Doctor’s Insights: Chronic Venous Insufficiency
In the News and In Your Legs
When the President of the United States was recently diagnosed with chronic venous insufficiency (CVI), it sparked a flurry of headlines and Google searches - but for millions of Americans living with heavy, swollen legs, this condition has been a daily concern for years.
CVI is often brushed off as a cosmetic issue or a natural part of aging. However, according to Partha Sardar, MD, an interventional cardiologist with advanced training in endovascular and vascular care, that misconception can delay treatment and lead to serious complications.
We connected with Dr. Sardar to discuss what CVI actually is, why it’s more than just “tired legs,” and how modern treatment options are helping patients.
What is Chronic Venous Insufficiency (CVI), and what causes it?
Chronic Venous Insufficiency is a condition where the leg veins have trouble returning blood to the heart due to weakened or damaged valves. This leads to blood pooling in the legs, causing increased venous pressure and symptoms like swelling, discomfort, and skin changes.
CVI develops gradually and is often linked to prior DVT (deep vein thrombosis), varicose veins, leg trauma, obesity, prolonged sitting or standing, inactivity, smoking, and family history. Early detection is key to managing progression.
What are some common symptoms of CVI that patients should watch for?
Symptoms range from subtle to severe. Early signs include swelling in the legs or ankles, heaviness, aching, and cramping or burning sensations—often worse with standing and relieved by leg elevation.
As CVI progresses, skin may become dry, itchy, or discolored, especially near the ankles. Varicose veins and slow-healing leg ulcers may also develop. Even “tired legs” can be an early warning sign.
Who’s most at risk for CVI, and what are some of the biggest misconceptions you hear about it?
CVI risk increases with age, especially after 50, and is more common in women—but also affects many men. Other risk factors include obesity, family history, DVT, leg trauma, pregnancy, sedentary lifestyle, and prolonged sitting or standing.
Common misconceptions about CVI:
- “It’s just cosmetic.” CVI can cause pain, swelling, skin damage, and ulcers—not just visible veins.
- “CVI is related to heart failure.” CVI and CHF are separate; both can cause leg swelling but have different causes.
- “Only women get CVI.” Many men, particularly over 50, are affected.
- “Compression stockings cure it.” They help manage symptoms but do not reverse the condition.
What treatment options are available, and how do you decide what’s right for each patient?
Treatment depends on symptom severity and overall health. Initial steps include lifestyle changes: staying active, elevating legs, managing weight, and avoiding prolonged sitting or standing. Compression stockings help improve circulation and reduce swelling.
If symptoms persist, minimally invasive procedures like sclerotherapy, radiofrequency ablation (RFA), or endovenous laser therapy (EVLT) may be used to close or remove affected veins. Treatment is personalized to ensure the best outcome.
What happens if CVI is left untreated? Is it dangerous?
Untreated CVI often worsens. Swelling may become chronic, and the skin can darken, thicken, or develop inflammation. Venous ulcers may form and are slow to heal, increasing infection risk.
Though not usually life-threatening, CVI can significantly impair mobility, daily function, and quality of life. Early diagnosis and treatment help prevent serious complications.
What advice do you give to someone who’s just been diagnosed with CVI?
Take early steps to manage CVI: stay active, elevate your legs, maintain a healthy weight, and avoid long periods of standing or sitting. Use compression stockings as recommended to reduce swelling.
Moisturize daily and watch for skin changes. Stay in touch with your healthcare provider for regular follow-up. While CVI is chronic, consistent care can keep symptoms under control and improve quality of life.
Key Takeaway
CVI may be common, but it’s far from harmless. Left untreated, it can chip away at quality of life - however, with early recognition and expert care, patients can stay ahead of symptoms and avoid serious complications.
As Dr. Sardar puts it, “CVI is manageable - if you take it seriously.”
Related