xml: <clinical_study>
    <!-- This xml conforms to an XML Schema at:
      https://clinicaltrials.gov/ct2/html/images/info/public.xsd -->
    <required_header>
      <download_date>ClinicalTrials.gov processed this data on September 20, 2023</download_date>
      <link_text>Link to the current ClinicalTrials.gov record.</link_text>
      <url>https://clinicaltrials.gov/ct2/show/NCT05982405</url>
    </required_header>
    <id_info>
      <org_study_id>Long effects of IMT</org_study_id>
      <nct_id>NCT05982405</nct_id>
    </id_info>
    <brief_title>Long-term Effects of Inspiratory Muscle Training in Chronic Venous Insufficiency</brief_title>
    <official_title>Long-term Effects of Inspiratory Muscle Training in Individuals With Chronic Venous Insufficiency</official_title>
    <sponsors>
      <lead_sponsor>
        <agency>Izmir Democracy University</agency>
        <agency_class>Other</agency_class>
      </lead_sponsor>
    </sponsors>
    <source>Izmir Democracy University</source>
    <oversight_info>
      <has_dmc>No</has_dmc>
      <is_fda_regulated_drug>No</is_fda_regulated_drug>
      <is_fda_regulated_device>No</is_fda_regulated_device>
    </oversight_info>
    <brief_summary>
      <textblock>
        The long-term effectiveness of inspiratory muscle training, which is known in the literature&#xD;
        to help venous return by increasing the pump effect of the diaphragm muscle, remains unclear&#xD;
        in individuals with chronic venous insufficiency. For this reason, in this study, it was&#xD;
        aimed to investigate the long-term results of inspiratory muscle training in individuals with&#xD;
        chronic venous insufficiency.&#xD;
      </textblock>
    </brief_summary>
    <detailed_description>
      <textblock>
        Initial treatment of chronic venous insufficiency (CVI) includes conservative methods such as&#xD;
        reducing symptoms and helping to prevent secondary problems and disease progression. If&#xD;
        conservative methods fail, further treatments based on anatomical and physiological&#xD;
        pathophysiological features should be applied. Treatment of CVI ranges from simple&#xD;
        compression stockings to very complicated venous reconstructions. Physiotherapy applications&#xD;
        also have an important place in the treatment of CVI and contain patient education, complex&#xD;
        decongestive physiotherapy, intermittent pneumatic compression, compression garment, venous&#xD;
        exercise programs, biomechanical stimulation therapy, proprioceptive neuromuscular&#xD;
        facilitation, relaxation techniques and hydrotherapy methods.&#xD;
  &#xD;
        Researches investigating the effectiveness of new physiotherapy applications in CVI are very&#xD;
        limited. In one of these publications, the effects of inspiratory muscle training (IMT) and&#xD;
        calf muscle exercise training (CMET) applied in addition to compression therapy (CT) on&#xD;
        quality of life (QoL), venous filling time, disease severity, pain, edema, range of motion,&#xD;
        muscle strength and functionality were investigated newly. IMT and CT were applied in group&#xD;
        1, CMET and CT were applied in group 2, and only CT was applied in group 3. As a result,&#xD;
        groups of 1 and 2 showed more improvement in these outcomes compared to other groups. Acute&#xD;
        effects of inspiratory muscle training in CVI was only shown in this study. The long-term&#xD;
        effectiveness of inspiratory muscle training is still unclear in individuals with CVI.&#xD;
        Therefore, this study aimed to investigate the long-term results of inspiratory muscle&#xD;
        training in individuals with CVI.&#xD;
      </textblock>
    </detailed_description>
    <overall_status>Not yet recruiting</overall_status>
    <start_date type="Anticipated">September 2023</start_date>
    <completion_date type="Anticipated">December 2024</completion_date>
    <primary_completion_date type="Anticipated">June 2024</primary_completion_date>
    <phase>N/A</phase>
    <study_type>Interventional</study_type>
    <has_expanded_access>No</has_expanded_access>
    <study_design_info>
      <allocation>Randomized</allocation>
      <intervention_model>Parallel Assignment</intervention_model>
      <primary_purpose>Supportive Care</primary_purpose>
      <masking>Single (Participant)</masking>
      <masking_description>Single-blind study; the patients will not be informed about training group or control group and they will be evaluated and trained at different places and times.</masking_description>
