Clinical and vascular ultrasound aspects in patients with chronic venous disease

Introduction: Chronic venous disease is a potentially disabling condition through its skin and life-threatening thromboembolic complications. This paper aims to assess clinical issues based on CEAP classification, risk factors and aspects of venous ultrasound in patients with chronic venous disease (CVD). Methods: The study group consisted of 136 patients with chronic venous disease presented for vascular ultrasound evaluation, the initially diagnosis being anamnestic and clinical. Th ere were noted demographic factors, risk factors for chronic venous disease, clinical appearance according with CEAP classification, history of venous thrombosis. In terms of vascular ultrasound the following parameters were analyzed: the presence and duration of venous reflux at provocation maneuvers, the presence of perforators, tissue edema and deep/superficial vein thrombosis. Chronic venous insufficiency was defined at least class 3 CEAP, and in patients with history of thrombosis venous disease was considered secondary. Results: Of the 136 patients (p) clinically and ultrasound diagnosed with CVD 113 (83%) had primary CVD and 23 (17%) secondary CVD. Regarding the CEAP classification, patients with primary CVD 63 (56%) were in C0s-C2 classes and 50 (44%) in classes C3-C6, and of patients with secondary CVD 3 (13%) were enrolled in classes C0s-C2 and 20 (87%) in classes C3-C6. 103 (75%) patients had venous reflux: 47 (35%) mild, 15 (11%) moderate and 38 (28%) severe. Pathologic perforators were found in 20 (15%) of p. Tissue edema was revealed by ultrasound in 50 (37%) p. 62 p (46%) had ultrasonographic appearance of DVT, 25 (18%) p SVT and 42 (31%) p varices. Of the enrolled p in classes C0s-C2 vascular ultrasound found 13 (19%) p with tissue swelling, 46 (68%) p with reflux at Valsalva maneuver in the SFJ and 10 (15%) p with DVT. Conclusions: 1. Venous ultrasonography is a useful diagnostic method in chronic venous disease because it provides clear information on the anatomy and hemodynamics of the venous system, objectively demonstrating venous valvular incompetence and venous thrombosis. 2. Venous ultrasonography identifies chronic venous disease in the early stages allowing application of appropriate therapeutic and prophylactic measures.

ISSN – online: 2734 – 6382
ISSN-L 1220-658X
ISSN – print: 1220-658X
The Romanian Journal of Cardiology is indexed by:
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CODE: 379
CME Credits: 10 (Romanian College of Physicians)