Venous Insufficiency

Veins are the blood vessels of the body that return blood from the arms, legs, and organs back to the heart. Venous insufficiency is a condition in which the flow of blood through the veins is impaired. Venous insufficiency can be caused by a number of disorders of the veins, particularly deep vein thrombosis (blood clot) or varicose veins.

What are the causes of venous insufficiency?

In healthy veins, there is continuous flow of blood from the limbs back toward the heart. There are valves within the veins of the legs that prevent the backflow of blood. Venous insufficiency occurs when forward flow through the veins is obstructed, as in the case of a blood clot, or if there is backward leakage of blood flow through damaged valves. In many cases of venous insufficiency, patients have both obstruction of forward flow and backward leakage of the veins.

The most common causes of venous insufficiency are previous cases of blood clots and varicose veins. In some cases, weakness of the leg muscles that help squeeze blood forward may also contribute to venous insufficiency.

What are the symptoms of venous insufficiency?

Symptoms of venous insufficiency include:

  • Edema (swelling)
  • Skin discoloration
  • Prominent varicose veins or ropy veins
  • Skin ulcers
  • Aching, burning, or throbbing sensations in the legs and feet
  • Cramping
  • Leg weakness

Medications and immobility can also affect the muscles and veins of the legs. Patients should also consider signs and symptoms of venous insufficiency before traveling or having surgery.

What are the risk factors for venous insufficiency?

Some of the risk factors that can contribute to venous insufficiency are:

  • Older age
  • Varicose veins
  • Previous deep vein thrombosis (blood clot)
  • Family history (other members of the family suffer from the disorder)
  • Obesity
  • Inactivity
  • Muscle weakness
  • Pregnancy
  • Injury to the legs
  • Cancer

 

How is venous insufficiency treated?

There are many treatment options for venous insufficiency, depending upon the condition that is causing it. The most common treatment for venous insufficiency is prescription-wear compression stockings. These special elastic stockings apply pressure at the ankle and lower leg and improve venous blood flow and reduce leg swelling.

Minimally-Invasive Treatments

Compared with surgical options like ligation and stripping, minimally-invasive treatments result in less pain and quicker recovery time, with most patients returning to routine activities the next day.

☼ Endovenous Ablation

Endovenous thermal ablation is a minimally-invasive treatment that involves the insertion of a thin, flexible tube called a catheter into a diseased vein to seal it shut using heat. Blood that would normally return toward the heart through these veins will then travel through other veins instead. The treated vein then dries up, shrinks and is absorbed by the body.

  • Radiofrequency Ablation uses radiofrequency energy to provide an even and uniform heat to contract the collagen in the vein walls, causing them to collapse and seal off.

☼ Sclerotherapy

Sclerotherapy is the injection of a chemical into a diseased vein, which causes the vein to seal off. As with endovenous ablation, blood will then reroute to other veins in the body. Multiple treatments may be needed to close the damaged vein. Vein specialists will often use Asclera treatments, which can be done in a doctor’s office without anesthesia. Patients are typically able to return to routine activities immediately but are encouraged to wear compression stockings for at least several days following the treatment. Some bruising may occur and patients are recommended to wait at least 4-6 weeks between treatments.

Surgical Treatments

☼ Vein Ligation and Stripping

Vein ligation and stripping are often performed in combination under general anesthesia. To perform ligation, the surgeon ties off the diseased vein. The surgeon then surgically removes, or strips, the diseased vein through two small incisions in the groin and calf. Recovery is more extensive than with the minimally-invasive treatment options.

If varicose veins are left untreated, they can progress to a more serious form of venous disease called CVI and result in signs and symptoms that worsen over time, including pain, swelling, restlessness and fatigue of the legs, as well as skin damage and ulcers in more severe cases. Those with the disease may experience symptoms that make walking and everyday tasks difficult.

How can venous insufficiency be prevented?

Prevention of venous insufficiency is important, especially if there is a strong family history. Strategies for prevention of blood clots can help you avoid chronic venous insufficiency. Prevention methods for each patient may be different; therefore, a physician should discuss and design a personal program for each situation.

You can help prevent venous insufficiency with the following steps:

  • Maintain a healthy body weight; lose weight if you are overweight.
  • Exercise regularly.
  • If you smoke, try to quit. Smoking is harmful to the circulation.
  • Protect your legs from injury.
  • Do not stand or sit in one place or position for very long; get up and move.