Treatment

How is CVI treated?

It is best treated early for good results and the goal of the treatment is to prevent pooling of the blood and leg ulcers. It is as follows:

  • Avoid prolonged sitting or standing
  • In long journeys keep flexing and extending your legs and ankles 10 times every 30 mins to keep the blood flowing through the leg veins.
  • If you have a standing job take frequent breaks to sit down and elevate your legs.
  • Exercise regularly – walks
  • Lose weight if over weight
  • Elevate your legs over the level of your heart.
  • Wear compression stockings
  • Antibiotics if skin is infected
  • Practice good skin hygine

Do compression stockings help?

This is the main stay of the treatment of CVI along with leg elevation. The grade of compression varies from 8-10 mmHg and goes upto 40-50 mmHg. Your doctor will recommend what is suitable for you.

Do drugs help?

  • Antibiotics – there is a role if cellulitis occurs or the patient develops infected ulcers.
  • Anticoagulation – may be given in post-thrombotic syndrome to prevent clot formation.
  • Multilayer compression dressings with topical wound care.
  • Skin care – moisturizers are used to prevent cracking of the skin. If there are no cracks in the skin then anti-itch cream maybe used (hydrocortisone + zinc oxide) to protect skin. At times anti-fungal cream may be used to prevent fungal infection. Leaking skin is treated with wet compresses.

Is sclerotherapy and RFA indicated in CVI?

Sclerotherapy injection is needed in the small veins causing them to disappear after collapsing. It generally involves multiple sittings. It is inexpensive and a simple technique performed in the outpatients. By this the pain and discomfort of these veins is lost and complications like venous ulceration and hemorrhage are prevented.

In Radio-Frequency Ablation (RFA) there is intense local heat within the vein ablating it. The targeted veins are closed shut but left in place to prevent excessive bruising. The patients return to normal activity the next day.

Is bypass surgery an option?

Healthy veins are removed from elsewhere in the body to re-route the blood around the veins affected by CVI. This only done as a last resort when all other options have been exhausted.

Can CVI be prevented?

The only way is to reduce the risk factors by following the following guidelines.

  • Eat a healthy balanced diet
  • Quit smoking
  • Exercise regularly
  • Avoid wearing restrictive clothing like tight girdles and belts.
  • Lose weight if over weight
  • Avoid prolonged sitting or standing.