Venous Disease: What You Need to Know about Chronic Venous Insufficiency (CVI)

Venous Disease: What You Need to Know about Chronic Venous Insufficiency (CVI)

The venous disease known as chronic venous insufficiency (CVI) affects the veins of your body. CVI is common, according to the Society for Vascular Surgery, possibly affecting up to 40 percent of people living in the United States.

The phrase ‘venous insufficiency’ means some of the veins do not work as well as they should. Chronic venous insufficiency means the condition will cause problems for a long time.

CVI – A Chronic Venous Disease

Arteries carry oxygen-rich blood from your heart to the rest of your body. Cells use this oxygen to perform various tasks. As they work, cells create waste, including carbon dioxide and other toxic byproducts. Blood carries these waste products away, clearing space for more oxygen.

Veins carry blood from your body cells back to your heart. Unlike arteries that get a little help from gravity to move blood downwards from your heart to your feet, your veins have to fight the force of gravity to carry it back upwards.

To help them keep blood moving in the right direction, veins have one-way valves that trap blood in small segments of the blood vessels in between heartbeats. These valves prevent gravity from pulling your blood downwards into your lower legs and feet.

In time, these valves can weaken and begin to function poorly. This allows blood to flow backwards and downwards, and eventually accumulate in your lower legs and feet. Blood pools in the veins in your lower extremities, causing pressure within those veins. Your body responds to the pressure by expanding the veins; bloated veins near the surface of your skin appear as bulging, twisted varicose veins.

The affected veins do a poor job of circulating blood. Instead of moving blood back up to the heart, the affected veins remain filled with oxygen-poor blood. In other words, the venous system becomes insufficient.

Malfunctioning valves are the most common cause of chronic venous insufficiency, according to the U.S. National Library of Medicine, but blood clots can also cause CVI. Certain risk factors can increase the likelihood that you will develop CVI, including:

  • Age – the risk for CVI increases as you get older
  • Family history of CVI
  • Being female
  • History of blood clots, also known as deep vein thrombosis, in your legs
  • Obesity
  • Pregnancy
  • Sitting or standing for long periods
  • Tall height

Vein doctors can diagnose and treat CVI. Diagnosis involves an examination of the veins in your legs and gathering a medical and family history, and may include a duplex ultrasound to evaluate your circulation. Treatment can include elevating your legs, regular exercise, wearing compression stockings, and undergoing medical treatments, such as VNUS Closure and EVLT.

If you think you have chronic venous insufficiency, make an appointment with your local vein doctor.

Ambulatory Phlebectomy: Yesterday and Today

Ambulatory Phlebectomy: Yesterday and Today

Ambulatory phlebectomy is a safe and effective treatment for varicose veins. Always embarrassing and sometimes painful, varicose veins have trouble humans since the dawn of time. Healers have searched for treatments for varicose veins for thousands of years. Today, many vein doctors consider phlebectomy to be the gold standard for varicose vein treatment.

Varicose veins affect up to 35 percent of people in the United States, according to the Society for Vascular Surgery. Twisted and bulging blue or purple veins ruin the appearance of skin on the backs of your legs. Varicose veins can also cause fatigue and aching in your legs or, in some cases, skin discoloration or even skin sores around your ankles.

Vein surgeons perform phlebectomy to remove varicose veins through incisions in the skin. In the earliest days of phlebectomy, and in vein stripping procedures still used today, surgeons remove large portions of veins. This procedure requires general anesthesia and hospitalization.

The word ‘ambulatory’ means something relates to walking. An ambulatory procedure means you can get up and walk around immediately afterwards – no hospitalization required. Ambulatory phlebectomy, therefore, is a procedure to remove varicose veins that requires very little downtime.

History of Phlebectomy

Healers have searched for effective varicose vein treatments since the early days of humankind. Hippocrates was the first to perform surgery for the varicose veins about 2400 years ago. Cornelius Celsus first described the phlebectomy procedure in the year 45 CE. Walther Hermann Ryff described the first phlebectomy hooks in the 1545 publication, Textbook of Surgery.

Medical practitioners and scientists made slow progress in developing the technique for a few centuries until Dr. Robert Muller, a Swiss dermatologist with a private practice in Neuchâtel, Switzerland, rediscovered phlebectomy in 1956. Muller developed his own instruments and technique then shared this information with other physicians.

