Project Description

Vein Disease

Definition • Diagnosis • Treatments

Vein Disease

Definition • Diagnosis • Treatments

What is Venous Reflux Disease?

Venous reflux disease is also known as venous stasis, venous insufficiency or venous incompetence. Venous reflux disease refers to ‘leaky valves’ in the veins of the legs. Reflux may occur in the deep and/or superficial leg veins. The deep veins are those within the muscle; they bring at least 80-90% of the blood from the legs back to the heart. The superficial veins are outside of the muscle and under the skin.

The main superficial veins are the Great Saphenous Vein that courses up the middle of the thigh and calf and the small sphaneous vein, which courses up the back of the calf. Normally, there are one-way valves within the leg veins, which help blood flow in one direction: toward the heart. This means blood is traveling against gravity.

The calf muscle also helps move blood toward the heart. When vein valves are leaky, blood flows backward (reflux) towards the feet. Blood pools in the lower legs, causing bulging veins at the surface. Symptoms include leg heaviness, leg fatigue, leg pain, ankle swelling, phlebitis (inflamed and painful veins) restless legs at night, and night cramps.

Venous reflux disease is progressive and worsens over time. Skin changes may also develop, including darkening of the skin around the ankles. The darkening of the skin is sometimes referred to as venous stasis skin changes. The skin can become dry and itchy (venous eczema). Eventually, the skin can break down causing a wound, called a venous leg ulcer.

Varicose Veins

We have treatment options!

Venules

Darkening of the skin around the ankles.

We have treatment options!

The darkening of the skin is sometimes referred to as venous stasis skin changes.

Vein Valves and Ulcers

We can Treat Vein Ulcers

Don't let this happen to YOU - Get treatment early!

Before and After Treatment

See what our treatments can do

We have many treatment options to help with your vein disease

STAGES OF DEVELOPMENT OF VARICOSE VEIN DISEASE

image showing Stages of Development of Varicose

HOW IS VENOUS REFLUX DISEASE DIAGNOSED?

In addition to your physical exam findings and medical history, an ultrasound examination is an important tool in the assessment of venous disease. Not all venous disease is visible to the naked eye, and it usually arises from veins that are beneath the surface of the skin, only visible by ultrasound technology.

The ultrasound allows us to see if the valves are leaky; it can detect the direction of blood flow and also detects blockages in the veins, for example from blood clots or scars within the veins from previous clots.  The ultrasound will determine exactly which veins are ‘bad’ or incompetent.  Reflux may be detected in the deep veins (within the muscle), the great and small saphenous veins, and/or branches of the saphenous veins.  This will help determine the treatment plan.

sample ultrasound image

Sample image of a vascular ultrasound  (veins)

HOW IS VENOUS REFLUX DISEASE TREATED?

Step 1: The Underlying Problem

The first step is to treat the underlying problem, the venous reflux. The specific pattern of venous reflux was detected by ultrasound. Venous reflux usually starts in the saphenous veins. The saphenous veins are most effectively treated with vein ablation procedures. This involves placing a small catheter within the vein and using heat or a solution to produce injury and eventual closure of the vein. The most commonly used treatments for the saphenous veins are radiofrequency ablation (RFA), laser ablation, mechanico-chemical ablation (MOCA or Clarivein), and in some cases Varithena Foam. The treatment Step recommendation is customized, based on where reflux is present and other clinical factors.

Step 2: Varicose Veins

After the underlying saphenous vein reflux is corrected, the bulging veins (varicose veins) can be treated by injecting a foamed medication that will cause them to scar and eventually dissolve (foam sclerotherapy), or to remove them using tiny incisions. The most common method is foam sclerotherapy. This is also known as ultrasound-guided foam sclerotherapy (UGFS).

Step 3: Spider Veins

Spider vein treatment is always considered a cosmetic procedure. If improved cosmesis is a goal of treatment, make sure to discuss this with your doctor and plan on having cosmetic treatment as the last step. Spider vein treatment is accomplished by sclerotherapy, which is an injection of a liquid medication into the spider veins. Ask your provider for an estimate about how many treatment sessions/ vials are necessary to get the results you want.

Step 1: The Underlying Problem

Venous Reflux

Image of Normal vs Diseased Leg Vein

Step 2: Varicose Veins

Foam Sclerotherapy

Varicose Veins in Legs

Step 3: Spider Veins

a cosmetic procedure

Spider Veins are treated with Sclerotherapy

OUR PATIENTS SAY

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Wonderful!! Dr. Bunke and staff are absolutely the best!!

The office is the perfect combination of professionalism,
kindness, efficiency, empathy and expert medical treatment and care.

Dr. Bunke is kind, friendly and so knowledgeable that you feel very comfortable that you will receive excellent treatment.

Rosemary P.

Dr. Lucas and her staff are incredible. They were so kind and nurturing while I was having the vein procedures. Highly recommend

Lauren G.

Anna M. Is the most professional and caring manager I have encountered in the medical industry.

Shaughn H.