Venous Insufficiency

(Varicose veins and wounds)

Veins are the soft blood vessels of the body which bring blood back to the heart after it has been used in the body to deliver oxygen. Blood flows slowly in the veins and have to fight gravity to travel all the way from the legs back up into the chest. The body uses one-way valves to allow the blood to travel up in increments but sometimes these valves do not work well (become faulty), and that condition is called “venous insufficiency.” Most commonly, the veins affected are the greater saphenous and small saphenous veins (GSV/SSV).

Signs and symptoms of venous insufficiency in the legs include: Varicose (bulging) veins, leg swelling, darkening of the skin around the shins/ankles, wounds around the shins/ankles, tenderness, burning, itching, heaviness, fatigue, and blood clots (venous thrombosis/DVT/SVT).

Risk factors for venous insufficiency include: Family history of varicose veins, long periods of standing or sitting-often related to your job, and history of blood clots in the legs.

Testing includes: Venous insufficiency ultrasound which includes special maneuvers such as squeezing the leg gently to examine forward/backwards flow within the veins.

Venous insufficiency can affect your quality of life and successful treatment can greatly help improve your daily comfort.

Treatment:

Compression stockings are a non-invasive therapy that can either be standalone treatment for venous insufficiency or an aid for your Vascular Surgeon to determine if surgical management is more likely to be successful for you. Most treatment plans include a trial of compression and this is often required by your insurance company prior to any vein procedures.

Radio Frequency Ablation (RFA) is a longstanding vascular procedure used to close down faulty veins so that the body can redirect blood to travel in the good veins instead. Your surgeon places a special catheter in the GSV or SSV and then injects a surrounding layer of fluid around the vein to protect the tissues from any generated heat while the RFA is performed.

VenaSeal is an innovative method to close down faulty veins using a surgical adhesive glue placed within the vein. Similarly, the body redirects blood to the good veins once the faulty vein is closed by the glue. Since this procedure does not generate heat, injection of fluid is not necessary around the vein prior to treatment. Patients who are sensitive to adhesives or allergic should not have this procedure.

Sclerotherapy is injection of a special medical foam which chemically irritates the inside of the faulty veins so they can form scar and close down so your blood can be re-directed to the good veins.

Phlebectomies are surgical excisions of large varicose veins through small incisions. These veins are too large to close down with any of the methods mentioned above.

All of these procedures are often comfortably done right in our outpatient clinic as opposed to performing them in the hospital.

Many patients require a combination of the above treatment options performed over a period of time. Venous disease is complex and even if you have had vein procedures in the past, the disease can come back on its own with aging. Talk to your primary doctor about a referral to a Vascular Surgeon to develop the treatment plan that is right for you.