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Objective To evaluate the heredity factor of the chronic venous disorders and odds ratio linked to maternal or paternal heredity. Methods Cross-sectional epidemiological study conducted in daily practice of medical practitioners on all patients consulting them. The practitioners described the venous status of all patients consulting them and recorded the familial past history of venous disease. Results Among 21319 patients, 60.4% have a familial history of chronic venous disorder: unilateral paternal 7.5%, unilateral maternal 40.9% and bilateral: 12.0%. Chronic venous disorder prevalence is 58.8% in the global population, 38.2% in the absence of parental history, 67.0% for unilateral paternal, 71.3% for unilateral maternal and 79.2% for bilateral (p < 0.0001). After adjustment on age and sex, results show significant (p < 0.0001) odds ratio of 3.2 for unilateral paternal, of 3.4 for unilateral maternal and of 5.6 for a history in both parents. In the context of a history in both parents, the odds ratio increased to 5.6 for women and 8.4 for men. Conclusion This large cross-sectional study confirms the association between heredity and venous disease, but its results could call into question the maternal predominant character of the chronic venous disorder heredity. [ABSTRACT FROM AUTHOR]

The article presents several abstracts on medical topics including effects of catheter-directed thrombolysis, risk assessment of the Caprini venous thromboembolism, and endovenous laser ablation presented at the 15th Meeting of the European Venous Forum in Paris, France from June 26-28, 2014.

Venous reflux often originates from saphenous trunks and their tributaries. In about 10% of the patients reflux derived from non-saphenous veins (NSV) such as those located in the buttock, postero-lateral thigh, vulva, lower posterior thigh, popliteal fossa, knee or along the peripheral nerves such as the tibial and sciatic nerve. It is also important to note that patients who had saphenous vein stripping or ablation have higher odds of presenting with NSV reflux. The majority of patients with NSV reflux have varicose veins and lower extremity oedema; however, about 10% of those patients present with skin damage. This paper analyses the patterns and types of NSV reflux for diagnosis and treatment purposes. [ABSTRACT FROM AUTHOR]

Pelvic congestion syndrome (PCS) is frequent and underestimated as both symptoms and signs are not specific. Furthermore, patients consult general practitioners as well as specialist gynaecologists, urologists, vascular surgeons and phlebologists who are frequently unaware of this condition. Investigation protocol must first eliminate other diseases with similar clinical disorders and then identify which veins are responsible for PCS related to compression or reflux. Selective venography is the more informative investigation but transvaginal ultrasound examination is a valuable screening test. Outcome analyses after endovenous treatment have been reported in several articles, but no randomized controlled trial is available for comparing various operative treatments knowing that most of them were undertaken after failure of medical treatment. In our experience, about two-thirds of patients were symptom-free after vein compression, stenting, or embolization at middle-term assessment. [ABSTRACT FROM AUTHOR]

Purpose: To detect the influence of pelvic vein incompetence (PVI) on pain levels in patients with varicosity of the lower limb. Materials and methods: Women of child-bearing age with symptomatic primary or recurrent varicosity of the greater saphenous vein (GSV) were prospectively included in two groups depending on the presence or absence of phlebographic signs of PVI. Pain assessment was carried out with the help of a visual analogue scale (VAS). Results: Forty women were included in the study. Nineteen of them had phlebographic evidence of PVI (group A), whereas 21 were included in the control group (group B). Patients of group A reported a higher median total pain level than patients of group B (group A median 62, range 25-100; group B median 32, range 0-100; P = 0.001). In group A, patients experienced a median level of pain of 67.2 at the lower limb in the standing position (range 40-100) versus a median of 50.3 (range 36-81) in patients of group B (P = NS). The median level of leg pain in the sitting position was 41.2 (range 0-67) in patients of group A and 38.1 (range 0-46) in women of group B (P = NS). Pelvic pain level in the standing position was higher (P = NS) in patients of group A (median 72.2, range 50-91), than in women of group B (median 20.1, range 0-41). In patients of group A, statistically significant (P = 0.0001) higher VAS scores for pelvic pain level in sitting (group = A median 67.2, range 59-71; group B median 18.1 range 0-35) were reported. Conclusions: In a small population of patients with GSV varicosity, overall pain levels were significantly higher in a subgroup of patients with phlebographic signs of PVI. This finding suggests that the presence of PVI might influence the intensity of varicosity symptoms. [ABSTRACT FROM AUTHOR]

