Capitol Vein Blog

Monday, September 23, 2013

Early Evaluation is Key with Varicose Veins

Most patients who come see me for varicose veins and leg pain have small to moderate sized surface veins and relatively normal color and texture to the skin around the lower calf and ankle. These patients often have what is termed “C2” in the CEAP Classification of venous disease. 

However, some patients have developed varicose veins that progress to a more severe form of the disease, often classed as “C4” in CEAP.  This means they exhibit pigmentation of the ankle skin and thickening of the skin, medically known as lipodermatosclerosis.  These skin changes occur as the elevated venous pressures target the lower leg, with gravity forcing the blood back down the leg.  Small blood cells may leak from the capillaries. As these cells are broken down and resorbed, the iron pigment is deposited in the tissues, leading to the permanent color changes.

Once patients develop lipodermatosclerosis, and if they go untreated, venous stasis ulceration can form. This is an open sore, usually on the inner ankle area due to varicose veins. Because the progression from uncomplicated varicose veins to these advanced stages is hard to predict, we advise patients to seek evaluation when they begin exhibiting symptoms instead of waiting for complications, such as blood clots and skin changes.

An evaluation with either Dr. Rosenberg or Dr. McNeill is usually followed by a venous duplex scan, with treatment based on the scan results. The Venefit Procedure is highly effective in treating saphenous vein reflux, and occasionally microphlebectomy or sclerotherapy is needed as well. These procedures help normalize venous flow and reduce the pressure in the lower leg.

As venous insufficiency is a legitimate medical problem and not cosmetic, most insurance providers cover varicose vein treatment. For more information on this condition, please visit one of our Virginia, Maryland or West Virginia vein centers.


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