What is vein disease?
Veins are the blood vessels that return blood to the heart from the body. To overcome the force of gravity, inside the veins are one-way valves which open to allow blood flow to the heart, and close to prevent “reflux” of blood back to the body. When these valves fail to function, or if the vein is damaged so the valves do not completely close, blood can begin to pool in the vein and cause a variety of vein complications.
Spider veins are the small, thread-like colored veins that are most often seen on the surface of the skin. Varicose veins are the large, rope-like veins which are often 1/4″ or larger in diameter. Varicose veins generally grow in size over time and can result in substantial pain and complications if not treated.
Varicose veins generally worsen over time. Initially, slight pain and restlessness in the diseased leg will be felt. If untreated, the pain will increase and additional symptoms such as heaviness, fatigue, itching, burning, and cramping at night may occur. Eventually, varicose veins can lead to open sores on the foot, blood clots and tissue loss.
Depending on the type and stage of vein disease, there are many different treatments. Dr. Overbeck can explain all of the options in our Las Colinas, Stephenville, or Granbury offices. The following are common treatments performed for vein disease, but not all are performed by Dr. Overbeck:
Compression Stockings For minor pain from varicose veins, a compression stocking may be beneficial. The compression stocking will assist the leg in the pumping of blood back to the heart. While the vein disease symptoms may be relieved, compression stockings will not make the varicose vein go away.
Sclerotherapy Used commonly for spider veins and small varicose veins, sclerotherapy involves injecting a small volume of a liquid into the diseased vein. The sclerosing liquid acts upon the lining of the vein. It is performed in a physician’s office and no anesthesia is required. Dr. Overbeck does not perform sclerotherapy in his office, however, recommends the following physicians for the treatment of spider veins:
Lori D. Stetler, M.D. – Dallas http://www.dallascosmeticderm.com/
Chris W. Crawford, M.D. and Laura L. Sears, M.D. – Dallas http://dallasassocderm.com/
Michael R. Whetstone, M.D. – Las Colinas http://lascolinasplasticsurgery.com/
Todd Plott, M.D – Fort Worth http://www.dermatologyalliancekeller.com/
Radiofrequency Ablation Using ultrasound, a catheter is positioned into the diseased vein through a small opening in the skin. The skin catheter powered by radiofrequency energy delivers heat to the vein wall. As the thermal energy delivers heat to the vein wall. As the thermal energy is delivered, the vein wall shrinks and is sealed closed. Once the diseased vein is closed, blood is re-routed to other healthy veins. Following the procedure, a simple bandage is placed over the incision site and additional compression is provided to aid healing. Patients who undergo this procedure typically resume normal activities within a day.
Ambulatory Phlebectomy Historically, the only treatment for large varicose veins has been to surgically remove or ‘strip’ the vein from the body. Surgical stripping is done in an operating room under anesthesia and requires a considerable recovery period for the patient. More recently, a modified version of stripping known as ambulatory phlebectomy has grown in use. In this version of surgical stripping, multiple incisions are made to hook and remove the vein one portion at a time. More incisions are made than in standard vein stripping, but the damage to the leg and post-surgery recovery time are minimized.
Patients should wait at least three months after pregnancy or major surgery before being treated for vein disease. Persons with deep vein thrombosis or incompetence and patients who cannot ambulate are not good candidates for treatment.
Because there are many veins in the leg, the blood that would have flowed through the closed vein simply flows through other healthy veins after the procedure. The loss of the diseased vein is not a problem for the circulatory system.
Common minor complications of procedures include bruising, mild itching, tingling, tenderness and tightness in the treated leg for up to two weeks, with maximum benefits seen 6 to 8 weeks after treatment.
Many insurance companies and Medicare will cover the treatment of the vein disease that is associated with substantial pain and other complications, but individual insurance companies may limit the type of covered therapy.
Fortunately, most vein disease can be seen by looking at the size and color of the vein at the skin surface. In some cases, however, the diseased vein may be deeper in the body and not visible through the skin. As a result, paying close attention to other symptoms is important in diagnosing vein disease. Many patients with vein disease experience cramping, aching, burning, itching, soreness or “tired” or “restless” legs, especially in the calf muscles. If you experience these symptoms, your physician can quickly and easily perform a test to determine if you have vein disease.
Vein disease of the legs is one of the most common medical conditions. Approximately half of the population has some form of vein disease. Varicose veins affect between 15-25% of all adults and approximately 50% of all people over the age of 50. Women have a higher incidence of vein disease than men.
The single most important cause of vein disease is heredity. Approximately 70% of all patients with varicose veins have parents with the same condition. Pregnancy, especially multiple pregnancies, is a contributing cause of vein disease. Other factors influencing vein disease are age, obesity and jobs which require long periods of standing.
Generally no. If you have a family history of vein disease, this is nothing you can do to change your genes. Being overweight can accelerate the progression of vein disease, and long periods of standing can also add to the problem. Diet and footwear are generally believed to be irrelevant in the formation of vein disease.