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What causes chronic venous insufficiency?

I have had varicose veins for many years and my doctor thinks I might now have chronic vein insufficiency. I am still waiting to go back to the doctor to confirm, but what causes this condition? Do varicose veins automatically lead to this? Is there anything I can do to prevent or reverse it?


Doctors Answers (5)

Chronic venous insufficiency is the name given for your vein disease. It just means that some of your veins are damaged, and blood is traveling in the opposite direction (called reflux). In these damaged veins there are valves, which normally close to prevent blood from going backwards, which are not closing completely, and blood is going in the wrong direction. Treatment involves closing these damaged veins so that your healthy veins can work better.

Venous insufficiency is inadequate venous circulation that primarily affects the circulation in the lower legs below the knees. It is caused by both genetic factors and environmental conditions including occupations with prolonged standing, multiple pregnancies, even choice of shoes contribute to the "wear and tear" of both the venous circulation and connective tissues. Venous insufficiency is a matter of degree and may be anywhere from mild to severe. Treatment of the underlying problem veins that have venous reflux (reversible blood flow) from defective vein valves and varicose veins can greatly improve venous circulation and slow or stop the progression of venous insufficiency. Treatment of reflux and varicose veins is typically done in an office-clinic based setting without changes in your normal activities (no down-time).

Venous insufficiency comes from abnormal veins which can be treated temporarily by wearing compression stockings or more definitively by ablation procedures.

Chronic Venous Insufficiency (CVI) is genetic in most cases. Progression is inevitable in most cases. Graded compression, Dailey walking and exercise, along with maintaining a fairly normal weight will slow the progression. Venous ablation is a fairly easy one hour procedure that will benefit individuals with progressive and symptomatic CVI. Most insurance will cover these treatments if you are symptomatic.

Firstly you should be fully evaluated by a board certified vascular trained surgeon who specializes in varicose vein treatment. This should include an ultrasound examination done in the standing position. Only this can give a definitive diagnosis of Chronic Venous Insufficiency (CVI). Your varicose veins do not cause this problem but the other way around. The valves in the saphenous veins fail, typically because you inherited this from someone in your family. This valve failure causes a back flow of blood to your legs and the varicose veins are like a pressure relief valve. There is no way to repair these valves in either the deep veins or saphenous veins. Current treatment protocols are to seal the incompetent saphenous vein using laser ablation and removing the bulging varicose veins using microphlebectomy. Both of these are minimally invasive, done the office with little or no down time. You should wear a medical grade prescribed compression hose which is measured and fitted to you as your insurance will demand you undergo conservative therapy prior to approving the treatments. This can vary from 6 weeks to 6 months. Exercise, weight loss, hydration,elevating the legs and taking some sort of anti-inflammatory medication (ibuprofen, aspirin, naproxen) are all part of this protocol.

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