28, 2, 2022

What is Venous Reflux Disease?

2022-03-17T10:21:46-07:00

What is Venous Reflux Disease?

 

Venous reflux disease is also known as venous stasis, venous insufficiency or venous incompetence and refers to ‘leaky valves’ in the veins of the legs. 

leaky valve

Reflux may occur in the deep and/or superficial leg veins. The deep veins are those within the muscle; they bring at least 80-90% of the blood from the legs back to the heart. The superficial veins are outside the muscle and under the skin. The main superficial veins are the Great Saphenous Vein that courses up the middle of the thigh and calf and small saphenous vein. Normally, there are one-way valves within the leg veins, which help blood flow in one direction: toward the heart. This means blood is traveling against gravity. The calf muscle also helps move blood toward the heart. When vein valves are leaky, blood flows backward (reflux) towards the feet. Blood pools in the lower legs, causing bulging veins at the surface. 

leakyveinvalves

Symptoms of Venous Reflux Disease:

 

Symptoms of venous reflux disease include; leg heaviness, leg fatigue, leg pain, ankle swelling, phlebitis (inflamed and painful veins), restless legs at night, and night cramps. Venous reflux disease is progressive and worsens over time. Skin changes may also develop, including darkening of the skin around the ankles. The darkening of the skin is sometimes referred to as venous stasis skin changes. The skin can become dry and itchy (venous eczema). Eventually, the skin can break down causing a wound, called a venous leg ulcer. All of which are possible symptoms of venous reflux disease to look out for. 

 

What influences the development of Venous Reflux Disease?

 

A patient is more likely to develop venous reflux disease if they are:

 

  • Overweight
  • Pregnant
  • Have a family history of vein disease
  • Have damage to the leg due to injury, surgery, or previous blood clots
  • High blood pressure
  • Lack of exercise
  • Smoking
  • A blood clot in a deep vein (calf or thigh) “deep vein thrombosis” 
  • Swelling and inflammation of a vein close to the skin, known as “phlebitis”

 

How is Venous Reflux Disease Diagnosed? 

 

In addition to physical exam findings and medical history, an ultrasound examination is an important tool in the assessment of venous disease. Not all venous disease is visible to the naked eye, and it usually arises from veins that are beneath the surface of the skin, only visible by ultrasound technology. 

 

The ultrasound allows us to see if the valves are leaky; it can detect the direction of blood flow and also detects blockages in the veins, for example from blood clots or scars within the veins from previous clots. The ultrasound will determine exactly which veins are “bad” or incompetent. Reflux may be detected in the deep veins (within the muscle), the great and small saphenous veins, and /or branches of the saphenous veins. This will help determine the treatment plan. 

 

What is Venous Reflux Disease?2022-03-17T10:21:46-07:00

A Deeper Look Into Varicose Veins

2022-03-01T16:31:12-08:00

Varicose veins are swollen, blue, bulging, twisted, superficial (those closest to the skin) veins of the leg. High pressure inside the superficial veins of the leg causes varicose veins, but genetics are thought to play a large, contributing role. As many as 40 million Americans have them. Left untreated, varicose veins may become worse. Persons with varicose veins often experience leg aches and fatigue. They may also incur skin changes such as rashes, redness and ulcers.

What factors influence development of varicose veins?

  • Age: People between the ages of 30 and 70 often have varicose veins. 
  • During pregnancy, 50 to 55 percent of American women experience varicose veins. In most cases, the veins return to normal within a year after childbirth.
  • Women who have multiple pregnancies may develop permanent varicose veins.  

 

Risk factors include:

o being overweight, or a family history of varicose veins

o standing or sitting for long periods of time

 

A vascular surgeon will review your medical history, do a physical exam and look at your prominent veins. You may be sent for a duplex ultrasound test, also known as a venous reflux study, to identify the causes of your varicose veins. The painless test uses high-frequency waves to measure the venous blood flow. The test helps the physician visualize the vein structure and the blood flow in the veins.

Most doctors will suggest lifestyle changes for patients. This includes:

  • maintaining the proper weight
  • elevating legs when resting
  • not sitting or standing for long periods of time 
  • wearing compression (elastic support) stockings

 

In some cases, a vascular surgeon will recommend additional treatments:

  • Sclerotherapy is the sealing of the veins via an injection of a medication. This procedure is done mainly for smaller spider veins. It is performed in a doctor’s office. The physician injects a chemical into the varicose veins to prevent the veins from filling with blood.
  • Vein Stripping is performed. The physician may make two small incisions, one in the groin area and another below the knee, through which the diseased veins are removed. This is an outpatient procedure, usually done under general anesthesia. Patients can resume their normal activities after four weeks.
  • Ablation and laser treatment are performed on patients with severe varicose veins. They are done under local or general anesthetic. The ablation procedure inserts a thin, flexible catheter into the leg vein. The tip of the catheter has tiny electrodes that heat and seal off the walls of the vein. Laser treatments use a tiny fiber placed in the vein through a catheter. The fiber sends out laser energy that closes the diseased portion of the vein. These two modes of treatment frequently replace stripping of the saphenous vein. They can be performed alone or in conjunction with removal of individual clusters of the veins known as small incision avulsion or ambulatory phlebectomy.

 

A Deeper Look Into Varicose Veins2022-03-01T16:31:12-08:00

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