Approximately 30 million adults in the United States may suffer from treatable, symptomatic, superficial venous insufficiency. Many of these patients as well as their primary care or specialty physicians may not be fully aware of the advances made in the treatment of venous insufficiency in the last 5-10 years. Since 2000, vein stripping has been replaced by endovenous closure procedures as the preferred treatment of patients with symptoms related to saphenous vein and other superficial venous insufficiency. Many patients once thought to have untreatable venous problems may now be excellent candidates for endovenous closure.
The deep system of veins within the muscular compartments of the legs communicates with the superficial system of veins under the skin and fatty tissue (outside the muscles) through a network of communicating veins which act as bridges between the two systems. The deep system returns more than 95% of the venous blood from the legs to the pelvis, while the superficial system accounts for 5% or less. Since leakiness in the superficial veins is responsible for more than 95% of patients' problems seen at LONE STAR HEART & VASCULAR, ultrasound evaluation of the lower extremity venous systems is an integral part of their comprehensive venous workup. This evaluation will ensure that any underlying vein problems are identified, and, if necessary, corrected before treatment of the external signs of venous disease is initiated. For example, prior to removing bulging veins in the calf, it is important to first identify the underlying leaky vein and seal it, thereby decreasing the chance that other bulging veins will develop in the future.
Veins can be divided into 2 categories:
- Varicose Veins: usually are the results of a breakdown of the Great Saphenous Vein, an internal vein on the inside of the thigh. The great saphenous vein is only visible with an ultrasound test; therefore, all patients with bulging varicose veins need ultrasound testing prior to treatment. This breakdown of saphenous vein one-way valves causes leakage of blood in the wrong direction. Blood leaks from the thigh into the calf and pools inside the calf veins. This pooling of pressurized blood causes veins to stretch, bulge, and become varicose. If left untreated, varicose veins can lead to dangerous blood clots or large ulcers inside of the ankle. Thanks to endovenous technology, both the saphenous vein and the varicose bulges are easily treated in the office with local anesthesia. Because varicose veins are a medical problem that can lead to complications if left untreated, the treatments are covered by most insurance carriers.
- Spider Veins: on the other hand, are purely cosmetic issues and pose no threat to a person's health. These are small red, purple and blue "threadlike" veins found on the surface of the skin. They are usually not associated with deeper vein issues, and therefore, ultrasound tests are not required for routine cases. These are treated with sclerotherapy and laser. spider veins, unfortunately are a lifelong battle for most patients. Even after successful treatment, the body tends to continue producing them. For this reason, most patients need intermittent maintenance treatments to keep their legs vein free. Spider vein treatments are done for cosmetic reasons and are not covered by most insurance carriers.
Risks and Causes:
These factors increase your risk of developing varicose veins: Age: varicose veins usually appear between ages 30 and 70 and get progressively worse. Sex: Women are more likely than men are to develop the condition. Hormonal changes during pregnancy or menopause may be a factor. Female hormones tend to relax vein walls. Taking hormone replacement therapy or birth control pills may increase your risk of varicose veins. Genetics: If other family members had varicose veins, there's a greater chance that you will too. Obesity: Being overweight puts added pressure on your veins.
Standing for long periods of time: Your blood doesn't flow as well if you're in the same position for long periods of time. Patient satisfaction results from identifying and properly treating the patient's primary concerns, i.e., medical and/or cosmetic issues. Not all symptomatic patients are aware of their symptoms because the onset may be insidious. Symptoms may include leg heaviness, pain or tenderness along the course of a vein, pruritus, burning, restlessness, night cramps, edema, skin changes, and paresthesias. After treatment, patients are often surprised to realize how much discomfort they had accepted as normal. Pain caused by venous insufficiency is often improved by walking or by elevating the legs. The pain of arterial insufficiency, conversely, is worse with ambulation and elevation. Pain and other symptoms of venous disease may worsen with the menstrual cycle, with pregnancy, and in response to exogenous hormonal therapy (eg, oral contraceptives).
What Are varicose veins & Spider veins?
Varicose and spider veins are extremely common in men and women. While spider veins are very small, reddish veins on the surface of the skin, varicose veins are much larger, bulging and "tangled" veins that appear blue in color. Men and women suffer from varicose veins, although women are much more likely to have them.
Patients often complain of heavy or tired legs, swelling in the lower leg or near the ankles, pain and tenderness upon touching the area of the vein, and a general sense of restlessness with the legs.
Both spider veins and varicose veins have a strong genetic component, but lack of exercise, weight gain and obesity, and sitting or standing for extended periods of time all contribute to the risk of developing varicose veins and venous insufficiency.
Once a vein becomes weakened, the elastic vein wall and valves that send blood back to the heart lose its strength, much like an old rubberband, and blood will start to pool in the vein.
While varicose veins initially are not symptomatic, they can be associated with and lead to more serious medical conditions, such as:
- Phlebitis - inflammation of the vein
- Thrombosis - blood clots form in the enlarged vein
- Venous Stasis Ulcers - ulcers that form when proper drainage in the enlarged vein is not available.
Treatment options for varicose and spider veins will vary from person to person as no two cases are the same. The proper procedure will require determining the actual cause of the varicose or spider veins. While many individuals with varicose veins do not seek treatment or therapy, untreated varicose veins can lead to painful ulcers, bleeding, and more serious medical conditions.
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Lone Star Heart & Vascular
425 Holderrieth Blvd.
Tomball, TX 77375
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