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Yes, many patients with no visible veins still suffer from the symptoms of venous reflux disease. Typically, varicose veins occur as the disease progresses and you may lack visible veins early in the disease process.
Venous insufficiency, also known as venous reflux, occurs when the valves within the veins do not efficiently circulate blood back to the heart and lungs. When the valves and vein walls become weakened it causes the blood to backflow and to pool in the feet, ankles, and calves which cause symptoms to occur. You may notice symptoms such as heaviness, aching, itching, burning, varicose veins/spider veins, discoloration, and even open wounds.
There are a handful of reasons as to why patients develop venous reflux. One of the main causes for the development of venous reflux is a strong family history of vein disease. It can come from your mother, grandmother, aunt, uncle, dad, etc…. and is carried down through genetics. Another cause of vein disease may be the profession in which you work. We see a large number of patients in professions that require long periods of standing or sitting. Some of the most common professions we see are nurses, hair dressers, postal workers, flight attendants, mechanics, and waiters/waitresses. Lastly, we see venous disease in individuals who have had an injury or surgery to the affected leg.
Yes, Varicose veins are the large blueish/green veins that have a ropey appearance and can be distended from the surface of the skin. Varicose veins are usually tender to the touch, and can itch and burn especially after a long day on your feet. Varicose veins are almost always associated with underlying venous issues.
Spider veins are the small blueish/purple veins just under the surface of the skin. They can resemble a web like shape and can also itch and burn at times. Sometimes these veins are not associated with underlying issues, and may just be a cosmetic in nature.
No, most visible veins occur because there is an underlying issue with some of the larger superficial veins within the legs. These are the veins that are typically responsible for the development of your symptoms. After these larger veins are treated, then we can focus on some of the cosmetic veins that may still be present.
Almost all medically necessary vein procedures are covered by insurance and Medicare. To ensure that your insurance will cover the procedures we run your benefits prior to performing any advanced imaging or procedures.
While every patient is different, there can be some pain associated with the numbing portion of the procedure. A small needle is used to inject lidocaine, sodium bicarbonate, and epinephrine around the vein to ensure that the patient will not feel the endovenous laser ablation (ELA) or radiofrequency ablation(RFA) once it is turned on to treat the affected vein, and to also prevent burning of the skin. We also offer of valium to help relax you during this process, or for the more needle shy individuals we can even use a light sedation for the duration of the procedure.
There is virtually no recovery time except for wearing your compression sock, and frequent walking. Some patients even return to work the same or next day after the procedure. For the first week we just ask that you refrain from heavy lifting (over 20 pounds) to ensure proper closure of the vein.
The treatment of veins is a process. Depending on how many veins you need to have treated, will determine how many visits you need. We typically only treat one main superficial vein at a time to help with the healing process and cause as little discomfort for the patient as possible. Only under special circumstances will we treat both legs on the same day.
This is a tricky question to answer, but the best answer is sometimes nothing, sometimes a lot. Some patients have venous reflux for years with no symptoms or changes in the disease, and may never elect to have them treated. Other patients will have a slow steady progression of the disease and will notice the symptoms getting worse, and possibly see the development or worsening of the visual varicose veins. It can progress even further and the development of skin changes and possibly the breakdown of skin in the lower legs may occur. This breakdown of the skin happens due to the lack of healthy oxygenated blood required to heal and maintain healthy tissue.
There are several conservative therapy options if you do not want to have the veins treated. You always have the option of wearing compression stockings on a daily basis, on long car rides/flights, prolonged periods of standing or sitting, or intermittently when symptoms are present. You can also implement changes in your lifestyle such as, increasing your daily activities or exercising, changing your diet, or adding supplements such as Vasculera or horse chestnut to your daily regimen. Keep in mind that making such changes will not “heal” the damaged valves in your veins, but will help in the management of your symptoms.
Some patients will return to normal activities the day after the procedure, others may take a little longer. We just ask that during the first week after the procedure you wear your compression sock, walk frequently, and don’t lift anything over 20 pounds. Almost all patients are pain free two weeks after the procedure.
We recommend having a driver for every ELA/RFA procedure that you are scheduled for due to the numbing of your leg during the procedure. If you take valium or choose to be put to sleep, then you MUST have a driver accompany you.
Yes, approximately 30% of the patients we treat are men.
No, venous reflux can affect any age group. We have treated patients as young as 16 and as old as 96. Our typical patient age range is from 40-75.
There are no incisions made during the procedure therefore scarring is minimal.
Yes, arteries are responsible for bringing oxygenated blood down from the heart to provide skeletal muscles and tissues the oxygen it needs to function properly. Arteries are usually associated with stenting and athrectomy (cleaning out) of blockages. Veins are responsible for taking the blood back to the heart and lungs to be re-oxygenated and circulated back through the body. We do not clean out the veins, we close the unhealthy veins down to re-direct blood flow to healthy veins in the deep system.
Most patients are here for 45min to an hour, but the actual procedure usually only takes 15-20 min once we get started. Majority of the time is spent prepping for the procedure.
The free screening is a quick ultrasound exam to determine whether or not you have venous reflux disease. The screening can take anywhere from 5 to 10 min depending on the extent of the disease. Once the free screening has been completed you will then be scheduled for a vein mapping if the exam was positive. The vein mapping is a more detailed ultrasound that can take up to 45 min in some cases. This mapping ultrasound is what will determine your treatment plan and insurance coverage.
We like our patients to be hydrated so that the veins are easily visualized and can be evaluated properly for venous reflux. Try to drink 32 oz. of water an hour before coming in to your vein screening or mapping. Do not drink caffeine the morning of your appointment to avoid constriction of the vessels.