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Leg Ulcers

Compression Therapy

Chronic venous insufficiency: a comprehensive review of management

02 August 2023

Articles

Abstract

Chronic venous insufficiency is an extensive progressive disease in need of public health attention. This insidious disease is a growing burden on patient quality of life and the health economy. Chronic venous insufficiency has become more pronounced in global populations, especially in regions exhibiting a higher rate of risk factors. It is critical for healthcare providers to recognise and intervene early to prevent ongoing and debilitating complications. This article provides a comprehensive review of chronic venous insufficiency outlining the anatomy, pathophysiology, clinical presentation, assessment and management options.

Chronic venous disease is a commonly underdiagnosed disease that progressively reduces a patient's quality of life (QoL) as well as placing an increasing burden on healthcare resources. Chronic venous disease involves telangiectasias, reticular veins, varicose veins, chronic venous insufficiency (CVI) and chronic venous hypertension. Symptoms of CVI include pain, skin discolouration, oedema and ulceration.^1–3 More specifically, CVI is a condition affecting the lower extremity venous system and involves complex venous pathology.^2,3 Prevalence of chronic venous disease should raise concern, especially as trends in longevity and obesity continue to rise.⁴ This article provides an overview of the anatomy, pathophysiology, clinical presentation and diagnosis of CVI, with a focus on management options to help improve early recognition and intervention.

The global prevalence of CVI varies widely, from <1–17% in men and <1–40% in women. These ranges are likely attributed to variations in the application of diagnostic criteria, the availability of medical resources to diagnose and treat, as well as the dispersion of risk factors unique to global populations.⁵ Common risk factors for CVI include: increasing age; family history of venous disease; smoking; obesity; prolonged standing or sitting; history of venous thrombosis; pregnancy; history of lower extremity trauma; or surgery.⁶ Women also show a higher incidence and prevalence of CVI than men at any age.¹

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