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Padberg FT, Ucuzian A, Dosluoglu H, Jacobowitz G, O'Donnell TF. Longitudinal assessment of health-related quality of life and clinical outcomes with at home advanced pneumatic compression treatment of lower extremity lymphedema. J Vasc Surg Venous Lymphat Disord 2024:101892. [PMID: 38636734 DOI: 10.1016/j.jvsv.2024.101892] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2024] [Revised: 03/23/2024] [Accepted: 04/07/2024] [Indexed: 04/20/2024]
Abstract
OBJECTIVE This prospective, longitudinal, pragmatic study describes at home treatment with a proprietary advanced pneumatic compression device (APCD) for patients with lower extremity lymphedema (LED). METHODS Following institutiona review board approval, four participating Veterans Affairs centers enrolled LED patients from 2016 to 2022. The primary outcome measures were health-related quality of life (HR-QoL) questionnaires (lymphedema quality of life-leg and the generic SF-36v2) obtained at baseline and 12, 24, and 52 weeks. The secondary outcome measures were limb circumference, cellulitis events, skin quality, and compliance with APCD and other compression therapies. RESULTS Because a portion of the trial was conducted during the coronavirus disease 2019 pandemic, 179 patients had 52 weeks of follow-up, and 143 had complete measurements at all time points. The baseline characteristics were a mean age of 66.9 ± 10.8 years, 91% were men, and the mean body mass index was 33.8 ± 6.9 kg/m2. LED was bilateral in 92.2% of the patients. Chronic venous insufficiency or phlebolymphedema was the most common etiology of LED (112 patients; 62.6%), followed by trauma or surgery (20 patients; 11.2%). Cancer treatment as a cause was low (4 patients; 2.3%). Patients were classified as having International Society for Lymphology stage I (68.4%), II (27.6%), or III (4.1%). Of the primary outcome measures, significant improvements were observed in all lymphedema quality of life-leg domains of function, appearance, symptoms, and emotion and the overall score after 12 weeks of treatment (P < .0001) and through 52 weeks of follow-up. The SF-36v2 demonstrated significant improvement in three domains at 12 weeks and in the six domains of physical function, bodily pain, physical component (P < .0001), social functioning (P = .0186), role-physical (P < .0006), and mental health (P < .0333) at 52 weeks. An SF-36v2 score <40 indicates a substantial reduction in HR-QoL in LED patients compared with U.S. norms. Regarding the secondary outcome measures at 52 weeks, compared with baseline, the mean limb girth decreased by 1.4 cm (P < .0001). The maximal reduction in mean limb girth was 1.9 cm (6.0%) at 12 weeks in ISL stage II and III limbs. New episodes of cellulitis in patients with previous episodes (21.4% vs 6.1%, P = .001) were reduced. The 75% of patients with skin hyperpigmentation at baseline decreased to 40% (P < .01) at 52 weeks. At 52 weeks, compliance, defined as use for 5 to 7 days per week, was reported for the APCD by 72% and for elastic stockings by 74%. CONCLUSIONS This longitudinal study of Veterans Affairs patients with LED demonstrated improved generic and disease-specific HR-QoL through 52 weeks with at home use of an APCD. Limb girth, cellulitis episodes, and skin discoloration were reduced, with excellent compliance.
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Affiliation(s)
- Frank T Padberg
- Department of Surgery, VA New Jersey Healthcare System, East Orange, NJ; Division of Vascular Surgery, Rutgers New Jersey Medical School, Newark NJ.
| | - Areck Ucuzian
- VA Maryland Healthcare System, Baltimore, MD; Division of Vascular Surgery, University of Maryland School of Medicine, Baltimore, MD
| | - Hasan Dosluoglu
- VA Western NY Healthcare System, Buffalo, NY; Division of Vascular Surgery, Department of Surgery, State University of New York, Buffalo, NY
| | - Glenn Jacobowitz
- VA New York Harbor Healthcare System, New York, NY; Division of Vascular and Endovascular Surgery, NYU Langone Health, New York, NY; Division of Vascular Surgery, Department of Surgery, NYU Grossman School of Medicine, New York, NY
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Teh R, Picazo Pineda F, Sieunarine K. Femoral canal lipoma presenting as chronic venous insufficiency. J Vasc Surg Cases Innov Tech 2023; 9:101275. [PMID: 37662572 PMCID: PMC10474485 DOI: 10.1016/j.jvscit.2023.101275] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2023] [Accepted: 07/03/2023] [Indexed: 09/05/2023] Open
Abstract
Lower limb venous obstruction secondary to a lipoma is a rare occurrence. Patients with these benign soft tissue tumors can be asymptomatic, or may experience symptoms of pain, parasthesia, paralysis and swelling secondary to compression on adjacent neurovascular structures. Duplex ultrasound examination is the first-line investigation, but has its limitations. We report on a case of venous obstruction syndrome misdiagnosed as chronic venous insufficiency on duplex ultrasound examination, from a deep-seated giant lipoma compressing on the common femoral and distal external iliac vein in a patient with Dercum's disease.
