Chronic Venous Insufficiency

Chronic venous insufficiency (CVI) is a condition where veins have difficulty sending blood from your limbs back to your heart. When blood collects in the leg veins and pools due to impaired circulation it is called stasis. CVI is associated with varicose veins and often causes swelling and pain in the legs. CVI affects almost 20 percent of men and 40 percent of women over the age of 50 years.

Causes

CVI is considered a long-term condition which is caused due to partial blocking of veins or leaking around the valves of veins. CVI can be caused due to age, family history, obesity, blood pressure inside the veins, history of deep vein thrombosis in legs, pregnancy, sitting or standing for long periods of time, lack of exercise and smoking.

Symptoms

The commonly seen symptoms of CVI include swelling in legs (especially while standing for long duration), itching or tingling of skin on legs, tiredness, pain in legs, venous stasis ulcers, heaviness and cramping in legs, change in skin color around the ankles (redness), varicose veins on surface (twisted and enlarged) and thickening of skin.

Diagnosis

CVI is diagnosed primarily by physical examination. Your doctor might recommend Doppler ultrasound imaging to detect improper vein functioning and any blockage of veins by blood clots. CT scan and MRI may be used to rule out any complications of swelling in the leg. Venogram may be recommended to get a clear picture of the blood vessels.

Treatment

Treatment of CVI focuses on reducing the symptoms. Your doctor may recommend the following treatments:

  • Moving legs often and keeping yourself active
  • Wearing compression stockings to reduce swelling
  • Avoid sitting or standing for long periods
  • Treat any infections and open wounds immediately
  • Lose weight in case you are overweight

In case you have severe CVI then your doctor may suggest the following treatments

  • Ablation – The vein disappears after heat treatment
  • Sclerotherapy - The veins harden and then disappear when salt water/saline is injected
  • Vein stripping – Small surgical incisions are made to remove the damaged vein in the leg
  • Valve repair- Small cut is made to repair the damaged vein valve in the leg
  • Angioplasty and stenting – This procedure uses a small balloon to broaden the blocked vein and increase the blood flow. A metal mesh is used to prevent narrowing of the vein in the future.
  • Bypass – A surgery which is used to reroute the flow of blood around the damaged or blocked vein.

CVI can worsen if left untreated. With simple exercise and change in lifestyle, it can make a difference and keep the symptoms of CVI under control.