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Shaydakov E, Porembskaya O, Geroulakos G. The May-Husni Procedure: A Reappraisal. Eur J Vasc Endovasc Surg 2015; 50:513-7. [PMID: 26238309 DOI: 10.1016/j.ejvs.2015.05.010] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2014] [Accepted: 05/23/2015] [Indexed: 10/23/2022]
Abstract
OBJECTIVES The May-Husni procedure is a rarely used saphenofemoral venous bypass because of the small number of patients with post-thrombotic segmental femoral vein obstruction alone and the lack of validated selection criteria. There are only a few institutional series reporting the use of this technique. The purpose of this report is to present the author's experience and critically review the literature. METHODS Within a 13 year period 12 patients with venous claudication, skin pigmentation, and severe pain and swelling of their legs underwent the May-Husni procedure. Their median age was 57 years (41-69 years). Imaging showed segmental venous obstruction of the femoral vein in all patients and poor or no inflow from the deep femoral vein. Two patients were lost to follow up and the remaining 10 patients were reviewed with a median follow up of 60 months (26-72 months). RESULTS The saphenopopliteal bypass remained patent in all patients at follow up. The development of reflux of the saphenous conduit in four patients did not affect the clinical improvement. Venous claudication resolved, hyper-pigmentation improved, and pain was relieved in all patients. Recanalization of the femoral vein 3 years following thrombosis was followed by recurrence of the post-thrombotic symptoms in two patients. CONCLUSIONS These results indicate that a highly selected subgroup of patients with severe symptomatic post-thrombotic syndrome secondary to chronic segmental obstruction of the femoral vein do well after the May-Husni procedure. In order to refine the criteria for the selection of patients who may benefit from this operation, there is a need for more studies that use a combination of hemodynamic and validated scales that diagnose and grade the severity of post-thrombotic syndrome.
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Kalodiki E, Fareed J, Syed D, Geroulakos G, Hoppensteadt D, Lattimer CR. Blood Sampled Directly from Varicose Veins Reveals Activation of Inflammatory Processes. J Vasc Surg Venous Lymphat Disord 2015; 3:119. [PMID: 26993700 DOI: 10.1016/j.jvsv.2014.10.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Lattimer C, Azzam M, Kalodiki E, Geroulakos G. Quantifying Saphenous Recirculation in Patients With Superficial Venous Insufficiency. J Vasc Surg Venous Lymphat Disord 2015; 3:133. [DOI: 10.1016/j.jvsv.2014.10.045] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Nicolaides A, Clark H, Labropoulos N, Geroulakos G, Lugli M, Maleti O. Quantitation of reflux and outflow obstruction in patients with CVD and correlation with clinical severity. INT ANGIOL 2014; 33:275-281. [PMID: 24861564] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
AIM Chronic venous disease (CVD) is the result of venous reflux, obstruction or a combination of both. So far, attempts to correlate venous hemodynamic measurements with symptoms and signs of CVD have produced poor to moderate results, probably because of lack of methods to quantitate obstruction and combine measurements of reflux and obstruction. Our hypothesis is that the combination of quantitative measurements of (a) overall reflux (superficial and deep) and (b) overall outflow resistance i.e. including the collateral circulation would provide a hemodynamic index that should be related to the severity of the disease. METHODS Twenty-five limbs with chronic venous disease and 1 limb from a healthy volunteer (VCSS 0-13) were studied. The clinical CEAP classification was C0 in one limb, C1 in 2 limbs, C2 in 10 limbs, C3 in 3 limbs, C4 in 1 limb, C5 in 6 limbs and C6 in 3 limbs. Air-plethysmography was used to measure reflux (VFI in mL/s) when the subject changed position from horizontal to standing. Subsequently, with the subject horizontal and the foot elevated 15 cm, simultaneous recordings of pressure and volume were made on release of a proximal thigh cuff inflated to 70 mmHg. Pressure change was recorded with a needle in the foot and volume change with air-plethysmography. Flow (Q in mL/min) was calculated at intervals of 0.1 seconds from tangents on the volume outflow curve. Outflow resistance (R) was calculated at 0.1 second intervals by dividing pressure by the corresponding flow (R=P/Q). R increased markedly at pressures lower than 25 mmHg due to decrease in vein cross-sectional area, so resistance at 25 mmHg (R25) was used in this study. RESULTS In a multivariable linear regression analysis with VCSS as the dependent variable, both VFI and R25 were independent predictors (P<0.001). Using the constant (0.595) and regression coefficients, the regression equation provided a Hemodynamic Index (HI) or estimated VCSS=0.595 + (VFI x 0.41) + (R25 x 98). Thus, HI could be calculated for every patient by substituting VFI and R25 in the equation. HI or calculated VCSS was linearly related to the observed VCSS (r=0.86). CONCLUSION The results indicate that the combination of quantitative measurements of reflux and outflow resistance provide a hemodynamic index which is linearly related to the VCSS. These findings need to be confirmed in larger series.
