Venous Disease
Venous disease, affecting the venous system, is one of the
most common maladies to affect the legs of people and to negatively impact
their quality of life. Mild forms present cosmetic concerns with the more
severe forms resulting in serious symptoms significantly reducing the quality
of life, mobility and productivity. The recently published Bonn study reported
just over 90% of the population has some level of venous disease with 17%
experiencing the more severe levels.
Venous disease presents in two main categories – chronic
venous insufficiency or venous thromboembolisms (blood clots).
Chronic venous insufficiency (CVI) is marked by a failure of
valves in the vein to function properly, resulting in stasis of blood and
ambulatory venous hypertension over an extended period of time. However, there
are transient occurrences of venous insufficiency such as during pregnancy,
which often reverse following the pregnancy. The most common presentation of
venous disease is telangiectasias (spider veins) found in 60% of the population
and varicose veins, which affect over 14% of the population. The more severe
presentations are swelling (edema), skin discoloration and ulceration.
Reflux occurs when valve malfunction allows backflow in
veins. The pump function is ineffective. Veins stay full, valves don't close,
and pressure in the veins remains abnormally high (venous hypertension).
Valve malfunction can be congenital (when a person is born
with it), which is rare; or acquired. Valve malfunction can be acquired
different ways:
Weak vein walls or valves can give way under
"normal" stresses.
High pressures or prolonged pressure (e.g. people who stand
in one place without moving for prolonged periods) can stretch vein wails so
valves don't work.
Valves can become damaged from obstructions in the veins
(blood clots)
Venousthromboembolism (VTE) is the formation of blood clots
in the venous system and is comprised by Deep Vein Thrombosis (DVT), which are
clots in the deep veins of the legs and torso affecting over 600,000 in the USA
each year and Pulmonary Embolism (PE) clots found in the lungs. PE is a life
threatening condition resulting in over 100,000 deaths per year in the USA
alone.
These clots will typically resolve themselves over time,
however many develop into a chronic condition developing into permanent
obstructions in the veins, which result in valve damage and hypertension. This
condition is known as Post Thrombotic Syndrome (PTS).
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