Overcoming Chronic Venous Insufficiency: Orsi’s Journey to Relief at Apex Heart & Vascular Care

Orsi’s 10-Year Struggle with Mysterious Leg Pain

For over a decade, Orsi lived with unexplained leg problems that left her frustrated and anxious. She suffered daily from heavy, aching legs and persistent swelling in her ankles. At times, her calves felt stiff and tight from the swelling, and simply getting through the day led to extreme leg fatigue. Not knowing the cause, Orsi grew increasingly worried – the uncertainty and discomfort took an emotional toll. Doctors were perplexed; some misdiagnosed her symptoms as muscle strain or simply “normal aging,” while others found nothing conclusive. Ten years passed without a real answer. The chronic pain and lack of validation began affecting her mental well-being, as it would for anyone. (Chronic pain often leads to anxiety or depression when unresolved.) Orsi was living in constant worry, wondering if she’d ever find relief.

A Turnaround at Apex: Diagnosis and Treatment at a NJ Vein Clinic

Everything changed when Orsi visited Apex Heart & Vascular Care, a leading vein clinic in New Jersey. Here, at last, she met specialists who looked beyond the surface. During her evaluation, the vascular team listened carefully to her history and symptoms. They performed a thorough examination and a quick, noninvasive ultrasound of her leg veins – a test that can confirm chronic venous insufficiency (CVI) by showing faulty vein valves. Sure enough, Orsi finally got her answer: she had chronic venous insufficiency, a form of vein disease where the valves in her leg veins weren’t working properly, causing blood to pool in her legs. This diagnosis explained everything – the heaviness, the swelling, the aching fatigue she’d endured for years.

With a clear diagnosis, Dr. Anuj Shah and the Apex team swiftly crafted a personalized treatment plan. Orsi underwent a state-of-the-art vein ablation procedure at our NJ clinic to seal off the malfunctioning vein and reroute blood flow. The procedure was minimally invasive – done with a catheter and heat energy under local anesthesia – and took under an hour. She also received sclerotherapy in our North Jersey office to treat the smaller varicose veins that had developed. The care team made sure she was comfortable and explained each step. Incredibly, Orsi felt relief the very same day. The constant pressure and heaviness in her leg eased immediately once the faulty vein was closed (many patients report that leg heaviness improves immediately after vein treatment). Over the next days and weeks, her swelling went down, her skin felt less tight, and her energy and confidence began to return. After 10+ years of suffering, Orsi finally found freedom from the pain – and peace of mind – thanks to proper treatment for her vein disease.

Orsi’s story has a happy ending, but it’s far from unique. Her experience highlights a widespread but often underdiagnosed problem. Chronic venous insufficiency was the hidden culprit behind her misery – and once identified, it was highly treatable. In fact, CVI is more common than many realize, affecting millions of people. Let’s take a closer look at what CVI is, why it happens, and how it can be addressed.

What Is Chronic Venous Insufficiency (CVI)?

Chronic venous insufficiency (CVI) is a progressive vein disease in which the veins in the legs cannot efficiently pump blood back to the heart. Normally, leg veins have one-way valves that keep blood moving upward. In CVI, those valves become damaged or weak, allowing blood to leak backward and pool in the lower legs. This pooled blood causes increased pressure in the veins (venous hypertension), leading to the symptoms and complications we see with CVI. In essence, CVI means the blood in your leg veins is insufficiently returned – it’s flowing the wrong way or not moving out effectively, resulting in stagnant blood in the leg.

CVI often develops gradually and can range from mild to severe. It is usually a chronic (long-term) condition that worsens over time without intervention. Early on, the signs may be subtle – a bit of swelling or leg fatigue at the end of the day. But as high pressure builds in the veins, it can start to cause more noticeable issues like varicose veins, skin discoloration, or even sores. (Varicose veins, those bulging twisted veins, are a common manifestation of venous insufficiency.) If left untreated, CVI can significantly impact quality of life and lead to serious complications like leg ulcers. We’ll discuss those risks later, but first, it helps to understand why CVI happens and who is most at risk.

