What is Chronic Venous Insufficiency & How is it Treated?

The veins and arteries in our bodies are very important. Without them, we would not be alive. Through these important bodily pathways, the most important body fluid passes through- blood. Blood carries oxygen and essential nutrients to all of our organs. If we lose almost 3 liters of our blood, then we can say goodbye to life in case we do not get blood transfusion immediately. Just like any bodily system we have, even the arterial and venous system is prone to numerous disorders.

One common venous system disorder that affects millions of people around the world is chronic venous insufficiency, abbreviated and also known as CVI. That is a disorder of the human venous system, in which the blood vessel veins are not able to push sufficient blood back to the central organ of the cardiovascular system- heart. Functional venous valves in the legs are most commonly affected by chronic venous insufficiency. If chronic venous insufficiency takes over significantly over venous system, then it is called and diagnosed chronic venous insufficiency. Medical conditions that come together in chronic venous insufficiency include:

• Varicose veins.
• Hidden varicose veins or superficial venous reflux.

Chronic venous insufficiency is sometimes referred to as Chronic Peripheral Venous Insufficiency. However, it must not be mixed up with a similar medical condition called PTS or Post Thrombotic Syndrome. The post thrombotic syndrome is a venous system condition, in which the deep blood vessel veins were previously damaged by Deep Vein Thrombosis.

Many people live with chronic venous insufficiency, this medical condition can be treated with several treatment options. It can be said that chronic venous insufficiency is prevalent higher in the female population than in the male population.

The signs of chronic venous insufficiency are grouped into three stages. These three stages dictate the degree as well as the intensity of care. The three stages of chronic venous insufficiency are:

• Stage I Chronic Venous Insufficiency: Pigmentation and edema.
• Stage II Chronic Venous Insufficiency: Skin pigmentation, dermatitis, edema.
• Stage III Chronic Venous Insufficiency: Ulceration, dermatitis, skin pigmentation, edema, varicosities.

The main function of the veins is to return blood from all of the organs back to the place where blood pumps from – the heart. In order for blood to reach the heart back again, it needs to flow in an upward manner from the veins located in the legs. The muscles in the feet and calf squeeze the veins with each step we make and push the blood upward all the way to the heart. The veins contain one-way valves that keep the blood flowing up to the heart and preventing it from flowing back down.

However, when chronic venous insufficiency kicks in, one-way valves in the veins become damaged. That makes the blood that flows back to the heart to leak backwards.

Vein valves usually become damaged as a result of the aging process. They also become dysfunctional due to extended sitting, prolonged standing, or as a result of both aging and reduced mobility. When both the veins and the one-way valves become weakened to the point where it becomes difficult for the blood to flow, blood pressure becomes elevated for a prolonged time. That leads to chronic venous insufficiency most of the time.

Most commonly, chronic venous insufficiency occurs as the result of a blood clot that manifests in the deep veins of the lower limbs. That medical condition when a clot forms in the legs is called Deep Vein Thrombosis, abbreviated and also known as DVT. Chronic venous insufficiency also happens due to various pelvic tumors and vascular malformations. Sometimes, chronic venous insufficiency occurs due to unknown reasons. Chronic venous insufficiency that is a result of Deep Vein Thrombosis is diagnosed as Post-Thrombotic Syndrome.

Some other causes of chronic venous insufficiency include:

• Arteriovenous fistula.
• Thrombophilia.
• Phlebitis.
• Obesity.
• May-Thurner syndrome.

There are several symptoms of chronic venous insufficiency, which might make your doctor suspect that you have this medical condition. Those signs and symptoms include:

• Itching or pruritus.
• Varicose veins.
• Phlebitic lymphedema.
• Persistent swelling of ankles and legs is a symptom of chronic venous insufficiency.
• Ulceration of the veins.
• Pain while you stand.
• Leg cramps.
• Weak legs.
• Tightness in calfs.

The medical professional that will follow your chronic venous insufficiency will most likely recommend you the following self-care steps of managing chronic venous insufficiency:

• Do not sit or stand for a long period. Even the slightest movement of your legs will make the blood flow to the heart.
• Take care of your wounds if you have infected wounds or sores.
• Exercise on a daily basis.
• Lose weight if you are obese.

