Venous Insufficiency (VI) & Chronic Venous Insufficiency (CVI)
What is Venous Insufficiency?
Venous insufficiency (VI) is a condition that occurs when the veins of the legs are not working properly and have difficulty sending blood back to the heart. Chronic venous insufficiency (CVI) is another name for the condition, due to its long-term nature. VI/CVI can cause what is known as “venous stasis,” a condition where the blood collects or pools in the veins.
Symptoms of Venous Insufficiency & Chronic Venous Insufficiency
Venous insufficiency (VI) and chronic venous insufficiency (CVI) can lead to potentially severe consequences— most notably pulmonary embolism. Pulmonary embolisms occur when a blood clot blocks the flow of blood to the lungs and starves the lung tissue of oxygen.
Treatment becomes more complex as CVI progresses. Due to these factors, watching for the following symptoms and getting early treatment are important.
Venous insufficiency symptoms in the legs include:
- Dull aching
- Feeling of heaviness
- Irritated or cracked skin
- Itching and tingling
- Lipodermatosclerosis: thickening & hardening of the skin on the legs and ankles
- Pain that abates when legs are raised
- Pain that worsens when standing
- Slow-healing wounds or ulcers on the legs or ankles
- Stasis dermatitis: red, swollen, crusted, or weepy skin
- Surface varicose veins & spider veins
When CVI becomes more progressed, more invasive treatments may be recommended.
Symptoms that may require invasive treatment include:
- Leg pain that makes your legs feel heavy or tired
- Skin sores that do not heal or recur
- Thickening and hardening of the skin on your legs and ankles
CVI is associated with varicose veins, which are enlarged, swollen and twisted veins close to the surface of the skin that often appear blue or purple. They can occur almost anywhere, but most commonly occur in the legs. Spider veins are also common, which are smaller red, purple, and blue twisted vessels that are visible under the surface of the skin.
CVI can also cause capillaries to burst— leading to local tissue inflammation and internal tissue damage. This condition causes ulcers on the skin surface. These venous stasis ulcers are difficult to heal and can easily become infected. If infection is not controlled, it can spread to surrounding tissue and cause a condition known as cellulitis.
Though there are many symptoms associated with VI and CVI, some people do not have any symptoms. These cases are more dangerous because patients may not be alerted to this serious problem.
Are you experiencing signs and symptoms of venous insufficiency (VI) and chronic venous insufficiency (CVI)? Schedule your consultation at Wellness & Surgery today.
Venous Insufficiency: Causes & Risk Factors
VI & CVI Causes
Malfunctioning vein valves and past blood clots are the most common causes of VI and CVI. When functioning properly, veins located deep in the legs keep blood moving toward the heart. In chronic venous insufficiency (CVI), vein walls become weak and valves are damaged. This damage causes the blood to leak backwards and stay in the veins, especially while standing.
CVI also may occur from pelvic tumors and vascular malformations. In some cases, no cause is determined.
When a blood clot gets stuck in a deep leg vein, this is a serious condition known as deep vein thrombosis (DVT). CVI that occurs due to DVT is also known as post-thrombotic syndrome. Up to 30 percent of patients with DVT will develop CVI within 10 years of diagnosis.
VI & CVI Risk Factors
Risk factors for venous insufficiency include:
- Tall height
- Sitting or standing for long periods
- History of deep vein thrombosis (DVT) in the legs
- Family history of venous insufficiency (VI)
- Female gender (related to levels of the progesterone hormone)
Venous Insufficiency Diagnosis
In order to accurately diagnose venous insufficiency (VI) and chronic venous insufficiency (CVI), Dr. Arad will perform a complete medical history and physical examination. Dr. Arad may also perform a quick, safe, and noninvasive Wellness Ultrasound which examines your blood’s circulation and creates an image of the blood vessels in your leg. You can learn more about our safe, diagnostic Wellness Ultrasound here.
A venogram may also be performed to diagnose venous insufficiency in the legs. During a venogram, an intravenous (IV) contrast dye is injected into the veins. This dye causes your blood vessels to appear opaque on an X-ray thereby allowing for a better view of your veins.
Venous Insufficiency Treatment
Venous insufficiency is most treatable in its earliest stages. Vascular medicine or vascular surgery specialists like Dr. Arad typically recommend a combination of treatments in order to prevent leg ulcers and reduce blood from pooling in the legs.
CVI worsens over time. Ease pain and irritation and prevent the condition from getting worse by following these self-care treatment strategies:
- Wear compression stockings: Compression stockings help prevent leg swelling and blood clots. This first-line therapy gently squeezes the legs, thereby moving blood up the legs and improving blood flow.
- Avoid long periods of standing or sitting
- Exercise regularly— especially walking
- Lose weight (if overweight)
- Elevate legs above the level of the heart while sitting and lying down
- Practice good skin hygiene—this includes treating skin infections with antibiotics
- If taking a long trip, flex and extend legs, feet, and ankles 10 times every 30 minutes—this keeps the blood flowing in your leg veins
- Take frequent breaks— sit down and elevate your feet when required to stand for long periods of time
- In cases of post-thrombotic syndrome, medication may be prescribed to prevent the formation of additional blood clots. Unna Boot is a special medicated wrap that combines multilayer compression with a zinc oxide gel-based wound cover to forms semi-rigid bandage.
Invasive medical treatment procedures include:
- Phlebectomy: a procedure where small incisions are made in the leg near the damaged vein and the vein is removed.
- Sclerotherapy: saline or a chemical solution is injected into the vein, which hardens and then disappears.
- Varicose vein stripping: a procedure during which the superficial saphenous vein is removed or tied off.
- Vein bypass: a portion of a healthy vein is used to replace a damaged portion of another vein.
- Lasers or radiofrequency treatments: such as vein-ablation.
- Catheter procedure: used to heat and seal off a larger vein.
What to Expect During a Consultation with Dr. Arad of Wellness & Surgery
During your consultation, Dr. Arad will review your symptoms and conduct a physical examination, as well as confirm a diagnosis of venous insufficiency (VI) or chronic venous insufficiency (CVI) using our diagnostic Wellness Ultrasound—which is completely safe, noninvasive, and takes approximately 20 minutes to complete.
Ready to eliminate venous insufficiency (VI) & chronic venous insufficiency (CVI) for good? Schedule your consultation at Wellness & Surgery today!