Chronic venous insufficiency (CVI) is a condition that causes blood to pool in the legs. In addition to being uncomfortable, CVI can lead to burst blood vessels, ulcers, and an increased risk of infection.
CVI is, fortunately, a condition that can be controlled if the proper steps are taken.
In This Article:
What Is Chronic Venous Insufficiency
Your veins are the series of tubes that blood flows through as it travels to the heart and back through the rest of your body. Each vein is a one-way street—blood can only flow in one direction.
To ensure that gravity and other factors don’t get in the way, your veins have a series of valves in them that prevent blood from backing up or lingering along its journey.
Sometimes, however, the vein walls or valve can weaken, become damaged, or get partially obstructed. This leads to blood pooling in the vein or leaking around the valve. CVI typically happens in the legs.
The following are considered risk factors for developing CVI:
- Varicose veins or a family history of them
- Inactivity, extended periods of standing or sitting
- Being female (CVI is associated with the progesterone hormone)
- Being over 50 years old
- Being tall
- A history of blood clots in the legs
Symptoms of Chronic Venous Insufficiency
Most of the symptoms of CVI relate to reduced blood flow in the legs. This can include a dull aching, heaviness, cramping, itching and tingling, or pain, with sensations increasing while standing but reducing when the leg is propped up. The pooling blood can also result in localized swelling and redness of the legs and ankles.
In some cases, the skin around the affected area may thicken or harden, taking on an almost leathery appearance. Lastly, CVI is often associated with varicose veins (twisted and swollen veins that are formed when the valves fail).
The pooling blood will continue to build up if the CVI is not addressed. As the swelling and pressure increase, the capillaries will eventually burst. This causes the skin to take on a reddish-brown coloration and become more vulnerable to injury. This sensitivity can lead to ulcers—open sores where the skin is eroded away. In addition to being painful, an ulcer has a greater chance of becoming infected.
Diagnosing and Treating Chronic Vascular Insufficiency
CVI is diagnosed following a physical examination and vascular ultrasound that analyzes the veins and vessels in your legs. As with any condition, catching it early offers the best chance at successful treatment. If not attended to, the pressure in your veins may lead to painful ulceration, and increase the risk of infection. Another concern is stasis and clotting of blood. These blood clots can get carried to the brain, heart, lungs and other important organs, and cause serious complications.
In the early stages, basic treatments may be enough to remedy the condition. These include:
- Quitting smoking
- Avoiding prolonged periods of standing or sitting without flexing your legs to promote blood flow
- Exercising regularly
- Keeping the legs elevated above your heart while sitting and lying down
- Losing weight
Your doctor may also prescribe compression stockings—a type of special sock that is meant to improve blood flow.
As CVI can make the skin more sensitive and vulnerable, proper skin hygiene is especially important. The skin should be kept moisturized so it can’t flake or crack easily. If an ulcer or other wound develops, layered compression bandages should be used to protect the skin while still maintaining blood flow. Your doctor can show you how to use compression bandages.
If your CVI is more advanced or does not respond to basic treatments, additional measures may be suggested by your doctor:
- Sclerotherapy: A saline (salt water) or chemical solution is injected into a varicose vein. The treatment may need multiple applications but is capable of causing the affected vein to collapse and recede, easing pain and reducing the risk of ulceration.
- Thermal ablation: A laser or high-frequency radio waves are used to create a localized, intense heat in the vein. This forces the affected blood vessels to close up and redirects blood through more stable routes.
- Microphlebectomy: This is a surgical intervention where incisions are made and the problem vein is removed. A similar procedure, called ligation and stripping, accomplishes a similar goal but is more extensive and has a longer recovery time.
- Angioplasty: If the problem is that a blood vessel or vein is merely narrowed, a tiny medical balloon can be inserted and inflated to restore proper form to the area. Should it be needed, a mesh called a stent will be left behind to help retain the shape.
- Bypass: Similar to a heart bypass, this procedure is where a vein is transplanted from elsewhere in the body to create an alternate route around a blocked or damaged vein.
Diet for Chronic Venous Insufficiency
In addition to basic factors like staying mobile and quitting smoking, a healthy diet can also be used to help manage CVI. Proper eating habits can help you maintain a healthy weight, but it can also help through a few other means. From a dietary standpoint, foods such as celery, grapes, green tea, citrus, kale, broccoli, peas, soy, hot peppers, and berries contain flavonoids that could reduce vascular inflammation and improve venous functions. Also, the extract of horse chestnut seeds is known to help reduce the swelling and itching in the legs.
Consider the following dietary changes to help manage or reduce your risk of CVI:
1. Eat more fiber
Straining during bowel movements (or simply spending a long time on the toilet seat) compresses blood vessels and can lead to damage or swelling. This is, after all, one way hemorrhoids can form. Fiber ensures the smoother passage of stool that requires less strain and is easier on your veins.
2. Eat more flavonoids
Flavonoids are a collection of chemicals that have been associated with certain cardiovascular benefits. The ones relevant to CVI reduce vascular inflammation risk and improve the functions of certain blood vessels. Flavonoids are found in numerous healthy foods such as grapes, green and white tea, citrus, kale, broccoli, peas, soy, celery, hot peppers, and red, blue, and purple berries.
3. Try chestnuts
Horse chestnut seeds, extracts in particular, are known to reduce the swelling and itching of CVI. Since herbal remedies can interact with medications, be sure to inform your doctor if you are taking or planning to take any.
If your CVI is more advanced, your doctor might suggest more serious measures like sclerotherapy, thermal ablation, microphlebectomy, angioplasty, or even a venous bypass to remedy the issue.
Don’t let it come to that. You could keep CVI at bay by simply quitting smoking, eating healthy, and being active. Even if you are on a long flight.
Sources for Today’s Article:
“Chronic Venous Insufficiency (CVI),” Cleveland Clinic web site; http://my.clevelandclinic.org/services/heart/disorders/hvi_chronic_venous_insufficiency, last accessed October 5, 2015.
Cooper, K., “Diet for Chronic Venous Disease,” Livestrong.com, last updated July 7, 2015; http://www.livestrong.com/article/518477-diet-for-chronic-venous-disease-in-a-patient/, last accessed October 5, 2015.
“Venous Insufficiency,” The New York Times web site; http://www.nytimes.com/health/guides/disease/venous-insufficiency/overview.html, last accessed October 5, 2015.
“Venous Insufficiency,” U.S. National Library of Medicine web site; https://www.nlm.nih.gov/medlineplus/ency/article/000203.htm., last accessed October 5, 2015.