Vascular - CVI

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Vascular testing is be required in the diagnosing and treatment of certain podiatric foot conditions.

Vascular testing is particularly relevant for patients with high-risk diabetes, poor circulation, peripheral artery disease (PAD), and chronic venous insufficiency (CVI).  (link to PAD)

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What is Chronic Venous Insufficiency?

Chronic venous insufficiency (CVI) is a form of venous disease that occurs when veins in your legs are damaged. As a result, these veins can’t manage blood flow as well as they should, and it’s harder for blood in your legs to return to your heart. CVI causes blood to pool in your leg veins, leading to high pressure in those veins.

CVI can happen due to damage in any of your leg veins.

These include your:

• Deep veins, which are large veins deep in your body that run through your muscle.

• Superficial veins, which are close to your skin’s surface.

• Perforating veins, which connect your deep and superficial veins.

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CVI may cause mild symptoms at first. But over time, this condition may interfere with your quality of life and lead to serious complications.

Chronic venous insufficiency vs. post-thrombotic syndrome

Both terms refer to the same problem of damaged leg veins. Post-thrombotic syndrome is chronic venous insufficiency caused by deep vein thrombosis (DVT).

DVT is a blood clot in a deep vein in your leg. “Post-thrombotic” means after a blood clot (which is also called a “thrombus”). After the blood clot is gone, it can leave scar tissue that damages your vein.

About 20% to 50% of people who’ve had DVT develop post-thrombotic syndrome, usually within one to two years.

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How common is chronic venous insufficiency?

Venous disease in general is very common. For example, varicose veins affect about 1 in 3 adults. Each year, about 1 in 50 adults with varicose veins go on to develop chronic venous insufficiency.

Chronic venous insufficiency usually affects people over age 50. The risk goes up the older you get.

Overall, chronic venous insufficiency affects about 1 in 20 adults.

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How does chronic venous insufficiency affect my body?

Chronic venous insufficiency slows down blood flow from your legs back up to your heart. Without treatment, CVI raises the pressure in your leg veins so much that your tiniest blood vessels (capillaries) burst. When this happens, the skin in that area takes on a reddish-brown color and can easily break open if bumped or scratched.

These burst capillaries can cause:

• Tissue inflammation in that area.

• Tissue damage.

• Venous stasis ulcers. These are open sores on your skin’s surface.

Venous stasis ulcers don’t heal easily, and they can become infected. The infection could spread to nearby tissue. This condition is known as cellulitis, which is dangerous if not treated right away.

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Symptoms and Causes

Chronic venous insufficiency causes many symptoms in your legs and feet. The symptoms may get worse, or you may notice new symptoms, as your condition progresses.

What are the signs and symptoms of chronic venous insufficiency?

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Chronic venous insufficiency signs and symptoms include:

• Achy or tired legs.

• Burning, tingling or “pins and needles” sensation in your legs.

• Cramping in your legs at night.

• Discoulored skin that looks reddish-brown.

• Oedema (swelling) in your lower legs and ankles, especially after standing a while or at the end of the day.

• Flaking or itching skin on your legs or feet.

• Full or heavy feeling in your legs.

• Leathery-looking skin on your legs.

• Ulcers (open sores), usually near your ankles. If they’re very painful, they may be infected.

• Varicose veins.

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Severe oedema in your lower leg can cause scar tissue to develop. This scar tissue traps fluid in your tissues. Your calf may feel large and hard to the touch. When this happens, your skin is more vulnerable to persistent ulcers.

You may not have all of these issues at once. Instead, you may only have one or two. Your signs and symptoms depend on how far your condition has progressed.

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