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Varicose Veins: More Than Skin Deep

by Dr. David Engleman

Some chalk it up to getting older or having a career that keeps them on their feet all day, while others point the finger of blame at their mother or their children. Whatever the reasons, many people who suffer from varicose veins find the blue or purple raised and twisting lines that transform nice looking legs into a 3-D road map of Italy unsightly and often painful.

In the cardiovascular system, the arteries carry blood away from the heart to the rest of the body. Veins are the avenue for the return trip, bringing blood from the body back to the heart. Tiny one-way valves regulate the ebb and flow of this journey. When valves malfunction, blood pools, creating a bulging varicose vein. One reason this condition is commonly seen in the legs is that the veins within the lower extremities are most under the influence of gravity

The normal function of the leg veins is to drain blood from the leg and back to the heart. This function is contingent on an intact set of one way venous valves. Once the valves are damaged, the blood flow leaks back down the legs, and elevates the venous pressure and eventually may lead to symptoms and complications. The symptoms may be as vague as mild swelling or easy leg fatigue. They can worsen to pain, tenderness, itching or cramping.

Because they appear on the surface of the skin, it may seem that varicose veins only pose a cosmetic problem. These enlarged, bulging veins are actually the end result of the leaky valves and high venous pressure. This can lead to future problems that are relatively easy to avoid if the condition is properly diagnosed and treated. These problems include thrombo-phlebitis and chronic skin and soft tissue damage that can lead to skin ulcers.

For some people, varicose veins can cause painful throbbing, itching or leg fatigue. In others the veins remain asymptomatic until the condition is very far advanced. In some cases, tiny sub-surface lines called telangiectasia or more commonly, spider veins, appear on the legs. Not all spider veins indicate a problem but can be an indication of venous disorders.

Both men and women can develop this condition. Women most commonly present at a younger age, in part because of the influence of hormones on the tone of the vein. Additionally, the pregnant uterus exerts pressure on the veins within the pelvis further damaging the valves. In the United States, up to 25 percent of women and 15 percent of men are affected by varicose veins. Besides age and gender, genetic factors also come into play. Varicose veins and venous disease are common among family members of affected patients.

Minimally Invasive Treatment

One of the biggest breakthroughs in removing varicose veins is applying laser or radio frequency energy to stop the flow within a malfunctioning vein. Instead of removing this vein surgically, we are able to guide a catheter into the vein via ultrasound technology. The catheter then delivers laser or radio energy to cause the vein to contract and seal.

Most of the new treatments take about an hour, and patients can be up and walking immediately. Not only are the newer treatments more effective, they are much less painful and can be done safer with a local anesthetic in an office setting. In fact, patients are encouraged to walk after undergoing these procedures to promote blood flow through the healthy remaining veins.

Prevention

Like many medical conditions, prevention strategies can be employed for good vein health. Maintaining normal body weight and exercise with calf muscle flexion are key methods of decreasing the pressure in the veins. A large component of venous disease however is inherited and is out of control of the patient. In some circumstances, prescription strength compression stockings may be helpful at improving symptoms and slowing the progression. Venous reflux disease is a misunderstood and under diagnosed condition that has new and effective treatment options that did not exist only a few years ago. If you have bulging twisty veins you may have venous reflux that could be treated without the need for traditional surgery. A simple 10 minute ultrasound done properly can determine if you have a more serious problem that could be addressed.

For more information please go to www.bellamd.com or call Bella MD at (214 378-6500).