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Chronic Venous Insufficiency

CHRONIC VENOUS INSUFFICIENCY

What is CVI?

The veins main role is to return blood flow back to the heart using muscles in the leg and feet along with one-way valves that prevent backflow due to gravity. Failure or weakening of the vein valves can lead to flow reversal that results in pooling of blood in the legs. Certain risk factors that may lead to CVI include:

  • Obesity

  • Pregnancy

  • Obstructive sleep apnea

  • Heart failure

  • Family history of varicose veins

  • Prior orthopedic surgeries leading to vein trauma

  • Blood clots

What are the Symptoms of CVI?

  • Leathery or flaky skin on the legs and ankles

  • Swollen legs/ankles provoked by prolonged standing or sitting

  • Restless leg symptoms

  • Leg heaviness and fatigue

  • Reddish-brown skin discoloration around the ankles

  • Varicose veins

  • Venous stasis ulcers

  • Bleeding veins

  • Purplish discoloration of the foot

What Tests can Help Diagnose CVI?

Vascular ultrasound is used to exclude a blood clot and identify if incompetent valves are present leading to venous reflux or insufficiency.

What are the Treatments of CVI?

CVI can be treated if diagnosed in the early stages. Strategies include:

  • Weight loss    

  • Leg elevation

  • Compression stocking to augment blood return

  • Avoidance of prolonged standing

  • Exercise

For more severe cases, particularly involving skin integrity and life-limiting symptoms, advanced therapies include: