What Is Venous Insufficiency and What Causes It?

What Is Venous Insufficiency and What Causes It?

What is venous insufficiency and what causes it? Rather than relying on random web searches, out-of-date resources, or word of mouth, it’s best to go straight to a medical professional to get the facts on a particular medical condition. When it comes to venous insufficiency, that resident expert is vascular doctor in Orlando, John D. Horowitz, MD, FACS. Dr. Horowitz, a highly skilled vascular surgeon, has been practicing Vascular Surgery in Orlando since 1993 and founded Central Florida Vein & Vascular Center in 2001. One of Central Florida’s top dedicated vein care facilities, the Center provides a level of expertise in vein care not seen anywhere else in the region. What’s more, Dr. Horowitz is a pioneer in minimally-invasive vein therapy and is board certified in both general and vascular surgery. He has earned academic distinctions through his numerous publications and teaching faculty appointments, and he is an active member of the Southern Vascular Society, the Florida Vascular Society, and the American College of Phlebology. Here, Dr. Horowitz explains all about venous insufficiency.

What is venous insufficiency? As we all know, the circulatory system transports blood to and from the heart. Arteries carry oxygenated blood to all the body’s organs and limbs, and veins return the blood to the heart. In the process of going back to the heart, the blood must flow upward through the veins in the legs. To enable this, muscles in the calves and feet contract with each step a person takes, squeezing the veins and helping to push the blood upward. And so that the blood continues its upward journey, and not go back down, the veins contain one-way valves. Venous insufficiency is a condition that occurs when the walls and/or the valves in a person’s leg veins are not working properly, creating a situation in which it is difficult for the blood to return from the legs to the heart. When this is a long-term rather than temporary problem, it is called chronic venous insufficiency, or CVI. As a result, CVI causes blood to “pool” or collect in these compromised veins; this pooling is also called stasis.

Why does CVI occur? Chronic venous insufficiency occurs when these one-way valves in the legs (and sometimes elsewhere) become damaged and allow the blood to flow backward. CVI can occur because of deep vein thrombosis (DVT), a disease in which a blood clot forms in the deep veins of the legs. CVI also can be caused by vascular defects and pelvic tumors. Sometimes the origins of a patient’s CVI remains unknown.

What are the symptoms? Symptoms vary, but often include some or all of the following:

  • Varicose veins
  • Swelling in the lower legs and ankles, especially after extended periods of standing
  • Aching or tiredness in the legs
  • Bleeding
  • Localized leg pain
  • Leathery-looking skin on the legs
  • Flaking or itching skin on the legs or feet
  • Venous stasis ulcers

Is this a serious condition? Yes! Chronic venous insufficiency is a serious medical condition. Although there are most definitely aesthetic reasons to treat CVI, it is not a cosmetic problem only. Furthermore, as the disease progresses, it becomes more serious and the treatments become more involved. It’s extremely important to see a vein specialist at the onset of symptoms – CVI won’t simply go away if you ignore it. The sooner it is diagnosed and treated, the better a patient’s odds of avoiding the most serious complications.

When CVI is left untreated, the pressure and swelling in the leg builds up until the capillary blood vessels burst. When this occurs, the skin in the area of the burst capillaries turns a reddish-brown and becomes easily broken when it comes into contact with other objects. Ultimately, this sometimes leads to open skin sores (venous stasis ulcers). These ulcers are at risk for infection and can take a long time to heal. What’s worse, the resultant infection can spread, a condition known as cellulitis.

Who is most at risk for developing CVI? Pregnant women are at particular risk of developing CVI, but anyone can develop CVI. Young and old, athletes and non-athletes. Sometimes people think men are at a lower risk for developing CVI, but, in fact, they are at a greater risk for delaying treatment because one of the primary symptoms, varicose veins, often goes ignored because of the proverbial, “out of sight, out of mind.”

Also, there is a genetic predisposition that may be present, but that is just one of many contributing factors. Again, the bottom line is that anyone displaying symptoms should schedule a consultation with a vein specialist right away.

How is it diagnosed? – The only way to correct chronic venous insufficiency is by obtaining treatment by a medical professional who is skilled in vascular issues. At Central Florida Vein & Vascular Center, we employ a venous reflux test to diagnose patients. The venous reflux test is a completely noninvasive examination that we use to test valve function in the leg veins. This diagnostic vascular ultrasound procedure typically is ordered for patients who report symptoms or signs that may be caused by venous disease. The test is performed on an outpatient basis, and usually takes no more than an hour to perform – oftentimes less. Because we use the venous reflux test for the sole purpose of making a diagnosis, it is covered by most insurance companies.

What are the treatment options? Chronic venous insufficiency can be treated with a number of advanced minimally-invasive and non-invasive procedures. Treatment options include endovenous laser treatment (EVLT) and ultrasound guided foam sclerotherapy (UGS), which is a needle-based technology. No matter which treatment is best for you, you’ll find that the recovery time is typically extremely short and the success rates are high.

We certainly appreciate vascular doctor in Orlando, Dr. Horowitz, setting the record straight on chronic venous insufficiency. If you have any other questions about CVI, or would like to schedule an appointment for a consultation, simply contact Dr. Horowitz and his staff at Central Florida Vein & Vascular Center today. You can contact them online, or call 407-545-3385.