Chronic Venous Insufficiency

Definition

Chronic venous insufficiency is caused by higher-than-normal blood pressure within the leg veins.

Venous Insufficiency

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Causes

Chronic venous insufficiency can be caused by blood clots or swelling and inflammation of the veins calledphlebitis. Blood clots in the legs, called deep vein thrombosis, can damage the valves in the veins. When people get chronic venous insufficiency after a blood clot, it may be referred to as post-thrombotic syndrome. When it occurs after phlebitis, it may be referred to as post-phlebitic syndrome.

Other causes of chronic venous insufficiency include:

• Absence or weakness of valves in the leg veins that is inherited at birth
• Increased venous pressure in the legs for any reason
• Varicose veins

Risk Factors

Risk factors that increase your chance of getting chronic venous insufficiency include:

• Obesity
• Physical inactivity
• Increased age (50 and over)
• Sex: female
• Family members with deep vein thrombosis or varicose veins
• Smoking
• Pregnancy
• Chronic constipation
• Regularly sitting or standing for long periods of time
• Wearing restrictive clothing such as very tight girdles or belts

Symptoms

When blood pools in the legs, it puts pressure on the veins. Sometimes, the blood leaks out into the tissues. This can discolor and damage the skin. It may even cause skin ulcers. Symptoms of chronic venous insufficiency can include:

• Swelling of the legs
• Pain in the legs, especially after walking:
  • Aching
  • Dullness
  • Tiredness
  • Cramping
• Red or brown darkening of the skin on the legs
• Varicose veins
• Ulcers on legs, especially around the inside of the ankles
• Scaling skin on legs
• Hard, leathery skin on legs

Diagnosis

The doctor will ask about your symptoms and medical history. A physical exam will be done. If the diagnosis is not clear from the exam or you are considering surgery, your doctor may have images taken of your bodily structures. This can be done with:

• Duplex scanning (venous ultrasound/ Doppler)
• Venogram

Treatment

After the valves have been damaged, they usually cannot be repaired. Treatment is aimed at maintaining blood flow and preventing it from pooling. Treatment involves the following:

Prevention

To help prevent chronic venous insufficiency, take steps to decrease your risk factors. These include:

• Maintain a healthful weight.
• Exercise regularly.
• If you smoke, quit.
• Avoid standing or sitting for long periods of time.
• Avoid wearing restrictive clothing such as girdles or belts.