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
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
Факторы риска
- increasing age
- family history
- smoking
- deep vein thrombosis
- orthostatic occupation
- female sex
- obesity (waist circumference)
- ligamentous laxity
Диагностические исследования
Исследования, которые показаны в первую очередь
- duplex ultrasound
Исследования, проведение которых нужно рассмотреть
- ascending phlebography
- CT venography
- magnetic resonance venography
- CT abdomen and pelvis
- abdomen and pelvis ultrasound
- intravascular ultrasound
- air plethysmography
Алгоритм лечения
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
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
A full list of sources referenced in this topic is available to users with access to all of BMJ Best Practice.
Отличия
- Diabetic foot ulcer
- Arterial ulcer
- Squamous cell carcinoma (Marjolin)
Больше ОтличияРекомендации
- ACR appropriateness criteria® lower extremity chronic venous disease
- European Society for Vascular Surgery (ESVS) 2022 clinical practice guidelines on the management of chronic venous disease of the lower limbs
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