INSUFISIENSI VENA KRONIK

AKINA MAULIDHANY TAHIR, M.D

AREA KOMPETENSI SKDI 2012

04/11/2023 Insufisiensi Vena Kronik 2

 DEFINISI

Gangguan vena menahun atau Chronic Venous Insufficiency (CVI) adalah gangguan aliran balik darah
dari tungkai ke jantung yang bersifat menahun.

CVI terjadi jika katup vena tidak berfungsi dengan baik, dan terjadi gangguan sirkulasi darah pada
vena tungkai.

CVI merupakan kondisi mengenai sistem vena ekstremitas bawah yang dapat menyebabkan
berbagai patologi, meliputi nyeri, bengkak, perubahan kulit, dan ulserasi.

1. Chronic venous insuffi ciency [Internet]. 2012 [cited 2014 June 6]. Available from: http://www.summitmedicalgroup.com/library/adult_health/aha_venous_insuffi ciency/
2. Eberhardt RT, Raff etto JD. Chronic venous insuffi ciency. Circulation 2005;111:2398-409.
3. Chronic venous insuffi ciency [Internet]. 2012 [cited 2014 June 6]. Available from: http://vasculardisease.org/chronic-venous-insuffi ciency-cvi/
04/11/2023 4. Understanding varicose veins - the basics [Internet]. 2014 [cited 2014 June 6]. Available from: http://www.webmd.com/skin-problems-and-treatments/understanding-varicose-veinsbasics. Insufisiensi
3 Vena Kronik
5. Varicose vein [Internet]. 2010 [cited 2014 June 6]. Available from: http://www.webcitation.org/5r1PRrJul.
 1. Chronic venous insuffi ciency [Internet]. 2012 [cited 2014 June 6]. Available from: http://www.summitmedicalgroup.com/library/adult_health/aha_venous_insuffi ciency/
2. Eberhardt RT, Raff etto JD. Chronic venous insuffi ciency. Circulation 2005;111:2398-409.
3. Chronic venous insuffi ciency [Internet]. 2012 [cited 2014 June 6]. Available from: http://vasculardisease.org/chronic-venous-insuffi ciency-cvi/
04/11/2023 4. Understanding varicose veins - the basics [Internet]. 2014 [cited 2014 June 6]. Available from: http://www.webmd.com/skin-problems-and-treatments/understanding-varicose-veinsbasics. 4
5. Varicose vein [Internet]. 2010 [cited 2014 June 6]. Available from: http://www.webcitation.org/5r1PRrJul. Insufisiensi Vena Kronik
PATOFISIOLOGI

1. Chronic venous insuffi ciency [Internet]. 2012 [cited 2014 June 6]. Available from: http://www.summitmedicalgroup.com/library/adult_health/aha_venous_insuffi ciency/
2. Eberhardt RT, Raff etto JD. Chronic venous insuffi ciency. Circulation 2005;111:2398-409.
3. Chronic venous insuffi ciency [Internet]. 2012 [cited 2014 June 6]. Available from: http://vasculardisease.org/chronic-venous-insuffi ciency-cvi/
04/11/2023 4. Understanding varicose veins - the basics [Internet]. 2014 [cited 2014 June 6]. Available from: http://www.webmd.com/skin-problems-and-treatments/understanding-varicose-veinsbasics.
5. Varicose vein [Internet]. 2010 [cited 2014 June 6]. Available from: http://www.webcitation.org/5r1PRrJul.
Insufisiensi Vena Kronik 5
GAMBARAN KLINIS
Tungkai terasa nyeri dan • Munculnya spider
berat (sering lebih buruk
• Pelebaran vena
veins (telangiektasis)
pada malam hari dan dekat di tungkai yang
setelah latihan atau berdiri
lama) permukaan kulit terkena

• Perubahan warna kulit • Kemerahan, kering, dan

• Pergelangan kaki menjadi kuning kecoklatan
gatal di daerah kulit,
bengkak, terutama yang mengilap di dekat
yang disebut dermatitis
pembuluh darah yang
pada malam hari terkena atau eksim stasis vena

