Venous Insufficiency Treatment in Lansdale and Bethlehem, PA
What is venous insufficiency?
Chronic venous insufficiency (CVI) is a condition in which the valves inside your leg veins do not close properly, allowing blood to flow backward and pool in the lower legs. This raises pressure in the veins and can cause tired, heavy, aching, or swollen legs, even when no varicose veins are visible on the skin. At Precision Vein Care, board-certified vascular surgeon James L. Guzzo, MD, FACS, diagnoses venous insufficiency with in-office ultrasound and treats it with minimally invasive procedures in Lansdale and Bethlehem.
Heavy, Tired, Swollen Legs? You May Not See the Cause
Many people assume that vein problems come with bulging veins. In reality, the veins most often responsible for venous insufficiency, such as the great saphenous vein, run deeper beneath the skin. They can leak for years without producing a single visible vein, while still causing real symptoms that affect your comfort and quality of life.
If your legs feel worse as the day goes on and better in the morning or when you put your feet up, venous insufficiency may be the reason.
Signs and Symptoms of Venous Insufficiency
- Legs that feel heavy, tired, or achy, especially after standing or sitting
- Swelling in the ankles or lower legs that improves with elevation
- Sock marks or indentations that linger at the end of the day
- Leg cramps, restlessness, or throbbing at night
- Itching, tingling, or a burning sensation in the lower legs
- Skin changes near the ankles, such as darkening, redness, dryness, or thickening
- Varicose veins or spider vein clusters around the ankle
- Slow-healing wounds or ulcers on the lower leg
What Causes Venous Insufficiency?
Your leg veins work against gravity, using one-way valves and calf muscle contractions to return blood to the heart. When valves weaken or are damaged, blood leaks backward (venous reflux) and collects in the lower legs. Common contributors include:
- Family history of vein disease
- Age
- Pregnancy, particularly multiple pregnancies
- Long hours on your feet or sitting at a desk
- Excess body weight
- Limited physical activity
- A previous deep vein thrombosis (DVT) or leg injury
Why Treating Venous Insufficiency Matters
Venous insufficiency is a progressive condition for many people. Without treatment, increased pressure in the veins can lead to worsening swelling, varicose veins, skin inflammation (stasis dermatitis), hardening of the skin, and in more advanced cases, open wounds called venous ulcers. Identifying and treating the problem early can help relieve symptoms and protect the health of your skin and legs.
Other Causes of Leg Swelling and Pain
Leg swelling can have many causes, including heart, kidney, or thyroid conditions, lymphedema, and certain medications. Leg pain that comes on while walking and eases with rest may be related to arteries rather than veins. A vascular evaluation helps sort out the true source. Precision Vein Care also offers a Vascular Triple Screen to check the carotid arteries, abdominal aorta, and leg arteries when appropriate.
How We Diagnose Venous Insufficiency
Diagnosis starts with a detailed discussion of your symptoms and a physical exam of your legs. Dr. Guzzo then performs a diagnostic venous duplex ultrasound in our office. This noninvasive test uses sound waves to show blood flow in real time, measure how long blood flows backward through each valve, and map exactly which veins are involved. Ultrasound findings also help document medical necessity for insurance.
Venous Insufficiency Treatment Options
Compression and Lifestyle Care
Medical-grade compression stockings, regular walking, leg elevation, and weight management can help reduce swelling and discomfort. Many insurance plans require a period of conservative care before approving procedures.
Minimally Invasive Vein Closure
When ultrasound confirms reflux, Dr. Guzzo can close the diseased vein so blood reroutes through healthy veins. Options performed in our office include:
- ClosureFast radiofrequency ablation, which uses gentle heat to seal the vein
- VenaSeal, which uses a medical adhesive to close the vein
- Varithena, an ultrasound-guided foam that treats twisted or hard-to-reach veins
- Ultrasound-guided sclerotherapy for smaller feeder veins
- Microphlebectomy to remove bulging surface veins
These procedures use local anesthetic, typically take about an hour, and allow you to walk out of the office the same day.
Learn more on our
Procedures page.
Insurance Coverage for Venous Insufficiency
Because venous insufficiency is a medical condition, evaluation and treatment are often covered by insurance when symptoms and ultrasound findings meet plan criteria. Precision Vein Care accepts many major plans, including Aetna, UnitedHealthcare, Blue Cross, Humana, Cigna, and Medicare. Our team can help you understand your coverage.
Meet Dr. James L. Guzzo, MD, FACS
James L. Guzzo, MD, FACS, is a board-certified vascular surgeon and the founder of Precision Vein Care. A Bethlehem native, Dr. Guzzo earned his medical degree from the University of Vermont College of Medicine, completed six years of general surgery residency at the University of Maryland Medical System in Baltimore, and completed fellowship training in Vascular and Endovascular Surgery at The Johns Hopkins Hospital.
Before opening Precision Vein Care, Dr. Guzzo spent nine years at Lehigh Valley Hospital in Allentown, where he served as Chief of the Division of Vascular and Endovascular Surgery and received teaching awards from the surgical residency program. He has authored more than two dozen peer-reviewed journal articles, book chapters, and presentations at national surgical meetings, and he is a Fellow of the American College of Surgeons.
Venous Insufficiency Care in Lansdale and Bethlehem
Precision Vein Care has two offices to serve patients across southeastern Pennsylvania. Our Lansdale office at 1000 Walnut Street, Suite 116, serves Montgomery and Bucks Counties, including North Wales, Hatfield, Souderton, Harleysville, Chalfont, and Doylestown. Our Bethlehem office at 5325 Northgate Drive, Suite 202, serves the Lehigh Valley, including Allentown, Easton, Nazareth, Hellertown, and Center Valley.
Frequently Asked Questions About Venous Insufficiency
Can you have venous insufficiency without varicose veins?
Yes. The veins that most often cause venous insufficiency sit deeper under the skin, so many people experience heaviness, swelling, and aching legs without any visible varicose veins. An ultrasound is the most reliable way to find out.
Why do my legs feel heavy at the end of the day?
When vein valves leak, blood pools in the lower legs as you stand or sit throughout the day. This added pressure can cause heaviness, fatigue, and swelling that often improves overnight or with elevation.
Is venous insufficiency serious?
Venous insufficiency is not usually an emergency, but it can progress over time and lead to skin changes and leg wounds. Early evaluation and treatment can help relieve symptoms and lower that risk.
Is the vein ultrasound painful?
No. A venous duplex ultrasound is noninvasive. A technologist or physician moves a handheld probe with warm gel over your leg, and you may feel light pressure.
Can venous insufficiency be cured?
Damaged vein valves do not repair themselves, but treatment can close the faulty veins and redirect blood flow to healthy ones. Many patients notice meaningful relief from heaviness, swelling, and aching after treatment.
Do compression stockings help venous insufficiency?
Compression stockings can help reduce swelling and discomfort by supporting the veins. They manage symptoms but do not correct the underlying reflux.
Find Out What Is Behind Your Leg Symptoms
You do not have to accept tired, heavy legs as part of life. Call (267) 627-1500 to schedule a vein screening with Dr. Guzzo at our Lansdale or Bethlehem office.
