Varicose Veins Q&A
What is a varicose vein?
Varicose veins are the bulged and ropey-looking raised veins that appear on the legs. They are caused by high blood pressure in the superficial veins in the leg causing the veins to weaken and bulge. This condition is referred to as venous insufficiency or reflux. Varicose veins in the legs affect the quality of life by causing pain, numbness, tingling, burning, aching, fatigue, heaviness, swelling and sleep related issues. They also may be a cause of unexplained pelvic pain in females and not just affecting the legs as was once contemplated. Varicose vein disease is caused by poor functioning or damaged valves in veins that can ultimately lead to ulcers and blood clots which can spread to the lungs and be lethal.
WHAT IS CHRONIC VENOUS INSUFFICIENCY (CVI)?
CVI is a progressive medical condition in which the valves that regulate blood flow direction from the legs to the heart no longer function, causing blood to pool in the legs and veins to swell. Healthy leg veins are designed to allow blood to flow against gravity from the legs back toward the heart. Tiny valves inside the veins open and close to help control the flow and pressure. CVI occurs when stresses on the venous system – like pregnancy, age or standing for long periods of time(2) – weaken the vein structure. When the veins become weakened or diseased, vein valves no longer promote efficient blood flow and blood pools in the legs. This impaired blood flow (or reflux) causes veins to expand, lose form and protrude from beneath the skin.
WHO IS AT RISK FOR CVI AND VERICOSE VEINS?
While CVI can affect anyone, gender and age are large factors that may increase your risk for developing the disease. For example, women older than 50 are more likely than others to develop venous disease that can lead to CVI. The disease can affect several members of the same family. Additionally, the following factors may increase your risk for developing varicose veins that can sometimes progress into CVI(2): Lack of exercise Lifestyle that requires standing for long periods of time Excess weight Current or previous pregnancies
CAN VARICOSE VEINS AND CVI BE PREVENTED?
For mild forms of venous disease, lifestyle changes may be recommended to control existing symptoms and prevent others. The following measures may help control varicose veins and CVI:(3) Manage blood pressure and body weight Exercise regularly, focusing on exercises that work your legs (run or walk) Elevate your legs whenever possible Avoid prolonged standing or sitting Avoid clothes that are tight around the waist, thighs or legs Strengthen calf muscles and avoid shoes that limit use of calf muscles (i.e., high heels) Eat a diet low in salt and rich in high-fiber foods Since varicose veins cannot always be prevented, it is important to talk to a vein specialist about treatment options before the condition progresses into CVI or symptoms worsen.
WHAT CAN HAPPEN IF I OVERLOOK MY VARICOSE VEINS AND SYMPTOMS OF CVI?
Treatments for diseased veins can be effective in eliminating the varicose veins and symptoms of CVI, and also preventing the condition from progressing. If left untreated, varicose veins can sometimes progress to become CVI, a more serious form of venous disease(1) that may present increasingly severe signs and symptoms over time. Those symptoms can include ankle swelling, fatigue, restlessness and pain of the legs, skin damage and ulcers.(2)
What treatments are available for varicose veins?
Radiofrequency Thermal Ablation (ClosureFast®)
The ClosureFast™ procedure provides controlled heat through radiofrequency energy in 20-second bursts which contract the collagen in the vein walls, causing them to collapse and seal. Once a leg vein is closed, blood flow is redirected to healthy veins. This procedure is performed using local anesthesia in the doctor’s office or an outpatient surgical facility. The procedure takes approximately 45-60 minutes, not including pre and post-procedure treatments.
The VenaSeal™ closure system uses a medical adhesive delivered endovenously to close the vein. This is a catheter-based treatment so the doctor will use a local anesthetic to numb the insertion site, usually in the groin. Once you are numb, the doctor will insert the catheter and thread it to the vein site. Small amounts of the adhesive will be sent through the catheter to the varicose veins to close and seal them.
Varithena (Chemical Vein Ablation):
Varithena® (polidocanol injectable foam) is a prescription medicine used to treat varicose veins caused by problems with the great saphenous vein (GSV) and other related veins. Varithena®. The medication is injected either directly into the vein or through a catheter. Treatment takes about an hour and patients can usually return to normal activities on the same day. Compression stockings will need to be worn for 2 weeks and heavy exercise should be avoided for the first week after treatment.
Sclerotherapy is a process used to treat varicose or spider veins in a patient, usually affecting the legs. The procedure uses a chemical called sclerosant to minimize the affected veins. The drug is injected into the varicose veins and can take anywhere from five to 30 minutes depending on how many veins are being treated. Sclerotherapy is often done under ultrasound guidance so the physician can deliver and monitor the injection.