Causes and Risk Factors of CVI

Why do some people develop chronic venous insufficiency? Often, it’s due to a combination of valve damage and vein wall weakness. Several factors can increase your risk of CVI:

• Family History and Genetics: If your family members have varicose veins or vein problems, you’re more likely to develop CVI. Inherited traits can affect vein structure and valve integrity.
• Age: Vein valves may weaken over time. CVI is more common in people over age 50, and risk continues to rise with age.
• Sex and Hormonal Factors: Women are at higher risk than men, partly due to hormones and pregnancy. In fact, studies show CVI (and related varicose veins) may affect up to 25–40% of women and about 10–20% of men. Hormonal changes (e.g. during pregnancy or from birth control) can relax vein walls, and the pressure of carrying a baby can strain leg veins.
• Prolonged Standing or Sitting: Occupations or lifestyles that involve standing all day (e.g. nurses, teachers, retail workers) or long periods of sitting (desk jobs, long-distance travel) can contribute to vein valve stress. When your legs stay in one position for hours, blood has a harder time fighting gravity and can begin to pool.
• Obesity: Excess weight puts added pressure on leg veins, which can damage valves over time. Obesity is a significant risk factor for CVI.
• History of Blood Clots (DVT): A deep vein thrombosis (DVT) – a blood clot in a deep leg vein – can scar the vein and permanently damage valves. CVI that results from a past DVT is sometimes called post-thrombotic syndrome. About 20–50% of people who’ve had a DVT develop chronic venous insufficiency in that limb afterwards.
• Prior Leg Injury or Surgery: Injury to the veins (like a bad leg fracture or surgery that involved veins) can compromise valve function.
• Sedentary Lifestyle: Lack of activity means the calf muscles (which normally help pump blood upward) aren’t working enough. Strong calf muscles push blood out of the legs; without movement, circulation suffers.
• Smoking: Tobacco use can damage blood vessels and reduce circulation, contributing to vein problems.
  Often, multiple factors are at play. In Orsi’s case, for example, her job required long hours on her feet, and she had a family history of varicose veins – a combination that likely set the stage for CVI. Knowing your risk factors can help you and your doctor stay vigilant for early signs of venous insufficiency.

Common Symptoms of Chronic Venous Insufficiency

Symptoms of chronic venous insufficiency can range from mild leg fatigue to significant skin changes. Many patients first notice leg heaviness and swelling, especially after long days, and symptoms tend to worsen over time if the underlying vein disease isn’t treated.

Chronic venous insufficiency often makes itself known through a variety of leg symptoms. You might experience one or several of the following signs as CVI progresses:

• Leg swelling (edema): Usually in the lower legs and ankles. Swelling is often worse in the evening and improves after elevating the legs or overnight rest.
• Heavy, achy legs: A persistent feeling of fullness, pressure, or heaviness in the legs, especially after standing for a while. Your legs may feel tired or like they have weights on them.
• Pain, throbbing or cramping: Some people feel dull pain or cramping in the calves. Nighttime leg cramps are also a common complaint. Orsi described it as a constant dull ache with occasional sharp “pins and needles” sensations.
• Leg fatigue or restlessness: Because blood isn’t circulating properly, your legs can feel fatigued easily. Some patients also report restless legs or an urge to move them for relief.
• Stiffness or tightness: As fluid builds up, legs can feel stiff or hard to move. Orsi’s “stiff” feeling was due to swelling, making her skin and muscles less flexible.
• Varicose veins or spider veins: CVI often leads to varicose veins – enlarged, bulging veins visible under the skin. Smaller spider veins (thin red/blue webs) can also appear. These vein changes are a red flag for underlying reflux (faulty valves).
• Skin changes: Over time, poor circulation can cause skin discoloration (a reddish-brown or purple tone, especially around the ankles). The skin on the lower legs may become flaky, itchy, or leathery in texture. You might notice persistent itchiness or rashes (sometimes misdiagnosed as dermatitis) due to blood pooling.
• Ulcers or sores: In advanced CVI, the high pressure in leg veins can cause wounds or open sores, usually near the ankles. These venous ulcers are often painful, slow to heal, and can easily become infected. They are a serious late-stage sign of chronic venous insufficiency.

Symptoms typically worsen as the day goes on (when you’ve been on your feet) and improve after elevating your legs or overnight. Many patients with CVI find mornings are their best time, with swelling minimal after lying down, but by day’s end, their shoes feel tight, and their legs feel heavy. If you’re noticing patterns like these – swollen ankles every evening, or aching legs that get better when you put your feet up – it may be time to get evaluated for CVI. Don’t dismiss these signs as just “getting older” or being on your feet too much. Chronic venous insufficiency is common and very treatable.

