Vein Disorders
You hear about them frequently. You can even see some of them through your skin. If you have varicose veins, spider veins or other venous disease, you are probably painfully aware of them. But how much do you really know about your veins? Do you know what role they play in your body’s everyday functioning—and therefore your health? It is important to know how the veins function to understand how vein disorders occur, are treated and can be prevented.
Vein Function
Veins are the blood vessels responsible for carrying blood to the heart, from all parts of the body. The blood receives help in combating the force of gravity from a series of one-way valves which move the blood through the veins. The valves function like curved doors, spaced at intervals along the inside wall of the vein. The valves open as blood flows toward the heart and then close to prevent the backward flow of blood.
When the valves are healthy (competent), they close tightly. When they are not healthy, (incompetent) they do not close completely and blood can then flow backward, pool inside the vein and cause the vein to dilate, meaning it swells or expands abnormally. This can lead to painful and sometimes serious medical conditions commonly known as venous disease. Some examples of venous disease are spider veins, varicose veins, venous stasis disease and thrombophlebitis.
Spider Veins
Spider veins are the least serious of the most common vein disorders. Spider veins are essentially smaller versions of varicose veins and are caused by blood pooling in the veins because the valves are not closing completely. Spider veins commonly appear during and after pregnancy as a small red or purple cluster of veins that are near the skin’s surface. Depending on how large or dark they are, they may appear unattractive but generally do not cause much discomfort.
Varicose Veins
Varicose veins are stretched, swollen veins that become that way because the valves do not close completely, and a significant amount of blood pools behind the valves. As the amount of pooled blood increases, the walls of the veins weaken. The dilation or ballooning of the veins can occur anywhere from the ankle to the groin. In addition to being unattractive, the condition that results from the valves functioning improperly and the weakened vein walls can be uncomfortable and even painful.
Venous Stasis Disease
Venous stasis disease occurs when incompetent valves cause blood to pool in the legs. Most chronic venous stasis disease results from lack of treatment or neglect of varicose veins, as well as deep vein thrombosis and/or phlebitis, which causes scarred valves that become incompetent. Because the valves are destroyed, venous blood pools in the lower third of the leg, which results in very high venous pressure in the ankle. Eventually, this high venous pressure may cause a venous ulcer through the skin.
Thrombophlebitis
Thrombophlebitis is an inflammation of the walls of a vein, which often results from a clot in the vein. The clot may partially or completely block the flow of blood. Thrombophlebitis can be caused by injury, stagnation of blood in a vein because of another disease or the blood’s increased tendency to clot. Sluggish blood flow increases the risk of developing thrombophlebitis because rapidly flowing blood is less likely to clot.
Who Suffers From Venous Disease?
Venous disease can affect anyone, but some people are more susceptible to certain types of venous disease. For example, women are three times more likely than men to have spider or varicose veins. Varicose veins also have a tendency to run in families. Other risk factors for varicose veins include age, obesity, pregnancy (pregnant women are more likely to develop spider and/or varicose veins) and extreme height. People with jobs that require them to stand for long periods often develop varicose veins as well.
Thrombophlebitis is more likely to occur in people who have had surgery, a baby or a long-standing illness requiring bed rest and inactivity. It is also more common in older people.
Symptoms
Vein problems are often hereditary and may reoccur periodically so it is important not to neglect the early signs of varicose veins, ulcer formation or even
troublesome spider veins. Neglect and lack of treatment can lead to long-term disability. In the case of varicose veins, the symptoms depend on the size and type of varicose veins in the legs. A feeling of heaviness in the legs is a common early symptom. Other symptoms include a feeling of fatigue in the leg muscles, aching in the legs, ankle swelling at the end of the day, skin discoloration, tenderness and soreness along the veins and night time leg cramps.
With venous stasis disease, symptoms occur primarily in the lower leg and can include swelling, tenderness, skin discoloration, dry, scaly, itchy skin, skin ulcers and pain when standing that is relieved with elevation.
Thrombophlebitis symptoms vary according to the site and length of the affected vein. Patients may experience swelling, pain, fever, redness and warm skin. Severe obstruction of the vein may cause the skin in the affected area to look blue, and pulling the toes toward the knees may cause calf pain.
Diagnosis
Varicose veins, which have several different configurations, and venous stasis disease may be diagnosed by one or more of the following: 1) history and physical exam; 2) inspection of the legs in the standing position which will show the visible varicose veins; and 3) testing of the venous system with venous imaging and venograms (an X-ray study).
