Varicose Veins
703-504-7950
What Are Varicose Veins?
Varicose veins are veins that have lost their effectiveness and become
elongated, bulged and thickened close to the skin's surface. Any
vein may become varicose, but the most commonly affected areas are the
legs and feet.
What Causes Varicose Veins?
As blood flows through your veins to the heart, stop valves in your
veins are supposed to close
to keep blood from flowing downward with gravity. As you age, your
veins can lose elasticity, causing them to stretch. When the valves
in the vein become weak and do not close properly, they allow blood
to flow backward and pool in the veins. This forces the vein walls
to enlarge and bulge out. This abnormal circulatory condition is called
venous insufficiency.
Image courtesy and copyright of Diomed Inc. EVLT is a Trademark of Diomed Inc. Diomed is a registered Trademark of Diomed Limited.
What Are the Symptoms?
Symptoms of varicose veins may include:
- aching pain, fatigue or heaviness in the leg
- burning, throbbing, cramping or swelling in the lower leg
- enlarged veins readily seen under the skin of the leg
- brownish-gray discoloration on the ankle
- itching around a vein
Some people may not have visible varicose veins, but still experience symptoms caused by dilated veins that place pressure on their nerves. Often symptoms of varicose veins worsen as the day progresses.
Many people who experience these symptoms find they need to sit down in the afternoon and elevate their legs to relieve their discomfort.
Severe cases of venous insufficiency can cause skin discoloration, ulceration or swelling, which require immediate medical attention.
Who Is at Risk for Varicose Veins?
Risk factors include age, family history, female gender and pregnancy. In
women, pregnancy, especially multiple pregnancies, is one of the most common
factors that accelerates the worsening of varicose veins. Additional factors
that do not cause varicose veins but may speed or worsen their development
include obesity, prolonged standing or physical trauma to the lower limbs.
Varicose veins affect one out of two people age 50 and older, and 15 to
25 percent of all adults.
How Is Venous Insufficiency Diagnosed?
An ultrasound test is used to painlessly map the major vein of the leg,
the greater saphenous vein, to assess vein anatomy, valve function and blood
flow changes.
Treatment Options
How Are Varicose Veins Treated?
People who experience mild symptoms can ease their discomfort by following
a few simple lifestyle recommendations. These include exercising regularly,
maintaining a healthy weight, wearing loose-fitting clothes, elevating the
legs during rest, wearing elastic support stockings and avoiding long periods
of standing or sitting.
However, if you experience severe symptoms, it may be necessary to medically treat your varicose veins. Your physician can help you decide which treatment is best for you based on the size and type of veins affected and the severity of your symptoms. Your options may include the following:
- Vein ligation or stripping are surgical procedures
that remove or "strip" faulty veins from the leg. These procedures
can be painful, have a long recovery time, and can result in the recurrence
of varicose veins.
- Phlebectomy also is a surgical technique used to remove abnormal veins through tiny incisions.
- Sclerotherapy is the injection of a vein-shrinking solution that is used to treat spider veins and very small varicose veins.
- Vein ablation is a minimally invasive alternative to surgery that uses radiofrequency or laser energy to close faulty veins to eliminate bulging and symptoms while leaving the vein in its place. This causes less trauma to the leg and fewer side effects than surgery.
How Is Vein Ablation Performed?
This minimally invasive treatment is an outpatient procedure performed
by an interventional radiologist - a doctor specializing in the
use of imaging techniques to see inside the body and treat conditions
without surgery.
During vein ablation, the interventional radiologists
applies a local anesthetic to the skin, then inserts a thin catheter,
about the size of a strand of spaghetti, into the vein. The catheter
is inserted through a tiny entry point, usually near the knee. Using
imaging guidance, the catheter is guided up the greater saphenous
vein in the thigh. Then laser or radiofrequency energy is applied
to the inside of the vein, heating and shrinking the vein walls, causing
them to seal the faulty vein so blood cannot flow through it. By closing
the greater saphenous vein, the varicose veins shrink and improve
in appearance. The treatment takes less than one hour.
Click
on image
for larger view.
Image courtesy and
copyright of Diomed Inc. EVLT is a Trademark of Diomed Inc. Diomed
is a registered Trademark of Diomed Limited.
Inova Alexandria Hospital?s interventional radiologists perform both Endovenous Laser Treatment (EVLTTM) and VNUS ? Closure vein ablation procedures to treat varicose veins.
Is the Loss of this Vein a Problem?
No. After treatment, the blood in the faulty veins is diverted to the many
normal veins in the leg, re-establishing normal flow.
What Happens After the Procedure?
After the procedure, your doctor may ask you to walk, wear compression stockings
and retrain from rigorous activity for a period of time. Many patients resume
normal activities within a day, with little or no pain. There is no scar
because the procedure does not require a surgical incision.
What Are the Complications of this Procedure?
You may experience the discomfort of minor soreness and bruising, which
can be treated with over-the-counter, non-aspirin pain relievers as needed.
Few patients also experience numbness, which passes quickly. You should
talk with your doctor about the possible complications of any procedure
you may choose.
Are Laser and Radiofrequency Energy Safe?
Yes. Only as a precaution, you may be given a pair of special glasses to
wear to protect your eyes.
How Successful Is Vein Ablation?
Greater than nine people out of ten who have had vein ablation remain free
of varicose veins for at least two years. This is a higher efficacy rate
than surgical vein ligation or stripping.
Does Insurance Cover Vein Ablation?
Many insurance carriers cover vein ablation, based on medical necessity
and symptom relief.
