Did you mean: (Venous Insufficiency and Varicosis)?
- [New methods of interventional treatment of varicose veins]. [Editorial]
- PMPol Merkur Lekarski 2019 Apr 29; 46(274):153-156
- Lower limb veins diseases belong to frequently occurring disease syndromes. It covers 62% of adult Poles. They are not only an aesthetic problem. They can cause a lot of subjective and objective ailm…
Lower limb veins diseases belong to frequently occurring disease syndromes. It covers 62% of adult Poles. They are not only an aesthetic problem. They can cause a lot of subjective and objective ailments significantly reducing the quality of life - from asymptomatic spider veins to permanent pain in lower limbs, especially in standing, fixed edema, skin lesions and ulceration. Superficial chronic venous insufficiency is due to incompetence of the saphenofemoral junction and great or small saphenous vein. Conventional surgery involves high ligation, stripping and phlebectomy. Recently, at the beginning of XXI century, minimally invasive endovenous techniques which became as alternatives to conventional surgery. Currently, the number of possible methods of treatment of venous disease available for use exceeds ten.
- Therapeutic potential of natural compounds in inflammation and chronic venous insufficiency. [Review]
- EJEur J Med Chem 2019 May 06; 176:68-91
- The term varicose vein refers to the twisted and swollen vein visible under the skin surface which occurs most commonly in the leg. Epidemiological studies report a varying percentage of incidences f…
The term varicose vein refers to the twisted and swollen vein visible under the skin surface which occurs most commonly in the leg. Epidemiological studies report a varying percentage of incidences from 2 to 56% in men and <1-60% in women. Venous insufficiency is most often caused by the damage to the valves and walls of the veins. The mechanism of varicose vein formation is complex. It is, however, based on hypotensive blood vessels, hypoxia, and other mechanisms associated with inflammation. This work describes mechanisms related to the formation and development of the varicose vein. It discusses risk factors, pathogenesis of chronic venous disease, markers of the epithelial and leukocyte activation, state of hypoxia and inflammation, reactive oxygen species (ROS) generation, and oxidative stress. Additionally, this paper describes substances of plant origin used in the treatment of venous insufficiency. It also considers the structure of the molecules, their properties, and their mechanisms of action, the structure-activity relationship and chemical properties of flavonoids and other substances. The flavonoids include quercetin derivatives, micronized purified flavonoid fraction (Daflon), natural pine bark extract (Pycnogenol), and others such as triterpene saponine, extracts from Ruscus aculeatus and Centella asiatica, Ginkgo biloba extract, coumarin dereivatives that are used in chronic venous insufficiency. Flavonoids are natural substances found in plants, including fruits, vegetables, flowers, and others. They are important to the circulatory system and critical to blood vessels and the blood flow. Additionally, they have antioxidant, antiinflammatory properties.
- Investigation and treatment of pelvic vein reflux associated with varicose veins: Current views and practice of 100 UK vascular specialists. [Journal Article]
- PPhlebology 2019 May 13; :268355519848621
- CONCLUSIONS: There is substantial variation in the management of pelvic vein reflux in the UK. There is need for further consensus and good clinical trial evidence to guide practice.
- Vascular training does matter in the outcomes of saphenous high ligation and stripping. [Journal Article]
- JVJ Vasc Surg Venous Lymphat Disord 2019 May 05
- CONCLUSIONS: Despite that the majority of VV surgery in Portugal is executed by general surgeons, this study highlights important advantages when it is performed by surgeons with vascular training.
- Protocol for a systematic review and meta-analysis of interventions for pathologic perforator veins in chronic venous disease. [Journal Article]
- BOBMJ Open 2019 May 01; 9(4):e024088
- Perforator veins (PVs) play an important role in the development of chronic venous insufficiency and ulceration. Procedures to eliminate incompetence and reflux in PV may include open surgery, subfas…
Perforator veins (PVs) play an important role in the development of chronic venous insufficiency and ulceration. Procedures to eliminate incompetence and reflux in PV may include open surgery, subfascial endoscopic surgery, intravenous ablation techniques and sclerotherapy. With the aim of filling the evidence gap, this is a protocol for a systematic review that will assess the effects of any form of intervention for the treatment of pathologic PVs of the lower limbs in patients with chronic venous disease.
- A comparison between Caucasian and Asian superficial venous anatomy and reflux patterns - Implications for potential precision endovenous ablation therapy. [Journal Article]
- PPhlebology 2019 Apr 29; :268355519845984
- CONCLUSIONS: The predominantly Asian cohort from Singapore had smaller diameter truncal veins, longer segments of truncal vein reflux and present later with more advanced chronic venous insufficiency compared to their American counterparts. This information could help tailor endovenous ablation on a more individualised basis in the future.