(CVI often goes undiagnosed for years – just like in Orsi’s case – because early symptoms can be mild or attributed to other causes. In fact, including mild cases, up to 40% of adults may have some degree of venous insufficiency or reflux in their leg veins, yet many don’t realize it.)

How Is CVI Diagnosed?

Diagnosing chronic venous insufficiency usually starts with a careful clinical evaluation. A vascular specialist (like Dr. Shah at Apex Heart & Vascular Care) will review your symptoms and medical history and perform a physical exam of your legs. They’ll look for visible signs of CVI, such as varicose veins, skin discoloration, or swelling. Often, just hearing about symptoms like leg heaviness that worsens with standing will raise suspicion for CVI.

The definitive way to diagnose CVI is through a duplex ultrasound of the leg veins. This is a painless imaging test that uses sound waves to visualize blood flow in your veins. It’s the gold standard test to confirm venous insufficiency. During the ultrasound, a technician or doctor will press a probe along your leg veins and may ask you to change positions or perform maneuvers (like tightening your abdominal muscles or bearing down) to see how the blood moves. The ultrasound can show whether blood is pooling or flowing backward (refluxing) in the veins and can locate exactly which valves are not functioning properly. It also helps rule out a blood clot (DVT) as a cause of your symptoms.

In Orsi’s case, an ultrasound at Apex’s vein clinic immediately identified reflux in her great saphenous vein – the main superficial vein running along the inner leg. This confirmed CVI and guided the treatment plan to target that vein. The ultrasound exam is noninvasive (no needles, no radiation) and typically takes only 20-30 minutes per leg. As soon as the test is done, the doctor can review the images and discuss the results with you.

Beyond ultrasound, no elaborate tests are usually needed for CVI. Sometimes doctors classify the severity of CVI using a clinical staging system called CEAP, which ranges from C0 (no visible signs) to C6 (active ulcer). Or they may calculate a Venous Clinical Severity Score to track improvement. But for the patient, the key point is that CVI is readily diagnosable with an office visit and an imaging test. If you have signs of CVI, getting a prompt diagnosis is important so you can start treatment and avoid complications.

Treatment Options for Chronic Venous Insufficiency

The good news is that chronic venous insufficiency is highly treatable, especially when caught early. At Apex Heart & Vascular Care, we offer a range of advanced therapies to improve circulation, relieve symptoms, and prevent long-term damage. Treatment plans are individualized, but they generally include a combination of lifestyle changes, compression therapy, and minimally invasive procedures to address the faulty veins. Here are the main treatment options for CVI – with a focus on the cutting-edge interventions Orsi received, vein ablation and sclerotherapy:

• Conservative Measures (Compression & Lifestyle): For mild cases or as a foundation of treatment, conservative therapy is often recommended. This includes wearing compression stockings daily to squeeze the legs and help push blood upward. Compression socks or tights (usually prescribed at 20-30 mmHg pressure) can significantly reduce swelling and discomfort by improving venous return. Additionally, lifestyle changes like regular exercise (walking, calf raises), losing weight if needed, and leg elevation throughout the day can all support better circulation. While these measures don’t fix the underlying valve problem, they can control symptoms and slow progression. Many patients feel relief in days or weeks with consistent compression use. However, compliance can be a challenge – stockings can be hot or hard to put on – and not everyone finds enough relief with conservative care alone. If symptoms persist or vein damage is advanced, we move to more definitive treatments.
• Endovenous Vein Ablation (Radiofrequency or Laser): Vein ablation is a minimally invasive procedure that has revolutionized CVI treatment in the past two decades. In this procedure, a thin catheter is inserted into the diseased vein (such as the great saphenous vein) via a tiny skin nick, usually near the knee. Under ultrasound guidance, the catheter is guided up the vein and then used to deliver heat energy – either radiofrequency (RF) or laser – to the vein walls. This heat effectively closes off the faulty vein from the inside, sealing it shut. The blood that used to pool in that vein is immediately rerouted to healthy veins deeper in the leg. The procedure is done with local numbing medicine, and patients are awake but comfortable throughout. There’s no surgical incision, just a band-aid afterward. At Apex (a premier provider of vein ablation in NJ), we perform this in-office procedure in under an hour. Patients walk out on their own and can resume normal activities by the next day. Vein ablation has a 98-99% initial success rate in closing the treated vein, and it provides prompt symptom relief – as Orsi experienced, her leg felt lighter the same day. Because it is far less invasive than old-style vein stripping surgery, complications are minimal, and recovery is quick. This treatment addresses the root cause of CVI (the refluxing vein) in a permanent way. Ablation is considered a first-line treatment for major vein reflux today, and it was a game-changer for Orsi’s recovery.
• Sclerotherapy: Sclerotherapy is an injectable vein treatment, often used for smaller varicose veins or spider veins that remain after the main refluxing vein is treated. In sclerotherapy, a medicine (sclerosant) is injected directly into the problem vein, causing the vein to scar and collapse. Foam or liquid sclerosants like polidocanol or sodium tetradecyl sulfate are commonly used. Sclerotherapy is very effective for veins that are too small for a catheter or for cosmetic improvements. It’s performed right in the office – no anesthesia needed – and multiple tiny veins can be treated in one session via a series of small injections. Afterward, the body gradually absorbs the closed veins. Orsi received sclerotherapy for some of the branching veins in her calf that were contributing to her symptoms and appearance. This further improved her circulation and helped fade the visible spider veins that had bothered her. Our team offers sclerotherapy in North Jersey as part of comprehensive CVI care, often in conjunction with an ablation procedure (ablation tackles the big source vein, and sclerotherapy cleans up the smaller veins). Patients may need 1-3 sclerotherapy sessions for full effect, depending on the extent of vein disease, but each session has little downtime – you can return to most activities the same day, with only minor restrictions like avoiding heavy exercise for a day or two.
• Ambulatory Phlebectomy (Microphlebectomy): In some cases of larger varicose veins near the surface, a minor procedure called phlebectomy is used. Through a few pinhole punctures in the skin, those bulging veins are physically removed with a special hook instrument. This is also done under local anesthesia and leaves virtually no scars. Phlebectomy can be an adjunct to ablation – for example, if a patient has a big varicose vein cluster on the calf, we might remove it at the time of ablation. This procedure wasn’t needed in Orsi’s case, but it’s another tool in the vein specialist’s kit.

All of the above treatments are offered at Apex Heart & Vascular Care, utilizing the latest technology and techniques. Which approach is right for a given patient depends on the severity of their CVI and their specific anatomy. In many cases, a combination approach yields the best outcome. For instance, vein ablation to close the main leaking vein, followed by sclerotherapy for any residual veins, and continued use of compression stockings during healing, is a common and highly successful strategy. The overarching goal is to restore healthy circulation by eliminating the veins that are causing blood to pool. Once those are closed (either by heat or medication), blood naturally finds its way through other veins back to the heart, and the pressure in the legs drops dramatically. Symptoms like swelling and pain improve as that pressure normalizes.

The phrase “leg swelling treatment” takes on a whole new meaning when we address why the leg is swollen. By treating the root cause (venous insufficiency), we’re providing a lasting solution, not just a temporary fix. Patients are often amazed at how much better their legs feel and look after these simple outpatient treatments. Orsi certainly was – she went from constant pain and puffy legs to feeling like she had her life back.

Why Early Treatment Matters: Risks of Leaving CVI Untreated

Chronic venous insufficiency isn’t just about nagging leg pain or unsightly veins – it’s a progressive medical condition that can lead to serious long-term complications if left untreated. It’s important to address CVI sooner rather than later, because the consequences can significantly impact your health and quality of life:

• Worsening Symptoms: CVI is typically a one-way street – without intervention, the pressure and pooling in the veins get progressively worse. What starts as mild ankle swelling and occasional heaviness can evolve into daily pain, more extensive swelling, and increasing skin damage. You might find your mobility decreasing because your legs hurt or feel too heavy to be active.
• Skin Changes and Ulcers: One of the most concerning outcomes of untreated CVI is the development of venous stasis ulcers. These are open sores that usually form around the ankles or lower leg, where the pooled blood causes the skin to break down. Before an ulcer appears, you’ll often see warning signs like skin discoloration (a brownish hue) and thickening of the skin (lipodermatosclerosis). Once ulcers form, they are often chronic – taking weeks or months to heal – and they tend to recur. In the U.S., about 4% of people over 65 with CVI will develop venous ulcers. Such ulcers are painful and can become infected, sometimes leading to serious tissue infection (cellulitis) or even systemic infection. They also require frequent medical care (wound care, bandaging, etc.). In fact, CVI ulcers are a significant healthcare burden and a major reason why CVI accounts for ~2% of healthcare costs. Treating CVI before it gets to this stage can prevent these difficult ulcers altogether.
• Blood Clots: Poor blood flow in the legs can increase the risk of clot formation. While CVI itself is caused by valve failure more than clots, the stagnant blood in varicose veins can sometimes clot within those superficial veins (a condition called superficial phlebitis). More dangerously, severe CVI can contribute to deep vein thrombosis (DVT) risk. Inflammation and reduced flow make clots more likely, and a DVT can be life-threatening if it travels to the lungs. Delayed treatment of CVI may therefore indirectly raise the chance of a clot complication.
• Infection and Cellulitis: As mentioned, skin that is chronically swollen and stretched (edematous) has a less robust blood supply. Even a small nick or bug bite on a swollen CVI-affected leg can turn into a spreading infection. Cellulitis (a deep skin infection) is more common in legs with CVI, and each bout of cellulitis can damage the tissue further, creating a vicious cycle.
• Lifestyle Limitations: Beyond the medical complications, untreated CVI can really limit day-to-day life. People with advanced CVI often can’t stand or walk for long without pain. They may need frequent breaks to elevate their legs. Choosing clothing becomes about hiding bulging veins or discolored skin. Sleep can be disrupted by leg cramps. The condition can also affect mental health – chronic pain and appearance changes can lead to social withdrawal or depression. Treating CVI before it reaches these stages can preserve your mobility and overall well-being.

In short, CVI is not something to ignore or “tough out.” The earlier you intervene, the easier it is to fix the problem and the less damage will occur. Orsi’s case is a perfect example: she endured 10+ years of progressive symptoms. By the time she came to us, she was inching toward advanced disease – but thankfully without an ulcer yet. We were able to step in, halt the progression, and reverse many of her symptoms. Now imagine if she never gotten a treatment: she could have ended up with serious ulcers or infections down the line. If you recognize any of the symptoms we described, seeking a vein evaluation now can save you from much worse problems later. Modern treatments like ablation and sclerotherapy stop the disease in its tracks, allowing the body to heal and preventing those dangerous complications.

Take the First Step – Schedule Your Vascular Evaluation

You don’t have to live with leg pain, swelling, or the anxiety of not knowing what’s wrong. Chronic venous insufficiency is common, but as Orsi’s journey shows, there is hope and help available. At Apex Heart & Vascular Care, we combine compassionate, patient-centered care with the latest in vascular technology to diagnose and treat vein disease. Our specialized team understands how CVI and varicose veins can affect every aspect of your life – from your ability to work and stay active to your peace of mind. We are here to listen to your concerns and provide solutions tailored to you.

If Orsi’s story resonated with you – if you’ve been suffering in silence with heavy, aching legs or swelling that won’t go away – don’t wait another day to get answers. The first step is a simple, thorough vascular evaluation at one of our New Jersey vein clinics. We will assess your symptoms, perform any necessary ultrasound diagnostics, and discuss a treatment plan to help you feel better right away. Most treatments are quick and virtually painless, and many patients experience significant relief immediately, just as Orsi did.

Your legs carry you through life – you deserve to have legs that feel healthy and strong. Let us help you get there. Contact Apex Heart & Vascular Care today to schedule a consultation and start your journey toward relief. We have multiple convenient locations across North Jersey and a proven track record of success in treating chronic vein conditions. Call us at 973-916-0002 to book your appointment or to speak with our friendly staff.

Don’t let another year go by living with pain or uncertainty. With the proper treatment, you can overcome chronic venous insufficiency and reclaim comfort and confidence in your legs. Take action now – a happier, healthier (and lighter-feeling) pair of legs is within reach! We at Apex are ready to guide you, just as we guided Orsi, every step of the way toward better vascular health.

Your relief can begin today – call 973-916-0002 and let’s get you back on your feet, free from CVI.

References:

1. Ullah I, et al. SCAI 2025 Guidelines for Chronic Venous Disease – Highlights.
2. Sorrentino D. Vein Health Statistics – Prevalence of CVI in Adults.
3. StatPearls. Chronic Venous Insufficiency – Symptoms, Progression & Complications.
4. Cleveland Clinic. Chronic Venous Insufficiency – Definition, Symptoms & Risk Factors.
5. Chang MC. WJCC 2024 Letter – CVI Prevalence and Treatment Approaches.
6. Vein Institute. Blog 2025 – CVI Overview and Modern Treatment Outcomes.