Varicose veins are swollen, twisted, blue veins that are close to the surface of the skin. Because valves in them are damaged, they hold more blood at higher pressure than normal. That forces fluid into the surrounding tissue, making the affected leg swell and feel heavy.
Unsightly and uncomfortable, varicose leg veins can promote swelling in the ankles and feet and itching of the skin. They may occur in almost any part of the leg but are most often seen in the back of the calf or on the inside of the leg between the groin and the ankle. Left untreated, patient symptoms are likely to worsen with some possibly leading to venous ulceration.
The normal function of leg veins - both the deep veins in the leg and the superficial veins - is to carry blood back to the heart. During walking, for instance, the calf muscle acts as a pump, contracting veins and forcing blood back to the heart.
To prevent blood from flowing in the wrong direction, veins have numerous valves. If the valves fail (a cause of venous reflux), blood flows back into superficial veins and back down the leg. This results in veins enlarging and becoming varicose. The process is like blowing air into a balloon without letting the air flow out again- the balloon swells.
To succeed, treatment must stop this reverse flow at the highest site or sites of valve failure. In the legs, veins close to the surface of the skin drain into larger veins, such as the saphenous vein, which run up to the groin. Damaged valves in the saphenous vein are often the cause of reversed blood flow back down into the surface veins.
Gravity is the culprit. The distance from the feet to the heart is the furthest blood has to travel in the body. Consequently, those vessels experience a great deal of pressure. If vein valves can't handle it, the backflow of blood can cause the surface veins to become swollen and distorted.
Conditions contributing to varicose veins include genetics, obesity, pregnancy, hormonal changes at menopause, work or hobbies requiring extended standing, and past vein diseases such as thrombophlebitis (i.e. inflammation of a vein as a blood clot forms.) Women suffer from varicose veins more than men, and the incidence increases to 50% of people over age 50.
Varicose veins may ache, and feet and ankles may swell towards day's end, especially in hot weather. Varicose veins can get sore and inflamed, causing redness of the skin around them. In some cases, patients may develop venous ulcerations.
Venous ulcers are areas of the lower leg where the skin has died and exposed the flesh beneath. Ulcers can range from the size of a penny to completely encircling the leg. They are painful, odorous open wounds which weep fluid and can last for months or even years. Most leg ulcers occur when vein disease is left untreated. They are most common among older people but can also affect individuals as young as 18.
ESES (pronounced SS) is an easy way to remember the conservative approach. It stands for Exercise, Stockings, Elevation and Still. Exercising, wearing compression hose, elevating and resting the legs will not make the varicose veins go away or necessarily prevent them from worsening because the underlying disease (venous reflux) has not been addressed. However, it may provide some symptomatic relief. Weight reduction is also helpful.
If there are inflamed areas or an infection, topical antibiotics may be prescribed. If ulcers develop, medication and dressings should be changed regularly.
There are also potentially longer-term treatment alternatives for visible varicose veins, such as sclerotherapy and phlebectomy.
A chemical injection, such as a saline or detergent solution, is injected into a vein causing it to "spasm" or close up. Other veins then take over its work. This may bring only temporary success and varicose veins frequently recur. This treatment is most effective on smaller surface veins, less than 1-2mm in diameter.
As with sclerotherapy, ambulatory phlebectomy is a surgical procedure for treating surface veins in which multiple small incisions are made along a varicose vein and it is "fished out" of the leg using surgical hooks or forceps. The procedure is done under local or regional anesthesia, in an operating room or an office "procedure room."
Vein stripping is an older procedure for treating varicose veins that involves inserting a wire into the affected vein and then pulling it out of the body. This is no longer recommended for patients; standards-setting medical organizations such as American Venous Forum now recommend more modern techniques such as laser and radiofrequency ablation, which are offered by Center for Vein Restoration. Vein stripping requires a long recovery time (2-3 weeks off work) and can cause pain, bruising and other problems, such as increased risk of DVT.
In simplest terms, arteries pump oxygen-rich blood FROM the heart, veins return Oxygen-depleted blood TO the heart.
Deep leg veins return blood directly to the heart and are in the center of the leg, near the bones. Superficial leg veins are just beneath the skin. They have less support from surrounding muscles and bones than the deep veins and may thus develop an area of weakness in the wall. When ballooning of the vein occurs, the vein becomes varicose. Perforator veins serve as connections between the superficial system and the deep system of leg veins.