    </study_design_info>
    <primary_outcome>
      <measure>Maximal inspiratory pressure (MIP)</measure>
      <time_frame>After 6-week training and 3 months after 6-week training ends.</time_frame>
      <description>The MIP which shows respiratory muscle strength will be evaluated using a portable mouth pressure measuring device based on American Thoracic Society and European Respiratory Society criteria.</description>
    </primary_outcome>
    <secondary_outcome>
      <measure>Maximal expiratory pressure (MEP)</measure>
      <time_frame>After 6-week training and 3 months after 6-week training ends.</time_frame>
      <description>The MEP which shows respiratory muscle strength will be evaluated using a portable mouth pressure measuring device based on American Thoracic Society and European Respiratory Society criteria.</description>
    </secondary_outcome>
    <secondary_outcome>
      <measure>Forced vital capacity (FVC)</measure>
      <time_frame>After 6-week training and 3 months after 6-week training ends.</time_frame>
      <description>Pulmonary function (Forced vital capacity (FVC)) will be evaluated with a spirometer.</description>
    </secondary_outcome>
    <secondary_outcome>
      <measure>Forced expiratory volume in the first second (FEV1)</measure>
      <time_frame>After 6-week training and 3 months after 6-week training ends.</time_frame>
      <description>Pulmonary function (Forced expiratory volume in the first second (FEV1)) will be evaluated with a spirometer.</description>
    </secondary_outcome>
    <secondary_outcome>
      <measure>FEV1 / FVC</measure>
      <time_frame>After 6-week training and 3 months after 6-week training ends.</time_frame>
      <description>Pulmonary function (FEV1 / FVC) will be evaluated with a spirometer.</description>
    </secondary_outcome>
    <secondary_outcome>
      <measure>Flow rate 25-75% of forced expiratory volume (FEF 25-75%)</measure>
      <time_frame>After 6-week training and 3 months after 6-week training ends.</time_frame>
      <description>Pulmonary function (Flow rate 25-75% of forced expiratory volume (FEF 25-75%)) will be evaluated with a spirometer.</description>
    </secondary_outcome>
    <secondary_outcome>
      <measure>Peak flow rate (PEF)</measure>
      <time_frame>After 6-week training and 3 months after 6-week training ends.</time_frame>
      <description>Pulmonary function (Peak flow rate (PEF)) will be evaluated with a spirometer.</description>
    </secondary_outcome>
    <secondary_outcome>
      <measure>Pain Intensity measured with the Numerical Rating Scale.</measure>
      <time_frame>After 6-week training and 3 months after 6-week training ends.</time_frame>
      <description>Pain intensity will be measured with the Numerical Rating Scale. This scale expresses the severity of pain with integers from 0 (no pain) to 10 (the worst possible pain).</description>
    </secondary_outcome>
    <secondary_outcome>
      <measure>Aerobic capacity</measure>
      <time_frame>After 6-week training and 3 months after 6-week training ends.</time_frame>
      <description>The six-minute walk test (6-MWT) will be performed according to the criteria of the American Thoracic Society for the evaluation of aerobic capacity.</description>
    </secondary_outcome>
    <secondary_outcome>
      <measure>Lower extremity strength</measure>
      <time_frame>After 6-week training and 3 months after 6-week training ends.</time_frame>
      <description>To determine lower extremity strength and functional mobility, the 30-second Sit-Up Test will be used in the chair.</description>
    </secondary_outcome>
    <secondary_outcome>
      <measure>Total quality of life score evaluated by Chronic Venous Disease Quality of Life Questionnaire</measure>
      <time_frame>After 6-week training and 3 months after 6-week training ends.</time_frame>
      <description>The score will be evaluated using Chronic Venous Disease Quality of Life Questionnaire. Each question is scored on a 5-item Likert scale. Higher scores indicate better quality of life.</description>
    </secondary_outcome>
    <number_of_arms>2</number_of_arms>
    <enrollment type="Anticipated">40</enrollment>
    <condition>Chronic Venous Insufficiency</condition>
    <arm_group>
      <arm_group_label>Training group</arm_group_label>
      <arm_group_type>Experimental</arm_group_type>
