Peripheral Venous Insufficiency

Peripheral Venous Insufficiency

What is vein disease? — Vein disease is a condition that can affect the veins in the legs. It can cause leg pain, varicose veins, swollen legs, or open sores. Varicose veins are swollen and twisted veins.
Vein disease happens when the veins in the legs do not work the right way. Normally, the veins in the legs carry blood from the legs back to the heart. The veins have valves inside them to help keep blood moving in only one direction (toward the heart). The valves open to let blood flow to the heart, and close to keep it from flowing back down the leg. Vein disease can happen when the valves are damaged or do not work well. This causes blood to collect in the legs. Blood is especially likely to collect in the legs when a person sits or stands for a long time without walking.
What conditions can cause vein disease? — Vein disease can be caused by:
A blood clot in a leg vein
Leg injury
Being pregnant, especially more than once – This causes a change in hormone levels that can weaken vein walls.
Weight gain
Vein disease can also run in families.
What are the symptoms of vein disease? — People with vein disease can have symptoms that include:
Leg pain, or the leg feeling tired or heavy, especially at the end of the day.
Swollen veins – "Spider veins" are small leg veins that are swollen (picture 1). "Varicose veins" are larger leg veins that are swollen and twisted (picture 2).
Swelling in the lower legs or ankles (figure 1) – People can have swelling at the end of the day or all the time.
Skin color changes – The skin can turn red or red-brown. Skin color changes often happen first around the ankle.
Open sores, also called "venous ulcers" – These are usually at the ankle and can be painful and ooze.
Is there a test for vein disease? — Yes. Your doctor or nurse will do an exam to look at your legs. He or she might also do a test called an ultrasound. An ultrasound can check how well the valves in the legs work. It can also see if any of the veins in the legs are blocked.
What can I do to reduce my symptoms? — To reduce swelling, you can:
Walk around, and try not to sit or stand in one place for a long time
Raise your legs up 3 or 4 times a day, for 30 minutes each time
Do exercises to point your toes and feet down and up a few times each day
To treat dry or itchy skin, you can:
Wash your legs each day with a gentle cleanser. Do not use regular soap, which can make skin more dry.
Use an unscented moisturizing cream or ointment while your skin is still damp. Petroleum jelly works well. Ask your doctor or nurse before using any other type of cream or ointment, because some can cause a rash.
If your skin problems are severe, your doctor or nurse might suggest special ointment, medicine, or bandages.
How is vein disease treated? — Doctors can use different treatments to treat symptoms and reduce swelling. These can include:
Special socks, bandages, or devices:
•"Compression stockings" are special socks that fit tightly over the ankle and leg. If your doctor or nurse recommends that you wear them, he or she will tell you which type to wear and how to put them on (figure 2 and table 1).
•"Compression bandages" are layers of bandages that wrap around a person's leg.
•A "compression pump" is a device that fits around the leg and squeezes the leg every few minutes.
Special coverings that are put on an open sore to help it heal
Medicines – Doctors can use different types of medicines to treat different symptoms. For example, people who cannot use compression stockings or bandages might be able to try medicines that help the veins work better. People with a skin infection might need antibiotics. People with itchy skin might need a prescription cream or ointment.
Procedures – Doctors can do procedures if other treatments do not work. A doctor can remove or destroy damaged veins so they can no longer fill with blood.
All topics are updated as new evidence becomes available and our peer review process is complete.
This topic retrieved from UpToDate on: Mar 30, 2020.
Topic 15729 Version 8.0
Release: 28.2.2 - C28.105
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