What Is Chronic Venous Insufficiency (CVI)? Causes, Symptoms & Treatments Explained

Chronic Venous Insufficiency (CVI) is a common yet often overlooked medical condition that affects millions of people, particularly those over the age of 50. It occurs when the veins in the legs struggle to return blood to the heart efficiently, causing blood to pool in the lower extremities. While it may start off with mild discomfort, if left untreated, CVI can lead to more serious complications such as ulcers, varicose veins, and mobility issues.

What Causes Chronic Venous Insufficiency?

At the core of CVI is a failure in the vein valves of the legs. Normally, these valves open and close to help push blood upward toward the heart. When they become damaged or weakened, blood can flow backward - a condition known as venous reflux. This leads to increased pressure in the veins, which can cause swelling, skin changes, and tissue damage over time.

Common risk factors include:

• Age: Risk increases with age.
• Gender: Women are more prone, especially after multiple pregnancies.
• Obesity: Excess weight puts additional pressure on leg veins.
• Prolonged standing or sitting: Common in certain professions like retail, teaching, or office work.
• Family history: Genetics can play a role in vein health.
• History of deep vein thrombosis (DVT): Blood clots can damage vein valves.

Symptoms of CVI

CVI often develops gradually. Some people may not notice symptoms right away, while others may experience increasing discomfort. Common symptoms include:

• Swelling in the lower legs or ankles (especially after long periods of standing)
• Aching, cramping, or heaviness in the legs
• Itching or tingling sensations
• Varicose veins (bulging, twisted veins visible under the skin)
• Skin discoloration, especially around the ankles
• Thickened or leathery skin
• Slow-healing sores or ulcers on the legs

Diagnosing the Condition

If CVI is suspected, a healthcare provider may perform a physical exam and order diagnostic tests such as a venous duplex ultrasound, which uses sound waves to check blood flow and identify reflux or clots in the veins.

Treatment Options

While chronic venous insufficiency cannot always be cured, it can be effectively managed and its progression slowed. Treatment typically focuses on improving blood flow, reducing symptoms, and preventing complications.

Conservative treatments:

• Compression stockings: These are often the first line of treatment and help improve circulation.
• Leg elevation: Raising the legs above the heart several times a day helps reduce swelling.
• Exercise: Regular walking strengthens leg muscles and encourages better blood flow.
• Weight management and diet: Reducing pressure on leg veins and improving overall health.

Medical and surgical options:

• Sclerotherapy: A solution is injected into affected veins to close them off.
• Endovenous ablation: A minimally invasive procedure using heat or laser to close damaged veins.
• Vein stripping or ligation: Surgical removal or tying off of affected veins (less common with modern techniques).
• Phlebectomy: Removal of varicose veins through small skin punctures.

Prevention and Long-Term Care

Even after treatment, CVI requires ongoing management. Preventive steps include:

• Avoiding long periods of standing or sitting
• Staying physically active
• Wearing compression garments as recommended
• Monitoring skin for changes or ulcers

Final Thoughts

Chronic Venous Insufficiency may sound like a minor issue at first glance, but it can significantly impact quality of life if not addressed. Fortunately, with early diagnosis and the right treatment plan, symptoms can be managed, and further complications can often be avoided. If you experience persistent leg swelling, discomfort, or visible vein changes, it’s worth talking to a healthcare professional to rule out CVI.