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The treatments to prevent the formation of blood clots is balanced against the risk of bleeding. [5] One of the goals of blood clot prevention is to limit venous stasis as this is a significant risk factor for forming blood clots in the deep veins of the legs. [6] Venous stasis can occur during the long periods of not moving.
Compression therapy helps decrease venous pressure, prevents venous stasis and impairments of venous walls, and relieves heavy and aching legs. Knee-high compression stockings are used not only to help increase circulation, but also to help prevent the formation of blood clots in the lower legs.
A venous ulcer tends to occur on the medial side of the leg, typically around the medial malleolus in the 'gaiter area' whereas arterial ulcer tends to occur on lateral side of the leg and over bony prominences. A venous ulcer is typically shallow with irregular sloping edges whereas an arterial ulcer can be deep and has a 'punched out' appearance.
This valvular incompetence combined with persistent venous obstruction from thrombus increases the pressure in veins and capillaries. Venous hypertension induces a rupture of small superficial veins, subcutaneous hemorrhage [7] and an increase of tissue permeability. That is manifested by pain, swelling, discoloration, and even ulceration.
Venous ulcers are common and very difficult to treat. Chronic venous ulcers are painful and debilitating. Even with treatment, recurrences are common if venous hypertension persists. Nearly 60% develop phlebitis which often progresses to deep vein thrombosis in more than 50% of patients. The venous insufficiency can also lead to severe hemorrhage.
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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Venous thrombi are caused mainly by a combination of venous stasis and hypercoagulability—but to a lesser extent endothelial damage and activation. [7] The three factors of stasis, hypercoagulability, and alterations in the blood vessel wall represent Virchow's triad, and changes to the vessel wall are the least understood. [8]
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