Chronic venous insufficiency (CVI) is a condition in which the veins in the legs are unable to return blood effectively back to the heart, leading to pooling of blood, increased venous pressure, and progressive damage to the surrounding tissues. It is most commonly caused by valve dysfunction or obstruction in the deep or superficial veins.

Normally, one-way valves in the veins keep blood flowing upward toward the heart. When these valves become weakened or damaged—due to aging, previous deep vein thrombosis (DVT), pregnancy, or prolonged standing—the blood flows backward (reflux), resulting in venous congestion.

Common symptoms of CVI include:

• Leg swelling, especially around the ankles

• Heaviness, aching, or cramping, worse with prolonged standing

• Varicose veins

• Skin discoloration or thickening (particularly around the lower leg)

• In advanced stages, venous ulcers may develop near the ankles

Diagnosis is typically confirmed with a duplex ultrasound, which visualizes blood flow and identifies valve incompetence or obstruction.

Management of CVI includes:

• Compression therapy, the cornerstone of treatment

• Leg elevation and regular movement

• Weight management and exercise

• Topical or oral medications for symptom relief and ulcer healing

When conservative treatments are insufficient, minimally invasive procedures such as endovenous ablation, foam sclerotherapy, or phlebectomy may be recommended to close abnormal veins and restore venous circulation.