Varicose veins: a clinical profile
DOI:
https://doi.org/10.18203/2349-2902.isj20215149Keywords:
Varicose veins, CEAP classification, Saphenofemoral junctionAbstract
Background: The CEAP classification includes classifying varicose veins on the basis of their clinical, etiological, anatomical and pathophysiological classification.
Methods: It was a prospective study of 50 patients presenting to a tertiary care hospital, MGM Medical College and Hospital, Kamothe, Maharashtra with varicose veins over a period of 2 years (November 2019 to November 2021). Institute Ethics Committee approval was obtained before start of study. All patients clinically diagnosed of symptomatic or complicated primary lower limb varicose veins with saphenofemoral and/or sapheno-popliteal incompetence with or without perforator incompetence were included. All cases with recurrent varicose veins were excluded. Result was tabulated and analysed at the end of the study using IBM SPSS software.
Results: The age group with maximum varicose vein was between 21-30 years and incidence being more common in male population. The majority of the patients had massive varicose veins (C2). Pain was the most frequent presenting symptom. The majority of the study group had both saphenofemoral junction and perforator incompetence. Primary varicose veins are far more common (76%) than secondary and congenital varicose veins.
Conclusions: Varicose veins are highly common in the Indian population. The CEAP classification has been a major contributor to advances in the field of varicose veins since its inception, and it has now become universally accepted due to its simplicity and reliability.
References
Williams NS, Bulstrode CJK, O'Connell R. Bailey & Love's Short Practice of Surgery. 24th ed. London: Hodder Arnold; 2008: 1514.
Mulla SA, Pai S. Varicose veins: a clinical study. Int Surg J. 2017;4(2):529-33.
Lee AJ, Evans CJ, Allan PL, Ruckley CV, Fowkes FG. Lifestyle factors and the risk of varicose veins: Edinburgh Vein Study. J Clin Epidemiol. 2003;56(2):171-9.
Vashist M, Godara R, Sen J, Panwar S. Management of varicose veins: Status of clinical examination and colour Doppler in the present Indian scenario. Int J Surg. 2008;20:1-4.
Staniszewska A, Tambyraja A, Afolabi E, Bachoo P, Brittenden J. The Aberdeen varicose vein questionnaire, patient factors and referral for treatment. Eur J Vasc Endovasc Surg. 2013;46(6):715-8.
Traub O, Berk BC. Laminar shear stress: mechanisms by which endothelial cells transduce an atheroprotective force. Arterioscler Thromb Vasc Biol. 1998;18(5):677-85.
Passerini AG, Milsted A, Rittgers SE. Shear stress magnitude and directionality modulate growth factor gene expression in preconditioned vascular endothelial cells. J Vasc Surg. 2003;37(1):182-90.
Sorescu GP, Song H, Tressel SL, Hwang J, Dikalov S, Smith DA, et al. Bone morphogenic protein 4 produced in endothelial cells by oscillatory shear stress induces monocyte adhesion by stimulating reactive oxygen species production from a nox1-based NADPH oxidase. Circulation Res. 2004;95(8):773-9.
Secomb TW, Hsu R, Pries AR. Effect of the endothelial surface layer on transmission of fluid shear stress to endothelial cells. Biorheology. 2001;38(2):143-50.
Zhao Y, Chien S, Weinbaum S. Dynamic contact forces on leukocyte microvilli and their penetration of the endothelial glycocalyx. Biophys J. 2001;80(3):1124-40.
Mulivor AW, Lipowsky HH. Role of glycocalyx in leukocyte-endothelial cell adhesion. Am J Physiol Heart Circ Physiol. 2002;283(4):1282-91.
Fronek HS. Fundamentals of Phlebology: Venous Disease for Clinicians. London: CRC Press; 2007.
