Chronic Venous Insufficiency

What Is Chronic Venous Insufficiency (CVI)?

• The cause of CVI is Venous Hypertension. The pressure inside the veins is too high.
• This is from reflux or outflow blockage.
• The venous blood is not healthy oxygenated and nutrient rich blood. It is the “used blood”, carrying waste products of cellular metabolism, like the sewer system of the body. When the sewer backs up things are not good.
• The leg may have the same heaviness, aching, tiredness, restlessness and cramping as with all vein problems.
• We call it CVI when there are more abnormalities than just spider veins and varicose veins. Swelling is the minimum additional finding.
• Varicose and spider veins may or may not be present. People get CVI without ever having varicose veins

• The leg is usually swollen. Sometimes the swelling goes above the knee.
• The skin may have a brown discoloration as if it were coffee stained. This happens on the inner lower leg first then may expand to the whole leg below the knee. It virtually never goes above the knee. It is called hemosiderin.
• There can be redness and inflammation which looks like an infection.  It is not usually associated with a fever or chills and does not continue to spread up the leg. Many doctors will treat this with antibiotics. They do not usually help.  
• The skin may get hard and contracted around the lower leg  such that the leg looks like an inverted champagne bottle.
• Large Thick waxy flakes may develop, dermatoliposclerosis.
• There can be areas of whitish scarring called atrophy blanche.
• Minor trauma to this skin can cause a wound that will not heal or takes a very long time to heal. This is known as venous leg ulcer.
• CVI will not reverse itself and will only worsen over time unless it is treated.