title: Correlations between ankle circumference, symptoms, and quality of life demonstrate the clinical relevance of minimal leg swelling reduction: results of a study in 1,036 Argentinean patients.
abstract: BACKGROUND
  Clinical classification (C) of patients suffering from chronic venous disorders according to the Clinical, Etiology, Anatomy, and Pathophysiology Classification takes into account signs and symptoms, but the C3 (venous edema) class has been identified as poorly specific. Patients in whom physicians fail to observe significant edema (sign) frequently report a feeling of swelling (symptom). Previous studies of venoactive drugs have demonstrated significant reduction in leg volume, but the correlation with a clinical improvement was lacking.
  
  
  OBJECTIVE
  To describe the clinical status of a sample of Argentinean patients presenting with venous symptoms and signs. To demonstrate the relationship between the reduction of leg swelling and the improvement of symptoms of chronic venous disorders (CVDs) and quality of life (QoL) in patients with CVD.
  
  
  METHODS
  One thousand thirty-six patients were included prospectively and submitted to medical interrogation and examination and specific and generic self-questionnaires. Patients included were reassessed using the same tools after phlebotropic treatment (Ruscus+hesperidin+ascorbic acid), the prescription of which was expected to induce variations in clinical status.
  
  
  RESULTS
  Significant correlations were observed between ankle circumference reduction and improvement of all symptoms in C2 to C3 patients: heaviness, pain, paraesthesia, and cramps. Such correlations were found in C0 to C1 patients. There was a correlation between improvement attained in QoL and the physical dimension of the Chronic Venous Insufficiency Questionnaire.
  
  
  CONCLUSIONS
  Our results demonstrate the relevance of moderate ankle swelling, which is not usually described clinically as edema and is probably a typical symptom of chronic venous disorders. Future studies should focus on this insufficiently analyzed clinical feature and put to better use more specific QoL questionnaires.
authors.affiliation: Cabinet de Phlebologie, Medecine Vasculaire, Nice, France. jj.guex@wanadoo.fr
authors.forename: Jean Jerome
authors.initials: JJ
authors.lastname: Guex
authors.forename: Ermenegildo
authors.initials: E
authors.lastname: Enrici
authors.forename: Sami
authors.initials: S
authors.lastname: Boussetta
authors.forename: Lucienne
authors.initials: L
authors.lastname: Avril
authors.forename: Camilo
authors.initials: C
authors.lastname: Lis
authors.forename: Charles
authors.initials: C
authors.lastname: Taieb
mesh_terms: D000328:Adult; D000842:Ankle / Q000033:anatomy & histology; D001118:Argentina; D001837:Body Weights and Measures; D004487:Edema / Q000175:diagnosis* / Q000628:therapy*; D005260:Female; D006801:Humans; D007866:Leg / Q000098:blood supply*; D008297:Male; D008875:Middle Aged; D016491:Peripheral Vascular Diseases / Q000175:diagnosis* / Q000628:therapy*; D011446:Prospective Studies; D011788:Quality of Life; D014680:Veins