What is Chronic Venous Insufficiency?

The veins in our lower body are tasked with carrying our blood to our hearts. Our valves and veins stop the blood from flowing backward and pooling. When the veins and valves are not working properly, it is called venous insufficiency. 

What is chronic venous insufficiency (CVI)?

Chronic venous insufficiency (CVI) is a condition that occurs when the veins in your legs struggle to efficiently return blood to your heart over time. This ongoing issue can lead to increased pressure in the veins, resulting in more advanced symptoms such as significant swelling, skin discoloration, thickened skin or even open sores known as venous ulcers.

While the terms “venous insufficiency” and “chronic venous insufficiency” are often used interchangeably, CVI specifically refers to the advanced, long-term stage of the condition. At this stage, complications can become more severe and may require specialized care.

If you’re experiencing symptoms like persistent swelling, pain, or noticeable changes in your skin, it’s essential to consult your healthcare provider. Early intervention can make a significant difference, helping to manage symptoms and prevent the condition from progressing further. At Ochsner, we’re here to provide expert care and innovative solutions to help you stay ahead of CVI.

What is the difference in venous insufficiency vs. chronic venous insufficiency?

Venous insufficiency is a condition where the veins in your legs struggle to return blood to your heart effectively. This can result in symptoms like swelling, pain, and visible vein issues such as varicose or spider veins.

CVI refers to the advanced, long-term stage of venous insufficiency. Over time, the persistent inability of the veins to return blood to the heart leads to increased pressure in the veins, causing more severe symptoms. These can include significant swelling, skin discoloration, thickened skin and even open sores known as venous ulcers.

While the terms are often used interchangeably, CVI specifically describes this more advanced and chronic stage of the condition. Early diagnosis and treatment are crucial to managing symptoms and preventing further complications.

What are the common causes of chronic venous insufficiency?

Chronic venous insufficiency (CVI) develops when the veins in your legs are unable to efficiently return blood to the heart over an extended period. This condition often arises from underlying issues that damage or weaken the veins and their valves. Here are the most common causes of CVI:

What are the common causes of venous insufficiency?

The most common causes of venous insufficiency are:

Along with varicose veins, vein thrombosis and spider veins, there are other causes and risk factors you may develop venous insufficiency. A few risk factors associated with venous insufficiency include:

1. Age
2. Family history
3. Obesity
4. Pregnancy
5. Smoking
6. Muscle weakness, leg injury or trauma

What are the symptoms of chronic venous insufficiency and venous insufficiency?

For varicose veins, the valves are often missing or not working correctly, causing blood and fluid to leak back through the damaged valves. The pressure can cause the veins to become inflamed, which can cause swelling and pain in your legs. The symptoms of venous insufficiency typically affect your legs and can include the following:

• Swelling in legs or ankles
• Pain that gets worse when you stand and gets better when you elevate your legs
• Leg cramps or charley horse
• Aching
• Throbbing
• Feeling of heaviness in your legs
• Itchy legs
• Weak legs
• Leg ulcers
• Skin that changes colors, especially around the ankles
• Irritated or cracked skin
• A tightness feeling in your calves

Other symptoms can include varicose veins, restless leg syndrome, and brown-colored skin near the ankles.

How is chronic venous insufficiency and venous insufficiency diagnosed?

CVI and venous insufficiency requires a medical diagnosis from a vascular surgeon. In addition to asking questions about your medical history and current and former symptoms, your physician will often perform a physical exam. A vascular surgeon may also use a special ultrasound on the lower body called a duplex ultrasound, which examines the way blood flows through your arteries and veins, to confirm a venous insufficiency diagnosis. Your doctor may also use a Venogram, which your doctor will put a contrast dye directly into your veins causing your blood vessels to appear opaque on an X-ray. This allows your doctor to see a clearer picture of the blood vessels.

How is chronic venous insufficiency and venous insufficiency treated?

Once venous insufficiency has been diagnosed, medical management treatment options include compression stockings, elevations and pneumatic pumps. Treatment therapy options can include:

1. Endovenous laser treatment – this is a minimally invasive treatment option in which a small optic fiber is inserted in order to heat and close abnormal veins. The body is then able to re-reroute blood flow through normal, healthy veins.
2. Stab phlebectomy – this is a minimally invasive procedure that removes varicose veins.
3. Sclerotherapy of spider, varicose veins or reticular veins – this involves injecting a solution into the vein. This causes the vein to scar, forcing blood to reroute through healthier veins.

Treatment for venous insufficiency is often covered by insurance. At Ochsner, we also provide low-cost sclerotherapy, injecting a solution directly into the vein, for patients whose insurance does not cover it.

As with most vascular and cardiovascular health conditions, adopting healthy lifestyle habits like eating well, exercising regularly and maintaining a healthy weight can help prevent complications from venous insufficiency. 

If you’re experiencing symptoms of venous insufficiency or chronic venous insufficiency, don’t wait to seek care. Early diagnosis and treatment can make a significant difference in managing the condition and improving your quality of life.