Conditions We Treat
Chronic Venous Insufficiency (CVI)
The underlying cause of varicose veins, leg swelling, skin damage, and restless legs. Understanding how CVI develops, how it is precisely diagnosed, and how modern in- office treatment restores healthy circulation.
What Is Chronic Venous
Insufficiency?
CVI is one of the most common causes of legs that feel heavy at the end of the day, swelling around the ankles, restless legs at night, and frequent leg cramping during sleep. It is also the underlying condition responsible for varicose veins and progressive skin changes in the lower legs. Despite how common it is, CVI is frequently underdiagnosed and left untreated for years.
Chronic venous insufficiency is the root cause behind most venous conditions, including varicose veins, leg swelling, skin changes, restless legs, and leg pain.
It occurs when the valves inside the leg veins fail. Instead of keeping blood moving upward toward the heart, faulty valves allow blood to flow backward and pool in the legs. This causes increased venous pressure, visible veins, discomfort, and progressive damage to circulation and skin over time.
The severity of CVI is clinically measured using the CEAP classification, ranging from C0, where no visible signs are present, through C6, which represents an active venous ulcer. This grading system helps guide diagnosis and ensures treatment is matched to the precise stage of the disease.
At a Glance
What Patients Should Know About CVI
Underlying cause of varicose veins, leg swelling, and skin damage
Of U.S. Adults have some degree of venous insufficiency
CEAP staging system used to classify CVI severity and guide treatment
Typically covered by insurance when confirmed by diagnostic ultrasound
Why CVI Should Not Be Left Untreated
A Progressive Condition That Worsens Over Time
Without treatment, venous pressure continues to build and the damage to surrounding
tissue worsens. Early diagnosis and treatment prevent this progression and protect long-
term leg health.
Valve Failure
Vein valves weaken — blood begins to reflux and pool in the lower legs
Swelling and Aching
Increasing aching, heaviness, fatigue, and ankle swelling develop
Varicose Veins
Veins stretch under pressure — bulging, twisted, rope- like veins appear
Skin Changes
Discoloration, thickening, and stasis dermatitis, usually near the ankles
Venous Ulcers
Painful open wounds that are slow to heal and prone to recurrence.
Increased risk of superficial blood clots and, in some cases, deep vein thrombosis is associated with untreated CVI. Early intervention leads to significantly better outcomes.
Common Signs and Symptoms of Chronic Venous Insufficiency
These are not simply signs of aging or a long day on your feet. They are recognizable
indicators of a diagnosable and treatable condition.
Bulging Varicose Veins
Bulging, twisted, or rope-like varicose veins in the legs
Swollen Ankles by Evening
Swelling in the ankles or legs, especially swollen ankles by evening
Leg Heaviness and Aching
Aching, heaviness, or throbbing pain, particularly after prolonged standing or sitting
Restless Legs and Tingling
Restless legs or tingling sensations, especially in the evenings and at night
Nighttime Leg Cramping
Leg cramping, especially at night or during rest
Skin Changes and Ulcers
Skin discoloration, thickening, or stasis dermatitis, usually near the ankles. Slow-healing wounds or venous ulcers in more advanced cases
Many patients notice symptoms for years before realizing vein disease may be present. It is common for legs to feel heavy at the end of the day, for aching to develop after long periods of standing, or for ankles to swell by evening. Some patients also experience restless legs at night or frequent leg cramping during sleep. These are not simply signs of aging or a long day on your feet. They are recognizable indicators of a diagnosable and treatable condition.
How We Diagnose CVI
This is not just a basic vein check. Our diagnosis is comprehensive and precise. At
The Vein Clinic of Dallas, we perform a thorough vein evaluation using advanced
diagnostics that go well beyond standard vein screening.
High-Resolution Diagnostic Ultrasound
Maps vein flow, identifies malfunctioning valves, and quantifies reflux to guide precise treatment planning.
Flow Dynamics Assessment
Evaluates how blood pressure and flow behave inside your veins under real conditions.
Thermal Vascular Imaging
Detects areas of inflammation or elevated pressure not visible on standard ultrasound.
