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Venous Disease Proposed by Ekbom as RLS Cause (1944)

Posted: Tue Nov 03, 2020 3:08 pm
by IThinkImInTorture
The effect of endovenous laser ablation on restless legs syndrome
C A Hayes 1 , J R Kingsley, K R Hamby, J Carlow
Affiliations

PMID: 18467618 DOI: 10.1258/phleb.2007.007051

Abstract

Objectives: Venous disease was proposed as a cause of restless legs syndrome (RLS) by Dr Karl A Ekbom in 1944, but has since remained largely unexplored. This study examines the effect of endovenous laser ablation (ELA) in patients with concurrent RLS and duplex-proven superficial venous insufficiency (SVI).

Methods: Thirty-five patients with moderate to very severe RLS (as defined by the 2003 National Institute of Health (NIH) RLS criteria) and duplex-proven SVI completed an international RLS rating scale questionnaire (IRLS) and underwent standard duplex examination to objectively measure the baseline severity of their conditions. They were separated into non-operative and operative cohorts. The operative cohort underwent ELA of refluxing superficial axial veins using the CoolTouch CTEV 1320 nm laser and ultrasound-guided sclerotherapy of the associated varicose veins with foamed sodium tetradecyl sulphate (STS). All patients then completed a follow-up IRLS questionnaire. Baseline and follow-up IRLS scores were compared.

Results: Operative correction of the SVI decreased the mean IRLS score by 21.4 points from 26.9 to 5.5, corresponding to an average of 80% improvement in symptoms. A total of 89% of patients enjoyed a decrease in their score of > or =15 points. Fifty-three percent of patients had a follow-up score of < or =5, indicating their symptoms had been largely alleviated and 31% had a follow-up score of zero, indicating a complete relief of RLS symptoms.

Conclusions: ELA of refluxing axial veins with the CTEV 1320 nm laser and foamed STS sclerotherapy of associated varicosities alleviates RLS symptoms in patients with SVI and moderate to very severe RLS.

Recommendations: SVI should be ruled-out in all patients with RLS before initiation or continuation of drug therapy.

Re: Venous Disease Proposed by Ekbom as RLS Cause (1944)

Posted: Thu Nov 26, 2020 5:50 am
by badnights
I have came across that one before. What I take from it is this: Lots of people with varicose veins have WED/RLS and many of them can be helped by the surgery; but most people with WED/RLS do not have varicose veins and will not be helped by the surgery.

I looked for other studies back then, but didn't find any. I saved a page from https://veininnovations.com, it's a vein surgery clinic, they claimed experience with using vein surgery to correct WED/RLS and quoted the same study published in Phlebology, but all of that information is now gone from their website. Perhaps they felt they were pushing the limits of defensible advertising.