Venous insufficiency is a health condition that affects the veins. It prevents them from transporting blood from the legs to the heart. Chronic venous insufficiency can cause extremely severe symptoms, including venous ulcers or wounds. Also called venous reflux, venous insufficiency is a disease that continues to progress as long as the victim fails to seek medical help at the leading varicose vein treatment center. According to research, 10 times more people live with a venous reflux disease than a peripheral arterial disease here in the U.S. Thus, the condition is currently considered a health problem rather than just a cosmetic issue. Thus, victims should be treated not only because they feel embarrassed by the appearance of their leg veins but also to stop a dangerous disease. Besides sclerotherapy injections, symptoms caused by the venous disease can be cured through endovenous ablation procedures.
Stripping surgery is an option, but it is no longer offered prior to other less invasive techniques. One thing people who live with varicose veins (a symptom of venous reflux disease) should know is that these are only going to worsen overtime. And as they do so, their quality of life will be greatly undermined. The bigger effect of this is that several workdays will be skipped by the victims every year, a big blow to employers. Note that around twenty-five million people in the U.S have this condition and about seven million of them display symptoms of chronic venous insufficiency. About seventy-two percent of ladies and forty-two percent of guys are anticipated to have developed varicose veins by the age of sixty years. That’s because varicose veins development is highly dependant on aging and gender.
How venous reflux develops
To understand how this disease develops, you should first know the structure of your legs’ venous system. Its anatomy consists of deep veins and superficial veins like saphenous veins. Superficial veins and deep veins are linked together by the perforating veins at the ankle, knee and mid-thigh. When blood is travelling back to the heart, three main factors must exist. First, there must be healthy vein valves that must close fully to stop blood from leaking and pooling in the vein. Secondly, the calf muscle pump’s action should compel blood towards the heart. Lastly, the movement of your diaphragm must create negative pressure that boosts the return of the deoxygenated blood to the heart. If one has a chronic venous insufficiency condition, the blood will leak rearward and pool in a leg vein.
Venous reflux manifests in the form of varicose veins, heaviness and tiredness in legs, swollen ankles, itchy veins, cramping pain and/or spider veins. If a victim fails to seek varicose vein treatment, the condition starts to get chronic. Eventually, it causes more severe symptoms such as odema that affects the entire lower leg, venous ulcerations, changes in skin color and texture, vein inflammation and bleeding and so on. After the development of venous insufficiency, veins dilate and enlarge and this ultimately stops the valves from closing properly. This results in refluxing, which is the pooling of blood in veins.
If valves are absent or totally damaged, the reflux problem tend to be worse. Moreover, if varicosities (varicose veins or varices) are untreated, they will worsen sooner or later. Once the advanced level of chronic venous insufficiency appears, most of the worst symptoms will be present. That’s why seeking early medical intervention is recommended, as you will be treated via sclerotherapy or another less invasive method.
These appear when one has a venous insufficiency condition without their knowledge. They are superficial veins that have enlarged because of increased pressure triggered by faulty valves. If left untreated, they worsen and trigger other problems. Varices are usually swollen, twisty, big veins that appear unattractive. They are more visible than spider veins and reticular veins. If varicose vein treatment is sought early, the blood circulation health in that particular part of your leg can be restored. For this to happen, you must go through a rigorous physical assessment and undertake a duplex ultrasound test. Some people have a bigger risk of developing a venous reflux disease and its major symptom–varicose veins.
To begin with, anyone who has entered old age is likely to develop spider veins and/or varicosities. Those who have family members with these conditions are even more likely to develop them before reaching old age. As aforesaid, females tend to develop venous reflux symptoms more than males because of their hormonal activities throughout their reproductive years. If you have had DVT (deep vein thrombosis) in your legs before, chances that you will have varices are high. Obese people and those who sit down or stand up for several hours are equally at risk of having varicose veins. As a person who might have noticed some signs of chronic venous insufficiency, you should extremely careful.
Seek help from the top vascular doctor like Dr. Namrata Khimani as soon as possible. Signs such as a dull ache, heaviness and cramping in legs that don’t go away should raise a red flag. If there is itching, tingling and pain that gets worse when you stand up and gets better when you elevate your legs, you should be almost sure that you could soon develop varicose veins. In case all the abovementioned symptoms are present, plus spider veins, seek varicose vein treatment right away. Sclerotherapy can be used to eradicate your spider veins and stop a reflux disease that hasn’t reached its chronic stage. If you notice all the above and fail to react, skin changes in legs will appear overtime. These include:
- Stasis dermatitis. This is a skin condition that is often accompanied by swollen, red, weepy or crusted skin.
- Larger, swollen and twisty varicose veins
- Ulcers or open wounds that take too long to heal and most covering ankles or the area above them.
- Skin will thicken and harden on ankles and legs, a condition called lipodermatosclerosis.
- Skin that gets easily irritated when scratched.
