Chronic Venous Insufficiency

Basic Facts

  • As people age, the veins located inside their legs may weaken and stretch. When veins weaken and lose the ability to pump blood effectively, a condition called chronic venous insufficiency (CVI) occurs.
  • Symptoms of CVI include varicose veins, skin problems such as sores, leg and ankle swelling, tight calves, and legs that feel heavy, tired, restless, or achy.
  • Veins return blood to the heart in two ways: either the force of the heart pumping fresh blood pushes blood back to the heart, or blood flows to the heart from the force of gravity. When blood has to fight gravity and flow up-stream back to the heart, the deep veins in the legs are utilized and the leg muscles contract to pump blood back toward the heart.
  • Vein walls are elastic, and many veins have small valves that only allow blood to flow in one direction. When leg muscles contract, they push inward against the elastic vein walls. This squeezes blood upward, opens the valves, and moves blood toward the heart. When leg muscles relax, the vein wall also relaxes and the valves inside the vein close to prevent blood from flowing backward. This method of pumping blood out of the legs is called the venous pump.
  • The venous pump is most effective when a person is walking and leg muscles are contracting. But when a person sits or stands, blood pressures in leg veins can build. Deep veins are usually able to withstand short periods of inactivity, but extended periods of increased pressure can stretch and weaken vein walls.
  • Increased blood pressure can stretch and damage vein walls. When this damage occurs, the veins may no longer be able to pump blood back to the heart.


Symptoms of CVI may include:

  • Varicose veins
  • Ulceration or skin breakdown
  • Lipodermatosclerosis (which may appear as a rash on the skin of the calves or ankles)
  • Reddened or discolored skin on the leg
  • Edema or swelling

Causes & Risk Factors

Venous hypertension (or, high blood pressure inside veins that persists over time) is a primary cause of CVI. The condition can also be caused by:

  • A thrombus (or, blood clot) that blocks blood flow in a vein, called deep vein thrombosis
  • Phlebitis (an inflammation of a superficial vein that causes a blood clot to form)

Risk factors may include:

  • Heredity
  • Obesity
  • Pregnancy
  • Sedentary lifestyle
  • Smoking
  • Jobs requiring long periods of standing or sitting in one place
  • Age and sex (women in their 50s are more prone to developing CVI)


Physicians can diagnose CVI after performing a careful medical history and physical examination. To confirm a diagnosis of CVI, the physician may also order one or more of the following tests:

  • Duplex ultrasound
  • Plethysmography
  • Venograms

Treatment Options

The primary goals of treatment for CVI are to restore a person to an active life and to minimize pain or disability. Typically, CVI does not pose a serious threat to life or limb, and with proper treatment, most people with this condition can continue to lead normal, active lives. In most cases, mild CVI can be treated on an outpatient basis with simple procedures. Treatment methods include:

  • Elastic compression therapy
  • Sclerotherapy
  • Vein stripping
  • Deep vein surgery
  • Valve repair

[NOTE: This is an abbreviated version of the complete article. If you would like to read this article in its entirety, please call our office at (307) 778‐1849 and ask to meet with one of our specialists to receive a ‘Prescription Pad’ registration form. If you already have a ‘Prescription Pad’ form, please login and follow the instructions listed on the form. If you experience any issues during the registration process, please call member services at 1 (800) 603-1420 for assistance.]

Medical Review Date: July 28, 2008 / Copyright © 2012 NorthPoint Domain, Inc. All rights reserved. This material cannot be reproduced in digital or printed form without the express consent of NorthPoint Domain, Inc. Unauthorized copying or distribution of NorthPoint Domain’s Content is an infringement of the copyright holder’s rights.