Chronic venous insufficiency

Abstract

CVD is a common problem with a significant impact on both afflicted individuals and the healthcare system. Normal venous function requires the axial veins with a series of venous valves, perforating veins to allow communication of the superficial to the deep venous system, and the venous muscle pumps. Dysfunction of any of the normal structures may lead to venous hypertension and development of CVI. There is a spectrum of manifestations of CVI with an emphasis on more serious consequences, such as skin changes and venous ulceration. There are a number of noninvasive and invasive techniques to assist in the diagnosis and management. The most commonly used is the venous duplex ultrasound to confirm the diagnosis and provide anatomic detail. APG may be used to assist in assessing the severity of disease and response to treatment. The treatment of CVI will be based on the severity of disease and guided by anatomic and pathophysiologic considerations. Compressive garments have been a mainstay in the management of CVI. Traditional surgical techniques and newer interventional methods are often reserved for unsatisfactory response to conservative measures, although earlier use of venous ablation should be considered in symptomatic patients. © 2014 American Heart Association, Inc.