Understanding Chronic Venous Insufficiency (CVI)
Veins are the blood vessels in our body that are responsible for moving blood back to the heart for reoxygenation. Built-in valves within the veins ensure that the blood keeps moving in the right direction. When these valves aren’t working properly, the blood flow to the heart can be slowed or stopped and the blood may instead flow backwards and collect/pool in the vein, increasing the risk of blood clots forming. When this occurs in the veins of the lower legs, thighs and pelvis, it can lead to a condition called chronic venous insufficiency. If CVI is untreated and the blood drainage is severely impaired, it can lead to a complete obstruction of blood flow in the vein.
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Causes and Symptoms of Chronic Venous Insufficiency (CVI)
The most common causes of venous insufficiency include:
- High blood pressure in the leg veins over time, due to sitting or standing for long periods
- A blood clot in a deep vein, often in the calf or thigh (deep vein thrombosis)
- Leg vein trauma due to injury, surgery or previous blood clots
- Prolonged immobilization of the leg, with or without casting
Additional factors which may increase your risk for developing this condition include:
- Excess weight or obesity
- Pregnancy or previous pregnancies
- Family history of venous disease
- Smoking
The symptoms of chronic venous insufficiency can mimic many other health problems so it is very important to be evaluated by a vascular specialist if you experience any of the following:
- Swelling in your legs or ankles
- Pain when walking that stops when you rest (claudication)
- Discoloration of the skin, often near the ankles
- Varicose veins
- Open sores on the legs (leg ulcers)
- Tight, achy feeling in your calves or itchy, painful legs
- Restless leg syndrome - an uncomfortable and urgent need to move your legs
- Frequent, painful leg cramps or muscle spasms (charley horse)
Noninvasive Diagnosis of Chronic Venous Insufficiency
If a patient presents with any of the symptoms listed above, the doctor will first perform a physical exam and take a complete family and medical history. If chronic venous insufficiency is suspected, the most common method used to confirm or rule out the condition is ultrasound - a completely noninvasive and painless procedure that uses sound waves to look at the structure of your leg veins and check the speed and direction of blood flow. The ultrasound technician will flag any abnormal results and send the images to your vascular specialist for interpretation. The test usually takes less than one hour.
UH Experts Offer Proven Venous Insufficiency Treatments
If the physical exam and imaging studies confirm a diagnosis of chronic venous insufficiency or obstruction, your doctor will develop a personalized treatment plan based on your age, general health and the severity of your symptoms. Treatment recommendations may include:
- Lifestyle modifications including regular exercise, good skin care and weight loss
- Compression therapy
- Medications to increase blood flow through the vessels
- Sclerotherapy if small varicose or spider veins are a symptom
- Endovenous ablation
- Venous Repair and Reconstructive Surgery