Q: I am 64 years old and have only recently started developing varicose veins in my legs. I'm using compression stockings, but they're uncomfortable during the warm months. What other options do I have to deal with them? Aside from the increased risk of a blood clot, do they pose any serious health risks? Will the varicose veins start to look worse as I get older?
— Tania-- Wichita, KS
A:
Varicose veins can be very unpleasant, particularly from a cosmetic point of view. These enlarged and tortuous veins usually show up in the legs; they are subject to high pressure when you’re upright and therefore likely to be uncomfortable and perhaps even painful while you're standing or walking. Varicose veins can also sometimes itch, and scratching them can cause ulcers. Ulcers that infect your veins can lead to blood clots — this is a condition known as superficial thrombophlebitis and is usually isolated to superficial veins. In rare cases, these blood clots can extend into deep veins, becoming a more serious problem. Still, varicose veins very rarely bring on serious complications. More than anything else, they are considered to be a cosmetic problem, which, unfortunately, can worsen as you grow older.
One of the options you might wish to consider to reduce the appearance of your varicose veins is surgical intervention. Vein stripping is one particular surgical treatment that can help. There are also newer, less-invasive treatments such as ultrasound-guided foam sclerotherapy, radiofrequency ablation, and endovenous laser treatment, each of which has its own pros and cons. Nonsurgical treatment options include elastic stockings, elevating the legs, and exercise.
Learn more WWW.CKPA.NET .
Showing posts with label spider veins. Show all posts
Showing posts with label spider veins. Show all posts
Friday, December 9, 2011
Thursday, February 3, 2011
Exploring The Potential Of Procedures That Address Venous Ulcer Etiology
The complexity of venous ulcerations leads to prolonged healing and doubt. Clinicians have traditionally treated venous wounds with debridement, multi-layer compression dressings and skin grafts.
Most of the literature focuses on various topical ointments, the use of allogenic grafting, compression therapies, etc. Unfortunately, there is little research on addressing the etiology of venous wounds. Understanding and treating the etiology in all aspects of medicine is imperative in order to achieve a successful result.
Venous insufficiency is a condition in which veins do not adequately return blood back to the central system. In the lower extremity, both the superficial and deep vein systems of the legs utilize valves to ensure cephalad flow. The deep vein system also uses muscular contraction to assist in pumping the blood upward. A perforating vein is a vein that penetrates a fascial plane and may connect the superficial venous system to the deep vein system or connect greater saphenous veins to small saphenous veins.
Over time, various risks factors such as heredity, hormones, pregnancy and prolonged standing cause the smooth muscle in the vein’s wall to relax. When this occurs, there is an inability of the vein valves to approximate. In the legs, the normal flow opposes gravity. However, with insufficiency, the blood refluxes and backflow occurs to the ankles. In severe cases, blood pooling leads to edema, hyperpigmentation, loss of skin turgor and ulceration. An ulcer can also occur after a varicose vein opens and causes bleeding.
Consider a patient who presents with a venous ulceration. In most cases, these patients receive wound care and compression therapy. One does not usually perform an ultrasound. Ultrasound is crucial in finding out where the insufficiency lies and which veins lead to the ulceration. It is imperative that the physician or registered vascular technician evaluates both the deep vein and superficial vein systems for reflux. Just scanning the deep vein system for a thrombus would be incomplete and will not identify the pathology involved.
Direct attention to the lower extremities while the patient is standing. Evaluate the deep vein system, including the femoral, popliteal, tibial and peroneal veins, and look for the presence of a thrombus and reflux. In the superficial system, test the greater and small saphenous veins as well as anterior and posterior circumflex and perforating veins.
In general, one should utilize the following guidelines to identify insufficiency in the superficial system: a greater saphenous vein larger than 0.4 cm in diameter, longer than 0.5 seconds of reflux and a small saphenous or perforating vein larger than 0.3 cm in diameter and 0.5 seconds of reflux. If varicosities are present, one can follow the varicosities towards their tributary. This is called vein mapping.