Objectives: Mounting evidence suggests that pelvic vein reflux is an important contributing factor to recurrent varicose veins. We compared the incidence in our specialist private unit (Unit A) with that of a District General Hospital (Unit B). Methods: Results of all female patient lower limb duplex ultrasound (LLDUS) and transvaginal pelvic ultrasound (TVUS) scans performed over a one-year period were retrospectively reviewed. Patients with refluxing veins emanating from the abdomen or pelvis on LLDUS (non-saphenous reflux) routinely proceeded to TVUS in Unit A. Results: In Unit A, non-saphenous reflux on LLDUS was present in 90-462 female patients (19.5%). In 81.1% of these, TVUS confirmed reflux in truncal pelvic veins (incidence 15.8%). In Unit B, non-saphenous reflux was present in 60-279 female patients (21.5%). Conclusion: One in five women presenting with varicose veins have reflux of non-saphenous origin. This is the case in specialist and non-specialist units. One in six has associated pelvic vein reflux. [ABSTRACT FROM AUTHOR]

The article presents abstracts on medical topics which include the survey concerning the short and long-term side-effects of sclerotherapy, the impact of Varisolve treatment to patient with detectable gas emboli in the middle cerebral artery (MCA), and the capacity of two sclerosing agents and placebo for sclerotherapy of C1-varicose veins.

Objectives: To prospectively study the profile of restless leg syndrome (RLS) in patients presenting to a phlebology practice. Methods: The study uses prospective questionnaire and clinical observation study. In all, 174 consecutive patients and 174 matched controls were evaluated in detail. The diagnosis of restless legs syndrome (RLS) was established by the International RLS study group (IRLSSG) criteria. Detailed clinical, systemic and Duplex ultrasound evaluations were done to establish the presence of chronic venous disorders (CVD) (reflux > 0.5s on augmentation manoeuvers and revised clinical, aetiological, anatomical and pathological [CEAP] criteria). Results: Of the 174 consecutive subjects studied (22M: 152F), 63 (36%) had evidence of RLS compared with only 34 of 174 of the controls (19%, P <0.05). Sixty-two (98%) of these RLS-positive study subjects were subsequently diagnosed with CVD. In comparison, 31 (91%) of the RLS-positive control subjects (n = 34) were found to have CVD. This prevalence of CVD was comparable with RLS-positive study subjects, but was significantly higher than the prevalence in CVD in RLS-negative controls (P <0.01). Only three (9%) of the controls had RLS without CVD. RLS-positive subjects were typically women above the age of 40 years (P <0.01 vs. men, P <0.01 vs. below 40 years). A significant difference in clinical presentation in the study subjects was the high prevalence of leg cramps in the RLS-positive subjects (P <0.01). None of the patients with RLS in this series gave history of anaemia, chronic renal failure or an established psychiatric or neurological disease as found pathognomic for RLS by others. Conclusions: RLS appears to be a common overlapping clinical syndrome in patients with CVD. Prospective blinded therapeutic trials are planned to study the influence of definitive treatments for CVD on sequential RLS scores. [ABSTRACT FROM AUTHOR]

