Varicose Veins
Deep venous thrombosis (DVT) treatment • May-Thurner Syndrome treatment • Superficial venous insufficiency/Varicose vein treatment • Inferior vena cava (IVC) filter removal • Vascular malformation sclerotherapy
Venous Insufficiency and Varicose Veins
The calf muscles play a crucial role in circulating blood from the legs back to the heart by exerting pressure on the leg veins. This action alone, however, isn’t sufficient to ensure a steady flow of blood towards the heart. Within the veins, there are valves that prevent blood from flowing backward when the calf muscles are at rest. These valves can become faulty due to various factors. When this happens, and the calf muscles contract, the defective valves permit blood to flow backward, leading to blood accumulation in the lower legs, a condition known as venous insufficiency. As a result, the leg veins may become enlarged and twisted, losing their ability to manage blood flow effectively. This state is commonly identified as varicose veins.
While many view varicose veins as merely an aesthetic issue, neglecting treatment can exacerbate symptoms and lead to more severe complications. Symptoms associated with varicose veins include aching, discomfort, bruising, a sensation of heaviness or itchiness in the legs, and swelling. These symptoms can occur even in the absence of visible varicose veins, a sign of venous insufficiency. In extreme cases, this condition can cause skin discoloration and ulcers near the ankle.
The great saphenous vein, a prominent superficial vein running from the ankle to the groin just beneath the skin, is the body’s longest vein. It returns blood from the lower extremities to the deep femoral vein at the groin level. Typically, this vein requires attention to alleviate symptoms related to venous insufficiency and varicose veins. In some instances, the issue might lie in the small saphenous vein or the perforator veins that link the deep and superficial venous systems.
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Treatments
Effectively managing venous insufficiency and varicose veins is highly dependent on a precise diagnosis from your healthcare provider. This process involves an extensive medical examination and an ultrasound assessment of the veins in your legs. Initially, you’ll be advised to adopt certain lifestyle modifications and use compression stockings as a first line of treatment, which is a prerequisite for your insurance to approve more invasive procedures. If these initial measures don’t yield the desired results, your physician might consider employing one or more advanced treatment options.
This prescription medication in the form of injectable foam is used to treat varicose veins, which are swollen, enlarged veins commonly found on the legs and feet. The treatment is minimally invasive and aims to improve both the symptoms and appearance of varicose veins by collapsing and sealing the affected veins. The medication is administered through a foam injection directly into the vein, which causes the vein walls to collapse. This helps reduce the vein’s visibility and alleviate associated symptoms such as aching, swelling, and skin irritation. The procedure is typically quick, does not require incisions, and allows patients to return to normal activities shortly after treatment, offering a convenient option for effective relief from varicose veins.
Sclerotherapy is a commonly used treatment for removing varicose veins and spider veins, involving the injection of a sclerosing solution into the affected veins. This solution causes irritation inside the vein, leading to scarring and the eventual disappearance of the vein from sight. As a result, blood flow is redirected to healthier veins. The total number of sclerotherapy sessions needed varies based on the individual’s condition and the severity of the varicose and spider veins. Generally, several treatments are necessary to fully eliminate spider or varicose veins.
Vascular Malformation
A vascular malformation is an abnormal cluster of blood vessels or lymphatics that typically exists from birth. It can disrupt the normal functioning of the affected area, leading to symptoms such as:
- Pain
- Swelling
- Bleeding
- Physical disfigurement
Like varicose and spider veins, vascular malformations can be addressed through sclerotherapy. The extent of the malformation may necessitate several treatment sessions for optimal results.
Deep Vein Thrombosis (DVT) and May-Thurner Syndrome (Iliac vein compression)
Deep vein thrombosis (DVT) is a serious condition where a blood clot forms in a deep vein, often in the legs, which can be life-threatening. This condition is typically caused by reduced blood flow in the legs, though clotting disorders can also contribute. The primary risk of DVT is the possibility of the clot dislodging and traveling to the lungs’ arteries, which could be extremely dangerous. Additionally, if a significant DVT is not properly addressed, it can cause permanent damage to the deep veins, leading to persistent pain and swelling in the affected limbs. This long-term complication is referred to as post-thrombotic syndrome (PTS).
Symptoms
Signs of acute deep vein thrombosis (DVT) consist of:
- Pain in the leg
- Newly developed swelling in the leg
- Localized tenderness
- Cramps in the muscles
Typically, individuals diagnosed with deep vein thrombosis (DVT) start treatment with anticoagulants, which aid the body in dissolving the clots. However, in cases where the clot is particularly large, anticoagulants might not be enough or may take too long to break down the clot completely. This can extend the period of discomfort for the patient and increase the likelihood of developing post-thrombotic syndrome (PTS).
In such situations, an Interventional Cardiologist or Radiologist performs may intervene by making a small incision near the knee to access the vein. Using a specialized catheter, the physician can navigate to the clot and remove it, which helps restore normal blood flow, eases symptoms, and diminishes the risk of PTS.
Additionally, DVT in the leg can occasionally be caused by May-Thurner Syndrome, where the vein draining the left leg is compressed between the right leg’s artery and the spine. If this compression is severe enough to cause DVT, it’s identified as May-Thurner Syndrome. In these cases, an Interventional Cardiologist or Radiologist performs can place a stent—a cylindrical metallic mesh—in the narrowed vein section to alleviate the compression, improve blood flow, and lower the risk of future DVT occurrences.