Patients come to Minnesota Vein Center having read all about varicose veins and the many symptoms associated with the condition.  Many patients, however, come to us with questions regarding specific terminology, especially the topic of chronic venous insufficiency. Venous Insufficiency is a chronic condition caused by high pressure in the veins in the legs. This medical condition causes problems with pain in the legs, swelling, varicosities and changes to the health of the skin. This Chronic Venous Insufficiency (CVI) also increases the risk of superficial phlebitis, which is usually accompanied by a small blood clot (which is not a dangerous clot) in a superficial vein of the legs. CVI can also cause restless leg syndrome and frequent muscle cramps. The part of our body that receives the biggest impact from the damage caused by CVI is the skin and the subcutaneous tissues of the leg. The ankles and lower parts of the calves are affected the most, because that is where the blood pressure is highest when standing. CVI can eventually cause a brownish discoloration of the skin, a thickening and/or hardening of the skin, unexplained itching (especially in areas over the varicose veins). CVI, if left untreated, can result in a large breakdown area in the skin which is painful and hard to heal. This is called a “venous ulcer”.  If not treated properly, it can last for several years and can make it difficult to walk even though there may be no increased in pain to the ulcerated area. Most of the time, this Venous Insufficiency or CVI  is caused by damaged valves in the Saphenous and/or the Perforating Veins. The damaged valves cannot be detected by clinical findings or on physical exam by your primary care physician. They can only be properly diagnosed by an ultrasound imaging study, called a venous duplex exam. At Minnesota Vein Center, we are able to perform this test in our office and review the results with patients immediately.  This information, combined with your clinical and physical findings will allow our physician to formulate and recommend to you a plan of treatment on your initial exam day. (To read more on the physiology of  advancing venous disease read Here)