1. Varicose Veins
1.1. Trauma to Saphenous Vein Damaging Valves
1.2. http://europepmc.org/articles/PMC3452481/pdf/12262_2009_Article_34.pdf
1.3. gradual venous distention from the effects of gravity on blood in the legs
2. Clinical Presentation
2.1. Venous Stasis Ulcers
3. Risk Factors
3.1. Female Gender
3.1.1. Pregnancy
3.2. Obesity
3.3. Previous Leg injury
3.4. Age
3.5. Smoking
3.6. Excessive Alcohol Consumption
3.7. Pregnancy
3.8. Deep Vein Thrombosis (DVT) Triad of Virchow
3.8.1. Venous Stasis
3.8.1.1. Immobility
3.8.1.2. Age
3.8.1.3. Congestive Heart Failure Left and Right sided Failure
3.8.2. Venous Endothelial Damage
3.8.2.1. Trauma
3.8.2.2. Intravenous Medications
3.8.3. Hypercoagulable States
3.8.3.1. Malignancy
3.8.3.2. Inherited Disorders
3.8.3.3. Pregnancy
3.8.3.4. Use of hormonal oral contraceptives
3.8.3.5. Hormone Replacement Therapy
4. Prevention
4.1. Excercise
4.2. Healthy Diet
4.3. Non Smoking
4.4. Lose Weight if overweight
5. Treatment
5.1. Wearing Compression Stockings
5.2. Heparin Therapy
5.3. Elevation of limbs
5.4. Surgical Ligation
5.5. Conservative Vein Resection and Strippping
6. Stages of CVI
6.1. Stage I
6.1.1. Stage I CVI - Edema of the foot and ankle is a common finding in patients with venous insufficiency. In this particular case, there is reflux from her saphenofemoral junction at the top of her leg all the way to the smaller branches going to her ankle and foot(Vein Clinics of America, 2012).
6.1.2. Corona phlebectatica consists of a myriad of tiny vein branches that are so fine and so numerous that individual veins can be difficult to delineate. These veins give the skin a red-pink hue that blanches upon finger pressure. Once pressure is released, the pink color returns immediately. Corona phlebectatica is almost always seen in association with larger underlying vein disease that might not be visible at the skin surface. Corona phlebectatica is often seen in combination with valve failure with resulting venous hypertension and chronic venous disorder(Vein Clinics of America, 2012). .
6.2. Stage II
6.2.1. Venous stasis dermatitis is seen less commonly. When it does occur, it can be symptomatic with tenderness and/or pruitis. Venous stasis dermatitis can commonly be confused with eczema. When the cause of the dermatitis is underlying vein disease that is not readily seen at the surface of the skin, accurate diagnosis relies upon duplex ultrasound evaluation of the venous system(Vein Clinics of America, 2012).
6.2.2. Lipodermatosclerosis is a finding that is quite commonly seen but not frequently recognized. The appearance of lipodermatosclerosis is more dramatic when there is associated edema, as seen in this picture. Lipodermatosclerosis causes a scarring and fibrosis of the skin and underlying subcutaneous tissue. This results in significant discoloration and retraction of the affected skin. (Vein Clinics of America, 2012).
6.3. Stage III
6.3.1. Ulceration defines Stage III or end stage chronic venous insufficiency. This is a diagnosis that few physicians will miss. No doctor ever wants one of his or her patients who has refluxing vein disease to develop this degree of venous insufficiency. The goal of treatment must be to take care of underlying vein disease before end-stage venous insufficiency is reached so that ulceration can be avoided(Vein Clinics of America, 2012). .