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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


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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