Chronic venous insufficiency

By | October 29, 2013

This could be defined as an impairment of the venous drainage of the leg at a local or regional level. It is parallel to arterial insufficiency which is impaired supply to tissues and organs. These are both haemodynamic terms. Whilst it is relatively easy to quantify arterial insufficiency, venous drainage is much harder to measure. Causes include venous obstruction, reflux and calf-muscle pump failure. Venous insufficiency can be subdivided into superficial or deep, depending on the venous system involved. Research directed at measuring and quantifying venous insufficiency would be a significant advance.

MALAY PATEL  Haemodynamic changes in blood flow within the veins of the leg veins are due to reflux, obstruction or combinations resulting in venous insufficiency and the clinical manifestations of venous disease. Venodynamic is suggested as an alternative term to haemodynamic because it focuses on venous flow instead of flow within all blood vessels. Ineffectively treated acute venous thrombosis ultimately causes venodynamic changes due to development of reflux or residual obstruction.

The term chronic implies duration of disease and this is rarely assessed at the time of a duplex examination. Symptom development is due to changes in morphology and function of tissue and the timing of development of symptoms in any type of venous disease are rarely reliable because of the lack of a venodynamic starting point. The development of venodynamic changes could have started many months or years before the development of symptoms. The word ‘chronic’ is therefore inappropriate when describing venous disease, unless the duration of the venodynamic abnormality can be specified.