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Chronic Venous Insufficiency - What to Know

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Chronic venous insufficiency (CVI) is a common condition that causes chronic pain and fatigue in the legs, among other symptoms. Here's what to know about it.

“Chronic venous insufficiency (CVI) is very common and often undiagnosed or dismissed,” says Firas Salti, MD, RphS, DABVLM at McFarland Vein Clinic.

Sympoms of Chronic Venous Insufficiency

Symptoms can have a significant impact on the quality of life. If you suffer from any of the following symptoms, you may benefit from medical treatment of varicose or spider veins. Symptoms can include:

  • Chronic leg pain, burning, throbbing and aching
  • Leg fatigue, tiredness or heaviness
  • Restless leg syndrome
  • Leg ulcers
  • Recurrent leg cellulites, eczema or itching
  • Leg swelling
  • Leg cramps

“Leg veins have valves direct the blood back to the heart. Normal functioning valves keep the blood flowing upward against gravity,” says Dr. Salti. “In cases of varicose veins, the valves aren’t functioning properly allowing blood to go back down causing the veins to dilate and blood to pool. Subsequently the pressure in the affected vein increases leading to permanent changes and damage to the skin at the calves and ankles.”

Risk Factors of Chronic Venous Insufficiency

Anyone is at risk of developing varicose veins over their lifetime. Varicose veins are three times more common in women than men. Risk factors include heredity, inactivity such as long periods of standing or sitting in one place, obesity and multiple pregnancies.

Complications of Chronic Venous Insufficiency

Vein diseases left untreated will always worsen and progress sometimes resulting in serious complications, including:

  • Painful and potentially life threatening thrombophlebitis (clotting in large varicose veins)
  • Recurrent skin infection in lower legs
  • Permanent hyperpigmentations at the ankle level (darkening of the skin)
  • Swelling in lower legs
  • Leg skin ulcers
  • Severe bleeding from superficial varicose or spider veins
  • Chronic and painful inflammation

How to Prevent Chronic Venous Insuffieciency

“Prevention and early intervention minimizes the risk of serious complication and the need for extensive procedures,” says Dr. Salti. “Fortunately, many safe and effective treatment options are now available for patients.”

How to Treat Chronic Venous Insufficiency

Based on the medical condition of your veins, different treatment options may be offered. The goals of treatment are to improve symptoms, prevent complications, slow the progression of the disease and improve the appearance of the legs.

Conservative Treatments

Conservative treatment of varicose veins includes elevating the ankles higher than the heart and exercising to strengthen the calf muscle.

“Compressive stocking therapy is a relatively inexpensive way to help relieve achiness and pain, especially for those that stand or sit a lot,” says Dr. Salti. “Stockings provide a gradient of pressure, highest at the ankle and decreasing as it moves up.”

Graduated compression stockings need to be fitted to get the right size and strength. These stockings are not the same as T.E.D. Hose.

“Most patients have a combination of varicose veins and spider veins. Different treatment methods may be best for each type of vein involved. Because of this, more than one treatment method will be required for most patients,” says Dr. Salti.


Endovenous laser ablation, ambulatory phlebectomy and sclerotherapy are outpatient procedures used to treat varicose and spider veins. The goal of these treatments is to get rid of the vein causing the problem.

“Laser ablation and phlebectomy are outpatient procedures that take approximately one hour. Current treatment options are less invasive and patients are able to walk immediately after treatment and return to their normal activities within a few days following the procedures,” says Dr. Salti.

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