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Jayaraj A, Rossi FH, Lurie F, Muck P. Diagnosis of chronic iliac venous obstruction. J Vasc Surg Venous Lymphat Disord 2024; 12:101744. [PMID: 38242206 DOI: 10.1016/j.jvsv.2023.101744] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2023] [Revised: 12/05/2023] [Accepted: 12/12/2023] [Indexed: 01/21/2024]
Abstract
Stenting has become the first line of treatment for symptomatic chronic iliofemoral venous obstruction in patients with quality-of-life-impairing clinical manifestations who have failed conservative therapy. Patient selection for such intervention is, however, dependent on clear identification of relevant clinical manifestations and subsequent testing to confirm the diagnosis. In this regard, the physician engaged in management of such patients needs to be well-aware of symptoms and signs of chronic iliofemoral venous obstruction, and instruments used to grade chronic venous insufficiency and determine quality of life, in addition to diagnostic tests available and their individual roles. This review serves to provide an overview of the diagnosis of chronic iliofemoral venous obstruction and patient selection for stenting.
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Affiliation(s)
- Arjun Jayaraj
- RANE Center for Venous and Lymphatic Diseases, St Dominic Hospital, Jackson, MS.
| | - Fabio H Rossi
- Dante Pazzanese Cardiovascular Institute, Sao Paulo, Brazil
| | - Fedor Lurie
- Jobst Vascular Institute, Toledo, OH; Division of Vascular Surgery, University of Michigan, Ann Arbor, MI
| | - Patrick Muck
- Division of Vascular Surgery, Department of Surgery, Good Samaritan Hospital, Cincinnati, OH
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2
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Bakas JM, van Montfrans C, Moelker A, van den Bos RR, Malskat WS, Verhagen HJ, van Rijn MJE. Quality of Life After Early Clot Removal for Acute Iliofemoral Deep Vein Thrombosis. EJVES Vasc Forum 2024; 61:44-49. [PMID: 38318434 PMCID: PMC10839761 DOI: 10.1016/j.ejvsvf.2023.12.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2023] [Revised: 11/24/2023] [Accepted: 12/29/2023] [Indexed: 02/07/2024] Open
Abstract
Objective To evaluate patient reported outcome measures after early clot removal for acute deep vein thrombosis (DVT), using the Chronic Venous Disease Quality of Life Questionnaire (CIVIQ-20) and the Short Form Health Survey (SF-36). Methods Cross sectional design. Patients who underwent early clot removal between June 2012 and November 2021 were asked to complete the two questionnaires once. Lower CIVIQ-20 and higher SF-36 scores indicate better quality of life (QoL). Primary endpoints were the median scores. The one sample Wilcoxon signed rank test was used to compare SF-36 physical and mental component summary (PCS and MCS) to the normative and CIVIQ-20 to the minimum. Secondary, non-parametric independent t test or Fisher's exact test examined how age, sex, body mass index, stent placement, re-intervention, and time of questionnaire completion related to QoL. Multivariable linear regression tested whether various variables were associated with QoL. Results The response rate was 73.5% (n = 39). Median time of questionnaire completion was 1.8 years (interquartile range [IQR] 3.1) after clot removal. The median CIVIQ-20 of 29.0 (IQR 28.0) was slightly higher than the minimum value 20.0 (p < .001). The median PCS (50.5, IQR 16.6) and median MCS (50.2, IQR 14.2) did not differ from the normative of 50.0. However, wide IQRs indicated impairments for a subgroup of patients. None of the tested variables affected QoL except for the finding that re-interventions had a significantly negative impact on the SF-36 MCS (standardised β coefficient of -0.4, p = .030). Conclusion Overall patient reported outcome measures were satisfactory after early clot removal, but impaired physical and mental functioning levels were present in a subgroup of patients. Re-interventions were found to have a negative impact on mental QoL. This finding was independent of time that had passed between the procedure and questionnaire completion. This study emphasises that mental functioning deserves attention, besides the widely recognised physical consequences after invasive acute iliofemoral DVT treatment.
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Affiliation(s)
- Jay M. Bakas
- Department of Vascular and Endovascular Surgery, Erasmus Medical Centre, Rotterdam, the Netherlands
| | | | - Adriaan Moelker
- Department of Radiology and Nuclear Medicine, Erasmus Medical Centre, Rotterdam, the Netherlands
| | | | - Wendy S.J. Malskat
- Department of Dermatology, Erasmus Medical Centre, Rotterdam, the Netherlands
| | - Hence J.M. Verhagen
- Department of Vascular and Endovascular Surgery, Erasmus Medical Centre, Rotterdam, the Netherlands
| | - Marie Josee E. van Rijn
- Department of Vascular and Endovascular Surgery, Erasmus Medical Centre, Rotterdam, the Netherlands
- Department of Dermatology, Erasmus Medical Centre, Rotterdam, the Netherlands
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de Almeida ILGI, Figueiredo PHS, Silva WT, Mendonça VA, Lacerda ACR, Lima VP, Bastone ADC, Costa HS. Reliability and validity of specific quality of life assessment questionnaires related to chronic venous insufficiency: a systematic review. J Vasc Bras 2022; 21:e20210229. [PMID: 36407663 PMCID: PMC9639578 DOI: 10.1590/1677-5449.202102292] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2021] [Accepted: 08/05/2022] [Indexed: 12/23/2022] Open
Abstract
This systematic review aimed to discuss the main findings regarding the reliability and validity of health-related quality of life questionnaires for chronic venous insufficiency. Searches were performed on the MEDLINE, CINAHL, Web of Science, LILACS, and Scopus databases. The search terms used were related to "venous insufficiency", and "quality of life". The CIVIQ-20 and CIVIQ-14 instruments had adequate internal consistency and both were able to discriminate disease severity. The VEINES-QoL showed adequate internal consistency but was not able to discriminate disease severity. Most studies did not demonstrate a correlation between VEINES-QoL and the mental component of the SF-36. The AVVQ had inadequate reliability but its validity was also doubtful when compared to the SF-36. The VARIShort demonstrated good internal consistency, reproducibility, and validity, but only the original study was included. For venous leg ulcers, the CCVUQ showed adequate reliability and validity when compared to VLU-QoL.
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Affiliation(s)
| | | | - Whesley Tanor Silva
- Universidade Federal dos Vales do Jequitinhonha e Mucuri – UFVJM, Diamantina, MG, Brasil.
| | | | | | - Vanessa Pereira Lima
- Universidade Federal dos Vales do Jequitinhonha e Mucuri – UFVJM, Diamantina, MG, Brasil.
