Chronic Venous Insufficiency: A Study Of Clinical Presentation At A Rural Hospital And Its Management In Interventional Radiology Clinic.

Abhinav Mohan; Pankaj Banode; Gaurav Sharma

Volume : VII, Issue : VI, June - 2018

Chronic Venous Insufficiency: A Study Of Clinical Presentation At A Rural Hospital And Its Management In Interventional Radiology Clinic.

Abhinav Mohan, Pankaj Banode, Gaurav Sharma

Abstract :

Background:

Chronic Venous Insufficiency (CVI) is a disease having varying clinical presentation from relatively earlysubclinical disease to overt chronic nonhealing venous leg ulcers. The etiopathogenesis of CVI is relatively complex owing to different risk factors and variable patient characteristics. Many a times theunderlying disease is masked with insidious and slow progression of disease and its manifestations. CVI inrural population of India has its own importance in its diagnosis and management, as rural population in ourcountry has longstanding disease with late presentations in contrast to urban areas where people aremore concerned with early skin changes. With advances in technology, popularity with minimally invasiveprocedures and availability of Interventional Radiology Clinic (IRC) it is becoming possible to treat these patients by minimally invasive IR procedures.

Aims and Objectives:

To study the demographic characteristics, risk factors, clinical features and management outcomesafter interventional radiology procedures in patients with chronic venous insufficiency.

Materials and Methods:

This was a prospective study of patients with chronic venous insufficiency conducted in department of interventional radiology of a medical institute situated in a rural area. The patients were included on the basis of a predefined inclusion and exclusion criteria and were evaluated for demographic and disease characteristics. A detailed history was taken in all the patients. Appropriate Imaging was done and patients were classified using CEAP classification. Patients were treated by Ablation, sclerotherapy or combination of these two. Followingtreatmentpatients were followed up for any complications. The data was tabulated and analyzed using Minitab Version 17.

Results:

Out of 72 studied cases of chronic venous insufficiency there were 47 (65.27%) males and 25 (34.72%) females with a M:F ratio of 1:0.53. The most common affected age group was found to be 41–50 years (27.77%) followed by 51–60 years (25%) and 31–40 years (22.22%). Majority of the patients (84.27%) belonged to rural areas while urban population consisted of only 15.27%. The common risk factors associated with CVI were found to beprolonged standing which was present in 33 (45.84%) patients. The other risk factors found were predisposing physical traits (38.9%), occupational (36.2%), visible–varicose veins (34.72 %). Most of the patients belonged to C6 (28/72) class and presented with active ulcers. Only 4 cases were managed conservatively. Ablation and sclerotherapy both was done in 58 patients while only sclerotherapy was done only in 1 patient. All the patients had excellent outcome and there were no complications in any patient during follow up except in 1 patient who was found to have progressed from Class 3 to Class 5.

Conclusion:

Management of chronic venous insufficiency by interventional radiological procedures is found to have excellent outcome with minimal complication rates.