- Ablation therapy with cyanoacrylate glue and laser for refluxing great saphenous veins - a prospective randomised study. [Journal Article]
- VASAVasa 2019 Apr 24; :1-8
- CONCLUSIONS: Management of incompetent great saphenous veins both endovenous cyanoacrylate ablation and laser ablation results in high occlusion rates. Endovenous cyanoacrylate ablation technique is fast and simple with low periprocedural pain that does not require tumescent anesthesia and compression stockings.
- Cardiovascular Disease: Chronic Venous Insufficiency and Varicose Veins. [Journal Article]
- FEFP Essent 2019; 479:16-20
- Chronic venous insufficiency (CVI) results from long-term venous hypertension in the legs caused by venous obstruction, venous valve incompetency, muscle pump dysfunction, or a combination of these. …
Chronic venous insufficiency (CVI) results from long-term venous hypertension in the legs caused by venous obstruction, venous valve incompetency, muscle pump dysfunction, or a combination of these. CVI occurs in 9.4% of men and 6.6% of women. It takes any of several forms, including leg pain and heaviness, leg edema that is worsened by prolonged standing and relieved by elevation, stasis dermatitis, skin fibrosis, skin ulcers, and varicose veins. If the patient history and/or physical examination results are suggestive of CVI, the diagnosis can be confirmed with duplex ultrasonography. The primary conservative treatment is use of compression stockings. Physical therapy and exercise programs often are recommended but little evidence supports their use. If a skin ulcer is present, appropriate wound care is indicated. Flavonoid drugs have been shown to improve venous function but none are approved for use in the United States. Diosmiplex, a flavonoid medical food product derived from oranges, is approved by the Food and Drug Administration for management of CVI and has shown some benefits. Patients with more severe manifestations of CVI should be referred to a vascular subspecialist for consideration of interventional therapies.
- Association between varicose veins anatomical pattern and procedural complications following endovascular laser photothermolysis for chronic venous insufficiency. [Journal Article]
- BJBraz J Med Biol Res 2019 Apr 08; 52(4):e8330
- We sought to assess clinical characteristics and pattern of collateral network involvement associated with development of truncal (systematized) versus diffuse/non-truncal (non-systematized) varicose…
We sought to assess clinical characteristics and pattern of collateral network involvement associated with development of truncal (systematized) versus diffuse/non-truncal (non-systematized) varicose veins (VVs) in patients undergoing endovascular laser photothermolysis for chronic venous insufficiency (CVI). Secondly, we aimed to assess whether the type of VVs influenced the procedural complications of endovascular laser therapy. A total of 508 patients with hydrostatic VVs of the lower limbs who underwent endovenous laser treatment were included, out of which 84.1% (n=427) had truncal VVs (group 1) and 15.9% (n=81) had diffuse (non-systematized) VVs (group 2). Patients with truncal varices were significantly older (47.50±12.80 vs 43.15±11.75 years, P=0.004) and those with associated connective tissue disorders were more prone to present diffuse VVs (P=0.004). Patients in group 1 presented a significantly higher number of Cockett 1 (P=0.0017), Cockett 2 (P=0.0137), Sherman (P<0.0001), and Hunter (P=0.0011) perforator veins compared to group 2, who presented a higher incidence of Kosinski perforators (P<0.0001). There were no significant differences regarding postoperative complications: thrombophlebitis (P=0.773), local inflammation (P=0.471), pain (P=0.243), paresthesia (P=1.000), or burning sensation (P=0.632). Patients with more advanced CEAP (clinical, etiologic, anatomic, pathophysiologic) classes were older (P<0.0001), more were males (39.05 vs 27.77%, P=0.0084), more were prone to present ulcers (P<0.0001) and local hyperthermia (P=0.019), and presented for endovenous phlebectomy after a longer time from symptom onset. In patients with CVI, systematized VVs were associated with a more severe clinical status and a distinct anatomical pattern of perforators network compared to non-systematized VVs, which is more common in advanced stages.
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- Therapeutic approach to chronic venous insufficiency - clinical benefits of red-vine-leaf-extract AS 195 (Antistax®). [Journal Article]
- PPharmazie 2019 04 01; 74(4):193-200
- CONCLUSIONS: Antistax® is a well-described herbal product with standardised starting materials and manufacturing process. Its active ingredients accumulate in the venous intima, preserve the endothelial barrier function, and inhibit the inflammatory and prothrombotic cascade behind the progression of CVD. Its efficacy was analysed in adequately planned and executed clinical trials in patients with mild to moderately severe CVD (CEAP C1s to C4). AS195 showed a statistically significant and clinically relevant efficacy over placebo: in objective endpoints like volumetry of lower leg edema, but also in outcomes directly relevant for patients like tension and heaviness of the legs, tingling, and pain. Supportive studies confirmed and validated these results also for the broader population treated in daily practice. AS195 was well tolerated in studies and in everyday therapy. There are no known interactions with other medications. In the later stages, it can be used in combination with compression, complementing the beneficial haemodynamic effects of compression at a cellular level. AS195 is an addition to compression and closes a therapeutic gap especially in patients, who cannot use compression stockings, but still require CVD therapy.