Chronic venous insufficiency (CVI) affects millions of people and is the leading cause of venous leg ulcers—wounds that refuse to heal despite months of standard care. Understanding this condition is the first step toward effective treatment and preventing serious complications.
What Is Venous Insufficiency?
Venous insufficiency occurs when the veins in your legs have trouble sending blood back to your heart. Normally, valves in your leg veins prevent blood from flowing backward. When these valves become weak or damaged, blood pools in the lower legs instead of returning to the heart efficiently.
This pooling creates increased pressure in the veins (venous hypertension), which damages surrounding tissue over time and can lead to painful, non-healing wounds.
Key Statistic:
Approximately 6-7 million people in the United States have venous insufficiency, and it accounts for 70-90% of all leg ulcers.
Causes and Risk Factors
Several factors can damage vein valves and lead to venous insufficiency:
Deep Vein Thrombosis (DVT)
Blood clots in deep leg veins can permanently damage valves. Even after the clot dissolves, valve function may not recover.
Age
Vein valves naturally weaken with age. CVI most commonly affects people over 50.
Pregnancy
Hormonal changes and increased blood volume during pregnancy put extra pressure on leg veins. Multiple pregnancies increase risk.
Prolonged Standing or Sitting
Jobs that require long periods of standing or sitting impair blood flow and strain vein valves.
Other Risk Factors
- • Obesity or excess weight
- • Family history of venous disease
- • Lack of physical activity
- • Smoking
- • Leg injuries or surgery
Recognizing the Symptoms
Early recognition is key. Venous insufficiency symptoms typically worsen throughout the day as blood pools in the legs:
Common Symptoms:
Why Venous Insufficiency Leads to Ulcers
Left untreated, chronic venous insufficiency progresses through stages:
Venous Hypertension
Pooled blood increases pressure in leg veins.
Inflammation & Damage
High pressure damages small blood vessels and surrounding tissue.
Skin Changes
Skin becomes discolored, thick, and fragile (lipodermatosclerosis).
Ulcer Formation
Damaged skin breaks down, creating an open wound that won't heal without addressing the underlying circulation problem.
Treatment Options
Effective treatment addresses both the underlying venous insufficiency and any existing ulcers:
Conservative Management
-
Compression Therapy: Medical-grade compression stockings (20-30 mmHg) are the cornerstone of treatment. They reduce swelling and improve venous return.
-
Leg Elevation: Elevate legs above heart level for 15-30 minutes several times daily.
-
Exercise: Walking activates calf muscle pump, helping push blood back to the heart.
Advanced Wound Care
For existing venous ulcers, regenerative therapies dramatically improve healing rates:
Amniotic Membrane Grafts
Provide growth factors and create optimal healing environment. 70-80% healing rate for venous ulcers.
Stem Cell Therapy
Promotes new blood vessel formation and tissue regeneration at cellular level.
Medical Procedures
In some cases, procedures to close or remove damaged veins may be recommended:
- • Endovenous ablation: Heat or laser closes damaged veins
- • Sclerotherapy: Chemical injection seals faulty veins
- • Phlebectomy: Surgical removal of diseased veins
The Bottom Line
Venous insufficiency is a progressive condition, but it's manageable with proper treatment. If you have symptoms of CVI or a venous ulcer that won't heal, advanced regenerative therapies combined with compression can help you achieve closure and prevent recurrence.