      <description>The individuals in the training group will be performed inspiratory muscle training using an inspiratory muscle training device (PowerBreathe®) at 30-50% of the maximal inspiratory pressure.</description>
    </arm_group>
    <arm_group>
      <arm_group_label>Control group</arm_group_label>
      <arm_group_type>Sham Comparator</arm_group_type>
      <description>Individuals in the control group will be performed thoracic expansion exercises.</description>
    </arm_group>
    <intervention>
      <intervention_type>Other</intervention_type>
      <intervention_name>Training group: Inspiratory muscle training</intervention_name>
      <description>The individuals in the training group will be performed inspiratory muscle training at 30-50% of the maximal inspiratory pressure. Inspiratory muscle training will be done using an inspiratory muscle training device (PowerBreathe®) that works with the threshold loading principle. Inspiratory muscle training will be done for 15 minutes per a session, 2 times per a day or, if tolerated, 30 minutes per a day and 1 time per a day, 5-7 days/week (one session under the supervision and the others at home), for a total of 6 weeks. Applications made at home will be followed with a diary.</description>
      <arm_group_label>Training group</arm_group_label>
      <other_name>Experimental: Training group</other_name>
    </intervention>
    <intervention>
      <intervention_type>Other</intervention_type>
      <intervention_name>Control group: Thoracic expansion exercise</intervention_name>
      <description>Individuals in the control group will be performed thoracic expansion exercises. Thoracic expansion exercises will be applied to individuals in an upright sitting position. In this position, individuals will place their hands on their lower ribs and then perform the cycle of &quot;deep breathing + holding the deep breath for 3 seconds + slowly emptying all the breath&quot; 3 times in a row. After this cycle, individuals will be asked to rest by taking 3-4 calm breaths. Immediately after, the individual will be asked to repeat the same cycle and repeat the cycle with calm breaths and rest until it reaches 10 repetitions. The individual will do this session 4 times a day. Individuals will do the first session of breathing exercises under supervision. In this way, incorrect exercise will be prevented. Other breathing exercise sessions will be done by individuals as a home program every day and 4 sessions a day during 6 weeks.</description>
      <arm_group_label>Control group</arm_group_label>
      <other_name>Sham Comparator: Control group</other_name>
    </intervention>
    <eligibility>
      <criteria>
        <textblock>
          Inclusion Criteria:&#xD;
  &#xD;
            -  18 years of age or older&#xD;
  &#xD;
            -  Volunteering to participate in the study&#xD;
  &#xD;
            -  Diagnosed with chronic venous insufficiency using duplex ultrasound and being under&#xD;
               standard medical treatment follow-up&#xD;
  &#xD;
            -  Being in one of the C1, C2, C3, C4 or C5 stages according to the Clinical, Etiology,&#xD;
               Anatomy and Pathophysiology (CEAP) classification&#xD;
  &#xD;
          Exclusion Criteria:&#xD;
  &#xD;
            -  Acute deep vein thrombosis, active ulcers, psychiatric disorder requiring prior vessel&#xD;
               ablation and/or prescription drug therapy,&#xD;
  &#xD;
            -  Any history of chronic disease or deep vein thrombosis that may interfere with&#xD;
               exercise capacity measurement,&#xD;
  &#xD;
            -  Having SARS-CoV-2 (COVID-19) or any acute infection,&#xD;
  &#xD;
            -  Being pregnant,&#xD;
  &#xD;
            -  History of arterial disease,&#xD;
  &#xD;
            -  Having advanced cardiorespiratory diseases, acute ulcer (&lt; 3 months) and diabetic&#xD;
               ulcers.&#xD;
        </textblock>
      </criteria>
      <gender>All</gender>
      <minimum_age>18 Years</minimum_age>
      <maximum_age>N/A</maximum_age>
      <healthy_volunteers>No</healthy_volunteers>
    </eligibility>
    <overall_official>
      <last_name>GÜLŞAH BARĞI, Assoc. Dr.</last_name>
      <role>Study Director</role>
      <affiliation>Izmir Democracy University</affiliation>
    </overall_official>
    <overall_official>
      <last_name>ÖZLEM ÇİNAR ÖZDEMİR, Assoc. Dr.</last_name>
      <role>Principal Investigator</role>
      <affiliation>Izmir Democracy University</affiliation>
    </overall_official>
    <overall_official>
      <last_name>CEMRE GÖRÜNMEZOĞLU, MSc</last_name>
