The Number of Pregnancies and Deliveries and Their Association with Selected Morphological and Hemodynamic Parameters of the Pelvic and Abdominal Venous System

Background: Although pregnancy has been identified as one of the risk factors for venous disease, the mechanism of this interaction remains unclear. Possibly, pregnancy results in overstrain and vein dilatation, which exceed their durability and persist after pregnancy. The aim of this study was the assessment of the relationship between the number of pregnancies in women with venous disease and the selected parameters of their venous systems. Patients and methods: The retrospective assessment concerned 518 patients subjected to the diagnostics of the venous system in the lower limbs and the abdomen/pelvis using ultrasound scan and magnetic resonance or computed tomography. Results: We found that the occurrence of pelvic venous symptoms increases proportionally to the number of pregnancies and is correlated with ovarian and parauterine vein dilatation/incompetence (e.g., 13.5% of nulliparous women reported pelvic pain, and reflux in left ovarian veins was detected in 21.4% of the patients from that group, whereas in women after two pregnancies, pain and reflux concerned 22.8% and 90.6% of patients, respectively). In the nulliparous group, the development of venous disease resulted from the presence of anatomic abnormalities in abdominal/pelvic veins. Conclusions: Our report proved that the number of pregnancies is correlated with the incidence of pelvic vein insufficiency. Although not specifically addressed in this study, some correlation was found with saphenous disease as well. However, further studies are necessary to provide more evidence about the role of pelvic vein insufficiency in chronic venous disease of the lower limbs.

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Chronic venous disease of the lower limbs and its complications in general medicine: the role of the expert doctor

Acta Phlebologica ◽

10.23736/s1593-232x.20.00466-x ◽

2020 ◽

Vol 21 (1-2) ◽

Author(s):

Giovanni Adamo ◽

Pier Luigi Antignani

Keyword(s):

General Medicine ◽

Lower Limbs ◽

Chronic Venous Disease ◽

Venous Disease

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The role of inflammatory reaction in chronic venous disease of the lower limb

International Surgery Journal ◽

10.18203/2349-2902.isj20191537 ◽

2019 ◽

Vol 6 (5) ◽

pp. 1835

Author(s):

Ketan Vagholkar ◽

Shivangi Garima ◽

Yash Kripalani

Keyword(s):

Lower Limb ◽

Lower Limbs ◽

Chronic Venous Disease ◽

Venous Disease ◽

Vascular Disorder ◽

Disease Awareness ◽

Prolonged Sitting ◽

Inflammatory Mechanism ◽

Prevention And Treatment

Chronic venous disease is the problem which is assuming alarming proportions in subjects whose occupation involves prolonged sitting or standing. The exact mechanism by which the venous system gets damaged continues to be a subject of endless research. The role of inflammation is a significant factor in the evolution of chronic venous disease. Awareness of this mechanism can help in both prevention and treatment of this complex vascular disorder. The paper reviews inflammatory mechanism underlying the pathogenesis of chronic venous disease in lower limbs.

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Clinical outcomes and overview of dedicated venous stents for management of chronic iliocaval and femoral deep venous disease

Vascular ◽

10.1177/1708538121989860 ◽

2021 ◽

pp. 170853812198986

Author(s):

Mohamed AH Taha ◽

Andrew Busuttil ◽

Roshan Bootun ◽

Bahgat AH Thabet ◽

Ayman EH Badawy ◽

...

Keyword(s):

Primary Treatment ◽

Venous System ◽

Lower Limbs ◽

Cochrane Library ◽

Venous Disease ◽

Venous Stenting ◽

Deep Venous System ◽

Pubmed Database ◽

Venous Stents

Objectives Venous stenting of the lower extremities has grown in popularity and is now considered a key component of the primary treatment strategy for the management of pathologically obstructive or stenotic lesions of the deep venous system. This review aims to provide an overview of the role of venous stenting in the management of chronic conditions affecting the deep venous system of the lower limbs. Methods An overview of venous stents design and current role of stenting procedure in individuals presenting with Chronic Venous Insufficiency (CVI) and presenting the current trials of dedicated venous stenting in management of chronic deep venous lesions. This review provides a focused insight on venous stent design, physical properties and the available dedicated venous stents selected studies with their related patency outcome based on selective literature search of the PubMed database and Cochrane library. Conclusions Dedicated venous stent technology is advancing at a rapid pace alongside the increased undertaking of endovascular deep venous stent reconstruction in the management of iliocaval vein pathologies. The ideal design(s) for venous stents remain unknown, although it is hoped that the presence of new dedicated venous stents in clinical practice will allow the generation of experience and data to advance our understanding in this area.