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Lattimer C, Kalodiki E, Kafeza M, Azzam M, Geroulakos G. Quantifying the Degree Graduated Elastic Compression Stockings Enhance Venous Emptying. J Vasc Surg 2014. [DOI: 10.1016/j.jvs.2013.11.083] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Lattimer C, Geroulakos G, Kalodiki E. Thigh Compression Significantly Improves Venous Emptying After Deep Vein Thrombosis. J Vasc Surg Venous Lymphat Disord 2014; 2:111. [DOI: 10.1016/j.jvsv.2013.10.024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Lattimer C, Kalodiki E, Azzam M, Geroulakos G, Fareed J, Hoppensteadt D. Regional and Systemic Prothrombotic Biomarkers in Varicose Vein Patients and Healthy Controls. J Vasc Surg Venous Lymphat Disord 2014; 2:114. [DOI: 10.1016/j.jvsv.2013.10.033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Lattimer CR, Kalodiki E, Azzam M, Makris GC, Somiayajulu S, Geroulakos G. Interim results on abolishing reflux alongside a randomized clinical trial on laser ablation with phlebectomies versus foam sclerotherapy. INT ANGIOL 2013; 32:394-403. [PMID: 23822942] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
AIM The early results of a randomised clinical trial comparing local anaesthesia endovenous laser ablation (EVLA) with concurrent phlebectomies versus ultrasound-guided foam sclerotherapy (UGFS) into the great saphenous vein (GSV) revealed that laser was more expensive but the results on abolition of reflux were similar. The interim results at 15 month follow-up are reported. METHODS Evaluations included ultrasound, the venous clinical severity score (VCSS), the Aberdeen varicose vein questionnaire (AVVQ) and the saphenous treatment score (STS). The global absence of reflux defined technical success. Adjuvant sclerotherapy to areas of reflux was administered on patient choice. RESULTS Occlusion of the GSV was more effective with EVLA at 42/44 (95.5%) versus 31/46 (67.4%) for UGFS. However both techniques were equally effective at abolishing global venous reflux. The number of legs (N.=100) with total reflux abolition, above-knee, below-knee or combined reflux and loss to follow-up was 18, 6, 12, 8, 6 with EVLA and 20, 8, 11, 7, 4 with UGFS, respectively. The VCSS, AVVQ and STS reduced compared to baseline (P<0.0005), but there was no statistical difference between the groups. The AVVQ remained unchanged between 3-15 months (P=0.601). Also during this time, 19/46(41%) UGFS versus 9/44(20%) EVLA legs received adjuvant treatment (2.1 times increase). However, overall, adjuvant foam was given 4.7 times more frequently in the UGFS patients. CONCLUSION EVLA and UGFS are equally effective at abolishing global venous reflux with overall success of 41% and 43%, respectively. The high reflux rate was not related to deterioration in quality of life indicating that this reflux was largely asymptomatic.
