The veins in your legs carry blood back to your heart. They have one-way valves that keep blood from flowing backward. If you suffer from Chronic Venous Insufficiency (CVI), the valves don’t work like they should and some of the blood may go back down into the legs. This causes blood to pool or collect in the veins.
Over time, CVI can cause pain, swelling and skin alterations. It may also lead to open sores known as leg ulcers.
Causes
A blood clot in a deep vein (called deep vein thrombosis) can damage a valve. If you don’t exercise, that can cause CVI too. Sitting or standing for long stretches of time causes pressure in the veins which may then weaken the valves.
Women are more likely than men to suffer from CVI. Your chances also might be higher if you are: obese; over age 50; pregnant or have been pregnant more than once; have a family history of CVI; have a history of blood clots; a smoker.
Symptoms
The following may be noticed: swelling or heaviness, especially in the lower leg and ankle; pain; itching; varicose veins (twisted, enlarged veins close to the surface of the skin); leathery skin.
Without treatment, pressure and swelling will burst the tiny blood vessels in the legs called capillaries. This could turn the skin reddish-brown, especially near the ankles, leading to swelling and ulcers. These ulcers are difficult to heal. They are also more likely to get infected, which can cause additional problems.
When any of these symptoms are present, medical help should be sought. The sooner the problem is addressed, the less likely it will be for the situation to develop into ulcers.
Diagnosis
Your doctor will take note of your medical history. The blood flow in your legs will be checked with a test called a vascular or duplex ultrasound (Doppler). Using sound waves, the doctor can see the blood vessel and check the speed and direction of the blood flow. Other specific exams might also be necessary to exclude or identify the cause for swollen legs.
Treatment
The main goal is to stop swelling and prevent leg ulcers. Your doctor may suggest a combination of various treatments based on age and symptoms. Some options to help manage CVI are: lifestyle changes, medical procedures or surgery.
Lifestyle changes: Include the use of compression stockings, movement and exercise. Compression stockings apply pressure on the legs to help blood flow. They come in different lengths, styles and tightness. Trying not to sit or stand for long periods of time will help. If you have to remain seated for long periods, stretch or wiggle your legs, feet and ankles often, to help blood flow. If you stand for long periods, take various breaks, sit and put your feet up. This helps lower the pressure in the veins of your legs. Exercise helps pump blood through your legs. Walking is a good, simple way to make your legs stronger and boost blood flow.
Medical procedures: If CVI has progressed, nonsurgical treatment may be needed, such as sclerotherapy or an endovenous thermal ablation. In sclerotherapy, a solution is injected into the problem vein. This causes a scar, forcing blood to flow through healthier veins. Endovenous thermal ablation uses high-frequency radio waves or laser to heat and close the problem vein.
Surgery: Fewer than one in 10 people need surgery for CVI and the options are:
▪ Ligation. The vein is cut and tied off so blood can’t flow through. Your doctor may also remove a vein that is very damaged. Patients usually go home on the same day.
▪ Microincision phlebectomy. This technique uses much smaller incisions, punctures and small hooks to remove damaged veins. Does not require hospital admission.
▪ Vein repair. The specialist treats the vein or the valves. This can be done through an open cut on the leg or through a smaller opening using a long, hollow catheter or tube.
▪ Vein transplant. The specialist removes the damaged vein and replaces it with a healthy one removed from another part of your body.
▪ Vein bypass. This is done on damaged veins in the upper thigh and only in the most severe cases. The specialist removes part of a healthy vein from another part of your body and uses it to reroute blood around the affected vein. This procedure requires a two-to-five-day hospital admission.
Article submitted by HPA Health Group
