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Chronic Venous Insufficiency

Chronic venous insufficiency is a condition that happens when the valves in your veins become weak or damaged. This causes blood to pool in your legs instead of return to your heart. It can put pressure on your vein walls and cause a range of symptoms.

At the UPMC Division of Vascular Surgery, we take a team approach to diagnose your chronic venous insufficiency. Then, we'll design a treatment based on your specific needs.

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What Is Chronic Venous Insufficiency?

Veins carry blood back to your heart. They rely on valves — or flaps — to open and close to allow the blood to move forward.

Chronic venous insufficiency is a vein condition.

It occurs when the valves become weak or damaged, allowing blood to pool in your legs instead of moving back your heart. This can put pressure on your vein walls and cause a range of symptoms.

Chronic venous insufficiency causes and risk factors

Weak or damaged valves cause chronic venous insufficiency.

Some risk factors that can lead to weak or damaged valves include:

  • Personal or family history of varicose veins
  • Being age 50 or older
  • Being female
  • Obesity
  • Pregnancy
  • Deep vein thrombosis (DVT), or a blood clot in a vein deep below your skin
  • Sitting or standing for long periods
  • Being physically inactive
  • Smoking

Chronic Venous Insufficiency Symptoms and Diagnosis

Symptoms of chronic venous insufficiency

Chronic venous insufficiency symptoms can include:

  • Heaviness, tiredness, aching, fatigue, swelling, or pain in your legs.
  • Skin discoloration in the middle of the calf or the ankle.
  • Skin ulcers, or wounds that do not heal.
  • Varicose veins — or large, swollen, twisted veins — that you can see under your skin. These may also cause burning, aching, heaviness, and pain.

Diagnosing chronic venous insufficiency

To diagnose chronic venous insufficiency, your UPMC vascular surgeon will:

  • Ask about your symptoms.
  • Review your medical history.
  • Give you a physical exam.

Your surgeon may also use imaging tests to confirm a chronic venous insufficiency diagnosis.

These tests may include:

  • Duplex ultrasound — uses sound waves to make pictures of your veins.
  • Computed tomography (CT) scan — uses cross-sectional x-rays and a computer to create detailed 3D images of your veins.

Chronic Venous Insufficiency Treatment

The goals of chronic venous insufficiency treatment are to:

  • Reduce the pooling of blood in your legs.
  • Prevent skin ulcers, or wounds that do not heal.

Treatment for chronic venous insufficiency may include:

  • Drugs to help clear up skin infections or prevent blood clots.
  • Compression stockings to offset the pressure on your vein walls.
  • Endovenous ablation, an outpatient treatment that uses a catheter and thermal (heat) energy to safely close a superficial vein.
  • Sclerotherapy, an outpatient procedure that uses injections to safely close a vein.
  • Stab phlebectomies, an outpatient procedure to remove superficial veins.
  • Venoplasty and stenting, a catheter-based treatment that uses a balloon and metal mesh tube to open a blocked vein.
  • Lifestyle changes, such as:
    • Avoiding standing or sitting for long periods.
    • Getting regular physical activity.
    • Losing weight.
    • Elevating your legs while you sit or lie down.
  • In rare cases, your doctor may consider open surgery.