Chronic Venous Insufficiency

Nobody is exempted to venous insufficiency. However, the symptoms exceeded more than two weeks it can already classified as chronic venous insufficiency. The terms postphlebitic syndrome and postthrombotic syndrome may also point out the same description.

Chronic venous insufficiency can pose a more serious result if not given proper medical attention. It can eventually lead to ulcerations or skin breakage on the skin making the person prone infections.

Women aging from 40 to 49 years old may present symptoms of venous insufficiency. It can related to the age as well as the body surface of the person. In men, this can be found in the older age group between 70 to 79 years old. There is also a strong familial tendency among the known cases. Some of the cases can be traced with a familial history of deep vein thrombosis. Taking a look at the lifestyle of patients can also be considered as a key factor in determining the cause of chronic venous insufficiency. Sedentary lifestyle can ultimately result in stasis of the muscles of the lower legs to contract in order to bring back the blood to the heart. Obesity has also been cited in medical literatures to be the causative factor.

Chronic venous insufficiency happens when the bicuspid valves are damaged. These valves help in preventing the backflow of the blood while it is being brought back to the heart. The damage to these valves allows the blood to pool around the lower extremity.

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Signs and symptoms:

  1. Varicose veins
  2. Leg cramps
  3. Skin ulcers on the legs
  4. Pedal Edema
  5. Lipodermatosclerosis – build of fats making it harder for the blood to circulate

Diagnostic Evaluation:

Doppler studies are done in order to know the blockage as well as the extent of the damaged valves. A colour-flow study is done in order to separate the veins that are doing well from those that are blocked or damaged. A Venogram is also used in order to assess the veins that are not fit for good circulation. Photoplethysmography is used in assessing the capillary refill. An infrared light is passed through the lower extremities during leg exercise, the slower the capillary refill the more it indicates incompetent veins on the legs.

Medical and Surgical Management:

  1. When ulceration is found, then surgical management must be done in order to prevent further skin breakdown.
  2.   Vein ligation may also be advised when the damage of the veins reached the saphenous system.  However, deep occlusion of veins is a known contraindication of the procedure.
  3. Use of antithrombotic socks is also advised.
  4. Having an active lifestyle can also prevent venous stasis. Stretching from time to time can also help in the circulation of the blood on the lower extremities.

Byron Webb Romero, RN, MSN

Finished BSN at Lyceum of the Philippines University, and Master of Science in Nursing Major in Adult Health Nursing at the University of the East Ramon Magsaysay Memorial Medical Center. Currently working at Manila Doctors College of Nursing as a Team Leader for Level I and II, Lecturer for Professional Nursing Subjects, and also a Clinical Instructor.

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