Open surgical reconstructions for non-malignant occlusion of large veins
Peter Gloviczki, Michael C. Dalsing, Bo Eklöf, Fedor Lurie, Thomas W. Wakefield, Monika L. Gloviczki in Handbook of Venous and Lymphatic Disorders, 2017
History and physical examination, complemented by a hand-held Doppler examination, should reveal signs and symptoms typical of venous congestion. Patients with venous occlusion have swelling and develop exercise-induced pain in the thigh or calf, known as venous claudication. This pain is described as a bursting pain in the thigh, and sometimes in the calf, that develops after exercise and is relieved by rest and leg elevation. The swollen leg has a cyanotic hue with distended varicose veins even in the supine position. Bilateral swelling indicates bilateral iliofemoral or caval occlusion or systemic disease. Collateral veins in the suprapubic and abdominal wall usually indicate pelvic venous occlusion. Bleeding from high-pressure varicosities is not infrequent. In some patients, venous congestion results in hyperhidrosis and significant fluid loss through the skin. Associated chronic lymphedema may also develop. Advanced disease presents with stasis skin changes and venous ulcerations. Patients with membranous occlusion of the IVC frequently will have evidence of hepatic failure and portal hypertension as well.17 For details of the clinical and diagnostic evaluation of the patients with chronic venous insufficiency, the readers are referred to Chapters 13, 14, and 29.
The menstrual cycle and the skin
Miranda A. Farage, Howard I. Maibach in The Vulva, 2017
The blood supply to the skin increases in the second phase of the menstrual cycle. Harvell et al. (17), demonstrated that the basal blood flow at the time of maximum progesterone secretion was significantly higher than on the day of maximum estrogen secretion. In another study, researchers observed a gradual dilation of the venous lumen, which reached its maximum diameter approximately 1 week prior to the onset of menstrual bleeding. This phenomenon may also be responsible for the subjective symptoms of chronic venous insufficiency in patients with varicose veins, in whom symptoms often increase in the second half of the cycle (18). In the premenstrual phase, not only does progesterone reach its highest level, but a high estrogen concentration is present as well; the combined effect of both hormones may be causally responsible for dilation of the vessels (18).
Impairment of cardiovascular functions
Ramar Sabapathi Vinayagam in Integrated Evaluation of Disability, 2019
A varicose vein is a common clinical condition due to chronic degenerative changes in the vessel and valves. The resultant chronic venous insufficiency may lead to venous ulceration and venous thrombosis if untreated. It may affect superficial veins, deep veins, and perforators. It can manifest as spider veins, reticular veins, edema, pigmentation, lipodermatosclerosis, trophic changes, and venous ulcer (22). Integrated Evaluation of Disability assigns impairment based on clinical symptoms, incompetence of superficial, deep veins and perforators, and complications of venous insufficiency (Table 9.6).
What is the optimal treatment technique for great saphenous vein diameter of ≥10 mm? Comparison of five different approaches
Published in Acta Chirurgica Belgica, 2021
Emre Kubat, Celal Selçuk Ünal, Onur Geldi, Erdem Çetin, Aydın Keskin
Chronic venous insufficiency (CVI) is a major public health problem and several factors have been suggested to be play a role in its etiology including age, sex, pregnancy, ethnicity, family history, and obesity [1]. It typically presents with leg pain, burning sensation, itching, heaviness, and restless legs and nocturnal leg cramps. Untreated CVI may lead to a broad range of conditions from telangiectasis to skin ulceration [1]. The incidence of varicose veins has been estimated as 1.4% annually equally in both sexes [2]. Symptomatic superficial venous insufficiency accounts for the majority of CVI cases and several treatment options are available including compression stockings, venoactive drugs, and surgery [1]. Of note, previous studies have demonstrated that surgical treatment is superior to medical treatment in case of symptomatic superficial venous insufficiency [1,3].
An appraisal of vascular endothelial growth factor (VEGF): the dynamic molecule of wound healing and its current clinical applications
Published in Growth Factors, 2022
Aakansha Giri Goswami, Somprakas Basu, Farhanul Huda, Jayanti Pant, Amrita Ghosh Kar, Tuhina Banerjee, Vijay Kumar Shukla
Widely accepted to arise in the background of chronic venous insufficiency and its antecedent microcirculatory dysfunction (Jünger et al. 2000), the venous ulcers are a significant cause of morbidity. The tissue hypoxia emanating from microcirculatory failure is a strong stimulant for VEGF expression and angiogenesis. It is believed that leukocyte activation as the result of ambulatory venous hypertension activates ECs to stimulate VEGF expression from keratinocytes, macrophages, and vascular stromal cells as part of the repair process. Kolano et al. (2020) observed a significant correlation between micro-vessel density and VEGF expression in patients with venous ulceration. The serum levels of VEGF can be directly correlated with the dermatological manifestation of venous ulcers (Shoab, Scurr, and Coleridge-Smith 1998) and increased VEGF expression pattern has been consistently observed in the advanced stages of chronic venous disease (Peschen et al. 1998). The resultant neo-vascularization and the long-term microvascular permeability cause fibrin cuff deposition and tissue edema, which interferes with tissue nutrition, and are credited for clinical skin damage.
Standing and sitting postures at work and symptoms of venous insufficiency – results from questionnaires and a Doppler ultrasound study
Published in International Journal of Occupational Safety and Ergonomics, 2021
Chronic venous insufficiency is a congenital or acquired dysfunction of the veins caused by venous valves insufficiency. It is the most common syndrome of the vessels of lower limbs in humans. Due to the incidence rate, chronic venous insufficiency is considered a social disease [4]. Chronic venous insufficiency is a disease that affects people of working age; therefore, the direct costs of treatment should be increased by costs related to work absenteeism. The aetiopathogenesis of chronic venous insufficiency is still not fully explained [15–17]. It is unclear whether the main cause of the disease involves hereditary or environmental factors.
Related Knowledge Centers
- Deep Vein Thrombosis
- Obesity
- Varicose Veins
- Vein
- Venous Ulcer
- Pregnancy
- Hyperpigmentation
- Post-Thrombotic Syndrome
- Genetics
- Itch