What is venous insufficiency?

Q: What are the common causes of venous insufficiency?

Varicose veins, Vein thrombosis and Spider veins

What is 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 are the common causes of venous insufficiency?

The most common causes of venous insufficiency are:

Varicose veins	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. When the vein is inflamed, they make the skin bulge out. Varicose veins are often on the calves, thighs and inside of the legs near the feet and ankles.
Vein thrombosis	Vein thrombosis occurs when a blood clot develops deep in your body because your veins are injured or the blood flowing through the vein is too sluggish. This typically occurs in your lower leg, thigh or pelvis. Vein thrombosis is not always visible, but can cause swelling and skin discoloration in the legs.
Spider veins	Spider veins occur when blood pools in the veins near the surface. This can be caused by trauma, heredity, obesity and fluctuations in hormone levels. Spider veins are smaller than varicose veins and are usually visible under the skin, but they do not make the skin bulge out like varicose veins. They tend to look like branches or spider webs. Spider veins are usually found on the legs or face.

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:

Age
Family history
Obesity
Pregnancy
Smoking
Muscle weakness, leg injury or trauma

What are the symptoms of 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.

What is chronic venous insufficiency?

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.

How is venous insufficiency diagnosed?

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 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:

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.
Stab phlebectomy – this is a minimally invasive procedure that removes varicose veins.
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.