Chronic Venous Insufficiency

Chronic venous insufficiency occurs when blood in the leg veins fails to flow back up to the heart properly over long period of time. Pooling of blood in the leg veins can interfere with the way that your skin exchanges oxygen, nutrients and waste products with your blood. If the exchange is disrupted over a long period of time, complications may develop.

Causes of chronic venous insufficiency include:

  • Untreated varicose veins
  • Calf muscle pump failure
  • Previous history of deep venous thrombosis.

Chronic venous insufficiency is associated with the following complications:

  1. Varicose eczema

    Varicose eczema is a condition that causes your skin to become red, scaly and flaky. It may be itchy and associated with blisters and crusting of your skin.

  2. Lipodermatosclerosis

    Lipodermatosclerosis causes your skin to become hardened and leathery tight. It is associated with marked skin hyperpigmentation with dark brown colour. The condition usually affects the skin area (gaiter area) just above the ankle. Lipodermatosclerosis is a warning sign. Unless the underlying cause is treated, the patient is at high risk of developing a venous ulcer

  3. Venous ulcers

    Venous ulcers are damage and loss of skin above the ankle. They are common in patients with CVI. They are difficult to heal and often recur.

    Approximately about 20% of patients will develop venous ulcers around the ankle. For patients with varicose veins, endovenous techniques and surgical stripping offer patients with great chance for relief of symptoms and consequently improved in quality of life.

    Venous leg ulcer


The aim of treatment is to improve chronic venous insufficiency related symptoms and complications (eg ulceration) by improving the return of blood to the heart. Treatment option should be tailored to the cause of the problem. Treatment options include:

  • Minimally invasive endovenous interventions
    1. Endovenous ablation procedures
    2. Sclerotherapy
  • Surgery
    1. Vein stripping surgery
    2. Phlebectomy
  • Conservative management
    1. Compression therapy (eg Stocking /bandaging)
    2. Medications (eg Daflon, Pentoxifylline)

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