Chronic Venous Insufficiency

Question 1

What is the pathophysiology of CVI

Answer 1

Venous hypertension from

1. Obstruction of flow
2. Dysfunction of valves
3. Failure of venous pump

Question 2

What is the clinical presentation of CVI

Answer 2

1. Venous dilation
2. Edema
3. Skin changes
4. Venous ulcer

Question 3

What is the CEAP classification of CVI

Answer 3

-

Question 4

What are the types of venous dilatation

Answer 4

1. Telangiectasis 0.1-1mm
2. Reticular veins 1-3mm
3. Varicosities - >3mm
4. Corno phlebecatica - underneath the ankle

Question 5

What is the hallmark of CVI

Answer 5

Edema worsened on dependency and better with recumbency

Question 6

What skin changes occur in CVI

Answer 6

1. Hyperpigmentation on gaiter area due to hemosiderin
2. Phlegmasia alba dolens
3. Atrophie blanche - avascular fibrotic scars
4. Eczema
5. Lipodermatosclerosis resulting in inverted champagne bottle sign
6. Cellulitis

Question 7

What is are the features of venous ulcer formation

Answer 7

Shallow, flat, moist ulcer commonly over medial malleoulus
Surrounding skin with CVI
Risk of SCC (Marjolin ulcer)