      <role>Principal Investigator</role>
      <affiliation>Izmir Democracy University</affiliation>
    </overall_official>
    <overall_official>
      <last_name>DÜNDAR ÖZALP KARABAY, Prof. Dr.</last_name>
      <role>Principal Investigator</role>
      <affiliation>Dokuz Eylul University</affiliation>
    </overall_official>
    <overall_contact>
      <last_name>GÜLŞAH BARĞI, Assoc. Dr.</last_name>
      <phone>+90 232 299 0739</phone>
      <email>gulsahbargi35@gmail.com</email>
    </overall_contact>
    <overall_contact_backup>
      <last_name>ÖZLEM ÇİNAR ÖZDEMİR, Assoc. Dr.</last_name>
      <phone>0232 299 0733</phone>
      <email>ozlem.cinar@idu.edu.tr</email>
    </overall_contact_backup>
    <location>
      <facility>
        <name>Izmir Democracy University</name>
        <address>
          <city>İzmir</city>
          <country>Turkey</country>
        </address>
      </facility>
      <contact>
        <last_name>GÜLŞAH BARĞI, Assoc. Dr.</last_name>
        <phone>0232 299 0739</phone>
        <email>gulsahbargi35@gmail.com</email>
      </contact>
      <contact_backup>
        <last_name>ÖZLEM ÇİNAR ÖZDEMİR, Assoc. Dr.</last_name>
        <phone>0232 299 0733</phone>
        <email>ozlem.cinar@idu.edu.tr</email>
      </contact_backup>
    </location>
    <location_countries>
      <country>Turkey</country>
    </location_countries>
    <reference>
      <citation>Aydin G, Yeldan I, Akgul A, Ipek G. Effects of inspiratory muscle training versus calf muscle training on quality of life, pain, venous function and activity in patients with chronic venous insufficiency. J Vasc Surg Venous Lymphat Disord. 2022 Sep;10(5):1137-1146. doi: 10.1016/j.jvsv.2022.04.012. Epub 2022 Jun 14.</citation>
      <PMID>35710091</PMID>
    </reference>
    <reference>
      <citation>Weiss RA, Munavalli G. Endovenous ablation of truncal veins. Semin Cutan Med Surg. 2005 Dec;24(4):193-9. doi: 10.1016/j.sder.2005.10.006.</citation>
      <PMID>16387263</PMID>
    </reference>
    <reference>
      <citation>Eberhardt RT, Raffetto JD. Chronic venous insufficiency. Circulation. 2005 May 10;111(18):2398-409. doi: 10.1161/01.CIR.0000164199.72440.08. No abstract available.</citation>
      <PMID>15883226</PMID>
    </reference>
    <verification_date>September 2023</verification_date>
    <study_first_submitted>July 28, 2023</study_first_submitted>
    <study_first_submitted_qc>August 5, 2023</study_first_submitted_qc>
    <study_first_posted type="Actual">August 8, 2023</study_first_posted>
    <last_update_submitted>September 13, 2023</last_update_submitted>
    <last_update_submitted_qc>September 13, 2023</last_update_submitted_qc>
    <last_update_posted type="Actual">September 15, 2023</last_update_posted>
    <responsible_party>
      <responsible_party_type>Principal Investigator</responsible_party_type>
      <investigator_affiliation>Izmir Democracy University</investigator_affiliation>
      <investigator_full_name>Gulsah Bargi</investigator_full_name>
      <investigator_title>Assoc. prof</investigator_title>
    </responsible_party>
    <keyword>Venous Insufficiency</keyword>
    <keyword>pain</keyword>
    <keyword>edema</keyword>
    <keyword>respiratory function tests</keyword>
    <keyword>maximal respiratory pressures</keyword>
    <keyword>exercise capacity</keyword>
    <keyword>quality of life</keyword>
    <condition_browse>
      <!-- CAUTION:  The following MeSH terms are assigned with an imperfect algorithm            -->
      <mesh_term>Venous Insufficiency</mesh_term>
    </condition_browse>
    <patient_data>
      <sharing_ipd>No</sharing_ipd>
    </patient_data>
    <!-- Results have not yet been posted for this study                                          -->
  </clinical_study>
  
  
text: download date: ClinicalTrials.gov processed this data on September 20, 2023
  link text: Link to the current ClinicalTrials.gov record.
  url: https://clinicaltrials.gov/ct2/show/NCT05982405
  org study id: Long effects of IMT
  nct id: NCT05982405
  lead sponsor: 
  has dmc: No
  is fda regulated drug: No
  is fda regulated device: No
  The long-term effectiveness of inspiratory muscle training, which is known in the literature
        to help venous return by increasing the pump effect of the diaphragm muscle, remains unclear
        in individuals with chronic venous insufficiency. For this reason, in this study, it was
        aimed to investigate the long-term results of inspiratory muscle training in individuals with
        chronic venous insufficiency.
