Peripheral Venous Disease Research Articles

Significant achievements: Major milestones for the Turkish Journal of Vascular Surgery

I am thrilled to share some groundbreaking news from The Turkish Journal of Vascular Surgery, a premier international open-access journal dedicated to vascular surgeons. Our mission is to advance the diagnosis, medical, endovascular, and surgical treatments of arterial, venous, and lymphatic diseases. By publishing cutting-edge articles focused on the investigation, management, and prevention of peripheral arterial, venous, and lymphatic diseases, as well as vascular access, trauma, and malformations, we strive to enhance the management of patients with vascular disorders globally. In an exciting development, our journal has been accepted into the prestigious Scopus index as of October 2023. This inclusion not only validates the high quality of our publications but also significantly enhances their visibility and impact in the scientific community. Moreover, articles published in 2022 and 2023 have also been indexed, ensuring that recent research contributions are readily accessible to a wider audience. Adding to this achievement, The Turkish Journal of Vascular Surgery was accepted into the Directory of Open Access Journals (DOAJ) in June 2024. This significant milestone underscores our dedication to providing unrestricted access to high-quality research and supporting the dissemination of knowledge within the vascular surgery field. These accomplishments mark a significant step forward in our journey to becoming the leading resource for vascular surgeons worldwide. Our inclusion in these prestigious indices not only recognizes the excellence of our contributors but also positions our journal at the forefront of vascular surgery research. We are immensely proud of these achievements and believe they will serve to further elevate the standing and influence of our journal. As we continue to evolve, we remain dedicated to supporting the vascular surgery community with the latest research, developments, and discussions in the field. Thank you for your unwavering support and valuable contributions to The Turkish Journal of Vascular Surgery. We eagerly anticipate your future submissions and collaborations, as together, we advance the frontier of vascular surgery.

The ultrasonographic diagnosis of lymph node varicose veins in the groin - an overlooked missing link in chronic venous disease?

Chronic venous disease is a common pathology characterized by valvular incompetence and venous hypertension. The venous network of the lymph nodes at the Scarpa triangle connects the superficial and the deep venous systems. This study aimed to describe infrainguinal intranodal venous dilatations and to evaluate the connection with peripheral venous disease. The study included 183 subjects (116 women, 67 men) who underwent Doppler ultrasound examinations of the venous system of the inferior limb in the context of chronic venous disease. The diagnosis of lymph node varices was based on well-defined criteria and the severity of the lymph node varices was established using an original classification. There was a statistically significant, moderately strong association, between the presence of intranodal varices and the great saphenous vein reflux (φ=0.341, p=0.000). There was a moderate-to-high positive correlation between intranodal varices and the chronic venous disease stage (rrb=0.457, p=0.000). Patients with more advanced stages of chronic venous insufficiency have a higher probability of presenting intranodal varices. Lymph node venous network identification could considerably impact clinical decision-making and treatment choices.

Comprehensive Review on Burden of Strokes and Cardiovascular Diseases in the Indian Scenario

Abstract: Heart disease and stroke are both types of cardiovascular diseases (CVD) and are among the most widespread and costly health problems as per statistics. 31% of all global deaths are due to CVD. Classical symptoms include angina, discomfort in arms & shoulders, shortness of breath, dizziness, cold, sweats, nausea and fatigue. The major risk factors for CVD include smoking, physical inactivity, excess body weight and unhealthy dietary pattern. Other factors that can contribute to CVD are blood pressure, cholesterol, impaired glucose control and sleep. There are a range of major clinical heart and CVD conditions that include stroke, congenital heart disease, coronary heart disease, rhythmic disorders, subclinical atherosclerosis, vascular disease, peripheral artery disease, heart failure and venous disease. This paper reviews different types of CVD conditions, core health behaviours and the associated outcomes such as quality of care, medical procedures, and economic burden. This review is an attempt to improve the understanding of heart disease and stroke that will be helpful on preventing and treating heart disease and improving overall cardiovascular health.

Assessing the Prevalence Rate of Gangrene Among Patients With Peripheral Vascular Disease in a Tertiary Care Hospital in Central India.

