Risk factors and severity of chronic venous disorder at Phra Nakhon Si Ayutthaya Hospital


  • Patompong Akkarapattanakool Department of Surgery, Phra Nakhon Si Ayutthaya Hospital


chronic venous disorder, varicose vein, highligation and venous stripping, endovenous thermal ablation, ultrasound-guided foam sclerotherapy


Chronic venous disorder is a common health problem. This study aims to evaluate the association of the risk factors and severity of chronic venous disorder and factors related to surgery in the patients at Ayutthaya Hospital. This descriptive observational study was conducted at Phra Nakhon Si Ayutthaya Hospital from July 2015 to September 2020 among 120 outpatients aged 18-80 years old with chronic venous disorder. All patients were diagnosed and classified using CEAP score. Duplex ultrasound was performed to identify affected location of the venous reflux in all patients. Data analysis was performed using t-test, one-way ANOVA and fisher’s exact test in SPSS. The diagnosed patients were majority females (60.8%) aged over 50 years old (68.3%) with prolonged occupational standing (99.2%), however there was no correlation between the prolonged standing and the severity of chronic venous disease (p=0.168). Majority of the patients have had 2 risk factors and the identified venous reflux location were saphenofemoral junction (60.8%) and great saphenous vein (61.7%). The associated risk factors to the surgery were male gender (p=0.018) and present of multiple clinical symptoms (p=0.002) and multiple locations of venous reflux (p<0.001). Chronic venous disorder is a common disease in Phra Nakhon Si Ayutthaya Hospital and the risk factors are identified however there is no correlation between the risk factors to the severity of the disease. Male gender, present of multiple clinical symptoms and multiple locations of venous reflux are associated with the surgical treatment. Accurated severity identification and location of venous reflux are related to proper of each patient treatment options.


Download data is not yet available.


Gloviczki P, Comerota AJ, Dalsing MC, Eklof BG, Gillespie DL, Gloviczki ML, et al. The care of patients with varicoes veins and associated chronic venous diseases: clinical practice guidelines of the Society for Vascular Surgery and the American Venous Forum. J Vasc Surg 2011;53(5Suppl):2S-48S.

Kanchanabat B, Ruangsetakit C, Stapanavatr W. Clinical characteristics of Thai chronic venous insufficiency (CVI) Patients. J Med Assoc Thai 2017;100:17-23.

Sermsathanasawadi N, Pruekprasert K, Pitaksantayothin W, Chinsakchai K, Wongwanit C, Ruangsetakit C, et al. Prevalence, risk factors, and evaluation of iliocaval obstruction in advance chronic venous insufficiency. J VasSurg Venous Lymphat Disord 2019;7:441-7.

Graham ID, Harrison MB, Nelson EA, Lorimer K, Fisher A. Prevalence of lower limb ulceration: a systematic review of prevalence studies. Adv Skin wound care 2003;16:305-16.

Beebe-Dimmer JL, Pfeifer JR. The epidermiology of chronic venous insufficiency and varicose veins. Ann Epidermiol 2005;15:175-84.

Wittens C, Davies AH, Baekgaard N, Broholm R, Cavezzi A, Chastanet S, et al. Editor’s choice-management of chronic venous disease: clinical practice guidelines of the European Society of Vascular Surgery (ESVS). Eur J VascEndovasc Surg 2015;49:678-737.

Criqui MH, Jamosmos M, Fronek A, Denenberg JO, Langer RD, Bergan J, et al. Chronic venous disease in an ethnically diverse population: the San Diego Population Study. Am J Epidemiol 2003;158:448-56.

Evans CJ, Fowkers FG, Ruckley CV, Lee AJ. Prevalence of varicose veins and chronic venous insufficiency in men and women in the general population: Edinburgh Vein Study. J Epidermiol Community Health 1999;53:149-53.

Callam MJ. Epidermiology of varicose veins. Br J Surg 1994;81:167-73.

Carpentier PH, Maricq HR, Biro C, Poncot-Makinen CO, Franco A. Prevalence, risk factors, and clinical patterns of chronic venous disorders of lower limbs: a population-based study in France. J Vasc Surg 2004;40:650-9.

Lee AJ, Evans CJ, Allan PL, Ruckley CV, Fowkes FG. Lifestyle factors and the risk of varicose veins: Edinburgh Vein Study. J Clin Epidermiol 2003,56:171-9.

Graham ID, Harrison MB, Nelson EA, Lorimer K, Fisher A. Prevalence of lower-limb ulceration: a systematic review of prevalence studies. Adv Skin Wound Care 2003;16:305-16.

Zoller B, Ji J, Sundquist J, Sundquist K. Family history and risk of hospital treatment of varicose veins in Sweden. Br J Surg 2012;99:948-53.

Kroeger K, Ose C, Rudofsky G, Roesener J, Hirche H. Risk factors for varicose veins. Int Angiol 2004;23:29-34.

Tuchsen F, Hannerz H, Burr H, Krause N. Prolonged standing at work and hospitalization due to varicose veins: a 12 year prospective study of the Danish population. Occup Environ Med 2005;62:847-50.

Lurie F, Passman M, Meisner M, Dalsing M, Masuda E, Welch H, et al. The 2020 update of the CEAP classification system and reporting standards. J Vasc Surg Venous Lymphat Disord 2020;8:342-51.

Eklof B, Rutherford RB, Bergan JJ, Carpantier PH, Gloviczki P, Kistner RL, et al. Revision of the CEAP classification for chronic venous disorders: consensus statement. J Vasc Surg 2004;40:1248-52.

Rass K, Frings N, Glowacki G, Hamsch C, Graber S, Vogt T, et al. Comparable effectiveness of endovascular laser ablation and high ligation with stripping of the great saphenous vein: two-year results of a randomized clinical trial (RELACS study). Arch Dermatol 2012;148:49-58.

Bergan J, Pascarella L, Mekenas L. Venous disorders: treatment with sclerosant foam. J Cardiovasc Surg 2006;47:9-18.

Darvall KA, Bate GR, Adam DJ, Silverman SH, Bradbury AW. Duplex ultrasound outcomes following ultrasound-guided foam sclerotherapy of symptomatic primary great saphenous varicoes veins. Eur J Vasc Endovasc Surg 2010;40:534-9.

Shadid N, Ceulen R, Nelemans P, Dirksen C, Veraart J, Schurink GW, et al. Randomized clinical trial of ultrasound-guided foam sclerotherapy versus surgery for the incompetent great saphenous vein. Br J Surg 2012;99:1062-70.

Proebstle TM, Vago B, Alm J, Gockeritz O, Lebard C, Pichot O. Treatment of the incompetent great saphenous vein by endovenous radiofrequency powered segmental thermal ablation: first clinical experience. J Vasc Surg 2008;47:151-6.

O’Donnell TF Jr, Passman MA, Marston WA, Ennis WJ, Dalsing M, Kistner RL, et al. Management of venous leg ulcers: clinical practice guidelines of the Society for Vascular Surgery (SVS) and the American Venous Forum(AVF). J Vasc Surg 2014;60(2suppl):3S-59S.

Lurie F, Kistner RL. Trends in patient reported outcomes of conservative and surgical treatment of primary chronic venous disease contradict current practices. Ann Surg 2011;254:363-7.



How to Cite

Akkarapattanakool ป. Risk factors and severity of chronic venous disorder at Phra Nakhon Si Ayutthaya Hospital. JPMAT [Internet]. 2022 Jan. 26 [cited 2022 Aug. 13];11(3):607-2. Available from: https://he01.tci-thaijo.org/index.php/JPMAT/article/view/249822



Original Article