One of Muller’s students and a former president of the Swiss Society of Phlebology, Dr Albert-Adrien Ramelet, created his own hooks and perfected the techniques to remove smaller veins. Venous surgeons still practice these techniques today, in both patients undergoing conventional vein stripping and those enjoying the benefits of modern ambulatory phlebectomy.

Ambulatory Phlebectomy Today

Today’s phlebectomy techniques are truly ambulatory – patients can go home immediately after undergoing the procedure in an outpatient clinic, and resume normal activities shortly thereafter.

 Modern vein doctors use state-of-the-art tools and sophisticated procedures, including ambulatory phlebectomy, to remove varicose veins. The surgeons use duplex ultrasound to create real-time images of blood vessels and the blood flowing within them to locate and diagnose varicose veins. Doctors administer local anesthesia to numb the treatment area rather than using general anesthesia that puts the patient to sleep. Venous surgeons now use extremely small surgical tools to make incisions and remove diseased veins, along with techniques that minimize bleeding, bruising, scars and complications.

If you have varicose veins and you are considering treatment, talk to your vein doctor about ambulatory phlebectomy.

 

What is VNUS Closure?

What is VNUS Closure?

VNUS Closure is a varicose vein treatment. Also known as VNUS ClosureFast or RF Closure, VNUS Closure is a state-of-the-art, minimally invasive procedure that effectively reduces the appearance of existing varicose veins. The procedure is relatively pain-free and is performed in outpatient clinics.

About the VNUS Closure Procedure

Before performing the VNUS Closure procedure, your vein doctor will use ultrasound to create a map of the leg veins to be treated. This may helps guide treatment for the best results possible.

To perform VNUS Closure, your vein surgeon inserts a thin flexible tube, known as a catheter, into the varicose vein. Your doctor then directs pulses of radiofrequency (RF) energy through the catheter into the walls of the varicose vein. The energy irritates the tissue lining the inside of the diseased vein, and this irritation causes the vein to close and seal shut. Your body routes blood through other veins. The treated vein breaks apart and, in time, nearby tissue absorbs the remnants of the vein.

Your vein doctor will dress the treated vein with a compression bandage to prevent bleeding. You will need to wear compression hose for several weeks following VNUS Closure. Your venous surgeon will give you specific instructions for care.

The procedure takes less than an hour, depending on the number of veins treated. It is an outpatient procedure – no hospital stay required and you can go home almost immediately after the procedure. VNUS Closure requires very little recovery time so you can probably resume most of your normal activities right away. Your vein surgeon may recommend that you walk, which speeds healing, but avoid strenuous activity for several days after the procedure.

Benefits of VNUS Closure

As with any procedure, there are benefits and drawbacks associated with VNUS Closure. Benefits include little or no discomfort and minimal bruising. There is very little to no scarring. VNUS Closure is an excellent treatment for varicose veins and a good alternative to invasive vein stripping techniques.

Potential complications include perforation of a blood vessel, a blood clot, infection and tingling from an adjacent nerve affected by the treatment. Discuss your risk of complications with your vein doctor.

VNUS Closure is not right for everyone. The procedure may be right for you if your varicose veins cause you discomfort or embarrassment, and you are in otherwise good health. VNUS Closure may not be right for you if you have a history of specific health problems. You may need to stop taking certain medications for a few days before the procedure. Only a vein doctor can determine if you are healthy enough for VNUS Closure.

For more information about VNUS Closure, talk with your local vein doctor. A vein surgeon can evaluate your varicose veins and help you decide if VNUS Closure is right for you.

 

Venous Disease: What to Know about Chronic Venous Insufficiency (CVI)

Venous Disease: What to Know about Chronic Venous Insufficiency (CVI)

The venous disease known as chronic venous insufficiency (CVI) affects the veins of your body. CVI is common, according to the Society for Vascular Surgery, possibly affecting up to 40 percent of people living in the United States.

The phrase ‘venous insufficiency’ means some of the veins do not work as well as they should. Chronic venous insufficiency means the condition will cause problems for a long time.

