aLL-inclusive vascular care

Healing Veins Is What We Do.

Reticular, Varicose or Spider Vein Concerns?

Considering that disfiguring vein problems affect 1 in 2 people over 50 and the fact that more women (whose legs may be more visible than men’s) are hampered by the problem than men, it’s no wonder that many people are eagerly seeking medical care for these very common problems.

Occurring mostly in the legs, these bulging, purple veins can appear in different parts of the body. The legs and ankles are most affected because blood is furthest from the heart at these points, meaning that they have far to travel back to the heart.

The valves in these extremities, furthermore, have a tendency to become weakened as people age, sometimes leading to venous insufficiency or reflux.
Age, however, is not the only cause of bulging, disfiguring veins. Other causes include:

EXCESSIVE STANDING/SITTING

CROSS-LEGGED SITTING

POOR DIET (EXCESSIVE SALT, FAT, ETC.)

PREGNANCY

OBESITY

INSUFFICIENT EXERCISE

WEARING EXCESSIVELY-TIGHT OUTFITS

GENETIC INCLINATIONS

HORMONAL IMBALANCES

TRAUMA

TREATMENTS

Sclerotherapy

Sclerotherapy

One of the most popular treatment options, Sclerotherapy involves using FDA-approved chemicals that help dry up/seal dysfunctional veins. The body naturally diverts blood to other healthier veins. Although more than one treatment may be needed, the veins disappear from sight.

Endovenous Laser Ablation (EVLA)

Endovenous Laser Ablation (EVLA)

This involves introducing a laser fiber which helps to deactivate and close off the offending vein(s). This procedure is quick and uncomplicated.

Ultrasound-Guided Chemical Ablation

Ultrasound-Guided Chemical Ablation

A strong chemical is injected into the vein using ultrasound guidance. Used mostly for deep-lying veins not amenable for lasers, this procedure effectively closes off bad veins.

Ambulatory Microphlebectomy

Ambulatory Microphlebectomy

Tiny incisions are made on the skin through which small sections of bad veins are withdrawn using tiny hooks.

Non-Thermal TREATMENTs

A variety of non-thermal treatment options are also available for varicose veins. These treatments include:

VenaSeal Cyanoacrylate:

Injects medical glue into the vein to cause closure.

Clarivein:

Guides a rotating catheter, which is a small, flexible tube, inside the vein to evenly disperse a chemical solution that results in complete closure.

Varithena:

A foam material is injected into a varicose vein to improve symptoms or appearance.

The main advantage of all of these techniques is the avoidance of multiple needle sticks for local anesthesia. There is also decreased risk for potential nerve damage that can occur with burns.

What are Varicose Veins?

Varicose veins are most often swollen, gnarled veins that most frequently occur in the legs, ankles and feet. They are produced by a condition known as venous insufficiency or venous reflux, in which blood circulating through the lower limbs does not properly return to the heart but instead pools up in the distended veins.

More than 25 million Americans suffer from venous reflux disease. The symptoms can include pain and fatigue in the legs, swollen ankles and calves, burning or itching skin, skin discoloration and leg ulcers. In less severe cases, thin, discolored vessels – “spider veins” – may be the only symptom.

Gender and age are two primary risk factors in the development of venous reflux. An estimated 72% of American women and 42% of men will experience varicose veins symptoms by the time they reach their sixties. Women who have been pregnant more than once and people who are obese, have a family history of varicose veins or spend a great deal of time standing have an elevated risk for the condition, but it can occur in almost anyone at almost any age. Varicose veins never go away without treatment and frequently progress and worsen over time.

Severe varicose veins can have a significant impact on the lives of people who work on their feet, such as nurses, teachers, and flight attendants. Research has shown that more than two million workdays are lost each year in the US, and annual expenditures for treatment total $1.4 billion.

What are SPIDER Veins?

Spider veins, also known medically as telangiectasia or venulectasias, are the mildest manifestation of venous insufficiency, similar to varicose veins but smaller. They are small, often tangled groups of tiny blood vessels just under the skin surface that frequently resemble spider webs or tree branches. They are generally red, blue or purple and are clearly visible, usually on the thighs, lower legs and face. Spider veins can sometimes cover large areas of skin, but they are a cosmetic problem only, rarely causing physical symptoms. At least a third of all women and a smaller percentage of men are believed to display the condition.

