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Ochsner vein clinic

What is Venous Insufficiency?

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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. 

Common causes of venous insufficiency

The most common causes of venous insufficiency are:

Varicose VeinsFor 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 ThrombosisVein 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 VeinsSpider 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:

  1. Age
  2. Family history
  3. Obesity
  4. Pregnancy
  5. Smoking
  6. 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.

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:

  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.

Ochsner Vascular and Endovascular Surgeons are Nationally Recognized. Make an appointment with our team today.

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