ABSTRACT
Ten to 35% of adults in the United States have some form of chronic venous insufficiency
(CVI) with venous ulcers affecting 4% of people over the age of 65 (1,2). Treatment of
patients with CVI and venous ulcers cost the U.S. government over one billion dollars a year.
In addition, 4.6 million work days per year are lost secondary to chronic venous disease (3,4).
The recurrent nature of the disease, the high cost to the healthcare system and the
ineffectiveness of current treatment modalities, underscore the need for CVI related research.
The past decade has refined our understanding of leukocyte mediated injury and elucidated
the role of inflammatory cytokines in lower extremity dermal pathology. In addition, our
understanding of pathologic cellular function and the molecular regulation of these processes
is increasing. This chapter will discuss the potential causes of varicose vein and venous ulcer
formation and the scientific evidence supporting these theories.
