[Chronic venous insufficiency today (a status determination)]

Primary as well as secondary cvi (due to deficiency of the deep venous reflux) is a disease that necessitates a thorough therapy planning and a life-long medical care. Neither operation nor sclerotherapy alone can cure these patients. Active measures must always be combined with conservative procedures such as individually manufactured pressure gradient stockings, occasional intermittent medical treatment of complications and careful guiding of the patients over many years. The first measure is of course a careful establishment of the diagnosis by clinical examination and modern technical methods such as Doppler ultrasound, plethysmography and, in selected cases, phlebography. The therapy concept must consider the advantages and disadvantages of the various methods. A combined treatment in team work with the vascular surgeon may be the starting point, but must always be followed by an intensive life-long guidance of the patients with additional treatments according to necessity.