Varicose veins are often misunderstood as simply a cosmetic issue, but when left untreated, they can progress into a more serious condition called chronic venous insufficiency (CVI).1
Listen to Dr Ginni Mansberg, Dr Venu Bhamidi, and Dr Adrian Ling talk about Chronic Venous Insufficiency and some of the more recent interventions that are now available for treatment. Fill out the form to receive your copy of the full podcast.
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UNDERSTANDING VEIN DISEASE
Healthy leg veins have valves that keep blood flowing to the heart. Vein disease develops when the valves stop working properly and allow blood to flow backward (i.e., reflux) and pool in the lower leg veins.
Venous reflux is a progressive medical condition and if left untreated, may worsen over time and develop into a more serious form of venous disease called chronic venous insufficiency (CVI).1
Chronic Venous Insufficiency
If CVI is left untreated, legs can sometimes develop painful sores or wounds on the skin’s surface called ulcers. Normally ulcers may appear near the ankles or lower leg and are brought on from the increased build-up of fluid and blood pressure from veins affected by CVI.1Glossary of terms
*This is one clinician's experience. Results may vary. This video is from the US website and content on the video may have references to another location.
Lack of exercise
Leg injury or trauma
Prolonged sitting or standing
Obesity or excess weight
Current or previous pregnancies
Aching or pain
Swelling or cramping
Heaviness, tiredness or restlessness
Brown, colored skin
Open sores or ulcers
Current treatment options
The goal of treatment for vein disease is to reduce or stop the backward flow of blood.
The following may be prescribed to treat varicose veins:
- Compression stockings
- Closing diseased vein through thermal ablation (a procedure that uses radiofrequency energy or heat to close the diseased vein, which redirects blood flow to healthy veins) or nonthermal treatment (a procedure that delivers a small amount of a medical adhesive to close the diseased vein, rerouting blood to nearby healthy veins).
A clinical challenge
Treating patients with venous ulcers is not easy. It is important to not only treat the wound but also identify the cause — enabling your patients to live without the discomfort of these wounds.
70% – 90% of all lower extremity ulcers are venous.5,6
1% of the Australian population are affected by venous leg ulcers. Venous leg ulcers cost the community in excess of $500 million per annum.8
More than half of venous ulcers treated are recurrent ulcerations.9
Superficial venous reflux is usually present in patients with venous leg ulcers ― yet many venous ulcer patients worldwide go unassessed or untreated for superficial venous reflux.5,10-12
With proper treatment, the progressive symptoms of vein disease may be preventable.
Without treatment, signs and symptoms may progress, impacting quality of life, and may lead to venous leg ulcers.1
Eberhardt RT, Raffetto JD. Chronic venous insufficiency. Circulation. 2014;130:333-346.
Gloviczki P, Comerota AJ, Dalsing MC, et al. The Care of Patients with Varicose Veins and Associated Chronic Diseases: Clinical Practice Guidelines of the Society for Vascular Surgery and the American Venous Forum. J Vasc Surg. May 2011;53(5 Suppl):2S-48S.
Johns Hopkins Medicine Health Conditions and Diseases. Available at: https://www.hopkinsmedicine.org/health/conditions-and-diseases/chronic-venous-insufficiency. Accessed May 14, 2019.
Strategic Market Assessment: Chronic Venous Insufficiency. Dymedex Consulting, LLC. November 2014.
O’Donnell TF Jr, Passman MA, Marston WA, et al. Management of venous leg ulcers: Clinical Practice Guidelines of the Society for Vascular Surgery® and the American Venous Forum. J Vasc. Surg. August 2014;60(2 Suppl):3S-59S.
Rice J (2014). Burden of venous leg ulcers in the United States. Journal of Medical Economics. 17(5), 347-356.
The Outpatient Wound Clinic Market 2013 Report and Analytics, Net Health Analytics (2010-2012 claims data).
Medical Textiles and Biomaterials for Healthcare, Subhash C. Anand, J F Kennedy, M Miraftab - 2005 / page 246
Outpatient Wound Clinic Market Performance Report. Net Health Analytics. October 2013.
Adam DJ, Naik J, Hartshorne T, Bello M, London NJ. The diagnosis and management of 689 chronic leg ulcers in a single-visit assessment clinic. Eur J Vasc Endovasc Surg. May 2003;25(5):462-468.
Devlin NJ, Shah KK, Feng Y, Mulhern B, van Hout B. Valuing health-related quality of life: An EQ-5D-5L value set for England. Health Econ. January 2018;27(1):7-22.
Gohel MS, Heatley F, Liu X, et al. A Trial of Early Endovenous Ablation in Venous Ulceration. N Engl J Med. May 31, 2018;378(22)2105-2114.