The human body is a complicated structure made up of a multitude of smaller components and systems that all work together, enabling you to function effectively. The circulatory system is one such component that is vital for optimal performance. Your arteries and veins are an integral part of this system.
Arteries carry blood containing oxygen and nutrients away from the heart to circulate it throughout the body, and veins return the deoxygenated blood back to the lungs and heart. Your veins have a tough job, working against gravity to push your blood upwards from the lower part of your body. To help with this, there are small one-way valves in your veins that prevent blood from flowing backwards. When these valves don’t function properly, movement of the blood becomes sluggish. It pools in the veins causing varicose veins, and resulting in a condition called Chronic Venous Insufficiency.
How Serious Is Chronic Venous Insufficiency?
Chronic Venous Insufficiency (CVI) by all accounts is a common condition that affects up to 20% of adults globally. It’s most commonly linked to varicosities or spider veins, which develop over time and can cause complications. Chronic venous insufficiency is perfectly treatable if caught early enough, however if left untreated it can cause leg ulcers and bleeding. In severe cases, it can result in deep vein thrombosis which is a life-threatening condition and could lead to death.
Who is at Risk of Developing This Condition?
As we mentioned, CVI is caused by incompetent vein valves, but these are more prevalent in people with certain risk factors. These indicators include the following:
- Gender – Women are more prone to developing CVI than men. In fact, women are almost twice as likely to suffer with this condition as their male counterparts.
- Age – CVI affects people over 50 more than the younger generation
- Obesity – Excessive fat puts more pressure on most areas of your body, including your veins. They become compressed, causing the valves to malfunction and allowing blood to flow backwards, or pool in the vessel.
- Pregnancy – During pregnancy your blood volume increases substantially and exerts additional pressure on your circulatory system. Your veins dilate to cope with this extra blood, your valves are under more pressure and your veins work less efficiently.
- Sedentary Lifestyle – Regular exercise promotes blood flow around your body. A lack of exercise reduces the strength and effectiveness of your veins leading to a sluggish blood flow. Sitting or standing for long periods of time when a work can also have a negative effect on vein efficiency.
- Leg Injury or trauma – Limited movement in your legs results in the veins becoming less effective and the blood won’t be pumped effectively around the body.
- Blood Clots or Deep Vein Thrombosis – These blockages in the veins cause blood to build up increasing pressure on the veins and potentially damaging the valves.
In some cases chronic venous insufficiency can also be caused by a family history of CVI, cancer, genetic defect, and smoking.
What Are The Signs of Chronic Venous Insufficiency?
If you suffer with varicose veins, you may experience no pain or discomfort at all. When the varicosities have resulted in CVI, the following symptoms may be present:
Swelling in the legs, feet and/or ankles
Swelling, or enema, will usually start in the feet and ankles, progressing up the lower leg. This leads to a feeling of tightness and discomfort in these areas. Enema is most common after long periods of sitting or standing, and you can alleviate the pressure by elevating your legs. Foot and leg exercises can also provide some relief, and encourage improved blood flow.
Pain and cramps in your legs
You might experience some pain in your lower legs that worsens when you stand up or raise your legs. Some sufferers may experience an aching or throbbing feeling in their legs, rather than pain. Leg cramps usually hit at night, often as a result of sustained lack of movement or if you’re lying with your legs bent at the knee.
New superficial varicose veins or spider veins
Varicose veins are an indication that the blood is not flowing effectively from your lower extremities. Not all varicose veins result from chronic venous insufficiency, but new ones appearing can indicate something more serious and it’s worth consulting a vein specialist.
Existing varicose veins that appear to have increased, or are bulging and blue, indicate swelling in the area and should also be checked out.
Discoloration or thickening of the skin around the feet and ankles
When the pressure builds up in your blood vessels as a result of chronic venous insufficiency, small capillaries burst causing the surface skin to take on a reddish-brown colour and become fragile. Local tissue can become inflamed or damaged and in extreme cases, this could lead to ulcers or open sores on the skin. Ulcers caused by venous insufficiency are difficult to heal and can become infected. If treatment isn’t sought timeously, the infection will spread to surrounding tissue causing a painful condition called cellulitis.
Extreme pressure in your veins can cause a small amount of blood to leak out into the surrounding skin. This is called stasis dermatitis or venous eczema and the affected skin becomes thicker and leathery.
It’s important not to ignore any of the above signs. Chronic venous insufficiency is treatable, but ignoring the signs will cause the situation to worsen and you may require a more extreme course of treatment.
What treatment is available?
Before you examine the medical and surgical treatments options available, give yourself a lifestyle audit by asking the following questions:
- Do you maintain a healthy diet?
- Is exercise part of your daily or weekly routine?
- How much of your workday is spent sitting at a desk?
- Do you suffer with stress?
- Are you a smoker?
Depending on your answers to these questions, you’ll be able to identify any changes that you should make to your lifestyle to promote vein health and improved blood flow.
Outside of changing your lifestyle, you may need to employ other treatments to assist with your condition. The most common of these is the use of compression stockings.
If you’ve ever had an operation in hospital, you’ll probably be familiar with compression stockings. They’re provided to post-op patients to prevent blood clots from developing. They have also proven to be effective in treating chronic venous insufficiency as they apply pressure to the lower legs and this encourages blood flow from the legs to the heart.
Your doctor might recommend or prescribe medication to treat this condition. The most common ones are diuretics and anticoagulants. Diuretics draw extra fluid from your body which is excreted by the kidneys. Anticoagulants have a thinning effect on your blood, which assists in prevention of blood clots. Your doctor may also prescribe Pentoxifylline. This drug promotes blood flow, especially through narrowed vessels and more specifically in the arms and legs.
In extreme cases of chronic venous insufficiency, one of the following surgeries may be required.
- Repair of damaged veins or valves
- Removal of the damaged vein
- Tying off varicose veins through endoscopic surgery
- Vein bypass using a healthy vein from elsewhere in your body. This surgery isn’t common in the lower limbs
- Laser surgery to close and diminish damaged veins
- Sclerotherapy for advanced cases of CVI and for small to medium veins. A chemical is injected into the vein to close it, and it’s absorbed by the body
- Catheter treatment for larger veins. The catheter is inserted into the vein to heat it which causes the vein to close.
While chronic venous insufficiency can be a scary condition, often resulting in serious health complications, it’s important to remember that it can be treated. You are responsible for your body. Look after it, check periodically for noticeably irregular veins, and consult a medical professional if you have any concerns.
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