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The Stages of Chronic Venous Insufficiency

The Stages of Chronic Venous Insufficiency

The Stages of Chronic Venous Insufficiency

(CVI) Chronic venous insufficiency is a disease that occurs when the leg veins are damaged. As a result, these veins cannot manage blood flow as well as they should, and it is more difficult for blood in the legs to return to the heart.

Chronic venous insufficiency causes blood to accumulate in the leg veins, resulting in high pressure. Chronic venous insufficiency may happen due to damage to any of the leg veins. These veins include your:

  • DEEP VEINS: These veins are large veins deep in your body that pass through your muscle.
  • SUPERFICIAL VEINS: These veins are close to the skin’s surface.
  • PERFORATING VEINS: These veins connect the deep and superficial veins.

Chronic venous insufficiency may cause mild symptoms initially. But over time, this condition may interfere with your quality of life and lead to severe difficulties.

Venous disease is widespread. For example, varicose veins affect approximately one in three adults. Each year, about one in fifty adults with varicose veins develop chronic venous insufficiency.

Chronic venous insufficiency typically affects individuals over the age of fifty. The risk increases as individuals get older.

Overall, chronic venous insufficiency affects about one in twenty adults.

How Chronic Venous Insufficiency Affects The Body?

Chronic venous insufficiency slows the blood outflow from the legs to the heart. In addition, without treatment, chronic venous insufficiency increases the pressure in the leg veins so much that the smaller blood vessels (capillaries) burst. When this happens, the skin in that area turns reddish-brown and may easily break if hit or scraped.

These burst capillaries may cause:

  • Tissue damage
  • Inflammation of the tissue in that area
  • Open sores on the skin’s surface (venous stasis ulcers)

Venous stasis ulcers do not heal quickly and may become infected. In addition, the infection may spread to nearby tissue. We know this condition as cellulitis, being dangerous if not treated immediately.

Symptoms and Signs of Chronic Venous Insufficiency

Symptoms and signs of chronic venous insufficiency include the following:

  • Tired or sore legs
  • Tingling or burning sensation in the legs
  • Discolored skin looking reddish-brown
  • Leg cramps
  • Swelling in the lower legs and ankles (edema), especially after long periods of standing or at the end of the day
  • Legs or feet skin itching or peeling
  • Legs feeling heavy or full
  • Legs skin leathery looking
  • Open sores (ulcers), typically near the ankles. When they are very painful, there may be an infection
  • Varicose veins

Severe swelling in the lower leg may cause scar tissue to appear. This scar tissue traps fluid in your tissues. As a result, your calf may feel large and rough to the touch. When this happens, your skin is more vulnerable to persistent ulcers.

You may not have all the above problems at once. Instead, you may have only one or two. Your symptoms and signs depend on the progression of your condition.


Venous disorder’s stages range from zero to six. “Venous disorder” is a general category for many possible vein problems, including chronic venous insufficiency (CVI). Clinical signs are the basis of these stages, which are indications your healthcare provider or physician can feel or see when examining your legs.

The venous disorders stages include the following:

–STAGE 0: You cannot feel or see signs. However, you may feel symptoms such as tired or achy legs.

–STAGE 1: The first stage is when you can see the blood vessels, including the formation of spider veins on the legs. These blood vessels look unsightly but do not always cause pain or discomfort. However, it would be wise to be aware of and pay attention to them.

–STAGE 2: When you see prominent, bulging veins on your legs and feet, you start to have varicose veins (at least three millimeters wide). Some individuals do not suffer discomfort with varicose veins, but many do.

–STAGE 3: There is swelling (edema) but no skin changes. (Chronic venous insufficiency diagnosis). They worsen if you do not heal your varicose veins at first glance. One of the things that occur when you do not get treatment is swelling.

This swelling results from poor circulation in your body and can significantly hinder your quality of life. Swelling may also contribute to damage to your lymphatic system.

–STAGE 4: When you leave your veins untreated, blood continues to accumulate in the area surrounding the damaged vein, causing skin discoloration or rashes; variations in the texture or color of your skin. In addition, the accumulation of blood on the surface may trigger an inflammatory response indicated by an itchy red rash (venous stasis dermatitis).

