Venous Insufficiency

Venous Insufficiency is a topic covered in the 5-Minute Emergency Consult.

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  • Inadequacy of the venous valves that causes impaired venous drainage leading to edema of the lower extremities.
  • A chronic condition of lower extremity vascular incompetence.
  • Normal blood flow in the venous system is unidirectional from the superficial veins to the deep veins.
  • Unidirectional flow is maintained by contraction of leg muscles and by valves within the veins.
  • Damage to the valves, e.g. following DVT, causes them to become rigid and they lose their ability to prevent retrograde blood flow properly.
  • Decreased venous return from lower extremities causes increased pressure and distention of the veins, which in turn causes separation of the valve leaflets.
  • Increased pressure transmitted into the dermal microcirculation results in extravasation of macromolecules and red blood cells causing inflammatory injury resulting in ulcer formation, skin changes, and poor ulcer healing.


  • Primary valve incompetence (most common)
  • Deep vein thrombosis (DVT)
  • Risk factors include advanced age, family history, smoking, sedentary lifestyle, obesity, lower extremity trauma, prior DVT, and pregnancy

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