Understanding Vein Disease
Understanding Vein Disease
 

To better understand vein disease (Venous Insufficiency), you should know the purpose and function of the veins in your body. Healthy veins pump blood back to the heart using one-way valves, which stop blood from moving in the opposite direction. Sometimes these valves weaken, allowing blood to flow backward and pool inside the veins. This backward flow, or reflux, causes a high-pressure build-up leading to Venous Insufficiency.

What are varicose veins?

Varicose veins are twisted, enlarged veins near the surface of the skin. They are most common in the legs and ankles. They usually aren't serious, but they can sometimes lead to other problems.

What causes varicose veins?

Varicose veins are caused by weakened valves and veins in your legs. Normally, one-way valves in your veins keep blood flowing from your legs up toward your heart. When these valves do not work as they should, blood collects in your legs, and pressure builds up. The veins become weak, large, and twisted.

Varicose veins often run in families. Aging also increases your risk.

Being overweight or pregnant or having a job where you must stand for long periods of time increases pressure on leg veins. This can lead to varicose veins.

What are the symptoms?

Varicose veins look dark blue, swollen, and twisted under the skin. Some people do not have any symptoms. Mild symptoms may include:

  • Heaviness, burning, aching, tiredness, or pain in your legs. Symptoms may be worse after you stand or sit for long periods of time.
  • Swelling in your feet and ankles.
  • Itching over the vein.

More serious symptoms include:

  • Leg swelling.
  • Swelling and calf pain after you sit or stand for long periods of time.
  • Skin changes, such as:
    • Color changes.
    • Dry, thinned skin.
    • Inflammation.
    • Scaling.
  • Open sores or you may bleed after a minor injury.

Varicose veins are common and usually aren't a sign of a serious problem. But in some cases, varicose veins can be a sign of a blockage in the deeper veins called deep vein thrombosis. If you have this problem, you may need treatment for it.

How are varicose veins diagnosed?

Your doctor will look at your legs and feet. Varicose veins are easy to see, especially when you stand up. Your doctor will check your legs for tender areas, swelling, skin color changes, sores, and other signs of skin breakdown.

You might need further tests if you plan to have treatment or if you have signs of a deep vein problem.

How are they treated?

Home treatment may be all you need to ease your symptoms and keep the varicose veins from getting worse. You can:

  • Wear compression stockings.
  • Prop up (elevate) your legs.
  • Avoid long periods of sitting or standing.
  • Get plenty of exercise.

If you need treatment or you are concerned about how the veins look, your options may include:

  • Sclerotherapy to close off the vein.
  • Laser treatment to close off the vein.
  • Radiofrequency treatment to close off the vein.
  • Phlebectomy, or stab avulsion, to remove the vein.
  • Ligation and stripping to tie off and remove the vein.
Spider Veins
Spider Veins
 

Spider veins are small, dark veins which are visible on the skin’s surface. Often, spider veins may be a sign of vein disease deeper in the leg. It’s wise to have a Venous Insufficiency evaluation, along with an overall treatment plan, BEFORE beginning to address spider veins.

In most cases, spider veins themselves are easy to treat. Performed in the office, micro-injections of medicine will shut down each small vein. Recovery is minimal and generally requires no downtime.

Pelvic Venous Insufficiency
 

What is Pelvic Venous Insufficiency?

There are many various causes of pelvic pain, but it’s often related to ovarian and pelvic varicose veins. Varicose veins are a result of valves in the veins that are not working correctly. Valves allow veins to return blood to the heart by preventing back-flow of blood in the vein. When these valves aren’t working, this allows the blood to collect in the vein resulting in bulging, pressurized veins. When these varicose veins are in the pelvis the condition is known as pelvic venous insufficiency (PVI) – also referred to as pelvic congestion syndrome.

What causes deep vein clots to form?

Blood clots can form in veins when you are inactive. For example, clots can form if you are paralyzed or bedridden or must sit while on a long flight or car trip. Surgery or an injury can damage your blood vessels and cause a clot to form. Cancer can also cause DVT. Some people have blood that clots too easily, a problem that may run in families.

What is the prevalence of Pelvic Venous Insufficiency?

Studies have shown that 30% of patients with chronic pelvic pain have pelvic venous insufficiency (PVI) as a cause of their pelvic pain. The majority of women are in their childbearing years or less than 45 years of age. Risk factors for PVI include multiple pregnancies, polycystic ovarian syndrome, the fullness of the leg veins, and hormonal dysfunction.

What are the symptoms of Pelvic Venous Insufficiency?

If your doctor suspects that you have DVT, you probably will have an ultrasound test to measure the blood flow through your veins and help find any clots that might be blocking the flow.

