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Surgical Management of Elderly Patients pp 287–295Cite as

Venous Disorders of the Leg

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Abstract

Venous disorders of the leg, either in the chronic or acute forms, may frequently affect elderly people. In this kind of population, the complications, such as chronic ulcers, may be more severe and often may impair quality of life also. All treatments (medical, surgical, and compressive) are possible in elderly age, but every choice must be properly tailored around the specific hemodynamic profile as well as the patient’s global health.

Keywords

  • Chronic venous disease
  • Elderly
  • Deep vein thrombosis
  • Venous ulcer, surgery
  • Endovascular

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Fig. 19.1
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Fig. 19.3

Abbreviations

ASVAL:

Ablation sélective des varices sous anésthesie locale

CDT:

Catheter-directed thrombolysis

CEAP:

Clinical-etiology-anatomy-pathophysiology

CHIVA:

Cure Hémodynamique de l’insuffisance veineuse en ambulatoire

CT:

Compression therapy

CVD:

Chronic venous disease

CVI:

Chronic venous insufficiency

CVLU:

Chronic venous leg ulceration

DVT:

Deep vein thrombosis

ECM:

Extracellular matrix

EVLA:

Endovascular laser therapy

GAG:

Glycosaminoglycan

LMWH:

Low molecular weight heparin

PAPS:

Percutaneous ablation of perforators

PAT:

Percutaneous aspiration thrombectomy

PCDT:

Pharmacomechanical catheter-directed thrombolysis

PTS:

Post-thrombotic syndrome

RFA:

Radiofrequency ablation

SEPS:

Subfascial endoscopic perforator vein surgery

VAD:

Venoactive drug

References

  1. Serra R, Grande R, Butrico L, Fugetto F, de Franciscis S. Epidemiology, diagnosis and treatment of chronic venous disease: a systematic review. Chirurgia. 2016;29(2):34–45.

    Google Scholar 

  2. Serra R, Buffone G, de Franciscis A, Mastrangelo D, Molinari V, Montemurro R, et al. A genetic study of chronic venous insufficiency. Ann Vasc Surg. 2012;26:636–42.

    CrossRef  Google Scholar 

  3. Robertson L, Evans C, Fowkes FG. Epidemiology of chronic venous disease. Phlebology. 2008;23:103–11.

    CrossRef  CAS  Google Scholar 

  4. Beebe-Dimmer JL, Pfeifer JR, Engle JS, Schottenfeld D. The epidemiology of chronic venous insufficiency and varicose veins. Ann Epidemiol. 2005;15:175–84.

    CrossRef  Google Scholar 

  5. Eklöf B, Rutherford RB, Bergan JJ, Carpentier PH, Gloviczki P, Kistner RL, et al. Revision of the CEAP classification for chronic venous disorders: consensus statement. J Vasc Surg. 2004;40:1248–52.

    CrossRef  Google Scholar 

  6. Serra R, Andreucci M, De Caridi G, Massara M, Mastroroberto P, de Franciscis S. Functional chronic venous disease: a systematic review. Phlebology. 2017;1:268355516686451. https://doi.org/10.1177/0268355516686451. [Epub ahead of print].

    CrossRef  Google Scholar 

  7. O’Hare JL, Earnshaw JJ. Practical advice for the treatment of venous disease in the elderly. Phlebology. 2008;23(3):101–2.

    CrossRef  Google Scholar 

  8. Etufugh CN, Phillips TJ. Venous ulcers. Clin Dermatol. 2007;25(1):121–30.

    CrossRef  Google Scholar 

  9. Canonico S, Campitiello F, Pacifico F, Sepe D, Lauletta V. Day care surgery of varicose veins in elderly patients. Vasc Surg. 1996;30(5):387–92.

    CrossRef  Google Scholar 

  10. de Franciscis S, Gasbarro V, Amato B, Buffone G, Grande R, Serra R. Hemodynamic surgery versus conventional surgery in chronic venous disease: a multicenter retrospective study. Acta Phlebologica. 2013;14:109–14.

    Google Scholar 

  11. Serra R, Gasbarro V, Barbetta A, De Caridi G, Massara M, Perri P, Ciranni S, Torcia G, Abatucci G, Andreucci M, Buffone G, de Franciscis S. Endovenous radiofrequency ablation of tributary veins reflux. Acta Phlebologica. 2016;17:61–3.

    Google Scholar 

  12. Müller R. Traitement des varices par la phlebéctomie ambulatoire. Bull Soc Fr Phléb. 1966;19:277–9.

    Google Scholar 

  13. Francheschi C. Thèorie et pratique de la cure conservatrice de l’insufisance veineuse en ambulatoire. Précy-sous- Thil: Editions de l’Armancon; 1988.

