Capitol Vein Blog

Friday, February 12, 2016

How To Avoid The Complications Of Varicose Veins

I saw this unfortunate woman in my Winchester, Virginia office yesterday with long term changes of venous stasis dermatitis due to varicose veins. As you can see, the red patch of skin near the ankle is quite large and causes her significant itching, tenderness and concern. She developed this over a year ago and has seen several doctors who have unfortunately misdiagnosed this as as simple eczema.

She finally saw a dermatologist who immediately recognized that the varicose veins in the lower leg were the direct cause of this condition, knows as venous stasis dermatitis. The only way to manage this effectively is precise treatment of varicose veins, the direct cause of the skin changes.

Normal venous flow in the leg is directed upwards against gravity, and the varicosities that you see in the calf are caused by weak one-way valves in the veins. As gravity is a constant pressure downwards, the weak valves allow pooling of blood in the lower leg, and this can cause the dermatitis, as well as skin ulcers, pain and swelling. Vein valve dysfunction is the cause of varicose veins.

We initially evaluate patients such as this with venous duplex ultrasound to give a road map of the entire leg venous system, as well as to assess for any associated blood clots. Once this information is available, we can then discuss optimal treatment. Most commonly, saphenous vein reflux is the cause of varicose veins. We use VNUS Closure, Clarivein and VenaSeal as office based modalities too eliminate the reflux and normalize venous flow.

In situations where there is extensive skin discoloration as seen in this patient's case, while we can help prevent a worsening condition, we cannot erase the skin changes. For this reason, the earlier we can intervene in varicose veins, the more likelihood the patients will have a normal appearing leg.

The experience of your treating physician should be an important criteria in your selection process. Be sure to seek the advice of a vascular surgeon expert in the evaluation and treatment of venous disease.

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