Definition

Chronic venous insufficiency (CVI) is a problem with the veins. Veins bring blood back to the heart. They have valves to keep blood moving in one direction. When the valves don’t close properly, blood can leak back. This can cause a backup of blood in the veins. The legs are a common place for blood to backup. This is because veins must work against gravity.

Venous Insufficiency
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Causes

Damage to the valves causes problems in the veins. This can be related to inflammation or low blood flow. Damage can happen because of:

  • Increase in blood pressure in the veins
  • Stuctural problems—some may be present from birth
  • Health conditions such as:

For some, the cause may remain unknown.

Risk Factors

Having DVT makes your chances of CVI higher. Other factors include:

  • Obesity
  • Lack of physical activity
  • Family members with the same problems
  • Smoking
  • Pregnancy
  • Regularly sitting or standing for long periods of time
  • Wearing tight clothing such as very tight girdles or belts

Symptoms

CVI may cause:

  • Swelling of the legs
  • Pain in the legs, especially after walking:
    • Aching
    • Dullness
    • Tiredness
    • Cramping
  • Red or brown darkening of the skin on the legs
  • Varicose veins
  • Ulcers on legs, especially around the inside of the ankles
  • Scaling skin on legs
  • Hard, leathery skin on legs

Diagnosis

The doctor will ask about your symptoms and health history. You may have:

  • A physical exam
  • Imaging tests such as:

Treatment

The goal of care is to maintain blood flow and prevent it from pooling in the veins. It may involve:

Improving Blood Flow

Your doctor may have you wear compression stockings. They squeeze veins in the legs. This helps keep the blood from pooling. You may need to keep your legs raised above your heart during rest or sleep.

Therapeutic massage of the lower legs can reduce discomfort and drain fluid buildup.

Movement

Walking and specific exercises for your legs and feet may help. Don’t sit or stand for long periods of time.

Skin Care

Mineral bath therapy may help to improve skin redness. Bandages or antibiotic cream can prevent skin infection. Wearing compression stockings may also promote healing.

Sclerotherapy or Ablation

Sclerotherapy involves injecting a caustic material into the affected veins. Scar tissue fills the veins. The blood is rerouted through veins that are working properly.

With ablation, a tiny electrode is inserted into the affected vein. Electricity scars the vein and blocks it off.

Over time, the body will resorb the vein that isn’t working (for both).

Surgery

If other care methods fail, surgery may be needed. The type of surgery will depend on the cause and test results. Options include:

  • Valve repair.
  • Vein stripping to remove the faulty vein.
  • Bypass surgery—A new length of artificial vein is connected to two areas of the malfunctioning vein. This allows the blood flow to bypass the area that is not working.

Prevention

To help lower your chances of CVI:

  • Maintain a healthy weight.
  • Exercise regularly.
  • If you smoke, talk to your doctor about how to quit.
  • Avoid standing or sitting for long periods of time.
  • Avoid wearing tight clothing such as girdles or belts.

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