When the veins in the legs are affected by Chronic Venous Insufficiency (CVI), they have trouble pumping blood back to the heart. As a result, blood may collect in the lower extremities, which can cause a host of problems.
Etiology and Risk Factors
Damaged or insufficient vein valves, which fail to adequately regulate blood flow, are a common cause of chronic venous insufficiency (CVI). The major role of these valves is to stop blood from going in the opposite direction. Causes of congenital vascular infection (CVI) include:
- Age
- A history of deep vein thrombosis (DVT)
- Family history of venous disease
- Obesity
- Pregnancy
- Prolonged standing or sitting
- Smoking
Symptoms of Chronic Venous Insufficiency
- Swelling in the legs or ankles (edema)
- Pain that worsens when standing and improves with leg elevation
- Leg heaviness and fatigue
- Varicose veins
- Changes in skin color and texture, often leading to a brownish or reddish discoloration
- Ulcers on the legs, particularly around the ankles
Diagnosis
Diagnosing CVI typically involves reviewing the patient’s medical history, conducting a physical exam, and using confirmatory imaging tests like Duplex ultrasound to evaluate blood flow and the condition of the leg veins.
Treatment and Management
| Lifestyle Changes | Medical Treatments | Surgical Procedures |
|---|---|---|
| Leg elevation | Compression therapy | Sclerotherapy |
| Weight management | Medications (e.g., diuretics, anticoagulants) | Endovenous laser therapy (EVLT) |
| Exercise | Wound care for ulcers | Vein stripping |
| Avoidance of long periods of standing or sitting | Valve repair or vein bypass |
In addition to the above treatments:
- Compression Therapy: This is crucial for managing CVI, involving the use of compression stockings to improve venous blood flow.
- Wound Care: For patients with venous ulcers, appropriate wound care and possibly referral to a specialist (wound care clinic) are important for healing and infection prevention.
- Pharmacotherapy: Can involve the use of pentoxifylline or aspirin therapy aimed in improving microcirculation and leg ulcer healing.
- Endovenous Ablation Procedures: These minimally invasive procedures use heat or chemical injections to close off abnormal veins.
Prevention
- The risk of developing CVI can be reduced by maintaining a healthy weight, exercising regularly, avoiding prolonged periods of sitting or standing, and by elevating the legs when possible.
Follow-Up and Prognosis
To track treatment success and make course corrections as needed, it is essential to have regular check-ins with a healthcare professional. If CVI is treated early and consistently, it can slow its course and enhance patients’ quality of life.
As a chronic illness, CVI often needs ongoing care throughout a person’s life. Nevertheless, with the right medication, the majority of patients with CVI will be able to control their symptoms and prevent more severe consequences, like leg ulcers.
A comprehensive care plan centered on symptom management and disease progression prevention for patients with CVI requires close collaboration between a primary care physician, a vascular specialist, and occasionally a dermatologist.
