Diagnosis and treatment of varicose veins. Part 1: definition, epidemiology, etiology, classification, clinical aspects, diagnostic and indications

摘要

This is the first of two articles on the diagnosis and treatment of varicose veins. Primary varicosis is a congenital degenerative disease of the peripheral venous system of the lower extremities. The realisation factors are age, female sex and pregnancy. Degeneration of the peripheral veins leads to dilatation of the lumen and insufficient closure of the valves resulting in a backflow of blood from deep to the superficial venous system. This leads to ambulatory hypertension in the superficial venous system and recirculation of noteworthy amounts of venous drainage blood in the affected leg. Without treatment this results in the long term in variable degrees of decompensation of the recirculation pathways and an increasing (volume-induced) secondary insufficiency of the deep venous system. The result corresponds to the clinical symptoms of chronic venous insufficiency (CVI). When treatment is started early enough the pathological course can be reduced or avoided. The various therapeutic measures will be described in the second article of this series.