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Chronic venous insufficiency (CVI) is a condition in which the valves in the veins of the leg don’t work properly, preventing blood from flowing back to your heart. This can lead to painful swelling and cramping, making standing and walking difficult.
About 150,000 people are diagnosed with CVI each year, affecting about 1 in 20 adults. While cosmetic signs of CVI include irritated, cracked, or flaky skin with bulging, unsightly varicose veins marring otherwise smooth legs, they only represent a small part of a larger picture.
Healthy veins have tiny valves that act like one-way doors, ensuring adequate blood travels back to your heart. But with CVI, these valves weaken or become damaged, making the blood pool in your legs instead and disrupting normal blood flow. Moreover, CVI is one type of a broader condition called peripheral vascular disease.
CardioVascular Health leads the country in innovative, comprehensive treatments for cardiovascular diseases and conditions like chronic venous insufficiency and peripheral vascular disease. Our multidisciplinary team of national-caliber physicians, interventional radiologists, and cardiovascular specialists strives to offer the most advanced modalities available for minimizing symptoms and improving quality of life, with techniques, technology, and procedures that reduce recovery time, lower the risk of complications, and produce superior outcomes in patient care. By combining our years of experience with a comprehensive, whole-person approach to treatment, we are setting new standards in CVI and PVD management throughout Oklahoma and the US.
Chronic venous insufficiency is a condition that disrupts the normal flow of blood in your legs because of damage to the valves in your veins. It is a type of peripheral vascular disease, which refers more broadly to problems with the blood flow in your circulatory system due to a number of causes.
To understand CVI, it’s better to first know about your veins and how they work. Unlike arteries that carry oxygenated blood away from the heart and lungs, veins are responsible for returning blood to the heart. This uphill journey is accomplished with the help of tiny one-way valves within the veins that prevent blood from flowing backward. In CVI, these valves—usually in the legs—may become weak or damaged, allowing blood to pool instead of flowing efficiently back to the heart. This pooling in the legs leads to the various signs and symptoms of CVI.
CVI is more likely to develop as you get older, and each year, about 2.6% of women and 1.9% of men develop CVI. Varicose veins are estimated to affect 5% to 30% of adults and are three times more common in women than men. Aging weakens our entire body, and veins are no exception. The valves weaken and stretch with age, making it harder for them to keep the flood flowing in the right direction.
Besides age, there are other risk factors and causes of CVI:
● Family history. Unfortunately, CVI can run in families. If you have close relatives with the condition, you're more likely to develop it yourself.
● Pregnancy. Pregnancy puts extra strain on the body, including the veins. The increased blood volume and pressure on your legs can sometimes lead to valve damage and CVI.
● Blood clots. Past blood clots in your legs, also known as deep vein thrombosis, can damage the valves and hinder blood flow, potentially leading to CVI.
● Inactivity. Standing or sitting for long periods with little movement can hinder blood circulation in your legs.
● Obesity. Carrying excess weight increases pressure in your veins throughout your body, including those in your legs. This extra pressure can take a toll on the valves and eventually lead to CVI.
While varicose veins are often the most apparent signs of chronic venous insufficiency, they’re not the only ones. CVI can cause a range of symptoms that don’t necessarily show in the affected area.
● Swelling (Edema). Swelling is a chief symptom of CVI and is most noticeable in the ankles and lower legs. It occurs because of blood pooling in the veins instead of returning to the heart. The swelling may be worse at the end of the day or if your job requires you to stand for longer periods.
● Pain and aching. The constant pressure from blood pooling in your legs can lead to a dull ache or throbbing sensation.
● Fatigue and heaviness. Your legs may feel heavy, tired, and sluggish because of the restricted blood flow and the extra effort your body needs to circulate blood against gravity.
● Itchy skin. Chronic Venous insufficiency can cause dry, itchy skin in the lower legs and ankles, also known as venous stasis dermatitis. It can be especially bothersome at night and may lead to scratching and irritation.
● Skin discoloration. One way to identify CVI is with a reddish-brown discoloration of the legs, which typically occurs as the condition progresses. Discoloration on the legs is a sign that the impaired blood flow has caused long-term damage.
