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Current Vascular Pharmacology Jul 2008Matrix metalloproteinases (MMPs) play a major role in extracellular matrix (ECM) turnover under both physiological and pathological conditions. Studies on venous tissues... (Review)
Review
Matrix metalloproteinases (MMPs) play a major role in extracellular matrix (ECM) turnover under both physiological and pathological conditions. Studies on venous tissues from experimental animals and humans identified several MMP subtypes, and showed significant changes in the expression and activity of specific MMPs during vein wall remodeling. Also, significant research has focused on the role of MMPs in chronic venous disease (CVD) and varicose vein formation in the lower extremities and their progression to thrombophlebitis and venous leg ulcer. Several hypotheses have been forwarded regarding the pathophysiological mechanisms underlying the relation between MMPs and the formation, progression and complications of varicose veins. The effects of MMPs on ECM degradation could result in significant venous tissue remodeling and degenerative and structural changes in the vein wall, leading to venous dilation and valve dysfunction. MMPs may also induce early changes in the endothelium and venous smooth muscle function in the absence of significant ECM degradation or structural changes in the vein wall. In addition, evidence suggests increased activity of MMPs in the advanced stages of chronic venous insufficiency (CVI) associated with skin changes and leg ulceration as well as in the wound fluid environment. Several pharmacological therapies and surgical strategies are being utilized in the management of varicose veins, with variable success and recurrence rates. Inhibition of MMPs may represent a novel therapeutic intervention to limit the progression of varicose veins to CVI and leg ulceration.
Topics: Animals; Humans; Matrix Metalloproteinases; Protease Inhibitors; Scleroderma, Localized; Thrombophlebitis; Varicose Veins; Veins
PubMed: 18673156
DOI: 10.2174/157016108784911957 -
Lymphatic Research and Biology Apr 2022Treatment for patients with comorbid lymphedema and varicose veins is controversial. Surgical options for these patients are limited. The study was aimed to investigate...
Treatment for patients with comorbid lymphedema and varicose veins is controversial. Surgical options for these patients are limited. The study was aimed to investigate the validity of combined lymphovenous anastomosis (LVA) and great saphenous vein stripping (GSVS) for comorbid lymphedema and varicose veins. Thirteen patients were involved in the study, and the detail was 21 edematous lower limbs (with coexisting varicose veins and lymphedema; the varicose vein and lymphedema [VL] group) who underwent combined GSVS and LVA therapy. Fifteen patients (with 30 edematous lower limbs and lymphedema only; the lymphedema [L] group) who underwent LVA only were included as a control group. GSVS was performed before LVA in the VL group. No significant differences were seen between the groups at baseline. There were no cases indocyanine green (ICG) lymphography pattern deteriorated after GSVS. No significant difference was seen in lymphatic detection rate; 129.71% ± 58.27% (67%-333%) in the VL group and 122.27% ± 39.47% (50%-250%) in the L group ( = 0.59 > 0.05), respective lymphatic diameters 0.66 ± 0.13 (0.45-0.9) mm and 0.75 ± 0.17 (0.45-1.0) mm ( = 0.07 > 0.05), and respective lymphedema improvement rate 12.17% ± 7.35% (0%-27.4%) and 12.65% ± 7.43% (3.7%-22.3%) ( = 0.86 > 0.05). In this study, stripping surgery does not cause lymphatic impairment, at least to the extent that would impede the success of an LVA procedure. Comorbid varicose veins and lymphedema can be treated surgically by a combination of LVA and GSVS.
Topics: Anastomosis, Surgical; Humans; Lymphatic Vessels; Lymphedema; Saphenous Vein; Varicose Veins
PubMed: 33794104
DOI: 10.1089/lrb.2019.0076 -
Phlebology Oct 2018
Topics: Humans; Varicose Veins
PubMed: 29262752
DOI: 10.1177/0268355517749113 -
Journal of Medical Engineering &... Aug 2019Varicose veins of lower extremity can be treated effectively with varicose vein therapy apparatus. In order to ensure its therapy effect, it is necessary to test the air...
Varicose veins of lower extremity can be treated effectively with varicose vein therapy apparatus. In order to ensure its therapy effect, it is necessary to test the air tightness of pneumatic circuit and other related performance parameters. The traditional manual testing method has some problems, such as large error, low efficiency and so on. This paper developed a multifunctional testing system based on LabVIEW software to overcome these shortcomings. The system is a combination of software and hardware, which can realise key components calibration, pneumatic circuit air tightness testing, gasbag pressure-resistance performance testing, pressure sensor performance testing and air pump performance testing. The multifunctional testing system realises the goal of automated human-computer interaction testing, which has a bright future in the aspects of application prospect.
