The Vein Clinic of Dallas

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 VCVI

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.

Conditions We Treat

Each condition below has a dedicated page with detailed information on causes,
symptoms, diagnosis, and treatment. Select the condition that best describes your
symptoms to learn more.

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 authorisations

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.

Frequently Asked Questions

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.