• Cedera ringan pada daerah

• Kram bisa terjadi yang terkena dapat
• Pada beberapa orang, kulit di
atas pergelangan kaki dapat
terutama saat
1. Chronic venous insuffi ciency [Internet]. 2012 [cited 2014 June 6]. Availablemenyebabkan perdarahan lebih ciency/
from: http://www.summitmedicalgroup.com/library/adult_health/aha_venous_insuffi
2. Eberhardt RT, Raff etto JD. Chronic venous insuffi ciency. Circulation 2005;111:2398-409. mengisut (lipodermatosklerosis)
3. Chronic venous insuffi ciency [Internet]. 2012 [cited 2014 June 6]. Availabledari normal atau membutuhkan
pergerakan tiba-tiba,
04/11/2023
from: http://vasculardisease.org/chronic-venous-insuffi ciency-cvi/
4. Understanding varicose veins - the basics [Internet]. 2014 [cited 2014 June 6]. Available from: http://www.webmd.com/skin-problems-and-treatments/understanding-varicose-veinsbasics.
karena lemak di bawah
Insufisiensi kulit6
Vena Kronik
waktu lama untuk
5. Varicose vein [Internet]. 2010 [cited 2014 June 6]. Available from: http://www.webcitation.org/5r1PRrJul.
STADIUM
C0 : •ti dakada tand a- tand ap en yakit vena yang terl ihat atau t erab a

C1 : •telang iektasia atau vena ret iku ler

• C2 : •vari ses (d ibedakan dari ven ar eti ku ler deng an d iameter > 3 mm)

• C3 •ed ema

• C4 •p er ub ah an pada kuli t seku nd er t erh ad ap p en yakit ven a kro n ik

C4b : •lip o dermat osklero sis at au at ro ph ie blanche

• C5 : •u lku s ven asemb uh

• C6 : • u lku s ven a akt if

1. Chronic venous insuffi ciency [Internet]. 2012 [cited 2014 June 6]. Available from: http://www.summitmedicalgroup.com/library/adult_health/aha_venous_insuffi ciency/
2. Eberhardt RT, Raff etto JD. Chronic venous insuffi ciency. Circulation 2005;111:2398-409.
3. Chronic venous insuffi ciency [Internet]. 2012 [cited 2014 June 6]. Available from: http://vasculardisease.org/chronic-venous-insuffi ciency-cvi/
04/11/2023 4. Understanding varicose veins - the basics [Internet]. 2014 [cited 2014 June 6]. Available from: http://www.webmd.com/skin-problems-and-treatments/understanding-varicose-veinsbasics.
5. Varicose vein [Internet]. 2010 [cited 2014 June 6]. Available from: http://www.webcitation.org/5r1PRrJul.
Insufisiensi Vena Kronik 7
DIAGNOSTIK

CVI terutama
•Akurasi pemeriksaan fisik dapat ditingkatkan dengan
didiagnosis bantuan alat Doppler, sehingga pemeriksa dapat
mendengarkan aliran darah.
dengan •Pemeriksaan paling akurat dan rinci adalah dengan
Venous Duplex Ultrasound yang dapat memberikan

pemeriksaan gambaran vena, sehingga adanya hambatan akibat

bekuan darah atau gangguan fungsi vena dapat dideteksi.

fisik.
1. Chronic venous insuffi ciency [Internet]. 2012 [cited 2014 June 6]. Available from: http://www.summitmedicalgroup.com/library/adult_health/aha_venous_insuffi ciency/
2. Eberhardt RT, Raff etto JD. Chronic venous insuffi ciency. Circulation 2005;111:2398-409.
3. Chronic venous insuffi ciency [Internet]. 2012 [cited 2014 June 6]. Available from: http://vasculardisease.org/chronic-venous-insuffi ciency-cvi/
04/11/2023 4. Understanding varicose veins - the basics [Internet]. 2014 [cited 2014 June 6]. Available from: http://www.webmd.com/skin-problems-and-treatments/understanding-varicose-veinsbasics.
5. Varicose vein [Internet]. 2010 [cited 2014 June 6]. Available from: http://www.webcitation.org/5r1PRrJul.
Insufisiensi Vena Kronik 8
 TERAPI KONSERVATIF

Mengangkat tungkai. Olahraga teratur, seperti berjalan, dapat memperkuat otot betis.

Pemakaian stocking kompresi. Pemakaian perangkat kompresi pneumatic intermiten

Obat anti-inflamasi seperti ibuprofen atau aspirin.

