How much swelling is an indication of CVI and do I need varicose vein surgery?

I have been told I have reflux in both deep and superficial veins and to watch for swelling. I have .5cm swelling in the ankle by the end of the day. Is this an indication of CVI?

Answers from doctors (12)


Advanced Vein Center

Published on Jul 03, 2012

Swelling is certainly an indication of CVI. However it can be seen with reflux in the deep system, the superficial system, or both.The decision to treat should not be based solely on how much swelling you have. Skin changes, achiness, heaviness are among other factors to be considered. There are people with no venous disease who get ankle swelling. If you only have ankle swelling, it can probably be managed with compression hose.

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Answered by Advanced Vein Center

Swelling is certainly an indication of CVI. However it can be seen with reflux in the deep system, the superficial system, or both.The decision to treat should not be based solely on how much swelling you have. Skin changes, achiness, heaviness are among other factors to be considered. There are people with no venous disease who get ankle swelling. If you only have ankle swelling, it can probably be managed with compression hose.

Published on Jul 11, 2012


More About Doctor Austin Vein Specialists

Published on Jul 03, 2012

Any degree of swelling can indicate chronic venous insufficiency. A decision on whether to offer you treatment depends on multiple factors, including any other symptoms, like pain or varicose vein complications. I would recommend a thorough history and physical by a vein physician, including a venous reflux ultrasound, to assess your condition. Many times the mild symptoms can be treated with conservative treatment, such as compression stockings.

Answered by Austin Vein Specialists (View Profile)

Any degree of swelling can indicate chronic venous insufficiency. A decision on whether to offer you treatment depends on multiple factors, including any other symptoms, like pain or varicose vein complications. I would recommend a thorough history and physical by a vein physician, including a venous reflux ultrasound, to assess your condition. Many times the mild symptoms can be treated with conservative treatment, such as compression stockings.

Published on Jul 11, 2012


General Vascular Surgery Group

Published on Jul 03, 2012

Swelling is very variable. We generally treat symptoms, not swelling alone, unless severe. Check with your MD. You should be wearing support stockings daily though. Swelling can have many causes, however, not just venous disease.

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Answered by General Vascular Surgery Group

Swelling is very variable. We generally treat symptoms, not swelling alone, unless severe. Check with your MD. You should be wearing support stockings daily though. Swelling can have many causes, however, not just venous disease.

Published on Jul 11, 2012


Lubbock Vein Specialists

Published on Jul 03, 2012

Since you state that you have documented reflux, and if you mean that your ankles are 0.5 cm larger at the end of the day than at the beginning of the day, that is a significant amount of swelling, and is
an indication of Chronic Venous Insufficiency (CVI). As to whether or not you need a varicose vein procedure, that can only be determined by a review of any previous treatments, medical history, and a physical examination performed by a qualified phlebologist, along with a Duplex venous examination. You may be a candidate for a procedure, or you may simply need to wear compression stockings.

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Answered by Lubbock Vein Specialists

Since you state that you have documented reflux, and if you mean that your ankles are 0.5 cm larger at the end of the day than at the beginning of the day, that is a significant amount of swelling, and is
an indication of Chronic Venous Insufficiency (CVI). As to whether or not you need a varicose vein procedure, that can only be determined by a review of any previous treatments, medical history, and a physical examination performed by a qualified phlebologist, along with a Duplex venous examination. You may be a candidate for a procedure, or you may simply need to wear compression stockings.

Published on Jul 11, 2012


Vein Specialists

Published on Jul 03, 2012

First of all, start thinking in terms of venous insufficiency rather than varicose veins as the working diagnosis. Then consider the symptoms you are having. If you are having minimal swelling and are not adversely affected by it, leave your veins alone for now. If you have moderate to severe swelling in the legs and you have leg cramps at night and/or have to get up to urinate several times a night and find that your legs are skinny again in the am, then consider more definitive therapy of your insufficiency. You should also ask your specialists which system is causing more problems, the deep or the superficial, since this will also have some bearing on the decision to close the superficial veins. There are ultrasound methods commonly used to stratify insufficiency and determine which system is the most abnormal (includes seconds of reflux and velocity of reflux flow).