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Treatment Peculiarity of the Chronic Trophic Ulcers with Different Pathogenic Mechanism

Acta Balneologica ◽

10.36740/abal202001102 ◽

2020 ◽

Vol 62 (1) ◽

pp. 12-16

Author(s):

Oksana K. Melekhovets ◽

Tetyana O. Kharchenko ◽

Victor F. Orlovskiy ◽

Iuirii V. Melekhovets ◽

Alevtina S. Radko ◽

...

Keyword(s):

Photodynamic Therapy ◽

Healing Process ◽

Modern Medicine ◽

Lower Limbs ◽

Chronic Venous Disease ◽

Venous Disease ◽

Second Stage ◽

Group 2

Introduction: Trophic ulcers of the lower extremities are an unresolved problem of modern medicine. The treatment of this pathology requires new methods that optimize care regimens and improve patients’ quality of life. Aim: The study to improve efficacy of treatment of the patients with trophic ulcers of the lower limbs with consideration to pathogenesis. M aterials and Methods: The study included 32 patients with chronic venous disease C6 (1st group) and 31 with diabetes mellitus type 2, moderate severity, compensation stage with diabetic foot syndrome II stage according to Wagner’s classification (2nd group). In addition to basic therapy in both groups photodynamic therapy was added at the first stage of the study, and at the second stage plasma rich in growth factors was prescribed. Results: At baseline evaluating of the chronic venous disease demonstrates that a total score in patient of the 1st group was 20,9 points on a modified VCSS scale; after two weeks – 15,71 points (improvement by 24.83%), and 6 weeks after–9,72 points (improvement by 53.49%). In patients with DM (2nd group) at the baseline a total score average was 13,91 points according to S(AD)SAD-1 scale; after 2 weeks – 12,29 (improvement by 11,65%), after 6 weeks – 6,39 points (improvement by 54,06%). Conclusions: The inclusion of photodynamic therapy and plasmatherapy in complex therapy in both groups led to a significant improvement of the healing process and helps to reduce the depth and area of the wound surface. However, the wound healing in patients in group 2 was slower.

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Dysregulations of MicroRNA and Gene Expression in Chronic Venous Disease

Journal of Clinical Medicine ◽

10.3390/jcm9051251 ◽

2020 ◽

Vol 9 (5) ◽

pp. 1251 ◽

Cited By ~ 2

Author(s):

Daniel P. Zalewski ◽

Karol P. Ruszel ◽

Andrzej Stępniewski ◽

Dariusz Gałkowski ◽

Jacek Bogucki ◽

...

Keyword(s):

Gene Expression ◽

Mononuclear Cells ◽

Varicose Veins ◽

Expression Profiles ◽

Lower Limbs ◽

Chronic Venous Disease ◽

Venous Disease ◽

Operating Characteristics ◽

Potential Biomarker ◽

Pathologic Features

Chronic venous disease (CVD) is a vascular disease of lower limbs with high prevalence worldwide. Pathologic features include varicose veins, venous valves dysfunction and skin ulceration resulting from dysfunction of cell proliferation, apoptosis and angiogenesis. These processes are partly regulated by microRNA (miRNA)-dependent modulation of gene expression, pointing to miRNA as a potentially important target in diagnosis and therapy of CVD progression. The aim of the study was to analyze alterations of miRNA and gene expression in CVD, as well as to identify miRNA-mediated changes in gene expression and their potential link to CVD development. Using next generation sequencing, miRNA and gene expression profiles in peripheral blood mononuclear cells of subjects with CVD in relation to healthy controls were studied. Thirty-one miRNAs and 62 genes were recognized as potential biomarkers of CVD using DESeq2, Uninformative Variable Elimination by Partial Least Squares (UVE-PLS) and ROC (Receiver Operating Characteristics) methods. Regulatory interactions between potential biomarker miRNAs and genes were projected. Functional analysis of microRNA-regulated genes revealed terms closely related to cardiovascular diseases and risk factors. The study shed new light on miRNA-dependent regulatory mechanisms involved in the pathology of CVD. MicroRNAs and genes proposed as CVD biomarkers may be used to develop new diagnostic and therapeutic methods.

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Duplex ultrasound investigation of the veins in chronic venous disease of the lower limbs – UIP Consensus Document. Part II: Anatomy

Phlebology The Journal of Venous Disease ◽

10.1258/026835506779115799 ◽

2006 ◽

Vol 21 (4) ◽

pp. 168-179 ◽

Cited By ~ 4

Author(s):

A Cavezzi ◽

N Labropoulos ◽

H Partsch ◽

S Ricci ◽

A Caggiati ◽

...

