Home Vein Disorders Chronic Venous Insufficiency

Chronic venous insufficiency (CVI) is a circulation issue that makes it harder for blood in your veins to return to your heart, most often in the legs. When tiny valves inside the veins weaken or become damaged, blood can flow backward and collect in the lower legs. Over time, that pressure can lead to swelling, discomfort, skin changes and sores.

If you’re noticing persistent heaviness, swelling or visible vein changes, it’s important to get checked sooner rather than later. Learn more about chronic venous insufficiency, common symptoms and how the team at Vein Centers of Connecticut can help you move forward with a personalized plan.

What Is Chronic Venous Insufficiency?

Inside your veins are small one-way valves that help push blood upward, especially from your legs, back toward your heart. When those valves don’t close how they should, blood can drift backward, settle in the lower legs and apply extra pressure that drives many CVI symptoms.

Chronic venous insufficiency describes long-term valve weakness and the circulation changes that follow. It can involve superficial veins near the skin, deeper veins in the legs, or both. Many patients experience a heavy, tired feeling in their legs, along with swelling that tends to worsen as the day progresses.

CVI may also be referred to as chronic venous disease or venous stasis. In some cases, the condition can develop after a blood clot (deep vein thrombosis), also known as post-thrombotic syndrome.

When left untreated, chronic venous insufficiency can progress and may lead to complications such as:

• Skin darkening or discoloration
• Redness, irritation or inflammation
• Hardening or thickening of the skin near the ankles
• Scarring and tissue changes
• Cellulitis (skin infection)
• Venous stasis ulcers (slow-healing sores)
• Infection related to open sores

Chronic venous insufficiency is common, and the risk tends to increase after age 50, as well as with other vein conditions like varicose veins or a history of blood clots. Even if your symptoms feel mild right now, early evaluation can help prevent long-term skin and circulation changes.

Symptoms of Chronic Venous Insufficiency

CVI symptoms often start gradually. Some people notice them only after a long day on their feet, while others feel discomfort more consistently. Early signs of chronic venous insufficiency may include:

• Swelling in the legs, ankles or feet
• A heavy, tight, achy or itchy feeling in the lower legs
• Areas of reddish-brown discoloration on the lower legs
• Varicose veins that continue to worsen over time
• Sores that heal slowly or keep returning

As chronic venous insufficiency progresses, symptoms may also include:

• Worsening aching, throbbing or fatigue in the legs
• Increasing pain when standing that improves with leg elevation
• Persistent tingling or burning sensations
• More noticeable edema (visible swelling)
• Dry, fragile skin that cracks easily
• Hard, thickened skin around the ankles
• Open sores or ulcers that look red, crusted or irritated and take longer to heal

Causes of Chronic Venous Insufficiency

Chronic venous insufficiency typically develops when vein valves weaken over time or vein damage disrupts normal blood flow. Several factors can increase your risk, including:

• Varicose veins or other chronic vein problems
• A history of deep vein thrombosis (DVT) or blood clots
• A family history of vein disease
• Excess weight, which increases pressure in the leg veins
• Pregnancy
• Jobs that require long periods of standing or sitting
• Reduced activity levels
• Being middle aged or older
• Past leg injury, trauma or surgery
• High blood pressure or other circulation-related conditions

Treatment and Diagnosis

At Vein Centers of Connecticut, diagnosis typically starts with a physical examination and conversation about what you’re feeling. We’ll evaluate your legs while you sit and stand, review your medical history and talk through symptoms and lifestyle.

An ultrasound is also part of every consultation. This non-invasive imaging test helps us assess vein structure and measure blood flow, including whether reflux is present and which veins are affected.

Based on your evaluation, your treatment plan may include one or more of the following:

• Lifestyle Changes to Improve Blood Flow: Simple steps include elevating your legs, walking regularly, avoiding long periods of sitting or standing, and wearing compression stockings.
• Medications and Symptom Support: If needed, medications may be used to address inflammation, support circulation, or treat skin irritation and infection. If ulcers are present, your plan may also include antibiotics or other targeted care based on your condition.
• Wound Care: If CVI has led to skin breakdown or ulcers, we’ll recommend an approach that supports healing and protects the skin barrier, including topical treatments and dressing guidance.
• Weight Management: When added pressure contributes to symptoms, even modest weight loss can improve circulation and reduce strain on vein valves.
• Ambulatory Phlebectomy: For certain varicose veins near the surface, this in-office procedure removes the vein through a series of very small incisions.
• Radiofrequency Ablation: This minimally invasive treatment uses heat to shrink and close unhealthy veins and redirect blood flow to healthier veins.
• Sclerotherapy: A targeted solution is used to close smaller varicose veins or spider veins so the body can naturally absorb them over time.