–STAGE 5: If you continue to leave your damaged veins untreated, venous insufficiency may progress to venous stasis ulcers and open sores resulting from skin tissue breakdown in the leg.

These sores and ulcers may be excruciating and make movement difficult. You do not want to reach this stage five of chronic venous insufficiency.

If you have advanced to this stage, you must evaluate and treat your veins as soon as possible. Treatment will help you heal the wounds and prevent a recurrence.

–STAGE 6: You have an active (acute) ulcer at stage six.

Your physician or healthcare provider will diagnose you with chronic venous insufficiency if you are at stage three or higher. In other words, having varicose veins does not mean you have chronic venous insufficiency. But varicose veins are signs of blood flow problems that could worsen over time.

So it is important to tell your healthcare provider or physician about any new varicose veins you detect.


Healthcare providers or physicians diagnose chronic venous insufficiency by physical exam and ultrasound. During the physical exam, your physician will do the following:

–CAREFULLY EXAMINE YOUR LEGS: Your physician will look for clinical signs of chronic venous insufficiency, such as changes in skin color or ulcers.

–PERFORM A VASCULAR ULTRASOUND: This noninvasive and painless examination uses sound waves to create a picture of your veins. It indicates which parts of your veins are damaged.

Your healthcare provider or physician will exclude other medical conditions causing your symptoms. This check-up may involve additional tests, such as an MRI (Magnetic Resonance Imaging).

Many individuals with chronic venous insufficiency also have peripheral arterial disease (PAD). Therefore, your healthcare provider may ask questions or perform tests to check for peripheral arterial disease. If you have chronic venous insufficiency and peripheral arterial disease, your physician will advise you on treatment strategies and precautions.


Chronic venous insufficiency is generally not life-threatening and does not result in amputation. But it is a progressive disease that may cause discomfort, aching, and reduced quality of life. Treatment may help control your symptoms and improve your enjoyment of living.

Venous ulcers are challenging to treat and can recur even after being treated. Therefore, keeping your medical appointments and attentively following your physician’s instructions is vital.


Treatment cannot reverse the damage to the valves in your veins. But it can change your symptoms, so you feel better and have an improved quality of life. In addition, some surgeries and procedures may target and remove the damaged veins so that blood no longer flows through them.

Likewise, physicians cannot help you cure chronic venous insufficiency. But they can help you learn how to manage the condition with lifestyle changes and other treatments they will recommend.

Awareness of the symptoms of chronic venous insufficiency is vital. With early intervention from your physician or healthcare provider, you may get medical attention and have an early diagnosis.

Suppose you are looking for vein surgery or vein removal options or are worried about any venous condition. In that case, the team of vein experts at Modern Heart and Vascular practice can tailor your personalized treatment plan.

With a personalized treatment plan, you can tackle any discomfort you are experiencing, which may help you feel and look your best.


What improvements can I expect after the non-surgical treatments?

After undergoing these non-surgical treatments, you can anticipate experiencing a range of improvements in your condition. Firstly, you will likely notice a significant reduction in pain and swelling. This can significantly enhance your everyday comfort and enable you to engage in previously challenging or limited activities. Additionally, these treatments can improve your ability to stand for extended periods and increase your walking distance, allowing you to be more mobile and independent. The overall result of these improvements is an enhancement in your quality of life, enabling you to enjoy a more comfortable and active lifestyle.

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Modern Heart and Vascular, a preventive cardiology medical practice, has several offices around Houston. We have locations in Humble, Cleveland, The Woodlands, Katy, and Livingston.

We are Modern Heart and Vascular Institute, a diagnostic and preventative medicine cardiology practice.

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At the Modern Heart and Vascular Institute, we offer state-of-the-art cardiovascular care with innovative diagnostic tools and compassionate patient care. Our priority at Modern Heart and Vascular Institute is prevention. We help patients lead healthier lives by avoiding unnecessary procedures and surgeries.

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This article does not provide medical advice. It is intended for informational purposes only. It is not a substitute for professional medical advice, diagnosis, or treatment. If you need cardiovascular care, please call us at 832-644-8930.

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