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INTERNATIONAL ANGIOLOGY

Rivista di Angiologia


Official Journal of the International Union of Angiology, the International Union of Phlebology and the Central European Vascular Forum
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International Angiology 1999 June;18(2):83-102

lingua: Inglese

Chron­ic ­venous dis­or­ders of the leg: epi­dem­i­ol­o­gy, out­comes, diag­no­sis and man­age­ment Sum­mary of an evi­dence-based ­report of the ­VEINES* task force

Kurz X., Kahn S. R. 1, Abenhaim L. 1, Clement D. 2, Norgren L. 3, Baccaglini U. 4, Berardi A. 1, Cooke J. P. 5, Cornu-Thenard A. 6, Depairon M. 7, Dormandy J. A. 8, Durand-Zaleski I. 9, Fowkes G. R. 10, Lamping D. L. 11, Paartsch H. 12, Scurr J. H. 13, Zuccarelli F. 14

From the Depart­ment of Phar­ma­col­o­gy, Uni­ver­sity of Liege, Bel­gium;
1 Cen­tre for Clin­i­cal Epi­dem­i­ol­o­gy and Com­mu­nity Stud­ies, Sir Mor­tim­er B. Davis Jew­ish Gen­er­al Hos­pi­tal, ­McGill Uni­ver­sity, Mon­treal, Que­bec, Can­a­da;
2 Depart­ment of Car­di­o­vas­cu­lar Dis­eas­es, Ghent Uni­ver­sity Hos­pi­tal, Bel­gium;
3 Depart­ment of Sur­gery, Lund Uni­ver­sity, Swe­den;
4 Clin­ic of Sur­gery I, Padua ­Research Uni­ver­sity, Italy;
5 Sec­tion of Vas­cu­lar Med­i­cine, Stan­ford Uni­ver­sity ­School of Med­i­cine, Stan­ford, USA;
6 Depart­ment of Car­di­ol­o­gy, Saint-­Antoine Hos­pi­tal, Paris, ­France;
7 Depart­ment of Inter­nal Med­i­cine, Divis­ion of Car­di­ol­o­gy, Vaud Uni­ver­sity Hos­pi­tal, Lau­sanne, Swit­zer­land;
8 Depart­ment of Sur­gery, St.-­George’s Hos­pi­tal, Lon­don, UK;
9 Depart­ment of Pub­lic ­Health, Henri-Mon­dor Hos­pi­tal, Paris, ­France;
10 Wolf­son Unit for Pre­ven­tion of Periph­er­al Vas­cu­lar Dis­eas­es, Depart­ment of Pub­lic ­Health Sci­enc­es, Uni­ver­sity of Edin­burgh, UK;
11 ­Health Ser­vic­es ­Research Unit, Lon­don ­School of ­Hygiene and Trop­i­cal Med­i­cine, UK;
12 Depart­ment of Der­ma­tol­o­gy, ­Wilhelmina’s Hos­pi­tal, Vien­na, Aus­tria;
13 The Mid­dles­ex Hos­pi­tal, Uni­ver­sity Col­lege and Mid­dles­ex ­School of Med­i­cine, Lon­don, UK;
14 Depart­ment of Angi­ol­o­gy-Phle­bol­o­gy, Saint-Mich­el Hos­pi­tal, Paris, ­France


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Background. To crit­i­cal­ly ­review the clas­sifi­ca­tion, epi­dem­i­ol­o­gy, out­comes, diag­no­sis and treat­ment of chron­ic ­venous dis­or­ders of the leg (CVDL), to issue evi­dence-based rec­om­men­da­tions, and to iden­ti­fy areas requir­ing fur­ther ­research.
Meth­ods. Arti­cles iden­ti­fied by an exten­sive lit­er­a­ture ­search were ­scored by mem­bers of an inter­na­tion­al task force. Only those arti­cles with a mod­er­ate or ­strong rat­ing for inter­nal valid­ity were ­retained.
­Results. A scor­ing ­system weigh­ing CVDL sever­ity accord­ing to the prob­abil­ity of ulcer occur­rence is pro­posed. Epi­dem­i­olog­i­cal data on the fre­quen­cy of CVDL and its risk fac­tors are ­reviewed. The fol­low­ing items are eval­u­at­ed: costs asso­ciat­ed with treat­ment; clin­i­cal out­comes relat­ed to CVDL and its treat­ment; avail­able gener­ic and dis­ease-spe­cif­ic meas­ures of qual­ity of life; diag­nos­tic pro­ce­dures used to ­detect ­venous ­reflux; and effi­ca­cy of available treat­ments.
Con­clu­sions. CVDL is an impor­tant pub­lic ­health prob­lem, based on its prev­a­lence, cost and ­impact on qual­ity of life. High-pri­or­ity areas for ­research on CVDL are iden­ti­fied.

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