Association of duplex ultrasonography findings with the severity of chronic venous disease in Thai patients
Introduction: Chronic venous disease (CVD) is characterized by venous hypertension and stasis, which occur because of valvular incompetence and/or venous outflow obstruction. This study aimed to investigate the relationship between CVD clinical presentation and duplex ultrasonography findings in a T...
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| Format: | Article |
| Language: | English |
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Elsevier
2023-06-01
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| Series: | Asian Journal of Surgery |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S1015958422014373 |
| _version_ | 1797816044392284160 |
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| author | Nawaphan Taengsakul |
| author_facet | Nawaphan Taengsakul |
| author_sort | Nawaphan Taengsakul |
| collection | DOAJ |
| description | Introduction: Chronic venous disease (CVD) is characterized by venous hypertension and stasis, which occur because of valvular incompetence and/or venous outflow obstruction. This study aimed to investigate the relationship between CVD clinical presentation and duplex ultrasonography findings in a Thai patient population. Method: This cross-sectional study examined patients diagnosed with CVD at the Chulabhorn Hospital Vascular Clinic (Bangkok, Thailand) between December 1, 2018 and October 1, 2021. Patient data was obtained from the medical records and review of lower limb venous ultrasonography studies. Patients were assessed using the Clinical, Etiological, Anatomical, and Pathological (CEAP) classification of venous disorders: mild-to-moderate CVD was defined as C1 to C3 and severe CVD was defined as C4 to C6. Results: Overall, 260 CVD patients were analyzed (60 men and 200 women). More than 75% of the patients were women and more than 80% had bilateral lower limb involvement. Factors associated with severe CVD were older age, female sex, high body mass index, hypertension, diabetes mellitus, and history of deep venous thrombosis. The most common CEAP classification was C2 (38.8%), followed by C1 (33.85%), C4 (12.2%), C3 (9.23%), C6 (3.46%), and C5 (2.31%). Two-thirds of the patients had great saphenous vein reflux and nearly half had perforator vein reflux. Perforator reflux and small saphenous vein reflux were significantly associated with severe CVD (P < 0.001 and P = 0.028, respectively). Higher number of venous systems involved was significantly associated with severe CVD (P = 0.005). Reflux time of the great saphenous vein correlated with severe CVD and VCSS (P = 0.026 and P = 0.037, respectively). Mean diameters of the superficial vein, perforator vein, and deep vein and reflux times of the perforator and deep veins were not significantly associated with severe CVD. Conclusion: The major risk factors for severe CVD are older age, female sex, high body mass index, hypertension, diabetes mellitus, and history of deep venous thrombosis. The most common CEAP classification was C2 (39%). Great saphenous vein reflux was the most common type of reflux in our study population. Increasing number of venous systems involved increased the risk of severe CVD. The presence of perforator vein reflux and small saphenous vein reflux also increased the risk of severe CVD. Reflux time of the great saphenous vein correlated with severe CVD and venous clinical severity score. |
| first_indexed | 2024-03-13T08:31:51Z |
| format | Article |
| id | doaj.art-52f0367ec5fe48d5b0188814369b2a30 |
| institution | Directory Open Access Journal |
| issn | 1015-9584 |
| language | English |
| last_indexed | 2024-03-13T08:31:51Z |
| publishDate | 2023-06-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Asian Journal of Surgery |
| spelling | doaj.art-52f0367ec5fe48d5b0188814369b2a302023-05-31T04:43:12ZengElsevierAsian Journal of Surgery1015-95842023-06-0146623042309Association of duplex ultrasonography findings with the severity of chronic venous disease in Thai patientsNawaphan Taengsakul0Department of Surgery, Chulabhorn Hospital, HRH Princess Chulabhorn College of Medical Science, Chulabhorn Royal Academy, Bangkok, ThailandIntroduction: Chronic venous disease (CVD) is characterized by venous hypertension and stasis, which occur because of valvular incompetence and/or venous outflow obstruction. This study aimed to investigate the relationship between CVD clinical presentation and duplex ultrasonography findings in a Thai patient population. Method: This cross-sectional study examined patients diagnosed with CVD at the Chulabhorn Hospital Vascular Clinic (Bangkok, Thailand) between December 1, 2018 and October 1, 2021. Patient data was obtained from the medical records and review of lower limb venous ultrasonography studies. Patients were assessed using the Clinical, Etiological, Anatomical, and Pathological (CEAP) classification of venous disorders: mild-to-moderate CVD was defined as C1 to C3 and severe CVD was defined as C4 to C6. Results: Overall, 260 CVD patients were analyzed (60 men and 200 women). More than 75% of the patients were women and more than 80% had bilateral lower limb involvement. Factors associated with severe CVD were older age, female sex, high body mass index, hypertension, diabetes mellitus, and history of deep venous thrombosis. The most common CEAP classification was C2 (38.8%), followed by C1 (33.85%), C4 (12.2%), C3 (9.23%), C6 (3.46%), and C5 (2.31%). Two-thirds of the patients had great saphenous vein reflux and nearly half had perforator vein reflux. Perforator reflux and small saphenous vein reflux were significantly associated with severe CVD (P < 0.001 and P = 0.028, respectively). Higher number of venous systems involved was significantly associated with severe CVD (P = 0.005). Reflux time of the great saphenous vein correlated with severe CVD and VCSS (P = 0.026 and P = 0.037, respectively). Mean diameters of the superficial vein, perforator vein, and deep vein and reflux times of the perforator and deep veins were not significantly associated with severe CVD. Conclusion: The major risk factors for severe CVD are older age, female sex, high body mass index, hypertension, diabetes mellitus, and history of deep venous thrombosis. The most common CEAP classification was C2 (39%). Great saphenous vein reflux was the most common type of reflux in our study population. Increasing number of venous systems involved increased the risk of severe CVD. The presence of perforator vein reflux and small saphenous vein reflux also increased the risk of severe CVD. Reflux time of the great saphenous vein correlated with severe CVD and venous clinical severity score.http://www.sciencedirect.com/science/article/pii/S1015958422014373Chronic venous diseaseCEAP classificationDuplex ultrasoundVenous refluxThailand |
| spellingShingle | Nawaphan Taengsakul Association of duplex ultrasonography findings with the severity of chronic venous disease in Thai patients Asian Journal of Surgery Chronic venous disease CEAP classification Duplex ultrasound Venous reflux Thailand |
| title | Association of duplex ultrasonography findings with the severity of chronic venous disease in Thai patients |
| title_full | Association of duplex ultrasonography findings with the severity of chronic venous disease in Thai patients |
| title_fullStr | Association of duplex ultrasonography findings with the severity of chronic venous disease in Thai patients |
| title_full_unstemmed | Association of duplex ultrasonography findings with the severity of chronic venous disease in Thai patients |
| title_short | Association of duplex ultrasonography findings with the severity of chronic venous disease in Thai patients |
| title_sort | association of duplex ultrasonography findings with the severity of chronic venous disease in thai patients |
| topic | Chronic venous disease CEAP classification Duplex ultrasound Venous reflux Thailand |
| url | http://www.sciencedirect.com/science/article/pii/S1015958422014373 |
| work_keys_str_mv | AT nawaphantaengsakul associationofduplexultrasonographyfindingswiththeseverityofchronicvenousdiseaseinthaipatients |