The Discord Outcome Analysis (DOA) as a Reporting Standard at Three Months and Five Years in Randomised Varicose Vein Treatment Trials.

Objectives: Treatment success for chronic superficial venous insufficiency could be defined as an improvement in three domains: (i) disease specific quality of life, (ii) clinical severity, (iii) reflux. The aim was to report these at five years using a Venn diagram to profile the outcomes: a discord outcome analysis (DOA).

Methods: Patients (n = 50 patients/legs in each treated group) were randomised to endovenous laser ablation (EVLA) with concurrent phlebectomies vs.

Neuromuscular electrical stimulation reduces sludge in the popliteal vein.

Background: The common peroneal nerve stimulator (CPNS) is a UK-approved device for reducing venous thromboembolism (VTE) risk. It resembles a wrist watch and is placed over the common peroneal nerve, discharging electricity at a rate of 1 impulse/s. It has been presumed that as blood flow slows, erythrocytes aggregate into ultrasound-detectable echogenic particles, described as venous sludge.

Quantifying saphenous recirculation in patients with primary lower extremity venous reflux.

Background: The great saphenous vein (GSV) in patients with superficial venous insufficiency might act as a beneficial conduit for antegrade venous drainage and also as a harmful conduit for promotion of reflux and/or recirculation and subsequent skin changes. The aim of this study was to measure the antegrade and retrograde GSV volume displacements during calf compression and release maneuvers. This was used to quantify harm over benefit with a recirculation index (RCI).

Pneumatic thigh compression reduces calf volume and augments the venous return.

Objectives: Reactive hyperaemia following thigh compression increases arterial inflow and venous outflow. The net effect can be measured by changes in calf volume quantified using air-plethysmography. The objective was to investigate the effect of thigh compression on venous return.

Hemodynamic changes in the femoral vein with increasing outflow resistance.

Introduction: In post-thrombotic and May-Thurner syndromes, the iliac veins may be scarred, compressed, or obstructed. Obesity and increased intra-abdominal pressure may also hamper the venous return. Therefore, measurements of outflow resistance (OR) impeding venous return may be helpful to select patients for intervention and to assess the impact of intervention.

Validation of the Villalta scale in assessing post-thrombotic syndrome using clinical, duplex, and hemodynamic comparators.

Introduction: The Villalta scale (VS) was developed by Prandoni and introduced as an abstract in 1994 as a disease-specific assessment questionnaire to diagnose and classify the severity of post-thrombotic syndrome (PTS). While validation using quality-of-life assessments and reproducibility have been reported as good, limited data exist as how the VS compares against generalized assessment tests in defining the severity of PTS. The aim of this study was to compare the VS against the Venous Clinical Severity Score (VCSS), the C of the CEAP classification, the Venous Segmental Disease Score (VSDS), and the Venous Filling Index (VFI) of air plethysmography.

Compression stockings significantly improve hemodynamic performance in post-thrombotic syndrome irrespective of class or length.

Background: Graduated elastic compression (GEC) stockings have been demonstrated to reduce the morbidity associated with post-thrombotic syndrome. The ideal length or compression strength required to achieve this is speculative and related to physician preference and patient compliance. The aim of this study was to evaluate the hemodynamic performance of four different stockings and determine the patient's preference.

The Aberdeen varicose vein questionnaire may be the preferred method of rationing patients for varicose vein surgery.

Rationing treatment of varicose veins (VVs) is of importance in countries with a public health service and limited funds. This study examines why and how the Aberdeen varicose vein questionnaire (AVVQ) can be used in achieving rationing. Baseline assessments prior to endovenous treatment included the venous clinical severity score (VCSS), venous filling index (VFI), and the refluxing great saphenous vein (GSV) diameter.

Hemodynamic changes at the saphenofemoral junction during the application of a below-knee graduated compression stocking.

Background: It is strongly recommended that patients wear compression after foam sclerotherapy, but pulling up a stocking may inadvertently flush foam into the femoral vein, which may increase the risk of systemic side effects and reduce great saphenous vein (GSV) occlusion rates.

Objective: The hypothesis was that a stocking pull-up maneuver would increase flow in the GSV. The aim was to quantify this using duplex ultrasound.

Saphenous pulsation on duplex may be a marker of severe chronic superficial venous insufficiency.

Background: Pulsatile flow in deep, perforating veins and varicose veins (VVs) has been described previously to support a hypothesis of arteriovenous (AV) fistulae in the pathogenesis of VVs. Its presence has also been suggested as a cause of failure of VV treatments. However, AV communications have never been adequately visualized and direct pressure tracings within leg veins have been inconclusive.

Long-term results of a randomized controlled trial on ultrasound-guided foam sclerotherapy combined with saphenofemoral ligation vs standard surgery for varicose veins.

Background: The long-term results of a prospective, randomized controlled trial in patients with primary varicose veins are reported.

Methods: Saphenofemoral ligation (SFL) was done in 73 patients (82 legs). In addition, 43 (23 women; age, 47) underwent stripping and multiple phlebectomies under general anesthesia (group S), and 39 (32 women; age, 49) had concurrent sclerotherapy under local anesthesia (group F).