|
Venous Stasis
Venous stasis refers to loss of proper
function of the veins in the legs that would normally carry blood back
toward the heart. This may occur following injury to the veins, which
can result in blood clots in the superficial veins known as superficial phlebitis, or following blood clots in the deep veins known as deep venous thrombosis. Swelling in the lower legs and ankle can also occur as a result of heart disease called Chronic Congestive Heart Failure and due to kidney disease. In some instances the cause of the swelling may not be easily identified. Diagnosis Individuals with this condition usually exhibit edema,
which means swelling, of the legs and ankles. The superficial veins in
the legs may be varicosed, causing the veins to be enlarged and appear
as a cord or a bunch of grapes. Patients often complain of a feeling of
fullness, aching, or tiredness in their legs. These symptoms are worse
with standing, and are relieved when the legs are elevated. As
the condition progresses the blood continues to collect in the feet,
ankles, and legs. The pigmentation from the red blood cells stains the
skin from the inside, and a reddish-brown discoloration develops on the
skin. This is called venous stasis dermatitis. In
severe cases of long-standing venous stasis, the skin begins to lose
its elasticity, and a sore may develop on the inside of the ankle. This
is known as venous stasis ulceration. This ulcer often will
drain large amount of fluid and will have a red base. Secondary
infection can complicate the ulcer and will require antibiotic
treatment. Further testing may be requested by your doctor to further evaluate the condition of your veins. This may include venous Doppler testing,
which uses sound waves to listen to the blood flow through the veins.
If there is a suspicion of an acute thrombosis (blood clots), a venogram may
be requested. This enables the veins to be visible on x-rays, and the
blood clot can be identified with greater certainty. Identification of
deep vein thrombosis is important, because failure to properly treat
may result in a blood clot breaking loose in the leg and traveling to
the lungs called pulmonary embolus, which can be fatal. Treatment The
most common treatments for venous stasis are rest, elevation, and
compression stockings. When elevating your feet the ideal position is
to have your feet above the level of your heart. This permits greater
return of blood back toward the heart. This usually means you are lying
down with your legs raised with pillows. The
compressive stockings come in different lengths. A knee high stocking
may be sufficient if the swelling is confined to the lower legs and
ankles. However if the swelling extends up to the knee, then a thigh
high or panty hose style elastic stocking may be required. The
compression stockings are also available in a variety of compression
strengths. The greater the compression the more squeeze the stocking
will apply to the leg. Generally, over-the-counter elastic stockings
are available (without prescription) in most pharmacies or surgical
supply stores. These have a compression range of 10 to 20 mm
compression. If these do not provide enough compression to control the
edema, then a prescription compression stocking may be necessary. These
begin at 30 to 40 mm compression, and are often referred to as T.E.D.
stockings. In more severe cases a higher level of compression may be
necessary. These stockings often need to be custom sized to each
individual leg, otherwise they are difficult to put on and may not
provide even compression throughout the extremity. Your doctor may also
use medications to reduce the swelling called Diuretics. Diuretics
increase the output of urine and your doctor should closely monitor the
use of this medication. If the cause of the swelling is due to heart
problems or kidney problems your doctor will evaluate the need to
adequately treat these conditions.
Back to Top
|
