From the Guidelines
Treatment of chronic venous stasis should prioritize compression therapy with graduated compression stockings (20-30 mmHg or 30-40 mmHg) as the cornerstone of treatment, as it has been shown to reduce venous stasis and improve symptoms 1.
Key Components of Treatment
- Compression therapy: graduated compression stockings (20-30 mmHg or 30-40 mmHg) worn daily from morning to night, with a minimum pressure of 20 to 30 mm Hg recommended, and pressures of 30 to 40 mm Hg advised for more severe disease 1
- Elevation of the affected leg: above heart level for 30 minutes, 3-4 times daily
- Regular exercise: particularly walking and calf muscle exercises to improve calf muscle pump function
- Weight loss: recommended for overweight patients
- Skin care: use mild, fragrance-free moisturizers daily and avoid scratching affected areas
- Wound care: moist wound healing with appropriate dressings changed regularly for venous ulcers
Pharmacological Options
- Venoactive drugs: micronized purified flavonoid fraction (Daflon) 500 mg twice daily, pentoxifylline 400 mg three times daily with meals, or horse chestnut seed extract 300 mg twice daily
- NSAIDs: like ibuprofen 400-600 mg three times daily for painful symptoms
Procedures for Severe Cases
- Endovenous ablation
- Sclerotherapy
- Surgical interventions These treatments aim to reduce venous hypertension, improve microcirculation, and enhance venous return, addressing the underlying pathophysiology of venous stasis, as supported by recent guidelines 1.
From the Research
Treatment of Chronic Venous Stasis
- Chronic venous stasis, also known as chronic venous insufficiency (CVI), is a condition where the veins have problems returning blood to the heart due to issues like blood clots or varicose veins.
- The treatment of chronic venous stasis often involves the use of graduated compression stockings, which are designed to improve blood flow and reduce swelling in the legs 2, 3, 4.
- Studies have shown that wearing graduated compression stockings can lead to a significant improvement in symptoms such as swelling, pain, and skin discoloration in patients with CVI 3.
- The use of compression stockings has also been found to be effective in reducing the cross-sectional area of veins and improving viscoelasticity in patients with chronic venous disease 5.
- However, adherence to treatment with compression stockings can be a problem, with one study finding that 44.2% of patients were non-adherent due to reasons such as financial constraints, pain, and ignorance of the need to wear them 6.
Types of Compression Stockings
- There are different types of compression stockings available, including knee-length and full-length stockings, as well as stockings with different levels of pressure 4.
- The choice of compression stocking will depend on the individual patient's needs and the severity of their condition.
- Some studies have compared the effectiveness of different types of compression stockings, but the results are often inconsistent and more research is needed to determine the optimum length and pressure of compression stockings 4.
Benefits and Limitations of Compression Stockings
- The benefits of compression stockings include improved blood flow, reduced swelling, and relief from symptoms such as pain and skin discoloration 2, 3.
- However, there are also some limitations to the use of compression stockings, including the potential for skin irritation and discomfort, as well as the need for regular replacement 4, 6.
- Overall, the use of compression stockings is a common and effective treatment for chronic venous stasis, but more research is needed to fully understand their benefits and limitations 2, 5, 3, 4, 6.