CVI – A Chronic Venous Disease

Arteries carry oxygen-rich blood from your heart to the rest of your body. Cells use this oxygen to perform various tasks. As they work, cells create waste, including carbon dioxide and other toxic byproducts. Blood carries these waste products away, clearing space for more oxygen.

Veins carry blood from your body cells back to your heart. Unlike arteries that get a little help from gravity to move blood downwards from your heart to your feet, your veins have to fight the force of gravity to carry it back upwards.

To help them keep blood moving in the right direction, veins have one-way valves that trap blood in small segments of the blood vessels in between heartbeats. These valves prevent gravity from pulling your blood downwards into your lower legs and feet.

In time, these valves can weaken and begin to function poorly. This allows blood to flow backwards and downwards, and eventually accumulate in your lower legs and feet. Blood pools in the veins in your lower extremities, causing pressure within those veins. Your body responds to the pressure by expanding the veins; bloated veins near the surface of your skin appear as bulging, twisted varicose veins.

The affected veins do a poor job of circulating blood. Instead of moving blood back up to the heart, the affected veins remain filled with oxygen-poor blood. In other words, the venous system becomes insufficient.

Malfunctioning valves are the most common cause of chronic venous insufficiency, according to the U.S. National Library of Medicine, but blood clots can also cause CVI. Certain risk factors can increase the likelihood that you will develop CVI, including:

  • Age – the risk for CVI increases as you get older
  • Family history of CVI
  • Being female
  • History of blood clots, also known as deep vein thrombosis, in your legs
  • Obesity
  • Pregnancy
  • Sitting or standing for long periods
  • Tall height

Vein doctors can diagnose and treat CVI. Diagnosis involves an examination of the veins in your legs and gathering a medical and family history, and may include a duplex ultrasound to evaluate your circulation. Treatment can include elevating your legs, regular exercise, wearing compression stockings, and undergoing medical treatments, such as VNUS Closure and EVLT.

If you think you have chronic venous insufficiency, make an appointment with your local vein doctor.

Ambulatory Phlebectomy: Yesterday and Today

Ambulatory Phlebectomy: Yesterday and Today

Ambulatory phlebectomy is a safe and effective treatment for varicose veins. Always embarrassing and sometimes painful, varicose veins have trouble humans since the dawn of time. Healers have searched for treatments for varicose veins for thousands of years. Today, many vein doctors consider phlebectomy to be the gold standard for varicose vein treatment.

Varicose veins affect up to 35 percent of people in the United States, according to the Society for Vascular Surgery. Twisted and bulging blue or purple veins ruin the appearance of skin on the backs of your legs. Varicose veins can also cause fatigue and aching in your legs or, in some cases, skin discoloration or even skin sores around your ankles.

Vein surgeons perform phlebectomy to remove varicose veins through incisions in the skin. In the earliest days of phlebectomy, and in vein stripping procedures still used today, surgeons remove large portions of veins. This procedure requires general anesthesia and hospitalization.

The word ‘ambulatory’ means something relates to walking. An ambulatory procedure means you can get up and walk around immediately afterwards – no hospitalization required. Ambulatory phlebectomy, therefore, is a procedure to remove varicose veins that requires very little downtime.

History of Phlebectomy

Healers have searched for effective varicose vein treatments since the early days of humankind. Hippocrates was the first to perform surgery for the varicose veins about 2400 years ago. Cornelius Celsus first described the phlebectomy procedure in the year 45 CE. Walther Hermann Ryff described the first phlebectomy hooks in the 1545 publication, Textbook of Surgery.

Medical practitioners and scientists made slow progress in developing the technique for a few centuries until Dr. Robert Muller, a Swiss dermatologist with a private practice in Neuchâtel, Switzerland, rediscovered phlebectomy in 1956. Muller developed his own instruments and technique then shared this information with other physicians.

One of Muller’s students and a former president of the Swiss Society of Phlebology, Dr Albert-Adrien Ramelet, created his own hooks and perfected the techniques to remove smaller veins. Venous surgeons still practice these techniques today, in both patients undergoing conventional vein stripping and those enjoying the benefits of modern ambulatory phlebectomy.

Ambulatory Phlebectomy Today

Today’s phlebectomy techniques are truly ambulatory – patients can go home immediately after undergoing the procedure in an outpatient clinic, and resume normal activities shortly thereafter.