With thrombophlebitis, ultrasound imaging is used to examine blood flow in the veins and can reveal whether the thrombophlebitis is in a surface or a deep vein. Thrombophlebitis that occurs in a vein near the surface of the skin is usually not dangerous. If the clot is in a deep vein, there is potential risk for it to break loose and travel to the lungs.
Treatment Options
Treatment for different types of venous disease, including varicose veins, can range from simple outpatient procedures to surgery depending on the type of disorder and its severity. The purpose of medical treatment is to prevent and treat complications and to relieve pain and discomfort. The Vein Center at the Arizona Heart Institute was created because disorders such as spider and varicose veins are not just a cosmetic problem, they are a vascular health problem. The physicians at the Vein Center are board-certified vascular surgeons who specialize in the treatment of vascular disease, including vein disorders.
Laser Ablation
Treatment for severe varicose veins used to involve complicated surgical procedures with lengthy recovery times. Fortunately, treatment methods have greatly improved because of laser procedures that eliminate the need for surgery and the long-recovery process. Lasers have been used effectively at treating other forms of
vascular disease for years. Now lasers are becoming the treatment of choice for venous disorders, including spider veins, varicose veins and more serious conditions such as venous stasis disease.
The vascular experts at the Arizona Heart Institute Vein Center use lasers to remove spider veins from the surface of the skin easily with little or no discomfort. For varicose veins, laser ablation can be used during a non-surgical, outpatient procedure. An ablation procedure is minimally invasive and requires only local anesthesia. A small catheter with a laser tip is introduced through a needle and passed up the length of the affected vein. The laser is “fired” several times inside the vein which causes the vein to collapse.
These outpatient laser procedures require only local anesthesia, no hospitalization and a minimal recovery period. Often they can be performed in the physician’s office. In many cases the patient’s activities will not be restricted and recovery time is quick. These procedures are also extremely safe and FDA approved.
Sclerotherapy
Sclerotherapy is a nonsurgical treatment for varicose veins involving the injection of a sclerosing solution into the veins to close them off completely. This outpatient procedure uses tiny needles, which cause a pricking sensation. Compression bandages must be worn for specified days after the injections. Several treatment sessions may be required.
Surgical Treatments
Surgical management of varicose veins consists of tying off and removing superficial veins just under the skin, a procedure called vein stripping. Sometimes veins are tied off without complete removal in a process called ligation. When the surface veins are removed or tied off, the flow of blood is rerouted to the deep veins, which carry the blood from the legs to the heart.
For venous stasis disease, surgical treatment includes removing dead tissue and skin grafting.
Other Treatments
Treatment of active deep vein thrombophlebitis may require hospitalization; however, “uncomplicated” cases can be treated on an outpatient basis. Blood-thinning medications may be prescribed along with bed rest; leg elevation; warm, moist compresses; and support stockings after the patient is permitted to walk. The affected area should not be massaged as this may dislodge the clot. Thrombophlebitis in a surface vein may be treated at home with short-term bed rest, leg elevation and warm, moist compresses.
Some basic medical treatments for varicose veins include wearing elastic bandages or support stockings; elevating the legs periodically; walking and swimming; avoiding prolonged standing; losing weight if needed; and not wearing constrictive clothing.
Treatments for venous stasis disease may include bed rest with the legs elevated; medications such as antibiotics for infections and diuretics to reduce swelling from fluid retention; and conscientious and frequent skin care.
Vein Function
Veins are the blood vessels responsible for carrying blood to the heart, from all parts of the body. The blood receives help in combating the force of gravity from a series of one-way valves which move the blood through the veins. The valves function like curved doors, spaced at intervals along the inside wall of the vein. The valves open as blood flows toward the heart and then close to prevent the backward flow of blood.
When the valves are healthy (competent), they close tightly. When they are not healthy, (incompetent) they do not close completely and blood can then flow backward, pool inside the vein and cause the vein to dilate, meaning it swells or expands abnormally. This can lead to painful and sometimes serious medical conditions commonly known as venous disease. Some examples of venous disease are spider veins, varicose veins, venous stasis disease and thrombophlebitis.
Spider Veins
Spider veins are the least serious of the most common vein disorders. Spider veins are essentially smaller versions of varicose veins and are caused by blood pooling in the veins because the valves are not closing completely. Spider veins commonly appear during and after pregnancy as a small red or purple cluster of veins that are near the skin’s surface. Depending on how large or dark they are, they may appear unattractive but generally do not cause much discomfort.
