Journal of Vascular Surgery
Volume 46, Issue 6, Supplement , Pages S4-S24 , December 2007

The hemodynamics and diagnosis of venous disease

  • Mark H. Meissner, MD

      Affiliations

    • Department of Surgery, University of Washington School of Medicine, Seattle, Wash
    • Corresponding Author InformationCorrespondence: Mark H. Meissner, MD, Department of Surgery, Box 356410, University of Washington Medical Center, 1589 NE Pacific Street, Seattle, WA 98195.
  • ,
  • Gregory Moneta, MD

      Affiliations

    • Department of Surgery, Oregon Health Sciences University, Portland, Ore
  • ,
  • Kevin Burnand, MD

      Affiliations

    • Department of Academic Surgery, St Thomas Hospital, London, United Kingdom
  • ,
  • Peter Gloviczki, MD

      Affiliations

    • Department of Surgery, Mayo Clinic, Rochester, Minn
  • ,
  • Joann M. Lohr, MD

      Affiliations

    • Lohr Surgical Specialists, Cincinnati, Ohio
  • ,
  • Fedor Lurie, MD

      Affiliations

    • Straub Foundation and Kistner Vein Clinic, Honolulu, Hawaii
  • ,
  • Mark A. Mattos, MD

      Affiliations

    • Department of Surgery, Wayne State University, Seattle, Wash
  • ,
  • Robert B. McLafferty, MD

      Affiliations

    • Department of Surgery, Southern Illinois University School of Medicine, Springfield, Ill
  • ,
  • Geza Mozes, MD

      Affiliations

    • private practice in Corpus Christi, Corpus Christi, Tex
  • ,
  • Robert B. Rutherford, MD

      Affiliations

    • private practice in Corpus Christi, Corpus Christi, Tex
  • ,
  • Frank Padberg, MD

      Affiliations

    • Department of Surgery, UMDNJ-New Jersey Medical School, Newark, NJ.
  • ,
  • David S. Sumner, MD

      Affiliations

    • Department of Surgery, Southern Illinois University School of Medicine, Springfield, Ill

Received 30 September 2006 ,Accepted 23 August 2007.

