Disease of the venous system
Statue of Ancient Rome Chronic venous insufficiency of lower extremity
anatomy Venous system of the legs is composed by two parallel and connected systems, the deep and superficial venous. These two systems was connected by perforating venous system
primary venous insufficiency etiological factor 1. Valvular incompetence →blood reflux→high pressure in venous→venous dilatation 2.Weak vessel wall→ dilatation→valvular incompetence
clinical manifestation Simple varicose venous—varicose of superficial vein , no complication complications— dystrophic complication in skins（eczema、ulcer） rupture to hemorrhage perforator venous insufficiency —ankle edema， dystrophic complication of ankle skins
Superficia varicose veins venous ulcer
diagnosis clinical manifestation imaging detection： phlebography color Dopple
Diagnostic studies Venography Forced Valsalva maneuver light region under valvula Normal valvula light region disappearing under valvula Valvula incompetence
treatment Conservative treatment： Compression Stockings or pressure bandages and lower extremity elevation Foam sclerotherapy Surgical treatment：high ligation and stripping of great (small) saphenous vein＋varicose vein stripping deligation of perforating venous!