Lower Extremity Chronic Venous Disease

By Dr. Bryan Kramer, MD and Grace Boyle, OMS-II - December 30, 2019

Definition: spectrum of lower extremity vein abnormalities that may be morphologic and/or functional in nature that lead to venous dilation 
  • May or may not be symptomatic 
  • Inadequate muscle pumps 
  • Incompetent venous valves (reflux)
  • Venous thrombosis (clotting)
  • Non-thrombotic venous stenosis 
Risk Factors: 
  • Advanced age 
  • Family history of venous disease 
  • Smoking
  • Sedentary lifestyle
  • Lower extremity trauma 
  • Prior venous thrombosis 
  • Pregnancy 
Symptoms and Clinical Signs:  
  • Symptoms: calf pain, leg heaviness and aching, swelling of the calves, muscle cramps, and skin irritation (tightness, dryness, itching) 
  • Clinical signs:
    • Telangiectasias: dilated intradermal and subdermal veins (spider veins)
      • Most prevalent clinical sign
    • Varicose veins: dilated, elongated, tortuous, dilated subcutaneous veins
      • >/= 3 mm in diameter 
      • Often concerning to patients for cosmetic reasons
  • Signs of more advanced disease:
    • Edema (swelling)
    • Skin changes
      • Hyperpigmentation (discoloration) and induration (hardening)
    • Ulceration
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