If you have all or some of the signs we have mentioned all through this article, ensure that you seek varicose vein treatment as soon as possible. A vein doctor will examine you physically and run some tests on you to find out whether your veins have a reflux problem, a different health condition or both. He or she will make their diagnosis based on how your leg veins appear when you are standing up or sitting down with your legs hanging down. A duplex ultrasound of legs might be requested to find out how blood circulates in your veins and to make sure there are no blood clots. If the results are positive, then your doctor will determine the best way to treat your chronic venous insufficiency problem.
Varicose vein treatment options, including sclerotherapy
A vein specialist must be accurate and careful when selecting a vein treatment method. They must base their decision on factors such as the size of your varices, how extensive the area they have attacked is and whether you have an existing health condition that might hinder a given varicose vein treatment technique. It is extremely important to tell your doctor about the drugs you are currently taking or whether you have a history of blood clots. If they feel that your vein condition is manageable without their medical intervention, they will offer the following suggestions:
- Exercise daily to lose weight, as being overweight is often known to worsen a vein problem.
- When working, take consistent breaks to avoid standing or sitting down for several hours. Being in a dormant working posture the entire day can interfere with the blood circulation and cause pain, swelling, heaviness and fatigue.
- Raising your legs after work to reduce swelling around the ankles and boost blood circulation.
- Show you how to care for the wounds, if they are present.
- Wear medical-grade compression stockings to enhance your blood flow. These are known to compress legs in a way that allows the blood to move towards the heart. As a result, your legs will stop swelling and this will protect you from blood clots.
- Provide some drugs to help you manage the discomfort triggered by chronic venous insufficiency.
In case your varicose veins specialist thinks that your problem is serious and must be solved, he or she will decide whether you need to undergo sclerotherapy or another therapy that is minimally invasive. That is if your leg pain is too much that it makes your legs heavy and/or tired. Moreover, proper varicose vein treatment is necessary if you have skin ulcers or lipodermatosclerosis. The options your vascular expert might recommend are:
- Sclerotherapy – This technique generally involves injections with a saline or chemical solution (scelerosing agent) that damages the problematic vein. As soon as the solution is injected into a vein, it begins to harden and close. Eventually, the vein disappears and gets re-absorbed by the body. This therapy is ideal for spider veins removal, although the modern foam sclerotherapy is advanced enough to successfully treat larger varicose veins.
- Endovenous ablation procedures – These techniques, just like sclerotherapy, are minimally invasive. One of these is radiofrequency ablation (RFA) and it is such a common technique for removing large varicose veins. The doctor uses heat to destroy the damaged vein. RFA is a catheter-based method that leads to the formation of a fibrous scar tissue afterwards. This technique is over ninety-five percent effective. The other method is endovenous laser ablation (EVLA) and it is ideal for the removal of small to medium-size varicose veins. It is a less invasive varicose vein treatment method that uses light to damage a vein. Like RFA, EVLA is super effective and ideal when a long recovery period is undesirable.
- Phlebectomy – This method entails small surgical incisions that enable the doctor to remove the damaged vein. As the incisions are small, the healing time is shorter than the one experienced by people who choose vein stripping surgery.
While stripping surgery or ligation is an option, it is hardly picked when the other therapies can work. As the entire superficial saphenous vein, a big vein, is removed, the side effects are bad. Victims take a whole month or longer to recover fully and resume their daily chores.
The worst complication of chronic venous insufficiency
As aforesaid, the venous reflux disease keeps on growing when it is not treated early enough. It therefore leads to complications that are difficult to treat. The worst of all is probably venous ulcers (also varicose ulcers, stasis, or insufficiency). These are real open wounds that are so difficult to cure and develop along your medial or lateral leg. Due to constant blood pooling triggered by chronic venous insufficiency, pressure mounts to a point of stretching the vein walls. In return, the stretched out walls allow proteins in the blood and blood cells to leak into the subcutaneous tissues that eventually disintegrate due to lack of oxygen and proper nutrients. This leads to the formation of ulcers that hurt a lot and don’t heal quickly. When these open wounds form you can tell. As they start to form, scaling and erythema of the lower leg, statis dermatitis, might be present. As well, hemosiderin staining might happen, triggering yellow and brown patches under the skin.
Additionally, dark red or purple skin changes might be seen due to blood leaking and seeping into the surrounding tissue. And when an ulcer is actively forming, there will be shallow, big wounds with uneven margins. These will form on your lower leg or ankles. An ulcer tends to have a red base and it can ooze blood if the infection is too serious. If the wound is infected or swollen, there will be pain and if not the wound will be painless. The whole leg might swell while the skin might turn reddish brown and firmer. Make sure you always elevate your leg to reduce pain and swelling. Above all, follow the instructions provided by the right varicose vein treatment doctor like Dr. Khimani. She is a Harvard Medical School resident and fellow who is known for her prowess when it comes to handling chronic venous insufficiency disease.