Similarities and Differences Between Chronic Venous Insufficiency and Venous Thrombosis

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Rahul Sood

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Chronic venous insufficiency (CVI) is quickly becoming the most common venous disease in the world — affecting as many as 2.5 million Americans. Likewise, venous thrombosis is another condition becoming more common across older populations. Since both affect the veins, it’s easy for some to think that they’re one and the same. But CVI and venous thrombosis happen differently, and symptoms vary per person.

So what are the similarities and differences between CVI and venous thrombosis? While they’re both venous conditions and may share similar treatments, CVI is what happens when blood pools in a person’s veins, usually in the legs and venous thrombosis is caused by a blood clot obstructing the veins. 

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Chronic Venous Insufficiency

Chronic venous insufficiency (CVI) or venous reflux is a widespread illness that affects millions of Americans a year. Typical symptoms include leg pain, edema, skin irritation, and the formation of varicose veins. Age, heredity, pregnancy, and obesity are all risk factors. Patients with CVI frequently complain of heaviness in the legs, as well as persistent venous ulcers.

If you don’t treat venous reflux, it usually gets worse over time. The patient may also develop intense pain, leg swelling, itching, and skin discoloration. Compression garments are a common form of management, but not many people follow medical advice about the length of therapy. Instead, many people choose to have surgery with varying degrees of success.

How It Happens

The arteries have the task of carrying blood from the heart to the rest of the body. On the other hand, blood gets back to the cardiac muscles via the veins, which have valves to prevent blood from flowing in the opposite direction. When this process fails to happen normally, venous insufficiency may happen.

Venous insufficiency occurs when the veins in your body have difficulty returning blood from your extremities to your heart. The valvular incompetence results in the accumulation of blood in the leg veins. 

Even though a number of different conditions can cause venous insufficiency, the most common ones are blood clots, varicose veins, as well as exposure to the following risk factors:

  • Obesity
  • Nicotine use
  • Cancers
  • Overexertion
  • Leg injuries
  • Prolonged periods of sitting or standing
  • Hypertension or high blood pressure

Despite the harsh symptoms that can happen to patients with CVI, recovery is possible. Treatment plans focus on reducing inflammation of the veins, as well as maintaining healthy lifestyle habits. There are also several non-surgical methods used to get rid of problem veins with valvular incompetence. 

Clinical Symptoms

The signs and symptoms of CVI vary per person, although these usually manifest in the legs. For some people, the symptoms may not be very clear at first. CVI symptoms typically get worse in the heat or during the later hours of the day. Pain also gets better when the legs are at a raised angle. 

Despite the variations in the symptoms, the patient’s experiences are crucial in making a diagnosis. The doctor will cross-reference these physical symptoms with CVI, alongside the use of other diagnostic methods.

Some of the most common CVI symptoms include:

  • Edema or swelling in the legs and ankles
  • Persistent leg cramps
  • Intense pain that worsens when standing but improves when the legs are raised
  • Pain that worsens when standing and improves when the legs are raised.
  • Heaviness of the legs
  • Feelings of itchiness
  • Weakness in the legs
  • Skin discoloration around the ankles
  • Venous leg ulcers
  • Formation of new varicose veins

How It’s Diagnosed and Treated

Doctors will begin the diagnosis by asking the patient about their medical history. It is crucial for the physician to know about previous venous conditions, such as deep vein thrombosis (DVT). Family history also plays an important role in the diagnosis since people whose relatives have CVI also have a higher chance of developing it. 

The doctor will also conduct a physical exam of the legs to check the calf veins and surrounding areas. Two other diagnostic procedures—duplex ultrasound and venogram—are used to determine if a patient has CVI. Both help the doctor identify problem veins through a resulting image. 

In a venogram procedure, the physician provides a contrast dye through intravenous infusion. The dye helps create a clear picture of the blood vessels through X-ray imaging. The resulting image will show a clear map of blood circulation, making it easy to identify any problem veins. 

The duplex ultrasound is a procedure used to observe the direction and rate of vein circulation. During the operation, doctors apply a small amount of gel to the general area where the patient feels symptoms. After this, a technician will push a handheld instrument that produces sound waves to bounce off the skin. This process results in a clear image that appears on a computer. 