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Yamuna U, Majumdar V, Saoji AA. Effect of Yoga on homocysteine level, symptomatology and quality of life in industrial workers with Chronic Venous Insufficiency: Study protocol for a randomized controlled trial. ADVANCES IN INTEGRATIVE MEDICINE 2022. [DOI: 10.1016/j.aimed.2022.02.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
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Yildiz ÇŞ, Özlü ZK. Examınatıon of self-care agency and quality of life in individuals with chronic venous disease. JOURNAL OF VASCULAR NURSING 2021; 39:114-119. [PMID: 34865721 DOI: 10.1016/j.jvn.2021.08.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2020] [Revised: 05/07/2021] [Accepted: 08/04/2021] [Indexed: 10/20/2022]
Abstract
AIM This study aims to investigate self-care agency and quality of life (QoL) in persons with chronic venous disease of the lower extremities. METHODS This descriptive study was carried out between December 2014 and September 2016. The study population consisted of patients admitted to Erzurum Regional Training and Research Hospital Clinic of Surgical Cardiovascular Diseases and who had been diagnosed with lower extremity venous disease. The study sample comprised 312 patients who meet the inclusion criteria among this population admitted at the said dates. For data collection, the Patient Information Form, Self-Care Agency Scale, and Venous Insufficiency Epidemiological and Economic Study - Quality of Life/Symptoms Scale (VEINES-QOL/SYM) were used. The data were evaluated using percentage distribution, means, analysis of variance, post-hoc test, t-test, Mann-Whitney U-test and Kruskal-Wallis test. RESULTS The mean Self-Care Agency Scale score of the patients with lower extremity venous disease was 102.33±18.20, and their mean VEINES-QOL/Sym score was 74.95±12.86, indicating a moderate level. CONCLUSION As a result, this study found the factors that significantly affected mean Self-Care Agency scores and mean QoL scores of the patients in terms of their level of education, employment status, BMI, smoking habits, and conditions about chronic diseases. Positive correlation was found between mean Self-Care Agency scores and QoL scores of the patients.
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Affiliation(s)
| | - Zeynep Karaman Özlü
- Department of Surgical Nursing, Faculty of Nursing, Anesthesiology Clinical Research Office, Atatürk University, Erzurum, Turkey.
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Hicks CW, Vavra AK, Goldsborough E, Rebuffatti M, Almeida J, Duwayri YM, Haurani M, Ross CB, Shah SK, Shireman PK, Smolock CJ, Yi J, Woo K. Current status of patient-reported outcome measures in vascular surgery. J Vasc Surg 2021; 74:1693-1706.e1. [PMID: 34688398 PMCID: PMC9834908 DOI: 10.1016/j.jvs.2021.05.038] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2021] [Accepted: 05/26/2021] [Indexed: 01/14/2023]
Abstract
A previously published review focused on generic and disease-specific patient-reported outcome measures (PROMs) relevant to vascular surgery but limited to arterial conditions. The objective of this project was to identify all available PROMs relevant to diseases treated by vascular surgeons and to evaluate vascular surgeon perceptions, barriers to widespread implementation, and concerns regarding PROMs. We provide an overview of what a PROM is and how they are developed, and summarize currently available PROMs specific to vascular surgeons. We also report results from a survey of 78 Society for Vascular Surgery members serving on committees within the Policy and Advocacy Council addressing the barriers and facilitators to using PROMs in clinical practice. Finally, we report the qualitative results of two focus groups conducted to assess granular perceptions of PROMS and preparedness of vascular surgeons for widespread implementation of PROMs. These focus groups identified a lack of awareness of existing PROMs, knowledge of how PROMs are developed and validated, and clarity around how PROMs should be used by the clinician as main subthemes for barriers to PROM implementation in clinical practice.
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Affiliation(s)
- Caitlin W Hicks
- Division of Vascular Surgery and Endovascular Therapy, Department of Surgery, Johns Hopkins University School of Medicine, Baltimore, Md
| | - Ashley K Vavra
- Division of Vascular Surgery, Department of Surgery, Northwestern Feinberg School of Medicine, Chicago, Ill
| | | | - Michelle Rebuffatti
- Division of Vascular Surgery, Department of Surgery, David Geffen School of Medicine at University of California Los Angeles, Los Angeles, Calif
| | - Jose Almeida
- Miami Vein and Division of Vascular and Endovascular Surgery, University of Miami Miller School of Medicine, Miami, Fl
| | - Yazan M Duwayri
- Division of Vascular Surgery and Endovascular Therapy, Emory University, Atlanta, Ga
| | - Mounir Haurani
- Division of Vascular Diseases and Surgery, The Ohio State University Wexner Medical Center, Columbus, Ohio
| | - Charles B Ross
- Vascular Center of Excellence, Piedmont Heart and Vascular Institute, Piedmont Healthcare, Atlanta, Ga
| | - Samir K Shah
- Division of Vascular Surgery, University of Florida, Gainesville, Fl
| | - Paula K Shireman
- Division of Vascular and Endovascular Surgery, Long School of Medicine, University of Texas Health San Antonio, Tex; Department of Surgery, South Texas Veterans Health Care System, San Antonio, Tex
| | - Christopher J Smolock
- Department of Vascular Surgery, Sydell and Arnold Miller Family Heart, Vascular, and Thoracic Institute, The Cleveland Clinic, Cleveland, Ohio
| | - Jeniann Yi
- Division of Vascular Surgery and Endovascular Therapy, Department of Surgery, University of Colorado, Aurora, Colo
| | - Karen Woo
- Division of Vascular Surgery, Department of Surgery, David Geffen School of Medicine at University of California Los Angeles, Los Angeles, Calif.
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Devoogdt N, Partsch H, Heroes AK, De Vrieze T, De Groef A, Geraerts I, Damstra RJ, Hafner J, Keeley V, Becker A, Mosti G, Brouwer E, Thomis S. The ICC Compression Questionnaire: A Comprehensive Tool to Evaluate Compression Materials or Devices Applied in Subjects with Lymphedema or Chronic Venous Disease. Lymphat Res Biol 2021; 20:191-202. [PMID: 33781091 PMCID: PMC9081015 DOI: 10.1089/lrb.2020.0125] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Background: Compression therapy is an important part of the treatment of patients with lymphedema or chronic venous disease. However, there is no validated questionnaire evaluating the effect of compression and its acceptance by the patient. Therefore, the aims of this study were to construct a questionnaire evaluating the effect of compression and its acceptance by the patient, that is, the Dutch ICC Compression Questionnaire (ICC-CQ), to investigate its reliability and validity, and to translate it into English. Methods and Results: Eleven experts in applying compression and 51 Dutch patients with experience of using compression were involved in the construction process. One part of the ICC-CQ has to be completed by the patient and evaluates seven domains. The other part has to be completed by the health care provider and comprises three domains. Reliability and validity of the final version was investigated in a new group of 79 Dutch-speaking patients with lymphedema or chronic venous disease, wearing compression garments (N = 52) or bandages (N = 27). Except for one domain, the Intraclass Correlation Coefficients for test–rest/interrater reliability ranged from 0.55 to 0.93. Cronbach's alpha for internal consistency ranged from 0.71 to 0.97. Eighty-nine percent of the patients fully understood the questionnaire indicating good face validity, and 87% found it complete indicating good content validity. Construct validity was considered good since 10 out of 11 hypotheses were accepted. Conclusion: The ICC-CQ is the first reliable and valid questionnaire evaluating different kinds of compression and the experience by patients with lymphedema or chronic venous disease.
