- What is phlebology?
- What is a phlebologist?
- How does the venous circulation work?
- What is chronic venous insufficiency (CVI)?
- What should I do if I have varicose veins?
- Can restless legs result from venous reflux disease?
- Does vein disease affect women and men equally?
- Can I be cured of my varicose veins?
- Should I be wearing compression stockings?
- What is a duplex ultrasound examination?
- Is sclerotherapy safe?
- What is ultrasound guided sclerotherapy?
- Why can't I just have the branches treated if the main superficial trunk is abnormal?
- What happens to my vein after it has been treated?
- Don't I need all of my veins?
- How long will I be out of action and unable to exercise?
- How is laser treatment different from vein stripping?
- Will insurance or Medicare cover treatment of my varicose veins?
- What is a "Trial of Conservative Therapy?"
Phlebology is the branch of medicine that deals with veins and disease of veins.
A Phlebologist is a physician who specializes in the diagnosis and treatment of vein disorders.
Arteries are blood vessels that carry blood away from the heart to the peripheral tissues. Blood travels down the arteries to the capillaries, where it drops off oxygen and nutrients, and picks up waste products. The blood leaves the capillaries and collects in the veins. The blood returns up the legs to the heart through the veins. Blood in the veins has to fight gravity on its return trip back to the heart. It does this with the assistance of muscle pumps and delicate one-way valves. When the leg muscles contract, they squeeze the veins that run within them, forcing the blood upward. The valves open to allow the blood to go up, and then snap shut to prevent the blood falling back down the leg. The final path is through the abdomen and alternating differences in pressure between the chestand abdomen move blood back to the heart. When our chest expands(a deep breath) the negative pressure vs the slightly elevated pressure in the abdomen causes venous blood to flow to the heart.
Chronic venous insufficiency is a progressive long-term condition. It is most commonly due to malfunctioning (incompetent) valves in the veins. It may also occur as the result of a past blood clot in the legs which can destroy valves in the deep veins or block the deep veins. Healthy leg veins are designed to allow blood to flow against gravity from the legs back toward the heart. Tiny valves inside the veins open and close to help control the flow and pressure. When the veins become weakened or diseased, vein valves no longer promote efficient blood flow and blood pools in the legs. This impaired blood flow (or reflux) causes veins to expand, lose form and protrude. At its worst CVI can lead to chronically damaged skin in the lower legs and even wounds that are slow to heal.
Walk and exercise: Strong leg muscles help pump blood back to the heart. Lose excess weight: Being overweight creates excess pressure in the abdomen and this interferes with the return of blood from the legs to the heart, and being overweight may lessen your benefit from treatment. Avoid prolonged standing or sitting: By keeping your legs moving, the leg muscles can do their "blood pumping job". Also elevating your legs when you are sitting lessens the negative effect of gravity. Get an evaluation: An evaluation from an experienced physician can guide you to the best treatment options.
Yes. Venous reflux disease can cause restless legs and in some patients restless leg syndrome.
More than half of all women will develop varicose vein disease over the course of their lifetime. However 40-45 percent of all men will develop it as well. The unique hormonal conditions that women face, such as pregnancy and menopause, often cause their veins to become worse. This is likely why more women than men seek treatment.
Varicose veins can be successfully treated but the disorder cannot be permanently cured. The treatment of the abnormal veins does not remove the original tendency of a patient to develop varicose veins. Therefore, many patients need to return for maintenance treatments after their initial treatment is completed.
Light compression stocking can reduce the feeling of heaviness in the legs, especially after standing for long periods of time. Heavy compression hose may help reduce inflammation and prevent development of more serious complications such as venous ulcers. Compression hose are made of strong elastic material and fit tightly at the feet and gradually become less tight at the knee/thigh. The pressure in the stockings is graded and this allows for the stockings to constantly squeeze the legs. This helps to reduce blood pooling in the leg veins, and reduce swelling in the feet and ankles. Also, hose are used to secure light dressings after your treatment for 48 hours and then daily for 3 weeks.
The venous duplex examination visualizes the anatomy and checks the flow characteristics of the veins beneath your skin. Useful information is gathered that is used to diagnose your specific vein problem and to plan and guide treatment.
Most patients do not experience any complications from sclerotherapy. However, some patients develop changes in skin pigment in locations where the veins are injected. Some patients may experience chemical burns of the skin while a rare patient may develop an allergy to the medication. Serious complications such as deep vein blood clots and unintentional arterial injection occur rarely.
Visual sclerotherapy refers to injection of surface veins that are visible to the naked eye. Some veins that need to be treated are below the surface of the skin and can best be injected with the aid of ultrasound imaging.
For the treatment of the visible veins to last a long time, the source must be controlled as well. Some insurance carriers will not pay for treatment of branch varicosities if an abnormal main trunk is not treated at the same time or before the branches are treated.
The treated vein is closed off from the rest of the veins in your leg, allowing the body to naturally redirect the blood flow to normal veins. The treated vein is then absorbed by your body over time.
Varicose veins are a burden on your circulation. Because the blood insideis traveling in the wrong direction, correcting the flow will improve your venous circulation.
Most people can resume normal activity the next day. Exercise may be limited by the need to wear compression hose for up to two weeks.
During a stripping procedure, the surgeon makes an incision in your groin and ties off the vein, after which a tool is threaded through the saphenous vein and is used to pull the vein out of your leg through a second incision lower in your leg. With laser treatment, there is no need for groin surgery. Instead, the vein remains in place and is sealed using a laser inserted through a small puncture. This greatly decreases the bruising and pain often associated with vein stripping. Vein stripping is usually performed in an operating room under general anesthesia, while laser treatment is performed in an office setting using local anesthesia.
Most insurance companies and Medicare recognize vein disease as a legitimate, covered medical expense and will cover the cost of vein treatment after a period of conservative management. If you are experiencing symptoms of venous disease it is worth finding out if your insurance will cover the cost of treatment.
A "Trial of Conservative Therapy" will vary according to your insurance plan, anywhere from 6 weeks to 4 months. This involves exercise, elevating legs, taking pain medicine if needed and wearing medical grade compression hose.