Chronic Venous Insufficiency (CVI) - Frequently Asked Questions

Chronic venous insufficiency often leads to venous leg ulcers, which represent approximately 70-90% of all chronic wounds. Due to the debilitating effects of chronic wounds, it is very important to understand chronic venous insufficiency and how to prevent, manage and treat it. Below are frequently asked questions about chronic venous insufficiency.

What is chronic venous insufficiency?

Chronic venous insufficiency (CVI) is a form of venous disease and is commonly the result of valve dysfunction, which occurs when veins in your legs are damaged, are too weak to do their job or don’t function properly.

What is the difference between venous insufficiency and chronic venous insufficiency?

While both venous insufficiency and chronic venous insufficiency (CVI) are conditions which affect the veins in your legs, chronic venous insufficiency represents a deeper, more serious, and longer-lasting version of venous insufficiency and carries with it the potential for greater medical and health complications. If venous insufficiency exists and is left untreated, it may progress into chronic venous insufficiency.

What happens if you have chronic venous insufficiency?

In normal circumstances the valves in your leg veins keep the blood flowing back up to your heart, but with CVI these veins aren’t able to manage the blood flow as well as they should. When this occurs it is harder for the blood in your legs to return to your heart and the blood begins to pool in your leg veins. The pooling of blood leads to high pressure in the veins which causes pain and swelling, may lead to changes in skin color, and increases the potential for blood clots to form within your veins and ulcers to develop on your legs, feet and toes.

Which leg veins are susceptible for developing chronic venous insufficiency?

CVI can occur in any of your leg veins, such as:

Deep veins, which are large veins deep in your body that run through your muscle.
Superficial veins, which are close to the surface of your skin.
Perforating veins, which are the veins that connect your deep and superficial veins.

What is the difference between chronic venous insufficiency and acute venous disease?

In general, the difference between chronic venous insufficiency and acute venous disease lies in the duration, the manifestation of symptoms, and the severity of the condition.

Acute venous disease and disorders frequently arise without any prior medical issues and are more likely to develop as a result of an injury or hereditary traits, but are also influenced by acquired risk factors such as lifestyle characteristics. Chronic venous insufficiency on the other hand, generally develops over time and is related to valve dysfunction, which occurs when veins in your legs are damaged, are too weak to do their job or don’t function properly. CVI can be associated with older age but is also dramatically influenced by acquired risk factors such as lifestyle characteristics, which may lead to the disease.

Acute venous diseases are characterized by short-term symptoms which last for about 14 days, and are not usually life-threatening. With prompt and proper treatment acute venous diseases usually do not progress into advanced stages. Chronic venous insufficiency however can result in severe conditions to including bleeding, ulcerations and development of open sores on the exterior of the leg. The severity and length of these conditions is what causes CVI to be classified as a chronic disease. The long-term consequences of CVI are significant, and left undiagnosed or untreated, chronic venous insufficiency can ultimately be fatal.

What Are The Symptoms Of Having Chronic Venous Insufficiency?

The symptoms of having chronic venous insufficiency may be mild at first, but with time, the mild symptoms of CVI may worsen and the chronic venous insufficiency may begin to interfere with the quality of your life and ultimately lead to other serious health complications. You may also notice new symptoms as the CVI progresses. The symptoms of chronic venous insufficiency appear in your legs and feet, and may include:

Leg pain such as aching, heaviness or cramping, which may also worsen with standing or sitting.
Swelling in the feet, ankles or lower legs.
Development of varicose veins, which are enlarged, twisted veins that are visible under the skin.
Changes in your skin such as discoloration, itching and scaling.
Fatigue in the legs and even the whole body.
Restless leg syndrome, which is characterized by the involuntary urge to move your legs.
Development of thrombophlebitis, which is the inflammation of a superficial vein, that causes redness, pain and swelling.

What is the relationship between chronic venous insufficiency and venous ulcerations?

Chronic venous insufficiency is a leading cause of venous ulcers, and specifically venous leg ulcers which are a type of chronic wound. These venous ulcers, also known as venous stasis ulcers, occur when oxygen-poor blood can’t flow from your extremities back to your heart and instead, it pools in your feet and legs, creating pressure in your veins. The pooling of this blood damages skin tissue and leads to the development of an ulcer which often occurs on your legs near your ankle.

