Symptoms | Diagnosis | Treatment
Venous disease is a broad category of conditions that affect veins within the body. The role of the venous system is to efficiently return blood back to the heart and lungs—an important part of the circulation of oxygenated blood through the body.
When valves in the veins that prevent blood from flowing backwards become weakened or damaged, allowing blood to pool in the veins instead of circulating efficiently, this is known as chronic venous insufficiency (CVI). This condition can result in swelling, aching or cramping in the legs or ankles.
When a blood clot forms in a deep vein (usually in the legs), it can partially or completely block the flow of blood through the vein. This is called deep vein thrombosis, and can cause swelling in the affected leg, pain, discoloration on the skin or leg heaviness or cramping.
When the right iliac artery compresses the left iliac vein in the pelvis, the flow of blood back to the heart slows down. This condition, known as May Thurner Syndrome, doesn’t always cause symptoms but swelling, leg pain or heaviness, varicose veins, skin discoloration and recurrent DVTs (usually on the left side) can occur.
Varicose veins are enlarged, twisted veins that typically appear just under the skin, and most commonly in the legs. They are caused by venous insufficiency, which develops when vein valves weaken or fail and allow blood to pool in the legs instead of flow back to the heart and lungs. In addition to being unsightly, they can cause swelling, aching or cramping in the legs and ankles.
The underlying issues that cause venous disease are typically damaged or weakened vein valves, obstructed blood flow and increased pressure inside the veins. Risk factors for venous disease include aging, family history, hormones, smoking, prolonged standing or sitting, being overweight, previous surgery or injury and pregnancy.
Symptoms usually develop gradually and worsen over time or after standing/sitting for long periods. These include:
The most severe symptoms can include chest pain, coughing up blood and a sudden shortness of breath. It this occurs, seek urgent medical attention.
Diagnosing venous disease typically involves one of the following:
A doctor evaluates your legs for the visible signs of venous disease, such as ulcers (sores), swelling or varicose veins.
This non-invasive test uses sound waves and a special computer to visualize the flow of blood through the veins to look for any abnormalities.
This test uses an x-ray and a contrast dye to evaluate blood flow. It is typically used for more complex cases and may also be used before deep vein treatment.
Often used to diagnose May Thurner Syndrome, this test uses ultrasound to precisely locate the source of vein compression and determine the extent of stenosis (blockage or narrowing).
The goal of treatment for venous disease is to relieve symptoms and improve circulation. Depending on the severity of the disease, one or more of the following approaches may be recommended:
These treatments can range from lifestyle modification (such as quitting smoking) to elevating the legs, exercising, losing weight or wearing compression stockings. In some cases, medications such as blood thinners, anti-inflammatory medications and antibiotics may be used.
For small varicose and spider veins, sclerotherapy may be used, which involves the use of the injection of a special medicine into the veins to collapse them. For larger varicose veins, endovenous laser therapy (EVLT), radiofrequency ablation (RFA) and non-thermal superficial venous sclerosant may be used to close off the affected veins. In more severe cases, endovascular repair treatments may be recommended.
Surgery is rarely used any longer to treat venous disease. It is appropriate when minimally invasive options are not suitable or if the disease is more advanced and has become life- or limb-threatening. These include vein “stripping” and bypass procedures. Ulcer surgery may be used in severe cases of chronic venous insufficiency.
At Pacific Vascular Access Care, we understand how the pain and inconvenience of venous disease can impact your life and happiness. We are a trusted provider of minimally invasive, outpatient vascular and interventional care and have extensive experience performing treatment procedures. We are committed to offering effective, non-surgical treatment options designed to restore your health and well-being.