Millions of Americans live with leg discomfort, visible veins, and persistent swelling without knowing the underlying cause. In many cases, the culprit is venous insufficiency — a circulatory condition that affects the veins in your legs and, if left untreated, can progress to more serious complications. Here’s what you need to know.
How Do Healthy Leg Veins Work?
Your leg veins have a challenging job: pushing blood upward against gravity to return it to the heart. To do this, veins rely on a series of one-way valves that open to allow blood to flow up and close to prevent it from falling back down. When these valves function properly, circulation is efficient and continuous.
When the valves weaken or become damaged, blood begins to pool in the lower legs rather than returning to the heart. This pooling increases pressure inside the veins, causing them to expand and pushing fluid into surrounding tissues. This is chronic venous insufficiency (CVI) — and it affects an estimated 40% of Americans, according to the National Heart, Lung, and Blood Institute.
What Causes Venous Insufficiency?
Several factors can contribute to the development of venous insufficiency:
Deep vein thrombosis (DVT): A blood clot in a deep leg vein can damage valve function permanently.
Genetics: A family history of vein disease significantly increases your risk.
Prolonged standing or sitting: Occupations that require long periods on your feet or at a desk put added strain on leg veins.
Pregnancy: The increased pressure on pelvic veins during pregnancy can affect valve function.
Age: Vein walls and valves naturally weaken over time.
Obesity: Excess body weight increases pressure on the venous system.
Prior vein injury or surgery: Trauma to the leg can compromise valve integrity.
Signs and Symptoms to Watch For
Venous insufficiency presents differently in different patients, but common symptoms include:
- Varicose veins — twisted, bulging veins visible beneath the skin
- Leg swelling, particularly in the ankles and lower legs
- A feeling of heaviness, aching, or fatigue in the legs
- Skin changes around the ankle, including discoloration or darkening
- Itching or a burning sensation along affected veins
- Restless legs, especially in the evenings
- Leg cramps at night
In more advanced cases, venous insufficiency can lead to ankle discoloration (corona phlebectatica), lipodermatosclerosis (hardening and thickening of skin), and venous ulcers — open sores near the ankle that are notoriously difficult to heal without treating the underlying venous disease.
How Is Venous Insufficiency Diagnosed?
Diagnosis begins with a clinical evaluation. Dr. Landau reviews your symptoms, medical history, and performs a physical examination of the affected legs. In most cases, a duplex ultrasound is ordered — a painless imaging study that maps the veins and measures blood flow in real time. Ultrasound allows the physician to identify which specific valves are failing and how extensively blood is refluxing downward.
The American Venous Forum’s CEAP classification system is commonly used to stage the severity of chronic venous disease, ranging from C0 (no visible signs) to C6 (active venous ulceration). An accurate diagnosis is essential for selecting the right treatment.
Treatment Options at Vein Care Medical Center
The good news: venous insufficiency is treatable, and the treatments offered at Vein Care Medical Center are minimally invasive, performed in-office, and require little to no downtime.
Depending on the location and severity of the refluxing veins, Dr. Landau may recommend:
- Endovenous Laser Ablation (EVLA): A laser fiber is inserted into the diseased trunk vein and delivers heat energy to close it permanently.
- Radiofrequency Ablation (RFA) / VenClose™: Radiofrequency energy collapses the vein wall segment by segment.
- VenaSeal™: Medical adhesive is used to physically seal the diseased saphenous vein without heat or large volumes of anesthesia.
- Varithena™: FDA-approved injectable foam specifically designed to treat the great saphenous vein (GSV) system.
- Sclerotherapy: Injection of sclerosant agents to eliminate smaller varicose and reticular veins contributing to the insufficiency pattern.
In many cases, treating the underlying trunk vein improves or resolves the surface varicose veins and associated symptoms without additional procedures.
Don’t Wait — Venous Insufficiency Progresses Over Time
Unlike many vascular conditions that remain stable, chronic venous insufficiency tends to worsen without intervention. The longer venous pressure goes unchecked, the greater the risk of skin damage, ulceration, and permanent changes to the leg tissue. Early treatment produces better results, faster recovery, and lower overall cost.
If you’re experiencing leg heaviness, swelling, visible veins, or ankle skin changes in the Los Angeles or Walnut area, contact Vein Care Medical Center at (323) 934-9191 to schedule your evaluation with Dr. Michael D. Landau, MD.
