Acute Venous Disease vs Chronic Venous Insufficiency: Symptoms, Causes, Differences, and Treatments

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Venous diseases can be a traumatically painful ailment, and it often takes prudent diagnosticians to identify their presence, especially that of venous insufficiency. Despite many types of venous diseases, they can all be classified as either acute venous disease or chronic venous insufficiency.  

So what are the differences between acute venous diseases and chronic venous insufficiency? The difference lies in the duration, the manifestation of symptoms, the severity of the venous disease, causal factors, prognosis, and recommended treatment options. It’s imperative to understand these differences and recognize them as early as possible for a speedy recovery and the eventual return to normalcy. 

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Types of Venous Diseases 

As mentioned earlier, venous diseases can either be grouped under acute venous disorders or under chronic venous insufficiency. While there are certain areas of similarity between them with regards to stemming from pre-existing conditions, there are key differences that prescribe different management plans. 

Acute venous diseases including pulmonary embolism and deep vein thrombosis frequently arise without any prior medical issues. Deep venous thrombosis, superficial venous thrombophlebitis, and venous trauma are examples of acute venous diseases. The most common cause of deep venous thrombosis (acute DVT) is the interaction of numerous hereditary and acquired risk factors.

On the other hand, chronic venous insufficiency (CVI) is when the valves that regulate blood flow back to your heart don't operate properly. As such, blood might back up into your legs. Blood will then pool or collect in the veins as a result of this. 

Chronic venous insufficiency can cause skin changes, leg pain, and edema over time. It can also cause a type of open sore on the exterior of the leg known as a venous ulcer. The severity of these symptoms is what causes CVI to be classified under chronic venous diseases

Acute Venous DiseaseChronic Venous Insufficiency Blood clots get developed in a superficial vein usuallyBlood clots occur in deep veins that are critical for circulationThe long-term effects of acute venous disease are minimalThe long-term consequences of chronic venous insufficiency are significantAcute venous disorders aren’t usually life-threateningAn untreated or undiagnosed chronic venous insufficiency can be fatalAcute venous diseases don’t usually progress into advanced stages with proper treatmentDelay in treatment can cause it to progress into more malignant stages of CVIIn acute venous diseases, mild bleed from varicose veins occursChronic venous Insufficiency is indicated by severe bleeding and ulcerations around varicose veinsThey can usually be resolved with medication and anticoagulant therapyIn severe cases, they may require minimally-invasive vascular surgery

Causes of Acute Venous Disorders and Chronic Venous Insufficiency

Despite differences in their effects, the major difference between the causes for acute venous disorders and chronic venous insufficiency lies in the location and severity of the blood clot. Blood clots in relatively benign and superficial veins for a short period of time are associated with acute venous diseases while chronic venous insufficiency is caused due to the blood clot and varicose veins occurring in deep veins. 

Apart from that, here are some of the common causes of venous insufficiency:

  1. Long periods of physical inactivity
  2. Unhealthy eating habits
  3. History of blood clots
  4. Weakening of valves due to old age
  5. Obesity and an unhealthy BMI
  6. Fatigued muscles
  7. Pregnancy
  8. Smoking

Moreover, acute venous disorders are more likely to be caused by accidental injuries while underlying medical and physical conditions are indicative of chronic venous insufficiency. 

Symptoms of Acute Venous Disease and Chronic Venous Insufficiency

In general, symptoms of acute venous disease and chronic venous insufficiency differ by duration and mortality.

Symptoms of Acute Venous Disease

  • Superficial Vein thrombosis
  • Mild variceal bleeding
  • Short-term symptoms lasting for about 14 days
  • Partial blocking of the vein
  • Temporary damage to the valves
  • Acute pain and swelling in the leg
  • Minor blood clots in the leg veins

Symptoms of Chronic Venous Insufficiency

  • Varicose veins
  • Venous stasis
  • Venous Hypertension
  • Chronic deep vein thrombosis
  • Chronic pain in lower limbs for a long time
  • Long-term symptoms that last well past 28 days
  • Painful muscle cramps and spasms in the legs
  • Total venous reflux with partial or complete blocking of the veins
  • Valves can get permanently damaged
  • Difficulty in sleeping (sleep apnea)
  • Intensive swelling with discoloration and skin changes
  • Leg vein ulcers
  • Itchiness and irritation combined with hardened skin

Diagnostic Measures for Acute and Chronic Venous Insufficiency

The first step to diagnosing these venous ailments is to begin by taking a comprehensive medical history of the patient. Depending on your lifestyle, genetics, hereditary conditions, and recent activities, the cause, and type of venous insufficiency can be identified. 

