Chronic venous insufficiency

Abstract

Chronic venous insufficiency of the lower extremities is a complicated disorder that affects the productivity and well-being of millions of people worldwide. Management requires careful differential diagnosis and a systematic long-term multidisciplinary care effort directed toward realistic goals within the context of the patient's lifestyle. Optimal therapy requires control of abnormal venous physiology combined with adjunctive treatments to correct secondary skin ulceration, infection, and lymphedema. Fundamental management tools are limb elevation, simple dressings, antibiotics, and elastic compression garments. Patients with large leg ulcers may benefit from split-thickness skin grafting. Other selected patients may benefit from ligation and stripping of superficial veins or subfascial interruption of perforating veins. New endoscopic methods have dramatically reduced morbidity from subfascial perforator surgery. Surgery directed at correcting valvular reflux and venous occlusion is possible in highly selected patients.

Venous Leg Ulcerations: A Treatment Update

“…Special points It is contraindicated in patients with cellulitis, ulcer necrosis, severe edema, arterial disease, and pain [13]. Complications include cyanosis, ulceration, purpura, and necrosis of the skin when applied incorrectly [5].…”

“…However, the simplicity of the technique, minimal care required by the patient, and time-tested clinician experience with the Unna boot allow it to remain a mainstay of therapy [13].…”

Effect of external valvuloplasty of the deep vein in the treatment of chronic venous insufficiency of the lower extremity

“…Chronic venous insufficiency (CVI) can be caused by femoral vein or deep vein insufficiency, or a combination of the two. Since Kistner 1 introduced the concept of primary venous valve incompetence of the leg, additional studies have revealed that deep vein valve incompetence is the major cause of primary chronic venous insufficiency (PCVI), 2 especially in those who are classified with CEAP class 4 higher.…”