What is Chronic Venous Insufficiency (CVI)?

Chronic Venous Insufficiency (CVI) Explained

Under the influence of gravity, blood faces a challenge returning from the feet to the heart. Walking helps as the calf muscles squeeze the veins, pushing the blood upwards. Veins also have valves that prevent backflow. If leg veins or valves are damaged or blocked, they can't efficiently return blood to the heart, resulting in Chronic Venous Insufficiency.

What are the symptoms of CVI?

• Standing pain
  A person with CVI may experience a ‘bursting and burning’ pain when first standing in the morning, this is caused when blood rushes at speed into the weakened veins. Also, a dull ache or heaviness can develop in the legs when standing.
• Swelling
  A common sign is swelling of the legs, particularly below the knee. This swelling can become more pronounced when sleeping in a seated position, as it contributes to increased blood pooling and may even lead to skin damage over time.
• Varicose veins
  Varicose veins are a prominent indication of blood backflow. These veins appear enlarged, twisted, and bulging, affecting about one-third of adults¹. Certain factors increase the likelihood of developing varicose veins, such as pregnancy, being overweight, or having a job that involves prolonged standing.

What can be done to treat the symptoms of CVI?

• Compression socks
  Compression therapy plays a pivotal role in treating CVI. It involves using specially designed bandages or stockings that apply gentle pressure from the toes up to the knee. This compression aids in promoting blood flow toward the heart, enhancing the muscle pump action, and preventing swelling in the lower limbs. However, it's important to note that compression therapy is not suitable for everyone. Individuals with Peripheral Arterial Disease (PAD), where the blood supply to the legs is already reduced, should avoid using compression therapy.
• Structured exercise and leg elevation
  People with CVI need to ensure they keep walking; when not walking it is important to keep the legs above the level of the heart when seated. If less mobile, ankle exercises are encouraged.
• Surgery
  When leg ulcers resulting from CVI become persistent and challenging to heal, a surgical procedure to remove the dead or dying tissue may be necessary to promote wound healing. Additionally, addressing the underlying cause, and repairing the malfunctioning valves in the leg veins, can significantly alleviate the symptoms of CVI. In cases where these treatments prove insufficient, other minimally invasive options come into play. Injections or laser therapy can be utilised to seal and shrink veins that experience reflux (backward flow of blood). This procedure is less invasive compared to traditional vein stripping and can serve as an effective alternative.