The Who, What, Where, and Why of Venous Insufficiency

Chronic venous insufficiency is a common vascular disorder. But it’s easily treatable.

Chronic venous insufficiency (CVI) refers to a breakdown in the blood flow from the leg veins to the heart. When blood becomes trapped in the veins, various side effects can occur. These include swelling, cramping, pain, restless leg syndrome, blood clots, and skin ulcers. A feeling of heaviness in the legs also often accompanies CVI, the root cause of varicose veins.

Chronic venous disease affects about 40 percent of the U.S. population. Spotting the early signs of CVI and understanding your risk factors can help you overcome what can be a painful and sometimes debilitating disease. If caught early, vein disease is treatable with conservative, non-surgical methods. If the condition progresses, you may need to undergo one of several minimally invasive surgeries.

But first - what is venous insufficiency?

Your arteries circulate oxygen-filled blood to your tissues and organs. Your leg veins return the deoxygenated blood to the heart for another oxygen boost. Venous insufficiency develops when blood flow is disrupted in your leg veins.

Your leg veins rely on tiny valves that open and close to push blood back to the heart. When these vein valves lose their strength, blood backslides and pools within the veins (a process known as venous reflux). When blood collects within the vein walls, it can lead to many symptoms of chronic venous insufficiency, including varicose veins, leg ulcers, blood clots, leg swelling, skin changes, pain, itching, and cramping. Many people with CVI also report restless leg syndrome, which causes uncontrolled movements of the legs, particularly at night.

Where does venous insufficiency occur?

CVI occurs most commonly in the legs and feet because the leg veins combat the greatest force of gravity. Your legs are farthest from your heart, so the veins face a tough uphill battle to pump blood back to the heart.

It’s also why CVI is the leading cause of deep vein thrombosis (DVT) or a blood clot deep in the leg veins. When the leg vein stretches outward as a visible varicose vein, the blood vessels inside the vein become prone to clumping and forming a clot. If the clot breaks away and travels to the lungs, it could cause a life-threatening pulmonary embolism. DVT symptoms include swelling, red, tender skin, and a feeling of warmth in the affected area of the leg.

Because CVI develops most often in the leg veins, your doctor may recommend non-surgical treatments that focus on the lower legs, such as wearing compression stockings. These tight garments come in different strengths and gently squeeze the leg veins to promote smoother blood flow. You can find most lower pressure compression stockings in drugstores or medical supply outlets, but higher pressure stockings require a doctor’s prescription. You should wear compression stockings all day, especially if you sit or stand for long periods or on a long plane or car ride. The socks can help prevent a blood clot from forming by keeping the blood flowing with gentle, continual pressure.

Who is at risk for venous insufficiency?

Numerous risk factors contribute to someone’s chances of developing venous insufficiency, so it’s no surprise that CVI affects so many people. Some of the top risk factors of venous insufficiency include:

• Gender. Hormonal changes during pregnancy and menopause affect veins and blood flow, so women tend to develop CVI more often than men.

• Age. As we age, our veins naturally lose strength and elasticity. Weakened veins allow blood to pool in the veins, leading to CVI.

• Family History. If an immediate family member was afflicted with CVI, you’re likely to develop the condition, too.

• Obesity. When you carry excess weight, you add extra pressure to the veins. Stressed-out veins cannot adequately pump blood from the legs to the heart.

• Sedentary Lifestyle. Sitting or standing for long periods prevents blood from circulating. Blood that stagnates in the leg veins causes uncomfortable CVI symptoms such as swelling, pain, and cramping.

• Smoking. Smoking damages your heart and lungs and can also harm your veins.

• Injury. A trauma to your veins from either a surgical procedure or an injury can cause venous insufficiency.

• Prior Blood Clots. A blood clot that develops within the deep veins of the legs is known as deep vein thrombosis (DVT). Those who have previously experienced DVT are at risk of secondary venous insufficiency or post-thrombotic syndrome.

• High Blood Pressure. When blood builds up in the leg veins, your blood pressure increases, potentially damaging the veins and capillaries. If your capillaries burst, you may experience discoloration in your skin.

Why does venous insufficiency occur?

You now know why venous insufficiency may develop and who is more likely to suffer from vein disease. Fortunately, there are several steps you can take to improve your vein health:

• Exercise. Your veins and calf muscles work together to keep blood moving through the leg veins. Walking, biking, swimming, and other workouts that engage the calf muscles promote circulation and help reduce CVI symptoms. Regular exercises can also prevent new varicose veins from forming. Even simply getting up from your desk for a short, brisk stroll or flexing your ankles while seated can help get the blood flowing in your legs.

• Eat a Healthy Diet. Colorful fruits and vegetables contain flavonoids that stimulate circulation and reduce inflammation. Avoid food products high in saturated fats and sodium, and drink plenty of water.

• Lose Weight. Ease the strain on your veins by shedding extra pounds.

• Stop Smoking. Smoking causes arterial disease and can also damage your veins. Talk to your healthcare provider about a smoking cessation program.

It’s essential to know your risk factors for CVI. Working with your vein specialist, you can treat CVI at its earliest stages and prevent the painful symptoms of CVI.

How to treat venous insufficiency

A vein specialist or vascular surgeon will review your medical history and symptoms and perform a physical exam to diagnose CVI. They may use a vascular or duplex ultrasound to visualize how blood flows through your leg veins. These images may also spot a blood clot.

The first line of treatment for venous insufficiency is conservative, non-surgical therapies such as compression stockings, elevating your legs, and exercise. Those methods may fail to relieve symptoms in some severe cases, and surgical intervention may be necessary.

Today’s surgical treatments for CVI are minimally invasive, requiring little to no local anesthesia. Procedures are completed during a brief office visit and usually take no more than an hour. Long gone are the days of invasive vein ligation and vein stripping procedures that require lengthy hospital stays. Instead, popular treatments include sclerotherapy, thermal ablation, and radiofrequency ablation, which destroys the diseased vein using a saline-based solution or heat. Ambulatory phlebectomy is another standard procedure that extracts the damaged vein via two tiny incisions.

It’s crucial to treat your vein disease. CVI can lead to severe complications if left untreated, such as a skin rash known as stasis dermatitis or varicose eczema. As blood builds up in the veins, fluid leaks into the tissues, and oxygen cannot reach the skin. The skin becomes discolored and scaly. If the stasis dermatitis progresses without treatment, an open sore could develop. These slow-healing venous ulcers are difficult to treat and could lead to further infection.

As you explore different treatments, you may encounter many so-called varicose vein cures that rely on herbal remedies or other non-medical methods. Although they may provide temporary symptom relief, these will not eliminate varicose veins. The only proven treatment for varicose veins and other symptoms of CVI is a vascular surgery performed by a certified vein specialist, phlebotomist, or vascular surgeon.

Explore your options

At Center for Vein Restoration (CVR), we provide state-of-the-art care for your veins. Our physicians can diagnose and treat your venous insufficiency with the latest technology and techniques. Let us expertly guide you to the best treatment option tailored to your individual needs! Contact one of our offices across the country to schedule a consultation.