Vascular Disease

Venous disease affects millions of people around the world. It is a condition during which veins become enlarged due to various reasons and result in a number of symptoms. The most common symptoms are: leg pain, swelling, heaviness, especially at the end of the day, itching, night cramps, discoloration, and painful bulging veins. In later stages, patients may experience phlebitis (inflamed veins with redness and pain), lipodermatosclerosis (hardening and discoloration of the skin), and venous ulcers.

• There are a number of factors that can cause veins: genetics, fluctuating weight, prolonged periods of standing, prolonged periods of sitting with little to no movement, pregnancy

• Regardless of whether or not you have symptoms, ultrasound is still recommended as visible veins can be caused by insufficiency in the deeper veins that are not visible.

• In most cases varicose veins are not serious, but they do worsen over time if left untreated. This can then cause symptoms such as:

  Itching
  Pigmentation around the ankles
  Ulcers at the ankles or open sores
  Pain
  Swelling
  Cramping
  Aching
  Itching
  Heaviness or tiredness
  Restlessness

• The reasons for developing venous disease can be different. The most common ones are: hereditary – when your parents or close relatives have this issue; socio-economic – obesity, sedentary lifestyle or luck of exercise, jobs requiring prolonged standing (barbers, cashiers, baristas, nurses, surgeons, etc.). 

  In addition, venous disease can appear as part of other medical conditions, which lead to the elevation of venous pressure (heart conditions, etc.) or as part of cancer. Also, women are more prone to developing varicose veins than men because of female hormones and pregnancies.

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• Modern technologies have revolutionized the way venous disease is treated. To compare, a little over a decade ago, the treatment of venous disease was performed in hospitals and resulted in a long recovery period and could lead to many side effects. 

  Currently, due to the growth of improved technologies, such treatment has become a
  simple, minimally invasive in-office procedure with a quick recovery period and minimal side effects. Typically, this procedure will take around 30 minutes. We have even seen cases when patients have returned to their normal activities the same day.

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We get asked this question very often. There is no simple answer to this question.

Typically, the treated veins don’t come back. However, usually progressive varicose vein disease is seen in patients with genetic predisposition. Such patients may develop multiple new varicose veins. That is why we recommend having routine follow-ups with the treating physician so the new varicose veins can be diagnosed earlier and treated. 

Please note that predisposed patients that have healthy food habits and exercise have a lower chance of recurrent disease.

There are multiple ways to treat varicose veins. Among those are laser treatment,
radiofrequency ablation, mechano-chemical occlusion, treatment with Varithena (similar to sclerotherapy), sclerotherapy, and microphlebectomy. 

There is no such thing as better modality. They are usually used for different conditions. The only thing that matters is the experience of the physician and the crew. All the modalities can be successfully used in the hands of an experienced physician.  

We recommend that the patients get treatment in a clinic that has experience with all the different treatment modalities because a combination of multiple modalities may be needed for best results.

Radio Frequency and Laser Ablation are minimally invasive varicose vein treatment procedures that use heat to collapse and seal off the targeted blood vessels. The ablated vein becomes a scar tissue and is absorbed by the body.

• Advantages: Effective and safe procedures with low complication rate and short recovery time.
• Disadvantages: Tumescent anesthesia is used, which requires several injections to deliver a fluid around the vein.

Mechano-Chemical Ablation with ClariVein®™ is one of the newest endovenous ablation technologies. ClariVein®™ combines two approaches, involving the use of a mechanical device to
destruct the vein to be treated, as well a sclerosing agent. ClariVein®™ is performed using a local anesthetic with ultrasound visualization of the veins.

• Advantages: No tumescent anesthesia is needed; the procedure usually takes less time.
• Disadvantages: Requires the use of a sclerosant (medication) to seal the vein. As with all medications, allergic reaction can occur.

Sclerotherapy involves an injection of a solution (we use Polidocanol) directly into the vein.  The solution irritates the lining of the blood vessel, causing it to collapse and stick together forming a clot. With time, the clot is absorbed by the body.

• Advantages: Very popular and effective method to treat spider veins and larger veins that cannot be treated with other modalities.
• Disadvantages: Potential allergic reaction; staining (skin darkening) in some cases (especially in patients with lighter skin color).

Varithena® is a relatively new, nonsurgical minimally invasive method. Similar to
sclerotherapy, it involves an injection of a specially prepared solution (1%
Polidocanol) into a treated vein, which leads to collapsing of the vein and
forming a clot. With time, the occluded vein is absorbed by the body.

• Advantages: Nonsurgical, minimally invasive, and quick procedure.
• Disadvantages: Potential allergic reaction and discoloration.