Treatment in patients will be influenced by multiple variables, including the cause of your venous reflux. Any other illnesses you have will also impact the treatment plan, especially if you take any medication for management. Any active venous leg ulcers may also delay the treatment, depending on your doctor’s discretion.

Some of the commonly prescribed treatment plans include:

  • Prescription medicine, including blood-thinning ones
  • Lifestyle changes
  • Compression garments
  • Surgery
  • Non-invasive vein removal procedures

Venous Thrombosis

Legs examined by a doctor.

Another common venous condition, venous thrombosis is what happens when blood clots form in the veins. The clots result in venous obstruction, which can produce painful symptoms that can affect daily functioning. 

How It Happens

The body’s initial response to prevent drastic blood loss is coagulation or clotting. The formed clots act as seals to stop cuts or wounds from bleeding profusely. These clots generally help the body restore itself, and they usually break down once healing is complete. However, there are instances when the body fails to dissolve the clots properly.

When a blood clot stays inside an artery or vein, it becomes a “thrombus.” A thrombus in the vein causes venous thrombosis, which can spell trouble for your lower extremities. In the worst case, venous thrombosis may affect the deeper veins of the body. This condition is also called deep vein thrombosis or DVT. It can be very painful and may require fast medical intervention. 

Venous thrombosis may happen randomly, but certain factors and conditions may place people at higher risk. These include:

  • Previous surgical operations
  • Sedentary lifestyle
  • Some oral contraceptives
  • Pregnancy
  • Inflammatory bowel disease
  • Obesity

Clinical Symptoms

Although venous thrombosis commonly occurs in the legs, it can happen in any part of the body. Clinical features depend on the area of the thrombus. People experiencing venous thrombosis in the legs may experience pain and swelling. They may also experience tightness in the ankles and surrounding calf muscles. Some patients may not even experience much discomfort in the initial stages of the condition. 

Patients may also develop venous thrombosis in the arm or neck. These commonly happen if they underwent a surgical procedure or treatment that required the insertion of a catheter. Swelling may occur in these areas, sometimes with accompanying inflammation. 

People who have conditions like Crohn’s disease and ulcerative colitis may also develop abdominal venous thrombosis. These may cause slight discomfort but can be fatal in rare cases.

There are also some instances of a vein thrombus traveling to the lung arteries, causing a pulmonary embolism (PE). PE cases may cause difficulty breathing, chest pain, and bloody cough. If you experience symptoms of PE, head to the emergency room right away for urgent medical care.

How It’s Diagnosed and Treated

Much like other conditions, venous thrombosis treatment begins with a medical history assessment. Your doctor will ask you about your physical symptoms. There will also be a physical exam to determine the sites of inflammation and skin discoloration. 

A combination of blood tests and non-surgical procedures may be used to determine if you have venous thrombosis. These include:

  • D-dimer test. This is a blood test used to check for a specific protein in the blood. Patients with severe cases of venous thrombosis usually have an elevated level of D-dimer protein. 
  • Duplex ultrasound and venography. Much like in CVI, ultrasound and venography can be used to determine if you have venous thrombosis. These procedures allow doctors to have an image of the affected veins. 
  • Magnetic resonance imaging (MRI). An MRI scan may help determine if there is a case of abdominal venous thrombosis. 

Treatment in patients of venous thrombosis involves the use of drugs, medical equipment, lifestyle changes, and non-invasive procedures. Surgical treatments may be used in extreme cases.

Blood thinners or anticoagulants are commonly used to prevent the body from developing more clots. These drugs also prevent existing thrombi from accumulating in size. Additionally, blood filters may be used to treat thrombosis in larger veins—these devices help prevent clots from traveling to the lungs. 

Lifestyle changes to help prevent further cases of thrombosis include light exercise and eating a healthy diet. Doctors will also ask you to wear compression stockings to help reduce blood pooling in your legs. These may become part of a patient’s daily attire for months to years, depending on the severity of their thrombosis. 

