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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.
How a varicose vein forms in a leg. Figure A shows a normal vein with a working valve and normal blood flow. Figure B shows a varicose vein with a deformed valve, abnormal blood flow, and thin, stretched walls. The middle image shows where varicose veins might appear in a leg. Comparison of healthy and varicose veins
The ASV which is often responsible for varicose veins, can be located at the 'alignment sign', where it is seen to align with the femoral vessels. On ultrasound at the saphenofemoral junction in the groin, the common femoral vein (CFV) with the GSV and the common femoral artery (CFA) create an image called the Mickey Mouse sign.
The skin surrounding a venous ulcer may be edematous (swollen) and there may be evidence of varicose veins; the skin surrounding an arterial ulcer may be pale, cold, shiny and hairless. Both venous and arterial ulcers may be painful, however arterial ulcers tend to be more painful, especially with elevation of the leg, for example when in bed.
Most cases of CVI can be improved with treatments to the superficial venous system or stenting the deep system. Varicose veins, for example, can now be treated by local anesthetic endovenous surgery. Rates of CVI are higher in women than in men. [4] [5] Other risk factors include genetics, smoking, obesity, pregnancy, and prolonged standing. [6]
CHIVA method is a type of surgery used to treat varicose veins that occur as a result of long term venous insufficiency. [1] The term is a French acronym for Conservatrice Hémodynamique de l'Insuffisance Veineuse en Ambulatoire (ambulatory conservative hemodynamic treatment venous insufficiency).
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