eMedicine Specialties > Vascular Surgery > Medical Topics

Chronic Venous Insufficiency: Multimedia

Author: Katherine E Brown, DO, Consulting Staff, Department of Surgery, University of California at San Diego
Contributor Information and Disclosures

Updated: May 11, 2009

Multimedia

Picture of venous valve: Thrombosis can begin as ...Picture of venous valve: Thrombosis can begin as blood flow becomes turbulent, permitting platelets to remain in the valve sinus. This forms the nidus of a thrombus.
Picture of venous valve: Thrombosis can begin as ...

Picture of venous valve: Thrombosis can begin as blood flow becomes turbulent, permitting platelets to remain in the valve sinus. This forms the nidus of a thrombus.

Hemodynamic charting of (a) healthy patients, (b)...Media file 2: Hemodynamic charting of (a) healthy patients, (b) patients with only varicose veins, (c) patients with incompetent perforator veins, and (d) patients with deep and perforator incompetence.
Hemodynamic charting of (a) healthy patients, (b)...

Hemodynamic charting of (a) healthy patients, (b) patients with only varicose veins, (c) patients with incompetent perforator veins, and (d) patients with deep and perforator incompetence.

Perforator vein bulging into subcutaneous tissue.Media file 3: Perforator vein bulging into subcutaneous tissue.
Perforator vein bulging into subcutaneous tissue.

Perforator vein bulging into subcutaneous tissue.

Chronic venous stasis ulcer.Media file 4: Chronic venous stasis ulcer.
Chronic venous stasis ulcer.

Chronic venous stasis ulcer.

Venous stasis ulcer and surrounding dystrophic ti...Media file 5: Venous stasis ulcer and surrounding dystrophic tissue.
Venous stasis ulcer and surrounding dystrophic ti...

Venous stasis ulcer and surrounding dystrophic tissue.

Venous insufficiency iliofemoral obstruction (Pal...Media file 6: Venous insufficiency iliofemoral obstruction (Palma operation). Saphenous vein from contralateral leg tunneled subcutaneously to the femoral vein of the affected limb. Cumulative patency of 75% at 5 years. Relieves venous claudication but may not heal ulcers or relieve swelling.
Venous insufficiency iliofemoral obstruction (Pal...

Venous insufficiency iliofemoral obstruction (Palma operation). Saphenous vein from contralateral leg tunneled subcutaneously to the femoral vein of the affected limb. Cumulative patency of 75% at 5 years. Relieves venous claudication but may not heal ulcers or relieve swelling.

Lower leg venous anatomy.Media file 7: Lower leg venous anatomy.
Lower leg venous anatomy.

Lower leg venous anatomy.

Perforating veins of the lower leg.Media file 8: Perforating veins of the lower leg.
Perforating veins of the lower leg.

Perforating veins of the lower leg.

Venogram demonstrating incompetent perforating ve...Media file 9: Venogram demonstrating incompetent perforating veins.
Venogram demonstrating incompetent perforating ve...

Venogram demonstrating incompetent perforating veins.

More on Chronic Venous Insufficiency

Overview: Chronic Venous Insufficiency
Workup: Chronic Venous Insufficiency
Treatment: Chronic Venous Insufficiency
Follow-up: Chronic Venous Insufficiency
Multimedia: Chronic Venous Insufficiency
References
Further Reading

References

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  2. Piulacks P. Pathogenic study of varicose veins. Angiology. 1953;4:59-100.

  3. Burnand KG, Whimster I, Naidoo A. Pericapillary fibrin in the ulcer-bearing skin of the leg: the cause of lipodermatosclerosis and venous ulceration. Br Med J (Clin Res Ed). Oct 16 1982;285(6348):1071-2. [Medline].

  4. Coleridge Smith PD, Thomas P, Scurr JH. Causes of venous ulceration: a new hypothesis. Br Med J (Clin Res Ed). Jun 18 1988;296(6638):1726-7. [Medline].

  5. Renner R, Gebhardt C, Simon JC, Seikowski K. Changes in quality of life for patients with chronic venous insufficiency, present or healed leg ulcers. J Dtsch Dermatol Ges. Apr 6 2009;[Medline].

  6. Carrasco OF, Ranero A, Hong E, Vidrio H. Endothelial Function Impairment in Chronic Venous Insufficiency: Effect of Some Cardiovascular Protectant Agents. Angiology. Feb 23 2009;[Medline].

  7. Morales-Cuenca G, Moreno-Egea A, Aguayo-Albasini JL. [General surgeons and varicose vein surgery.]. Cir Esp. Apr 2009;85(4):205-13. [Medline].

  8. Casian D, Gutsu E, Culiuc V. Surgical treatment of severe chronic venous insufficiency caused by pulsatile varicose veins in a patient with tricuspid regurgitation. Phlebology. 2009;24(2):79-81. [Medline].

