Chronic Venous Insufficiency (CVI)

See also :

• Varicose Veins
• Phlebitis

Chronic venous insufficiency (CVI) is a condition that occurs when the venous wall and/or valves in the leg veins are not working effectively, making it difficult for blood to return to the heart from the legs. CVI causes blood to “pool” or collect in these veins, and this pooling is called stasis. What causes chronic venous insufficiency? Veins return blood to the heart from all the body’s organs. To reach the heart, the blood needs to flow upward from the veins in the legs. Calf muscles and the muscles in the feet need to contract with each step to squeeze the veins and push the blood upward. To keep the blood flowing up, and not back down, the veins contain one-way valves.

Chronic venous insufficiency occurs when these valves become damaged, allowing the blood to leak backward. Valve damage may occur as the result of aging, extended sitting or standing or a combination of aging and reduced mobility. When the veins and valves are weakened to the point where it is difficult for the blood to flow up to the heart, blood pressure in the veins stays elevated for long periods of time, leading to CVI.

CVI most commonly occurs as the result of a blood clot in the deep veins of the legs, a disease known as deep vein thrombosis (DVT). CVI also results from pelvic tumors and vascular malformations, and sometimes occurs for unknown reasons. Failure of the valves in leg veins to hold blood against gravity leads to sluggish movement of blood out of the veins, resulting in swollen legs.

Chronic venous insufficiency that develops as a result of DVT is also known as post-thrombotic syndrome. As many as 30 percent of people with DVT will develop this problem within 10 years after diagnosis. If you have risk factors for CVI, you are more likely than other people to develop the disease. The most important risk factors are:

• Deep vein thrombosis (DVT)
• Varicose veins or a family history of varicose veins
• Obesity
• Pregnancy
• Inactivity
• Smoking
• Extended periods of standing or sitting
• Female sex
• Age over 50

Who is affected by chronic venous insufficiency? An estimated 40 percent of people in the United States have CVI. It occurs more frequently in people over age 50, and more often in women than in men.

Symptoms

• Swelling in the lower legs and ankles, especially after extended periods of standing
• Aching or tiredness in the legs
• New varicose veins
• Leathery-looking skin on the legs
• Flaking or itching skin on the legs or feet
• Stasis ulcers (or venous stasis ulcers)
• If CVI is not treated, the pressure and swelling increase until the tiniest blood vessels in the legs (capillaries) burst. When this happens, the overlying skin takes on a reddish-brown color and is very sensitive to being broken if bumped or scratched.
• At the least, burst capillaries can cause local tissue inflammation and internal tissue damage. At worst, this leads to ulcers, open sores on the skin surface. These venous stasis ulcers can be difficult to heal and can become infected. When the infection is not controlled, it can spread to surrounding tissue, a condition known as cellulitis.

CVI is often associated with varicose veins, which are twisted, enlarged veins close to the surface of the skin. They can occur almost anywhere, but most commonly occur in the legs.

Home remedies

How is chronic venous insufficiency treated or managed? Like any disease, CVI is most treatable in its earliest stages. Vascular medicine or vascular surgery specialists typically recommend a combination of treatments for people with CVI. The goals of treatment are to reduce the pooling of blood and prevent leg ulcers. Some of the basic treatment strategies include:

• Avoid long periods of standing or sitting: If you must take a long trip and will be sitting for a long time, flex and extend your legs, feet, and ankles about 10 times every 30 minutes to keep the blood flowing in the leg veins. If you need to stand for long periods of time, take frequent breaks to sit down and elevate your feet.
• Exercise regularly. Walking is especially beneficial.
• Lose weight if you are overweight.
• Elevate your legs while sitting and lying down, with your legs elevated above the level of your heart.
• Wear compression stockings.
• Practice good skin hygiene.
• CVI patients who supplement with French Pine Bark extract can experience a dramatic improvement in blood flow.
• Red Vine Leaf extract reduced CVI symptoms including lower leg edema, a swelling caused by fluid retention. Those taking the higher dosage showed greater and a more sustained improvement
• Grape seed extract is said to help treat chronic venous insufficiency and ease symptoms like swelling and cramping.
• Diosmin may help treat chronic venous insufficiency, according to a study published in the Serbian journal Acta Chirurgica Lugoslavica in 2008. A condition in which the veins do not effectively return blood from the legs to the heart, chronic venous insufficiency is associated with varicose veins, ankle swelling, and nighttime leg cramping.
• Supplements containing a combination of hesperidin, extract of the herb Butcher's Broom, and ascorbic acid (a form of Vitamin C) may help treat chronic venous insufficiency

Warnings

The seriousness of CVI, along with the complexities of treatment, increase as the disease progresses. That’s why it is very important to see your doctor if you have any of the symptoms of CVI. The problem will not go away if you wait, and the earlier it is diagnosed and treated, the better your chances of preventing serious complications.

Medical Disclaimer

This information is not meant to be substituted for medical advice. Always consult a medical professional regarding any medical problems and before undertaking any treatment or dietary changes.