[Syndrome of lower limb volume enlargement in varicosity: causes and medical approaches].
This paper provides the results of examination of 413 patients aged 15 to 79 years (mean age 43.2 years) with different stages of CVI seen from 1995 to 2005. A complex of methods was employed: the clinical nmltimodality examination, multilevel volumetric monitoring before and after daily orthostatic loading, occlusion plethysmography, multilevel ultrasound duplex scanning of the venous system arid subcutis as well as radiography. Only in the third of cases (n=149, 36.0%) was primarily of distal character attended by lesion of the foot and leg, with clear daily dynamics and dependence on the daily orthostatic loading-eaema proper. Two types of edema were distinguished: 1)with pronounced daily dynamics and return to the initial parameters in the morning hours (131 patients) and 2) with moderate daily dynamics of edema and the lack of return to the initial parameters in the morning hours (18 patients). Such difference stems from the type of coexistent lymphatic insufficiency (with a high and low drop). However, only the first type is initially determined by venous insufficiency. The majorityof this group patients were found to suffer thrombosis of the ti-bial veins in the presence of varicosity running a prolonged course. Hinetyone patients (22.0%) had a proximally oriented enlargement, with pronounced orthostasodependerice, of the muscle segments of the limb because of orthostasodependent phlebopaxhy. In the remaining 173 (41.9%) patients examined, vascular eaema was coupled with non-vascular causes of limb size enlargement (arthrosis of leg joints, lipoedema) or the latter ones were isblated. The aim of the present study was to analyze the causes of the syndrome of limb size enlargement in varicosity with the purpose of upgrading the efficacy and trend of the treatment.
Tsukanov
Iu T
IuT
Surgical Diseases, Center for Advanced Medical Training, State Medical Academy, Omsk Scientific Center of Lymphophlebology, OSMA, Omsk, Russia.
Tsukanov
A Iu
AIu
D000293:Adolescent; D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D035002:Lower Extremity / Q000033:anatomy & histology*; D008196:Lymph; D008297:Male; D008875:Middle Aged; D013577:Syndrome; D014648:Varicose Veins / Q000473:pathology*