Variant formation of left common iliac vein by the confluence of four veins.

Common iliac vein variations are relatively rare compared to the variations of external and internal iliac veins. A rare pattern of formation of common iliac vein by the confluence of four veins is being reported here. The left common iliac vein was formed by the union of left external iliac vein, internal iliac vein, iliolumbar vein and a common trunk formed by the obturator and vesical veins. External iliac vein and obturator veins were connected by a communicating vein. Both external and common iliac veins were respectively medial to the external and common iliac arteries. Knowledge of this variant formation of common iliac vein could be useful to radiologists, gynecologists and orthopedic surgeons.

The venous patterns of the cubital fossa in subjects from Brazil.

Venous punctures are among the most common procedures performed by healthcare professionals. In particular, the cubital fossa is the site where the venous accesses are frequently made due to the number of superficial veins and the numerous anastomoses in this region. The arrangement of these venous connections is of particular interest for clinical application in several areas, thus, the healthcare professional must possess knowledge about these vessels and their anatomical relationships. The present study aims to analyze the venous pattern of the cubital fossa among individuals from Brazil. This study was approved by a Research Ethics Committee. The sample had 100 healthy individuals (50 men and 50 women). The superficial veins of the cubital fossa were analyzed with the aid of a sphygmomanometer. When inflated, the pressure in the forearm increased and the veins became prominent. It was observed that in the selected sample the types with the highest prevalence were the Type I and Type VII, both with 22% in 200 limbs studied. The chi2 test showed a significant statistical difference between the anastomosis pattern and the sex of the studied sample. The anastomotic pattern of the superficial veins of the studies sample is similar to African, European and Asian populations. The study of these variations is necessary to provide scientific basis for the healthcare professional during a venipuncture in order to avoid iatrogenic errors and damages in cutaneous nerves or neighboring arteries.

Pretreatment with Astragaloside IV protects human umbilical vein endothelial cells from hydrogen peroxide induced oxidative stress and cell dysfunction via inhibiting eNOS uncoupling and NADPH oxidase - ROS - NF-κB pathway.

Endothelial cell injury caused by reactive oxygen species (ROS) plays a critical role in the pathogenesis of cardiovascular disorders. Astragaloside IV (AsIV) possesses potent antioxidant properties against oxidative stress through undefined mechanism(s). We sought to investigate whether AsIV protects human umbilical vein endothelial cells (HUVECs) from hydrogen peroxide (H2O2) induced oxidative stress focusing on eNOS uncoupling and the NADPH oxidase - ROS - NF-κB pathway. Compared with HUVECs incubated with H2O2 alone, pretreatment with AsIV significantly increased the viability of HUVECs, which was accompanied with apparent increase in nitric oxide (NO) production and decrease in intracellular superoxide anion production. Furthermore, pretreatment with AsIV increased endothelial nitric oxide synthase (eNOS) dimer/monomer ratio and its critical cofactor tetrahydrobiopterin (BH4) content, decreased Nox4 protein expression (the most abundant Nox isoform in HUVECs), inhibited translocation of NF-κB p65 subunit into nuclear fraction while enhanced the protein expression of IκB-α (the inhibitor of NF-κB p65), reduced the levels of IL-1ß, IL-6, and TNF-α in HUVECs medium, and decreased iNOS protein expression. These results suggest that AsIV may protect HUVECs from H2O2-induced oxidative stress via inhibiting NADPH oxidase - ROS - NF-κB pathway and eNOS uncoupling.

[A case of idiopathic myointimal hyperplasia of mesenteric veins]. / Un cas d'hyperplasie myointimale idiopathique des veines mésentériques du côlon.

The idiopathic myointimal hyperplasia of mesenteric veins is a rare pathology, affecting recto-sigmoid and mimicking clinically an inflammatory chronic disease of the bowel. Only about fifteen cases have been reported in the literature. This lesion is characterized by a myointimal thickening of the mesenteric veins, without inflammatory infiltrate of the vascular wall, differentiating it from vasculitis. We present here the case of a 48-year-old man, in whom the diagnosis of ulcerative colitis then digestive vasculitis had first been raised.

The impact of radiofrequency ablation on quality of life/symptoms (VEINES-QOL/Sym questionnaire score) in patients with chronic venous insufficiency.

