Chronic venous insufficiency occurs when your leg veins do not allow blood to flow back to the heart. Normally, valves in your veins keep blood flowing towards your heart. But when these valves don’t work well, blood can also flow backwards. This can cause blood to pool in your legs. You can find more information below.
What is chronic venous insufficiency?
Chronic venous insufficiency (CVI) is a condition that occurs when the venous wall or valves in the leg veins do not work effectively, making it difficult for blood to return from the legs to the heart. This condition causes blood to pool or pool in these vessels, and this accumulation is called stasis .
Who is affected?
No such study has been done in Turkey, but about 40 percent of people in the United States have this condition. It is observed in people over 50 years of age and is more common in women than men.
What causes chronic venous insufficiency?
Veins return blood from all organs of the body back to the heart. To reach the heart, blood must flow upward through the veins in the legs. The calf muscles and the muscles in the feet need to contract with each step to tighten the veins and push the blood upwards. To keep blood flowing and not going down, the veins contain one-way valves.
Chronic venous insufficiency occurs when these valves are damaged, allowing blood to leak backwards. Valve damage can occur as a result of aging, prolonged sitting, standing, or a combination of aging and mobility. When the veins and valves weaken to the point where it is difficult for blood to flow to the heart, the blood pressure in the veins rises for a long time, leading to a CVI condition.
This condition most often occurs as a result of a blood clot in the deep veins of the legs, a disease known as deep vein thrombosis (DVT) . Chronic venous insufficiency is also caused by pelvic tumors and vascular malformations and sometimes occurs for unknown reasons. Failure of the valves in the leg veins to hold the blood against gravity causes the blood to move slowly through the veins and causes the legs to swell.
CVI that develops as a result of DVT is also known as the post-thrombotic syndrome . Up to 30% of people with DVT will develop this problem within 10 years of diagnosis.
Who is at risk?
If you have risk factors for chronic venous insufficiency, you are more likely than other people to develop the disease. The most important risk factors are:
- Deep vein thrombosis (DVT)
- Varicose veins or a family history of varicose veins
- To smoke
- standing or sitting for long periods of time
- Be woman
- over 50
What are the symptoms of chronic venous insufficiency?
The severity of the chronic venous insufficiency state, along with the complexity of treatment, increases as the disease progresses. That’s why it’s so important to see your doctor if you have any of the symptoms. The problem won’t go away if you wait, and the sooner it’s diagnosed and treated, the better your chances of preventing serious complications.
Symptoms of chronic venous insufficiency include:
- Swelling in the lower legs and ankles, especially after standing for long periods of time
- Pain or fatigue in the legs
- Formation of new varicose veins
- Different-looking skin on the legs
- Rash or itchy skin on the legs or feet
- Stasis ulcers (or venous stasis ulcers)
If chronic venous insufficiency is not treated, the pressure and swelling will increase until the smallest blood vessels (capillaries) in the legs burst. When this happens, the overlying skin takes on a reddish-brown color and is very susceptible to damage if bumped or scratched.
Capillary bursts can cause local tissue inflammation and internal tissue damage. At worst, this leads to ulcers, open sores on the skin surface. These venous stasis ulcers can be difficult to heal and can become infected. When the infection is not controlled, it can spread to the surrounding tissue as a condition known as cellulitis .
Chronic venous insufficiency is often associated with varicose veins, which are twisted, enlarged veins near the surface of the skin. They can occur almost anywhere, but are most commonly seen on the legs.
How is chronic venous insufficiency diagnosed?
To diagnose ktonic venous insufficiency, your doctor will want to obtain a complete medical history and perform a physical examination. During the physical exam, the doctor will carefully examine your legs. A test called a vascular ultrasound may be used to examine the blood circulation in your legs .
During vascular ultrasound, a transducer (a small, hand-held device) is placed on the skin over the vessel to be examined. The transducer emits sound waves that bounce off the vessel. These sound waves are recorded and an image of the vein is created and displayed on a monitor.
Treatment and management of chronic venous insufficiency
Like any disease, this disease is best treatable in its earliest stages. Vascular medicine or vascular surgery specialists typically recommend a combination of treatments for people with chronic venous insufficiency. Some basic and home treatment strategies include:
- Avoid prolonged standing or sitting: If you have to take a long trip and sit for a long time, stretch and lengthen your legs, feet, and ankles about 10 times every 30 minutes to keep blood flowing through the leg veins. If you have to stand for long periods of time, take frequent breaks to sit and raise your feet.
