Chronic venous insufficiency: clear answers and caring treatment in Honolulu

What is chronic venous insufficiency?

Your leg veins carry blood up toward your heart. Tiny one-way valves inside them open to let blood through, then close so it can’t slip back down. With CVI, some of those valves no longer close fully. Blood falls back and collects in the lower legs, which raises the pressure in your veins.

Over time, that pressure can stretch veins, cause swelling and, in some people, damage the skin around the ankles.

Common symptoms

• Aching, heavy, or tired legs, often worse at the end of the day
• Swollen ankles or lower legs
• Cramping or restless legs, especially at night
• Itching or tingling around the ankles
• Varicose veins (bulging, twisted veins)
• Darkened, thickened, or tight skin near the ankles
• Sores that are slow to heal

How common is it?

More common than most people think. About 1 in 20 adults has chronic venous insufficiency, and about 1 in 3 adults has varicose veins.¹ Each year, about 1 in 50 adults with varicose veins goes on to develop CVI.¹

Your chances are higher with age, a family history of vein problems, pregnancy, a job that keeps you standing or sitting for long periods, extra weight, or a past blood clot in the leg.

Why it’s worth treating

CVI rarely gets better on its own. In a long-term study of the general population, vein disease got worse in 58% of people over 13 years, and almost 1 in 3 people with varicose veins developed skin changes.² At its most advanced, CVI can lead to leg ulcers. About 80% of leg ulcers are caused by vein problems.³

Treatment helps. In a 450-patient trial, treating the faulty vein early healed leg ulcers in a median of 56 days, versus 82 days when treatment was delayed.⁴ Treating the faulty vein has also been shown to cut ulcer recurrence at 12 months by more than half, compared with compression stockings alone.³

Keep doing what you love in Hawaii

Whether you are walking the neighborhood, working on your feet, spending time with family, or traveling between islands, leg discomfort can get in the way. Our goal is to help you understand your options so you can move forward with confidence.

How we diagnose it

1. Free vein screening call. Tell us what you’re noticing. We’ll answer basic questions and let you know if your insurance covers treatment.
2. Ultrasound. A painless duplex ultrasound in our office shows how blood flows in your leg veins and which valves are leaking.
3. A clear plan. Dr. Yeo reviews your results with you and recommends the treatment that fits your veins, schedule, and budget.

Treatment options

Most treatment closes the faulty vein so blood reroutes through healthy veins nearby. Everything is done in our office with local numbing, and most people return to normal activity the same day.

• VenaSeal seals a larger faulty vein with a medical adhesive.
• ClosureFast closes a larger faulty vein with gentle heat.
• Varithena uses a medicated microfoam that can reach twisted veins.
• Microphlebectomy removes bulging veins near the surface.
• Ultrasound-guided sclerotherapy closes veins beneath the skin, including smaller varicose veins and spider veins.

Compression stockings, walking, and raising your legs can ease symptoms, but they don’t repair leaking valves. Some insurance plans ask you to try compression stockings for a period before covering a procedure. Read about insurance and cost.

Sources

1. Cleveland Clinic, “Chronic Venous Insufficiency (CVI).”
2. Lee AJ et al. Progression of varicose veins and chronic venous insufficiency in the general population in the Edinburgh Vein Study. J Vasc Surg Venous Lymphat Disord. 2015;3(1):18–26.
3. Collins L, Seraj S. Diagnosis and Treatment of Venous Ulcers. Am Fam Physician. 2010;81(8):989–996.
4. Gohel MS et al. A Randomized Trial of Early Endovenous Ablation in Venous Ulceration (EVRA). N Engl J Med. 2018;378:2105–2114.