Superficial vein thrombosis in patients with varicose veins: role of thrombophilia factors, age and body mass.

OBJECTIVES: To investigate the association of various risk factors including thrombophilia defects, in patients with varicose veins (VVs) and history of episodes of superficial vein thrombosis (SVT). MATERIALS AND METHODS: Two hundred and thirty patients with primary VVs were included in this prospective study. A total of 128 (43 men, age 56 ± 13) had an acute episode or a previous history of SVT, while 102 patients (27 men, age 48 ± 12) did not. Coagulation profile investigation included serum levels of protein C (PC), protein S (PS), anti-thrombin III (AT III), plasminogen (Plg), A(2) antiplasmin (A(2)Apl) and activated protein C resistance (APCR). This was performed at least 3 months after the SVT episode to ensure that the results were not altered. Age and body mass index (BMI) were also assessed. RESULTS: PC deficiency was detected in 3/128 (2.3%), PS deficiency in 19/128 (14.8%), AT III deficiency in 29/128 (22.7%), Plg deficiency in 9/128 (7%), A(2)Apl excess in 3/128 (2.3%) and APCR in 9/128 (7%) patients with SVT and 0/102 (0%), 3/102 (2.9%), 15/102 (14.7%), 6/102 (5.8%), 0/102 (0%) and 1/102 (0.9%) in the control group, respectively. BMI greater than 30 kg m(-2) was associated with SVT. In logistic regression analysis SVT was associated with PS deficiency (odds ratio (OR) 6.7, p = 0.004, 95% confidence interval (CI) 1.83-24.53), obesity (OR 3.5, p = 0.003, 95% CI 1.53-8.05) and age (OR 1.038, p = 0.001, 95% CI 1.01-1.06). CONCLUSIONS: Obesity, age and PS deficiency were found as factors associated with SVT episodes in patients with VVs.

The importance of ophthalmic artery hemodynamics in patients with atheromatous carotid artery disease.

AIM: The aim of this paper was to provide an insight on the role of the ophthalmic artery blood flow changes due to significant carotid stenosis and the effects of carotid revascularization on the eye and cerebral circulation. METHODS: An electronic search (Medline) of the English literature was attempted. Measurements of Peak Systolic Velocity (PSV), end-diastolic velocity (EDV), mean velocity (Vmean), Resistance Index (RI) and flow direction, obtained in OA and its branches using transcranial Doppler, in to patients with significant stenosis >70% subjected to surgical or endovascular treatment, or in those with occlusion (unilateral or bilateral), symptomatic or not, in both eyes, prior to or/and after endarterectomy or stenting. RESULTS: As the degree of internal carotid artery (ICA) stenosis increases, the PSV in ophthalmic artery (OA) decreases. In severe stenoses the flow is not detectable or a reversed flow may be present. Following carotid endarterctomy or stenting, in almost all patients antegrade flow was detected, while in the patients with preoperative antegrade flow, an increase of the velocities was detected postoperatively. CONCLUSION: The reduced blood flow in the OA has consequences in the eye circulation. OA contributes to the collateral pathways in the perfusion of the brain but the importance of this collateral pathway has not been completely clarified.