Varicose Veins
Varicose veins are stretched, swollen veins that become that way because the valves do not close completely, and a significant amount of blood pools behind the valves. As the amount of pooled blood increases, the walls of the veins weaken. The dilation or ballooning of the veins can occur anywhere from the ankle to the groin. In addition to being unattractive, the condition that results from the valves functioning improperly and the weakened vein walls can be uncomfortable and even painful.
Venous Stasis Disease
Venous stasis disease occurs when incompetent valves cause blood to pool in the legs. Most chronic venous stasis disease results from lack of treatment or neglect of varicose veins, as well as deep vein thrombosis and/or phlebitis, which causes scarred valves that become incompetent. Because the valves are destroyed, venous blood pools in the lower third of the leg, which results in very high venous pressure in the ankle. Eventually, this high venous pressure may cause a venous ulcer through the skin.
Thrombophlebitis
Thrombophlebitis is an inflammation of the walls of a vein, which often results from a clot in the vein. The clot may partially or completely block the flow of blood. Thrombophlebitis can be caused by injury, stagnation of blood in a vein because of another disease or the blood’s increased tendency to clot. Sluggish blood flow increases the risk of developing thrombophlebitis because rapidly flowing blood is less likely to clot.
Who Suffers From Venous Disease?
Venous disease can affect anyone, but some people are more susceptible to certain types of venous disease. For example, women are three times more likely than men to have spider or varicose veins. Varicose veins also have a tendency to run in families. Other risk factors for varicose veins include age, obesity, pregnancy (pregnant women are more likely to develop spider and/or varicose veins) and extreme height. People with jobs that require them to stand for long periods often develop varicose veins as well.
Thrombophlebitis is more likely to occur in people who have had surgery, a baby or a long-standing illness requiring bed rest and inactivity. It is also more common in older people.
Symptoms
Vein problems are often hereditary and may reoccur periodically so it is important not to neglect the early signs of varicose veins, ulcer formation or even
troublesome spider veins. Neglect and lack of treatment can lead to long-term disability. In the case of varicose veins, the symptoms depend on the size and type of varicose veins in the legs. A feeling of heaviness in the legs is a common early symptom. Other symptoms include a feeling of fatigue in the leg muscles, aching in the legs, ankle swelling at the end of the day, skin discoloration, tenderness and soreness along the veins and night time leg cramps.
With venous stasis disease, symptoms occur primarily in the lower leg and can include swelling, tenderness, skin discoloration, dry, scaly, itchy skin, skin ulcers and pain when standing that is relieved with elevation.
Thrombophlebitis symptoms vary according to the site and length of the affected vein. Patients may experience swelling, pain, fever, redness and warm skin. Severe obstruction of the vein may cause the skin in the affected area to look blue, and pulling the toes toward the knees may cause calf pain.
Diagnosis
Varicose veins, which have several different configurations, and venous stasis disease may be diagnosed by one or more of the following: 1) history and physical exam; 2) inspection of the legs in the standing position which will show the visible varicose veins; and 3) testing of the venous system with venous imaging and venograms (an X-ray study).
With thrombophlebitis, ultrasound imaging is used to examine blood flow in the veins and can reveal whether the thrombophlebitis is in a surface or a deep vein. Thrombophlebitis that occurs in a vein near the surface of the skin is usually not dangerous. If the clot is in a deep vein, there is potential risk for it to break loose and travel to the lungs.
Treatment Options
Treatment for different types of venous disease, including varicose veins, can range from simple outpatient procedures to surgery depending on the type of disorder and its severity. The purpose of medical treatment is to prevent and treat complications and to relieve pain and discomfort. The Vein Center at the Arizona Heart Institute was created because disorders such as spider and varicose veins are not just a cosmetic problem, they are a vascular health problem. The physicians at the Vein Center are board-certified vascular surgeons who specialize in the treatment of vascular disease, including vein disorders.
Laser Ablation
Treatment for severe varicose veins used to involve complicated surgical procedures with lengthy recovery times. Fortunately, treatment methods have greatly improved because of laser procedures that eliminate the need for surgery and the long-recovery process. Lasers have been used effectively at treating other forms of
vascular disease for years. Now lasers are becoming the treatment of choice for venous disorders, including spider veins, varicose veins and more serious conditions such as venous stasis disease.
The vascular experts at the Arizona Heart Institute Vein Center use lasers to remove spider veins from the surface of the skin easily with little or no discomfort. For varicose veins, laser ablation can be used during a non-surgical, outpatient procedure. An ablation procedure is minimally invasive and requires only local anesthesia. A small catheter with a laser tip is introduced through a needle and passed up the length of the affected vein. The laser is “fired” several times inside the vein which causes the vein to collapse.
