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Venous

Chronic Venous Insufficiency

A condition where the veins in your legs have trouble sending blood back to your heart, causing pooling and swelling.

Chronic venous insufficiency occurs when leg vein valves fail, causing blood to pool — leading to swelling, varicose veins, and in advanced cases, venous ulcers. It is common but often underdiagnosed.

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Illustration showing blood pooling in leg veins due to chronic venous insufficiency

Chronic venous insufficiency leads to blood pooling in the lower legs, which can cause persistent swelling, skin discoloration, and leg ulcers.

Symptoms

  • Ankle and calf swelling worsening throughout the day
  • Leg aching or heaviness after prolonged standing
  • Varicose veins
  • Skin discolouration or thickening near the ankles
  • In advanced cases: venous ulcers and slow-healing ankle wounds

Causes & Risk Factors

  • Prior deep vein thrombosis (post-thrombotic syndrome)
  • Prolonged standing or sitting
  • Pregnancy and obesity
  • Advancing age
  • Family history of venous disease

Diagnosis

  • Clinical leg examination
  • Duplex ultrasound — gold standard for mapping venous anatomy and identifying valve reflux
  • CT or MR venography for complex cases

Treatment Options

  • Compression therapy with medical-grade stockings
  • Radiofrequency ablation or endovenous laser therapy for significant reflux
  • Sclerotherapy for varicose and reticular veins
  • Surgical intervention for refractory disease
  • Dedicated wound care for venous ulcers

Concerned About Chronic Venous Insufficiency?

Dr. Peter Chang offers specialist assessment and personalised management at Paragon Medical Centre, Singapore.