It could also be recommended to you to wear compression stockings to improve the blood flow in your legs in case you were diagnosed with chronic venous insufficiency. What compression stockings do is that they gently and carefully squeeze your lower extremities to help move the blood up to the heart. Compression stockings prevent formation of blood clots slightly. They also prevent leg swelling.

When advanced skin changes become present as a result of underlying chronic venous insufficiency, your medical care provider:

• Should explain which skin treatments can help your skin condition that is a result of your chronic venous insufficiency.
• May recommend certain medical drugs that will help you with your skin condition.

Your medical doctor may recommend invasive treatment of your chronic venous insufficiency if:

• You experience leg pain, which may make you feel you have heavy and tired legs.
• Skin sores that are caused by improper blood flow.
• Hardening and thickening of the skin of the legs and the ankles- Lipodermatosclerosis.

Invasive surgical procedures used for the treatment of chronic venous insufficiency include:

• Sclerotherapy: Either a chemical solution or salt water is injected directly into the vein of a person with chronic venous insufficiency. The vein after sclerotherapy hardens and later on vanishes.
• Laser and radiofrequency surgical procedures are also used to treat chronic venous insufficiency.
• Phlebectomy: Small or microscopic surgical cuts are made in the extremity near the damaged vein. The vein is later on removed through incision.
• Varicose vein stripping medical procedure is used to tie off or remove an enormous vein in the leg called superficial saphenous vein.

Other surgical procedure for chronic venous insufficiency include:

• Ligation.
• Surgical repair.
• Linton procedures.
• Vein transplantation.
• Endovenous laser ablation.
• Subfascial endoscopic perforator operation.
• Hemodynamic surgery.

Conservative treatment of chronic venous insufficiency includes:

• Skin lubrication.
• Manual compression lymphatic massage treatment.
• Ankle pump.
• Sequential compression pump.
• Blood pressure medical drugs.
• Resting and raising of your legs above the level of the heart.
• Trendelenburg position.

There are also two experimental treatment options for the population that suffers from chronic venous insufficiency. The two experimental treatments for chronic venous insufficiency are:

• Valve transposition.
• Valve repair.

Treatment of chronic venous insufficiency also depends on the stage of that disease. These are the usual treatments depends on the stage:

• Stage I Chronic Venous Insufficiency: Proper skin care and the usage of gradient elastic stockings.
• Stage II Chronic Venous Insufficiency: Proper skin care, gradient elastic stocking, topical steroids.
• Stage III Chronic Venous Insufficiency: Ulcer care protocol that will include bio-occlusive dressings, antiseptic solution. Gradient elastic stockings. Effective adjunctive therapy that would include gradient compression therapy.

Like with any medical condition, there is natural treatment for chronic venous insufficiency. People who want to start a natural treatment of their chronic venous insufficiency are particularly advised to take certain herbal remedies.

Some of the herbal remedies for chronic venous insufficiency include:

• Butcher’s Broom – 10 mg per Day.
• Gotu Kola – 120 mg per Day.
• Grape Leaf – 360 mg per Day for 12 Weeks.
• Mesoglycan – 100 mg per Day.
• Pycnogenol – 100 mg per Day.

Most of the population with chronic venous insufficiency are obese and had lacked a diet rich in fibers. To treat chronic venous insufficiency, an obese person that has this illness needs to lose weight.

Persons that suffer from chronic venous insufficiency should consult a professional dietician that will make for them a diet rich in fibers and proteins.

As it was mentioned before, the lack of exercise is one of the causes of chronic venous insufficiency. That is why one diagnosed with this condition of the venous system must exercise on a regular basis for effective treatment of chronic venous insufficiency. Even walking for a couple of minutes each day or light jogging might relieve the symptoms of chronic venous insufficiency.

You should especially exercise your calf muscles if you were recently diagnosed with chronic venous insufficiency. The movement of calf muscles promotes the blood flow to the heart. These are the exercises people with chronic venous insufficiency should perform:

• Flexing.
• Simple calf raises.
• Bicycling.
• Walking.
• Swimming.

The best way to prevent the development of chronic venous insufficiency is to eat healthy, exercise regularly and avoid sitting and standing for a long period. Also, it is advised to regulate blood pressure to the persons that want to prevent chronic venous insufficiency.