    Google Scholar 

  14. Solis JV, Ribè L, Portero JL, Rio J. Stripping saphenectomy, CHIVA and laser ablation for the treatment of the saphenous vein insufficiency. Ambul Surg. 2009;15:11–4.

    Google Scholar 

  15. Onida S, Davies AH. CHIVA, ASVAL and related techniques—concepts and evidence. Phlebology. 2015;30(2 Suppl):42–5.

    CrossRef  Google Scholar 

  16. Jaworucka-Kaczorowska A, Oszkinis G, Huber J, Wiertel-Krawczuk A, Gabor E, Kaczorowski P. Saphenous vein stripping surgical technique and frequency of saphenous nerve injury. Phlebology. 2015;30(3):210–6.

    CrossRef  Google Scholar 

  17. Lam H, Chao L. Endovascular ablation therapies for varicose veins in elderly patients. Int J Gerontol. 2014;8:219–22.

    CrossRef  Google Scholar 

  18. Serra R, Rizzuto A, Rossi A, Perri P, Barbetta A, Abdalla K, Caroleo S, Longo C, Amantea B, Sammarco G, de Franciscis S. Skin grafting for the treatment of chronic leg ulcers – a systematic review in evidence-based medicine. Int Wound J. 2017;14:149–57.

    CrossRef  Google Scholar 

  19. Carpentier PH, Becker F, Thiney G, Poensin D, Satger B. Acceptability and practicability of elastic compression stockings in the elderly: a randomized controlled evaluation. Phlebology. 2011;26(3):107–13.

    CrossRef  CAS  Google Scholar 

  20. Silverstein RL, Bauer KA, Cushman M, Esmon CT, Ershler WB, Tracy RP. Venous thrombosis in the elderly: more questions than answers. Blood. 2007;110(9):3097–101.

    CrossRef  CAS  Google Scholar 

  21. Prandoni P. Treatment of patients with acute deep vein thrombosis and/or pulmonary embolism: efficacy and safety of non-VKA oral anticoagulants in selected populations. Thromb Res. 2014;134(2):227–33.

    CrossRef  CAS  Google Scholar 

  22. Rabinovich A, Kahn SR. The postthrombotic syndrome: current evidence and future challenges. J Thromb Haemost. 2017;15(2):230–41. https://doi.org/10.1111/jth.13569. [Epub ahead of print].

    CrossRef  CAS  Google Scholar 

  23. Goktay AY, Senturk C. Endovascular treatment of thrombosis and embolism. Adv Exp Med Biol. 2017;906:195–213.

    CrossRef  Google Scholar 

  24. Kuo TT, Huang CY, Hsu CP, Lee CY. Catheter-directed thrombolysis and pharmacomechanical thrombectomy improve midterm outcome in acute iliofemoral deep vein thrombosis. J Chin Med Assoc. 2017;80(2):72–9.

    CrossRef  Google Scholar 

  25. Patterson BO, Hinchliffe R, Loftus IM, Thompson MM, Holt PJ. Indications for catheter-directed thrombolysis in the management of acute proximal deep venous thrombosis. Arterioscler Thromb Vasc Biol. 2010;30(4):669–74.

    CrossRef  CAS  Google Scholar 

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Acknowledgments

The authors have no conflict of interests to declare.

This chapter received no funding.

Authors’ Contribution

SdF and RS contributed equally to this work.

They both conceived the chapter, participated in its design, drafted, and revised it critically.

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Authors and Affiliations

  1. Department of Medical and Surgical Sciences, Interuniversity Center of Phlebolymphology (CIFL), International Research and Educational, Program in Clinical and Experimental Biotechnology, University Magna Graecia of Catanzaro, Catanzaro, Italy

    Stefano de Franciscis & Raffaele Serra

Authors
  1. Stefano de Franciscis
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  2. Raffaele Serra
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Corresponding author

Correspondence to Raffaele Serra .

Editor information

Editors and Affiliations

  1. Department of General and Mininvasive Surgery, Cristo Re Hospital, Rome, Italy

    Prof. Antonio Crucitti

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de Franciscis, S., Serra, R. (2018). Venous Disorders of the Leg. In: Crucitti, A. (eds) Surgical Management of Elderly Patients. Springer, Cham. https://doi.org/10.1007/978-3-319-60861-7_19

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  • DOI: https://doi.org/10.1007/978-3-319-60861-7_19

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