Chronic venous insufficiency

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Chronisch-venöse Insuffizienz Stadium (III)

Chronic Venous Insufficiency (CVI) is a medical condition where the veins, primarily in the lower limbs, fail to pump blood back to the heart effectively. This condition is characterized by the malfunctioning of the venous wall and/or valves in the leg veins, leading to prolonged venous hypertension, venous ectasia, and in severe cases, to leg ulcers.

Causes and Risk Factors

The primary cause of CVI is damage to the veins or valves in the lower extremities, which can be due to a variety of factors including deep vein thrombosis (Deep vein thrombosis), phlebitis, and congenital absence of venous valves. Risk factors for developing CVI include age, family history of venous disease, obesity, pregnancy, prolonged standing or sitting, and a history of leg injury.

Symptoms

Symptoms of CVI may include leg swelling (Edema), varicose veins, aching or tiredness in the legs, skin discoloration (Hyperpigmentation), and in severe cases, leg ulcers (Venous ulcer). The severity of symptoms can vary widely among individuals.

Diagnosis

Diagnosis of CVI involves a physical examination and may include imaging tests such as Duplex ultrasound, which assesses blood flow and the structure of leg veins. The CEAP classification (Clinical-Etiologic-Anatomic-Pathophysiologic) is commonly used to grade the severity of CVI.

Treatment

Treatment aims to improve blood flow in the leg veins and may include lifestyle changes, medication, compression therapy, and in some cases, surgery. Lifestyle changes can include weight loss, regular exercise, and elevating the legs when resting. Compression stockings are often recommended to support the veins and reduce swelling. Surgical options may include vein stripping, laser therapy, or valve repair.

Prevention

Preventive measures for CVI focus on improving blood flow and reducing pressure in the leg veins. These can include maintaining a healthy weight, exercising regularly, avoiding prolonged periods of standing or sitting, and wearing compression stockings if recommended by a healthcare provider.

Complications

If left untreated, CVI can lead to serious complications such as venous leg ulcers, which are challenging to treat and may significantly impact quality of life. Other complications can include recurrent venous thrombosis and chronic pain.

See Also

• Varicose veins
• Deep vein thrombosis
• Edema
• Venous ulcer