By Jeffrey M. Levine, MD, and Michael Cioroiu, MD, FACS
Up to 40 percent of women and 17 percent of men suffer from chronic venous insufficiency, a condition marked by swollen ankles, and feelings of leg tightness or heavy, tired legs. Chronic venous insufficiency may also be associated with varicose veins, which are swollen, bulging or twisted veins that you can see through the skin. In severe cases, chronic venous insufficiency can lead to non-healing leg ulcers.
What causes chronic venous insufficiency?
The vascular system is composed of arteries and veins. Arteries take blood away from the heart, while veins bring blood back. Normally, valves in the leg veins, in conjunction with the pumping action of leg muscles, keep blood moving against gravity up toward the heart. With chronic venous insufficiency, vein walls are weakened and valves are damaged, resulting in higher pressure than normal. This high pressure causes blood to back up and sometimes leak out of the vessels, contributing to swelling.
What are the risk factors for this condition?
Risk factors for venous insufficiency include the following:
• History of blood clots in the legs
• Smoking
• Age
• Obesity
• Sitting or standing for long periods
• Family history of venous insufficiency
• History of pregnancy
Is phlebitis related to chronic venous insufficiency?
Diseases of the veins include phlebitis, when a vein becomes swollen or inflamed leading to a blood clot. Blood clots of the deep veins are called DVT, or deep vein thrombosis, and can lead to potentially fatal clots breaking off and traveling into the lungs — a condition known as pulmonary embolus. A history of DVT is sometimes a precursor to chronic vascular insufficiency.
How can I prevent or treat leg ulcers if I have this condition?
One of the most serious complications of chronic venous insufficiency is leg ulceration. Ulcers related to venous disease can start with a bump, cut or scratch, and take months to heal. One mainstay of treatment is to overcome the effects of gravity and swelling with leg elevation and compression stockings.
At the Mount Sinai Beth Israel Center for Advanced Wound Care, we take care of patients with chronic wounds related to venous insufficiency. With techniques of compression therapy and judicious choice of topical treatments, along with back-up and collaboration with a staff of outstanding vascular surgeons, our healing rates have matched or exceeded other wound centers in the United States.
To find an excellent doctor who is right for you, please call our Physician Referral Service at 866.804.1007.
This post was co-authored by guest blogger Michael Cioroiu, MD, Center for Advanced Wound Care, and Dr. Levine.