  9. Gasparis AP, Tsintzilonis S, Labropoulos N. Extraluminal lipoma with common femoral vein obstruction: a cause of chronic venous insufficiency. J Vasc Surg. Feb 2009;49(2):486-90. [Medline].

  10. Navarro TP, Nunes TA, Ribeiro AL, Castro-Silva M. Is total abolishment of great saphenous reflux in the invasive treatment of superficial chronic venous insufficiency always necessary?. Int Angiol. Feb 2009;28(1):4-11. [Medline].

  11. Vanscheidt W, Ukat A, Partsch H. Dose-response of compression therapy for chronic venous edema--higher pressures are associated with greater volume reduction: two randomized clinical studies. J Vasc Surg. Feb 2009;49(2):395-402, 402.e1. [Medline].

  12. Maksimovic ZV, Maksimovic M, Jadranin D, Kuzmanovic I, Andonovic O. Medicamentous treatment of chronic venous insufficiency using semisynthetic diosmin--a prospective study. Acta Chir Iugosl. 2008;55(4):53-9. [Medline].

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Further Reading

Clinical guidelines

Leg ulcer guidelines: a pocket guide for practice.
Smith and Nephew, Ltd. - Private For Profit Organization.  2002 (revised 2006 Jan).  39 pages.  NGC:005254

Summary algorithm for venous ulcer care with annotations of available evidence.
Association for the Advancement of Wound Care - Private Nonprofit Organization.  2005.  25 pages.  NGC:004280

Guideline for management of wounds in patients with lower-extremity venous disease.
Wound, Ostomy, and Continence Nurses Society - Professional Association.  2005.  42 pages.  NGC:004431

Clinical trials

Assess the Efficacy and Tolerability of Antistax Film-Coated Tablets in Patients With Chronic Venous Insufficiency

THERMES ET VEINES: Spa for Prevention of Leg Ulcers

A New Method of Surgically Treating Varicose Veins and Venous Ulcers - a Study to Assess Clinical and Economic Value

Related eMedicine topics

Stasis Dermatitis

Deep Venous Thrombosis

Deep Venous Thrombosis and Thrombophlebitis

Varicose Veins

Venous Insufficiency

Keywords

chronic venous insufficiency, CVI, superficial venous insufficiency, venous insufficiency, postphlebitic syndrome, postthrombotic syndrome lipodermatosclerosis, superficial venous incompetence, venous incompetence, valvular incompetence, hypercoagulability, Virchow triad, venous stasis, venous stasis ulcers, venous reflux, stasis dermatitis, stasis ulcer, venous ulcer, DVT, deep vein thrombosis, varicose veins, junctional high-pressure disease, perforator high-pressure disease, venous hypertension, varicosities, varicosity, telangiectasia, venectasia, spider vein, vein disease, venous disease, swollen veins, telangiectatic veins

Contributor Information and Disclosures

Author

Katherine E Brown, DO, Consulting Staff, Department of Surgery, University of California at San Diego
Disclosure: Nothing to disclose.

Medical Editor

William H Pearce, MD, Chief, Division of Vascular Surgery, Violet and Charles Baldwin Professor of Vascular Surgery, Department of Surgery, Northwestern University School of Medicine
William H Pearce, MD is a member of the following medical societies: American College of Surgeons, American Heart Association, American Surgical Association, Association for Academic Surgery, Association of VA Surgeons, Central Surgical Association, New York Academy of Sciences, Society for Vascular Surgery, Society of Critical Care Medicine, Society of University Surgeons, and Western Surgical Association
Disclosure: Nothing to disclose.

Pharmacy Editor

Francisco Talavera, PharmD, PhD, Senior Pharmacy Editor, eMedicine
Disclosure: Nothing to disclose.

Managing Editor

Vincent Lopez Rowe, MD, Assistant Professor of Surgery, Department of Surgery, Division of Vascular Surgery, University of Southern California Medical Center
Vincent Lopez Rowe, MD is a member of the following medical societies: American College of Surgeons, Association for Academic Surgery, Peripheral Vascular Surgery Society, Society for Clinical Vascular Surgery, and Society for Vascular Surgery
Disclosure: Nothing to disclose.

CME Editor

Paolo Zamboni, MD, Professor of Surgery, Chief of Day Surgery Unit, Chair of Vascular Diseases Center, University of Ferrara, Italy
Paolo Zamboni, MD is a member of the following medical societies: American Venous Forum and New York Academy of Sciences
Disclosure: Nothing to disclose.

Chief Editor

William H Pearce, MD, Chief, Division of Vascular Surgery, Violet and Charles Baldwin Professor of Vascular Surgery, Department of Surgery, Northwestern University School of Medicine
William H Pearce, MD is a member of the following medical societies: American College of Surgeons, American Heart Association, American Surgical Association, Association for Academic Surgery, Association of VA Surgeons, Central Surgical Association, New York Academy of Sciences, Society for Vascular Surgery, Society of Critical Care Medicine, Society of University Surgeons, and Western Surgical Association
Disclosure: Nothing to disclose.

 
 
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