Venous insufficiency

THE VENOUS INSUFFICIENCY: A DISEASE OF THE VENOUS CAPITAL

The venous insufficiency: a universal disease

(Mettre les chiffres)

What is the venous capital?

Just like we possess a sun capital at birth, we possess a venous capital. The venous capital represents the quality of the structures of the whole venous network.

The veins in the lower limbs are vessels of various sizes which will make the blood go back up towards the heart thanks to valves which work as anti-return lids.

When veins have a good quality structure, these valves prevent the blood from coming down again in standing position.
The venous capital is different from individual to individual and deteriorates naturally with age under the influence of various aggravating factors : hormone, sedentary lifestyle, obesity, heat, work in a prolonged standing position…

But the venous capital depends also strongly on the heredity. A new study (mettre un lien vers ladite étude!!) has just shown that 60 % of the venous insufficient patients have a family heredity with a risk of a more important and faster deterioration of their venous capital, being translated by a poor circulation.

What are the symptoms of a deterioration of the venous capital?

Some types of venous insufficiency have no symptoms whatsoever. However, there are usually a wide variety of symptoms including:

  • a feeling of heaviness in the legs, especially at the end of the day, soothed by putting feet up or by walking
  • swelling in the legs, particularly around the ankles and calves
  • tingling or numbness
  • muscle cramps
  • itching, restlessness, etc.

These symptoms are most commonly felt in the calves and tend to increase as the day goes on and during hot weather.

Ask your doctor to examine your legs

“In a recent report from the Vein Consult Program (VCP), a large cohort of over 90,000 outpatients from 20 countries who were consulting their general practitioners for any reasons were screened for venous insufficiency. Out of these patients, 20% had typical CVD leg symptoms without signs and were assigned to Clinical Etiologic Anatomic Pathophysiologic classification(CEAP) class C0s and a further 22% were assigned to class C1.”1

“Since July 2017, 90 patients have participated in 3 screening programs in Hong Kong and 33 patients were evaluated with CVD risk leading to a consultation with the doctor”.

CEAP classification1:

  • C0 : No visible or palpable signs of venous disease
  • C1 : Telangiectasias or reticular veins
  • C2 :  Varicose veins
  • C3 :  Edema
  • C4 :  Changes in skin and subcutaneous tissues secondary to CVD
    • a. pigmentation or eczema
    • b. lipodermatosclerosis or atrophie blanche
  • C5 :  Changes in skin and subcutaneous tissues secondary to CVD
  • C6 :  Healed venous ulcer
  • C7 :  Active venous ulcer+   a: asymptomatic      or   s: symptomatic

Complete the self-test below while waiting for your consultation

The Phleboscore* test is a tool proposed to assess your potential risk of suffering, or not, from vein insufficiency and its progression.

It allows you to take care of your venous disease as early as possible to prevent disease progression.

 

1.  Sex
A –   Male
B –   Female

2. Age
A –   under 14
B –   14-29
C –   30-45
D –   over 45

3. How long have you had a sedentary lifestyle?
A –   active lifestyle
B –   1-3 years
C –   3-10 years
D –   over 10 years

4. Do you weigh more than you would like?
A –   no
B –   yes, 1-5 kg
C –   yes, 5-10 kg
D –   yes, over 10kg

5. How many times have you given birth?
A –   never
B –   once
C –   twice
D –   more than twice

6. Which position are you in for most of the working day?
A –   seated, on feet, or standing for less than 4h a day
B –   seated, on feet, or standing for 4h-8h a day
C –   seated, on feet, or standing for more than 8h a day
D –   seated, on feet, or standing for more than 8h a day, plus frequent travelling by car, train or plane

 7.  Do you have a family history of varicose veins?
A –   no
B –   one parent
C –   both parents
D –   both parents, one with complications (leg ulcer)

8. Do you walk, swim, cycle, jog, and/or go to gym?
A –   yes, at least 3h a week
B –   less than 3h a week
C –   occasionally (vacation time)
D –   never

9. Do your legs ever feel heavy?
A –   no, never
B –   occasionally
C –   often
D –   virtually all the time (considerable pain)

10. Is this heaviness increased by:
A –   hot weather
B –   the pill and hormone replacement therapy?
C –   menstruation?
D –   no, I don’t suffer from heavy legs

11. Do you ever have swollen ankles?
A –   no, never
B –   only in hot weather, or during long trip by plane, train, or car
C –   yes, almost every day, but only in the evening
D –   yes, every day, from the morning onward

Calculate your self-test score :

Answer A : 0 point
Answer B : 1 point
Answer C : 2 points
Answer D : 3 points

Add all the marks together, to get your final score.

Self-test score :

  • Low risk (score ≤11): “You have a low risk of venous disease. Follow the lifestyle recommendations to keep your veins healthy.”
  • Middle risk (score 12-22): “You are at risk of venous insufficiency and/or already have it as indicated by various signs. Act now by making lifestyle changes (sport, care of venous system) and seeking treatment (venotonics, compression hosiery, lymph drainage, etc.).”,
  • High risk (≥23): “You already have established venous insufficiency or are at high risk of suffering from it sometime in the future. Disease progression can be stopped by means of medical treatment (sclerosis, surgery, laser therapy) and the benefits consolidated by observing the lifestyle measures.”

 

*From Doctor Blanchemaison, Angiologist, Assistant professor, University of Medecine, Paris, France

What is the vein health?

The vein health represents the quality of the structures of the whole venous network.

The veins in the lower limbs are vessels of various sizes which will make the blood go up towards the heart, thanks to the valves which work as anti-return lids.

When veins have a good quality structure, these valves prevent the blood from coming down again in standing position. 
The venous potential is different from individual to individual and deteriorates naturally with age under the influence of various aggravating factors : hormone, sedentary lifestyle, obesity, heat, work in a prolonged standing position…

But the venous potential depends also strongly on the heredity1.

What are the symptoms of a deterioration of the venous health?

Some types of venous insufficiency have no symptoms whatsoever. However, there are usually a wide variety of symptoms including1:

Leg pain.
Heavy legs.
Swollen legs.

These symptoms are most commonly felt in the calves and tend to increase as the day goes on and during hot weather1,7.

Daflon 500mg. Micronized purified flavonoid fraction (MPFF)

Daflon 500mg is a drug recommended in the treatment of the symptoms of the lower limbs (feeling of heaviness, pain, night cramps) and anal pain1,3.

Ask advice from your pharmacist. Read attentively the instructions before use. If the symptoms persist, consult your doctor.

References: 1- Nicolaides A et al. Int Angiol.2014 ;33(2):126-139. 3- Cospite M. Angiology.1994; 45(6-Part 2):566-573. 7-https://www.advancedveincarecenter.com/why-do-your-legs-hurt-more-in-the-summer/