Background Peripheral vascular disease (PVD) includes peripheral arterial disease (PAD) and venous disease. PAD is a chronic progressive atherosclerotic disease leading to partial or total peripheral vascular occlusion. PAD typically affects the abdominal aorta, iliac arteries, lower limbs,andoccasionally theupper extremities. Assessing the prevalence of gangrene among PVD patients is crucial for understanding the burden of this condition and informing clinical management strategies. This study aimed to estimate the prevalence rate of gangrene among patients diagnosed with peripheral vascular disease. Methods This case-control study was conducted at the General Surgery department of Jawaharlal Nehru Medical College and Acharya Vinoba Bhave Rural Hospital, Wardha, India. Patients diagnosed with PVD who presented with gangrene of the lower limb were included. Detailed demographic data were collected, and clinical examinationsand diagnostic tests were performed to assess the severity and extent of gangrene. Statistical analysis was conducted to estimate the prevalence of gangrene among PVD patients. Results Among the 100 participants, the age distribution ranged from 21 to over 70 years, with a mean age of 52.89. Gender distribution showed that 30% of the participants were female and 70% were male. The prevalence of gangrene among PVD patients was found to be 35%, with 65% patients not presenting with gangrene. Conclusion The findings of this study highlight the significant prevalence of gangrene among patients diagnosed with peripheral vascular disease. The implications of these findings for clinical practice and management strategies are discussed further, along with potential avenues for further research. The study provides valuable insights into the burden of gangrene among PVD patients. Early detection and appropriate management of PVD are crucial for preventing the development of gangrene and improving patient outcomes.

An Integrated Management (Ayurveda and Modern Medicine) of Peripheral Vascular Disease with Non-Healing Wound -A Case Study


 Peripheral vascular disease (PVD) includes peripheral arterial disease (PAD) and venous disease. PAD is a chronic progressive atherosclerotic disease leading to partial or total peripheral vascular occlusion. In ayurveda it is compared with Vatarakta, classified as a Mahavatavyadhi and as a separate disease in the literature has evoked attention of the Ayurvedic physicians and scholars because of its versatility in symptoms.In this case study, A Case of 54 years old male patient came to OPD of shalyatantra department Parul institute of Ayurveda with complains of wound over right foot, Throbbing pain and discoloration, Swelling over foot, Pus discharge, Fever on /off, unable to walk. with past history Amputation of left 3rd toe- in 2019 and Injury with thorn before 25 days ago. with addiction of tea, alcohol and Tobacco. In general examination patient was k/c/o HTN and DM since 20-25 years.Treatment protocol for this patient given was - 1. Blood sugar management 2. Wound care 3. Saman chikitsa (symptomatic management) 4. Jalokaavacharan 5. Debridement over sole of foot 6. Compartment syndrome (fasciotomy) over sole with 1 vertical line and above 2 vertical line incision 7. Amputation. which provided significant relief in the chief complaints and ultimately prevented major deformity in the form of amputation.Conclusion: Life style of patient improved remarkable. Patient could be able to walk after treatment . Pain and Discoloration decreased.

The Prevalence of Cardiovascular Complications and Causes of AngioJet Failure: A Post-Marketing Surveillance Study Based on the MAUDE (Manufacturer and User Facility Device Experience) Database.

Background and objective Aspiration thrombectomy devices, such as the AngioJet Solent Omni (Boston Scientific Corporation,Marlborough, MA) have been approved by the US FDA for the treatment of thrombi in peripheral arterial disease, venous disease, and AV fistulas. However, there is a dearth of real-world data on the most common modes of failure and complications associated with the AngioJet Solent Omni. In this study, we aimed to address this scarcity of data. Methods The MAUDE (Manufacturer and User Facility Device Experience) database was queried for reports of device failure and adverse events spanning the period from October 2012 to December 2021. Results A total of 499 events were reported during the study period. After the exclusion of duplicate reports, the final analysis included 450 reports. The most common mode of failure was catheter breakage/kinking during suction thrombectomy with 137 reports (30%). The most common vessel associated with events was the superficial femoral artery or vein, which was documented in 82 reports (18.2%). The most common adverse clinical outcome was the embedding of a piece of the device in the patient, which occurred in seven reports (1.6%). There were seven (1.6%) events of death reported during the period studied. Conclusions Based on our findings, theAngioJet Solent Omni deviceprovides promising results; however, it is important to evaluate device safety. It is associated with complications including device embedment, catheter breakage/kinking, and death, and these adverse events are linked to patient characteristics and risk factors.

