Chronic Venous Insufficiency vs Peripheral Arterial Disease: What’s the Difference?

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One of the risks of developing vascular diseases like chronic venous insufficiency and peripheral arterial disease is that it can often be difficult to tell them apart from one another, which can complicate any diagnosis and treatment. And given the several complications that can develop from vascular diseases, it's important to understand the exact type of vascular disease you’re dealing with so you can start on an effective treatment option immediately.

So what's the difference between conditions like chronic venous insufficiency (CVI) and peripheral arterial disease (PAD)? While both are conditions that affect the blood vessels, CVI affects your venous system and PAD affects your arteries. It's important to know the difference since their symptoms can manifest in similar ways but possible treatments can also differ between them.

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What is Chronic Venous Insufficiency?

Chronic venous insufficiency is a condition where your veins experience an excess pooling of blood. This condition often occurs in your legs, since they're constantly going against gravity to get blood back up to your heart. When your body gets into a state where your veins are starting to struggle to circulate the blood back to the heart, blood starts to pool in your veins - causing CVI.


CVI has a variety of causes, but the vast majority of cases are usually because of damaged vein valves or vein walls. These damaged veins can distort, swell, twist, and otherwise prevent the normal flow of blood through them, which can manifest in chronic venous insufficiency if left untreated.

Some of the common causes for this condition include:

  • Leg injuries: usually caused by accidents or similar trauma to the legs
  • Hormonal changes: either because of medications like birth control or conditions like pregnancy
  • Pre-existing conditions: high blood pressure and diabetes can easily affect vein systems
  • Blood clotting in deep veins: cases like deep-vein thrombosis can also cause blockages
  • Lifestyle: people who sit around all the time or don't keep their legs elevated

Chronic venous insufficiency doesn't always start out as a chronic condition: in some cases, acute causes like varicose veins can trigger CVI if left untreated. This is why it's important to immediately ascertain the cause of your condition so you can start on the right treatment option.


The symptoms of CVI are usually found in the lower half of your body, from your legs to your feet. These symptoms are generally not very serious in the beginning, but can quickly become more difficult to manage the longer they're left untreated.

  • Varicose veins
  • Skin discoloration and rough skin texture
  • Painful swelling of the legs and ankles
  • Sensitive or itchy skin
  • Pain when you move your legs or stay still for too long

The symptoms of CVI are far worse depending on your personal conditions - for example, obese patients may experience far worse symptoms or more severe types of pain from CVI. 


On its own, chronic venous insufficiency is not a fatal disease - and the treatments for the condition can offer significant relief and head off far more serious symptoms. But like any disease that affects your blood and your circulatory system, there can be complications if your CVI isn't treated.

  • Burst capillaries: with the excess blood pooling in your veins, smaller blood vessels like your capillaries can get overwhelmed by the increased pressure and burst
  • Venous ulcers: burst capillaries and other failing or damaged cell walls can erupt in venous ulcers - open sores in your skin that can don't heal easily
  • Cellulitis: any open sores or wounds on the skin are at higher risk of being infected by bacteria, which can cause skin infections that can spread all over your legs

Complications from CVI can be difficult to treat because your body's own healing response is compromised by your condition. In many cases, treating CVI is the best way to prevent or recover from these adverse effects.

What is Peripheral Arterial Disease?

Peripheral arterial disease occurs when your arteries - the blood vessels responsible for bringing your blood all over your body - don't let blood flow freely anymore. This can be particularly deadly for the extremities of your body like the legs and feet since they don't get the oxygen and nutrients they need from your body to function well.


Arteries that aren't working properly can cause a cascade of issues with your body, and to the arteries themselves. Any injury or condition that affects your arterial walls can trigger PAD, but some culprits are more likely than others.

  • Atherosclerosis: plaque buildup on the artery walls caused by excess fat and cholesterol in your body, usually the most common cause
  • Arterial inflammation: from pre-existing conditions or injury to the arteries around the legs
  • Limb injuries: excessive trauma and other damage to the circulatory system in your legs can also trigger PAD
  • Medical history: people who have experienced heart attacks, strokes, and other problems with their blood
  • Genetics and age: the older the patient is, the more they're at risk of PAD, especially if it runs in the family

Peripheral arterial disease is a common condition that affects millions of people, though it's important to get to the main cause to start immediate treatment. Untreated PAD can lead to severe complications - and even if it doesn't, it can greatly impact your quality of life.


One reason why PAD can be so difficult to manage for doctors and patients alike is that symptoms can often differ depending on your body. Some patients may not even have symptoms at all until a severe complication already occurs. Things to watch out for include:

  • Slow healing for injuries sustained around the legs and feet
  • Consistent leg aches and cramps that only stop when you rest
  • Skin discoloration or uneven skin tone, usually along with the shades of blue
  • Hair and nails growing slower than usual
  • Differences in sensation and temperature between one leg and the other

Peripheral arterial disease usually manifests as a failure of your limbs to receive any oxygen and nutrients that they need. If one of your arms or legs suddenly starts behaving or feeling differently for no reason at all, you should get yourself screened for PAD.