- Exercise regularly: Walking is particularly beneficial.
- Stay at a healthy weight: If you are overweight, lose your excess weight.
- Elevate your legs : Elevate your legs at heart level while sitting or typing.
- Wear compression stockings: These stockings are very useful.
- Use the medicines prescribed by the doctor: Use the antibiotics prescribed by your doctor as needed to treat skin infections.
- Stay clean: Pay particular attention to your skin hygiene.
The goal of treatment is to reduce the pooling of blood and prevent leg ulcers.
The most conservative approach is to wear properly fitted support stockings (also called compression stockings). Compression stockings can be purchased from some pharmacies and medical supply stores and come in a variety of styles, including below-the-knee, above-the-knee, and pantyhose styles. They also come in different compressions ranging from 8 to 10 mm Hg, 40 to 50 mm Hg. Your doctor can recommend the compression that is right for you. For stockings with a compression greater than 20 mm Hg, you will need a prescription.
If you are wearing compression stockings, be sure to remove them at the end of the day to wash, dry and clean and check your skin. Make sure that the socks are appropriate because the healthiest are the appropriate socks. Poorly fitting elastic stockings can make your condition worse by blocking blood flow to the area where they are gathered.
Some studies have shown that combining elastic stockings with prescription medications to improve blood flow is very effective.
Antibiotics may be prescribed to clear up skin infections associated with chronic venous insufficiency. Deeper infections and ulcers can also be treated with antibiotics.
If you have post-thrombotic syndrome, your doctor may prescribe medication to prevent additional blood clots from forming.
A special medicated dressing known as Unna Boot combines multilayer compression with a zinc oxide gel-based dressing that creates a semi-rigid bandage. Other multi-layer compression systems are also available and are often used in combination with topical wound care products.
It is important to practice good skin hygiene. Keep your skin moisturized so it doesn’t flake or crack easily. If the skin is inflamed, your doctor may recommend an anti-itch cream containing hydrocortisone. These may include a cream containing zinc oxide to protect the skin, or an antifungal cream to prevent fungal infections.
If you have ulcers on your legs, your doctor will show you how to apply layered compression bandages to protect the skin and blood flow.
Nonsurgical treatments include sclerotherapy and endovenous thermal ablation.
Sclerotherapy involves the injection of a solution directly into the capillaries or small varicose veins, which causes them to collapse and disappear. Several sclerotherapy treatments are usually required to achieve the desired results. Sclerotherapy is simple, relatively inexpensive, and can be done during the exam. Sclerotherapy can relieve the pain and discomfort of these veins, helping to prevent complications such as venous bleeding and ulceration. It is also often done for aesthetic reasons.
Endovenous thermal ablation is a newer technique that uses laser or high-frequency radio waves to generate intense local heat in the affected vein. For more information about this technique, you can watch the related video prepared by Mayo Clinic .
For less than 10 percent of patients requiring surgical treatment, options include vessel ligation and stripping, micro-incision/outpatient phlebectomy, and bypass surgery. Here is a brief review of each of these techniques below. Your doctor can recommend the most appropriate treatment for you.
Ligation and stripping are often done together. Vein ligation is a procedure in which a vascular surgeon cuts and ligates problem veins. Most patients recover within a few days and can resume normal activities. Stripping is the surgical removal of larger vessels through two small incisions. Stripping is a more extensive procedure and recovery can take up to 10 days. It usually causes bruising for a few weeks after surgery.
Micro- incision/outpatient phlebectomy is a minimally invasive procedure in which small incisions or pinholes are made on the veins and a phlebectomy hook is used to remove the problematic veins.
Vein bypass in the leg is similar to bypass surgery on the heart. It involves using a portion of a healthy vein transplanted from another part of your body to reroute blood around the vein affected by chronic venous insufficiency. Bypass is used for treatment in the upper thigh and only in the most severe cases, when no other treatment has been effective.
Can chronic venous insufficiency be prevented?
To reduce your risk of developing SVI, follow these guidelines:
- Get a healthy and balanced eating habit.
- Quit smoking.
- Exercise regularly.
- Avoid wearing restrictive clothing such as tight belts and tight clothing.
- If you are overweight, lose weight.
- Avoid sitting or standing for long periods of time.