Venous Insufficiency



  • 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
  • Contraction of leg musculature and competent venous valvular function maintain this unidirectional flow
  • 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
  • Lower-extremity venous valvular incompetence leads to chronic venous insufficiency and venous varicosities
  • Inadequacy of the venous valvular function causes impaired venous drainage, leading to lower-extremity edema
  • Chronic venous insufficiency and resultant increased venous pressure transmission into the dermal microcirculation leads to extravasation of macromolecules and red blood cells causing inflammatory injury, resulting in skin integrity changes, ulcer formation, and poor healing


  • Primary valve incompetence
  • Deep vein thrombosis (DVT)
  • Risk factors:
    • Advanced age (estimated prevalence of 5–30% of adult population)
    • Sex (female:male predominance of 3:1)
    • Family history of venous varicosity
    • DVT or phlebitis
    • Leg edema
    • Obesity
    • Pregnancy
    • Prior lower-extremity injury

There's more to see -- the rest of this topic is available only to subscribers.