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International Angiology 2020 Mar 26

DOI: 10.23736/S0392-9590.20.04273-X


language: English

Bioelectrical impedance analysis of leg edema and its association with venous functions in patients with saphenous varicose veins

Toshiya NISHIBE 1, 2 , Masayasu NISHIBE 1, Shinobu AKIYAMA 2, Saori NUKAGA 2, Hitoshi OGINO 2, Jun KOIZUMI 3, Alan DARDIK 4

1 Department of Surgery, Eniwa Midorino Clinic, Eniwa, Japan; 2 Department of Cardiovascular Surgery, Tokyo Medical University, Tokyo, Japan; 3 Department of Diagnostic Radiology, Tokai University School of Medicine, Isehara, Japan; 4 Department of Surgery, Yale University School of Medicine, New Haven, CT, USA


BACKGROUND: To quantitatively evaluate edema of the lower legs in patients with saphenous varicose veins, and to determine the association between leg edema and venous hemodynamics of the lower legs.
METHODS: The data of 140 patients with saphenous varicose veins visiting Eniwa Midorino Clinic from April 2018 to November 2019 were retrospectively analyzed. Body composition values, including mass index (BMI), extracellular water / total body water (ECW/TBW) of each leg, and skeletal muscle mass of each leg, were measured by segmental multi-frequency bioelectrical impedance analyzer. Overall venous hemodynamics of the leg, including functional venous volume, venous filling index (VFI), and ejection fraction, was assessed using air-plethysmography. Saphenous and deep vein reflux was evaluated by duplex scan.
RESULTS: A total of 140 patients (58 men and 82 women) with a mean age of 66.0 years (range, 21 to 84 years) were analyzed. On visual inspection, 204 legs had saphenous-type varicose veins, while 76 legs did not. The legs were divided into 2 groups according to the presence or absence of leg edema, which was defined as ECW/TBW ≥ 0.390 and < 0.390, respectively; 178 legs had leg edema and the remaining 102 legs had no leg edema. In univariate analysis, there were significant differences in age, sex, the presence of saphenous varicose veins, hypertension, and VFI between legs with edema and those without edema. Multivariable logistic regression analysis for leg edema detected age, female gender, and VFI as an independent risk factor for leg edema.
CONCLUSIONS: Leg edema was objectively evaluated by bioelectrical impedance analysis in patients with saphenous varicose veins. Older age, female gender, and increased venous reflux were identified as independent risk factors for leg edema.

KEY WORDS: Varicose veins; Edema; Hemodynamics

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