Chronic Venous Insufficiency of the Lower Limbs in Nice
Dr. Ilya Khantalin, Vascular Surgeon in the Alpes-Maritimes
Chronic Venous Insufficiency of the Lower Limbs
Dr. Ilya Khantalin in Nice
Chronic venous insufficiency (CVI) of the lower limbs is a common condition that affects blood return through the veins in the legs. It occurs when the veins—which play a crucial role in returning blood from the legs to the iliac veins, then the inferior vena cava, and ultimately to the heart—fail to perform this function effectively. This venous dysfunction causes blood pooling, mainly in the superficial venous network of the lower limbs, leading to a variety of symptoms and increasing discomfort for the patient.
As a vascular surgeon in Saint-Laurent-du-Var, Dr. Ilya Khantalin provides personalized care and follow-up for chronic venous insufficiency to optimize available therapeutic options.
Arterial diseases are now treated using modern techniques validated by the Haute Autorité de Santé, with a focus on innovation and adherence to recognized surgical protocols.
Vascular diseases are classified as Long-Term Illnesses (Affections de Longue Durée – ALD), allowing for 100% coverage by French Social Security.
Understanding Chronic Venous Insufficiency of the Lower Limbs
Vascular Surgeon in Saint-Laurent-du-Var
Veins are equipped with one-way valves that prevent blood from flowing backward under the influence of gravity. In cases of venous insufficiency, these valves malfunction or become incompetent, allowing blood to pool in the lower limbs. This can cause various symptoms: heavy legs, pain, swelling (edema), nighttime cramps, and, in more advanced stages, visible varicose veins or venous ulcers.
Venous insufficiency is usually progressive. Common risk factors include heredity, female sex, age, sedentary lifestyle, obesity, and repeated pregnancies.
Symptoms and Treatments of Chronic Venous Insufficiency
Vascular Surgery Specialist in Saint-Laurent-du-Var
Symptoms and Diagnosis
Symptoms of venous insufficiency may include:
- Heavy and tired legs, especially at the end of the day
- Visible varicose veins under the skin, and aesthetic imperfections
- Swelling in the ankles and calves
- Pain and nighttime cramps
- Itching and a feeling of warmth in the legs
Diagnosis involves a clinical examination, complemented by a venous Doppler ultrasound of the lower limbs. This non-invasive and painless test allows for observation of blood flow and identification of reflux areas and valve condition. Accurate diagnosis is key to appropriate treatment planning.
Treatment Options
Treatment aims to improve venous return, relieve symptoms, and prevent complications. Options range from compression therapy to surgical techniques, chosen based on disease severity, symptom type, and the patient’s overall health.
Elastic Compression
Often the first line of treatment for mild to moderate venous insufficiency. Compression stockings or tights apply graduated pressure to the legs, promoting upward blood flow. This method effectively relieves symptoms such as edema and heaviness and may also be used alongside other treatments to enhance outcomes.
Sclerotherapy
A minimally invasive technique used for small varicose veins and spider veins. It involves injecting a sclerosing agent into the affected vein, causing it to close gradually. Blood is then naturally redirected through healthier veins. Sclerotherapy is generally well tolerated and does not require hospitalization. Several sessions may be needed for optimal results.
Endovenous Laser Treatment and Radiofrequency Ablation
These modern alternatives to traditional surgery target larger varicose veins. A laser fiber or radiofrequency probe is inserted into the diseased vein. The heat generated closes the vein, resulting in progressive resorption. These procedures offer effective outcomes with minimal recovery time.
Surgery: Stripping and Phlebectomy
For advanced venous insufficiency or when other treatments fail, surgical intervention may be required. Stripping involves removing the diseased saphenous vein, while phlebectomy entails extracting superficial varicose veins through small incisions. Surgery is typically reserved for patients with extensive varicosities or severely compromised venous networks.
Treatment Indications and Follow-Up
Each treatment option has specific indications, and care must be tailored to the individual. Treatment choice depends on symptom severity, disease progression, and patient preferences.
Post-treatment, regular follow-up is vital to assess effectiveness and prevent recurrence. Follow-up visits help adjust care, whether through continued compression, physical activity, or additional sclerotherapy sessions if needed.
Prevention and Lifestyle
Healthy habits can help prevent venous insufficiency or slow its progression. Recommendations include:
- Regular physical activity: Walking, swimming, and cycling boost circulation
- Avoid prolonged standing: Alternate between standing and sitting when possible
- Avoid direct heat exposure: Hot baths and extended sun exposure may worsen symptoms
- Balanced diet: Maintaining a healthy weight reduces pressure on leg veins
Chronic venous insufficiency is a common condition, but its impact can be effectively managed with accurate diagnosis and tailored treatment.