Advertisement

Chronic Venous Insufficiency: Clinical Features and Investigations

  • Subramoniam Vaidyanathan
Chapter

Abstract

The clinical diagnosis of chronic venous insufficiency (C3 to C6 clinical classes) is relatively simple with the telltale evidence of varicose veins and the dermal changes in the gaiter area. The external manifestations are very often similar in both primary and secondary CVI. Identification of the underlying hemodynamic abnormalities is necessary in making this distinction. History and clinical examination cannot always indicate the nature and severity of the underlying pathology. Detailed diagnostic investigations are needed to sort out these issues. This is an essential requirement since the treatment options are different in the two sets of patients.

Keywords

Varicose Vein Popliteal Vein Venous Ulcer Chronic Venous Insufficiency Deep Venous System 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

References

  1. 1.
    Bradbury A, Ruckley CV. Clinical presentation and assessment of patients with venous disease. In: Gloviczki P, editor. Handbook of venous disorders: guidelines of the American Venous Forum. 3rd ed. London: Hodder Arnold; 2009. p. 331–41.Google Scholar
  2. 2.
    Scott TE, LaMorte WW, Gorin DR, Menzoian JO. Risk factors for chronic venous insufficiency: a dual-case control study. J Vasc Surg. 1995;22:622–8.PubMedCrossRefGoogle Scholar
  3. 3.
    Evans CJ, Fowkes FGR, Ruckley CV, Lee AAJ. Prevalence of varicose veins and chronic venous insufficiency in men and women in general population: Edinburgh Vein Study. J Epidemiol Community Health. 1999;53:149–53.PubMedCrossRefPubMedCentralGoogle Scholar
  4. 4.
    Nicolaides AN. Investigation of chronic venous insufficiency: a consensus statement. Circulation. 2000;102:e 126–63.CrossRefGoogle Scholar
  5. 5.
    Eklof B, Rutherford RR, Bergan JJ, Carpentie PH, Gloviczki P, Kistner RL, Meisssner MH, Moneta GL, Myers K, Padberg FT, Perrin C, Ruckley V, Coleridge- Smith P, Wakefield TW. Revision of the CEAP classification for chronic venous disorders: consensus statement. J Vasc Surg. 2004;40:1248–52.PubMedCrossRefGoogle Scholar
  6. 6.
    Gillespie DL. Venous ulcer diagnosis, treatment and prevention of recurrences. J Vasc Surg. 2010;52:8S–14.PubMedCrossRefGoogle Scholar
  7. 7.
    Barwel JR, Taylor M, Deacon J, Davies C, Whyman MR, Poskitt KR. Ankle motility is a risk factor for healing of chronic venous leg ulcers. Phlebology. 2001;16:38–40.CrossRefGoogle Scholar
  8. 8.
    Ochenduszklewicz U, Matkowski R, Szenglarewlcz B, Kornafel J. Marjolin’s ulcer: malignant neoplasm arising in scars. Rep Pract Oncol Radiother. 2006;11(3):135–8.CrossRefGoogle Scholar
  9. 9.
    Abai B, Labropoulos N. Duplex ultrasound scanning for chronic venous obstruction and valvular incompetence. In: Gloviczki P, editor. Handbook of venous disorders: guidelines of the American Venous Forum. 3rd ed. London: Hodder Arnold; 2009. p. 142–55.Google Scholar
  10. 10.
    Rafetto JD, Eberhardt RT. Chronic venous disorders; general considerations. In: Cronenwett JL, Johnston KW, editors. Rutherford’s vascular surgery. 7th ed. Philadelphia: Saunders/Elsevier; 2010. p. 831–843 e.CrossRefGoogle Scholar
  11. 11.
    Gloviczki P, Comerota AJ, Dalsing MC, Eklof BG, Gillespie DL, Gloviczki ML, Lohr JM, Mc Lafferty RB, Meissner MH, Murad MH, Padberg FT, Pappas PJ, Passman MA, Raffeto JD, Vasquez MA, Wakefield TW. The care of patient with varicose veins and associated chronic venous diseases: clinical practice guidelines of the Society for Vascular Surgery and the American Venous Forum. J Vasc Surg. 2011;53(5 Suppl):2s–48.PubMedCrossRefGoogle Scholar
  12. 12.
    Lim KH, Hill G, Tarr G, van Rij A. Deep venous reflux: definition and associated clinical and physiological significance. J Vasc Surg Venous Lymphat Disord. 2013;1(4):325–32.CrossRefGoogle Scholar
  13. 13.
    Robertson L, Lee AJ, Gallagher K, Carmichael SJ, Evans CJ, Mc Kinstry BH, Fraser SCA, Allan PL, Welder D, Ruckley C, Fowkes FG. Risk factors for chronic ulceration in patients with varicose veins; a case control study. J Vasc Surg. 2009;49:1490–8.PubMedCrossRefGoogle Scholar
  14. 14.
    Kistner RL. Primary venous valve incompetency of the leg. Am J Surg. 1980;140:218–24.PubMedCrossRefGoogle Scholar
  15. 15.
    Vaidyanathan S, Balakrishnan V. The role of ambulatory venous pressure studies in venous disorders of the lower limbs. Indian J Surg. 1986;48:391–404.Google Scholar
  16. 16.
    Rutherford RB, Moneta GL, Padberg Jr FT, Meissner MH. Outcome assessment in chronic venous disease. In: Gloviczki P, editor. Handbook of venous disorders: guidelines of the American Venous Forum. 3rd ed. London: Hodder Arnold; 2009. p. 684–93.Google Scholar
  17. 17.
    Raju S. A pressure based technique for the detection of acute and chronic venous obstruction. Phlebology. 1988;3:207–16.Google Scholar
  18. 18.
    Raju S, Neglen P. High prevalence of non thrombotic iliac vein lesions in chronic venous diseases: a permissive role in pathogenicity. J Vasc Surg. 2006;44:136–44.PubMedCrossRefGoogle Scholar
  19. 19.
    Kistner RL, Eklof B. Classification and etiology of chronic venous disease. In: Gloviczki P, editor. Handbook of venous disorders: guidelines of the American Venous Forum. 3rd ed. London: Hodder Arnold; 2009. p. 37–46.Google Scholar

Copyright information

© Springer India 2015

Authors and Affiliations

  1. 1.General SurgeryAmrita Institute of Medical Sciences, Amrita LaneKochiIndia

Personalised recommendations