Capitol Vein Blog

Wednesday, January 11, 2017

Pregnancy and Varicose Veins...Know the Risks

I just read a very interesting article in Venous Times discussing the risk factors for blood clots in women and pregnancy. We know that varicose veins increase the risk of venous thromboembolism (venous blood clots) because the flow in these large ropy veins is abnormal. The study in the Venous Times  confirms that within the first six weeks after delivery, clot risk remain high due to elevated hormone levels. As to the increased risk associated with varicose veins, we strongly believe that women with symptomatic varicosities should undergo evaluation and treatment between pregnancies, as opposed to waiting until she is done with all pregnancies. Each successive pregnancy causes more and more vein damage with exacerbation of symptoms and additive risk.

Not only will varicose vein treatment, usually with VNUS Closure or microphlebectomy, alleviate symptoms of aching, heaviness, throbbing and fatigue in the leg, it will also reduce the risk of phlebitis as blood flow is normalized.

The various office based procedures we use to treat varicose veins are all done under local anesthesia and allow immediate return to normal activity. Your medical insurance plan usually considers these treatments medically necessary because the risk of non-treatment is progressive vein enlargement with the potential for skin damage, skin ulcers and DVT.

Again, women in child bearing years should undergo varicose vein evaluation and treatment between pregnancies so further pregnancies are better tolerated. As vascular surgeons with many years of extensive experience treating venous disorders, both Dr. Rosenberg and Dr. McNeill are best suited to give you the thorough evaluation you need for optimal results.

Friday, December 16, 2016

Don't Neglect Your Varicose Veins

Varicose veins are caused by are not only unsightly, but cause leg pain, cramps, risk of blood clots and skin damage due to elevated pressures in the veins. Blood should flow up the leg against gravity, but as the one-way valves weaken, blood is forced downward from groin to foot. It's similar to inflating a balloon--as the air pressure is increased, the balloon inflates and deforms. Similarly, as the vein pressure is increased, the veins swell, enlarge and deform.

Fortunately, treatment is highly effective, long lasting and simply done in the office under local anesthesia. Importantly, your insurance plan often cover the treatment because we all recognize that if left untreated, varicose veins progress and increase the risk of longer term side effects. We see patients with these kind of veins come in with sudden blood clots (phlebitis) and rashes that could be prevented by treating these veins at an early stage.

Endovenous ablation with VNUS Closure is the "gold standard" treatment for saphenous vein reflux, the usual cause of varicosities. VNUS Closure lets us use a heated wire to shrink the refluxing vein, thereby establishing normal blood flow and circulation to the leg. Microphlebectomy is also used to remove small surface veins. The photo you see above is of a patient who underwent both procedures, and as you can see, the results are impressive.

A newer procedure, VenaSeal, allows us to seal the vein using a glue instead of a heated wire. The advantage of this is a couple of fewer needles for local anesthesia, but importantly, insurance does not cover this particular treatment. Insurance is actually quite good for the VNUS Closure and phlebectomy.

If you have concerns about your veins and have varicose veins that are bulging and unsightly, let us give you advice and management guidelines that will help prevent longer term problems.

Tuesday, August 16, 2016

Blood Clot Risk With Varicose Veins

I saw an interesting patient yesterday who came to the office complaining of two weeks of a progressively painful left leg. She has a many year history of mildly painful varicose veins and was discouraged to undergo varicose vein treatment by her family doctor who did not realize the potential risks that patients with varicose veins face. Varicose veins clearly present a medical problem and treatment is recognized as medically necessary by insurance payers.

By the time the patient saw me, she had a painful, swollen leg and tender hard varicose veins. Clearly, she had a superficial phlebitis of these large varicosities, but her venous duplex scan unexpectedly showed an extensive DVT that began as phlebitis in the varicose veins. This life threatening complication is a known risk factor complicating even mild to moderate varicose veins. I started her on Xarelto immediately and she will have a long course of blood thinners with potential long term effects of the blood clot.

It's important to understand that varicose veins involve disordered and turbulent blood flow that encourages clot formation. Commonly large surface varicose vein symptoms include leg pain, heaviness, fatigue, throbbing and even restless leg syndrome. However, both phlebitis and DVT are know complications that we hope to avoid by early treatment of varicose veins.

Saphenous vein reflux is the typical cause of varicose veins, and this is effectively and easily treated with VNUS Closure as well as VenaSeal and Clarivein, all of which are office based procedures performed under local anesthesia with immediate return to normal activity.

Patients should remain aware that varicose veins represent abnormal circulation in the leg, and treatment is very successful at preserving good leg health, a critical factor in maintaining a healthy lifestyle.