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VEIN DISORDERS

In the United States nearly 65% of the population have some degree of varicose veins. However, only about 2 to 3% of the population that would benefit from a venous procedure actually seek treatment. This is mostly due to the lack of information regarding the disease and the available procedures for intervention. We will help familiarize you with an understanding of venous disease and the cutting-edge technology we offer for therapy.

What Causes Varicose Veins?

A common misconception about varicose veins is that they only happen in women. In fact, in the population that suffers from varicose veins, nearly 40% are men. Risk factors for varicose veins include genetic predisposition (if your mother or father had them), prolonged standing from work or lifestyle, increased height, congenital valvular dysfunction, obesity, and multiple pregnancies. They can also result from a history of a deep venous thrombosis or DVT. Genetic predisposition probably plays the most significant role. One study showed that if both your mother and father had varicose veins, there is a 90% chance that you also will have them. To understand how varicose veins form, it is important to understand the anatomy of a healthy vein and an unhealthy vein. Veins have valves that help the blood flow ONE WAY back up to your heart. When these valves become diseased and the veins become larger, the blood that is only supposed to go back up to your heart starts pooling in your feet and legs.

The underlying reflux of the superficial venous system (the Great Saphenous Vein and the Short Saphenous Vein and possible accessory veins) continues to worsen. As this happens, new veins form to decrease the pressure build up in the superficial venous system. These new veins start forming closer and closer to the skin and eventually you see them at the skin level.

Drawing of Superficial Veins

What is the Anatomy of the Venous System?

There are three main types of veins in your legs: Deep Veins: These carry between 97% to 99% of the blood back up to your heart from your legs. They are the most important vein system in your legs. Perforator Veins: These veins are bridges between the superficial veins and the deep veins. Frequently these are the culprits behind ulcers of the lower leg. Superficial Veins: These are the closest to the skin but are not visible. There are two main veins of this system called the Great Saphenous Vein and the Short Saphenous Vein. However, this system has the greatest variation and can have accessory or additional veins also. The picture below describes the anatomy of the superficial and the deep system. The picture on the right shows the anatomy of the perforator vein system.

Vein Graphic of the legs
venous ulcer

Are there different types of veins?

There are three main types of veins in your legs: 
 
  1. Superficial Veins: These are the closest to the skin but are not visible. There are two main veins of this system called the Great Saphenous Vein and the Short Saphenous Vein. However, this system has the greatest variation and can have accessory or other additional veins.
     
  2. Perforator Veins: These veins are bridges between the superficial veins and the deep veins. Frequently these are the culprits behind ulcers of the lower leg.
     
  3. Deep Veins: These carry between 97% to 99% of the blood back up to your heart from your legs. They are the most important vein system in your legs.
Femoral Saphenous Leg Vein Diagram
  • Discomfort
  • Skin changes
  • Ulcerations
  • Clots
  • Deep Vein Thrombosis
  • Burning Sensation
  • Cramping
  • Restless Legs

What Are The Risks Associated With Having Varicose Veins?

Varicose veins can lead to discomfort, skin changes, work absences, and significant medical and emotional disability as reflected by decreased scores on health-related quality-of-life surveys. Patients with varicose veins have an increased number of inflammatory and clotting markers. There are other more severe complications that can be associated with varicose veins which include ulcerations and clots in your deep veins. These clots can then travel to your lungs and they are called pulmonary embolisms. A recent study showed that among adults diagnosed with varicose veins, there was a significantly increased association of DVT (Deep Vein Thrombosis). The findings also noted a higher incidence of PE (Pulmonary Embolism).
Another risk of varicose vein disease is the formation of venous ulcers. Venous ulcers form on an area that has continuous trauma from blood that is sitting in one place without much movement. Think of it as how your hands look after you wash dishes in a sink with still water. Imagine doing that for years without taking a break… eventually your skin starts to break down. When this process happens on your legs, an ulcer will form. Ulcers are very difficult to treat with physical therapy or compression therapy because the underlying disease is not treated. The only way to treat the underlying disease is to close the diseased vein underneath the ulcer. The following pictures show before and after laser ablation treatments and grafting of venous ulcers.

NL - Before
Before
NL - Month 3 After
After
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MORE FAQ's

Venous disease does not simply improve by itself. You can control for symptoms with the use of compression stockings and lifestyle changes such as weight loss and exercise.

 
There have been a number of trials that showed that non-procedural interventions such as compression therapy and lifestyle changes do not offer a long-term solution to the disease. Interventions such as the Endovenous Laser Ablation showed significant improvement in quality of life and symptom relief.

Available studies show that although stockings improve symptoms temporarily they DO NOT treat the underlying disease. The disease most commonly will continue to progress. Adherence to stockings is also very difficult given the discomfort of wearing them for several hours and if fitting is problematic. Compression therapy is often a Band-Aid for the problem.

Given that this is a recognized disease, the treatments are covered by insurance if you meet certain criteria. You will be responsible for your plans deductible, co-payment, co-insurance. Our insurance specialist team will work with your insurance company. Many insurance policies dictate the order in which vein procedures can be performed. Our team will discuss the specific requirements of your insurance and work on a treatment plan that suits you.
 
If you do not want to go through insurance, we can create a payment plan for you.