Venous insufficiency

Written by Ann Pietrangelo | Published on August 20, 2012
Medically Reviewed by George Krucik, MD

What is Venous Insufficiency?

Your arteries carry blood from your heart out to the rest of your body. Your veins carry blood back to the heart, and valves in the veins stop the blood from flowing back. When your veins have trouble sending blood from your limbs back to the heart, it is called venous insufficiency (VI). In this condition, blood does not flow back properly to the heart, causing blood to pool in your legs.

Several factors can cause VI, though most commonly it’s caused by blood clots (deep vein thrombosis) and varicose veins.

Symptoms include pain, swelling, and ulcers of the legs. Treatment options depend on the cause, but include prescription medications and surgery.

Even for if you have a family history of venous insufficiency, there are simple steps you can take to lessen your chances of developing the condition.

Causes of Venous Insufficiency

Most often, the condition is a result of blood clots or varicose veins. In varicose veins, the valves are often missing or impaired.)

VI is more common in women than in men. According to The University of Chicago Medical Center, it is also more likely to occur in women between 40 and 49 and men between 70 and 79 (UCM). Other risk factors include:

  • blood clots
  • varicose veins
  • obesity
  • pregnancy
  • smoking
  • cancer
  • muscle weakness, leg injury, or trauma
  • swelling of a superficial vein (phlebitis)
  • family history of venous insufficiency
  • inactivity (sitting or standing for long periods of time without moving can cause high blood pressure in the leg veins and increase risk)

Symptoms of Venous Insufficiency

Symptoms of VI can include:

  • swelling of the legs or ankles (edema)
  • pain that gets worse when you stand and subsides when you raise your legs
  • leg cramps
  • aching, throbbing, or a feeling of heaviness in your legs
  • itchy legs
  • weak legs
  • thickening of the skin on your legs or ankles
  • skin that is changing color, especially around the ankles
  • leg ulcers
  • varicose veins
  • a feeling of tightness in your calves

How Venous Insufficiency Is Diagnosed

To determine if you have this condition, your doctor will want to perform a physical examination and take a complete medical history. He or she may also order some imaging tests to pinpoint the source of the problem. These tests may include a venogram or a duplex ultrasound.

During a venogram, your doctor will put an intravenous (IV) contrast dye into your veins. This dye will provide your doctor with a clearer X-ray picture of your blood vessels.

A duplex ultrasound is a vascular ultrasound procedure that can assess the structure of the leg veins and the flow of blood.

How Venous Insufficiency Is Treated

Treatment will depend on many factors, including the reason for the condition and your particular health status and history. Other factors your doctor will consider are:

  • your specific symptoms
  • your age
  • the severity of your condition
  • how well you can tolerate medications or procedures

Treatment for VI can include:

Improving Blood Flow

To improve blood flow:

  • keep your legs elevated whenever possible
  • wear compression stockings to apply pressure to lower legs
  • keep your legs uncrossed when seated
  • exercise regularly

Medications

There are also a number of medications that may help those suffering from this condition. These include:

  •  
    •  
      • diuretics: medications that draw extra fluid from your body through your kidneys
      • anticoagulants: medications that thin the blood
      • pentoxifylline (Trental): a medication that helps to improve blood flow

Surgery

Sometimes more serious cases of VI require surgery. Your doctor may suggest one of the following surgery types:

  • surgical repair of veins or valves
  • removing (stripping) the damaged vein
  • minimally invasive endoscopic surgery to clip and tie off veins
  • vein bypass (a healthy vein is transplanted from somewhere else in your body); this procedure is generally used only when the upper thigh is affected and only for very severe cases after nothing else has been effective

Sclerotherapy

This treatment method is generally reserved for advanced VI. In sclerotherapy, a chemical is injected into the damaged vein so that it is no longer able to carry blood. Blood will return to the heart through other veins, and the damaged vein will eventually be absorbed by the body.

How to Prevent Venous Insufficiency

If you have a family history of VI, there are steps you can take to lessen your chances of developing the condition. Some steps everyone should take are:

  • Don’t sit or stand in one position for long stretches of time—get up and move around frequently.
  • Don’t smoke—if you do smoke, quit.
  • Get regular exercise.
  • Maintain a healthy body weight.

Chronic Cerebrospinal Venous Insufficiency

When there is an abnormality in the blood drainage from the brain and spinal cord, it is called chronic cerebrospinal venous insufficiency (CCSVI). In 2009, Dr. Paolo Zamboni, of the University of Ferrara in Italy, theorized that CCSVI may be a factor in developing multiple sclerosis (MS), and that surgical treatment for CCSVI may be effective in treating MS (National MS Society).

Research on CCSVI and the possible connection to MS is ongoing.

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