title: Clinical presentation and patterns of venous reflux in Thai patients with chronic venous insufficiency (CVI).
abstract: OBJECTIVE
  To study the extent of chronic venous insufficiency (CVI) in Thai patients by assessing venous clinical severity scores (VCSSs), venous disability scores (VDSs) and prevalence of lower limb venous reflux in a cohort of patients attending a vascular surgery clinic.
  
  
  METHODS
  Prospective comparative cohort study.
  
  
  METHODS
  All patients presenting with CVI (Clinical, Etiology, Anatomy and Pathophysiology (CEAP) C4-6) in our vascular surgery clinic between October 2006 and December 2008 were enrolled and compared with the same number of control patients.
  
  
  METHODS
  A standardised interview was conducted to document each patient's history of venous disease, VCSS and VDS. Duplex ultrasonography of selected superficial and deep veins was performed.
  
  
  RESULTS
  There were 41 patients, mean age 58 years and a mean body mass index (BMI) of 26.7. Of 58 limbs, 35%, 19% and 47% were of CEAP clinical stages C4, C5 and C6, respectively. Previous deep vein thrombosis (DVT) was reported by 7% and major leg trauma by 9% of patients. The mean VCSS was 9.7 and mean VDS was 1.0. VDS 2 or 3 were found in 10% of patients. The VCSS 2 and 3 for pain, oedema and inflammation were found in 22%, 26% and 0% of C6 legs. The prevalence of combined superficial and deep vein reflux was 71%. The prevalence of isolated superficial and deep vein reflux were 8% and 17%, respectively. One patient had iliac vein occlusion. Compared with the control group, risk factors that were found to be significant were physical findings of varicose veins, history of leg trauma, standing posture and BMI.
  
  
  CONCLUSIONS
  Thai patients with CVI were relatively young. Visible varicose veins, pain, oedema and inflammation were uncommon and most patients could maintain their usual activities despite advanced venous disease. An association with obesity was not common. Despite a low prevalence of a history of previous DVT, the prevalence of deep vein reflux was high and commonly combined with superficial venous reflux.
authors.affiliation: Vascular Unit, Department of Surgery, Bangkok Metropolitan Medical College, Vajira Hospital, 681 Samsain Rd., Dusit, Bangkok 10300, Thailand. burapa@vajira.ac.th
authors.forename: B
authors.initials: B
authors.lastname: Kanchanabat
authors.forename: Y
authors.initials: Y
authors.lastname: Wongmahisorn
authors.forename: W
authors.initials: W
authors.lastname: Stapanavatr
authors.forename: P
authors.initials: P
authors.lastname: Kanchanasuttirak
authors.forename: A
authors.initials: A
authors.lastname: Manomaiphiboon
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D044466:Asian People / Q000706:statistics & numerical data; D016022:Case-Control Studies; D002908:Chronic Disease; D004487:Edema / Q000208:ethnology; D005260:Female; D006801:Humans; D007407:Interviews as Topic; D035002:Lower Extremity / Q000098:blood supply*; D008297:Male; D008875:Middle Aged; D010146:Pain / Q000208:ethnology; D015995:Prevalence; D011446:Prospective Studies; D012720:Severity of Illness Index; D013785:Thailand; D018616:Ultrasonography, Doppler, Duplex; D014648:Varicose Veins / Q000208:ethnology; D014689:Venous Insufficiency / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000208:ethnology*; D020246:Venous Thrombosis / Q000208:ethnology