Venous InsufficiencySymptoms, Doctors, Treatments, Advances & More
Learn About Venous Insufficiency
Venous insufficiency is a condition in which the veins have problems sending blood from the legs back to the heart.
Chronic venous stasis; Chronic venous disease; Leg ulcer - venous insufficiency; Varicose veins - 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
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
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 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), a chemical solution, or foam 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, radiofrequency ablation, or a technique that uses a glue/foam to seal the vein.
- Varicose vein stripping -- Used to remove or tie off a large vein in the leg called the superficial saphenous vein.
New York University
Thomas Maldonado is a Vascular Surgeon in New York, New York. Dr. Maldonado is rated as an Elite provider by MediFind in the treatment of Venous Insufficiency. His top areas of expertise are Thoracic Aortic Aneurysm, Abdominal Aortic Aneurysm (AAA), Venous Insufficiency, Carotid Artery Surgery, and Thrombectomy.
Texas Health Heart, Lung And Vascular Surgical Specialists
Raul Ortega, M.D., is a vascular surgeon who specializes in carotid disease, aortic disease, vein disease, adult cardiac surgery, minimally invasive thoracic surgery and lung cancer screening program. He is fellowship-trained in minimally-invasive techniques for the treatment of arterial and venous disease.Originally from McAllen, Texas, Ortega has dedicated his life to studying vascular disorders and learning how to both prevent and treat them. He attended Baylor University and obtained his M.D. degree at the University of Texas Medical Branch in Galveston. Upon finishing in Galveston, he spent the next eight years in the Northeast completing his surgical training.It was during this time that Ortega was able to finish his vascular fellowship under the auspices of the renowned Dr. H. Dardik at Mt. Sinai-Englewood program in Englewood, N.J. Dardik is widely accepted as a leader in the practice of limb salvage surgery, and in 2002 the Society for Clinical Vascular Surgery conferred a Lifetime Achievement Award to Dardik in recognition of his contributions to both the society and vascular surgery.It didn't take long for Ortega and his family to realize they missed the friendly people and sense of community in Texas, and in 2010 they relocated and he established his clinic in Denton. Ortega is happy to be involved in the ground-breaking medical field of vascular surgery because he sees the wide array of applications it provides to people in need: it can potentially help save lives by aortic surgery, save limbs through leg and arm revascularization, prevent strokes using carotid surgery, help treat vein disease with various varicose vein treatments, and help people on dialysis by creating arteriovenous fistulas.In his spare time, Ortega enjoys playing tennis and spending time with his wife and three children. Dr. Ortega is rated as a Distinguished provider by MediFind in the treatment of Venous Insufficiency. His top areas of expertise are Lymphedema-Distichiasis Syndrome, Aagenaes Syndrome, Milroy Disease, Carotid Artery Surgery, and Endoscopy.
Amc
Gary Siskin is an Interventional Radiologist in Albany, New York. Dr. Siskin is rated as an Elite provider by MediFind in the treatment of Venous Insufficiency. His top areas of expertise are Venous Insufficiency, Ascites, Ureterocele, Liver Embolization, and Bone Marrow Aspiration.
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.
Contact 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.
Summary: The goal of this clinical trial is to learn if TR987 0.1% gel + Standard of Care works better than Standard of Care alone to treat Venous Leg Ulcers (VLUs). It will also provide additional information about the safety of drug TR987 0.1% gel.
Summary: Post-thrombotic syndrome (PTS) is the most common chronic complication of deep vein thrombosis (DVT), with major consequences for patient quality of life and cost of management. Identifying patients at high risk of developing PTS could be useful for its prevention and may lead to more appropriate therapeutic strategies to reduce its incidence and severity. Prognostic tools for predicting risk are ...
Published Date: May 10, 2024
Published By: Neil Grossman, MD, Saint Vincent Radiological Associates, Framingham, MA. Review provided by VeriMed Healthcare Network. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.
Dalsing MC, Maleti O, Westin GG. Chronic venous insufficiency: deep vein valve reconstruction. In: Sidawy AN, Perler BA, eds. Rutherford's Vascular Surgery and Endovascular Therapy. 10th ed. Philadelphia, PA: Elsevier; 2023:chap 159.
Markovic JN, Shortell CK. Treatment of chronic venous disorders. In: Sidawy AN, Perler BA, eds. Rutherford's Vascular Surgery and Endovascular Therapy. 10th ed. Philadelphia, PA: Elsevier; 2023:chap 157.
Pascarella L, Marston W. Venous disease. In: Townsend CM Jr, Beauchamp RD, Evers BM, Mattox KL, eds. Sabiston Textbook of Surgery. 21st ed. St Louis, MO: Elsevier; 2022:chap 65.