References 

  1. Woolard RH. The development of the principal arterial stems in the forelimb of the pig. In:  Washington CI editors. Contributions to embryology. Washington, DC: Carnegie Institution of Washington; 1992;p. 139–154
  2. Ballaun C, Weninger W, Uthman A, Weich H, Tschachler E. Human keratinocytes express the three major splice forms of vascular endothelial growth factor. J Invest Dermatol. 1995;104:7–10
  3. Nicholson CP, Gloviczki P. Embryology and development of the vascular system. In:  White RA,  Hollier LH editor. Vascular surgery: basic science and clinical correlations. Philadelphia: JB Liipincott; 1994;p. 3–20
  4. Browse NL, Irvine AT, Wilson NM. Embryology and radiographic anatomy. In:  Browse NL,  Irvine AT,  Wilson NM editor. Diseases of the veins. 2nd ed.. London: Arnold; 1999;p. 23–48
  5. Mozes G, Carmichael SW, Gloviczki P. Development and anatomy of the venous system. In:  Gloviczki P,  Yao JST editor. Handbook of venous disorders. 2nd ed.. London: Arnold; 2001;p. 11–24
  6. Noel AA, Gloviczki P, Cherry KJ, Rooke TW, Stanson AW, Driscoll DJ. Surgical treatment of venous malformations in Klippel-Trenaunay syndrome. J Vasc Surg. 2000;32:840–847
  7. Cherry KJ, Gloviczki P, Stanson AW. Persistent sciatic vein: diagnosis and treatment of a rare condition. J Vasc Surg. 1996;23:490–497
  8. Gloviczki P. Vascular malformations. In:  Moore WS editors. Vascular and endovascular surgery: a comprehensive review. 7th ed.. Philadelphia: Saunders; 2005;
  9. Caggiati A, Bergan JJ, Gloviczki P, Jantet G, Wendell-Smith CP, Partsch H. Nomenclature of the veins of the lower limbs: an international interdisciplinary consensus statement. J Vasc Surg. 2002;36:416–422
  10. Caggiati A, Bergan JJ. The saphenous vein: derivation of its name and relevant anatomy. J Vasc Surg. 2002;35:172–175
  11. Mozes G, Gloviczki P, Menawat SS, Fisher DR, Carmichael SW, Kadar A. Surgical anatomy for endoscopic subfascial division of perforating veins. J Vasc Surg. 1996;24:800–808
  12. Caggiati A, Bergan JJ, Gloviczki P, Eklof B, Allegra C, Partsch H. Nomenclature of the veins of the lower limb: extensions, refinements, and clinical application. J Vasc Surg. 2005;41:719–724
  13. Mozes G, Kadar A, Carmichael SW. Surgical anatomy of the perforating veins. In:  Gloviczki P editors. Atlas of endoscopic perforator vein surgery. London: Springer-Verlag; 1998;p. 17–28
  14. Katz AI, Chen Y, Moreno AH. Flow through a collapsible tube: experimental analysis and mathematical model. Biophysical J. 1969;9:1261–1279
  15. Alimi YS, Barthelemy P, Juhan C. Venous pump of the calf: a study of venous and muscular pressures. J Vasc Surg. 1994;20:728–735
  16. Araki CT, Back TL, Padberg FT, Thompson PN, Jamil Z, Lee BC, et al. The significance of calf muscle pump function in venous ulceration. J Vasc Surg. 1994;20:872–877
  17. Ludbrook J. The musculovenous pumps of the human lower limb. Am Heart J. 1966;71:635–641
  18. Pollack AA, Wood EH. Venous pressure in the saphenous vein at the ankle in man during exercise and changes in posture. J Appl Physiol. 1949;1:649–662
  19. White JV, Katz ML, Cisek P, Kreithen J. Venous outflow of the leg: anatomy and physiologic mechanism of the plantar venous plexus. J Vasc Surg. 1996;24:819–824
  20. Shepherd JT. Role of the veins in the circulation. Circulation. 1966;33:484–491
  21. Katz ML, Comerota AJ, Kerr RP, Caputo GC. Variability of venous-hemodynamics with daily activity. J Vasc Surg. 1994;19:361–365
  22. Henry JP, Gauer OH. The influence of temperature upon venous pressure in the foot. J Clin Invest. 1950;29:855–861
