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Chronic venous insufficiency

Последний просмотренный: 5 Jun 2025
Last updated: 22 Jun 2023

Резюме

Определение

Анамнез и осмотр

Ключевые диагностические факторы

  • corona phlebectatica (malleolar flare or ankle flare)
  • ankle swelling
  • hyperpigmentation (brawny edema)
  • lipodermatosclerosis
  • atrophie blanche
  • leg ulcers
Полная информация

Другие диагностические факторы

  • leg fatigue, aching, and/or discomfort
  • heavy legs
  • leg cramps
  • telangiectasias
  • reticular veins
  • dilated tortuous veins
  • dry and scaly skin
  • skin burning and itching
  • unilateral leg swelling
Полная информация

Факторы риска

  • increasing age
  • family history
  • smoking
  • deep vein thrombosis
  • orthostatic occupation
  • female sex
  • obesity (waist circumference)
  • ligamentous laxity
Полная информация

Диагностические исследования

Исследования, которые показаны в первую очередь

  • duplex ultrasound
Полная информация

Исследования, проведение которых нужно рассмотреть

  • ascending phlebography
  • CT venography
  • magnetic resonance venography
  • CT abdomen and pelvis
  • abdomen and pelvis ultrasound
  • intravascular ultrasound
  • air plethysmography
Полная информация

Алгоритм лечения

ПРОДОЛЖЕНИЕ

all symptomatic patients

Составители

Авторы

Joseph L. Mills Sr, MD

Professor and Chief

Division of Vascular Surgery and Endovascular Therapy

Michael E. DeBakey Department of Surgery

Baylor College of Medicine

Houston

TX

Раскрытие информации

JLM declares that he has no competing interests.

David G. Armstrong, DPM, MD, PhD

Professor of Surgery

Director of Southwestern Academic Limb Salvage Alliance (SALSA)

Keck School of Medicine of University of Southern California (USC)

Los Angeles

CA

Раскрытие информации

DGA declares that his work is partially supported by grants from the National Institutes of Health and the National Institute of Diabetes and Digestive and Kidney Diseases.

Рецензенты

Anahita Dua, MD, MS, MBA, FACS

Assistant Professor of Surgery

Massachusetts General Hospital/Harvard Medical School

Boston

MA

Раскрытие информации

AD declares that she has no competing interests.

Paul Tisi, MBBS, MS, FRCSEd

Medical Director/Consultant Vascular Surgeon

Bedford Hospital

Bedford

UK

Раскрытие информации

PT declares that he has no competing interests.

Список литературы

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Основные статьи

Lurie F, Passman M, Meisner M, et al. The 2020 update of the CEAP classification system and reporting standards. J Vasc Surg Venous Lymphat Disord. 2020 May;8(3):342-52. Аннотация

De Maeseneer MG, Kakkos SK, Aherne T, et al. Editor's choice - European Society for Vascular Surgery (ESVS) 2022 clinical practice guidelines on the management of chronic venous disease of the lower limbs. Eur J Vasc Endovasc Surg. 2022 Feb;63(2):184-267.Полный текст  Аннотация

Bergan JJ, Schmid-Schönbein GW, Smith PD, et al. Chronic venous disease. N Engl J Med. 2006 Aug 3;355(5):488-98. Аннотация

American Vein and Lymphatic Society (American College of Phlebology). Treatment of superficial venous disease of the lower leg. Feb 2016 [internet publication].Полный текст

Статьи, указанные как источники

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