<\/span><\/h1>\n\n\n\n30 million people in the United States live with chronic venous insufficiency.<\/strong> Around 150,000 new people are diagnosed every year(1).<\/p>\n\n\n\nChances are that someone you know has this condition \u2013 or that someone may even be you!<\/p>\n\n\n\nChronic venous insufficiency may be known for its symptoms: leg swelling, skin changes, and discomfort. But chronic venous insufficiency can be a sign of something worse down the road. It’s important to familiarize yourself with this condition.<\/p>\n\n\n\n
Let\u2019s learn how to identify chronic venous insufficiency: the causes, signs, symptoms, and treatment options.<\/p>\n\n\n\n
<\/span>How does chronic venous insufficiency start?<\/strong><\/span><\/h2>\n\n\n\nChronic venous insufficiency is classified as either primary or secondary:<\/p>\n\n\n\n
Patients with primary chronic venous insufficiency<\/strong> may be born with the condition. They might have abnormal vein walls or less elastin, which means their veins don\u2019t stretch as well as others. In any case, these issues are out of one\u2019s control and do not stem from another condition.<\/p>\n\n\n\nSecondary chronic venous insufficiency<\/strong> is, well, secondary to another condition. And it often develops because the patient already has deep vein thrombosis.<\/p>\n\n\n\nDeep vein thrombosis, or DVT, is a disease where blood clots form in the veins, usually in the legs(3). DVT triggers inflammation, causing damage to vein walls. This causes secondary chronic venous insufficiency.<\/p>\n\n\n\n
Someone may have an increased risk of developing CVI if they are female, obese, or pregnant. Smoking also increases risk. Prolonged standing and having May-Thurner syndrome do as well(1).<\/p>\n\n\n\n
The veins bring blood back to the heart, pushing blood upwards from the legs. To do this, the muscles of the calves and the valves of the veins work together.<\/p>\n\n\n\n
However, chronic venous insufficiency patients may experience leaks or obstruction in the veins. This results in a pressure increase in the lower extremities. Blood flow, vein blockages, valves, and calf muscles all impact pressure.<\/p>\n\n\n\n
When CVI is secondary to DVT, repeated vein wall injury from DVT causes the veins to scar. These scars narrow the blood passageway, increasing venous pressure. <\/p>\n\n\n\n
<\/span>Chronic Venous Insufficiency Symptoms<\/strong><\/span><\/h2>\n\n\n\nPatients with CVI experience pain, leg discomfort, ankle and leg swelling, or itching. They may also feel \u201cprickling,\u201d cramping, or heaviness in the lower limbs after standing too long(4).<\/p>\n\n\n\n
In severe cases, ulcers, pigmentation, thickening, and wound healing delays are possible. Ulcers near the ankles may especially have trouble healing.<\/p>\n\n\n\n
<\/span>Diagnosis of Chronic Venous Insufficiency<\/strong><\/span><\/h2>\n\n\n\nTo diagnose chronic venous insufficiency, the doctor might ask if:<\/p>\n\n\n\n
\nYou\u2019ve ever been pregnant<\/li>\n\n\n\n You have a family history of CVI<\/li>\n\n\n\n Your job job involves heavy lifting or prolonged standing<\/li>\n<\/ul>\n\n\n\nThey will also review your full medical history. They’ll look for conditions like obesity and hypertension. The doctor will also examine your legs, noting size, texture, and color. <\/p>\n\n\n\n
If they suspect CVI, you might receive more testing. One example is the venous duplex ultrasound scan. This is one of the best way to locate problematic veins(6)<\/p>\n\n\n\n
Venous plethysmography is another noninvasive test. This uses infrared light to determine the amount of blood pumped during exercise. The physician can measure the amount of leakage, obstruction, or muscle use.<\/p>\n\n\n\n
Your physician might request magnetic resonance venography or CT venography. This test is much more invasive and is for more complex CVI cases (7).<\/p>\n\n\n\n
Your doctor may also rule out other conditions with MRI or CT scans.<\/p>\n\n\n\n
<\/span>Chronic Venous Insufficiency Classification<\/strong><\/span><\/h2>\n\n\n\nClinical, Etiology, Anatomic, and Pathophysiology (CEAP) classification<\/strong> helps physicians consistently identify and treat vein disease(8):<\/p>\n\n\n\n\nClinical (C)<\/strong> classification divides vein disease into categories of severity based on symptoms.<\/li>\n\n\n\nEtiologic (E)<\/strong> helps describe the disease\u2019s cause.<\/li>\n\n\n\nAnatomic (A)<\/strong> identifies which veins are insufficient.<\/li>\n\n\n\nPathophysiological (P)<\/strong> helps identify how the disease impacts the body. (Examples include reflux, thrombosis, or obstruction.)<\/li>\n<\/ul>\n\n\n\nDoctors also classify CVI with Venous Clinical Severity Scoring, or VCSS. VCSS uses different attributes to identify disease severity: absent, mild, moderate, or severe. This is often used in assessing the patient\u2019s response to treatment(8).<\/p>\n\n\n\nTable 1.<\/em>CEAP Classification. (8)<\/p>\n\n\n\n<\/span>Chronic Venous Insufficiency Treatments<\/strong><\/span><\/h2>\n\n\n\nCEAP classification and VCSS will identify CVI severity. From there, the doctor will recommend treatment.<\/p>\n\n\n\n
The goal of treatment is to improve circulation and prevent further vein damage. Treatments might also focus on reducing swelling, healing venous ulcers, and managing pain.<\/p>\n\n\n\n
Treatments include: <\/p>\n\n\n\n
<\/span>Lifestyle changes<\/strong><\/span><\/h3>\n\n\n\nSmoking causes several health problems, including vein issues. Smoking restricts the blood flow in our lower limbs. Nicotine also impacts vein elasticity. Stopping a smoking habit can greatly improve your vein health.<\/p>\n\n\n\n
Eating a balanced diet is also crucial. Extra weight on your body can add extra stress on your legs, worsening symptoms.<\/p>\n\n\n\n