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Published on: December 9, 2022
Clinical analysis of the corona phlebectatica
Jean-François Uhl1, André Cornu-Thenard, Bernadette Satger
1URDIA research unit-EA4465-University Paris Descartes, Paris, France. jf.uhl@wanadoo.fr
Insights
Blue telangiectases and "stasis spots" are key indicators for assessing chronic venous disorders (CVD) severity. These components of corona phlebectatica (CP) provide valuable clinical information for patients with venous insufficiency.
Area of Science:
- Vascular Medicine
- Dermatology
- Medical Diagnostics
Background:
- Corona phlebectatica (CP) involves visible ankle vessels: "venous cups," red and blue telangiectases, and capillary "stasis spots."
- CP presence correlates with chronic venous disorders (CVD) severity and incompetent leg perforators.
- The study aimed to identify the most informative CP components for assessing CVD clinical severity.
Purpose of the Study:
- To determine which components of corona phlebectatica (CP) are most effective in evaluating the clinical severity of chronic venous disorders (CVD).
- To establish the diagnostic value of individual CP signs in relation to established CVD classifications.
Main Methods:
- A multicenter study involving 262 patients (524 limbs) with CVD.
- Clinical evaluation using a standardized form for CEAP "C" items and the four CP components.
- Statistical analysis to assess the external validity of CP components as severity indexes against CEAP "C" classes.
Main Results:
- "Stasis spots" and blue telangiectases showed a significant linear association with increasing CVD severity (CEAP "C" classes).
- Red telangiectases and "venous cups" had less clear relationships with CVD severity.
- Blue telangiectases were more sensitive but less specific than "stasis spots" for advanced venous insufficiency (CEAP "C4-6").
Conclusions:
- Only blue telangiectases and "stasis spots" are valuable indicators for CVD evaluation.
- These two CP components should be considered in the assessment of patients with chronic venous disorders.
- Further studies are recommended to confirm the reproducibility of these findings for clinical application.
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.
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