What is the definition of Venous Insufficiency?

Venous insufficiency is a condition in which the veins have problems sending blood from the legs back to the heart.

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What are the alternative names for Venous Insufficiency?

Chronic venous stasis; Chronic venous disease; Leg ulcer - venous insufficiency; Varicose veins - venous insufficiency

What are the causes for Venous Insufficiency?

Normally, valves in your deeper leg veins keep blood moving forward toward the heart. With long-term (chronic) venous insufficiency, vein walls are weakened and valves are damaged. This causes the veins to stay filled with blood, especially when you are standing.

Chronic venous insufficiency is a long-term condition. It is most commonly due to malfunctioning (incompetent) valves in the veins. It may also occur as the result of a past blood clot in the legs.

Risk factors for venous insufficiency include:

  • Age
  • Family history of this condition
  • Female sex (related to levels of the hormone progesterone)
  • History of deep vein thrombosis in the legs
  • Obesity
  • Pregnancy
  • Sitting or standing for long periods
  • Tall height

What are the symptoms for Venous Insufficiency?

Pain or other symptoms include:

  • Dull aching, heaviness, or cramping in legs
  • Itching and tingling
  • Pain that gets worse when standing
  • Pain that gets better when legs are raised

Skin changes in the legs include:

  • Swelling of the legs
  • Irritated or cracked skin if you scratch it
  • Red or swollen, crusted, or weepy skin (stasis dermatitis)
  • Varicose veins on the surface
  • Thickening and hardening of the skin on the legs and ankles (lipodermatosclerosis)
  • Wound or ulcer that is slow to heal on the legs or ankles

What are the current treatments for Venous Insufficiency?

Your provider may suggest that you take the following self-care steps to help manage venous insufficiency:

  • Do not sit or stand for long periods. Even moving your legs slightly helps keep the blood flowing.
  • Care for wounds if you have any open sores or infections.
  • Lose weight if you are overweight.
  • Exercise regularly.

You can wear compression stockings to improve blood flow in your legs. Compression stockings gently squeeze your legs to move blood up your legs. This helps prevent leg swelling and, to a lesser extent, blood clots.

When more advanced skin changes are present, your provider:

  • Should explain which skin care treatments can help, and which can make the problem worse
  • May recommend some drugs or medicines that may help

Your provider may recommend more invasive treatments if you have:

  • Leg pain, which may make your legs feel heavy or tired
  • Skin sores caused by poor blood flow in the veins that do not heal or recur
  • Thickening and hardening of the skin on the legs and ankles (lipodermatosclerosis)

Choices of procedures include:

  • Sclerotherapy -- Salt water (saline) or a chemical solution is injected into the vein. The vein hardens and then disappears.
  • Phlebectomy -- Small surgical cuts (incisions) are made in the leg near the damaged vein. The vein is removed through one of the incisions.
  • Procedures that can be done in a provider's office or clinic, such as using a laser or radiofrequency.
  • Varicose vein stripping -- Used to remove or tie off a large vein in the leg called the superficial saphenous vein.

What is the outlook (prognosis) for Venous Insufficiency?

Chronic venous insufficiency tends to get worse over time. However, it can be managed if treatment is started in the early stages. By taking self-care steps, you may be able to ease the discomfort and prevent the condition from getting worse. It is likely that you will need medical procedures to treat the condition.

When should I contact a medical professional for Venous Insufficiency?

Call your provider if:

  • You have varicose veins and they are painful.
  • Your condition gets worse or does not improve with self-care, such as wearing compression stockings or avoiding standing for too long.
  • You have a sudden increase in leg pain or swelling, fever, redness of the leg, or leg sores.
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REFERENCES

Dalsing MC, Maleti O. Chronic venous insufficiency: deep vein valve reconstruction. In: Sidawy AN, Perler BA, eds. Rutherford's Vascular Surgery and Endovascular Therapy. 9th ed. Philadelphia, PA: Elsevier; 2019:chap 159.

Freischlag JA, Heller JA. Venous disease. In: Townsend CM Jr, Beauchamp RD, Evers BM, Mattox KL, eds. Sabiston Textbook of Surgery. 20th ed. Philadelphia, PA: Elsevier; 2017:chap 64.

Pascarella L, Shortell CK. Chronic venous disorders: nonoperative management. In: Sidawy AN, Perler BA, eds. Rutherford's Vascular Surgery and Endovascular Therapy. 9th ed. Philadelphia, PA: Elsevier; 2019:chap 157.

  • Condition: Chronic Venous Ulcers
  • Journal: Wounds : a compendium of clinical research and practice
  • Treatment Used: Human Recombinant Epidermal Growth Factors versus Conventional Therapy
  • Number of Patients: 48
  • Published —
The study researched the outcomes of human recombinant epidermal growth factors versus conventional therapy for treating chronic venous ulcers.
  • Condition: Chronic Superficial Venous Insufficiency
  • Journal: Journal de medecine vasculaire
  • Treatment Used: Endovenous Radiofrequency
  • Number of Patients: 135
  • Published —
This study tested the safety and efficacy of using endovenous radiofrequency to treat patients with chronic superficial venous insufficiency.
Clinical Trial
  • Status: Not yet recruiting
  • Phase: N/A
  • Intervention Type: Procedure
  • Participants: 20
  • Start Date: June 1, 2021
Endovasculer Treatement of Male Pelvic Venous Insufficiency
Clinical Trial
  • Status: Not yet recruiting
  • Intervention Type: Device
  • Participants: 80
  • Start Date: May 15, 2021
The Evaluation of Pain Severity in the Lower Limb Caused by Chronic Venous Insufficiency