Peripheral venous disease symptoms do not occur in approximately half the patients who have this condition. Peripheral venous disease (PVD), a circulatory disorder in which the veins that carry blood from the hands and feet to the heart become damaged or blocked, can occur anywhere in the body. However, it most often affects the arms and legs, and is commonly caused by a blood clot.

A feeling of heaviness, throbbing, or aching in the legs

One or both feet feel cold

One or both feet change color

As functional venous valves are required to provide for efficient blood return from the lower extremities, this condition typically affects the legs. If the impaired vein function causes significant symptoms, such as swelling and ulcer formation, it is referred to as chronic venous disease. It is sometimes called chronic peripheral venous insufficiency and should not be confused with post-thrombotic syndrome in which the deep veins have been damaged by previous deep vein thrombosis.

signs and symptoms may include:

 

Varicose veins

Chronic leg edema and skin changes

Restlessness

Itching

Cramping

Diabetic Ulcers

Heaviness or tiredness

Open skin sores

Did you know?

About 50% of patients with severe venous reflux disease have central vein compression or May-Thurner syndrome, which is easily treated with venous stenting treatment. If you’ve had previous vein ablations and are still experiencing swelling and/or pain you may have central vein compression. Call us for a consultation. We can help.

Chronic venous disease (or Chronic Venous Insufficiency “CVI”) is the failure of the function of the valves in the veins of the leg. This causes the pressure in the veins of the leg to increase, which causes swelling and secondary skin changes. There are several types of chronic venous diseases, which range in seriousness, including:

 

Saphenous vein reflux — Backflow of blood in the legs due to malfunctioning valves in the veins of the legs

 

Nonthrombotic iliac venous lesions — Damaged veins in the hip area (not related to clots)

 

Chronic deep venous thrombosis (DVT) –Blood clots that forms in a vein deep inside your body, usually the legs.

 

 

 

Prevalence in Women vs Men

1% – 40% of Women    &   1% – 17% of Men

 

Why is DVT so serious?

Bottom line, DVT is a blood clot located in the deep veins, usually of the legs. This clot can break off and travel through the venous bloodstream and through the right side of the heart to land in the lung, obstructing the arteries there (causing a pulmonary embolism). Approximately 350-600,000 Americans and 400-550,000 Europeans suffer from DVT.

 

Over 40% of patients suffer from swelling, claudication, and ulceration after a DVT. The most common veins affected are the veins in the legs (femoral veins) and the veins in the pelvis (iliac veins). When a DVT is located in the pelvis, the risk of recurrent DVT and complications doubles.

 

What are the risk factors?

Older age, family history of venous disease, history of blood clots, obesity, having a standing occupation, pregnancy, female gender, high-impact physical activity, and obstructive sleep apnea

 

What are the symptoms and signs?

Pain, swelling or heaviness in the lower leg and ankle, itchiness, skin discoloration at the ankle, edema or swelling, and irritated or inflamed varicose veins

 

How is it diagnosed?

Symptoms reported by patient to doctor

Signs identified by doctor during exams

Venography: procedure in which an x-ray of the veins (called a venogram) is taken after a special dye is injected into the veins

Doppler ultrasound: test that uses high-frequency sound waves to measure the amount of blood flow through your arteries and veins, usually those that supply blood to your arms and legs. This study can detect abnormal blood flow in an artery or vein.

Magnetic resonance imaging (MRI)

Intravascular ultrasound (IVUS)

Can it be prevented with lifestyle changes?

There are several ways you can help improve blood flow in your leg veins:

 

Stay active by exercising, which helps boost blood flow in the body.

Try not to sit or stand for long periods of time. If you are required to stand a lot, sit down periodically and put your feet up to help lower the pressure in your leg veins.

Wear graduated compression stockings. These come in a variety of sizes and help venous blood move back to the heart by putting pressure on your legs.

What are the treatment options?

Patients with chronic venous disorders are treated according to the type of disorder, its severity, and how much venous reflux it causes. The treatment goal is to improve symptoms, appearance, and skin changes due to chronic venous disease, and to reduce edema and ulcers.

 

For symptomatic varicose veins (pain, itching), a period of conservative treatment (varying duration) is often required by insurance carriers before proceeding with ablation therapy

 

Conservative Treatment Strategies

These treatments are recommended for most patients with venous disease including:

 

Leg elevation and exercise (helps transport oxygen to the skin, decreasing inflammation).

 

Regards,

John Mathews

Editorial Assistant

Journal of Phlebology and Lymphology