Capitol Vein Blog

Thursday, March 15, 2012

Does the Location of Leg Varicose Veins Matter?

Patients sometimes ask why VNUS Closure, which treats varicose veins using a  catheter inserted near the knee, is the recommended treatment, when the only visible veins appear far lower on the surface of the leg. It helps for those patients to rethink treating their varicose veins as a whole-leg health matter, not just a surface condition.

In assessing varicose veins, the first step is an ultrasound scan of the leg to look at the direction of blood flow. The reason varicose veins appear on the lower leg is that the veins become unable to resist the downward push of gravity, and blood flows backward down the leg instead of upward.

Even though the most prominent veins patients notice may be in the lower leg, or even in the ankle, treating the cause of the problem is key to a long term successful result. If your ultrasound shows that you have reflux (backflow) in the veins of the upper leg, it is important to treat this before the visible calf veins are addressed.

VNUS Closure (now called the Venefit Procedure) is the best method to treat the upper leg vein, often followed by phlebectomy of the visible surface veins of the lower leg. Both procedures are typically covered by health insurance.

If you have questions concerning your varicose veins, see us for an evaluation at any of our Maryland, Virginia or West Virginia offices, and Dr. Rosenberg or Dr. McNeill will be happy to advise you.


Anonymous said...

I have gradually developed "prominent" veins in my legs. To clarify, these are not varicose or spider veins, but regular veins that have become larger and bulge out more than normal. I've gotten a full workup from a vein specialist, and ultrasound ruled out any problems with the deep veins in my leg. Because the full evaluation ruled out other problems, the doctor told me this is mainly a cosmetic issue. I was given prescription-grade compression stockings, but they're not always very practical, especially in hot weather. And they won't really fix the veins, just possibly stop/slow them from getting worse.

I might elect to have these veins treated with sclerotherapy. But I have a few nagging questions that no one has really answered to my satisfaction...

Once the prominent vein(s) are treated or removed, how does this affect blood flow in the remaining veins? Doesn't this just add to the burden of other veins that need to compensate for loss of blood flow in the treated veins? If so, doesn't this increase chances that those veins will also become more prominent eventually? Or are my prominent veins already doing a poor job of helping out with blood flow (in which case removing them wouldn't change the burden on other veins)?

Obviously, there's going to be a limit on how many superficial veins can/should be removed from the leg. Is there a standard guideline for determining this?

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