CONDITIONS · MARYLAND & VIRGINIA
Venous Insufficiency & Varicose Veins
Heavy, aching legs, swelling and prominent veins can reflect chronic venous insufficiency (CVI), a problem with blood returning toward the heart. Learn how a vein evaluation can clarify your options.
What is chronic venous insufficiency (CVI)?
Leg veins rely on one-way valves to keep blood moving toward the heart. When vein walls or valves do not work well, blood can pool and pressure can build in the legs. This long-term problem is called chronic venous insufficiency, or CVI. Varicose veins are enlarged, twisted veins that may occur with venous insufficiency, but the terms do not mean exactly the same thing.
CVI, varicose veins and spider veins are different
CVI describes impaired blood return and increased pressure in the leg veins. Varicose veins are larger, bulging veins that may ache or swell. Spider veins are smaller surface veins and are often primarily a cosmetic concern. An examination and, when appropriate, ultrasound help determine whether visible veins are connected to a deeper valve problem.
More than a change in appearance
- Leg aching, heaviness, fatigue or swelling, often after standing.
- Bulging varicose veins, itching, skin irritation or changes in skin color.
- Thickened skin or a slow-healing sore near the ankle in more advanced disease.
Who is more likely to develop venous insufficiency?
- A history of deep vein thrombosis or another condition that damaged leg veins.
- Pregnancy, obesity, reduced mobility, or sitting or standing for long periods.
- Older age or a family history of venous insufficiency or varicose veins.
A closer look with ultrasound
A history, examination and, when appropriate, a venous duplex ultrasound help assess flow and valve function. Your clinician considers whether symptoms match the findings and whether other circulation concerns need attention.
From daily care to vein treatment
A care plan may include movement, elevation and appropriately prescribed compression. For selected symptomatic veins, a procedure such as endovenous ablation may be discussed. Treating one vein does not guarantee that all visible veins or symptoms will disappear.
Tell us what matters to you
Describe whether your main concern is discomfort, swelling, skin changes or appearance. Bring information about past vein treatments or blood clots. Ask how a proposed treatment addresses your symptoms, what follow-up involves, and what your insurance requires.
More about this concern
Your questions, answered.
What is the difference between varicose veins and venous insufficiency?
Varicose veins are enlarged surface veins. Chronic venous insufficiency describes a problem with blood returning through the leg veins. They may occur together, but visible veins alone do not establish the severity or cause of symptoms.
Can venous insufficiency cause leg swelling?
Yes. Increased pressure in the leg veins can contribute to swelling, aching and heaviness. Sudden swelling in one leg needs urgent assessment because a blood clot or another condition may be responsible.
Can CVI cause skin discoloration or ulcers?
Long-standing venous pressure can contribute to itching, inflammation, darker skin and sores near the ankle. Skin breakdown or a wound that is not healing should be assessed promptly.
Are varicose veins only a cosmetic concern?
Some cause no symptoms, but others are associated with aching, swelling or skin problems. The reason for treatment should be discussed individually.
Will I need a vein procedure?
Not necessarily. The symptoms, ultrasound findings, response to conservative care and your preferences guide the decision.
Let’s talk about your next step.
Our team can help you choose an office in Maryland or Virginia and confirm where your evaluation or procedure will take place.
Patient education sources
General educational information, not a diagnosis or an individual treatment recommendation. Your clinician can explain which options are appropriate for you.