{"id":7065,"date":"2024-10-10T10:25:53","date_gmt":"2024-10-10T10:25:53","guid":{"rendered":"https:\/\/venaziel.de\/phlebology\/chronic-venous-insufficiency-cvi-causes-diagnosis-and-modern-treatment-options\/"},"modified":"2026-04-20T12:20:29","modified_gmt":"2026-04-20T12:20:29","slug":"chronische-venoese-insuffizienz-cvi","status":"publish","type":"page","link":"https:\/\/venaziel.de\/en\/phlebology\/chronische-venoese-insuffizienz-cvi\/","title":{"rendered":"CVI: Causes, diagnosis and modern treatment options"},"content":{"rendered":"<p><span style=\"font-weight: 400;\">This article explains how CVI is diagnosed, what treatment options are available, and why modern methods such as VenaSeal (vein glue) play an important role in phlebology. It also explains how the condition is related to varicose veins (varicosis) and what preventive measures those affected can take.<\/span><\/p>\n<p>&nbsp;<\/p>\n<h2><span style=\"font-weight: 400;\">Causes of chronic venous insufficiency (CVI)<\/span><\/h2>\n<p><span style=\"font-weight: 400;\">The causes of CVI are varied and usually result from a combination of genetic factors and external influences. The most important risk factors include<\/span><\/p>\n<ul>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><b>Genetic predisposition:  <\/b><span style=\"font-weight: 400;\">A family history increases the risk of developing CVI. Individuals with first-degree relatives who suffer from <a href=\"https:\/\/venaziel.de\/venenzentrum-leistungen\/krampfadern-entfernen\/\">varicose veins<\/a> or other venous diseases have a significantly higher risk of being affected as well.<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><b>Standing or sitting for long periods:  <\/b><span style=\"font-weight: 400;\">Occupations that require prolonged standing or sitting promote the backflow of blood in the legs. Venous return is made more difficult, leading to chronic strain on the veins.<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><b>Overweight: <\/b><span style=\"font-weight: 400;\">Being overweight puts additional pressure on the veins in the legs and promotes the development of chronic venous insufficiency.<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><b>Pregnancy:  <\/b><span style=\"font-weight: 400;\">During pregnancy, hormonal changes and the pressure of the growing fetus on the veins lead to increased stress on the venous system. This can lead to CVI temporarily or in the long term.<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><b>Age: <\/b><span style=\"font-weight: 400;\">With increasing age, the elasticity of the vein walls deteriorates, which leads to an increased likelihood of venous valve insufficiency and thus to CVI.<\/span><\/li>\n<\/ul>\n<p>&nbsp;<\/p>\n<h2><span style=\"font-weight: 400;\">Connection between CVI and varicosis (varicose veins)<\/span><\/h2>\n<p><span style=\"font-weight: 400;\">There is a close connection between CVI and the development of varicose veins, also known as varicosis. Varicose veins are caused by the backflow of blood in the superficial veins, which leads to their enlargement. In truncal varicosis, larger veins are affected, especially the great saphenous vein or the small saphenous vein. These veins play a crucial role in returning blood to the heart. Untreated varicosis can worsen CVI and lead to more serious complications, such as skin changes, venous ulcers, or deep vein thrombosis.<\/span><\/p>\n<p>&nbsp;<\/p>\n<h2><span style=\"font-weight: 400;\">Classification of CVI according to CEAP<\/span><\/h2>\n<p><span style=\"font-weight: 400;\">The CEAP classification is used to better classify the severity of CVI and the affected anatomical structures. It is based on four criteria: clinical presentation (C), etiology (E), anatomy (A), and pathophysiology (P). This classification helps to accurately document the condition of the veins and the course of the disease.