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Chronic venous insufficiency

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492: 430: 243: 153: 401:. This is a rare condition in which blood clots occur in the iliofemoral vein due to compression of the blood vessels in the leg. The specific problem is compression of the left common iliac vein by the overlying right common iliac artery. Many May-Thurner compressions are overlooked when there is no blood clot. More and more of them get nowadays diagnosed and treated (by stenting) due to advanced imaging techniques. 36: 366: 950: 705:
are common and very difficult to treat. Chronic venous ulcers are painful and debilitating. Even with treatment, recurrences are common if venous hypertension persists. Nearly 60% develop phlebitis which often progresses to deep vein thrombosis in more than 50% of patients. The venous insufficiency
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Insufficiency within a venous segment is defined as reflux of more than 0.5 seconds with distal compression. Invasive venography can be used in patients who may require surgery or have suspicion of venous stenosis. Other modalities that may be employed are: ankle-brachial index to exclude arterial
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CEAP classification is based on Clinical, Etiological (causal), Anatomical, and Pathophysiological factors. According to Widmer Classification for assessment of chronic venous insufficiency (CVI), diagnosis of chronic venous insufficiency is clearly differentiated from varicose veins. It has been
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pathology, air or photoplethysmography, intravascular ultrasound, and ambulatory venous pressures, which provides a global assessment of venous competence. Venous plethysmography can assess for reflux and muscle pump dysfunction but the test is laborious and rarely done.
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which is a treatable condition. As functional venous valves are required to provide for efficient blood return from the lower extremities, this condition typically affects the legs. If the impaired vein function causes significant symptoms, such as swelling and
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Azhdari M, Zilaee M, Karandish M, Hosseini SA, Mansoori A, Zendehdel M, Khodarahpour S (2020). "Red Vine Leaf Extract (AS 195) Can Improve Some Signs and Symptoms of Chronic Venous Insufficiency, a Systematic Review".
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Most cases of CVI can be improved with treatments to the superficial venous system or stenting the deep system. Varicose veins for example can now be treated by local anesthetic endovenous surgery.
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The venous filling time after the patient is asked to stand up from a seated position also is used to assess for CVI. Rapid filling of the legs less than 20 seconds is abnormal.
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Malignancy, malignant degeneration being a rare but important complication of venous disease since tumors that develop in the setting of an ulcer tend to be more aggressive.
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Avril, Stéphane; Badel, Pierre; Dubuis, Laura; Rohan, Pierre-Yves; Debayle, Johan; Couzan, Serge; Pouget, Jean-Fraçois (25 January 2012). Gefen, Amit (ed.).
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The most common cause of chronic venous insufficiency is reflux of the venous valves of superficial veins. This may in turn be caused by several conditions:
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Surgical treatment of CVI attempts a cure by physically changing the veins with incompetent valves. Surgical treatments for CVI include the following:
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barrier due to venous insufficiency, making patients more susceptible than the general population to contact sensitization and subsequent dermatitis.
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by a clinician for characteristic signs and symptoms are sufficient in many cases in ruling out systemic causes of venous hypertension such as
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Tilting the bed so that the feet are above the heart. This may be achieved by using a 20 cm (7-inch) bed wedge or sleeping in a 6 degree
1812: 1157: 978: 1817: 100: 1078: 415:(an abnormal connection or passageway between an artery and a vein) may cause chronic venous insufficiency even with working vein valves. 72: 693:) is an ultrasound guided, minimally invasive surgery strategic for the treatment of varicose veins, performed under local anaesthetic. 119: 79: 1014:
Barron GS, Jacob SE, Kirsner RS (Sep 2007). "Dermatologic complications of chronic venous disease: medical management and beyond".
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can also lead to severe hemorrhage. Surgery for CVI remains unsatisfactory despite the availability of numerous procedures.
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Frick, RW (March 2000). "Three treatments for chronic venous insufficiency: escin, hydroxyethylrutoside, and Daflon".
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and efforts to prevent the condition from getting worse instead of effecting a cure. This may include
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developed to guide decision-making in chronic venous insufficiency evaluation and treatment.
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Antignani, P. L. (August 2001). "Classification of chronic venous insufficiency: a review".
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Mild chronic venous insufficiency, with increased pigmentation of the lower legs.
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National Center for Biotechnology Information, U.S. National Library of Medicine
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CVI is not a benign disorder and, with its progression, can lead to morbidity.
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Subfascial endoscopic perforator surgery. Tying off the vein with an endoscope.
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Pain, a feature of venous disease often overlooked and commonly undertreated.
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Robertson LA, Evans CJ, Lee AJ, Allan PL, Ruckley CV, Fowkes FG (May 2014).
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Venous insufficiency conservative, hemodynamic and ambulatory treatment (
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Rates of CVI are higher in women than in men. Other risk factors include
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Frequent periods of rest elevating the legs above the heart level
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Deep and superficial vein thrombosis may in turn be caused by
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Text was copied from this source, which is available under a
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Signs and symptoms of CVI in the leg include the following:
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Ultrasonography of chronic venous insufficiency of the legs
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Mowatt-Larssen, Eric; Shortell, Cynthia (2010). "CHIVA".
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Creative Commons Attribution 4.0 International License
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in which the deep veins have been damaged by previous
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European Journal of Vascular and Endovascular Surgery
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Red vine leaf extract may have a therapeutic benefit.
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J Epidemiol Community Health.: 149–153. 517:C1: the presence of reticular or spider veins 8: 607:Manual compression lymphatic massage therapy 1072: 1070: 2139: 2041:Chronic cerebrospinal venous insufficiency 1866: 1538: 1499: 1468: 1454: 1446: 1324: 747: 745: 151: 134: 879: 838: 523:C3: Presence of edema but no skin changes 120:Learn how and when to remove this message 874:(2). Eur J Vasc Endovasc Surg.: 208–14. 656:. Tying off a vein to prevent blood flow 514:C0: no obvious feature of venous disease 285:CVI in the leg may cause the following: 918: 916: 914: 912: 910: 908: 906: 715: 276:Chronic swelling of the legs and ankles 206:chronic peripheral venous insufficiency 543:Secondary (trauma, birth control pill) 1813:Hereditary hemorrhagic telangiectasia 1077:Patrick C Alguire, Barbara M Mathes. 756:. Whiteley Publishing. Archived from 7: 1818:Generalized essential telangiectasia 1054:The Lecturio Medical Concept Library 526:C4: skin discoloration, pigmentation 58:adding citations to reliable sources 682:Valve transposition (experimental) 25: 1301:10.1053/j.semvascsurg.2010.01.008 1089:Topic last updated: Dec 04, 2017. 326:. It represents late sequelae of 322:plaques of ivory white skin with 1968:Cerebral venous sinus thrombosis 948: 208:and should not be confused with 200:formation, it is referred to as 34: 973:. Springer. pp. 218, 220. 302:, also known as varicose eczema 45:needs additional citations for 1919:Hepatic veno-occlusive disease 1270:"Chronic Venous Insufficiency" 1050:"Chronic Venous Insufficiency" 724:"Chronic Venous Insufficiency" 546:Congenital (Klipper trenaunay) 69:"Chronic venous insufficiency" 1: 1731:Aneurysm of sinus of Valsalva 1585:Monckeberg's arteriosclerosis 336:, an indurated plaque in the 27:Pooling of blood in the veins 2036:Chronic venous insufficiency 1661:Aortoiliac occlusive disease 1289:Seminars in Vascular Surgery 779:Patel S, Surowiec S (2022). 566:No obvious anatomic location 246:Chronic venous insufficiency 179:Chronic venous insufficiency 138:Chronic venous insufficiency 2051:Inferior vena cava syndrome 2046:Superior vena cava syndrome 1773:Vertebral artery dissection 1763:Intracranial berry aneurysm 1146:Hafner, JĂĽrg (1999-01-01). 1109:10.1177/0003319701052001S03 679:Valve repair (experimental) 613:Sequential compression pump 388:Superficial vein thrombosis 2258: 2152:Hypertensive heart disease 1803:Arteriovenous malformation 1778:Familial aortic dissection 1231:10.1177/000331970005100303 1028:10.1016/j.avsg.2007.07.002 881:10.1016/j.ejvs.2014.05.017 520:C2: Obvious varicose veins 422: 234:, and prolonged standing. 2177:Renovascular hypertension 2120:Hepatic artery thrombosis 1768:Carotid artery dissection 1721:Abdominal aortic aneurysm 1571:Intermittent claudication 1534:Peripheral artery disease 931:. StatPearls Publishing. 669:Endovenous Laser Ablation 529:C5: Ulcer that has healed 204:. It is sometimes called 159: 150: 2162:Hypertensive nephropathy 1975:Post-thrombotic syndrome 1956:Paget–Schroetter disease 1748:Coronary artery aneurysm 1726:Thoracic aortic aneurysm 1149:Management of Leg Ulcers 210:post-thrombotic syndrome 2217:Orthostatic hypotension 2199:White coat hypertension 1676:Fibromuscular dysplasia 1640:Carotid artery stenosis 624:Blood pressure medicine 574:Obstruction, thrombosis 470:doppler ultrasonography 382:postthrombotic syndrome 2189:Pulmonary hypertension 2172:Secondary hypertension 2167:Essential hypertension 2157:Hypertensive emergency 1998:Portacaval anastomosis 1934:Portal vein thrombosis 1576:Critical limb ischemia 1477:Cardiovascular disease 1103:. 52 Suppl 1: S17–26. 925:"Venous Insufficiency" 781:"Venous Insufficiency" 685:Hemodynamic surgeries. 662:. Removal of the vein. 638:Trendelenburg position 580:Obstruction and reflux 500: 446: 370: 247: 202:chronic venous disease 146:Chronic venous disease 2194:Systolic hypertension 1939:Renal vein thrombosis 1798:Arteriovenous fistula 1790:Vascular malformation 1758:Intracranial aneurysm 1645:Renal artery stenosis 1176:Phytotherapy Research 831:10.1136/jech.53.3.149 620:Compression stockings 601:symptomatic treatment 494: 434:B-flow ultrasonograph 432: 423:Further information: 413:Arteriovenous fistula 368: 245: 2108:Paradoxical embolism 2103:Cholesterol embolism 1929:May–Thurner syndrome 1924:Budd–Chiari syndrome 1907:Deep vein thrombosis 1902:primarily lower limb 1681:Raynaud's phenomenon 752:Whiteley MS (2011). 628:Hydroxyethylrutoside 438:great saphenous vein 436:over a valve of the 399:May–Thurner syndrome 378:Deep vein thrombosis 334:Lipodermatosclerosis 328:lipodermatosclerosis 272:Phlebetic lymphedema 214:deep vein thrombosis 54:improve this article 2184:Benign hypertension 1274:hopkinsmedicine.org 760:on October 25, 2017 730:on January 17, 2016 583:No venous pathology 18:Venous hypertension 2098:Pulmonary embolism 2008:Esophageal varices 1946:upper limb / torso 1590:Arteriolosclerosis 1409:External resources 501: 447: 443:Video is available 371: 306:Contact dermatitis 248: 238:Signs and symptoms 2242:Vascular diseases 2229: 2228: 2225: 2224: 2069:Arteries or veins 2064: 2063: 1889:Venous thrombosis 1856: 1855: 1838:Cherry hemangioma 1738:Aortic dissection 1689: 1688: 1524:Buerger's disease 1443: 1442: 1182:(10): 2577–2585. 1159:978-3-8055-6654-4 980:978-3-642-24618-0 549:No cause is known 300:Stasis dermatitis 267:Hyperpigmentation 176: 175: 132:Medical condition 130: 129: 122: 104: 16:(Redirected from 2249: 2140: 1951:Mondor's disease 1894:Thrombophlebitis 1867: 1543:Arteriosclerosis 1539: 1500: 1470: 1463: 1456: 1447: 1325: 1313: 1312: 1284: 1278: 1277: 1276:. 8 August 2021. 1266: 1251: 1250: 1214: 1208: 1207: 1188:10.1002/ptr.6705 1170: 1164: 1163: 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1106: 1102: 1095: 1092: 1080: 1073: 1071: 1067: 1055: 1051: 1045: 1042: 1037: 1033: 1029: 1025: 1022:(5): 652–62. 1021: 1017: 1016:Ann Vasc Surg 1010: 1008: 1006: 1004: 1002: 1000: 998: 994: 982: 976: 972: 971: 963: 960: 956: 951: 938: 934: 930: 926: 919: 917: 915: 913: 911: 909: 907: 903: 891: 887: 882: 877: 873: 869: 865: 858: 855: 850: 846: 841: 836: 832: 828: 824: 820: 816: 809: 806: 794: 790: 786: 782: 775: 772: 759: 755: 748: 746: 742: 729: 725: 719: 716: 709: 707: 704: 703:Venous ulcers 696: 694: 692: 684: 681: 678: 675: 672: 670: 667: 664: 661: 658: 655: 652: 651: 650: 644: 639: 635: 632: 629: 626: 623: 621: 618: 615: 612: 609: 606: 605: 604: 602: 594: 589: 582: 579: 576: 573: 572: 570: 565: 562: 559: 556: 555: 553: 548: 545: 542: 539: 538: 536: 531: 528: 525: 522: 519: 516: 513: 512: 510: 509: 508: 505: 499:(45 x 30 mm). 498: 493: 486: 484: 481: 477: 475: 471: 467: 463: 462:heart failure 459: 455: 451: 444: 439: 435: 431: 426: 418: 416: 414: 410: 408: 407:thrombophilia 400: 397: 395: 392: 389: 386: 383: 379: 376: 375: 374: 369:Venous valves 367: 360: 356: 353: 351: 348: 345: 342: 339: 335: 332: 329: 325: 321: 317: 314: 311: 307: 304: 301: 298: 296: 295:Venous ulcers 293: 291: 290:Venous stasis 288: 287: 286: 281: 278: 275: 273: 270: 268: 265: 262: 258: 256: 253: 252: 251: 244: 237: 235: 233: 229: 225: 220: 217: 215: 211: 207: 203: 199: 194: 193: 192:venous reflux 188: 184: 180: 172: 169: 167: 163: 158: 154: 149: 145: 141: 136: 124: 121: 113: 102: 99: 95: 92: 88: 85: 81: 78: 74: 71: â€“  70: 66: 65:Find sources: 59: 55: 49: 48: 43:This article 41: 37: 32: 31: 19: 2144:Hypertension 2056:Venous ulcer 2035: 1962: 1945: 1913: 1901: 1871:Inflammation 1752: 1711: 1600:Hyperplastic 1561:Fatty streak 1504:Inflammation 1427: 1416: 1392: 1381: 1370: 1355: 1340: 1292: 1288: 1282: 1273: 1222: 1218: 1212: 1179: 1175: 1168: 1148: 1141: 1100: 1094: 1082:. Retrieved 1057:. Retrieved 1053: 1044: 1019: 1015: 984:. Retrieved 969: 962: 940:. Retrieved 928: 893:. Retrieved 871: 867: 857: 822: 