Chronic venous insufficiency

Sometimes bulging leg veins can be more than a cosmetic issue – they can painful. And if it’s chronic venous insufficiency, our vein specialists are here to help you with expert treatment and compassionate care.

What is chronic venous insufficiency?

Your veins return blood back to your heart. Tiny valves in your veins open and close as the blood flows up your legs, working against the pull of gravity. When you have chronic venous insufficiency, it means these valves have weakened or stopped functioning normally, preventing blood from moving as it should and causing it to pool in the veins of you lower leg.

The accumulating blood builds pressure inside your veins, causing blood to leak out into your skin and surrounding tissue. This can cause pain, skin changes and swelling that may lead to sores, called venous ulcers, on your legs.

With chronic venous insufficiency, you may or may not have varicose veins. Varicose veins are blue, bulging, twisted veins on your legs that appear when excess blood pools in the veins that are near your skin’s surface.

Symptoms of chronic venous insufficiency

If you have signs of chronic venous insufficiency, talk with your doctor. Symptoms include:

• Swelling in your lower legs and ankles, especially after standing

• Leg cramping, heaviness, weakness or fatigue

• Restless legs or tired, achy legs and feet, sometimes with burning, throbbing or numbness
• Itchy or flaky skin on your legs and feet
• Discolored or leathery skin on your legs
• Sores on your legs or ankles that won’t heal
• New or worsening varicose veins
• Lipodermatosclerosis, a series of skin changes that include pain, redness, swelling, sores and small white scarred areas

Causes of chronic venous insufficiency

Although chronic venous insufficiency tends to be seen more often in women, the condition is fairly common in both men and women. 

You’re more likely to get venous insufficiency if you have certain risk factors including:

• Being age 50 and over
• Family history of the condition
• Long periods of standing or inactivity 
• Overweight or obesity
• High blood pressure
• Pregnancy

Diagnosing chronic venous insufficiency

To diagnose chronic venous insufficiency, we’ll start with a thorough physical exam and ask about your family history. We’ll carefully examine your legs for swelling, discolored skin, varicose veins and other signs. 

We may check the blood pressure in your legs or do a duplex ultrasound, a test that uses sound waves to observe blood flow in your legs.

Find out more about our heart and vascular testing and diagnosis.

Treating chronic venous insufficiency

We’re here to help you improve the health of your veins so your legs feel better and you’re more comfortable. Our vascular specialists are experts in preventing and managing chronic venous insufficiency and provide the most advanced treatment procedures available. 

For prevention and early management of the condition, we may recommend:

• Exercising regularly 
• Taking short walks if you sit or stand for long periods
• Elevating your legs when possible
• Maintaining a healthy weight
• Taking antibiotics to treat skin infections
• Frequently washing and moisturizing your legs and feet 
• Wearing compression stockings

If your chronic venous insufficiency is more severe, your treatment plan may include:

• Compression wraps over your ankles and legs
• Medications
• Procedures, such as
• Sclerotherapy, a quick, in-office procedure where we insert a solution into varicose veins so they collapse and eventually disappear
• Endovenous ablation treatment, an outpatient procedure where we use ultrasound to guide a catheter to the affected vein and deliver an energy source such as a laser to seal it closed 
• Ambulatory phlebectomy, a minimally invasive procedure that removes problem veins through tiny incisions
• Vein ligation and stripping, surgically tying and removing the affected vein
• Surgical bypass to reroute blood flow around a blocked vein, using a portion of a normal vein taken from another place in the body