Recommendations for the diagnosis and treatment of chronic venous disease

  • Nada Kecelj Leskovec Dermatovenerološka klinika Univerzitetni klinični center Ljubljana
  • Matija Kozak Klinični oddelek za žilne bolezni Interna klinika Univerzitetni klinični center Ljubljana
  • Ana Slana Dermatovenerološka klinika Univerzitetni klinični center Ljubljana
  • Katarina Šmuc Berger Dermatovenerološka ambulanta Splošna bolnišnica Izola
  • Andrej Šikovec Kirurški oddelek Splošna bolnišnica Novo mesto
  • Matej Makovec Kirurški oddelek Splošna bolnišnica Novo mesto
  • Aleš Blinc Klinični oddelek za žilne bolezni Interna klinika Univerzitetni klinični center Ljubljana
  • Ivan Žuran Interni oddelek Splošna bolnišnica Celje
  • Tanja Planinšek Ručigaj Dermatovenerološka klinika Univerzitetni klinični center Ljubljana
Keywords: chronic venous insufficiency, varicose veins, compression therapy, endovascular therapy

Abstract

Clinical manifestations of chronic superficial venous insufficiency are described, followed by recommendations for diagnostic evaluation and various treatment possibilities.

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References

Ramelet AA, Perrin M, Kern P, Bounameaux H. Phlebology. 5th ed. Paris: Elsevier; 2008.

Leu AJ, Leu HJ, Franzeck UK, Bollinger A. Microvascular changes in chronic venous insufficiency – a review. Cardiovasc Surg. 1995;3(3):237–45.

Widmer LK. Peripheral venous disorders: prevalence and sociomedical importance – observations in 4,529 apparently healthy persons. Basle Study III. Bern: Hans Huber; 1978.

Porter JM, Moneta G and International Consensus Comittee on Chronic Venous Disease. Reporting standards in venous disease. J Vasc Surg. 1995;21(4):635–45.

Vasquez MA, Rabe E, McLafferty RB, Shortell CK, Marston WA, Gillespie D, et al. American Venous Forum Ad Hoc Outcomes Working Group. Revision of the venous clinical severity score: venous outcomes consensus statement: special communication of the American Venous Forum Ad Hoc Outcomes Working Group. J Vasc Surg. 2010;52 (5):1387–96.

Pannier-Fischer, E. Rabe. Epidemiologie der chronischen Venenerkrankungen. Der Hautarzt. 2003;54(11):1037–44.

Agus GB, Allegra C, Arpaia G, Botta G, Cataldi A, Gasbarro V, et al. Guidelines for the diagnosis and treatment of chronic venous insufficiency. Int Angiol. 2001;20 (2):3–37.

Mlačak B. Klinično pomembne varice v populaciji občine Metlika. Zdrav Vestn. 1988;7:16–35.

The management of chronic venous disorders of the leg: An evidence-based report of an international task force. Phlebology. 1999;14 (Suppl 1):52–66.

Gloviczki P1, Comerota AJ, Dalsing MC, Eklof BG, Gillespie DL, Gloviczki ML, et al. The care of patients with varicose veins and associated chronic venous diseases: clinical practice guidelines of the Society for Vascular Surgery and the American Venous Forum. J Vasc Surg. 2011;53 (Suppl): 2S–48S.

Depalma RG, Kowallek DL, Barcia TC, Cafferata HT. Target selection for surgical intervention in severe chronic venous insufficiency: comparison of duplex scanning and phlebography. J Vasc Surg. 2000;32(5):913–20.

Berden P, Ključevšek T. Venografija in magnetna resonanca v diagnostiki venske tromboze. Med Razgl. 2000;39 Suppl 2;23–8.

Palfreyman SJ, Lochiel R, Michaels JA. A systematic review of compression therapy for venous leg ulcers. Vasc Med. 1998;3(4):301.

Šikovec A, Planinšek-Ručigaj T, Košiček M, Kozak M, Videčnik V, Mulej M, et al. Smernice za odkrivanje in zdravljenje kroničnega venskega popuščanja. Zdrav Vestn. 2005;74 (4):193–202.

