When the veins become damaged, it can be difficult for the blood to flow up them and back to the heart. The damage shows itself as injured valves, and while they will let blood through, they will not hold it there ready to move on, but rather allow it to flow back to the feet. Venous insufficiency symptoms are likely to show. Arteries are the vessels that ensure that blood leaves the heart and travels around the rest of the body. Once the oxygen has been taken from it, the blood needs to get back to the heart and it is here that the problem can occur. When the leg veins do not do their job, it is classed as chronic venous insufficiency. At this point, you will require the advice of the most trusted vein doctors near you. You need to know how to look after the veins and also know how to prevent spider veins from forming or worsening, if they are already there. Our bodies contain three different types of veins:
- Veins lying near to the surface of the skin. These are called superficial veins.
- Veins that lie inside groups of muscles known as deep veins.
- Perforating veins – These connect the deep veins and superficial veins.
The body’s largest vein is the vena cava and it goes straight to the heart with deep veins leading into it. When we are upright, the leg veins have to help the blood force its way upwards towards the heart. To make sure that this happens, the veins in the legs and feet are squeezed to keep the blood pumping. When the squeezing stops, the valves snap shut and keep the blood locked in the vein it was in. When this is happening, it is known as the venous pump. When you live your life either sitting or standing a lot, the walls of the veins often stretch too much and end up accepting too much blood. The valves become damaged and the interior walls of the vein stretch and at this point CVI appears and venous insufficiency symptoms will begin. It is important to know how to prevent spider veins and varicose veins if you sit down or stand up for several hours.
What are the Causes of CVI?
Once blood leaves the organs, it is the job of the veins to return it to the heart. Every time we take a step, the muscles in the feet and calves propel the blood upwards and the one-way valves close to stop it from leaking. Once the valves are damaged, chronic venous insufficiency sets in and if it is due to age and lack of mobility, it is hard to stop it. CVI is declared once the veins can no longer stop the blood going back where it came from.
When DVT – deep vein thrombosis, occurs, then CVI will follow. It can also stem from issues such as vascular malformation, a pelvic tumor and sometimes for no discernible reason at all. As the blood stays in the veins and stretches them out, the legs start to swell, and the veins become visible and resemble a knotted rope. When the cause of CVI is DVT, it is also called post-thrombotic syndrome and when someone has DVT they are more likely to develop it. Results show that within 10 years, 30% of sufferers will succumb to them.
Risks associated with chronic vein insufficiency
When you have certain conditions or follow a certain lifestyle, you will find that you become more susceptible to CVI and need to search out vein doctors. Some of the more obvious and important factors are:
- Varicose veins
- A family history of varicose veins
- Pregnancy – they may not appear until after the second or third.
- Obesity even to a small degree
- Being female,
- Reaching the age of 50
- Long periods of sitting down or standing up
Who does chronic venous insufficiency affect? You might ask. Up to 40% of the American population suffers from CVI. Women more than men will be affected and reaching the age of 50 seems to be a catalyst.
Diagnosis of Chronic Venous Insufficiency
The longer you suffer from this, the more serious it becomes and the more detailed the treatment will have to be to negate venous insufficiency symptoms. As soon as you are aware that you are showing signs of CVI, you should visit the doctor. It is not something that is going to heal on its own and only serious complications will come from waiting to get treatment. Symptoms are:
- Additional varicose veins
- Changes to the skin on the legs. It takes on a leathery texture.
- Swollen legs and ankles, usually after you have been standing or sitting down for several hours at the workplace or elsewhere.
- Stasis ulcers or open wounds that are so difficult to heal.
- Skin that is itchy and starts to flake. This is called varicose eczema.
The outcome of not having treatment will be burst capillaries – these are the small blood vessels in the legs. The legs will start to feel tender and change color from the normal shade to brownish red. There can be tissue damage caused, as well as inflammation. And if you are unfortunate, you will not just get away with that. Ulcers can form, and infection can set in. When burst capillaries are left untreated, cellulitis can result. While these veins can occur anywhere in the body, it does tend to be the legs that are the first to get them and to suffer the worst as vein doctors will tell you.
Diagnosing CVI with your vein doctors
You are going to have to make an appointment with the vein doctors and undergo a medical examination. They will also want to know all about your past if they do not already know your medical history. A duplex ultrasound will be performed, and this will track the blood circulation. It is easy to do, and the vein doctors will hold a device called a transducer and it will be held over the vein they are interested in. Sound waves will be emitted, and they will bounce back from the vein being recorded as it happens. There will also be an image developed and the vein doctors will be able to see this on a screen.
