What Is Venous
Your arteries carry blood from your heart out to the rest of your
body. Your veins carry blood back to the heart, and valves in the veins stop
the blood from flowing backward. When your veins have trouble sending blood
from your limbs to the heart, it’s known as venous insufficiency. In this
condition, blood doesn’t flow back properly to the heart, causing blood to pool
in the veins in your legs.
Several factors can cause venous insufficiency, though it’s most
commonly caused by blood clots (deep vein thrombosis) and varicose veins. Even
if you have a family history of venous insufficiency, there are simple steps
you can take to lower your chances of developing the condition.
Causes of Venous Insufficiency
Venous insufficiency is most often caused by either blood clots
or varicose veins. In healthy veins, there is a continuous flow of blood from
the limbs back toward the heart. Valves within the veins of the legs help
prevent the backflow of blood.
The most common causes of venous insufficiency are previous cases
of blood clots and varicose veins. When forward flow through the veins is
obstructed — such as in the
case of a blood clot — blood builds
up below the clot, which can lead to venous insufficiency. In varicose veins,
the valves are often missing or impaired and blood leaks back through the
damaged valves. In some cases, weakness in the leg muscles that squeeze blood
forward can also contribute to venous insufficiency.
Venous insufficiency is more common in women than in men.
According to The
University of Chicago Medical Center, it’s also more likely to occur in
women between 40 and 49 and in men between 70 and 79. Other risk factors
weakness, leg injury, or trauma
of a superficial vein (phlebitis)
history of venous insufficiency
(sitting or standing for long periods of time without moving can cause high
blood pressure in the leg veins and increase your risk)
Symptoms of Venous
Symptoms of venous insufficiency include:
of the legs or ankles (edema)
that gets worse when you stand and gets better when you raise your legs
throbbing, or a feeling of heaviness in your legs
of the skin on your legs or ankles
that is changing color, especially around the ankles
feeling of tightness in your calves
How Is Venous Insufficiency
Your doctor will want to do a physical examination and take a
complete medical history to figure out if you have venous insufficiency. They
may also order some imaging tests to pinpoint the source of the problem. These
tests may include a venogram or
a duplex ultrasound.
During a venogram, your doctor will put an intravenous (IV)
contrast dye into your veins. Contrast dye causes
the blood vessels to appear opaque on the X-ray image, which helps the doctor
see them on the image. This dye will provide your doctor with a clearer X-ray
picture of your blood vessels.
A type of test called a
duplex ultrasound may be used to test the speed and direction of blood flow in
the veins. A technician will place some gel on the skin and then press a small
hand-held device (transducer) against your skin. The transducer uses sound
waves that bounce back to a computer and produce the images of blood flow.
How Venous Insufficiency Is
Treatment will depend on many factors, including the reason for
the condition and your health status and history. Other
factors your doctor will consider are:
severity of your condition
well you can tolerate medications or procedures
common treatment for venous insufficiency is
prescription-wear compression stockings. These special elastic stockings apply
pressure at the ankle and lower leg. They help improve blood flow and can reduce
leg swelling. Compression stockings come in a range of prescription strengths
and different lengths. Your doctor will help you decide what the best type of
compression stocking is for your treatment.
Treatment for venous insufficiency can include several different
Improving Blood Flow
Some tips to improve your blood flow include:
your legs elevated whenever possible
compression stockings to apply pressure to lower legs
your legs uncrossed when seated
There are also a number of medications that may help those
suffering from this condition. These include:
medications that draw extra fluid from your body through your kidneys
medications that thin the blood
- pentoxifylline (Trental): a medication that helps
improve blood flow
Sometimes more serious cases of venous insufficiency require
surgery. Your doctor may suggest one of the following surgery types:
repair of veins or valves
(stripping) the damaged vein
invasive endoscopic surgery —
the surgeon inserts a thin tube with a camera on it to help see and tie off varicose
bypass (a healthy vein is transplanted from somewhere else in your body) — this procedure is generally used
only when the upper thigh is affected and only for very severe cases after
nothing else has worked
surgery — this relatively new
treatment uses lasers to either fade or close the damaged vein with strong
surges of light in a small, specific place. It involves no surgical cuts.
This outpatient procedure (you won’t have to spend the night in
the hospital) involves your doctor numbing certain spots on your leg, then
making small pricks and removing smaller varicose veins.
This treatment method is generally reserved for advanced venous
insufficiency. In sclerotherapy, a chemical is injected into the damaged vein
so that it is no longer able to carry blood. Blood will return to the heart
through other veins, and the damaged vein will eventually be absorbed by the
body. Sclerotherapy is used to destroy small to medium veins. A chemical is
injected into the damaged vein so that it is no longer able to carry blood.
In severe cases, your doctor can use a catheter procedure for
larger veins. They’ll insert a catheter (a thin tube) into the vein, heat the
end of it, and then remove it. The heat will cause the vein to close and seal
as the catheter is taken out.
How to Prevent Venous
If you have a family history of venous insufficiency, there are
steps you can take to lessen your chances of developing the condition:
sit or stand in one position for long stretches of time — get up and move
smoke and if you do smoke, quit.
a healthy body weight.