C-56 | Marijuana Use Associated With Increased Risk of Deep Venous Thrombosis and Pulmonary Embolism: A Nationwide Study

Lower extremity venous disease can be a debilitating disease with poor quality of life and can lead to complications including pulmonary embolism (PE) that confer an increased risk of mortality. The impact of active marijuana use on outcomes with peripheral venous disease including deep venous thrombosis (DVT) and PE has not been well studied and remains rarely reported. De-identified patient data from the National Inpatient Sample (NIS) from 2016-2019 were queried. Inclusion criteria included diagnosis of marijuana use. Patients were further stratified with diagnoses of DVT and PE. Data was analyzed using SPSS software in a binary logistic regression model, a p value <0.001 was considered statistically significant, and samples were standardized for comparison using predicted probabilities. Of the 30m+ patients in the NIS from 2016 to 2019, there were 623,768 patients diagnosed as marijuana users. Of these patients, 409 (0.07%) were diagnosed with a DVT and 3042 (0.49%) were diagnosed with a PE. Marijuana users were at more than double the risk of being diagnosed with a DVT and PE as compared to non marijuana users (OR = 2.263, 2.504, respectively; p<0.001). A total of 979 marijuana users died during hospitalization, but were at no increased risk of mortality when diagnosed with DVT or PE. Marijuana users had an average age of 37.4 years, even distribution across genders, were more likely to be white and more likely to be elective admissions (p<0.001). Marijuana use has been linked to alterations in platelet function and coagulation cascade. Our data reveals that marijuana users have a higher prevalence of DVT and PE than the general population. They were at no increased risk of mortality which may be attributed to patients being younger on average. Further studies need to be conducted to determine whether these patients undergo more interventions and suffer from subsequent complications.

COVID-19 Enfekte Hastalarda Tromboembolik Olayların Araştırılması

Aim: In this study, we sought to determine patient characteristics and clinical outcomes of patients who experience this complication, as well as the frequency of thromboembolic events (TEE) in COVID-19 patients hospitalized. Materials and Methods: Between January 2020 and December 2021, all the patients with positive COVID-19 PCR test results were enrolled in this study. The data of the cases that developed TEE with the diagnosis of COVID-19 were evaluated retrospectively. Results:During this time, 2,845 inpatients were admitted with COVID-19. Among this group, 96 patients (3.37%) had COVID-19 - related TEE. The mean age was 63.76±13.85 years (range, 28–80 years) with 46 men (47.92%) and 50 women (52.08%). Of the patients, 46 of 96 (47.92%) had severe COVID-19, and 50 of 96 (52.08%) had only mild respiratory symptoms. Severe COVID-19 group patients were older but there was not statistically significance between the groups. Peripheral venous disease was more common in mild COVID-19 group, while peripheral arterial disease is more common in severe COVID-19 group.CRP, uric acid, troponin, creatinine,D-dimer and leukocyte levels were higher in severe COVID-19 patients with TEE (p&amp;lt;0.05). Peripheral venous disease was present in 81 of 96 (84.37%), peripheral arterial disease in 5 of 96 (5.2%), and pulmonary embolism in 11 (11.45%) cases. One patient (1.04%) had both peripheral venous disease and pulmonary embolism. The overall mortality was 6.25% (6/96). Conclusion: COVID-19-associated thrombotic process affects more frequently veins than arteries. Given the significant observed risk for TEE in COVID-19, diagnostic imaging for TEE should be evaluated with a high degree of clinical suspicion.

Venous Evaluation

The vascular lab (VL) provides unequalled information regarding venous disease especially in the depiction and characterization of venous waveforms. This article provides the indications, protocol, and diagnostic criteria for peripheral and central venous disease and venous mapping. Venous evaluation is one of the most common studies performed at vascular labs (VL). Patient may present with swelling for evaluation of thrombosis, central obstruction, or venous insufficiency, or may need preoperative planning prior to a bypass or dialysis access creation. It is my hope that the added value a VL brings to the sonographic evaluation of veins, beyond the compressibility of the veins, is the utmost respect and attention to the depiction and characterization of the venous waveform.

Intravascular ultrasound guidance for lower extremity arterial and venous interventions.

This review details the utility of intravascular ultrasound (IVUS) for the management of peripheral artery and venous disease. The purpose of this document is to provide an update in the use of IVUS in peripheral arterial and venous pathology and demonstrate the use of IVUS as a practical diagnostic imaging procedure to evaluate and treat peripheral vascular disorders. IVUS, a diagnostic tool that relies on sound waves to produce precise images of the vessel being evaluated, was originally introduced to the medical community for the purposes of peripheral artery imaging, though it was quickly adapted for coronary interventions with positive outcomes. The utility of IVUS includes vessel measurement, pre- and post-procedural planning, treatment optimisation, and detection of thrombus, dissection or calcium severity. While angiography remains the standard imaging approach during peripheral intervention, multiple observational studies and small prospective trials have shown that in comparison, IVUS provides more accurate imaging detail, which may improve procedural outcomes. IVUS can also address limitations of angiography, including the need to administer contrast medium and eliminate the ambiguity associated with other forms of imaging. This review provides contemporary examples of where IVUS is being used during peripheral intervention as well as representative imaging to serve as a resource for the practising clinician.

