Chronic Venous Insufficiency Meaning
Chronic venous insufficiency (CVI) is a condition that occurs when the vein walls or valves in the leg veins do not work effectively. This makes it difficult for blood to return to the heart from the legs. CVI causes blood to pool in the veins, and this pooling is called stasis.
Symptoms of Chronic Venous Insufficiency
The onset of chronic venous insufficiency is characterized by the following symptoms:
- Swelling in the legs.
- Varicose veins in the legs.
- Pain in the calf that feels like pressure and is accompanied by itching.
- The appearance of pain in the legs when walking disappears when resting.
- Skin turns dark.
- Wounds appear on the legs which are difficult to treat.
- Sudden movements in the legs occur without command ( restless leg syndrome ).
If not treated properly, this condition can cause blood vessels to become inflamed, or even rupture. When blood vessels become inflamed, the skin in the area will appear reddish. This condition can cause infection or cellulitis in the tissue around the blood vessels, as well as the appearance of wounds that are difficult to treat.
Causes of Chronic Venous Insufficiency
Veins function to return blood to the heart after circulating from all organs of the body. To reach the heart, blood needs to flow upward from the veins in the legs. The calf muscles and leg muscles also need to contract with each step to squeeze the veins and push the blood upward. To keep the blood flowing upward, and not backward, the veins also have one-way valves.
But when experiencing this condition, the valves become damaged, allowing blood to leak backward. Valve damage can occur as a result of aging, sitting or standing for too long, or a combination of aging and decreased mobility. When blood vessels and valves weaken to the point where blood has difficulty flowing to the heart, blood pressure in the blood vessels remains high for a long period of time. This condition will also lead to CVI.
CVI most often occurs as a result of a blood clot in the deep veins of the leg, or a condition known as deep vein thrombosis (DVT). CVI can also result from pelvic tumors and vascular malformations and sometimes occurs for unknown reasons. Failure of the valves in the leg veins to hold blood against gravity causes blood to move slowly out of the veins. This condition causes the legs to swell.
Chronic venous insufficiency that develops as a result of deep vein thrombosis (DVT) is also known as post-thrombotic syndrome. As many as 30 percent of people with DVT will develop the problem within 10 years of diagnosis.
Chronic Venous Insufficiency Risk Factors
There are many things that put someone at greater risk of developing venous insufficiency, including:
- The presence of blood clots.
- The presence of varicose veins.
- Obesity.
- Is pregnant.
- Smoker.
- Have cancer.
- Weak leg muscles, or have had a leg injury.
- Experiencing swelling of superficial veins (phlebitis).
- There are family members who have venous insufficiency.
- An inactive lifestyle (sitting or standing for long periods without moving much can cause high blood pressure in the leg veins and increase the risk).
Diagnosis of Chronic Venous Insufficiency
To ensure that the swollen legs are caused by this condition, the doctor will ask about the events that caused the swelling in the legs and the diseases that the sufferer has had or is currently suffering from. After that, the doctor will perform a physical examination and further examinations, in the form of:
- Leg Doppler Ultrasound. A Doppler ultrasound is performed to check the speed and direction of blood flow. The doctor will attach and press the ultrasound device to the patient’s swollen leg.
- Venography. This procedure is performed to see the condition of the veins suspected of experiencing chronic venous insufficiency, with the help of X-rays. The doctor will first insert a special dye (contrast) into the blood vessels. After that, an X-ray scan is performed.
- MRV ( Magnetic Resonance Venography ). This method is used to see the condition of veins suspected of experiencing chronic venous insufficiency, with the help of magnetic waves.
Chronic Venous Insufficiency Treatment
In mild cases of chronic venous insufficiency, the doctor will advise the sufferer to exercise regularly, avoid sitting cross-legged, and avoid hanging leg positions. The doctor will also ask the sufferer to use special stockings. These stockings are called compression stockings, which will help smooth blood flow in the legs so that leg swelling can subside.
If the condition does not improve with the use of stockings, there are several other treatment methods that can be done to relieve chronic venous insufficiency, namely:
1. Medicines
Some types of drugs that can be taken to treat chronic venous insufficiency include:
- Blood thinners, to prevent blood clots from forming.
- Diuretic drugs, to reduce fluid buildup in the body.
- Medicines to improve blood flow.
2. Injectable drugs
Injecting a special drug into a vein to injure and close the vein. The closed vein will be absorbed by the body, and blood flow will pass through another vein.
3. Radiofrequency ablation or RFA
The RFA method is carried out with the help of a small tube (catheter) and a special light to close the problematic vein so that blood does not flow through the vessel.
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Surgery
In severe cases of chronic venous insufficiency, the doctor will recommend surgery. Surgery for chronic venous insufficiency can be done to:
- Repairing damaged veins or valves.
- Lifting veins that experience chronic venous insufficiency.
- Performing a new vein graft ( venous bypass ), so that blood flow does not pass through the vein experiencing chronic venous insufficiency.
- Tying or closing damaged veins.
Chronic Venous Insufficiency Complications
Common complications of CVI include:
- Venous ulcer.
- Skin infection.
- Ulceration.
- Hyperpigmentation of the surrounding skin from hemosiderin degradation.
Chronic Venous Insufficiency Prevention
If a family member has chronic venous insufficiency, there are several things the sufferer can do to prevent it from happening. These preventive measures can also be done as a combination of treatments for someone who has been diagnosed with CVI:
- Avoid standing or sitting for long periods of time.
- Exercise regularly, at least walk often.
- Lose excess weight.
- Elevate your legs when sitting and lying down, it is recommended that your legs are higher than your heart.
- Wear compression stockings.
- Take antibiotics as needed to treat skin infections.
- Keep your skin clean.