With the presence of a venous ulcer, the ultrasonographer will be able to scan over the ulcer and trace it back to the insufficient vein. The ulcer is usually a direct extension from a superficial varicosity. However, the underlying etiology is a result of insufficiency of the superficial, deep or perforating vein system. By addressing the insufficient vein either through ultrasound guided chemical ablation or endovenous ablation, venous ulcerations heal on an average of four weeks barring that no infection is present.
Key Insights On Ultrasound Guided Chemical Ablation
Ultrasound guided chemical ablation is a treatment in which one injects a sclerosant into the refluxing vein. The two most common sclerosants are sodium tetradecyl sulfate (Sotradecol, Angiodynamics), which recently received FDA approval, and polidocanol (Asclera, Merz). Traditional saline injections are not strong enough to treat large veins and should be reserved for cosmetic spider and reticular veins only.
With ultrasound guidance, inject liquid sclerosant or foam sclerosant (sclerosant mixed with air or CO2) into the insufficient vein. Foam has become widely accepted for its advantages. Foam solution makes more contact with the vein wall due to increased surface area properties, disperses quicker and stays in the vein longer than liquid. Furthermore, one can easily visualize and follow the solution on ultrasound during treatment. With sclerotherapy treatment, the chemical damages the vessel wall. The vein hardens and the body breaks it down. Larger and deeper veins will harden, thicken and shrink but may not disappear altogether.
One does not directly inject the ulceration but rather the insufficient vein along its course. If one performs ultrasound chemical ablation alone, it will take a few treatments before treatment addresses the veins at the ulceration site. Accordingly, this method usually occurs after an ablative procedure. Only perform this treatment on the superficial and perforating vein systems. Do not inject the deep venous system.
A Closer Look At Endovenous Laser Ablation
Endovenous laser or radiofrequency ablation is a procedure that closes the long segment of the insufficient vein. First access the insufficient vein under the guidance of ultrasound. Through the access needle, insert a guide wire. Remove the needle and place a dilator and sheath over the wire and into the vessel. Remove the wire and the dilator, and leave the sheath in the vein. Proceed to instill a fiber optic laser or catheter for radiofrequency. Confirm the placement of the fiber or cathode exiting the end of the sheath. Be sure to avoid superficial/deep vein junctions by at least 1.5 inches.
Then deliver anesthetic agents mixed with saline, creating what is known as a sea of tumescence. After administering adequate anesthetic, remove the sheath along with the laser and/or catheter while delivering laser energy or radiofrequency. One must apply enough laser energy or radiofrequency to the vein in order to create appropriate closure and stop the flow through the insufficient portion. After the procedure, the patient wears compression stockings and bandages over the ulceration for approximately one week.
Follow-up with the patient includes the use of post-procedure ultrasound to confirm the success of the procedure (namely ensuring there is no deep thrombus) and mapping the vein to the ulcerated site.
Perform traditional debridement and have the patient wear compression dressings for two weeks. After the two-week period, if the ulceration has not already healed, ultrasound guided chemical ablation may close any remaining branches of veins that have reflux flow. Do not inject sclerosant directly through the ulceration. It is imperative to treat any and all vessels leading to the ulceration but it is not necessary to treat all superficial vein structures if insufficiency is not present.
Over the course of therapy, the ulceration will decrease in size and the vessels will become hardened. Perform injections every three to four weeks. Four to six sessions may be needed to complete the course of therapy. On ultrasound, these vessels will not be able to compress and there is no filling on color flow Doppler.
Final Thoughts
It is important to note that once an individual has venous insufficiency, it does not go away and may in fact affect other veins. Other veins may become insufficient due to increased load and hypertension, and new vessels can develop. This process is called neovascularization. It is necessary to perform maintenance and follow-up care to ensure a new ulceration does not develop.
Performing procedures to improve and control the chronic venous insufficiency should be the focus of venous ulcer healing. Depending on the size and healing potential of the patient, the wound healing time is significantly shorter. This positively affects all aspects of patient care including increased patient adherence, decreased risk of infection, decreased healthcare costs and more efficient medical care.
Most of the literature focuses on various topical ointments, the use of allogenic grafting, compression therapies, etc. Unfortunately, there is little research on addressing the etiology of venous wounds. Understanding and treating the etiology in all aspects of medicine is imperative in order to achieve a successful result.
