What Causes Varicose Veins During Pregnancy

The babycenter.com has a rather well written article on the risk of varicose veins during pregnancy. We know that women with varicose veins outnumber men by about 4:1, and much of this increased incidence has to do with the hormones progesterone and estrogen.

Both of these cause general relaxation of the small muscle cells which predispose to varicose veins.

Once the inner leg veins become unable to resist forces of gravity, then bulging, aching leg veins ensue. Treatment for this condition is best done with VNUS Closure, and this is occasionally followed by micro-phlebectomy or sclerotherapy. During pregnancy, use of medical grade support hose are very beneficial, as is continued exercise (as advised by your obstetrician) and limiting pregnancy weight gain if possible.

One issue I take with the article on babycenter.com is the statement that the large pregnant uterus puts pressure on the abdominal veins later in pregnancy, leading to the varicose veins. While this can occur is rare cases, it is the elevated hormone levels that really lead to the leg veins. This is evidenced by the appearance of many varicose veins in the leg during the first and second trimesters, before the uterus has attained its large size.

Questions pertaining to varicose veins can always be addressed to our staff at any of our four Maryland, Virginia, or West Virginia offices. Dr. Rosenberg and McNeill often teach about venous disease nationally and are happy to answer your questions.

Flying May Put You at Risk For Leg Blood Clots

A recent CBS News article, which discussed the risk of leg blood clots during long distance flights, presented some opinions that may be misleading - and Capitol Vein & Laser would like to offer some clarification.

The article suggested that sitting in window seats increases the risk of clots because there is less chance of getting out of the seat and walking the aisle. Physicians quoted in the article correctly stated that the chance of getting a blood clot while flying is twice the rate in non-flyers, but the risk is still relatively low. However, patients with varicose veins also have an increased risk of blood clots associated with long flights.

Venous blood flow in the legs begins near the foot and ascends the leg toward the groin, against gravity. Prolonged sitting reduces the ability of the leg muscles to pump the blood up the leg, thus increasing the risk of slow flow and blood clots. One way to increase the flow in the veins is to exercise, which in a confined airplane means walking every few hours, or at least doing foot exercises while sitting. We know that the use of medical-grade support hose can reduce the risk of clot formation, and we strongly recommend that passengers on long flights use these garments, even if the passengers have a low risk of blood clots. 

The authors of the article seem to resist this recommendation, though they give no rationale for their comment. The vein experts at Capitol Vein & Laser strongly advocate that passengers on long flights use support hose to reduce clot formation and leg swelling. Once you land, there is no reason to continue using the hose, unless they make your legs feel better. 

While the stockings do not guarantee you won’t form a clot, they do help reduce your risk. If you have leg pain or swelling even after using the stockings, be sure to seek medical advice so that serious problems can be avoided or diagnosed and treated.

Dr. McNeill and Dr. Rosenberg are happy to discuss this further with you at any of the practice's four offices in Maryland, Virginia or West Virginia.

New Treatment Option for Varicose Veins

You may have read the recent article on FoxNews.com about a new method to treat varicose veins with a foamed agent. Capitol Vein & Laser participated in the clinical study that assessed whether Varisolve, the medicine referred to in the article, was safe and effective in treating saphenous vein reflux.

Reflux in this vein is the primary cause of lower leg varicose veins. The current optimal treatment uses VNUS Closure, which internally heats the vein, causing it to shrink and obliterate.

One advantage we noted in our Varisolve patients was the absence of any pain during the procedure. Delivering the medication was a bit more cumbersome than performing VNUS Closure, but there was no need for local anesthesia beyond the very first injection site in the leg.

We still believe that the results with VNUS Closure are outstanding, with little discomfort during the procedure, immediate recovery and excellent success. Currently, VNUS Closure is the best method to treat saphenous vein reflux, though as we rethink treatment for varicose veins in future years, Varisolve may play a role.

Varisolve may have promise as a future treatment for varicose veins, but the data presented to the FDA are still preliminary and additional clinical studies are required. It may be several years before the FDA approves this treatment for use in the United States.

Dr. Garth Rosenberg and Dr. Paul McNeill are recognized leaders in the management of venous disease, teaching on the national level and participating in significant clinical trials concerning new treatments for varicose veins. Either doctor can discuss the Varisolve study, or other questions related to your varicose veins, at any of the four offices in Maryland, Virginia or West Virginia.

Spider Veins During Pregnancy: What Can Be Done?

Spider veins during pregnancy can be a rather painful condition that seems to worsen as you approach term. Fortunately, these small surface thread veins are not usually a cause of serious medical problems, though the symptoms of aching, stinging and pain may be disconcerting.

The hormones of pregnancy (estrogen and progesterone) cause the previously painless veins to become a source of discomfort. These hormones, which allow your body to accommodate the baby, also work on the veins, leading them to enlarge and become more diffuse.

We do not advise intervention for spider veins during pregnancy, as there is an unknown potential risk to the fetus of any injected medication. Your best option during pregnancy is to use medical-grade support hose to the knee, thigh or waist, depending on the location of the spider veins. These garments give added compression to the small veins, reducing the discomfort.

Once you deliver the baby, your estrogen and progesterone levels drop quickly, and many of these painful veins will recede. However, they rarely disappear completely, and the postpartum period is the perfect time to address spider veins.

Sclerotherapy is the most effective and least painful way to rid your legs of these unattractive spider veins. The medications we use are highly effective and nearly painless. You should not wait until you're done having children. In fact, it is ideal to treat spider veins between pregnancies, so that succeeding pregnancies do not lead to the same or a worsening condition.

The vascular surgeons and nurses at Capitol Vein & Laser have many years of experience treating varicose veins and spider veins, and are always available to answer your questions.