<\/span><\/p>\n<h3><span style=\"font-weight: 400;\">C &#8211; Clinical presentation (Clinical)<\/span><\/h3>\n<ul>\n<li><span style=\"font-weight: 400;\">C0: No visible or palpable signs of venous disease.<\/span><\/li>\n<li><span style=\"font-weight: 400;\">C1: Spider veins (telangiectasia) and reticular veins.<\/span><\/li>\n<li><span style=\"font-weight: 400;\">C2: Varicose veins (varicosis), visibly tortuous veins.<\/span><\/li>\n<li><span style=\"font-weight: 400;\">C3: Edema (swelling), which indicates impaired venous function.<\/span><\/li>\n<li><span style=\"font-weight: 400;\">C4a: Skin changes such as pigmentation and eczema.<\/span><\/li>\n<li><span style=\"font-weight: 400;\">C4b: Advanced skin changes, including lipodermatosclerosis and atrophie blanche.<\/span><\/li>\n<li><span style=\"font-weight: 400;\">C5: Healed venous ulcers.<\/span><\/li>\n<li><span style=\"font-weight: 400;\">C6: Active, open venous ulcers (ulcers).<\/span><\/li>\n<\/ul>\n<h3><span style=\"font-weight: 400;\">E &#8211; Etiology (Etiological)<\/span><\/h3>\n<ul>\n<li><span style=\"font-weight: 400;\">Ep: Primary venous insufficiency without recognizable cause.<\/span><\/li>\n<li><span style=\"font-weight: 400;\">It: Secondary venous insufficiency due to previous deep vein thrombosis or other venous diseases.<\/span><\/li>\n<li><span style=\"font-weight: 400;\">Ec: Congenital venous disease.<\/span><\/li>\n<\/ul>\n<h3><span style=\"font-weight: 400;\">A &#8211; Anatomy (Anatomical)<\/span><\/h3>\n<ul>\n<li><span style=\"font-weight: 400;\">As: Superficial veins are affected.<\/span><\/li>\n<li><span style=\"font-weight: 400;\">Ad: Deep veins are affected.<\/span><\/li>\n<li><span style=\"font-weight: 400;\">Ap: Perforating veins (connection between deep and superficial veins) are affected.<\/span><\/li>\n<\/ul>\n<h3><span style=\"font-weight: 400;\">P &#8211; Pathophysiology (Pathophysiological)<\/span><\/h3>\n<ul>\n<li><span style=\"font-weight: 400;\">Pr: Reflux (backflow of blood due to defective venous valves).<\/span><\/li>\n<li><span style=\"font-weight: 400;\">Buttocks: Obstruction (narrowing or blockage of the veins).<\/span><\/li>\n<\/ul>\n<p><span style=\"font-weight: 400;\">The CEAP classification makes it possible to systematically record the disease and select the right therapy for the respective degree of severity of the CVI.<\/span><\/p>\n<p>&nbsp;<\/p>\n<h2><span style=\"font-weight: 400;\">Diagnosis of CVI<\/span><\/h2>\n<p><span style=\"font-weight: 400;\">A comprehensive diagnosis of chronic venous insufficiency is essential to accurately determine the extent of the disease and plan appropriate therapy. <a href=\"https:\/\/venaziel.de\/en\/phlebology\/\">Modern phlebology<\/a> offers various diagnostic procedures that enable a precise assessment of venous function.<\/span><\/p>\n<h3><span style=\"font-weight: 400;\">1. clinical examination and medical history<\/span><\/h3>\n<p><span style=\"font-weight: 400;\">The first step in diagnosing CVI is a detailed medical history, in which the phlebologist asks the patient about symptoms, family history, and possible risk factors. Particular attention is paid to typical complaints such as swelling, a feeling of heaviness in the legs, pain, cramps, or skin changes. This is followed by a clinical examination, in which the doctor assesses visible signs such as varicose veins, skin changes, or ulcers.