Chronic Venous Insufficiency

• First-line therapy: compressive therapy
  • Sx CVD: elastic compression stockings exerting a pressure of ≥15 mmHg at the ankle
  • CVD + edema (CEAP class C3): compression treatment using below knee elastic compression stockings, inelastic bandages or adjustable compression garments, exerting a pressure of 20–40 mmHg at the ankle
  • CVD + lipodermatosclerosis and/or atrophie blanche (CEAP class C4b): compression treatment using below knee elastic compression stockings, exerting a pressure of 20–40 mmHg at the ankle
• Diuretic agents are not as effective in the setting of chronic venous disease
• Duplex ultrasound is the primary diagnostic test of choice in patients with CVD ¹
  • provides information about venous anatomy, patency, vein wall pathology, and flow

Algorithm source: ¹

Footnotes

1. De Maeseneer MG, Kakkos SK, Aherne T, et al. Editor’s choice - European Society for Vascular Surgery (ESVS) 2022 clinical practice guidelines on the management of chronic venous disease of the lower limbs. Eur J Vasc Endovasc Surg 2022;63:184-267. ↩ ↩²