What is Chronic Venous Insufficiency?
Chronic venous insufficiency, CVI, is a long-term condition that occurs when the blood flows backward through the leg veins. This backflow is due to venous reflux where the valves are damaged. Since the blood is flowing backward and cannot reach the heart it builds up in the leg.
The blood that now circulates through the leg is not healthy blood but the used blood that carries waste products from cells. This backflow will cause heaviness, aching, tiredness, restlessness and cramping in the leg. Additionally, venous insufficiency can lead to vascular disease. While not always present along with CVI patients can develop varicose and spider veins.
Venous Insufficiency Candidates
Venous insufficiency can affect anyone but women and patients over the age of 50 have an increased risk. Other factors that increase the risk of developing venous insufficiency include:
- Elevated cholesterol levels
- Family history of vascular disease
- High blood pressure
- Inactive lifestyle
- Sitting or standing for long periods
Symptoms Of Venous Insufficiency
While many patients with venous insufficiency may be asymptomatic, many may have one or more of the following symptoms:
- Discoloration or hardening of the skin on the legs
- Dull aching, heaviness, or cramping in the legs
- Itching, numbness or tingling in the area
- Pain made worse by standing
- Pain that abates when legs are elevated
- Swelling of the legs or feet
- Ulcers on the legs or ankles
- Varicose veins
What Does Chronic Venous Insufficiency Look Like?
When a patient is suffering from chronic venous insufficiency there are some physical identifiers that can help in diagnosing the condition. The leg will appear swollen and the swelling can travel above the knee. The skin can develop hemosiderin which is a brown discoloration, similar to the color of a coffee stain. This happens on the inner lower leg first then may expand to the entire shin area of the leg. There can be redness and inflammation which looks like an infection. Doctors typically prescribe antibiotics in this case but they tend to have no effect.
Additionally, the skin may get hard and contracted around the lower leg and large thick waxy flakes may develop or dermatoliposclerosis. There can be areas of whitish scarring called atrophie blanche or venous leg ulcers. Minor trauma to this skin can cause a wound that will not heal or takes a very long time to heal. CVI will not reverse itself and will only worsen over time unless patients seek medical attention to treat it.
Diagnosing Venous Insufficiency
Dr. Draughn and our staff at Vein Specialists of the Carolinas can effectively diagnose chronic venous insufficiency using a number of methods. A simple physical examination or a round of blood tests can accurately diagnose chronic venous insufficiency. For a more in-depth diagnosis, Dr. Draugh may use an angiography or an x-ray of the patient’s blood vessels. To determine the blood pressure difference from the leg to the arm an ankle-brachial index, or ABI, is used. Finally, a doppler ultrasound can determine the amount of blood flow through the arteries and veins.
Treating Chronic Venous Insufficiency
Chronic venous insufficiency is best treated promptly in order to prevent any complications, further, or permanent damage. Treatment will vary based on the patient and the degree of the condition. Many of the vein procedures used to treat venous insufficiency are done in our office, minimally invasive, and under local anesthesia.
In some cases, it is impossible to prevent venous insufficiency from occurring but Dr. Draughn recommends leading a healthy lifestyle. This is usually the first course of treatment for mild cases. This lifestyle can include a healthy diet, maintaining a healthy weight level, exercising, stop smoking, treat leg wounds promptly, and sitting or standing for too long. Those changes can increase the chance of vascular health and help patients avoid venous insufficiency. Additionally, compression stockings or garments can be worn to reduce pressure and prevent blood pooling or flowing backward.
If a patient is experiencing a chronic case of venous insufficiency may require surgery. These procedures would cut off the blow flow from the damaged veins and divert it through other vessels. These treatments include sclerotherapy, endovenous laser ablation (EVLA), surgical stripping and microphlebectomy.
Venous Insufficiency Risks
If venous insufficiency is left untreated, it may result in serious complications. These may include cellulitis, deep vein thrombosis or DVT, peripheral neuropathy, thrombophlebitis, ulcerations on the legs or feet, and worsening varicose veins.
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