How to Treat Chronic Venous Insufficiency?

What Is Chronic Venous Insufficiency?

If you have chronic venous insufficiency, the veins in your legs are not working as they should, especially the tiny valves that typically help push blood back up to your heart. When those valves weaken or get damaged, blood can flow incorrectly and start collecting in your legs.

Usually, these valves act like one-way doors, keeping blood moving in the right direction. But you might notice swelling, heaviness, or discomfort when they do not work correctly.

What Are the Causes and Risk Factors for Chronic Venous Insufficiency?

Chronic venous insufficiency can be of three types: congenital, primary, and secondary, depending on the cause.

• If it is congenital, you were born with specific changes in your leg veins, like malformations or missing valves that typically help control blood flow.

• Primary causes happen when something changes in your veins over time, like if a vein becomes too wide, the valve inside cannot close all the way, so blood does not move like it should.

• The secondary type usually develops after deep vein thrombosis (DVT is a blood clot formation in a deep vein). Even after the clot is gone, it can leave behind scar tissue, cause inflammation, and damage the vein, making it harder for blood to flow correctly.

Some things make you more likely to end up with chronic venous insufficiency. These are as follows:

• If you are over 50, your risk naturally goes up.

• Women tend to face this problem more often, mainly because of hormone changes like higher progesterone.

• If someone in your family has had vein issues, you could also be at a higher risk.

• A history of blood clots in your legs (deep vein thrombosis) also raises the risk.

• Being overweight or dealing with pregnancy puts extra strain on your veins.

• Smoking or drinking alcohol can raise your chances.

• If you stand or sit for a prolonged period of time, and if your leg muscles are weak, it is harder for your body to pump blood as it should.

• Injuries or trauma to your legs.

• Some conditions, like phlebitis (when a vein becomes swollen), can worsen matters.

• May-Thurner syndrome is a condition in which your leg gets squeezed or blocked, causing more trouble with blood flow.

What Are the Signs and Symptoms of Chronic Venous Insufficiency?

Chronic venous insufficiency symptoms can differ for each person, and you might not have all of them. They often show up gradually, one after another, depending on how your condition progresses.

• You might notice pain in your legs that worsens when you stand for a long time, but feels better when you put your feet up.

• You may feel burning, tingling, or heaviness in your legs and have swelling around the ankles. Your legs might also feel itchy, weak, achy, or tired, and nighttime leg cramps can be common.

• Over time, the skin on your legs might change, turning reddish-brown.

• You may have a feeling of tightness around the calf muscles.

• Even your skin may have a leathery texture.

• If the problem is not treated, ulcers (open sores) might develop.

• You may also notice varicose veins, those enlarged, twisted veins visible under the skin.

What Are the Six Stages of CVI?

• Stage 0: You will not feel or see any signs or symptoms, but your legs might feel tired or heavy.

• Stage 1: Small veins start to show up, becoming thin, twisted, and web‑like; these are called spider veins.

• Stage 2: You notice larger varicose veins (at least three millimeters wide).

• Stage 3: Your legs swell up, though your skin still looks normal.

• Stage 4: Your skin changes color and texture.

• Stage 5: An ulcer develops on the leg.

• Stage 6: The ulcer becomes infected, which can be painful and take longer to heal.

Most people are diagnosed with chronic venous insufficiency once they hit stage 3. It is important to remember that varicose veins are not always the same as chronic venous insufficiency, but can lead to it if left untreated. That is why seeing your doctor early, even if you are only at the spider vein stage, can help prevent things from worsening.

How Is Chronic Venous Insufficiency Diagnosed?

CEAP classification is used to identify CVI: C (clinical), E (etiological), A (anatomical), and P (pathophysiologic). Clinically, your doctor will check for visible symptoms; etiologically, your doctor will find out the cause. Anatomically, your doctor will check the anatomical site and pathophysiology of the venous pathology.

