Throughout the month we have focused on blood clots affecting the lower extremity veins and blood clots in the lungs. Another venous disease that VIP commonly sees are varicose veins. Some of the risk factors for varicose vein include excessive weight, older age, female gender, inactivity, leg injury, pregnancy and smoking. Patients often experience sensations in the legs such as a heavy feeling, burning, itching or aching. If severe, varicose veins can appear as a skin rash, color changes in the skin, or sores/ulcers. Today, Jenny King, FNP-C and Nikki Uhlhorn, FNP-C will lead us in a discussion about varicose vein.
I have these ugly, ropey veins in my legs. What are they and how did they get there?
What you are describing are varicose veins. They are usually caused from reflux in a slightly deeper vein that you cannot see.
Reflux? What exactly is that?
Veins take unoxygenated blood back to your heart using a series of one way valves. Reflux occurs when these valves become weak, allowing the blood to flow backwards and pool in the veins. The result of this pooling is the “ropey” or bulging appearance of the vein, such as you described.
That doesn't sound good. How do I find out for sure if I have reflux?
The only way to know for sure is to have an ultrasound. We will perform a standing ultrasound in our office while carefully mapping out your superficial venous system.
Oh. But now that I have them, what can VIP do for me?
We will first give you a prescription for medical grade compression hose. These should make your leg feel better and can delay the progression of varicose veins, but will not cure the reflux. To treat the vein with reflux , our skilled physicians perform an endovenous laser ablation or radiofrequency ablation of the vein. This is procedure is done through a very small puncture in the skin. The diseased vein is subsequently shrunk and sealed close. Once the diseased vein is closed, other healthy veins take over normal blood flow.
In conjunction with the ablation, sclerotherapy (injection of the varicose veins) is performed. In some cases where there are very large or extensive varicosities, the physician will make several tiny incisions to hook out segments of the larger veins. Patients with extensive varicose veins may require more than one treatment setting.
That sounds like a lot of treatment. How long will I be in the hospital?
This is performed on an outpatient basis, and typically takes less than an hour. Most patients are back to their normal activities that afternoon or the following morning.
Anything I need to worry about?
The procedure is very low risk as far as complications. You can expect some mild-moderate discomfort post procedure, depending on the extent of treatment needed. There is a slight chance of developing a deep vein thrombosis (DVT); however, our physicians are very careful when treating the veins and use ultrasound guidance to assist them. In addition, there is a small chance of a superficial skin burn from the laser catheter, but this too is very unlikely. Lastly, there is approximately a 5% chance of these veins reopening, necessitating a repeat treatment.