[Comprehensive management of chronic venous insufficiency]

The choice among the therapeutic options available for chronic venous insufficiency of the lower limbs is based on a precise analysis of the disease itself and the exact nature of the patient's complaints and expectations. Comprehensive care requires a careful clinical examination and complementary exploration with ultrasonography when required for decision making and knowledge of the personal, social and professional situation as well as a documented evaluation of the treatment methods, their theoretical or real value and their assumed mechanism of action, their long-term effects when known and their limitations. Elastic support, if prescribed correctly is useful whatever the degree of clinical expression: simple functional manifestations, varicose veins or impaired trophism. Vasculoprotective or venotonic drugs have various actions. They can be used for the treatment of all degrees of symptomatic chronic insufficiency. More radical treatment of varicose veins, whether surgical or by sclerosis, depend on the anatomic presentation, the degree of venous stasis and the importance of the symptomatology but also on the desires of a patient well informed of the advantages and limitations of each technique. Comprehensive care for chronic venous insufficiency requires personalized care.