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Nicolaides A, Fareed J, Kakkar AK, Comerota AJ, Goldhaber SZ, Hull R, Myers K, Samama M, Fletcher J, Kalodiki E, Bergqvist D, Bonnar J, Caprini JA, Carter C, Conard J, Eklof B, Elalamy I, Gerotziafas G, Geroulakos G, Giannoukas A, Greer I, Griffin M, Kakkos S, Lassen MR, Lowe GDO, Markel A, Prandoni P, Raskob G, Spyropoulos AC, Turpie AG, Walenga JM, Warwick D. Key Questions to be Answered. Clin Appl Thromb Hemost 2013. [DOI: 10.1177/1076029612474840x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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Lattimer CR, Kalodiki E, Azzam M, Geroulakos G. Reflux time estimation on air-plethysmography may stratify patients with early superficial venous insufficiency. Phlebology 2013; 28:101-8. [DOI: 10.1177/0268355513476205] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Objectives It has been suggested that quantification of haemodynamic parameters of venous disease may complement clinical assessment and may help identify a group of patients with severe venous disease or alternatively patients with early venous disease. However, there has been very little work to prove this hypothesis. The venous filling index (VFI) of air-plethysmography (APG) can quantify severity and treatment effect but has limited discriminatory value. However, the components of the VFI, total venous volume (VV) and time to reach 90% of VV (VFT90), have never been fully studied. The aim was to investigate the contribution of VV and VFT90 to an elevated VFI and determine their relationship to great saphenous vein (GSV) diameter and clinical severity scoring. Method Ninety-three consecutive patients/legs (22–78 years) with primary GSV reflux (>0.5 seconds) awaiting endovenous treatment were recruited. CEAP (clinical, aetiological, anatomical and pathological elements) assessments were: 33 (35.5%) C2, 14 (15.0%) C3, 29 (31.2%) C4a, 5 (5.4%) C4b, 7 (7.5%) C5 and 5 (5.4%) C6. The median venous clinical severity score (VCSS) was 6 (2–20) and the averaged GSV diameter at three sites was 7.5 mm (4–12). The VFI, VV and VFT90 were recorded using APG. Results There was no correlation between the VV and the VFT90 ( r = −0.103, P = 0.324). The VFI, VV and VFT90 significantly correlated ( P < 0.0005, Spearman) with the GSV diameter: r = 0.623, r = 0.567, r = −0.432, respectively, and the C of CEAP ( P < 0.05): r = 0.4, r = 0.225, r = −0.343, respectively. None of the 25 (26.9%) patients with a VFT90 > 25 seconds were among the 17 (18.3%) patients in categories C4b–6 or with a VCSS > 9 ( P = 0.005, Fisher's exact test, corrected odds ratio: 17.3). Conclusions The VFT90 complements the VFI as a marker of severe superficial venous insufficiency. However, in contrast to the VFI, it may have discriminatory value in stratifying patients with early disease into two groups based on the severity of haemodynamic impairment.
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Nicolaides A, Fareed J, Kakkar AK, Comerota AJ, Goldhaber SZ, Hull R, Myers K, Samama M, Fletcher J, Kalodiki E, Bergqvist D, Bonnar J, Caprini JA, Carter C, Conard J, Eklof B, Elalamy I, Gerotziafas G, Geroulakos G, Giannoukas A, Greer I, Griffin M, Kakkos S, Lassen MR, Lowe GDO, Markel A, Prandoni P, Raskob G, Spyropoulos AC, Turpie AG, Walenga JM, Warwick D. Periprocedural Management of Antithrombotic Therapy and Use of Bridging Anticoagulation. Clin Appl Thromb Hemost 2013; 19:220-3. [DOI: 10.1177/1076029612474840v] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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Nicolaides A, Fareed J, Kakkar AK, Comerota AJ, Goldhaber SZ, Hull R, Myers K, Samama M, Fletcher J, Kalodiki E, Bergqvist D, Bonnar J, Caprini JA, Carter C, Conard J, Eklof B, Elalamy I, Gerotziafas G, Geroulakos G, Giannoukas A, Greer I, Griffin M, Kakkos S, Lassen MR, Lowe GDO, Markel A, Prandoni P, Raskob G, Spyropoulos AC, Turpie AG, Walenga JM, Warwick D. Cost-Effectiveness of Prevention and Treatment of VTE. Clin Appl Thromb Hemost 2013; 19:224-5. [DOI: 10.1177/1076029612474840w] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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Nicolaides A, Fareed