Venous insufficiency

• Alternative Names

  Chronic venous insufficiency

• Causes, incidence, and risk factors

  Venous insufficiency is caused by problems in one or more deeper leg veins. Normally, valves in your veins keep your blood flowing back towards the heart so it does not collect in one place. But the valves in varicose veins are either damaged or missing. This causes the veins to remain filled with blood, especially when you are standing.

  The condition may also be caused by a blockage in a vein from a clot (deep vein thrombosis).

  Chronic venous insufficiency is a long-term condition. It occurs because of partial vein blockage or blood leakage around the valves of the veins.

  Risk factors for venous insufficiency include:

  • History of deep vein thrombosis in the legs
  • Age
  • Being female (related to levels of the hormone progesterone)
  • Being tall
  • Genetic factors
  • Obesity
  • Pregnancy
  • Prolonged sitting or standing
• Symptoms
  • Dull aching, heaviness, or cramping in legs
  • Itching and tingling
  • Pain that gets worse when standing
  • Pain that gets better when legs are raised
  • Swelling of the legs

  People with chronic venous insufficiency may also have:

  • Redness of the legs and ankles
  • Skin color changes around the ankles
  • Varicose veins on the surface (superficial)
  • Thickening of the skin on the legs and ankles
  • Ulcers on the legs and ankles
• Treatment

  Take the following steps to help manage venous insufficiency:

  • Use compression stockings to decrease chronic swelling.
  • Avoid long periods of sitting or standing. Even moving your legs slightly will help the blood in your veins return to your heart.
  • Care for wounds aggressively if any skin breakdown or infection occurs.

  Surgery (varicose vein stripping) may be recommended.

• References

  Bergan JJ, Schmid-Schonbein GW, Smith PD, et al. Chronic venous disease. N Engl J Med. 2006;355(5):488-498.

  Freischlag JA, Heller JA. Venous disease. In: Townsend CM, Beauchamp RD, Evers BM, Mattox KL, eds. Sabiston Textbook of Surgery. 18th ed. Philadelphia, Pa: Saunders Elsevier; 2008: chap 68.

Review Date: 6/1/2009

Reviewed By: Jeffrey Heit, MD, Internist with special emphasis on preventive health, fitness and nutrition, Philadelphia VA Medical Center, Philadelphia, PA. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.