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Chronic Venous Insufficiency

  • Cynthia M. Johnson, MA
Publication Type:


Chronic Venous Insufficiency


Chronic venous insufficiency (CVI) is when the veins and valves in the legs do not work as they should. This can cause a backup of blood in the veins, especially in the legs.

Venous Insufficiency.

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In some people, the cause of CVI is not known. In others, damage to the valves causes problems in the veins. Common causes of this are:

Risk Factors

This problem is more common in people who have DVT. Other things that may raise the risk of CVI are:

  • Obesity
  • Lack of physical activity
  • Having family members with the same problems
  • Smoking
  • Pregnancy


A person with CVI may have:

  • Leg swelling
  • Pain in the legs, especially after walking:
    • Aching
    • Dullness
    • Tiredness
    • Cramping
  • Red or brown darkening of the skin on the legs
  • Enlarged veins
  • Leg sores, especially around the inside of the ankles
  • Scaling skin on the legs
  • Hard, leathery skin on the legs


The doctor will ask about symptoms and health history. A physical exam may be done. This may be enough to suspect CVI.

Images of the veins may be taken. This can be done with an ultrasound. This can confirm the diagnosis.


The goal of treatment is to keep blood flowing and prevent it from pooling in the veins. Ways to do this are:

  • Compression stockings to keep blood from pooling in the legs
  • Regular exercise
  • Procedures to reroute blood flow, such as:
    • Sclerotherapy
    • Ablation

People who are not helped by these methods may need surgery. The type of surgery will depend on the cause of CVI.


To lower the risk of CVI:

  • Keep a healthy weight.
  • Exercise regularly.
  • Avoid smoking.




  • Practice guidelines on treatment of superficial venous disease of lower leg. American College of Phlebology website. Available at: www.phlebology.org/wp-content/uploads/2014/10/SuperficialVenousDiseaseGuidelines.pdf.
  • Chronic venous insufficiency. Society for Vascular Surgery website. Available at: https://vascular.org/patients-and-referring-physicians/conditions/chronic-venous-insufficiency.
  • Chronic venous insufficiency and postphlebitic syndrome. Merck Manual Professional Version website. Available at: https://www.merckmanuals.com/professional/cardiovascular-disorders/peripheral-venous-disorders/chronic-venous-insufficiency-and-postphlebitic-syndrome.
  • Venous insufficiency. EBSCO DynaMed website. Available at: https://www.dynamed.com/condition/venous-insufficiency.


  • Marcin Chwistek, MD
Last Updated:

This content is reviewed regularly and is updated when new and relevant evidence is made available. This information is neither intended nor implied to be a substitute for professional medical advice. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with questions regarding a medical condition.