Vein Disorders and Treatment
Understanding Superficial Venous Reflux
Veins carry blood back to the heart. Your legs contain a network of veins. Superficial veins (near the surface of the skin) connect to perforating veins. Perforating veins carry blood from the superficial veins to the deep veins of the thigh and calf. Healthy leg veins contain valves that open and close to assist the return of blood back to the heart. Venous reflux disease develops when the valves that keep blood flowing from the legs back to the heart become damaged or diseased. This can cause blood to pool in your legs, which can lead to a progression of symptoms.
Venous Reflux Disease Symptoms
Spider veins, medically known as telangiectasias are dilated capillary veins less than 2 mm. in diameter. They are small blue to red appearing blood vessels that lie close to the surface of the skin and occur either in lines or web-like patterns. They are usually visible on the legs but sometimes are visible around the nose and lips and are commonly referred to as “broken veins”. While they can ache, burn or itch now and then, they are usually not symptomatic. Spider veins are not harmful and are simply unsightly.
Varicose veins are rope-like blue vessels under the skin, usually ¼ inch or larger in diameter. They are most often branches from the saphenous trunk veins and have enlarged due to the excess pressure in the saphenous system. Varicose veins are unsightly and often painful. A clotted varicose vein causes a condition called phlebitis, in which the skin overlying the site of the clot becomes hot, red and painful. Besides the visible symptoms, physical symptoms include tiredness, restless legs at night, heaviness in the leg, pain, aching, itching, throbbing and swelling, burning or a cramping sensation.
Left Untreated, Venous Reflux Can Progress to Other Conditions
Leg Swelling (Edema)
Vein disorders Beyond the purely cosmetic concerns about spider veins and the pain, fatigue, and discomfort that result from varicose veins, venous reflux is a progressive disease that can lead to other, more significant circulatory problems as it worsens. Swelling of the leg is a further sign that damaged or diseased vein valves are not functioning properly. Since the blood cannot be effectively returned to the heart, it pools in the leg resulting in higher than normal pressure (venous hypertension) and causes the leg to swell. This swelling is called edema.
In addition, when blood flow out of the legs through superficial and perforating veins is inadequate, this higher-than-normal pressure can result in damage to the skin. Progression of venous reflux can lead to changes in the skin’s color (hyperpigmentation) as well as changes in skin texture.
The most severe stage of venous reflux disease is when the inadequate blood flow results in an ulcer, commonly near the ankle. In fact damaged or diseased perforating veins are the source of venous reflux in nearly two-thirds of venous ulcer patients.1 These ulcers are raw and painful wounds which may not always be healed using only antibiotics or salves. Our practice is experienced in offering the most progressive approaches in treating patients with advanced symptoms of venous reflux, including venous leg ulcers.
Click below to view a 30-second video clip about venous reflux.
After a comprehensive evaluation that includes an ultrasound examination of the veins, our vein specialists will determine the optimal treatment for each patient’s needs.
VNUS Closure™ procedure
Treating Venous Ulcers
The Closure Procedure
Doug Selvidge The VNUS Closure Procedure, an alternative treatment option to traditional vein stripping surgery, brings state-of-the-art technology to an age-old disease.The Closure procedure is performed on an outpatient basis. Using ultrasound guidance, your physician will position the Closure catheter into the diseased vein through a small opening in the skin. The slender catheter delivers radiofrequency (RF) energy to the catheter, which heats the vein wall. As the vein wall is heated and the catheter was withdrawn, the collagen in the wall shrinks and the vein closes. Once the diseased vein is closed, blood is re-routed to other healthy veins. Following the procedure, a simple bandage is placed over the insertion site, and additional compression may be provided to aid healing. Your doctor may encourage you to walk at frequent intervals and to refrain from prolonged standing and strenuous activities for a period of time. Patients who undergo the Closure procedure typically resume normal activities within a day.
Highlights of the Closure procedure
Click below to view a short video about the VNUS Closure procedure.
– Relief of symptoms
– Resume normal activity within a day
– Outpatient procedure
– Local or general anesthesia
– Good cosmetic outcome with minimal to no scarring, bruising or swelling
Ambulatory phlebectomy is a method of surgical removal of surface veins. This is usually completed in our office using local anesthesia. Incisions are tiny (stitches are generally not necessary) and typically leave imperceptible puncture mark scars. Post-operative discomfort is minimal. After the vein has been removed by phlebectomy, a bandage and/or compression stocking is worn for a short period.
SclerotherapySclerotherapy is a cosmetic medical procedure used to treat varicose veins and spider veins. A tiny needle is used to inject a solution directly into the vein. The solution irritates the lining of the vessel, causing it to swell and stick together, and the blood to clot. Over time, the body will absorb the treated vein. Mild discomfort may occur, and a cramping sensation may be felt for 1 to 2 minutes when larger veins are injected. The number of veins injected in one session is variable, depending on the size and location of the veins, and the patient’s overall medical condition. Anywhere from one to several sclerotherapy sessions may be needed for any vein region. Medically prescribed support hose and/or bandages may need to be worn for several days to several weeks to assist in the resolution of the veins. In general, spider veins respond to treatment in 3 to 6 weeks, and larger veins respond in 3 to 4 months.
Treating the Venous Ulcer (Treating Perforating Veins)
In the United States, it is estimated that up to 1.8 million people are afflicted with venous ulcers which are the most common chronic wounds treated in wound care centers.1,2 More than half of the venous ulcers treated are recurring ulcerations or wounds that might have healed before, but later return.Conventional treatments for venous ulcer patients include the use of antibiotics, salves, and compression therapy. But these treatments have often resulted in high failure and recurrence rates.Attempts to heal the skin without correcting the underlying venous insufficiency can lead to a delayed ulcer healing and recurrence.1, 3, 4, 5The VNUS ClosureRFS™ Stylet allows our practice to offer you a minimally-invasive option to traditional surgery for the venous ulcers on your legs. It is the only endovenous ablation device specifically cleared by FDA for the treatment of incompetent perforating veins, the most common origin of your leg ulcers. This outpatient treatment can be either the primary procedure or it can be performed in addition to another outpatient leg vein Closure™ procedure, using the VNUS ClosureFAST™ catheter, when chronic venous insufficiency disease of your large saphenous veins has been diagnosed.