Venous Stasis

Venous Stasis starts as functional venous valves are required to provide for efficient blood return from the lower extremities, venous stasis often occurs in the veins of the legs. Itching (pruritus) is sometimes a symptom, along with discoloration (purple or brown) of the legs. Symptoms of venous stasis include edema or chronic swelling of the legs and ankles. The skin may react with varicose eczema, local inflammation, discoloration, thickening, and an increased risk of ulcers and cellulitis. The condition has been known since ancient times and Hippocrates used bandaging to treat it. It is better described as chronic peripheral venous insufficiency.

Venous Stasis
Venous Stasis

The venous system contains valves responsible for preventing backflow of blood to the legs due to gravity. When these valves fail, either because of blood clots, or they no longer able to function properly, blood begins to pool in the lower extremities. In the early stages, small areas of brown discoloration occur around the ankle region. This brown color is a byproduct of blood breakdown called hemosiderin. This is commonly referred to as venous valve incompetence.

Venous Stasis Treatment

Venous valve incompetence is treated conservatively with manual compression lymphatic massage therapy, skin lubrication, sequential compression pump, ankle pump, compression stockings, blood pressure medicine, frequent periods of rest elevating the legs above the heart level and using a 20 cm (7-inch) bed wedge during sleep. Surgical treatments include the old Linton procedures and the newer subfascial endoscopic perforator vein surgery. Some experimental valve repair or valve transposition procedures as well as some hemodynamic surgeries are being pursued. This whole field of medicine while ancient is still filled with complications e.g. Sometimes an artery can strangulate a vein or sometimes an arteriovenous fistula (an abnormal connection or passageway between an artery and a vein) may be causing the apparent poor venous return.

Patients are often encouraged to walk while wearing the prescribed medical stockings and to sleep in a 6 degree Trendelenburg position. Obese or pregnant patients might be advised by their physicians to forgo the tilted bed.