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Lattimer C. R.
Josef Pflug Vascular Laboratory, Ealing Hospital and Imperial College, London, UK
Chronic venous disease (CVD) affects approximately a quarter of the adult population and causes a considerable burden on the health of these patients. The true extent of the severity of the disease is hampered because of reduced public awareness, operational difficulties in diagnosis, and the perception that varicose veins are mainly a cosmetic inconvenience. Consequently the disease receives little attention in public health care systems which focus on life threatening conditions and those which cause obvious morbidity like cancer, cardiac disease and stroke. This review aims to correct these misconceptions by addressing the full scope of CVD, including the post-thrombotic syndrome and venous ulceration. The severity of conditions like telangectasiae and edema and the symptoms they cause are frequently underestimated, especially if varicose veins are not present to alert the patient or doctor. The definition, diagnosis, scope, epidemiology, progression and cost of CVD are discussed with evidence to explain how these underestimate the severity of the disease. It is anticipated that once CVD achieves greater recognition this will open up greater opportunities for treatment. These include surgery, endovenous ablation, stenting, compression, venoactive drugs like micronized purified flavonoid fraction and other drugs such as sulodexide and pentoxifylline.