Chronic Venous Insufficiency

Chronic Venous Insufficiency (CVI) of the legs, also known as Varicose Veins, is a prevalent condition affecting nearly a third of the population. Although most cases are asymptomatic, some patients do exhibit symptoms such as pigmentation, stasis eczema, intractable itching, and the development of ulcers. The primary cause of symptoms is venous hypertension or stasis, which is characterized by the pooling of blood in the veins near the ankle and slightly above. This occurs when the valves inside the vein fail to prevent reflux, leading to stasis. The valve incompetence can occur in the superficial or deep venous system and can be caused by infection, trauma, congenital factors, obesity, hypercoagulability leading to clotting, or prolonged periods of inactivity. Interestingly, approximately 40% of CVI patients could develop a Deep Vein Thrombosis (DVT) that resolves spontaneously (subclinical DVT). This can lead to consequences such as incompetent perforators and reflux. Diagnosis of CVI, DVT, reflux, and incompetent perforators is typically done through an ultrasound and colour Doppler, which is considered the gold standard for these diagnoses. In addition to the ultrasound, mandatory blood tests include CRP, D-Dimer, lipid profile, liver function test, and homocysteine levels. This resource is expected to be beneficial for the medical community as it provides a comprehensive understanding of a common ailment that is often misunderstood.