Tired, achy legs and swelling that worsens by day’s end can be more than just signs of fatigue. They may point to chronic venous insufficiency (CVI). This widespread vein disorder affects millions of people, particularly adults over 50 and those who spend long hours standing or sitting. CVI occurs when the veins in the legs struggle to return blood to the heart. Instead, blood pools in the legs, causing discomfort and a range of other symptoms.
Healthy veins rely on one-way valves to push blood upward against gravity. When these valves become weakened or damaged, blood flows backward, or “refluxes,” and accumulates in the lower extremities. Left untreated, CVI can lead to skin discoloration, painful ulcers, and even a higher risk of blood clots. While it’s a chronic condition, advances in minimally invasive procedures and lifestyle management make it possible to live comfortably and reduce symptoms significantly.
What Causes Chronic Venous Insufficiency?
Several factors can contribute to the development of CVI. The most common cause is valve damage in the leg veins, which can result from aging, prolonged sitting or standing, or a history of deep vein thrombosis (DVT). Family history and genetics also play a role—if your parents had varicose veins or CVI, your risk increases.
Other contributing factors include obesity, pregnancy, and a sedentary lifestyle. These conditions increase pressure in the leg veins, weakening the vein walls and impairing proper blood flow. Trauma to the legs or surgeries involving veins may also impair valve function and lead to CVI.
Recognizing the Symptoms
CVI symptoms often begin subtly but can become more intense over time. The most common signs include:
- Leg swelling, especially at the ankles
- Heaviness or aching in the legs after standing for long periods
- Cramping or throbbing in the calves
- Varicose veins or spider veins
- Skin changes such as dryness, itching, or a reddish-brown discoloration near the ankles
- Open sores or ulcers, especially around the inner ankle area
Symptoms usually worsen throughout the day and improve with leg elevation or rest.
How Is CVI Diagnosed?
A diagnosis of CVI starts with a thorough medical history and physical exam. Physicians often use ultrasound imaging to assess blood flow in the veins and detect valve failure. This non-invasive test shows real-time images of vein function and helps guide treatment decisions.
Depending on the findings, your provider may classify the severity of your venous disease using the CEAP (Clinical, Etiological, Anatomical, Pathophysiological) system to ensure appropriate care planning.
Conservative Treatment Options
Initial management of CVI often begins with conservative strategies aimed at improving circulation and reducing symptoms. These include:
- Compression stockings: Graduated compression helps push blood upward and prevents pooling.
- Leg elevation: Raising the legs several times a day can reduce swelling.
- Exercise: Walking and leg-strengthening activities encourage healthy blood flow.
- Weight management: Maintaining a healthy weight reduces strain on veins.
- Medications: Some patients benefit from venoactive drugs that support vein wall function.
These measures are effective for mild to moderate CVI but may not address the underlying venous damage in advanced cases.
Minimally Invasive Treatments
When conservative care is insufficient, interventional radiologists offer several outpatient procedures to treat the diseased veins directly:
- Endovenous Laser Ablation (EVLA): A thin laser fiber is inserted into the vein to seal it shut using heat.
- Radiofrequency Ablation (RFA): Similar to EVLA, this uses radiofrequency energy to close the vein.
- Sclerotherapy: A solution is injected into small veins to make them collapse and fade.
- Microphlebectomy: Small incisions are made to remove varicose veins close to the skin’s surface.
These treatments typically require only local anesthesia and allow most patients to resume daily activities quickly.
Risks and Recovery
While minimally invasive treatments for CVI are generally safe, potential risks include bruising, temporary nerve irritation, or, rarely, blood clots. Patients are advised to avoid strenuous activity for a week or two post-procedure but are encouraged to walk to maintain circulation.
Follow-up appointments ensure proper healing and evaluate whether additional veins require treatment. Most people experience significant symptom relief and cosmetic improvement after treatment.
When to See a Specialist
Early diagnosis and treatment of CVI can prevent long-term complications. You should seek medical advice if you experience persistent leg swelling, skin changes, or ulcerations. CVI tends to worsen over time without intervention, and timely care can protect your vascular health and improve daily comfort.
Interventional radiologists are specially trained in diagnosing and treating venous disease using image-guided, minimally invasive techniques. Their expertise allows for tailored treatment plans that address each patient’s unique condition.
Chronic venous insufficiency is more than a cosmetic concern. It’s a medical condition that can significantly affect quality of life if not addressed. From early symptoms like swelling and heaviness to more serious issues like skin ulcers, recognizing the signs and seeking proper care is essential. Fortunately, with today’s advanced, minimally invasive treatments and supportive lifestyle strategies, managing CVI is entirely achievable.
If you’re experiencing signs of venous insufficiency or have concerns about your vein health, VidaVascular offers personalized, expert care to help you feel better and prevent further complications. Contact us today to schedule a consultation.
Reference:
https://www.sirweb.org/for-patients/conditions-and-treatments/superficial-venous-disease
