A systematic review exploring the link between chronic venous disease and neuropathy.
Vritika Ravisangar, Jessica Bowie, Marwah Salih et al.
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In 30 seconds
This systematic review examined objective evidence of neuropathy in patients with chronic venous disease (CVD), excluding studies involving comorbidities that predispose to peripheral neuropathy. Eight studies were included from 2313 records identified. Reported neuropathy prevalence ranged from 33% to 100%, although estimates were difficult to compare because assessment methods varied. The evidence included sensory and motor neuropathy, and patients with more severe CVD (C5-C6) had significantly worse neuropathy. The review also described possible mechanisms involving venous hypertension, microangiopathy, and nerve ischemia or hypoxia.
Key findings
- Across the included studies, reported neuropathy prevalence ranged from 33% to 100%; heterogeneous methods limited direct comparison.
- Most studies assessed sensory neuropathy; vibration detection thresholds were used in five studies and temperature discrimination in four.
- Patients with more severe CVD (C5-C6) had significantly worse neuropathy.
- Evidence included sensory and motor neuropathy, affecting several nerve-fiber types.
Why it matters
Neuropathic symptoms may accompany CVD and could reflect sensory or motor nerve involvement, rather than venous pain alone. Sensory impairment may increase vulnerability to skin trauma and potentially contribute to venous leg ulceration. Recognising this possible association can inform clinical assessment, while the wide prevalence range cautions against treating any single estimate as definitive.
What to keep in mind
Only eight studies were included, and neuropathy assessment methods varied substantially; the review reported no pooled confidence intervals, limiting comparability of prevalence estimates.