  Initial treatment of chronic venous insufficiency (CVI) includes conservative methods such as
        reducing symptoms and helping to prevent secondary problems and disease progression. If
        conservative methods fail, further treatments based on anatomical and physiological
        pathophysiological features should be applied. Treatment of CVI ranges from simple
        compression stockings to very complicated venous reconstructions. Physiotherapy applications
        also have an important place in the treatment of CVI and contain patient education, complex
        decongestive physiotherapy, intermittent pneumatic compression, compression garment, venous
        exercise programs, biomechanical stimulation therapy, proprioceptive neuromuscular
        facilitation, relaxation techniques and hydrotherapy methods.
  
        Researches investigating the effectiveness of new physiotherapy applications in CVI are very
        limited. In one of these publications, the effects of inspiratory muscle training (IMT) and
        calf muscle exercise training (CMET) applied in addition to compression therapy (CT) on
        quality of life (QoL), venous filling time, disease severity, pain, edema, range of motion,
        muscle strength and functionality were investigated newly. IMT and CT were applied in group
        1, CMET and CT were applied in group 2, and only CT was applied in group 3. As a result,
        groups of 1 and 2 showed more improvement in these outcomes compared to other groups. Acute
        effects of inspiratory muscle training in CVI was only shown in this study. The long-term
        effectiveness of inspiratory muscle training is still unclear in individuals with CVI.
        Therefore, this study aimed to investigate the long-term results of inspiratory muscle
        training in individuals with CVI.
  allocation: Randomized
  intervention model: Parallel Assignment
  primary purpose: Supportive Care
  masking: Single (Participant)
  masking description: Single-blind study; the patients will not be informed about training group or control group and they will be evaluated and trained at different places and times.
  measure: Maximal inspiratory pressure (MIP)
  time frame: After 6-week training and 3 months after 6-week training ends.
  description: The MIP which shows respiratory muscle strength will be evaluated using a portable mouth pressure measuring device based on American Thoracic Society and European Respiratory Society criteria.
  measure: Maximal expiratory pressure (MEP)
  time frame: After 6-week training and 3 months after 6-week training ends.
  description: The MEP which shows respiratory muscle strength will be evaluated using a portable mouth pressure measuring device based on American Thoracic Society and European Respiratory Society criteria.
  measure: Forced vital capacity (FVC)
  time frame: After 6-week training and 3 months after 6-week training ends.
  description: Pulmonary function (Forced vital capacity (FVC)) will be evaluated with a spirometer.
  measure: Forced expiratory volume in the first second (FEV1)
  time frame: After 6-week training and 3 months after 6-week training ends.
  description: Pulmonary function (Forced expiratory volume in the first second (FEV1)) will be evaluated with a spirometer.
  measure: FEV1 / FVC
  time frame: After 6-week training and 3 months after 6-week training ends.
  description: Pulmonary function (FEV1 / FVC) will be evaluated with a spirometer.
  measure: Flow rate 25-75% of forced expiratory volume (FEF 25-75%)
  time frame: After 6-week training and 3 months after 6-week training ends.
  description: Pulmonary function (Flow rate 25-75% of forced expiratory volume (FEF 25-75%)) will be evaluated with a spirometer.
  measure: Peak flow rate (PEF)
  time frame: After 6-week training and 3 months after 6-week training ends.
  description: Pulmonary function (Peak flow rate (PEF)) will be evaluated with a spirometer.
  measure: Pain Intensity measured with the Numerical Rating Scale.
  time frame: After 6-week training and 3 months after 6-week training ends.
  description: Pain intensity will be measured with the Numerical Rating Scale. This scale expresses the severity of pain with integers from 0 (no pain) to 10 (the worst possible pain).
  measure: Aerobic capacity
  time frame: After 6-week training and 3 months after 6-week training ends.
  description: The six-minute walk test (6-MWT) will be performed according to the criteria of the American Thoracic Society for the evaluation of aerobic capacity.
  measure: Lower extremity strength
  time frame: After 6-week training and 3 months after 6-week training ends.
  description: To determine lower extremity strength and functional mobility, the 30-second Sit-Up Test will be used in the chair.
