Evaluatıng大隐静脉返流模式对Clınıcal Severıty及治疗的影响Modalıty

Aykut Kadıoğlu
{"title":"Evaluatıng大隐静脉返流模式对Clınıcal Severıty及治疗的影响Modalıty","authors":"Aykut Kadıoğlu","doi":"10.31579/2692-9392/159","DOIUrl":null,"url":null,"abstract":"Objectives: This research aimed to determine the impact of reflux patterns in patients with great saphenous vein (GSV) insufficiency on clinical severity and management. Methods: We evaluated 771 lower extremities of 452 patients having GSV insufficiency with Doppler Ultrasound. We characterized the reflux patterns like previously done in the literature: type 1, GSV reflux without the involvement of perimalleolar region or saphenofemoral junction (SFJ); type 2, GSV reflux involving perimalleolar region; type 3, GSV reflux involving SFJ; type 4, GSV reflux involving both perimalleolar region and SFJ. Then we conducted a study to evaluate the relationship between GSV reflux type and age, gender, venous clinical severity score (VCSS), clinical, etiological, anatomical and pathophysiological elements (CEAP), body mass index (BMI) and gave an effort to compare the groups by therapeutic strategies. Results: The mean age was 44±11 years. The male-to-female ratio was 0.49. The most commonly observed reflux pattern was type 3 (48%) in patients with GSV insufficiency and varicose veins. Patients with type 1 reflux were younger, had lower BMI, and had a better clinical situation (p=0.002). VCSS was associated with perimalleolar region involvement, as increased in type 2 reflux than type 1, and higher VCSS was related to SFJ involvement as defined in type 3 reflux. Type 4 reflux patients had the highest VCSS that means the most severe clinical presentation. Sclerotherapy was the most common treatment modality in type 1 reflux (p<0.001). Also, in type 2 and type 4 reflux, sclerotherapy was more preferred than type 3 (p<0.001). Type 4 reflux pattern required mostly radiofrequency ablation, compared with type 3 (28.2% vs 20.5%; p<0.05) after initial diagnosis. Cyanoacrylate glue embolization was the appropriate therapeutic option in only 3.2% of type 4 reflux patients, which was significantly lower than type 3. Conclusion: According to the reflux pattern classification system based on SFJ and malleolar region involvement as practiced in this study, we described a correlation between VCSS, CEAP, BMI, and the extent of venous insufficiency. This correlation with consideration of cosmetic reasons and vein diameter measurements can suggest further treatment modality. Advances in knowledge: We investigated a practical, clinically applicable, and widely accepted standard method for classifying GSV insufficiency. Mapping venous insufficiency with such a system is essential to determine the clinical severity and the most appropriate treatment modality.","PeriodicalId":72284,"journal":{"name":"Archives of medical case reports and case study","volume":null,"pages":null},"PeriodicalIF":0.0000,"publicationDate":"2023-02-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Evaluatıng the Impact of Great Saphenous Veın Reflux Pattern on Clınıcal Severıty and Treatment Modalıty\",\"authors\":\"Aykut Kadıoğlu\",\"doi\":\"10.31579/2692-9392/159\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"Objectives: This research aimed to determine the impact of reflux patterns in patients with great saphenous vein (GSV) insufficiency on clinical severity and management. Methods: We evaluated 771 lower extremities of 452 patients having GSV insufficiency with Doppler Ultrasound. We characterized the reflux patterns like previously done in the literature: type 1, GSV reflux without the involvement of perimalleolar region or saphenofemoral junction (SFJ); type 2, GSV reflux involving perimalleolar region; type 3, GSV reflux involving SFJ; type 4, GSV reflux involving both perimalleolar region and SFJ. Then we conducted a study to evaluate the relationship between GSV reflux type and age, gender, venous clinical severity score (VCSS), clinical, etiological, anatomical and pathophysiological elements (CEAP), body mass index (BMI) and gave an effort to compare the groups by therapeutic strategies. Results: The mean age was 44±11 years. The male-to-female ratio was 0.49. The most commonly observed reflux pattern was type 3 (48%) in patients with GSV insufficiency and varicose veins. Patients with type 1 reflux were younger, had lower BMI, and had a better clinical situation (p=0.002). VCSS was associated with perimalleolar region involvement, as increased in type 2 reflux than type 1, and higher VCSS was related to SFJ involvement as defined in type 3 reflux. Type 4 reflux patients had the highest VCSS that means the most severe clinical presentation. Sclerotherapy was the most common treatment modality in type 1 reflux (p<0.001). Also, in type 2 and type 4 reflux, sclerotherapy was more preferred than type 3 (p<0.001). Type 4 reflux pattern required mostly radiofrequency ablation, compared with type 3 (28.2% vs 20.5%; p<0.05) after initial diagnosis. Cyanoacrylate glue embolization was the appropriate therapeutic option in only 3.2% of type 4 reflux patients, which was significantly lower than type 3. Conclusion: According to the reflux pattern classification system based on SFJ and malleolar region involvement as practiced in this study, we described a correlation between VCSS, CEAP, BMI, and the extent of venous insufficiency. This correlation with consideration of cosmetic reasons and vein diameter measurements can suggest further treatment modality. Advances in knowledge: We investigated a practical, clinically applicable, and widely accepted standard method for classifying GSV insufficiency. Mapping venous insufficiency with such a system is essential to determine the clinical severity and the most appropriate treatment modality.\",\"PeriodicalId\":72284,\"journal\":{\"name\":\"Archives of medical case reports and case study\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":0.0000,\"publicationDate\":\"2023-02-06\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Archives of medical case reports and case study\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.31579/2692-9392/159\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"\",\"JCRName\":\"\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Archives of medical case reports and case study","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.31579/2692-9392/159","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"","JCRName":"","Score":null,"Total":0}
引用次数: 0

