Congestive Lower Extremity Failure
Chubak, Melin, Massey and Gloviczki propose a new educational model for understanding phlebolymphoedema – congestive lower extremity failure (CLEF). They discuss the revised Starlings Principle for vascular fluid flow through the integument. They highlight the functions of the endothelial glycocalyx. They then go on to use the congestive heat failure model as an analogy for their new model of CLEF. The end result of CLEF being oedema, leg fatigue, limb heaviness, pain, and then inflammatory processes such as haemosiderin deposition, lipodermatosclerosis, tissue fibrosis and ultimate ulceration. Their editorial is a fascinating read and this new educational paradigm absolutely resonates with me.
Chubak JA, Melin MM, Massey HT, Gloviczki,ML Congestive lower extremity failure: an educational model for improved understanding of phlebolymphedema. J Vasc Surg Venous Lymphat Disord 2024;12:101737