Purpose: Chronic venous insufficiency is defined as a progressive disease that impairs the quality of life. Symptomatic patients can be treated with a 97% success rate through endovenous radiofrequency ablation (RFA) procedures. The aim of this study is to evaluate the effect and impact of RFA therapy on both the Venous Insufficiency Epidemiological and Economic Study Quality of Life/Symptom Questionnaire (VEINES-QOL/Sym) scale and the VEINES-QOL/Sym severity score in patients with isolated vena saphena magna insufficiency. Methods: Between March and June 2018, a retrospective analysis was conducted on 45 patients with a healthy vena saphena parva. They were divided into two groups based on the diameter of the great saphenous vein (GSV). Patients with GSV < 6 mm were assigned to group I (n = 22, 15 males, 7 females, mean age 52.45 ± 13.98 years), while patients with GSV ≥ 6 mm were assigned to group II (n = 23, 14 males, 9 females, mean age 55.04 ± 10.18 years). The pre-procedural Clinical-Etiology-Anatomy-Pathophysiology (CEAP) classification and post-procedural quality of life and symptom assessment at 12-24 months were evaluated using the VEINES-QOL/Sym questionnaire scale. Results: When all patients were assessed in terms of the VEINES-QOL/Sym questionnaire scale, compared to the previous year, it was found that 57.8% of patients (n = 26) still experienced complaints, and 24.4% of patients (n = 14) reported slightly worse symptoms than the previous year. In group II, 56.5% of patients (n = 13) reported experiencing similar complaints as the previous year, while 30.4% (n = 7) noted slightly worse symptoms. Conclusions: Our study findings revealed that the increase in vessel diameter does not significantly impact the severity of symptoms and quality of life outcomes after RFA therapy; however, it does have a notable impact on the improvement of symptom characteristics. As a result, early intervention for symptomatic patients is crucial in order to address their symptoms and improve their quality of life.

A comparison of tablet-based and paper-based venous insufficiency epidemiologic and economic study quality of life/symptom questionnaire for assessment of chronic venous disease.

OBJECTIVE: To comparatively evaluate performances of tablet-based versus paper-based Venous Insufficiency Epidemiologic and Economic Study-Quality of Life/Symptom (VEINES-QOL/Sym) questionnaire. METHODS: We prospectively evaluated 78 consecutive patients who completed tablet-based and paper-based VEINES-QOL/Sym questionnaires and compared their scores, completion time, data entry time, and ease of use. We used Student's t-test and Wilcoxon test for quantitative variables, Bland-Altman test and kappa coefficient for agreement between questionnaires and patients, respectively. Spearman's correlation coefficient was used to assess correlations. RESULTS: Most participants (83.3%) found it easier to use the tablet device. Less time was needed to complete the tablet-based (median, 4.75; IQR, 3-7 min) than the paper-based (median, 8.3; IQR, 6.3-11.3 min) questionnaire (p < .001). Better educated patients took less time to complete paper-based (p = .003) and tablet-based (p = .001) questionnaires and considered the latter easier to use (p = .010). CONCLUSIONS: The tablet-based VEINES-QOL/Sym proved to be an easy-to-use and time-saving tool.

Assessment of venous disease with different venous disease specific scales in Behçet's disease patients with deep vein thrombosis.

Objectives: Post-thrombotic syndrome (PTS) is a frequent and important consequence of deep vein thrombosis (DVT) for Behcet`s disease (BD) patients. Although various clinical scales are used to diagnose PTS, Villalta scale was accepted as the standard tool to diagnose and grade the severity of PTS. Poor quality of life (Qol) in the general population was defined for patients with PTS, however, studies in BD patients with PTS is limited. Our aim was to compare the performance of different scales to assess venous disease in BD patients with a history of DVT and to assess the relationship with quality of life.Methods: Patients with BD (n = 194, M/F:157/37, age:39.1 ± 9.5 years) with a DVT history were investigated. Villalta, VCSS,CEAP scale and SF 36,Veines scales were used to assess venous disease and QoL respectively.Results: Among BD patients, 120 (61.9 %) patients were classified as having PTS by Villalta and of patients 18% had severe PTS. Half of patients with CEAP score <4 were classified as having PTS. Also, 42% of patients with CEAP>4 and almost two third of VCSS classified severe CVD patients was grouped in severe PTS by Villalta scale. VCSS and Villalta classified PTS patients had decreased disease specific and general Qol scores compared to the patients without PTS. Also, severe PTS group (by VCSS) had decreased veines QoL scores and PCS compared to mild/moderate group.Conclusion: BD patients with DVT have a high risk of PTS. Our results show that both Villalta scale and VCSS should be used to assess venous disease BD patients with DVT. However, VCSS classified severity of PTS can show better correlation with venous disease -specific QoL.