Modern vein doctors use state-of-the-art tools and sophisticated procedures, including ambulatory phlebectomy, to remove varicose veins. The surgeons use duplex ultrasound to create real-time images of blood vessels and the blood flowing within them to locate and diagnose varicose veins. Doctors administer local anesthesia to numb the treatment area rather than using general anesthesia that puts the patient to sleep. Venous surgeons now use extremely small surgical tools to make incisions and remove diseased veins, along with techniques that minimize bleeding, bruising, scars and complications.

If you have varicose veins and you are considering treatment, talk to your vein doctor about ambulatory phlebectomy.

 

What Causes Spider Veins?

Spider veins are very common, however, these unappealing, and sometimes unsightly veins that are easily visible through your skin, show up as small purple, red, and blue vessels that twist and turn. Due to their physical appearance, they can cause you a great deal of distress. They can also make walking long distances more difficult, or they may ache, throb, or even burn.

Often found behind your knee, these superficial dilated blood vessels can also be found anywhere on the body, and liken to varicose veins but are smaller, and closer to the surface of your skin. In medical speak, spider veins are known as telangiectasia.

According to information from Everyday Health, a study showed that out of a group of 1,566 people, 84 percent had these veins on their right legs.   

What causes spider veins?

Around 50 to 55 percent of women, and 40 to 45 percent of U.S. men suffer from a vein problem of some sort, according to the Office on Women’s Health, U.S. Department of Health and Human Services. Caused by increased pressure within your veins, spider veins are hereditary, and become more commonly found as you age.

If you work in a job that requires you to stand for protracted periods of time, the pressure in your leg veins is more likely to cause you to suffer from spider veins.

Other factors that increase your risk of being predisposed to spider veins include:

  • Obesity

  • Using birth control pills

  • Hormonal fluctuations of puberty, pregnancy, and menopause

  • History of blood clots

  • Post-menopausal hormone replacement

  • Conditions that cause pressure within the abdomen, for example, constipation, tumors, and wearing girdles

  • Lack of movement

  • Sun exposure

Lowering your risk of spider veins

Although you might not be able to completely prevent spider veins appearing on your body, you can lower your risk by following these steps:

  • Keep your blood flowing by regularly exercising.

  • Wear support hosiery if you spend a lot of time on your feet.

  • Relieve pressure on your legs by keeping your weight at a healthy level and by averting standing or sitting for long periods.

  • Put your feet up when you’re resting.

  • Wear sunscreen when you’re outdoors.

Spider veins are a result of various factors, through keeping the above tips in mind, you have a much better chance of avoiding getting them.

If you have spider veins and would like to get them treated, contact us here at the Columbus Vein Center at (614) 515-2440. As a leading vein clinic in Columbus, we specialize in a variety of vein treatments and procedures, including sclerotherapy, endovenous laser treatment, ambulatory phlebectomy, VNUS ClosureFast, and duplex ultrasound.

 

 

How a Vein Specialist Treats Spider Veins

The appearance of spider veins creates distress in many patients.  Although these small red or blue blood vessels seldom cause medical problems, their cosmetic impact easily affects a person’s self-confidence.  A vein specialist can offer two types of treatment to eliminate spider veins once conservative measures such as making lifestyle changes or wearing compression stockings have failed to satisfy a patient.

How a Vein Specialist Uses Sclerotherapy

This treatment has been around since the 1930s, according to the Cleveland Clinic.  Fewer than 10 percent of patients who undergo the procedure experience no response to it.  In a single session, doctors estimate that they can get rid of as many as 80 percent of the veins they treat.  Sometimes providers combine sclerotherapy with ultrasound to map potential problem veins.

Sclerotherapy is normally an outpatient procedure performed at a vein clinic or a doctor’s office.  Specialists who perform it are typically interventional radiologists or vascular surgeons.  They consider the technique the gold standard of spider vein treatment.

Physicians eliminate targeted veins by using a fine needle to inject a special foam or liquid called a sclerosing agent.  This agent irritates the walls of the vein.  This causes the vessel’s walls to scar and the vein to close off and eventually fade from view.

Sclerotherapy is a minimally invasive procedure that causes little discomfort.  A typical session lasts 30 minutes or less.  Most patients return to their normal routines the same day as their appointments, except for activities the physician considers strenuous. 

