 AE 2 mm and the distribution was 62% < 6 mm, 30% between 6 and 8 mm, and 8% > 8 mm. The study showed a clear association between clinical class and GSV diameter (the higher the clinical class, the larger the diameter; p < .0001), between venous symptoms and diameter (the larger the diameter, the higher the intensity of symptoms, p < .0001 for overall discomfort) and between proximal extent of reflux and diameter (the more proximal the extent of reflux, the larger the diameter, p < .0001). Conclusion: The DIAGRAVES study demonstrated that in France for patients consulting with CVDs, more than half of the incompetent GSVs had a diameter < 6 mm, while large diameters were relatively infrequent. This should be kept in mind when considering management strategies in patients with CVDs.

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Optimising venous assessment for free tissue transfer in the lower limb

Cooper

Pafitanis

2021

Journal of Plastic, Reconstructive & Aesthetic Surgery

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Phlebosclerosis in lower extremities veins

Cited by 8 publications

References 14 publications

Phlebosclerosis in lower extremities veins – a systematic review

Phlebosclerosis in lower extremities veins – a systematic review

Great Saphenous Vein Diameters in Phlebological Practice in France: A Report of the DIAGRAVES Study by the French Society of Phlebology

Optimising venous assessment for free tissue transfer in the lower limb

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