Editor's Choice – Management of Chronic Venous Disease

Davies, Alun H.

doi:10.1016/j.ejvs.2015.02.007

Cited by 688 publications

(258 citation statements)

References 509 publications

(364 reference statements)

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“…Guidelines based on evidence from several randomised controlled trials recommend compression therapy—a system of elastic or non-elastic garments or modified devices that provide specific range of graduated compression pressure, highest at the ankle, that should be applied or supervised by adequately trained nurses—as the mainstay of treatment to promote venous leg ulcer healing 921303435. Compression promotes venous and lymphatic return, improves microcirculation, and reduces inflammation 343637…”

Section: How To Treat Venous Leg Ulcers?mentioning

confidence: 99%

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Diagnosis and management of venous leg ulcers

Lim

Baruah²,

Bahia

2018

BMJ

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Section: How To Treat Venous Leg Ulcers?mentioning

confidence: 99%

“…Consider these options if patients are unable to comply with multicomponent compression bandaging 1935…”

Section: How To Treat Venous Leg Ulcers?mentioning

confidence: 99%

Diagnosis and management of venous leg ulcers

Lim

Baruah²,

Bahia

2018

BMJ

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“…As well as superficial venous surgery, several other interventional treatment options are available, such as endothermal treatments (endovenous laser ablation (EVLA) and radiofrequency ablation (RFA)), and ultrasound‐guided foam sclerotherapy (UGFS). These have shown excellent results in the treatment of chronic venous disease without ulceration1 8, 9. However, there is very little RCT evidence about their effectiveness in treating venous leg ulcers.…”

Section: Introductionmentioning

confidence: 99%

Cost‐effectiveness of treatments for superficial venous reflux in patients with chronic venous ulceration

et al. 2018

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BackgroundVenous leg ulcers impair quality of life significantly, with substantial costs to health services. The aim of this study was to estimate the cost‐effectiveness of interventional procedures alongside compression therapy versus compression therapy alone for the treatment of chronic venous leg ulceration.MethodsA Markov decision analytical model was developed. The main outcome measures were quality‐adjusted life‐years (QALYs) and lifetime costs per patient, from the perspective of the UK National Health Service at 2015 prices. Resource use included the initial procedures, compression therapy, primary care and outpatient consultations. The interventional procedures included superficial venous surgery, endothermal ablation and ultrasound‐guided foam sclerotherapy (UGFS). The study population was patients with a chronic venous ulcer who were eligible for either compression therapy or an interventional procedure. Data were obtained from systematic review and meta‐analysis of RCTs.ResultsSurgery gained 0·112 (95 per cent c.i. −0·011 to 0·213) QALYs compared with compression therapy alone, with a difference in lifetime costs of €−1330 (−3570 to 1262). Given the expected savings in community care, the procedure would pay for itself within 4 years. There was insufficient evidence regarding endothermal ablation and UGFS to draw conclusions.DiscussionThis modelling study found surgery to be more effective and less costly than compression therapy alone. Further RCT evidence is required for both endothermal ablation and UGFS.

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“…По данным Международного союза фле-бологов, эта патология встречается почти у 60% людей [3]. Трофические язвы (ТЯ) являются тя-желым осложнением ХВН и поражают до 5% ра-ботоспособного населения [2,17]. В 12,5% случа-ев пациенты с венозными ТЯ вследствие сниже-ния трудоспособности вынуждены преждевре-менно прекращать трудовую деятельность [6].…”

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