President Trump’s medical condition is common

Venous insufficiency, the medical condition President Donald Trump was recently diagnosed with, is a common but potentially debilitating problem.

According to a National Library of Medicine StatPearls article, venous insufficiency (also called chronic venous insufficiency or CVI) affects a large number of American adults, including:

• As much as 40 percent of women.
• Approximately 17 percent of men.

About 4 percent of adults over 65 get leg ulcers as a result of the condition.

“It’s really super, super common,” said Cape Cod Healthcare vascular surgeon Elizabeth A. Mahanor, MD, FACS.

“I’m doing vein surgery every week in my office,” she said.

What Is Venous Insufficiency?

Valves in veins work by keeping blood flowing in one direction – toward the heart. Venous insufficiency results when weak valves allow blood to collect in the legs, according to a National Library of Medicine Medline Plus article. It’s a progressive condition that can’t be completely cured but can be slowed, Dr. Mahanor said.

The veins that are usually involved, called superficial veins, are located near the surface, though the condition can entail problems with deep veins and the perforator veins that connect the superficial and deep systems.

Symptoms may include feelings of heaviness, itchiness, throbbing or pain in the legs, as well as spider and varicose veins, according to a July 17 news release from the American Heart Association. The condition can affect the skin. Irritated red, scaly patches may thicken and turn weepy and crusty. Skin ulcers or wounds resistant to healing can occur.

Risk factors for venous insufficiency include sitting or standing for long periods, a sedentary lifestyle, age (over 55), family history of venous insufficiency, having had deep vein thrombosis (DVT, a clot in deep vein) or leg injury, obesity, tobacco use, pregnancy and being female. Both the physical burden of being pregnant and hormonal changes make pregnant women more susceptible, Dr. Mahanor said.

“A lot of times they will get better once the child is delivered. A lot of times they will get worse,” she said.

First Line of Treatment

Treatment typically begins with wearing compression socks, which need to be used regularly to be effective, Dr. Mahanor said. Because these may be difficult for pregnant women to use, she suggests trying very tight pantyhose. Losing excess weight, elevating the legs and exercises that activate the calf muscle, such as walking and cycling, can help.

“All vascular surgeons wear compression socks” because they’re on their feet for long periods and they know that puts them at risk, she said. “I’ve been wearing them since I was an intern.”

Surgical treatments include using radiofrequency ablation, laser, injection of a chemical solution to collapse a vein (sclerotherapy) and a special glue or foam to seal off a problem vein. Efforts can be made with topical steroids and antibiotics and other medications to promote healthy skin and fight infection to avoid ulcers from poor circulation, according to the AHA.

“Ulcers are tough to treat,” Dr. Mahanor said. “The skin that grows (back) is not of the same quality; there is more scar tissue. Once it happens, (the chance of recurrence) is pretty high.”

Do This if You Have Symptoms

Seek medical care, if you are having symptoms of venous insufficiency. Diagnosis often utilizes a duplex ultrasound that combines regular ultrasound with Doppler ultrasound to measure blood flow, location of the problem and how your vein valves are working.

“You can literally see how long it’s taking valves to close,” Dr. Mahanor said.

She urged people to seek help without delay and to tell their doctor if they have symptoms.

“A lot of people will ignore it for years,” she said. “When they come in, their legs are hurting so much.

“We can definitely give them a better quality of life, if it’s caught in time. You don’t want it to get that far.”