Chronic Venous Insufficiency (CVI) occurs when the valves of the vein do not function properly, impairing blood circulation in the leg veins. Vein blockage or damaged valves in the vein can lead to CVI. This can occur due to blood clots in the deep veins of your legs, a condition known as deep vein thrombosis (DVT). However, the risk of DVT is low when a blood clot forms in the superficial veins, ones that lie close to the skin.
Understanding the Condition
Causes of Chronic Venous Insufficiency
Blood flows back from the legs to the heart through vein valves. When the valves don’t function properly, they fail to close, reversing the flow of blood (venous reflux). This arises when the vein wall becomes weak. If one has a history of blood clots, or if vein valves are absent at birth, the valve thus gets damaged from DVT.
Faulty valves increase pressure inside your leg, causing high blood pressure in the vein. It leads to an enlargement of varicose veins, and other symptoms such as swelling, pigmentation changes, and sores or ulcers on the ankle or lower leg.
Unfortunately, venous reflux is progressive and may lead to advanced symptoms, even affecting the pelvis. Vein blockage in the pelvis may further worsen varicose vein symptoms and require separate treatment.
Symptoms
CVI may be asymptomatic and pose no immediate health concerns. When symptoms are present, the common ones experienced are heaviness, pain, fatigue, throbbing, burning, itching, and muscle cramping.
Over time, CVI may result in varicose veins, characterized by ankle and foot swelling on the lower leg. In severe cases, the skin may break down and the varicose veins may bleed. When blood clots form in the veins, quick medical attention becomes important.
Risk Factors
The prevalence of CVI ranges from 25-40% in women and 10-20% in men. Family history may play a role. Women over the age of 50 and those who have had multiple pregnancies may be predisposed to the condition.
Other risk factors include a sedentary lifestyle, obesity, high blood pressure, and clots in deep or superficial veins.
Diagnosis
- Physical examination
- Doppler ultrasound to listen to blood flow and determine venous reflux
- Venous duplex ultrasound scan to view blood clots
Treatment of Chronic Venous Insufficiency
Treatment for Chronic Venous Insufficiency (CVI) depends on the severity of your condition. In many cases, lifestyle changes such as regular exercise, maintaining a healthy weight, elevating your legs, and avoiding prolonged sitting or standing can help manage symptoms. Compression stockings may be recommended to support blood flow, reduce swelling, and prevent skin complications.
For moderate to severe cases of CVI, advanced treatments are available to close off faulty veins, improve circulation, and reduce symptoms effectively. These include Endovenous Laser Vein Treatment, Endovenous RF Ablation, and Ultrasound-Guided Chemical Ablation, which target the underlying cause of CVI with minimally invasive techniques.
Endovenous Laser Vein Treatment (EVLT)
Endovenous Laser Vein Treatment uses laser energy delivered through a thin catheter to heat and seal the affected vein, redirecting blood flow to healthier veins and relieving symptoms such as swelling, leg heaviness, and varicose veins. This treatment is performed under local anesthesia and typically allows you to return to your normal activities quickly.
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Endovenous RF Ablation
Endovenous RF Ablation (radiofrequency ablation) is a minimally invasive procedure that uses radiofrequency energy to heat and close the diseased vein, improving blood circulation in the legs and reducing symptoms of CVI. The treatment is comfortable and effective, with minimal downtime and rapid symptom relief.
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Ultrasound-Guided Chemical Ablation
Ultrasound-Guided Chemical Ablation precisely delivers a medical foam or solution into the varicose vein using ultrasound for accurate guidance. This causes the vein walls to collapse and seal shut, redirecting blood to healthier veins and resolving venous insufficiency symptoms without the need for surgical incisions.
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