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Understanding Chronic Venous Disease: A Critical Overview of Its Pathophysiology and Medical Management
Miguel A Ortega1,2,3, Oscar Fraile-Martínez1,2, Cielo García-Montero1,2
1Department of Medicine and Medical Specialities, Faculty of Medicine and Health Sciences, University of Alcalá, 28801 Alcalá de Henares, Spain.
Insights
Chronic venous disease (CVD), often presenting as varicose veins (VVs), affects many globally. This review details CVD
Area of Science:
- Vascular Medicine
- Genetics
- Epidemiology
Background:
- Chronic venous disease (CVD) is a prevalent condition with diverse clinical presentations, from mild telangiectasias to severe venous ulcerations.
- Varicose veins (VVs) represent the most common manifestation of CVD, impacting a significant portion of the global population.
- The precise etiological mechanisms underlying CVD remain incompletely understood, with evidence suggesting a complex interplay of genetic predisposition and environmental factors.
Purpose of the Study:
- To consolidate current knowledge on the epidemiology, etiology, and risk factors of CVD.
- To provide a comprehensive overview of the pathophysiology of CVD, including hemodynamic alterations and cellular changes.
- To detail clinical manifestations, diagnostic approaches, and therapeutic strategies for managing patients with CVD, and to explore future research directions.
Main Methods:
- This review synthesizes existing literature on chronic venous disease.
- It examines epidemiological data, etiological factors, and risk profiles associated with CVD.
- Pathophysiological mechanisms, clinical presentations, diagnostic tools, and treatment options are critically analyzed.
Main Results:
- CVD is multifactorial, involving genetic and environmental influences leading to ambulatory venous hypertension.
- Pathophysiological consequences include microcirculatory changes, inflammation, hypoxia, venous wall remodeling, and epigenetic variations with systemic implications.
- Effective clinical management is crucial for mitigating disease progression and improving patients' quality of life.
Conclusions:
- Understanding the complex pathophysiology of CVD is essential for effective patient management.
- Current knowledge highlights the need for comprehensive strategies encompassing diagnosis, treatment, and ongoing research.
- Further investigation into CVD mechanisms and therapeutic targets is warranted to improve patient outcomes and quality of life.
Abstract:
Chronic venous disease (CVD) is a multifactorial condition affecting an important percentage of the global population. It ranges from mild clinical signs, such as telangiectasias or reticular veins, to severe manifestations, such as venous ulcerations. However, varicose veins (VVs) are the most common manifestation of CVD. The explicit mechanisms of the disease are not well-understood. It seems that genetics and a plethora of environmental agents play an important role in the development and progression of CVD. The exposure to these factors leads to altered hemodynamics of the venous system, described as ambulatory venous hypertension, therefore promoting microcirculatory changes, inflammatory responses, hypoxia, venous wall remodeling, and epigenetic variations, even with important systemic implications. Thus, a proper clinical management of patients with CVD is essential to prevent potential harms of the disease, which also entails a significant loss of the quality of life in these individuals. Hence, the aim of the present review is to collect the current knowledge of CVD, including its epidemiology, etiology, and risk factors, but emphasizing the pathophysiology and medical care of these patients, including clinical manifestations, diagnosis, and treatments. Furthermore, future directions will also be covered in this work in order to provide potential fields to explore in the context of CVD.
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