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Affiliation(s)
- Ryan Teh
- Department of Vascular Surgery, Fiona Stanley Hospital, Murdoch, Western Australia
| | | | - Kishore Sieunarine
- Department of Vascular Surgery, Hollywood Private Hospital, Nedlands, Western Australia
- Curtin University Medical School, Bentley, Western Australia
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Jiménez-Román R, Salazar-Álvarez AE, Moral LFRD. Ambulatory surgery for chronic venous insufficiency using radiofrequency thermoablation: quality and satisfaction. CIR CIR 2023; 91:672-677. [PMID: 37844889 DOI: 10.24875/ciru.22000187] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2022] [Accepted: 07/02/2022] [Indexed: 10/18/2023]
Abstract
BACKGROUND Chronic venous disease is a frequent and prevalent pathology. Its surgical treatment has been shown to be cost-effective. Thermal endoablation performed as major outpatient surgery (MAS) is the technique of choice. OBJECTIVE To know the satisfaction of patients after MAS and the quality of care provided. METHOD Observational, descriptive, cross-sectional study, carried out between January 2019 and March 2020. A survey was carried out on patients who underwent endovascular radiofrequency thermoablation in two hospitals in Spain, consisting of two questionnaires: one ad hoc and one another of satisfaction (SERCAL). Quality indices for MAS were measured. RESULTS We analyzed 156 episodes. 145 interventions were carried out. We found 4 (2.8%) unscheduled admissions. 3 patients (2.1%) attended the emergency department. There was a 99.3% success rate. 100% of the patients had pre-surgical recommendations and informed consent. We obtained 48 surveys (response rate: 33.1%). All the patients gave a rating greater ≥ 8 in quality of care (x = 9.83) and would recommend this procedure to their relatives (x = 9.71). CONCLUSIONS Endovascular radiofrequency thermoablation performed in MAS has a high success rate and a very low rate of admission and visit to the emergency room. Patient satisfaction is high.
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Affiliation(s)
- Renato Jiménez-Román
- Servicio de Angiología y Cirugía Vascular, Hospital Quironsalud San José
- Servicio de Angiología y Cirugía Vascular, Complejo Hospitalario Quironsalud Ruber Juan Bravo. Madrid, España
| | - Andrés E Salazar-Álvarez
- Servicio de Angiología y Cirugía Vascular, Hospital Quironsalud San José
- Servicio de Angiología y Cirugía Vascular, Complejo Hospitalario Quironsalud Ruber Juan Bravo. Madrid, España
| | - Luis F Riera-Del Moral
- Servicio de Angiología y Cirugía Vascular, Hospital Quironsalud San José
- Servicio de Angiología y Cirugía Vascular, Complejo Hospitalario Quironsalud Ruber Juan Bravo. Madrid, España
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Chen J, Chebli L. Case Report of a Chronic Wound Due to Venous Insufficiency Following a Traumatic Arteriovenous Fistula. Open J Clin Diagn 2021; 11:47-51. [PMID: 34721947 PMCID: PMC8555910 DOI: 10.4236/ojcd.2021.112003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Chronic lower limb wounds are common. They can be of arterial or venous origin. In this article, we will present a clinical case of a 30-year-old patient with a chronic injury to the right medial malleolus. In his history, we can note a gunshot wound to the right leg. Ultrasonography and CT angiography helped in the diagnosis of traumatic arteriovenous fistula. The patient underwent a fistula embolization which allowed the wound to heal. The clinical presentation, additional examinations and the latest treatment recommendations will be discussed in this article.