SIGN Guideline 120:Management of chronic venous leg ulcers. Edinburgh: Scottish Intercollegiate Guidelines Network; 2010.

Foy White-Chu E, Conner-Kerr TA. Overview of guidelines for the prevention and treatment of venous leg ulcers : a US perspective. J Multidisc Health. 2014;7:111–7.

Smith JJ, Brown L, Greenhalgh RM, Davies AH. Randomised triual of pre-operative colour duplex marking in primary varicose vein surgery: outcome is not improved. Eur J vasc Endovasc Surg 2002;23(4):336–43.

Palfreyman SJ, Michaels JA. A systematic review of compression hosiery for uncomplicated varicose veins. Phlebology. 2009;24 (1):13–33.

O’Meara S, Cullum N, Nelson EA, Dumville JC. Compression for venous leg ulcers. Cochrane Database Syst Rev. 2012;11:CD000265.

Nicolaides AN, Allegra C, Bergan J, Bradbury A, Cairols M, Carpentier P, et al. Management of chronic venous disorders of the lower limbs: guidelines accordingto scientific evidence. Int Angiol- 2008;27 (1):1v59.

Bergan JJ, Pascarella L, Schmid-Schoenbein GW. Pathogenesis of primary chronic venous disease: Insights from animal models of venous hypertension. J Vasc Surg. 2008;47 (1):183–92.

Ramelet AA. Venoactive Drugs. In Goldman PG, Guex JJ, Weiss RA eds. In Sclerotherapy. 5th ed. Paris: Elsevier; 2011.

Allaert FA. Meta-analysis of the impact of the principal venoactive drugs agents on malleolar venous edema. Int Angiol. 2012;31 (4):310–5.

Gohel MS, Davies AH. Pharmacological treatment in patients with C4, C5 and C6 venous disease. Phlebology. 2010;25 (1):35–41.

Coleridge-Smith P, Lok C, Ramelet AA. Venous leg ulcer: a meta-analysis ofadjunctive therapy with micronized purified flavonoid fraction. Eur J Vasc Endovasc Surg. 2005;30 (2):198–208.

Pittler MH, Ernst E. Horse chestnut seed extract for chronic venous insufficiency. Cochrane Database Syst Rev. 2012 (14);11. CD003230

Jull AB, Arroll B, Parag V, Waters J. Pentoxifylline for treating venous leg ulcers. Cochrane Database Syst Rev. 2012;12. CD001733

Rabe E, Guex JJ, Morrison N, Ramelet AA, Schuller-Petrovic S, Scuderi A,Staelens I, Pannier F. Treatment of chronic venous disease with flavonoids:recommendations for treatment and further studies. Phlebology. 2013;28 (6):308–19.

Kesteven P, Robinson B. Superficial thrombophlebitis followed by pulmonary embolism. J R Soc Med. 2001;94:186–7.

Blumenberg RM, Barton E, Gelfand ML, Skudder P, Brennan J. Occult deep venous thrombosis complicating superficial thrombophlebitis. J Vasc Surg. 1998;27(2):338–43.

Decousus H, Epinat M, Gillot K, Quenet S, Boissier C, Tardy B. Superficial vein thrombosis: risk factors, diagnosis and treatment. Curr Opin Pulm Med. 2003;9(5):393–7.

Kearon C, Kahn SR, Agnelli G, Goldhaber S, Raskob GE, Comerota AJ. Antithrombotic therapy for venous thromboembolic disease: American College of Chest Physicians Evidence-Based Clinical Practice Guidelines. Chest. 2008;133 (6 l): 454S–545S.

Decousus H, Prandoni P, Mismetti P, Bauersachs RM, Boda Z, Brenner B, et al. Fondaparinux for the treatment of superficial-vein thrombosis in the legs. N Engl J Med. 2010;363 (13):1222–32.

Kunimoto B, Cooling M, Gulliver W, Houghton P, Orstead H, Sibbald RG. Best practices for the prevention and treatment of venous leg ulcers. Ostomy Wound Manage. 2001, 47(2):34–50.

