Chronic Venous Insufficiency

What is chronic venous insufficiency?

Chronic venous insufficiency occurs when your leg veins don’t allow blood to flow back up to your heart. Normally, the valves in your veins make sure that blood flows toward your heart. But when these valves don’t work well, blood can also flow backwards. This can cause blood to collect (pool) in your legs.

If this condition is not treated, you may have:

  • Pain

  • Swelling

  • Cramps

  • Skin changes

  • Varicose veins

  • Leg ulcers

Chronic venous insufficiency is not a serious health threat. But it can be painful and disabling.

What causes chronic venous insufficiency?

You are more likely to have this condition if you:

  • Are overweight

  • Are pregnant

  • Have a family history of the problem

  • Had damage to your leg due to injury, surgery, or previous blood clots

Other causes of chronic venous insufficiency include:

  • High blood pressure in the leg veins over time, due to sitting or standing for long periods

  • Lack of exercise

  • Smoking

  • A blood clot in a deep vein, often in the calf or thigh (deep vein thrombosis)

  • Swelling and inflammation of a vein close to the skin, often in the legs (phlebitis)

What are the symptoms of chronic venous insufficiency?

Symptoms of chronic venous insufficiency may include:

  • Swelling in your legs or ankles

  • Tight feeling in your calves or itchy, painful legs

  • Pain when walking that stops when you rest

  • Brown-colored skin, often near the ankles

  • Varicose veins

  • Leg ulcers that are sometimes hard to treat

  • Having an uncomfortable feeling in your legs and an urge to move your legs (restless legs syndrome)

  • Painful leg cramps or muscle spasms (charley horse)

The symptoms of chronic venous insufficiency may seem like other health conditions. Talk with your healthcare provider for a diagnosis.

How is chronic venous insufficiency diagnosed?

Your provider will take your medical history and give you an exam. You may also have an imaging test called a Duplex ultrasound. This looks at blood flow and the structure of your leg veins. It checks the speed and direction of blood flow in the blood vessel.

What is the treatment for chronic venous insufficiency?

Your healthcare provider will create a treatment plan for you based on:

  • Your age, overall health, and medical history

  • How serious your case is

  • How well you handle certain medicines, treatments, or therapies

  • Your signs and symptoms

  • If your condition is expected to get worse

  • What you would like to do

Treatment may include:

  • Improving blood flow in your leg veins. Keeping your legs raised (elevated) can reduce swelling and help increase blood flow. Wearing compression stockings may also help. Regular exercise can also improve blood flow.

  • Medicines. Medicines that increase blood flow through the vessels may be used along with compression therapy to help heal leg ulcers. Aspirin can also be used to help ulcers heal. Medicines that draw excess fluid from the body through the kidneys (diuretics) are not often used. But they may be used if other conditions such as heart failure or kidney disease are also linked to the swelling.

  • Endovenous laser ablation or radiofrequency ablation (RFA). This is a minimally invasive procedure. A tube (catheter) puts heat right into the affected vein. This closes the vein. Once the vein is closed, less blood pools in the leg. Overall blood flow is improved.

  • Sclerotherapy. This may be used if your case is more serious. A chemical is injected into the affected veins. The chemical causes scarring in the veins so that they can no longer carry blood. Blood then returns to the heart through other veins. The body absorbs the scarred veins.

  • Surgery. This is done in severe cases. Ligation is a type of surgery that may be used.  The affected vein is tied off so that blood no longer flows through it. If the vein or its valves are heavily damaged, the vein will be removed. This is called vein stripping.