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Chronic Venous Insufficiency, The Big Picture

In this post, I'd like to talk about CVI (Chronic Venous Insufficiency) from a 30,000 foot view. What causes it? How do I know if I have it? How is it treated? I will be borrowing a bit of content from Lympha Press, our pneumatic compression pump vendor, as they have done a great job summing it up into fewer words.


What is CVI?


"Chronic venous insufficiency (CVI) affects many adults age 50 and above. It can cause significant health problems including pain, skin changes, and edema. It also causes chronic leg wounds known as venous stasis ulcers (VSU’s).


CVI is often caused by damage to the one-way valves in the veins in the legs. Damaged valves allow blood to flow backwards, increasing the pressure in the veins. The pressure causes fluid to leak out of the vein capillaries.


Edema accumulates, and can cause significant leg swelling. It slows oxygen and nutrient delivery to the tissues, while damage to blood vessels triggers inflammation.

Skin changes occur, including hardening (fibrosis), pigmentation, stasis dermatitis (itchy, flaky skin), and skin breakdown. Venous stasis ulcers develop.


Symptoms



The problem will not go away if you wait, and the earlier it is diagnosed and treated, the better your chances of preventing serious complications.


Symptoms include:

  • Swelling in the lower legs and ankles, especially after extended periods of standing

  • Aching or tiredness in the legs

  • New varicose veins

  • Leathery-looking skin on the legs

  • Flaking or itching skin on the legs or feet

  • Stasis ulcers (or venous stasis ulcers)

If CVI is not treated, the pressure and swelling increase until the tiniest blood vessels in the legs (capillaries) burst. When this happens, the overlying skin takes on a reddish-brown color and is very sensitive to being broken if bumped or scratched.


At the least, burst capillaries can cause local tissue inflammation and internal tissue damage. At worst, this leads to ulcers, open sores on the skin surface. These venous stasis ulcers can be difficult to heal and can become infected. When the infection is not controlled, it can spread to surrounding tissue, a condition known as cellulitis.

CVI is often associated with varicose veins, which are twisted, enlarged veins close to the surface of the skin. They can occur almost anywhere, but most commonly occur in the legs.


Diagnosis


"To diagnose CVI, your doctor will perform a complete medical history and physical exam. During the physical exam, the doctor will carefully examine your legs.A test called a vascular or duplex ultrasound may be used to examine the blood circulation in your legs. During the vascular ultrasound, a transducer (small hand-held device) is placed on the skin over the vein to be examined. The transducer emits sound waves that bounce off the vein. These sound waves are recorded, and an image of the vessel is created and displayed on a monitor."


Treatments for CVI and Venous Stasis Ulcers (Wounds)


Static compression is the most common form of treatment. This includes compression stockings and bandaging. Intermittent pneumatic compression therapy (IPC) is another method to treat CVI and leg ulcers and Lympha Press is the right system for that !


Pneumatic Compression treats CVI by:

Increasing venous blood return. This reduces the production of edema fluid and helps prevent further damage to veins.Increasing lymph transport. This removes edema, moving edema proximally toward functional lymph vessels which enables edema removal when the local vessels are damaged by inflammation.


Pneumatic compression pumps speed healing of venous stasis ulcers and prevents their recurrence by:

  • Increasing oxygenation to the wound bed. Increased oxygenation helps heal wounds.

  • Assisting wound closure by reducing the swelling that keeps the wound edges apart.

  • Increasing venous return during the daily treatment sessions.

Pneumatic pumps are easy to use at home, as part of a total care plan including static compression (such as compression stockings) and wound care.

They reduce edema significantly, and can be used daily to improve venous circulation and prevent progression.


The Lympha Press PCD-51 ™  is designed to treat CVI edema. It provides accurate pressure and automatic or user-selected pause, to ensure complete deflation for vascular refill in between compression waves."





Warning: This Slideshow is very graphic. It shows the progression of untreated CVI.

Viewer Discretion Advised.





Sources:

https://my.clevelandclinic.org/health/diseases/16872-chronic-venous-insufficiency-cvi/diagnosis-and-tests

http://www.lympha-press.com/about-venous-insufficiency/


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