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Affiliation(s)
- Nele Devoogdt
- Department of Rehabilitation Sciences, KU Leuven-University of Leuven, Leuven, Belgium.,Department of Physical Medicine and Rehabilitation, University Hospitals Leuven, Leuven, Belgium.,Department of Vascular Surgery, Centre for Lymphoedema, University Hospitals of Leuven, Leuven, Belgium
| | - Hugo Partsch
- Department of Dermatology, Medical University of Vienna, Vienna, Austria
| | - An-Kathleen Heroes
- Department of Rehabilitation Sciences, KU Leuven-University of Leuven, Leuven, Belgium.,Department of Physical Medicine and Rehabilitation, University Hospitals Leuven, Leuven, Belgium.,Department of Vascular Surgery, Centre for Lymphoedema, University Hospitals of Leuven, Leuven, Belgium
| | - Tessa De Vrieze
- Department of Rehabilitation Sciences, KU Leuven-University of Leuven, Leuven, Belgium.,Department of Physical Medicine and Rehabilitation, University Hospitals Leuven, Leuven, Belgium
| | - An De Groef
- Department of Rehabilitation Sciences, KU Leuven-University of Leuven, Leuven, Belgium.,Department of Physical Medicine and Rehabilitation, University Hospitals Leuven, Leuven, Belgium
| | - Inge Geraerts
- Department of Rehabilitation Sciences, KU Leuven-University of Leuven, Leuven, Belgium.,Department of Physical Medicine and Rehabilitation, University Hospitals Leuven, Leuven, Belgium
| | - Robert J Damstra
- Department of Dermatology, Phlebology and Lympho-vascular Medicine, Expert Center for Lympho-Vascular Medicine, Nij Smellinghe Hospital, Drachten, the Netherlands
| | - Juerg Hafner
- Division of In-patient Dermatology, Dermatosurgery and Phlebology, Department of Dermatology, University Hospital of Zurich, Zurich, Switzerland
| | - Vaughan Keeley
- Department of Palliative Medicine, Lymphoedema Clinic, University Hospitals of Derby and Burton NHS Foundation Trust, Derby, United Kingdom.,Medical School, University of Nottingham, Nottingham, United Kingdom
| | | | - Giovanni Mosti
- Department of Angiology, Barbantini Clinic, Lucca, Italy
| | - Els Brouwer
- Department of Sales Phlebology/Lymphology, Medi International, Bayreuth, Germany
| | - Sarah Thomis
- Department of Vascular Surgery, Centre for Lymphoedema, University Hospitals of Leuven, Leuven, Belgium
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Serra R, Ielapi N, Bitonti A, Candido S, Fregola S, Gallo A, Loria A, Muraca L, Raimondo L, Velcean L, Guadagna S, Gallelli L. Efficacy of a Low-Dose Diosmin Therapy on Improving Symptoms and Quality of Life in Patients with Chronic Venous Disease: Randomized, Double-Blind, Placebo-Controlled Trial. Nutrients 2021; 13:nu13030999. [PMID: 33808784 PMCID: PMC8003468 DOI: 10.3390/nu13030999] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2021] [Revised: 03/14/2021] [Accepted: 03/16/2021] [Indexed: 11/20/2022] Open
Abstract
Chronic Venous Disease (CVD) is a common medical condition affecting up to 80% of the general population. Clinical manifestations can range from mild to more severe signs and symptoms that contribute to the impairment of the quality of life (QoL) of affected patients. Among treatment options, venoactive drugs such as diosmin are widely used in the symptomatic treatment in all clinical stages. The aim of this study is to determine the effectiveness of a new formulated diosmin in relieving symptoms and improving QoL in patients suffering from CVD. In this randomized, double-blind, placebo-controlled, multicenter clinical study, CVD patients with a Clinical-Etiology-Anatomy-Pathophysiology (CEAP) classification system between C2 and C4 were randomized to receive a bioavailable diosmin (as μsmin® Plus) 450 mg tablet once daily or a placebo for 8 weeks. Clinical symptoms and QoL were monitored using the measurement of leg circumference, visual analogue scale (VAS) for pain, Global Index Score (GIS) and Venous Clinical Severity Score (VCSS). A total of 72 subjects completed the study. From week 4, leg edema was significantly decreased in the active group (p < 0.001). An improvement in the VAS score was observed in the active group compared to placebo at the end of treatment (p < 0.05). GIS and VCSS scores were significantly improved in the active group at week 8 (p < 0.001). No treatment related-side effects were recorded. The results of this study showed that the administration of low-dose μsmin® Plus was safe and effective in relieving symptoms and improving QoL in subjects with CVD.
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Affiliation(s)
- Raffaele Serra
- Interuniversity Center of Phlebolymphology (CIFL), International Research and Educational Program in Clinical and Experimental Biotechnology, University Magna Graecia of Catanzaro, Viale Europa, 88100 Catanzaro, Italy; (N.I.); (S.F.); (A.G.)
- Department of Medical and Surgical Sciences, University of Catanzaro, 88100 Catanzaro, Italy
- Correspondence: ; Tel.: +39-0961-364-7380
| | - Nicola Ielapi
- Interuniversity Center of Phlebolymphology (CIFL), International Research and Educational Program in Clinical and Experimental Biotechnology, University Magna Graecia of Catanzaro, Viale Europa, 88100 Catanzaro, Italy; (N.I.); (S.F.); (A.G.)
- Department of Public Health and Infectious Disease “Sapienza”, University of Rome, 00153 Rome, Italy
| | | | - Stefano Candido
- Intensive Care Unit, Pugliese Ciaccio Hospital of Catanzaro, 88100 Catanzaro, Italy;
| | - Salvatore Fregola
- Interuniversity Center of Phlebolymphology (CIFL), International Research and Educational Program in Clinical and Experimental Biotechnology, University Magna Graecia of Catanzaro, Viale Europa, 88100 Catanzaro, Italy; (N.I.); (S.F.); (A.G.)
