Venous Stasis

What Is Venous Stasis?

Venous stasis is the swirling, slowing down or pooling of blood inside leg veins.  This condition is also called venostasis. This pooling is a direct result of malfunctioning vein valves, sitting for too long or varicose veins.  When malfunctioning vein valves are left untreated, and as it progresses, venous stasis can cause increasing pain and swelling in affected areas while also increasing the risk of blood clots and contributing to the formation of varicose veins, venous stasis ulcers, and stasis dermatitis.

Most often observed in the legs, this condition is more common in people with chronic venous insufficiency and people who travel often.

Venous Stasis Causes

Venous stasis develops as a result of damaged valves in the veins interfering with blood’s ability to flow upwards and towards the heart; serious cases of venous stasis are commonly accompanied by swelling and fluid retention in the ankles and lower legs.

Veins are responsible for carrying deoxygenated blood from the tissue and organs of the body back to the heart.  As part of this process, one-way valves located throughout  the veins keep blood flowing towards the heart and prevent it from flowing backwards.   Over time, and as these vein valves continue to weaken, blood can start to leak backward and pool within the veins.  As this happens, and as the affected valve(s) and vein(s) continue to weaken, blood starts to pool within the vein, resulting in the condition known as chronic venous insufficiency.

There are many factors that contribute to the development of venous stasis, including:

• Repeatedly standing or sitting for extended periods of time
• Long flights on an airplane
• Long car rides 
• Blood clots
• Varicose veins

Venous Stasis Symptoms

Venous stasis is a condition that does not typically go away on its own.  Progressive in nature, without taking steps to address the condition, symptoms become increasingly severe and can include:

• Swelling in the lower legs and ankles
• Feeling of tightness, pain, or “itchiness” in the affected areas
• Browning or discoloration of the skin located near and around the ankles
• Varicose veins
• A localized feeling of “heaviness” or tiredness 
• Leg ulcers

Stasis Dermatitis

Of the symptoms associated with this condition, stasis dermatitis tends to be among the most uncomfortable and potentially serious.  Causes by fluid build up resulting from varicose veins, poor circulation, and progressive heart disease, stasis dermatitis is characterized by significant fluid build up in the lower legs, discoloration of the skin on the ankles and/or shins, thickening of the skin, and the appearance of difficult-to-treat sores known as venous stasis ulcers.

Venous Stasis Diagnosis

Venous stasis is often diagnosed after a thorough medical history and physical exam has been completed. Since many of the veins are located underneath the surface of the skin, most exams will include a vein ultrasound. The venous ultrasound is non-invasive and emits sound waves that travel through the skin and is used to diagnose reversal of flow inside the veins.  This diagnostic ultrasound is then used to identify the specific locations of venous stasis, as well as to identify a plan of treatment to address areas of venous stasis in the veins.

Venous Stasis Treatment Options

Like most treatments for issues involving the veins, venous stasis treatments tend to start with the most conservative options before progressing to increasingly invasive treatment options.

Most responsive when treated early in the condition, treatment, at least initially,  typically includes wearing compression stockings, losing weight, increasing exercise, and avoiding long periods of sitting or standing.

Venous stasis can often require treatment through a number of minimally invasive procedures, including:

• Endovenous laser ablation (EVLT)
• Radiofrequency ablation (RFA)
• VenaSeal
• Varithena
• Ultrasound Guided Sclerotherapy

In rare cases, patients may require invasive procedures. The two most common invasive surgical treatment options for advanced venous stasis are vein stripping and phlebectomy. During a vein stripping procedure, a series of two to three incisions are made on the leg and the entire vein is removed; the vein is then tied off and the incisions are closed with stitches.

Phlebectomy is similar to vein stripping, but is more commonly used on smaller veins.  During a phlebectomy, several tiny incisions are made along the vein; the vein is then removed in several pieces.

Both vein stripping and phlebectomy are considered invasive surgical  treatment options and are typically performed while the patient is under general anesthesia. These procedures in the United States are typically no longer performed due to the advancement of minimally invasive vein procedures.