Treating and dealing with chronic venous insufficiency symptoms
As with all afflictions, the earlier that it is treated the better. A vascular specialist will be used to carrying out treatment and will know what will be best to try first, often depending upon the venous insufficiency symptoms. There are a number of treatments they will want to try, and they include:
- Sitting and standing for long periods must be avoided. Move around, flex the legs and make sure that there is nothing stopping the blood flowing. If you work sitting or standing, take breaks when you can and do the opposite.
- Walking will always help, and all exercises will have a benefit.
- Being overweight is going to be an issue and this should be reduced as soon as possible.
- Try to keep the legs raised as often as possible even if it means putting a support under the bottom of the bed.
- Keep the skin in good condition
- Use antibiotics as soon as there is an infection
- Wear compression stockings.
If you do this, it should be possible to keep down blood pooling and stop leg ulcers, therefore reducing the venous insufficiency symptoms.
These can be either provided by the doctor or purchased from a pharmacy. They have between 8mm and 10mm HG up to around 50 HG, and can be full length or around the knee. It should be the decision of the vein doctors as to what type of stocking is used and if they suggest a high HG – upwards of 20 mm, then there will have to be a prescription. They should not be slept in and skin care is more important than normal during this time. They have to fit correctly as if they do not, it is not just the case that there will be no benefit, but things could get worse. It is considered good practice to take medication as well, if there are no improvements from stockings alone.
If a skin infection occurs, these will be needed. It is not enough just to clear the infection however; the veins must be dealt with to limit further symptoms occurring.
To prevent further blood clots, additional medication will be provided for anyone with post-thrombotic syndrome. An Unna Boot is often used. This combines zinc oxide gel with layers of compression and the covering become partially rigid. Topical wound care products can also be used to help with venous insufficiency symptoms. Diet can be changed, and certain herbal supplements have shown signs of helping. The horse chestnut extract in Vena-Stat is said to give relief, but it must be an additional item rather than a replacement for medication. You should check with the vein doctors in case it will react badly with what they have prescribed.
Caring for the skin
Moisturizing is vital and anti-itch medication may be provided as long as the skin is not broken. Hydrocortisone is one of the main ones and there should be antifungal cream as well. If there is leakage, a wet compress will be needed. A layered compression bandage will be needed if ulcers have already formed.
Treatment that is nonsurgical
Two of the main ones are sclerotherapy and endovenous thermal ablation and both can repel venous insufficiency symptoms.
- Sclerotherapy –Here there will be a solution injected into the veins – including spider veins. They will collapse and shortly after they will be absorbed into the body. It is not an expensive procedure and is effective, plus there is no need to go to hospital as the doctor can do it. Often it is carried out when the need is cosmetic, but also helps stop ulcers and hemorrhages. This is important as they are both among the more serious venous insufficiency symptoms.
- Endovenous thermal ablation–This is a more recent form of treatment and uses high-frequency laser waves or a laser to heat up the vein. The heat causes the vessel to close and leaves little bleeding or bruising. It is not painful and does not require time to be taken away from work.
When surgery is needed from your vein doctors
Only 1 in 10 people will require surgical procedures to deal with their venous insufficiency symptoms. When they do it will be:
- Bypass surgery,
- Stripping and ligation
- Ambulatory phlebectomy
As with other forms of treatment, vein doctors will determine the best one.
Ligation and stripping surgery
With vein ligation a cut will be made and the veins tied off by a vascular surgeon. It only needs a few days for recovery. With stripping, two cuts are made, and the vein is taken out and this is the more detailed procedure. It can take over a week to fully recover from this. There is also likely to be extensive bruising for a few weeks, but this is a small price to pay to be rid of venous insufficiency symptoms. Microincision/ambulatory phlebectomy requires a needle to puncture the skin above the vein and a hook is used to remove it.
Undamaged veins will be taken from somewhere else in the body and fitted in where the removed damaged vein once was. Usually, it will be used in the most drastic cases and especially in the upper thigh and anywhere where there have been serious venous insufficiency symptoms discovered.
Can CVI be prevented?
To limit the risk of CVI you should take advice from the vein doctors and do the following.
- Eat healthily and take exercise
- Don’t smoke
- Move around rather than stand or sit for a long time
- Keep to a healthy weight
- Don’t wear tight clothes.
If you do all the above-mentioned things, you will keep your leg veins healthier and prevent the development of varicose veins, spider veins, venous ulcers and other symptoms.