Associação entre a classificação CEAP e alterações no Eco-doppler venoso dos membros inferiores

 

Miguel Maia, Joana Ferreira, Sandrina Braga, João Vasconcelos, Pedro Brandão, Alexandra Canedo, Guedes Vaz.

Centro Hospitalar de Vila Nova de Gaia/Espinho EPE, Serviço de Angiologia e Cirurgia Vascular

Correspondência

 

RESUMO

Objectivos: Correlacionar as manifestações clínicas da classificação CEAP com as alterações no Eco-Doppler venoso dos membros inferiores.

Material e métodos: Foram avaliados 806 membros (403 doentes consecutivos), submetidos a Eco-Doppler venoso dos membros inferiores no decurso da investigação de insuficiência venosa crónica.

Resultados: Média de idades de 46,8 anos, 360 mulheres e 43 homens.

Constatou-se uma diferença entre o número de doentes sintomáticos conforme o género, 62,5% mulheres versus 44,2% homens (p<0,001). Doentes com idade =60 anos também foram mais frequentemente classificados como sintomáticos (p<0,001).

A atribuição de uma classe C sintomática correlacionou-se com insuficiência da veia grande safena e de perfurantes mediais da perna (p<0,001).

Membros classificados como assintomáticos, C1a e C2a, apresentaram insuficiência de perfurantes mediais da perna em apenas 36,4%, enquanto que a mesma foi identificada em 64,9% nos membros C0s, C1s e C2s, em 76% dos membros C3s e C4s e em 100% dos membros C5s e C6s (p<0,001).

Os membros classificados como C3s apresentaram insuficiência venosa profunda em 20,5% dos casos, contrastando com apenas 5,2% nos restantes membros (p<0.001;OR:4,686).

Conclusões: Os doentes classificados como sintomáticos foram mais frequentemente mulheres com idade =60 anos.

A presença de insuficiência da veia grande safena e de perfurantes mediais da perna correlacionou-se com a presença de sintomas.

Verificou-se uma associação entre insuficiência de perfurantes mediais da perna e gravidade das manifestações clínicas da classificação CEAP.

A presença de insuficiência venosa profunda foi mais frequente em membros classificados como C3s.

Palavras-Chave: Ceap manifestações clínicas, Insuficiência venosa crónica, Eco-doppler

 

Association between the CEAP classification and Duplex-scan findings

ABSTRACT

Objective: The aim of our study was to correlate the clinical manifestations of the CEAP classification with insufficiency at lower extremity venous ultrasound examination.

Methods: Eight hundred and six extremities (corresponding to 403 consecutive patients) were evaluated by vascular ultrasonography during the investigation of chronic venous insufficiency.

Results: Mean age of 46,8 years-old, 360 women and 43 men.

There was a statistically significant difference between symptomatic patients according to gender, 62,5% women versus 44,2% men (p <0,001). Patients with =60 years-old were also more frequently classified as symptomatic (p <0,001)

A symptomatic C class was more often attributed to limbs with great saphenous vein and medial leg perforators insufficiency.

The extremities classified as asymptomatic, C1a and 2a, presented medial leg perforators insufficiency in only 36,4%, opposing to 64,9% of insufficiency in limbs classified as C0s, C1s and C2s, 76% in limbs graded C3s and C4s and to 100% of the limbs classified as C5s and C6s (p <0,001).

In 20,5% of the extremities graded as C3s there was deep venous insufficiency on ultrasound, whereas in the other extremities only 5,2% had deep venous insufficiency. (p <0.001;OR:4,686).

Conclusions: Symptomatic patients were more frequently women with =60 years-old.

Great saphenous vein and medial leg perforators insufficiency correlated with the presence of symptoms.

There was a significant association between medial leg perforators insufficiency and the severity of the clinical manifestations of CEAP classification.

Deep venous insufficiency was more frequent in extremities classified as C3s.

Key Words: Ceap classification, Chronic venous insufficiency, Clinical picture, Echo-doppler

 

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Correspondência

Autor Correspondente Miguel Maia

Centro Hospitalar de Vila Nova de Gaia/Espinho EPE, Serviço de Angiologia e Cirurgia Vascular

Rua Conceição Fernandes 4434-502 Vila Nova de Gaia

Telf. 227 865 100 Fax. 227830209 Tlm pessoal: 914927543

Email: miguelopmm@hotmail.com