Spider veins are capillaries, thin vessels directly connected with the larger venous system, and like varicose veins they are caused by venous reflux. Spider veins may be isolated or associated with “feeder” veins or with larger underlying varicose veins, but they are not varicose veins – they do not bulge above the skin surface and do not require medical treatment.

Spider veins can be diagnosed merely by sight. They tend to take on one of three characteristic patterns – a “sunburst” or spider-web pattern radiating outward from a central point, a “tree-branch” pattern, or a “matting” or linear pattern that may be nothing more than a set of thin lines. Even in the absence of physical discomfort, some physicians observing spider veins prefer to conduct ultrasound exams to determine the extent of the problem and the underlying causes of the condition.

Risk factors for spider veins are similar to those for varicose veins – age, heredity, pregnancy, hormonal changes, obesity and extended periods of standing – as well as sun exposure, particularly in fair-skinned people, and injuries to the skin surface. Some physicians believe that exercise, weight loss and the wearing of support hose and flat shoes instead of high heels can reduce the incidence of spider veins.

Spider vein treatments are non-invasive or minimally invasive and include sclerotherapy and laser procedures. They are considered cosmetic procedures and are not covered by health insurance or Medicare unless a more serious underlying condition is diagnosed.

FAQ

It is unclear if varicose veins can be prevented, but certain actions may help limit the disease’s progression and symptoms. Routine exercise, maintaining a normal weight, avoiding excessively long periods of standing or sitting, and the use of compression stockings may all help alleviate symptoms.

Spider veins are small veins near the skin surface and appear as webs of blue, purple or red. Heredity is a significant contributing factor in the development of spider veins. Other predisposing conditions include excessive sun exposure and prolonged standing. Spider veins may also be a sign of an underlying malfunction of the larger leg veins. In this case sclerotherapy may be required to achieve satisfactory results. While surface laser and sclerotherapy are effective at closing the veins present at the time of treatment; neither of these procedures stops the body from making new spider veins. Thus, over time, additional treatment may be required to maintain the cosmetic appearance. Spider veins are generally considered a cosmetic issue and medical treatment is not required.

The term ‘varicose veins‘ is often used to describe everything from smaller, spider veins (red or blue veins on the surface of the skin) up to true varicose veins (swollen, bulging veins with a rope-like appearance). Varicose veins are quite common, with one in three woman and one in five men experience problems. Varicose vein symptoms can include swelling, tiredness, heavy feeling, leg fatigue, leg pain, as well as burning and itching sensations.

Varicose veins are almost always associated with venous reflux. This occurs when the valves in the leg veins don’t work well, and backward blood flow causes pooling in the lower leg. Without treatment, the pressure this creates may increase over time and cause additional varicose veins and symptoms. People with a family history and who are older, obese or are pregnant may be at increased risk of developing varicose veins.

If you have underlying venous disease (e.g., venous reflux), the pressure created by backflow of blood and pooling in the lower legs may create a progressive condition that only gets worse with time. This may lead to additional spider veins and varicose veins, and in some cases can lead to swelling and venous ulcers at the lower calf and ankle. Only a trained vein specialist can effectively evaluate your spider veins or varicose veins.

Procedures like VNUS Closure/Venefit and ambulatory phlebectomy, when shown to be medically necessary, are commonly covered by Medicare and insurance providers. Sclerotherapy for spider veins is generally considered a cosmetic procedure and usually not covered. Consult your local insurance provider to determine your exact eligibility and coverage as well as cost.

Sometimes the same factors that helped to cause your first spider veins or varicose veins (e.g., family history, age, obesity, female hormones, etc.) will make you predisposed to develop additional vein conditions. If a specific vein is properly treated, it usually does not recur, but it is possible that other veins may become diseased. This is why it is important that even if you have what appear to be simple, cosmetic spider veins, that you consult a vein specialist who can determine if you have an underlying condition (venous reflux). If you do, and you don’t treat the cause of the problem, additional spider veins or varicose veins are likely to develop.

Procedures like sclerotherapy and Closure act to close down a faulty vein. The vein being closed is dysfunctional and is allowing blood to flow backwards and pool, so leaving it open only makes things worse. The body contains numerous other healthy veins that are still functional and can easily take up the additional flow. Treatment of the faulty veins almost always results in improved blood flow in the overall vein system.

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