Chronic Venous Insufficiency (CVI)

Chronic Venous Insufficiency (CVI) is a long-term condition in which the veins in the legs cannot efficiently return blood back to the heart. This happens mainly due to weakened vein walls and damaged valves inside the veins.

Why It Happens

• Veins have one-way valves that keep blood flowing upward toward the heart.
• When these valves become weak or damaged, blood pools in the legs → causing pressure, swelling, and skin changes.

Common Causes

• Varicose veins (most common)
• History of deep vein thrombosis (DVT)
• Valve damage due to aging
• Long periods of standing or sitting
• Obesity
• Pregnancy
• Smoking
• Trauma to the leg

Symptoms

Symptoms usually get worse as the day goes on:

Early Symptoms

• Leg heaviness or tiredness
• Swelling of ankles and lower legs
• Aching or throbbing pain
• Cramping (especially at night)
• Itching around the ankles

Advanced Symptoms

• Skin discoloration (dark brown/black around ankles)
• Hard, thick, shiny skin
• Varicose veins
• Dry, scaly skin
• Venous ulcers (wounds over the ankle that heal slowly)
• Repeated skin infections (cellulitis)

Diagnosis

• Doppler ultrasound (to check blood flow & valve function)
• Visual examination of skin and swelling pattern

Treatment

Treatment depends on severity. Usually a combination of the following:

1. Compression Therapy (most important)

• Compression stockings (20–30 mmHg or 30–40 mmHg depending on severity)
• Helps blood move upward

2. Lifestyle Changes

• Elevate legs 3–4 times/day (15–20 minutes)
• Regular walking
• Avoid standing or sitting for long periods
• Weight reduction
• Stop smoking
• Avoid crossing legs while sitting

3. Medications

These help symptoms but don’t cure:

• Venoactive drugs like diosmin/hesperidin
• Pentoxifylline (helps healing of ulcers)
• Pain relievers if needed
• Antibiotics only if infection is present

4. Medical Procedures (if severe)

• Endovenous laser therapy (EVLT)
• Radiofrequency ablation (RFA)
• Sclerotherapy
• Vein stripping

These close or remove damaged veins to improve flow.

Complications if Untreated

• Venous ulcers
• Chronic leg swelling
• Skin hardening
• Infection
• Deep vein thrombosis (rare)

Quick Home Care Tips

• Wear compression stockings daily
• Walk for 20–30 minutes
• Keep legs raised above heart level
• Drink plenty of water
• Avoid tight clothing
• Maintain good skin hygiene to prevent infection