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What to do in case of chronic venous insufficiency?

Post by 
Dr. Mohamed Salama
March 30, 2022

he inability of the veins to carry blood from the body and
and extremities back to the heart is called venous insufficiency. If treatment for venous insufficiency, which usually occurs in the legs, is delayed, the condition becomes chronic and symptoms become apparent. Those who have venous insufficiency complain of swollen, tired or aching legs.

What is chronic venous insufficiency?
Dr. Salama: Chronic venous insufficiency is when the vein walls or valves in the affected veins (usually in the legs) no longer function properly. In this case, it is difficult for the blood to flow back from the legs to the heart. As a result, blood backs up in the affected veins. Such a condition is called congestion. Untreated venous insufficiency can lead to potentially serious complications.

Are there any risk factors?
Dr. Salama: The most common cause of chronic venous insufficiency is a blood clot in the deep veins of the leg, also known as deep vein thrombosis. However, chronic venous insufficiency can also be caused by pelvic tumors and vascular malformations. Risk factors for developing chronic venous insufficiency primarily include deep vein thrombosis, varicose veins, a personal or even family history, injury, age over 50, obesity or pregnancy. Other risk factors include sitting too often or being sedentary for long periods of time, smoking, standing too often, or not moving or resting the legs for long periods of time.

What symptoms indicate chronic venous insufficiency?
Dr. Salama: In the early stages, symptoms of chronic venous insufficiency can be very subtle. Sometimes inconspicuous warning signs such as itchy legs or darkening of the skin around the ankles are dismissed as dry skin, tan lines or other discoloration. A vascular specialist should examine you if you have any or all of the following symptoms of chronic venous insufficiency: brownish or darkening skin on the lower legs, leg cramps, itching, restlessness, pain in the legs, swelling of the lower legs or ankles when resting or walking, leg ulcers, tightness in the calves and new varicose veins.

When should you seek treatment?
Dr. Salama: An estimated 40% of people in the EU have chronic venous insufficiency, but only 10% seek treatment, according to the Society of Vascular Medicine. This is more common in people who are 50 years or older and more common in women than men. The best time to seek treatment for chronic venous insufficiency is when you notice the first signs of chronic venous insufficiency. Those who have doubts about the symptoms should play it safe and have their veins examined by a specialist. The condition, which can have serious consequences, is very treatable and it is worth seeking appropriate therapies for your well-being.

How is chronic venous insufficiency treated?
Dr. Salama: Treatment for chronic venous insufficiency includes lifestyle changes such as smoking cessation, weight loss and exercise. Medical interventions include minimally invasive treatments and surgery.

What are the treatment options?
Dr. Salama: The most conservative approach to treatment is compression stockings. These tight-fitting stockings support the legs and help optimize blood flow. Sometimes antibiotics are used to treat skin infections. Other medications may be prescribed to prevent blood clots or to treat dermatitis, fungus, or other conditions. These medications include topical creams and/or tablets. Sometimes a so-called Unna Boot, a medicated poultice, is also used.
Sclerotherapy is an injection therapy that uses a small needle to inject a medication into the veins that destroys the vein wall. This helps to close the vein completely so that it is soon broken down by the body.
Endovenous ablation is a minimally invasive therapy that uses radiofrequency or laser energy to close the problematic veins.

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