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Venous insufficiency: causes, treatment, symptoms

by Josephine Andrews
Published: Last Updated on 312 views

Venous insufficiency is understood to mean a disrupted function of the veins, which is usually caused by an obstructed blood flow. The veins on the legs are usually affected by venous insufficiency. Doctors also refer to the clinical picture as venous insufficiency. Read more about the causes and treatment of venous insufficiency!

ICD codes for this disease:

ICD codes are internationally valid codes for medical diagnoses. They can be found, for example, in doctor’s letters or on certificates of incapacity for work.

I87O22 _

quick overview

  • Symptoms: spider veins, varicose veins, water retention, brown and bruises, skin changes
  • Treatment: compression stockings, removal of varicose veins
  • Causes and risk factors: hereditary predisposition, standing and sitting for long periods of time, female gender, older age, overweight
  • Diagnostics: Physical and ultrasound examination
  • Course and prognosis: If treated early, the progression of venous insufficiency can be slowed down. Possible complications are varicose veins and thrombosis
  • Prevention: Regular exercise, healthy nutrition, vein exercises

What is venous insufficiency?

In the case of venous weakness, medically called venous insufficiency, the function of the veins is partially disturbed. The veins are the blood vessels that collect the deoxygenated blood from the periphery of the body and transport it back to the heart. The heart pumps it into the pulmonary circulation. Here it is oxygenated again, flows back to the heart and then through the arteries to the tissues and organs.

Since the veins, which are below the heart, transport the blood up to the heart against gravity, they have a special structure. Inside there are so-called vein valves, which, like a valve, prevent the blood from flowing back.

Venous insufficiency usually begins with a gradual failure of these venous valves. If these no longer close properly, the evacuation of the blood is impaired. It builds up in the upstream vein sections. Over time, the pressure exerted by the slumped blood causes the wall of the vein to give way and the vein widens.

Such dilated veins finally appear on the skin surface as fine spider veins resembling a spider’s web or – in the case of larger veins – as bluish, tortuous, clearly protruding varicose veins. If the venous insufficiency progresses, in some cases a clinical picture develops: chronic venous insufficiency (CVI).

What are the symptoms?

People with venous insufficiency often complain of swollen, tired or aching legs, especially at the end of the day. The symptoms often increase, especially in the warm summer months, as the blood vessels expand due to the heat.

The symptoms of venous insufficiency vary depending on the severity. Possible signs of venous insufficiency are:

  • Small, reddish to bluish spider web-like fine vein markings, so-called spider veins, which mainly appear on the side or back of the thighs
  • Clearly protruding veins, especially on the lower leg, calf or behind the knee
  • Varicose veins: They are usually found on the lower leg and calf and are easily recognizable by the bulging, thickened, tortuous bluish veins.
  • Fluid retention (oedema) in the ankles or lower legs
  • Skin changes: brownish pigmentation in the ankle area, dry, scaly, itchy skin areas (eczema) or open skin patches. Such changes indicate chronic venous venous insufficiency.

How is venous insufficiency treated?

Which therapy is suitable for venous insufficiency depends primarily on its severity. An important step in treatment is to help blood flow in the veins. Compression stockings or bandages, for example, are helpful here. They compress the veins, which prevents blood from backing up.

In the case of pronounced symptoms of venous insufficiency, such as severe edema, doctors often prescribe draining medication. They treat skin eczema with moisturizing and sometimes also anti-inflammatory creams and ointments.

Spider veins bother those affected mostly for cosmetic reasons. From a medical point of view, they do not necessarily require therapy. However, it is possible to have them sclerosed by a doctor. To do this, he injects a chemical substance into the affected vessel (sclerotherapy). The method is also suitable for small varicose veins of superficial veins.

In the case of larger varicose veins, on the other hand, it is often necessary to remove the affected vein sections for health reasons. This happens, for example, as part of an operation (vein stripping) or when the doctor closes the affected vessel sections using radio waves or a laser.

You can read more information about varicose veins and how they are treated here .

Some people use home remedies or ointments for venous insufficiency that contain horse chestnut extract, for example. There is evidence that the horse chestnut relieves symptoms of chronic venous insufficiency, such as pain, itching or edema.

Home remedies have their limits. If the symptoms persist over a longer period of time, do not get better or even get worse, you should always consult a doctor.

What is the cause of venous insufficiency?

The cause of venous insufficiency is often a hereditary predisposition. A vein problem usually affects several members of a family. The risk of venous insufficiency also increases with age. Most of those affected notice the first signs from around the age of 30, rather later.

Women are much more frequently confronted with vein problems such as venous insufficiency, spider veins or varicose veins. The special structure of the connective tissue is probably one reason for them. The female sex hormones, especially estrogen, also ensure loose connective tissue. Therefore, pregnancy, during which the estrogen concentration is particularly high, is also considered a risk factor for venous insufficiency.

In addition, obesity and previous blood clots in the veins (thrombosis) increase the risk of venous diseases. Activities that involve sitting or standing for long periods also promote vein problems such as venous insufficiency.

How is venous insufficiency diagnosed?

For the diagnosis of venous insufficiency, it is advisable to consult a specialist in vascular and venous diseases (phlebologist). In a detailed conversation, he first inquires about the medical history (anamnesis). Among other things, he asks whether several family members have to do with venous insufficiency or other vein problems and whether thrombosis has occurred in the past.

During the subsequent physical examination, the doctor looks at the veins in the patient’s legs. He pays particular attention to whether spider veins or varicose veins can be seen. Swellings on the legs or skin changes give important indications of venous insufficiency: They point to chronic venous insufficiency.

An ultrasound examination can be used to assess the condition of the veins. The doctor recognizes, for example, whether the venous valves are defective. A special procedure, known as Doppler sonography, makes the blood flow within the vein visible. The doctor discovers a disturbed blood flow or possibly a blood clot.

How does venous insufficiency progress?

The course of venous insufficiency depends primarily on the degree of its severity. If you have a mild, incipient vein weakness treated early, it is usually possible to stop or at least slow down its progression. If varicose veins already exist as a result of venous weakness, the risk of other diseases such as venous thrombosis increases.

How can venous insufficiency be prevented?

Since venous insufficiency is inherent in many cases, it often cannot be avoided in principle. However, there are some measures that can prevent vein problems from getting worse:

  • Move as often as possible, do sports several times a week, for example cycling, swimming or walking. Take the stairs instead of the elevator or escalator.
  • If you spend a long time sitting or standing, do foot exercises. Try this exercise: alternately move the toes towards the shins and the floor. Rock your heels to your toes and back several times, letting your feet rotate.
  • Try to avoid being overweight by paying attention to your diet, ie eating lots of fresh fruit and vegetables and little sweets and fat . Excess kilos favor and aggravate venous insufficiency.

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