Behçet's disease phenotypes and clinical outcomes: A cohort study in egyptian patients

IntroductionBehçet's disease (BD) is a systemic inflammatory disease with various presentations. The data on the course of BD in Egyptian patients are limited. ObjectivesThe objective of the study was to describe the evolution and association of the different phenotypes of BD. Material and methodsThis chronological cohort study included adult Egyptian patients suffering from BD. Demographic data and the chronological order of the disease's manifestations were collected. ResultsThe study included 233 patients. Their mean age at the onset of the disease was 26.3±6.9 years. The mean duration from onset of the disease to meeting the criteria was 11.2±30.3 months. The mean duration of the disease was 96.8±72.2 months. On onset of the disease, the most common phenotypes were mucocutaneous (84.5%), musculoskeletal (15.9%), ocular (14.6%) and peripheral venous disease (PVD) (7.3%); on the other hand, pulmonary, peripheral arterial and great vessel phenotypes evolved several years after onset of the disease. The mean time from meeting the criteria to the evolution of a new phenotype was 53.8±58.7 months. Associations between the different phenotypes were observed: PVD and superficial thrombophlebitis, peripheral arterial disease and PVD; another association was also observed between aortic involvement and cerebrovascular disease. ConclusionBD could continue to evolve several years after onset of the disease, making the previous belief about BD yield questionable. BD tends to respect the anatomy of the affected system. Some phenotypes tend to coexist, suggesting a shared aethiopathogeny and that the disease is of a systemic nature.

Long-term incidence and outcomes of obesity-related peripheral vascular disease after bariatric surgery

Background and aimsPatients with obesity are at high risk of suffering from arterial and venous peripheral vascular disease (PVD). Bariatric surgery is an effective strategy to achieve weight reduction for patients with obesity. The long-term impact of bariatric surgery on obesity-related morbidity is subject to increasing research interest. This study aimed to ascertain the impact of bariatric surgery on the long-term occurrence of PVD in patients with obesity.MethodsThe study population was extracted from the Clinical Practice Research Datalink, a nation-wide database containing primary and secondary care records of consenting patients. The intervention cohort was 2959 patients who had undergone bariatric surgery during follow-up; their controls were 2959 propensity-score-matched counterparts. The primary endpoint was development of any PVD: arterial or venous. Secondary endpoints were incident peripheral arterial disease alone, incident peripheral venous disease alone.ResultsThree hundred forty-six patients suffered a primary endpoint during follow-up. Bariatric surgery did not improve peripheral vascular disease rates as a whole, but it was associated with significantly lower event rates of arterial disease (HR = 0.560, 95%CI 0.327–0.959, p = 0.035) but higher event rates of venous disease (HR = 1.685, 95%CI 1.256–2.262, p < 0.001).ConclusionsBariatric surgery was associated with significantly reduced long-term occurrence of arterial disease but increased occurrence of venous disease in patients with obesity.

The Role of RIPK1 and RIPK3 in Cardiovascular Disease.

Cardiovascular diseases, including peripheral arterial and venous disease, myocardial infarction, and stroke, are the number one cause of death worldwide annually. In the last 20 years, the role of necroptosis, a newly identified form of regulated necrotic cell death, in cardiovascular disease has come to light. Specifically, the damaging role of two kinase proteins pivotal in the necroptosis pathway, Receptor Interacting Protein Kinase 1 (RIPK1) and Receptor Interacting Protein Kinase 3 (RIPK3), in cardiovascular disease has become a subject of great interest and importance. In this review, we provide an overview of the current evidence supporting a pathologic role of RIPK1 and RIPK3 in cardiovascular disease. Moreover, we highlight the evidence behind the efficacy of targeted RIPK1 and RIPK3 inhibitors in the prevention and treatment of cardiovascular disease.

Behçet's Disease Phenotypes and Clinical Outcomes: A Cohort Study in Egyptian Patients.

