Patients with Chronic Venous Insufficiency: Treatment Modalites of Venous Impairment and Its Complications during Two Years Period in Primary Care Center

Background: Venous disease is a common health problem in developed countries. The aim of this study was to research the medical treatment strategy, complication due to venous impairment including leg ulcer, deep and/or superficial phlebothrombosis related to chronic venous insufficiency (CVI) two years follow-up. Patients and Methods: This prospective study has been planned in our Family and Children Health Center. 196 patients who have CVI have been included for the study. The mean age of these patients was 45.0 ± 12.4 y (17 - 80 y). One hundred patients were female and the remaining 96 patients were male. The main complaints of the patients were leg pain, visible varices, skin hyperpigmentation and leg edema. Twenty-eight patients were hypertensive and 22 were diabetics. Cardiovascular specialists did recommend a mikronize flavonoid fractions, calcium dobesilat or oxerutine as a medical treatment. Also, compression bandage or stockings have been recommended additionally. Results: During two years period, leg ulcer developed in 10 patients (7 female and 3 male). Deep venous thrombosis has been detected by doppler USG in these patients who used antiaggregant and anticoagulants. We also detected deep venous thrombosis in two pregnant women. Control doppler ultrasonography showed that venous regurgitation increased from grade I to grade III or IV in 44 patients (33 female, 11 male; p < 0.05). Superficial venous thrombotic events related to CVI have been detected in nine patients. Dermatotrophyc changes and deep venous disease were common in women (OR = 0.7 for both) (p = 0.0032). Visible varicose veins were closely linked; 87.3% of legs were concordant and 13.7% discordant. The age-adjusted prevalence of edema, superficial events, and deep events were estimated as 32.2%, 19.3%, and 29.6%, respectively, compared with 1.2%, 0.3%, and 1.1% for legs visibly and functionally normal. Conclusion: Our study results showed that CVI complications and its complaints are more common in females. Complications because of CVI are more common and complaints are more severe in patients who did not use regularly pharmacologic treatment and compression stockings. Complications such as venous thrombosis and dermatotrophyc changes due to CVI are common especially in obese females. To decrease leg complaints due to venous stasis and its complication pharmacologic treatment together with compression stockings or bandage use regularly are very important factors.