Venous Disease —Scope of the Problem Vein Problems seen in 50-55% of females 40-45% of males Varicose veins present in 1 out of 2 people age 50 and older
What Are The Risk Factors For Varicose and Spider Veins?
Risk Factors for DevelopingVaricose or Spider Veins Family members with vein problems Increasing age Hormonal changes Puberty BCP’s Hormonal Replacement Pregnancy Obesity Leg injury Prolonged standing (weakens valves) Sun exposure (spider veins)
Why do Varicose and Spider Veins Usually Appear in the Legs?
Gravitational Pressure Can Overwhelm Vein’s One-Way Valves
Are Varicose and Spider Veins Painful or Dangerous?
Spider and Varicose VeinsSpider vv usually do not need medicaltreatment. But varicose vv usually enlargeand worsen over time.Severe varicose veins can cause healthproblems including: Blood clots Sores or skin ulcers Ongoing swelling and skin irritation/rashes
Common Symptoms ofVaricose Veins Aching pain Easily tired legs Leg heaviness/fatigue Leg swelling Darkening of the skin Numbness in legs Itching Irritated rash in legs Night cramps Restless legs Bleeding/skin breakdown
Prevention/Symptom Reliefof Venous Disease Wear sunscreen (prevents spider veins) Exercise to improve leg strength, circulation, and vein strength Control weight to reduce the pressure on your legs Elevate your legs when resting as much as possible
Prevention/Symptom Reliefof Venous Disease (cont.) Do not stand/sit for prolonged periods of time. Stand up and move around every 30 minutes Wear elastic support stockings Eat a low salt diet to reduce swelling Eat a high fiber diet to reduce constipation
Should I See a Doctor About My Varicose Veins?
See a PhysicianAbout Your Varicose Veins If: The veins become swollen, red, tender, or warm to the touch There are sores/rashes on the leg or near the ankle with the varicose veins You have bothersome symptoms as described above
Closure of Varicose Veins With Laser Fiber Inside Vein (Endovenous)
Endovenous Laser Closureof Varicose Veins Treatment for larger varicose veins of legs (saphenous veins) Successful in 98% of patients Performed in-office Well tolerated with local anesthesia Fewer complications with avoidance of general anesthesia Has replaced old procedure of ligation and stripping of varicose veins
PostoperativeEndovenous Laser Treatment Dress leg with compression bandage Walk for 20 minutes Compression stocking for 2–4 weeks Resume normal activities Anti-inflammatories for 2–4 weeks Over-the-counter pain medications (Ibuprofen)
Great Saphenous VeinPre-Treatment Pre-Treatment 1 WkWeek Post Treatment One Post-EVLT
Small Saphenous Vein Pre-Treatment 1 Wk Post-EVLTPre-Treatment One Week Post Treatment
Advantages of Endovenous LaserTreatment of Varicose Veins Lower treatment costs compared to surgery Minimal scarring Minimal down time Faster return to normal activity Excellent symptom relief Vein closure maintained with long term follow-up
Injection Sclerotherapy for Spider Veins Office procedure, no anesthesia Physician injects solution (Polidocanol) into vein that causes vein walls to swell, stick together, and seal shut Same vein may need to be treated more than once Most patients can expect 50-75% improvement Out-of-Pocket expense
Topical Laser Sclerotherapy for Spider Veins Topical laser beam sends burst of light through skin into vein to make vein slowly fade and disappear No needles, but heat from laser on skin can be painful 2-5 treatments/site generally needed Not effective for veins > ¼ inch diameter Out-of-Pocket expense
You’re (Not So) Vein —Conclusions Venous disease is an epidemic in the U.S. Most is inherited (don’t say your parents never gave you anything) Treat smaller (spider) veins with topical laser or sclerotherapy (out-of-pocket expense) Treat larger (varicose) veins with endovenous laser (usually covered by insurance for patients with symptoms)