Abstract
Venous disease is more common than peripheral arterial disease. Pathophysiologically, venous disease can be associated with obstruction, reflux, or both. A common feature in chronic venous disease is ambulatory venous hypertension. Inflammatory and pro-thrombotic mechanisms can be activated. The current therapies, including compression, ablation, and recanalization are discussed.
Highlights
Venous disease is more common than peripheral arterial disease, affecting nearly 30 million in the United States of America (USA) alone [1,2,3,4]
Studies appear to suggest an increase in varicose veins of type I collagen content and a decrease in type III collagen content, the latter being a factor in venous elasticity [24,25]
Compression therapy remains the mainstay of therapy though adherence can be poor
Summary
Venous disease is more common than peripheral arterial disease, affecting nearly 30 million in the United States of America (USA) alone [1,2,3,4]. In certain disease states, such as in muscle pump inefficiency, venous reflux, or obstruction, ankle venous pressure remains elevated. The calf muscles, in particular the soleus, are thought to be primarily responsible for deep vein pump action [13,14] This may explain why a sedentary lifestyle or neuromuscular degenerative disease. Elevated venous pressure may lead to maladaptive remodeling of the venous wall, leading to the development of enlarged and tortuous veins [15,16]. This process is associated with venous valve dysfunction [17]. It has been proposed that the predisposition to varicose veins is inherited in an autosomal dominant pattern with variable penetrance and with greater expression in the setting of hormonal factors, such as progesterone and estrogen, favoring disease prevalence in women [20]
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