Depending on their size, most spider veins vanish in a matter of several weeks to a few months.  Some might require more than one treatment for elimination. 

Laser Therapy for Spider Veins

For some patients, laser therapy is an effective treatment for a spider vein problem or for eliminating varicose veins up to 3 mm in diameter.  The Office on Women’s Health indicates that this procedure involves sending light bursts through the patient’s skin directly into a targeted vessel.

While this treatment utilizes no incisions or needles, the heat generated by the laser can cause pain, reduced somewhat by cooling.  Most patients require as many as five treatments, each lasting around 20 minutes, to eliminate spider veins in their legs before achieving sufficient fading and a satisfactory cosmetic result.  Unfortunately, doctors cannot safety treat all skin colors or types with laser technology. 

The path to eliminating spider veins begins with a visit to a vein doctor.  After taking a medical history and conducting a physical exam, the physician will explain the various treatment options for which the patient is a candidate.  The choice of therapy involves both the doctor’s recommendation and patient preference.

Because no treatment for spider veins can keep new vessels from developing, some patients return to a vein clinic periodically for additional treatments.

 

What to Expect with Duplex Ultrasound

What to Expect with Duplex Ultrasound

Duplex ultrasound uses sound waves to create very detailed pictures of organs and structures inside your body that may not show up well on conventional x-rays. A vein doctor uses duplex ultrasound to create images of the veins in your legs. The test helps your vein specialist evaluate your circulatory system. Duplex ultrasound captures images in real time, which means your vein doctor can see the blood flowing through your veins.

Ultrasound is safe and painless. It uses the same sonar technology that captains use to guide submarines and anglers use to find fish. The ultrasound machine emits a high-frequency sound wave that bounces off tissue and back to the machine. A computer translates information gathered from the sound wave, such as loudness and pitch, into an image. Unlike traditional x-rays that use ionizing radiation to create images, ultrasound does not expose you to dangerous radiation.

Doctors use duplex ultrasound to detect problems in your veins, such as blood clots. Clinicians can also use ultrasound to help guide the placement of needles into a vein for precise injection of medications and lowered risk of bleeding, nerve injury, or other complications associated with injections.

The Duplex Ultrasound Procedure

There are no special preparations for duplex ultrasound of your legs. Wear comfortable, loose-fitting clothing for your ultrasound test. Your vein doctor will use the ultrasound machine on your legs, so wear clothing that makes it easy to expose your legs.

For the test, you will lay face-up on an examination table; you may need to roll slightly to one side or the other to improve the quality of the images. The person performing the ultrasound, known in that capacity as the sonographer, applies a clear water-based gel to the examination area. This gel improves contact between the machine and your skin.

The sonographer presses a handheld wand, known as a transducer, to the surface of your skin and moves it over your legs. The sonographer may sweep the area quickly to get a big picture, or angle the transducer in one spot to hone in on one area of interest.

During the procedure, you may hear pulse-like sounds that change in pitch as the sonographer measures blood flow. The test should be painless and most patients tolerate it well.

The procedure takes only a half hour to 45 minutes, depending on the complexity of the exam. The sonographer will wipe off any residual ultrasound gel, which does not stain or discolor clothing or skin.

You can resume normal activities immediately after an ultrasound. There are no risks or harmful effects associated with duplex ultrasound, according to the Society for Vascular Surgery. Your results should be immediately available to your vein doctor and available to you shortly thereafter.

For more information about what you can expect from duplex ultrasound, talk with your vein doctor.

 

 

How to Get Rid of Varicose Veins

Millions of Americans suffer from varicose veins, those large, swollen, ropy veins that are typically dark blue or purple in color. The Society for Interventional Radiology estimates that 15 to 25% of adults have varicose veins, with rates jumping to half of all adults over age 50. The good news is that there are effective ways to get rid of varicose veins. Learn how lifestyle changes can decrease your risk of future varicose veins while effective vein clinic treatments can get rid of existing vein problems.

 

How to Lower Your Risk of Getting Varicose Veins

Your veins traverse the length of your body, delivering deoxygenated blood back to the heart to be replenished with nutrients. Veins rely on blood pressure and special valves to keep blood flowing the correct direction. When the walls of the veins become thinner or weak, they tend to bulge outward and have difficulty pushing blood toward the heart. This is particularly problematic for the long veins of your legs, which must deliver blood from your feet back up to the heart.

