Enfermedad venosa crónica. Conceptos actuales y avances terapéuticos

Abstract

IntroductionChronic venous disease (CVD) is the most prevalent vascular disorder and consumes a great amount of economic and health resources, particularly in its final outcome of venous ulcer. EtiopathogenyBasic genetic molecular research has enabled more precise knowledge of the condition's aetiopathogeny and pathophysiology and is applied practically towards prevention and treatment. DiagnosisA correct initial diagnosis, both clinical and haemodynamic, with Doppler ultrasound, will enable the implementation of appropriate medical treatment to improve symptoms and delay or prevent progression to advanced stages of the disease. Venous hypertension (VHT) is the fundamental pathophysiological event in CVD. TreatmentCorrecting VHT with postural measures and compression therapy and venoactive drugs to act on its consequences are the basic pillars of medical treatment and are generally applied. Surgical treatment of varices is of proven benefit compared to conservative treatment in patients who are candidates for it. Surgical techniques have seen huge advances over the past decade and the classical paradigm of phlebo-extraction has been changed for endoluminal treatments. Sclerotherapy plays an essential role for aesthetic situations, for the elderly and frail or for patients at high surgical risk.