Chronic Venous Insufficiency

Chronic venous insufficiency (CVI) is a condition that causes blood to pool in the leg’s veins, making it harder for blood to return to the heart from the legs. This pooling is also known as ‘stasis’.

What causes chronic venous insufficiency?

Veins return blood to the heart from the body organs. Blood must flow upward from the veins in the legs. Both calf muscles and the muscles in the feet need to contract with each step to squeeze the veins and push blood upward. The veins contain one way valves that help keep blood flowing upward. CVI occurs when there is a  blood clot in the deep veins of the legs, known as deep vein thrombosis (DVT).

Failure or weakening of the vein valves leads to inability to move blood upward against gravity and leads to sluggish blood flow out of the veins.

What are the symptoms of chronic venous insufficiency?

Symptoms of chronic venous insufficiency include:

Swollen legs and ankles usually after extended periods of standing

Leathery skin on the legs

Restlessness, fatigue or achiness in the legs

New varicose veins (swollen veins visible through the skin)

Venous stasis ulcers

IF CVI remains untreated, the pressure and swelling continue until the smallest blood vessels (capillaries) burst. The overlying skin becomes reddish brown in color and is at risk for being broken if bumped or scratched.

How is chronic venous insufficiency diagnosed?

Your doctor can diagnose CVI by performing a complete medical history and physical exam including a leg exam. Vascular Ultrasound is used to examine blood circulation in the legs.  During the test, a small transducer (hand held wand) is placed on skin over the vein to be examined. The transducer emits sounds waves that will bounce off the vein. The sound waves are recorded and translated into an image that can be displayed in real time on a monitor.

How is chronic venous insufficiency treated?

CVI is most treatable in its early stages. Strategies include lifestyle changes, medication, and medical procedures or surgery. The goal of treatment is to reduce blood pooling and prevent leg ulcers.

Lifestyle changes that could help relieve your symptoms include:

Wear compression stockings

Avoid standing or sitting for long periods of time

Maintain a healthy body weight

Exercise regularly

Elevate your legs while sitting and lying down

Practice good skin hygiene

You may also be prescribed medication, including:

Antibiotics to clear skin infections

Medicated wraps and creams

Medication to prevent blood clots from forming

More severe cases may require a medical or surgical procedure, including:

Endovenous thermal, ablation and sclerotherapy

Valve repair surgery

Vein ligation and stripping

Vein bypass

Circulation problems


Charles A. Shoultz, Jr., M.D., F.A.C.C.   •   Charles A. Shoultz, III, M.D., F.A.C.C.   •   Rodney A. Brown, M.D., F.A.C.C.
William R. Pitts, M.D., F.A.C.C.   •   Donald S. (Buck) Cross, M.D., F.A.C.C. • Andrew K. Day, M.D., F.A.C.C.
Sherwin F. Attai, M.D., F.A.C.C.   •   Shawn J. Skeen, M.D. F.A.C.C.   •   Harvey R. Chen, M.D. F.A.C.C.
Adam M. Falcone, M.D., F.A.C.C.   •   Brian C. Barnett, M.D., F.A.C.C.

Diplomates, American Board of Internal Medicine,
Cardiovascular Disease, Interventional Cardiology, Clinical Cardiac Electrophysiology