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A Journal on Heart and Vascular Diseases

Official Journal of the Italian Society of Angiology and Vascular Pathology
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Minerva Cardioangiologica 1999 May;47(5):167-74

language: Italian

Relationships between clinical and instrumental patterns in venous pathology (capillaroscopic classification of the medial perimalleolar area)

Luca S., Nicolosi E., Romeo S.


Background. The high incidence of chronic venous insufficiency makes it quite an ordinary topic in the outpatients departments of vascular units. Furthermore, due to the discrepancy between symptoms and Doppler c.w reports, it is necessary to face this problem with the help of very sensitive instrumental methods. Therefore, the main aim of this article is to find out which method, among those used in the outpatients department of phlebology, is sensitive enough to estabilish a relationship between clinical and instrumental patterns in venous diseases.
Methods. Fifty-one subjects were studied: 44 affected by venous disease and 7 healthy subjects. All patients underwent clinical examination followed by classification by Widmer criteria, Doppler c.w., infrared photoplethysmography and capillaroscopy of the medial malleolus.
Results and conclusions. Capillaroscopy demonstrated to have the highest sensitivity, allowing to find out pathological alterations in subjects complaining of symptoms and with normal Doppler c.w. findings. Furthermore, the findings of venular networks (pathological) in the malleoli of healthy subjects, made it necessary to modify the current capillaroscopic classification (based upon three types of pictures: normal, reticular and halo formations), into a new extended version based on five steps, with three types of reticular sub-classes, in which the different gauge of the venules is satisfactorily related to the symptoms referred by the patients.

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