Assessment of venous leg symptoms in patients with hemorrhoidal disease (VEIN-HEMORRHOID study).

BACKGROUND: Coexistence of dilating venous diseases in different vascular territories has raised the idea that they have similar vascular wall abnormality in their evolutionary process. Accordingly, we aimed to evaluate venous leg symptoms in patients with hemorrhoidal disease (HD) by means of VEINES-Sym questionnaire. MATERIALS AND METHODS: The study involved 249 consecutive patients who underwent colonoscopy and met the inclusion criteria. Presence and grading of HD were made according to Goligher's classification. All patients were examined for the existing of varicose vein and classified in respect of CEAP classification. All participants were requested to answer the VEINES-Sym questionnaire. RESULTS: There was not statistically significant differences between the patients without HD (grade 0 or I) and with HD (Grade II or III) in respect to clinical characteristics except female predominance in hemorrhoid group (p = 0.07). Scores of heavy legs, swelling, burning sensation, restless leg, throbbing, tingling, and total VEINES score were significantly lower (ie: worse) in hemorrhoid group. Logistic regression analysis revealed that female gender and total VEINES score were independently associated with HD (OR: 2.03, 95% CI: 1.17-3.52, p = 0.01; OR: 0.96, 95% CI: 0.92-0.99, p = 0.02, respectively). Among all venous leg symptoms, severity of heavy legs, night cramps, swelling and aching were significantly correlated with the grades of HD. CONCLUSION: We have shown significant association between the HD and venous leg symptoms reflected by total VEINES score and significant correlation between the HD grade and venous leg symptoms severity including heavy legs, swelling, night cramps and aching legs.

Linear lesions for treating the recurrence of persistent atrial tachyarrhythmia after cryoballoon ablation of atrial fibrillation.

BACKGROUND: There is no consensus on the most effective radiofrequency ablation strategy for the initial or repeated treatment of persistent atrial tachyarrhythmia (ATa). OBJECTIVE: To describe success and complication rates after the creation of left atrial (LA) linear lesions for recurrent persistent ATa following an index cryoballoon pulmonary vein isolation (PVI), and to identify predictors of ATa recurrence. METHODS: During March 2013 to March 2020, we prospectively included all consecutive patients undergoing repeat procedures for the treatment of persistent ATa. Radiofrequency ablation consisting of the creation of linear lesions: a roofline, a mitral isthmus and/or septal line, and a cavotricuspid isthmus line. All patients were prospectively followed up for ATa recurrence. RESULTS: Overall, 133 patients underwent 170 procedures after initial cryoballoon PVI (n=715). At least one pulmonary vein reconnection was observed in 60 patients (45.1%), all of whom underwent successful re-disconnection. After all the procedures, >90% of patients had a lesion pattern consisting of a roofline, a mitral isthmus and/or septal line, and a cavotricuspid isthmus line. ATa was terminated in 41 patients (35%). There were three cases of tamponade (3/170 procedures, 1.8%). Ninety-two patients (69.2%) were in sinus rhythm after a median (interquartile range) of 36 (21-53) months since the index cryoballoon PVI. Diagnosis-to-ablation time and LA area were predictors of recurrence in multivariable analysis. CONCLUSION: The creation of linear lesions is a safe and effective treatment strategy for the recurrence of persistent ATa after cryoballoon PVI. Longer diagnosis-to-ablation time and larger LA area were predictive of ATa recurrence.

Are routine cryoballoon procedural characteristics predictive of atrial arrhythmia recurrence in the long term?

