1. Venous mx 16-17

2. Simple spider veins to complex dermal sclerosis and ulcer formations.
Venous Disease (CVI)
Simple spider veins to complex dermal sclerosis and ulcer formations.

3. Venous Anatomy

4. Obstruction Reflux and/or incompetence
Venous Pathology
Obstruction
Reflux and/or incompetence

5. Venous Obstruction As a result of DVT or superficial phlebitis
As a result of extrinsic compression
1. Tumors
2. Vascular compression (May-Thurner
syndrome)

6. Venous Reflux
Spider Veins
Varicose Veins

7. Venous Statis w/wo Ulcer
Venous Reflux
Edema
Venous Statis w/wo Ulcer

8. Venous History of Patient
Pain
Edema
Ulcers

9. Physical Exam of Patient
Supine and Standing
Objective findings of spider or varicose veins
Skin changes (hypopigmentation to atrophic blanch and atherosclerosis)
Edema (typically pitting)
Ulcer formation
Pulses

10. Interventional Therapy
Sclerotherapy
Endovenous Ablation
Surgical

11. Sclerotherapy

12. Endovenous Ablation

13. Treatment 1. Leg elevation – above heart level 30 min.
2. Compression therapy - compression stockings , pneumatic compression device
3. Exercises – With leg elevation
Ankle mvts.
external rotation of hips,
Hip adduction,
Repeated walking movement

14. Self care Avoid static posture for more than hour
Avoid constructing clothing around calves
Avoid high heels
Watch you weight
Exercise
Avoid crossing your legs while sitting

15. Similarities and Differences
Arterial symptoms produced by exercise and relieved by resting even standing
Venous symptoms worsened by standing and improved by exercise and leg elevation

16. Treatment Differences
In the arterial system, treatment is aimed at opening and restoring blood flow
In the venous system, treatment is aimed at obstructing and eliminating dysfunctional blood vessels

17. ANATOMY & PHYSIOLOGY
LYMPHATIC FLUID COLLECTS & RETURNS TO VENOUS CIRCULATION BY EMPTYING INTO SUBCLAVIAN VEINS
WHEN INTERSTITIAL FLUID PRESSURE INCREASES LYMPHATIC FLOW INCREASES
WHEN DRAINAGE IS IMPAIRED EDEMA ENSUES (FLUID COLLECTS)

18. INTERVENTIONS
Elevation and immobilization of the extremity
Elastic stockings
Na restriction
Antibiotics/antifungals for infection
Diuretics
Analgesics