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Chronic venous insufficiency and venous ulceration
1Division of Internal Medicine, University of Florida, Gainesville, USA.
Journal of General Internal Medicine
|June 1, 1997
Summary
Chronic venous insufficiency (CVI) is a common problem affecting leg circulation. Management by primary care physicians using lifestyle changes and inexpensive treatments can effectively address this recurrent condition.
Area of Science:
- Vascular Medicine
- Epidemiology
- Medical Literature Review
Background:
- Chronic venous insufficiency (CVI) is a prevalent condition impacting leg venous circulation.
- It presents a wide clinical spectrum, from cosmetic issues to severe ulceration and fibrosing panniculitis.
- CVI contributes to significant morbidity and healthcare costs.
Purpose of the Study:
- To synthesize current literature on leg venous circulation.
- To review the epidemiology, pathophysiology, and treatment of CVI.
- To provide information relevant to general internists managing CVI.
Main Methods:
- Comprehensive literature search of English-language articles (1966-1996) using MEDLINE and cross-references.
- Inclusion of articles on epidemiology, pathophysiology, and treatment of CVI.
- Specific focus on randomized controlled trials for treatment efficacy assessment.
Main Results:
- Duplex Doppler ultrasonography is valuable for ruling out deep venous thrombosis and CVI mimics.
- Leg elevation and compression stockings are effective CVI treatments; intermittent pneumatic compression may be needed for difficult cases.
- Topical agents and surgery show limited benefit for ulcer healing or overall CVI management.
Conclusions:
- Chronic venous insufficiency is a persistent and recurring medical challenge.
- Primary care physicians can effectively manage CVI using accessible, cost-effective treatments and lifestyle modifications.