American Venous Forum (AVF): Annual Meeting

SAN DIEGO – Great saphenous vein diameter is a poor surrogate marker for assessing the impact of superficial venous incompetence on a patient's quality of life, results from a study of 91 patients showed.

The finding runs counter to the current practice of some health insurance carriers that use great saphenous vein (GSV) diameter to determine coverage for treatment of axial venous insufficiency.

"It is inappropriate to use GSV diameter as a sole criterion for determining medical necessity for the treatment of GSV reflux," Dr. Kathleen Gibson said at the annual meeting of the American Venous Forum. "Further investigation should be undertaken to look for more appropriate surrogate markers to guide treatment decisions."

Dr. Gibson and her associates collected data from the charts of 91 patients who were prospectively enrolled in two varicose vein trials that examined changes in quality-of-life measures with different varicose vein treatments. It was the first study of its kind, said Dr. Gibson, a vascular surgeon at Lake Washington Vascular in Bellevue, Wash.

The current analysis looked for correlations between GSV diameter and quality-of-life measures prior to any vein treatment.

GSV diameter was measured on duplex ultrasound within 5 cm of the saphenofemoral junction, while the patient was standing. Clinicians also determined Venous Clinical Severity Score (VCSS), and patients completed the Chronic Venous Insufficiency Questionnaire 2 (CIVIQ-2), the Venous Insufficiency Epidemiological and Economic Study-Quality of Life (VEINES-QOL) questionnaire, and the VEINES Symptoms (VEINES-SYM) questionnaire prior to treatment.

Values for VCSS range from 0 to 30, with 30 being the most severe. Scores on the CIVIQ-2 range from 0 to 100, with 100 being the most severe. Higher scores on both the 25-item VEINES-QOL and the 10-item VEINES-SYM indicate better outcomes.

The mean age of patients was 45 years, 72 were women, and the mean GSV diameter was 6.77 mm.

Dr. Gibson reported that the mean VCSS value was 6.4 (range 2-12). The mean CIVIQ-2 score was 42.5 (range 20-85), the mean VEINES-QOL score was 82.7 (range 35-188), and the VEINES-SYM scores had a mean value of 40.5 (range 12-60).

Before vein treatment, there was a moderate correlation between VCSS and QOL measures, she said, and a strong correlation between VCSS and patient-derived quality-of-life measures, which were both significant (P less than .01).

Scatter plot analysis and Pearson correlation coefficients revealed a poor correlation between GSV diameter and VCSS, and no correlation between GSV diameter and any of the following: CIVIQ-2, VEINES-SYM, or VEINES-QOL.

"The only statistically significant findings we had for correlation were a weak correlation between height and body mass index and GSV diameter," Dr. Gibson said. "There was no statistical significance with the weak correlation we saw with VCSS and GSV diameter, and no correlation with any of the quality-of-life surveys. For reflux time, there was a trend toward a weak correlation inversely with height and BMI."

Dr. Gibson said that she had no relevant financial disclosures.

SAN DIEGO – Great saphenous vein diameter is a poor surrogate marker for assessing the impact of superficial venous incompetence on a patient's quality of life, results from a study of 91 patients showed.

The finding runs counter to the current practice of some health insurance carriers that use great saphenous vein (GSV) diameter to determine coverage for treatment of axial venous insufficiency.

"It is inappropriate to use GSV diameter as a sole criterion for determining medical necessity for the treatment of GSV reflux," Dr. Kathleen Gibson said at the annual meeting of the American Venous Forum. "Further investigation should be undertaken to look for more appropriate surrogate markers to guide treatment decisions."

Dr. Gibson and her associates collected data from the charts of 91 patients who were prospectively enrolled in two varicose vein trials that examined changes in quality-of-life measures with different varicose vein treatments. It was the first study of its kind, said Dr. Gibson, a vascular surgeon at Lake Washington Vascular in Bellevue, Wash.

The current analysis looked for correlations between GSV diameter and quality-of-life measures prior to any vein treatment.

GSV diameter was measured on duplex ultrasound within 5 cm of the saphenofemoral junction, while the patient was standing. Clinicians also determined Venous Clinical Severity Score (VCSS), and patients completed the Chronic Venous Insufficiency Questionnaire 2 (CIVIQ-2), the Venous Insufficiency Epidemiological and Economic Study-Quality of Life (VEINES-QOL) questionnaire, and the VEINES Symptoms (VEINES-SYM) questionnaire prior to treatment.

Values for VCSS range from 0 to 30, with 30 being the most severe. Scores on the CIVIQ-2 range from 0 to 100, with 100 being the most severe. Higher scores on both the 25-item VEINES-QOL and the 10-item VEINES-SYM indicate better outcomes.

The mean age of patients was 45 years, 72 were women, and the mean GSV diameter was 6.77 mm.

Dr. Gibson reported that the mean VCSS value was 6.4 (range 2-12). The mean CIVIQ-2 score was 42.5 (range 20-85), the mean VEINES-QOL score was 82.7 (range 35-188), and the VEINES-SYM scores had a mean value of 40.5 (range 12-60).

Before vein treatment, there was a moderate correlation between VCSS and QOL measures, she said, and a strong correlation between VCSS and patient-derived quality-of-life measures, which were both significant (P less than .01).

Scatter plot analysis and Pearson correlation coefficients revealed a poor correlation between GSV diameter and VCSS, and no correlation between GSV diameter and any of the following: CIVIQ-2, VEINES-SYM, or VEINES-QOL.

"The only statistically significant findings we had for correlation were a weak correlation between height and body mass index and GSV diameter," Dr. Gibson said. "There was no statistical significance with the weak correlation we saw with VCSS and GSV diameter, and no correlation with any of the quality-of-life surveys. For reflux time, there was a trend toward a weak correlation inversely with height and BMI."

Dr. Gibson said that she had no relevant financial disclosures.

SAN DIEGO – Great saphenous vein diameter is a poor surrogate marker for assessing the impact of superficial venous incompetence on a patient's quality of life, results from a study of 91 patients showed.

The finding runs counter to the current practice of some health insurance carriers that use great saphenous vein (GSV) diameter to determine coverage for treatment of axial venous insufficiency.

"It is inappropriate to use GSV diameter as a sole criterion for determining medical necessity for the treatment of GSV reflux," Dr. Kathleen Gibson said at the annual meeting of the American Venous Forum. "Further investigation should be undertaken to look for more appropriate surrogate markers to guide treatment decisions."

Dr. Gibson and her associates collected data from the charts of 91 patients who were prospectively enrolled in two varicose vein trials that examined changes in quality-of-life measures with different varicose vein treatments. It was the first study of its kind, said Dr. Gibson, a vascular surgeon at Lake Washington Vascular in Bellevue, Wash.

The current analysis looked for correlations between GSV diameter and quality-of-life measures prior to any vein treatment.

GSV diameter was measured on duplex ultrasound within 5 cm of the saphenofemoral junction, while the patient was standing. Clinicians also determined Venous Clinical Severity Score (VCSS), and patients completed the Chronic Venous Insufficiency Questionnaire 2 (CIVIQ-2), the Venous Insufficiency Epidemiological and Economic Study-Quality of Life (VEINES-QOL) questionnaire, and the VEINES Symptoms (VEINES-SYM) questionnaire prior to treatment.

Values for VCSS range from 0 to 30, with 30 being the most severe. Scores on the CIVIQ-2 range from 0 to 100, with 100 being the most severe. Higher scores on both the 25-item VEINES-QOL and the 10-item VEINES-SYM indicate better outcomes.

The mean age of patients was 45 years, 72 were women, and the mean GSV diameter was 6.77 mm.

Dr. Gibson reported that the mean VCSS value was 6.4 (range 2-12). The mean CIVIQ-2 score was 42.5 (range 20-85), the mean VEINES-QOL score was 82.7 (range 35-188), and the VEINES-SYM scores had a mean value of 40.5 (range 12-60).

Before vein treatment, there was a moderate correlation between VCSS and QOL measures, she said, and a strong correlation between VCSS and patient-derived quality-of-life measures, which were both significant (P less than .01).

Scatter plot analysis and Pearson correlation coefficients revealed a poor correlation between GSV diameter and VCSS, and no correlation between GSV diameter and any of the following: CIVIQ-2, VEINES-SYM, or VEINES-QOL.

"The only statistically significant findings we had for correlation were a weak correlation between height and body mass index and GSV diameter," Dr. Gibson said. "There was no statistical significance with the weak correlation we saw with VCSS and GSV diameter, and no correlation with any of the quality-of-life surveys. For reflux time, there was a trend toward a weak correlation inversely with height and BMI."

Dr. Gibson said that she had no relevant financial disclosures.

SAN DIEGO – The manifestations of chronic venous insufficiency generally increase with higher body mass index, results from a national screening program demonstrated.

However, venous abnormalities on screening duplex ultrasound were not correlated with increasing BMI.

"We did not find an increase in obstruction or venous reflux in higher-BMI individuals, which leads us to believe that obesity in and of itself is a contributor to chronic venous disease in the absence of valvular insufficiency," Dr. Colleen Moore said at the annual meeting of the American Venous Forum.

To determine differences in venous disease across a spectrum of BMI, Dr. Moore and her associates analyzed results from the National Venous Screening program. The program, launched by the American Venous Forum in 2005, was designed to educate participants about venous thromboembolism (VTE) risk, varicose veins, and chronic venous insufficiency through screening, literature, promotional materials, and an interview with a venous expert.

"The program strives to identify those at risk for VTE, the presence of venous obstruction or reflux on a modified duplex ultrasound, and the presence of chronic venous insufficiency based on a quick leg inspection," said Dr. Moore, of the vascular surgery department at Southern Illinois University, Springfield. "It then empowers individuals to go forth and inform their primary care providers and family of their risk of venous disease and the presence of venous disease."

Dr. Moore and her colleagues divided participants into six BMI categories: underweight (less than 18.5 kg/m²), normal weight (18.5-24.9), overweight (25-29.9), obese (30-34.9), morbidly obese (35-39.9), and supermorbidly obese (greater than 40).

The researchers collected several data points for comparison, including demographic and health information, a VTE risk assessment, venous quality of life with the Chronic Venous Insufficiency Questionnaire 2 (CIVIQ2), and an abbreviated duplex ultrasound. Participants in the screening program also underwent a lower-extremity inspection and were assigned a CEAP classification (based on clinical severity, etiology or cause, anatomy, and pathophysiology).

Dr. Moore presented findings from 7,227 people who have been screened since 2005. Of these, 1.3% were underweight, 34.9% were normal weight, 34.8% were overweight, 16.6% were obese, 7.7% were morbidly obese, and 4.7% were supermorbidly obese.

The prevalence of diabetes significantly increased incrementally with BMI (from 4.9% in the normal-weight group to 25.2% in the supermorbidly obese group), as did the prevalence of hypertension (from 22.9% in the normal-weight group to 54.3% in the supermorbidly obese group).

Mean VTE risk-assessment scores significantly increased incrementally with BMI (from 3.3 in the normal-weight group to 4.1 in the supermorbidly obese group), as did mean quality-of-life scores (from 20.3 in the normal-weight group to 29.0 in the supermorbidly obese group). "We looked at social activities such as the ability to play sports or do housework," Dr. Moore said. "As you become heavier those scores increase, indicating a worse quality of life, and are statistically significant, compared with the normal-weight individuals."

