Can deep vein thrombosis be predicted after varicose vein operation in women in rural areas?
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Department of General, Vascular Surgery and Angiology University of Medical Sciences, Poznań, Poland
Individual Medical Practice, Poznań, Poland
Department for Health Problems of Ageing, Institute of Rural Health, Lublin, Poland
Ann Agric Environ Med 2014;21(3):601–605
Chronic venous disease is a group of symptoms caused by functional and structural defects of the venous vessels. One of the most common aspects of this disease is the occurrence of varicose veins. There are many ways of prevention and treatment of varicose veins, but in Poland the leading one is still surgery. As in every medical procedure there is the possibility of some complications. One of them is deep vein thrombosis (DVT). The diagnosis of DVT can be difficult, especially when access to a specialist is limited, such as in case of rural patients.

The aim of the study:
The aim of the study was estimation of the influence of LMWH primary prophylaxis on the formation of postoperative DVT, as well as sensitivity and specificity of clinical examination and D-dimer value in diagnosis of postoperative DVT in women.

Material and Methods:
The study was conducted in a group of 93 women operated on in the Department of General, Vascular Surgery and Angiology at the Karol Marcinkowski University of Medical Sciences in Poznań, Poland. The patients had undergone a varicose vein operation and were randomly divided into two groups: A – 48 women receiving LMWH during two days of the perioperative period, B – 45 women receiving LMWH during seven days of the perioperative period.

There was no significant difference in the postoperative DVT complications in both groups. The value of D-dimer >0.987 mcg/ml and swelling >1.5 cm of shin (in comparison to the preoperative period) plays a significant role in diagnosis of DVT.

The extended primary prophylaxis with LMWH does not affect the amount or quality of thrombotic complications after varicose vein operation. If the DVT occurs, the evaluation of the D – dimer and careful clinical examination can be a useful method for its diagnosis.

Iwona Bojar   
Department for Health Problems of Ageing, Institute of Rural Health, Lublin, Poland
1. Linton RR. The post – trombotic ulceration of the lower extremity: Its etiology and surgical treatment. Am J Surg. 1953; 107: 415.
2. Lafuma A, Fagnani F, Peltier PF, Rauss A. Venous disease in France: an unrecognized public health problem. J Mal Vasc. 1994; 19: 185–189.
3. De Castro-Silva. M. Chronic venous insufficiency of thelower limbs and its socioeconomic significance. Int Angiol. 1991; 10: 152–157.
4. Kurz X, Kahn SR, Abenhaim L, Clement D, Norgren L, Baccaglini U, et al. Chronic venous disorders of the leg:epidemiology, outcomes, diagnosis and management. Summaryof an evidence-based report of the VEINES task force.Venous Insufficiency Epidemiologic and Economic Studies. Int Angiol. 1999; 18: 83–102.
5. Allaert FA, Cazaubon M, Causse C, Lecomte Y, Urbinelli R. Venous disease and ergonomics of female employment. Int Angiol. 2005; 24: 265–271.
6. Grzela T, Jawień A. Epidemiologia przewlekłej niewydolności żylnej. Przew Lek. 2004; 8: 29–32 (in Polish).
7. Brand FN, Dannenberg AL, Abbott RD, Kannel WB. The epidemiology of varicose veins: the Framingham Study. Am J Prev Med. 1988; 4: 96–101.
8. Korthuis RJ, Anderson DC, Granger DN. Role of neutrofilendothelial cell adhesion in inflammatory disorders. J Crit Care. 1994; 9: 47–71.
9. Epidemiologia, koszty i jakość życia. In: Ramelet AA, Monti M (eds.) Flebologia Przewodnik. Via Medica, Gdańsk 2003.p.53–60 (in Polish).
10. Ramelet AA, Monti M. Leczenie uciskowe. In: Ramelet AA, Monti M (eds.). Flebologia Przewodnik. Via Medica, Gdańsk 2003.p.263–272 (in Polish).
11. Vayssairat M, Ziani E, Houot B. Placebo controlled efficacy of class 1 elastic stockings in chronic venous insufficiency of the lower limbs. J Mal Vasc. 2000; 25: 256–262.
12. Benigni JP, Sadoun S, Allaert FA, Vin F. Efficacy of Class1 elastic compression stockings in the early stages of chronic venous disease. A comparative study. Int Angiol. 2003; 22: 383–932.
13. Charles H. Does leg ulcer treatment improve patients’ quality of life? J Wound Care. 2004; 13: 209–213.
14. Loftus S. A longitudinal, quality of life study comparing four layer bandaging and superficial venous surgery for the treatment of venous leg ulcers. J Tissue Viability. 2001; 11: 14–19.
15. Ibegbuna V, Nicolaides AN, Sowade O, Leon M, Geroulakos G. Venous elasticity after treatment with Daflon 500 mg. Angiology 1997; 48: 45–49.
16. Juteau N, Bakri F, Pomies JP, Foulon C, Rigaudy P, Pillion G, et al. The human saphenous vein in pharmacology: effect of a new micronized flavonoidic fraction (Daflon 500 mg) on norepinephrine induced contraction. Int. Angiol. 1995; 14: 8–13.
17. Struckmann JR, Nicolaides AN. Flavonoids. A review of the pharmacology and therapeutic efficacy of Daflon 500mg in patients with chronic venous insufficiency and relateddisorders. Angiology 1994; 45: 419–428.
18. Tsouderos Y. Venous tone: are the phlebotonic propertiespredictive of a therapeutic benefit? A comprehensive viewof our experience with Daflon 500 mg. Z Kardiol. 1991; 80(7): 95–101.
19. Gargouil YM, Perdrix L, Chapelain B, Gaborieau R. Effectsof Daflon 500 mg on bovine vessels contractility. Int Angiol. 1989; 8: 19–22.
20. Janssens D, Delaive E, Houbion A, Eliaers F, Remacle J,Michiels C. Effect of venotropic drugs on the respiratory activity of isolated mitochondria and in endothelial cells. Br J Pharmacol. 2000; 130: 1513–1524.
21. Takase S, Pascarella L, Lerond L, Bergan JJ, Schmid-Schonbein GW. Venous hypertension, inflammation and valveremodeling. Eur J Vasc Endovasc Surg. 2004; 28: 484–493.
22. Zatoński W, Przewoźniak K, Sulkowska U, West R, Wojtyła A. Tobacco smoking in countries of the European Union. Ann Agric Environ Med. 2012; 19(2): 181–192.
23. Bőhler K, et al. Systemic Activation of Coagulation and Fibrinolysis during Varicose Vein Stripping Dermatol Surg. 1997; 23: 46–50.
24. Hinterhuber G et al., Extended Monitoring of Hemostatic Activation After varicose Vein Surgery Under General Anesthesia. Dermatol Surg. 2006: 32: 632–639.
25. Pączkowska M. Dostępność świadczeń zdrowotnych w opinii Polaków. Centum Systemów Informacyjnych Ochrony Zdrowia, Warszawa 2006 (in Polish).