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Venous insufficiency

Chronic venous stasis; Chronic venous disease; Leg ulcer - venous insufficiency; Varicose veins - venous insufficiency

Venous insufficiency is a condition in which the veins have problems sending blood from the legs back to the heart.

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Venous insufficiency

Causes

Normally, valves in your deeper leg veins keep blood moving forward toward the heart. With long-term (chronic) venous insufficiency, vein walls are weakened and valves are damaged. This causes the veins to stay filled with blood, especially when you are standing.

Chronic venous insufficiency is a long-term condition. It is most commonly due to malfunctioning (incompetent) valves in the veins. It may also occur as the result of a past blood clot in the legs.

Risk factors for venous insufficiency include:

Symptoms

Pain or other symptoms include:

Skin changes in the legs include:

Exams and Tests

Your health care provider will do a physical exam and ask about your symptoms and medical history. Diagnosis is often made based on the appearance of leg veins when you are standing or sitting with your legs dangling.

A duplex ultrasound exam of your leg may be ordered to:

Treatment

Your provider may suggest that you take the following self-care steps to help manage venous insufficiency:

You can wear compression stockings to improve blood flow in your legs. Compression stockings gently squeeze your legs to move blood up your legs. This helps prevent leg swelling and, to a lesser extent, blood clots.

When more advanced skin changes are present, your provider:

Your provider may recommend more invasive treatments if you have:

Choices of procedures include:

Outlook (Prognosis)

Chronic venous insufficiency tends to get worse over time. However, it can be managed if treatment is started in the early stages. By taking self-care steps, you may be able to ease the discomfort and prevent the condition from getting worse. It is likely that you will need medical procedures to treat the condition.

When to Contact a Medical Professional

Contact your provider if:

Related Information

Foot, leg, and ankle swelling
Deep vein thrombosis
Varicose veins
Stasis dermatitis and ulcers
Varicose vein stripping
Varicose vein - noninvasive treatment

References

Dalsing MC, Maleti O, Westin GG. Chronic venous insufficiency: deep vein valve reconstruction. In: Sidawy AN, Perler BA, eds. Rutherford's Vascular Surgery and Endovascular Therapy. 10th ed. Philadelphia, PA: Elsevier; 2023:chap 159.

Markovic JN, Shortell CK. Treatment of chronic venous disorders. In: Sidawy AN, Perler BA, eds. Rutherford's Vascular Surgery and Endovascular Therapy. 10th ed. Philadelphia, PA: Elsevier; 2023:chap 157.

Pascarella L, Marston W. Venous disease. In: Townsend CM Jr, Beauchamp RD, Evers BM, Mattox KL, eds. Sabiston Textbook of Surgery. 21st ed. St Louis, MO: Elsevier; 2022:chap 65.

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Review Date: 5/10/2024  

Reviewed By: Neil Grossman, MD, Saint Vincent Radiological Associates, Framingham, MA. Review provided by VeriMed Healthcare Network. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.

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