Publication details
Clinical and functional investigations of lower limbs venous system disease and their correlation. Poster
| Authors | |
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| Year of publication | 2009 |
| Type | Appeared in Conference without Proceedings |
| MU Faculty or unit | |
| Citation | |
| Description | In the group of 50 patients with CVD symptoms at both lower limbs, who visited the ambulance of phlebology in the years 2004-2006, a clinical finding evaluation according to CEAP classification was performed and there was carried out the investigation of the lower limbs venous system via digital photoplethysmography and ultrasound detection. Results comparison was performed according to CEAP at 100 lower limbs with clinical symptoms C1-C6. CEAP classification Class C: Based on the clinical picture evaluation according to CEAP classification, 27 patients were included in the class C1, 39 patients were included in the class C2, 14 patients into classes C3 and C4 each and 6 patients into classes C5 and C6 each. Class E: Based on anamnestic data and also according to ultrasound examination results, chronic venous disease aetiology was determined at patients. Varicose veins primary aetiology was determined at 92 patients, 8 patients had secondary varicose veins, 50% thrombotic occlusion in VP was proved via ultrasound examination at 1 patient. Class A: Based on ultrasound examination and clinical investigation of lower limbs veins, superficial venous system infliction was determined in 45 cases, deep venous system infliction was determined in 23 cases, perforators’ infliction in 3 limbs and at 42 patients, the limb was without infliction or evincible anatomic anomaly. Class P: In the group of patients, there was reflux in lower limb’s superficial or deep venous system determined in 57 cases, 50% obstruction in lower limb’s deep venous system was determined at 1 patient. Venous system infliction was not found at 42 patients. D-PPG investigation Normal value of venous filling time was determined at 46 patients, venous muscular pump disorder of 1st grade at 15 patients, of 2nd grade at 28 patients and 3rd grade disorder was determined at 11 patients. Doppler ultrasonography Patients’ lower limbs venous system investigation was performed via ultrasound detection. At 42 patients, no infliction of the superficial venous system was determined, superficial venous system infliction was determined at 45 patients and deep venous system infliction was determined at 27 patients, while 50% thrombotic occlusion in VP was proved at 1 patient. Regarding the fact that 1 patient was inflicted and regarding the diversity of the infliction type, this patient was not included into further calculations and comparisons. Both superficial and deep infliction of the venous system of lower limbs was determined at 13 patients Resultant kappa coefficient value 0.344 corresponds with low conformity measure when comparing CVD symptoms classification results in the class C and D-PPG results. It might be said that D-PPG investigation results do not depend on CVD changes clinical picture and does not practically correlate with CEAP classification. Kappa coefficient value 0.522 corresponds with and average conformity when comparing investigation results according to C class of CEAP classification and ultrasound examination results. Comparison of D-PPG investigation results and the ultrasound examination results with kappa coefficient value 0.552 also corresponds with the average conformity measure. Kappa coefficient value is already significantly higher in these comparisons, however, it is necessary to be aware that there are still cases, in which D-PPG and ultrasound examinations do not conform in venous system infliction’s seriousness. Kappa coefficients proved only low or average examinations results conformity when compared mutually. As well, the determination of reliability, sensitivity and specificity intervals and the overall accuracy of D-PPG and CEAP classification investigation results in relation to DUS, did not proved sufficient reliability of these investigations, which can not be recommended as first choice examinations at the diagnosis of lower limbs venous system diseases and they can serve as supplementary examinations only. |