VaricoseVeins

What is Chronic Venous Insufficiency (CVI)?

Under the pull of gravity, blood struggles to get back from the feet to the heart. Strong calf muscles squeeze the veins as you walk, helping to push blood upwards. Valves within the veins also act like doors to prevent backflow. Damage or blockages to the leg veins or valves renders them insufficient in their task of returning blood to the heart; blood then pools in the veins of the feet and ankles in a common condition termed Chronic Venous Insufficiency.

10 Things You Need To Know About CVI

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Varicose veins

Varicose veins are a common sign of back-flowed blood, a symptom of CVI. Appearing thickened and twisted, these engorged veins affect approximately one third of adults, and are more likely if you are pregnant, overweight, or spend a lot of time standing.(1)

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Swelling

Another symptom of CVI is swelling of the legs, predominately below the knee. Sleeping in a chair increases blood pooling, and may result in skin damage. Swelling can be resolved when you put your feet up.

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Slow healing ulcers

Around 80% of leg ulcers are associated with CVI. Almost always occurring in the region between the ankle and mid-calf, they can take months to heal, and sometimes never heal. Other skin changes brought about by blood-pooling include discolouration, tightening, itching and eczema.

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Standing pain

A general dull ache or heaviness can develop in the legs when standing, but this can be eased upon elevation of the legs, which is normal for most people. A person with CVI will experience a ‘bursting and burning’ pain when first standing in the morning, this is caused when blood rushes at speed into the weakened veins caused by CVI.

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Structured exercise and leg elevation

“When on their feet, they [people with CVI] need to be walking; when not walking they should be lying down or seated so that their legs are above the level of their heart. If less mobile, they should be encouraged to perform ankle exercises” writes Ruth Martin, leg ulcer specialist nurse. Use of a Revitive Circulation Booster will replicate these ankle exercises, assisting in the activation of the calf muscle pump, boosting poor circulation.

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Compression Socks

Compression therapy, through bandages or stockings, is the cornerstone of treatment for CVI. Needed from toe to knee, it facilitates the flow of blood to the heart by augmenting the action of the muscle pump preventing swelling. However, it is contraindicated in people with peripheral arterial disease, where the blood supply to the leg is already reduced.

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Second heart stimulation

Your calf muscles are your second heart, pumping blood upwards towards your core, reducing lower limb blood pooling. Revitive Circulation Booster devices have been shown to improve circulation in people with CVI (2), as the IsoRocker feature replicates heel-toe raises without undue pressure – supporting the calf muscles to contract and relax. 

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Surgery

When leg ulcers caused by CVI persist, an operation to remove the dead or dying tissue may be necessary to promote wound healing (3); repairing the valves in leg veins may also reduce the symptoms of CVI (4). Injections or laser therapy to seal and shrink veins that have reflux are performed when other therapies fail, and are less invasive than traditional vein stripping.

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The surgeon’s test for CVI

In 1890, German surgeon Friedrich Trendelenberg introduced a test that determines how well valves in the leg veins are working (5). Asking patients to stand up, after lying down with their leg raised and their saphenous vein compressed by a finger, he would monitor the speed at which blood refills the leg: leaky valves allow backflow and more rapid refill.

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Spacemen and giraffes

Have you ever seen a giraffe with swollen legs? Why do spacemen wear anti-G suits? The giraffe’s super-tight skin on its stilt-like legs is imitated in the astronaut’s inflatable suit (6). Both help push blood back to the heart, protecting the extremities from stretch and the rest of the body from starvation.

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Revitive Medic Circulation Booster® actively improves circulation by stimulating the muscles in your legs and feet.

1. MD Vein & Skin Specialists (2021) Risk factors associated with chronic venous hypertension https://www.mdveins.com/blog/risk-factors-associated-with-chronic-venous-hypertension

 2. Ravikumar R, Williams KJ, Babber A et al (2016) Randomised Controlled Trial: Potential benefit of a footplate neuromuscular electrical stimulation device in patients with chronic venous disease. https://www.ejves.com/article/S1078-5884(16)30481-6/fulltext

 3. Gethin G, Cowman S, Kolbach DN (2015) Debridement for venous leg ulcers. Cochrane Database of Systematic Reviews, Issue 9. Art. No.: CD008599. DOI: 10.1002/14651858.CD008599.pub2

 4. National Institute for Health and Care Excellence (2007) Lower limb deep vein valve reconstruction for chronic deep venous incompetence. IPG219 https://www.nice.org.uk/guidance/ipg219/chapter/2-The-procedure

 5. Physiopedia (2021) Brodie-Trendelenberg Test

https://www.physio-pedia.com/Brodie%E2%80%93Trendelenburg_Test

 6. National Geographic (2019) Unique anatomy sets giraffe apart in the animal kingdom. https://www.nationalgeographic.com/animals/article/graphic-shows-giraffes-unique-evolution-traits

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