  23. Plate G, Brudin L, Eklof B, Jensen R, Ohlin P. Congenital vein valve aplasia. World J Surg. 1986;10:929–934
  24. Goldman MP, Fronek A. Anatomy and pathophysiology of varicose veins. J Dermatol Surg Oncol. 1989;15:138–145
  25. Burnand KG. The physiology and hemodynamics of chronic venous insufficiency of the lower limb. In:  Gloviczki P,  Yao JST editor. Handbook of venous disorders Guidelines of the American Venous Forum. 2nd ed.. London: Arnold; 2001;p. 49–57
  26. Christopoulos DG, Nicolaides AN, Szendro G, Irvine AT, Bull ML, Eastcott HH. Air-plethysmography and the effect of elastic compression on venous hemodynamics of the leg. J Vasc Surg. 1987;5:148–159
  27. Nicolaides AN, Hussein MK, Szendro G, Christopoulos D, Vasdekis S, Clarke H. The relationship of venous ulceration with ambulatory venous pressure measurements. J Vasc Surg. 1993;17:414–419
  28. Padberg FT, Johnston MV, Sisto SA. Structured exercise improves calf muscle pump function in chronic venous insufficiency: a randomized trial. J Vasc Surg. 2004;39:79–87
  29. Nicolaides AN. Investigation of chronic venous insufficiency: a consensus statement. (France, March 5-9, 1997) Circulation. 2000;102:E126–E163
  30. Hosoi Y, Zukowski A, Kakkos SK, Nicolaides AN. Ambulatory venous pressure measurements: new parameters derived from a mathematic hemodynamic model. J Vasc Surg. 2002;36:137–142
  31. Travers JP, Brookes CE, Evans J, Baker DM, Kent C, Makin GS, et al. Assessment of wall structure and composition of varicose veins with reference to collagen, elastin and smooth muscle content. Eur J Vasc Endovasc Surg. 1996;11:230–237
  32. Lowell RC, Gloviczki P, Miller VM. In vitro evaluation of endothelial and smooth muscle function of primary varicose veins. J Vasc Surg. 1992;16:679–686
  33. Gandhi RH, Irizarry E, Nackman GB, Halpern VJ, Mulcare RJ, Tilson MD. Analysis of the connective tissue matrix and proteolytic activity of primary varicose veins. J Vasc Surg. 1993;18:814–820
  34. Rose SS, Ahmed A. Some thoughts on the aetiology of varicose veins. J Cardiovasc Surg. 1986;27:534–543
  35. Cotton LT. Varicose veins (Gross anatomy and development). Br J Surg. 1961;48:589–597
  36. Alexander CJ. The theoretical basis of varicose vein formation. Med J Aust. 1972;1:258–261
  37. Johnson BF, Manzo RA, Bergelin RO, Strandness DE. Relationship between changes in the deep venous system and the development of the post-thrombotic syndrome after an acute episode of lower limb deep vein thrombosis: a one- to six-year follow-up. J Vasc Surg. 1995;21:307–313
  38. Arcelus JI, Caprini JA, Hoffman KN, Fink N, Size GP, Fareed J, et al. Laboratory assays and duplex scanning outcomes after symptomatic deep vein thrombosis: preliminary results. J Vasc Surg. 1996;23:616–621
  39. Killewich LA, Macko RF, Cox K, Franklin DR, Benjamin ME, Lilly MP, et al. Regression of proximal deep venous thrombosis is associated with fibrinolytic enhancement. J Vasc Surg. 1997;26:861–868
  40. Rosfors S, Eriksson M, Leijd B, Nordstrom E. A prospective follow-up study of acute deep venous thrombosis using colour duplex ultrasound, phlebography and venous occlusion plethysmography. Int Angiol. 1997;16:39–44
  41. Clarke GH, Vasdekis SN, Hobbs JT, Nicolaides AN. Venous wall function in the pathogenesis of varicose veins. Surgery. 1992;111:402–408
  42. Hopkins NF, Spinks TJ, Rhodes CG, Ranicar AS, Jamieson CW. Positron emission tomography in venous ulceration and liposclerosis: study of regional tissue function. Br Med J (Clin Res Ed). 1983;286:333–336Jan 29
  43. Pappenheimer JR. Passage of molecules through capillary walls. Physiol Rev. 1953;33:387–423
