VASCULAR & INTERVENTIONAL RADIOLOGY- Vein problems are common. But they’re also treatable.

VASCULAR & INTERVENTIONAL RADIOLOGY- Vein problems are common. But they’re also treatable.

– Joseph G. Rusnak, M.D.

Varicose vein disease is a health issue which affects 20-25% of women and 10-15% of men. The problematic veins range in size from small, unsightly spider veins to those well over one centimeter in size.

The underlying problem is the loss of competency of the valves within the veins. If the valves are not functioning properly, blood pools in the veins rather than returning to the heart. Over time, the veins distend because of the chronic pressure, resulting in varicosities.

A genetic predisposition is the most common cause of varicose veins. Pregnancy is also a contributing factor. Less common causes include obesity and trauma.

Some patients don’t have any symptoms. Others may experience painful effects, such as swelling, itching, or an overall tired and heavy feeling in the leg. There can be a discoloration of the skin, especially adjacent to the medial ankle. Skin ulcers may develop when long-term varicose vein disease occurs.

Elevation of the leg, weight loss and exercise can help relieve the symptoms. Prolonged standing may make the symptoms worse. Compression stockings can provide some relief by preventing the varicosities from distending because of too much blood.

Medical intervention is often recommended for the treatment of varicose veins. This starts with a thorough physical exam of the leg and an ultrasound of the affected veins. The ultrasound is a critical component as it provides an image of the greater saphenous and lesser saphenous veins, which are deep within the leg muscle. The radiologist evaluates the health of these veins and the connecting veins between them.

Treatment options include sclerotherapy, laser ablation or radio frequency ablation. Sclerotherapy is an injection of medication into a vein, causing the vein to scar down and disappear. It is typically used on smaller veins like spider veins. Ablations are used for treatment of varicose veins caused by problems with one of the saphenous veins. They are performed under local anesthetic and a small puncture is made into the vein. Real time ultrasound is used for guidance.

Energy is converted to heat, which injures the vein wall causing it to collapse. The body sends cells to fix the injury and in the process gets rid of the vein. The patient does not feel the heat. There may be some short-term bruising or discomfort after the procedure.

Mild pain is alleviated by over-the-counter analgesics. The patient is instructed to wear compression stockings for two weeks after the ablation. Normal activity and work can resume immediately. Vigorous exercise should be delayed for one week.

Southtowns Radiology has been treating varicose vein disease for six years, bringing relief to thousands of patients. A referral from a primary care physician will start the process for treatment of this unsightly and often painful disease.