- EthosLab SRL, 80100 Catanzaro, Italy
| | - Alessandro Gallo
- Interuniversity Center of Phlebolymphology (CIFL), International Research and Educational Program in Clinical and Experimental Biotechnology, University Magna Graecia of Catanzaro, Viale Europa, 88100 Catanzaro, Italy; (N.I.); (S.F.); (A.G.)
- EthosLab SRL, 80100 Catanzaro, Italy
| | - Antonio Loria
- Thoracic Surgery Unit, Annunziata Hospital of Cosenza, 87100 Cosenza, Italy;
| | - Lucia Muraca
- Department of General Medicine, Health Agency of Catanzaro, 88100 Catanzaro, Italy;
| | - Luca Raimondo
- Department Emergency, Pugliese Ciaccio Hospital of Catanzaro, 88100 Catanzaro, Italy;
| | | | - Simone Guadagna
- Opera CRO, a Tigermed Company 10 Cozia St., 300209 Timisoara, Romania;
| | - Luca Gallelli
- Department of Health Sciences, University of Catanzaro, 88100 Catanzaro, Italy;
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Kim TI, Zhang Y, Guzman RJ, Ochoa Chaar CI. Trends of hospital-based surgery for varicose veins in the elderly. J Vasc Surg Venous Lymphat Disord 2020; 9:146-153.e2. [PMID: 32360785 DOI: 10.1016/j.jvsv.2020.04.016] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2020] [Accepted: 04/14/2020] [Indexed: 10/24/2022]
Abstract
OBJECTIVE The treatment of varicose veins has shifted during the past decade to the office setting. Although recent studies have demonstrated the safety of venous ablation for the elderly in the office, a paucity of data is available on the contemporary outcomes of surgery for varicose veins in the operating room. The present study analyzed the trends and outcomes of varicose vein surgery in the elderly using a large national database. METHODS The American College of Surgeons National Surgical Quality Initiative Program database (2005-2017) was reviewed. Patients undergoing vein ablation or open surgery (ie, high ligation, stripping, phlebectomy) for venous insufficiency were identified using Current Procedural Terminology codes and the principal diagnosis. The patients were stratified into 3 age groups <65, 65 to 79, and ≥80 years. The preoperative and operative characteristics and outcomes were compared. Logistic regression was performed to identify the risk factors associated with any adverse event, defined as any morbidity or mortality. RESULTS A total of 48,615 venous surgeries had been performed, with 9177 (18.9%) performed in patients aged 65 to 79 years and 1180 (2.4%) in patients aged ≥80 years. The proportion of patients in the 65- to 79-age group had steadily increased during the study period from 12.8% in 2005 to 22.3% in 2017 (P < .01). The proportion of patients aged ≥80 years had remained stable (P = .23). Patients aged ≥80 years had significantly more comorbidities, were more likely to have undergone vein ablation alone (P < .01), were more likely to be treated for ulceration (P < .01) and less likely to have received general anesthesia (P < .01) compared with the younger age groups. Overall morbidity increased significantly with increased age group (P < .01) but remained low (2.5%). Mortality was very low (0.02%) and not significantly different among the age groups. The factors independently associated with any adverse event were dialysis (odds ratio [OR], 7.12; 95% confidence interval [CI], 3.3-15.6), American Society of Anesthesiologists classification per unit increase (OR, 1.2; 95% CI, 1.02-1.3), use of general anesthesia (OR, 1.2; 95% CI, 1.0-1.4), and combined venous ablation and open procedures compared with venous ablation alone (OR, 1.3; 95% CI, 1.0-1.5). However, age was not associated with adverse events (OR, 1.0; 95% CI, 1.0-1.0). CONCLUSIONS Varicose vein surgery is safe for all age groups and is being increasingly offered to the elderly. High-risk patients might benefit from the avoidance of hybrid procedures and general anesthesia when possible to minimize the occurrence of adverse events. Conservative measures should be exhausted before surgery for the dialysis population.
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Affiliation(s)
- Tanner I Kim
- Division of Vascular Surgery, Yale School of Medicine, New Haven, Conn
| | - Yawei Zhang
- Department of Surgery, Yale School of Medicine, New Haven, Conn; Department of Environmental Health Sciences, Yale School of Public Health, New Haven, Conn
| | - Raul J Guzman
- Division of Vascular Surgery, Yale School of Medicine, New Haven, Conn
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Mallick S, Sarkar T, Gayen T, Naskar B, Datta A, Sarkar S. Correlation of Venous Clinical Severity Score and Venous Disability Score with Dermatology Life Quality Index in Chronic Venous Insufficiency. Indian J Dermatol 2020; 65:489-494. [PMID: 33487704 PMCID: PMC7810071 DOI: 10.4103/ijd.ijd_485_20] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Background Chronic venous insufficiency (CVI) is an underestimated public health problem involving the lower limbs. It exerts a significant impact on patient's quality of life (QoL). The severity of the disease was measured by venous clinical severity score (VCSS) and venous disability score (VDS). Aims The aim of the study was to evaluate VCSS, VDS, and dermatology life quality index (DLQI) among the patients of CVI and to evaluate the correlation among DLQI with VCSS, VDS, and leg ulcer. Materials and Methods In this institution-based cross-sectional study, clinically and sonographically confirmed cases of CVI were included. Clinical severity of the disease and disability were assessed by using VCSS and VDS, respectively. QoL was assessed by a validated DLQI questionnaire. Correlation between DLQI with VCSS and VDS was analyzed. The association between DLQI with different characteristics of the ulcer was also evaluated. Results Mean VCSS, VDS, and DLQI in the study population were 11 ± 4.96, 1.47 ± 0.67, and 6.94 ± 3.87, respectively. Both VCSS and VDS had a strong positive correlation with DLQI. The number of active ulcers, size of the ulcer, and duration of the ulcer had a strong positive correlation, whereas the age of onset of the disease had a negative correlation and duration of the disease had poor correlation with DLQI. Pain (P = 0.03) and edema (P = 0.04) had significant association with VDS. Conclusion VCSS and VDS are important tools for measuring severity and disability in CVI, respectively. CVI had a strong impact on patients QoL more than it was thought hitherto.