  44. Landis EM, Gibbon JH. The effects of temperature and of tissue pressure on the movement of fluid through the human capillary wall. J Clin Invest. 1933;12:105–138
  45. Burnand KG, Whimster I, Naidoo A, Browse NL. Pericapillary fibrin in the ulcer-bearing skin of the leg: the cause of lipodermatosclerosis and venous ulceration. Br Med J (Clin Res Ed). 1982;285:1071–1072
  46. Browse NL, Burnand KG. The cause of venous ulceration. Lancet. 1982;2:243–245
  47. Van De Scheur M, Falanga V. Pericapillary fibrin cuffs in venous disease. Dermatol Surg. 1997;23:955–959
  48. Coleridge Smith PD. Update on chronic-venous-insufficiency-induced inflammatory processes. Angiology. 2001;52(Suppl 1):S35–S42
  49. Coleridge Smith PD, Thomas P, Scurr JH, Dormandy JA. Causes of venous ulceration: a new hypothesis. Br Med J (Clin Res Ed). 1988;296:1726–1727
  50. Eklof B, Rutherford RB, Bergan JJ, Carpentier PH, Gloviczki P, Kistner RL, et al. Revision of the CEAP classification for chronic venous disorders: consensus statement. J Vasc Surg. 2004;40:1248–1252
  51. Rutherford RB, Padberg FT, Comerota AJ, Kistner RL, Meissner MH, Moneta GL. Venous severity scoring: an adjunct to venous outcome assessment. J Vasc Surg. 2000;31:1307–1312
  52. Kakkar VV, Flanc C, Howe CT, Clarke MB. Natural history of postoperative deep-vein thrombosis. Lancet. 1969;2:230–232
  53. Barnes RW, Wu KK, Hoak JC. Fallibility of the clinical diagnosis of venous thrombosis. JAMA. 1975;234:605–607
  54. Cranley JJ, Canos AJ, Sull WJ. The diagnosis of deep venous thrombosis (Fallibility of clinical symptoms and signs). Arch Surg. 1976;111:34–36
  55. Haeger K. Problems of acute deep venous thrombosis. Angiology. 1969;20:219–223
  56. Berberich J, Hirsch S. Die rontgenographische darstellung der arterien und venen ani lebeneden menschen. Klin Wochenschr. 1923;2:2226
  57. Wells PS, Hirsh J, Anderson DR, Lensing AWA, Foster G, Kearon C, et al. Accuracy of clinical assessment of deep-vein thrombosis. Lancet. 1995;345:1326–1330
  58. Fletcher JP, Kershaw LZ, Barker DS, Koutts J, Varnava A. Ultrasound diagnosis of deep venous thrombosis. Med J Aust. 1990;153:453–455
  59. Sauerbrei E, Thomson J, McLachlan M, Musial J. Observer variation in lower limb venography. J Can Assoc Radiol. 1981;32:28–29
  60. de Valois JC, van Schaik CC, Verzibergen F, van Ramshorst B, Eikelboom BC, Meuwissen OJAT. Contrast venography: from gold standard to “golden backup” in clinically suspected deep vein thrombosis. Eur J Radiol. 1990;11:131–137
  61. Nadich J, Feinberg A, Karp-Harman H, Karmel M, Tyma C, Stein H. Contrast venography: reassessment of its role. Radiology. 1988;168:97–100
  62. Talbot S. Use of real-time imaging in identifying deep venous obstruction: a preliminary report. Bruit. 1982;VI:41–42
  63. Rabinov K, Paulin S. Roentgen diagnosis of venous thrombosis in the leg. Arch Surg. 1972;104:134–144
  64. Kistner RL, Ferris EB, Randhawa G, Kamida C. A method of performing descending venography. J Vasc Surg. 1986;4:464–468Nov
  65. Lohr J. Bilateral lower extremity duplex scanning revisited. Dis Mon. 2005;51:79–85
  66. Sheiman R, Weintraub J, McArdle C. Bilateral lower extremity US in the patient with bilateral symptoms of deep venous thrombosis: assessment of need. Radiology. 1995;196:379–381
  67. Strothman G, Blebea J, Fowl R. Contralateral duplex scanning for deep venous thrombosis is unnecessary in patients with symptoms. J Vasc Surg. 1995;22:543–547
  68. White RH, McGahan JP, Daschbach MM, Hartling RP. Diagnosis of deep-vein thrombosis using duplex ultrasound. Ann Int Med. 1989;111:297–304
  69. Kearon C, Julian JA, Math M, Newman TE, Ginsberg JS. Noninvasive diagnosis of deep venous thrombosis (McMaster Diagnostic Imaging Practice Guidelines Initiative). Ann Intern Med. 1998;128:663–677
