Lower Extremity Venous Disease

Lower extremity venous disease is extremely common, with varicose veins remaining the most frequently encountered venous condition followed by chronic venous insuffi ciency.1,2 The two conditions often occur together, but each condition may also be present clinically without the other. Lower extremity venous disease comprises a clinical spectrum ranging from completely asymptomatic telangiectasias to symptomatic varicose veins to debilitating venous ulcers.1,2 The most frequently encountered symptoms associated with varicose veins include leg swelling, pain, itching, nocturnal cramping, and leg heaviness. Patients with chronic venous insuffi ciency often present with leg edema, skin hyperpigmentation, stasis dermatitis of the skin involving the ankles, fi brosis of the subcutaneous fat (lipodermatosclerosis), and ulceration.1,2 Lower extremity venous ulceration remains a signifi cant worldwide health problem resulting in signifi cant morbidity.1,2 Deep venous thrombosis (DVT) of the lower extremities is another highly prevalent venous condition encountered by health care providers of all disciplines.3 Much has been published regarding venous thromboembolic disease4-8; therefore, the content of this chapter is limited to the intrinsic venous disorders of the lower extremities.