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Venous Insufficiency and The Main Causes


Venous insufficiency usually refers to lower extremity swelling, trophic skin changes, and discomfort secondary to venous hypertension. Chronic venous insufficiency is a prevalent pathological process.

Disability-related to chronic venous insufficiency is attributed to decreased quality of life and loss of work productivity. In most cases, incompetent valves are the cause. Each year, approximately one hundred and fifty thousand new patients are diagnosed with venous insufficiency, and the medical sector spends nearly five hundred million dollars on the care of these patients.

Venous Insufficiency

Arteries supply blood from the heart to the rest of the body, veins transport the blood circulating back to the heart, and valves in the veins prevent blood from flowing back.

It is known as venous insufficiency when your veins have trouble sending blood from your extremities back to your heart. In this condition, blood does not return correctly to the heart, causing blood to pool in the veins of the legs.

Several factors can cause this, although the most common causes are blood clots, such as deep vein thrombosis and varicose veins. Even though there was a family history of venous insufficiency, there are easy actions you can follow to minimize your chances of developing the condition.

venous insufficiency Leg

Main Causes Of Venous Insufficiency

Blood clots or varicose veins are often the leading causes of venous insufficiency.

In healthy veins, blood flow from the extremities to the heart is continuous. Valves within the leg veins help to avoid the backflow of blood. The most typical causes of venous insufficiency are previous cases of blood clots and varicose veins.

When obstruction of the forward flow through the vein presents itself, such as in the case of a blood clot, blood builds up beneath the clot, which can result in venous insufficiency.

When the valves are missing or damaged, and blood leaks back through the affected valves, varicose veins occur. In some situations, weakness in the leg muscles that push blood forward can also add to venous insufficiency.

Venous insufficiency is more frequent in women than in men. It is also more likely to develop in adults over 50 years old.

Some other risk factors include:

  • Varicose veins
  • Blood clots
  • Pregnancy
  • Muscle weakness, leg injury, or trauma
  • Family history of venous insufficiency
  • Smoking
  • Swelling of a superficial vein, known as phlebitis
  • Obesity
  • Cancer
  • Being sitting down or standing up for long periods without movement

Venous Insufficiency Symptoms

The symptoms of venous insufficiency include:

  • Edema, swelling of the legs or ankles
  • Soreness that gets worse when you stand up and gets better when you raise your legs
  • Leg discomfort
  • Weak legs
  • Itchy legs
  • Pain, pounding, or heaviness in the legs
  • The thickness of the skin on the legs or ankles
  • Leg ulcers
  • Varicose veins
  • Feeling of tightness in the calves




Diagnosing Venous Insufficiency

Your physician will want to perform a physical exam and take a complete medical history to determine if you have venous insufficiency.

Doctors may also order imaging tests to identify the origin of the problem. These tests may incorporate a venogram or a duplex ultrasound.


In a Venogram, your physician will place an intravenous IV and contrast dye into your veins. The contrast dye will make the blood vessels appear opaque in the x-ray image, which helps the doctor see them in the image. In addition, this dye will give your doctor a clearer x-ray image of your blood vessels.


Doctors use duplex ultrasound to evaluate the velocity and direction of blood flow in the veins.

A specialist will place some gel on the skin and then press a small hand-held device, a transducer, against the area. The transducer uses sonic waves that bounce off a computer and produce images of blood flow.

Prognosis Venous Insufficiency

Venous insufficiency is not a benign condition, and it involves enormous morbidity. Without correction, the condition is progressive. Venous ulcers are frequent and very complicated to treat; they are achy and disabling. Even with treatment, recurrences are frequent if venous insufficiency continues.

Nearly sixty percent of patients develop phlebitis, which often progresses to deep vein thrombosis in more than fifty percent of patients. Venous insufficiency can also lead to severe bleeding. Surgery for venous insufficiency remains unsatisfactory despite the availability of numerous procedures. In addition, the cost of care to the patient is enormous.

The condition of venous insufficiency tends to worsen over time. However, doctors can help you control it if you start the treatment in the early stages. By taking self-care measures, you may be able to relieve discomfort and prevent the situation from getting worse. However, you may need medical procedures to treat the condition.

