When people have venous disease, the valves inside your veins become damaged.
As a result, the valves may not close completely, allowing blood to leak backward or flow in both directions. This can cause varicose veins, blood clots, and generalized discomfort interfering with daily activities. What are the risk factors for chronic venous insufficiency?
Symptoms of Venous Insufficiency include:
Swelling of the legs or ankles (edema)
Pain that gets worse when you stand and gets better when you raise your legs.
Aching, throbbing, or a feeling of heaviness in your legs
Thickening of the skin on your legs or ankles
To diagnose chronic venous insufficiency, your doctor asks about your health history to determine the extent of your symptoms.
To diagnose chronic venous insufficiency, your doctor asks about your health history to determine the extent of your symptoms. He or she also performs a physical exam to look for swelling, skin changes, varicose veins, or ulcers on the leg. Your doctor may also recommend certain diagnostic imaging tests.
Nonsurgical treatments include sclerotherapy and endovenous thermal ablation.
Sclerotherapy involves the injection of a solution directly into spider veins or small varicose veins that causes them to collapse and disappear. Several sclerotherapy treatments are usually required to achieve the desired results. Sclerotherapy is simple, relatively inexpensive, and can be performed in the doctor’s office. Sclerotherapy can eliminate the pain and discomfort of these veins and helps prevent complications such as venous hemorrhage and ulceration. It is also frequently performed for cosmetic reasons.
Endovenous thermal ablation is a newer technique that uses a laser or high-frequency radio waves to create intense local heat in the affected vein. The technology is different with each energy source, but both forms of local heat close up the targeted vessel. This treatment closes off the problem veins but leaves them in place so there is minimal bleeding and bruising. Compared with ligation and stripping, endovenous thermal ablation results in less pain and a faster return to normal activities, with similar cosmetic results.
For the less than 10 percent of patients who require surgical treatment, the options include vein ligation and stripping, microincision/ambulatory phlebectomy, and bypass surgery. Here is a brief review of each of these techniques. Your doctor can recommend the treatment that is most appropriate for you.
Ligation and stripping often are performed in combination. Vein ligation is a procedure in which a vascular surgeon cuts and ties off the problem veins. Most patients recover in a few days and can resume their normal activities. Stripping is the surgical removal of larger veins through two small incisions. Stripping is a more extensive procedure and may require up to 10 days for recovery. It usually causes bruising for several weeks after surgery.
Microincision/ambulatory phlebectomy is a minimally invasive procedure in which small incisions or needle punctures are made over the veins, and a phlebectomy hook is used to remove the problem veins.
Vein bypass in the leg is similar to heart bypass surgery, just in a different location. It involves using a portion of healthy vein transplanted from elsewhere in your body to reroute blood around the vein affected by CVI. A bypass is used for the treatment of CVI in the upper thigh and only in the most severe cases when no other treatment is effective.