Chronic Venous Insufficiency (CVI)

Chronic venous insufficiency (CVI), also called venous insufficiency or venous reflux disease, happens when the valves inside your leg veins stop working the way they should, so instead of flowing back up to your heart, blood pools in your legs. Over time, this causes swelling, aching, and visible veins that get worse without treatment. CVI is progressive, meaning it won't go away on its own. The good news: it's a treatable vein condition, with minimally invasive options that get most patients back to normal activity within a day or two.

What Our Vein Doctors Look For

When you come in for a vein evaluation, our vein doctors start by understanding what's going on with your legs before recommending any treatment. A duplex ultrasound may be recommended to see how blood is flowing through your veins and check for reflux. A typical CVI evaluation includes:

• A physical exam of your legs
• A conversation about your symptoms, health history, and family history
• A review of your treatment options based on what we find

Because CVI has six recognized stages that range from spider veins to open ulcers, this evaluation helps your care team figure out exactly where you are and what treatment will help most. Schedule a free* evaluation with our vein doctors.

Schedule Your Free Vein Evaluation

*Subject to insurance eligibility

Symptoms of CVI

CVI symptoms show up in two ways: what you can see, and what you can feel. Symptoms often get worse at night, on hot days, or after long periods of sitting or standing.
Physical symptoms:

• Aching or throbbing legs
• Cramping
• Itching or burning
• Heaviness or fatigue in the legs
• Restless legs
• Leg pain that improves when you elevate your legs

Visual symptoms:

• Varicose veins
• Spider veins
• Leg or ankle swelling (edema)
• Skin discoloration, especially around the ankles
• Thickening skin
• Leg ulcers

What Causes CVI, and Who's at Risk?

Venous insufficiency develops when pressure builds up in the veins of your legs, a condition called venous hypertension. That extra pressure makes it hard for blood to flow back to your heart, so it flows backward through the vein valves instead. When those valves can't close properly, a condition called valvular incompetence, blood pools in the legs rather than moving on. CVI is a condition affecting up to 35% of adults in the United States, (1 in 2 women, and 1 in 3 men). Common causes and risk factors include:

• Genetics and family history of vein disease
• Age (vein valves naturally weaken over time)
• Pregnancy and hormonal changes
• Obesity
• A sedentary lifestyle or lack of exercise
• Jobs that require prolonged standing or sitting (teaching, nursing, hairdressing, and similar roles)
• A history of deep vein thrombosis (DVT) or blood clots

If CVI Goes Untreated

CVI is progressive. Left untreated, it can lead to more serious complications, including:

• Open sores or ulcers that can become infected
• Blood clots
• Post-thrombotic syndrome (a complication that can follow DVT)
• In rare cases, pulmonary embolism

If you notice new or worsening symptoms, it's worth talking to a vein specialist rather than waiting for things to improve on their own.

Treatment Options for CVI

Most cases of CVI are treated with minimally invasive procedures that target the source of the problem: the deeper, larger veins in your legs (often called the truncal or saphenous veins) where reflux usually starts. Closing off these veins reroutes blood to healthier veins nearby and relieves pressure.

Which treatment is right for you depends on your vein anatomy, your symptoms, and your lifestyle. Your vein specialist will walk you through the options during your evaluation.

Prevention and Long-Term Maintenance

There's no guaranteed way to prevent CVI, since genetics play a large role. But these wellness habits can help manage symptoms and support healthier circulation over time:

• Stay active with regular movement or exercise
• Wear graduated compression stockings, especially during long periods of standing or sitting
• Maintain a healthy weight
• Elevate your legs when resting
• Avoid prolonged sitting or standing when possible
• Stay hydrated

These strategies won't cure CVI, but they can make a real difference in day-to-day comfort, and they support the results of any treatment you receive.