● Restless Legs Syndrome (RLS). This condition can be a symptom of CVI and causes an irresistible urge to move your legs, especially at night. The constant movement can disrupt sleep and contribute to daytime fatigue. Up to 84% of patients with venous insufficiency also have symptoms of RLS.
CVI might start subtly, with just tired legs or spider veins, but it can eventually develop into something more critical. Some possible complications of CVI include:
● Venous ulcers. A severe complication of CVI, venous ulcers are open sores often located just above the ankles. Due to poor blood flow, the skin doesn’t receive the oxygen and nutrients it needs to heal.
● Infections. Untreated CVI soon becomes a breeding ground for bacteria, especially around open wounds like venous ulcers.
● Lipodermatosclerosis. This is a condition where the skin and underlying tissues in the lower leg harden and thicken. It’s a consequence of long-term CVI and can be quite painful, making even simple tasks like walking uncomfortable.
● Mental health concerns. A 2013 study on chronic venous disease found that patients reported a significant decline in their quality of life as the condition worsened. Additionally, people with varicose veins have an increased risk of major depressive disorder.
If you are already experiencing initial symptoms like leg swelling, pain, or varicose veins, it’s essential to get a proper diagnosis. Early detection of chronic conditions can help prevent more severe complications down the road.
The first step in diagnosing CVI is usually a physical exam by your doctor. They’ll:
● Ask about your medical history
● Examine your legs
● Check your blood flow
While a physical exam can provide valuable clues, imaging tests can pinpoint the severity. Some commonly used diagnostic tests include:
● Ultrasound. This painless test uses sound waves to create images of your veins. It can help assess blood flow direction and identify any blockages.
● Doppler ultrasound. This advanced version of ultrasound uses sound waves to visualize your veins, measure blood flow velocity, and assess how well the valves in your veins are working.
● Venography. During this X-ray imaging technique, a contrast dye is injected into your vein to highlight blood flow and identify any blockages or abnormalities.
There is no cure for CVI, but you can take steps to manage it and keep your legs feeling their best. From conservative lifestyle changes to minimally invasive surgical treatments, there are ways to help relieve symptoms and improve proper blood flow. However, remember that the best treatment approach depends on the severity of your condition.
Here are a few lifestyle changes that can help improve the symptoms of CVI:
● Compression stockings. These tight-fitting stockings improve blood flow and reduce swelling.
● Leg elevation. Regularly elevating your legs helps blood flow back toward the heart.
● Exercise. Regular activity or exercises that work your calves help improve circulation and prevent blood from pooling.
● Weight management. For those who are overweight, losing weight reduces the pressure on veins and improves circulation.
● Skin care. Proper care, including moisturizing, prevents irritation from dry or itchy skin.
When conservative treatments no longer provide relief, your doctor may suggest a minimally invasive treatment or surgery. These innovative, cutting-edge treatments help patients find relief from more severe symptoms of CVI.
At CardioVascular Health Clinic, our specialist offer an array of minimally invasive treatment options to help minimize or reduce the symptoms of CVI, including:
● Sclerotherapy. This minimally invasive procedure involves injecting a solution into varicose veins to cause them to scar and collapse.
● Thermal ablation. Techniques like radiofrequency or laser ablation use heat to damage and close varicose veins.
● Phlebectomy. This surgical procedure removes small varicose veins through tiny incisions.
While chronic venous insufficiency cannot be reversed, it does not have to degrade your quality of life. Early diagnosis and treatment of chronic venous insufficiency can mean the difference between a manageable condition and more severe health risks or complications.
If you’re experiencing any of the above symptoms, don’t wait for your condition to worsen; schedule a consultation today with the experts at CardioVascular Health Clinic. We specialize in providing comprehensive, integrated care for chronic venous insufficiency, peripheral venous disease, and other cardiovascular conditions, and we can help you find relief from your pain and discomfort. Contact CardioVascular Health Clinic today to schedule an appointment and take the first step toward a pain-free life.