BACKGROUND: Cryoballoon ablation is an effective procedure to treat atrial fibrillation (AF). However, AF recurrence rate at 1-year follow-up is approximately 20% despite improvements in ablation technique. AIM: To find factors predictive of AF recurrence following a first pulmonary vein isolation procedure using a second-generation cryoballoon (PVI-2CB). METHODS: This was an observational, retrospective, single-centre study. From June 2012 to April 2017, all patients who had a PVI-2CB procedure and a scheduled follow-up at Rouen University Hospital were included. The primary endpoint was atrial arrhythmia (AA) recurrence (e.g. AF, flutter or tachycardia), considering a blanking period of 2 months following the procedure. Secondary endpoints were procedural variables for each pulmonary vein (successful isolation, time to disconnection, total cryoballoon application time, number of cryoballoon applications, level of occlusion during cryoballoon application leading to successful disconnection and lowest temperature reached during successful cryoballoon application), occurrence of redo procedures, use of antiarrhythmic drugs and adverse events. RESULTS: The initial population consisted of 239 patients; six were excluded for lack of procedural variable data, giving an analysed population of 233 patients. The AA recurrence rate was 36.9% (mean follow-up 25±14 months). Mean time to AA recurrence was 10±12 months. No procedural variable was found to be predictive of AA recurrence. Only major left atrial enlargement (defined as diameter>50mm or left atrial area>30cm2 or left atrial volume>50mL/m2) was predictive (odds ratio 2.70, 95% confidence interval 1.54-4.72; P=0.001). Forty-one patients had redo procedures (17.6% of analysed population); in this subgroup, 75.6% had at least one pulmonary vein reconnected, mainly the right inferior pulmonary vein. CONCLUSIONS: At long-term follow-up, up to one-third of patients had AA recurrence after PVI-2CB. Important atrial remodelling was the only factor predictive of AA recurrence, whereas no procedural variable was found to be predictive.

Predictors of Poor Quality of Life after Primary Lower Limb Deep Venous Thrombosis: A Perspective from a Developing Nation.

Objective: We aimed to determine predictors of poor long term quality of life, using the VEINES Quality of Life (QOL) questionnaire, in patients with lower limb deep venous thrombosis (DVT). Material and Methods: This study included adult patients with primary lower limb DVT between January 2007 and December 2017. Post thrombotic syndrome (PTS) was assessed using the Villalta score and Quality of Life (QoL) by the VEINES quality of life questionnaire. Results: Our study included 125 patients, 57 (45.6%) of whom were males. The patient population's median age was 41 years (IQR: 34-47 years). The median follow up was 450 days (IQR: 390-1020 days). PTS occurred in 49 (39.2%) patients. Independent predictors of poor quality of life post DVT were progression to PTS, complete occlusion of vein, proximal (Ileofemoral) DVT, poor control of INR, poor compliance with compression stockings, severity of PTS, ileofemoral DVT and poor control of therapeutic anticoagulation. Conclusion: Predictors who are independently associated with poor quality of life post DVT are PTS, inability to maintain therapeutic anticoagulation and ileofemoral DVT.

[Cardiac CT-Scan: Utility for the management of chest pain, cardiovascular screening and before atrial fibrillation ablation procedure]. / Scanner cardiaque : intérêt dans le bilan des douleurs thoraciques, dans le dépistage cardiovasculaire et dans le bilan pré-ablation de fibrillation auriculaire.

Cardiac CT-scan is recommended for sorting patients presenting with stable or acute chest pain with low to intermediate risk of coronary artery disease (CAD). Recent studies have shown its reliability for diagnosing CAD in high-risk patients, notably those with acute coronary syndrome (ACS) without ST-elevation. Coronary CT-scan also represents a great opportunity for the screening of atherosclerosis in patients at risk and allows a better prevention of coronary artery disease by introduction of preventive treatments in patients with abnormal coronary CT-scan, especially statins. It is useful for the follow-up of patients who underwent a coronary arteries revascularization with either stents or bypasses. Coronary arteries calcium scoring appears to be an independent predictive factor of cardiovascular and total mortality and its use is recommended for stratifying the cardiovascular risk. However, its interpretation remains unobvious and the patient management is poorly improved by the results. Anyway, if the score is above zero, atherosclerosis is present and therefore a lipid lowering treatment should be discussed. Cardiac CT-scan has become the Gold Standard exam before an aortic valve replacement, for the measurement of the aortic root notably, allowing the best prothesis selection. Before atrial fibrillation ablation procedure by pulmonary vein isolation, the cardiac CT-scan allows a 3-D visualization of the two atria, especially the left atrium, and rules out any suspicion of cardiac thrombus. It allows the research of an anomalous pulmonary venous connection. The 3-D support will also enable the operator to navigate in the heart during the ablation procedure.

[Local, regional and systemic dissemination of choroidal melanoma : Clinical and pathological correlation from 2 cases]. / Dissémination locorégionale et systémique du mélanome choroïdien : corrélation anatomoclinique à partir de 2 cas.

