[Venous insufficiency in the lower limbs]

Abstract

Background: Venous insufficiency is a common condition that presents with various symptoms and is often treated inadequately. The purpose of the article is to provide an overview of the prevalence, recommended investigations and indications for treatment of venous insufficiency.

Material and method: The literature reviewed was identified through a non-systematic search in PubMed based on the authors' experience in research, investigations and treatment of this patient group.

Results: Venous insufficiency is a common condition with a prevalence of about 30 %. Some patients will develop distal dystrophic skin changes (prevalence <or= 3 %) and a few will experience venous leg ulcers (prevalence < 1 %). Dystrophic skin changes and venous leg ulcers can be caused by an isolated superficial venous insufficiency, accessible for varicose vein surgery.

Interpretation: Further evaluations (e.g. colour duplex scanning and direct measurement of venous pressure or plethysmography) are recommended for all patients with skin changes, recurrent varices, previous deep venous thrombosis or other circumstances rendering it difficult to conclude from clinical investigations. Indications for superficial venous surgery are mainly based on symptoms. Prophylactic surgery on superficial veins is considered only in cases with dystrophic skin changes or ulcers. Compression therapy represents the best prophylactic measure to reduce varicose vein progression.