Behçet's disease (BD) is a systemic inflammatory disease with various presentations. The data on the course of BD in Egyptian patients are limited. The objective of the study was to describe the evolution and association of the different phenotypes of BD. This chronological cohort study included adult Egyptian patients suffering from BD. Demographic data and the chronological order of the disease's manifestations were collected. The study included 233 patients. Their mean age at the onset of the disease was 26.3±6.9 years. The mean duration from onset of the disease to meeting the criteria was 11.2±30.3 months. The mean duration of the disease was 96.8±72.2 months. On onset of the disease, the most common phenotypes were mucocutaneous (84.5%), musculoskeletal (15.9%), ocular (14.6%) and peripheral venous disease (PVD) (7.3%); on the other hand, pulmonary, peripheral arterial and great vessel phenotypes evolved several years after onset of the disease. The mean time from meeting the criteria to the evolution of a new phenotype was 53.8±58.7 months. Associations between the different phenotypes were observed: PVD and superficial thrombophlebitis, peripheral arterial disease and PVD; another association was also observed between aortic involvement and cerebrovascular disease. BD could continue to evolve several years after onset of the disease, making the previous belief about BD yield questionable. BD tends to respect the anatomy of the affected system. Some phenotypes tend to coexist, suggesting a shared aethiopathogeny and that the disease is of a systemic nature.

Severe Behçet's disease equally affects both genders in Egyptian patients: A multicentre retrospective follow-up study.

Behçet's disease is a relapsing multisystemic disease. Its highest prevalence is seen along the Silk Road. While several studies reported gender disparities, others didn't. Scarce data are available about the Arabs and the gender differences detected in some ethnicities could not be applied to others. Our study aimed to detect gender differences among a cohort of adult Egyptian patients with Behçet's disease. Medical files of 255 adult patients diagnosed with Behçet's disease at the Rheumatology and Rehabilitation Department of Kasr Al-Aini Hospital, Cairo University and the Internal Medicine Department of Tanta University, between 2002 and 2018, were retrospectively reviewed. The demographic features, the cumulative clinical features, the use, if any, of an intravenous pulse of methylprednisolone and immunosuppressive/biological drugs, and the frequency of the cumulative damage to the different organ systems were described. The disease severity score was calculated as well. The study revealed a prominent male predominance; the male to female ratio was 6.7:1. Acne/pseudofolliculitis was more common in males (28.6% vs 13.2%, p=0.046); the same was observed regarding any vascular involvement and peripheral venous disease (36.3% vs 18.4%, p=0.03 and 30.4% vs 13.2%, p=0.03, respectively). On the other hand, encephalitis and cranial nerve lesions were more prevalent in females (15.8% vs 6%, p=0.03 and 10.5% vs 3.2%, p=0.04, respectively). Severe Behçet's disease equally affects Egyptian males and females. BD should not be considered a benign disease in Egyptian females. The same quality of medical care should be equally offered to both genders.

Outcomes of the V-Healthy Awareness Campaign That Empowers High-School Students to Understand and Diagnose Vascular Disease Risk Factors

Just imagine the impact of empowering young high-school students to become the Sherlock Holmes of vascular health and disease. V-Healthy is a grassroots vascular education and awareness campaign that educates high-school students of the importance of vascular disease risks they face today and its impact decades later. Since 2016, >300 volunteer educators including vascular surgeons, primary care physicians, allied health care providers, and teachers have participated in the V-Healthy campaign that educated >12,000 students in 40 high schools on the implications of vascular disease risks. Students participated in didactics and hands-on workshops focused on the impact of vascular disease risk factors on peripheral artery disease, venous disease, aortic aneurysms and dissections, and stroke. In 3 years, 1210 students have participated in a Diagnosing Hypertension (HTN) study, which included monitoring daily blood pressures in their parents for a week, and participated in creating a public service announcement focused on vascular health education and awareness in their communities. An additional 2950 students participated in a survey questionnaire on the impact of the V-Healthy campaign. Of the previously undiagnosed 1210 parents who participated in the Diagnosing HTN study, >50% were hypertensive; 10% had pre-HTN (120-129/<80 mm Hg), 31% had stage 1 HTN (130-139/80-89 mm Hg), and an additional 20% had stage 2 HTN (≥140/≥90 mm Hg). Of the 2950 students who participated in the V-Healthy survey, 99% reported that they had a better understanding of vascular health; 90% recognized HTN, diabetes, smoking, obesity, and family history as risk factors; 84% would discuss vascular health with their families; and 76% were interested in learning more about their vascular health. V-Healthy is a grassroots campaign that allows vascular surgeons to lead community vascular health education and awareness and to have an impact on change. HTN is prevalent and an under-recognized vascular disease risk factor that can be used as a focal point for public vascular health education and awareness. The V-Healthy project identifies a process that can be used to develop outreach programs that empower high-school students to understand the implications of vascular disease risks and promote vascular health in our communities.

