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Association between vein diameters, reflux characteristics, and clinical severity in patients with chronic venous insufficiency in Northwest China.
J Vasc Surg Venous Lymphat Disord. 2021 03; 9(2):401-408.e1.JV

Abstract

OBJECTIVE

Our goal was to summarize the relationship between vein diameters, reflux characteristics, and clinical severity in consecutive patients with chronic venous insufficiency (CVI) in Northwest China.

METHODS

We evaluated 531 consecutive patients with CVI (249 women) who presented to the Department of Ultrasound of Xijing Hospital from September 2017 to July 2019. Reflux times and the mean diameters of the great saphenous, the small saphenous, and the calf perforator veins based on duplex ultrasound scans obtained in the standing position were recorded. Venous-specific assessment tools-the Heaviness, Achiness, Swelling, Throbbing, Itching (HASTI) score, the Venous Clinical Severity Score (VCSS), and the Clinical, Etiological, Anatomical, Pathophysiological (CEAP) class-were analyzed. Regression analysis was used to investigate the relationship between the clinical scores, vein diameters, and reflux times. A P value of less than .05 was considered statistically significant.

RESULTS

We analyzed 531 consecutive patients with 728 limbs. The mean age was 55.24 ± 11.38 years; the mean body mass index (BMI) was 24.75 ± 3.49 kg/m2. Three hundred thirty-four patients (62.9%) presented with unilateral limb findings and 197 (37.1%), with bilateral limb involvement. No significant changes were noted in age and BMI across CEAP classes (F = 2.322 and F = 3.917, respectively; P > .05 for both). Both the HASTI score (r2 = 0.8741; P < .001) and the VCSS (r2 = 0.9257; P < .001) correlated with the CEAP class. The HASTI score strongly correlated with the mean diameters of the great saphenous and small saphenous veins (r2 = 0.9252, r2 = 0.6304, respectively; P < .001 for both) similarly to VCSS (r2 = 0.9396, r2 = 0.7195, respectively; P < .001 for both). The HASTI score and VCSS correlated equally with the mean diameters of the calf perforator veins (r = 0.7773 and r = 0.7781, respectively; P < .001 for both). In those with C6, both great saphenous vein (F = 4.608; P < .001) and small saphenous vein reflux times (F = 14.97; P < .001) were significantly higher than those in C1. Both the HASTI score and VCSS strongly associated with the reflux times of the great saphenous (r2 = 0.7706 and r2 = 0.8181, respectively; P < .001 for both) and small saphenous veins (r2 = 0.6470 and r2 = 0.7865, respectively; P < .001 for both).

CONCLUSIONS

This analysis is one of the few epidemiologic studies of patients with CVI in Northwest China. Age and BMI did not correlate with CEAP class. Both the HASTI score and VCSS correlated strongly with the CEAP classification; vein diameters and reflux time in both the great saphenous vein and the small saphenous vein, indicating the validity of these outcome tools to venous hemodynamics and to CVI in general.

Authors+Show Affiliations

Department of Ultrasound, Xijing Hospital of the Forth Military Medical University, Xian, China.Department of Ultrasound, Xijing Hospital of the Forth Military Medical University, Xian, China.Department of Ultrasound, Xijing Hospital of the Forth Military Medical University, Xian, China.Department of Orthopedics, China Rehabilitation Research Center, Beijing Charity Hospital, Beijing, China.Department of Ultrasound, Xijing Hospital of the Forth Military Medical University, Xian, China.Department of Ultrasound, Xijing Hospital of the Forth Military Medical University, Xian, China.Department of Ultrasound, Xijing Hospital of the Forth Military Medical University, Xian, China.Department of Ultrasound, Xijing Hospital of the Forth Military Medical University, Xian, China.Department of Ultrasound, Xijing Hospital of the Forth Military Medical University, Xian, China.Department of Ultrasound, Xijing Hospital of the Forth Military Medical University, Xian, China.Department of Ultrasonic Diagnosis and Treatment Center, Xian International Medical Center Hospital, Xian, China.Department of Ultrasound, Xijing Hospital of the Forth Military Medical University, Xian, China.University of California, Davis, Vascular Center, Sacramento, Calif. Electronic address: ywchi@ucdavis.edu.

