What is Chronic Venous Disease?

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Chronic Venous Disease (CVD) refers to other chronic conditions related to or caused by veins that become diseased or abnormal. These problems can include:

  • Varicose veins and spider veins
  • Leg Swelling and Leg Pain
  • Chronic venous insufficiency
  • Leg skin changes
  • Leg ulcers
  • Phlebitis
  • Vascular Malformations

Varicose Veins

Varicose veins are dilated, thickened, elongated and twisted blood vessels that don't control blood flow as they should. In some cases, they can be small spider veins and even appear thread-like. In other cases they may appear as large grape-like clusters under the skin.

Symptoms

  • Aching pain
  • Easily tired legs
  • Leg heaviness
  • Swelling in the legs
  • Darkening of the skin (in severe cases)
  • Numbness in the legs
  • Itching or irritated rash on the legs

Risk Factors

Varicose veins occur more often in women than men, especially during pregnancy (starting in the first trimester), during the last 14 days of the menstrual cycle, and in people who have a job for which they must stand for long periods of time.

Treatment

There are several procedures that can be used alone or in combination to treat varicose veins. These include:

  • Sclerotherapy, in which a doctor injects the veins with a solution that causes the vein to close and the blood is then directed through healthier veins. This is a common treatment option, but may require multiple treatments. It is useful for treating small and medium sized varicose veins.
  • Microsclerotherapy, which is similar to sclerotherapy, but uses different solutions and injection techniques. It is especially effective in treating spider veins.
  • Laser surgery, in which the heat from a laser beam destroys spider vein, but does not harm the skin. It is usually less effective than sclerotherapy for varicose veins in the legs. It also causes side effects, such as bruising, blistering and discoloration.
  • Surgical vein stripping, in which the varicose vein is removed through small incisions at the groin, knee and ankle. This is an option for treating larger varicose veins.
  • Endovenous thermal ablation, in which a thin tube (catheter) is inserted into the vein. Then, the surgeon applies heat through the tube, causing the vein to collapse. A scar results and the blood is forced through nearby healthy veins. This procedure is also used to treat larger varicose veins.
  • Coil embolization, in which a catheter is first places into a large vein in the leg or calf; then, a small coil is inserted into the catheter and guided into the vein; alcohol is then injected. The alcohol is an irritant to the vein lining and causes it to close and scar. Again, the blood is rerouted to nearby health veins. This procedure requires local anesthesia.
  • Ambulatory phlebectomy, in which the doctor removes larger varicose veins in the legs through a series of tiny skin punctures (holes). Local anesthesia is used. There is usually little scarring.
  • Endoscopic perforator vein surgery, which is used for advanced varicose veins that have caused leg ulcers. The doctor makes a small incision and inserts a thin video camera to see and then close veins near the skin that lead to the deep veins in the legs.

Complications

Left untreated, varicose veins can expected to enlarge and worsen. As a result, the symptoms will become more severe. Additional health problems can result. These include:

  • Severe venous insufficiency, a severe pooling of blood in the veins that slows the return of blood to the heart. This can lead to condition can cause deep vein thrombosis and pulmonary embolism.
  • Sores or skin ulcers.
  • Ongoing irritation, swelling and painful rashes on the legs.

For further information please consult following chapters of Layman's Handbook of Venous Disorders:

Chapter 11: Physiology of Venous Insufficiency

Chapter 12: Chronic Venous Insufficiency Presentation

Chapter 13: Compression Therapy for Venous Disorders and Venous Ulceration

Chapter 15: Sclerotherapy for Venous Disease

Chapter 16: Surgical Therapy for Chronic Venous Insufficiency