Venous insufficiency is a condition in which veins do not adequately return blood back to the central system. In the lower extremity, both the superficial and deep vein systems of the legs utilize valves to ensure cephalad flow. The deep vein system also uses muscular contraction to assist in pumping the blood upward. A perforating vein is a vein that penetrates a fascial plane and may connect the superficial venous system to the deep vein system or connect greater saphenous veins to small saphenous veins.
Over time, various risks factors such as heredity, hormones, pregnancy and prolonged standing cause the smooth muscle in the vein’s wall to relax. When this occurs, there is an inability of the vein valves to approximate. In the legs, the normal flow opposes gravity. However, with insufficiency, the blood refluxes and backflow occurs to the ankles. In severe cases, blood pooling leads to edema, hyperpigmentation, loss of skin turgor and ulceration. An ulcer can also occur after a varicose vein opens and causes bleeding.
Consider a patient who presents with a venous ulceration. In most cases, these patients receive wound care and compression therapy. One does not usually perform an ultrasound. Ultrasound is crucial in finding out where the insufficiency lies and which veins lead to the ulceration. It is imperative that the physician or registered vascular technician evaluates both the deep vein and superficial vein systems for reflux. Just scanning the deep vein system for a thrombus would be incomplete and will not identify the pathology involved.
Direct attention to the lower extremities while the patient is standing. Evaluate the deep vein system, including the femoral, popliteal, tibial and peroneal veins, and look for the presence of a thrombus and reflux. In the superficial system, test the greater and small saphenous veins as well as anterior and posterior circumflex and perforating veins.
In general, one should utilize the following guidelines to identify insufficiency in the superficial system: a greater saphenous vein larger than 0.4 cm in diameter, longer than 0.5 seconds of reflux and a small saphenous or perforating vein larger than 0.3 cm in diameter and 0.5 seconds of reflux. If varicosities are present, one can follow the varicosities towards their tributary. This is called vein mapping.
With the presence of a venous ulcer, the ultrasonographer will be able to scan over the ulcer and trace it back to the insufficient vein. The ulcer is usually a direct extension from a superficial varicosity. However, the underlying etiology is a result of insufficiency of the superficial, deep or perforating vein system. By addressing the insufficient vein either through ultrasound guided chemical ablation or endovenous ablation, venous ulcerations heal on an average of four weeks barring that no infection is present.
Key Insights On Ultrasound Guided Chemical Ablation
Ultrasound guided chemical ablation is a treatment in which one injects a sclerosant into the refluxing vein. The two most common sclerosants are sodium tetradecyl sulfate (Sotradecol, Angiodynamics), which recently received FDA approval, and polidocanol (Asclera, Merz). Traditional saline injections are not strong enough to treat large veins and should be reserved for cosmetic spider and reticular veins only.
With ultrasound guidance, inject liquid sclerosant or foam sclerosant (sclerosant mixed with air or CO2) into the insufficient vein. Foam has become widely accepted for its advantages. Foam solution makes more contact with the vein wall due to increased surface area properties, disperses quicker and stays in the vein longer than liquid. Furthermore, one can easily visualize and follow the solution on ultrasound during treatment. With sclerotherapy treatment, the chemical damages the vessel wall. The vein hardens and the body breaks it down. Larger and deeper veins will harden, thicken and shrink but may not disappear altogether.
One does not directly inject the ulceration but rather the insufficient vein along its course. If one performs ultrasound chemical ablation alone, it will take a few treatments before treatment addresses the veins at the ulceration site. Accordingly, this method usually occurs after an ablative procedure. Only perform this treatment on the superficial and perforating vein systems. Do not inject the deep venous system.
A Closer Look At Endovenous Laser Ablation
Endovenous laser or radiofrequency ablation is a procedure that closes the long segment of the insufficient vein. First access the insufficient vein under the guidance of ultrasound. Through the access needle, insert a guide wire. Remove the needle and place a dilator and sheath over the wire and into the vessel. Remove the wire and the dilator, and leave the sheath in the vein. Proceed to instill a fiber optic laser or catheter for radiofrequency. Confirm the placement of the fiber or cathode exiting the end of the sheath. Be sure to avoid superficial/deep vein junctions by at least 1.5 inches.