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Affiliation(s)
- Subhadeep Mallick
- Form the Department of Dermatology, IPGME & R, Kolkata, West Bengal, India
| | - Tanusree Sarkar
- Department of Dermatology, Burwdan Medical College, Purba Bardhaman, West Bengal, India
| | - Tirthankar Gayen
- Form the Department of Dermatology, IPGME & R, Kolkata, West Bengal, India
| | - Biswanath Naskar
- Form the Department of Dermatology, IPGME & R, Kolkata, West Bengal, India
| | - Adrija Datta
- Form the Department of Dermatology, IPGME & R, Kolkata, West Bengal, India
| | - Somenath Sarkar
- Department of Dermatology, B. S Medical College, Bankura, West Bengal, India
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Shiferson A, Aboian E, Shih M, Pu Q, Jacob T, Rhee RY. Iliac venous stenting for outflow obstruction does not significantly change the quality of life of patients with severe chronic venous insufficiency. JRSM Cardiovasc Dis 2019; 8:2048004019890968. [PMID: 31839939 PMCID: PMC6893555 DOI: 10.1177/2048004019890968] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2019] [Revised: 09/24/2019] [Accepted: 11/01/2019] [Indexed: 01/01/2023] Open
Abstract
Purpose Percutaneous endovenous iliac stenting has emerged as a new modality in the treatment of advanced chronic venous insufficiency with outflow obstruction. However, the effect of this intervention on the quality of life remains unclear. We examined the impact of iliac venous stenting for outflow obstruction as compared to conservative medical management on the quality of life in severe chronic venous insufficiency patients. Methods Medical records of all patients with CEAP class 5 and 6 disease (N = 172) who underwent ilio-caval venography with intravascular ultrasonography (IVUS) at a single institution over a seven-year period, were reviewed for this case-control study. Quality of life evaluation was performed utilizing the Chronic Venous Insufficiency Quality of Life Questionnaire (CIVIQ-20) one year after the index procedure. Results Of the 172 severe chronic venous insufficiency patients, 109 were stented and 63 patients were treated medically based on their venography and IVUS results. The indication for stenting was confirmation of IVUS determined surface area or diameter outflow stenosis of greater than 50% within the common or external iliac venous systems. Eighty patients (47%) responded with completed CIVIQ-20 questionnaires for analysis. Of these, 47 were from the stented group and 33 from the non-stented group. At least moderate persistent pain or discomfort post-procedure was reported by 20 (43%) stented group patients and 19 (58%) non-stented group patients. Scores for all the other criteria in the CIVIQ-20 were similar between the groups. The mean total CIVIQ-20 score was 45.23 and 47.13, respectively, in stented group and non-stented group patients. (p = 0.678). Conclusion There was no significant difference in the quality of life reported by CEAP 5 and 6 patients who underwent iliac venous stenting versus those who were treated medically for presumed iliac outflow obstruction. Prospective studies are needed to determine the true value of iliac venous stenting based on IVUS criteria in the management advanced chronic venous insufficiency.
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Affiliation(s)
| | | | | | | | | | - Robert Y Rhee
- Robert Y Rhee, 4802 Tenth Ave, Brooklyn, NY
11219, USA.
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12
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Outcome measurement instruments for peripheral vascular malformations and an assessment of the measurement properties: a systematic review. Qual Life Res 2019; 29:1-17. [PMID: 31549367 PMCID: PMC6962285 DOI: 10.1007/s11136-019-02301-x] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/09/2019] [Indexed: 11/06/2022]
Abstract
Purpose The Outcome measures for vascular malformation (OVAMA) group reached consensus on the core outcome domains for the core outcome set (COS) for peripheral vascular malformations (venous, lymphatic and arteriovenous malformations). However, it is unclear which instruments should be used to measure these domains. Therefore, our aims were to identify all outcome measurement instruments available for vascular malformations, and to evaluate their measurement properties. Methods With the first literature search, we identified outcomes and instruments previously used in prospective studies on vascular malformations. A second search yielded studies on measurement properties of patient- and physician-reported instruments that were either developed for vascular malformations, or used in prospective studies. If the latter instruments were not specifically validated for vascular malformations, we performed a third search for studies on measurement properties in clinically similar diseases (vascular or lymphatic diseases and benign tumors). We assessed the methodological quality of these studies following the Consensus-based Standards for the selection of health Measurement Instruments methodology, and evaluated the quality of the measurement properties. Results The first search yielded 27 studies, none using disease-specific instruments. The second and third search included 22 development and/or validation studies, concerning six instruments. Only the Lymphatic Malformation Function Instrument was developed specifically for vascular malformations. Other instruments were generic QoL instruments developed and/or partly validated for clinically similar diseases. Conclusions Additional research on measurement properties is needed to assess which instruments may be included in the COS. This review informs the instrument selection and/or the development of new instruments. Systematic review registration PROSPERO, 42017056242. Electronic supplementary material The online version of this article (10.1007/s11136-019-02301-x) contains supplementary material, which is available to authorized users.
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13
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[Health related quality of life in chronic venous disease: Systematic literature review]. JOURNAL DE MEDECINE VASCULAIRE 2017; 42:290-300. [PMID: 28964388 DOI: 10.1016/j.jdmv.2017.07.001] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/16/2017] [Accepted: 06/21/2017] [Indexed: 11/20/2022]
Abstract
OBJECTIVE Excepting life-threatening situations, improvement of health-related quality-of-life is the main therapeutic goal in chronic disease. The purpose of this review was to study the different ways of assessing Quality-of-Life (QoL) in patients with chronic venous disease (CVD) (CEAP classes C3 to C6). METHODS A literature search was conducted with three databases: MEDLINE, WEB OF SCIENCE and COCHRANE LIBRARY in order to identify articles with the PRISMA reporting guidelines. Then we compared psychometric performance of general and specific QoL questionnaires for a French population with CVD. RESULTS A total of 481 articles were identified, from which 25 were selected and analyzed. CIVIQ 20, CIVIQ 14 and VEINES Qol/sym are the specific health related QoL scales validated for a French population with CVD. VEINES Qol/sym was specifically validated in patients with leg ulcer or post-thrombotic syndrome (PTS). CIVIQ 14 is a CIVIQ 20 optimized to be used more widely in international studies and validated in milder forms of the CVD spectrum (C0 à C4). The general health related QoL scales are SF-36, SF-12 and EQ-5D. EQ-5D is simple and provides health state utility values. CONCLUSION CIVIQ 14 is a simple specific health-related QoL scale for less severe CVD. VEINES Qol/sym was developed for severe CVD and PTS but clinically relevant point scales remain to be assessed. EQ-5D is a generic scale to be preferred to assess economic impact based on a cost-utility analysis.
