Chronic Venous Insufficiency


Chronic venous insufficiency (CVI) is a condition where the veins have difficulty returning the blood from your limbs back to your heart. When blood collects in the leg veins and pools due to impaired circulation it is called stasis. CVI is associated with varicose veins and often causes swelling and pain in the legs. CVI affects almost 20 percent of men and 40 percent of women over the age of 50 years and is related to risk of venous ulcer formation.


CVI is considered a long-term condition which is secondary to partial blocking of veins or incompetence of the valves of veins. Age, family history, obesity, venous blood pressure, history of deep vein thrombosis, pregnancy, sitting or standing for long periods of time, lack of exercise and smoking are all pre-disposing conditions.


The commonly seen symptoms of CVI include swelling in legs (especially while standing for long duration), itching or tingling of skin on legs, tiredness, pain in legs, venous stasis ulcers, heaviness and cramping in legs, change in skin colour around the ankles (redness or dark pigmentation), varicose veins on surface (twisted and enlarged) and thickening of skin.


CVI is diagnosed primarily by physical examination however Doppler ultrasound imaging is used to assess improper vein functioning and plan treatment. CT scan and MRI may be used to rule out some conditions.


Our treatment of CVI focuses on treating the root causes where possible- the following modalities are all possibilities:

  • Ablation – Laser or RF energy delivered from inside vein causes disappearance
  • Sclerotherapy – The veins harden and then disappear when Sclerosant is injected
  • Vein stripping – From distant incision, device advanced inside vein, locked and vein pulled out
  • Ambulatory Phlebectomy – Small incisions (often <3mm) are made to remove the damaged vein
  • Valve repair – Incision made down to vein to repair the damaged valve in deep vein
  • Angioplasty and stenting – This procedure uses a small balloon to broaden the blocked vein and increase the blood flow. A metal mesh is used to prevent narrowing of the treated segment

CVI will usually progress if left untreated.