Varicose Vein Treatment
An estimated 40 percent of people in the United States have chronic venous insufficiency. Venous insufficiency can present itself as a spider or varicose veins and may be a sign of significant underlying venous disease. Venous insufficiency can be the result of heredity, age, gender, weight, history of deep vein thrombosis (blood clots), multiple pregnancies, inactivity and occupations that require prolonged sitting or standing.
Signs and Symptoms
- Swollen ankles
- Leg cramps
- Restless legs
When the veins are damaged, gravity will hinder normal blood flow causing blood to form pools in the weakened, damaged veins. The pooling blood causes these veins to enlarge. Twisted masses of veins beneath the surface of the skin, known as varicose veins, often result. Varicose veins are larger and located deeper in the leg than spider veins. Spider veins are small red, blue and purple veins on the surface near the skin.
How are Varicose Veins Treated?
There are generally 2 treatment options:
· Conservative measures such as the use of compression stockings and change in lifestyle
· Corrective treatment such as endovenous laser therapy, ambulatory phlebectomy, and sclerotherapy.
Endovenous Laser Therapy
Endovenous Laser Therapy (EVLT) or Venous Ablation is a technique that uses a laser fiber to close down the enlarged varicose veins. The procedure is performed in our office and takes about 30-45 minutes. A small laser catheter is passed into the affected vein with guidance from the ultrasound machine. The laser is then turned on and the entire vein closed down. The laser is fired at multiple locations and the entire procedure is performed with some local anesthesia. The closed vein is reabsorbed into the body and the blood supply in that area is naturally rerouted to other veins. Recovery is rapid and involves minimal pain.
Varicose Vein during Pregnancy
Effect of Pregnancy on the Venous System
During pregnancy, many hormonal changes occur in the body that has a profound effect on the veins. Blood volume increases between 40% to 50%, while increased amounts of progesterone cause the vein walls to dilate and become less elastic.
The pressure of the fetal head in the pelvis can compress the iliac veins and obstruct venous outflow from the legs. As the baby grows, the uterus enlarges and applies pressure on important veins that return blood to the heart. This pressure can cause a slowing of the blood flow and valve damage, resulting in swelling, leg discomfort, and even varicose veins. A pregnant woman’s feet and legs may start to swell after sitting or standing for only a short time. In principle, this is a completely normal symptom. However, if your feet are already swollen when you get up in the morning, consult your doctor. While these symptoms may subside after delivery, with each subsequent pregnancy, they are less likely to completely disappear.
Pregnant patients are encouraged to have an evaluation during pregnancy and treatment is encouraged after delivery.
Pregnancy and DVT
Women who are pregnant are at a high risk for the development of a Deep Vein Thrombosis, known as DVT. One reason is due to the increased blood volume at full term.
Additionally, pregnancy causes hormonal changes that increase blood coagulability, a measure of how easily blood clots. The expanding uterus puts pressure on blood vessels, restricting blood flow from the legs and pelvis back to the heart.
Slower blood flow increases the risk of Deep Vein Thrombosis. The risk continues during the postpartum period until the woman’s hormonal levels return to their pre-pregnancy state.
Common Leg Health Problems During Pregnancy
Venous disorders and leg health problems are among the most frequent medical conditions in North America. You may experience these conditions for the first time during pregnancy. For example, swollen feet, tired aching legs and a feeling of heaviness in the legs are among everyday symptoms that pregnant women may experience.
These symptoms are especially frequent when:
• a history of varicose veins and venous disease exists in the family
• a venous condition was already present before the pregnancy
• The woman sits and stands for prolonged periods of time while pregnant
• The woman does not exercise regularly during the pregnancy, or
• The woman has had more than one pregnancy
Pregnancy plays a role in the development of varicose veins. 30% of women pregnant for the first time, and 55% of women who have had two or more full-term pregnancies develop varicose veins.
Ultrasound is a non-invasive imaging scan that uses sound waves to “see” inside your body. At the Vascular Institute of Virginia, we have an expert team of physicians, nurses, and technologists who are highly trained in ultrasound imaging.
Venous Duplex Ultrasound Scan
The purpose of a venous duplex ultrasound scan is to evaluate venous blood flow in the patient’s arms and/or legs. Patients may experience symptoms such as pain, swelling or varicose veins in the arms or legs. These scans can aid in the diagnosis of venous abnormalities such as a suspected blood clot in a deep vein of the leg (DVT); narrowing or closure (occlusion) of a vein; or impaired blood flow (venous insufficiency).
A Venous Doppler ultrasound study may be part of a venous duplex ultrasound examination. Doppler ultrasound is a special ultrasound technique that allows the physician to see and evaluate blood flow through arteries and veins in the abdomen, arms, legs, neck, or within various body organs such as the liver or kidneys.