What is venous insufficiency?

Heart Health, Women's Care
Jul 27, 2023

Also known as venous reflux, Vascular Surgeon Dr. Peter Hunt explains this very common condition and how to treat it

Do your legs ever feel heavy or throb, especially after sitting or standing for long periods of time? Do you ever wonder why you and not your best friend have those pesky varicose or spider veins up and down your legs?

If so, you may have a condition called venous insufficiency, or also called venous reflux.

Normally, the valves in your veins make sure that blood flows up the legs and towards the heart. Venous reflux occurs when incompetent valves cause the backwards flow of blood in the veins, explains Dr. Peter Hunt, vascular surgeon with St. Joseph’s/Candler Physician Network – Vascular Specialists. Dr. Peter Hunt

This can cause blood to collect in your legs, leading to spider and varicose veins and swelling. The most common symptoms are achiness, heaviness and throbbing in the legs. Then for many of us ladies especially, there’s the unpleasant appearance of those pesky blue and purple roping veins on our legs.

Related Article: The ugly truth about varicose, spider veins

“It’s not this horrible pain. It’s not going to lead to a blood clot or stroke,” Dr. Hunt says. “But what it does lead to is varicose veins and then chronic swelling. With that chronic swelling, it can limit your ability to work. It also can lead to changes in the legs where you get this brownish-rust color staining of the skin. That can be permanent.”

“All of these things add up to not total disability, but affecting quality of daily life.”

Anyone is at risk of venous insufficiency, but women experience it more frequently than men, Dr. Hunt says. There’s also no specific reason why someone may develop the condition; although, some say pregnancy could be one reason.

If you do develop venous insufficiency, you don’t have to live with it; however, the majority of Americans do. More than 30 million people in the U.S. have venous insufficiency, but only about 1.9 million seek treatment for it.

“People will just live with the heaviness, throbbing in the legs, especially when they have been standing for a long period of time,” Dr. Hunt says. “Some people will just put their legs up to feel better, which can happen when you put them up.”

However, if that doesn’t work or you don’t want to live with the symptoms and varicose veins, there are two treatment options if an ultrasound confirms the diagnosis of venous insufficiency.

One is radiofrequency ablation (RFA). RFA uses a catheter (or wire) that goes up inside the vein through an IV. The end of the wire heats up and burns the veins on the inside, Dr. Hunt explains. This procedure requires numbing the entire area around the vein so the surrounding structures don’t get injured by the heat and for the comfort of the patient. The numbing part can sting and tends to be the worst part of the procedure, Dr. Hunt says.

Another option is called VenaSeal, an in-office procedure that uses a special adhesive (similar to super glue) to basically clog up the vein and stop the blood from sitting there, Dr. Hunt explains. Dr. Hunt uses a special caulking gun to insert the glue into the vein.

VenaSeal does not require numbing medication. VenaSeal also can treat longer lengths of the vein as opposed to RFA because of a nerve that sits near the lower portion of the vein. The heat from RFA can damage the nerve, causing numbness in the calf, Dr. Hunt says. The only limitation with VenaSeal is you can’t have any allergies to glue, tapes or adhesives.

Related Article: A quick, safe way to eradicate varicose veins

Both RFA and VenaSeal are covered by Medicare, Tricare and some commercial insurance providers for patients with symptoms, however not all commercial insurance covers VenaSeal yet. If no symptoms from the veins are present, vein procedures are considered cosmetic and the patient would have to pay out of pocket. Dr. Hunt says he averages three vein treatment procedures a week.

Interested in finding out if venous insufficiency is causing your varicose veins or heaviness and throbbing of your legs? Request an appointment with one of our three vascular specialists here.



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