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Chronic venous insufficiency: clinical and duplex correlations. The Edinburgh Vein Study of venous disorders in the general population.

Abstract

OBJECTIVE

The objective of this study was to determine the prevalence of chronic venous insufficiency (CVI) in the general population and to correlate its clinical features with sonographically proven venous reflux.

DESIGN OF STUDY

The study design was a cross-sectional survey of the general population.

SUBJECTS AND METHOD

Ambulatory men and women, aged 18-64 years, were selected randomly from 12 general practices. Subjects were examined for CVI. Eight segments of the deep and superficial veins were assessed for reflux by means of duplex scanning.

RESULTS

A total of 1566 subjects were screened (867 women, mean age 44.8 years; 699 men, mean age 45.8 years) of whom 124 were diagnosed as having CVI: 95, grade 1; 19, grade 2; and 10, grade 3. The age-adjusted prevalence for the whole population was 9.4% in men and 6.6% in women. Prevalence of CVI correlated closely with age and sex, being 21.2% in men >50 years and 12.0% in women >50 years. Heaviness and tension, and a feeling of swelling, aching, and itching, were significantly associated with worsening grade of CVI. CVI was significantly associated with reflux in all deep and superficial segments. The frequency of reflux in both superficial and deep segments increased with the clinical severity of disease. In 30.8% of subjects with CVI in the left leg, reflux was limited to the superficial system.

CONCLUSIONS

The prevalence of CVI rises steeply with age. There is a strong correlation between venous symptoms and the presence and severity of CVI. CVI is associated in approximately one third of the subjects with incompetence limited to the superficial system and in these a good therapeutic outcome could be expected from surgery to the superficial veins. The severity of clinical features, including Basle CVI grade 1, correlates significantly with prevalence of valvular reflux in the deep and superficial systems. If leg ulcers are to be prevented by timely intervention, a better understanding of the natural history of the association between presenting features and disordered hemodynamics is required.

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  • Publisher Full Text
  • Authors+Show Affiliations

    ,

    Vascular Surgery Unit and the Department of Medical Imaging, Royal Infirmary of Edinburgh, Scotland.

    , , ,

    Source

    Journal of vascular surgery 36:3 2002 Sep pg 520-5

    MeSH

    Adolescent
    Adult
    Age Factors
    Aged
    Chronic Disease
    Cross-Sectional Studies
    Female
    Heart Valve Diseases
    Humans
    Male
    Middle Aged
    Prevalence
    Random Allocation
    Scotland
    Sex Factors
    Ultrasonography, Doppler, Duplex
    Venous Insufficiency

    Pub Type(s)

    Journal Article

    Language

    eng

    PubMed ID

    12218976

    Citation

    Ruckley, C Vaughan, et al. "Chronic Venous Insufficiency: Clinical and Duplex Correlations. the Edinburgh Vein Study of Venous Disorders in the General Population." Journal of Vascular Surgery, vol. 36, no. 3, 2002, pp. 520-5.
    Ruckley CV, Evans CJ, Allan PL, et al. Chronic venous insufficiency: clinical and duplex correlations. The Edinburgh Vein Study of venous disorders in the general population. J Vasc Surg. 2002;36(3):520-5.
    Ruckley, C. V., Evans, C. J., Allan, P. L., Lee, A. J., & Fowkes, F. G. (2002). Chronic venous insufficiency: clinical and duplex correlations. The Edinburgh Vein Study of venous disorders in the general population. Journal of Vascular Surgery, 36(3), pp. 520-5.
    Ruckley CV, et al. Chronic Venous Insufficiency: Clinical and Duplex Correlations. the Edinburgh Vein Study of Venous Disorders in the General Population. J Vasc Surg. 2002;36(3):520-5. PubMed PMID: 12218976.
    * Article titles in AMA citation format should be in sentence-case
    TY - JOUR T1 - Chronic venous insufficiency: clinical and duplex correlations. The Edinburgh Vein Study of venous disorders in the general population. AU - Ruckley,C Vaughan, AU - Evans,Christine J, AU - Allan,Paul L, AU - Lee,Amanda J, AU - Fowkes,F Gerald R, PY - 2002/9/10/pubmed PY - 2002/10/12/medline PY - 2002/9/10/entrez SP - 520 EP - 5 JF - Journal of vascular surgery JO - J. Vasc. Surg. VL - 36 IS - 3 N2 - OBJECTIVE: The objective of this study was to determine the prevalence of chronic venous insufficiency (CVI) in the general population and to correlate its clinical features with sonographically proven venous reflux. DESIGN OF STUDY: The study design was a cross-sectional survey of the general population. SUBJECTS AND METHOD: Ambulatory men and women, aged 18-64 years, were selected randomly from 12 general practices. Subjects were examined for CVI. Eight segments of the deep and superficial veins were assessed for reflux by means of duplex scanning. RESULTS: A total of 1566 subjects were screened (867 women, mean age 44.8 years; 699 men, mean age 45.8 years) of whom 124 were diagnosed as having CVI: 95, grade 1; 19, grade 2; and 10, grade 3. The age-adjusted prevalence for the whole population was 9.4% in men and 6.6% in women. Prevalence of CVI correlated closely with age and sex, being 21.2% in men >50 years and 12.0% in women >50 years. Heaviness and tension, and a feeling of swelling, aching, and itching, were significantly associated with worsening grade of CVI. CVI was significantly associated with reflux in all deep and superficial segments. The frequency of reflux in both superficial and deep segments increased with the clinical severity of disease. In 30.8% of subjects with CVI in the left leg, reflux was limited to the superficial system. CONCLUSIONS: The prevalence of CVI rises steeply with age. There is a strong correlation between venous symptoms and the presence and severity of CVI. CVI is associated in approximately one third of the subjects with incompetence limited to the superficial system and in these a good therapeutic outcome could be expected from surgery to the superficial veins. The severity of clinical features, including Basle CVI grade 1, correlates significantly with prevalence of valvular reflux in the deep and superficial systems. If leg ulcers are to be prevented by timely intervention, a better understanding of the natural history of the association between presenting features and disordered hemodynamics is required. SN - 0741-5214 UR - https://www.unboundmedicine.com/medline/citation/12218976/Chronic_venous_insufficiency:_clinical_and_duplex_correlations__The_Edinburgh_Vein_Study_of_venous_disorders_in_the_general_population_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0741521402000873 DB - PRIME DP - Unbound Medicine ER -