PURPOSE: To describe didactically the local, regional and systemic spread of choroidal melanoma. PATIENTS AND METHODS: Two patients who had undergone primary enucleation for the management of choroidal melanoma in 2018 at the University Hospital of Nice were included. Extrascleral extension and invasion of the vortex veins were evaluated, as well as synchronous and metachronous metastases, based on our database. RESULTS: Patient 1 was diagnosed with large choroidal melanoma with partial scleral invasion and vortex vein involvement. Cytogenetic analysis demonstrated a loss of chromosome 3, and a gain of chromosome 8q. Systemic work-up was unremarkable. Patient 2 was diagnosed with a large choroidal melanoma with extrascleral extension and vortex vein involvement. Cytogenetic analysis demonstrated a loss of chromosome 3 and a gain of chromosome 8q. Systemic work-up revealed several liver metastases. A total of 1762 patients were included in our database. Eighty-five patients (4.8 %) and 46 patients (2.6 %) experienced vortex vein invasion and extrascleral extension respectively. Patients with vortex vein invasion were diagnosed with synchronous and metachronous liver metastases in 1.2 % and 18.8 % respectively. Patients with extrascleral extension had synchronous and metachronous liver metastases in 6.5 % and 30.4 % respectively. The mean follow-up was 49.4 months (1-180). CONCLUSION: Extrascleral extension and vortex vein invasion illustrate the local, regional and systemic spread of choroidal melanoma. The latter are often associated with genetically aggressive tumours associated with high metastatic risk.

Venous leiomyosarcoma arising from the radiocephalic vein.

Vascular leiomyosarcoma is a very rare soft tissue neoplasma. We are reporting a vascular leiomyosarcoma case arising from an unusual site: the radiocephalic vein. Despite a poor prognosis, after surgery and radiotherapy, the patient was alive without signs of recurrence two years later.

[Usefulness of Electroanatomical Mapping in Rhythmology]. / Die Rolle des elektroanatomischen Mappings in der Rhythmologie.

Usefulness of Electroanatomical Mapping in Rhythmology Abstract. Atrial fibrillation is the most common arrhythmia and its prevalence is rising. Therapeutic options include drug treatment and interventional catheter ablation via pulmonary vein isolation (PVI). This procedure was associated with long fluoroscopy times which carried risks for patients and physicians. Electroanatomical mapping (EAM) is a tool to visualize anatomy, voltage and activation of the heart chambers. Current EAM systems used in clinical practice include CARTO®, EnSite NavX® and Rhythmia®. Magnetic fields and impendance approaches are used to create 3D shells of the chambers. The catheter can be used to either collect electrograms or to ablate the target tissue. When using EAM, fluoroscopy time is significantly decreased, and complications can be monitored. Images from CT, MRI or intracardiac echo can be used as a template for creating a map or merged with an existing map to enhance anatomic accuracy.

Two-year clinical outcome after a single cryoballoon ablation procedure: A comparison of first- and second-generation cryoballoons.

BACKGROUND: The ablation of paroxysmal atrial fibrillation (PAF) by cryoballoon has increased dramatically in recent years. However, there are few data comparing first- and second-generation cryoballoons. AIM: To compare safety and mid-term (2-year) efficacy of first- and second-generation cryoballoons in PAF ablation, using cryoballoon size tailored to pulmonary vein anatomy. METHODS: In this single-centre study, we included the last 50 consecutive PAF patients who underwent cryoballoon-based pulmonary vein isolation using the first-generation cryoballoon (CB-1) and the first 50 patients using the second-generation cryoballoon (CB-2). The choice of 23 or 28mm cryoballoon was driven by patient anatomy. After discharge, follow-up was with systematic outpatient visits at 3, 6, 9, 12 and 24 months, including 12-lead electrocardiogram, Holter monitoring and telephone interviews, plus additional electrocardiograms, as required, in case of symptoms. Arrhythmia recurrence was defined as a documented atrial tachycardia or fibrillation episode>30seconds after a 3-month blanking period. RESULTS: At 24 months, freedom from arrhythmia after a single procedure was similar for both generations of cryoballoon (72.0% and 72.0% for CB-1 and CB-2, respectively; P=0.95). Mean procedure and fluoroscopy times were longer in the CB-1 group than in the CB-2 group: 139±37.8 vs 95.2±21.3minutes and 10.2±7.2 vs 5.1±2.4minutes, respectively (P<0.02 for both). Transient right phrenic nerve palsy occurred only in the CB-1 group (five patients, 9.8%). CONCLUSIONS: CB-1 and CB-2 showed similar efficacy for PAF ablation, with similar arrhythmia recurrence 24 months after a single ablation procedure. However, our findings suggest that CB-2 may have more effective cooling capabilities, enabling shorter procedure and fluoroscopy times.

