Many people inherit vein disorders. The incidence is higher in women than men. In the United States, nearly 50% of the adult population suffers from painful and unsightly vein diseases. The most common forms being spider and varicose veins.
The doctor will gather information before recommending a treatment approach for your vein problem. Before moving ahead with treatment he must rule out more serious problems with the deep vein system. The root of most vein problems is venous insufficiency (veins not functioning well in carrying blood back to the heart)
Spider veins are small blue or red vessels visible within the skin, usually on the leg, face, neck or chest. Varicose veins are dilated and ropy-appearing blue vessels visible under the skin, ¼-inch or larger in diameter. Varicose veins typically cause pain, fatigue and swelling – and sometimes even more serious complications.
Until recently, the removal of varicose veins required the actual stripping of the vein – a surgical procedure that requires an overnight hospital stay, a painful recovery period – and possible scarring from incisions and post-operative infections.
After your evaluation, the physician will develop a treatment plan. This plan is tailored to your individual needs. You may have several options. Your treatment options may include injections, minimally invasive procedures, or surgery. One or more of these may be recommended. All treatments destroy or remove veins. (The remaining veins take over the workload, carrying the blood where it needs to go. Blood flow then becomes more efficient.)
TREATMENT OPTIONS
The FDA – cleared Endoluminal Laser Ablation of the Greater Saphenous Vein procedure sounds complicated – but it’s actually a very quick, minimally invasive therapy, which causes little or no side effects, and has shown to be highly effective in eliminating varicose veins.
During the 45-minute procedure, the involved area of your leg is anesthetized and a thin laser fiber is placed into the affected vein. The physician will then deliver laser energy via the fiber to damage and eventually eliminate the vein. The fiber is then removed and a compression bandage is put on your leg. Walking immediately following the procedure is encouraged, and normal activities can be resumed.
The laser can also be used for spider veins. The wavelength safely passes through the skin and is absorbed by the targeted blood vessel. The vein will gradually disappear, leaving the skin intact.
When organs and muscles in the body receive an insufficient supply of oxygen-rich blood, they literally become starved and alert you to this fact by producing pain. If the blockage occurs in the arteries supplying the legs, the resulting symptom is a cramping pain in the hips, thighs or calf muscle and can limit even casual walking. If the cycle of pain is relieved with rest, we call the condition intermittent claudication. Pain that occurs during rest can sometimes be alleviated by lowering the legs so the force of gravity shunts blood into the feet. If blood circulation becomes so severely restricted that the legs and feet are perpetually starved for nutrition, gangrene—or death of the tissue—can occur. Without treatment, the entire foot or possibly part of the leg may have to be amputated.
Other symptoms of peripheral vascular disease in the lower extremity include: coldness of the leg, foot or toes; paleness of the leg or foot if elevated; blue/red discoloration of the foot or toes; loss or decreased growth of hair on the legs; dry, fragile or shiny-looking skin; numbness, tingling or pain in the leg, foot or toes; sores that do not heal.
Other conditions can also cause these symptoms. Therefore, a thorough examination with a physician is necessary.
Symptoms of peripheral vascular disease in the carotid arteries include: sudden, temporary weakness or numbness of the face, arm and/or leg on one side of the body; temporary loss of speech or trouble speaking or understanding speech; temporary dimness or loss of vision, particularly in one eye; unexplained dizziness, unsteadiness or sudden falls. Transient Ischemic Attacks (TIAs) are mini-strokes and illicit the same symptoms named above except they are temporary.
Symptoms of peripheral vascular disease in the renal arteries include; hypertension (high blood pressure-consistently higher than 140/90); abnormal kidney function blood test.
DIAGNOSIS
When any of the above-named symptoms occur, a history and physical examination accompanied by an ultrasound Doppler test are initially performed. The ultrasound Doppler test visualizes the inside of the arteries using sound waves to determine if there is plaque buildup, and if so, to what extent. This test is simple and painless. If the test shows that the stenosis (or narrowing of the artery) is severe, then a test called an arteriogram or aortagram will give your physician the complete information he or she needs to properly diagnosis your condition.
Chronic venous insufficiency is a common problem in the U.S., affecting approximately 5% of the general population. It is estimated that ½ million patients suffer from ulceration of the lower extremity as a result of longstanding venous disease.
An elaborate network of one-way valves normally prevents venous reflux into the lower extremity which can result in venous hypertension. Incompetence of this valvular system secondary to either dilatation (varicosity) or to previous deep vein thrombosis allows gravity to act on a longer column of fluid. The basic laws of physics predict an increase in venous pressure the longer the column of fluid becomes (the more valves impaired). In turn, venous hypertension is believed to be the underlying cause of all events that eventually lead to the sequelae of chronic venous insufficiency – leg edema (swelling), hyperpigmentation, varicose veins, and ulceration. The clinical features of chronic venous insufficiency may be subtle but are often evident to the experienced clinician. Duplex ultrasonography and standard phlebography (venography) are helpful in establishing the diagnosis and severity of venous insufficiency.
An aortic aneurysm is a weak area in the aorta, the main blood vessel that carries blood from the heart to the rest of the body. As blood flows through the aorta, the weak area bulges like a balloon and can burst if the balloon gets too big. A small aneurysm may require no immediate treatment other than “watchful waiting” - checking the aneurysm with CT scanning or an Ultrasound regularly to be certain it does not grow. If an aneurysm reaches a certain size, however, there is danger that it will burst and bleed uncontrollably (hemorrhage). In these cases treatment is necessary.
Peripheral Vascular Disease, or PVD, is a condition in which the arteries that carry blood to the arms or legs become narrowed or clogged. This interferes with the normal flow of blood, sometimes causing pain but often causing no symptoms at all. The most common cause of PVD is atherosclerosis (often called hardening of the arteries). Atherosclerosis is a gradual process in which cholesterol and scar tissue build up, forming a substance called “plaque” that clogs the blood vessels. In some cases, PVD may be caused by blood clots that lodge in the arteries and restrict blood flow. Smoking is the largest risk factor for development of PVD. Lifestyle and dietary habits contribute as well.
TREATMENT ALTERNATIVES
Many treatments can be used to improve blood flow through arteries and veins. The latest interventions for treating vascular disease can bring swift relief and be more cost effective than surgery. Most procedures require out-patient or in-office surgery or no more than an overnight hospital stay. Patients can now enjoy an early return to most normal activities sooner.