Lower extremity duplex ultrasound is used in the diagnosis of chronic venous insufficiency. A transducer (small hand-held device) is put on the skin above the vein to be investigated during vascular ultrasonography. 

In this procedure, sound waves are emitted by the transducer and bounce off the vein. The recorded sound waves are used to develop a picture of the affected vein which is generated and displayed on the monitor. In more recent times, interventional radiology imaging is done to get conclusive evidence of the type of venous disorder. 

The local tissue effects of venous insufficiency are caused by a combination of elevated venous pressure and decreased cellular metabolite clearance from the lower extremities. Untreated venous insufficiency can lead to the following complications:

  • Venous hypertension
  • Secondary lymphedema
  • Pulmonary embolism (PE)
  • Peripheral arterial disease
  • Post-thrombotic syndrome
  • Venous ulceration
  • Deep venous thrombosis (DVT)

Regardless of whether you suffer from an acute venous disorder or chronic venous insufficiency, it’s important to use the right diagnostic measures to identify it as early as possible to get the best prognosis for recovery. 

This is because when it’s left untreated, the pressure and swelling in your legs will burst the capillaries, which are microscopic blood vessels. This may cause your skin to turn reddish-brown, especially around your ankles. Swelling and ulceration can result as a result of this. These ulcers are extremely difficult to heal, and they’re also more likely to become contaminated, which can lead to further complications.

Treatment for Acute and Chronic Venous Insufficiency

Horse chestnuts

A patient suffering from chronic venous insufficiency should be treated according to the degree and nature of their condition. Reducing edema, mitigating pain, maintaining skin discolorations, healing ulcers, and eliminating uncomfortable varicose veins are among the therapeutic goals. Compression therapy, weight management, leg elevation, and exercise targeting the calf muscles are viable treatment strategies. 

Non-surgical Treatments

  • Herbal Therapy: The herbal dietary supplement Vena-Stat, which comprises a derivative of horse chestnut extract, has helped some patients. Herbal preparations should not be used in place of your prescription prescriptions, and they should be used with caution because vascular medicine has the propensity to interact with your present medications. Any possible drug interactions should be discussed with your doctor or pharmacist.
  • Medication and use of anticoagulants/antibiotics: Some medicines that enhance blood flow through the vessels may be used to help heal leg ulcers and acute venous diseases. Meanwhile, aspirin and other anticoagulants can also be used to aid in the healing of ulcers by helping ease the blood flow. On the other hand, antibiotics may also be administered to treat CVI-related skin infections, but the underlying condition must first be treated to avoid recurrence. 
  • Physical Therapy: Physical therapy and regular physical exercise is the best way to improve blood flow and circulation in the affected veins. Maintaining a higher (elevated) position for your legs will assist minimize swelling. Compression stockings may also be beneficial. 
  • Unna Boot: An Unna Boot is a special medicated wrap that combines multilayer compression with a zinc oxide gel-based wound cover to create a semi-rigid bandage. There are several multilayer compression systems on the market, and they're frequently utilized in conjunction with topical wound care solutions.

Surgical and Medical Procedures Offered by the Vein Center Doctor

Vascular surgery is rarely ever required for mild cases of acute venous diseases. In advanced stages of CVI, however, surgeries may become a necessity to mitigate the venous ulcerations and heal the varicose veins. In fact, only 10 in 100 patients require intensive surgery or medical procedures to treat their chronic vein insufficiency. 

Here at The Vein Center Doctor, we strive to provide medical excellence in the diagnosis, treatment, and management of venous diseases (both acute and chronic). We offer comprehensive surgical and medical procedures that will help relieve you of the adverse health effects of CVI. 

