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Chronic Venous Insufficiency ( CVI )

The disorder known more popularly as deep vein thrombosis causes the excessive clotting of blood in the veins and this results in the inflammation of the veins brining on the condition called chronic venous insufficiency (CVI). The sluggish movement of the blood out of the venous system that comes about due to the simple failure of the valves in the veins of the leg can retain blood against the pull of gravity; such a situation can also cause CVI. A dull ache is the symptom of the condition, which worsens if the person stands for longer periods of time on a continuous basis, the feet, and the calves' swell up during the condition. Ulceration often follows the darkening of the skin as blood supply is lost in cases where the onset of CVI is left unchecked or when no alleviating measures are taken. The formation of varicose veins is the usual result of CVI.

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Some precautions are necessary in affected individuals, standing or sitting for prolonged periods of time in a single position must be avoided, moreover all individuals afflicted by chronic venous insufficiency when seated should make sure that they raise their legs from time to time, movement is very important at all times. The blood in the veins is induced to move about through activities such as walking and all physical activity will affect the rate of circulating blood. Furthermore as an added measure the veins in the legs can be buffered or supported to a large extent by wearing tight-fitting compression stockings normally sold in drug stores.

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Supplements and herbs

The integrity and strength of the venous system is maintained by the use of the plant based natural substances known as bioflavonoids supplemented along with the diet. Bioflavonids known as hydroxyethylrutosides (HR), that are derivatives of rutin have been the most extensively utilized types of the bioflavonoids in most studies conducted thus far. The effectiveness of the HR in clearing edema in the legs and in eliminating other signs of CVI has been conclusively shown in these studies done on patients. Dosages of the bioflavonoids included tablets in strengths of 500 mg administered twice daily for a treatment period of 12 weeks, the results of this double blind studies were on the whole very effective and positive as far as the potential of the bioflavonoid was concerned. Under medical guidance, ulcers caused by CVI have also been successfully treated in many patients; these were all supervised by medical doctors and must not be attempted alone. While the effectiveness of HR in combating chronic venous insufficiency has been shown, the other types of bioflavonoids and their potentialities vis a vis CVI remains a mystery. High dosage strengths of easily available citrus bioflavonoids in 300-500 mg tablets consumed three to four times daily is the usual recommended treatment regimen given by nutritionally oriented doctors.

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Traditional use has also been made of the horse chestnut and several monitored and some partially monitored researches have shown it to be effective in treating problems with an impaired venous system. The active ingredient or compound in the horse chestnut is a substance known as aescin. Patients with CVI were administered 50 mg of aescin two times a day during the treatment period in one medical investigation of the effectiveness of the compound. There was a lessening of swollen tissues, which is a good sign of the property of the aescin in strengthening the capillaries of the affected individual.

Another double blind study using low quantities of a another substance contained in just two 50 mg pills was administered to patients, this substance is found in the seed extracts of the grape, the name of the compound in question is a groups of natural bioflavonoids known as oligomeric proanthocyanidins (OPCs), these OPC's were able to greatly strengthen the capillaries of the afflicted individuals on whom the testing was done. Women with CVI were assisted in combating the condition in a double blind French study that utilized 150 mg of the compound daily. Positive results were also obtained in another French double blind research that increase the dosage to 300 mg of the substance daily, with each dose being a hundred mgs, the effectiveness of the compound was evident in just four weeks of the treatment period and all the patients showed improvement.

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The herb known commonly as the butcher's broom has also seen traditional use in correcting impaired veins. Compared to patients on placebos, a study using a combined dose of the butcher's broom herb, the vitamin C and the bioflavonoid hesperidin found a great deal of improvement in the patients. Standardized extracts containing 15-30 mg of ruscogenins per capsule administered thrice a day have also proven to be effective in combating the disorder. Herbalists have also traditionally treated the onset of CVI by using the gotu kola herb as the supplement.

Folk healers employ the essential oil obtained from maritime pine (scientific name Pinus pinaster), which is indigenous to the Mediterranean region, to treat conditions like bronchitis, neuralgia and rheumatism. The bark of this evergreen tree contains high amounts of benzoic acid, cinnamic acid, phenolic acids and procyanidins and is employed to cure chronic venous insufficiency (CVI), venous ulcers and varicose veins.

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During a study undertaken by M. R. Cesarone and associates and carried in 'Phytomedicine' (September 2010 edition), they tested the extract of a homogeneous bark of maritime pine on patients suffering from acute and prolonged CVI. The scientists discovered that the bark extract was more effectual in lessening the symptoms associated with the condition as well as reducing the leakage from the capillaries in comparison to compression stockings, which are the usual treatment for chronic venous insufficiency. Moreover, the scientists discovered that using the maritime pine bark extract together with compression stockings proved to be additionally useful in comparison to using any of them independently. They observed that the maritime pine bark extract is effective in putting of all symptoms associated with CVI, including preventing edema, muscle cramps as well as accelerate the curing the leg ulcers. The findings of this research endorse using the extract of maritime pine bark to treat chronic venous insufficiency. However, you need to be careful not to use this extract in conjunction with any anti-coagulant medicament.

Additional things you may do

Similar to any other ailment, chronic venous insufficiency is very much treatable, provided it is detected in the initial stages. Generally, specialists in vascular medicine and surgery recommend using a mishmash of therapies for people suffering from chronic venous insufficiency. Some of the fundamental treatment approaches are discussed in brief below.

