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What Are Vein Valves?

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The valves inside the leg veins can be seen on ultrasound. The arrow points to a valve in the great saphenous vein within the leg.

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Leg veins have one-way valves that prevent blood from flowing backward. Diseased valves are ‘leaky’ and allow blood flow both forward and backward, eventually causing bulging of the veins, i.e., varicose veins.

In the circulatory system, the veins carry de-oxygenated blood back to the heart. The leg veins carry blood toward the heart, against gravity. Therefore, the leg veins have one-way valves the prevent back flow of blood. When the valves do not function properly, they allow blood to flow backward, causing pooling of blood. This  is referred to as venous reflux or venous insufficiency. Eventually, the backflow of the blood will cause varicose veins to develop and symptoms related to the increased pressure in the leg veins such as leg heaviness, aching, swelling, restless legs, night cramps, throbbing and pain. 

8 Warning Signs of Vein Disease: #2 Discoloration of the Skin

 

Discoloration of the Skin

venous leg ulcers

Chronic venous insufficiency (CVI) can cause the skin to become discolored, usually around the ankles. Over time, ulcerations or skin wounds may develop.

Over time, leakage of the blood into the area surrounding the veins can cause tissue to die. The resulting pooling of blood in the tissue causes a darkening of the skin. It is at this stage that the skin is actually stained by your own blood.  This is also known as venous stasis skin changes, skin hyperpigmentation or venous stasis dermatitis because the skin is often inflamed, itchy and eczema-like.  This is most frequently caused by venous reflux, an underlying condition that can be treated. When skin changes like these are present, the condition is termed chronic venous insufficiency.  Over time, the skin condition may worsen and the skin may become darker, firm to touch, scaly and itchy, and the skin may break down causing a venous leg ulcer.

What are Vein Valves?

healthy_and_diseased_valves

In healthy veins, the valves close after the blood flows towards the heart, preventing back flow.
When veins become dilated, the valves cannot close properly, allowing blood to flow back towards the ankle.

Vein valves play a critical role in helping blood flow through the veins back to the heart. Like swinging doors, valves open to allow blood to flow toward the heart and flap closed again to prevent the flow of blood back down the legs. If the veins become dilated, the flap-like valves cannot completely close, making them incapable of preventing the back flow of blood. This ‘back flow’ of blood through dysfunctional valves is called venous reflux or venous insufficiency.

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Why Didn’t My Spider Veins Go Away?

Before and After spider vein treatment at La Jolla Vein Care. This picture demonstrates that spider veins (reddish spider like vessels) can stem from underlying feeder vessels (the blue vein). The feeder vein can be compared to the ‘root’ of a weed; If you clip the surface branches of a weed without pulling the root of the problem, the weed will never go away.
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Veins in certain locations, like in the inner knee or inner thighs and inner ankles, often arise from underlying venous incompetence of a vein called the great saphenous vein that runs from the groin along the inner thigh to the ankle. If spider veins do not respond to treatment, it is important to have an ultrasound evaluation to determine if there is an underlying source of the problem.  Once the underlying problem is properly identified, it can be treated. 

Spider veins can be the ‘tip of the iceberg’ and represent a bigger problem, that is not visible to the naked eye. For example, as seen in the first image, spider veins can arise from blue ‘feeder’ veins, which must be treated for best results.

Spider veins can also stem from an underlying problem such as venous reflux in larger veins, such as the great saphenous vein. As demonstrated in the second picture, spider veins in the inner knee, inner ankle and inner thighs can originate from this vein. This can only be determined by ultrasound examination. It is important to have your vein evaluated by a trained specialist. Effective treatment depends on an accurate and thorough diagnosis.

What is a Venous Insufficiency / Duplex Ultrasound Test?

 

The Duplex Ultrasound examination, also called a venous insufficiency study allows us to visualize the blood vessels that are not visible to the naked eye, even blood vessels that are deep within the muscles.  The ultrasound examination is used to both identify the veins that have faulty valves and to map the anatomy of the veins, creating a ‘road map.’  This is necessary to make an accurate assessment of the cause and extent of the varicose veins, as well as to formulate the best treatment plan.  This should be done for any individual being evaluated for varicose veins, leg swelling, patients who have failed prior treatment, patients who are symptomatic and in some patients with certain anatomic patterns of spider veins.

Duplex ultrasound uses sound waves to get images of your blood vessels.  It also helps determine how fast blood moves through the vessels.

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One of our vascular sonographers, evaluating the great saphenous vein in the thigh with duplex ultrasound.

At La Jolla Vein Care, the venous duplex study will be performed by one of our registered vascular technologists, who have specialized training in the science of vascular sonography (RVT). It is performed in the standing position, which is important in obtaining an accurate study result.  This examination takes approximately 45-60 minutes. Following the study, the doctor will personally discuss the results with our patients to ensure a complete understanding of the ultrasound findings.  Insurance typically covers this type of diagnostic study.

 

Free Varicose Vein Screening

If you experience the discomfort and swelling of varicose veins, you may be suffering from venous insufficiency or venous reflux disease. Approximately 25 million people in the United States suffer from this condition. Currently, La Jolla Vein Care is offering a free varicose vein screening for a limited time. During the screening, you’ll get a patient history, examination of your the legs, and a recommend plan of treatment (if necessary).  So call (858) 550-0330 today and schedule an appointment. It’s the first step in keeping you healthy and looking good—and it’s free!