These outpatient laser procedures require only local anesthesia, no hospitalization and a minimal recovery period. Often they can be performed in the physician’s office. In many cases the patient’s activities will not be restricted and recovery time is quick. These procedures are also extremely safe and FDA approved.
Sclerotherapy
Sclerotherapy is a nonsurgical treatment for varicose veins involving the injection of a sclerosing solution into the veins to close them off completely. This outpatient procedure uses tiny needles, which cause a pricking sensation. Compression bandages must be worn for specified days after the injections. Several treatment sessions may be required.
Surgical Treatments
Surgical management of varicose veins consists of tying off and removing superficial veins just under the skin, a procedure called vein stripping. Sometimes veins are tied off without complete removal in a process called ligation. When the surface veins are removed or tied off, the flow of blood is rerouted to the deep veins, which carry the blood from the legs to the heart.
For venous stasis disease, surgical treatment includes removing dead tissue and skin grafting.
Other Treatments
Treatment of active deep vein thrombophlebitis may require hospitalization; however, “uncomplicated” cases can be treated on an outpatient basis. Blood-thinning medications may be prescribed along with bed rest; leg elevation; warm, moist compresses; and support stockings after the patient is permitted to walk. The affected area should not be massaged as this may dislodge the clot. Thrombophlebitis in a surface vein may be treated at home with short-term bed rest, leg elevation and warm, moist compresses.
Some basic medical treatments for varicose veins include wearing elastic bandages or support stockings; elevating the legs periodically; walking and swimming; avoiding prolonged standing; losing weight if needed; and not wearing constrictive clothing.
Treatments for venous stasis disease may include bed rest with the legs elevated; medications such as antibiotics for infections and diuretics to reduce swelling from fluid retention; and conscientious and frequent skin care.
Improving Vein Disease
If you already have some form of vein disease in your legs, there are steps you can take to improve your condition. Some of these tips can also be used for the prevention of spider veins, varicose veins and other vein disorders.
1. Stay active.
Regular exercise helps improve your circulation. If you already have venous disease, get your physician’s permission first before beginning an exercise program. When lying in bed or traveling for prolonged periods, move your feet up and down and rotate your ankles to make foot circles. When you do this, the calf muscles pump blood in the direction of the heart and may result in less pooling. Being active and eating a low-fat balanced diet will also help you control your weight. Obesity is a common cause of circulation problems, including vein disease.
- Avoid standing or sitting in one position for a long
period of time – this makes blood pool in the legs.
- Do not sit with your legs crossed.
- Raise up on your toes several times an hour – again, this flexes the calf muscles and helps push the blood toward the heart.
- Shift weight from one foot to the other while standing.
- Elevate your legs several times a day for 10 to 15 minutes. At work, set aside rest periods for leg elevation. It is best to raise the legs higher than the level of the heart. If possible, try lying on the floor with your legs on a chair or against the wall.
2. Avoid injury to the legs & feet.
- If you do become injured, treat it correctly. Cover any wound with a plain, sterile gauze pad. Do not apply any ointments.
- Report all injuries to your doctor.
3. Inspect your legs & feet every day.
- Check for redness, dry skin, blisters and/or cracks and calluses, which may allow bacteria to grow and
infection to form. You may develop breaks in your skin that you can’t feel. Use a mirror to check the soles of your feet.
- See your doctor about any foot problems.
4. Keep legs & feet clean, soft & dry.
- Wash daily with mild soap and lukewarm water.
Dry thoroughly with a soft towel, especially between
the toes.
- Apply lanolin, a similar mild cream or a skin lotion that does not contain alcohol to prevent dry, cracked skin.
- Dust your feet with powder to control perspiration.
- Wear clean, absorbent socks or stockings, preferably cotton or wool. Change your socks every day.
5. Choose appropriate clothing.
- Wear support stockings at all times when you are awake. You may remove them before you go to sleep.
- Do not wear girdles, garters or socks that have tight elastic bands, or other tight clothing that restricts your circulation.
- Buy shoes at midday when your feet are slightly swollen (they will have swollen too much by evening). Shop for shoes at stores that employ experienced salespeople; you’ll get a better fit.
6. Do not smoke.
- Tobacco smoking narrows the blood vessels, further restricting blood supply to the skin.
Trust your legs-and your veins-to the vascular specialists at Arizona Heart Institute. Call the Vein Center at 602-240-6150.
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Arizona Heart Institute
2632 N. 20th St.
Phoenix, AZ 85006
(602) 604-5123
The information presented in this site should not replace the medical advice of your physician.
You should not use this information to diagnose or treat any disease
without first consulting with your physician or other healthcare provider.
