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Zenati N, Bosson JL, Blaise S, Carpentier P. [Health related quality of life in chronic venous disease: Systematic literature review]. J Med Vasc 2017; 42:290-300. [PMID: 28964388 DOI: 10.1016/j.jdmv.2017.07.001] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/16/2017] [Accepted: 06/21/2017] [Indexed: 11/20/2022]
Abstract
OBJECTIVE Excepting life-threatening situations, improvement of health-related quality-of-life is the main therapeutic goal in chronic disease. The purpose of this review was to study the different ways of assessing Quality-of-Life (QoL) in patients with chronic venous disease (CVD) (CEAP classes C3 to C6). METHODS A literature search was conducted with three databases: MEDLINE, WEB OF SCIENCE and COCHRANE LIBRARY in order to identify articles with the PRISMA reporting guidelines. Then we compared psychometric performance of general and specific QoL questionnaires for a French population with CVD. RESULTS A total of 481 articles were identified, from which 25 were selected and analyzed. CIVIQ 20, CIVIQ 14 and VEINES Qol/sym are the specific health related QoL scales validated for a French population with CVD. VEINES Qol/sym was specifically validated in patients with leg ulcer or post-thrombotic syndrome (PTS). CIVIQ 14 is a CIVIQ 20 optimized to be used more widely in international studies and validated in milder forms of the CVD spectrum (C0 à C4). The general health related QoL scales are SF-36, SF-12 and EQ-5D. EQ-5D is simple and provides health state utility values. CONCLUSION CIVIQ 14 is a simple specific health-related QoL scale for less severe CVD. VEINES Qol/sym was developed for severe CVD and PTS but clinically relevant point scales remain to be assessed. EQ-5D is a generic scale to be preferred to assess economic impact based on a cost-utility analysis.
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Goudot G, Del Giudice C, Pellerin O, Courtois MC, Galloula A, Messas E, Mirault T, Sapoval M. [Recanalization procedure of the common femoral vein following iatrogenic femoral chronic occlusion: 3 cases]. J Med Vasc 2017; 42:237-243. [PMID: 28705343 DOI: 10.1016/j.jdmv.2017.05.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/07/2016] [Accepted: 04/18/2017] [Indexed: 10/19/2022]
Abstract
Common femoral vein occlusion (CFVO) is frequently found in patients with chronic venous insufficiency. The iatrogenic form, secondary to either central catheter or surgery, is very rare but highly symptomatic. Classical compression therapy barely improves the clinical status of these patients, making them suitable candidates for an interventional procedure for venous recanalization. METHODS We report here three consecutive cases of iatrogenic CFVO referred to our outpatient clinic because the disease had an impact on daily life activities. We detail the recanalization procedure, the Doppler control and the short-term outcome. RESULTS In each case, endovascular recanalization required rigid material (rigid guide or Colapinto needle) to cross the fibrous adhesions before angioplasty could be performed with stenting. The procedure required two attempts in each case, underlining its complexity, but eventually enabled effective recanalization. No major complication occurred per- or post-procedure. One month later, a duplex Doppler control confirmed the permeability of the common femoral vein. The patients had experienced rapid and significant symptom improvement. CONCLUSION Patients suffering from severe chronic venous insufficiency caused by iatrogenic CFVO can benefit from endovascular recanalization. Although these procedures may be complex due to the extensive fibrosis at the Scarpa and require specialized equipment, no major complications were observed. Patency of the recanalization persisted at least one month after the procedure. Symptom relief was good.
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Affiliation(s)
- G Goudot
- Service de médecine vasculaire, hôpital européen Georges-Pompidou, université Paris Descartes, Sorbonne Paris Cité, Assistance publique-Hôpitaux de Paris (AP-HP), 75015 Paris, France; Inserm U970, PARCC, université Paris Descartes, Sorbonne Paris Cité, 75015 Paris, France
| | - C Del Giudice
- Service de radiologie interventionnelle vasculaire et oncologique, hôpital européen Georges-Pompidou, 20, rue Leblanc, 75015 Paris, France
| | - O Pellerin
- Service de radiologie interventionnelle vasculaire et oncologique, hôpital européen Georges-Pompidou, 20, rue Leblanc, 75015 Paris, France
| | - M C Courtois
- Service de médecine vasculaire, hôpital européen Georges-Pompidou, université Paris Descartes, Sorbonne Paris Cité, Assistance publique-Hôpitaux de Paris (AP-HP), 75015 Paris, France
| | - A Galloula
- Service de médecine vasculaire, hôpital européen Georges-Pompidou, université Paris Descartes, Sorbonne Paris Cité, Assistance publique-Hôpitaux de Paris (AP-HP), 75015 Paris, France
| | - E Messas
- Service de médecine vasculaire, hôpital européen Georges-Pompidou, université Paris Descartes, Sorbonne Paris Cité, Assistance publique-Hôpitaux de Paris (AP-HP), 75015 Paris, France; Inserm U970, PARCC, université Paris Descartes, Sorbonne Paris Cité, 75015 Paris, France
| | - T Mirault
- Service de médecine vasculaire, hôpital européen Georges-Pompidou, université Paris Descartes, Sorbonne Paris Cité, Assistance publique-Hôpitaux de Paris (AP-HP), 75015 Paris, France; Inserm U970, PARCC, université Paris Descartes, Sorbonne Paris Cité, 75015 Paris, France
| | - M Sapoval
- Service de radiologie interventionnelle vasculaire et oncologique, hôpital européen Georges-Pompidou, 20, rue Leblanc, 75015 Paris, France.
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Carpentier PH, Satger B, Poensin D, Carpentier LF. [Chromametry, a promising technique for the quantification of skin changes in chronic venous disorders]. ACTA ACUST UNITED AC 2013; 38:236-42. [PMID: 23816047 DOI: 10.1016/j.jmv.2013.05.007] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2012] [Accepted: 05/25/2013] [Indexed: 11/17/2022]
Abstract
OBJECTIVE The development and validation of new clinimetric tools is essential for the progress of clinical research in the field of chronic venous insufficiency. Chromametry is a simple, quick and non-invasive technique that measures the color of the skin. The aim of this study was to evaluate the ability of this technique to quantify skin pigmentation as a marker of severity of chronic venous disease and to assess the variability of measurements obtained in this condition. METHODS Chomametry was performed on three different sites on each lower limb in 42 patients undergoing a spa treatment in La Léchère (Savoie) for chronic venous disorders (CVD). Four series of measurements were taken by two investigators for each patient, at two sessions two to four days apart. RESULTS The chromameter readily measured the pigmentation index (PI). The PI increased with higher clinical class (CEAP classification) for measurements made at the malleolar level (r=0.48; P<0.001) and the supra-malleolar area (r=0.55; P<0.001), but not at the level of the anterior tibial tuberosity (r=-0.09; P=0.45). The repeatability and the intra- and inter-observer reproducibility of this PI index were 15%, 18% and 21% respectively of the mean of the observed difference at the malleolar level. The chromameter also provided an erythema index, which appears to be less relevant and more variable than the PI, but which might add potentially useful information regarding the characterization of skin inflammation related to the venous disease. CONCLUSION This study shows that chromametry can be used in clinical research studies to quantify skin changes associated with CVD. Whether it can also be useful for early detection and follow-up of patients with venous trophic changes remains to be investigated.
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Affiliation(s)
- P H Carpentier
- Centre de recherche universitaire de La Léchère, université Joseph-Fourier, 73260 La Léchère, France.
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