Most importantly, you need to keep away from sitting or standing for prolonged periods. In case it is necessary to undertake a long journey and you need to keep seated for a prolonged period, you should loosen and stretch your legs, ankles and feet roughly 10 times once in 30 minutes with a view to allow proper blood circulation in the veins of the leg. On the other hand, if you are required to keep standing for a prolonged period, you should take breaks frequently and sit down or lift up your feet.

In addition, you need to undertake work-outs every day, especially walking will prove to be beneficial. In case you are overweight, try to reduce those extra pounds. When you are sitting or lying down you should raise your legs and keep the legs raised above the heart's level. You also need to put on compression stockings and take antibiotics according to requirements to heal the skin infections.

It is important to remember that the objective of all these therapies is to lessen the clotting of blood in the veins and avoid development of leg ulcers.

Generally, chronic venous insufficiency is not considered to be a severe risk to our health. During the treatment, the main objective of your physician will be to lessen disability as well as pain due to CVI.

If the chronic venous insufficiency is mild, it is likely that your physician will suggest you to wear compression stockings. Precisely speaking, compression stocking are flexible stockings that compress the veins and prevent flow of too much blood backward. By this means, compression stockings are often able to help in curing sores on the skin as well as avoid their recurrence. If you have CVI, it is likely that you will be required to use compression stockings for your entire life.

Provided you do not stand for prolonged periods and elevate your legs, you will be able to prevent the swelling as well as other symptoms associated with chronic venous insufficiency, as these will help to lessen the pressure on the veins. If it is essential for you to remain standing for prolonged periods, you should loosen up and stretch the leg muscles from time to time to ensure the proper blood circulation through the veins in the legs. The symptoms of chronic venous insufficiency can also be reduced if you try to maintain a perfect body weight or lose weight in case you are obese.

It is possible to treat even more severe incidences of chronic venous insufficiency by administering injections, a treatment process known as sclerotherapy. Alternately, such cases can be cured by means of surgery. It may be noted that less than 10 per cent people suffering from chronic venous insufficiency need to undergo surgery to cure their condition. There are various types of surgical treatments for CVI, including ablation, bypass surgery, angioplasty (also known as stenting of veins), valve repair and vein stripping.

Although there are various surgical processes to treat CVI, your vascular surgeon will suggest the procedure that is most suitable for your condition.

The sclerotherapy process involves injecting a chemical into the affected veins by the physician. This chemical thoroughly scrapes the veins in such a manner that the blood does not fill anomalous veins any more. In normal circumstances blood would have returned to the heart through these veins, but after sclerotherapy the blood will flow in other veins. Eventually, the body will absorb the veins that have been injected with the chemical.

In ablation, a thread-like, supple tube known as catheter is placed inside a varicose vein. Minute electrodes discharged from the catheter tip heat up the varicose vein walls obliterating the vein tissue. Like the chemical in the case of sclerotherapy, in this case the varicose vein is unable to transport blood after the catheter destroys the tissues of the affected vein and, eventually, the body absorbs the tissues of the vein.

The surgical process called vein stripping involves the surgeon making a tiny slit in the region of the groin. In addition, one more incision is made in the calf area lower than the knee. Subsequently, the surgeon separates and links all veins related to the saphenous vein - the major superficial vein present in the leg. The surgeon will then get rid of this vein from the leg. He/ she may make a small slit avulsion (a process known as ambulatory phlebectomy) either separately or simultaneously with the vein stripping procedure. Such tiny incision avulsions enable the surgeon to do away with the cluster of varicose veins separately from your leg by way of the small cuts.

When the problem becomes further extensive, it is likely that your surgeon will ask you to undergo a bypass surgery with a view to treat chronic venous insufficiency that may occur in the pelvis or the upper region of the thigh. For instance, the surgeon may also join a non-natural vein, known as a graft, or even connect a transplanted vein to any vein that has not been damaged by chronic venous insufficiency with a view to facilitate blood circulation from the leg affected by CVI around the vein that has been blocked. Generally, bypass surgery is considered to be a safe process. However, it involves some amount of risk regarding deep-vein thrombosis (DVT) as well as infections at the points where the incisions are made. In fact, surgeons usually recommend bypass surgery only to patients whose condition is quite grave.

While undertaking valve repair, surgeons work to abridge the valves present within the veins with a view to enhance the functioning of the valve. First, a tiny incision is made into the skin and then the surgeon severs the vein affected by chronic venous insufficiency. Next, the surgeon will fold or insert the flaps of the valve. The surgeon may possibly also implant a fabric sleeve all around the exterior of the vein affected by CVI in order to assist in pressing the vein walls together to ensure the proper functioning of the valve.

In very serious incidences of chronic venous insufficiency, surgeons are most likely to suggest the patient to undergo stenting or angioplasty. Precisely speaking, an angioplasty surgery involves employing a balloon to forcibly open up a constricted or blocked part of any vein, while a stent is actually a metallic support tube that ensures that the constricted areas of the vein remain open. In a number of cases, the surgeon may employ the stenting procedure to clear a vein blockage, subject to the location of the blockage inside the vein. Stenting is carried out by making tiny vein punctures with the help of small needles. Such punctures may be made at the back of the knee or in the region of the groin. Usually, angioplasty as well as stenting is considered to be a safe and secure processes.

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Comments

From Marva - Nov-10-2014
I have CVI and I find wearing compression stockings really help, also taking a combination of herbs called CIRCULEG, it has horse chestnut, gotu kola, butcher's broom, vitamin C and flavonoids. It really helps.
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