17, 3, 2022

The Four Best Ways to Treat Venous Disease

2022-03-17T10:25:13-07:00

Symptoms to look for in venous disease:

 

La Jolla Vein Care offers various ways for venous disease treatment. While there are numerous excellent ways to treat venous disease, we have named four of our favorite ways to treat it. What is venous disease and how does it happen? Venous disease occurs when backwards flow (or “reflux”) is present in the superficial veins of the legs. This can cause pain, fatigue, itching, swelling, and varicose veins, which can lead to venous disease. Night-time symptoms include leg cramps and restless legs. Advanced disease can produce skin damage and wounds that do not heal. 

At La Jolla Vein Care, an ultrasound is used to identify the source of backwards flow in the veins and develop a personalized treatment plan. 

The best symptomatic and cosmetic results are achieved when superficial vein reflux is treated from its source, starting with the main superficial veins of the legs and leaving the skin-level (cosmetic) treatment for last. 

 

Each specific treatment plan depends on the patient’s goals. Some patients are only concerned about symptomatic improvement and avoiding complications of long term venous reflux disease. Others may be interested in cosmetic improvement. In either case, we can generally achieve an 80% improvement in symptoms and appearance of the legs. Many patients also report improvement in swelling  after venous disease treatment.  

 

Venous Disease Treatment: Saphenous Vein Reflux with a Catheter Ablation Procedure

 

The great and small saphenous travel down the inner leg and back of the leg, respectively. These veins tend to be straight and far from skin and nerves, which allows us to treat them with minimally invasive catheter procedures that are potent and precise. A catheter is a very thin tube that is inserted into the vein, similar to an IV, through which the doctor can apply heat, a rotating wire, and or medication. All modalities are about 95% effective in closing the diseased vein. None require a skin incision, so they do not leave a scar. 

 

Venous Disease Treatment: Branch Vein Reflux

 

Ultrasound-guided foam sclerotherapy is the most common treatment for branches of the saphenous veins and portions of the saphenous veins which cannot be treated with a catheter procedure (e.g. if they are too close to skin or nerves). The veins are localized with ultrasound, then the medication is given through a tiny needle. Several treatments may be needed, as we can only administer a small amount of foam per day. Large or resistant veins may require more than one injection. For very large bulging varicose veins through tiny skin incisions. This allows many veins to be treated in one day. 

 

Venous Disease Treatment: Spider Veins with Cosmetic Sclerotherapy 

 

Following treatment of the “underlying reflux” with the ultrasound-guided procedures, you may still have some prominent veins at the skin level. These can be treated with cosmetic sclerotherapy. 

 

Venous Disease Treatment: Compression of Stockings 

 

Prior to approval of treatments for vein disease, insurers require patients to try compression stockings. Medicare requires a 3-month trial of compression supervised by the treating physician. We recommend patients should wear the 20-30 mmHg thigh-high stockings for at least a day before treatment to confirm they fit. 

 

The Four Best Ways to Treat Venous Disease2022-03-17T10:25:13-07:00

How is Venous Reflux Disease Treated?

2022-03-17T10:19:57-07:00

How is Venous Reflux Disease Treated? 

 

Step 1: Identifying the underlying problem

The first step is to treat the underlying problem, venous reflux disease. The specific pattern of venous reflux disease was detected by ultrasound. Venous reflux usually starts in the saphenous veins. The saphenous veins are most effectively treated with vein ablation procedures. This involves placing a small catheter within the vein and using heat or a solution to produce injury and eventful closure of the vein. The most commonly used treatments for the saphenous veins are radiofrequency ablation (RFA), laser ablation, mechanico-chemical ablation (MOCA or Clarivein), and in some cases Varithena Foam. The treatment recommendation is customized, based on where reflux is present and other clinical factors.  

radiofreqgraphic

Step 2: Varicose Veins

 

After the underlying saphenous vein reflux is corrected, the bulging veins (varicose veins) can be treated by injecting a foamed medication that will cause them to scar and eventually dissolve (foam sclerotherapy), or to remove them using tiny incisions. The most common method is foam sclerotherapy. This is also known as ultrasound-guided foam sclerotherapy (UGFS). Both these treatments can treat venous reflux disease. 

 

Step 3: Spider Veins 

 

Spider vein treatment is always considered a cosmetic procedure. If improved cosmesis is a goal of treatment, make sure to discuss this with your doctor and plan on having cosmetic treatment as the last step. Spider vein treatment is accomplished by sclerotherapy, which is an injection of liquid medication into the spider veins. Ask your provider for an estimate about how many treatment sessions/ vials are necessary to get the results you want. 

 

How is Venous Reflux Disease Treated?2022-03-17T10:19:57-07:00

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
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