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Lower extremity edema and venous insufficiency - Buffalo Niagara Vein Treatment Center and
Friday, August 23, 2013



Edema is the accumulation of fluid in the interstitial space that occurs as capillary filtration exceeds the limits of lymphatic drainage.  This produces clinical signs and symptoms known as edema. Edema in the lower extremities is associated with chronic venous insufficiency.  This chronic accumulation of edema in one or both lower extremities is consistent with a diagnosis of venous insufficiency.  Patients with venous insufficiency complain of aching and pain in the legs, heaviness and tiredness of the legs, cramping,  throbbing and restless legs as well as swelling or edema. 


Patients with venous insufficiency have associated signs such as stasis dermatitis, hyperpigmentation and sometimes lipodermatosclerosis which supports the diagnosis of chronic venous insufficiency.


When compression stockings do not alleviate lower extremity swelling, there is a need to perform additional diagnostic testing such as duplex venous ultrasonography. Rarely, additional tests may be performed when proximal deep vein thrombosis cannot be excluded and these include venography or magnetic resonance venography (MRV). 


The preferred treatment of chronic venous insufficiency is the use of ablation technique such as the VNUS closure procedure, endovenous laser therapy (EVLT) and the ClariVein procedures.


Browny, nonpitting skin with edema characterizes lymphedema which can be present in one or both extremities.  Lymphedema is mot commonly secondary in the United States and the western world and it is due to underlying tumor, lower extremity trauma, pelvic surgery, lymphadenopathy or previous radiation therapy or secondary to venous insufficiency.  The use of rutosides and compression stocking devices may be helpful in these patients.


For the treatment of venous insufficiency and secondary lymphedema contact Hratch Karamanoukian, MD FACS at the Vein Treatment Center with offices in Williamsville, New York and Clarence, New York.  Dr. Karamanoukian can be contacted through and or by calling 716-839-3638. are partners with




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