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Affiliation(s)
- Jialiang Chen
- Department of Vascular Surgery, CHU Brugmann, Brussels, Belgium
| | - Louis Chebli
- Department of Vascular Surgery, CHU Brugmann, Brussels, Belgium
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Aranke M, Pham CT, Yilmaz M, Wang JK, Orhurhu V, An D, Cornett EM, Kaye AD, Ngo AL, Imani F, Farahmand Rad R, Varrassi G, Viswanath O, Urits I. Topical Sevoflurane: A Novel Treatment for Chronic Pain Caused by Venous Stasis Ulcers. Anesth Pain Med 2021; 11:e112832. [PMID: 34221949 PMCID: PMC8241821 DOI: 10.5812/aapm.112832] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2021] [Revised: 02/14/2021] [Accepted: 02/14/2021] [Indexed: 11/16/2022] Open
Abstract
In the US, an estimated 1 - 2% of chronic venous insufficiency (CVI) patients (of 6 - 7 million nationwide) develop at least one venous stasis ulcer (VSU) during their illness. Of these, approximately 40% develop subsequent ulcers, making VSU prognostically poor. Current management of VSU is costly, with poor prognosis, high recurrence rate, inadequate pain management, and significantly reduced quality of life (QoL). Topical volatile anesthetic agents, such as sevoflurane, offer improved pain relief and symptom control in patients suffering from chronic VSU. The immediate impact of topical sevoflurane in reducing pain associated with ulcer bed debridement has several implications in improving the quality of life in patients with CVI induced ulcers and in the prognosis and healing of the ulcers. This review summarizes a topical formulation of a volatile anesthetic and its implications for the management of VSUs.
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Affiliation(s)
- Mayank Aranke
- Texas Tech University Health Sciences Center, School of Medicine, Harvard TH Chan School of Public Health, Lubbock, Texas, USA
| | - Cynthia T Pham
- Georgetown University School of Medicine, MedStar Georgetown University Hospital, Washington, DC, USA
| | | | | | | | - Daniel An
- Georgetown University School of Medicine, MedStar Georgetown University Hospital, Washington, DC, USA
| | - Elyse M. Cornett
- LSU Health Shreveport, Department of Anesthesiology, Shreveport, LA, USA
| | - Alan David Kaye
- LSU Health Shreveport, Department of Anesthesiology, Shreveport, LA, USA
| | - Anh L Ngo
- Pain Specialty Group, Portsmouth, NH, USA
| | - Farnad Imani
- Pain Research Center, Department of Anesthesiology and Pain Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Reza Farahmand Rad
- Pain Research Center, Department of Anesthesiology and Pain Medicine, Iran University of Medical Sciences, Tehran, Iran
| | | | - Omar Viswanath
- LSU Health Shreveport, Department of Anesthesiology, Shreveport, LA, USA
- Creighton University School of Medicine, Department of Anesthesiology, Omaha, NE, USA
- Valley Pain Consultants – Envision Physician Services, Phoenix, AZ, USA
- University of Arizona College of Medicine-Phoenix, Department of Anesthesiology, Phoenix, AZ, USA
| | - Ivan Urits
- LSU Health Shreveport, Department of Anesthesiology, Shreveport, LA, USA
- Southcoast Health, Southcoast Health Physicians Group Pain Medicine, Wareham, MA, USA
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Mendes-Andrade I, Dias-Neto M, Rocha-Neves J, Mansilha A. The Burden of Post-Thrombotic Syndrome in a Long-Term Retrospective Cohort in Northern Portugal. ACTA MEDICA PORT 2021; 34:35-43. [PMID: 33159722 DOI: 10.20344/amp.13567] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2020] [Revised: 03/25/2020] [Accepted: 03/23/2020] [Indexed: 11/20/2022]
Abstract
INTRODUCTION Post-thrombotic syndrome is a frequent and disabling complication of deep venous thrombosis. Its incidence is not described in the Portuguese population. The objective of this study is to report the incidence and severity of post-thrombotic syndrome after the initial episode of deep venous thrombosis. MATERIAL AND METHODS This is an observational, unicentric, retrospective cohort of patients who had a first episode of deep venous thrombosis in the lower limb, documented with duplex ultrasound (n = 101). The modified Villalta score was applied by phone interview for the diagnosis and staging of post-thrombotic syndrome. The quality of life of patients was measured with the modified CIVIQ 14 classification. RESULTS Median follow-up time was six years (interquartile range 1). Severe post-thrombotic syndrome was present in 27% of patients and moderate in 33%. Performing physical activity at the time of the interview was associated with lower incidence of post-thrombotic syndrome (relative risk 0.489; 95% confidence interval = 0.320 - 0.748). Body weight gain after deep venous thrombosis (relative risk 2.188; 95% confidence interval 1.137 - 4.210) and lower education levels (relative risk 2.005; 95% confidence interval 1.297 - 3.098) were associated positively with post-thrombotic syndrome. Quality of life was 90 ± 17 vs 64 ± 18 vs 43 ± 15 in patients without postthrombotic syndrome, with moderate post-thrombotic syndrome and with severe post-thrombotic syndrome, respectively (p < 0.001). DISCUSSION The long-term incidence of post-thrombotic syndrome in a cohort of patients from Northern Portugal is higher than in other studies and correlates with worse adjusted CIVIQ-14 scores. CONCLUSION Large studies of prospective nature could provide more definitive evidence.