In this procedure, a medicine called a sclerosant is injected into the problem vein. It "foams," filling the vein and initiating a reaction that results in vein closure. Blood is then naturally rerouted around the affected area and the vein later is reabsorbed by the body. The physician administering the treatment uses ultrasonongraphy - sound waves - to guide the procedure for maximum accuracy and safety.
Insurance coverage for varicose vein treatment varies depending on your insurance provider and your specific policy. In general, most insurance providers separate vein treatments into two categories, Medically Necessary Procedures and Cosmetic Procedures.
Larger veins that are symptomatic (pain, aching, burning, itching and/or swelling along with additional criteria set by your insurance) are usually considered medically necessary and are covered by your insurance.
After documentation of venous insufficiency (the valves in your legs are not properly functioning), which is determined by an ultrasound, most insurance providers consider this in-office procedure to be medically necessary.
At Center for Vein Restoration, we know that the insurance process can be very confusing. Our expert staff will submit your claim and acquire pre-certification for your procedure, when deemed necessary by your insurance provider. However, it is best to call your insurance company to find out the details of your policy.
Visual Sclerotherapy - for treatment of spider veins - is considered cosmetic and is not covered by most insurance plans.
(1). Simple office - based procedure.
(2). The treatment takes less than an hour and provides immediate relief of symptoms.
(3). Immediate return to normal activity with little or no pain. There may be minor soreness or bruising, along the areas where local anesthesia was used, which can be treated with over-the-counter pain relievers (Tylenol or Ibuprofen).
(4). No scars or stitches - the treatment does not require a surgical incision, just a small needle stick in the skin, about the size of a pencil tip.
(5). Immediate return to normal activity.
(6). The sucess rate for vein ablation is 97%.
(7). Love your legs again!
- Drink plenty of water!
- If you were prescribed sedative medication, please take 1 hour before your procedure.
- If you have taken sedative prior to your procedure make sure you have someone available to drive you to and from your appointment. (Taxi lists are available upon request.)
- Do bring your compression stockings with you the day of our procedure.
- Wear loose comfortable clothing such as long pants, shorts or a skirt.
- Undergarments may get stained, as the doctor preps the entire leg including the groin area.
- For more information visit www.loveyourlegsagain.org and click on vein surgery icon.
- Bring a referral to your first procedure if required by your insurance. If you have any questions concerning this please call us. (Each patient treatment plan and insurance plan is different. An additional referral may be needed.)
- Avoid prolonged sitting or standing.
- Refrain from strenuous activities and heavy lifting for 2 weeks, however, walking is encouraged.
- Wear compression stockings during the day for the first 3 days. (Take them off at night.)
- Pain Medication:Tylenol or Ibuprofen as needed.
- Schedule your follow-up Duplex (ultrasound) scan within 48-72 hours after your procedure.
- If you plan on sitting for more than 3 hours, try to get up and move around every hour. The use of aspirin is highly recommended.
- You may shower, but no tub baths, swimming, or hot tubs for the first week.
- In rare occasions bleeding through the bandages may occur. Lie down, elevate your leg and apply direct pressure until bleeding has stopped.
- It is normal to experience some tenderness and possibly bruising along the areas where local anesthesia was administered. Continue taking pain medication as needed.
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- Center for Vein Restoration presents a CME Event
- Important Questions Regarding Your Leg Health
- What Is Causing Your Swollen Legs?
- Have Varicose Veins or Leg Pain? It Is Possible To Love Your Legs Again
- Sclerotherapy: A Brief History
- Is Your Leg Pain Venous Insufficiency?
- How Is Your Leg Health?
- Groundbreaking Treatment For Venous Ulcers Gives Patients Hope
- Pregnancy and Varicose Veins
- Varicose Veins and Health Insurance
- Seniors and Varicose Veins
- What Factors Can Cause Varicose Veins Or Venous Insufficiency To Develop?
- Does Being Overweight Put You At Risk For Varicose Veins & Vein Disease?
- Are Your Legs Swelling Due To The Summer Heat Venous Disease?
- Can Compression Stockings Enhance Your Leg Health?