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Chronic venous insufficiency (CVI) is a medical condition characterized by blood pooling in the veins, leading to increased pressure and strain on the vein walls. [1] The most common cause of CVI is superficial venous reflux, which often results in the formation of varicose veins , a treatable condition. [ 2 ]
The management of lipodermatosclerosis may include treating venous insufficiency with leg elevation and elastic compression stockings. [9] In some difficult cases, the condition may be improved with the additional use of the fibrinolytic agent, stanozol. Fibrinolytic agents use an enzymatic action to help dissolve blood clots.
In chronic venous insufficiency, sonographic examination is of most benefit; in confirming varicose disease, making an assessment of the hemodynamics, and charting the progression of the disease and its response to treatment. It has become the reference standard for examining the condition and hemodynamics of the lower limb veins.
Venous ulcer is defined by the American Venous Forum as "a full-thickness defect of skin, most frequently in the ankle region, that fails to heal spontaneously and is sustained by chronic venous disease, based on venous duplex ultrasound testing."
Risk factors include obesity, lack of exercise, leg trauma, and family history of the condition. [3] They also develop more commonly during pregnancy. [3] Occasionally they result from chronic venous insufficiency. [2] Underlying causes include weak or damaged valves in the veins. [1]
[2] [3] Other conditions that may present similarly include lipohypertrophy, chronic venous insufficiency, and lymphedema. [2] It is commonly misdiagnosed. [5] The condition is resistant to weight loss methods; however, unlike other fat it is not associated with an increased risks of diabetes or cardiovascular disease. [4]
Stasis dermatitis is diagnosed clinically by assessing the appearance of red plaques on the lower legs and the inner side of the ankle. Stasis dermatitis can resemble a number of other conditions, such as cellulitis and contact dermatitis, and at times needs the use of a duplex ultrasound to confirm the diagnosis or if clinical diagnosis alone is not sufficient.
Unlike arterial ultrasonography, venous ultrasonography is carried out with the probe in a transversal position, (perpendicular to the vein axis), displaying cross-sections of the veins. [4] All collateral veins are better detected this way, including perforator veins , but of most importance is the detection of venous thrombosis .
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