Abstract
Chronic venous insufficiency (CVI) is a common, but underdiagnozed clinical disorder associated with a variety of signs and symptoms. The presence of leg edema in association with varicose veins, and venous leg ulcer in later disease stages defines the disease. The pathogenesis of chronic venous disease is based on venous reflux, obstruction, or a combination thereof. Prior postthrombotic syndrome is one of risk factor for CVI which may explain observed prevalence of thrombophilia in CVI. Color flow duplex ultrasound is the gold standard for nearly all diagnostic issues related to chronic venous disease. Compression stockings are the mainstay for conservative management. Earlier use of venous ablation therapy should be considered in symptomatic patients with superficial tortuous vein
Highlights
Chronic venous insufficiency (CVI) describes a condition that affects the venous system of the lower extremities including symptoms and sings such as pain, edema, heaviness, noctural cramps, hyperpigmentation, venous eczema, and ulcerations in advanced stages
The CEAP (Clinical-Etiology-Anatomic-Pathophysiologic) system is an excellent classification of chronic venous disease including CVI as more advanced stages in CEAP system (Eklöf, 2006)
Class C3 defines the onset of CVI with presence of leg edema, and may persist in untreated cases with varicose veins
Summary
Chronic venous insufficiency (CVI) describes a condition that affects the venous system of the lower extremities including symptoms and sings such as pain, edema, heaviness, noctural cramps, hyperpigmentation, venous eczema, and ulcerations in advanced stages. The CEAP (Clinical-Etiology-Anatomic-Pathophysiologic) system is an excellent classification of chronic venous disease including CVI as more advanced stages in CEAP system (Eklöf, 2006). All six clinical classes of chronic venous disease (C1-C6) are characterized by pathophysiological signs and clinical symptoms, such as presented in modification. Class C2 represents small varicose veins, but without clinical signs of CVI. Class C3 defines the onset of CVI with presence of leg edema, and may persist in untreated cases with varicose veins. C4 class demonstrates constant leg edema, varicose veins with trophic skin lesions, purpura and eczema. Class C5 indicates healed leg ulcer e.g. showing improvement. Reversible edema limited to foot and ankle Varices, atrophie blanche, persistent edema extended above ankle Healed leg ulcer Active leg ulcer
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