  measure: Total quality of life score evaluated by Chronic Venous Disease Quality of Life Questionnaire
  time frame: After 6-week training and 3 months after 6-week training ends.
  description: The score will be evaluated using Chronic Venous Disease Quality of Life Questionnaire. Each question is scored on a 5-item Likert scale. Higher scores indicate better quality of life.
  arm group label: Training group
  arm group type: Experimental
  description: The individuals in the training group will be performed inspiratory muscle training using an inspiratory muscle training device (PowerBreathe®) at 30-50% of the maximal inspiratory pressure.
  arm group label: Control group
  arm group type: Sham Comparator
  description: Individuals in the control group will be performed thoracic expansion exercises.
  intervention type: Other
  intervention name: Training group: Inspiratory muscle training
  description: The individuals in the training group will be performed inspiratory muscle training at 30-50% of the maximal inspiratory pressure. Inspiratory muscle training will be done using an inspiratory muscle training device (PowerBreathe®) that works with the threshold loading principle. Inspiratory muscle training will be done for 15 minutes per a session, 2 times per a day or, if tolerated, 30 minutes per a day and 1 time per a day, 5-7 days/week (one session under the supervision and the others at home), for a total of 6 weeks. Applications made at home will be followed with a diary.
  arm group label: Training group
  other name: Experimental: Training group
  intervention type: Other
  intervention name: Control group: Thoracic expansion exercise
  description: Individuals in the control group will be performed thoracic expansion exercises. Thoracic expansion exercises will be applied to individuals in an upright sitting position. In this position, individuals will place their hands on their lower ribs and then perform the cycle of "deep breathing + holding the deep breath for 3 seconds + slowly emptying all the breath" 3 times in a row. After this cycle, individuals will be asked to rest by taking 3-4 calm breaths. Immediately after, the individual will be asked to repeat the same cycle and repeat the cycle with calm breaths and rest until it reaches 10 repetitions. The individual will do this session 4 times a day. Individuals will do the first session of breathing exercises under supervision. In this way, incorrect exercise will be prevented. Other breathing exercise sessions will be done by individuals as a home program every day and 4 sessions a day during 6 weeks.
  arm group label: Control group
  other name: Sham Comparator: Control group
  criteria: 
  gender: All
  minimum age: 18 Years
  maximum age: N/A
  healthy volunteers: No
  last name: GÜLŞAH BARĞI, Assoc. Dr.
  role: Study Director
  affiliation: Izmir Democracy University
  last name: ÖZLEM ÇİNAR ÖZDEMİR, Assoc. Dr.
  role: Principal Investigator
  affiliation: Izmir Democracy University
  last name: CEMRE GÖRÜNMEZOĞLU, MSc
  role: Principal Investigator
  affiliation: Izmir Democracy University
  last name: DÜNDAR ÖZALP KARABAY, Prof. Dr.
  role: Principal Investigator
  affiliation: Dokuz Eylul University
  last name: GÜLŞAH BARĞI, Assoc. Dr.
  phone: +90 232 299 0739
  email: gulsahbargi35@gmail.com
  last name: ÖZLEM ÇİNAR ÖZDEMİR, Assoc. Dr.
  phone: 0232 299 0733
  email: ozlem.cinar@idu.edu.tr
  facility: 
  contact: 
  contact backup: 
  country: Turkey
  citation: Aydin G, Yeldan I, Akgul A, Ipek G. Effects of inspiratory muscle training versus calf muscle training on quality of life, pain, venous function and activity in patients with chronic venous insufficiency. J Vasc Surg Venous Lymphat Disord. 2022 Sep;10(5):1137-1146. doi: 10.1016/j.jvsv.2022.04.012. Epub 2022 Jun 14.
  PMID: 35710091
  citation: Weiss RA, Munavalli G. Endovenous ablation of truncal veins. Semin Cutan Med Surg. 2005 Dec;24(4):193-9. doi: 10.1016/j.sder.2005.10.006.
  PMID: 16387263
  citation: Eberhardt RT, Raffetto JD. Chronic venous insufficiency. Circulation. 2005 May 10;111(18):2398-409. doi: 10.1161/01.CIR.0000164199.72440.08. No abstract available.
  PMID: 15883226
  responsible party type: Principal Investigator
  investigator affiliation: Izmir Democracy University
  investigator full name: Gulsah Bargi
  investigator title: Assoc. prof
  mesh term: Venous Insufficiency
  sharing ipd: No