Chronic venous insufficiency (CVI) occurs when the valves in the leg veins become damaged or impaired, making it difficult for blood to return from the legs to the heart. This leads to blood pooling in the legs, resulting in various complications like swelling and ulcers. Read on to learn more about this condition.

Causes of Chronic Venous Insufficiency

Below are some risk factors that increase the likelihood of developing CVI:

• Obesity
• Pregnancy
• Family history of venous disorders
• Leg injuries due to trauma, surgery, or previous blood clots

CVI can also develop due to the following factors:

• Smoking
• Lack of physical activity
• High venous pressure over time from prolonged sitting or standing
• Inflamed veins close to the skin (often in the legs)
• Deep vein thrombosis (DVT), a blood clot in a deep vein, usually in the leg or thigh

Stages of Chronic Venous Insufficiency

Venous disorders, including CVI, are classified into stages from 0 to 6 based on symptoms observed during the physical examination. Below is an overview of the stages:

• Stage 0: No visible or palpable signs, though leg pain and fatigue may be present.
• Stage 1: Visible veins, including spider veins.
• Stage 2: Varicose veins with a diameter of at least 3 millimeters.
• Stage 3: Leg swelling without noticeable skin changes.
• Stage 4: Changes in skin color or texture.
• Stage 5: Healed ulcers.
• Stage 6: Active, open ulcers.

CVI is typically diagnosed at stage 3 or higher. While the presence of varicose veins alone does not indicate CVI, they are often a sign of blood flow problems that can worsen over time. Therefore, it is essential to report new varicose veins to a healthcare provider.

Chronic Venous Insufficiency Symptoms 

Here are common signs o, further imaging tests, such as CT scans or MRI, may be performed before any medical or surgical intervention.

Chronic Venous Insufficiency Treatment 

Various treatment options are available for CVI, including lifestyle changes, medications, and surgical interventions:

1) Improving Blood Flow

The following lifestyle practices can help improve blood circulation in the legs:

• Elevating the legs for 30 minutes or more at least 3 times a day to reduce pressure in the leg veins
• Regular exercise
• Losing excess weight
• Wearing compression stockings to enhance blood flow and reduce swelling

2) Medications

A doctor may prescribe medications to manage CVI, such as:

• Diuretics: To remove excess fluid from the body
• Anticoagulants: To thin the blood and prevent clotting
• Pentoxifylline: To improve blood flow

3) Non-Surgical Procedures

Non-surgical treatments include:

• Sclerotherapy: Injection of a liquid or foam solution into varicose veins to make them disappear
• Endovenous thermal ablation: Uses laser or radiofrequency energy to heat and close large veins while leaving them in place, minimizing bruising and bleeding

4) Surgical Interventions

In more severe cases, surgery may be necessary, including:

• Vein ligation and stripping: Often performed together, this involves tying off the damaged vein (ligation) and removing it through small incisions (stripping)
• Ambulatory phlebectomy: A minimally invasive procedure where the surgeon makes tiny incisions or needle punctures to remove surface veins using a hook
• Endoscopic vein surgery: A less invasive surgery targeting veins near the ankle. A surgeon uses a clip to close damaged veins, promoting ulcer healing and preventing recurrence
• Vein bypass surgery: Similar to coronary artery bypass surgery but performed in the leg. A healthy vein from another part of the body is used to redirect blood flow around the damaged vein. This method is reserved for severe cases when other treatments are ineffective

Conclusion

CVI is a serious condition that requires early medical attention. If you notice any signs of CVI, consult a doctor to diagnose the underlying cause and receive appropriate treatment. Early intervention can prevent complications and improve outcomes.f CVI:

• Swelling in the lower legs and ankles, especially after prolonged standing or by the end of the day
• Nighttime leg cramps
• Red or brown skin discoloration
• Leg pain and heaviness
• Burning and tingling sensations in the legs
• Itchy or scaly skin on the legs or feet
• Open ulcers near the ankles, which may become infected if painful
• Varicose veins

Diagnosis of Chronic Venous Insufficiency

Diagnosis begins with a medical history and physical examination, focusing on signs such as skin discoloration and ulcers. A doctor may recommend imaging techniques, such as venous Doppler ultrasound, which uses sound waves to assess blood flow and detect clots or valve problems. In some cases