<\/span><\/p>\n<h3><span style=\"font-weight: 400;\">2. duplex sonography (ultrasound)<\/span><\/h3>\n<p><span style=\"font-weight: 400;\">Duplex sonography is the most important diagnostic tool in CVI diagnosis. It is a combination of ultrasound and Doppler technology that allows the structure of the veins and blood flow to be visualized in real time. Sonography enables the precise assessment of the venous valves and shows whether there is backflow of blood (reflux). This method is non-invasive, painless and enables a detailed analysis of the superficial and deep veins.<\/span><\/p>\n<p><picture class=\"wp-picture-7059\" style=\"display: contents;\"><source type=\"image\/avif\" srcset=\"https:\/\/venaziel.de\/wp-content\/uploads\/2024\/10\/doppler-sonography-cvi-jpg.avif 1200w, https:\/\/venaziel.de\/wp-content\/uploads\/2024\/10\/doppler-sonography-cvi-250x167-jpg.avif 250w, https:\/\/venaziel.de\/wp-content\/uploads\/2024\/10\/doppler-sonography-cvi-1024x683-jpg.avif 1024w, https:\/\/venaziel.de\/wp-content\/uploads\/2024\/10\/doppler-sonography-cvi-768x512-jpg.avif 768w\" sizes=\"(max-width: 1200px) 100vw, 1200px\"><img data-dominant-color=\"83918e\" data-has-transparency=\"false\" style=\"--dominant-color: #83918e;\" decoding=\"async\" class=\"lazyload alignnone size-full wp-image-7059 not-transparent\" src=\"https:\/\/venaziel.de\/wp-content\/uploads\/2024\/10\/doppler-sonography-cvi.jpg\" data-orig-src=\"https:\/\/venaziel.de\/wp-content\/uploads\/2024\/10\/doppler-sonography-cvi.jpg\" alt=\"Leg vascular doppler in standing position in clinic-cvi\" width=\"1200\" height=\"800\" title=\"\" srcset=\"data:image\/svg+xml,%3Csvg%20xmlns%3D%27http%3A%2F%2Fwww.w3.org%2F2000%2Fsvg%27%20width%3D%271200%27%20height%3D%27800%27%20viewBox%3D%270%200%201200%20800%27%3E%3Crect%20width%3D%271200%27%20height%3D%27800%27%20fill-opacity%3D%220%22%2F%3E%3C%2Fsvg%3E\" data-srcset=\"https:\/\/venaziel.de\/wp-content\/uploads\/2024\/10\/doppler-sonography-cvi-200x133.jpg 200w, https:\/\/venaziel.de\/wp-content\/uploads\/2024\/10\/doppler-sonography-cvi-250x167.jpg 250w, https:\/\/venaziel.de\/wp-content\/uploads\/2024\/10\/doppler-sonography-cvi-400x267.jpg 400w, https:\/\/venaziel.de\/wp-content\/uploads\/2024\/10\/doppler-sonography-cvi-600x400.jpg 600w, https:\/\/venaziel.de\/wp-content\/uploads\/2024\/10\/doppler-sonography-cvi-768x512.jpg 768w, https:\/\/venaziel.de\/wp-content\/uploads\/2024\/10\/doppler-sonography-cvi-800x533.jpg 800w, https:\/\/venaziel.de\/wp-content\/uploads\/2024\/10\/doppler-sonography-cvi-1024x683.jpg 1024w, https:\/\/venaziel.de\/wp-content\/uploads\/2024\/10\/doppler-sonography-cvi.jpg 1200w\" data-sizes=\"auto\" data-orig-sizes=\"(max-width: 1200px) 100vw, 1200px\" \/><\/picture><\/p>\n<h3><span style=\"font-weight: 400;\">3. light reflection rheography (LRR)<\/span><\/h3>\n<p><span style=\"font-weight: 400;\">Light reflection rheography is a method for measuring venous return in the legs. Infrared light is directed onto the skin to record blood flow in the superficial veins. This method is particularly helpful in assessing the functional status of the venous valves and determining the severity of CVI.<\/span><\/p>\n<h3><span style=\"font-weight: 400;\">4. phlebography<\/span><\/h3>\n<p><span style=\"font-weight: 400;\">Phlebography is used in more complex cases of CVI, especially when deep vein thrombosis is suspected. In this procedure, a contrast agent is injected into the veins to visualize their course and any constrictions or blockages on X-rays. This method is used less frequently because duplex sonography provides sufficient information in most cases.<\/span><\/p>\n<h3><span style=\"font-weight: 400;\">5. venous pressure measurement<\/span><\/h3>\n<p><span style=\"font-weight: 400;\">Venous pressure measurement is another method for assessing the severity of CVI. The pressure in the veins is measured before and after compression to determine how well the venous valves are functioning and whether venous return is normal.