Topics: Computers; Equipment Design; Humans; Lower Extremity; Pressure; Software; Varicose Veins
PubMed: 31671002
DOI: 10.1080/03091902.2019.1681530 -
European Journal of Vascular and... Apr 2011The study aimed to evaluate a wide range of apoptotic markers in the vein wall of patients with superficial chronic venous disease (SCVD) compared with normal veins.
OBJECTIVES
The study aimed to evaluate a wide range of apoptotic markers in the vein wall of patients with superficial chronic venous disease (SCVD) compared with normal veins.
DESIGN
This was an observational study.
METHODS
Vein specimens were obtained from 19 patients suffering from SCVD. From each patient, a specimen of the proximal part of the great saphenous vein (GSV), a specimen of the distal part of the vein and a specimen of a varicose tributary were obtained. Immunohistochemical analysis was used to localise the expression of BAX, p53, Caspase 3, BCL-2, BCL-6, BCL-xs, BCL-xl and Ki-67. Vein specimens from 10 healthy GSVs were used as controls.
RESULTS
Saphenous vein specimens from patients with SCVD showed increased BAX, Caspase 3, BCL-xl and BCL-xs (p < 0.01 for all) and Ki-67 (p = 0.02) compared with healthy GSVs. In the venous disease group, GSV specimens from the distal ankle area showed increased BAX (p < 0.01) and BCL-xs (p = 0.031) compared with varicose tributaries specimens, which subsequently showed increased BAX (p = 0.044), Caspase 3 (p = 0.028) and BCL-xs (p = 0.037) compared with specimens from the proximal GSV. In addition, in the venous disease group, specimens from distal GSV showed increased BAX (p < 0.01), Caspase 3 (p = 0.019) and BCL-xs (p = 0.014) compared with the proximal GSV.
CONCLUSION
Varicose veins exhibit increased apoptotic activity, by means of increased BAX, Caspase 3, BCL-xl and BCL-xs, compared with normal veins. Patients with varicose vein disease show increased apoptosis in the distal saphenous trunk compared with the proximal saphenous trunk, suggesting an association between chronic venous hypertension and apoptosis.
Topics: Apoptosis; Apoptosis Regulatory Proteins; Biomarkers; Case-Control Studies; Chronic Disease; Female; Humans; Immunohistochemistry; Male; Middle Aged; Saphenous Vein; Up-Regulation; Varicose Veins; Venous Pressure
PubMed: 21262580
DOI: 10.1016/j.ejvs.2010.11.033 -
Circulation. Cardiovascular Genetics Aug 2012
Meta-Analysis Review
Topics: Family Health; Genetic Predisposition to Disease; Humans; Inheritance Patterns; Mutation; Varicose Ulcer; Varicose Veins
PubMed: 22896013
DOI: 10.1161/CIRCGENETICS.112.963439 -
Vascular Oct 2021We aimed to evaluate peripheral varicose vein symptoms including ecchymosis and coldness by using the Venous Insufficiency Epidemiological and Economic Study-Quality of... (Observational Study)
Observational Study
OBJECTIVES
We aimed to evaluate peripheral varicose vein symptoms including ecchymosis and coldness by using the Venous Insufficiency Epidemiological and Economic Study-Quality of Life/Symptoms (VEINES-QoL/Sym) questionnaire.
METHODS
A total of 1120 patients were enrolled to the analysis after the exclusion of 199 patients who did not match the inclusion criteria. Patients were asked to answer the VEINES-Sym questionnaire and questions about ecchymosis and coldness. Scores of ecchymosis and coldness were calculated similar to VEINES-Sym questionnaire. Classifications of peripheral varicose vein were made according to the clinical part of clinical, etiological, anatomical, and pathophysiological classification system and patients with grade 2 or higher were considered as positive for peripheral varicose vein.
RESULTS
Frequency of symptoms present in the VEINES-Sym instrument, ecchymosis and coldness were significantly higher in patients with peripheral varicose vein. Mean score of each symptom was significantly lower in peripheral varicose vein patients including scores of ecchymosis and coldness. Logistic regression analysis revealed that presence of hemorrhoids and all symptoms in VEINES-Sym questionnaire except restless leg were significantly and independently associated with peripheral varicose vein. Besides, ecchymosis (odds ratio: 2.04, 95% confidence interval: 1.34-3.08, = 0.008) but not coldness was significantly and independently associated with peripheral varicose vein. There was also significant correlation of VEINES-Sym score with ecchymosis ( = 0.43, < 0.001) and coldness ( = 0.47, < 0.001).
CONCLUSIONS
Venous leg symptoms present in VEINES-Sym questionnaire except restless legs, presence of hemorrhoids and ecchymosis are significantly and independently associated with peripheral varicose vein. Not only ecchymosis but also coldness has shown an independent association with total VEINES-Sym score.