 

Certain lifestyle factors make it more likely that you will develop varicose veins. If you want to prevent varicose veins from forming, try the following suggestions:

 

  • Do not stand or sit for long periods of time. People who are constantly on their feet at work, such as factory line workers or baristas, are more likely to have blood pooling in their legs. Whenever possible, keep moving to promote better blood flow.

  • Elevate your legs. Sleeping with a pillow under your ankles can keep blood flowing efficiently.

  • Lose weight. People who are overweight or obese tend to put a greater strain on their cardiovascular systems. Losing weight lowers your risk of varicose veins.

  • Exercise. Physical activity improves muscle tone and vascular health. Additionally, moving more frequently keeps your blood pumping properly through your veins.

 

How to Get Rid of Varicose Veins

Although lifestyle factors can make it less likely that you will get varicose veins in the future, the veins you have cannot be removed through lifestyle changes alone. Fortunately, there are many safe and effective treatments to get rid of varicose veins. For example, VNUS Closure and endovenous laser treatment (EVLT) use radiofrequency and laser energy, respectively, to close affected veins. The veins are then reabsorbed by the body. Another treatment, called sclerotherapy, collapses veins using a special chemical. In contrast, ambulatory phlebectomy involves the manual removal of the vein through a tiny incision.

 

There are pros and cons to each of these forms of treatment. That is why it is important for you to talk to your varicose vein specialist today. Together, you can determine what type of treatment makes the most sense for you and create an individualized treatment plan.

Understanding Your Vein Treatment Options for Varicose Veins

Varicose veins are a sign of venous disease, in which the body’s veins can no longer effectively transport blood back to the heart to receive more oxygen. Fortunately, varicose veins can be treated by a vein specialist. As a patient, however, it can be confusing to understand all of the varicose vein treatment options available to you. Knowing the pros and cons of each approach can help you talk to your doctor and arrive at a treatment plan that is best for you.

 

Vein Treatment Options for Varicose Veins

Ambulatory Phlebectomy

Phlebectomy refers to the practice of stripping out veins and has been practiced for hundreds of years. Today, varicose vein specialists practice a form of this treatment called ambulatory phlebectomy. Ambulatory phlebectomy involves the creation of a tiny incision, allowing veins to be extracted using a hook-like instrument. Patients must wear compression stockings for at least two weeks after the procedure to prevent complications. This procedure is particularly beneficial for large veins.

 

VNUS Closure

VNUS Closure is a non-invasive procedure in which your vein doctor inserts a tiny catheter into the affected vein, allowing radiofrequency (RF) energy to be targeted at the vein walls. This causes the vein to collapse and become reabsorbed. One of the greatest benefits of this approach is that it is non-invasive and results in minimal discomfort or scarring.

 

Endovenous Laser Treatment

Like VNUS Closure, endovenous laser treatment (EVLT) involves the application of energy directly to the vein. In this case, it is laser energy that is applied, creating heat that collapses vein walls. EVLT typically takes less than one hour and is very effective in treating varicose veins, making it a popular vein treatment option.

 

Sclerotherapy

Sclerotherapy involves the application of a special chemical, called a sclerosant, into the varicose vein. This chemical causes the vein to collapse, allowing the body to reabsorb the tissue. The chemical is injected through a tiny needle, making this procedure non-invasive and associated with very little bruising. Patients typically resume their normal activities within a day or two of this treatment.

 

Ultrasound Guided Sclerotherapy

A more state-of-the-art form of sclerotherapy relies on ultrasound to guide placement of the chemical agent. This is particularly useful for veins that are deep below the skin’s surface, making it challenging to precisely pinpoint their location. In ultrasound guided sclerotherapy, ultrasound imaging is first used to identify the vein location. Then, this information guides the injection of the sclerosant to ensure precision and accuracy of results.

 

After you make an appointment at the Columbus Vein Center, you will receive a comprehensive evaluation to determine what vein treatment options are most appropriate for your situation. Ask your vein doctor plenty of questions to arrive at a treatment plan that works for you.

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