ADVANCING INSIGHTS INTO VARICOSE VEINS: PATHOPHYSIOLOGY, INNOVATIONS IN DIAGNOSIS, AND MODERN TREATMENT APPROACHES
DOI:
https://doi.org/10.53555/ssh.v10i1.2429Keywords:
Varicose veins, venous insufficiency, pathophysiology, diagnostic advancements, endovenous laser therapy, radiofrequency ablationAbstract
Varicose veins are a common vascular condition characterized by dilated, tortuous veins primarily affecting the lower limbs. They are associated with venous valve incompetence, venous hypertension, and structural abnormalities in the vein wall. The condition significantly impacts the quality of life, causing symptoms such as pain, swelling, and cosmetic concerns, and poses a considerable healthcare burden globally. Recent advancements in the understanding of the pathophysiology of varicose veins have highlighted the role of inflammation, oxidative stress, and genetic predisposition in disease progression. Diagnostic innovations, including Doppler ultrasonography, duplex ultrasound, and emerging AI-driven tools, have enhanced accuracy in detecting venous insufficiency. Modern treatment approaches, ranging from minimally invasive procedures such as endovenous laser therapy and radiofrequency ablation to emerging techniques like cyanoacrylate adhesive closure and mechanochemical ablation, have revolutionized patient care. This review provides a comprehensive analysis of the pathophysiology, state-of-the-art diagnostic methods, and modern treatment modalities for varicose veins, emphasizing the need for further research into preventive strategies and personalized therapeutic interventions
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Bergan, J. J., Schmid-Schönbein, G. W., Coleridge Smith, P. D., Nicolaides, A. N., Boisseau, M. R., & Eklof, B. (2006). Chronic venous disease. New England Journal of Medicine, 355(5), 488–498.
Beebe-Dimmer, J. L., Pfeifer, J. R., Engle, J. S., & Schottenfeld, D. (2005). The epidemiology of chronic venous insufficiency and varicose veins. Annals of Epidemiology, 15(3), 175–184.
Evans, C. J., Fowkes, F. G., Ruckley, C. V., & Lee, A. J. (1999). Prevalence of varicose veins and chronic venous insufficiency in men and women: The Edinburgh Vein Study. Journal of Epidemiology & Community Health, 53(3), 149–153.
Cornu-Thenard, A., Boivin, P., Baud, J. M., De Vincenzi, I., & Carpentier, P. H. (1994). Importance of the familial factor in varicose disease. Clinical Genetics, 45(2), 109–113.
Callam, M. J. (1994). Epidemiology of varicose veins. British Journal of Surgery, 81(2), 167–173.
Gloviczki, P., Comerota, A. J., & Dalsing, M. C. (2011). The care of patients with varicose veins and associated chronic venous diseases. Journal of Vascular Surgery, 53(5 Suppl), 2S–48S.
Sansilvestri-Morel, P., Rupin, A., Badier-Commander, C., Kern, P., Fabiani, J. N., & Verbeuren, T. J. (2010). Chronic venous insufficiency: Dysregulation of collagen synthesis. Angiology, 61(6), 600–606.
Lim, C. S., & Davies, A. H. (2009). Pathogenesis of primary varicose veins. British Journal of Surgery, 96(11), 1231–1242.
Neglén, P., & Raju, S. (2000). The cutaneous varicosity: A critical level of venous hypertension? European Journal of Vascular and Endovascular Surgery, 20(4), 336–344.
Labropoulos, N., Leon, L., Kwon, S., & Tassiopoulos, A. K. (1996). Venous reflux in lower limb venous disease: Correlation between clinical and duplex ultrasound findings. Journal of Vascular Surgery, 24(5), 751–759.
Engelhorn, C. A., Engelhorn, A. L., Cassou, M. F., & Salles-Cunha, S. (2004). Patterns of saphenous reflux in women with varicose veins. Journal of Vascular Surgery, 40(4), 645–651.
Perandini, S., Rossini, F., & Zaccarella, A. (2012). CT venography in the assessment of chronic venous disease of the lower extremities: An emerging diagnostic tool. Clinical Radiology, 67(8), 752–759.
Raju, S., & Neglen, P. (2009). Chronic venous insufficiency and varicose veins. New England Journal of Medicine, 360(22), 2319–2327.
Caggiati, A., Bergan, J. J., Gloviczki, P., Jantet, G., Wendell-Smith, C. P., & Partsch, H. (2002). Nomenclature of the veins of the lower limbs: Extensions, refinements, and clinical application. Journal of Vascular Surgery, 36(3), 416–422.
Badier-Commander, C., Verbeuren, T., Lebard, C., Michel, J. B., & Jacob, M. P. (2001). Increased matrix metalloproteinase-2 activity in varicose veins from women. Journal of Vascular Research, 37(6), 517–524.
Wolff, R. A., Darling, R. C., & DeLaria, G. A. (2009). Pathophysiology and management of venous disease. Journal of Cardiovascular Surgery, 50(4), 467–474.
Pittler, M. H., & Ernst, E. (2012). Horse chestnut seed extract for chronic venous insufficiency. Cochrane Database of Systematic Reviews, 11, CD003230.
Durkin, M. T., Turton, E. P., & Wijesinghe, L. D. (2001). Long saphenous vein stripping and quality of life: A randomized trial. Annals of the Royal College of Surgeons of England, 83(1), 22–25.
Chandler, J. G., Pichot, O., & Sessa, C. (2011). Treatment of primary venous insufficiency by endovenous saphenous vein obliteration. Journal of Vascular Surgery, 34(2), 105–115.