Lifestyle Changes to Prevent CVI and Venous Thrombosis

Lifestyle changes can help prevent CVI and venous thrombosis, although they will not treat these conditions on their own. These involve increasing physical activity, consuming healthier food, and taking supplements.

The risk of CVI increases when a person sits or stands for prolonged periods of time. If you have a job that confines you to a desk or makes you stand for hours, it is best to take frequent breaks to prevent blood from pooling in the legs. Most people are advised to elevate their feet when sitting.

Additionally, overweight and obese patients are also asked to increase their physical activity and watch their meal portions. Obesity is linked to higher risks of CVI and thrombosis. Before trying out new workout routines, make sure to notify your doctor to ensure safety. Some exercises may exacerbate symptoms of CVI.

There are also a few herbal supplements that may be used as a complementary measure to increase protection against CVI. Some of the most well-known ones include the following:

  • Horse chestnut seed extract
  • Micronized purified flavonoid fraction
  • Rutosides
  • French maritime pine bark extract

The efficacy of these supplements has not been fully studied. Their supposed benefits are based on limited clinical trials. Make sure to consult your doctor before taking any of these substances.

Effective CVI and Venous Thrombosis Treatments Offered at Vein Center Doctor

There are a few non-invasive vein treatments that doctors can use to treat CVI and venous thrombosis. Vein Center Doctor offers 4 of them, namely:

  • Sclerotherapy
  • VenaSeal
  • Venous Compression Therapy
  • RFA for Varicose Veins


Sclerotherapy is a non-invasive treatment option that removes varicose and spider veins. The process involves the use of chemicals to seal off the problem veins. This form of therapy helps improve the appearance of the leg veins. Additionally, sclerotherapy can drastically improve pain and inflammation caused by malfunctioning veins.

Doctors begin the process by cleaning the affected area. After sterilizing the site, a sealant will be injected. The solution will shut off the malfunctioning vein, allowing blood to flow into healthier blood vessels freely. The body absorbs the sealed vein after a few months.


VenaSeal is another treatment option that uses a special medical adhesive to seal off problem veins. The procedure works by shutting out the entire vein altogether, diverting blood circulation to the surrounding healthier veins.

Specialists will also use ultrasound equipment to get a clearer view of the problem veins. The sound waves will also help guide the insertion of the catheter, which will be used to release the adhesive into the veins.

Venous Compression Therapy

Venous compression therapy uses garments to manage conditions like CVI and venous thrombosis. These special garments apply a healthy amount of venous pressure onto the affected area—encouraging healthy blood circulation.

This form of treatment works best when paired with other procedures, like sclerotherapy and VenaSeal. The garments help keep the healing veins in check, reducing inflammation in the treated area. Doctors typically advise patients to wear these garments for a couple of months to maximize the effects on venous function.

RFA for Varicose Veins

Radiofrequency ablation (RFA) is a non-invasive procedure that removes varicose veins through heat therapy. Through a small cut in the skin, doctors will insert a catheter directly into the vein. An apparatus is then used to release radiofrequency waves.

The heat will disrupt the blood flow in the problem veins, forcing them to shrink. Blood circulation will flow through the healthier veins in the nearby area. Like in sclerotherapy and VenaSeal, the body absorbs the vein on its own after a few weeks or months.

Get the Best Vein Treatment Options At Vein Center Doctor

Vein Center Doctor is a top healthcare provider that serves areas in New York and New Jersey. The clinic offers 4 safe treatment plans that address your vascular disease. We believe that invasive treatment isn’t necessary to resolve conditions like superficial thrombophlebitis, CVI, and other similar venous diseases.

With the help of our team of doctors, you can begin your journey to restoring your vein health. To know more about how to treat your superficial veins, book a consultation with our team today.

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Rahul Sood


About Rahul Sood

Dr. Rahul Sood is a triple board-certified physician who specializes in cosmetic vein treatment, namely spider veins and varicose veins, as well as any accompanying issues related to venous insufficiency such as leg pain. He has carried out over 10,000 leg procedures during 10-plus year career and is highly regarded throughout Westchester County and New Jersey.

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