Chronic Venous Insufficiency

Blood circulation occurs in the body when the oxygen-rich blood is carried by the arteries, from the heart to the rest of the body. The veins then carry the oxygen-less blood back to the heart. The blood in the limbs must be pushed up by the veins, for the purpose, due to gravity. This process is helped by the valves in the veins, which squeeze the blood back to the heart. However, due to various disorders and diseases, these veins can get affected, in turn weakening the valves as well. The result is that these valves are not able to prevent the blood from flowing in the reverse, thus they end up sending the oxygen-less blood back to the limbs. As a result, the affected limb swells up and gives rise to many other complications. This is known as chronic venous insufficiency and it mostly affects the legs. Walking can provide relief in such a condition, as when the leg muscles squeeze, the blood is pumped back to the heart. However, if you sit or stand for a long time, the blood pools in the leg veins and the blood pressure increases. To know more on chronic venous insufficiency, like its causes, symptoms, diagnosis and treatment, go through the lines that follow.

Causes

Blockage in the veins, from a clot
Damage to the valves
Blood leakage around the valves

Symptoms

There is aching, cramping and heaviness in the legs.
The pain worsens when standing.
There is itching and tingling sensation.
Swelling of the legs.
Redness around the legs and ankles.
Change in the color of the skin around the ankles.
The skin on the legs and ankles thickens.
There might be ulcers as well.

Diagnosis

Pursuing medical history and physical examination.
Duplex ultrasound
Plethysmography
Venograms

Treatment

Compression Stockings

This is recommended for mild cases of chronic venous insufficiency.
The elastic stockings squeeze veins and stop blood from flowing backwards.
Patients will have to wear the stockings daily, for the rest of their lives.

Sclerotherapy

A chemical is injected into the affected veins.
This chemical scars the insides of the veins, so that the faulty ones are no longer filled with blood.
The body then gradually absorbs the veins that receive the chemical injection.

Ablation

In this treatment, a catheter tube is inserted into the varicose veins.
The catheter tip contains tiny electrodes that heat the walls of the veins, destroying the tissue.
Thus, the veins are unable to carry blood.

Vein Stripping

A small incision is made in the groin area and another on the calf, below the knee.
All the veins associated with the saphenous vein, which is the main superficial vein in the leg, are tied off.
The vein is then removed from the leg.

Bypass

This treatment is used in case of serious and extensive problems.
It is used to treat the chronic venous insufficiency in the upper thigh or pelvis.
An artificial vein can be connected or transplanted onto a healthy vein, to help the blood flow.

Valve Repair

The valves inside the vein is shortened to improve its function.
An incision is made on the skin and the affected vein is cut and the valve flaps are fold or tucked.
To maintain the valve function, the vein walls are pressed with a fabric sleeve.

Angioplasty &Stenting

This is recommended for severe cases of chronic venous insufficiency.
A tiny balloon is inserted to push open the blocked vein.
Then, a stent is inserted to keep the narrow portion open.
Small needle punctures in the knee or groin are done to perform this procedure.

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