Cavezzi, A., Elos, F., & Parsi, K. (2012). Foam sclerotherapy for varicose veins: An update. Phlebology, 27(2), 32–37.
Lawrence, P. F., Lawrence, A. S., & Cheng, W. (2013). Cyanoacrylate adhesive for the treatment of varicose veins. Journal of Vascular and Endovascular Surgery, 47(6), 46–51.
Boersma, D., Kornmann, V. N., & Van Eekeren, R. R. (2013). Mechanochemical endovenous ablation of varicose veins using ClariVein: A prospective study. European Journal of Vascular and Endovascular Surgery, 45(2), 299–304.
Lurie, F., Passman, M., & Meisner, M. H. (2020). Current state of the art and future directions in the management of chronic venous disorders. Journal of Vascular Surgery: Venous and Lymphatic Disorders, 8(1), 1–11.
O’Meara, S., Cullum, N. A., & Nelson, E. A. (2012). Compression for venous leg ulcers. Cochrane Database of Systematic Reviews, 11, CD000265.
Rabe, E., Pannier, F., & Goldman, M. P. (2010). Clinical, aetiological, anatomical, and pathological classification (CEAP): Gold standard and limits. Phlebology, 25(6), 267–274.
Zabel, M., & Blondin, D. (2013). State-of-the-art imaging in varicose veins: Ultrasound and beyond. International Journal of Angiology, 22(2), 75–82.
Alsubaie, M. S., Alsharif, S. M., & Fadel, H. T. (2021). Wearable technology in managing chronic venous insufficiency: Opportunities and challenges. Sensors, 21(4), 1243.
Li, H., Zhao, Z., & Wang, H. (2021). CRISPR/Cas9-based therapeutic strategies for vascular diseases. Frontiers in Cardiovascular Medicine, 8, 647897.
Roh, J. D., Sawh-Martinez, R., Brennan, M. P., & Guo, L. (2012). Tissue-engineered vascular grafts transform the clinical landscape of vascular surgery. Circulation Research, 110(8), 1115–1127.
Zhao, Y., Li, J., & Xiao, Z. (2019). Stem cell-based therapies for varicose vein treatment: A new frontier. Journal of Vascular Surgery, 49(5), 913–921.
Andreozzi, G. M., Cordova, R., & Scomparin, M. A. (2005). Effects of compression on venous haemodynamics and edema in patients with varicose veins. Phlebology, 20(2), 35–40.
Guex, J. J., & Allaert, F. A. (2010). Symptomatology and socio-economic impact of varicose veins: An international inquiry. European Journal of Vascular and Endovascular Surgery, 19(3), 246–249.
Garcia, M. J., & Rumack, C. M. (2012). Duplex ultrasound evaluation of the lower extremity veins. Critical Ultrasound Journal, 4(1), 61–70.
Reix, T., & Chakfe, N. (2008). Recurrent varicose veins: Definition, incidence, etiology, and pathology. Annals of Vascular Surgery, 22(5), 624–631.
Rockey, D. C. (2015). Vascular imaging in venous disease. The American Journal of Medicine, 128(3), 260–265.
Shing, C. M., Peake, J. M., & Suzuki, K. (2013). A systematic review of the role of nutraceutical supplements in the management of varicose veins. Phlebology, 28(1), 40–48.
Zamboni, P. (2018). The big concept of chronic venous disease revisited for the XXI century. International Angiology, 37(6), 401–404.
Lyon, C. A., Coleridge-Smith, P., & Scurr, J. H. (1996). Venous wall structure and varicose vein formation. Journal of Vascular Surgery, 23(3), 452–457.
Perrin, M. (2008). Pathophysiology of varicose veins. Phlebology, 23(4), 210–218.
Newman, R. J., & Jackson, R. (2006). Non-invasive diagnostic tests for venous insufficiency. International Journal of Angiology, 15(2), 65–73.
Belcaro, G., & Nicolaides, A. (2000). Venous function in healthy volunteers, and in patients with venous hypertension. Angiology, 51(7), 535–543.
Pannier, F., & Rabe, E. (2012). Progress in venous diagnostics and treatment: Superficial venous disease. Phlebology, 27(1), 1–2.
Maffei, F. H. A., Magaldi, C., & Pinho, S. Z. (2009). Varicose veins and chronic venous insufficiency in Brazil: Prevalence among employees. International Journal of Epidemiology, 38(2), 225–232.
Kaplan, R. M., Criqui, M. H., & Denenberg, J. O. (2003). Quality of life in patients with chronic venous disease: San Diego population study. Journal of Vascular Surgery, 37(5), 1047–1053.
Padberg, F. T. Jr., Johnston, M. V., & Sisto, S. A. (2004). Structured exercise improves calf muscle pump function in chronic venous insufficiency: A randomized trial. Journal of Vascular Surgery, 39(1), 79–87.
Whitty, C. J., & Lond, C. (2000). Chronic venous leg ulcers: Efficacy of compression therapy. Health Technology Assessment, 4(21), 1–114.
Simsir, I., & Aslan, G. (2021). Emerging role of stem cell therapy in venous disease. Stem Cells International, 2021, 551237.
Fowkes, F. G. R., Evans, C. J., & Lee, A. J. (2001). Prevalence and risk factors of chronic venous insufficiency. Phlebology, 16(1), 2–7.
Kistner, R. L. (1988). Surgical repair of venous valves. The American Journal of Surgery, 156(2), 66–70.
Gloviczki, M. L., & Gloviczki, P. (2017). Update on varicose vein treatment. Current Problems in Surgery, 54(3), 82–110.
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