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Affiliation(s)
- Inês Mendes-Andrade
- Faculty of Medicine. University of Porto. Porto; Department of Physical Medicine and Rehabilitation. Centro de Medicina de Reabilitação de Alcoitão. Cascais. Portugal
| | - Marina Dias-Neto
- Faculdade de Medicina. Universidade do Porto. Porto. Cardiovascular Research & Development Unit. Faculdade de Medicina. Universidade do Porto. Porto. Portugal
| | - João Rocha-Neves
- Department of Angiology and Vascular Surgery. São João Hospital. Porto. Unit of Anatomy. Department of Biomedicine. Faculdade de Medicina. Universidade do Porto. Porto. Portugal
| | - Armando Mansilha
- Department of Surgery and Physiology. Faculdade de Medicina. Universidade do Porto. Porto. Cardiovascular Research & Development Unit. Faculdade de Medicina. Universidade do Porto. Porto. Portugal
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Castelo Branco S, Costa M, Vasconcelos A. Chronic Venous Insufficiency and Dystrophic Subcutaneous Calcification. ACTA MEDICA PORT 2019; 32:165. [PMID: 30896399 DOI: 10.20344/amp.11110] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2018] [Accepted: 09/21/2018] [Indexed: 11/20/2022]
Affiliation(s)
| | - Mylene Costa
- Serviço de Medicina Interna. Hospital Pedro Hispano. Matosinhos. Portugal
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Tavares PA, Landsman V, Gomez N, Ferreiras A, Lopez RA. Association of Venous Leg Ulcers With Ankle Range of Motion in People Attending Chiropractic Mobile Clinics in the Dominican Republic. J Chiropr Med 2017; 16:263-270. [PMID: 29276458 DOI: 10.1016/j.jcm.2017.08.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2016] [Revised: 05/27/2017] [Accepted: 08/04/2017] [Indexed: 11/25/2022] Open
Abstract
Objective The goal of the study was to determine if there was an association between chronic venous disorders (CVDs), particularly venous leg ulcers, and ankle range of motion (ROM) in the Dominican Republic. Methods Chronic venous disorders were classified using the clinical manifestations portion (C) of the CEAP (clinical manifestations, etiology, anatomy, pathophysiology) method. The legs of participants attending mobile chiropractic clinics in rural, low-income areas in the Dominican Republic were assessed for clinical signs of CVD and venous ulcers. Ankle ROM was then measured, and photographs of the legs were taken. The 6 clinical stages of CVD were divided into 3 groups: normal legs (normal), no ulcer CVD, and ulcer CVD (healed and active). Multiple linear regression of ankle ROM against CVD grouping was used to test the association. Results Eight of the 837 patients for whom CVD classification was obtained had venous ulcers (healed or active) on at least 1 leg. About 30% relative reduction in ROM (ankle dorsiflexion plus plantar flexion) was observed between the ulcer group and the normal group. Regression analysis comparing legs with ulcers to healthy legs (normal), adjusted for age, gender, indicator for obesity, and previous leg trauma, revealed a significant decrease of approximately 14° (P = .0007) in ankle ROM. Age was also found to be strongly significant in the regression analysis, 1 year of aging was associated with a decrease of 0.16° (P < .0001) in ankle ROM (approximately 1.6° in 10 years). Conclusion A significant decrease was observed in ankle ROM for participants with active and healed leg venous ulcers compared with those without ulcers. There appeared to be an association between venous leg ulcers and ankle ROM in this sample.