Then deliver anesthetic agents mixed with saline, creating what is known as a sea of tumescence. After administering adequate anesthetic, remove the sheath along with the laser and/or catheter while delivering laser energy or radiofrequency. One must apply enough laser energy or radiofrequency to the vein in order to create appropriate closure and stop the flow through the insufficient portion. After the procedure, the patient wears compression stockings and bandages over the ulceration for approximately one week.
Follow-up with the patient includes the use of post-procedure ultrasound to confirm the success of the procedure (namely ensuring there is no deep thrombus) and mapping the vein to the ulcerated site.
Perform traditional debridement and have the patient wear compression dressings for two weeks. After the two-week period, if the ulceration has not already healed, ultrasound guided chemical ablation may close any remaining branches of veins that have reflux flow. Do not inject sclerosant directly through the ulceration. It is imperative to treat any and all vessels leading to the ulceration but it is not necessary to treat all superficial vein structures if insufficiency is not present.
Over the course of therapy, the ulceration will decrease in size and the vessels will become hardened. Perform injections every three to four weeks. Four to six sessions may be needed to complete the course of therapy. On ultrasound, these vessels will not be able to compress and there is no filling on color flow Doppler.
Final Thoughts
It is important to note that once an individual has venous insufficiency, it does not go away and may in fact affect other veins. Other veins may become insufficient due to increased load and hypertension, and new vessels can develop. This process is called neovascularization. It is necessary to perform maintenance and follow-up care to ensure a new ulceration does not develop.
Performing procedures to improve and control the chronic venous insufficiency should be the focus of venous ulcer healing. Depending on the size and healing potential of the patient, the wound healing time is significantly shorter. This positively affects all aspects of patient care including increased patient adherence, decreased risk of infection, decreased healthcare costs and more efficient medical care.
Wednesday, December 8, 2010
Varicose veins: Live with it or treat it?
Varicose veins may look ugly but for a lucky majority who develop them, their appearance will be the only cause of concern. Distended and dilated, these veins appear just below the skin and can create a spider web pattern of blue and purple lines that make sufferers self- conscious. But for a small percentage, varicose veins can cause itching and pain, and even lead to wounds that make some form of treatment necessary.
The good news is that treatment – both surgical and non-surgical – has proven effective time and again, says Dr. Rezni Cassim, Vascular and Transplant Surgeon and lecturer at the Professorial Surgical Unit at the National Hospital.
As you read this, approximately five litres of blood is wending its way through your system. Travelling along an intricate system of veins and arteries, the blood circulates throughout your body. The arteries carry the blood from your heart out to your body, and the veins carry the blood from your body back to your heart. The blood travelling along your arteries is a rich red, an indicator that it is full of oxygen. The blood travelling back along your veins, on the other hand, is much darker because your body has extracted the oxygen in the blood. That’s why veins look purple or blue.
“Going down is easy, high arterial pressure and gravity sends the blood down,” says Dr. Cassim, speaking of the movement along the arteries. Going up, on the other hand, is a fight against gravity and is helped by a system of valves in the veins. “The venous system is designed in such a way that there is a one way flow, with valves stopping the blood from flowing back and defects in the valves are the cause of most problems. " Such defects can appear anywhere, from groin to just above ankle, and cause varicose veins. A malfunctioning valve can create a long column of blood, resulting in what is known as venous hypertension. The venous hypertension may cause varicose veins and its complications.
Dr. Cassim explains that the condition is most often familial, appearing in a member or members of the same family. Aside from the hereditary component, varicose veins can be aggravated by pregnancy. The body has dual systems of veins – one is deep seated and other superficial. If the deep veins are blocked, those just under the skin must cope with a greater load and can develop varicose veins.
An arteriovenous fistula can cause varicose veins in places like your arms. Arteriovenous fistuli represent abnormal connections or passageways between an artery and a vein. In a healthy system, blood flows from arteries, into capillaries and then into veins. An arteriovenous fistula however, can cause the blood to bypass the capillaries and flow directly from artery into vein.
