Venous oedema

If the volume of your legs is constantly increased, and pressure on the affected part leaves an indent, you have oedema. The cause could be venous or lymphatic. A doctor’s consultation will provide the correct diagnosis. Compression therapy is the basic therapy for oedema.

Man and woman playing chess in a lobby

Your legs are swollen, especially in the evening and summer, and these swellings disappear when you raise your legs? These might be the first signs of venous disease. If the leg remains swollen even after elevating your legs, it could be oedema.

Whatever is the case, you should visit a health care professional for proper diagnosis and to check for underlying causes.

What is venous oedema?

Oedema is defined as a perceptible increase in the volume of fluid in the skin and subcutaneous tissue. Applying pressure on oedema will leave an indentation that remains on the skin after the pressure is released.

Venous oedema usually first occurs in the ankle region; it may also extend to the leg and foot.

What causes venous edema?

There are many causes of oedema, such as standing or sitting for long periods of time, physical inactivity, chronic venous disease, lymphoedema, heredity, pregnancy, surgery, and trauma.

Oedemas of venous origin develop when venous valves don’t close properly and blood stagnates in the veins, thereby preventing the blood vessels from properly functioning.

For an affected person, there is often no visible difference between venous oedema and lymphoedema. In any case, if you experience swelling, you should visit your doctor for correct diagnosis and treatment.

What can I do about venous edema?

Your healthcare professional will examine your symptoms as well as the presence of varicose veins, trophic skin disorders or skin ulcers that may be associated with a venous disease.

By means of ultrasound, the doctor can visualize the blood flow and check if the development of your edema is associated with a venous disorder and if the superficial veins or the system of deep veins in your legs are affected.

Early diagnosis of oedema is essential to prevent disease progression and to avoid more serious complications.

Medical compression therapy: a non-invasive treatment

To help with venous oedema, medical compression therapy is used as basic non-invasive treatment. 

Your healthcare professional can prescribe medical compression stockings. The elastic material of the medical compression stocking provides an active pressure to the leg and gently squeezes the vein walls together.

The strongest pressure is applied at the ankle and decreases going upwards along the leg, thereby easing blood flow back towards the heart, reducing venous pressure, and improving overall circulation.

In some cases, a massage-like technique called manual lymphatic drainage (MLD) can help as well.

Other treatment options for venous oedema

Venous oedema originates from an underlying venous disorder, which can be treated with non-invasive compression therapy, but also with more invasive techniques. Different treatment options include: 

Chemical ablation (ultrasound-guided foam sclerotherapy)
right_arrow

Injection of a liquid, foam, or glue under ultrasound guidance that causes the veins to shrink and collapse.

Phlebectomy and vein stripping
right_arrow

Surgical removal of varicose veins. Superficial veins are removed through small incisions (micro-incision phlebectomy); deep veins are removed via vein stripping.

Summary

Oedema can be a sign of a venous disorder.

Basic medical knowledge on venous disorders

  • With the term chronic venous disorder (CVD) we describe a long-standing condition involving impaired venous return.
  • If vein valves don’t close properly, a reflux results: the blood leaks downwards and stagnates in the vein, thereby leading to venous hypertension. This condition is known as chronic venous insufficiency (CVI) which may cause oedema, skin change, and, in some cases, ulcerations.
  • If left untreated, chronic venous insufficiency can result in the formation of serious disorders, including phlebitis and pulmonary embolism. To distinguish the different manifestations of CVD, the CEAP classification system is used.
  • Acute venous disorders usually occur without pre-existing conditions, but they can also be triggered by chronic venous disorders. In any case, medical treatment is immediately required. Acute venous disorders include superficial thrombophlebitis, deep vein thrombosis (DVT), pulmonary embolism, post-thrombotic syndrome, and variceal bleeding.

 

 

Further reading