Chronic venous insufficiency ( CVI ) is a blood flow disorder in the venous blood vessels in the legs. This condition is characterized by pain and swelling in the legs.
Veins have valves that help blood flow from the rest of the body back to the heart. On CVI, the valves do not work properly. The condition makes blood unable to flow to the heart so it accumulates in the leg veins.
Chronic venous insufficiency is a disease that develops in the long term (chronic). This disease should be treated immediately so as not to cause serious complications.
Causes of Chronic Venous Insufficiency
Chronic venous insufficiency occurs due to blockage or interference in the function of valves in the veins. This condition can be caused by:
- A congenital disorder that causes weak venous valves from birth
- Leg injuries that cause wounds to veins or venous valves, can be due to accidents or surgical complications
- Damage to the venous valve due to vein blockage in the leg, one of which is due to deep vein thrombosis (DVT)
- The habit of sitting or standing for too long makes the venous valve weak
- Lack of activity or exercising, either because you are old or have been injured
- Tumor in the pelvic area
Risk factors for chronic venous insufficiency _ _ _
There are several factors that can increase the risk of damage to the venous valve, namely:
- Age above 50 years
- Female sex
- Consumption of birth control pills
- Smoking habits
- High blood pressure or hypertension
- Less consumption of fibrous food
- Overweight or obesity
- Have suffered from deep vein thrombosis
- History of chronic venous insufficiency in the family
- Jobs that require standing or sitting for long periods of time
Symptoms of Chronic Venous Insufficiency
Chronic venous insufficiency can cause the sufferer to experience a number of symptoms in the legs, namely:
- Swelling or heaviness
- Swelling of veins or varicose veins
- Restless feeling that you always want to move your legs ( restless leg syndrome )
- Skin color turns dark
- Cramps or tension
When should you go to the doctor?
Check with a doctor if you experience the above symptoms. If not treated properly, CVI can cause capillary blood vessels to swell and burst. These conditions can increase the risk of infection or cellulitis in the tissue around blood vessels, as well as the appearance of wounds that are difficult to treat.
Immediately check with a doctor if your leg is swollen, especially if it happens after sitting or standing for too long.
Diagnosis of Chronic Venous Insufficiency
To ensure that the swelling in the leg is caused by CVI, the doctor will ask about the event that triggered the swelling, as well as any diseases that the patient has or is currently suffering from. The doctor will also perform a physical examination and further examination, in the form of:
Duplex USG on the leg
Duplex USG aims to check the speed and direction of blood flow in the Doctor will attach and press the USG device to the patient's swollen leg.
procedure aims to see the condition of veins suspected to be affected by CVI, with the help of X-rays and special dyes (contrast).
MRV ( Magnetic Resonance Venography )
This method aims to see the condition of veins suspected to be affected by CVI, with the help of magnetic waves.
Chronic Venous Insufficiency Treatment
In mild CVI, the doctor will recommend the patient to exercise regularly and not sit cross-legged. If possible, position your feet higher than your heart when sitting or lying down.
The doctor will also advise the patient to use compression stockings. These stockings can help improve blood flow so that swelling in the legs can be reduced. To be effective, consult with a doctor regarding the right type of socks.
If the use of compression stockings is not effective, there are several other treatment methods that can be used to relieve CVI, namely:
Some types of drugs that can be consumed to overcome CVI are:
- Antibiotics, to treat infections caused by open wounds on the skin
- Anticoagulant drugs (blood thinners), such as warfarin and rivaroxaban , to prevent blood clotting
- Diuretic drugs , such as furosemide, to reduce the accumulation of fluid in the body
- Drugs to improve blood flow, such as pentoxifylline
Non-surgical medical procedures
This procedure aims to close the injured vein so that blood will flow through another vein. There are three methods that can be done, namely:
- Sclerotherapy , which is by injecting a special drug into the problematic vein
- Endovenous laser ablation , which is by heating the problematic vein using laser light
- Radiofrequency ablation (RFA), which is by heating the injured vein using high frequency radio waves
Surgical procedures _
In severe enough CVI, the doctor will recommend surgery. The purpose is to:
- Repairing damaged veins or valves
- Lifting the veins affected by CVI
- Perform a new vein graft ( venous bypass ) so that the blood flow does not pass through the vein that has CVI
- Tying or closing damaged veins
Complications of Chronic Venous Insufficiency
Some of the complications that can appear as a result of chronic venous insufficiency are:
- Deep vein thrombosis
- Pulmonary embolism
- Leg ulcers ( stasis ulcers )
- An increasing number of venous vessels that suffer from CVI.
Prevention of Chronic Venous Insufficiency
A person who has a family history of CVI can reduce the risk of contracting this disease by taking the following steps:
- Stop smoking
- Exercise regularly
- Consume healthy, balanced nutritious food
- Avoid sitting or standing for too long
- Do not wear clothes or belts that are too tight
- Maintain an ideal weight