Varicose Veins and Venous Reflux Disease

CURING VARIOUS VASCULAR CONDITIONS

Keep arteries and veins in your body healthy and fully functional with help from the specialists of Sam Houston Heart & Vascular Center.

Our team provides an array of vascular care services in Houston, Cypress, and Magnolia, TX. Don’t let minor issues worsen.

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VENOUS REFLUX DISEASE

Varicose veins are gnarled, enlarged veins. Any vein may become varicose, but the veins most commonly affected are those in your legs and feet.

That's because standing and walking upright increases the pressure in the veins of your lower body.

For many people, varicose veins and spider veins — a common, mild variation of varicose veins — are simply a cosmetic concern.

For other people, varicose veins can cause aching pain and discomfort.

Sometimes varicose veins lead to more-serious problems.

Varicose veins may also signal a higher risk of other circulatory problems.

Treatment may involve self-care measures or procedures by your doctor to close or remove veins.

Causes of Venous Reflux Disease

Arteries carry blood from your heart to the rest of your tissues. Veins return blood from the rest of your body to your heart, so the blood can be recirculated. To return blood to your heart, the veins in your legs must work against gravity.

Muscle contractions in your lower legs act as pumps, and elastic vein walls help blood return to your heart. Tiny valves in your veins open as blood flows toward your heart then close to stop blood from flowing backward.

Causes of varicose veins can include:

• Age. As you get older, your veins can lose elasticity, causing them to stretch. The valves in your veins may become weak, allowing blood that should be moving toward your heart to flow backward.

  Blood pools in your veins, and your veins enlarge and become varicose. The veins appear blue because they contain deoxygenated blood, which is in the process of being recirculated through the lungs.

• Pregnancy. Some pregnant women develop varicose veins. Pregnancy increases the volume of blood in your body, but decreases the flow of blood from your legs to your pelvis. This circulatory change is designed to support the growing fetus, but it can produce an unfortunate side effect — enlarged veins in your legs.

  Varicose veins may surface for the first time or may worsen during late pregnancy, when your uterus exerts greater pressure on the veins in your legs. Changes in your hormones during pregnancy also may play a role. Varicose veins that develop during pregnancy generally improve without medical treatment three to 12 months after delivery.

RISK FACTORS

These factors increase your risk of developing varicose veins:

• Age. The risk of varicose veins increases with age. Aging causes wear and tear on the valves in your veins that help regulate blood flow. Eventually, that wear causes the valves to allow some blood to flow back into your veins where it collects instead of flowing up to your heart.

• Sex. Women are more likely to develop the condition. Hormonal changes during pregnancy, premenstruation or menopause may be a factor because female hormones tend to relax vein walls. Taking hormone replacement therapy or birth control pills may increase your risk of varicose veins.

• Family history. If other family members had varicose veins, there's a greater chance you will too.

• Obesity. Being overweight puts added pressure on your veins.

• Standing or sitting for long periods of time. Your blood doesn't flow as well if you're in the same position for long periods.

COMPLICATIONS

Complications of varicose veins, although rare, can include:

• Ulcers. Extremely painful ulcers may form on the skin near varicose veins, particularly near the ankles. Ulcers are caused by long-term fluid buildup in these tissues, caused by increased pressure of blood within affected veins.

  A discolored spot on the skin usually begins before an ulcer forms. See your doctor immediately if you suspect you've developed an ulcer.

• Blood clots. Occasionally, veins deep within the legs become enlarged. In such cases, the affected leg may swell considerably. Any sudden leg swelling warrants urgent medical attention because it may indicate a blood clot — a condition known medically as thrombophlebitis.

• Bleeding. Occasionally, veins very close to the skin may burst. This usually causes only minor bleeding. But, any bleeding warrants medical attention because there's a high risk it can happen again.

SIGNS AND SYMPTOMS OF VEIN DISEASE

NON-SURGICAL TREATMENT IS AVAILABLE

• Vascular System Legs
  
  
• Human Leg with Varicose Veins Before and After Treatment
• Irregular Varicose Veins on Woman Leg

TREATMENT OPTIONS FOR VENOUS REFLUX DISEASE

WHAT IS THE TREATMENT FOR CHRONIC VENOUS INSUFFICIENCY?

Specific treatment will be determined by your doctor based on: Your age, overall health and medical history, Extent of the disease, Your tolerance for specific medications, procedures, or therapies, Your signs and symptoms, Expectations for the course of the disease Your opinion or preference.

Chronic venous insufficiency treatment may include:

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 compression stockings to apply pressure on the legs and help blood flow. Other methods include keeping the legs uncrossed when sitting and regular exercise.

Medications. Diuretics (medications used to draw excess fluid from the body through the kidneys) should typically not be used unless there are other separate conditions such as heart failure or kidney disease that are also contributing to the swelling. Medications that improve the flow of blood through the vessels may be used in combination with compression therapy to help heal leg ulcers. Aspirin can also be used to help ulcers heal.

Sclerotherapy. For patients whose condition is more advanced, sclerotherapy may be prescribed. This involves injecting a chemical into the affected veins. The chemical causes scarring in the veins so that they can no longer carry blood. Blood then returns to the heart through other veins and the body absorbs the scarred veins.

Surgery. Surgery is recommended in fewer than 10% of people with chronic venous insufficiency. Surgical procedures that may be used to treat the condition include:

• Ligation. This procedure involves tying off an affected vein so that blood no longer flows through it. If the vein and/or its valves are heavily damaged, the vein will be removed ("vein stripping").

• Surgical repair. A vein and/or valves may be surgically repaired, either through an open incision or with the use of a long catheter (hollow tube).

• Vein transplant. This involves transplanting a healthy vein from another body area and replacing the diseased vein with the healthy vein.

• Subfascial endoscopic perforator surgery. A minimally-invasive procedure performed with an endoscope (a small, flexible tube with a light and a lens on the end). The perforator veins (veins found in the calf area) are clipped and tied off. This allows blood to drain into healthy veins and improves ulcer healing.

WE SPECIALIZE IN ENDOVENOUS RADIOFREQUENCY ABLATION

VNUS CLOSURE

The endovenous radiofrequency ablation (or VNUS Closure) procedure is a minimally-invasive vein treatment used to treat the great saphenous (GSV), small saphenous (SSV) and perforator veins. It uses a patented radiofrequency catheter inserted into the vein, which applies RF energy to heat the vein. This causes the vein to collapse and seal shut. The VNUS Closure procedure has been FDA-approved since 1999 and over 250,000 procedures have been performed worldwide. The VNUS Closure procedure is performed in an office, and under local anesthesia.

Steps of the endovenous radiofrequency ablation procedure are:

• Physician uses ultrasound to map the course of vein

• Radiofrequency (Closure) catheter is inserted (through a small puncture) into the vein

• Local anesthetic solution is 'infiltrated' (infused) into the area around the vein

• Radiofrequency energy is applied to heat the vein and collapse the vein shut

• Patients usually are asked to walk immediately after the procedure. Walking is encouraged to stimulate reduced pressure on the veins and minimize the risk of complications.

• Compression stockings are usually prescribed for one to two weeks following the procedure

The endovenous radiofrequency ablation procedure has shown success rates (reflux-free) of 90% with up to 2 year follow-up. Patients are walking after the procedure and generally resume normal activity the same day.

Possible side effects of the Closure procedure include bruising, swelling and numbness, but these are generally only temporary. Endovenous radiofrequency ablation (VNUS Closure) is usually covered by most insurers (e.g., Medicare and private insurers). Eligibility generally requires proof of medical necessity.