Quality-of-life assessments regarding physical function such as the ability to walk briskly or climb stairs yielded similar results.

Mean CEAP scores significantly increased incrementally with BMI (from 1.4 in the normal-weight group to 1.9 in the supermorbidly obese group), as did mean venous clinical severity scores (from 2.6 in the normal-weight group to 4.3 in the supermorbidly obese group).

Dr. Moore also reported that evidence of venous obstruction on duplex examination appeared to increase across the BMI spectrum, but this did not reach statistical significance. The same association was seen for venous reflux as assessed by duplex examination.

Dr. Moore said that she had no relevant financial conflicts to disclose.

SAN DIEGO – The manifestations of chronic venous insufficiency generally increase with higher body mass index, results from a national screening program demonstrated.

However, venous abnormalities on screening duplex ultrasound were not correlated with increasing BMI.

"We did not find an increase in obstruction or venous reflux in higher-BMI individuals, which leads us to believe that obesity in and of itself is a contributor to chronic venous disease in the absence of valvular insufficiency," Dr. Colleen Moore said at the annual meeting of the American Venous Forum.

To determine differences in venous disease across a spectrum of BMI, Dr. Moore and her associates analyzed results from the National Venous Screening program. The program, launched by the American Venous Forum in 2005, was designed to educate participants about venous thromboembolism (VTE) risk, varicose veins, and chronic venous insufficiency through screening, literature, promotional materials, and an interview with a venous expert.

"The program strives to identify those at risk for VTE, the presence of venous obstruction or reflux on a modified duplex ultrasound, and the presence of chronic venous insufficiency based on a quick leg inspection," said Dr. Moore, of the vascular surgery department at Southern Illinois University, Springfield. "It then empowers individuals to go forth and inform their primary care providers and family of their risk of venous disease and the presence of venous disease."

Dr. Moore and her colleagues divided participants into six BMI categories: underweight (less than 18.5 kg/m²), normal weight (18.5-24.9), overweight (25-29.9), obese (30-34.9), morbidly obese (35-39.9), and supermorbidly obese (greater than 40).

The researchers collected several data points for comparison, including demographic and health information, a VTE risk assessment, venous quality of life with the Chronic Venous Insufficiency Questionnaire 2 (CIVIQ2), and an abbreviated duplex ultrasound. Participants in the screening program also underwent a lower-extremity inspection and were assigned a CEAP classification (based on clinical severity, etiology or cause, anatomy, and pathophysiology).

Dr. Moore presented findings from 7,227 people who have been screened since 2005. Of these, 1.3% were underweight, 34.9% were normal weight, 34.8% were overweight, 16.6% were obese, 7.7% were morbidly obese, and 4.7% were supermorbidly obese.

The prevalence of diabetes significantly increased incrementally with BMI (from 4.9% in the normal-weight group to 25.2% in the supermorbidly obese group), as did the prevalence of hypertension (from 22.9% in the normal-weight group to 54.3% in the supermorbidly obese group).

Mean VTE risk-assessment scores significantly increased incrementally with BMI (from 3.3 in the normal-weight group to 4.1 in the supermorbidly obese group), as did mean quality-of-life scores (from 20.3 in the normal-weight group to 29.0 in the supermorbidly obese group). "We looked at social activities such as the ability to play sports or do housework," Dr. Moore said. "As you become heavier those scores increase, indicating a worse quality of life, and are statistically significant, compared with the normal-weight individuals."

Quality-of-life assessments regarding physical function such as the ability to walk briskly or climb stairs yielded similar results.

Mean CEAP scores significantly increased incrementally with BMI (from 1.4 in the normal-weight group to 1.9 in the supermorbidly obese group), as did mean venous clinical severity scores (from 2.6 in the normal-weight group to 4.3 in the supermorbidly obese group).

Dr. Moore also reported that evidence of venous obstruction on duplex examination appeared to increase across the BMI spectrum, but this did not reach statistical significance. The same association was seen for venous reflux as assessed by duplex examination.

Dr. Moore said that she had no relevant financial conflicts to disclose.

SAN DIEGO – The manifestations of chronic venous insufficiency generally increase with higher body mass index, results from a national screening program demonstrated.

However, venous abnormalities on screening duplex ultrasound were not correlated with increasing BMI.

"We did not find an increase in obstruction or venous reflux in higher-BMI individuals, which leads us to believe that obesity in and of itself is a contributor to chronic venous disease in the absence of valvular insufficiency," Dr. Colleen Moore said at the annual meeting of the American Venous Forum.

To determine differences in venous disease across a spectrum of BMI, Dr. Moore and her associates analyzed results from the National Venous Screening program. The program, launched by the American Venous Forum in 2005, was designed to educate participants about venous thromboembolism (VTE) risk, varicose veins, and chronic venous insufficiency through screening, literature, promotional materials, and an interview with a venous expert.

"The program strives to identify those at risk for VTE, the presence of venous obstruction or reflux on a modified duplex ultrasound, and the presence of chronic venous insufficiency based on a quick leg inspection," said Dr. Moore, of the vascular surgery department at Southern Illinois University, Springfield. "It then empowers individuals to go forth and inform their primary care providers and family of their risk of venous disease and the presence of venous disease."

Dr. Moore and her colleagues divided participants into six BMI categories: underweight (less than 18.5 kg/m²), normal weight (18.5-24.9), overweight (25-29.9), obese (30-34.9), morbidly obese (35-39.9), and supermorbidly obese (greater than 40).

The researchers collected several data points for comparison, including demographic and health information, a VTE risk assessment, venous quality of life with the Chronic Venous Insufficiency Questionnaire 2 (CIVIQ2), and an abbreviated duplex ultrasound. Participants in the screening program also underwent a lower-extremity inspection and were assigned a CEAP classification (based on clinical severity, etiology or cause, anatomy, and pathophysiology).

Dr. Moore presented findings from 7,227 people who have been screened since 2005. Of these, 1.3% were underweight, 34.9% were normal weight, 34.8% were overweight, 16.6% were obese, 7.7% were morbidly obese, and 4.7% were supermorbidly obese.

The prevalence of diabetes significantly increased incrementally with BMI (from 4.9% in the normal-weight group to 25.2% in the supermorbidly obese group), as did the prevalence of hypertension (from 22.9% in the normal-weight group to 54.3% in the supermorbidly obese group).

Mean VTE risk-assessment scores significantly increased incrementally with BMI (from 3.3 in the normal-weight group to 4.1 in the supermorbidly obese group), as did mean quality-of-life scores (from 20.3 in the normal-weight group to 29.0 in the supermorbidly obese group). "We looked at social activities such as the ability to play sports or do housework," Dr. Moore said. "As you become heavier those scores increase, indicating a worse quality of life, and are statistically significant, compared with the normal-weight individuals."

Quality-of-life assessments regarding physical function such as the ability to walk briskly or climb stairs yielded similar results.

Mean CEAP scores significantly increased incrementally with BMI (from 1.4 in the normal-weight group to 1.9 in the supermorbidly obese group), as did mean venous clinical severity scores (from 2.6 in the normal-weight group to 4.3 in the supermorbidly obese group).

Dr. Moore also reported that evidence of venous obstruction on duplex examination appeared to increase across the BMI spectrum, but this did not reach statistical significance. The same association was seen for venous reflux as assessed by duplex examination.

Dr. Moore said that she had no relevant financial conflicts to disclose.

SAN DIEGO – The manifestations of chronic venous insufficiency generally increase with higher body mass index, results from a national screening program demonstrated.

However, venous abnormalities on screening duplex ultrasound were not correlated with increasing BMI.

"We did not find an increase in obstruction or venous reflux in higher-BMI individuals, which leads us to believe that obesity in and of itself is a contributor to chronic venous disease in the absence of valvular insufficiency," Dr. Colleen Moore said at the annual meeting of the American Venous Forum.

To determine differences in venous disease across a spectrum of BMI, Dr. Moore and her associates analyzed results from the National Venous Screening program. The program, launched by the American Venous Forum in 2005, was designed to educate participants about venous thromboembolism (VTE) risk, varicose veins, and chronic venous insufficiency through screening, literature, promotional materials, and an interview with a venous expert.

"The program strives to identify those at risk for VTE, the presence of venous obstruction or reflux on a modified duplex ultrasound, and the presence of chronic venous insufficiency based on a quick leg inspection," said Dr. Moore, of the vascular surgery department at Southern Illinois University, Springfield. "It then empowers individuals to go forth and inform their primary care providers and family of their risk of venous disease and the presence of venous disease."

Dr. Moore and her colleagues divided participants into six BMI categories: underweight (less than 18.5 kg/m²), normal weight (18.5-24.9), overweight (25-29.9), obese (30-34.9), morbidly obese (35-39.9), and supermorbidly obese (greater than 40).

The researchers collected several data points for comparison, including demographic and health information, a VTE risk assessment, venous quality of life with the Chronic Venous Insufficiency Questionnaire 2 (CIVIQ2), and an abbreviated duplex ultrasound. Participants in the screening program also underwent a lower-extremity inspection and were assigned a CEAP classification (based on clinical severity, etiology or cause, anatomy, and pathophysiology).

Dr. Moore presented findings from 7,227 people who have been screened since 2005. Of these, 1.3% were underweight, 34.9% were normal weight, 34.8% were overweight, 16.6% were obese, 7.7% were morbidly obese, and 4.7% were supermorbidly obese.

The prevalence of diabetes significantly increased incrementally with BMI (from 4.9% in the normal-weight group to 25.2% in the supermorbidly obese group), as did the prevalence of hypertension (from 22.9% in the normal-weight group to 54.3% in the supermorbidly obese group).

Mean VTE risk-assessment scores significantly increased incrementally with BMI (from 3.3 in the normal-weight group to 4.1 in the supermorbidly obese group), as did mean quality-of-life scores (from 20.3 in the normal-weight group to 29.0 in the supermorbidly obese group). "We looked at social activities such as the ability to play sports or do housework," Dr. Moore said. "As you become heavier those scores increase, indicating a worse quality of life, and are statistically significant, compared with the normal-weight individuals."

Quality-of-life assessments regarding physical function such as the ability to walk briskly or climb stairs yielded similar results.

Mean CEAP scores significantly increased incrementally with BMI (from 1.4 in the normal-weight group to 1.9 in the supermorbidly obese group), as did mean venous clinical severity scores (from 2.6 in the normal-weight group to 4.3 in the supermorbidly obese group).

Dr. Moore also reported that evidence of venous obstruction on duplex examination appeared to increase across the BMI spectrum, but this did not reach statistical significance. The same association was seen for venous reflux as assessed by duplex examination.

Dr. Moore said that she had no relevant financial conflicts to disclose.

SAN DIEGO – The manifestations of chronic venous insufficiency generally increase with higher body mass index, results from a national screening program demonstrated.

However, venous abnormalities on screening duplex ultrasound were not correlated with increasing BMI.

"We did not find an increase in obstruction or venous reflux in higher-BMI individuals, which leads us to believe that obesity in and of itself is a contributor to chronic venous disease in the absence of valvular insufficiency," Dr. Colleen Moore said at the annual meeting of the American Venous Forum.

To determine differences in venous disease across a spectrum of BMI, Dr. Moore and her associates analyzed results from the National Venous Screening program. The program, launched by the American Venous Forum in 2005, was designed to educate participants about venous thromboembolism (VTE) risk, varicose veins, and chronic venous insufficiency through screening, literature, promotional materials, and an interview with a venous expert.