They fall into two categories: congenital fistula which a person may be born with and acquired fistula which develop after birth and may have been caused by trauma/surgery. A big fistula can allow a large volume of blood, under high pressure to flood the vein. The latter, not having been designed to channel so much blood with high pressure, becomes distended. Apart from these there are other rare secondary causes for varicose veins.
Many of Dr. Cassim’s patients are young people. For younger patients, the appearance of the veins is often embarrassing. “The younger they are, the more concerned they tend to be,” says Dr. Cassim, adding that aside from such cosmetic concerns, 90% of his patients will not have any problem. But varicose veins can cause complications. You can have swelling of the legs, because of the pressure, itchiness of the leg, eczema, pain, pigmentation and ulcers (wounds). “When inadvertently traumatised the veins may bleed heavily, and patients should immediately apply pressure to prevent further blood loss,” says Dr. Cassim, emphasising that bleeding should stop in approximately 15 minutes.
“These complications present a reason to treat varicose veins,” he says, “the diagnosis itself is very simple.”
The ulcer is one of the most unpleasant complications, simply because it can take so long to heal. Dr. Cassim has seen patients who have struggled with one for 10 years. “We use a technique called strapping to treat it – it’s a special way of putting pressure on the ulcer to heal it – but that can also take 3 to 6 months to heal,” he says, adding, “All this can be prevented at an early stage.” If you have varicose veins with pigmentation, itching or skin changes, consider it your cue to seek medical advice.
Though varicose veins are simple enough to treat, what doctors are worried about is the possibility of an underlying secondary cause. “If there is a sudden onset of varicose veins, it is better to seek treatment,” cautions Dr. Cassim. However, if you’ve had varicose veins for several years and experienced none of these complications, and do not want treatment for cosmetic concerns, you can choose to leave them untreated.
For those who are interested in non-invasive treatment for complications, Dr. Cassim recommends the wearing of a graduated pressure stocking during the day. The stockings help to force the blood upwards. At night, keeping the legs elevated will encourage healthy circulation. These must become the habits of a lifetime if they are to be effective. Exercising, losing weight, and avoiding long periods of standing can also help. For those who are self- conscious, however, wearing a stocking might not seem like a viable solution.
Doctors seeking to treat varicose veins can choose to do a duplex scan to identify the malfunctioning valves in the vein. There are many invasive methods to treat varicose veins. Dr. Cassim describes the process as akin to getting a haircut – except the time scale differs radically. The varicose veins can recur in 60% of patients in 6 to 8 years. Of course, 40% will be recurrence free. Doctors often employ minimally invasive techniques such as sclerosant injection, foam therapy, or laser ablation to treat these veins.
Other patients, more interested in a long term solution, will opt to have the veins completely removed in an operation. It includes “vein stripping” and the surgery occurs under anaesthesia. Because so much of the blood flows through the deeper veins in the legs, the superficial veins can usually be removed or ablated without serious harm. In the end, it’s the patient who makes the choice, says Dr. Cassim, adding that each approach has its advantages and disadvantages.
The good news is that treatment – both surgical and non-surgical – has proven effective time and again, says Dr. Rezni Cassim, Vascular and Transplant Surgeon and lecturer at the Professorial Surgical Unit at the National Hospital.
As you read this, approximately five litres of blood is wending its way through your system. Travelling along an intricate system of veins and arteries, the blood circulates throughout your body. The arteries carry the blood from your heart out to your body, and the veins carry the blood from your body back to your heart. The blood travelling along your arteries is a rich red, an indicator that it is full of oxygen. The blood travelling back along your veins, on the other hand, is much darker because your body has extracted the oxygen in the blood. That’s why veins look purple or blue.
“Going down is easy, high arterial pressure and gravity sends the blood down,” says Dr. Cassim, speaking of the movement along the arteries. Going up, on the other hand, is a fight against gravity and is helped by a system of valves in the veins. “The venous system is designed in such a way that there is a one way flow, with valves stopping the blood from flowing back and defects in the valves are the cause of most problems. " Such defects can appear anywhere, from groin to just above ankle, and cause varicose veins. A malfunctioning valve can create a long column of blood, resulting in what is known as venous hypertension. The venous hypertension may cause varicose veins and its complications.
