Men and women can suffer from a vein condition venous insufficiency. It occurs when the veins found in our legs (or hands) have faulty valves. Due to damaged valves that don’t close fully, deoxygenated blood begins to flow backward and pooling in veins. When a person has chronic venous insufficiency, some of their deoxygenated blood makes it to the heart while the rest leaks through the faulty valves to the veins. While venous insufficiency tends to result mainly from deep vein thrombosis (formation of blood clots in deep veins) and varicose veins, it can also be due to a different vascular problem. That’s why you need to have your symptoms evaluated at the top vein center in your area.
Chronic venous insufficiency manifestation
Chronic venous disease is not one of those health issues that should be ignored. When left untreated, CVI can become so severe that it can lead to serious health complications and socioeconomic issues. Being a real bother in the US, CVI affects up to twenty-five million adults. Six percent of these people have advanced venous reflux disease (another name for chronic venous insufficiency) and in deep suffering. As studies have shown, the most prevalent sign of venous disease is spider veins (telangiectasias or thread veins).
Besides these, some people develop reticular veins and/or varicose veins. In each case, pain, swelling around ankles, itching, ulcers and skin discoloration are to be expected. Chronic venous insufficiency indicates superior kinds of venous disorders: venous eczema, cured or active venous ulcers, hyperpigmentation, atrophie blanche and lipodermatosclerosis.
CVI occurrence rates
If early actions are not taken to cure spider veins, varicose veins (varicosities or varices) might follow. Smaller ones tend to be treatable via sclerotherapy and endovenous laser ablation therapy. But, if they are ignored, varices tend to worsen. In the US, it is estimated that these abnormal leg veins’ prevalence ratio is 3:1. Three represents the number of female suffers while one represents the amount of male victims.
One study, the San Valentino Vascular Screening Project, tested 30,000 people via clinical assessment and duplex ultrasound and concluded that a prevalence rate of seven percent for varicose veins existed. In yet another study, the Edinburgh Vein Study, 1,566 participants were assessed via duplex ultrasound for the venous reflux disease. It was discovered that chronic venous insufficiency was present in up to 9.4 percent of men and 6.6 percent of females and that it worsened with the aging process.
That is, twenty-one percent in males older than fifty years and twelve percent in females older than fifty years. Thus, CVI was more prevalent as the subjects of the study got older. There was also another study that was done globally involving 91,000 samples: Vein Consult Program. Researchers found out that clinical significant chronic venous disease affected up to sixty percent. And, the prevalence of varicose veins was higher in developed nations than in developing nations.
Furthermore, researchers discovered that the factors that put people at risk of Chronic venous insufficiency were sex, age, genetics, obesity, pregnancy, past leg injury and phlebitis. Other statistics show that untreated varicose veins and the underlying venous disease results to up 0.3 percent prevalence of venous ulcers. All the same, only one percent of the adult population in the United States lives with either healed or active venous ulcers.
Moreover, about 2.5 million people are believed to have chronic venous disease in the country and twenty percent of them end up having venous ulcers. After they heal, venous ulcers can recur. These types of wounds can hurt a lot and limit your ability to participate in social and work-related activities, affect your quality of life and reduce your finances.
Disability caused by venous ulcerations that occur when people fail to go seek help at a great vein center results to loss of productive business or work hours. These are estimated to be up to two million work days per annum. If ulcers worsen, they can lead to one seeking early job retirement. A study found that twelve percent of employees living with venous ulcers sought early retirement.
As for the financial burden incurred by the U.S healthcare system during the treatment of chronic venous ulcers, it is approximated that one billion dollars are spent every year.
Why do I have chronic venous insufficiency?
According to doctors offering services at a vein center, chronic venous reflux disease is either triggered by varicose veins or blood clotting. When veins are healthy, the blood flow from your legs to the heart is flawless. That’s because the valves inside the leg veins are functional, meaning that they stop the blood from leaking and pooling in veins.
Unfortunately, valves can become faulty and fail to close fully. There can also be missing valves that will cause blood leakage. Further, when leg muscles are weak, their pumping action will not effectively squeeze blood forward; hence, chronic venous insufficiency. Basically, risk factors or causes of CVI are:
- Being dormant for several hours. That is, being seated or remaining standing for prolonged periods of time without changing your posture can cause hypertension in your veins. This can increase your risk of developing chronic venous reflux disease.
- Blood clotting, especially deep vein thrombosis.
- Varicose veins that are left untreated can worsen your reflux disease.
- Being too heavy(obesity) can place excessive pressure on leg veins and trigger CVI
- Being a pregnant woman is associated with varicose veins and spider veins. While they disappear after giving birth, these abnormal veins can persistent if other pregnancies are carried.
- Having cancer now or in the past is also associated with this vein disorder.
- A leg injury or muscle weakness can as well cause chronic venous disease.
- Superficial veins that are swollen, a condition called phlebitis.
- Genetics or a case where people in your bloodline suffer from varicosities and related issues.
Signs that you have ongoing chronic venous insufficiency
By failing to see your vein center vascular doctor early, you will end up having CVI and its complications. So, to know when this condition is affecting you, look for these symptoms:
- Swollen legs and ankles, what is otherwise called edema.