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Affiliation(s)
- Patricia A Tavares
- Division of Clinical Education, Canadian Memorial Chiropractic College, North York, Ontario, Canada
| | - Victoria Landsman
- Division of Graduate Education and Research, Canadian Memorial Chiropractic College, North York, Ontario, Canada.,Institute for Work and Health, Toronto, Ontario, Canada
| | | | | | - Ramon A Lopez
- Private Practice, Santo Domingo, Dominican Republic.,Fundación Sol Naciente, Santo Domingo, Dominican Republic
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Sasani MR, Dehghan AR, Ali Reza N. The relationship of multiple sclerosis and cerebral developmental venous anomaly with an advantageous role in the multiple sclerosis diagnosis. Iran J Neurol 2017; 16:168-172. [PMID: 29736221 PMCID: PMC5937001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
Background: There is a suggestion for a role of abnormal cranial venous drainage in the etiopathogenesis of multiple sclerosis (MS). Moreover, it seems that cerebral developmental venous anomaly (DVA), a cerebrovascular malformation, is frequently seen in the magnetic resonance imaging (MRI) of MS patients. This study is set out to evaluate the relationship between MS and cerebral DVA, with its possible role in the MS diagnosis. Methods: We compared MRI of 172 MS patients and of 172 age- and sex-matched subjects without MS. Then, we recorded and analyzed the presence, number, and location of developmental venous anomalies. Results: Frequency of DVA did not have a significant statistical difference (P = 0.148) in subjects with MS (12.21%) and without MS (7.55%). Moreover, a difference of anatomic distribution of supratentorial developmental venous anomalies was not statistically significant (P = 0.690, for juxtacortical, P = 0.510 for subcortical, and P = 0.420 for periventricular DVAs) in two groups. Conclusion: Our investigation does not provide supporting evidence for a relationship between etiopathogenesis of MS and DVA. Furthermore, it may not be possible to use cerebral DVA as ancillary MRI finding to make MS diagnosis simpler and more accurate.
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Affiliation(s)
- Mohammad Reza Sasani
- Medical Imaging Research Center, Shiraz University of Medical Sciences, Shiraz, Iran, Department of Radiology, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Ali Reza Dehghan
- Department of Radiology, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Nikseresht Ali Reza
- Autoimmune Diseases Research Center, Shiraz University of Medical Sciences, Shiraz, Iran, Department of Neurology, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
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Matic M, Matic A, Djuran V, Gajinov Z, Prcic S, Golusin Z. Frequency of Peripheral Arterial Disease in Patients With Chronic Venous Insufficiency. Iran Red Crescent Med J 2016; 18:e20781. [PMID: 26889387 PMCID: PMC4752728 DOI: 10.5812/ircmj.20781] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/31/2014] [Revised: 08/08/2014] [Accepted: 09/06/2014] [Indexed: 11/27/2022]
Abstract
Background: It is estimated that about 15% (10% - 30% in most of the studies) of the total adult population has some aspects of the Chronic Venous Insufficiency (CVI). Frequency of the Peripheral Arterial Disease (PAD) in the adult population is 3% - 4%. Studies dealing with etiopathogenesis of leg ulcers show that between 10% and 18% of all ulcers are of mixed, arterial-venous origin. Objectives: The purpose of this study was to find out if there is a higher frequency of PAD among CVI patients in comparison with the control group, as well as to discover some common risk factors for CVI and PAD. Patients and Methods: This cross-sectional descriptive study was conducted at the dermatovenereological clinic, clinical center of Vojvodina, Serbia. A total of 162 examinees were included. All patients were examined for the existence of CVI and staged according to CEAP (Clinical, etiology, anatomy and patophysiology) classification. In this way, 3 groups were formed: Patients with the mild forms of CVI (stage 1 - 4 by CEAP classification), 57 patients; patients with the severe forms of CVI (stage 5 and 6 by CEAP classification), 55 patients; control group (no CVI), 50 patients. Also, the Ankle Brachial Pressure Index (ABPI) was assessed in all subjects, and its value of ≤ 0.9 was set as criteria for diagnosis of PAD. The same sample was divided according to the presence of PAD into two groups. The most important risk factors for CVI and PAD were identified for each patient through complete examination, medical record and appropriate questionnaire. Results: Our results showed that the risk factors for CVI were high Body Mass Index (BMI), hypertension, predominantly standing position during work and positive family history for CVI. In the same sample it was found that 28 (17.28%) patients had PAD. Relevant risk factors for PAD in the present study were: high BMI, hypertension, diabetes and a positive family history for PAD. Comparison of frequency of PAD among patients with severe forms of CVI and control group showed that this difference was statistically significant (P = 0.0275; OR 3.375; 95% CI 1.125 - 10.12). After multivariate analyses, adjusted odds ratio OR was still statistically significant. Conclusions: The peripheral arterial disease is more frequent in patients with the severe form of CVI, than in patients without CVI. Concomitant risk factors for CVI and PAD were high BMI and hypertension. In each patient with severe CVI it is necessary to determine the ABPI, in order to exclude the presence of PAD.
