Clinical analysis of the corona phlebectatica

• Published in: Journal of vascular surgery 2012, Vol.55 (1), p.150-153
• Main Authors: Uhl, Jean-François, MD, Cornu-Thenard, André, MD, Satger, Bernadette, MD, Carpentier, Patrick H., MD
• Format: Article
• Language: English
• Subjects: Aged; Ankle; Biological and medical sciences; Capillaries - pathology; Chronic Disease; Dilatation, Pathologic; Female; France; Hematologic and hematopoietic diseases; Humans; Male; Medical sciences; Middle Aged; Physical Examination; Platelet diseases and coagulopathies; Predictive Value of Tests; Sensitivity and Specificity; Severity of Illness Index; Skin - blood supply; Surgery; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases; Surveys and Questionnaires; Telangiectasis - diagnosis; Vascular surgery: aorta, extremities, vena cava. Surgery of the lymphatic vessels; Venules - pathology
• ISSN: 0741-5214; 1097-6809
• DOI: 10.1016/j.jvs.2011.04.070

Background The corona phlebectatica (CP) is classically described as the presence of abnormally visible cutaneous blood vessels at the ankle with four components: “venous cups,” blue and red telangiectases, and capillary “stasis spots.” Previous studies showed that the presence of CP is strongly related to the clinical severity of chronic venous disorders (CVD) and the presence of incompetent leg perforators. The aim of this study was to select the most informative components of the CP in the assessment of the clinical severity of CVD patients. Methods A multicentric series of 262 unselected patients (524 limbs) consulted for CVD were clinically evaluated using a standardized form to record the CEAP “C” items and the presence of the four CP components. Standard categorical and ordinal statistics were used to describe the external validity of the CP components as severity indexes, taking the “C” classes as reference. Results “Stasis spots” ( P < .001; r = .44) and blue telangiectases ( P < .01; r = .32) were linearly associated with the ascending order of “C” classes, whereas the relationship is less clear for the red telangiectases and the “venous cups.” The association pattern of the four components showed that only the blue telangiectases and the “stasis spots” were consistent with each other. Blue telangiectases were found more sensitive (0.91 vs 0.75) but less specific (0.52 vs 0.80) than “stasis spots” for advanced venous insufficiency (CEAP “C4-6”). Conclusion This study shows that only blue telangiectases and “stasis spots” provide valuable information in patients with CVD and deserve to be taken into account in the evaluation of such patients. Further studies are needed to show the reproducibility of this data, which we regard as essential for clinical use.