Chronic Venous Insufficiency (CVI): Symptoms, Treatment
Overview
Chronic venous insufficiency (CVI) is a venous system disorder that occurs when the blood flow from the legs to the heart is blocked. Normally, the valves in your veins are responsible for blood flows toward your heart. But when these valves don’t work well, blood can also flow backwards. This can cause blood to pool in your legs.
Generally, CVI is not a life-threatening condition, but it can be painful and disabling. Varicose veins and superficial venous reflux are medical conditions that can accompany CVI. Millions of people around the world are affected by this disease. In the United States, an estimated 40% of people have it.
Causes
CVI is caused by the incompetency of vein valves, but doctors do not know why these valves are functioning improperly. Some experts think that a blood clot in a deep vein in your leg (called deep vein thrombosis) can damage a valve. Other risk factors for developing CVI include:
- Being a female
- Aging over 50
- Obesity
- High blood pressure in the leg veins
- Family history
- A history of blood clots
- Smoking
- Pregnancy
- Lack of exercise
- Leg injury, muscle weakness, оr trauma
- Prolonged sitting or standing
Symptoms
Most signs and symptoms of CVI are mild and will not disable your limbs. They may seem like those of other health conditions. Typical symptoms include:
- Heaviness, swelling, and pain in the affected legs
- Weakness and itchiness in the affected limbs
- Thickening of the skin on legs or ankles
- Tightness in the calf
- Enlarged and twisted veins, known as varicose veins
- Brown-colored skin, often near the ankles
- Leg ulcers that are sometimes hard to treat
- Leg cramps or muscle spasms
Diagnosis
In order to accurately diagnose CVI, your doctor will perform a complete history and physical examination. Additional tests that can help your doctor confirm the diagnosis include:
- Venogram
In this imaging test, IV dye is injected into the veins causing them to appear opaque on an X-ray image. This helps your doctor look at blood flow and the structure of your leg veins.
- Duplex ultrasound
Duplex ultrasound is used to test the speed and the direction of blood flow in your veins. This can help your doctor see if your leg veins are functioning properly.
Treatment
The treatment plan is usually tailored based on the patient’s specific conditions and symptoms. Treatment methods for CVI are focused on reducing symptoms and preventing severe complications. Options may include:
- Compression stockings
These can help put pressure on the legs, pushing blood flow upwards and improving the efficiency of the circulation
- Medicines
Medicines that increase blood flow through the vessels may be used along with compression therapy to help heal leg ulcers. Aspirin can also be used to help ulcers heal. Various substances, including horse chestnut seed and collagen, have been suggested as remedies for venous disease.
- Endovenous laser ablation or radiofrequency ablation (RFA)
This is a minimally invasive procedure. Doctors will insert a catheter into the affected vein to close it. Once the vein is closed, fewer blood pools in the leg. Thus, overall blood flow is improved.
- Sclerotherapy
This may be used if your case is more serious. A chemical is injected into the affected veins, causing scarring in the veins so that they can no longer carry blood. Blood then returns to the heart through other veins.
- Surgery
In severe cases, surgical treatment is needed. Ligation is a type of surgery that may be used. The affected vein is tied off so that blood no longer flows through it. If the vein or its valves are heavily damaged, the vein will be removed. This is called vein stripping. In rare conditions, vein bypass surgery may be necessary.
Even with very successful treatment, recurrence of CVI is common, and you may need further care.
Keyword: chronic venous insufficiency (CVI).
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