Are there other contributing causes of venous uclers?

In addition to chronic venous insufficiency, other contributing factors that cause venous ulcers include:

High blood pressure (hypertension), which damages blood vessel walls.
Venous obstruction (a vein blockage) that is oftentimes caused by blood clots.
Venous reflux, when blood flows backward through weak or damaged valves.

What happens if I develop a venous ucler?

A venous ulcer that develops can take several months to heal and in severe cases, the ulcer never heals. Venous ulcers can also quickly worsen, thereby putting you at risk for additional health complications. If undiagnosed and left untreated a venous ulcer can lead to you losing the affected limb and can even be fatal.

How will I know if I have a venous ucler?

In addition to having a visible shallow wound with irregular borders, the symptoms of having a venous ulcer include:

Discoloration of the surrounding skin.
Swelling (edema).
Itching, tingling, heaviness and a dull, painful ache.
Foul odor emitting from the wound site.
Pus or other fluid that oozes from the sore.

How can chronic venous insufficiency be treated?

There are several methods for treating and managing chronic venous insufficiency, including:

Compression therapy
Medications
Minimally Invasive Nonsurgical treatment
Surgical treatment (Invasive)

Of the available treatment methods, is one of them preferred over the others?

Generally, compression therapy is the primary and desired method for treating CVI as it is a non-invasive way to help reduce the swelling and discomfort that is present in your legs. The compression will help your veins “push” the blood back through the venous system to the heart and prevent it from pooling in your leg.

What does compression therapy mean?

Compression therapy broadly refers to the use of specially designed medical-grade compression products to achieve the gradient compression that you need to treat and manage chronic venous insufficiency.

What are these medical-grade compression products?

The specially designed medical-grade compression products used for compression therapy include short stretch compression bandages, compression stockings or compression wraps.

Do I need a prescription to purchase medical-grade compression products?

Generally the compression therapy products used for compression therapy may be purchased without a prescription. If a higher level or more complex method of compression is needed to treat your particular case of CVI, you should consult with your medical professional to ensure that you will have a compression product that provides the proper level of compression that you need.

Are there medications that can treat chronic venous insufficiency?

Some of the medications which may be prescribed to treat CVI include antibiotics and anticoagulants (blood thinners). While these medications can address the side affects of having CVI, they won’t treat the primary or underlying causes of the disease.

How do I treat chronic venous insufficiency if a venous ulcer is present?

There are several ways to address CVI along with treating an existing venous ulcer. You can place a wound dressing under your compression garment. With this method, it is recommended to use an adjustable compression wrap which will make the placement and removal of the dressing easy to perform. You may also choose to use a specially designed multilayer compression bandage or a medicated wrap known as an Unna boot which combine compression along with medication to treat the venous ulcer.

Can chronic venous insufficiency be reversed?

The short answer is that there is no full-proof way to prevent chronic venous insufficiency, and once it occurs it cannot be fully reversed. However, with proper treatment CVI can be effectively treated and managed.

What can I do to help prevent or manage chronic venous insufficiency?

Although with older age you have a greater risk of developing a venous condition, there are several steps for treating and managing chronic venous insufficiency. Any effective treatment plan will generally include making lifestyle changes or modifications as the first step of treating your CVI. This includes:

Stay active and avoid a sedentary lifestyle with limited physical activity.
Lifting your legs above the level of your heart for 30 minutes or longer at least three times per day can help reduce pressure in your leg veins.
Walking and other forms of exercise can help blood flow better in your leg veins. Each time you take a step, your calf muscle squeezes and helps your veins pump blood back up to your heart. Keeping your legs active and making your calf muscles stronger will help improve your blood flow.
Extra weight and obesity can put pressure on your veins and damage the valves. Therefore it is important to maintain a healthy weight. If you are suffering from CVI, you should consider working with your health care provider or nutritionist to develop a healthy and manageable plan for achieving weight loss and weight management.
Current smoking habits and a history of smoking can contribute to chronic venous insufficiency and therefore you should consider to stop smoking as a positive lifestyle change.

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Additional Resources For Understanding Venous Disease

Click here to read more about understanding venous insufficiency.

Click here to read more about chronic venous insufficiency.

Click here to read more about venous insufficiency ulcers and venous ulcerations.

Click here to read more about treating venous insufficiency venous ulcerations.