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Magill’s Medical Guide, 9th Edition

Venous insufficiency

by Muhammad S. Khan, MD

Category: Disease/Disorder

Anatomy or system affected: Venous system, legs

Specialties and related fields: Vascular surgery, wound care

Definition: Venous valve dysfunction causing decreased blood return from the legs to the heart.

CAUSES AND SYMPTOMS

Venous insufficiency is a common condition caused by failure of the venous valve system present in the leg. It normally prevents backwards flow of blood to allow forward flow towards the heart. Failure of this process leads to pooling of blood in the leg. It can be classified into congenital, primary or secondary causes.

Congenital venous insufficiency is due to abnormal anatomy present at birth such as absence of any venous valves. Primary venous insufficiency is most common of the three and is usually due to acquired, faulty venous valves (varicose veins). An exact cause is unknown but risk factors include older age, female gender, pregnancy and obesity. Secondary causes are usually found after blood clots in the leg (deep vein thrombosis). Risk factors include cancer, obesity, tobacco use, prolonged immobilization.

Patients present with feelings of heaviness, swelling and discomfort. Overtime they can develop skin color changes and even ulceration of the skin in severe disease. These ulcers are usually painless and found above the inside part of ankle. Varicose veins appear as visible, dilated veins in the leg.

TREATMENT AND THERAPY

Initial treatment is non-operative. Mainstay of therapy include leg elevation, exercise and use of compression stockings. Ulcers require long term wound care which can vary from topical chemical agents to surgical debridement (removal of dead skin).

Information on Venous Insufficiency

Causes: Venous valve dysfunction of the leg most commonly caused by varicose veins or blood clots

Symptoms: Heaviness, swelling, discomfort, skin color changes and leg ulcers

Duration: Chronic

Treatments: Initially leg elevation, exercise, compression stockings. Interventions include thermal ablation, sclerotherapy and vein stripping.

Operative treatment of varicose veins include a wide variety of options which either shrink the vein or remove it completely (vein stripping). The former include thermal ablation or ultrasound-guided sclerotherapy. Vein stripping involves tying off and removing the major superficial vein of the leg or just removing the small branches thru tiny incisions.

See also: Venous diseases, Varicose veins, Deep vein thrombosis, Legulcers, Vascularsurgery, Wound care.

For Further Information:

1 

Chronic Venous Insufficiency. Society for Vascular Surgery. vascular.org/patient-resources/vascular-conditions/chronic-venous-insufficiency.

2 

What Are Varicose Veins? NHLBI, NIH. www.nhlbi.nih.gov/health/health-topics/topics/vv/.

3 

Gloviczki P, Comerota AJ, Dalsing MC, et al. “The care of patients with varicose veins and associated chronic venous diseases: clinical practice guidelines of the Society for Vascular Surgery and the American Venous Forum.” J Vasc Surg. 2011;53(5 Suppl):2S-48S.

4 

Eberhardt RT, Raffetto JD. “Chronic venous insufficiency.” Circulation. 2014;130(4):333-46.

Citation Types

Type
Format
MLA 9th
Khan, Muhammad S. "Venous Insufficiency." Magill’s Medical Guide, 9th Edition, edited by Anubhav Agarwal,, Salem Press, 2022. Salem Online, online.salempress.com/articleDetails.do?articleName=MMG2022_1443.
APA 7th
Khan, M. S. (2022). Venous insufficiency. In A. Agarwal, (Ed.), Magill’s Medical Guide, 9th Edition. Salem Press. online.salempress.com.
CMOS 17th
Khan, Muhammad S. "Venous Insufficiency." Edited by Anubhav Agarwal,. Magill’s Medical Guide, 9th Edition. Hackensack: Salem Press, 2022. Accessed September 16, 2025. online.salempress.com.