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What Can I Expect If I Have Chronic Venous Insufficiency

May 5, 2023 1:15:15 PM Dr. Jonathan Levison, MD, FACS
What Can I Expect If I Have Chronic Venous Insufficiency

Chronic Venous Insufficiency (CVI) is a medical condition that affects the circulation of blood in the legs. If you have been diagnosed with this condition, it is natural to wonder what to expect. In this blog post, we will discuss the different stages of CVI, CEAP classifications, symptoms, and quality of life factors to help you understand and manage your condition better.

What is CVI and Who is at Risk?

CVI is a progressive condition, which means that it gets worse over time. It typically starts with varicose veins, which are swollen and twisted veins that can be seen under the skin. In the early stages, you may experience mild discomfort, such as aching or heaviness in the legs, especially after standing or sitting for long periods. You may also experience swelling, itching, and cramping in the legs.

As the condition progresses, you may develop skin changes, such as discoloration, thickening, and ulceration. These changes are due to poor venous circulation, which causes a buildup of fluid and waste products in the tissues. If left untreated, CVI can lead to serious complications, such as venous ulcers and deep vein thrombosis (DVT).

You are more at risk if you are:

  • Over the age of 50
  • Have a relative with the condition. Weak, or even absent, valves can be congenital.
  • Were assigned female at birth. CVI is linked to progesterone levels
  • Pregnant
  • Overweight or obese
  • Tall

A history of deep vein thrombosis and a habit of sitting or standing for long periods also increase your risk. You can reduce risk by taking breaks from long-term sitting or standing. If you work an office job, try to get up and walk around every hour or so.

Diagnosing CVI

To help diagnose and manage CVI, doctors use a system called the CEAP classification. This system categorizes CVI into different stages based on the severity of symptoms and physical findings.

CEAP classification starts with Class 0, which indicates that there are no visible or palpable signs of CVI. Class 1 indicates the presence of spider veins or reticular veins. Class 2 indicates the presence of varicose veins. Class 3 indicates edema or swelling due to CVI. Class 4 indicates skin changes, such as discoloration, thickening, or inflammation. Class 5 indicates the presence of healed venous ulcers, and Class 6 indicates the presence of active non-healing venous ulcers.

What are the Symptoms of CVI?

The symptoms and severity of CVI can vary depending on the stage of the condition. In the early stages, you may experience mild discomfort and swelling. As the condition progresses, you may experience more severe symptoms, such as pain, itching, and skin changes. If you have advanced CVI with venous ulcers, you may experience significant pain and mobility issues that can affect your quality of life.

Symptoms of CVI include:

  • Aching, heaviness, or cramping in the legs
  • Itching or tingling in the legs
  • Pain that gets worse when you stand up or better when you elevate your legs Swelling of your legs
  • Irritated or cracked skin
  • Stasis dermatitis, which is red, swollen, crusted, or weepy skin
  • Varicose veins
  • Lipodermatosclerosis, which is thickening and hardening of the skin on the legs and ankles.
  • Slow healing of wounds or ulcers

Treating and Managing CVI

CVI is not typically serious unless it goes untreated for an extended period of time. It generally gets worse over time. Treatment should be started as early as possible.

Managing CVI involves a combination of lifestyle changes, medication, and medical procedures. Your doctor may recommend compression stockings to reduce the collection of venous blood in the extremity thereby reducing swelling. You may also need to make changes to your diet and exercise routine to improve your overall health and reduce the risk of complications.

In some cases, medical procedures may be necessary to treat CVI. These procedures may include endovenous laser or radiofrequency ablation, microphlebectomy, sclerotherapy, or surgical intervention. These procedures can help alleviate symptoms and improve venous circulation.

How CVI Can Affect Your Quality of Life

If treated, CVI is generally easy to manage. However, if not treated, it can impact your quality of life by:

  • Making it painful to stand up and move around. This can result in spending more time sitting, which then worsens the condition.
  • Making your legs unsightly so you are not comfortable wearing shorts or skirts, which can result in discomfort in hot weather as well as impacting your self- esteem.
  • Forcing you to wear compression stockings. Unfortunately, compression stockings must be worn every day to prevent your condition from getting worse.
  • Impacting your relationships both because of aesthetics and because you may have difficulty engaging in activities
  • Reducing sleep quality

CVI can have a significant impact on your quality of life. With proper management, you can reduce the risk of complications and improve your overall health. It is essential to work closely with your doctor and follow their recommendations to manage your condition effectively. By staying informed and taking an active role in your care, you can improve your quality of life and maintain your overall health and well-being.

Contact the Vein Institute of NJ at The Cardiovascular Care Group to discuss your CVI diagnosis, treatment and management options. Make an appointment today!

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