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

32730997

Citation

Yang, Qian, et al. "Association Between Vein Diameters, Reflux Characteristics, and Clinical Severity in Patients With Chronic Venous Insufficiency in Northwest China." Journal of Vascular Surgery. Venous and Lymphatic Disorders, vol. 9, no. 2, 2021, pp. 401-408.e1.
Yang Q, Zhao Y, Chen X, et al. Association between vein diameters, reflux characteristics, and clinical severity in patients with chronic venous insufficiency in Northwest China. J Vasc Surg Venous Lymphat Disord. 2021;9(2):401-408.e1.
Yang, Q., Zhao, Y., Chen, X., Tang, P., Li, L., Zhao, J., Han, Y., Wu, D., An, L., Zhang, B., Zhou, X., Liu, L., & Chi, Y. W. (2021). Association between vein diameters, reflux characteristics, and clinical severity in patients with chronic venous insufficiency in Northwest China. Journal of Vascular Surgery. Venous and Lymphatic Disorders, 9(2), 401-e1. https://doi.org/10.1016/j.jvsv.2020.07.006
Yang Q, et al. Association Between Vein Diameters, Reflux Characteristics, and Clinical Severity in Patients With Chronic Venous Insufficiency in Northwest China. J Vasc Surg Venous Lymphat Disord. 2021;9(2):401-408.e1. PubMed PMID: 32730997.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Association between vein diameters, reflux characteristics, and clinical severity in patients with chronic venous insufficiency in Northwest China. AU - Yang,Qian, AU - Zhao,Yongfeng, AU - Chen,Xi, AU - Tang,Peng, AU - Li,Lamei, AU - Zhao,Junfeng, AU - Han,Yongfeng, AU - Wu,Dangjie, AU - An,Li, AU - Zhang,Binqing, AU - Zhou,Xiaodong, AU - Liu,Liwen, AU - Chi,Yung-Wei, Y1 - 2020/07/28/ PY - 2020/05/09/received PY - 2020/07/09/accepted PY - 2020/7/31/pubmed PY - 2021/4/29/medline PY - 2020/7/31/entrez KW - Chronic venous insufficiency KW - Clinical, Etiological, Anatomical, Pathophysiological classification (CEAP) KW - Color Doppler ultrasound KW - Heaviness, Achiness, Swelling, Throbbing, Itching (HASTI) KW - Varicose veins of the lower extremities KW - Venous Clinical Severity Score (VCSS) SP - 401 EP - 408.e1 JF - Journal of vascular surgery. Venous and lymphatic disorders JO - J Vasc Surg Venous Lymphat Disord VL - 9 IS - 2 N2 - OBJECTIVE: Our goal was to summarize the relationship between vein diameters, reflux characteristics, and clinical severity in consecutive patients with chronic venous insufficiency (CVI) in Northwest China. METHODS: We evaluated 531 consecutive patients with CVI (249 women) who presented to the Department of Ultrasound of Xijing Hospital from September 2017 to July 2019. Reflux times and the mean diameters of the great saphenous, the small saphenous, and the calf perforator veins based on duplex ultrasound scans obtained in the standing position were recorded. Venous-specific assessment tools-the Heaviness, Achiness, Swelling, Throbbing, Itching (HASTI) score, the Venous Clinical Severity Score (VCSS), and the Clinical, Etiological, Anatomical, Pathophysiological (CEAP) class-were analyzed. Regression analysis was used to investigate the relationship between the clinical scores, vein diameters, and reflux times. A P value of less than .05 was considered statistically significant. RESULTS: We analyzed 531 consecutive patients with 728 limbs. The mean age was 55.24 ± 11.38 years; the mean body mass index (BMI) was 24.75 ± 3.49 kg/m2. Three hundred thirty-four patients (62.9%) presented with unilateral limb findings and 197 (37.1%), with bilateral limb involvement. No significant changes were noted in age and BMI across CEAP classes (F = 2.322 and F = 3.917, respectively; P > .05 for both). Both the HASTI score (r2 = 0.8741; P < .001) and the VCSS (r2 = 0.9257; P < .001) correlated with the CEAP class. The HASTI score strongly correlated with the mean diameters of the great saphenous and small saphenous veins (r2 = 0.9252, r2 = 0.6304, respectively; P < .001 for both) similarly to VCSS (r2 = 0.9396, r2 = 0.7195, respectively; P < .001 for both). The HASTI score and VCSS correlated equally with the mean diameters of the calf perforator veins (r = 0.7773 and r = 0.7781, respectively; P < .001 for both). In those with C6, both great saphenous vein (F = 4.608; P < .001) and small saphenous vein reflux times (F = 14.97; P < .001) were significantly higher than those in C1. Both the HASTI score and VCSS strongly associated with the reflux times of the great saphenous (r2 = 0.7706 and r2 = 0.8181, respectively; P < .001 for both) and small saphenous veins (r2 = 0.6470 and r2 = 0.7865, respectively; P < .001 for both). CONCLUSIONS: This analysis is one of the few epidemiologic studies of patients with CVI in Northwest China. Age and BMI did not correlate with CEAP class. Both the HASTI score and VCSS correlated strongly with the CEAP classification; vein diameters and reflux time in both the great saphenous vein and the small saphenous vein, indicating the validity of these outcome tools to venous hemodynamics and to CVI in general. SN - 2213-3348 UR - https://www.unboundmedicine.com/medline/citation/32730997/Association_between_vein_diameters_reflux_characteristics_and_clinical_severity_in_patients_with_chronic_venous_insufficiency_in_Northwest_China_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S2213-333X(20)30416-9 DB - PRIME DP - Unbound Medicine ER -