Varicose veins during pregnancy: risk factors and impact on quality of life

Sena Dilek Aksoy, PhD, RN Department of Midwifery, Faculty of Health Science, Kocaeli University, Kocaeli, Turkey Derya Kanza Gul, MD School of Medicine Health, Medipol University, Istanbul, Turkey Ayça Solt Kirca, PhD, RM Department of Midwifery, School of Health, Kirklareli University, Kirklareli, Turkey ABSTRACT Objective: This study was carried out to examine the risk factors for varicose veins during pregnancy and their impact on quality of life. Material and methods: This was a prospective, cross-sectional observational study in pregnant women in their second and third trimesters. In addition to the collection of sociodemographic and lifestyle data, the presence of varicose…

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Treatment of iliofemoral deep vein thrombosis: challenges, opportunities, and future perspectives

Marie Josee E. van Rijn, MD, PhD Department of Vascular and Endovascular Surgery, Erasmus University Medical Center, P.O. Box 2040, 3000 CA Rotterdam, The Netherlands Jay M. Bakas, MD Department of Vascular and Endovascular Surgery, Erasmus University Medical Center, P.O. Box 2040, 3000 CA Rotterdam, The Netherlands ABSTRACT Acute iliofemoral deep vein thrombosis (DVT) is more symptomatic than a thrombosis distal to the common femoral vein and increases the risk of postthrombotic syndrome (PTS), which reduces quality of life, and increases medical costs. To provide the best possible medical care, it all starts with identifying iliofemoral DVT. This will be…

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Management of hypodermitis or lipodermatosclerosis: an up-to-date review

Lourdes Reina-Gutierrez, MD Medical Doctor specialized in Angiology and Vascular Surgery, Head of the Angiology and Vascular Department of University Hospital Central de la Cruz Roja, Madrid, Spain and Professor of Medicine Grade in Alfonso X el Sabio University Alfonso Sanjuanbenito-Reina, MD Medical Doctor at University Hospital Ramon y Cájal, Madrid, Spain ABSTRACT Hypodermitis or lipodermatosclerosis (LDS) is a chronic inflammatory process of the dermis and subcutaneous layer in the legs of patients with advanced chronic venous disease (CVD). It is one of the clinical findings for class C4b in the CEAP classification (clinical, etiological, anatomical, and pathophysiological) of CVD….

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Progress in the management of venous disease during our five decades as surgeons

Peter NEGLÉN, MD, PhD1, Bo EKLÖF, MD, PhD2 1Trimiklini, Cyprus; 2Råå, Sweden Abstract The authors’ experience spans 5 decades of development in the management of venous disease. They describe their journey through the open surgery era; the transforming introduction of duplex ultrasound scanning; the establishment of consensus-driven classification, terminology, and investigatory planning, hugely important for research and patient care; and the emergence of minimally invasive endovascular procedures during the 21st century with greater acceptability by patients, minimal morbidity/ mortality, and wider application than open surgery. The management of patients with venous disease has progressed immensely since the 1960s. Introduction At…

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Update on calf vein thrombosis

Pier Luigi ANTIGNANI, MD, PhD, FIUA, MRSM, DFAVF, FESVM, EFACP; President of the International Union of Angiology; Director, Vascular Center, Nuova Villa Claudia, Rome, Italy Abstract Calf deep vein thrombosis, defined as thrombosis confined to the calf veins of the lower limbs, is a frequent finding in symptomatic outpatients and inpatients when the ultrasound examination is extended to the deep veins of the whole leg. The prevalence of the disease is between 5% and 33% of all deep vein thrombosis (DVT) cases detected by ultrasound, low in symptomatic patients and higher in asymptomatic patients at high risk of DVT. Thrombi…

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Role of anticoagulation treatment in the prevention of post-thrombotic syndrome

Christos KARATHANOS, MD, PhD1; Athanasios GIANNOUKAS,MD, PhD2; 1Consultant Vascular Surgeon; 2Professor of Vascular Surgery and Head of the Department; Department of Vascular Surgery, University Hospital of Larissa, Faculty of Medicine, School of Health Sciences, University of Thessaly, Larissa, Greece Abstract Post-thrombotic syndrome (PTS) develops after deep vein thrombosis (DVT) of the lower limbs and may affect up to 50% of patients after proximal DVT. Prevention is of paramount importance as there is no gold standard for treatment of established PTS. Pharmacological or mechanical thromboprophylaxis is recommended to prevent PTS. Effective DVT treatment with vitamin K antagonists (VKAs), direct oral anticoagulants…

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Pharmacological correction of total venous reflux in patients with varicose veins

Nikolai KHOREV,1 MD, PhD; Darya KUZNETSOVA,2 MD, PhD 1Department of Cardiology and Cardiovascular Surgery, Altai State Medical University, Barnaul, Russia 2Department of Pathological Anatomy, Department of Pathophysiology Altai State Medical University, Barnaul, Russia Abstract The study was aimed at evaluating the efficacy of micronized purified flavonoid fraction (MPFF) in patients with primary chronic venous disease (CVD). It included 35 patients with varicose veins of the lower extremities (18 with bilateral and 7 with unilateral lesion). A total of 53 legs with varicose veins were evaluated in 3 groups based on the CEAP (Clinical, Etiology, Anatomic, Pathophysiology classification system) clinical class:…

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Is compression necessary after endovenous thermal ablation of varicose veins? Clarifying a (com)pressing matter

Matthew TAN, BSc, MBBS, MRCS, AFHEA; Alun H. DAVIES, MA, DM, DSc, FRCS, FHEA, FEBVS, FLSW, FACPh Section of Vascular Surgery, Department of Surgery and Cancer, Charing Cross Hospital, Imperial College London, London, United Kingdom Abstract Chronic venous disease (CVD) represents a significant impact on patients’ lives with negative financial, social, and health-related quality of life consequences. The gold standard for treatment of varicose veins and CVD is now considered to be endovenous thermal ablation (EVTA). Although compression is widely prescribed for patients post EVTA, there is widespread disagreement on the optimal compression regimen and if compression is even required…

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CHIVA versus ablation

Claude FRANCESCHI, MD Angiologist, Consultant with Groupe Hospitalier Paris Saint Joseph, Paris, France Abstract CHIVA is the French acronym for Conservatrice et Hémodynamique de l’Insuffisance Veineuse en Ambulatoire, ie, Conservative and Hemodynamic Treatment of Venous Insufficiency in outpatients. Ablation is not conservative, and CHIVA is based on a different hemodynamic approach. It is counterintuitive because it is difficult to imagine that the varicose veins could disappear without ablation either by extraction or by endovenous destruction. This treatment raises scientific questions that require us to revisit our understanding of classical venous pathophysiology in light of what echo-Doppler has contributed to our…

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The place of micronized purified flavonoid fraction in the management of chronic venous disease from an international guidelines’ perspective

Sergey Gennadievich GAVRILOV, MD, PhD Jorge H. ULLOA, MD1; Sebastian CIFUENTES, MD2; Antonio SOLANO, MD2; Valentin FIGUEROA, MD2 1Vascular Surgeon, Chief of Vascular Surgery Department, Fundación Santa Fe de Bogotá University Hospital; Professor of Surgery, Universidad de los Andes School of Medicine, Bogotá, Colombia. 2Vascular Surgery Research Fellow, Vascular Surgery Department, Fundación Santa Fe de Bogotá University Hospital, Bogotá, Colombia. Abstract Chronic venous disease (CVD) is a highly prevalent disorder with a broad spectrum of symptoms determined by disease stage and whether there is deep or superficial venous system compromise. The treatment goal for CVD is to slow and prevent…

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