<\/span><\/p>\n<p>&nbsp;<\/p>\n<h2><span style=\"font-weight: 400;\">Modern treatment methods for CVI<\/span><\/h2>\n<p><span style=\"font-weight: 400;\">The treatment of chronic venous insufficiency has developed rapidly in recent years. Thanks to modern, minimally invasive procedures, it is now possible to treat CVI effectively without the need for complex operations. The most important treatment methods are:<\/span><\/p>\n<h3><span style=\"font-weight: 400;\">1. compression therapy<\/span><\/h3>\n<p><span style=\"font-weight: 400;\">Compression therapy is the cornerstone of any CVI treatment. It works by wearing compression stockings or bandages that exert pressure on the veins and support the return of blood to the heart. Compression therapy is particularly effective in the early stages of CVI, but can also be used in combination with other treatment methods in advanced stages.<\/span><\/p>\n<h3><span style=\"font-weight: 400;\">2. VenaSeal (vein glue)<\/span><\/h3>\n<p><span style=\"font-weight: 400;\"><a href=\"https:\/\/www.medtronic.com\/de-de\/patienten\/produkte-therapien\/krampfadern-behandeln\/therapien-von-medtronic\/venaseal-closure-system.html\" target=\"_blank\" rel=\"noopener\">VenaSeal<\/a> is an innovative, minimally invasive procedure for the treatment of CVI and truncal varicosis based on the application of a special medical adhesive. In this method, the vein glue is injected into the diseased vein using a thin catheter probe, where it sticks the vein walls together and closes the vein. The blood flow is then redirected via healthy veins. <a href=\"https:\/\/venaziel.de\/venenzentrum-leistungen\/venenkleber-venaseal\/\">VenaSeal is particularly gentle<\/a>, as no heat or chemicals are used and no compression stockings are required after the procedure. Patients can usually return to their normal activities on the same day. The method is considered one of the most effective and comfortable treatments for CVI.<\/span><\/p>\n<p><picture class=\"wp-picture-5821\" style=\"display: contents;\"><source type=\"image\/avif\" srcset=\"https:\/\/venaziel.de\/wp-content\/uploads\/2024\/09\/VenaSeal-for-krampfadern-behandlung.1-jpg.avif 1200w, https:\/\/venaziel.de\/wp-content\/uploads\/2024\/09\/VenaSeal-for-krampfadern-behandlung.1-250x167-jpg.avif 250w, https:\/\/venaziel.de\/wp-content\/uploads\/2024\/09\/VenaSeal-for-krampfadern-behandlung.1-1024x683-jpg.avif 1024w, https:\/\/venaziel.de\/wp-content\/uploads\/2024\/09\/VenaSeal-for-krampfadern-behandlung.1-768x512-jpg.avif 768w\" sizes=\"(max-width: 1200px) 100vw, 1200px\"><img data-dominant-color=\"c3bdc3\" data-has-transparency=\"false\" style=\"--dominant-color: #c3bdc3;\" decoding=\"async\" class=\"lazyload alignnone size-full wp-image-5821 not-transparent\" src=\"https:\/\/venaziel.de\/wp-content\/uploads\/2024\/09\/VenaSeal-for-krampfadern-behandlung.1.jpg\" data-orig-src=\"https:\/\/venaziel.de\/wp-content\/uploads\/2024\/09\/VenaSeal-for-krampfadern-behandlung.1.jpg\" alt=\"VenaSeal-for-vein-treatment\" width=\"1200\" height=\"800\" title=\"\" srcset=\"data:image\/svg+xml,%3Csvg%20xmlns%3D%27http%3A%2F%2Fwww.w3.org%2F2000%2Fsvg%27%20width%3D%271200%27%20height%3D%27800%27%20viewBox%3D%270%200%201200%20800%27%3E%3Crect%20width%3D%271200%27%20height%3D%27800%27%20fill-opacity%3D%220%22%2F%3E%3C%2Fsvg%3E\" data-srcset=\"https:\/\/venaziel.de\/wp-content\/uploads\/2024\/09\/VenaSeal-for-krampfadern-behandlung.1-200x133.jpg 200w, https:\/\/venaziel.de\/wp-content\/uploads\/2024\/09\/VenaSeal-for-krampfadern-behandlung.1-250x167.jpg 250w, https:\/\/venaziel.de\/wp-content\/uploads\/2024\/09\/VenaSeal-for-krampfadern-behandlung.1-400x267.jpg 