Chronic Venous Insufficiency (CVI)

CVI is rarely an emergency, but it is progressive. Untreated, elevated venous pressure can lead to chronic swelling, skin damage, and eventually venous ulcers — open wounds that are difficult to heal.

Treating CVI earlier is simpler, more comfortable, and more effective than treating its complications later.

Genetics is the biggest factor — CVI runs strongly in families. Pregnancy, prolonged standing or sitting, age, weight, and prior blood clots also contribute. Because the underlying causes persist, vein disease deserves monitoring even after successful treatment.

Yes — modern treatment is minimally invasive and performed in the office. Procedures like radiofrequency ablation close diseased veins through a tiny puncture under local anesthesia, with most patients back to normal activity the same day. Traditional vein stripping surgery is rarely needed today.

Varicose veins are a symptom; CVI is the underlying condition. The bulging veins you can see are usually fed by a refluxing vein you cannot see.

Treating only the visible veins without addressing the source is why vein problems recur — and why we always start with an ultrasound.

No — compression manages symptoms by supporting the veins from the outside, but it does not repair failed valves. It is a genuinely useful first-line measure, and most insurers require a compression trial before approving definitive treatment. If symptoms persist, ablation treats the actual cause.

A vein consultation with duplex ultrasound is the definitive answer. The study is non-invasive, takes about 30 to 45 minutes in our office, and shows exactly how your vein valves are functioning — with results reviewed the same day.

In most cases, yes. CVI treatment is covered by most major insurance plans, including Medicare, when it is medically necessary. That means your symptoms and vein disease are documented and confirmed on an ultrasound, rather than treated purely for appearance.

Insurance considers care 'medically necessary' when you have symptomatic disease, think aching, swelling, heaviness, skin changes, or ulcers, backed by imaging that shows faulty valves. Cosmetic-only vein work is not covered. At our St. Johns clinic, we confirm the diagnosis first, then help you understand what your plan is likely to cover before you commit to treatment.

CVI is a progressive condition, so waiting generally allows the underlying valve problem to continue. Symptoms like swelling, heaviness, and skin discoloration often gradually worsen, and over time some people develop harder-to-treat changes such as skin thickening or slow-healing ulcers near the ankle.

The upside of acting sooner is that early, symptomatic disease is usually more straightforward to manage with minimally invasive, in-office care, and it is more likely to meet the medical-necessity bar for insurance coverage. Being evaluated does not commit you to a procedure; it simply tells you where you stand.

If you are still researching before booking, our blog explains what chronic venous insufficiency is and whether it is dangerous. When you are ready for a personalized answer, a consultation at our Jacksonville-area clinic is the next step.