Last reviewed: November 2017
Last updated: November  2017

Summary

Definition

History and exam

Key diagnostic factors

  • corona phlebectatica (malleolar flare or ankle flare)
  • ankle swelling
  • hyperpigmentation (brawny edema)
  • lipodermatosclerosis
  • atrophie blanche
  • leg ulcers

Other diagnostic factors

  • leg fatigue, aching, and/or discomfort
  • heavy legs
  • leg cramps
  • telangiectasias
  • reticular veins
  • dilated tortuous veins
  • dry and scaly skin
  • skin burning and itching
  • unilateral leg swelling

Risk factors

  • increasing age
  • family history
  • smoking
  • DVT
  • orthostatic occupation
  • female gender
  • obesity (waist circumference)
  • ligamentous laxity

Diagnostic investigations

Investigations to consider

  • ascending phlebography
  • CT venography
  • magnetic resonance venography
  • CT abdomen and pelvis
  • intravenous ultrasound
  • air plethysmography
Full details

Treatment algorithm

Contributors

Authors VIEW ALL

Professor and Chief

Division of Vascular Surgery and Endovascular Therapy

Michael E. DeBakey Department of Surgery

Baylor College of Medicine

Houston

TX

Disclosures

JLM declares that he has no competing interests.

Professor of Surgery

Director of Southern Arizona Limb Salvage Alliance (SALSA)

Department of Surgery

University of Arizona College of Medicine

Tucson

AZ

Disclosures

DGA declares that he has no competing interests.

Peer reviewers VIEW ALL

Division of Vascular Surgery

Brigham and Women's Hospital

Boston

MA

Disclosures

RAK has received NIH research funds greater than 6 figures USD. RAK has no other competing interests.

Medical Director/Consultant Vascular Surgeon

Bedford Hospital

Bedford

UK

Disclosures

PT declares that he has no competing interests.

Chief of Vascular Surgery

Tufts Medical Center

Boston

MA

Disclosures

MDI is the author of a study referenced in this monograph.

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