By. Dr. Ramesh Paladugu, MD, RVT, RPVI, FACS | Dr. Mythili Paladugu, MD, DABA, RPVI
Also known as Phlebitis, Post-Thrombotic Syndrome, Venous Insufficiency, Venous Leg Ulcer. If you have CVI, valves in your veins (usually in the leg or sometimes the arms) don't work, causing blood to pool in your legs and putting increased pressure on the walls of the veins. May be due to valve dysfunction (usually hereditary) or due to valve destruction after a deep vein thrombosis (DVT) or blood clot.
The picture on the right shows a property functioning valve that is able to close completely .
Fairly common, usually chronic
May affect up to 40% of the U.S population. More common in women (especially after multiple pregnancies) and in people who are middle-aged or older.
Treatable - Preventing Complications is Important
• Usually treated with exercise, compression stockings and weight loss if applicable.
• In some cases, may require vein ablation or vein stripping.
• Occasionally treated with angioplasty and stents.
• Preventing severe complications such as venous leg ulcers is key.
Even with very successful treatment, recurrence is common, and you may need further care.
Most symptoms are mild, and not limb-threatening.
Heaviness, swelling & pain
You may feel heaviness in the affected limb, as well as swelling and pain. Sometimes there is a darkening of the skin. An open sore or ulcer may develop—if your leg is affected, usually on the inside of the ankle—and it may be difficult to heal.
Enlarged and twisted veins close to the surface of the skin are a sign of a milder form of venous disease. You may feel burning, aching, heaviness and pain.
Vein valves become incompetent, especially when standing, for unknown reasons.
A blood clot in a deep vein that causes your vein valves to fail and may completely block the vein. This causes greater swelling and can lead to tissue changes that may cause darkening of the skin, dermatitis or ulcers.
See a Vascular Surgeon
You will be asked questions about symptoms and medical history, including questions about family members. The vascular surgeon will also perform a physical exam.
Tests May Be Recommended• Duplex ultrasound testing to look at your vein valves and see if they work.
• In cases where severe swelling occurs and is difficult to treat, a computer tomography (CT) scan of the venous system to look for vein narrowing or blockage in your abdomen.
The picture on the top right illustrates how a blockage can cause swelling and inflammation in the leg.
Preventing Complications is Important severe swelling and ulcers from developing.
• Compression garments relieve symptoms and aid ulcer healing.
• If superficial veins are affected, they may be treated through vein ablation or injection.
•If varicose veins develop and are close to the skin, they may be removed through superficial vein stripping, usually an outpatient procedure.
• If deep veins are affected, in severe cases
• Preventing severe complications such as venous leg ulcers is key angioplasty and stenting maybe recommended.
• In rare cases, surgical bypass may be required.
The image on the bottom right depicts how the compression stockings work.
Maintain Good Overall Health to Decrease Your Risk of CVI
• Maintain a normal weight
• Exercise regularly
• Wear compression garments
• Maintain good skin care
• If you have had a deep vein thrombosis (DVT), it is essential to stick with any anticoagulation medications you have been prescribed.