Evaluation of Chronic Venous Insufficiency

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Chronic Venous Insufficiency Evaluation at RCI

What is chronic venous insufficiency (CVI)?

Chronic Venous Insufficiency (CVI) is a condition in which the veins have problems sending blood from the legs back to the heart. The veins’ valves do not function properly, and the circulation of blood in the leg veins is impaired. This causes the veins to stay filled with blood, especially when you are standing.

CVI is a common cause of leg pain and swelling and is commonly associated with varicose veins. If left untreated, CVI can cause pain, swelling and leg ulcers.

What causes CVI?

Normally, when the leg muscles contract, they squeeze the deep veins of the legs, aiding in circulation. Veins contain one-way valves that keep the blood from flowing in the opposite direction toward the foot. These valves can gradually wear out, leading to blood leaking backward and pooling in the veins of the leg. Over time, the veins weaken and stretch. Blood clots, varicose veins or superficial veins that are dilated due to faulty valves can also cause CVI.

Who is affected by CVI?

An estimated 40% of Americans have CVI. It occurs more frequently in people age 50 and older and more often in women than in men.

Risk factors include:

  • Age
  • Family history
  • History of deep venous thrombosis (blood clots in the leg veins)
  • Hormonal changes (pregnancy, menopause or hormone therapy)
  • Immobilization after surgery or injury
  • Obesity
  • Prolonged standing

What are symptoms of CVI?

The seriousness of CVI, along with the complexities of treatment, increases as the disease progresses. That’s why it’s very important to see your doctor if you have any symptoms of CVI. The problem will not go away if you wait, and the earlier it is diagnosed and treated, the better your chances are of preventing serious complications.

Signs and symptoms of CVI include:

  • Heavy, tight, tired, achy or restless legs
  • Skin that becomes discolored, feels leathery, flaky and/or itchy
  • Swelling in the legs and/or ankles (often the first sign)
  • Ulcers and/or sores that won’t heal
  • Varicose veins

How is CVI diagnosed?

Early diagnosis allows for effective treatment in most cases, and can help avoid more serious problems like venous ulcers down the road. To diagnose CVI, your doctor will perform a complete medical history and physical exam. During the physical exam, the doctor will carefully examine your legs.

The most accurate and detailed test is a vascular duplex ultrasound exam. This provides an ultrasound image of the vein to detect any blood clots or improper vein function.

How is CVI treated or managed?

Like any disease, CVI is most treatable in its earliest stages. Interventional radiologists and vascular medicine or vascular surgery specialists typically recommend a combination of treatments for people with CVI. The goals of treatment are to reduce the pooling of blood and prevent leg ulcers.

Some of the basic treatment strategies include:

  • Antibiotics, if there is infection of the skin and underlying tissue
  • Avoiding long periods of standing or sitting
    • If you need to take a long trip and will be sitting for a long time, flex and extend your legs, feet and ankles 10 times every 30 minutes to keep blood flowing
    • If you need to stand for long periods of time, take frequent breaks to sit down and elevate your feet
  • Compression therapy to relieve swelling
  • Elevating your legs above the level of your heart while sitting and lying down
  • Exercising regularly—walking is especially beneficial
  • Losing weight if you are overweight
  • Practicing good skin hygiene

How do I make an appointment for CVI?

To receive an informational packet or set up your initial consultation appointment, call RCI’s Vein & Interventional Clinic at 319-261-0636 or toll free at 800-747-0121.

Schedule Now Using our Contact Form

Compression stockings

With early diagnosis, most cases of CVI can be managed with treatment as simple as compression stockings. Compression stockings can be purchased at pharmacies and medical supply stores and come in various styles including below-the-knee, above-the-knee and pantyhose styles.

Definitive therapies

EVLT, ultrasound phlebectomy (AP) and sclerotherapy sometimes have a role in definitive treatment. Many patients require endovascular therapies performed in the hospital including venography, thrombolytic therapy, angioplasty and/or stent placement and, rarely, surgical interventions such as venous bypass.

All of our interventional radiologists are board certified by the American Board of Radiology with Certificates of Advanced Qualification (CAQs) in vascular and interventional radiology. They are members of the Society for Interventional Radiology (SIR).

For more information on interventional radiology procedures, visit www.sirweb.org.
RCI is accredited by the American College of Radiology (ACR).

Contact RCI

RCI Imaging Center
1948 First Avenue NE
Cedar Rapids, IA 52402
Hours: Monday – Friday,
7:30 a.m. – 5 p.m.
Phone: 319-364-0121
Toll Free: 800-747-0121
Fax: 319-364-5684

Vein & Interventional Clinic
1948 First Avenue NE
Cedar Rapids, IA 52402
Hours: Monday – Friday,
8 a.m. – 5 p.m.
Phone: 319-261-0636
Toll Free: 800-747-0121
Fax: 319-364-5684

For billing and
insurance questions:

RCI Business Services
1956 First Avenue NE
Cedar Rapids, IA 52402
Hours: Monday – Friday
8 a.m. – 4 p.m.
Phone: 319-832-1735
Toll Free: 800-747-9729
Fax: 319-832-1747

mailing address:

Radiology Consultants of Iowa
PO Box 338
Cedar Rapids, IA 52406