Chronic venous insufficiency (CVI) is a progressive condition that causes increased pressure in the leg veins and complications in the legs.

It is caused by:

• broken valves in the veins with blood going backwards in the leg
• current or prior deep vein thrombosis (DVT)
• compression and narrowing of the deep veins with decreased blood flow

Both the superficial veins in the leg, just under the skin, and the deep veins under the muscle and bone can be affected by CVI

This increased pressure in the leg veins can result in:

• varicose veins
• leg or ankle swelling,
• darkened or pigmented skin at the ankle or calf
• warmth and skin redness in the calf or ankle area
• chronic sores at the ankle or calf known as venous ulcers that last more than a month

Patients may experience:

• Swelling in the thigh, calf, ankles, or feet
• Leg heaviness and fatigue worse after prolonged sitting or standing;
• An achy/throbbing leg pain, worsening pressure towards the end of the day. Symptoms usually improve with leg elevation.

Anyone can develop CVI. 40 million Americans have varicose veins, 6 million have skin darkening/ inflammation and 500,000 have non healing venous  ulcers. Left untreated CVI can worsen, but there are  certain conditions that increase the likelihood of having this condition.

These can include:

• Family history of venous disease
• Previous trauma (e.g. bone fracture) or injury can damage veins, interfering with normal blood flow.
• Sex can play a role as women are twice as likely to develop the condition.
• Medications such as birth control and infertility drugs can increase estrogen and progesterone, hormones associated with higher risks for spider veins
• Pregnancy places pressure on a women’s pelvic area and veins, resulting in spider and varicose veins
• Obesity or being overweight

Diagnosing CVI requires a careful evaluation by a vascular surgeon and an ultrasound study of the leg veins to diagnose blockages and valve failure. Diagnosing and treating CVI is important, since it will worsen over time and become harder to treat.

Depending on the severity of your condition, treatment options may include lifestyle changes, elevating your legs when resting, and wearing compression stockings. If this is not effective or adequate, there are a number of minimally invasive procedures that are performed in the office to treat superficial and deep CVI, including:

• Superficial vein ablation
• Superficial vein phlebectomy
• Angioplasty and stenting of deep vein occlusion or stenosis
• Thrombectomy to remove acute DVT