Chronic venous insufficiency
Epidemiology
Venous pathology is a common disease:
- Chronic venous insufficiency affects 20 to 35% of French people*
- That’s between 13 and 20 million
- More than 110,000 new cases per year are identified
Use of care:
- 11% of women very frequently resort to city care because of varicose veins and circulatory disorders of the lower limb,
- It is the 2nd cause of use of city care after 45 years,
It is estimated that pathology is responsible for 2.6% of health expenditure*.
*Study reference to be added at the end of the page
What you need to know – Pathology reminder
What is chronic venous insufficiency?
Chronic venous insufficiency (CVI) encompasses all manifestations related to a functional or physical abnormality of the venous system caused by a malfunction of the venous valves of the legs.
Varicose veins are the most common symptom of CVI. Varicose veins are manifested by visible dilated veins, corresponding to an anatomical network either well defined (systematized varicose veins) or diffuse (unsystematized varicose veins).
Appearance of a varicose vein
Varicose veins are permanent dilatations of the veins, most often on a lower limb.
The veins in the legs travel blood from the feet to the heart, thanks to valves that prevent blood from coming back down (valve system).
A progressive disease
Without treatment, the symptoms of venous insufficiency worsen over time:
- Heavy legs, spider veins
- Varicose veins
- Skin disorders: dermatitis, eczema
- Hypodermatitis
- Phlebitis: formation of a blood clot
- Ulcer: open wound with tissue destruction
In case of venous insufficiency, the valves become incontinent and no longer allow blood to rise: veins dilate, varicose veins appear.
Which veins can be incontinent?
The deep venous system provides 85 to 90% of venous return, but is rarely subject to venous insufficiency. Superficial veins are most often affected.
The superficial venous system is located in the fat between the fascia and the skin. It consists mainly of:
- The Great saphenous vein (formerly called the internal saphenous vein) on the inner side of the limb between the foot and groin
- The Small saphenous vein (ex-external saphenous vein) on the posterior surface of the calf between the foot and the knee.
The superficial and deep venous system of each lower limb are connected by about 140 communications called “perforating”.
Risk factors
A risk factor is a condition, pathology or behavior that makes it more likely that a disease will occur.
In chronic venous insufficiency, the risk factors are:
- Obesity,
- Pregnancy and especially repeated pregnancies,
- Heat,
- A sedentary lifestyle or prolonged standing or sitting at work,
- Deep vein thrombosis,
- Age (worsening of the disease with age).
Treatments
Venous pathology is a progressive pathology. It is therefore important to take care of it quickly, with a response adapted to the stage of the pathology. For more information, LSO Medical invites you to consult your general practitioner and vascular doctor.
When the pathology advances, varicose veins may appear. There are several techniques to remove or destroy these diseased veins:
[1] European Society for Vascular Surgery (ESVS), “European Society for Vascular Surgery (ESVS) 2022 clinical practice guidelines on the management of chronic disease of the low limbs”, January 11 – 2022
[2] Society for Vascular Surgery (SVS), American Venous Forum (AVF), American Vein and Lymphatic Society (AVLC), “The 2022 Society for Vascular Surgery, American Venous Forum, and American Vein and Lymphatic Society clinical practice guidelines for the management of varicose veins of the lower extremities. Part I, Duplex Scanning and Treatment of Superficial Truncal Reflux”, October 11 – 2022