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14
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Sinožić T, Baždarić K, Šverko D, Ružić A, Katić M. Validation of the Croatian version of CIVIQ quality of life questionnaire in patients with chronic venous disorders. Croat Med J 2017; 58:292-299. [PMID: 28857522 PMCID: PMC5577646 DOI: 10.3325/cmj.2017.58.292] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
AIM To test the psychometric properties of the Croatian version of the Chronic Venous Insufficiency Quality of Life (CIVIQ) Questionnaire and to assess the quality of life in patients with chronic venous disorders of all stages. METHODS This cross-sectional study performed between 2014 and 2015 in a private family practice assessed the factorial validity, cross-sectional validity, and reliability of the Croatian CIVIQ 20-item questionnaire completed by 428 adult patients (78% women) with chronic venous disorders classified according to the Clinical-Etiologic-Anatomic-Pathophysiologic (CEAP) C classification as stages C1-C6. RESULTS Median patient age was 52 years (5th-95th percentile, 30-77). The distribution according to the clinical stages of chronic venous disorders was as follows: C1 (n=78, 18%), C2 (n=192, 45%), C3 (n=53, 12%), C4 (n=44, 10%), C5 (n=13, 3%), and C6 (n=48, 11%). The CIVIQ-20 factorial structure was unstable, and six items were excluded from the analysis to test the psychometric properties of the shortened version (CIVIQ-14). CIVIQ-14 has three dimensions (physical, psychological, and pain). Internal consistency reliability is high for the entire CIVIQ-14 (Cronbach α=0.92) and for all CIVIQ-14 dimensions (α≥0.80). The median quality of life significantly decreased with higher CEAP C stages as follows: C1/C2 (86, 50-100); C3/C4 (75, 36-98); C5/C6 (67, 31-95) (P<0.001). Post-hoc analysis showed a higher quality of life in C1/C2 than in other groups (P<0.001). CONCLUSION The shortened CIVIQ-14 version is useful for assessing the quality of life in patients with chronic venous disorders in everyday clinical practice. To achieve a stable validated instrument, we recommend a cross-cultural validation of items that have loadings on more than one factor.
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Affiliation(s)
- Tamara Sinožić
- Tamara Sinožić, Barba Rike 5a, 51417 Mošćenička Draga, Croatia,
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15
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Özdemir ÖC, Tonga E, Tekindal A, Bakar Y. Cross-cultural adaptation, reliability and validity of the Turkish version of the Chronic Venous Disease Quality of Life Questionnaire (CIVIQ-20). SPRINGERPLUS 2016; 5:381. [PMID: 27066388 PMCID: PMC4814390 DOI: 10.1186/s40064-016-2039-2] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/01/2016] [Accepted: 03/21/2016] [Indexed: 11/30/2022]
Abstract
Background Chronic venous disease (CVD) is a well-defined and known disorder which impact on related-health quality of life (QoL). The Chronic Venous Insufficiency Quality of Life Questionnaire (CIVIQ) is a disease-specific instrument to measure the impact of chronic venous insufficiency on patients’ lives. The purpose of this study is to cross-culturally adapted the Chronic Venous Disease Quality of Life Questionnaire (CIVIQ-20) for Turkish-speaking patients and determine the psychometric properties of reliability, validity and factor structure in a Turkish population with CVD. Methods The CIVIQ-20 was translated into Turkish and culturally adapted using a double forward–backward protocol according to established guidelines. Individuals (n = 140) with venous diseases completed the CIVIQ-20, Venous Insufficiency Epidemiological and Economic Study (VEINES-QoL/Sym) and Nottingham Health Profile (NHP) questionnaires at baseline and 1 month later. Results Cronbach’s α value was 0.93. Test–retest reliability was determined as moderate (ICC2:1 = 0.80). There was a significant correlation between CIVIQ-Tk and Nottingham and VEINES-QoL total scores (Nottingham 1: r = 0.770; p < 0.00, Nottingham 2: r = 0.7000; p < 0) (VEINES-QoL: r = −0.574; p < 0.00, VEINES-QoL 2: −0.592, p: 0.00). The measurement error were calculated from SEM and MDC90. The SEM was 2.63 and the MDC90 was 5.79. Exploratory factor analysis demonstrated a three factor structure that explained 56.32 % of total variance. Conclusion The CVIQ-20 Turkish is a reliable and valid instrument for Turkish speaking patients with chronic venous insufficiency.
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Affiliation(s)
- Özlem Cinar Özdemir
- The Institute of Health Sciences, School of Physical Therapy and Rehabilitation, Abant İzzet Baysal University, 14130 Bolu, Turkey
| | - Eda Tonga
- The Faculty of Health Sciences, Marmara University, Istanbul, Turkey
| | - Agah Tekindal
- Department of Biostatistics, Izmir University, Izmir, Turkey
| | - Yesim Bakar
- The Institute of Health Sciences, School of Physical Therapy and Rehabilitation, Abant İzzet Baysal University, 14130 Bolu, Turkey
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Quality of life in patients with chronic venous disease in Turkey: influence of different treatment modalities at 6-month follow-up. Qual Life Res 2015; 25:1527-36. [DOI: 10.1007/s11136-015-1180-7] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/05/2015] [Indexed: 11/25/2022]
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17
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Wittens C, Davies AH, Bækgaard N, Broholm R, Cavezzi A, Chastanet S, de Wolf M, Eggen C, Giannoukas A, Gohel M, Kakkos S, Lawson J, Noppeney T, Onida S, Pittaluga P, Thomis S, Toonder I, Vuylsteke M, Kolh P, de Borst GJ, Chakfé N, Debus S, Hinchliffe R, Koncar I, Lindholt J, de Ceniga MV, Vermassen F, Verzini F, De Maeseneer MG, Blomgren L, Hartung O, Kalodiki E, Korten E, Lugli M, Naylor R, Nicolini P, Rosales A. Editor's Choice - Management of Chronic Venous Disease: Clinical Practice Guidelines of the European Society for Vascular Surgery (ESVS). Eur J Vasc Endovasc Surg 2015; 49:678-737. [PMID: 25920631 DOI: 10.1016/j.ejvs.2015.02.007] [Citation(s) in RCA: 501] [Impact Index Per Article: 55.7] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
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18
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Health-related quality-of-life scales specific for chronic venous disorders of the lower limbs. J Vasc Surg Venous Lymphat Disord 2014; 3:219-27.e1-3. [PMID: 26993844 DOI: 10.1016/j.jvsv.2014.08.005] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2014] [Accepted: 08/23/2014] [Indexed: 11/20/2022]
Abstract
OBJECTIVE We conducted a systematic review of the literature about quality-of-life (QOL) scales in chronic venous disorders (CVDs) comprising leg ulcers to identify the respective advantages and deficits of existing tools. METHODS A research protocol was built following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement and the PICO (population, intervention, comparator, and outcome) criteria. The following databases were screened: MEDLINE, SCOPUS, EMBASE, CINHAL, and Cochrane. Psychometric and linguistic validation studies in English were included, as were clinical trials that have used QOL scales in CVDs. The data search was up to date as of October 31, 2013. RESULTS Inclusion criteria were met in 103 of the 511 recorded references, in which 10 scales were identified: two for the full spectrum of CVDs, three for patients with CVDs without leg ulceration, four for leg ulcers, and one exclusively for patients with varicose veins. Among them, the ChronIc Venous Insufficiency Questionnaire (CIVIQ), Aberdeen Varicose Vein Questionnaire (AVVQ), and VEnous INsufficiency Epidemiological and Economic Study on Quality of Life (VEINES-QOL) scales were the most highly used according to the literature, and CIVIQ and VEINES-QOL were the most extensively validated scales and had the longest iterative validation process. A total of 31 psychometric and linguistic validations of the 10 QOL scales and 66 clinical trials that have used these scales were identified. The validation studies were based on acceptability, content validity, construct validity, reliability, and responsiveness. The clinical trials were composed of 25 randomized controlled trials and 41 observational studies. Only the randomized controlled trials are considered in the present article. CONCLUSIONS This systematic review confirmed that CVDs have an important effect on QOL. The majority of the studies addressed the application rather than the validation of the 10 identified scales. Two scales, CIVIQ and VEINES-QOL, emerged as being thoroughly validated instruments, although factorial stability was not demonstrated for the VEINES-QOL. Our findings confirm a paucity of validation studies.
