Different types of venous conditions

What is venous disease?

Venous disease comprises acute and chronic (long-term) manifestations. An example of an acute venous disease is deep vein thrombosis, which is the formation of a blood clot inside the vein.

Chronic venous disease, also abbreviated as CVD, is characterized by a variety of clinical manifestations and symptoms. CVD can present as spider veins or varicose veins in early stages, up to skin changes or venous leg ulcers in the case of chronic venous insufficiency. Chronic venous disease affects about every third to fourth adult worldwide. The frequency increases with age. Professions that require prolonged standing or sitting, pregnancy, overweight, and genetic factors can all impair the normal function of the veins and vein valves.

The following sections focus on chronic venous disease. You can find more information about acute disease, such as deep vein thrombosis, here.

What causes chronic venous disease?

The underlying causes of chronic venous disease are damaged vein walls and vein valves that result in impaired venous return. The pooling of venous blood in the legs causes higher pressure inside the venous system, also called venous hypertension. As a reaction to this high pressure, the veins become larger and further impair the function of the vein valves, creating a vicious circle. These changes affect blood circulation, initiate inflammatory reactions, and result in a remodeling of the vein walls and valves.

Signs and symptoms of chronic venous disease

Heavy or tired legs, itching sensations, or swollen ankles can be the first signs of a chronic venous disease. The Clinical Etiological Anatomical Pathophysiological (CEAP) classification is the most used system to distinguish between different clinical manifestations, causes and locations of chronic venous disease.

Feet and legs showing the clinical stages of chronic venous disease, from no visible signs (C0) to active venous ulcers (C6).

The clinical stages of chronic venous disease are:

C0 = Earliest stage with no visible signs of venous disease but other signs such as heavy legs

C1 = Spider veins (also called telangiectasia) or reticular veins are tiny or small dilated, visible veins located in the upper layer of the skin

C2 = Varicose veins are tortuous and enlarged superficial veins

C3 = Edema (swelling of the leg and ankle)

C4 = Skin changes, including brown spots (pigmentation), inflammatory changes (eczema), scarring and hardening of the skin

C5 and C6 = Healed (C5) or active (C6) venous leg ulcers (wounds of the lower leg that don’t heal within two weeks).

The more advanced CEAP stages C3 to C6 are named chronic venous insufficiency (CVI).

How can venous disease be treated?

The appropriate treatment of chronic venous disease mainly depends on the stage and severity of the disease. However, wearing compression stockings is part of the basic therapy for all individuals with this condition. Compression exerts external pressure on the lower limbs and so improves the venous return. Wearing compression stockings can significantly alleviate symptoms, reduce the swelling in your legs, support the healing of sores and wounds caused by venous disease, and prevent complications of venous insufficiency.

Deep vein thrombosis

Learn about the risks, symptoms, and preventive measures for deep vein thrombosis (DVT), a condition where blood clots form in deep veins, typically in the legs.