"The program strives to identify those at risk for VTE, the presence of venous obstruction or reflux on a modified duplex ultrasound, and the presence of chronic venous insufficiency based on a quick leg inspection," said Dr. Moore, of the vascular surgery department at Southern Illinois University, Springfield. "It then empowers individuals to go forth and inform their primary care providers and family of their risk of venous disease and the presence of venous disease."

Dr. Moore and her colleagues divided participants into six BMI categories: underweight (less than 18.5 kg/m²), normal weight (18.5-24.9), overweight (25-29.9), obese (30-34.9), morbidly obese (35-39.9), and supermorbidly obese (greater than 40).

The researchers collected several data points for comparison, including demographic and health information, a VTE risk assessment, venous quality of life with the Chronic Venous Insufficiency Questionnaire 2 (CIVIQ2), and an abbreviated duplex ultrasound. Participants in the screening program also underwent a lower-extremity inspection and were assigned a CEAP classification (based on clinical severity, etiology or cause, anatomy, and pathophysiology).

Dr. Moore presented findings from 7,227 people who have been screened since 2005. Of these, 1.3% were underweight, 34.9% were normal weight, 34.8% were overweight, 16.6% were obese, 7.7% were morbidly obese, and 4.7% were supermorbidly obese.

The prevalence of diabetes significantly increased incrementally with BMI (from 4.9% in the normal-weight group to 25.2% in the supermorbidly obese group), as did the prevalence of hypertension (from 22.9% in the normal-weight group to 54.3% in the supermorbidly obese group).

Mean VTE risk-assessment scores significantly increased incrementally with BMI (from 3.3 in the normal-weight group to 4.1 in the supermorbidly obese group), as did mean quality-of-life scores (from 20.3 in the normal-weight group to 29.0 in the supermorbidly obese group). "We looked at social activities such as the ability to play sports or do housework," Dr. Moore said. "As you become heavier those scores increase, indicating a worse quality of life, and are statistically significant, compared with the normal-weight individuals."

Quality-of-life assessments regarding physical function such as the ability to walk briskly or climb stairs yielded similar results.

Mean CEAP scores significantly increased incrementally with BMI (from 1.4 in the normal-weight group to 1.9 in the supermorbidly obese group), as did mean venous clinical severity scores (from 2.6 in the normal-weight group to 4.3 in the supermorbidly obese group).

Dr. Moore also reported that evidence of venous obstruction on duplex examination appeared to increase across the BMI spectrum, but this did not reach statistical significance. The same association was seen for venous reflux as assessed by duplex examination.

Dr. Moore said that she had no relevant financial conflicts to disclose.

SAN DIEGO – The manifestations of chronic venous insufficiency generally increase with higher body mass index, results from a national screening program demonstrated.

However, venous abnormalities on screening duplex ultrasound were not correlated with increasing BMI.

"We did not find an increase in obstruction or venous reflux in higher-BMI individuals, which leads us to believe that obesity in and of itself is a contributor to chronic venous disease in the absence of valvular insufficiency," Dr. Colleen Moore said at the annual meeting of the American Venous Forum.

To determine differences in venous disease across a spectrum of BMI, Dr. Moore and her associates analyzed results from the National Venous Screening program. The program, launched by the American Venous Forum in 2005, was designed to educate participants about venous thromboembolism (VTE) risk, varicose veins, and chronic venous insufficiency through screening, literature, promotional materials, and an interview with a venous expert.

"The program strives to identify those at risk for VTE, the presence of venous obstruction or reflux on a modified duplex ultrasound, and the presence of chronic venous insufficiency based on a quick leg inspection," said Dr. Moore, of the vascular surgery department at Southern Illinois University, Springfield. "It then empowers individuals to go forth and inform their primary care providers and family of their risk of venous disease and the presence of venous disease."

Dr. Moore and her colleagues divided participants into six BMI categories: underweight (less than 18.5 kg/m²), normal weight (18.5-24.9), overweight (25-29.9), obese (30-34.9), morbidly obese (35-39.9), and supermorbidly obese (greater than 40).

The researchers collected several data points for comparison, including demographic and health information, a VTE risk assessment, venous quality of life with the Chronic Venous Insufficiency Questionnaire 2 (CIVIQ2), and an abbreviated duplex ultrasound. Participants in the screening program also underwent a lower-extremity inspection and were assigned a CEAP classification (based on clinical severity, etiology or cause, anatomy, and pathophysiology).

Dr. Moore presented findings from 7,227 people who have been screened since 2005. Of these, 1.3% were underweight, 34.9% were normal weight, 34.8% were overweight, 16.6% were obese, 7.7% were morbidly obese, and 4.7% were supermorbidly obese.

The prevalence of diabetes significantly increased incrementally with BMI (from 4.9% in the normal-weight group to 25.2% in the supermorbidly obese group), as did the prevalence of hypertension (from 22.9% in the normal-weight group to 54.3% in the supermorbidly obese group).

Mean VTE risk-assessment scores significantly increased incrementally with BMI (from 3.3 in the normal-weight group to 4.1 in the supermorbidly obese group), as did mean quality-of-life scores (from 20.3 in the normal-weight group to 29.0 in the supermorbidly obese group). "We looked at social activities such as the ability to play sports or do housework," Dr. Moore said. "As you become heavier those scores increase, indicating a worse quality of life, and are statistically significant, compared with the normal-weight individuals."

Quality-of-life assessments regarding physical function such as the ability to walk briskly or climb stairs yielded similar results.

Mean CEAP scores significantly increased incrementally with BMI (from 1.4 in the normal-weight group to 1.9 in the supermorbidly obese group), as did mean venous clinical severity scores (from 2.6 in the normal-weight group to 4.3 in the supermorbidly obese group).

Dr. Moore also reported that evidence of venous obstruction on duplex examination appeared to increase across the BMI spectrum, but this did not reach statistical significance. The same association was seen for venous reflux as assessed by duplex examination.

Dr. Moore said that she had no relevant financial conflicts to disclose.

SAN DIEGO – The manifestations of chronic venous insufficiency generally increase with higher body mass index, results from a national screening program demonstrated.

However, venous abnormalities on screening duplex ultrasound were not correlated with increasing BMI.

"We did not find an increase in obstruction or venous reflux in higher-BMI individuals, which leads us to believe that obesity in and of itself is a contributor to chronic venous disease in the absence of valvular insufficiency," Dr. Colleen Moore said at the annual meeting of the American Venous Forum.

To determine differences in venous disease across a spectrum of BMI, Dr. Moore and her associates analyzed results from the National Venous Screening program. The program, launched by the American Venous Forum in 2005, was designed to educate participants about venous thromboembolism (VTE) risk, varicose veins, and chronic venous insufficiency through screening, literature, promotional materials, and an interview with a venous expert.

"The program strives to identify those at risk for VTE, the presence of venous obstruction or reflux on a modified duplex ultrasound, and the presence of chronic venous insufficiency based on a quick leg inspection," said Dr. Moore, of the vascular surgery department at Southern Illinois University, Springfield. "It then empowers individuals to go forth and inform their primary care providers and family of their risk of venous disease and the presence of venous disease."

Dr. Moore and her colleagues divided participants into six BMI categories: underweight (less than 18.5 kg/m²), normal weight (18.5-24.9), overweight (25-29.9), obese (30-34.9), morbidly obese (35-39.9), and supermorbidly obese (greater than 40).

The researchers collected several data points for comparison, including demographic and health information, a VTE risk assessment, venous quality of life with the Chronic Venous Insufficiency Questionnaire 2 (CIVIQ2), and an abbreviated duplex ultrasound. Participants in the screening program also underwent a lower-extremity inspection and were assigned a CEAP classification (based on clinical severity, etiology or cause, anatomy, and pathophysiology).

Dr. Moore presented findings from 7,227 people who have been screened since 2005. Of these, 1.3% were underweight, 34.9% were normal weight, 34.8% were overweight, 16.6% were obese, 7.7% were morbidly obese, and 4.7% were supermorbidly obese.

The prevalence of diabetes significantly increased incrementally with BMI (from 4.9% in the normal-weight group to 25.2% in the supermorbidly obese group), as did the prevalence of hypertension (from 22.9% in the normal-weight group to 54.3% in the supermorbidly obese group).

Mean VTE risk-assessment scores significantly increased incrementally with BMI (from 3.3 in the normal-weight group to 4.1 in the supermorbidly obese group), as did mean quality-of-life scores (from 20.3 in the normal-weight group to 29.0 in the supermorbidly obese group). "We looked at social activities such as the ability to play sports or do housework," Dr. Moore said. "As you become heavier those scores increase, indicating a worse quality of life, and are statistically significant, compared with the normal-weight individuals."

Quality-of-life assessments regarding physical function such as the ability to walk briskly or climb stairs yielded similar results.

Mean CEAP scores significantly increased incrementally with BMI (from 1.4 in the normal-weight group to 1.9 in the supermorbidly obese group), as did mean venous clinical severity scores (from 2.6 in the normal-weight group to 4.3 in the supermorbidly obese group).

Dr. Moore also reported that evidence of venous obstruction on duplex examination appeared to increase across the BMI spectrum, but this did not reach statistical significance. The same association was seen for venous reflux as assessed by duplex examination.

Dr. Moore said that she had no relevant financial conflicts to disclose.

SAN DIEGO – The manifestations of chronic venous insufficiency generally increase with higher body mass index, results from a national screening program demonstrated.

However, venous abnormalities on screening duplex ultrasound were not correlated with increasing BMI.

"We did not find an increase in obstruction or venous reflux in higher-BMI individuals, which leads us to believe that obesity in and of itself is a contributor to chronic venous disease in the absence of valvular insufficiency," Dr. Colleen Moore said at the annual meeting of the American Venous Forum.

To determine differences in venous disease across a spectrum of BMI, Dr. Moore and her associates analyzed results from the National Venous Screening program. The program, launched by the American Venous Forum in 2005, was designed to educate participants about venous thromboembolism (VTE) risk, varicose veins, and chronic venous insufficiency through screening, literature, promotional materials, and an interview with a venous expert.

"The program strives to identify those at risk for VTE, the presence of venous obstruction or reflux on a modified duplex ultrasound, and the presence of chronic venous insufficiency based on a quick leg inspection," said Dr. Moore, of the vascular surgery department at Southern Illinois University, Springfield. "It then empowers individuals to go forth and inform their primary care providers and family of their risk of venous disease and the presence of venous disease."

Dr. Moore and her colleagues divided participants into six BMI categories: underweight (less than 18.5 kg/m²), normal weight (18.5-24.9), overweight (25-29.9), obese (30-34.9), morbidly obese (35-39.9), and supermorbidly obese (greater than 40).

The researchers collected several data points for comparison, including demographic and health information, a VTE risk assessment, venous quality of life with the Chronic Venous Insufficiency Questionnaire 2 (CIVIQ2), and an abbreviated duplex ultrasound. Participants in the screening program also underwent a lower-extremity inspection and were assigned a CEAP classification (based on clinical severity, etiology or cause, anatomy, and pathophysiology).

Dr. Moore presented findings from 7,227 people who have been screened since 2005. Of these, 1.3% were underweight, 34.9% were normal weight, 34.8% were overweight, 16.6% were obese, 7.7% were morbidly obese, and 4.7% were supermorbidly obese.

