Around 40% of the U.S. population lives with venous disease, or chronic venous insufficiency. Those with venous disease may experience a range of symptoms in the legs including pain, swelling, aching, cramping, restlessness, burning, numbness and dermatitis. Ropey, bulging varicose veins and networks of tiny red and blue spider veins are the most visible symptoms. In more extreme cases, especially when venous disease goes untreated, a patient can have bleeding and ulcerations in the legs. Fortunately, there are exceptional treatments that can eliminate these symptoms and get patients back on their feet.
Venous disease is caused by a malfunction in the valves that help regulate blood flow in the legs. Our veins have tiny “gates” shaped like an inverted “V”. In healthy veins, these gates open and close completely as the leg muscles pump blood back toward the heart. In diseased veins, the gates no longer shut tightly and allow blood to pool in the veins. Eventually, the pooling blood stretches the vein walls. This situation decreases circulation, resulting in the variety of unpleasant symptoms noted above.
There is no single cause of venous disease. In many cases, lifestyle can play a role. Being constantly on one’s feet, or sitting most of the day at a desk can be factors. However, heredity also affects whether or not one is susceptible to venous disease. Other factors can include injury and pregnancy. Otherwise healthy people can develop venous disease, including athletes!
Doctors use ultrasound to determine the extent of venous disease and whether the problem is primarily cosmetic or springs from veins deeper in the legs. In almost all cases, the initial method of treatment is a three-month compression stocking trial. This trial is both a conservative first approach to treatment and is also typically required by insurance. Compression stockings are sometimes so effective at eliminating symptoms that no further treatments are needed. However, when compression stockings do not resolve symptoms, other minimally invasive and essentially painless treatments are available. The approach to treating venous disease depends on an individual patient’s circumstances.
Typically a patient has one of three problems:
Treatment first addresses deeper problems before cosmetic concerns. This approach stops the problem at its source. When the interior veins are diseased, addressing only cosmetic issues may not eliminate symptoms, or only relieve them temporarily.
Spider veins are often merely cosmetic and require a simple treatment called sclerotherapy. In sclerotherapy, the doctor injects medicine that irritates the interior of the veins, making them “sticky.” The vein walls then “stick” together, effectively sealing off the vein. More than one treatment is almost always required to get the best results. Typically only 50-60% of veins are closed at once, so the patient returns one or more times to complete treatment. Dive deeper into spider veins.
While varicose veins are often visible just under the skin, they typically indicate that there is a problem in one or more superficial veins branching off from the deep vein that extends through the leg. Doctors use laser ablation, one of the gold-standard treatments for venous disease, to close off the diseased veins and eliminate symptoms. In a laser ablation procedure, the doctor first numbs the treatment area before inserting a small IV into the diseased vein. Then, a small laser fiber is inserted into the IV and, as it is removed, emits a beam that closes the vein. In this procedure, the vein is not removed and the body eventually absorbs it. Circulation is not adversely affected because blood reroutes through alternate channels.
Varicose veins visible at the surface of the leg are addressed through microphlebectomy. After numbing the leg, tiny incisions – only 1-2mm – allow the doctor to insert a tiny hook that teases the vein out for removal. The incisions are essentially the size of paper cuts and close on their own without scarring.
After laser ablation and microphlebectomy, sclerotherapy treats any remaining aesthetic symptoms. This method of treating venous disease from the “inside out” consistently resolves all symptoms, leaving patients free of pain and discomfort. In rare cases where symptoms are not completely resolved, additional rounds of treatment can be employed. Treatments for venous disease are treated in-house and typically take 25 minutes or less. Learn more about varicose veins.
Venous disease treatment requires little preparation on the part of the patient. It’s fine to eat a normal meal, and patients can drive themselves to and from the procedure. If a patient anticipates feeling nervous before treatment, the doctor can prescribe an anti-anxiety medication. (In these cases, of course, the patient needs a driver.) Patients stay awake during the procedure because there is only the brief discomfort of the initial numbing injection.
After treatment, the patient wears compression stockings and leg wraps for 48 hours. After two days, the patient removes the leg wraps but keeps wearing the compression stockings for five more days (seven days total). Any discomfort is typically mild and manageable using over-the-counter pain relievers like ibuprofen. Patients can resume normal daily activities and return to work, but should take it easy. Those in professions that require standing may consider taking one day off to rest, but this is not required. Engaging in strenuous exercise and activity immediately after treatment can impair the healing process, so patients should avoid more vigorous activities for five days. After a week, there is a follow-up appointment that includes an ultrasound to check on healing. The doctor and patient can then discuss any additional treatments or care instructions if needed.
Venous disease treatments are well-tested, safe and effective. Patients may experience bruising or uncomfortable clotting in the superficial veins, but these issues are minor and resolve on their own. Numbness and clots in the deep veins are issues of more concern, but these occur rarely.
The majority of patients are completely pain free after completing treatment for venous disease. If there are any lingering symptoms or concerns, the doctor will address these to the extent possible. Venous disease treatment involves minimal pain and minimal risk, with the likelihood of excellent results. In many cases, health insurance will pay for vein treatment.
If you are experiencing any symptoms of venous disease, then contact a vein specialist for an appointment. If you live in the Westminster and areas of Colorado, call Artemis to schedule your free vein consultation. We want you to live free of the pain and discomfort caused by venous disease, and our caring, experienced team will be with you every step of the way.
