Chronic venous insufficiency – cause, symptoms and treatment
Chronic venous insufficiency (CVI) is the underlying disease behind varicose veins, leg swelling and venous leg ulcers. Duplex ultrasound assessment can clarify the cause, and treatment can relieve symptoms, but no treatment can guarantee that the disease will not progress.
Written and medically reviewed by Bahir Hadi, specialist in surgery, PhD
Short answer
What is chronic venous insufficiency?
Chronic venous insufficiency means the valves in the leg veins no longer close properly, so blood flows the wrong way and pools in the leg. It causes heavy legs, swelling, skin changes and, at worst, venous leg ulcers. The condition is assessed from the clinical picture together with duplex ultrasound. CEAP is a classification describing clinical findings, aetiology, anatomy and pathophysiology, and is not in itself an indication for treatment.
What is venous insufficiency?
The valves in the leg veins no longer close properly. Blood flows backwards (reflux), pressure rises and the veins dilate – from spider veins through varicose veins to skin changes and leg ulcers.
Symptoms
- Heavy, tired legs late in the day.
- Ankle swelling.
- Nocturnal calf cramps and restless legs.
- Itching and brown discoloration around the ankle.
- Visible varicose veins or spider veins.
CEAP classification
CVI is staged from C0 (no visible signs) to C6 (active venous leg ulcer). CEAP is a classification and not in itself an indication for treatment. Treatment is considered after an overall assessment of symptoms, duplex findings, clinical class, any complications, arterial status and the preferences of the patient.
Diagnosis
The diagnosis is based on duplex ultrasound, interpreted together with the history and clinical examination. The scan is preferably performed standing when that is possible; pressure from the probe can be felt but it is not usually associated with significant pain. It maps reflux in each vein.
Treatment
If the scan shows a leaking main vein that causes symptoms, the European vascular surgery guideline (ESVS 2022) recommends heat treatment from inside the vein, for example laser (EVLA/EVLT), over stripping and foam. Conservative measures with compression, activity and elevation are planned individually; compression class and wearing pattern depend on symptoms, skin condition and arterial status.
Contact and appointments
Online booking is not available. Please call the clinic or ask your GP for a referral, so we can find the right appointment.
If you are in health insurance group 1 and have a valid referral from your GP, the examinations and treatments covered by the clinic's public health agreement are covered by the Danish public health insurance, so you pay nothing for them yourself. If you are in health insurance group 2, there is usually a small co-payment under the health insurance rules. If you are paying yourself, contact the clinic for a price.
Call the clinic
+45 39 64 01 25
Phone hours
Phone hours: Mon–Thu 09:00–12:00
Address
Hans Edvard Teglers Vej 9, 1st floor · 2920 Charlottenlund
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Contact information
- Hans Edvard Teglers Vej 9, 1st floor · 2920 Charlottenlund
- +45 39 64 01 25
- mail@kirurgen.dk
- Phone hours: Mon–Thu 09:00–12:00
For referring physicians
Provider number: 215430