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Acta Phlebologica 2018 August;19(2):40-6

DOI: 10.23736/S1593-232X.18.00425-3


language: English

Varicose veins and the chronicity of venous pathology

Leonardo ALUIGI

Italian Society of Vascular Investigation, Bologna, Italy

Varicose disease is key in the clinical management of venous pathology, both because of its prevalence, especially in the female population (50-55%), and because of the marked tendency to relapse recur after treatment, but above all because varicose veins represent an objective sign of the venous chronicity in the so-called chronic venous disease (CVD). The topic of chronicity concerns all venous clinical pictures and the medical community today is well aware of this, from management of recurrent symptoms, to recurrences of the treated varicose pathology and of the severe ulcerative forms, up to patients with thrombosis, recently defined as “chronic,” due to the tendency to recur up to twenty years from the episode of VTE and to the incidence of severe forms (C4-C6) of the post-thrombotic syndrome (5-10%), characterized by skin changes and ulcers. Also, for the patient with VTE, the varicose disease today represents a risk factor because of recurrences. On the other hand, the hemodynamic and inflammatory nature, of venous pathophysiology favors a vicious circle which supports the dilation of the venous walls, the degradation of valve architecture and the progressive deformation of venous segments, varicose veins, precisely. The passage to the varicose disease therefore represents the true watershed between an early stage of the disease, very often purely symptomatic, which periodically becomes active due to exogenous causes (e.g. standing for long periods of time, hot season, etc.) and a chronic varicose stage, more or less symptomatic, kept active by endogenous, hemodynamic and inflammatory causes, which increase individual vulnerability to exacerbate the symptoms and to progression in clinical pictures.

KEY WORDS: Varicose veins - Venous thromboembolism - Thrombosis

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