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Chronic venous insufficiency

Chronic venous insufficiency (CVI) is a progressive medical condition that may worsen over time and affect the veins and vessels in the leg that carry oxygen-poor blood back toward the heart. Signs and symptoms may include pain, swelling, and fatigue of the legs, as well as skin damage and ulcers. CVI is often preceded by varicose veins.1

Signs and symptoms2

  • Varicose veins

  • Aching or pain

  • Swelling

  • Cramping

  • Heaviness or tiredness

  • Itching

  • Restlessness

  • Skin changes and/or discoloration

  • Open sores or ulcers

Risk factors2 

  • Family history

  • Lack of exercise

  • Leg injury or trauma

  • Prolonged sitting or standing 

  • Obesity or excess weight

  • Current or previous pregnancies

  • Smoking

With proper treatment, the progressive symptoms of chronic venous insufficiency are preventable, without treatment, signs and symptoms may progress — significantly impacting quality of life and leading to venous leg ulcers.

Venous leg ulcers

A clinical challenge

Treating patients with venous ulcers is not easy. It is important to not only treat the wound but also identify the cause — enabling your patients to live without the discomfort of these wounds.
 

  • 70–90% of all lower extremity ulcers are venous.3,4

  • 1 million people in the U.S. are affected by venous leg ulcers.3,4

  • More than half of venous ulcers treated are recurrent ulcerations.5
     

Superficial venous reflux is usually present in patients with venous leg ulcers ― yet many venous ulcer patients worldwide go unassessed or untreated for superficial venous reflux.3,6-8

Percentage of venous leg ulcer

Living with venous leg ulcers compromises quality of life

Due to pain, mobility limitations, and other consequences, venous leg ulcers have a significant impact on patients.9-11

Cost of care

  • $15 billion spent by U.S. payers in managing VLU patients4

  • $6,500 more  spent annually to treat VLU patients than others4

Early endovenous ablation treatment matters

The Evra Study: a randomized trial of early endovenous ablation in venous ulceration

Early endovenous ablation of superficial venous reflux with compression therapy resulted in shorter time to ulcer healing compared to compression therapy alone.7

Evra Study key results7

Evra Study key findings7

32%

Faster ulcer healing time in the early treatment group

56 days

Median time to ulcer healing, compared to 82 in the control group

28 days

More ulcer-free time during the first year in the early treatment group

Connect with a representative

Look up. Go beyond the wound.

Find CVI in your venous leg ulcer patients.

Venous leg ulcers may be caused by chronic venous insufficiency (CVI) due to reflux in any of the venous systems — superficial, perforator, or deep — when the valves of the veins have failed or the vein has become obstructed.12,13

Differentiate arterial ulcer from venous ulcer

Identify venous reflux

Treat with early endovenous ablation and compression

Comprehensive venous duplex ultrasound examination of the lower extremity should be performed in all patients with a suspected venous leg ulcer.

Step one: Differentiate arterial ulcer from venous ulcer.

Ulcer appearance, together with the medical history and physical exam, should be used to determine the differential diagnosis and see if a venous leg ulcer is suspected.

Arterial ulcer

Venous ulcer

 

Characteristic Arterial ulcer Venous ulcer
Location Toes or foot Malleolus or metatarsal
Appearance Irregular margin, cool cyanotic Typically sloped edges, may have exudate, irregular shape
Foot temperature Cold Warm
Pain Usually severe Mild
Sensation Variable, often decreased Present, variable (pain, temperature)
Arterial pulses Absent Present, variable (pain, temperature)
Veins Collapsed Dilated, varicosities, edema

Step two: Identify venous reflux.

Comprehensive venous duplex ultrasound examination of the lower extremity should be performed in all patients with a suspected venous leg ulcer in order to identify the cause and help determine the right treatment. The Society of Vascular Surgery (SVS) and the American Venous Forum (AVF) 2014 venous leg ulcer guidelines provide a strong recommendation for conducting this exam.3

View venous leg ulcer guidelines (open in new window)

Step three: Treat with early endovenous ablation and compression.

Our comprehensive tool kit empowers you to select the best approach for each patient. 

Our varicose veins and venous leg ulcer treatments