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Vein Disease
Houston Vein Disease Treatment
Have you been putting up with painful varicose or unsightly spider veins without realizing that they may be signs of a deeper problem?
Leg fatigue, aching pain and swelling may be symptoms of venous insufficiency. Venous insufficiency is a medical diagnosis used to describe faulty veins. This can cause permanent damage if left untreated. Though these ugly veins may appear similar to you, their significance can vary. You should be evaluated by a vein specialist who can determine the underlying causes of vein problems and offer you all the state-of-the-art methods of treatment.
Who should treat your veins?
Veins of any size should be treated by a physician who understands venous physiology. As a Board Certified Vascular Surgeon with over 22 years of experience, Dr. Bardwil understands venous disease and can help you choose among the available treatment options. Dr. Bardwil will meet with you for a comprehensive venous evaluation. Our mission is to provide compassionate, cutting edge, personalized care to our patients in a comfortable, pleasant environment.
What are varicose veins?
Varicose Veins are dilated and ropy-appearing blue vessels visible under the skin, often a 1/4 inch or larger in diameter.
What are spider veins?
Spider Veins are small blue or red vessels visible within the skin, usually on the leg, face, neck or chest. It is estimated that 50% of the adult population suffers from vein diseases. Factors that contribute to Varicose Veins:
- Heredity (the most common cause)
- Pregnancy
- Hormone Replacement Therapy
- Birth Control Pills
- Prolonged Standing or Sitting
- Obesity
- Increasing Age
Normal Vein Anatomy
There are two systems of veins in your legs, deep veins and superficial veins. The deep veins are beneath the muscle. The superficial veins are above the muscles. The veins have one way valves which, when functioning properly, allow the blood to flow from the foot and calf up the leg and from superficial veins into the deep ones. Eighty percent of varicose vein problems arise from the Greater Saphenous Vein.
Superficial Venous Reflux and Venous Insufficiency
We use the term venous reflux to describe when the blood flows in two directions instead of one as described above. This is usually caused by abnormal venous valves. Since the feet are in a more gravity dependent location, blood tends to stagnate in the lower legs. This is what we mean by venous insufficiency. Although venous insufficiency and venous reflux are often used interchangeably, venous insufficiency is a recognized medical diagnosis and treatment is usually covered by insurance.
When we see varicose veins and/or leg swelling this alerts us to the possibility of venous insufficiency. As this condition becomes more progressive, one may experience skin discoloration and eventually sores referred to as venous stasis ulcers. Eighty percent of varicose vein problems arise from the Greater Saphenous Vein.
In order to treat the varicose veins effectively, the greater saphenous vein must be treated first if it is abnormal. If we just removed the varicose veins, without treating the underlying problem, then varicose veins would form.
Venous Stasis Ulcers
When venous insufficiency is left untreated over many years, the constant pressure from the dilated veins may cause a leaking of inflammatory cells into the tissues. This leaking causes brown stains on the skin referred to as venous stasis changes. This is a sign that the condition has become more serious.
In cases where the stasis is severe, a breakdown of the tissue may occur, resulting in what is called a chronic venous stasis ulcer. Venous stasis ulcers are very difficult to treat and are chronic in nature. They tend to reopen just when you thought it was healed.
Venous stasis ulcers do not occur in all patients with varicose veins. Unfortunately, we cannot definitively predict who will go on to develop this complication. When skin changes begin to appear, the likelihood of an ulcer increases. It is obviously better to treat the vein problems before this occurs. Once the ulcers do occur, treatment of the leg veins will usually facilitate healing and reduce the incidence of recurrence.
Evaluation of Venous Insufficiency
Treatment begins with proper evaluation. A complete history is taken. This includes a family history of vein problems or blood clots. Use of birth control and hormone replacement are also important. A sedentary lifestyle is another contributing factor. Other important aspects in the history include medications, previous surgery, trauma, and previous vein treatments.
A physical exam is performed and this is followed by a venous duplex ultrasound. During the ultrasound examination, the deep and superficial veins are examined for blood clots and for function. It is our belief that this examination is an extension of the physical exam and is vital in assessing your leg veins.
