Chronic Venous Insufficiency (CVI)
Venous insufficiency occurs when a person's vein valves fail to function normally. This means that the veins are less capable of returning blood to the heart.
Venous insufficiency is frequently chronic as well. Leg and foot swelling, varicose veins, and hurting legs are all symptoms of this illness.
What is Chronic Venous Insufficiency?
Chronic venous insufficiency (CVI) is a common cause of leg pain and swelling that is often associated with varicose veins. It occurs when the vein valves cannot function properly, causing blood circulation in the leg veins to be disrupted. CVI can be caused by faulty venous valves or a vein obstruction. Deep vein thrombosis (DVT), or blood clots in the legs deep veins, can cause both. If a clot forms in the superficial veins, DVT is exceedingly unlikely to occur. Varicose veins, swelling, and colouring of the legs, itching, and the formation of ulcers near the ankles are all symptoms of CVI.
What are Varicose Veins?
Varicose veins are enlarged to the point of being visible on the legs. The superficial veins which are closest to the skin, are affected by this condition. The damaged veins appear under the skin as blue bulging, twisted masses. Varicose veins are common in people who stand a lot of time on their feet.
Excess blood collects in the superficial veins of the leg can result in varicose veins. Long periods of sitting or standing can cause increased pressure on the vein walls. This pressure extends the vein, weakening the one-way internal valves that open to allow blood to flow through and close to prevent blood from flowing backwards. Blood can back up and pool in your veins when these valves are compromised or broken, causing them to enlarge.
Similar to varicose veins seen with superficial veins, chronic venous insufficiency (CVI) is a condition that occurs when blood pools in the superficial and deep leg veins. CVI can occur with or without the presence of varicose veins. This condition develops when the blood pressure in the veins is abnormally high. CVI can occur after veins have been damaged by injuries or blood clots. People with CVI often have a combination of symptoms.
Symptoms of Chronic Venous Insufficiency
Chronic venous insufficiency (CVI) symptoms are minor at first, people may dismiss them as having been caused by other conditions. Your legs may feel sore and tired because of your day. However, if you suspect CVI, you should not ignore your symptoms or expect them to go away. The longer you go without therapy, the worse your symptoms will get. The following are typical symptoms:
- Swelling in your lower legs and ankles
- Achy legs
- Tired legs
- Itchiness
- Dry skin
- Varicose veins
- An open sore or ulcer
CVI related to varicose veins are purple, twisting, elevated veins on your legs. They are also caused by damaged vein valves. Small blood vessels in your legs may break due to the pressure if CVI is not treated. Because of the ruptured blood vessel, your skin may have a reddish-brown colour and may develop ulcers or open sores. These lesions, known as venous stasis, can be infectious and are difficult to heal.
Risk Factors of Chronic Venous Insufficiency
Chronic venous insufficiency is more common in women and adults over the age of 50. Other risk factors are:
- Deep vein thrombosis (DVT)
- Extended periods of sitting or standing
- Family history
- Inactivity
- Obesity
- Pregnancy
- Smoking
- Varicose veins
Diagnosis
The first step in identifying venous insufficiency is a physical examination. Before making a diagnosis, a doctor will also examine a person's medical history and current health status.
The following diagnostic methods can assist identify whether a person has venous insufficiency:
Venogram
This exam uses X-ray technology to examine the flow of blood through the veins. It involves the injection of contrast material into a vein. Venograms are used by physicians to detect blood clots and detect varicose veins.
Duplex ultrasound
This noninvasive test determines the speed and direction of blood flow through veins and arteries.
Additional venous insufficiency medical tests may include:
- CT scan
- MRI scan
- Blood tests
Treatment
To manage venous insufficiency, your doctor may recommend the following self-care measures:
- Do not sit or stand for extended periods. Moving your legs even a little helps to keep the blood circulating.
- If you have any open sores or infections, take care of your wounds.
- If you are overweight, try to lose weight
- Regular exercise is essential.
You can improve blood flow in your legs by wearing compression stockings. Compression stockings gently squeeze your legs, causing blood to flow up your legs. This helps in the prevention of leg edema and, to a lesser extent, blood clots.
If you have more extensive skin changes, your doctor will:
- Specify which skincare treatments can help and which can worsen the problem.
- Specify treatments or medicines that may help.
Your provider may offer more invasive treatments if you have:
- Leg pain, which may cause your legs to feel heavy or tired.
- Skin sores caused by inadequate blood flow in the veins that do not heal or recur.
- Thickening and hardness of the skin of the legs and ankles (lipodermatosclerosis)
Procedure options include:
- Sclerotherapy involves injecting saltwater (saline) or a chemical solution into a vein. The vein hardens and then fades.
- Phlebectomy involves small surgical cuts (incisions) in the leg near the injured vein. The vein is removed by a single incision.
- Procedures that can be performed in a provider's office or clinic, such as those involving the use of a laser or radiofrequency.
- Varicose vein stripping is a procedure that is used to remove or tie off a major vein in the leg, known as the superficial saphenous vein.
