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Chronic Venous Insufficiency


Chronic Venous Insufficiency (CVI) is a medical condition that occurs when the normal blood flow is disrupted within the venous network over a period of time. The primary role of veins within the venous circulation is to transport “dirty blood (blood that is deoxygenated and now contains all of the metabolic by-products given off by the body) back through the liver and kidneys to be filtered out. Once cleaned, the veins then carry the blood back to the heart and thru the lungs to be reoxygenated prior to finding its way into the arterial circulation. When the veins are not working properly, as in the case of Chronic venous insufficiency, blood is not carried back through the body as efficiently as it normally would, resulting in a pooling of venous blood somewhere along its normal path back to the heart. In the majority of cases, this pooling takes place in some portion of the lower extremities due to gravity. A pooling of blood within veins results in an increase in pressure and congestion within the lumen of the effected vein. Eventually pressure and congestion of this nature, will give rise to a gradual dilation of the vein wall. When present at or near the skin level, the result is a ropey Varicose vein.

In the majority of cases, CVI develops in the setting of varicose vein disease, but it has also been seen in connection to other medical conditions such as a prior blood clot history, and even congenital issues. Although most associate CVI with the presence of varicose veins, it is important to note that CVI often presents with a level of inflammation in and around the affected veins. Since venous blood is deoxygenated and contains all of the metabolic waste products of the body, this makes venous blood quite corrosive in nature. It is this corrosive quality that leads to an irritation of the lumen of vein when venous blood is allowed to pool. Chronic irritation of the vein walls stimulates an inflammatory response from the body. Over time this inflammation will lead to not only systemic symptoms but also localized damage to the surrounding tissue. This is why people who have had CVI for any prolonged period of time, will often notice physical changes to their legs as a result of the CVI.

Symptoms of CVI

The symptoms of CVI of the legs parallel the symptoms of varicose vein disease:

  • aching, pain
  • heaviness
  • itching, burning
  • throbbing
  • restlessness
  • swelling

If left untreated, chronic venous insufficiency will result in irreversible damage to the skin and soft tissue in the form of:

  • progressive, worsening swelling or edema
  • discoloration of the skin of the lower leg (red or brown appearing)
  • changes in the texture of the skin/soft tissue – becoming tight or leathery
  • rashes or dermatitis may occur
  • venous stasis ulcers or sores may occur

Preventing CVI

Chronic venous insufficiency is best contained by addressing the underlying cause. For instance, when varicose vein disease is the driving force behind the person’s CVI, it is best to seek the help of a phlebologist, a physician specializing in the treatment and care of varicose vein disease. Time is of the essence. The longer the varicose vein disease is allowed to persist, the greater the risk of developing irreversible manifestations of CVI that may affect your quality of life and activity level in the future. This is why the goal in preventing CVI is to treat the varicose vein issues BEFORE any skin and soft tissue changes have occurred.

When to contact a Vein Specialist:

  • If you have a prior history of a blood clot, or Deep vein thrombosis (DVT), it is important to take steps to avoid the development of Post-Thrombotic Syndrome and/or the development of a second blood clot.
  • If you have a family history of varicose vein disease or a family member with signs or symptoms of CVI (skin or soft tissue changes), you should at least get a vein specialist evaluation to assess your risk of developing CVI in the future. It is important to understand that vein disease is an inherited disorder. Just because you do not see obvious varicose veins on your legs does not necessarily mean you do not have varicose vein disease. A varicose vein on the leg does not develop overnight. It can take years to develop. Call our vein specialists today to get evaluated.

Can I do anything to decrease my risk?

As in the case of many medical conditions with an inherited potential, a person is unfortunately limited in what they can do to actually decrease the risk of developing the condition. Medical science is finding that regular exercise, eat a healthy diet, lose weight (if you are overweight), avoid long periods of inactivity (prolonged sitting and/or standing), and wearing properly fitted compression stockings may help decrease your risk of developing CVI. Furthermore, clinical outcome data is beginning to suggest that addressing the underlying problem, in many cases the presence of a varicose vein disease issue, helps significantly in reducing if not nearly eliminating the risk of developing CVI. If you are concerned about having CVI, please call us today at 314.842.1441 to set up your free consultation with our dedicated staff of vein experts at STL Vein & Cosmetics.

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