The venous wall and valvular function in chronic venous insufficiency.

The present paper is an overview taking into account the four most important etiological factors which can be involved in the development of chronic venous insufficiency (CVI): (1) weakness of the vascular wall including connective tissue and smooth muscle, (2) dysfunction and damage of the venous endothelium, (3) damage of the venous valves and (4) disturbancies of the microcirculation. The first three can be implicated in the development of reflux and venous hypertension and it is difficult to pin-point one single factor as being the most important. Disturbancies of the microcirculation eventually lead to the typical complications of CVI. With better understanding of the disease process it is possible to attack the causative factors leading to CVI and prevent and heal complications.