Vein Conditions

Peripheral Vein Disease is most common among men and women over age 50. A family history of early arthrosclerosis predisposes one to PVD. Modifiable risk factors include smoking, hyperlipidemia, hypertension, diabetes, and obesity. People with a history of vascular problems like heart attack, angina, and stroke are at risk.

Types of vein diseases:

  • Chronic Venous Insufficiency
  • Varicose Veins
  • Deep Vein Thrombus
  • Leg Ulcers- Venous and Arterial types
  • Peripheral Artery Disease (PAD)

1. Chronic Venous Insufficiency (CVI)

Veins are hollow tubes with small valves that keep blood flowing in the correct direction. When the valves are open, blood flows in the direction of gravity, toward the feet. When the valves are closed, the blood is prevented from flowing into the legs, instead flowing from the extremities toward the lungs where it picks up oxygen. When the valves malfunction, blood flows backwards, toward the feet. To compensate, the veins bulge and swell. Because the blood is not flowing well inside the veins, it pools in the legs and feet, and increases pressure in the veins. Increased pressure in the veins causes the vein walls to weaken, and further damages the valves. This is called chronic venous insufficiency.

Causes

Chronic vein diseases including Deep Vein Thrombus, phlebitis (veins swell due to inflammation), varicose veins, inherited disorders, smoking, standing and sitting too long, pregnancy, and obesity can all cause CVI.

Symptoms of CVI

  • Ankle and leg swelling
  • Feeling of heaviness in the legs
  • Aching
  • Restlessness
  • Fatigue
  • Pain on standing
  • Cramps
  • Itching and tingling
  • Varicose veins

Treatment

Treatment depends on your age, specific symptoms, the severity of your condition and your general health. The goal is to improve blood flow. Use of compression stockings decreases swelling. Moving the legs regularly will keep blood flowing.

If your condition is severe, your doctor may recommend the following treatments:

  • Surgical repair of damaged veins or valves
  • A vein bypass- reroutes blood flow around the blocked vein
  • Angioplasty with stenting
  • Endovascular (within the vein) thermal ablation is a minimally invasive treatment option to address CVI and varicose veins. The treatment involves a thin, flexible tube, called a catheter that is inserted into a diseased vein.  Thermal ablation is used to heat the vein and seal it shut. Blood will then travel back to the heart through other veins, and overtime the body will absorb the vein.  Endovascular thermal ablation has been around for several years and is less painful and quicker than other treatment options available for CVI and varicose veins.
  • Sclerotherapy- a chemical solution is injected into the damaged vein causing it to collapse, and be absorbed by the body. Other veins will pick up the job of carrying blood to the heart.

2. Varicose Veins

Varicose veins look ugly, but more importantly they can cause CVI. Here the valves malfunction causing ankles and legs to swell. Long standing varicose veins can lead to leg ulcers.

Primary varicose veins are associated with heredity, age, gender and pregnancy. Secondary varicose veins are deep vein occlusions associated with Deep Vein Thrombus DVT).

Exercise, weight loss, blood pressure control, leg elevation and compression stockings are standard treatments for varicose veins. Endovascular minimally invasive surgery is used to ablate the veins, improve appearance, and facilitate rerouting of blood to the lungs. 50% of those with various veins are likely to develop recurrent varicose veins.

3. Deep Vein Thrombus (DVT)

This is where blood clots form and in severe cases, ulcers form on the lower legs. Any obstruction in the veins can increase pressure further damaging the valves. Symptoms include leg pain and hardness of the calves. But, in about half the cases, there are no symptoms and no pain. It is not usually life-threatening, but can result in a pulmonary embolism. This is a life-threatening condition where the clot breaks loose and travels to the lungs.

DVT Risk factors

The risk of DVT increases with the more risk factors you have.

  • History of previous DVT or venous thrombosis
  • Prolonged sitting or restricted mobility such as long distance travel
  • Age over 40
  • Surgery (especially orthopedic) or major injury
  • Prolonged bed rest or immobility
  • High blood pressure
  • Heart attack or stroke
  • Congestive heart failure
  • Chronic respiratory failure
  • Excessive weight
  • Sedentary lifestyle
  • Smoking
  • Varicose veins
  • High estrogen levels such as in pregnancy or use of birth control pills
  • Some forms of cancer

Diagnosis

DVT is a serious condition. A simple ultrasound can diagnose DVT. The sooner the condition is diagnosed, the better chance you have to avoid the risk of serious complications.

Complications

Pulmonary embolism (PE) – where a clot breaks loose from a vein and travels to the lungs. 50% of the time, there are no symptoms. Symptoms include: pain on walking, especially in the ball of the foot, leg and ankle swelling, shortness of breath, and difficulty exercising.

Treatment

If DVT is not treated quickly, almost 25% of patients will end up with PE. Treatment is focused on preventing PE. Blood thinners are prescribed as the first line treatment. Anticoagulant therapy should continue for at least 3-6 months, or more. At one year after treatment, the risk of PE decreases from 5% to almost no risk.

3. Phlebitis

Inflammation of the superficial veins. Often there is no obvious cause. It can be caused by minor injuries to the leg veins. Simple phlebitis can be treated at home with leg elevation, compression stockings, warm compresses, and over- the- counter anti-inflammatory drugs. CVI can affect anyone. Men and women are equally affected. Treatment depends on the stage of the disease. Consult the experts at BASS. They have the experience and skills you can rely on to provide you with excellent care.