Chronic venous insufficiency ? You're Not Alone !

Chronic Venous Insufficiency (CVI) is a medical catch-all term that refers to a variety of circulatory problems, usually involving the legs.

These circulatory problems start when blood begins to pool in the veins, stretching delicate vein tissue and producing tell-tale symptoms that may include spider veins, varicose veins, and localized swelling (or in medical-ese: "edema"). As time goes by, progressive damage to tiny one-way valves inside the veins produces the cluster of painful and distressing symptoms known as Chronic venous insufficiency.

Thanks in part to our sedentary lifestyle, greater longevity, diet, and other factors, vein problems today afflict large segments of the world's adult population. Chronic Venous Insufficiency (CVI) involving the lower limbs is estimated to affect from 10-50% of men and 50-55% of women, while varicose veins make their unwanted appearance in as many as 33% of adult women and 20% of men. [Italian College of Phlebology]. Some studies suggest that varicose veins are one of the top three medical conditions, trailing only allergies and high blood pressure in overall prevalence. [Vannoni]

The vast majority of Chronic Venous Insufficiency (CVI) sufferers are women (by approximately 10 to 1). Vein problems also tend to appear at an earlier age in women than in men. [Boccalon]. By the age of 50, about 41% of women have developed some type of abnormal leg vein symptom.
While unsightly varicose veins can represent a significant source of frustration and distress for both men and women, Chronic Venous Insufficiency (CVI) is far more than just an "appearance" issue. Chronic Venous Insufficiency (CVI) takes a significant toll on such basic activities as climbing stairs, performing household chores, and the ability to simply stand for extended periods of time.

As Chronic Venous Insufficiency (CVI) progresses, leg ulcers may result in as many as 1% of the population, a potentially serious complication which tends to increase with age. [Simka]. Studies examining "quality of life" issues have observed that over 80% of leg ulcer sufferers report that the condition adversely affects their mobility, and can produce emotional feelings of anger, resentment, depression, and social isolation in addition to moderate to severe physical pain [Phillips]. And as if that weren't bad enough, the financial costs associated with Chronic Venous Insufficiency (CVI) have been estimated at more than $1 billion annually in the United States alone, according to one 2003 study. [Simka].

What Causes Chronic Venous Insufficiency ?

The short if not exactly sweet answer is that Chronic Venous Insufficiency results from damage to the one-way valves located inside the veins. This damage can stem from a variety of sources, including blood clots; trauma (injury) to the vein; high venous pressure; or simple progressive weaking of the vein wall from age. But to get a better understanding of Chronic Venous Insufficiency, it's important to look at the overall role that veins play in the body.

Our hearts push nutrient- and oxygen-rich blood out to the tissues through an array of branching arteries. Veins collect and feed blood back to the heart for re-oxygenation. But this return trip is anything but simple. For one thing, blood from our extremities has an uphill fight against gravity to reach the heart. And while the rhythmic influx of fresh blood provides a certain indirect push for the depleted blood, we don't have heart muscle beating at the tip of our toes to force blood back along its long return journey.
What we do have in our legs, however, are muscles located along the deep leg veins which actually contract to help "pump" blood back to the heart. This process works most effectively when the large leg muscles are active, as, for example, when you're walking. Long periods of sitting or standing tend to produce increased pressure inside the deep leg veins, as the blood moves back to the heart more sluggishly.

Working in parallel with the deep leg veins is another, more superficial, network of veins, located closer to the skin and carrying blood at far lower pressures. Connecting these two vein systems are "perforator" channels. If a faulty valve or blood clot increases pressure inside the deep veins, the perforator channels in turn "bleed off" excess pressure into the spidery superficial veins. These normally very small, elastic veins can in turn stretch and balloon, and additional one-way valves can be damaged.

One-way valves, as we've seen, are crucial to the success of the veins' pumping action. When these valves are not effective in preventing a backflow of blood, the result is Chronic Venous Insufficiency : chronic venous insufficiency.

Age alone increases the risk of Chronic Venous Insufficiency to some extent, since some loss of muscle tone and blood vessel elasticity typically accompanies the aging process. Other Chronic Venous Insufficiency risk factors include heredity; obesity; pregnancy; and smoking. Since long periods of sitting or standing can tend to promote blood pooling and reduce effective blood flow, Chronic Venous Insufficiencyalso tends to be job-related. Tight-fitting clothing such as girdles or boots can also contribute. Even as seemingly unrelated a conditon as constipation -- also a more prevalent condition for women and linked at least in part to inactivity -- may be a co-occurring condition or may, as a result of increased pressured from straining, directly contribute to Chronic Venous Insufficiency.