Here are a few of our noteworthy treatment options: 

1) Sclerotherapy

Sclerotherapy involves targeting the affected varicose or spider veins by directly injecting a solution into them. This solution also streamlines the blood flow by causing the varicose veins to collapse. 

It’s a minimally invasive medical procedure that provides pain relief to the patients while also serving as insurance against further progression into venous ulceration or venous hemorrhage. It achieves this by redirecting blood flow away from scarred veins and into the healthy veins. 

2) Ambulatory Phlebectomy

This is also a minimally invasive surgical procedure for treating chronic venous insufficiency and complicated cases of acute venous diseases. The process involves making micro-incisions, cuts, or needle punctures along the affected vein. 

After this, phlebectomy is performed to remove the damaged veins and streamline blood flow back to normalcy. Small hooks are employed to perform this type of vascular surgery successfully. 

3) Venous Repair and Transplant

The surgeon will attempt to repair the damaged venous valves that are causing venous reflux. This is achieved by making an open cut in the leg near the affected vein. An alternative is to insert a catheter through a small incision or opening into the vein. In cases in which repair of the vein or valve isn’t viable, a vein transplant is a feasible option. 

4) Stripping and Litigation

These are 2 separate procedures that are performed sequentially one after the other to treat patients suffering from acute venous diseases or CVI. Vein ligation is a treatment in which the troublesome veins are cut and tied off by a vascular surgeon. Blood will no longer flow through the afflicted vein because it has been shut off. 

The vein will be removed if it or its valves are severely damaged. The surgical removal of bigger veins through two small incisions is known as vein stripping. Stripping is a more involved treatment that can take up to 10 days to recover from. Bruising frequently lasts for several weeks after surgery.

5) Venous Bypass

Vein bypass surgery involves rerouting blood around the vein afflicted by CVI by using a healthy vein transplanted from another part of your body. They'll utilize it to divert blood around the vein that's been damaged. Only in the most severe cases of CVI in the upper thigh is bypass surgery performed. In most cases, hospitalization for 2 to 5 days is considered normal. 

6) Endovenous Thermal Ablation

Endovenous thermal ablation is a recent treatment that creates severe local heat in the afflicted vein using laser or high-frequency radio waves. Each energy source has its own technology, but both types of local heat close in on the target vessel. The veins are sealed while remaining in place, resulting in minimal bleeding and bruising. 

As opposed to ligation and stripping, endovenous thermal ablation causes less pain and allows for a faster return to regular activities while maintaining equal cosmetic benefits. This procedure is also called radiofrequency ablation or RFA. 

Management and Preventive Measures

Despite the differences between acute venous diseases and chronic venous insufficiency, the management measures are more or less the same. 

Management Methods

  • Ensure you prioritize a good, hygienic skincare routine
  • Use compression stockings to help your recovery
  • Apply topical ointments and antifungal creams over the venous ulcers
  • Wet compressions can also provide relief from the pain and cramps
  • Make sure you don’t sit or stand for long hours
  • Keep your skin moisturized and drink plenty of water
  • Minimize the amount of sodium in your diet

Preventive Measures

  • Ensure that you are not overweight or obese as this is a serious risk factor
  • Make sure you stick to a highly disciplined and consistent physical exercise regiment
  • Avoid smoking at all costs
  • Maintain a healthy and balanced diet
  • Abstain from wearing tight clothing or apparel that can further restrict venous blood flow
  • Avoid extended periods of sedentary behavior 

Safe and Long-term Treatments for Venous Insufficiency at Vein Center Doctor

Acute venous disorders and chronic venous insufficiency are often underestimated in terms of the impact they have on your overall health. With women having a significantly greater likelihood of getting venous diseases, it has been observed that most complications are a direct repercussion of delayed diagnosis and treatment. Trusted clinics that offer many different treatment options for your venous conditions must be tapped right away. 

At Vein Center Doctor, we can easily spot the signs and symptoms of your vascular disorders at once and give you excellent outpatient vein treatments. Dr. Rahul Sood leads a team of some of the best vein care professionals, ensuring that our treatments and surgeries are both safe and have high success rates. To book your consultation, get in touch with us today.

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