VenousInsufficiency

Overview

Your veins are the blood vessels that bring blood back to your heart. Venous insufficiency symptoms occur when your leg veins can’t do this effectively and blood pools in your legs instead of flowing upward toward your heart.

About 40% of all Americans have chronic venous insufficiency. Causes and risk factors include genetics, obesity, pregnancy and hypertension (high blood pressure). It’s more likely to affect women and those over age 50.

Symptoms

Symptoms of venous insufficiency include:

Edema, or swelling, in the lower legs and ankles, especially after standing
Itchy or flaky skin on the legs and feet
Leg cramping or weakness
New varicose veins or worsening of existing varicose veins
Skin discolorations or leathery skin on the legs
Tired, achy legs and feet, sometimes with burning or throbbing sensations
Ulcers or wounds on the legs and ankles that have trouble healing

Diagnosis

To diagnose venous insufficiency, your doctor will ask about your medical history and perform a physical exam, carefully checking your legs for varicose veins or related signs. He or she may check the blood pressure in your legs.

To confirm a diagnosis, your doctor may perform a duplex ultrasound, a test that uses sound waves to detect blood clots and observe blood flow in the legs.

Services & Treatment

Like many conditions, it is better to prevent venous insufficiency from occurring. If that’s not possible, early treatment is the next best option. Tips for prevention and early treatment include:

Get regular exercise
If you have to sit or stand for long periods, try to take short walking breaks whenever possible
If you smoke, quit
Maintain a healthy weight
Take antibiotics to treat skin infections
Take good care of your legs and feet by washing your skin frequently and using a moisturizing lotion
Wear compression stockings

In more severe cases, your doctor may recommend:

Compression wraps over your ankles and legs
Medication
Nonsurgical procedures, such as sclerotherapy or endovenous thermal ablation

Your doctor may also recommend surgery, such as:

Surgical bypass to reroute blood flow around a blocked vein. Your surgeon will remove the diseased portion of vein and replaces it with a graft, which is a portion of a normal vein taken from another site in the body. Bypass surgery is typically reserved for patients who have severe venous insufficiency, resulting in a painful, swollen leg and/or non-healing wounds.
Microincision/ambulatory phlebectomy is a minimally invasive procedure that removes problem veins through tiny incisions.
Ligation and stripping. Ligation refers to the surgical tying of veins through a small incision in the skin to prevent pooling of blood. Stripping refers to the removal of the vein. In many instances, the vein is removed using a minimally invasive surgical procedure called venous ablation.

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