Arteries play an important role in your health. They’re responsible for carrying blood from the heart to the rest of your body. Your veins then carry blood back to your heart. When veins are healthy and working properly, they have valves that prevent the blood from flowing backward.
But when things go wrong, venous insufficiency can develop.
What is Venous Insufficiency?
Venous insufficiency occurs when the veins have difficulty transporting blood from your limbs back to your heart. Because the blood does not flow properly, it pools in the veins in the legs.
With this condition, blood is unable to flow forward because the vein is obstructed. Or, the vein’s valves may be damaged or missing, which causes blood to leak through the damaged valves.
Venous insufficiency is more common in adults over the age of 50, and particularly women.
Causes of Venous Insufficiency
Chronic venous insufficiency can develop for a number of reasons, but the most common causes are:
- Varicose veins: Occur when the veins become enlarged and overfilled with blood. Varicose veins are usually raised and swollen with a red or purple color.
- Blood clots: Clots may develop in arteries or veins; they may develop when there is no injury; or they may not dissolve after an injury heals.
Risk factors for venous insufficiency can include:
- Muscle weakness
- Sitting or standing for long periods of time without movement
- Family history of venous insufficiency
- Swelling of the phlebitis
- High blood pressure
Signs and Symptoms of Venous Insufficiency
Venous insufficiency can cause a variety of symptoms, including:
- Pain in the affected vein
- Redness or discoloration in the skin
- A sense of heaviness in the affected limb
- Weak legs
- Itchy legs
- Thickening of the skin around the ankles
- Leg cramps
- Pain that gets worse when you stand and better when you raise your legs
- A feeling of tightness in the calves
- Leg ulcers
How Do You Diagnose Chronic Venous Insufficiency?
A physical examination is the first step to treating venous insufficiency. Your doctor will also take a complete medical history and may order imaging tests to locate the source of the problem.
Imaging tests may include:
A duplex ultrasound tests the speed and direction of blood flow in the veins. Gel is placed on the skin and a transducer is pressed against the affected area. The transducer sends sound waves back to a computer to produce images of blood flow.
With a venogram, the doctor puts an intravenous contrast dye into the veins. The dye causes the blood vessels to appear opaque on X-ray machines. This helps doctors see the veins on the image.
Venous Insufficiency Treatments
Venous insufficiency can be treated through lifestyle changes, medication and procedures. Treatment will depend on a variety of factors, including the cause of the condition and your health status.
Medical grade compression stockings is the most common treatment for venous insufficiency. These stockings apply pressure to the lower leg and ankle to help move blood flow properly while reducing leg swelling.
Depending on the severity of the condition, lifestyle changes may be sufficient enough to resolve the issue. These changes may include:
- Maintaining a healthy weight: Obesity can contribute to the development of weakened or blocked valves in the legs. Adopting a healthy diet and exercising regularly can help you maintain a healthy weight.
- Exercise: Increasing your activity levels will get the blood flowing to improve circulation. Strengthening the muscles in the legs can help pump blood toward the heart.
- Elevate the legs: Sitting or standing for long periods of time can cause the blood to pool in the leg veins. Moving your legs will help improve blood flow to the heart. When seated, raising your legs by placing them on a footstool can help improve blood flow if you can’t get up and move around. Avoid crossing your legs.
- Avoid tight clothing: Tight clothing can restrict blood flow to the legs. This seems counter intuitive since we mentioned compression stockings are one of the most popular treatments options. However, medical grade compression stockings help reduce swelling in the legs and in turn help promote healthy blood flow. Tight clothing in general (Spanx garments, girdles, etc..) can restrict proper blood flow and should be avoided when possible.
Medications may be prescribed to manage venous insufficiency, including:
- Pentoxifylline: Improves blood flow
- Diuretics: Draws extra fluid from the body, which is excreted through the kidneys
- Anticoagulants: Thins the blood
Surgery may be required in cases of severe venous insufficiency. Doctors may recommend one of the following procedures:
- Removing the damaged vein.
- Surgical repair of the valves or veins.
- Vein bypass, which transplants a healthy vein from somewhere else in the body. Typically, this is used as a last resort in very severe cases.
- Endoscopic surgery, during which the surgeon inserts a thin tube with a camera attached to see and tie off varicose veins.
- Laser surgery, which uses lasers to close or fade the damaged vein.
Sclerotherapy is generally used for more advanced cases of venous insufficiency. During the procedure, a chemical is injected into the damaged vein to prevent it from carrying blood. Closing down the vein will allow the blood to return to the heart through other veins. The damaged vein will eventually be reabsorbed by the body.
Sclerotherapy is used to destroy small and medium veins.
An ambulatory phlebectomy is an outpatient procedure during which your doctor numbs certain spots on your leg and makes small pricks in those areas to remove smaller varicose veins.
In severe cases, a catheter procedure can be used for larger veins. A catheter is inserted into the vein, and the end is heated and then removed. The heat causes the vein to close and seal as the catheter is removed.
To be clear, if you feel like you may be suffering from chronic venous insufficiency, it should be evaluated by a medical professional. It is a serious medical condition and needs attention.