How is it treated?

Women with PVI usually complain of dull aching and heaviness in the pelvis that is exacerbated by standing, pregnancy, and menstruation. Occasionally this pain may be felt in the lower back. There may also be visible varicose veins in the groin area, buttocks, or upper thigh.

What is venous insufficiency?

Venous insufficiency is a problem with the flow of blood from the veins of the legs back to the heart. It's also called chronic venous insufficiency or chronic venous stasis.

Veins have valves that keep the blood moving in one direction—toward the heart. In venous insufficiency, the valves in the veins of the leg don't work right. So fluid pools in the legs. This can lead to problems that include.

What causes the problem?

Venous insufficiency is sometimes caused by deep vein thrombosis and high blood pressure inside leg veins.

You are more likely to have venous insufficiency if you:

  • Are older.
  • Are female.
  • Are overweight.
  • Don't get enough physical activity.
  • Smoke.
  • Have a family history of varicose veins.

What are the symptoms?

Symptoms affect the legs and may include:

  • Swelling, often in the ankles.
  • Varicose veins.
  • Itching.
  • Cramping.
  • Skin sores (ulcers).
  • Aching or a feeling of heaviness.
  • Changes in skin color.

How is it diagnosed?

Your doctor can diagnose venous insufficiency by examining your legs and by using a type of ultrasound test (duplex Doppler) to find out how well blood is flowing in your legs.

How is it treated?

You can wear compression stockings, which are tighter at the ankles than at the top of the legs, to reduce swelling and to relieve pain. They also can help venous skin ulcers heal. But there are different types of stockings, and they need to fit right. So your doctor will recommend what you need.

You also can try to:

  • Get more exercise, especially walking. It can increase blood flow.
  • Avoid standing or sitting for a long time, which can make the fluid pool in your legs.
  • Keep your legs raised above your heart when you're lying down. This reduces swelling.
Deep Vein Thrombosis (DVT)
Blausen_0290_DeepVeinThrombosis

Blausen.com staff (2014). "Medical gallery of Blausen Medical 2014". WikiJournal of Medicine 1 (2). DOI:10.15347/wjm/2014.010. ISSN 2002-4436., Blausen 0290 DeepVeinThrombosis, CC BY 3.0

What is deep vein thrombosis?

Deep vein thrombosis (DVT) is a (thrombus) in a deep vein, usually in the legs.

Clots can form in and in veins. Blood clots with inflammation in superficial veins (called superficial thrombophlebitis or phlebitis) rarely cause serious problems. But clots in deep veins (deep vein thrombosis) require immediate medical care.

These clots are dangerous because they can break loose, travel through the bloodstream to the lungs, and block blood flow in the lungs (pulmonary embolism). Pulmonary embolism is often life-threatening. DVT can also lead to long-lasting problems. DVT may damage the vein and cause the leg to ache, swell, and change color.

Blood clots most often form in the calf and thigh veins, and less often in the arm veins or pelvic veins. This topic focuses on blood clots in the deep, but diagnosis and treatment of DVT in other parts of the body are similar.

What causes deep vein clots to form?

Blood clots can form in veins when you are inactive. For example, clots can form if you are paralyzed or bedridden or must sit while on a long flight or car trip. Surgery or an injury can damage your blood vessels and cause a clot to form. Cancer can also cause DVT. Some people have blood that clots too easily, a problem that may run in families.

What are the symptoms?

Symptoms of DVT include swelling of the affected leg. Also, the leg may feel warm and look redder than the other leg. The calf or thigh may ache or feel tender when you touch or squeeze it or when you stand or move. Pain may get worse and last longer or become constant.

If a blood clot is small, it may not cause symptoms. In some cases, pulmonary embolism is the first sign that you have DVT.

How is deep vein thrombosis diagnosed?

If your doctor suspects that you have DVT, you probably will have an ultrasound test to measure the blood flow through your veins and help find any clots that might be blocking the flow.

How is it treated?

Treatment lowers the chance that the blood clot will grow or that a piece of the clot might break loose and flow to your lungs.

Treatment for DVT usually involves taking blood thinners (anticoagulants) for at least 3 months to prevent existing clots from growing.

Your doctor also may recommend that you prop up or elevate your leg when possible, take walks, and wear compression stockings. These measures may help reduce the pain and swelling that can happen with DVT.

How can deep vein thrombosis be prevented?

There are things you can do to prevent DVT. You might take an anticoagulant medicine to prevent blood clots. You might also wear compression stockings. You can try to get up and out of bed as soon as possible after an illness or surgery. If you are sitting for a long time, like during a long flight, you can exercise your legs to help blood flow.