What is venous insufficiency?
Veins are blood vessels that return impure blood from the organs, arms, legs to the heart for purification. Valves in your legs act as gates and allow the one-way flow of blood toward the heart. In extreme cases, the valves get damaged and the walls of the veins weaken, causing the veins to retain blood, especially while standing. This condition is called venous insufficiency.
What causes venous insufficiency?
Venous insufficiency can be caused by a number of disorders of the veins:
- Varicose veins are blood vessels that are abnormally dilated which appear blue or red in color, swollen, twisted and can be painful. They occur most commonly in the thighs, inside of leg or back of calves.
- Spider veins (telangiectasia) are the smaller, flat, abnormally dilated blood vessels visible on the skin.
- Pelvic congestion syndrome (pelvic venous insufficiency) is one of the causes of chronic pelvic pain in women. The hormonal changes and weight gain along with anatomic changes in the pelvic structure during pregnancy weaken the walls of the ovarian veins causing them to enlarge. The dilation of these veins causes dysfunctioning of the valves, leading to the backward flow of blood that pools within the pelvis. This further leads to pelvic varicose veins and causes symptoms of heaviness and pain in the pelvic region.
Certain factors such as age, being female, pregnancy, being tall, obesity and standing or sitting for long periods of time can increase your risk of venous insufficiencies.
What are the symptoms of venous insufficiency?
Venous insufficiency is characterized by pain that worsens while standing and improves when legs are raised, cramps, heaviness, swelling, itching and tingling sensation, slow healing wounds on the legs or ankles, discoloration around the ankles, and thickening of skin on the ankles and legs.
How is venous insufficiency diagnosed?
When you present to your doctor’s clinic with these symptoms, your doctor will conduct a thorough physical examination and may order some of the below tests.
- Ultrasound: a test using sound waves to view the flow of blood through the blood vessels.
- Pelvic venography: most accurate method for diagnosis of pelvic congestion syndrome. In this, X-rays are used to visualize the veins, after a contrast dye is injected.
How is venous insufficiency treated?
Your doctor may first suggest conservative methods to treat vascular insufficiency. These may involve lifestyle changes such as
- Avoid sitting or standing for long hours without taking a break.
- Physical activity should be included in your daily routine. This will help improve circulation in the veins.
- Obesity will increase the risk of pressure being exerted on the blood walls. Lose weight if you are obese.
- Avoid wearing tight clothes that may interrupt the circulation.
- Avoid wearing high-heeled shoes. Calf muscles put in a lot of energy when you try to walk in heels. Thus when the calf muscles are at rest the circulation will be improved.
Severe cases of vascular insufficiency may be managed through the following treatments:
- Sclerotherapy: recommended for treatment of spider veins and varicose veins. The therapy is safe, simple, and quick and involves the injection of a sclerosing/irritant solution where the spider veins or varicose veins are present. The sclerosing solution irritates the lining of the blood vessel causing the vein to swell and stick together. Over time, the venous blemishes turn into scar tissue and may disappear.
- Ablation: uses heat to close off and destroy the veins
- Vein stripping: removal of affected vein through small surgical incisions made in the leg
- Bypass: redirects the flow of blood around the damaged vein by using a tube or blood vessel removed from another part of the body
- Valve repair: surgical repair of the damaged valve
- Angioplasty and stenting: opens up a narrowed or blocked vein. A long tube with a balloon attached is inserted into the blocked vein. The balloon is inflated and the plaque is compressed against the wall of the vein, widening the opening of the vein for better flow of blood. A metal mesh called a stent is sometimes inserted into the vein to keep it from narrowing again.