Vascular surgery resident education and hands-on training in vascular laboratory testing

Diagnostic testing performed in the noninvasive vascular laboratory is a cornerstone of care for patients with suspected or known vascular disease. The Society for Vascular Surgery has mandated that vascular surgery resident training include mentored experience in performing vascular laboratory testing and interpreting its results. The trainee should be experienced with vascular laboratory instrumentation and testing protocols, be knowledgeable in ultrasound imaging of vascular anatomy, and be competent to classify disease severity relevant to the study indication. The scope of test interpretation should include peripheral arterial, peripheral venous, cerebrovascular, and visceral abdominal testing using duplex ultrasound supplemented by indirect physiologic testing for peripheral arterial and venous disease. The emergence of endovascular therapy has expanded duplex ultrasound applications in the areas of screening, procedural imaging, and surveillance following intervention. Pre-procedure testing to assess disease location and severity, and vein mapping for dialysis access or extremity bypass grafting provide important patient-specific information that can reduce the need for more invasive vascular imaging. It is recommended that trainees acquire the hand-on skills to perform duplex testing in vascular clinic and inpatient sites, such as the emergency department and operating room. Training programs should have a structured vascular laboratory curriculum that documents annual educational milestones that encompass both test interpretation aptitude and hands-on duplex scanning skills. Before completion of training, the resident should acquire documented experience in test interpretation sufficient to take the Physician Vascular Interpretation examination, which is required for American Board of Surgery certification as a vascular surgeon.

Percutaneous transluminal angioplasty in haemodialysis patients with central or peripheral venous stenosis

Dysfunction of arteriovenous fistulae (AVF), which result from peripheral or central venous occlusive illness, occurs very often in haemodialysis patients. In therapy, endovascular open procedures are prefered. Our study illustrated the clinical success of percutaneous transluminal angioplasty (PTA) for the treatment of these patient. A retrospective analysis was applied on patients presenting during a 2-years term with haemodialysis failure and ipsilateral arm swelling coherant with peripheral and/or central venous stenosis. PTA was performed as clinically and angiografically indicated. Technical success of PTA was defined less than 30% residual stenosis and clinical success was illustrated by resolution of pain and edema along with preservation of the AVF. Our study shows a subgroup of 26 patients that presented with symptomatic peripheral or central venous occlusive disease. Mean follow-up was 12.4 months (range, 3-24 months). PTA was successful in 26 patients 11 of whom were with central lesions and 15 of whom were with peripheral lesions. We were stated for central lesions PTA had a priority patency rates of 81.8%, 60%, 37.5% and supported primary patency rates of 90.9%, 70%, 62.5% at 3, 6, 12 months. For peripheral lesions, primary patency rates of 86.7%, 78.5%, 66.6% at 3, 6 and 12 months and assisted primary patency rates of 93.3%, 85.7% and 75%, separately. PTA for central and peripheral venous stenosis is be a successful and safe procedure in hemodialysis patients. In patients with lesions that are responsible for dilation, continuous functional access in the affected extremity is sustained, especially for patients with peripheral venous stenosis.

Peripheral venous disease and its implications for military practice

AbstractPeripheral venous disease includes a spectrum of conditions which can be considered in two categories, corresponding to venous anatomy: superficial, and deep. Superficial diseases, including varicose veins and superficial thrombophlebitis, are relatively common conditions which present in the primary care setting and require appropriate management. Deep vein thrombosis (DVT) can significantly impact on operational capability and future deployability and employability.This review discusses venous anatomy and physiology, and the clinical picture of venous disease, including classification and management within the military setting.

How posture influences venous blood flow in the lower limbs: results of a study using photoplethysmography

Prolonged standing or sitting is one of the factors for chronic venous insufficiency. The aim of the study was to determine the impact of static load of the lower limbs on the functioning of the venous system. The study included 10 healthy young participants, with no peripheral venous disease. All participants took part in examinations in two variants: variant 1, sitting for 20 min with the lower limbs bent in the knee joints at 90°; variant 2, standing for 20 min with no additional load. Before and after each test, the venous refilling time (VRT) was determined using photoplethysmography. Statistical analysis demonstrated that the VRT was significantly shortened only after application of variant 2. Furthermore, even variants with small loads applied to healthy young participants can induce in them effects on the parameters describing the peripheral circulation.