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Understanding Chronic Venous Insufficiency

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Understanding Chronic Venous Insufficiency

Chronic venous insufficiency is a condition that causes the veins in the legs to restrict blood flow back to the heart. When the blood can’t flow back to the heart, it can sometimes push back into the legs creating pools of blood in the lower legs and feet. Although this condition isn’t a major health threat, it can be painful and disabling. Here is a guide to understanding chronic venous insufficiency.

Symptoms

There are many symptoms of chronic venous insufficiency, which makes it difficult to readily identify. Always consult a doctor if you have any health concerns.

Here are the symptoms to watch out for when concerned you may have chronic venous insufficiency:

  • Swelling in the legs, ankles, and feet—especially in the lower legs
  • Aching pain in the legs
  • Fatigued legs
  • Varicose veins
  • Leg skin that appears leathery
  • Flaking or itching skin on legs and feet
  • Stasis ulcers or venous stasis ulcers
  • Pain that worsens when standing and becomes relieved when elevating legs above heart
  • Stasis dermatitis: red, swollen, or crusty skin
  • Thickening and hardening of the leg and ankle skin
  • Wounds on the legs and feet that will not heal

If you are experiencing any or all of these symptoms, mention them to your health care provider, it could be indicative of chronic venous insufficiency.

Causes

While there is no exact cause of chronic venous insufficiency, there are multiple different risk factors that increase the chances of developing it. 40 percent of people in the United States have it and most commonly occurs in elderly women.

Here are the other risk factors for developing chronic venous insufficiency:

  • Personal history of deep vein thrombosis
  • Personal history of varicose veins
  • Family history of varicose veins
  • Obesity
  • Pregnancy
  • Prolonged inactivity
  • Smoking
  • Extended periods of standing or sitting
  • Being female
  • Being over 50

Let your doctor know if you have any of these risk factors to help with a proper diagnosis and apt treatment. Having these risk factors doesn’t mean you have the condition; it simply increases your risk for developing it.

Prevention

While even when taking all the preventative steps, it is still possible to develop chronic venous insufficiency; however, preventative measures vastly lower the risk. Here are some things you can do to prevent developing the condition:

  • Eat a balanced and healthy diet: talk to your healthcare provider about what a healthy diet looks like for you
  • Quit smoking: smoking increases the risk of developing countless conditions—talk to your doctor for help quitting
  • Exercise regularly: movement helps by keeping your blood flowing, so try to get at least 30 minutes a day
  • Avoid wearing restrictive clothing such as tight belts or girdles: these can restrict blood flow
  • Lose weight if you’re overweight: losing weight lessens the pressure on your veins and allows for a better functioning circulatory system
  • Avoid prolonged sitting or standing: inactivity can allow blood to pool in the legs and feet

For more details and ways to lower your risk for developing chronic venous insufficiency, consult a doctor.

Diagnosis

To get a chronic venous insufficiency diagnosis, you will need to visit a doctor. The doctor will inspect your legs when standing and when sitting on an exam table with your legs dangling. The appearance of your legs will indicate any issue. Then, the doctor should go over your medical history—be sure to mention any of the risk factors listed above that you may have.

If a medical professional needs to perform more than a visual inspection, they may order a vascular or duplex ultrasound to examine the blood circulation in your legs.

Treatment

Chronic venous insufficiency is a condition that typically worsens over time, especially if left untreated for a long period of time. It is easier to manage when caught during the early stages, and individuals can lessen it with self-care methods and medical procedures. While there is no definite cure for this condition, it’s manageable— you can lessen the pain and prevent future issues to an extent.

Self-care treatment options:

  • Avoid standing or sitting for long periods of time: keep your blood flowing
  • Exercise regularly: this helps your circulatory system
  • Lose weight if you are overweight: lessen the burden on your heart and veins
  • Elevate your legs when sitting or lying down: raise legs above your heart until symptoms lessen
  • Wear medical compression tights: when worn properly at the right compression level (which may require a doctor’s prescription), these will gently squeeze your legs and encourage your blood to flow
  • Practice good skin hygiene: keep your skin moisturized so it can’t crack easily

Medical treatment options:

  • Take antibiotics as needed to treat any skin infections
  • Other medications prescribed by a doctor—see below

Sclerotherapy

Sclerotherapy is when a medical professional injects a solution directly into the problem veins, causing them to collapse. This treatment prevents further complications, treats the problem and the cosmetic issues, and eliminates pain and discomfort. Several treatments are typically necessary.

Endovenous thermal ablation

This is a newer technique that uses lasers or high-frequency radio waves to create intense heat localized to the problem area. It results in lessened pain and allows for fast recovery time.

Ligation and stripping

Professionals typically perform these together. During ligation, a vascular surgeon cuts and ties off the problem veins, and patients require a few days of recovery time. Stripping is the surgical removal of larger veins through two small incisions. This procedure is more invasive and requires over a week of recovery time.

Microincision/ambulatory phlebectomy

Microincision, or ambulatory phlebectomy, is a minimally invasive procedure with low recovery time. A surgeon makes small incisions called needle punctures over the veins that aren’t functioning properly. Then, they use a phlebectomy hook to remove the veins.

Vein bypass

Vein bypass surgery is a very similar procedure to a heart bypass surgery. The surgeon takes a portion of one of your healthy veins from somewhere else in your body and transplants it to the area that isn’t functioning properly. This helps to reroute the blood around the vein that has become affected by chronic venous insufficiency. This is a very invasive procedure and is only for the most severe cases. These cases typically occur in the upper thigh rather than the standard lower leg and ankle locations. This makes other treatment options ineffective in many cases.

Understanding Chronic Venous Insufficiency 

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  • Elyse Aufmann
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