Objectives: Tostudy the clinical spectrum of recurrent varices after surgery (REVAS) and the efficacy of sclerotherapy under the comprehensive objective mapping, precise image-guided injection, antireflux positioning and sequential sclerotherapy (COMPASS) technique in their management. Methods: Design: prospective open study with 1.5-5.7-year follow up. Patients: 253 legs of 168 consecutive patients who had received previous surgery for primary varicosity. Main outcome measures: obliteration, recanalization, residual reflux, neovascularization, venous dysfunction score and cumulative obliteration. Results: REVAS presents as a symptomatic chronic venous disease of women in their fifties, a decade later than primary varicosities are reported. Almost 75% of REVAS occurred at the groin, mostly with features of chronic venous disease. The COMPASS technique achieved sustained obliteration in 97% of the groin varices and in 100% of the thigh and isolated refluxes around the popliteal fossa. The cumulative obliteration rate was sustained at >90% and obliteration of perforator reflux was sustained. There was a significant decrease in the venous dysfunction score. In the mean 3.1±1.7 years of follow up, only 3% possible neovascularization was seen. There were no serious adverse experiences reported. Conclusions: REVAS is a symptomatic chronic venous disease requiring skilled medical attention. The COMPASS technique appears to be more efficacious than the presently available surgical approaches to its long-term management. [ABSTRACT FROM AUTHOR]

Aim: To determine the percentage of varicose vein recurrence after compression sclerotherapy of a specific primary varicose vein, the anterolateral thigh vein (lateral accessory saphenous vein), without saphenofemoral junction (SFJ) incompetence at yearly intervals in a long-term follow-up study, and to investigate factors influencing recurrence. Patients and methods: Of 117 patients recruited, 11 were lost to follow up; therefore 106 patients were evaluated: 97 women, mean age 42 years (range 21-72) and nine men, mean age 47 years (range 21-67). If SFJ incompetence was present, surgical ligation of the junction was performed. Primary varicose veins were treated with compression sclerotherapy using polidocanol. A total of 111 limbs were studied. Results: Recurrent varicose veins were found after six months in 6% of cases, after one year in 18% (cumulative percentage), after two years in 28%, after three years in 36%, after four years in 46%and after five years in 54%. No differences could be detected between the recurrence group and the group without recurrence regarding length of varicose veins, amount of polidocanol used, number of injections, circumference of the leg or age of the patient. The varicose vein diameter was significantly larger in the recurrence group. Conclusions: Compression sclerotherapy with polidocanol of the anterolateral thigh vein (lateral accessory saphenous vein) without SFJ incompetence results in a high recurrence rate. Recurrence depends only on the vessel diameter, and not on the length of the varicose vein, amount of sclerosant used or patient age. [ABSTRACT FROM AUTHOR]

Objective: To evaluate the role of subjective symptoms, grade of disability and axial reflux in superficial veins in different clinical stages of varicose veins (VVs). Methods: A total of 172 legs with primary venous insufficiency from 126 patients were studied. The examination involved evaluation of the CEAP clinical class and clinical disability score (CDS), recording of any symptoms of varicose disease, and a hand-held Doppler (HHD) examination of the superficial veins. Colour-flow duplex imaging (CFDI) was also performed in 22% of the legs. Results: The rate of insufficiency of the great saphenous vein (GSV) was 83% in complicated legs (C4-6), and 68% in uncomplicated legs (C2-3), (P > 0.05). There was a difference between complicated and uncomplicated legs in the insufficiency of the whole GSV [C4-6: n = 18 (39%) versus C2-3: n = 12 (12%), P < 0.005]. Sensation of pain was noted in 68% of the legs in class C1, 60% of those in class C2-3 and 81% of those in class C4-6. Sensation of oedema was recorded in 70% of the legs in class C1, 65% of those in class C2-3 and 86% of those in class C4-6, respectively. CDS classes 2-3 were significantly more frequent among complicated legs (C4-6: 54% versus C2-3 12%, P < 0.005). Conclusions: Leg symptoms are frequent throughout classes C1-6. Their clinical usefulness is therefore limited. CDS parallels well with the clinical classification. In complicated disease the whole saphenous vein is more frequently insufficient. [ABSTRACT FROM AUTHOR]