Moffatt CJ, Oldroyd MI, Greenhalgh RM, Franks PJ. Palpating pulses is insufficient in detecting arterial insufficiency in patients with leg ulceration. Phlebology. 1994;9(4):170–2.

Planinšek Ručigaj T. How to Choose the Proper Dressings in Venous Leg Ulcers care. Rewiews in Vascular Medicine. 2013;2(2):58–61.

Rabe E, Breu FX, Cavezzi A, Coleridge Smith P, Frullini A, Gillet JL, et al. . European guidelines for sclerotherapy in chronic venous disorders Phlebology. Phlebology. 2014;29(6):338–54.

Yamaki T, Hamahata A, Soejima K, Kono T, Nozaki M, Sakurai H. Prospective randomised comparative study of visual foam sclerotherapy alone or in combination with ultrasound-guided foam sclerotherapy for treatment of superficial venous insufficiency: preliminary report. Eur J Vasc Endovasc Surg. 2012;43(3):343–7.

Kern P, Ramelet AA, Wütschert R, Hayoz D. Compression after sclerotherapy for telangiectasiastelangiectasias and reticular leg veins. A randomized controlled study. J Vasc Surg. 2007;45(6):1212–6.

Peterson JD, Goldman MP, Weiss RA, Duffy DM, Fabi SG, Weiss MA, et al. Treatment of reticular and telangiectatic leg veins: double-blind, prospective comparative trial of polidocanol and hypertonic saline. Dermatol Surg. 2012;38(8):1–9.

Ceulen RPM, Jagtmann EA, Sommer A, Teule GJJ, Schurink GWH, Kemerink GJ. Blocking the saphenafemoral junction during ultrasound guided foam sclerotherapy – assessment of a presumed safety-measure procedure. Eur J Vasc Endovasc Surg. 2010;40(6):772–6.

Cavezzi A, Tessari L. Foam sclerotherapy techniques: different gases and methods of preparation, catheter versus direct injection. Phlebology. 2009;24(6):247–51.

Blaise S, Bosson JL, Diamand JM. Ultrasound-guided sclerotherapy of the great saphenous vein with 1 % vs. 3 % polidocanol foam: a multicentre double-blind randomised trial with 3-year follow-up. Eur J Vasc Endovasc Surg. 2010;39(6):779–86.

Nootheti PK, Cadag KM, Magpantay A, Goldman MP. Efficacy of graduated compression stockings for an additional 3 weeks after sclerotherapy treatment of reticular and telangiectatic leg veins. Dermatol Surg. 2009;35(1):53–8.

Stanley PRW, Bickerton DR, Campbell WB. Injection sclerotherapy for varicose veins – a comparison of materials for applying local compression. Phlebology. 1991;6(1):37–9.

Breu FX, Guggenbichler S, Wollmann JC. 2nd European Consensus Meeting on Foam Sclerotherapy, 28–30 April 2006, Tegernsee, Germany. Vasa. 2008;37(71):1–32.

Rabe E, Pannier F, Gerlach H, Breu FX, Guggenbichler S, Wollmann JC. Leitlinie Sklerosierungsbehandlung der Varikose. Phlebologie. 2008;37(1):27–34.

Stücker M, Reich S, Hermes N, Hermes N, Altmeyer P. Safety and efficiency of perilesional sclerotherapy in leg ulcer patients with postthrombotic syndrome and/or oral anticoagulation with Phenprocoumon. J Dtsch Dermatol Ges. 2006;4(9):734–8.

Hamel-Desnos CM, Gillet J-L, Desnos PR, Allaert F. Sclerotherapy of varicose veins in patients with documented thrombophilia: a prospective controlled randomized study of 105 cases. Phlebology. 2009;24(4):176–82.

Gachet G, Spini L. Sclérothérapie des varices sous anticoagulants. Phlébologie. 2002;55(2):41–4.

Zipper SG. Nervus peronäus-Schaden nach Varizensklerosierung mit Aethoxysklerol. Versicherungsmedizin. 2000;4(5):185–7.

Sadek M, Kabnick LS, Berland T, et al. Update on endovenous laser ablation: 2011. Perspect Vasc Surg Endovasc Ther. 2011;23(4):233–7.

