Information On Chronic Venous Insufficiency (CVI )

Information On Chronic Venous Insufficiency (CVI )
Chronic venous insufficiency is an advanced stage of venous
disease caused either by superficial (severe varicose veins) or deep
(after deep vein thrombosis) venous pathology and characterized by an
increased venous pressure during walking. Most often this condition is
seen in the veins of the lower extremities. Symptoms include leg
swelling, leg pain, and muscle cramps. This condition can predispose to
venous thrombosis.

When the veins aren't returning blood to the heart well enough, the
cells lining the veins don't receive enough oxygen, so they release
substances in the blood. These substances cause inflammation. As part
of inflammation, swelling occurs. Swelling is one symptom of venous
insufficiency, and it also makes it harder for the veins to work,
increasing the problem of venous insufficiency. The same substances
that produce swelling increase the fragility of the veins. This would
contribute to varicose veins.

The usual treatment in the early stages of CVI is elastic stocking
to apply external pressure to the system and dressings and salves to
treat the ulcers. The only treatment for advanced stages of the disease
was surgery to tie off the perforator veins to relieve the pressure in
the superficial system.

Now, however, techniques have been developed which permit vascular
surgeons to either repair damaged valves in the large veins of the
upper leg, or to bypass them using a length of vein with healthy valves
from somewhere else in the body. Only one or two key valves must be
restored to normal function to return pressures in the system to normal.

To date, however, only a fairly small percentage of the vascular
surgeons competent to perform the operation have become familiar with
it. This is unfortunate, given the lifetime of misery CVI can cause
those it afflicts, and the relief the surgery bestows, both from the
condition's chronic pain and all but incurable leg ulcers.

Three substances have proved useful in treating chronic venous
insufficiency: horse chestnut extract, oxerutins, and Daflon. Horse
chestnut extract is sold over-the-counter in the U.S. as Venastat. The
other two are available in Europe but not the U.S.

The active ingredient of horse chestnut extract is escin. Oxerutins
is a mixture of substances chemically derived from rutin, a
naturally-occurring substance. Daflon is a mixture of 90% diosmin and
10% hesperidin, two bioflavanoids. Diosmin and hesperidin are found in
citrus fruits.