Chronic venous insufficiency (CVI) occurs when there is a long-term problem with the valves inside the veins. Vein valves are tiny, one-way flaps inside the vein that keep blood moving back toward the heart. When these valves become weakened or damaged because of genetics, pregnancy, injury or aging, they allow blood to flow backward and pool inside the vein. This can lead to bulging, ropy veins and skin changes. While this condition is not usually a serious health threat, it is often painful and disabling. Symptoms of CVI include:
- Swelling in the lower legs and ankles (especially after extended periods of standing)
- Aching or tiredness in the legs
- New varicose veins
- Leathery-looking skin on the legs
- Flaking or itching skin on the legs or feet
- Stasis or venous stasis ulcers (a breakdown of skin caused by fluid build-up in the skin from poor vein function)
According to the Cleveland Clinic, a multispecialty academic medical center in Cleveland, Ohio, an estimated 40% of people in the United States struggle with CVI. They also report it occurs more frequently in people over age 50 and more often in women than in men.
Chronic venous insufficiency stages
The treatment for CVI depends on how far the vein disease has progressed and is measured in stages. Health professionals use standard Clinical, Etiological, Anatomical and Pathophysiological (CEAP) classifications to quickly diagnose the exact progression of and treatment options for CVI. While all four letters can be used, it is often staged using just the C or clinical classifications. Here is a complete list of clinical classifications:
Clinical staging shows how the disease is affecting your body. Each C stage below is also given an A or B classification. A means there are no symptoms and B means there are symptoms. For example, stage C3A means your legs are swollen, but you are not experiencing pain. Using this standard, doctors can quickly assess the degree of swelling, overall skin quality and vein function and assign an appropriate clinical classification:
- CO: No visible signs
- C1: Visible veins or blood vessels
- C2: Varicose (bulging) veins
- C3: Edema (swelling)
- C4: Changes to skin quality (color, temperature, moisture level, elasticity, etc.)
- C4a: This stage often involves red, itchy skin as well as small brown or grey markings.
- C4b: This stage involves more drastic or painful changes to the skin like thickening or hardening.
- C4c: This stage involves visible veins and blood vessels around your ankles, a condition called corona phlebectatica.
- C5: Healed ulcers
- C6: Open ulcers
Risk factors for chronic venous insufficiency
If you have any of the following risk factors for CVI, you are more likely than other people to develop the disease:
- Deep vein thrombosis
- Varicose veins or a family history of varicose veins
- Extended periods of standing or sitting (regularly)
Winter is the best time to get treatment for vein diseases like spider veins, varicose veins and chronic venous insufficiency. Not only are swelling and vein dilation less during cooler months, but it will also make wearing compression stockings (if needed) much more comfortable. Visit a Virginia Vein Care location near you and talk to one of our skilled vein care specialists to get started.