Understanding Varicose Veins & Venous Insufficiency

Ashchi Heart & Vascular Center PhotoMajdi Ashchi, DO, FACC, FSCAI, FSVMB, FABVM

Medical Director

Affecting over 25 million people in the United States, venous insufficiency, or varicose veins, can be caused by heredity, age, gender, pregnancy, life-style and occupation. Because venous insufficiency is a progressive disease, symptoms will worsen if left untreated.

Venous Insufficiency Overview

Venous insufficiency, or more notably varicose veins, is a condition in which the veins have a problem sending blood from the legs back to the heart. This happens through a combination of weakened vein walls, and faulty venous valves. Varicose veins are enlarged and twisted rope-like veins that appear near the surface of the skin. While veins anywhere in the body can become varicosed, the veins most affected are those in the legs, most notably on the calves and inner thighs.

Under normal circumstances one-way two cusp valves in the veins open and enable blood to flow upward and toward the heart. If the walls are weak and the valves faulty, the blood will pool in the lower leg creating a pressure build up which further weakens the veins, causing them to become twisted (varicosed), enlarged, and painful. Over time, the increased pressure can cause additional valves to fail. This venous reflux (leaking valves) or venous insufficiency, leads to the development of varicose veins and spider veins. An example of painful varicose veins found elsewhere in the body are hemorrhoids, which are simply varicose veins found in the anus.

Who is Affected?

If you suffer from venous insufficiency (leaking veins or valves) you are a member of a very large club, with over 25 million members nationally. Half of all Americans over the age of 50, and two-thirds of women, over 60 have this condition. Many factors can cause venous insufficiency, but main factors are heredity, age, female gender, number pregnancies, life-style, weight and occupation.

Signs and Symptoms

While in many cases venous disease may be seen on the skin surface, however, in many cases oftentimes they are not. Once again, even if you do not visually see varicose or spider veins on the surface of the skin, it is not indicative of what is happening underneath the surface. Therefore, symptoms often associated with venous disease include leg pain, heaviness, throbbing, swelling, itching, restlessness, fatigue, numbness, cramping and burning.

Small spider veins may actually be caused by larger veins, and large ropey superficial varicose veins may be a symptom of something larger.

As bad as they may look and feel, varicose veins and spider veins are not usually considered a serious medical problem. However, large varicose veins may indicate a critical blockage in deeper veins, a condition called deep vein thrombosis, that can be life threatening.

That is why it is important to meet with a doctor and a practice that dedicates itself to treating venous disorders such as Ashchi Heart & Vascular Center. Our technologists are trained to do the proper testing “Vein Insufficiency” ultrasound Doppler study which is painless, reproducible and non-invasive. The ultrasound Doppler classifies the insufficiency (leakage) on a scale of 0-3 or higher. Zero (0) being normal or no leakage with 1 being mild and 3 being severe insufficiency or leakage in the valve of the vein.

Treatment Options

Proper medical evaluation and treatment of varicose veins is important, because venous insufficiency is a progressive disease, symptoms will worsen if left untreated.

The evaluation includes a visual and physical examination of the legs and feet by a physician, who checks for inflammation, areas that are tender to touch, changes in skin color, ulcerations, and other signs of skin breakdown. These skin breakdowns are classified by your physician from one to six on a clinical, etiology, anatomical, and pathophysiological (CEAP) scale.

In most cases a special ultrasound test called a venous insufficiency duplex is ordered to determine if the valves in the veins are functioning properly, and to check for evidence of a blood clot. Based on the test findings, a treatment plan will be recommended by your physician to best treat this disease.

Basic to complex treatments are offered at Ashchi Heart & Vascular Center. Board Certified Cardiac & Vascular Specialist, Dr. Ashchi will attend to these treatment plans. Such treatment includes risk factor modification, compression stocking, laser or radiofrequency ablation of veins, sclerotherapy treatment, VenaSeal™ treatment, phlebectomy or in some cases a combination of any of these treatments. Each patient is treated on a personal level with the utmost compassion and integrity.

To find out if you are a candidate for treatment or for more information, please call Ashchi Heart & Vascular at (904) 222-6656.

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