What is Venous Insufficiency?

Venous insufficiency is a health condition developed when the valves of the veins make it difficult for deoxygenated blood to move back to the heart. The blood instead accumulates in the leg veins, causing pain, discomfort, and abnormal discoloration in the leg area.

What Is Venous Insufficiency?

Learning how blood vessels, such as the arteries, capillaries and veins, work is essential to understand venous insufficiency. While the arteries carry blood away from the heart to nourish organs with oxygen-rich blood and nutrients, the veins carry deoxygenated blood toward the heart. The capillaries are channels through which the exchange of nutrients and oxygen occurs.

The veins have built-in one-way valves that help keep the blood flowing toward the heart. These valves are crucial in the arms and legs, where they prevent the backflow of blood in response to the pull of gravity.

When these valves do not work as they should, blood pools in the legs, puts increased pressure on the walls of the veins and causes poor blood flow from the legs to the heart, causing venous insufficiency. Valve dysfunction (usually hereditary), valve destruction after a deep vein thrombosis and blood clots are some of the reasons behind the reduced blood circulation.

Most symptoms are mild and not limb-threatening, such as:

• Enlarged and twisted veins in the legs that look rope-like and are close to the surface of the skin (varicose veins)
• Throbbing, pain or a feeling of heaviness in the legs
• Swelling of the legs or ankles (edema)
• Pain that worsens when standing up and gets better when the legs are raised
• Leg cramps
• Flaky and itchy skin
• Thickened and brownish skin discoloration below the knees
• Open sore or ulcer that does not heal—if your leg is affected, usually on the inside of the ankle

These symptoms are all signs of a problem with a person's blood circulation. If you have any of these symptoms, consulting a healthcare provider is a good first step to help determine whether you have venous insufficiency.

Is Venous Insufficiency Dangerous?

If left untreated, chronic venous insufficiency can progress and result in post-phlebitic syndrome, which causes chronic swelling, pain and discoloration of the skin. The skin can break down in severe cases, allowing an ulcer (open sore) to form. These ulcers are difficult to heal. Venous insufficiency can also lead to severe hemorrhage without proper treatment. 

What Causes Venous Disease?

Varicose veins, or inflammation with or without clots in the veins called phlebitis, excessive body weight and pregnancy are some causes of venous insufficiency. Some people are born with leaky or dysfunctional valves, while other venous insufficiency may be the result of trauma, prolonged standing, hormonal changes or deep vein thrombosis. It is more common in women (especially after multiple pregnancies) than in men and more likely in middle-aged or older adults. 

What Is Venous Insufficiency Surgery?

Treatment for venous insufficiency varies depending on the severity of the condition, the underlying cause and the patient's health history. Other factors to consider are the patient's specific symptoms, age and tolerance for medications or procedures.

The most common treatment involves prescription compression stockings, specialized elastic stockings that apply pressure at the ankle and lower leg, improve blood flow, and reduce leg swelling. Compression stockings come in various prescription strengths and lengths.

Additionally, some medications may help manage venous insufficiency, such as:

• Diuretics: Medications that draw excess fluid from your body, which is then excreted through the kidneys
• Anticoagulants: Blood-thinning medications
• Pentoxifylline (Trental): A medication that enhances blood flow

Some venous insufficiency is so severe that surgery may be necessary to help treat the symptoms. These surgical options are:

• Surgical repair of veins and valves
• Vein removal
• Minimally invasive endoscopic surgery: Uses a thin tube with a camera that helps tie off varicose veins.
• Vein bypass: Transplanting a healthy vein from another body part (usually in the upper thigh). This is typically used as a treatment option in severe cases.
• Laser surgery: A newer technique that uses lasers to fade or close damaged veins with precise and strong bursts of light.

Other treatment options for venous insufficiency include:

• Ambulatory phlebectomy: An outpatient procedure involving numbing and pricking specific areas on the leg to remove varicose veins
• Sclerotherapy: A treatment method primarily reserved for advanced venous insufficiency, targeting small to medium veins. In sclerotherapy, a chemical is injected into the damaged vein so it can no longer carry blood. As a result, the blood reroutes through healthier veins, and the damaged vein eventually gets absorbed by the body.
• Catheter procedures: Generally used in severe cases of venous insufficiency. In a catheter procedure, the doctor inserts a thin tube (catheter) into the vein, heats the catheter's end and then removes it to close and seal the vein as it is withdrawn.

Find a Vascular Surgeon in San Antonio

Whether you need preventive or emergency vascular care, we are here to help. To schedule an appointment with a vascular surgeon, connect with our network of providers here or call 888-417-4961 to find a physician near you. For questions about your coverage, please contact your insurance provider directly or visit our patient resources page for your billing and insurance questions. If you have specific questions regarding insurance coverage at any Baptist Medical Network location, call us at 210-606-9071.

If you are experiencing pain or discomfort from an undiagnosed condition or injury, visit us at Baptist Medical Network for proper diagnosis and advice on the best treatment options for your situation. If it’s an emergency, please call 911 or go to the nearest emergency room.

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