The prevalence of diabetes significantly increased incrementally with BMI (from 4.9% in the normal-weight group to 25.2% in the supermorbidly obese group), as did the prevalence of hypertension (from 22.9% in the normal-weight group to 54.3% in the supermorbidly obese group).

Mean VTE risk-assessment scores significantly increased incrementally with BMI (from 3.3 in the normal-weight group to 4.1 in the supermorbidly obese group), as did mean quality-of-life scores (from 20.3 in the normal-weight group to 29.0 in the supermorbidly obese group). "We looked at social activities such as the ability to play sports or do housework," Dr. Moore said. "As you become heavier those scores increase, indicating a worse quality of life, and are statistically significant, compared with the normal-weight individuals."

Quality-of-life assessments regarding physical function such as the ability to walk briskly or climb stairs yielded similar results.

Mean CEAP scores significantly increased incrementally with BMI (from 1.4 in the normal-weight group to 1.9 in the supermorbidly obese group), as did mean venous clinical severity scores (from 2.6 in the normal-weight group to 4.3 in the supermorbidly obese group).

Dr. Moore also reported that evidence of venous obstruction on duplex examination appeared to increase across the BMI spectrum, but this did not reach statistical significance. The same association was seen for venous reflux as assessed by duplex examination.

Dr. Moore said that she had no relevant financial conflicts to disclose.

SAN DIEGO – The manifestations of chronic venous insufficiency generally increase with higher body mass index, results from a national screening program demonstrated.

However, venous abnormalities on screening duplex ultrasound were not correlated with increasing BMI.

"We did not find an increase in obstruction or venous reflux in higher-BMI individuals, which leads us to believe that obesity in and of itself is a contributor to chronic venous disease in the absence of valvular insufficiency," Dr. Colleen Moore said at the annual meeting of the American Venous Forum.

To determine differences in venous disease across a spectrum of BMI, Dr. Moore and her associates analyzed results from the National Venous Screening program. The program, launched by the American Venous Forum in 2005, was designed to educate participants about venous thromboembolism (VTE) risk, varicose veins, and chronic venous insufficiency through screening, literature, promotional materials, and an interview with a venous expert.

"The program strives to identify those at risk for VTE, the presence of venous obstruction or reflux on a modified duplex ultrasound, and the presence of chronic venous insufficiency based on a quick leg inspection," said Dr. Moore, of the vascular surgery department at Southern Illinois University, Springfield. "It then empowers individuals to go forth and inform their primary care providers and family of their risk of venous disease and the presence of venous disease."

Dr. Moore and her colleagues divided participants into six BMI categories: underweight (less than 18.5 kg/m²), normal weight (18.5-24.9), overweight (25-29.9), obese (30-34.9), morbidly obese (35-39.9), and supermorbidly obese (greater than 40).

The researchers collected several data points for comparison, including demographic and health information, a VTE risk assessment, venous quality of life with the Chronic Venous Insufficiency Questionnaire 2 (CIVIQ2), and an abbreviated duplex ultrasound. Participants in the screening program also underwent a lower-extremity inspection and were assigned a CEAP classification (based on clinical severity, etiology or cause, anatomy, and pathophysiology).

Dr. Moore presented findings from 7,227 people who have been screened since 2005. Of these, 1.3% were underweight, 34.9% were normal weight, 34.8% were overweight, 16.6% were obese, 7.7% were morbidly obese, and 4.7% were supermorbidly obese.

The prevalence of diabetes significantly increased incrementally with BMI (from 4.9% in the normal-weight group to 25.2% in the supermorbidly obese group), as did the prevalence of hypertension (from 22.9% in the normal-weight group to 54.3% in the supermorbidly obese group).

Mean VTE risk-assessment scores significantly increased incrementally with BMI (from 3.3 in the normal-weight group to 4.1 in the supermorbidly obese group), as did mean quality-of-life scores (from 20.3 in the normal-weight group to 29.0 in the supermorbidly obese group). "We looked at social activities such as the ability to play sports or do housework," Dr. Moore said. "As you become heavier those scores increase, indicating a worse quality of life, and are statistically significant, compared with the normal-weight individuals."

Quality-of-life assessments regarding physical function such as the ability to walk briskly or climb stairs yielded similar results.

Mean CEAP scores significantly increased incrementally with BMI (from 1.4 in the normal-weight group to 1.9 in the supermorbidly obese group), as did mean venous clinical severity scores (from 2.6 in the normal-weight group to 4.3 in the supermorbidly obese group).

Dr. Moore also reported that evidence of venous obstruction on duplex examination appeared to increase across the BMI spectrum, but this did not reach statistical significance. The same association was seen for venous reflux as assessed by duplex examination.

Dr. Moore said that she had no relevant financial conflicts to disclose.

SAN DIEGO – Great saphenous vein diameter is a poor surrogate marker for assessing the impact of superficial venous incompetence on a patient’s quality of life, results from a study of 91 patients showed.

The finding runs counter to the current practice of some health insurance carriers that use great saphenous vein (GSV) diameter to determine coverage for treatment of axial venous insufficiency.

"It is inappropriate to use GSV diameter as a sole criterion for determining medical necessity for the treatment of GSV reflux," Dr. Kathleen Gibson said at the annual meeting of the American Venous Forum. "Further investigation should be undertaken to look for more appropriate surrogate markers to guide treatment decisions."

Dr. Gibson and her associates collected data from the charts of 91 patients who were prospectively enrolled in two varicose vein trials that examined changes in quality-of-life measures with different varicose vein treatments. It was the first study of its kind, said Dr. Gibson, a vascular surgeon at Lake Washington Vascular in Bellevue, Wash.

The current analysis looked for correlations between GSV diameter and quality-of-life measures prior to any vein treatment.

GSV diameter was measured on duplex ultrasound within 5 cm of the saphenofemoral junction, while the patient was standing. Clinicians also determined Venous Clinical Severity Score (VCSS), and patients completed the Chronic Venous Insufficiency Questionnaire 2 (CIVIQ-2), the Venous Insufficiency Epidemiological and Economic Study-Quality of Life (VEINES-QOL) questionnaire, and the VEINES Symptoms (VEINES-SYM) questionnaire prior to treatment.

Values for VCSS range from 0 to 30, with 30 being the most severe. Scores on the CIVIQ-2 range from 0 to 100, with 100 being the most severe. Higher scores on both the 25-item VEINES-QOL and the 10-item VEINES-SYM indicate better outcomes.

The mean age of patients was 45 years, 72 were women, and the mean GSV diameter was 6.77 mm.

Dr. Gibson reported that the mean VCSS value was 6.4 (range 2-12). The mean CIVIQ-2 score was 42.5 (range 20-85), the mean VEINES-QOL score was 82.7 (range 35-188), and the VEINES-SYM scores had a mean value of 40.5 (range 12-60).

Before vein treatment, there was a moderate correlation between VCSS and QOL measures, she said, and a strong correlation between VCSS and patient-derived quality-of-life measures, which were both significant (P less than .01).

Scatter plot analysis and Pearson correlation coefficients revealed a poor correlation between GSV diameter and VCSS, and no correlation between GSV diameter and any of the following: CIVIQ-2, VEINES-SYM, or VEINES-QOL.

"The only statistically significant findings we had for correlation were a weak correlation between height and body mass index and GSV diameter," Dr. Gibson said. "There was no statistical significance with the weak correlation we saw with VCSS and GSV diameter, and no correlation with any of the quality-of-life surveys. For reflux time, there was a trend toward a weak correlation inversely with height and BMI."

Dr. Gibson said that she had no relevant financial disclosures.

SAN DIEGO – Great saphenous vein diameter is a poor surrogate marker for assessing the impact of superficial venous incompetence on a patient’s quality of life, results from a study of 91 patients showed.

The finding runs counter to the current practice of some health insurance carriers that use great saphenous vein (GSV) diameter to determine coverage for treatment of axial venous insufficiency.

"It is inappropriate to use GSV diameter as a sole criterion for determining medical necessity for the treatment of GSV reflux," Dr. Kathleen Gibson said at the annual meeting of the American Venous Forum. "Further investigation should be undertaken to look for more appropriate surrogate markers to guide treatment decisions."

Dr. Gibson and her associates collected data from the charts of 91 patients who were prospectively enrolled in two varicose vein trials that examined changes in quality-of-life measures with different varicose vein treatments. It was the first study of its kind, said Dr. Gibson, a vascular surgeon at Lake Washington Vascular in Bellevue, Wash.

The current analysis looked for correlations between GSV diameter and quality-of-life measures prior to any vein treatment.

GSV diameter was measured on duplex ultrasound within 5 cm of the saphenofemoral junction, while the patient was standing. Clinicians also determined Venous Clinical Severity Score (VCSS), and patients completed the Chronic Venous Insufficiency Questionnaire 2 (CIVIQ-2), the Venous Insufficiency Epidemiological and Economic Study-Quality of Life (VEINES-QOL) questionnaire, and the VEINES Symptoms (VEINES-SYM) questionnaire prior to treatment.

Values for VCSS range from 0 to 30, with 30 being the most severe. Scores on the CIVIQ-2 range from 0 to 100, with 100 being the most severe. Higher scores on both the 25-item VEINES-QOL and the 10-item VEINES-SYM indicate better outcomes.

The mean age of patients was 45 years, 72 were women, and the mean GSV diameter was 6.77 mm.

Dr. Gibson reported that the mean VCSS value was 6.4 (range 2-12). The mean CIVIQ-2 score was 42.5 (range 20-85), the mean VEINES-QOL score was 82.7 (range 35-188), and the VEINES-SYM scores had a mean value of 40.5 (range 12-60).

Before vein treatment, there was a moderate correlation between VCSS and QOL measures, she said, and a strong correlation between VCSS and patient-derived quality-of-life measures, which were both significant (P less than .01).

Scatter plot analysis and Pearson correlation coefficients revealed a poor correlation between GSV diameter and VCSS, and no correlation between GSV diameter and any of the following: CIVIQ-2, VEINES-SYM, or VEINES-QOL.

"The only statistically significant findings we had for correlation were a weak correlation between height and body mass index and GSV diameter," Dr. Gibson said. "There was no statistical significance with the weak correlation we saw with VCSS and GSV diameter, and no correlation with any of the quality-of-life surveys. For reflux time, there was a trend toward a weak correlation inversely with height and BMI."

Dr. Gibson said that she had no relevant financial disclosures.

SAN DIEGO – Great saphenous vein diameter is a poor surrogate marker for assessing the impact of superficial venous incompetence on a patient’s quality of life, results from a study of 91 patients showed.

The finding runs counter to the current practice of some health insurance carriers that use great saphenous vein (GSV) diameter to determine coverage for treatment of axial venous insufficiency.

"It is inappropriate to use GSV diameter as a sole criterion for determining medical necessity for the treatment of GSV reflux," Dr. Kathleen Gibson said at the annual meeting of the American Venous Forum. "Further investigation should be undertaken to look for more appropriate surrogate markers to guide treatment decisions."

Dr. Gibson and her associates collected data from the charts of 91 patients who were prospectively enrolled in two varicose vein trials that examined changes in quality-of-life measures with different varicose vein treatments. It was the first study of its kind, said Dr. Gibson, a vascular surgeon at Lake Washington Vascular in Bellevue, Wash.

The current analysis looked for correlations between GSV diameter and quality-of-life measures prior to any vein treatment.

