What is Venous Insufficiency?

Vein Disease

Premier Vein Center

The deep system of veins within the muscular compartments of the legs communicates with the superficial system of veins under the skin and fatty tissue (outside the muscles) through a network of communicating veins which act as bridges between the two systems. The deep system returns more than 95% of the venous blood from the legs to the pelvis, while the superficial system accounts for 5% or less. Since leakiness in the superficial veins is responsible for more than 95% of patients’ problems seen at the Premier Vein Center, ultrasound evaluation of the lower extremity venous systems is an integral part of their comprehensive venous workup. This evaluation will ensure that any underlying vein problems are identified, and, if necessary, corrected before treatment of the external signs of venous disease is initiated. For example, prior to removing bulging veins in the calf, it is important to first identify the underlying leaky vein and seal it, thereby decreasing the chance that other bulging veins will develop in the future.

Approximately 30 million adults in the United States may suffer from treatable, symptomatic, superficial venous insufficiency. Many of these patients as well as their primary care or specialty physicians may not be fully aware of the advances made in the treatment of venous insufficiency in the last 5-10 years. Since 2000, vein stripping has been replaced by endovenous closure procedures as the preferred treatment of patients with symptoms related to saphenous vein and other superficial venous insufficiency. Many patients once thought to have untreatable venous problems may now be excellent candidates for endovenous closure. He is also very skilled in microphlebectomy (removal of large ropey veins through tiny incisions) as well as treatment of all types of smaller varicose and spider veins with sclerotherapy (injections or laser).

Cause

The two main causes of venous insuficiency are heredetary and pregnancy.

Veins are an important part of the vascular system. Arteries deliver blood to bodily tissues, while veins transport blood back to the heart using one-way valves. Varicose veins occur when the valves in your veins malfunction. As one gets older, veins lose elasticity, causing them to stretch out. When that happens, blood that should be moving toward the heart may flow backward. Blood pools in leg veins, and subsequently enlarge and become varicose. Varicose veins have lost their normal function and the ability to transport blood. Varicose veins can be more than unsightly. Varicose veins can compromise the nutrition of the skin and lead to eczema, inflammation or even ulceration of the lower leg. They can be quite painful. To improve circulation and muscle tone, follow these tips: Exercise: Get your legs moving. Walking is a great way to encourage blood circulation in your legs. Ask to recommend an appropriate activity level customized for you. Control your weight: Shedding excess pounds takes unnecessary pressure off your veins. Watch what you wear: Avoid high heels. Low-heeled shoes work calf muscles more, which is better for your veins. Don’t wear tight clothes around your calves or groin. Tight panty-leg girdles, for instance, can restrict circulation. Elevate your legs: To improve circulation, take three or four 10- to 15-minute breaks daily to elevate your legs above the level of your heart. For example, lie down with your legs resting on three or four pillows. Avoid long periods of sitting or standing: Make a point of changing your position?frequently to encourage blood flow. Don’t sit with your legs crossed: This position can aggravate circulatory problems.

Symptoms

Patient satisfaction results from identifying and properly treating the patient’s primary concerns, i.e., medical and/or cosmetic issues. Not all symptomatic patients are aware of their symptoms because the onset may be insidious. Symptoms may include leg heaviness, pain or tenderness along the course of a vein, pruritus, burning, restlessness, night cramps, edema, skin changes, and paresthesias. After treatment, patients are often surprised to realize how much discomfort they had accepted as normal. Pain caused by venous insufficiency is often improved by walking or by elevating the legs. The pain of arterial insufficiency, conversely, is worse with ambulation and elevation. Pain and other symptoms of venous disease may worsen with the menstrual cycle, with pregnancy, and in response to exogenous hormonal therapy (eg, oral contraceptives).