September 2013

What are Varicose Veins?

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Your veins are designed as one-way tubes that carry blood back to the heart after it has been pumped away from your heart by your arteries. To do this, veins have to work against gravity. One-way valves in the veins assist with this transportation of blood. If these valves are not able to close fully, blood fills the veins and causes them to dilate (stretch), creating symptoms such as itching, burning and aching. Abnormal veins may be superficial and visible under the skin or they may hide deeper in the tissue (usually detected with ultrasound). As many as 40 million Americans are affected by abnormal veins.

Symptoms

Symptoms include leg swelling, itching, burning, and aching pain. More serious complications include increased bleeding with trauma, skin discolorations, and skin ulcers that develop spontaneously and are difficult to heal.

Causes
The major causes of varicose veins include heredity, gender (varicosities can affect both men and women, but are more common in women), and pregnancy. Varicose veins can also be caused by standing occupations, age, obesity, and leg injury. Over time, varicose veins may grow in size and number.

Treatments
Several treatment options are available today. Treatment often begins with exercise, leg elevation, weight loss and prescription compression hosiery worn on a daily basis. However, leg elevation and compression hosiery will not cure varicose veins and their symptoms.

Patients with varicose veins will often undergo a non-invasive ultrasound to determine if the valves are working properly within the main veins of the legs. If a malfunction is detected after ultrasound, then a vein closure procedure may be considered to cure the problem. The closure procedure is an office-based treatment in which a catheter (equipped with a laser) is placed in the main malfunctioning vein. Under ultrasound guidance, the vein is then numbed with local anesthesia. The catheter is guided by ultrasound again to cover the length of the malfunctioning vein until it reaches the point where it joins a deeper vein. The heat produced by the laser in the catheter then “closes” the vein. This procedure redirects blood to healthy veins. As varicose veins are often branches of the malfunctioning vein, they will no longer be able to receive blood and dilate. Not only do patients see an improved look to their legs, but they also realize
relief from their aching, itching and burning symptoms. After the procedure, the leg is wrapped and patients are able to return home the same day. If the patient is a candidate, most insurance companies cover this procedure.

Any varicose veins that remain can be treated with a procedure called phlebectomy. This removes veins by making micro-incisions over visible varicosities. Although this procedure does require a few small incisions, cosmetic and symptomatic results are excellent. This procedure is also performed in the office under local anesthesia, and patients return home directly after the procedure.

Sclerotherapy is a commonly used treatment for small visible veins, often called “spider veins.” A liquid or foam solution is injected directly into the veins with a tiny needle and the vein walls stick together. As the vein can no longer accept blood, it is reabsorbed by the body and eventually disappears. This process may require multiple treatments for the best cosmetic result. As with any injection, some patients may have an allergic reaction to the solution.

For more information or to schedule an appointment, call Dr. Michelle DesChamplain at Savannah Vascular and Cardiac Institute (912) 352-8346. Appointments are also available at our new office located at Legacy Medical Center in Okatie, South Carolina.

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