Improvement in patient-reported outcomes of varicose veins following treatment with polidocanol endovenous microfoam.

Objective To evaluate the relationship between patient-reported symptoms and functional and psychological impact of varicose veins following treatment with polidocanol endovenous microfoam (PEM) 1%. Methods Data were pooled from two randomized trials on VV treatment. Wilson-Cleary health outcomes path model was applied to evaluate impact of VVSymQ™ symptom score improvement on modified VEINES-QOL/Sym functional and psychological scores. Change scores were evaluated for (i) PEM 1% versus placebo groups and (ii) quartiles of symptom improvement. Cumulative distribution function curves were generated to compare percentage of patients with various levels of functional and psychological improvement including clinically meaningful improvement across two treatment groups. Multivariable regression models of change scores and clinically meaningful changes were estimated. Results In 221 patients (109 PEM 1%; 112 placebo), PEM 1% was associated with median improvements of 2.5 points and 4.0 points on the m-VEINES-QOL/Sym functional limitations and m-VEINES-QOL/Sym psychological limitations scores, compared to 0 and 1.0 point improvements, respectively, for placebo. Cumulative distribution function curves revealed that 20-30% more patients in PEM 1% group achieved clinically meaningful functional and psychological improvement versus placebo group. Conclusions Patients with above-average symptom improvement had better functional and psychological improvement. PEM 1% treatment had higher odds of clinically meaningful functional and psychological improvement.

[Health related quality of life in chronic venous disease: Systematic literature review]. / Évaluation de la qualité de vie liée à l'insuffisance veineuse chronique (IVC). Revue systématique de la littérature.

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.

Health-related quality of life after deep vein thrombosis.

BACKGROUND: Health-related quality of life (HRQoL) is known to be impaired in patients who develop post-thrombotic syndrome (PTS) following deep vein thrombosis (DVT). However, there is limited knowledge of the long-term HRQoL after DVT compared to controls without DVT. The objectives of this study were to evaluate long-term HRQoL following DVT and to compare that with age and sex matched control group and to population norms as well as to investigate possible predictors for reduced HRQoL. METHODS: HRQoL was evaluated in 254 patients with confirmed DVT using the generic EQ-5D and the diseases specific VEINES-QOL/Sym questionnaire, whereas PTS was assessed by the Villalta scale. Patients were asked to give the EQ-5D questionnaire to two friends of same age- (±5 years) and sex (buddy controls). RESULTS: Patients scored significantly lower on all dimensions of EQ-5D compared to controls. EQ-5D index value was lower in patients compared with buddy controls; mean 0.79 (SD 0.17; IQR 0.72-1.00) versus 0.9 (SD 0.12; IQR 0.80-1.00), p < 0.001. EQ-5D index value was also significantly lower than age- and sex-adjusted population norms (p < 0.001). PTS and obesity (BMI >30/m(2)) were significantly associated with impaired HRQoL assessed by EQ-5D index value (odds ratio [OR] 11.0: 95 % confidence interval [CI] 4.6-29.7; and 2.3: 95 % CI 1.1-4.8, respectively) and VEINES-QOL (OR 28.2: 95 % CI 10.6-75.0; and OR 4.1: 95 % CI 1.7-9.7, respectively). CONCLUSION: Long-term HRQoL was significantly impaired in DVT patients compared with buddy controls and population norms. PTS and obesity were independently associated with impaired HRQoL.

[Well-Tried and New Ones ­ Update Varicose Vein Treatment 2016]. / Altbewährtes und Neues - Update Krampfaderbehandlung 2016.

Venous leg symptoms are frequent, but their relevance is frequently underestimated. With the introduction of effective, minimal-invasive endovenous treatment modalities the treatment of varicose veins has recently made major advances. The basis of every treatment decision is a competent anamnesis, clinical investigation and duplex scan. Outpatient varicose vein treatment using endovenous methods has been proofed to be at least as effective as traditional varicose vein surgery but is associated with fewer adverse events. Accordingly, the endovenous methods are exspected to replace surgery as goldstandard treatment and endovenous thermal vein ablation (Laser/Radiofrequency) is accepted by the Swiss Federal Office of Public Health for general reimbursment since 1st january 2016. All currently available methods have their advantages and limitations, the individual selection based on the present symptoms, anatomic findings and patients' preferences is fundamental for an optimal treatment result and maximized patient satisfaction.