Clinical presentation includes increasing leg pain, fatigue, and heaviness with prolonged standing, associated with dilated tortuous veins.
More severe cases exhibit progressive skin changes, venous stasis dermatitis, lipodermatosclerosis, and frank ulceration.
Underlying venous insufficiency is most efficiently documented, localized, and graded by duplex ultrasound.
Conservative treatment requires graded compression.
Open surgical or endovenous treatment options may be used in highly selected cases.
Venous ulceration and bleeding are recognized complications.
Serial images of severe CVI (C6) and chronic ulceration of the right lower extremity
From the collection of Dr Joseph L. Mills
- corona phlebectatica (malleolar flare or ankle flare)
- ankle swelling
- hyperpigmentation (brawny edema)
- atrophie blanche
- leg ulcers
- leg fatigue, aching, and/or discomfort
- heavy legs
- leg cramps
- reticular veins
- dilated tortuous veins
- dry and scaly skin
- skin burning and itching
- unilateral leg swelling
1st Tests To Order
- duplex ultrasound
Other Tests to Consider
- ascending phlebography
- CT venography
- magnetic resonance venography
- CT abdomen and pelvis
- intravenous ultrasound
- air plethysmography
all symptomatic patients
- graded compression stockings
- with superficial venous reflux
- endovenous ablation or saphenectomy
- with angiomata and varicosities
- endovenous ablation or injection sclerotherapy
- with perforating vein incompetence
- endovenous ablation
- with iliac vein obstruction
- percutaneous iliac angioplasty and stenting
- with deep venous reflux
- venous valvular reconstruction
- with leg pain
- horse chestnut seed extract