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Cited by 945Diagnosis and Treatment of Venous DiseasesVenous Thromboembolism Diagnosis and ManagementVascular anomalies and interventions

Investigation of Chronic Venous Insufficiency: A Consensus Statement

Nicolaides, A. N.·2000·Circulation
DOI 10.1161/01.cir.102.20.e126
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Abstract

Abstract—This consensus document provides an up-to-date account of the various methods available for the investigation of chronic venous insufficiency of the lower limbs (CVI), with an outline of their history, usefulness, and limitations. CVI is characterized by symptoms or signs produced by venous hypertension as a result of structural or functional abnormalities of veins. The most frequent causes of CVI are primary abnormalities of the venous wall and the valves and secondary changes due to previous venous thrombosis that can lead to reflux, obstruction, or both. Because the history and clinical examination will not always indicate the nature and extent of the underlying abnormality (anatomic extent, pathology, and cause), a number of diagnostic investigations have been developed that can elucidate whether there is calf muscle pump dysfunction and determine the anatomic extent and severity of obstruction or reflux. The difficulty in deciding which investigations to use and how to interpret the results has stimulated the development of this consensus document. The aim of this document was to provide an account of these tests, with an outline of their usefulness and limitations and indications of which patients should be subjected to the tests and when and of what clinical decisions can be made. This document was written primarily for the clinician who would like to learn the latest approaches to the investigation of patients with CVI and the new applications that have emerged from recent research, as well as for the novice who is embarking on venous research. Care has been taken to indicate which methods have entered the clinical arena and which are mainly used for research. The foundation for this consensus document was laid by the faculty at a meeting held under the auspices of the American Venous Forum, the Cardiovascular Disease Educational and Research Trust, the European Society of Vascular Surgery, the International Angiology Scientific Activity Congress Organization, the International Union of Angiology, and the Union Internationale de Phlebologie at the Abbaye des Vaux de Cernay, France, on March 5 to 9, 1997. Subsequent input by co-opted faculty members and revisions in 1998 and 1999 have ensured a document that provides an up-to-date account of the various methods available for the investigation of CVI.

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Authors
Nicolaides, A. N.
Affiliations
Imperial College London (GB)
Corresponding author
Nicolaides, A. N.
ORCID
Nicolaides, A. N.
Venue
Circulation
Publisher
Ovid Technologies (Wolters Kluwer Health)
Published
2000-11-14
Volume
102
Issue
20
Pages
E126-63
ISSN
  • 0009-7322 (ISSN-L)
  • 1524-4539
DOI
10.1161/01.cir.102.20.e126
OpenAlex
W2082224498
Cited by
945
References
474
Citations by year
2026: 16 · 2025: 17 · 2024: 12 · 2023: 17 · 2022: 13 · 2021: 22 · 2020: 18 · 2019: 12 · 2018: 19 · 2017: 33 · 2016: 32 · 2015: 34 · 2014: 43 · 2013: 37 · 2012: 39
FWCI
50.77
Type
journal article
Language
en
Open access
closed
Locations
  • Circulation (publishedVersion)
  • PubMed (publishedVersion)
Funders
  • American Venous Forum
  • Servier
Topics
  • Health Sciences › Medicine › Surgery › Diagnosis and Treatment of Venous Diseases
  • Health Sciences › Medicine › Internal Medicine › Venous Thromboembolism Diagnosis and Management
  • Health Sciences › Medicine › Surgery › Vascular anomalies and interventions
Keywords
chronic venous insufficiency, lower limb venous disease, venous reflux, venous obstruction, venous thrombosis, venous hypertension, diagnostic testing
MeSH terms
Chronic Disease, Contrast Media, Diagnostic Techniques, Cardiovascular, Diagnosis, Differential, Eczema, Female, Humans, Leg, Male, Microcirculation, Ovary, Phlebography, Plethysmography, Predictive Value of Tests, Severity of Illness Index, Thermography, Ultrasonography, Varicose Ulcer, Varicose Veins, Venous Insufficiency, Venous Pressure, Incidence, Photoplethysmography, Western World

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