  70. Becker D, Philbrick J, Abbitt P. Real-time ultrasonography for the diagnosis of lower extremity deep venous thrombosis. Arch Intern Med. 1989;149:1731–1734
  71. Lensing A, Davidson B, Prins M, Buller H. Diagnosis of deep-vein thrombosis with ultrasound imaging in symptomatic patients and asymptomatic high-risk patients. In:  Hull R,  Raskob G,  Pineo G editor. Venous thromboembolism: an evidence-based atlas. Armonk, NY: Futura Publishing Co; 1996;p. 115–124
  72. Atri M, Herba MJ, Reinhold C, Leclerc J, Ye S, Illescas FF, et al. Accuracy of sonography in the evaluation of calf deep vein thrombosis in both postoperative surveillance and symptomatic patients. AJR. 1996;166:1361–1367
  73. In:  Semrow CM,  Friedell ML,  Buchbinder D editor. The efficacy of ultrasonic venography in the detection of calf vein thrombosis (10th annual meeting of the Society of Noninvasive Vascular Technology). 1984;Toronto, Ontario
  74. Greenfield LJ. Free floating thrombus and pulmonary embolism. Arch Intern Med. 1997;157:2661–2662(letter)
  75. Voet D, Afschrift M. Floating thrombi: diagnosis and follow-up by duplex ultrasound. Br J Radiol. 1991;64:1010–1014
  76. Baldridge E, Martin M, Welling R. Clinical significance of free-floating venous thrombi. J Vasc Surg. 1990;11:62–69
  77. Radomski JS, Jarrell BE, Carabasi RA, Yang SL, Koolpe H. Risk of pulmonary embolus with inferior vena cava thrombosis. Am Surg. 1987;53:97–101
  78. Prandoni P, Villalta S, Polistena P, Bernardi E, Cogo A, Girolami A. Symptomatic deep-vein thrombosis and the post-thrombotic syndrome. Haematologica. 1995;80:42–48
  79. Meissner MH, Caps MT, Bergelin RO, Manzo RA, Strandness DE. Propagation, rethrombosis, and new thrombus formation after acute deep venous thrombosis. J Vasc Surg. 1995;22:558–567
  80. Prandoni P, Lensing A, Cogo A, Cuppini S, Villalta S, Carta M, et al. The long-term clinical course of acute deep venous thrombosis. Ann Intern Med. 1996;125:1–7
  81. Prandoni P, Lensing AW, Prins MH, Bernardi E, Marchiori A, Bagatella P, et al. Residual venous thrombosis as a predictive factor of recurrent venous thromboembolism. Ann Intern Med. 2002;137:955–960
  82. Hull RD, Carter CJ, Jay RM, Ockelford PA, Hirsch J, Turpie AG, et al. The diagnosis of acute, recurrent, deep venous thrombosis: a diagnostic challenge. Circulation. 1983;67:901–906
  83. Murphy TP, Cronan JJ. Evolution of deep venous thrombosis: a prospective evaluation with US. Radiology. 1990;177:543–548
  84. Ohgi S, Ito K, Tanaka K, Hara H, Mori T. Echogenic types of venous thrombi in the common femoral vein by ultrasonic B-mode imaging. Vasc Surg. 1991;25:253–258
  85. Hertzberg BS, Kliewer MA, DeLong DM, Lalouche KJ, Paulson EK, Frederick MG, et al. Sonographic assessment of lower limb vein diameter: implications for the diagnosis and characterization of deep venous thrombosis. Am J Roentgenol. 1997;168:1253–1257
  86. Sumner D, Mattos M. Diagnosis of deep vein thrombosis with real-time color and duplex scanning. In:  Bernstein E editors. St. Louis: Mosby; 1993;
  87. The Intersocietal Commission for the Accredidation of Vascular Laboratories. Part II Vascular Laboratory Operations (Peripheral Venous Testing). 2005;http://www.intersocietal.org/icavl/apply/standards.htm
  88. Ziyeh S, Spreer J, Rossler J, Strecker R, Hochmuth A, Schumacher M, et al. Parkes Weber or Klippel-Trenaunay syndrome? (Non-invasive diagnosis with MR projection angiography). Eur Radiol. 2004;14:2025–2029
  89. Godshall CJ. Computed tomographic angiography allows accurate planning of the setting and technique of open and percutaneous vascular interventions. Am J Surg. 2005;190:218–220