Varicose veins in the legs. The diagnosis and managementof varicose veins. NICE clinical guideline 168. July 2013. [cited 18.3.2017] . Available from: http://www.nice.org.uk/nicemedia/live/14226/64566/64566.pdf

Endovenous laser treatment of the long saphenous vein.NICE interventional procedure guidance 52. March 2004 [cited 18.3.2017] . Available from: http://www.nice.org.uk/IP209overview2.

Radiofrequency ablation of varicose veins. NICE interventionalprocedure guidance 8. September 2003 [cited 18.3.2017] Available from:. http://www.nice.org.uk/ip132overview.

van den Bos RR, Milleret R, Neumann M, Nijsten T. Proof-of-principle study of steam ablation as novel thermal therapy for saphenous. J Vasc Surg. 2011:53 (1):181–6.

Kabnick LS. Varicose veins: endovenous treatment, In: Cronenwett 7thJL, Johnston KW, editors. Rutherford’s vascular surgery. ed. Philadelphia: Saunders; 2010. p. 871–88, 233.

Pavlovic MD, Schuller-Petrovic S, Pichot O, Rabe E, Maurins U, Morrison N, et al. Guidelines of the First International Consensus Conference on Endovenous Thermal Ablation for Varicose Vein Disease–ETAV Consensus Meeting 2012. Phlebology. 2014;17(1):1–17.

Carradice D, Samuel N, Wallace T, Mazari FA, Hatfield J, Chetter I. Comparing the treatment response of great saphenous and small saphenous vein incompetence following surgery and endovenous laser ablation: a retrospective cohort study. Phlebology. 2012;2783):128–34.

Gloviczki P, Gloviczki ML. Guidelines for the management of varicose veins. Phlebology. 2012 Mar;27 Suppl 1:2–9

Anwar MA, Lane TRA, Davies AH. Complications of radiofrequency ablation of varicose veins. Phlebology. 2012;27 (1):34–9.

Myers KA, Jolley D. Outcome of endovenous laser therapy for saphenous reflux and varicose veins: medium-term results assessed by ultrasound surveillance. Eur J Vasc Endovasc Surg. 2009;37(4):239–45.

Šikovec A. The treatment of saphenous vein occlusion by endovenous laser ablation (EVLA) with a 1064 nm VSP Nd: YAG laser. Journal of the Laser and Health Academy, 2009, 1:1–5. Knipp BS, Blackburn SA, Bloom JR, Fellows E, Laforge W, Pfeifer JR, et al. Endovenous laser ablation: venous outcomes and thrombotic complications are independent of the presence of deep venous insufficiency. J Vasc Surg. 2008;48(12):1538–45.

Dwerryhouse S, Davies B, Harradine K, Earnshaw JJ. Stripping the long saphenous vein reduces the rate of reoperation for recurrent varicose veins: five-year results of a randomized trial. J Vasc Surg. 1999;29(5):589–92.

Hobbs T. Perioperative venography to ensure accuarte saphenopopliteal vein ligation. BMJ. 1980;280(12):1578–9.

Gale SS, Lee JN, Walsh ME, Wojnarowski DL, Comerota AJ. A randomized, controlled trial of endovenous thermal ablation using the 810-nm wavelength laser and the ClosurePLUS radiofrequency ablation methods for superficial venous insufficiency of the great saphenous vein. J Vasc Surg. 2010;52(6):645–50.

Shepherd AC, Gohel MS, Brown LC, Metcalfe MJ, Hamish M, Davies AH. Randomized clinical trial of VNUS ClosureFAST radiofrequency ablation versus laser for varicose veins. Br J Surg. 2010;97(10):810–8.

Published
2017-09-01
How to Cite
1.
Kecelj Leskovec N, Kozak M, Slana A, Šmuc Berger K, Šikovec A, Makovec M, Blinc A, Žuran I, Planinšek Ručigaj T. Recommendations for the diagnosis and treatment of chronic venous disease. TEST ZdravVestn [Internet]. 1Sep.2017 [cited 29Mar.2024];86(7-8):345-89. Available from: http://vestnik-dev.szd.si/index.php/ZdravVest/article/view/2631
Section
Professional Article