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ULTIMO FASCICOLOINTERNATIONAL ANGIOLOGY

Rivista di Angiologia


Official Journal of the International Union of Angiology, the International Union of Phlebology and the Central European Vascular Forum
Indexed/Abstracted in: BIOSIS Previews, Current Contents/Clinical Medicine, EMBASE, PubMed/MEDLINE, Science Citation Index Expanded (SciSearch), Scopus
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International Angiology 2003 Giugno;22(2):182-7

 ORIGINAL ARTICLES

Pat­terns of ­venous ­reflux in limbs with ­venous ­ulcers. Impli­ca­tions for treat­ment

Ioannou C. V. 1, Giannoukas A. D. 1, Kostas T. 1, Kafetzakis A. 1, Liamis A. 1, Touloupakis E. 1, Tsetis D. 2, Katsamouris N. 1

1 Divi­sion of Vas­cu­lar Sur­gery, Uni­ver­sity Hos­pi­tal of Herak­lion, Uni­ver­sity of Crete Med­i­cal ­School, Herak­lion, Crete, ­Greece
2 Depart­ment of Radiol­o­gy, Uni­ver­sity Hos­pi­tal of Herak­lion, Uni­ver­sity of Crete Med­i­cal ­School, Herak­lion, Crete, ­Greece

Aim. To inves­ti­gate the ana­tom­ic dis­tri­bu­tion of vein ­reflux in limbs with ­healed or ­active ­ulcers (CEAP V and VI).
Meth­ods. Sixty limbs (58 patients) belong­ing to CEAP class­es V and VI were iden­ti­fied from 798 limbs (519 patients) with ultra­son­i­cal­ly prov­en chron­ic ­venous insuf­fi­cien­cy (CVI). Age, gen­der, dura­tion of the ­venous ulcer, and his­to­ry of deep ­venous throm­bo­sis were cor­re­lat­ed to the ana­tom­ic dis­tri­bu­tion of the ­venous ­reflux.
­Results. The prev­a­lence of ­active or ­healed ­ulcers in limbs with CVI was 7.5%. Among 60 limbs with ­ulcers, pri­mary CVI was ­present in 34 (56.7%) and post-throm­bot­ic CVI in 26 limbs (43.3%). No dif­fer­ence in age and gen­der was found ­between the 2 ­groups (p=0.2 and p=0.8, respec­tive­ly). How­ev­er, the dura­tion of the ulcer was long­er in limbs with post-throm­bot­ic CVI (p<0.05). The prev­a­lence of per­fo­ra­tor ­reflux was 41.2% (14/34) in limbs with pri­mary CVI and 38.5% (10/26) in limbs with post-throm­bot­ic CVI (p=0.8). Super­fi­cial ­venous insuf­fi­cien­cy, with or with­out per­fo­rat­ing vein ­reflux, was the com­mon­est pat­tern in limbs with pri­mary CVI; it was rare in limbs with post-throm­bot­ic CVI (22/34 or 64.7% vs 2/26 or 7.7%, p<0.01). Deep vein insuf­fi­cien­cy was ­present in 35.3% (12/34) of the limbs with pri­mary CVI and in 92.3% (24/26) of the limbs with post-throm­bot­ic CVI (p<0.01).
Con­clu­sion. Super­fi­cial ­venous insuf­fi­cien­cy, with or with­out per­fo­rat­ing vein ­reflux, was the com­mon­est pat­tern in limbs with pri­mary CVI, where­as, deep ­venous insuf­fi­cien­cy was ­present in most of the limbs with post-throm­bot­ic CVI. The prev­a­lence of per­fo­rat­ing vein ­reflux was com­par­able in both set­tings. Thus, elim­i­na­tion of super­fi­cial ­reflux is expect­ed to ­result in ulcer heal­ing of most limbs with pri­mary CVI, where­as, the value of such treat­ment in post-throm­bot­ic limbs is not clear.

lingua: Inglese


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