Chronic venous insufficiency / Varicose veins: Symptoms and treatment
Η Chronic venous insufficiency is a condition in which the veins cannot return blood to the heart effectively, leading to blood pooling in the lower limbs . Varicose veins—dilated, swollen veins—are often a result of this condition and most commonly appear in the legs Professor of Vascular Surgery and Director of the Vascular Surgery Clinic at Athens Medical Centre,, Associate Professor of Vascular Surgery and Director of the 3rd Department of Vascular Surgery at Athens Medical Centre, explains venous insufficiency (varicose veins) and the available treatments.
What are chronic venous insufficiency and varicose veins?
Η Chronic venous insufficiency insufficiency occurs when the veins—mainly in the legs—do not function properly and struggle to return blood to the heart. This is usually due to venous valves failing to close correctly, allowing blood to stagnate or flow backwards (reflux). Varicose veins are a common sign of chronic venous disease: the veins become enlarged, twisted and visible under the skin, typically in the lower limbs.
Symptoms of Venous Insufficiency & Varicose Veins
Symptoms may include:
- Swelling of the leg of the legs or ankles, especially later in the day or after prolonged standing
- Feeling of heaviness or fatigue in the legs
- Aching pain or a burning sensation during activity or after standing for long periods
- Visible varicose veins (dilated, blue or purple veins) that may be swollen and uncomfortable.
- Pale or bluish skin discolouration around the affected veins, such as darkened spots or excessive dryness.
- Open sores/venous ulcers near the ankle that may heal slowly
- Muscle cramps particularly at night.
- Itching or irritation around the affected veins
Causes and Risk Factors
The causes and risk factors for venous insufficiency and varicose veins include:
Causes:
- Valve weakness/failure: valves may weaken or become damaged, causing reflux
- Genetic predisposition: inherited tendency towards weaker vein walls/valves
- Ageing: veins lose elasticity and valves may not close effectively
- Sedentary lifestyle or prolonged standing: reduces efficient venous return
Risk factors
- Increasing age: Οι μεγαλύτεροι σε ηλικία άνθρωποι είναι πιο επιρρεπείς στη φλεβική ανεπάρκεια.
- Female sex (often related to hormonal changes, pregnancy, or contraception): Women are more prone to developing venous insufficiency and varicose veins, mainly due to hormonal changes during pregnancy or the use of contraceptives.
- Pregnancy: The increased pressure on the veins in the legs during pregnancy can lead to varicose veins.
- Excess weight: Obesity increases pressure on the veins in the legs, worsening the condition.
- Family history: If someone in the family has varicose veins or venous insufficiency, the risk is higher.
- Lack of regular exercise: Lack of mobility reduces blood circulation and promotes fluid buildup in the veins.
- Smoking (may damage blood vessel walls and contribute to progression): Smoking can damage the walls of blood vessels and contribute to the development of varicose veins.
Treatment: venous insufficiency / varicose veins
Treatment depends on severity and individual needs.
1. Conservative management:
- Antiplatelet/anticoagulan(when appropriate) to relieve swelling, discomfort and inflammation
- Graduated compression stockingsto improve venous return and reduce swelling
- Regular exerciseto improve circulation and reduce symptoms
2. Interventional Methods:
- Sclerotherapyinjection of a sclerosant to close affected veins and relieve symptoms
- Ablation of superficial veins (using endovenous laser, radiofrequency, or medical adhesive (glue))
- Traditional open surgery (stripping of the vein) in selected cases
Preventing progression
- Avoid of prolonged standing or sitting
- Increase of daily physical activity(walking is particularly helpful)
- Maintain a healthy weight and avoiding obesity
If you notice swelling, pain, or skin changes in your legs, prompt specialist assessment is recommended. Visit Dr. Bisdas for a comprehensive evaluation and an individualised treatment plan aimed at improving quality of life and preventing complications.
