We have all seen someone walking down the street and noticed large bulging varicose veins and thought “they should really see a doctor about that”. Varicose veins or prominent spider veins are the most obvious sign of venous disease and represent a medical condition called venous insufficiency that is much more than just varicose veins. Venous insufficiency can manifest as a variety of signs and symptoms, many of which may not immediately come to mind when thinking about venous disease.
Venous insufficiency is a condition where the valves in the superficial venous system in the legs fail and, over time, lead to impaired blood return to the heart. Blood pools in the leg veins, especially when in the standing or sitting position, leading to abnormally high pressure in the veins or venous hypertension, which leads to the many signs and symptoms of venous insufficiency.
Venous insufficiency is a very common and often under-diagnosed condition affecting millions of Americans. It is estimated to be present in as much as 40% of the population and becomes more prevalent after age 50. Heredity is the major risk factor, as are a history of blood clots or DVT, obesity, standing or sedentary occupation, female gender and prior pregnancies, although the condition afflicts many
men as well.
Most people are aware of the most common sign of venous insufficiency which is varicose veins, but many people without varicose veins also have venous insufficiency. Leg swelling as well as achy, heavy or tired legs at the end of the day are also common symptoms. In severe cases, the skin around the ankles can become discolored, thickened or even ulcerated over time.
As the pressure in the venous system builds throughout the day when patients are on their feet, symptoms progress and are worse in the evening and at bedtime. This is when the lesser known symptoms of venous insufficiency such as restless legs, leg cramps and excessive urination become problematic and can rob a patient of a good night’s sleep. All of these symptoms can be caused by venous disease and many patients’ symptoms improve with treatment for venous insufficiency. A trial of compression hose can predict which symptoms will most likely improve or respond to venous treatment.
Modern vein evaluation and intervention is much different than it was years ago. Prior to 2000, procedures such as vein stripping were very invasive, required general anesthesia, and had unacceptably high complication rates. For this reason, most patients with venous insufficiency were forced to suffer as there were no effective treatment options available other than compression hose and leg elevation.
At Vein Specialists in Fort Myers and Bonita Springs/Naples, we offer comprehensive, modern vein evaluation and care. I am board-certified vascular surgeon focused 100% on the management of venous disease. My team will start by taking a detailed history and physical exam and then offer detailed ultrasound evaluations in our office which is the gold standard in evaluating venous disease. We are then able to formulate the best treatment plan for each individual patient.
In many cases the best treatment option for patients with venous insufficiency is something called endovenous ablation or vein closure. This can be accomplished with either (laser or radiofrequency) either heat or medical adhesive (VenaSeal). Both techniques permanently seal the poorly functioning veins thus decreasing the venous pressure in the legs and significantly improving vein related symptoms. This procedure is minimally invasive and offered under local anesthesia in both our office locations with minimal discomfort. Other treatment options such as removal of varicose veins through small incisions called microphlebectomy or sclerotherapy for spider veins are also offered.
If you or a loved one has varicose veins or any of the other signs or symptoms of venous insufficiency such as leg swelling, fatigue, achiness, cramps or restless legs please consider visiting our website at Weknowveins.com for more information or call 239-694-VEIN(8346) to schedule your vein evaluation.