Going with the flow: Varicose vein treatment removes unsightly veins, improves blood flow
Special to The Union
For more information about the SNMH Vein and Vascular Clinic, call 530-274-6197.
Twisted, bulging, enlarged veins that can ache, burn, or throb … for as many as 20 million Americans, varicose veins are an uncomfortable fact of life.
The American Society of Vascular Surgery estimates that 33 percent of women and 17 percent of men are living with varicose veins. Some vein issues are simply cosmetic, while other problems can cause aching pain, discomfort and can affect mobility and quality of life. Left untreated, vein disease can lead to serious and significant problems.
The Vein and Vascular Center at Dignity Health Sierra Nevada Memorial Hospital provides treatment options for serious cases of vein disease, including painful varicose veins.
“Varicose veins are caused by a problem with the valves in some of the upstream veins,” explains radiologist Robert Crockett, MD. “The valves ordinarily prevent blood flow back down the legs, but malfunctioning valves allow venous blood to flow toward the feet, or allow flow from the larger veins in the center of the legs to the surface. The valves can malfunction because of injury to the valves, scarring from prior blood clots, over dilation from upstream compression such as in pregnancy, but usually from just not being made quite sturdy enough for the job.”
Dr. Crockett says varicose veins generally require treatment when they have significant symptoms such as swelling and pain.
“If the increased venous pressure from those abnormal valves persists long enough, the skin in the calf regions can start to break down,” Dr. Crockett says. “This causes skin darkening and scarring, and ultimately non-healing wounds or ulcers. If the skin over dilated varicose veins gets thin, these varicose veins can suddenly bleed, often briskly, causing a medical emergency. While these veins may be unsightly, our main concern is to alleviate symptoms and prevent progression of the disease to ulceration and bleeding.”
Unsightly veins that have no long-term disease risk and have no symptoms are considered cosmetic. Dr. Crockett says insurers typically will not cover these procedures intended to simply improve the appearance of the legs.
For people living with vein disease symptoms, Dr. Crockett will discuss the range of treatment options, beginning with simply watching the veins to see if the disease progresses to the point of requiring treatment.
This is preferred if the disease is mild and symptoms are minimal.
The next option is to wear compression stockings, using prescription, custom-fitted, medical grade compression stockings.
While these can be expensive, and bothersome to put on and wear, the stocking usually will cut patient swelling and pain quite a bit if the symptoms are originating from vein disease.
For those veins requiring interventional treatment, Dr. Crockett says there are a few options.
“We have three ways to treat abnormal veins – sclerotherapy, radio- frequency heating, and glue,” Dr. Crockett says. “The idea is to rough up or irritate the inside of the underlying culprit veins with a special soap (sclerotherapy) or with just the right amount of heat (radiofrequency endovenous ablation). Or we can glue the vessels closed with a specially formulated adhesive. Once the vessel is roughed up a little inside, the vessels are held closed for several weeks with compression stockings so that the vessels heal closed. With the glue technique, no stockings are needed. Once closed, the treated veins atrophy and eventually disappear.”
While patients are often concerned with how blood can get back to the heart from the legs if the veins disappear, Dr. Crockett explains that without treatment, the vessels are taking blood away from the heart and are doing the person no good.
The patient is actually much better off removing the abnormal veins which forces the blood to return through healthy veins.
Dr. Crockett says vein treatment at SNMH is typically about 95 percent effective and recovery from varicose vein treatment is typically smooth and relief is often immediate. “If the abnormal vessels were causing the persons symptoms, typically the person will notice an immediate and significant decrease in those symptoms. The vessels we treat may be a little sore for a few weeks, and there may be some bruising, but that is typically mild.”
However, because there are often other, underlying health issues that contribute to vein disease, Dr. Crockett encourages his patients to focus on improving their overall health, too.
“A healthy body generally means healthy veins,” Dr. Crockett says. “Treating abnormal veins is part of the picture of the overall health of a patient, but the staples of good diet, weight control, exercise, and a healthy lifestyle go a long way toward preventing problems, and toward hastening healing when treatment is needed.”
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