What is the role of venous hypertension in the pathogenesis of chronic venous insufficiency (CVI)?

Updated: Oct 22, 2018
  • Author: Robert Weiss, MD; Chief Editor: William D James, MD  more...
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Answer

Venous hypertension in diseased veins is thought to cause CVI through the following sequence of events [2] :

  • Increased venous pressure transcends the venules to the capillaries, impeding flow

  • Low-flow states within the capillaries cause leukocyte trapping

  • Trapped leukocytes release proteolytic enzymes and oxygen free radicals, which damage capillary basement membranes

  • Plasma proteins (eg, fibrinogen) leak into the surrounding tissues, forming a fibrin cuff

  • Interstitial fibrin and resultant edema decrease oxygen delivery to the tissues, resulting in local hypoxia

  • Inflammation and tissue loss result


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