Keyword(s):

Lower Limb ◽

Duplex Ultrasound ◽

Lower Limbs ◽

Chronic Venous Disease ◽

Specific Reference ◽

Venous Disease ◽

Perforating Veins ◽

Consensus Document ◽

Wide Range ◽

Ultrasound Investigation

Objectives: Duplex ultrasound investigation has become the reference standard in assessing the morphology and haemodynamics of the lower limb veins. The project described in this paper was an initiative of the Union Internationale de Phlébologie (UIP). The aim was to obtain a consensus of international experts on the methodology to be used for assessment of the anatomy of superficial and perforating veins in the lower limb by ultrasound imaging. Design: Consensus conference leading to a consensus document. Methods: The authors performed a systematic review of the published literature on duplex anatomy of the superficial and perforating veins of the lower limbs. Afterwards, they invited a group of experts from a wide range of countries to participate in this project. Electronic submissions from the authors and the experts (text and images) were made available to all participants via the UIP website. The authors prepared a draft document for discussion at the UIP Chapter meeting held in San Diego, USA, in August 2003. Following this meeting, a revised manuscript was circulated to all participants and further comments were received by the authors and included in subsequent versions of the manuscript. Eventually, all participants agreed on the final version of the paper. Results: The experts have made detailed recommendations concerning the methods to be used for duplex ultrasound examination as well as the interpretation of images and measurements obtained. This document provides a detailed methodology for complete ultrasound assessment of the anatomy of the superficial and perforating veins in the lower limbs. Conclusions: The authors and a large group of experts have agreed on a methodology for the investigation of the lower limbs venous system, by duplex ultrasonography, with specific reference to the anatomy of the main superficial veins and perforators of the lower limbs in healthy and varicose subjects.

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Association between obesity and the aggravation of limited range of ankle mobility in chronic venous disease

Phlebology The Journal of Venous Disease ◽

10.1177/02683555211055350 ◽

2021 ◽

pp. 026835552110553

Author(s):

Sergio Q Belczak ◽

Rubiana Neves Ramos ◽

Jose Maria Pereira de Godoy

Keyword(s):

Varicose Veins ◽

Limited Range ◽

Lower Limbs ◽

Chronic Venous Disease ◽

Venous Disease ◽

Limited Joint Mobility ◽

Group Iii ◽

Group I ◽

Significant Difference ◽

Ankle Mobility

Aim The aim of the present study was to show that an increase in weight leads to the aggravation of limited joint mobility. Method One hundred sixteen patients with varicose veins of the lower limbs and body mass index (BMI) higher than 30 kg/m2 were evaluated at the Belczak Clinic in Maringá, Brazil. All patients were evaluated by the same physician, and the goniometric readings were performed on all patients by a physiotherapist. The participants were then divided into three groups based on BMI: Group I—BMI between 30 and 40. Group II—BMI between 40 and 50, and Group III—BMI > 50. Results There is a significant difference between the groups detected. Conclusion The present findings show that an increased BMI in obese individuals with chronic venous disease is associated with a progressive limitation of ankle mobility.

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One Day Surgery for Chronic Venous Disease of the Lower Limbs

Phlebology ’95 ◽

10.1007/978-1-4471-3095-6_218 ◽

1995 ◽

pp. 491-491

Author(s):

G. Constantinova ◽

E. Gradusov ◽

T. Alekperova

Keyword(s):

Day Surgery ◽

Lower Limbs ◽

Chronic Venous Disease ◽

Venous Disease

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Diagnostic imaging of pelvic congestive syndrome

Phlebology The Journal of Venous Disease ◽

10.1177/0268355514568063 ◽

2015 ◽

Vol 30 (1_suppl) ◽

pp. 67-72 ◽

Cited By ~ 11

Author(s):

CWKP Arnoldussen ◽

MAF de Wolf ◽

CHA Wittens

Keyword(s):

Chronic Pelvic Pain ◽

Lower Abdominal Pain ◽

Clinical Suspicion ◽

Venous Disease ◽

Pelvic Congestion Syndrome ◽

Pelvic Vein ◽

Interventional Imaging ◽

Surgery Department ◽

Vein Insufficiency ◽

Pelvic Congestion

Many female patients are affected by chronic pelvic pain and a significant number of referrals to the gynecology department result in a clinical suspicion of pelvic congestion syndrome. Additionally, patients referred to the vascular surgery department for venous disease can also present with complaints of a persistent dull lower abdominal pain in addition to typically distributed leg varicosities (that extend from the leg through the pelvic floor) which should be evaluated for the presence of pelvic congestion syndrome. In this article, we focus on imaging pelvic vein insufficiency and related (extending) varicosities: how should we evaluate the pelvic veins, what are the signs to look for, and what are the currently established criteria for (pre-interventional) imaging.

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