Cezary Szary1,2, Justyna Wilczko1, Dominika Plucinska1, Anna Pachuta1, Marcin Napierala1, Anna Bodziony1, Michal Zawadzki1,3, Jerzy Leszczynski1,4, Zbigniew Galazka4, Tomasz Grzela1,5. 1. Clinic of Phlebology, 02-034 Warsaw, Poland. 2. Diagnostic Imaging Center MRI & CT, Center of Sport Medicine, 02-034 Warsaw, Poland. 3. Department of Radiology, Center of Postgraduate Medical Education, 01-813 Warsaw, Poland. 4. Department of General, Endocrine and Vascular Surgery, Medical University of Warsaw, 02-091 Warsaw, Poland. 5. Department of Histology and Embryology, Medical University of Warsaw, 02-002 Warsaw, Poland.
Abstract
INTRODUCTION: The current treatment of venous disease is focused on reflux elimination in main venous trunks, especially in the saphenous vein. However, a high recurrence rate, independent of the method of treatment, suggests that the reason of low effectiveness may be due to a strategy focused on symptoms, without considering their origin. METHOD: The aim of study was the comparison of retrospective data from 535 women with venous disease, either after treatment (n = 183) or not treated before (n = 352). The analysis concerned clinical symptoms and the results of the extended diagnostics, including the examination of the lower limb, pelvic and abdominal veins either using duplex-doppler ultrasound as well as venography with computed tomography or magnetic resonance. RESULTS: The comparison of selected venous system parameters revealed more advanced disease progression in previously treated patients, compared to non-treated individuals (e.g., ipsi- or bilateral incompetence of sapheno-phemoral junction-29.5% vs. 20.4%, at P < 0.05 and 13.6% vs. 7.7% at P < 0.05, respectively). This difference could be explained by post-treatment alterations in the venous system, an older age and the higher number of pregnancies in the recurrence group. However, both groups did not differ in regards to the symptoms of pelvic venous insufficiency or the frequency of relevant variants/abnormalities in venous system. CONCLUSIONS: Based on the aforementioned findings, we postulate the revision of treatment strategy, which should consider abdominal and pelvic veins as the source of reflux in many female subjects.
INTRODUCTION: The current treatment of venous disease is focused on reflux elimination in main venous trunks, especially in the saphenous vein. However, a high recurrence rate, independent of the method of treatment, suggests that the reason of low effectiveness may be due to a strategy focused on symptoms, without considering their origin. METHOD: The aim of study was the comparison of retrospective data from 535 women with venous disease, either after treatment (n = 183) or not treated before (n = 352). The analysis concerned clinical symptoms and the results of the extended diagnostics, including the examination of the lower limb, pelvic and abdominal veins either using duplex-doppler ultrasound as well as venography with computed tomography or magnetic resonance. RESULTS: The comparison of selected venous system parameters revealed more advanced disease progression in previously treated patients, compared to non-treated individuals (e.g., ipsi- or bilateral incompetence of sapheno-phemoral junction-29.5% vs. 20.4%, at P < 0.05 and 13.6% vs. 7.7% at P < 0.05, respectively). This difference could be explained by post-treatment alterations in the venous system, an older age and the higher number of pregnancies in the recurrence group. However, both groups did not differ in regards to the symptoms of pelvic venous insufficiency or the frequency of relevant variants/abnormalities in venous system. CONCLUSIONS: Based on the aforementioned findings, we postulate the revision of treatment strategy, which should consider abdominal and pelvic veins as the source of reflux in many female subjects.
Authors: P Coleridge-Smith; N Labropoulos; H Partsch; K Myers; A Nicolaides; A Cavezzi Journal: Eur J Vasc Endovasc Surg Date: 2005-10-14 Impact factor: 7.069
Authors: S Gianesini; S Occhionorelli; E Menegatti; M Zuolo; M Tessari; P Spath; S Ascanelli; P Zamboni Journal: Phlebology Date: 2014-04-22 Impact factor: 1.740
Authors: S K Van der Velden; M Lawaetz; M G R De Maeseneer; L Hollestein; T Nijsten; R R van den Bos Journal: Eur J Vasc Endovasc Surg Date: 2016-03-16 Impact factor: 7.069
Authors: Stefanie A Gauw; James A Lawson; Clarissa J van Vlijmen-van Keulen; Pascal Pronk; Menno T W Gaastra; Michael C Mooij Journal: J Vasc Surg Date: 2015-10-23 Impact factor: 4.268