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Catarinella FS, Nieman FHM, Wittens CHA. An overview of the most commonly used venous quality of life and clinical outcome measurements. J Vasc Surg Venous Lymphat Disord 2014; 3:333-40. [PMID: 26992316 DOI: 10.1016/j.jvsv.2014.09.003] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2014] [Accepted: 09/08/2014] [Indexed: 01/22/2023]
Abstract
BACKGROUND Modern medicine should no longer rely solely on technical success to evaluate treatments. The treatment of venous disease has seen many new developments, insights, and treatment modalities. Combining clinical scores with quality of life (QoL) outcome measurements is becoming the new norm for evaluation of treatments. Many different outcome assessment instruments are currently available, indicating a lack of consensus. METHODS We set out to find the most reliable and comprehensive scoring instrument for clinical and QoL measurement in venous disease. In this review, we focus on the eight most widely used instruments. For clinical assessment, these are the Clinical, Etiologic, Anatomic, and Pathologic (CEAP) classification, Villalta scale, and Venous Clinical Severity Score (VCSS); for generic QoL, the 36-Item Short Form Health Survey (SF-36) and EQ-5D questionnaires; and for disease-specific QoL, the Aberdeen Varicose Vein Questionnaire (AVVQ), Chronic Venous Insufficiency Questionnaire (CIVIQ), and VEnous INsufficiency Epidemiological and Economic Study on Quality of Life/Symptoms (VEINES-QOL/Sym) questionnaire. Each instrument is reviewed. CONCLUSIONS For the accurate evaluation of treatment outcomes, socioeconomic, QoL, and clinical aspects must be assessed. None of the available disease-specific instruments is suited to use in uniform outcome measurement for the whole spectrum of venous disease. A new combined QoL and clinical instrument is needed to validly assess and compare the outcomes of venous treatments. The VEINES-QOL/Sym is currently the most valid instrument to assess disease-specific QoL.
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Affiliation(s)
- Fabio S Catarinella
- Department of Venous Surgery, Maastricht University Medical Centre, Maastricht, The Netherlands.
| | - Fred H M Nieman
- Department of Clinical Epidemiology and Medical Technology Assessment, Maastricht University Medical Centre, Maastricht, The Netherlands
| | - Cees H A Wittens
- Department of Venous Surgery, Maastricht University Medical Centre, Maastricht, The Netherlands; Department of Vascular Surgery, Universitäts Klinikum, Aachen, Germany
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20
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Radak DJ, Vlajinac HD, Marinković JM, Maksimović MŽ, Maksimović ŽV. Quality of life in chronic venous disease patients measured by short Chronic Venous Disease Quality of Life Questionnaire (CIVIQ–14) in Serbia. J Vasc Surg 2013; 58:1006-13. [DOI: 10.1016/j.jvs.2011.08.003] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2011] [Revised: 08/09/2011] [Accepted: 08/09/2011] [Indexed: 11/25/2022]
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21
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Molski P, Kruczyński J, Molski A, Molski S. Manual lymphatic drainage improves the quality of life in patients with chronic venous disease: a randomized controlled trial. Arch Med Sci 2013; 9:452-8. [PMID: 23847666 PMCID: PMC3701980 DOI: 10.5114/aoms.2013.35343] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/07/2011] [Revised: 08/22/2011] [Accepted: 10/02/2011] [Indexed: 11/30/2022] Open
Abstract
INTRODUCTION Manual lymphatic drainage (MLD) is an adjunctive method of chronic venous disease (CVD) therapy. Evaluation of the change at the clinical stage, hemodynamic parameters and quality of life (QoL) following venous system surgery in CVD patients undergoing MLD preoperatively are the most interesting aspects of the study. MATERIAL AND METHODS The CVD patients qualified for elective surgery of the venous system were randomly divided into 2 groups: the MLD group (n = 38) and the control group (n = 32). In the preoperative period, the MLD group underwent a series of MLD through a period of 2 weeks. The control group did not undergo MLD preoperatively. Both groups were evaluated for CVD staging on the day of qualification for surgery and between 25 and 30 days post-operatively. Additionally, the MLD group was evaluated after the series of MLD. The CVD staging was evaluated in both groups with a QoL questionnaire (CIVIQ), CEAP classification, foot volumetry (FV) and venous refilling time (VRT). RESULTS PARAMETER VALUES OBTAINED IN THE MLD GROUP (BEFORE TREATMENT/AFTER MLD/AFTER SURGERY): CEAP 2.23/2.15/2.10, VRT 15/13/15.6, FV 3625/3472/3418, CIVIQ-complaints: 54.4/43.8/38.2 and CIVIQ-meaning: 57.3/49.3/43.1. Parameter values obtained in control group (before surgery/after surgery): CEAP 2.4/2.12, VRT 13/14.9, FV 3581/3559, CIVIQ-complaints: 51.9/38.7 and CIVIQ-meaning: 53.7/40.6. The CVD patients statistically improved in CEAP staging, FV and QoL in both groups (p < 0.05). CONCLUSIONS The MLD alone significantly reduced FV in patients with CVD, also improving their QoL. The MLD applied in CVD patients at the preoperative stage results in better surgical outcome, which is demonstrated by reduced disease progression, FV reduction and improvement in the QoL.
