What is chronic venous insufficiency?

It’s a very common condition. That’s one thing Dr. Scott Musicant, a vascular surgeon with Sharp Community Medical Group and affiliated with Sharp Grossmont Hospital, wants people to know about the condition President Donald Trump was recently diagnosed with. “We see it every day in my office,” he says.

Dr. Musicant is talking about chronic venous insufficiency (CVI), a type of chronic venous disease common in older adults. According to the American Heart Association, CVI is related to an increased risk for heart issues, specifically cardiovascular disease, and is associated with advanced age, obesity, smoking and a sedentary lifestyle.

“Chronic venous insufficiency is a pretty common syndrome, where we see patients who have abnormal vein flow out of their legs back to the heart,” Dr. Musicant says. “Arteries take blood from the heart down to the feet, and veins are responsible for returning blood to the heart. The veins have valves inside them that allow blood to go in one direction. However, if those valves become abnormal, then you get chronic venous insufficiency and high pressure in the lower legs.”

The result is that blood pools in the legs, which can cause swelling, varicose veins and skin changes, including red, itchy patches. Symptoms of CVI include:

• Pain

• Itch

• Bleeding

• Aching

• Cramping

• Throbbing

• Leg fatigue

• Heaviness

• Restless leg

“I think the main complications we see are with regard to pain, heaviness and throbbing over time,” Dr. Musicant says. “You can also get dilated varicose veins as a result of CVI. When things get really severe, you can actually end up with ulcers or sores that develop over time.”

Treating CVI

According to Dr. Musicant, the best treatment for CVI is prevention. “Being active, walking a lot, and controlling your weight can significantly decrease your risk of chronic venous insufficiency,” he says.

However, if you are seeing signs of CVI, talk with your doctor about your concerns and what can be done to provide relief and prevent the worsening of the condition. Dr. Musicant says that treatment usually includes:

• Compression therapy, which can include the use of stretch bandaging, elastic garments, graded compression stockings and pneumatic pumps

• Medications, such as topical anti-inflammatory steroid medications, antibiotics and diuretics

• Minimally invasive procedures, during which a catheter is inserted into a vein in the leg using local anesthesia to close off veins with abnormal reflux

“I usually recommend that people with CVI wear compression socks when they're standing, walking or sitting for long periods, particularly during long plane flights or car rides,” says Dr. Musicant. “Elevation is also effective. But don't be afraid if your doctor refers you to a vascular specialist for further consultation. We see patients with CVI every day, and not everyone will require medications or treatments.”

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