Publications and Key Points on Varicose Veins and Its Symptoms
Varicose veins, a prevalent vascular condition, have been extensively studied in various publications. These studies emphasize the significance of recognizing the signs and symptoms associated with this condition. Common key symptoms include the appearance of dark-blue or purple veins, swelling, and persistent aching in the affected legs. Early detection and lifestyle modifications, such as regular exercise, leg elevation, and wearing compression stockings, are vital in managing symptoms effectively. Understanding the insights from these publications empowers individuals to proactively address varicose veins and improve their overall well-being.
| Study | Key Point |
|---|---|
| Kistner RL. Primary venous valve incompetence of the leg. Am J Surg 1980;140:218. | Perforator incompetence leads to indurated skin with ulceration Tibial, Popliteal or Femoral Incompetence results in aching and swelling in leg |
| Widmer LK. Peripheral Venous Disorders: Prevalence and Socio-medical Importance: Observations in 4529 Apparently Healthy Persons: Basle Study III. Huber; 1978. | Similar range of complaints in both men and women Increased Incidence of complaints among women and older patients |
| Strandness DE, Thiele BL. Selected topics in venous disorders: pathophysiology, diagnosis, and treatment. (No Title). 1981. | Symptoms caused by varicose veins improve with age as the amount of activity is decreased |
| Parish TD. Varicosis, aesthetics, and pain. Am J Cosmetic Surg 1998;15:143. | Nonsaphenous Reflex patients had twice the incidence of painful legs than patients with saphenous reflex (43% vs 22%) |
| Weiss R, Weiss M. Resolution of pain associated with varicose and telangiectatic leg veins after compression sclerotherapy. J Dermatol Surg Oncol 1990;16:333. | 53% of patients (n = 350) who sought treatment for veins less than 1 mm size showed symptoms including swelling, burning, throbbing and cramping with tired felling |
| Murray RY. A retrospective analysis of varying symptoms in patients presenting for sclerotherapy of telangiectasia. J Dermatol Surg Oncol 1994 (abstract);20:70. | 69% of patients (n = 401) who sought treatment for telangiectasia showed symptoms including pain, burning, throbbing and heaviness |
| Fegan WG, Lambe R, Henry M. Steroid hormones and varicose veins. Lancet 1967;290:1070. | 27.7% of women with varicose veins have premenstrual pain in their varices |
| MacCausland AM. Varicose veins in pregnancy. Cal West Med 1939;50:258. | Varicose veins during pregnancy appear to be more symptomatic than those unassociated with pregnancy. |
| Isaacs MN. Symptomatology of vein disease. Dermatol Surg 1995;21:321 | Symptoms specific to venous disease were found to correlate with the presence of both small vein and large vein disease. Vein size did not predict the presence or severity of symptoms |
| McEnroe CS, O’Donnell TF Jr, Mackey WC. Correlation of clinical findings with venous hemodynamics in 386 patients with chronic venous insufficiency. Am J Surg 1988;156:148. | Varicose Vein = cutaneous marker for venous insufficiency |
| Morano JU, Raju S. Chronic venous insufficiency: assessment with descending venography. Radiology 1990;174:441 | Descending Venography in patients with CVI (n = 644) 2% patients with only superficial reflux 18% with both deep and superficial reflux Rest had deep reflux |
| Train JS, Schanzer H, Peirce EC II, et al. Radiological evaluation of the chronic venous stasis syndrome. JAMA 1987;258:941. | Ascending Venography in patients with CVI, 20% patients have isolated perforator incompetence as the only demonstrable abnormality |
| Walsh JC, Bergan JJ, Beeman S, et al. Femoral venous reflux is abolished by greater saphenous vein stripping. J Dermatol Surg Oncol 1994;20:65. | Identification of patients with superficial venous insufficiency is important because they may respond to sclerotherapy or surgical treatment of superficial system alone |
| Moore DJ, Himmel PD, Sumner DS. Distribution of venous valvular incompetence in patients with postphlebotic syndrome. J Vasc Surg 1986;3:49. | Strong association between severity of clinical signs and superficial venous incompetence |
| Almgren B, Eriksson I. Valvular incompetence in superficial, deep and perforator veins of the limbs with varicose veins. Acta Chir Scand 1990;156:69. | All patients with either active or healed venous ulcerations have evidence of perforator incompetence. Almost all the patients with cutaneous abnormalities have incompetence of perforator veins. |