818: 808: 796:. Retrieved 784: 774: 762:. Retrieved 758:the original 734:November 13, 732:. Retrieved 728:the original 718: 700: 691:CHIVA method 688: 648: 598: 595:Conservative 506: 502: 497:venous ulcer 482: 478: 458:hypervolemia 448: 411: 404: 372: 350:Inflammation 284: 249: 221: 218: 205: 201: 190: 182: 178: 177: 116: 110:October 2020 107: 97: 90: 83: 76: 64: 52:Please help 47:verification 44: 2209:Hypotension 1753:head / neck 1605:Cholesterol 1495:capillaries 1418:MedlinePlus 986:12 November 557:Superficial 464:. A duplex 454:examination 226:, smoking, 143:Other names 2125:Vasculitis 2115:Thrombosis 2076:Angiopathy 2020:Varicocele 2013:Hemorrhoid 1843:Halo nevus 1699:dissection 1490:arterioles 1383:DiseasesDB 1084:2017-09-12 929:StatPearls 895:January 8, 764:January 8, 710:References 630:medication 616:Ankle pump 590:Management 563:Perforator 466:ultrasound 355:Cellulitis 80:newspapers 1879:Phlebitis 1620:Trans fat 1556:Foam cell 1512:Arteritis 1479:(vessels) 1429:eMedicine 1394:SNOMED CT 1219:Angiology 1204:216047649 1117:0003-3197 1101:Angiology 697:Prognosis 554:Anatomic 537:Etiology 511:Clinical 419:Diagnosis 394:Phlebitis 310:epidermal 280:Leg ulcer 259:Itching ( 232:pregnancy 166:Specialty 2236:Category 2093:Embolism 1695:Aneurysm 1632:Stenosis 1566:Atheroma 1517:Aortitis 1486:Arteries 1399:20696009 1309:20685567 1247:19421726 1239:10744007 1196:32314844 1133:45542090 1125:11510593 1036:17823046 937:28613694 890:24951373 849:10396491 793:28613694 654:Ligation 645:Surgical 320:atrophic 261:pruritus 224:genetics 1914:abdomen 1595:Hyaline 1377:D014689 840:1756838 540:Primary 450:History 228:obesity 94:scholar 1423:000203 1366:459.81 1307:  1245:  1237:  1202:  1194:  1156:  1131:  1123:  1115:  1059:9 July 1034:  977:  942:9 July 935:  888:  847:  837:  798:9 July 791:  577:Reflux 495:Acute 474:b-mode 361:Causes 96:  89:  82:  75:  67:  2029:Other 1862:Veins 1712:torso 1654:Other 1388:13734 1351:I87.2 1243:S2CID 1200:S2CID 1129:S2CID 198:ulcer 187:veins 101:JSTOR 87:books 1963:head 1493:and 1372:MeSH 1361:9-CM 1305:PMID 1235:PMID 1192:PMID 1154:ISBN 1121:PMID 1113:ISSN 1061:2021 1032:PMID 988:2020 975:ISBN 944:2020 933:PMID 897:2015 886:PMID 845:PMID 800:2021 789:PMID 766:2015 736:2010 560:Deep 472:and 460:and 452:and 73:news 1610:LDL 1357:ICD 1342:ICD 1297:doi 1227:doi 1184:doi 1105:doi 1024:doi 876:doi 835:PMC 827:doi 183:CVI 56:by 2238:: 1714:: 1697:/ 1488:, 1432:: 1421:: 1397:: 1386:: 1375:: 1364:: 1349:: 1346:10 1303:. 1293:23 1291:. 1272:. 1255:^ 1241:. 1233:. 1223:51 1221:. 1198:. 1190:. 1180:34 1178:. 1127:. 1119:. 1111:. 1069:^ 1052:. 1030:. 1020:21 1018:. 996:^ 927:. 905:^ 884:. 872:48 870:. 866:. 843:. 833:. 823:53 821:. 817:. 787:. 783:. 744:^ 230:, 216:. 1891:/ 1701:/ 1469:e 1462:t 1455:v 1359:- 1344:- 1334:D 1311:. 1299:: 1249:. 1229:: 1206:. 1186:: 1162:. 1135:. 1107:: 1087:. 1063:. 1038:. 1026:: 990:. 957:. 946:. 899:. 878:: 851:. 829:: 802:. 768:. 738:. 640:. 468:( 390:. 340:. 263:) 181:( 123:) 117:( 112:) 108:( 98:· 91:· 84:· 77:· 50:. 20:)

Index

Venous hypertension

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Specialty
Vascular surgery
veins
venous reflux
ulcer
post-thrombotic syndrome
deep vein thrombosis
genetics
obesity
pregnancy

Varicose veins
pruritus
Hyperpigmentation
Phlebetic lymphedema
Leg ulcer
Venous stasis

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