What Is Chronic Venous Insufficiency?

Chronic Venous Insufficiency Overview

Chronic venous insufficiency can happen after you get a blood clot in veins deep in your legs.
Chronic venous insufficiency can happen after you get a blood clot in veins deep in your legs.

Veins are like your body’s highway system. They move blood from your organs to your heart. To get to the heart, blood must move up through the veins in your legs.

Sometimes blood doesn’t flow easily upward through your legs. Instead, it can pool in the veins, especially when you’re standing. This condition is called venous insufficiency. If it’s ongoing, it’s chronic venous insufficiency. About 4 in 10 people in the United States have it.

Here is information about what causes it, what its symptoms are, how doctors diagnose and treat it, and what you can expect from the treatment.

What Causes Chronic Venous Insufficiency?

This condition can happen when the walls of your veins become weak. Or, you can get it when valves that normally run one way start to let blood leak backward.

Most of the time, chronic venous insufficiency happens after you get a blood clot in veins deep in your legs -- a condition called deep vein thrombosis or DVT. Up to 30% of people with DVT develop venous insufficiency within 10 years of diagnosis.

Chronic venous insufficiency can also be a result of:

  • Aging
  • Immobility
  • Defects in your veins
  • Tumors in your pelvis
  • Unknown causes

You’re more likely to develop venous insufficiency if you are:

People with family members who have this condition also have increased risk.

Venous Insufficiency Symptoms

Changes in how your legs look and feel could be signs of venous insufficiency. Symptoms can include:

  • Ankle and lower leg swelling, especially after standing for a long time
  • Tired or achy legs
  • Veins that are twisted and have grown larger (called varicose veins)
  • Skin that looks leathery
  • Flaky or itchy skin on your legs or feet
  • Wounds on your skin from pooled blood in your veins (called venous stasis ulcers)

As the condition gets worse, it becomes harder to treat. If you have any of these symptoms, talk to your doctor right away.

How Doctors Diagnose Venous Insufficiency

Before your doctor can diagnose you, she will ask about your medical history and then examine your legs for swelling, skin changes, varicose veins, or ulcers.

Your doctor may also recommend imaging tests to figure out what’s causing your symptoms. There are two types of tests that can help make a diagnosis:

Duplex Ultrasound: This test, also called vascular ultrasound, helps doctors get a closer look at blood flow in your leg veins. During this test, a technologist squeezes gel onto your leg and then presses a small hand-held tool (called a transducer) against your skin. The device sends out sound waves that bounce off the veins or the blood cells moving through your veins. An ultrasound machine then records the sound waves, creates an image, and displays it on a computer screen.

Venogram: For this test, a specialist injects a safe dye (called contrast dye) into your vein. This causes your vein and blood flow to show up in the image.

There are different types of venograms:

  • Magnetic resonance -- uses radio waves to show blockages or valve problems in your veins
  • Computed tomography -- uses X-rays and computer software to see blood flow and find clots in your legs

For a venogram, a health care provider inserts an IV to deliver the contrast dye into a vein. The test can take from 45 to 60 minutes or longer.

Venous Insufficiency Treatment and Management

It’s best to treat this condition as soon as possible. Experts usually recommend a mix of different home and medical treatments that include:

  • Movement and regular exercise to keep blood flowing
  • Weight loss
  • Compression stockings
  • Antibiotics for skin infections and ulcers
  • Moisturizer to prevent flaky and cracked skin
  • Prescription skin creams to prevent itching and infection

You might need more advanced non-surgical treatment for venous insufficiency. Those treatments include:

  • Sclerotherapy: The doctor injects a chemical solution into the vein to stop blood flow. The faulty vein eventually breaks down and disappears.
  • Venous ablation: The doctor uses a laser or high-frequency radio waves to create heat in the vein and close it off.

Fewer than 10% of people with this condition need surgery. Your doctor will recommend the best treatment option for you.

References
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Cleveland Clinic: “Chronic Venous Insufficiency (CVI),” “Vascular Ultrasound.”

Mayo Clinic: “Varicose veins.”

Winchester Hospital: “Venous Stasis Ulcer.”

NYU Langone Health: “Diagnosing Chronic Venous Insufficiency.”

Radiologyinfo.org: “Venography.”

Indian Journal of Medical Research: “Correlation of obesity & comorbid conditions with chronic venous insufficiency: Results of a single-centre study.”

University of Iowa Hospitals & Clinics: “Venous ulcers.”

Columbia Surgery: “Chronic Venous Insufficiency (CVI).”

Johns Hopkins Medicine: “Chronic Venous Insufficiency.”
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