400w, https:\/\/venaziel.de\/wp-content\/uploads\/2024\/09\/VenaSeal-for-krampfadern-behandlung.1-600x400.jpg 600w, https:\/\/venaziel.de\/wp-content\/uploads\/2024\/09\/VenaSeal-for-krampfadern-behandlung.1-768x512.jpg 768w, https:\/\/venaziel.de\/wp-content\/uploads\/2024\/09\/VenaSeal-for-krampfadern-behandlung.1-800x533.jpg 800w, https:\/\/venaziel.de\/wp-content\/uploads\/2024\/09\/VenaSeal-for-krampfadern-behandlung.1-1024x683.jpg 1024w, https:\/\/venaziel.de\/wp-content\/uploads\/2024\/09\/VenaSeal-for-krampfadern-behandlung.1.jpg 1200w\" data-sizes=\"auto\" data-orig-sizes=\"(max-width: 1200px) 100vw, 1200px\" \/><\/picture><\/p>\n<h3><span style=\"font-weight: 400;\">3. radiofrequency ablation (RFA)<\/span><\/h3>\n<p><span style=\"font-weight: 400;\">Radiofrequency ablation is a minimally invasive procedure in which a catheter probe is inserted into the affected vein. High-frequency waves heat the vein from the inside, leading to a controlled closure. Radiofrequency ablation is particularly gentle because it is less painful than laser therapy and allows for a quick recovery time. The method is suitable for patients with varicosis and chronic venous insufficiency.<\/span><\/p>\n<h3><span style=\"font-weight: 400;\">4. endovenous laser therapy (EVLT)<\/span><\/h3>\n<p><span style=\"font-weight: 400;\">Endovenous laser therapy is another minimally invasive method for treating varicose veins and CVI. Here, a laser is inserted into the affected vein, which closes the vein by heat. The advantage of this method lies in its precision and the rapid recovery of patients. It is often used in combination with other procedures, especially when larger veins are affected.<\/span><\/p>\n<h3><span style=\"font-weight: 400;\">5. sclerotherapy<\/span><\/h3>\n<p><span style=\"font-weight: 400;\">Sclerotherapy is often used to <a href=\"https:\/\/venaziel.de\/en\/phlebology\/behandlung-von-besenreisern\/\">treat smaller veins or spider veins<\/a>. In this procedure, a special solution is injected into the affected vein, which triggers an inflammation of the vein wall. This closes the vein and redirects the blood flow via healthy veins. Sclerotherapy is particularly effective in the treatment of smaller veins and can be used in combination with other procedures to treat larger varicose veins.<\/span><\/p>\n<p>&nbsp;<\/p>\n<h2><span style=\"font-weight: 400;\">Prevention and lifestyle changes<\/span><\/h2>\n<p><span style=\"font-weight: 400;\">Prevention plays a crucial role in preventing or slowing the progression of chronic venous insufficiency. People with a genetic predisposition or risk factors in particular should pay attention to their veins and make certain lifestyle changes.<\/span><\/p>\n<h3><span style=\"font-weight: 400;\">1. regular exercise<\/span><\/h3>\n<p><span style=\"font-weight: 400;\">Regular exercise promotes blood circulation and prevents blood from pooling in the legs. Endurance sports such as walking, swimming or cycling are particularly effective because they activate the calf muscles and support venous return. People who have to sit or stand for long periods should take regular breaks to move around.<\/span><\/p>\n<h3><span style=\"font-weight: 400;\">2. weight management<\/span><\/h3>\n<p><span style=\"font-weight: 400;\">Being overweight increases the pressure on the veins and promotes the development of CVI. A healthy body weight helps to reduce the pressure on the venous system and reduce the risk of complications.<\/span><\/p>\n<h3><span style=\"font-weight: 400;\">3. leg movements during long periods of sitting or standing<\/span><\/h3>\n<p><span style=\"font-weight: 400;\">If prolonged sitting or standing cannot be avoided, simple leg exercises should be performed to promote blood flow. Elevating the legs during breaks or circling the feet helps to avoid swelling and improve venous return.