Sign, Symtoms, Risk Factors, and Reflux Patterns of Venous Disease

Prepared by Joseph Raffetto, MD
Corresponding chapter in Handbook of Venous Disorders Chapters: 10 and 28

Bradbury A, Evans C, Allan P, Lee A, Ruckley CV, Fowkes FG. What are the symptoms of varicose veins? Edinburgh vein study cross sectional population survey. BMJ 1999;318:353-6.

PMID: 9933194
Comment: The Edinburgh Vein Study is a large cross sectional study that randomly enrolled 1566 subjects. This study found sex differences related to trunk varices and difference in the reported symptoms.

Bradbury A, Evans CJ, Allan P, Lee AJ, Ruckley CV, Fowkes FG. The relationship between lower limb symptoms and superficial and deep venous reflux on duplex ultrasonography: The Edinburgh Vein Study. J Vasc Surg 2000;32:921-31.

PMID: 11054224
Comment: This excellent study is a continuation of the Edinburgh study population. The study assess symptoms related to venous disease and patterns of venous reflux based on duplex ultrasound, and the relation togender.

Ruckley CV, Evans CJ, Allan PL, Lee AJ, Fowkes FG. Chronic venous insufficiency: clinical and duplex correlations. The Edinburgh Vein Study of venous disorders in the general population.       J Vasc Surg 2002;36:520-5.

PMID: 12218976
Comment: As part of the Edinburgh vein study, this study attributed increasing venous symptoms with worsening reflux grade. The severity of clinical presentation was strongly associated with the valvular reflux.

Carpentier PH, Poulain C, Fabry R, Chleir F, Guias B, Bettarel-Binon C; Venous Working Group of the Société Française de Médecine Vasculaire. Ascribing leg symptoms to chronic venous disorders: the construction of a diagnostic score. J Vasc Surg 2007;46:991-6.

PMID: 17980285
Comment: This interesting study evaluates a scoring system, which assigns likelihood ratios, to distinguish symptoms of chronic venous disease versus other diseases.

Carpentier PH, Maricq HR, Biro C, Ponçot-Makinen CO, Franco A. Prevalence, risk factors, and clinical patterns of chronic venous disorders of lower limbs: a population-based study in France. J Vasc Surg 2004;40:650-9.

PMID: 15472591
Comment: This is another excellent population based study in the general population defining prevalence of venous disease in men and women, risk factors associated with venous disease and progression to more advanced forms of chronic venous disease, and symptoms.

Maurins U, Hoffmann BH, Lösch C, Jöckel KH, Rabe E, Pannier F. Distribution and prevalence of reflux in the superficial and deep venous system in the general population--results from the Bonn Vein Study, Germany. J Vasc Surg 2008;48:680-7.

PMID: 18586443
Comment: This excellent large cross sectional population based study evaluates the prevalence of venous reflux with relation to gender, age, and clinical class, and the associated symptoms in patients with chronic venous disease.