Dr. Cassim explains that the condition is most often familial, appearing in a member or members of the same family. Aside from the hereditary component, varicose veins can be aggravated by pregnancy. The body has dual systems of veins – one is deep seated and other superficial. If the deep veins are blocked, those just under the skin must cope with a greater load and can develop varicose veins.
An arteriovenous fistula can cause varicose veins in places like your arms. Arteriovenous fistuli represent abnormal connections or passageways between an artery and a vein. In a healthy system, blood flows from arteries, into capillaries and then into veins. An arteriovenous fistula however, can cause the blood to bypass the capillaries and flow directly from artery into vein.
They fall into two categories: congenital fistula which a person may be born with and acquired fistula which develop after birth and may have been caused by trauma/surgery. A big fistula can allow a large volume of blood, under high pressure to flood the vein. The latter, not having been designed to channel so much blood with high pressure, becomes distended. Apart from these there are other rare secondary causes for varicose veins.
Many of Dr. Cassim’s patients are young people. For younger patients, the appearance of the veins is often embarrassing. “The younger they are, the more concerned they tend to be,” says Dr. Cassim, adding that aside from such cosmetic concerns, 90% of his patients will not have any problem. But varicose veins can cause complications. You can have swelling of the legs, because of the pressure, itchiness of the leg, eczema, pain, pigmentation and ulcers (wounds). “When inadvertently traumatised the veins may bleed heavily, and patients should immediately apply pressure to prevent further blood loss,” says Dr. Cassim, emphasising that bleeding should stop in approximately 15 minutes.
“These complications present a reason to treat varicose veins,” he says, “the diagnosis itself is very simple.”
The ulcer is one of the most unpleasant complications, simply because it can take so long to heal. Dr. Cassim has seen patients who have struggled with one for 10 years. “We use a technique called strapping to treat it – it’s a special way of putting pressure on the ulcer to heal it – but that can also take 3 to 6 months to heal,” he says, adding, “All this can be prevented at an early stage.” If you have varicose veins with pigmentation, itching or skin changes, consider it your cue to seek medical advice.
Though varicose veins are simple enough to treat, what doctors are worried about is the possibility of an underlying secondary cause. “If there is a sudden onset of varicose veins, it is better to seek treatment,” cautions Dr. Cassim. However, if you’ve had varicose veins for several years and experienced none of these complications, and do not want treatment for cosmetic concerns, you can choose to leave them untreated.
For those who are interested in non-invasive treatment for complications, Dr. Cassim recommends the wearing of a graduated pressure stocking during the day. The stockings help to force the blood upwards. At night, keeping the legs elevated will encourage healthy circulation. These must become the habits of a lifetime if they are to be effective. Exercising, losing weight, and avoiding long periods of standing can also help. For those who are self- conscious, however, wearing a stocking might not seem like a viable solution.
Doctors seeking to treat varicose veins can choose to do a duplex scan to identify the malfunctioning valves in the vein. There are many invasive methods to treat varicose veins. Dr. Cassim describes the process as akin to getting a haircut – except the time scale differs radically. The varicose veins can recur in 60% of patients in 6 to 8 years. Of course, 40% will be recurrence free. Doctors often employ minimally invasive techniques such as sclerosant injection, foam therapy, or laser ablation to treat these veins.
Other patients, more interested in a long term solution, will opt to have the veins completely removed in an operation. It includes “vein stripping” and the surgery occurs under anaesthesia. Because so much of the blood flows through the deeper veins in the legs, the superficial veins can usually be removed or ablated without serious harm. In the end, it’s the patient who makes the choice, says Dr. Cassim, adding that each approach has its advantages and disadvantages.
Sunday, September 26, 2010
Ease leg pain, improve appearance
When warm weather came, Angela Snodgrass shunned wearing shorts. Only capris. They covered up the unattractive veins in her legs.
As a physical therapist and mother of two young children, she's on her feet a lot. Since her first pregnancy seven years ago, she had itching, ankle swelling and dull, aching pains in her legs.
