Chronic Venous Insufficiency; Assessment and Treatment
Many people who land on this page want to know one thing: “Why do my legs feel heavy, swollen, or uncomfortable — and is it something serious?” Chronic venous insufficiency (CVI) is a common cause of these symptoms. It happens when the valves in the leg veins do not work as well as they should, allowing blood to pool in the lower legs. CVI is a long‑term condition that requires careful assessment to identify the underlying cause and plan effective, minimally invasive treatment.
CVI and varicose veins are related, but they are not exactly the same. Varicose veins are visible surface veins that have become enlarged. CVI is the underlying problem that causes blood to flow the wrong way inside the veins. Some people have CVI without visible varicose veins, while others have varicose veins as part of CVI. Both conditions can be assessed with a clinical examination and a duplex ultrasound scan, which shows how the veins are working.
What causes chronic venous insufficiency?
Chronic venous insufficiency (CVI) can develop for a number of reasons, often related to how well the veins in the legs are able to return blood to the heart. Common risk factors include a family history of vein problems, age‑related changes in the veins, pregnancy, and long periods of standing or sitting, which can place extra strain on the leg veins. CVI may also occur following a previous deep vein thrombosis (DVT), leg injury, or in people who are overweight, all of which can damage vein valves and impair circulation.
You can also read the NHS overview of varicose veins and related vein problems here:NHS: Varicose veins.
Symptoms of Chronic Venous Insufficiency
People with chronic venous insufficiency (CVI) often experience a range of symptoms affecting the legs. These may include heavy or tired legs, swelling around the ankles, aching or throbbing discomfort, and itching or dry skin. Many people also notice visible varicose veins, skin darkening or thickening around the lower legs, night‑time cramping, or restless legs. In more advanced cases, poor circulation can lead to slow‑healing wounds or venous leg ulcers, which require prompt specialist assessment.
Symptoms often feel worse at the end of the day or after long periods of standing.
How Chronic Venous Insufficiency is Diagnosed
Diagnosing chronic venous insufficiency involves two key steps: a detailed clinical assessment and a duplex ultrasound scan.
Clinical assessment: A qualified vascular surgeon will examine your legs in detail and ask about your symptoms, medical history, and any previous vein problems.
Duplex ultrasound scan: A duplex ultrasound scan is the key test for chronic venous insufficiency. It confirms the presence of venous reflux and, following consultant interpretation, allows the correct veins to be identified and selected for treatment.
What Is Chronic Venous Insufficiency and Why It Needs Assessment
CVI is not just a cosmetic issue. When left untreated, it can progress and lead to increasing discomfort, skin inflammation, pigmentation changes, venous eczema, and leg ulcers. Early assessment helps reduce the risk of complications.
Treatment Options for Chronic Venous Insufficiency
Treatment depends on the pattern of vein reflux and the severity of symptoms. Options may include supportive measures or minimally invasive procedures. You can read more about the treatments we offer here:
If you have skin changes or a slow-healing wound, it is sensible to arrange an assessment early. The NHS also provides information on leg ulcers here:NHS: Leg ulcer. We have a specialised multidisciplinary leg ulcer clinic run by a fully qualified and experienced team of dedicated staff who work together to help your ulcer heal and provide advice on any surgical intervention or procedure that may be needed to prevent the ulcer from returning. This clinic has been helping local residents for more than 20-years. You can read about it in greater detail here.
Consultant‑Led Care for Chronic Venous Insufficiency
As a consultant-led medical centre for vein problems in Swindon, we focus on clear diagnosis and a plan that matches your scan findings.
Your appointment includes a clinical assessment and a duplex ultrasound, followed by a clear explanation of what the scan shows and what options may be suitable. If you are suffering from ulcer disease, we can book you into our specialised venous ulcer clinic for an in-depth assessment.
If you would like a consultant‑led assessment to investigate chronic venous insufficiency and discuss treatment options, you can contact our team directly:
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