Varicose Veins …. A New Approach
By Dave Roberts
Varicose veins and spider veins are often mischaracterized as a cosmetic problem. Actually, they are a sign of an underlying disorder of the circulatory system called venous insufficiency. By age sixty, 70% of women will suffer from this condition. Left untreated, it can lead to a chronic, debilitating, and sometimes limb-threatening condition. Unfortunately this disease process is under-diagnosed and under-treated. Sadly, many patients opt for treatments that address only the superficial appearance of veins only to find that the veins reappear. Some superficial, skin deep treatments leave the veins worse than before treatment and cause the skin to appear blotchy or discolored. The underlying cause is never considered, diagnosed, or properly treated. Modern treatment of this age old problem can now be accomplished with an array of minimally invasive techniques in an outpatient setting.
Varicose vein disease afflicts women with twice the frequency as men. Many of my patients comment that the first veins became visible or worsened during the third trimester or in the peripartum. This is the result of being gravid and living with gravity. A woman’s blood volume will increase significantly during pregnancy. Veins act as the storage vessels for the extra blood volume. That extra blood late in pregnancy can overwhelm the veins below the heart, and damage the valves within the leg veins that normally function to protect the skin veins below. After delivery, some women are fortunate as these valves snap back and function properly; however in many others the valves continue to malfunction. The blood in the leg veins does not flow properly back to the heart. Instead, gravity pulls that blood downwards, and ultimately causes the skin veins to bulge.
Over time this unhealthy circulatory pattern can lead to tissue damage including swelling, dermatitis, and ulceration. As the blood is not flowing properly, the varicosities may clot, causing phlebitis, or they may rupture and bleed. Additional risks of untreated venous insufficiency include deep venous thrombosis and pulmonary embolism, a potentially fatal event. Patients with venous insufficiency may complain of aching, fatigue, itching or restless legs. Symptoms worsen at the end of the day. Relief is obtained with leg elevation, support stockings and pain medication. Because symptom onset is gradual, this disease may take decades to become apparent. All too often patients and physicians alike defer seeking care.
"Spider Veins" or telangiectasias may be an early sign of venous insufficiency that appear when tiny skin veins, previously invisible, become engorged and enlarge. We evaluate many patients who present for treatment of spider veins, who have had superficial injection treatments, only to see reappearance after 6-12 months. Worse still, some who opt for superficial laser treatments of leg spider veins exchange the veins for dark blotches in the skin. The underlying problem is never treated. A careful specialist ultrasound evaluation will usually show a deeper source vein.
A new outpatient treatment called the Closure? Procedure uses radio frequency energy to close the leaky source vein, and eliminate the major cause of varicose veins. With the Closure Procedure, a tiny catheter placed into the leaky source vein delivers a form of light energy to the vein wall. This energy causes collagen in the vein to change shape, closing the vein. This elegant procedure is completed in about an hour with minimal or no discomfort and a return to work or normal activity the same day.
Closure is covered by most all insurances and is performed in our outpatient surgienter devoted exclusively to vein care. Clinical studies have shown outstanding safety, efficacy, and patient satisfaction. Patients are delighted with symptom relief and cosmetic improvement, 98% of whom would recommend Closure for a friend.
Maryland Vein Professionals specializes in the treatment of varicose veins using the VNUS Closure Procedure, demonstrated to produce superior outcomes with literally no recovery time. Paid by insurance.