GSV diameter was measured on duplex ultrasound within 5 cm of the saphenofemoral junction, while the patient was standing. Clinicians also determined Venous Clinical Severity Score (VCSS), and patients completed the Chronic Venous Insufficiency Questionnaire 2 (CIVIQ-2), the Venous Insufficiency Epidemiological and Economic Study-Quality of Life (VEINES-QOL) questionnaire, and the VEINES Symptoms (VEINES-SYM) questionnaire prior to treatment.

Values for VCSS range from 0 to 30, with 30 being the most severe. Scores on the CIVIQ-2 range from 0 to 100, with 100 being the most severe. Higher scores on both the 25-item VEINES-QOL and the 10-item VEINES-SYM indicate better outcomes.

The mean age of patients was 45 years, 72 were women, and the mean GSV diameter was 6.77 mm.

Dr. Gibson reported that the mean VCSS value was 6.4 (range 2-12). The mean CIVIQ-2 score was 42.5 (range 20-85), the mean VEINES-QOL score was 82.7 (range 35-188), and the VEINES-SYM scores had a mean value of 40.5 (range 12-60).

Before vein treatment, there was a moderate correlation between VCSS and QOL measures, she said, and a strong correlation between VCSS and patient-derived quality-of-life measures, which were both significant (P less than .01).

Scatter plot analysis and Pearson correlation coefficients revealed a poor correlation between GSV diameter and VCSS, and no correlation between GSV diameter and any of the following: CIVIQ-2, VEINES-SYM, or VEINES-QOL.

"The only statistically significant findings we had for correlation were a weak correlation between height and body mass index and GSV diameter," Dr. Gibson said. "There was no statistical significance with the weak correlation we saw with VCSS and GSV diameter, and no correlation with any of the quality-of-life surveys. For reflux time, there was a trend toward a weak correlation inversely with height and BMI."

Dr. Gibson said that she had no relevant financial disclosures.

SAN DIEGO – Great saphenous vein diameter is a poor surrogate marker for assessing the impact of superficial venous incompetence on a patient’s quality of life, results from a study of 91 patients showed.

The finding runs counter to the current practice of some health insurance carriers that use great saphenous vein (GSV) diameter to determine coverage for treatment of axial venous insufficiency.

"It is inappropriate to use GSV diameter as a sole criterion for determining medical necessity for the treatment of GSV reflux," Dr. Kathleen Gibson said at the annual meeting of the American Venous Forum. "Further investigation should be undertaken to look for more appropriate surrogate markers to guide treatment decisions."

Dr. Gibson and her associates collected data from the charts of 91 patients who were prospectively enrolled in two varicose vein trials that examined changes in quality-of-life measures with different varicose vein treatments. It was the first study of its kind, said Dr. Gibson, a vascular surgeon at Lake Washington Vascular in Bellevue, Wash.

The current analysis looked for correlations between GSV diameter and quality-of-life measures prior to any vein treatment.

GSV diameter was measured on duplex ultrasound within 5 cm of the saphenofemoral junction, while the patient was standing. Clinicians also determined Venous Clinical Severity Score (VCSS), and patients completed the Chronic Venous Insufficiency Questionnaire 2 (CIVIQ-2), the Venous Insufficiency Epidemiological and Economic Study-Quality of Life (VEINES-QOL) questionnaire, and the VEINES Symptoms (VEINES-SYM) questionnaire prior to treatment.

Values for VCSS range from 0 to 30, with 30 being the most severe. Scores on the CIVIQ-2 range from 0 to 100, with 100 being the most severe. Higher scores on both the 25-item VEINES-QOL and the 10-item VEINES-SYM indicate better outcomes.

The mean age of patients was 45 years, 72 were women, and the mean GSV diameter was 6.77 mm.

Dr. Gibson reported that the mean VCSS value was 6.4 (range 2-12). The mean CIVIQ-2 score was 42.5 (range 20-85), the mean VEINES-QOL score was 82.7 (range 35-188), and the VEINES-SYM scores had a mean value of 40.5 (range 12-60).

Before vein treatment, there was a moderate correlation between VCSS and QOL measures, she said, and a strong correlation between VCSS and patient-derived quality-of-life measures, which were both significant (P less than .01).

Scatter plot analysis and Pearson correlation coefficients revealed a poor correlation between GSV diameter and VCSS, and no correlation between GSV diameter and any of the following: CIVIQ-2, VEINES-SYM, or VEINES-QOL.

"The only statistically significant findings we had for correlation were a weak correlation between height and body mass index and GSV diameter," Dr. Gibson said. "There was no statistical significance with the weak correlation we saw with VCSS and GSV diameter, and no correlation with any of the quality-of-life surveys. For reflux time, there was a trend toward a weak correlation inversely with height and BMI."

Dr. Gibson said that she had no relevant financial disclosures.

SAN DIEGO – Great saphenous vein diameter is a poor surrogate marker for assessing the impact of superficial venous incompetence on a patient’s quality of life, results from a study of 91 patients showed.

The finding runs counter to the current practice of some health insurance carriers that use great saphenous vein (GSV) diameter to determine coverage for treatment of axial venous insufficiency.

"It is inappropriate to use GSV diameter as a sole criterion for determining medical necessity for the treatment of GSV reflux," Dr. Kathleen Gibson said at the annual meeting of the American Venous Forum. "Further investigation should be undertaken to look for more appropriate surrogate markers to guide treatment decisions."

Dr. Gibson and her associates collected data from the charts of 91 patients who were prospectively enrolled in two varicose vein trials that examined changes in quality-of-life measures with different varicose vein treatments. It was the first study of its kind, said Dr. Gibson, a vascular surgeon at Lake Washington Vascular in Bellevue, Wash.

The current analysis looked for correlations between GSV diameter and quality-of-life measures prior to any vein treatment.

GSV diameter was measured on duplex ultrasound within 5 cm of the saphenofemoral junction, while the patient was standing. Clinicians also determined Venous Clinical Severity Score (VCSS), and patients completed the Chronic Venous Insufficiency Questionnaire 2 (CIVIQ-2), the Venous Insufficiency Epidemiological and Economic Study-Quality of Life (VEINES-QOL) questionnaire, and the VEINES Symptoms (VEINES-SYM) questionnaire prior to treatment.

Values for VCSS range from 0 to 30, with 30 being the most severe. Scores on the CIVIQ-2 range from 0 to 100, with 100 being the most severe. Higher scores on both the 25-item VEINES-QOL and the 10-item VEINES-SYM indicate better outcomes.

The mean age of patients was 45 years, 72 were women, and the mean GSV diameter was 6.77 mm.

Dr. Gibson reported that the mean VCSS value was 6.4 (range 2-12). The mean CIVIQ-2 score was 42.5 (range 20-85), the mean VEINES-QOL score was 82.7 (range 35-188), and the VEINES-SYM scores had a mean value of 40.5 (range 12-60).

Before vein treatment, there was a moderate correlation between VCSS and QOL measures, she said, and a strong correlation between VCSS and patient-derived quality-of-life measures, which were both significant (P less than .01).

Scatter plot analysis and Pearson correlation coefficients revealed a poor correlation between GSV diameter and VCSS, and no correlation between GSV diameter and any of the following: CIVIQ-2, VEINES-SYM, or VEINES-QOL.

"The only statistically significant findings we had for correlation were a weak correlation between height and body mass index and GSV diameter," Dr. Gibson said. "There was no statistical significance with the weak correlation we saw with VCSS and GSV diameter, and no correlation with any of the quality-of-life surveys. For reflux time, there was a trend toward a weak correlation inversely with height and BMI."

Dr. Gibson said that she had no relevant financial disclosures.

SAN DIEGO – Great saphenous vein diameter is a poor surrogate marker for assessing the impact of superficial venous incompetence on a patient’s quality of life, results from a study of 91 patients showed.

The finding runs counter to the current practice of some health insurance carriers that use great saphenous vein (GSV) diameter to determine coverage for treatment of axial venous insufficiency.

"It is inappropriate to use GSV diameter as a sole criterion for determining medical necessity for the treatment of GSV reflux," Dr. Kathleen Gibson said at the annual meeting of the American Venous Forum. "Further investigation should be undertaken to look for more appropriate surrogate markers to guide treatment decisions."

Dr. Gibson and her associates collected data from the charts of 91 patients who were prospectively enrolled in two varicose vein trials that examined changes in quality-of-life measures with different varicose vein treatments. It was the first study of its kind, said Dr. Gibson, a vascular surgeon at Lake Washington Vascular in Bellevue, Wash.

The current analysis looked for correlations between GSV diameter and quality-of-life measures prior to any vein treatment.

GSV diameter was measured on duplex ultrasound within 5 cm of the saphenofemoral junction, while the patient was standing. Clinicians also determined Venous Clinical Severity Score (VCSS), and patients completed the Chronic Venous Insufficiency Questionnaire 2 (CIVIQ-2), the Venous Insufficiency Epidemiological and Economic Study-Quality of Life (VEINES-QOL) questionnaire, and the VEINES Symptoms (VEINES-SYM) questionnaire prior to treatment.

Values for VCSS range from 0 to 30, with 30 being the most severe. Scores on the CIVIQ-2 range from 0 to 100, with 100 being the most severe. Higher scores on both the 25-item VEINES-QOL and the 10-item VEINES-SYM indicate better outcomes.

The mean age of patients was 45 years, 72 were women, and the mean GSV diameter was 6.77 mm.

Dr. Gibson reported that the mean VCSS value was 6.4 (range 2-12). The mean CIVIQ-2 score was 42.5 (range 20-85), the mean VEINES-QOL score was 82.7 (range 35-188), and the VEINES-SYM scores had a mean value of 40.5 (range 12-60).

Before vein treatment, there was a moderate correlation between VCSS and QOL measures, she said, and a strong correlation between VCSS and patient-derived quality-of-life measures, which were both significant (P less than .01).

Scatter plot analysis and Pearson correlation coefficients revealed a poor correlation between GSV diameter and VCSS, and no correlation between GSV diameter and any of the following: CIVIQ-2, VEINES-SYM, or VEINES-QOL.

"The only statistically significant findings we had for correlation were a weak correlation between height and body mass index and GSV diameter," Dr. Gibson said. "There was no statistical significance with the weak correlation we saw with VCSS and GSV diameter, and no correlation with any of the quality-of-life surveys. For reflux time, there was a trend toward a weak correlation inversely with height and BMI."

Dr. Gibson said that she had no relevant financial disclosures.

SAN DIEGO – The annual incidence of new trunk varicose veins was 2.1% in adults during nearly 7 years of follow-up, results from a large study showed.

The findings come from a 6.6-year follow-up of patients in the Bonn Vein Study I, a population-based, cross-sectional study conducted in 2000. The study evaluated the incidence of chronic venous disorders in 1,350 men and 1,722 women aged 18-79 years in Bonn, Germany, and in two nearby rural townships. The Bonn Vein Study II, the current analysis, aimed to identify the incidence and risk factors for progression of preexisting chronic venous disease among those in the Bonn Vein Study I, Dr. Felizitas Pannier said at the annual meeting of the American Venous Forum.

Between August 2007 and October 2008, Dr. Eberhard Rabe, of the dermatology department at the University of Bonn, and his associate, Dr. Pannier, contacted all of the Bonn Vein Study I participants and asked them to answer a questionnaire and to undergo clinical examination including a duplex ultrasound. Of the original 3,072 participants, 1,978 responded.

