Efficacy of complex decongestive therapy in a patient with deep venous insufficiency: A case report

Deep venous insufficiency (DVI) affects 30% of individuals with superficial venous insufficiency (SVI). It is caused by valvular incompetence or obstruction, leading to venous hypertension. While conservative treatment is compression therapy, there is evidence supporting the efficacy of complex decongestive therapy (CDT), although it has not been studied in patients with DVI without ulcerations.

We present a program for the evaluation and treatment of CDT in patients with DVI.

The patient was a 49-year-old woman with bilateral DVI classified as C3 according to the Clinical-Etiological-Anatomical-Pathophysiological (CEAP) classification. She experienced pain, heaviness, mild edema, decreased quality of life (QoL), and retrograde reflux > 0.5 seconds in the deep venous system of both extremities (femoral, common femoral, and popliteal veins). The patient was evaluated using ultrasound, impedance measurement, circumferential measurements, and the Venous Clinical Severity Score (VCSS) and Chronic Venous InsufficiencyQualityofLifeQuestionnaire (CIVIQ-20). She underwent CDT (manual lymphatic drainage, pressotherapy, and bandaging) twice a week for 4 weeks, with follow-up assessments conducted after treatment and at 6 weeks.

The patient reported a decrease in pain and heaviness (VCSS), along with an increase in QoL (CIVIQ-20) (60.8% T1, 67.1% T2), flow velocity in the deep veins, and decreased reflux. While there was no improvement in edema, the fat mass in the extremities was reduced.

CDT was effective in improving severity and symptoms in this patient with DVI. Randomized controlled studies are necessary to further demonstrate the efficacy of this treatment in patients with DVI.