Gel topikal membantu mengelola gejala yang berkaitan dengan varises, seperti peradangan, nyeri, bengkak,
gatal, dan kulit kering. Steroid topikal diperlukan jika terjadi .dermatitis stasis
1. Chronic venous insuffi ciency [Internet]. 2012 [cited 2014 June 6]. Available from: http://www.summitmedicalgroup.com/library/adult_health/aha_venous_insuffi ciency/
2. Eberhardt RT, Raff etto JD. Chronic venous insuffi ciency. Circulation 2005;111:2398-409.
3. Chronic venous insuffi ciency [Internet]. 2012 [cited 2014 June 6]. Available from: http://vasculardisease.org/chronic-venous-insuffi ciency-cvi/
04/11/2023 4. Understanding varicose veins - the basics [Internet]. 2014 [cited 2014 June 6]. Available from: http://www.webmd.com/skin-problems-and-treatments/understanding-varicose-veinsbasics.
5. Varicose vein [Internet]. 2010 [cited 2014 June 6]. Available from: http://www.webcitation.org/5r1PRrJul.
9 Vena Kronik
Insufisiensi
MANAJEMEN INTERVENSI AKTIF

•Skleroter Tekn •Strippi

Tek
api ng
•Terapi ik •Ligasi
ablasi :
Radiofre Non- Vena nik
dan
Be
quency
Ablation
atau
Bed Phlebe
ctomy
Endoven
ous Laser
Therapy
ah •Cryosu dah
rgery
1. Chronic venous insuffi ciency [Internet]. 2012 [cited 2014 June 6]. Available from: http://www.summitmedicalgroup.com/library/adult_health/aha_venous_insuffi ciency/
2. Eberhardt RT, Raff etto JD. Chronic venous insuffi ciency. Circulation 2005;111:2398-409.
3. Chronic venous insuffi ciency [Internet]. 2012 [cited 2014 June 6]. Available from: http://vasculardisease.org/chronic-venous-insuffi ciency-cvi/
04/11/2023 4. Understanding varicose veins - the basics [Internet]. 2014 [cited 2014 June 6]. Available from: http://www.webmd.com/skin-problems-and-treatments/understanding-varicose-veinsbasics.
5. Varicose vein [Internet]. 2010 [cited 2014 June 6]. Available from: http://www.webcitation.org/5r1PRrJul.
Insufisiensi Vena Kronik 10
 1. Chronic venous insuffi ciency [Internet]. 2012 [cited 2014 June 6]. Available from: http://www.summitmedicalgroup.com/library/adult_health/aha_venous_insuffi ciency/
2. Eberhardt RT, Raff etto JD. Chronic venous insuffi ciency. Circulation 2005;111:2398-409.
3. Chronic venous insuffi ciency [Internet]. 2012 [cited 2014 June 6]. Available from: http://vasculardisease.org/chronic-venous-insuffi ciency-cvi/
04/11/2023 4. Understanding varicose veins - the basics [Internet]. 2014 [cited 2014 June 6]. Available from: http://www.webmd.com/skin-problems-and-treatments/understanding-varicose-veinsbasics.
5. Varicose vein [Internet]. 2010 [cited 2014 June 6]. Available from: http://www.webcitation.org/5r1PRrJul.
Insufisiensi Vena Kronik 11
KESIMPULAN

Ganggguan vena menahun banyak dijumpai di semua kalangan, pada tahapan tertentu sangat
mengganggu pasien.

Gejalanya mulai dengan hanya keluhan kosmetik, rasa berat dan kram pada kaki, hingga ulkus yang
sulit sembuh.

Gangguan vena menahun mempunyai beberapa stadium klinis sesuai dengan penanganan yang
berbeda.

Stocking kompresi merupakan terapi konservatif andalan, dan pada pasien yang refrakter terhadap
obat dan terapi yang kurang invasif, teknik bedah harus dipertimbangkan.

1. Chronic venous insuffi ciency [Internet]. 2012 [cited 2014 June 6]. Available from: http://www.summitmedicalgroup.com/library/adult_health/aha_venous_insuffi ciency/
2. Eberhardt RT, Raff etto JD. Chronic venous insuffi ciency. Circulation 2005;111:2398-409.
3. Chronic venous insuffi ciency [Internet]. 2012 [cited 2014 June 6]. Available from: http://vasculardisease.org/chronic-venous-insuffi ciency-cvi/
04/11/2023 4. Understanding varicose veins - the basics [Internet]. 2014 [cited 2014 June 6]. Available from: http://www.webmd.com/skin-problems-and-treatments/understanding-varicose-veinsbasics. Insufisiensi Vena Kronik 12
5. Varicose vein [Internet]. 2010 [cited 2014 June 6]. Available from: http://www.webcitation.org/5r1PRrJul.