A study of risk factors of chronic venous insufficiency and its association with features suggestive of preceding or present deep venous thrombosis

Abstract

Background:Deep venous thrombosis (DVT), even though resolved, may damage the valves and may lead to chronic venous insufficiency (CVI). We designed the present study to examine the thrombotic markers or other ultrasound features in the absence of active thrombosis in patients presenting with features suggestive of CVI.Materials and Methods:It was a cross-sectional study of 50 DVT patients. We collected a detailed history of presenting symptoms (onset, progression, and duration) and associated history of aggravating factors. After classifying the patients, color Doppler investigation for DVT and venous incompetence and blood investigations such as Factor V, D-Dimer, total cholesterol, total triglycerides, homocysteine, high-density lipoproteins, low-density lipoproteins (LDL), and very LDL were done.Results:We found a raised Factor V significantly more in patients classified as severe under clinical classification compared with nonsevere (19% and 0%; P = 0.05) and in patients with a high Venous Severity Clinical Score (VSCS) compared to those with a low VSCS score (17% and 0%; P = 0.03). We also found that perforators were significantly more in patients with a high VSCS score (88% and 58%; P = 0.02), in patients with a primary venous etiology compared with those without any venous etiology (97% and 1%; P < 0.0001), in patients with obstruction/reflux compared to those without any pathology (95% and 0%; P < 0.0001), and in patients with severe clinical classification compared with nonsevere patient (95% and 55%; P = 0.002).Conclusions:Clinical or subclinical DVT, an important cause of CVI, may not always be seen on ultrasound, especially after resolution. However, they may have the presence of blood parameters (Factor V and hyperhomocysteinemia) suggestive of DVT; these can be used as proxy markers for the current or previous DVT.

Understanding Chronic Venous Disease: A Critical Overview of Its Pathophysiology and Medical Management

“…Primary CVI is identified as a risk factor for suffering DVT [ 51 ]. In turn, clinical or subclinical DVT is identified as a potential cause of CVI [ 92 ]. A central link in this bidirectional relationship may reside on different genes shared in both pathologies, such as the THBD (thrombomodulin) and MTHFR (methylenetetrahydrofolate reductase) [ 43 ].…”

Statins effects on venous wall in patients with chronic venous disease

“…Several studies recommend that statins may be an alternative to anticoagulant treatment in thrombus formation and embolic events prevention [31,32]. Considering the fact that deep venous thrombosis is one of the most frequent etiological factors responsible for CVD occurrence [33], and superficial venous thrombophlebitis is associated with the CVD progression as well [34,35], the effects of statins may explain the observations related to the SG. Intraluminal thrombi where noted in 2.25 times lower percentage in the SG (4 patients) comparing with CG (9 patients).…”

Impact of statin treatment on patients diagnosed with chronic venous disease. Morphological analysis of the venous wall and clinical implications

“…Also, some studies suggest that statins may be an alternative to anticoagulant treatment in the prevention of thrombus formation and embolic events. 27,28 It is also documented that deep vein thrombosis is one of the main factors incriminated in the occurrence of chronic venous disease, 29 and superficial venous thrombophlebitis is correlated with the progression of chronic venous disease. 30,31 Our study identified the presence of intraluminal thrombi in the control group (9 cases) in a 2.25 times higher percentage than in the study group (4 cases).…”