摘要

目的:本研究旨在确定大隐静脉(GSV)功能不全患者的反流模式对临床严重程度和治疗的影响。方法:应用多普勒超声对452例GSV功能不全患者771例下肢进行评价。我们的特点是反流模式像以前的文献所做的:1型,GSV反流没有累及踝周区或隐股交界处(SFJ);2型,GSV反流累及踝周区;3型,GSV反流累及SFJ;4型,GSV反流累及踝周区和SFJ。然后,我们进行了一项研究,评估GSV反流类型与年龄、性别、静脉临床严重程度评分(VCSS)、临床、病因、解剖和病理生理因素(CEAP)、体重指数(BMI)的关系,并试图通过治疗策略对两组进行比较。结果:患者平均年龄44±11岁。男女比例为0.49。在GSV功能不全和静脉曲张患者中,最常见的反流模式是3型(48%)。1型反流患者年龄较小,BMI较低,临床情况较好(p=0.002)。VCSS与踝周区受累相关,2型反流患者的VCSS高于1型反流患者,而较高的VCSS与3型反流中定义的SFJ受累相关。4型反流患者的VCSS最高,这意味着最严重的临床表现。硬化疗法是1型反流最常见的治疗方式(p<0.001)。此外,在2型和4型反流中,硬化疗法比3型更受欢迎(p<0.001)。与3型相比,4型反流型主要需要射频消融(28.2% vs 20.5%;p < 0.05)。只有3.2%的4型反流患者采用氰基丙烯酸酯胶栓塞治疗,这一比例明显低于3型。结论:根据本研究中基于SFJ和踝区受累的反流模式分类系统,我们描述了VCSS、CEAP、BMI与静脉功能不全程度的相关性。这种相关性与考虑美容原因和静脉直径测量可以建议进一步的治疗方式。知识进展:我们研究了一种实用的、临床适用的、被广泛接受的分类GSV功能不全的标准方法。用这样的系统测绘静脉功能不全对于确定临床严重程度和最合适的治疗方式至关重要。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Evaluatıng the Impact of Great Saphenous Veın Reflux Pattern on Clınıcal Severıty and Treatment Modalıty
Objectives: This research aimed to determine the impact of reflux patterns in patients with great saphenous vein (GSV) insufficiency on clinical severity and management. Methods: We evaluated 771 lower extremities of 452 patients having GSV insufficiency with Doppler Ultrasound. We characterized the reflux patterns like previously done in the literature: type 1, GSV reflux without the involvement of perimalleolar region or saphenofemoral junction (SFJ); type 2, GSV reflux involving perimalleolar region; type 3, GSV reflux involving SFJ; type 4, GSV reflux involving both perimalleolar region and SFJ. Then we conducted a study to evaluate the relationship between GSV reflux type and age, gender, venous clinical severity score (VCSS), clinical, etiological, anatomical and pathophysiological elements (CEAP), body mass index (BMI) and gave an effort to compare the groups by therapeutic strategies. Results: The mean age was 44±11 years. The male-to-female ratio was 0.49. The most commonly observed reflux pattern was type 3 (48%) in patients with GSV insufficiency and varicose veins. Patients with type 1 reflux were younger, had lower BMI, and had a better clinical situation (p=0.002). VCSS was associated with perimalleolar region involvement, as increased in type 2 reflux than type 1, and higher VCSS was related to SFJ involvement as defined in type 3 reflux. Type 4 reflux patients had the highest VCSS that means the most severe clinical presentation. Sclerotherapy was the most common treatment modality in type 1 reflux (p<0.001). Also, in type 2 and type 4 reflux, sclerotherapy was more preferred than type 3 (p<0.001). Type 4 reflux pattern required mostly radiofrequency ablation, compared with type 3 (28.2% vs 20.5%; p<0.05) after initial diagnosis. Cyanoacrylate glue embolization was the appropriate therapeutic option in only 3.2% of type 4 reflux patients, which was significantly lower than type 3. Conclusion: According to the reflux pattern classification system based on SFJ and malleolar region involvement as practiced in this study, we described a correlation between VCSS, CEAP, BMI, and the extent of venous insufficiency. This correlation with consideration of cosmetic reasons and vein diameter measurements can suggest further treatment modality. Advances in knowledge: We investigated a practical, clinically applicable, and widely accepted standard method for classifying GSV insufficiency. Mapping venous insufficiency with such a system is essential to determine the clinical severity and the most appropriate treatment modality.
求助全文
通过发布文献求助,成功后即可免费获取论文全文。 去求助
来源期刊
自引率
0.00%
发文量
0
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
确定
请完成安全验证×
copy
已复制链接
快去分享给好友吧!
我知道了
右上角分享
点击右上角分享
0
联系我们:info@booksci.cn Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。 Copyright © 2023 布克学术 All rights reserved.
京ICP备2023020795号-1
ghs 京公网安备 11010802042870号
Book学术文献互助
Book学术文献互助群
群 号:481959085
Book学术官方微信