Your doctor will ask questions about your symptoms and medical history and then physically check your legs. They will look for signs of chronic venous insufficiency (CVI), such as ulcers, skin color changes, or swelling.

However, to ensure the diagnosis, they usually recommend imaging tests. One of the most common is a duplex ultrasound. The sound waves are used to check in what direction your blood moves through your veins. During the scan, your doctor uses a small handheld device on your skin. It picks up the sound waves, records your blood flow, and shows real‑time images on a computer screen, all without pain.

How to Treat Chronic Venous Insufficiency?

There are plenty of options for treating chronic venous insufficiency, from simple lifestyle changes to surgical procedures. Regardless of your treatment, the primary goals are always the same: reduce pain, improve blood flow in your veins, and keep the skin on your legs looking and feeling healthy.

1. Lifestyle Changes: Doctors start with lifestyle changes as the first step for most people.

• Exercise: Daily walks and a few minutes of simple leg exercises can work wonders. They strengthen your calf muscles, which act like pumps to help push blood back up toward your heart.

• Elevating Your Legs: Propping your legs above heart level a few times daily helps reduce swelling and stops blood from pooling in your legs. Aim for at least three sessions of leg elevation every day.

• Wear Loose Clothing and Avoid Tight Heels: You should wear loose clothing and avoid tight heels because tight clothing or footwear may restrict blood flow to your legs.

• Weight Management: Carrying extra weight puts more pressure on your veins and can damage those tiny valves that keep blood flowing correctly. Your doctor can help you devise a diet plan that works for you, and it is a good idea to cut back on foods that might cause you to gain more weight.

• Keeping Your Skin Healthy: Looking after the skin on your legs is as important as looking after the veins inside them. Wash your legs gently daily and moisturize them with a lotion. This helps prevent dryness, itching, and irritation.

• Go Easy on the Salt: Consuming more salt can cause fluid retention, leading to swollen legs. That extra swelling puts pressure on your veins and can weaken their walls, so avoid salt.

• Compression Stockings: These are tight elastic bands that decrease leg swelling.

2. Medicines: Certain medicines can help improve blood flow in your veins, mainly when used with compression therapy to speed up the healing of leg ulcers. In some cases, Aspirin is recommended to help ulcers heal faster. If there is an infection, you may need antibiotics. Your doctor may prescribe anticoagulants (blood thinners) for blood clots.

3. Non‑Surgical Treatments:

• Endovenous Thermal Ablation: Your doctor will perform this procedure under local anesthesia. They will use a laser to insert a catheter into your damaged vein. This will produce heat, block your damaged vein, and move the blood to your healthier vein.

• Sclerotherapy: During this procedure, your doctor injects a chemical solution into your vein. The solution hardens the vein, and then it disappears.

4. Surgical Treatments: When the above treatment fails, this one is adopted.

• Varicose Vein Ligation and Stripping: Usually done together, these involve tying off (ligating) the damaged vein and removing (stripping) it through small incisions.

• Phlebectomy: A minor, minimally invasive procedure where small superficial veins are removed using a fine needle.

• Vein Bypass: If other treatments do not work, your surgeon can create a new pathway for blood to flow by bypassing the damaged vein and connecting it to a healthy one nearby.

• SEPS (Subfascial Endoscopic Perforator Surgery): A minimally invasive procedure where your surgeon uses a tiny clip to block damaged perforating veins (located above your ankle) so that the blood will not move in that area.

Conclusion:

Chronic venous insufficiency mainly affects your legs when the blood struggles to reach your heart. If you are over 50, you can be the target person. So to get rid of this type of condition, you should go for lifestyle changes and treatments, like surgical and non-surgical options. Either you should adopt lifestyle changes, like physical exercise, leg elevation, weight management, and wearing loose clothing.

A Key Takeaway Note From iCliniq:

CVI affects your legs. If this happens to you, do not ignore it. There is a need to consult your doctor or to know about treatment options, either surgical or non-surgical; you can contact our specialists at icliniq.com.