J, Kakkar AK, Comerota AJ, Goldhaber SZ, Hull R, Myers K, Samama M, Fletcher J, Kalodiki E, Bergqvist D, Bonnar J, Caprini JA, Carter C, Conard J, Eklof B, Elalamy I, Gerotziafas G, Geroulakos G, Giannoukas A, Greer I, Griffin M, Kakkos S, Lassen MR, Lowe GDO, Markel A, Prandoni P, Raskob G, Spyropoulos AC, Turpie AG, Walenga JM, Warwick D. Introduction. Clin Appl Thromb Hemost 2013; 19:118-20. [DOI: 10.1177/1076029612474840a] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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Nicolaides A, Fareed J, Kakkar AK, Comerota AJ, Goldhaber SZ, Hull R, Myers K, Samama M, Fletcher J, Kalodiki E, Bergqvist D, Bonnar J, Caprini JA, Carter C, Conard J, Eklof B, Elalamy I, Gerotziafas G, Geroulakos G, Giannoukas A, Greer I, Griffin M, Kakkos S, Lassen MR, Lowe GDO, Markel A, Prandoni P, Raskob G, Spyropoulos AC, Turpie AG, Walenga JM, Warwick D. Burns. Clin Appl Thromb Hemost 2013; 19:161. [DOI: 10.1177/1076029612474840g] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
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Nicolaides AN, Fareed J, Kakkar AK, Comerota AJ, Goldhaber SZ, Hull R, Myers K, Samama M, Fletcher J, Kalodiki E, Bergqvist D, Bonnar J, Caprini JA, Carter C, Conard J, Eklof B, Elalamy I, Gerotziafas G, Geroulakos G, Giannoukas A, Greer I, Griffin M, Kakkos S, Lassen MR, Lowe GD, Markel A, Prandoni P, Raskob G, Spyropoulos AC, Turpie AG, Walenga JM, Warwick D. Prevention and treatment of venous thromboembolism--International Consensus Statement. INT ANGIOL 2013; 32:111-260. [PMID: 24402349] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
The aim of this document is to provide a clear and concise account of the evidence regarding efficacy or harm for various methods available to prevent and manage venous thromboembolism (VTE).
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Nicolaides A, Fareed J, Kakkar AK, Comerota AJ, Goldhaber SZ, Hull R, Myers K, Samama M, Fletcher J, Kalodiki E, Bergqvist D, Bonnar J, Caprini JA, Carter C, Conard J, Eklof B, Elalamy I, Gerotziafas G, Geroulakos G, Giannoukas A, Greer I, Griffin M, Kakkos S, Lassen MR, Lowe GDO, Markel A, Prandoni P, Raskob G, Spyropoulos AC, Turpie AG, Walenga JM, Warwick D. The Problem and the Need for Prevention. Clin Appl Thromb Hemost 2013; 19:121-2. [DOI: 10.1177/1076029612474840b] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
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Nicolaides A, Fareed J, Kakkar AK, Comerota AJ, Goldhaber SZ, Hull R, Myers K, Samama M, Fletcher J, Kalodiki E, Bergqvist D, Bonnar J, Caprini JA, Carter C, Conard J, Eklof B, Elalamy I, Gerotziafas G, Geroulakos G, Giannoukas A, Greer I, Griffin M, Kakkos S, Lassen MR, Lowe GDO, Markel A, Prandoni P, Raskob G, Spyropoulos AC, Turpie AG, Walenga JM, Warwick D. Heparin-Induced Thrombocytopenia. Clin Appl Thromb Hemost 2013; 19:208-13. [DOI: 10.1177/1076029612474840s] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
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Nicolaides A, Fareed J, Kakkar AK, Comerota AJ, Goldhaber SZ, Hull R, Myers K, Samama M, Fletcher J, Kalodiki E, Bergqvist D, Bonnar J, Caprini JA, Carter C, Conard J, Eklof B, Elalamy I, Gerotziafas G, Geroulakos G, Giannoukas A, Greer I, Griffin M, Kakkos S, Lassen MR, Lowe GDO, Markel A, Prandoni P, Raskob G, Spyropoulos AC, Turpie AG, Walenga JM, Warwick D. Diagnosis and Anticoagulant Treatment. Clin Appl Thromb Hemost 2013; 19:187-98. [DOI: 10.1177/1076029612474840n] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
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Nicolaides A, Fareed J, Kakkar AK, Comerota AJ, Goldhaber SZ, Hull R, Myers K, Samama M, Fletcher J, Kalodiki E, Bergqvist D, Bonnar J, Caprini JA, Carter C, Conard J, Eklof B, Elalamy I, Gerotziafas G, Geroulakos G, Giannoukas A, Greer I, Griffin M, Kakkos S, Lassen MR, Lowe GDO, Markel A, Prandoni P, Raskob G, Spyropoulos AC, Turpie AG, Walenga JM, Warwick D. Prevention and Treatment of Venous Thromboembolism. Clin Appl Thromb Hemost 2013; 19:116-8. [DOI: 10.1177/1076029612474840] [Citation(s) in RCA: 46] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
