What is Venous Insufficiency?  

Venous insufficiency is defined as when the blood is not properly flowing back to the heart and pools in your legs. Usually, there are valves in the veins that regulate the blood flow back towards the heart [1].  But if the valves do not work correctly, venous insufficiency may occur, and the blood will accumulate in the lower extremity.

 

What are the Signs and Symptoms of Venous Insufficiency?

Signs and symptoms might vary depending upon the severity of the disease. Here are some common signs and symptoms of the venous insufficiency [2]:

• Itchy legs
• Varicose veins
• Swelling of lower extremity
• Leg ulcers
• Pain when you stand
• Feeling of heaviness in your legs
• Tightness in calves
• Weak legs
• Leg cramps
• Bleeding
• Chronic pain
• Discoloration of the legs
• Deep vein thrombosis

It is not a life-threatening disorder, but it may be painful and cause disability in the patients.

 

Causes and Risk Factors:

Venous insufficiency can be caused by the formation of blood clots in the deep veins of the legs or varicose veins. In normal blood vessels, blood moves back towards the heart, and the veins' valves prevent the blood's backflow. But in venous insufficiency, due to the formation of blood clots or abnormal functioning of the venous valves, blood accumulates in the legs.

 In the case of varicose veins, the valves are impaired and damaged, so the blood leaks through the valves [2]. The incidence of venous insufficiency is higher among women than men. According to the research, the risk of venous insufficiency increases among people above 50. Other risk factors of venous insufficiency include [3]:

• Smoking
• Obesity
• Pregnancy
• Cancer
• Leg injury
• Muscular weakness of legs
• Genetics
• Trauma
• Long periods of standing or laying
• Sedentary lifestyle
• Hypertension
• Use of oral contraceptive

 

How is Venous Insufficiency Diagnosed?

Your physician does complete medical and family history and physical examination to diagnose venous insufficiency. Imagining examinations or tests may be required by physicians to find out the problem. Duplex ultrasound may be done to evaluate the blood flow and the direction of blood flow in the veins of the legs.

 

Management of the Venous Insufficiency:

Your physician will create a care plan for you that will be based on your age, medical history, family history, health status, severity, signs, and symptoms. Treatment of venous insufficiency may include improved blood flow to the legs. Compression stockings may be used for better results. Patients are asked to keep their legs elevated. This will help to reduce inflammation and increase blood supply to the legs. [4]

 

Medication management of venous insufficiency:

Following medicines can help manage the problem:

• Anticoagulants such as blood thinners are prescribed to prevent blood clot formation.
• Diuretics are used to prevent edema of the lower extremity and to remove extra fluid from the body.
• Surgical treatment of venous insufficiency includes removing damaged veins, bypassing veins, laser surgery, and endoscopic surgery to tie the varicose veins.

 

References:

1. https://www.ncbi.nlm.nih.gov/books/NBK430975/
2. https://www.ncbi.nlm.nih.gov/books/NBK430975/#:~:text=Patients%20with%20chronic%20venous%20insufficiency,%2C%20and%20fatigue%2C%20and%20itching.
3. https://www.ncbi.nlm.nih.gov/books/NBK430975/#:~:text=Chronic%20venous%20insufficiency%20pathophysiology%20is,perforating%20veins%20that%20connect%20them.
4. https://www.ncbi.nlm.nih.gov/books/NBK430975/#:~:text=Treatment%20%2F%20Management&text=Most%20patients%20should%20initially%20be,benefits%20patients%20who%20remain%20compliant.

 

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