Complications from PAD are far more severe compared to other venous conditions since the lack of nutrients and oxygen to your limbs can cause the muscles and tissue to break down entirely. Aside from the loss in movement, your body will be less likely to recover from any injuries or wear and tear.

  • Gangrene: tissue death caused by the lack of oxygen to the specific body part, usually resulting in amputation
  • Infection: sores and other wounds in a PAD-affected area are less likely to heal faster, which can mean infection
  • Heart attack and stroke: disrupted blood flow can affect your entire circulatory system, which can affect the blood flow to essential organs like the brain and heart

Complications from PAD become far more serious if you're over the age of 50 since your body's slowing processes mean you're less likely to handle an adverse complication well. In worst-case scenarios, the complications caused by the peripheral arterial disease can be fatal.

What Are the Treatments for These Vascular Diseases?

Doctors examining a blood vessel

As vascular diseases, the main focus of your treatments for CVI and PAD would be to restore the normal function of the affected veins and arteries, and manage your symptoms before they get worse. Because they both affect the blood vessels, treatments for CVI and PAD can sometimes be one and the same.

1) Medications

Suitable for CVI and PAD

Medications for CVI and PAD will often focus on restoring proper blood flow to your blood vessels, either by removing anything that causes a plaque buildup or by dilating the blood vessels so your blood pressure normalizes. These medications can also be used to help lower the severity of your symptoms, especially when your condition has progressed significantly before you managed to get treatment.

Keep in mind that medications are usually not the only treatment option a healthcare provider will consider: in most cases, they're usually supporting treatments alongside a primary treatment option. However, medication may be enough if your vascular disease was caught early - for more information, consult your doctor.

2) Thrombolysis

Suitable for CVI and PAD

A specific application of drugs is via the use of thrombolytic therapy or the removal of blood clots through medication. Because blood clots can pose a potential long-term threat to any circulatory system, thrombolysis is often used as a treatment to slow down and eventually dissolve any clotting in your system. It's most effective as a treatment after strokes and heart attacks, which are complications you can experience from vascular disease.

Thrombolytic therapy should be done with caution, as one of its most common side effects is excessive bleeding. If a facility isn’t well-equipped to handle a patient that needs thrombolysis, going through with this treatment may result in serious complications.

3) Sclerotherapy

Suitable for CVI

For patients who are looking for non-invasive options to treat their veins, sclerotherapy has become one of the most popular methods in the last few years. Sclerotherapy is a treatment where a special compound is injected into your affected veins, which causes them to thicken and then seal themselves shut. The resulting scarred vein can no longer accept any blood flow at all and is reabsorbed back into the body after some time.

Sclerotherapy is especially effective with severe CVI since it redirects your blood flow towards the veins that are still functioning properly, which can ensure that normal blood flow gets returned to your heart. It's relatively non-invasive since it requires no surgery or incisions, and patients can resume their normal activities after being prescribed sufficient rest by their doctors.

4) Angioplasty

Suitable for PAD

Angioplasty is a procedure where a catheter is inserted inside your damaged blood vessel with a small balloon on the tip. This balloon inflates once it's in the blocked area, flattening any plaque that you have against the artery walls and re-opening the artery that potentially widens the overall size of the artery as well to increase blood flow.

In some cases, your doctor may also insert a stent, which is a mesh tube that stays inside the artery after your procedure and expands to keep the artery unblocked. Typically, these surgical treatments are reserved for major blocked arteries that are close to the heart or if the patient needs a quick treatment option to stabilize their blood flow again.

5) Lifestyle Changes

Suitable for CVI and PAD

In the cases where CVI and PAD have been caught early, lifestyle changes like a healthier diet, quitting smoking, and consistent exercise are often enough to manage the symptoms of either vascular condition. By keeping the body in good shape, patients can restore normal function to their circulatory system and drastically improve their quality of life at the same.

Lifestyle changes can also help in cases of severe CVI or PAD to speed up recovery or improve results. While this type of treatment may require a comprehensive look and recovery routine for the patient, having a lifestyle that helps keep your body healthy is one of the best ways to avoid any further complications with either vascular disease.

Get Treatment for Varicose Veins, Deep Vein Thrombosis, and Other Vascular Diseases at Vein Center Doctor Today

While peripheral arterial disease and chronic venous insufficiency are both conditions where something goes wrong with your blood flow, understanding the difference between these venous diseases is the best way to get symptoms treated before they get worse. Differences in these conditions can also inform your risk factor for developing either disease, especially if your family history or medical history indicates you're at risk.

As experts in vascular diseases, Vein Center Doctor can help you with conditions like peripheral artery disease or varicose veins with effective long-term treatment. As specialists in non-invasive procedures, we pride ourselves on our facilities, customer service, and the efficacy of our treatments.

Reach out to us today and call 1-862-227-1054.

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