At work, she took breaks from standing by sitting on a stool. At home, she couldn't stand up after showering to finish getting ready for work due to pain in her calves.
"It just got progressively worse," said Snodgrass, 32, of Connersville, Ind.
"The varicose veins bothered one leg during my first pregnancy and then the other, too, during my second pregnancy. I also noticed more spider veins," she said, while getting injection treatments at the Decatur Vein Clinic in Greenwood.
Last month, she started to get relief at the clinic. As she nears the end of her treatments, which included endovenous laser procedures and injections, her pain and unsightly veins are almost gone.
Like Snodgrass, many women - and some men - are getting help from a number of minimally invasive procedures available to help aching, painful legs and enlarged veins that can appear twisted and bulging.
"All you have to do is spend a day at the pool and you see how many people it affects," said Dr. William Finkelmeier, a vascular surgeon with VeinSolutions. "It's really a significant problem."
About 50 percent to 55 percent of women and 40 percent to 45 percent of men in the U.S. suffer from some type of vein problem, the Office on Women's Health in the U.S. Department of Health and Human Services says. Young women also are affected, particularly because of pregnancy.
Vein-clinic doctors say public education about treatments is improving, and varicose vein research has advanced in the past 15 years.
This month, a new injectable liquid drug, Asclera, approved by the Food and Drug Administration in April, became available in the United States. It primarily can be used to treat tiny, spider veins or small varicose veins.
With deeper varicose veins, clinics normally first use laser or radiofrequency endovenous techniques. They involve putting a small tube into a vein, inserting a probe with a device at the tip that heats up the inside of the vein and closes it off.
The problem is that many people delay or don't seek treatment.
"Most of our folks have been dealing with symptoms - legs aching, throbbing, heaviness - for five to 10 years before coming in," said Dr. Jeffery Schoonover, regional medical director for Vein Clinics of America
BARB BERGGOETZ • THE INDIANAPOLIS STAR • JULY 6, 2010
As a physical therapist and mother of two young children, she's on her feet a lot. Since her first pregnancy seven years ago, she had itching, ankle swelling and dull, aching pains in her legs.
At work, she took breaks from standing by sitting on a stool. At home, she couldn't stand up after showering to finish getting ready for work due to pain in her calves.
"It just got progressively worse," said Snodgrass, 32, of Connersville, Ind.
"The varicose veins bothered one leg during my first pregnancy and then the other, too, during my second pregnancy. I also noticed more spider veins," she said, while getting injection treatments at the Decatur Vein Clinic in Greenwood.
Last month, she started to get relief at the clinic. As she nears the end of her treatments, which included endovenous laser procedures and injections, her pain and unsightly veins are almost gone.
Like Snodgrass, many women - and some men - are getting help from a number of minimally invasive procedures available to help aching, painful legs and enlarged veins that can appear twisted and bulging.
"All you have to do is spend a day at the pool and you see how many people it affects," said Dr. William Finkelmeier, a vascular surgeon with VeinSolutions. "It's really a significant problem."
About 50 percent to 55 percent of women and 40 percent to 45 percent of men in the U.S. suffer from some type of vein problem, the Office on Women's Health in the U.S. Department of Health and Human Services says. Young women also are affected, particularly because of pregnancy.
Vein-clinic doctors say public education about treatments is improving, and varicose vein research has advanced in the past 15 years.
This month, a new injectable liquid drug, Asclera, approved by the Food and Drug Administration in April, became available in the United States. It primarily can be used to treat tiny, spider veins or small varicose veins.
With deeper varicose veins, clinics normally first use laser or radiofrequency endovenous techniques. They involve putting a small tube into a vein, inserting a probe with a device at the tip that heats up the inside of the vein and closes it off.
The problem is that many people delay or don't seek treatment.
"Most of our folks have been dealing with symptoms - legs aching, throbbing, heaviness - for five to 10 years before coming in," said Dr. Jeffery Schoonover, regional medical director for Vein Clinics of America
BARB BERGGOETZ • THE INDIANAPOLIS STAR • JULY 6, 2010
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