About Varicose Veins
Varicose Vein disease is a disease of pressure. The hallmark of varicose vein disease is valvular incompetence with reflux.
About 60% of the U.S. population have some degree of varicose veins.
The Peripheral Heart
During the act of walking, muscles of the calf contract and relax. With contraction, the blood in the deep venous system is squeezed towards the heart. With muscle relaxation, the veins dilate and create a suction phenomenon, which draws blood into the veins. This system of squeezing and filling is similar to the heart giving rise to the term peripheral heart.
The Need for Competent Valves
Like the heart, the lower extremity venous system needs competent valves to control pressure and regulate blood flow. Leaking, or incompetent valves allow blood to reflux (flow the wrong way). This results in high venous pressure. The high venous pressure causes varicose veins, reticular veins, and spider veins.
Abnormal Venous Return
Superficial vein walls lack the strength to withstand high pressure. The increased pressure causes the veins to dilate and become tortuous. The recirculation of deoxygenated blood filled with metabolic waste products further damages the tissues and skin of the legs. Ultimately, the tissue gets firm, discolored and may break down resulting in painful ulcers.
Causes of Varicose Veins
- Gender
- Posture
- Height/Weight
- Occupation
- Hormones (Estrogen, Progesterone, Pregnancy)
- Primary Valvular Incompetence
- Decreased Number of Valves
- Aging
- Incompetent Perforating Veins
- A-V Malformations
- Vein Wall Weakness
- Secondary Valvular Incompetence (Phlebitis, DVT)
Varicose Vein Treatment
At the Laramie Medical Spa and Vein Center we use a combination of Laser and Sclerotherapy to treat venous disease.
The keys to successful treatment of varicose vein, reticular veins, and spider veins:
- Treat the highest point of reflux first
- Treat Larger Veins before treating smaller ones.
- Apply Pressure
Reflux in the Great Saphenuos Vein (the largest varicose vein) is treated best by a method called endovenous laser ablation (EVLA).
This method allows the placement of a laser into the diseased vein through 2-3mm incision. The vein is then sealed by destroying the lining of the vein with the energy emitted from the laser. Long segments of vein (30-45cm) can be treated with this minimally invasive technique with little or no down time.
Reflux from perforator and reticular veins are best treated by injection with a sclerosant. A sclerosant is a medicine that damages the lining of the vein, causing it to seal and ultimately be reabsorbed by the body. Deep veins require ultrasound guidance to get the sclerosant into the vein.
Spider Veins are the "tip of the iceberg" and should be treated after the larger venous tributaries are treated. Spider veins can be treated with a surface laser or sclerotherapy. Laser treatment of spider veins alone fails to treat the underlying cause of the spider veins, and usually results in early recurrence.
Potential Complications of Sclerotherapy
As with any medical procedure, there may be complications associated with sclerotherapy. Complications are rare and they will be recognized.
The most common complications of sclerotherapy are:
- Localize urticaria
- Post-sclerotherapy hyperpigmentation
- Matting
- Pain
- Superficial Thombophlebitis
- Blisters
- Skin Necrosis
- Swelling
- Bruising
- Scarring
- Ankle Edema
- Systemic Allergic Reactions
- Vaso-Vagal Reactions
- Nerve Damage
- Localized Hirsutism
- DVT (Deep Venous Thrombosis)
- Arterial Injection (Rare)