  90. Morris CS, Rogers FB, Najarian KE, Bhave AD, Shackford SR. Current trends in vena caval filtration with the introduction of a retrievable filter at a level I trauma center. J Trauma. 2004;57:32–36
  91. Keeling WB, Haines K, Stone PA, Armstrong PA, Murr MM, Shames ML. Current indications for preoperative inferior vena cava filter insertion in patients undergoing surgery for morbid obesity. Obes Surg. 2005;15:1009–1012
  92. Tanchajja S, Mohaideen AH. A simple technique to identify the proper vertebrae in the placement of the intraluminal filter in the inferior vena cava. Surg Gynecol Obstet. 1991;172:242–243
  93. Conners MS, Becker S, Guzman RJ, Passman MA, Pierce R, Kelly T, et al. Duplex scan-directed placement of inferior vena cava filters: a five-year institutional experience. J Vasc Surg. 2002;35:286–291
  94. Gamblin TC, Ashley DW, Burch S, Solis M. A prospective evaluation of a bedside technique for placement of inferior vena cava filters: accuracy and limitations of intravascular ultrasound. Am Surg. 2003;69:382–386
  95. Danetz JS, McLafferty RB, Ayerdi J, Gruneiro LA, Ramsey DE, Hodgson KJ. Selective venography versus nonselective venography before vena cava filter placement: evidence for more, not less. J Vasc Surg. 2003;38:928–934
  96. Aljabri B, MacDonald PS, Satin R, Stein LS, Obrand DI, Steinmetz OK. Incidence of major venous and renal anomalies relevant to aortoiliac surgery as demonstrated by computed tomography. Ann Vasc Surg. 2001;15:615–618
  97. Fraser DG, Moody AR, Martel A, Morgan PS. Re-evaluation of iliac compression syndrome using magnetic resonance imaging in patients with acute deep venous thromboses. J Vasc Surg. 2004;40:604–611
  98. Fraser DG, Moody AR, Morgan PS, Martel A. Iliac compression syndrome and recanalization of femoropopliteal and iliac venous thrombosis: a prospective study with magnetic resonance venography. J Vasc Surg. 2004;40:612–619
  99. Myers KA, Ziegenbein RW, Zeng GH, Matthews PG. Duplex ultrasonography scanning for chronic venous disease: patterns of venous reflux. J Vasc Surg. 1995;21:605–612
  100. Welkie J, Comerota A, Katz M, Aldridge S, Kerr R, White J. Hemodynamic deterioration in chronic venous disease. J Vasc Surg. 1992;16:733–740
  101. Sumner DS. Diagnosis of deep venous thrombosis. In:  Rutherford RB editors. Vascular surgery. 4th ed.. Philadelphia: WB Saunders; 1995;p. 1698–1743
  102. Folse R, Alexander RH. Directional flow detection for localizing venous valvular incompetency. Surgery. 1970;67:114–121
  103. McMullin GM, Coleridge Smith PD. An evaluation of Doppler ultrasound and photoplethysmography in the investigation of venous insufficiency. Aust N Z J Surg. 1992;62:270–275Apr
  104. Weingarten M, Branas C, Czeredarczuk M, Schmidt J, Wolfert C. Distribution and quantification of venous reflux in lower extremity chronic venous disease. J Vasc Surg. 1993;18:753–759
  105. Masuda EM, Kistner RL, Eklof B. Prospective study of duplex scanning for venous reflux: comparison of valsalva and pneumatic cuff techniques in the reverse trendelenburg and standing positions. J Vasc Surg. 1994;20:711–720
  106. van Bemmelen PS, Bedford G, Beach K, Strandness DE. Quantitative segmental evaluation of venous valvular reflux with duplex ultrasound scanning. J Vasc Surg. 1989;10:425–431
  107. Hanrahan LM, Araki CT, Fisher JB, Rodriguez AA, Walker G, Woodson J, et al. Evaluation of the perforating veins of the lower extremity using high resolution duplex imaging. J Cardiovasc Surg. 1991;32:87–97
