What is the predominant cause of chronic venous insufficiency?

Chronic venous insufficiency (CVI) primarily occurs due to dysfunction in the venous system, often as a result of valvular incompetence. Previous deep vein thrombosis (DVT) is a significant risk factor for developing CVI because when a thrombosis occurs, it can damage the vein walls and valves. This impairment leads to blood flow abnormalities, resulting in increased venous pressure and the eventual development of chronic insufficiency.

The other factors listed, while they may contribute to vascular health issues, do not have the same direct impact on the venous system as previous DVT. For example:

• Arterial disease mainly affects arterial circulation and does not directly lead to the venous problems seen in CVI.

• Obesity can contribute to increased venous pressure but is often considered a risk factor rather than a predominant cause.

• Hypertension primarily affects arterial systems and does not directly cause venous insufficiency.

Thus, previous deep vein thrombosis stands out as the main cause due to its direct effect on the venous valves, leading to chronic venous insufficiency.