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Baylor Medical Center at Frisco

 
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Baylor Health Care System > Physicians & Locations > Frisco > About Us > Health Briefs > Don't Let Varicose Veins Hold You Back

Don't Let Varicose Veins Hold You Back 

Varicose veins can get in the way of life. Whether they are small spider veins or large, bulging veins, they can make it embarrassing to put on a pair of shorts. No one should have to hide their legs because of how they look. But chronic venous disease – the medical condition that causes most varicose veins – is more than just a cosmetic issue. It can make your legs feel sore, swollen and heavy, and can ultimately lead to more advanced findings like skin changes and ulcerations, all of which can significantly impact your quality of life. Fortunately, there are simple treatment options that can help.

Arteries carry fresh blood from the heart to fuel the rest of the body. Veins are low pressure collecting vessels that return the used blood back to the heart. In order for the veins to move that used blood in the right direction, they are lined with a series of one way valves. In the legs, these valves prevent gravity from pulling the blood back toward the feet.

Chronic venous disease occurs when problems develop with some of the valves, allowing blood to flow in both directions, not just toward the heart.  When this happens in the legs, the used blood drains more slowly and extra blood builds up in the legs, causing the signs and symptoms typical of chronic venous disease.

Chronic venous disease affects all adult age groups and both sexes, although it is seen more frequently in women than men.  It is estimated that more than 30 million Americans suffer from varicose veins, and 6 million have skin changes associated with venous insufficiency – a more advanced form of venous disease. Of those 30 million people, only 1.9 million seek treatment each year, meaning that more than 90 percent go undiagnosed and untreated.

Signs and Symptoms

There are several signs and symptoms associated with chronic venous insufficiency, including:

  • Varicose and spider veins
  • Swelling in legs and/or ankles
  • Tight feeling calves or itchy painful legs
  • Leg heaviness
  • Restless leg symptoms
  • Leg pain and cramping
  • Skin changes (e.g. redness, thickening of the skin, usually on the insides of the lower legs)
  • Skin ulcerations

“Visible findings such as prominent veins, swelling or skin changes do not have to be present to suspect chronic venous disease,” said Mark McQuaid, MD, a general surgeon and vein specialist on the medical staff at Baylor Medical Center at Frisco. “An individual may just have some vague leg discomfort or restlessness that progresses as the day goes on.”

Causes

“Leaky valves can develop for a number of reasons, the most common being a genetic predisposition,” said Dr. McQuaid. “If one parent has venous disease, their child will have a 50 percent chance of having it, but if both parents have it, there is a greater than 90 percent chance that their child will as well.”

Hormonal influences on the vessels make females more susceptible than men. Also, history of pregnancy, an occupation where someone sits or stands for prolonged periods of time, and trauma (including lower extremity surgery) all increase the risk of developing venous disease.

Diagnosis

If a person has signs or symptoms that are suggestive of venous disease, the first step is to have a venous evaluation performed by a vein specialist. That would consist of a thorough history and physical examination and, when appropriate, a specialized ultrasound evaluation to identify the abnormal veins. All of this is performed in the physician’s office, often on the same day.

Treatment Options

Once leaky valves are identified, treatment options may include:

  • Conservative measures to improve blood flow in the leg veins Methods to help increase blood flow in the leg veins include elevating the legs to reduce pressure in the leg veins and the use of compression stockings. Other measures include keeping the legs uncrossed when sitting and regular exercise.
  • Invasive surgical measures
    These have largely been replaced by minimally invasive procedures, due to the frequent need for hospitalization, the use of general or regional anesthesia, significant post-operative discomfort, lengthy recovery times and high recurrence and failure rates.
    • Ligation and stripping
      This procedure involves tying off an affected vein so blood no longer flows through it. If the vein and/or its valves are heavily damaged, the vein will be removed.
  • Minimally invasive procedures
    Office based procedures which do not require hospitalization, are performed under local anesthesia, involve minimal post-procedural discomfort, require shorter recovery times, and have higher success rates than invasive surgery. Treatment involves shutting down the diseased veins and allowing the used blood to return to the heart through other, healthy veins. The treated veins turn into scar tissue and are eventually absorbed by the body.
    • Thermal (heat) ablation
      Using catheters to heat up and damage the walls of the diseased veins from the inside.
    • Sclerotherapy
      This involves injecting a chemical into the affected veins. The chemical causes scarring in the veins so that they can no longer carry blood.
    • Phlebectomy
      Removal of prominent bulging veins through a series of very small incisions and specialized hooks.

Vein Screenings

“Both men and women of all ages, if they display signs and symptoms or risk factors, should schedule regular vein screenings,” urges J. Andrew Skiendzielewski, DO, physician on the medical staff at Baylor Frisco. “The benefits can be as simple as getting rid of spider and varicose veins, controlling symptoms so you can be more active during the day, or letting you get a good night of sleep because your restless leg symptoms are improved. What I typically tell patients is that we are looking to improve their quality of life in both the short and long term.”

More significantly, the progression of the more advanced findings in the legs – particularly the skin changes and ulcerations – can be controlled. Aside from the associated discomfort and lifestyle limitations, skin changes can be an indication of unhealthy tissue related to the underlying venous insufficiency, and put patients at risk for painful or potentially life and limb threatening infections and ulcerations.

“Many people are suffering from their vein issues when they simply don’t have to. This may be because they are not aware that treatment options exist, or possibly out of concern that any treatments would not be covered by their insurance company” added Dr. Skiendzielewski. “We are constantly trying to raise awareness that chronic venous disease is a serious medical condition that requires treatment in order to prevent short and long term consequences, and that most vein treatments are covered by medical insurance plans.”

Call 1.800.4.BAYLOR for a referral to a vein specialist on the medical staff at Baylor Medical Center at Frisco.

Register for a free Varicose Vein Screening Event at Baylor Frisco