Take steps to get to the bottom of leg vein issues

You may suffer from chronic venous insufficiency, or CVI, and not even know this could be the cause of your discomfort. While varicose veins, spider veins and dark skin patches are a visible sign of CVI, other symptoms, such as pain, itchiness and/or heaviness in the legs, unexplained leg swelling, restless legs, cuts and sores on the leg that don’t heal, or ulcers that suddenly appear, are not always recognized as signs of this condition.

According to the Society for Vascular Surgery, as much as 40 percent of the U.S. population may be affected by CVI.

Just like it sounds, venous insufficiency means that the vein is underperforming. If you think of the vascular system as a roadway, one network of arteries carries blood away from the heart toward the extremities and another network of veins then carries the blood back to the heart.

The veins in your legs contain tiny valves to help move your blood toward your heart, often against the pull of gravity. While each valve slams shut, the blood is pushed forward and upward. If these valves fail, the blood’s flow slips backwards, which causes a “traffic jam” or pooling of blood to occur in your legs.

Over time, this can result in the above-listed symptoms.

Several conditions can cause these valves to fail, including heredity, lack of exercise, the additional stress on the venous system caused by obesity, pregnancy, long periods of sitting or standing or a pelvic tumor.

Ultrasound is typically used to diagnose CVI. The exam must evaluate all three venous systems in the legs, the deep veins, which are typically examined when diagnosing deep vein thrombosis (blood clot), as well as the superficial and perforating venous systems, where venous insufficiency typically occurs.

A venogram, an X-ray performed with contrast dye, is another way doctors can view the vein structure for defects.

Many conservative treatments can provide relief from the symptoms of CVI. If the patient is obese, weight loss often reduces symptoms significantly. Regular exercise, wearing compression stockings and elevating the legs when at rest, can also reduce pain, itching and swelling.

Diuretics or pills that draw water from the body should not be used consistently to address swelling from CVI unless there are issues, such as heart failure or kidney disease, that are contributing to the swelling.

Just as fixing a faulty pipe is preferred over mopping up a puddle of water each day, eliminating, fixing or replacing the poorly performing vein can provide relief.

Surgical treatments have dramatically changed from a decade ago, when the vein “stripping” was popular. Now, tiny instruments are used through a hole about the size of a needle to perform outpatient procedures.

Sclerotherapy is a procedure that involves injecting a chemical into the vein that produces scarring and renders the vein unusable. This allows other healthy veins to efficiently take over the compromised vein’s work while it shrivels up and is absorbed by the body.

Using a laser or radio waves, the vascular surgeon can close the faulty vein from the inside. In some cases, vein repair also might be possible through minimally invasive techniques.

If you have any of the symptoms listed above, and they are interfering with the quality of your life, you should talk to your doctor about testing for CVI.

While the condition isn’t life threatening, it can be painful, and in extreme cases it can lead to disability.

Oaks is a vascular surgeon at UPMC Susquehanna.

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