Venous Insufficiency Stages

The venous disorder is a broad categorization for many vein issues, including venous insufficiency. The medical area bases these stages on clinical symptoms, which doctors may see when examining your legs. Venous disorder stages include:

  • Stage 0: no signs you can see nor feel. You may feel symptoms such as sore or tired legs.
  • Stage 1: Visible blood vessels, which include spider veins.
  • Stage 2: Varicose veins a minimum of three millimeters wide.
  • Stage 3: Edema, which is swelling, but no skin alterations.
  • Stage 4: Changes in the color or texture of your skin.
  • Stage 5: Healed ulcer.
  • Stage 6: Acute ulcer, active.

From stage 3 or higher, the diagnosis would be chronic venous insufficiency. In other words, having varicose veins does not mean you have chronic venous insufficiency, but varicose veins are a sign of blood flow issues that could worsen over time. So it is necessary to tell your physician about any new varicose veins you notice.

Treating Venous Insufficiency

Treating venous insufficiency will depend on many factors, including the nature of the condition and your health status and history. Other factors your doctors will also consider are:

  • Your particular symptoms
  • Your age
  • The seriousness of your condition
  • How well-tolerated the medications and procedures are for you

The most frequent treatment for venous insufficiency is prescription compression stockings, which apply pressure to the ankle and lower leg. These special elastic stockings help improve blood flow and can reduce leg swelling.

Compression stockings come in a variety of prescription strengths and different lengths. Your doctor will help you decide which type of compression stocking is best for your treatment.

Treatments may include several different strategies:


Next, here are some tips to improve blood flow:

  • Keep your legs raised whenever possible.
  • Use compression stockings to put pressure on the lower legs.
  • Keep your legs uncrossed when sitting down.
  • Exercising regularly.


Several other medications may also help those with this condition. These include:

  • Diuretic: a pill that removes extra fluid from your body that the kidneys excrete.
  • Anticoagulants: medication that thins the blood.
  • Pentoxifylline, Trental: a medicine that helps improve blood flow.


Sometimes the most severe cases of venous insufficiency require surgery. Your physician may suggest one of the following types of surgery:

  • Perform a surgical repair of valves or veins.
  • Perform a removal or stripping of the affected vein.
  • Minimum invasive endoscopic surgery: the surgeon places a thin tube with a camera to help see and tie off varicose veins.
  • Laser surgery: a somewhat new treatment that utilizes lasers to fade or seal the affected vein with powerful waves of light in a small, targeted spot.
  • Vein bypass: the surgeon transplants a healthy vein from another body area. It is used only in the upper thigh and as a last resort in severe cases.

Ambulatory Phlebectomy

The ambulatory phlebectomy is an outpatient procedure, which means you will not have to stay overnight in the hospital; it involves your doctor numbing certain spots on your leg, making small punctures, and removing smaller varicose veins.


Sclerotherapy is a method of treatment usually reserved for acute venous insufficiency.

In sclerotherapy, the physician injects a specific chemical into the damaged vein so it can no longer carry blood. Instead, the blood will return to the heart through other veins, and the body will eventually absorb the affected vein.

Also, to destroy small to medium-sized veins, physicians utilize sclerotherapy. They inject a specific chemical into the affected vein so it can no longer carry blood.


In extreme cases, physicians may perform a procedure by catheter for more prominent veins. They will introduce a catheter, which is a thin tube, into the vein, heat the end, and then withdraw it. The heat will shut up the vein and seal as the doctor removes the catheter.


Preventing Venous Insufficiency

In case you have a known family history of venous insufficiency, you can take actions to decrease your chances of having the condition:

  • Do not be sitting down or standing up in one position for long periods. Instead, get up and move around frequently.
  • Do not smoke, but if you do smoke, quit as soon as possible.
  • Exercise regularly.
  • Maintain healthy body weight.

We are Modern Heart and Vascular Institute, a diagnostic and preventative medicine cardiology practice. For more information, contact us.

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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.

Every heart has a story… What’s yours?

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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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