Venous Insufficiency: Causes, Symptoms, and Diagnosis

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Venous Insufficiency: Causes, Symptoms, and Diagnosis

What is venous insufficiency?

Your arteries carry blood from your heart to the rest of your body. Your veins carry blood back to the heart, and valves in the veins stop the blood from flowing backward.

When your veins have trouble sending blood from your limbs back to the heart, it’s known as venous insufficiency. In this condition, blood doesn’t flow back properly to the heart, causing blood to pool in the veins in your legs.

Several factors can cause venous insufficiency, though it’s most commonly caused by blood clots (deep vein thrombosis) and varicose veins.

Even if you have a family history of venous insufficiency, there are simple steps you can take to lower your chances of developing the condition.
Causes of venous insufficiency

Venous insufficiency is most often caused by either blood clots or varicose veins.

In healthy veins, there is a continuous flow of blood from the limbs back toward the heart. Valves within the veins of the legs help prevent the backflow of blood.

The most common causes of venous insufficiency are previous cases of blood clots and varicose veins.

When forward flow through the veins is obstructed — such as in the case of a blood clot — blood builds up below the clot, which can lead to venous insufficiency.

In varicose veins, the valves are often missing or impaired, and blood leaks back through the damaged valves.

In some cases, weakness in the leg muscles that squeeze blood forward can also contribute to venous insufficiency.

Venous insufficiency is more common in women than in men. It’s also more likely to occur in adults over the age of 50, according to the Cleveland Clinic.

Other risk factors include:

blood clots
varicose veins
muscle weakness, leg injury, or trauma
swelling of a superficial vein (phlebitis)
family history of venous insufficiency
sitting or standing for long periods of time without moving

Symptoms of venous insufficiency

Symptoms of venous insufficiency include:

swelling of the legs or ankles (edema)
pain that gets worse when you stand and gets better when you raise your legs
leg cramps
aching, throbbing, or a feeling of heaviness in your legs
itchy legs
weak legs
thickening of the skin on your legs or ankles
skin that is changing color, especially around the ankles
leg ulcers
varicose veins
a feeling of tightness in your calves

How is venous insufficiency diagnosed?

Your doctor will want to do a physical examination and take a complete medical history to figure out if you have venous insufficiency.

They may also order some imaging tests to pinpoint the source of the problem. These tests may include a venogram or a duplex ultrasound.

During a venogram, your doctor will put an intravenous (IV) contrast dye into your veins.

Contrast dye causes the blood vessels to appear opaque on the X-ray image, which helps the doctor see them on the image. This dye will provide your doctor with a clearer X-ray picture of your blood vessels.
Duplex ultrasound

A type of test called a duplex ultrasound may be used to test the speed and direction of blood flow in the veins.

A technician will place some gel on the skin and then press a small hand-held device (transducer) against this area. The transducer uses sound waves that bounce back to a computer and produce the images of blood flow.
How venous insufficiency is treated

Treatment will depend on many factors, including the reason for the condition and your health status and history. Other factors your doctor will consider are:

your specific symptoms
your age
the severity of your condition
how well you can tolerate medications or procedures

The most common treatment for venous insufficiency is prescription compression stockings. These special elastic stockings apply pressure at the ankle and lower leg. They help improve blood flow and can reduce leg swelling.

Compression stockings come in a range of prescription strengths and different lengths. Your doctor will help you decide what the best type of compression stocking is for your treatment.

Treatment for venous insufficiency can include several different strategies:

Improving blood flow

Here are some tips to improve your blood flow:

Keep your legs elevated whenever possible.
Wear compression stockings to apply pressure to your lower legs.
Keep your legs uncrossed when seated.
Exercise regularly.


There are also a number of medications that may help those who have this condition. These include:

diuretics: medications that draw extra fluid from your body that is then excreted through your kidneys
anticoagulants: medications that thin the blood
pentoxifylline (Trental): a medication that helps improve blood flow

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