During a mean follow-up of 6.6 years, the incidence of varicose veins was 2.1% per year, with no differences between men and women. The incidence rate increased with age: 1.1% per year for those younger than age 39, 2.0% per year for those aged 40-59, and 2.8% per year for those older than age 59.

The incidence of grade C6 insufficiency was 2% per year, with no differences between men and women. The incidence rate increased with age: 0.6% per year for those younger than age 39, 1.5% per year for those aged 40-59, and 3.3% per year for those older than age 59.

Dr. Pannier reported that over the 6.6 years of follow-up, the prevalence of varicose veins increased from 22.7% to 25.1%, while the prevalence of chronic venous insufficiency rose from 14.5% to 16.0%. She also noted that among participants who had grade C2 insufficiency (simple varicose veins) in the Bonn Vein I study, 19.8% progressed to higher C-classes (functional abnormalities) in the nonsaphenous varicose veins, while 31.8% progressed to higher C-classes in the saphenous varicose veins.

Multivariate analysis revealed that the significant risk factors for progression of venous disease were age (relative risk of 1.02 per year), obesity (RR 3.47), and a swelling sensation (RR 1.68).

Dr. Pannier said that neither she nor Dr. Rabe had any relevant financial disclosures.

SAN DIEGO – The annual incidence of new trunk varicose veins was 2.1% in adults during nearly 7 years of follow-up, results from a large study showed.

The findings come from a 6.6-year follow-up of patients in the Bonn Vein Study I, a population-based, cross-sectional study conducted in 2000. The study evaluated the incidence of chronic venous disorders in 1,350 men and 1,722 women aged 18-79 years in Bonn, Germany, and in two nearby rural townships. The Bonn Vein Study II, the current analysis, aimed to identify the incidence and risk factors for progression of preexisting chronic venous disease among those in the Bonn Vein Study I, Dr. Felizitas Pannier said at the annual meeting of the American Venous Forum.

Between August 2007 and October 2008, Dr. Eberhard Rabe, of the dermatology department at the University of Bonn, and his associate, Dr. Pannier, contacted all of the Bonn Vein Study I participants and asked them to answer a questionnaire and to undergo clinical examination including a duplex ultrasound. Of the original 3,072 participants, 1,978 responded.

During a mean follow-up of 6.6 years, the incidence of varicose veins was 2.1% per year, with no differences between men and women. The incidence rate increased with age: 1.1% per year for those younger than age 39, 2.0% per year for those aged 40-59, and 2.8% per year for those older than age 59.

The incidence of grade C6 insufficiency was 2% per year, with no differences between men and women. The incidence rate increased with age: 0.6% per year for those younger than age 39, 1.5% per year for those aged 40-59, and 3.3% per year for those older than age 59.

Dr. Pannier reported that over the 6.6 years of follow-up, the prevalence of varicose veins increased from 22.7% to 25.1%, while the prevalence of chronic venous insufficiency rose from 14.5% to 16.0%. She also noted that among participants who had grade C2 insufficiency (simple varicose veins) in the Bonn Vein I study, 19.8% progressed to higher C-classes (functional abnormalities) in the nonsaphenous varicose veins, while 31.8% progressed to higher C-classes in the saphenous varicose veins.

Multivariate analysis revealed that the significant risk factors for progression of venous disease were age (relative risk of 1.02 per year), obesity (RR 3.47), and a swelling sensation (RR 1.68).

Dr. Pannier said that neither she nor Dr. Rabe had any relevant financial disclosures.

SAN DIEGO – The annual incidence of new trunk varicose veins was 2.1% in adults during nearly 7 years of follow-up, results from a large study showed.

The findings come from a 6.6-year follow-up of patients in the Bonn Vein Study I, a population-based, cross-sectional study conducted in 2000. The study evaluated the incidence of chronic venous disorders in 1,350 men and 1,722 women aged 18-79 years in Bonn, Germany, and in two nearby rural townships. The Bonn Vein Study II, the current analysis, aimed to identify the incidence and risk factors for progression of preexisting chronic venous disease among those in the Bonn Vein Study I, Dr. Felizitas Pannier said at the annual meeting of the American Venous Forum.

Between August 2007 and October 2008, Dr. Eberhard Rabe, of the dermatology department at the University of Bonn, and his associate, Dr. Pannier, contacted all of the Bonn Vein Study I participants and asked them to answer a questionnaire and to undergo clinical examination including a duplex ultrasound. Of the original 3,072 participants, 1,978 responded.

During a mean follow-up of 6.6 years, the incidence of varicose veins was 2.1% per year, with no differences between men and women. The incidence rate increased with age: 1.1% per year for those younger than age 39, 2.0% per year for those aged 40-59, and 2.8% per year for those older than age 59.

The incidence of grade C6 insufficiency was 2% per year, with no differences between men and women. The incidence rate increased with age: 0.6% per year for those younger than age 39, 1.5% per year for those aged 40-59, and 3.3% per year for those older than age 59.

Dr. Pannier reported that over the 6.6 years of follow-up, the prevalence of varicose veins increased from 22.7% to 25.1%, while the prevalence of chronic venous insufficiency rose from 14.5% to 16.0%. She also noted that among participants who had grade C2 insufficiency (simple varicose veins) in the Bonn Vein I study, 19.8% progressed to higher C-classes (functional abnormalities) in the nonsaphenous varicose veins, while 31.8% progressed to higher C-classes in the saphenous varicose veins.

Multivariate analysis revealed that the significant risk factors for progression of venous disease were age (relative risk of 1.02 per year), obesity (RR 3.47), and a swelling sensation (RR 1.68).

Dr. Pannier said that neither she nor Dr. Rabe had any relevant financial disclosures.

SAN DIEGO – The annual incidence of new trunk varicose veins was 2.1% in adults during nearly 7 years of follow-up, results from a large study showed.

The findings come from a 6.6-year follow-up of patients in the Bonn Vein Study I, a population-based, cross-sectional study conducted in 2000. The study evaluated the incidence of chronic venous disorders in 1,350 men and 1,722 women aged 18-79 years in Bonn, Germany, and in two nearby rural townships. The Bonn Vein Study II, the current analysis, aimed to identify the incidence and risk factors for progression of preexisting chronic venous disease among those in the Bonn Vein Study I, Dr. Felizitas Pannier said at the annual meeting of the American Venous Forum.

Between August 2007 and October 2008, Dr. Eberhard Rabe, of the dermatology department at the University of Bonn, and his associate, Dr. Pannier, contacted all of the Bonn Vein Study I participants and asked them to answer a questionnaire and to undergo clinical examination including a duplex ultrasound. Of the original 3,072 participants, 1,978 responded.

During a mean follow-up of 6.6 years, the incidence of varicose veins was 2.1% per year, with no differences between men and women. The incidence rate increased with age: 1.1% per year for those younger than age 39, 2.0% per year for those aged 40-59, and 2.8% per year for those older than age 59.

The incidence of grade C6 insufficiency was 2% per year, with no differences between men and women. The incidence rate increased with age: 0.6% per year for those younger than age 39, 1.5% per year for those aged 40-59, and 3.3% per year for those older than age 59.

Dr. Pannier reported that over the 6.6 years of follow-up, the prevalence of varicose veins increased from 22.7% to 25.1%, while the prevalence of chronic venous insufficiency rose from 14.5% to 16.0%. She also noted that among participants who had grade C2 insufficiency (simple varicose veins) in the Bonn Vein I study, 19.8% progressed to higher C-classes (functional abnormalities) in the nonsaphenous varicose veins, while 31.8% progressed to higher C-classes in the saphenous varicose veins.

Multivariate analysis revealed that the significant risk factors for progression of venous disease were age (relative risk of 1.02 per year), obesity (RR 3.47), and a swelling sensation (RR 1.68).

Dr. Pannier said that neither she nor Dr. Rabe had any relevant financial disclosures.

SAN DIEGO – The annual incidence of new trunk varicose veins was 2.1% in adults during nearly 7 years of follow-up, results from a large study showed.

The findings come from a 6.6-year follow-up of patients in the Bonn Vein Study I, a population-based, cross-sectional study conducted in 2000. The study evaluated the incidence of chronic venous disorders in 1,350 men and 1,722 women aged 18-79 years in Bonn, Germany, and in two nearby rural townships. The Bonn Vein Study II, the current analysis, aimed to identify the incidence and risk factors for progression of preexisting chronic venous disease among those in the Bonn Vein Study I, Dr. Felizitas Pannier said at the annual meeting of the American Venous Forum.

Between August 2007 and October 2008, Dr. Eberhard Rabe, of the dermatology department at the University of Bonn, and his associate, Dr. Pannier, contacted all of the Bonn Vein Study I participants and asked them to answer a questionnaire and to undergo clinical examination including a duplex ultrasound. Of the original 3,072 participants, 1,978 responded.

During a mean follow-up of 6.6 years, the incidence of varicose veins was 2.1% per year, with no differences between men and women. The incidence rate increased with age: 1.1% per year for those younger than age 39, 2.0% per year for those aged 40-59, and 2.8% per year for those older than age 59.

The incidence of grade C6 insufficiency was 2% per year, with no differences between men and women. The incidence rate increased with age: 0.6% per year for those younger than age 39, 1.5% per year for those aged 40-59, and 3.3% per year for those older than age 59.

Dr. Pannier reported that over the 6.6 years of follow-up, the prevalence of varicose veins increased from 22.7% to 25.1%, while the prevalence of chronic venous insufficiency rose from 14.5% to 16.0%. She also noted that among participants who had grade C2 insufficiency (simple varicose veins) in the Bonn Vein I study, 19.8% progressed to higher C-classes (functional abnormalities) in the nonsaphenous varicose veins, while 31.8% progressed to higher C-classes in the saphenous varicose veins.

Multivariate analysis revealed that the significant risk factors for progression of venous disease were age (relative risk of 1.02 per year), obesity (RR 3.47), and a swelling sensation (RR 1.68).

Dr. Pannier said that neither she nor Dr. Rabe had any relevant financial disclosures.

SAN DIEGO – The annual incidence of new trunk varicose veins was 2.1% in adults during nearly 7 years of follow-up, results from a large study showed.

The findings come from a 6.6-year follow-up of patients in the Bonn Vein Study I, a population-based, cross-sectional study conducted in 2000. The study evaluated the incidence of chronic venous disorders in 1,350 men and 1,722 women aged 18-79 years in Bonn, Germany, and in two nearby rural townships. The Bonn Vein Study II, the current analysis, aimed to identify the incidence and risk factors for progression of preexisting chronic venous disease among those in the Bonn Vein Study I, Dr. Felizitas Pannier said at the annual meeting of the American Venous Forum.

Between August 2007 and October 2008, Dr. Eberhard Rabe, of the dermatology department at the University of Bonn, and his associate, Dr. Pannier, contacted all of the Bonn Vein Study I participants and asked them to answer a questionnaire and to undergo clinical examination including a duplex ultrasound. Of the original 3,072 participants, 1,978 responded.

During a mean follow-up of 6.6 years, the incidence of varicose veins was 2.1% per year, with no differences between men and women. The incidence rate increased with age: 1.1% per year for those younger than age 39, 2.0% per year for those aged 40-59, and 2.8% per year for those older than age 59.

The incidence of grade C6 insufficiency was 2% per year, with no differences between men and women. The incidence rate increased with age: 0.6% per year for those younger than age 39, 1.5% per year for those aged 40-59, and 3.3% per year for those older than age 59.