<\/span><\/p>\n<h3><span style=\"font-weight: 400;\">4. avoid tight clothing<\/span><\/h3>\n<p><span style=\"font-weight: 400;\">Tight clothing in the area of the legs or waist can impede blood flow and should be avoided. Loose-fitting clothing supports blood circulation and reduces the risk of swelling and discomfort.<\/span><\/p>\n<h3><span style=\"font-weight: 400;\">5. stop smoking<\/span><\/h3>\n<p><span style=\"font-weight: 400;\">Smoking not only affects lung and heart health, but also worsens blood circulation and increases the risk of thrombosis. Quitting smoking can slow the progression of CVI and reduce the risk of serious complications.<\/span><\/p>\n<h2><span style=\"font-weight: 400;\">Conclusion<\/span><\/h2>\n<p><span style=\"font-weight: 400;\">Chronic venous insufficiency is a widespread and often underestimated disease that, if left untreated, can lead to serious complications such as venous ulcers. Thanks to modern treatment methods such as VenaSeal (vein glue), radiofrequency ablation and endovenous laser therapy, patients can now be treated effectively and gently. Early diagnosis and therapy are crucial to stop the progression of the disease and improve the quality of life. VenaZiel offers innovative and tailored treatment options to provide optimal care for patients with CVI and varicosis.<\/span><\/p>\n<p>&nbsp;<\/p>\n","protected":false},"excerpt":{"rendered":"<p>Chronic venous insufficiency (CVI) is a widespread condition of the venous system that affects millions of people worldwide. It arises from inadequate function of the venous valves, which normally prevent the backflow of blood from the legs to the heart. However, if these valves fail, blood pools in the veins of the legs, leading to increased pressure, swelling, and long-term damage such as varicose veins (varicosis), skin changes, and even venous ulcers.<\/p>\n<p>CVI develops insidiously and is often only recognized in later stages, when symptoms such as swelling, pain or visible varicose veins have already appeared. People who lead a sedentary lifestyle or have to stand for long periods at work are particularly affected. As the disease is chronic, its course steadily worsens without treatment. Early diagnosis and the right treatment are crucial to improving the quality of life of those affected and preventing serious complications.<\/p>\n","protected":false},"author":1,"featured_media":7056,"parent":4959,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":{"footnotes":""},"class_list":["post-7065","page","type-page","status-publish","has-post-thumbnail","hentry"],"_links":{"self":[{"href":"https:\/\/venaziel.de\/en\/wp-json\/wp\/v2\/pages\/7065","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/venaziel.de\/en\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/venaziel.de\/en\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/venaziel.de\/en\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/venaziel.de\/en\/wp-json\/wp\/v2\/comments?post=7065"}],"version-history":[{"count":9,"href":"https:\/\/venaziel.de\/en\/wp-json\/wp\/v2\/pages\/7065\/revisions"}],"predecessor-version":[{"id":50432,"href":"https:\/\/venaziel.de\/en\/wp-json\/wp\/v2\/pages\/7065\/revisions\/50432"}],"up":[{"embeddable":true,"href":"https:\/\/venaziel.de\/en\/wp-json\/wp\/v2\/pages\/4959"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/venaziel.de\/en\/wp-json\/wp\/v2\/media\/7056"}],"wp:attachment":[{"href":"https:\/\/venaziel.de\/en\/wp-json\/wp\/v2\/media?parent=7065"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}