What Is Vein Disease?

Chronic Venous Disease (CVD) refers to other chronic conditions related to or caused by veins that become diseased or abnormal. These problems can include:

• Varicose veins and spider veins
• Leg Pain and Leg Swelling
• Chronic venous insufficiency
• Leg skin changes
• Leg ulcers
• Phlebitis
• Vascular Malformations
• Varicose Veins

Varicose veins are veins that become dilated, thickened, twisted or elongated blood vessels that don’t control blood flow as they should. The pressure in normal veins is low and the pressure in diseased veins is higher. In some cases, they can be small spider veins and even appear thread-like. In other cases they may appear as large grape-like clusters under the skin. Some patients may have varicose veins that are not visible to the naked eye, however are easily identified under diagnostic ultrasound. 

Symptoms

• Aching pain
• Easily tired legs
• Leg heaviness
• Swelling in the legs
• Brown darkening of the skin 
• Numbness in the legs (pressure from the venous insufficiency can adversely effect the nerves in the feet and ankles)
• Itching or irritated rash on the legs (stasis dermatitis)

Risk Factors

Varicose veins occur in both men and women.  Statistically 55% of women over the age of 50 and 45% of men over the age of 50 have medically treatable vein disease.  The anatomy of the deeper veins in the abdomen and pelvis are the root cause of superficial venous disease in 50% of cases and almost always the cause in patients who have reoccurrance.  Vein disease is more often in women than men, this is due to pregnancy and hormonal changes. Otheher risk factors include obesity, standing for long periods of time, sitting for long periods of time, trauma and family history or heredity. 

Treatment

There are several procedures that can be used alone or in combination to treat varicose veins. These include:

Sclerotherapy, in which a provider injects the veins with a solution that causes the vein to close and the blood is then directed through healthier veins. This is a common treatment option, but may require multiple treatments. It is useful for treating small and medium sized varicose veins.

Microsclerotherapy, which is similar to sclerotherapy, but uses different solutions and injection techniques. It is especially effective in treating spider veins.

Laser surgery, in which the heat from a laser beam destroys spider vein, but does not harm the skin. It is usually less effective than sclerotherapy for varicose veins in the legs. It also causes side effects, such as bruising, blistering and discoloration.

Surgical vein stripping, in which the varicose vein is removed through small incisions at the groin, knee and ankle. This is an option for treating larger varicose veins.

Endovenous thermal ablation, in which a thin tube (catheter) is inserted into the vein. Then, the surgeon applies heat through the tube, causing the vein to collapse. A scar results and the blood is forced through nearby healthy veins. This procedure is also used to treat larger varicose veins.

Coil embolization, in which a catheter is first places into a large vein in the leg or calf; then, a small coil is inserted into the catheter and guided into the vein; alcohol is then injected. The alcohol is an irritant to the vein lining and causes it to close and scar. Again, the blood is rerouted to nearby healthy veins. This procedure requires local anesthesia.

Ambulatory phlebectomy, in which the doctor removes larger varicose veins in the legs through a series of tiny skin punctures (holes). Local anesthesia is used. There is usually little scarring.

Endoscopic perforator vein surgery, which is used for advanced varicose veins that have caused leg ulcers. The doctor makes a small incision and inserts a thin video camera to see and then close veins near the skin that lead to the deep veins in the legs.