Dr. Pannier reported that over the 6.6 years of follow-up, the prevalence of varicose veins increased from 22.7% to 25.1%, while the prevalence of chronic venous insufficiency rose from 14.5% to 16.0%. She also noted that among participants who had grade C2 insufficiency (simple varicose veins) in the Bonn Vein I study, 19.8% progressed to higher C-classes (functional abnormalities) in the nonsaphenous varicose veins, while 31.8% progressed to higher C-classes in the saphenous varicose veins.

Multivariate analysis revealed that the significant risk factors for progression of venous disease were age (relative risk of 1.02 per year), obesity (RR 3.47), and a swelling sensation (RR 1.68).

Dr. Pannier said that neither she nor Dr. Rabe had any relevant financial disclosures.

SAN DIEGO – The annual incidence of new trunk varicose veins in adults during 13 years of follow-up is 1.36% results from a large study showed.

There were no differences in the annual incidence rate between men and women, but the risk of developing new trunk varicose veins increased significantly with age. The annual incidence of new trunk varicose veins also rose steadily with increasing BMI, but did not reach significance, perhaps because of the size of the study.

Those are key findings from the Edinburgh Vein Study, one of the first efforts to longitudinally measure the adult incidence of trunk varicose veins and to examine factors which increase the risk of varicose veins.

"There have been several studies conducted throughout the world, which have looked into the prevalence of varicose veins and associated risk factors, but few have examined new disease," Dr. Lindsay A. Robertson said at the annual meeting of the American Venous Forum. "While it is important to know about the prevalence of varicose veins, the design of studies is such that we cannot differentiate between the cause and effect. Therefore, it is important to start with people free of venous disease, [and] look at the risk factors, and then we can determine the true effect of such risk factors on the development of venous disease."

The Edinburgh Vein Study was a population cohort study conducted from 1994 to 1996 in a random sample of 1,566 citizens of Edinburgh, who were between the ages of 18 and 64 years. Dr. Robertson of the University of Edinburgh and her associates invited survivors of that cohort to participate in a 13-year follow-up examination, which included clinical classification of venous disease using CEAP, a duplex scan of leg veins, and measurements of height and weight, as well as a questionnaire for lifestyle risk factors such as mobility at work, smoking, pregnancy, previous treatment for varicose veins, and family history.

From baseline there were 1,446 survivors. Of those, 880 took part in the follow-up study, for a response rate of 60.4%. Of these, 490 were women and 390 were men. Their mean age was 60 years.

Dr. Robertson presented findings from 555 of the 880 participants who had no trunk varicose veins at baseline. Of these 555 participants, 101 developed grade C2 trunk varicose veins in any leg during the 13-year follow-up, for an overall incidence rate of 18.2% and an annual incidence rate of 1.36%. The annual incidence in men and women was similar (1.31% and 1.39%, respectively).

The annual incidence of new trunk varicose veins rose significantly with age, rising 0.73% per year among those aged 18-34 years, 1.23% among those aged 35-44 years, 1.62% among those aged 45-54 years, and 1.93% among those aged 55-64 years.

The annual incidence of new trunk varicose veins also rose steadily with increasing BMI, rising 1.06% per year among those who were underweight, 1.28% among those who were normal weight, 1.41% among those who were overweight, and 1.54% among those who were obese. These differences did not reach statistical significance, "but it’s thought that with higher numbers [of participants], these differences would reach statistical significance," Dr. Robertson said.

An association between the development of new trunk varicose veins and pregnancy was also observed. For example, the annual incidence of new trunk varicose veins was 1.24% among women who had never been pregnant, compared with 2.04% among women who had been pregnant at least four times. This finding was "borderline statistically significant," she said. "But with higher numbers of participants in each group, it’s thought that this would reach statistical significance."

The annual incidence of new varicose veins among participants who reported having a family history of varicose veins (defined as having a mother or father with the condition) was significantly higher compared with those who reported no family history of the condition (1.74% vs. 1.14%, respectively).

There was no significant difference in the annual incidence of new trunk varicose veins among those who reported a history of smoking at baseline compared with those who said that they never smoked (1.32% vs. 1.40%, respectively).

The cumulative incidence of new trunk varicose veins at follow-up was 13% among those who had no reflux at baseline, 23% among those who had deep reflux at baseline, 35% among those who had superficial reflux at baseline, and 42% among those who had deep and superficial reflux at baseline.

The study was funded by Scotland’s Chief Scientist Office. Dr. Robertson said that she had no relevant financial disclosures to make.

SAN DIEGO – The annual incidence of new trunk varicose veins in adults during 13 years of follow-up is 1.36% results from a large study showed.

There were no differences in the annual incidence rate between men and women, but the risk of developing new trunk varicose veins increased significantly with age. The annual incidence of new trunk varicose veins also rose steadily with increasing BMI, but did not reach significance, perhaps because of the size of the study.

Those are key findings from the Edinburgh Vein Study, one of the first efforts to longitudinally measure the adult incidence of trunk varicose veins and to examine factors which increase the risk of varicose veins.

"There have been several studies conducted throughout the world, which have looked into the prevalence of varicose veins and associated risk factors, but few have examined new disease," Dr. Lindsay A. Robertson said at the annual meeting of the American Venous Forum. "While it is important to know about the prevalence of varicose veins, the design of studies is such that we cannot differentiate between the cause and effect. Therefore, it is important to start with people free of venous disease, [and] look at the risk factors, and then we can determine the true effect of such risk factors on the development of venous disease."

The Edinburgh Vein Study was a population cohort study conducted from 1994 to 1996 in a random sample of 1,566 citizens of Edinburgh, who were between the ages of 18 and 64 years. Dr. Robertson of the University of Edinburgh and her associates invited survivors of that cohort to participate in a 13-year follow-up examination, which included clinical classification of venous disease using CEAP, a duplex scan of leg veins, and measurements of height and weight, as well as a questionnaire for lifestyle risk factors such as mobility at work, smoking, pregnancy, previous treatment for varicose veins, and family history.

From baseline there were 1,446 survivors. Of those, 880 took part in the follow-up study, for a response rate of 60.4%. Of these, 490 were women and 390 were men. Their mean age was 60 years.

Dr. Robertson presented findings from 555 of the 880 participants who had no trunk varicose veins at baseline. Of these 555 participants, 101 developed grade C2 trunk varicose veins in any leg during the 13-year follow-up, for an overall incidence rate of 18.2% and an annual incidence rate of 1.36%. The annual incidence in men and women was similar (1.31% and 1.39%, respectively).

The annual incidence of new trunk varicose veins rose significantly with age, rising 0.73% per year among those aged 18-34 years, 1.23% among those aged 35-44 years, 1.62% among those aged 45-54 years, and 1.93% among those aged 55-64 years.

The annual incidence of new trunk varicose veins also rose steadily with increasing BMI, rising 1.06% per year among those who were underweight, 1.28% among those who were normal weight, 1.41% among those who were overweight, and 1.54% among those who were obese. These differences did not reach statistical significance, "but it’s thought that with higher numbers [of participants], these differences would reach statistical significance," Dr. Robertson said.

An association between the development of new trunk varicose veins and pregnancy was also observed. For example, the annual incidence of new trunk varicose veins was 1.24% among women who had never been pregnant, compared with 2.04% among women who had been pregnant at least four times. This finding was "borderline statistically significant," she said. "But with higher numbers of participants in each group, it’s thought that this would reach statistical significance."

The annual incidence of new varicose veins among participants who reported having a family history of varicose veins (defined as having a mother or father with the condition) was significantly higher compared with those who reported no family history of the condition (1.74% vs. 1.14%, respectively).

There was no significant difference in the annual incidence of new trunk varicose veins among those who reported a history of smoking at baseline compared with those who said that they never smoked (1.32% vs. 1.40%, respectively).

The cumulative incidence of new trunk varicose veins at follow-up was 13% among those who had no reflux at baseline, 23% among those who had deep reflux at baseline, 35% among those who had superficial reflux at baseline, and 42% among those who had deep and superficial reflux at baseline.

The study was funded by Scotland’s Chief Scientist Office. Dr. Robertson said that she had no relevant financial disclosures to make.

SAN DIEGO – The annual incidence of new trunk varicose veins in adults during 13 years of follow-up is 1.36% results from a large study showed.

There were no differences in the annual incidence rate between men and women, but the risk of developing new trunk varicose veins increased significantly with age. The annual incidence of new trunk varicose veins also rose steadily with increasing BMI, but did not reach significance, perhaps because of the size of the study.

Those are key findings from the Edinburgh Vein Study, one of the first efforts to longitudinally measure the adult incidence of trunk varicose veins and to examine factors which increase the risk of varicose veins.

"There have been several studies conducted throughout the world, which have looked into the prevalence of varicose veins and associated risk factors, but few have examined new disease," Dr. Lindsay A. Robertson said at the annual meeting of the American Venous Forum. "While it is important to know about the prevalence of varicose veins, the design of studies is such that we cannot differentiate between the cause and effect. Therefore, it is important to start with people free of venous disease, [and] look at the risk factors, and then we can determine the true effect of such risk factors on the development of venous disease."

The Edinburgh Vein Study was a population cohort study conducted from 1994 to 1996 in a random sample of 1,566 citizens of Edinburgh, who were between the ages of 18 and 64 years. Dr. Robertson of the University of Edinburgh and her associates invited survivors of that cohort to participate in a 13-year follow-up examination, which included clinical classification of venous disease using CEAP, a duplex scan of leg veins, and measurements of height and weight, as well as a questionnaire for lifestyle risk factors such as mobility at work, smoking, pregnancy, previous treatment for varicose veins, and family history.

From baseline there were 1,446 survivors. Of those, 880 took part in the follow-up study, for a response rate of 60.4%. Of these, 490 were women and 390 were men. Their mean age was 60 years.

Dr. Robertson presented findings from 555 of the 880 participants who had no trunk varicose veins at baseline. Of these 555 participants, 101 developed grade C2 trunk varicose veins in any leg during the 13-year follow-up, for an overall incidence rate of 18.2% and an annual incidence rate of 1.36%. The annual incidence in men and women was similar (1.31% and 1.39%, respectively).

The annual incidence of new trunk varicose veins rose significantly with age, rising 0.73% per year among those aged 18-34 years, 1.23% among those aged 35-44 years, 1.62% among those aged 45-54 years, and 1.93% among those aged 55-64 years.

The annual incidence of new trunk varicose veins also rose steadily with increasing BMI, rising 1.06% per year among those who were underweight, 1.28% among those who were normal weight, 1.41% among those who were overweight, and 1.54% among those who were obese. These differences did not reach statistical significance, "but it’s thought that with higher numbers [of participants], these differences would reach statistical significance," Dr. Robertson said.

An association between the development of new trunk varicose veins and pregnancy was also observed. For example, the annual incidence of new trunk varicose veins was 1.24% among women who had never been pregnant, compared with 2.04% among women who had been pregnant at least four times. This finding was "borderline statistically significant," she said. "But with higher numbers of participants in each group, it’s thought that this would reach statistical significance."

The annual incidence of new varicose veins among participants who reported having a family history of varicose veins (defined as having a mother or father with the condition) was significantly higher compared with those who reported no family history of the condition (1.74% vs. 1.14%, respectively).

There was no significant difference in the annual incidence of new trunk varicose veins among those who reported a history of smoking at baseline compared with those who said that they never smoked (1.32% vs. 1.40%, respectively).