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Affiliation(s)
- Pawel Molski
- Department of Physiotherapy, Eskulap Health Centre, Bydgoszcz, Poland
- Department of General Orthopaedics, Musculoskeletal Oncology and Trauma Surgery, Poznan University of Medical Sciences, Poznan, Poland
| | - Jacek Kruczyński
- Department of General Orthopaedics, Musculoskeletal Oncology and Trauma Surgery, Poznan University of Medical Sciences, Poznan, Poland
| | - Andrzej Molski
- Department of Vascular Surgery, Eskulap Health Centre, Bydgoszcz, Poland
| | - Stanislaw Molski
- Department of Vascular Surgery, Eskulap Health Centre, Bydgoszcz, Poland
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22
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Biemans AAM, Kockaert M, Akkersdijk GP, van den Bos RR, de Maeseneer MGR, Cuypers P, Stijnen T, Neumann MHA, Nijsten T. Comparing endovenous laser ablation, foam sclerotherapy, and conventional surgery for great saphenous varicose veins. J Vasc Surg 2013; 58:727-34.e1. [PMID: 23769603 DOI: 10.1016/j.jvs.2012.12.074] [Citation(s) in RCA: 106] [Impact Index Per Article: 9.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2012] [Revised: 12/17/2012] [Accepted: 12/22/2012] [Indexed: 11/16/2022]
Abstract
BACKGROUND Many case series have been published on treatments of varicose veins, but comparative randomized controlled trials remain sparse. OBJECTIVE To compare the anatomic success rate, frequency of major complications, and quality-of-life improvement of endovenous laser ablation (EVLA), ultrasound-guided foam sclerotherapy (UGFS), and conventional surgery (CS), after 1-year follow-up. METHODS A total of 240 consecutive patients with primary symptomatic great saphenous vein reflux were randomized to EVLA, UGFS, or CS, consisting of high ligation and short stripping. Primary outcome was anatomic success defined as obliteration or absence of the treated vein on ultrasound examination after 1 year. Secondary outcomes were complications, improvement of the "C" class of the CEAP classification, and improvement of disease-specific (Chronic Venous Insufficiency Quality-of-Life Questionnaire) and general (EuroQol 5) quality-of-life scores. RESULTS More than 80% of the study population was classified as C2 or C3 venous disease. After 1 year, the anatomic success rate was highest after EVLA (88.5%), followed by CS (88.2%) and UGFS (72.2%) (P < .001). The complication rate was low and comparable between treatment groups. All groups showed significant (P < .001) improvement of EuroQol 5 and Chronic Venous Insufficiency Quality-of-Life Questionnaire scores after therapy; 84.3% of all treated patients showed an improvement of the "C" of the CEAP classification. CONCLUSIONS After 1-year follow-up, EVLA is as effective as CS and superior to UGFS according to occlusion on ultrasound duplex. Quality of life improves after treatment in all groups significantly.
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Affiliation(s)
- Anke A M Biemans
- Department of Dermatology, Erasmus Medical Center, Rotterdam, The Netherlands
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Chi YW, Schul M, Gibson K, Rosenblatt M, Kabnick L, Jaff M. Chronic venous disorder registry: A new perspective. Phlebology 2013; 29:415-27. [DOI: 10.1177/0268355513484143] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Chronic venous disorder is one of the most prevalent medical conditions in the US that carries significant economic and health burden. The knowledge into venous pathophysiology, how it develops, and the true quality of life benefits of various treatment options are largely unknown. A truly meaningful clinical data capture system specifically for venous disorder may provide answers to the paucity of data. We describe a modern system to capture research and best practice data using the state of art information technology.
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Affiliation(s)
- Yung-Wei Chi
- Division of Cardiovascular Medicine, University of California, Davis Medical Center, Sacramento, CA, USA
| | - Marlin Schul
- Lafayette Regional Vein & Laser Center, Lafayette, IN, USA
| | | | | | - Lowell Kabnick
- Department of Surgery, New York University Vein Center, New York, NY, USA
| | - Michael Jaff
- Vascular Center, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
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Launois R, Mansilha A, Lozano F. Linguistic validation of the 20 item-chronic venous disease quality-of-life questionnaire (CIVIQ-20). Phlebology 2013; 29:484-7. [DOI: 10.1177/0268355513479582] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Our objective was to review the linguistic validation of the 20 item-ChronIc Venous dIsease quality-of-life Questionnaire (CIVIQ-20) in the countries that have used it since its publication in 1996. Seventeen linguistic versions of CIVIQ-20 were validated using forward/backward methodology in patients presenting with chronic venous disease, stages C0s to C4 of the CEAP (clinical, aetiological, anatomical and pathological) classification (patients with venous ulcers were excluded). Most obstacles in the cross-cultural validation of CIVIQ-20 related to content and semantic equivalence. Confirmation of cultural relevance by experts with the native language as their mother tongue and the use of forward/backward translation methodology partly resolved these difficulties. CIVIQ-20 is valid for the assessment of treatment effects in multinational studies.
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Affiliation(s)
- R Launois
- Réseau d’Evaluation en Economie de la Santé (REES), Paris, France
| | - A Mansilha
- Vascular Surgery Unit, Faculty of Medicine of University of Porto, Hospital CUF Porto, Porto, Portugal
| | - F Lozano
- Vascular Surgery Unit, University Hospital of Salamanca, Salamanca, Spain
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25
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Construction and international validation of CIVIQ-14 (a short form of CIVIQ-20), a new questionnaire with a stable factorial structure. Qual Life Res 2011; 21:1051-8. [PMID: 21947689 DOI: 10.1007/s11136-011-0008-3] [Citation(s) in RCA: 42] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/04/2011] [Indexed: 12/13/2022]
Abstract
BACKGROUND The factorial instability of the CIVIQ-20 social dimension in different populations has necessitated the development of a new stable questionnaire to interpret results from international studies. OBJECTIVE Construction of a stable and psychometrically validated questionnaire from CIVIQ-20. METHODS AND MAJOR FINDINGS A prospective, international study was used to construct a stable CIVIQ scale and to validate its psychometric properties. An iterative process was implemented to eliminate the more unstable items (six), and the social and physical dimensions were combined. The resulting instrument comprised 14 items, split into three dimensions (pain, physical, and psychological), and was named CIVIQ-14. The stability of the CIVIQ-14 factorial structure was confirmed in Polish, Czech, Spanish, and French populations using principal component analysis and multitrait/multimethod analysis. Psychometric assessment demonstrated that CIVIQ-14 was reliable (intra-class coefficient >0.8; weighted kappa >0.8), valid (correlation coefficients between dimension scores and clinical severity scores between 0.3 and 0.6), and sensitive (effect sizes >0.6 for psychological dimension; >0.8 for the other dimensions). CONCLUSION CIVIQ-14 is a reliable, valid, and sensitive instrument applicable to international studies of patients with chronic venous disease.
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