| Smith JJ, Garratt AM, Guest M, et al. Evaluating and improving health-related quality of life in patients with varicose veins. J Vasc Surg 1999;30:710. | (n=137) Aberdeen Varicose Vein Questionnaire. Patients having worse health preoperatively than post-operative. Patients have reduced Quality of Life (QOL) compared to general population with significant improved at 6 weeks after surgery. |
| Kurz X, Lamping DL, Kahn SR, et al. Do varicose veins affect the quality of life? Results of an international population-based study. J Vasc Surg 2001;34:641. | 5688 consecutive patients in Belgium, Canada, France and Italy. QOL in patients with varicose veins is associated with concomitant venous disease rather than varicose veins per se. |
| Kaplan RM, Criqui MH, Denenberg JO, et al. Quality of life in patients with chronic venous disease: San Diego population study. J Vasc Surg 2003;37:1047. | (n = 2404) University of California, San Diego Medical Centre. Adverse QOL in patients with CVD. Effect of venous disease is more on the functional scale (what a person can do) and doesn’t seem to affect the well being aspect (how a person feels) |
| Allen EV, Barker NW, Hines EA Jr. Peripheral vascular diseases. Philadelphia: Saunders; 1946. | Ankle oedema is the first manifestation of CVI |
| Guex JJ, Enrici E, Boussetta S, et al. Correlations between ankle circumference, symptoms, and quality of life demonstrate the clinical relevance of minimal leg swelling reduction: results of a study in 1,036 Argentinean patients. Dermatol Surg 2008;34: 1666. | Ankle circumference, Symptoms and QOL Moderate ankle swelling secondary to CVI |
| Lofgren KA. Varicose veins: their symptoms, complications, and management. Postgrad Med 1979;65:131. | True ‘pitting’ edema is rare, perhaps resulting from increased dermal fibrosis present in lipodermatosclerosis. |
| Hojensgard IC, Sturup H. On the function of the venous pump and the venous return from the lower limbs. Acta Derm Venerol Suppl (Stockh) 1952;29(Suppl.):169. | The edema usually found is restricted to a limited area drained by capillaries that empty directly into the varicose or incompetent perforating veins. |
| . Caggiati A, Rosi C, Casini A, et al. Skin iron deposition characterizes lipodermatosclerosis and leg ulcer. Eur J Vasc Endovasc Surg 2010;40:777. | Severe skin changes don’t occur until iron overload is present |
| Zamboni P, Izzo M, Tognazzo S, et al. The overlapping of local iron overload and HFE mutation in venous leg ulcer pathogenesis. Free Radic Biol Med 2006;40:1869. | Link between pro-inflammatory properties of ferric ions and venous ulcer and genetic inborn error of metabolism |
| Wenner A, Leu HJ, Spycher M, et al. Ultrastructural changes of capillaries in chronic venous insufficiency. Exp Cell Biol 1980;48:1 | Extravasation appears to be caused by increased intravascular pressure and not chemotaxis, as occurs with white blood cells |
| Dinn A, Henry M. Value of light weight elastic tights in standing occupations. Phlebology 1989; 4-45 | Patients often do not fully appreciate the potential improvement in the comfort and well-being of their legs until they undergo treatment for blood vessel issues, such as compression sclerotherapy, or begin using lightweight graduated compression stockings (at 20 mmHg). |
| Maessen-Visch MB, Sommer A, De Paepe JA, et al. Change in microcirculation in patients with atrophie blanche visualized by laser Doppler perfusion imaging and transcutaneous oxygen measurement. Phlebology 1998;13:45. | Basic resting flow in atrophie blanche is higher compared to normal skin and patients with chronic venous incompetence. Also there is marked decrease in flow in response to treating venous hypertension. |
| Labropoulos N, Giannoukas AD, Nicolaides AN, et al. New insights into the pathophysiologic condition of venous ulceration with color-flow duplex imaging: implications for treatment? J Vasc Surg 1995;22:45. | Distal venous reflux - impact on skin changes and ulcerations. Superficial vein reflux is more harmful than deep venous reflux |
| Yamaki T, Nozaki M, Sasaki K. Color duplex ultrasound in the assessment of primary venous leg ulceration. Dermatol Surg 1998; 24:1124 | Patient with primary venous leg ulceration should be managed with ablation of superficial venous reflux and ablation of outward flow through perforating veins |
| Gooley NA, Sumner DS. Relationship of venous reflux to the site of venous valvular incompetence: implications for venous reconstructive surgery. J Vasc Surg 1988;7:50. | 20-25% Ulcerations have superficial venous insufficiency, either alone with perforating vein incompetence or as a significant component combined with deep venous insufficiency. |
QOL – Quality of Life, CVI – Chronic Venous insufficiency, CVD – Chronic venous Disease