Vein Light Mapping
Visualizes surface veins for accurate treatment planning and precise injection guidance.
How We Treat CVI
All treatments are minimally invasive, performed in-office, and require no downtime. Treatment is tailored to your specific diagnostic findings and may include:
Radiofrequency Ablation (RFA)
Heat-based closure of malfunctioning veins
to eliminate venous reflux at its source.
VenaSeal Closure
Medical adhesive that seals the faulty vein
without heat or tumescent anesthesia.
Varithena Microfoam Ablation
Injectable microfoam for larger or tortuous
vein segments not suited to thermal
treatment.
Microphlebectomy
Removal of visible varicose veins through tiny, precise openings with no significant scarring.
Compression and Long-Term Support
Compression therapy and long-term vein health support to reinforce results and reduce the risk of recurrence.
In-Office Procedures No surgery. No vein stripping.
Every treatment is performed entirely in- office by Dr. Poonawala. Most patients return
to daily activities the same day.
Is Treatment Covered by Insurance?
Yes. Chronic venous insufficiency is a medical condition, not a cosmetic concern. When symptoms such as swelling, pain, aching, skin changes, and documented venous reflux are present and confirmed by diagnostic ultrasound, treatment is typically covered by most insurance plans. We will work with you to confirm your benefits and obtain any required authorisations before treatment begins.
Symptoms must be documented
Swelling, pain, aching, skin changes, and venous reflux confirmed by ultrasound
Both evaluation and treatment covered
The diagnostic evaluation and treatment procedures are generally eligible for coverage
We handle all authorizations
Our team confirms your benefits and manages prior authorisation requirements before treatment begins
Plans accepted
BCBS, Anthem, Medicare, Aetna, Cigna, United Healthcare and more
Results You Can Expect
Reduced leg swelling and pressure, with improvement often noticeable within weeks
Relief from heaviness, aching, throbbing, and end-of-day fatigue in the legs
Visibly improved or eliminated varicose veins as treated veins are absorbed over time
Healthier skin with reduced discoloration, inflammation, and stasis dermatitis
Lower risk of further progression toward venous ulcers or permanent skin changes
Reduced risk of superficial clots and deep vein thrombosis associated with untreated venous stasis
Why Choose the Vein Clinic of Dallas?
Physician-Led Care. Nothing Delegated
Your entire care, from evaluation and diagnosis through treatment and long-term follow-up, is personally led by Dr. Husein Poonawala. Nothing is delegated.
Advanced Diagnostics Beyond the Basics
High-resolution ultrasound, flow dynamics testing, thermal vascular imaging, and vein light mapping give us a complete picture of your venous health that standard vein exams cannot provide.
Minimally Invasive, In-Office Treatment
No surgery. No vein stripping. No hospital visits. Procedures are tailored to your diagnostic findings and performed in- office with no downtime.
Long-Term Vein Health Focus
We focus on correcting the underlying disease, not just managing its symptoms. Ongoing follow-up and prevention strategies are part of every care plan.
This is vein care at its highest level. Physician-led, precise, and thoughtfully done right.
Dr. Husein Poonawala MD, DABVLM | The Vein Clinic of Dallas
Frequently Asked Questions
Is chronic venous insufficiency the same as varicose veins?
Can chronic venous insufficiency get worse over time if left untreated?
What is the difference between chronic venous insufficiency and a blood clot?
How long does recovery take after CVI treatment?
Is CVI treatment covered by insurance?
Why do my legs cramp at night?
Can CVI cause restless legs at night?
Why do my legs feel heavy at the end of the day?
Take the First Step Toward Lasting Relief
If your legs feel heavy at the end of the day, swell around the ankles, develop restless
sensations, or cramp at night, chronic venous insufficiency may be the underlying cause. A
comprehensive vein evaluation can identify the source and determine the most effective
path to lasting relief.
Schedule your consultation with The Vein Clinic of Dallas, serving Flower Mound,
Southlake, Coppell, Denton, Irving, and the greater DFW area.