Chronic Venous Insufficiency (CVI)

Chronic venous insufficiency (CVI) occurs when the veins in the legs cannot effectively return blood to the heart due to weakened valves. This leads to leg swelling, skin discoloration, and sometimes painful ulcers. CVI is a progressive condition that can develop after deep vein thrombosis, varicose veins, or prolonged standing.

At The Medical Group of New Jersey, our vascular surgeons diagnose and treat CVI using ultrasound-guided imaging, compression therapy, and advanced venous procedures to improve circulation, promote healing, and prevent long-term complications.

Symptom Onset & Initial Evaluation

Chronic venous insufficiency (CVI) develops when the valves in the leg veins no longer function properly, allowing blood to pool instead of flowing back toward the heart. Symptoms often appear gradually and can worsen over time if untreated.

Common signs and symptoms include:

• Persistent leg swelling or heaviness, especially after long periods of standing
• Skin darkening or thickening around the ankles (hyperpigmentation or lipodermatosclerosis)
• Itching, dryness, or flaking skin resembling eczema
• Non-healing wounds or venous ulcers near the lower legs or ankles

During your initial visit, your vascular specialist will review your symptoms, medical history, and daily activities that affect venous pressure, such as jobs requiring prolonged standing or sitting. A duplex ultrasound is typically performed to assess valve function, blood flow direction, and vein health.

Diagnosis

Accurate diagnosis is key to determining the extent of vein damage and identifying both superficial and deep vein involvement.

• Duplex Ultrasound: The primary imaging test that detects valve reflux and vein dilation.
• Photoplethysmography (PPG): Measures how quickly veins refill with blood, helping gauge disease severity.
• Venous Pressure Studies: Used in complex or recurrent cases to assess overall venous function.

At The Medical Group of New Jersey, vascular testing is performed on-site by experienced technologists, allowing for precise evaluation and same-day treatment planning.

Treatment

The main goals of CVI treatment are to relieve symptoms, prevent ulcers, and improve leg circulation to enhance comfort and mobility.

Conservative & Medical Therapy

Many patients benefit from noninvasive management strategies designed to reduce swelling and improve blood flow:

• Graduated compression therapy: The cornerstone of CVI care, compression stockings or wraps help support veins and reduce leg swelling.
• Medications: In select cases, diuretics or venoactive agents may help manage swelling or vein tone.
• Lifestyle modifications: Regular walking, leg elevation, and maintaining a healthy weight all promote better circulation.

Procedural Options

For patients with persistent symptoms or advanced disease, minimally invasive procedures can help correct reflux and restore healthy blood flow:

• Endovenous Ablation: Uses heat energy (laser or radiofrequency) to close malfunctioning veins.
• Sclerotherapy or Microphlebectomy: Treats visible varicose veins and improves overall venous function.
• Wound Care and Debridement: Specialized care for patients with venous ulcers to promote healing and prevent infection.

At The Medical Group of New Jersey, our vascular specialists provide comprehensive, personalized care, combining medical therapy, advanced procedures, and wound management to meet each patient’s unique needs.

Ongoing Management & Long-Term Prevention

CVI is a chronic condition that requires consistent, long-term management to prevent recurrence and protect vein health.

• Daily compression therapy: Continue wearing compression stockings or wraps as prescribed.
• Regular follow-up: Periodic ultrasound exams to monitor vein health and detect early signs of reflux.
• Skin care: Keep legs moisturized and check daily for redness, scaling, or open sores.
• Exercise: Gentle walking or calf-raise exercises strengthen the leg muscles that help pump blood upward.
• Avoid prolonged sitting or standing: Move your legs frequently throughout the day to improve circulation.

Our multidisciplinary vascular team partners with wound care, dermatology, and primary care specialists to provide lifelong vein health and prevention of future complications.