WKRG.com - Vein Disease

Vein Disease

Vein problems can be painful and unsightly.  This includes varicose veins, spider veins, leg ulcers, and deep vein thrombosis (DVT), otherwise known as blood clot.

The veins return the blood to the heart.  They are not affected by the same types of diseases as the arteries, but they may develop insufficiency, which can cause swelling or varicose veins, and sometimes the development of clots.  Using ultrasound, we can determine the function of the veins and look for the presence of clot in the veins.

In general, there are two categories of vein disease. Varicose veins are described as engorged "rope-like" veins that are twisted and measure  ¼" in diameter. They generally grow in size over time and can cause tingling, itching, substantial pain, leg swelling, and even leg ulcers. They are caused by venous reflux, blood flowing the wrong direction through leaky valves in the legs.  The reflux can be visualized by performing a noninvasive, painless venous ultrasound while standing.  Over time, the increased venous pressure on the legs can cause the bulging varicosities, skin color changes, and leg ulcers. 
Once the development of leg ulcers occurs the healing process could take months due to swelling and extensive wound care therapy could be needed. The risk factors for developing varicose veins include heredity, pregnancy, obesity, standing a long time, and possibly trauma.  Conservative therapy of varicose veins includes exercise, weight loss, leg elevation, and compression stockings.

New techniques are being used to surgically treat the underlying venous reflux.  An ablative laser using heat can sclerose or close the vein in which blood is flowing the wrong direction.  Then small one-centimeter stabs are performed to pull out the bulging varicosities.  Postoperative venous ultrasounds are performed to ensure closesure of the vein and check for deep vein thrombosis.

Spider veins are the small, thread-like red colored veins on the surface of the skin. Many people seek treatment for spider veins for cosmetic reasons, but they also may cause discomfort.  These occur for the same reasons as varicose veins, but more often then varicose veins.  Currently, we use the only FDA-approved sclerosing agent, Sotratetradecyl solution, to inject these superficial veins.  The solution causes irritation and inflammation in the vein causing it to scar down and not be able to fill with blood.  This treatment requires multiple sessions and is not a permanent solution; more spider veins may arise in other areas over time.

Laser therapy for spider and reticular veins delivers light that is absorbed by the blood vessels causing the small veins to close. This therapy can be used for patients who have an aversion to needles and is also helpful in treating the smallest blood vessels after initial injection sclerotherapy.

Chronic Leg Swelling- Before	Chronic Leg Swelling- After