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Answered by Vein Specialists

First of all, start thinking in terms of venous insufficiency rather than varicose veins as the working diagnosis. Then consider the symptoms you are having. If you are having minimal swelling and are not adversely affected by it, leave your veins alone for now. If you have moderate to severe swelling in the legs and you have leg cramps at night and/or have to get up to urinate several times a night and find that your legs are skinny again in the am, then consider more definitive therapy of your insufficiency. You should also ask your specialists which system is causing more problems, the deep or the superficial, since this will also have some bearing on the decision to close the superficial veins. There are ultrasound methods commonly used to stratify insufficiency and determine which system is the most abnormal (includes seconds of reflux and velocity of reflux flow).

Published on Jul 11, 2012


NYU Vein Center - Morristown

Published on Jul 03, 2012

The swelling is most likely a result of CVI.

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Answered by NYU Vein Center - Morristown

The swelling is most likely a result of CVI.

Published on Jul 11, 2012


Veins etc. at Comprehensive Cardiovascular Consultants

Published on Jul 03, 2012

It might be a sign consistent with the documented venous insufficency. You need to follow up your doctor.

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Answered by Veins etc. at Comprehensive Cardiovascular Consultants

It might be a sign consistent with the documented venous insufficency. You need to follow up your doctor.

Published on Jul 11, 2012


Cosmetic Vein Centers of Texas

Published on Jul 03, 2012

Yes, but correcting the superficial venous reflux helps many patients.

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Answered by Cosmetic Vein Centers of Texas

Yes, but correcting the superficial venous reflux helps many patients.

Published on Jul 11, 2012


Vanish Vein and Laser Center

Published on Jun 01, 2012

There is no absolute number for the amount of swelling that is due to CVI. You should not have any swelling normally at any time. Even if you have swelling, it may not be due to CVI. The fact that you have superficial and deep reflux probably is contributing to the swelling. You should follow up with a vein care specialist and, at the very least, wear support hose.

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Answered by Vanish Vein and Laser Center

There is no absolute number for the amount of swelling that is due to CVI. You should not have any swelling normally at any time. Even if you have swelling, it may not be due to CVI. The fact that you have superficial and deep reflux probably is contributing to the swelling. You should follow up with a vein care specialist and, at the very least, wear support hose.

Published on Jul 11, 2012


The Vein Treatment Center

Published on May 30, 2012

Edema has many etiologies. You also have to find out the degree of CVI. The best way to do that is to have a consultation with your cardiologist and a phlebologist/vascular surgeon.

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Answered by The Vein Treatment Center

Edema has many etiologies. You also have to find out the degree of CVI. The best way to do that is to have a consultation with your cardiologist and a phlebologist/vascular surgeon.

Published on Jul 11, 2012


Intermountain Vein Center

Published on May 15, 2012

Swelling is a typical sign of any reflux in veins. Superficial veins can still be treated and would possibly help those deep veins function better.

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Answered by Intermountain Vein Center

Swelling is a typical sign of any reflux in veins. Superficial veins can still be treated and would possibly help those deep veins function better.

Published on Jul 11, 2012


The Sheen Vein Institute

Published on May 14, 2012

You have CVI or chronic venous insufficiency purely based on the fact that you have reflux in the superficial veins of the legs. However, if you have deep vein reflux, which typically means that vessels like the common femoral vein or popliteal veins are refluxing, your vein issues are much more problematic. Although CVI can affect any vein, superficial or deep, it predominantly affects the superficial system. This area of your venous system, can be treated. However, deep system reflux can not be treated and may ultimately be the cause of your leg swelling.

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Answered by The Sheen Vein Institute

You have CVI or chronic venous insufficiency purely based on the fact that you have reflux in the superficial veins of the legs. However, if you have deep vein reflux, which typically means that vessels like the common femoral vein or popliteal veins are refluxing, your vein issues are much more problematic. Although CVI can affect any vein, superficial or deep, it predominantly affects the superficial system. This area of your venous system, can be treated. However, deep system reflux can not be treated and may ultimately be the cause of your leg swelling.

Published on Jul 11, 2012


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