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Nicolaides A, Fareed J, Kakkar AK, Comerota AJ, Goldhaber SZ, Hull R, Myers K, Samama M, Fletcher J, Kalodiki E, Bergqvist D, Bonnar J, Caprini JA, Carter C, Conard J, Eklof B, Elalamy I, Gerotziafas G, Geroulakos G, Giannoukas A, Greer I, Griffin M, Kakkos S, Lassen MR, Lowe GDO, Markel A, Prandoni P, Raskob G, Spyropoulos AC, Turpie AG, Walenga JM, Warwick D. Thrombolytic Therapy. Clin Appl Thromb Hemost 2013; 19:198-204. [DOI: 10.1177/1076029612474840o] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023] Open
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Nicolaides A, Fareed J, Kakkar AK, Comerota AJ, Goldhaber SZ, Hull R, Myers K, Samama M, Fletcher J, Kalodiki E, Bergqvist D, Bonnar J, Caprini JA, Carter C, Conard J, Eklof B, Elalamy I, Gerotziafas G, Geroulakos G, Giannoukas A, Greer I, Griffin M, Kakkos S, Lassen MR, Lowe GDO, Markel A, Prandoni P, Raskob G, Spyropoulos AC, Turpie AG, Walenga JM, Warwick D. Surgical Thrombectomy. Clin Appl Thromb Hemost 2013; 19:205-6. [DOI: 10.1177/1076029612474840q] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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Makris G, Lattimer C, Lavida A, Geroulakos G. Availability of Supervised Exercise Programs and the Role of Structured Home-based Exercise in Peripheral Arterial Disease. Eur J Vasc Endovasc Surg 2012; 44:569-75; discussion 576. [DOI: 10.1016/j.ejvs.2012.09.009] [Citation(s) in RCA: 83] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2012] [Accepted: 09/12/2012] [Indexed: 11/26/2022]
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Makris G, Lattimer C, Lavida A, Geroulakos G. Availability of Supervised Exercise Programs and the Role of Structured Home-based Exercise in Peripheral Arterial Disease. J Vasc Surg 2012. [DOI: 10.1016/j.jvs.2012.10.075] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Lattimer CR, Kalodiki E, Azzam M, Geroulakos G. Responsiveness of individual questions from the venous clinical severity score and the Aberdeen varicose vein questionnaire. Phlebology 2012. [DOI: 10.1258/phleb.2012.012080] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Objectives The venous clinical severity score (VCSS) and the Aberdeen varicose vein questionnaire (AVVQ) improve after treating chronic venous insufficiency (CVI). The aim was to examine how and why they improve by evaluating the change in each individual question. Methods This was an analysis on prospectively collected data from a clinical study on 100 patients (58% female) with CVI (C2 = 34, C3 = 14, C4a = 29, C4b = 9, C5 = 7, C6 = 7) who were randomized to endovenous laser ablation ( n = 50) or foam sclerotherapy ( n = 50). The change scores (performance) of each question of the VCSS (questions 1–10) and the AVVQ (questions 1–13) were calculated by subtracting the score at three weeks, and three months, from the pre-treatment score. Results Both the median, interquartile range (IQR), VCSS and the AVVQ scores improved from 6 (4) and 21.4 (15.1) at baseline to 3 (4) and 18.6 (12.1) at three weeks ( P < 0.0005, P = 0.031) to 2 (3) and 8.8 (13.6) at three months, ( P < 0.0005, P < 0.0005), respectively. The performance of the first three questions of the VCSS (pain, extent of varicosities, oedema) were the most contributory to the overall score. Questions 5, 7, 8, 9 on ulceration improved the most individually but did not contribute significantly to the overall score. Questions 5, 9 of the AVVQ on stocking use and ulceration failed to contribute statistically to the overall improvement at three months. Conclusion The majority of the individual questions of the VCSS and AVVQ responded to change. However, the cause of a poor response was multifactorial with statistical dilution playing a significant role. Stratification of patients according to ulceration may allow better comparisons.
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Lattimer CR, Azzam M, Kalodiki E, Geroulakos G. Venous filling time using air-plethysmography correlates highly with great saphenous vein reflux time using duplex. Phlebology 2012; 29:90-7. [DOI: 10.1258/phleb.2012.012042] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
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