- Having leg cramps at night, especially
- Worsening legs pain when you stand on your feet but improves when you elevate your legs.
- Throbbing, aching and/or a feeling of heaviness in legs.
- Itchiness and weakness in legs
- Skin discoloration and/or thickening of skin on your ankles or other parts of lower leg.
- Venous ulcers
- Varicose veins, reticular veins and/or spider veins
- Leg calves feeling tighter than usual.
As soon as you notice a few of the afore-mentioned symptoms of venous reflux disease, start searching for a top vein center in your area. We would highly recommend Dr. Michael Nguyen, M.D, a highly qualified vascular expert operating in New York, New Jersey and other states.
Diagnosis of CVI
Once you locate a reliable vein center and get in touch with your vein doctor, the next thing is the diagnosis of your condition. First of all, a physical examination will be done where a total medical history will be requested to help the doctor find out if you have chronic venous insufficiency. Here are the commonly offered tests:
· Venogram – This test is done with an intravenous (IV) contrast dye that is injected into the abnormal leg vein. It then causes the vein to get darker on an X-ray image and to be easy to distinguish from unhealthy veins.
· Duplex ultrasound – This test is used to assess the direction and speed of blood flow in your veins. So, the doctor assigned by your vein center will apply some gel on your skin and then press a tiny, hand-held gadget called a transducer against the skin. This special device uses sound waves that keep on bouncing back to a PC screen and then generating the pictures of the blood flow in your veins.
· Intravascular ultrasound – A vein center expert will use a catheter, ultrasound probe to see the periluminal vascular system. It detects the stenotic disease of the venous system.
· Ambulatory Venous Pressure – When checking the hemodynamics of chronic venous insufficiency, the ambulatory venous pressure monitoring is so crucial. It entails a situation where a needle is inserted into the dorsal foot vein and then connected to a pressure transducer device. The vein center doctor determines pressure after exercises and at rest while one is in an upright posture. As well, he or she can monitor the pressure prior to and after the placement of an ankle cuff. This is to help him or her differentiate between deep vein reflux from superficial vein reflux.
Other less invasive techniques used to diagnose venous reflux disease include air plethysmography and computed tomography and magnetic resonance. Your vein center will be able to determine the best options for you.
How is chronic venous insufficiency cured?
The first medical trick is almost always sclerotherapy. Depending on how serious your diagnosis is, you might be treated with other less invasive but more effective techniques. Generally, here is what to expect from the preferred vein center:
· Conservative management – This is the first management step of CVI. The vein center doctors take conservative measures to minimize your symptoms and stop the development of secondary complications like venous ulcers. Medical-grade compression stockings are a strong component of conservative therapy. These are known to oppose the hydrostatic forces of high blood pressure in veins. As these stockings have different strengths, your vascular doctor will select the best ones for you. Generally, these will be those elastic stockings having 20 to 50mmHG of tension. Those starting from 30 to 40mm HG of tension tend to be so beneficial as far as reducing pain, edema, skin pigmentation and overall leg health.
However, these will be more helpful if worn seventy percent and above of the time. If chronic venous disease has gone to an extent of causing ulcers, medical grade stockings can be so useful in healing current ones and preventing recurrence. On average, over ninety percent of people with ulcers can get better in about 5.3 months. Another means of getting rid of CVI naturally is to lose weight through exercise and proper diet. Not only would exercise promote the calf muscle pump function. It would as well help you lose weight. Elevation of legs after work is a must to get rid of swelling and pain. While at your work place, try not to keep the same posture for too long as this can worsen your varicose veins.
· Medical intervention – Sclerotherapy is going to be your vein doctor’s first suggestion. It is a great treatment for spider veins and small to medium-sized (1 to 4mm in diameter) varicose veins. This technique can be used individually or together with a different technique such as surgery, but will depend on your vein doctor’s decision. Sclerotherapy is still great when one has bleeding varicosities. It entails an injection with a saline solution or a modern sclerosing substance like foam. If the veins being treated are small in diameter, the sclerosing agent should be diluted to prevent tissue inflammation and necrosis.
Besides sclerotherapy, a vein center might decide to conductive an endovenous ablation therapy: radiofrequency ablation therapy and laser ablation therapy. Radiofrequency ablation makes use of radio frequency energy to destroy a problematic leg vein while laser therapy uses light to heat up and close a vein. When RFA therapy is chosen, it is often to treat a Greater Saphenous Vein (GSV) and makes a great alternative to vein stripping surgery.
The heat generated during radio frequency ablation causes a local thermal injury to the vein wall, resulting to thrombosis and fibrosis. Up to ninety percent of those treated via RFA no longer suffer from saphenous vein reflux. Ninety-five percent notice a great deal of improvement as far as symptoms. Laser and radiofrequency ablation therapies are conducted under tumescent anesthesia to keep the skin from developing burns and to reduce pain.
While there is a risk of having deep vein thrombosis and pulmonary embolism, its rate of prevalence is so low. This is true particularly when a renowned doctor like Dr. Michael Nguyen is selected. Surgery is obviously the last option performed by most vascular specialists when treating chronic venous insufficiency. Surgery tends to work best when a patient has chronic venous ulcers that have refused to heal, causing disability.