Chronic Venous Insufficiency and Varicose Veins

Arteries bring oxygen-rich blood from your heart to the rest of your body and veins return oxygen-poor blood back to your heart. When your leg veins cannot pump enough blood back to your heart, you have chronic venous insufficiency (CVI).

When sitting or standing for an extensive period of time the blood in your leg veins can pool and increase the venous blood pressure. Deep veins and perforating veins are usually able to withstand short periods of increased pressures. However, sitting or standing for a long time can stretch vein walls because they are flexible. Over time, in susceptible individuals, this can weaken the walls of the veins and damage the vein valves, causing CVI.

Varicose Veins may result due to the repetitive stretching of these veins. Varicose veins are swollen veins that you can see through the skin. They often appear blue and bulging and may be tender to the touch.

Symptoms of CVI may include swelling of the ankles and your calves may feel tight. Your legs may also feel heavy, tired, restless, or achy. You may feel pain while walking or shortly after stopping.

CVI can also cause problems with leg swelling because of the pressure of the blood pooling in the veins. In severe cases, CVI can cause non healing ulcers to form on the lower parts of the leg.

CVI is usually not considered a serious health risk. Your physician’s priority will focus treatment on decreasing your pain and associated disability.

To confirm a diagnosis of CVI, the physician may order a duplex ultrasound. Duplex ultrasound uses painless sound waves higher than human hearing can detect. Duplex ultrasound allows your physician to measure the speed of blood flow and to see the structure of your leg veins.

Your physician may recommend compression stockings initially for mild cases of CVI. Compression stockings are elastic stockings that squeeze your veins and stop excess blood from flowing backward. In this way, compression stockings can often also help heal skin sores and prevent them from returning. You may need to wear compression stockings daily for the rest of your life.

Radiofrequency Ablation uses a thin, flexible tube called a catheter inserted into a varicose vein under ultrasound guidance. The thin catheter delivers heat to the vein wall, causing the vein wall to shrink and seal closed as the catheter is withdrawn. Once the diseased vein is closed the blood will flow through other healthy veins.

Radiofrequency Ablation with Stab Phlebectomy is a procedure completed as above and in addition removing varicose veins on the surface of the legs. This procedure involves making tiny punctures or incisions through which the varicose veins are removed.

The incisions are so small no stitches are required. Veins are very collapsible such that even large veins may be removed through the tiny incisions used in this technique. The patient is able to walk following the procedure.

After treatment, a compression bandage and/or compression stocking are worn. Your physician will advise you how long to wear any bandages or compression hose. Many physicians recommend that you walk or resume your normal daily activity within twenty four hours. This reduces pressure in the veins, and increases the flow in the veins and reduces the risk of forming a blood clot.