Can plethysmography have a greater place in the diagnosis, treatment and follow-up of chronic venous insufficiency?

Yıl 2024, Cilt: 10 Sayı: 2, 204 - 209, 04.03.2024

Temmuz Taner , Hakan Guven

https://doi.org/10.18621/eurj.1294890

Öz

Objectives: Chronic venous insufficiency (CVI) is one of the most common venous diseases. CVI is an important clinical picture with a high prevalence, low quality of life, and high diagnosis and treatment costs. Therefore, diagnosis, follow-up, and treatment are important for the patient's socioeconomic and life quality. In this study, we aimed to better examine a test used in the diagnosis, treatment, and follow-up of CVI.

Methods: In this retrospective study, 683 patients diagnosed with CVI, who had endovenous laser ablation (EVLA) indications were evaluated between June 2013 and November 2018. EVLA procedure performed on all patients. Preoperative, postoperative 1st and 6th month Doppler USG (ultrasonography), plethysmography, and VCSS (Venous Clinical Severity Score) questionnaire was made to all patients.

Results: As a result of our study, we found that there was a significant difference between the preoperative plethysmography and VCSS results of the patients and the postoperative 1st and 6th month results. With the significant difference in the VCSS questionnaire, we have shown that plethysmography gives accurate results in the diagnosis and treatment of CVI since it is an individual, quantitative, and easy test.

Conclusions: EVLA is an effective and safe method in patients with venous insufficiency. Since Doppler USG is person and device dependent, we think that plethysmography, which can be used in every clinical setting and provides quantitative results independent of the person, can be used more frequently in the diagnosis and treatment of venous insufficiency. In addition, we think that plethysmography can be used as a valuable additional method in the diagnosis and follow-up of such patients, due to the venous hemodynamic data that Doppler USG cannot provide.

Anahtar Kelimeler

Chronic venous disease, plethysmography, endovenous laser ablation

Destekleyen Kurum

Bursa City Hospital

Kaynakça

• 1. Engin M, Goncu MT. The role of plateletcrit and neutrophil lymphocyte ratio in showing the clinical severity of the disease in patients with chronic venous insufficiency. Ann Med Res. 2020;27:1385-1390. doi: 10.5455/annalsmedres.2019.12.866.
• 2. Aydın U, Engin M, Türk T, Ata Y. The effectiveness of different treatment methods in isolated telangiectasia and reticular vein treatment: A single-center prospective randomized study. Phlebology. 2022;37(1):26-32. doi: 10.1177/02683555211030739.
• 3. Rooke TW, Heser JL, Osmundson PJ. Exercise strain-gauge venous plethysmography: evaluation of a "new" device for assessing lower limb venous incompetence. Angiology. 1992;43(3 Pt 1):219-228. doi: 10.1177/000331979204300307.
• 4. Labropoulos N. How Does Chronic Venous Disease Progress from the First Symptoms to the Advanced Stages? A Review. Adv Ther. 2019;36(Suppl 1):13-19. doi: 10.1007/s12325-019-0885-3.
• 5. Biemans AA, Kockaert M, Akkersdijk GP, et al. Comparing endovenous laser ablation, foam sclerotherapy, and conventional surgery for great saphenous varicose veins. J Vasc Surg. 2013;58(3):727-734. doi: 10.1016/j.jvs.2012.12.074.
• 6. Min RJ, Khilnani NM, Golia P. Duplex ultrasound evaluation of lower extremity venous insufficiency. J Vasc Interv Radiol. 2003;14(10):1233-1241. doi: 10.1097/01.rvi.0000092663.72261.37.
• 7. Lee W, Chung JW, Yin YH, et al. Three-Dimensional CT venography of varicose veins of the lower extremity: image quality and comparison with doppler sonography. AJR Am J Roentgenol. 2008;191(4):1186-1191. doi: 10.2214/AJR.07.3471.
• 8. Kohler TR, Strandness DE Jr. Noninvasive testing for the evaluation of chronic venous disease. World J Surg. 1986;10(6):903-910. doi: 10.1007/BF01658638.
• 9. Duchene M, Amiel M, Barbe R. Evaluation of the clinical pharmacological activity of a phlebotonic agent. Application to the study of Daflon 500 mg. Int Angiol. 1988;7(2 Suppl):25-32.
• 10. Amato C. Advantage of a micronized flavonoidic fraction (Daflon 500 mg) in comparison with a nonmicronized diosmin. Angiology. 1994;45:531-536.
• 11. Eberhardt RT, Raffetto JD. Chronic venous insufficiency. Circulation. 2005;111(18):2398-2409. doi: 10.1161/01.CIR.0000164199.72440.08.
• 12. Passman MA, McLafferty RB, Lentz MF, et al. Validation of Venous Clinical Severity Score (VCSS) with other venous severity assessment tools from the American Venous Forum, National Venous Screening Program. J Vasc Surg. 2011;54(6 Suppl):2S-9S. doi: 10.1016/j.jvs.2011.05.117.
• 13. Lozano Sánchez FS, Sánchez Nevarez I, González-Porras et alSociedad Española de Angiología y Cirugía Vascular (SEACV); Sociedad Española de Médicos de Atención Primaria (SEMERGEN); Sociedad Española de Medicina Familiar y Comunitaria (SEMFYC). Quality of life in patients with chronic venous disease: influence of the socio-demographical and clinical factors. Int Angiol. 2013;32(4):433-441.
• 14. De Maeseneer MG, Kakkos SK, Aherne T, et al. Editor's Choice - European Society for Vascular Surgery (ESVS) 2022 Clinical Practice Guidelines on the Management of Chronic Venous Disease of the Lower Limbs. Eur J Vasc Endovasc Surg. 2022 Feb;63(2):184-267. doi: 10.1016/j.ejvs.2021.12.024.
• 15. Periferik Arter ve Ven Hastalıkları In: Editör: Prof. Dr. A. Kürşat Bozkurt. Ulusal Tedavi Kılavuzu. 2021
• 16. Ramelet AA, Boisseau MR, Allegra C, et al. Veno-active drugs in the management of chronic venous disease. An international consensus statement: current medical position, prospective views and final resolution. Clin Hemorheol Microcirc. 2005;33(4):309-319.
• 17. Malskat WS, Poluektova AA, van der Geld CW, et al. Endovenous laser ablation (EVLA): a review of mechanisms, modeling outcomes, and issues for debate. Lasers Med Sci. 2014;29(2):393-403. doi: 10.1007/s10103-013-1480-5.