Perhaps you’ve probably written it off as getting older or pain that everyone has. Perhaps you’ve asked your physician about it and, seeing normal looking legs without bulging varicose veins, he’s reassured you that it’s nothing. Perhaps you’ve even had an ultrasound of your legs, only to be told you “don’t have a blood clot.”
These are all things we hear frequently from people who have leg heaviness, pain, cramping, and fullness – people who have Chronic Venous Insufficiency (CVI). CVI is a condition where some of the veins of the legs have a defect resulting in inability to circulate blood from the legs back to the heart, against the force of gravity. In addition, blood may actually flow backwards down these veins (venous reflux), resulting in the calves and lower legs becoming engorged with fluid by the end of the day.
CVI sometimes results in obvious varicose veins, leg swelling, darkening of the skin, and ulceration. It can also occur with no obviously visible findings – the legs may look completely normal – causing patients and doctors to dismiss the symptoms. Left untreated, CVI can progress to injure the skin of the lower legs, resulting in frequent infections (cellulitis), skin damage (venous stasis), and even chronic wound (venous ulcers).
About 80% of patients with CVI have a parent with circulatory issues like varicose veins. Exacerbating factors include occupations with prolonged standing (nurses, flight attendants, and restaurant workers are regularly affected), multiple pregnancies, excess weight, and advanced age. About 1 out of 5 people over 70 years of age may be affected.
The diagnosis of CVI can be made definitively by an ultrasound performed by a credentialed physician (look for someone with an RVT or RPhS designation) with the patient in the standing position, the position being critical to assessing the function of the veins under the force of gravity. During testing, your physician should be able to demonstrate to you where veins are weakened or blood flow is reversed (reflux), the cardinal sign of CVI.
Treatment for CVI, EndoVenous Laser Ablation (EVLA), is performed in the office in about
30 minutes with no subsequent downtime and is covered by Medicare and commercial insurance. Once treated, 98% of patients have a lifelong cure with many commenting afterwards, “I didn’t realize my legs were supposed to feel this way!
I feel great!”
M. Albert Malvehy, MD, RVT, dABVLM, specializes exclusively in the diagnosis and treatment of venous disease and sees patients in Delray Beach at the Delray Vein Center at Feinstein Dermatology.
Vein Specialist in Delray Beach, FL 6140, West Atlantic Avenue
Delray Beach, FL 33484
1 (888) 357-DERM • (561) 498-4407 • DelrayVein.com