Peripheral Vascular Partners

Chronic Venous Insufficiency

What is Chronic Venous Insufficiency (CVI)?

Vein problems are among the most widespread chronic health conditions in the U.S. By age 50, nearly 40% of women and 20% of men have serious leg vein problems. At least 20 to 25 million Americans have varicose veins. Varicose veins, or enlarged veins found in legs and feet, are hereditary. They can often develop after pregnancy, trauma or injury. 


Chronic venous insufficiency (CVI) is a common cause of leg pain and swelling. CVI occurs when the valves of the veins do not close properly, and blood return from the leg veins is impaired. It is also associated with varicose veins.CVI may affect up to 20% of adults.

What are the causes of Chronic Venous Insufficiency (CVI)?

CVI is caused by either poorly functioning vein valves or blockage in the veins. Vein valves are designed to allow blood to flow against gravity from the legs back to the heart. When the valves fail to close properly, gravity wins and the flow reverses. This is called venous reflux. Vein valves may fail to close due to: 


  • Vein wall weakness that causes the vein to enlarge so that the valves cannot close 
  • A history of deep vein thrombosis (DVT), blood clots in the deep veins of the legs that damage the valve 
  • Being born without vein valves

Regardless of cause, when valves do not work properly, it can cause a buildup of venous pressure in the leg, leading to venous hypertension, or high blood pressure in the vein. This may result in enlargement of the varicose veins and over time an increased likelihood of other symptoms, such as swelling, skin changes, and chronic ulcers at the ankles or lower leg. 


Venous reflux is often the underlying cause of painful varicose veins, and it worsens over time. If left untreated, it can cause more advanced, or complicated, symptoms of CVI. Sometimes the source of the problem is not even in the legs, but in the pelvis or hip area. Blockage of the veins in the pelvic area may cause more severe symptoms of varicose veins and requires separate treatment. 

What are the symptoms associated with Chronic Venous Insufficiency (CVI)?

Varicose veins may cause no symptoms or immediate health problems. However, when varicose veins are associated with CVI, the most common signs are: 


  • Ankle and foot swelling that progresses up the lower leg 
  • Skin changes in the lower leg that include: 
  • Discoloration 
  • Eczema 
  • Scarring, or hard, thickened skin and ulceration (a break on the skin’s surface) 
  • Aching 
  • Restlessness 
  • Tiredness/leg fatigue 
  • Pain or throbbing 
  • Burning 
  • Itching 
  • Muscle cramping 


In advanced cases, breakdown of the skin may cause bleeding from varicose veins and blood clots (thrombophlebitis). 

How is Chronic Venous Insufficiency (CVI) treated?

CVI can be treated with various non invasive procedures

CVI is primarily diagnosed by physical examination. Methods to assist with diagnosis include: 


  • Doppler, a handheld instrument that allows the provider to listen to blood flow 
  • Venous duplex ultrasound exam, which provides an ultrasound image (a picture of the vein) to detect any blockage caused by blood clots or venous reflux. It is the most accurate and detailed method. 


Chronic Venous Insufficiency (CVI) is treated at Peripheral Vascular Partners using various therapies including Ablation therapy, Sclerotherapy and VenaSeal therapy.