  108. Neglen P, Raju S. A comparison between descending phlebography and duplex Doppler investigation in the evaluation of reflux in chronic venous insufficiency: a challenge to phlebography as the “gold standard”. J Vasc Surg. 1992;16:687–693
  109. Baker SR, Burnand KG, Sommerville KM, Lea Thomas M, Wilson NM, Browse NL. Comparison of venous reflux assessed by duplex scanning and descending phlebography in chronic venous disease. Lancet. 1993;341:400–403
  110. Masuda E, Kistner R. Prospective comparison of duplex scanning and descending venography in the assessment of venous insufficiency. Am J Surg. 1992;164:254–259
  111. Labropoulos N, Leon M, Nicolaides AN, Giannoukas AD, Volteas N, Chan P. Superficial venous insufficiency: correlation of anatomic extent of reflux with clinical symptoms and signs. J Vasc Surg. 1994;20:953–958
  112. Gooley NA, Sumner DS. Relationship of venous reflux to the site of venous valvular incompetence: implications for venous reconstructive surgery. J Vasc Surg. 1988;7:50–59
  113. Louisy F, Cauquil D, Andre-Deshays C, Schroiff P, Lazerges M, Lafaye C, et al. Air plethysmography: an alternative method for assessing peripheral circulatory adaptations during spaceflights. Eur J Appl Physiol. 2001;85:383–391
  114. Bays R, Healy D, Atnip R, Neumyer M, Thiele B. Validation of air plethysmography, photoplethysmography, and duplex ultrasonography in the evaluation of severe venous stasis. J Vasc Surg. 1994;20:721–727
  115. Barnes RW, Collicott PE, Sumner DS, Strandness DE. Noninvasive quantitation of venous hemodynamics in the postphlebitic syndrome. Arch Surg. 1973;107:807–814
  116. Yang D, Sacco P. Reproducibility of air plethysmography for the evaluation of arterial and venous function of the lower leg. Clin Physiol Funct Imaging. 2002;22:379–382
  117. Christopoulos D, Nicolaides AN, Cook A, Irvine A, Galloway JM, Wilkinson A. Pathogenesis of venous ulceration in relation to the calf muscle pump function. Surgery. 1989;106:829–835
  118. Meissner MH, Natiello C, Nicholls SC. Performance characteristics of the venous clinical severity score. J Vasc Surg. 2002;36:889–895
  119. Ricci MA, Emmerich J, Callas PW, Rosendaal FR, Stanley AC, Naud S, et al. Evaluating chronic venous disease with a new venous severity scoring system. J Vasc Surg. 2003;38:909–915
  120. Kakkos SK, Rivera MA, Matsagas MI, Lazarides MK, Robless P, Belcaro G, et al. Validation of the new venous severity scoring system in varicose vein surgery. J Vasc Surg. 2003;38:224–228
  121. Perrin M, Dedieu F, Jessent V, Blanc M-P. Evaluation of the new venous severity scoring system for chronic venous disease of the lower limbs: An observational study conducted by French angiologists. Phlebolymphology. 2006;13:6–16
  122. Launois R, Reboul-Marty J, Henry B. Construction and validation of a quality of life questionnaire in chronic lower limb venous insufficiency (CIVIQ). Qual Life Res. 1996;5:539–554
  123. Garratt AM, Ruta DA, Abdalla MI, Russell IT. Responsiveness of the SF-36 and a condition-specific measure of health for patients with varicose veins. Qual Life Res. 1996;5:223–234
  124. Smith JJ, Guest MG, Greenhalgh RM, Davies AH. Measuring the quality of life in patients with venous ulcers. J Vasc Surg. 2000;31:642–649
  125. Lamping DL, Schroter S, Kurz X, Kahn SR, Abenhaim L. Evaluation of outcomes in chronic venous disorders of the leg: development of a scientifically rigorous, patient-reported measure of symptoms and quality of life. J Vasc Surg. 2003;37:410–419

 Competition of interest: none

PII: S0741-5214(07)01529-7

doi: 10.1016/j.jvs.2007.09.043

Journal of Vascular Surgery
Volume 46, Issue 6, Supplement , Pages S4-S24 , December 2007