Chronic venous insufficiency

There are several reasons why the vein valves may not be working properly:

• Failure of the valves in superficial veins: pre-existing weakness of the vein valves, direct injury, inflammation, enlarged veins and vein valves caused by hormonal changes or venous hypertension.
• Failure of the valves in deep veins: damage results from blood clots in the deep veins, also called deep vein thrombosis.

Risk factors for CVI include age, gender, family members who are also affected by chronic venous disease such as varicose veins, being overweight, pregnancy, previous leg injuries or inflammation of the veins (also called phlebitis). Prolonged sitting or standing is one of the behavioral factors that can result in CVI.

Your healthcare professional will take your complete medical history and will perform a physical exam, including the inspection and palpation of the skin. You may also receive a Duplex ultrasound, which is a noninvasive testing that visualises the blood flow and the structure of the leg veins.

In most cases, this will be enough to confirm the diagnosis of a chronic venous disease. Further imaging techniques are:

• Magnetic resonance venography
• Computer tomography venography
• Invasive imaging (venogram or intravascular ultrasound)

CVI results from a venous disease that was not or insufficiently treated. Therefore, early recognition and appropriate intervention are important to prevent the development of more severe stages of chronic venous disease. Here are some basic strategies to prevent CVI:

• Exercise regularly 
• Maintain a healthy weight 
• Avoid long periods of sitting or standing 
• Take short breaks to raise the legs 
• Wear compression stockings 

The goal of all these strategies is to prevent the pooling of blood in your legs and thus to prevent venous hypertension.