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Chronic Venous Insufficiency

Healthy leg veins have valves that keep blood flowing to the heart. Chronic venous insufficiency (CVI) develops when the valves stop working correctly and allow blood to flow backward (i.e. reflux) and pool in the lower leg veins. This pooling is called statis, which makes it difficult for blood to return to the heart from the legs (although sometimes it can occur in the arms).

Chronic venous insufficiency is also known as Phlebitis, Post-Thrombotic Syndrome, Venous Insufficiency, Venous Leg Ulcer, or Venous Reflux Disease.

Chronic venous insufficiency, one of the underlying causes of venous ulcers, is a potentially serious and progressive medical condition. Symptoms can worsen over time if left untreated.

Chronic Venous Insufficiency Progress


Chronic venous insufficiency may cause the following symptoms in your legs:

  • Varicose veins
  • Bulging veins
  • Aching
  • Swelling
  • Cramping
  • Heaviness or tiredness in legs
  • Itching
  • Open skin sores and leg ulcers
  • Restlessness
  • Skin discoloration

Who is at Risk?

Chronic venous insufficiency is a fairly common condition that may affect up to 40% of the U.S. population. It is more common in women, especially after multiple pregnancies, and in middle-aged or older people. Chronic Venous Insufficiency is two times more prevalent than coronary heart disease (CHD) and five times more prevalent than peripheral arterial disease (PAD).

Chronic venous insufficiency can affect anyone; gender and age are factors that may increase your risk. For example, women older than 50 are more likely than others to develop CVI. Other factors that may increase your risk include:

  • Family history
  • Sedentary lifestyle
  • Trauma
  • Prolonged standing
  • Obesity or excess weight
  • Current or previous pregnancies
  • Smoking
  • Prevention

For mild forms of chronic venous insufficiency, lifestyle changes may be recommended by your doctor to control existing symptoms and prevent others. The following measures may help prevent varicose veins and CVI:

  • Manage body weight
  • Exercise regularly, focusing on activities that work your legs (run or walk)
  • Elevate your legs whenever possible
  • Avoid prolonged standing or sitting
  • Avoid clothes that are tight around the waist, groin, or legs
  • Avoid shoes that limit the use of calf muscles (such as high heels)
  • Eat a diet low in salt and rich in high-fiber foods


Varicose veins are often misunderstood as a cosmetic problem, and many people living with them do not seek treatment. The good news is that there are minimally invasive treatment options available for varicose veins and chronic venous insufficiency.

Treatment options include wearing compression stockings, exercise, and medicine that increases blood flow. For appropriate cases, Main Line Spine utilizes a segmental radiofrequency ablation (RFA) procedure to close the affected veins.

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