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Affiliation(s)
- Milan Matic
- Dermatovenereological Clinic, Clinical Center of Vojvodina, Novi Sad, Serbia
- Faculty of Medicine, University of Novi Sad, Novi Sad, Serbia
- Corresponding Author: Milan Matic, Dermatovenereological Clinic, Clinical Center of Vojvodina, Novi Sad, Serbia. Tel: +381-637722423, Fax: +381-21421215, E-mail:
| | - Aleksandra Matic
- Pediatric Clinic, Institute for Child and Youth Health Care of Vojvodina, Novi Sad, Serbia
- Faculty of Medicine, University of Novi Sad, Novi Sad, Serbia
| | - Verica Djuran
- Dermatovenereological Clinic, Clinical Center of Vojvodina, Novi Sad, Serbia
- Faculty of Medicine, University of Novi Sad, Novi Sad, Serbia
| | - Zorica Gajinov
- Dermatovenereological Clinic, Clinical Center of Vojvodina, Novi Sad, Serbia
- Faculty of Medicine, University of Novi Sad, Novi Sad, Serbia
| | - Sonja Prcic
- Pediatric Clinic, Institute for Child and Youth Health Care of Vojvodina, Novi Sad, Serbia
- Faculty of Medicine, University of Novi Sad, Novi Sad, Serbia
| | - Zoran Golusin
- Dermatovenereological Clinic, Clinical Center of Vojvodina, Novi Sad, Serbia
- Faculty of Medicine, University of Novi Sad, Novi Sad, Serbia
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Jandaghi AB, Amanian D, Roudbari SA, Kanafi AR, Pourghorban R. Evaluation of hemodynamic properties of cerebral venous drainage in patients with multiple sclerosis: a case-control study. Pol J Radiol 2014; 79:323-7. [PMID: 25250100 PMCID: PMC4170839 DOI: 10.12659/pjr.890690] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2014] [Accepted: 04/08/2014] [Indexed: 11/09/2022] Open
Abstract
Background The purpose of this study was to compare patients with multiple sclerosis and healthy control subjects as regards hemodynamics of cerebral venous drainage. Material/Methods Between December 2012 and May 2013, 44 consecutive patients with multiple sclerosis and 44 age- and sex-matched healthy subjects underwent the B-mode, color Doppler, and duplex Doppler evaluations of the internal jugular vein (IJV) and vertebral vein. The following four parameters were investigated: IJV stenosis, reversal of postural control of the cerebral venous outflow pathways, absence of detectable blood flow in the IJVs and/or vertebral veins, and reflux in the IJVs and/or vertebral veins in the sitting or supine position. Results In the study group, IJV stenosis, postural control reversal of the cerebral venous outflow pathways, and absence of flow in the IJVs and/or vertebral veins were found in 3 (6.8%), 2 (4.5%), and 3 (6.8%) patients, respectively. In the control group, IJV stenosis (P=0.12), postural control reversal of the cerebral venous outflow pathways (P=0.50), and absence of flow (P=0.12) were not detected. Abnormal reflux was found neither in multiple sclerosis patients nor in healthy subjects. Conclusions No significant difference in the cerebral venous drainage through the IJV or vertebral vein was found between patients with multiple sclerosis and healthy subjects within any of the investigated ultrasonographic parameters.
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Affiliation(s)
- Ali Babaei Jandaghi
- Department of Radiology, Poursina Hospital, Guilan University of Medical Sciences, Rasht, Iran ; Guilan Road Trauma Research Center, Guilan University of Medical Sciences, Rasht, Iran
| | - Dayan Amanian
- Department of Radiology, Poursina Hospital, Guilan University of Medical Sciences, Rasht, Iran
| | - Seyed Ali Roudbari
- Department of Radiology, Poursina Hospital, Guilan University of Medical Sciences, Rasht, Iran
| | | | - Ramin Pourghorban
- Department of Radiology, Shohada-e-Tajrish Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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