The cumulative incidence of new trunk varicose veins at follow-up was 13% among those who had no reflux at baseline, 23% among those who had deep reflux at baseline, 35% among those who had superficial reflux at baseline, and 42% among those who had deep and superficial reflux at baseline.

The study was funded by Scotland’s Chief Scientist Office. Dr. Robertson said that she had no relevant financial disclosures to make.

SAN DIEGO – The annual incidence of new trunk varicose veins in adults during 13 years of follow-up is 1.36% results from a large study showed.

There were no differences in the annual incidence rate between men and women, but the risk of developing new trunk varicose veins increased significantly with age. The annual incidence of new trunk varicose veins also rose steadily with increasing BMI, but did not reach significance, perhaps because of the size of the study.

Those are key findings from the Edinburgh Vein Study, one of the first efforts to longitudinally measure the adult incidence of trunk varicose veins and to examine factors which increase the risk of varicose veins.

"There have been several studies conducted throughout the world, which have looked into the prevalence of varicose veins and associated risk factors, but few have examined new disease," Dr. Lindsay A. Robertson said at the annual meeting of the American Venous Forum. "While it is important to know about the prevalence of varicose veins, the design of studies is such that we cannot differentiate between the cause and effect. Therefore, it is important to start with people free of venous disease, [and] look at the risk factors, and then we can determine the true effect of such risk factors on the development of venous disease."

The Edinburgh Vein Study was a population cohort study conducted from 1994 to 1996 in a random sample of 1,566 citizens of Edinburgh, who were between the ages of 18 and 64 years. Dr. Robertson of the University of Edinburgh and her associates invited survivors of that cohort to participate in a 13-year follow-up examination, which included clinical classification of venous disease using CEAP, a duplex scan of leg veins, and measurements of height and weight, as well as a questionnaire for lifestyle risk factors such as mobility at work, smoking, pregnancy, previous treatment for varicose veins, and family history.

From baseline there were 1,446 survivors. Of those, 880 took part in the follow-up study, for a response rate of 60.4%. Of these, 490 were women and 390 were men. Their mean age was 60 years.

Dr. Robertson presented findings from 555 of the 880 participants who had no trunk varicose veins at baseline. Of these 555 participants, 101 developed grade C2 trunk varicose veins in any leg during the 13-year follow-up, for an overall incidence rate of 18.2% and an annual incidence rate of 1.36%. The annual incidence in men and women was similar (1.31% and 1.39%, respectively).

The annual incidence of new trunk varicose veins rose significantly with age, rising 0.73% per year among those aged 18-34 years, 1.23% among those aged 35-44 years, 1.62% among those aged 45-54 years, and 1.93% among those aged 55-64 years.

The annual incidence of new trunk varicose veins also rose steadily with increasing BMI, rising 1.06% per year among those who were underweight, 1.28% among those who were normal weight, 1.41% among those who were overweight, and 1.54% among those who were obese. These differences did not reach statistical significance, "but it’s thought that with higher numbers [of participants], these differences would reach statistical significance," Dr. Robertson said.

An association between the development of new trunk varicose veins and pregnancy was also observed. For example, the annual incidence of new trunk varicose veins was 1.24% among women who had never been pregnant, compared with 2.04% among women who had been pregnant at least four times. This finding was "borderline statistically significant," she said. "But with higher numbers of participants in each group, it’s thought that this would reach statistical significance."

The annual incidence of new varicose veins among participants who reported having a family history of varicose veins (defined as having a mother or father with the condition) was significantly higher compared with those who reported no family history of the condition (1.74% vs. 1.14%, respectively).

There was no significant difference in the annual incidence of new trunk varicose veins among those who reported a history of smoking at baseline compared with those who said that they never smoked (1.32% vs. 1.40%, respectively).

The cumulative incidence of new trunk varicose veins at follow-up was 13% among those who had no reflux at baseline, 23% among those who had deep reflux at baseline, 35% among those who had superficial reflux at baseline, and 42% among those who had deep and superficial reflux at baseline.

The study was funded by Scotland’s Chief Scientist Office. Dr. Robertson said that she had no relevant financial disclosures to make.

SAN DIEGO – The annual incidence of new trunk varicose veins in adults during 13 years of follow-up is 1.36% results from a large study showed.

There were no differences in the annual incidence rate between men and women, but the risk of developing new trunk varicose veins increased significantly with age. The annual incidence of new trunk varicose veins also rose steadily with increasing BMI, but did not reach significance, perhaps because of the size of the study.

Those are key findings from the Edinburgh Vein Study, one of the first efforts to longitudinally measure the adult incidence of trunk varicose veins and to examine factors which increase the risk of varicose veins.

"There have been several studies conducted throughout the world, which have looked into the prevalence of varicose veins and associated risk factors, but few have examined new disease," Dr. Lindsay A. Robertson said at the annual meeting of the American Venous Forum. "While it is important to know about the prevalence of varicose veins, the design of studies is such that we cannot differentiate between the cause and effect. Therefore, it is important to start with people free of venous disease, [and] look at the risk factors, and then we can determine the true effect of such risk factors on the development of venous disease."

The Edinburgh Vein Study was a population cohort study conducted from 1994 to 1996 in a random sample of 1,566 citizens of Edinburgh, who were between the ages of 18 and 64 years. Dr. Robertson of the University of Edinburgh and her associates invited survivors of that cohort to participate in a 13-year follow-up examination, which included clinical classification of venous disease using CEAP, a duplex scan of leg veins, and measurements of height and weight, as well as a questionnaire for lifestyle risk factors such as mobility at work, smoking, pregnancy, previous treatment for varicose veins, and family history.

From baseline there were 1,446 survivors. Of those, 880 took part in the follow-up study, for a response rate of 60.4%. Of these, 490 were women and 390 were men. Their mean age was 60 years.

Dr. Robertson presented findings from 555 of the 880 participants who had no trunk varicose veins at baseline. Of these 555 participants, 101 developed grade C2 trunk varicose veins in any leg during the 13-year follow-up, for an overall incidence rate of 18.2% and an annual incidence rate of 1.36%. The annual incidence in men and women was similar (1.31% and 1.39%, respectively).

The annual incidence of new trunk varicose veins rose significantly with age, rising 0.73% per year among those aged 18-34 years, 1.23% among those aged 35-44 years, 1.62% among those aged 45-54 years, and 1.93% among those aged 55-64 years.

The annual incidence of new trunk varicose veins also rose steadily with increasing BMI, rising 1.06% per year among those who were underweight, 1.28% among those who were normal weight, 1.41% among those who were overweight, and 1.54% among those who were obese. These differences did not reach statistical significance, "but it’s thought that with higher numbers [of participants], these differences would reach statistical significance," Dr. Robertson said.

An association between the development of new trunk varicose veins and pregnancy was also observed. For example, the annual incidence of new trunk varicose veins was 1.24% among women who had never been pregnant, compared with 2.04% among women who had been pregnant at least four times. This finding was "borderline statistically significant," she said. "But with higher numbers of participants in each group, it’s thought that this would reach statistical significance."

The annual incidence of new varicose veins among participants who reported having a family history of varicose veins (defined as having a mother or father with the condition) was significantly higher compared with those who reported no family history of the condition (1.74% vs. 1.14%, respectively).

There was no significant difference in the annual incidence of new trunk varicose veins among those who reported a history of smoking at baseline compared with those who said that they never smoked (1.32% vs. 1.40%, respectively).

The cumulative incidence of new trunk varicose veins at follow-up was 13% among those who had no reflux at baseline, 23% among those who had deep reflux at baseline, 35% among those who had superficial reflux at baseline, and 42% among those who had deep and superficial reflux at baseline.

The study was funded by Scotland’s Chief Scientist Office. Dr. Robertson said that she had no relevant financial disclosures to make.

SAN DIEGO – The annual incidence of new trunk varicose veins in adults during 13 years of follow-up is 1.36% results from a large study showed.

There were no differences in the annual incidence rate between men and women, but the risk of developing new trunk varicose veins increased significantly with age. The annual incidence of new trunk varicose veins also rose steadily with increasing BMI, but did not reach significance, perhaps because of the size of the study.

Those are key findings from the Edinburgh Vein Study, one of the first efforts to longitudinally measure the adult incidence of trunk varicose veins and to examine factors which increase the risk of varicose veins.

"There have been several studies conducted throughout the world, which have looked into the prevalence of varicose veins and associated risk factors, but few have examined new disease," Dr. Lindsay A. Robertson said at the annual meeting of the American Venous Forum. "While it is important to know about the prevalence of varicose veins, the design of studies is such that we cannot differentiate between the cause and effect. Therefore, it is important to start with people free of venous disease, [and] look at the risk factors, and then we can determine the true effect of such risk factors on the development of venous disease."

The Edinburgh Vein Study was a population cohort study conducted from 1994 to 1996 in a random sample of 1,566 citizens of Edinburgh, who were between the ages of 18 and 64 years. Dr. Robertson of the University of Edinburgh and her associates invited survivors of that cohort to participate in a 13-year follow-up examination, which included clinical classification of venous disease using CEAP, a duplex scan of leg veins, and measurements of height and weight, as well as a questionnaire for lifestyle risk factors such as mobility at work, smoking, pregnancy, previous treatment for varicose veins, and family history.

From baseline there were 1,446 survivors. Of those, 880 took part in the follow-up study, for a response rate of 60.4%. Of these, 490 were women and 390 were men. Their mean age was 60 years.

Dr. Robertson presented findings from 555 of the 880 participants who had no trunk varicose veins at baseline. Of these 555 participants, 101 developed grade C2 trunk varicose veins in any leg during the 13-year follow-up, for an overall incidence rate of 18.2% and an annual incidence rate of 1.36%. The annual incidence in men and women was similar (1.31% and 1.39%, respectively).

The annual incidence of new trunk varicose veins rose significantly with age, rising 0.73% per year among those aged 18-34 years, 1.23% among those aged 35-44 years, 1.62% among those aged 45-54 years, and 1.93% among those aged 55-64 years.

The annual incidence of new trunk varicose veins also rose steadily with increasing BMI, rising 1.06% per year among those who were underweight, 1.28% among those who were normal weight, 1.41% among those who were overweight, and 1.54% among those who were obese. These differences did not reach statistical significance, "but it’s thought that with higher numbers [of participants], these differences would reach statistical significance," Dr. Robertson said.

An association between the development of new trunk varicose veins and pregnancy was also observed. For example, the annual incidence of new trunk varicose veins was 1.24% among women who had never been pregnant, compared with 2.04% among women who had been pregnant at least four times. This finding was "borderline statistically significant," she said. "But with higher numbers of participants in each group, it’s thought that this would reach statistical significance."

The annual incidence of new varicose veins among participants who reported having a family history of varicose veins (defined as having a mother or father with the condition) was significantly higher compared with those who reported no family history of the condition (1.74% vs. 1.14%, respectively).

There was no significant difference in the annual incidence of new trunk varicose veins among those who reported a history of smoking at baseline compared with those who said that they never smoked (1.32% vs. 1.40%, respectively).

The cumulative incidence of new trunk varicose veins at follow-up was 13% among those who had no reflux at baseline, 23% among those who had deep reflux at baseline, 35% among those who had superficial reflux at baseline, and 42% among those who had deep and superficial reflux at baseline.

The study was funded by Scotland’s Chief Scientist Office. Dr. Robertson said that she had no relevant financial disclosures to make.