Topics: Adult; Body Temperature Regulation; Ecchymosis; Female; Hemorrhoids; Humans; Lower Extremity; Male; Middle Aged; Predictive Value of Tests; Reproducibility of Results; Restless Legs Syndrome; Risk Assessment; Risk Factors; Surveys and Questionnaires; Turkey; Varicose Veins; Veins; Venous Insufficiency
PubMed: 33334264
DOI: 10.1177/1708538120980207 -
Ugeskrift For Laeger Jun 2015The aim of this article is to review the current use of compression after varicose vein treatment. Five randomized controlled trials and one systematic review was chosen... (Review)
Review
The aim of this article is to review the current use of compression after varicose vein treatment. Five randomized controlled trials and one systematic review was chosen for evaluation. No benefit was found when comparing either long duration compression with short duration, or compression with no compression. Additionally, patient compliance was low. The evidence is based on underpowered and heterogeneous groups. Thus, no contribution to a consensus regarding the use of post varicose vein treatment compression can be made.
Topics: Humans; Patient Compliance; Postoperative Care; Stockings, Compression; Time Factors; Treatment Outcome; Varicose Veins
PubMed: 26058435
DOI: No ID Found -
International Angiology : a Journal of... Apr 2020Varicose veins recurrence rate remained almost unchanged despite the constant technological advancement in its treatment. The aim of this study is to evaluate the...
Anterior accessory saphenous vein confluence anatomy at the sapheno-femoral junction as risk factor for varicose veins recurrence after great saphenous vein radiofrequency thermal ablation.
BACKGROUND
Varicose veins recurrence rate remained almost unchanged despite the constant technological advancement in its treatment. The aim of this study is to evaluate the variable accessory saphenous vein (ASV) anatomy at the sapheno-femoral junction (SFJ) as a possible risk factor for recurrent varicose vein (RVV) after great saphenous vein (GSV) radiofrequency thermal ablation (RTA).
METHODS
Two-hundred consecutive patients affected by chronic venous disease (mean age 52.4±10.3 years; 187 women; CEAP C2-C6; 25.2±1.4), underwent to RTA from 2014 to 2016, at our Institute. Preoperatively all patients underwent duplex-ultrasound scanning, reporting the anatomical site, extension of reflux and the ASV anatomy at the SFJ. Duplex ultrasound and physical examination was performed postoperatively at 1, 6 and 12 months, and yearly thereafter.
RESULTS
Patients were divided in two groups based on the anatomical site of reflux: group A (N.=187) including GSV and SFJ, group B (N.=82) including SFJ reflux. There was no preoperative statistical difference between the two groups. At a mean follow-up of 29.7±2.4 months, a freedom from recurrent varicose vein and GSV recanalization was: 100% and 100% at 1 month, 95.9% and 99.1% at 1 year, 93.7% and 96.7% at 3 years, respectively. A higher rate of RVV was documented for patients in group A at 3-year of follow-up (P=0.042). Cox regression analysis found, among five potential predictors of outcome, that direct confluence of ASV in SFJ (HR=1.561; 95% CI: 1.0-7.04; P=0.032) was a negative predictors of 1-year RVV.
CONCLUSIONS
Sapheno-femoral junction morphology may affect recurrent varicose veins formation. In particular, a concomitant incompetence of the accessory saphenous vein or its directly confluence into the SFJ could represent an indication to simultaneous treatment by non-surgical techniques (RTA or laser) and avoid surgical ligation.
Topics: Adult; Female; Femoral Vein; Follow-Up Studies; Humans; Male; Middle Aged; Proportional Hazards Models; Radiofrequency Ablation; Recurrence; Regional Blood Flow; Retrospective Studies; Risk Factors; Saphenous Vein; Time Factors; Ultrasonography, Doppler, Duplex; Varicose Veins; Vascular Patency
PubMed: 32043339
DOI: 10.23736/S0392-9590.20.04271-6 -
Phlebology Mar 2012Varicose veins are an extremely common condition causing morbidity; however, with current financial pressures, treatment of such benign diseases is controversial. Many... (Review)
Review
Varicose veins are an extremely common condition causing morbidity; however, with current financial pressures, treatment of such benign diseases is controversial. Many procedures allow the treatment of varicose veins with minimal cost and extensive literature supporting differing approaches. Here we explore the underlying evidence base for treatment options, the effect on clinical outcome and the cost-benefit economics associated with varicose vein treatment. The method of defining clinical outcome with quality-of-life assessment tools is also investigated to explain concepts of treatment success beyond abolition of reflux.
Topics: Humans; Quality of Life; Varicose Veins
PubMed: 22312062
DOI: 10.1258/phleb.2012.012s22