14, 6, 2021

Complications of Untreated Varicose Veins

2021-06-14T20:00:18-07:00

Varicose veins and their underlying cause, venous reflux disease can cause a wide array of symptoms, including leg pain, swelling, aching, heaviness, restless legs, and nocturnal leg cramps.

If left untreated, superficial venous reflux disease can progress to cause skin changes and other complications.

Complications of untreated venous disease include:
1. Superficial Thrombophlebitis (STP)
A thrombophlebitis is swelling and inflammation of a vein caused by a blood clot. There are two main types of thrombophlebitits: deep venous thrombosis (affects deeper, larger veins) and superficial thrombophlebitis (affects veins near the skin surface). This is often referred to as an STP.

The following symptoms are often associated with thrombophlebitis:
Inflammation (swelling) in the part of the body affected
Pain in the part of the body affected
skin redness, warm and tenderness over the vein
Often a ‘hard knot’ or lump can be felt within the vein.

An STP is common complication of varicose veins because blood is pooling and not circulating well. But, it can also indicate an underlying problem with blood clotting. In some cases, there may also be a concurrent blood clot in other veins, such as the deep veins (DVT) which can be serious. For this reason, a duplex ultrasound examination is used to look at the deep veins and other veins not visible to the naked eye for the presence of blood clots.

STP can usually be treated with aspirin or other anti-inflammatory medication to reduce pain and inflammation, compression stockings, and cold/warm packs to also reduce inflammation and discomfort. The discomfort is usually improved within 6 weeks but it can take a few months to resolve.
2. Deep Venous Thrombosis (DVT)
If the blood clot is in a varicose vein near a deep vein or perforator vein, it can extend into the deep system, causing a DVT. For example, a spontaneously thrombosed great saphenous vein, can extend into the common femoral vein and cause a pulmonary embolism (PE). Also, a varicose vein blood clot can extend into a perforator vein and travel to the deep system. It is important to have an ultrasound examination of superficial blood clots to determine a concurrent DVT is present, determine exact location and extent of the superficial clot to make sure it is not near a deep or perforator vein. If it is, a blood thinner may be recommended or serial ultrasounds to monitor the clot may be recommended.
3. Spontaneous Vein Hemorrhage
Untreated varicose veins are at a higher than usual risk of bleeding or spontaneous rupture. Over time, varicose veins become larger, and the vein wall becomes weak and stretched out. These veins, which are already weak are also under high pressure (because of venous reflux, or the ‘backflow’ and pooling of blood in these veins). As a result, the high pressure can cause the veins to spontaneous burst and bleed heavily. Because they are under high pressure, they bleed like an arterial bleed and patients describe the bleeding as ‘blood shooting across the room.’ The varicose veins that are susceptible are veins closest to the surface of the skin

Most patients describe that it occurs during or after a warm shower (warm water causes veins to relax and dilate, allowing more blood to pool within the veins) or during sleep. It is painless and patients report that they notice it because they feel something wet in bed. Patients who are on blood thinners can lose large amounts of blood, especially if it occurs while they are sleeping. Some people have required blood transfusions. The small blue spider veins around the ankle are equally at risk of rupture as are the larger bulging veins.If someone you know has experienced bleeding from their varicose veins, they should be seen by a doctor. Treatment will prevent the veins from bursting again. This is a common condition that we see at La Jolla Vein Care.

4. Venous Leg Ulcer
A leg ulceration is the most severe form of chronic venous insufficiency. This is referred to as a ‘venous leg ulcer.’ Venous leg ulcers make up 70% of all chronic leg wounds. Therefore, the venous leg ulcer is much more common than a diabetic or arterial ulcer. It is caused from long-standing pressure within the leg veins, resulting from 1) venous reflux through faulty valves, 2) a blockage within the deep veins or 3) from the inability to use the calf muscles or a combination. Venous reflux is the most common cause for a venous leg ulcer. The increased pressure within the leg veins (we call this venous hypertension) causes an inflammatory response. Inflammation then causes changes in the skin, usually around the ankles (this is where pressure is the greatest). The inflammatory process will cause the skin around the ankles to become brown or discolored, and eventually the skin will break open. The leg wound can be healed by treating the underlying vein condition.

5. Venous stasis and venous eczema
Venous stasis skin changes refers to darkening around the skin. It is associated with itching often, due to inflammation of the skin. It indicates long standing venous disease, called chronic venous insufficiency. Progression can lead to ulceration.
Venous leg ulcers can also be prevented by early intervention with non-invasive procedures. If you have signs of chronic venous insufficiency (such as skin discoloration around the ankles) you should address your underlying vein condition to prevent the skin from breaking open.

Complications of Untreated Varicose Veins2021-06-14T20:00:18-07:00

10, 4, 2020

6 Stages of Venous Disease, Which Stage Am I?

2021-11-13T12:32:18-08:00

Venous Reflux Disease is progressive and worsens over time.

venous disease is progressive and worsens over time.

venous disease is progressive and worsens over time.

Venous reflux disease is also known as venous stasis, chronic 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 saphenous 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

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. See the image to better understand the 6 main stages of venous disease. Stage 6 is the open leg wound, known as a venous leg ulcer.

Stage 1. Healthy Veins, Stage 2. Spider Veins

Stage 1. Healthy Veins, Stage 2. Spider Veins

Stage 3. reticular veins and varicose veins

Stage 3. reticular veins and varicose veins

Stage 4. Venous Nodes - Edema venous insufficiency

Stage 4. Venous Nodes - Edema venous insufficiency

Stage 5. Chronic insufficiency

Stage 5. Chronic insufficiency

Stage 6. Venous eczema and venous leg ulcer

Stage 6. Venous eczema and venous leg ulcer

6 Stages of Venous Disease, Which Stage Am I?2021-11-13T12:32:18-08:00

6, 5, 2016

Are Stasis Ulcers or Leg Wounds Caused Varicose Veins?

2020-12-19T01:41:45-08:00

healed ulcer

70% of chronic leg wounds are a result of long standing varicose veins and underlying venous insufficiency. Ulcers, or leg wounds are usually preceded by changes of the skin such as a brownish skin discoloration around the ankles and stasis dermatitis. A venous leg ulcer is often referred to as a ‘stasis ulcer’ since blood is stagnant in varicose veins.

Are Stasis Ulcers or Leg Wounds Caused Varicose Veins?2020-12-19T01:41:45-08:00

27, 8, 2014

Complications of Untreated Varicose Veins #4: Leg Ulceration

2021-11-04T16:09:57-07:00
leg_ulcer_rendering

Venous leg ulcers make up 70% of all chronic leg wounds. They usually occur in the inner ankle or outer ankle locations.

ulcer-1_fotor

Before and after treatment of a venous leg ulcer.
Copyright @ La Jolla Vein Care.

A leg ulceration is the most severe form of chronic venous insufficiency.  This is referred to as a ‘venous leg ulcer.’  Venous leg ulcers make up 70% of all chronic leg wounds.  Therefore, a venous leg ulcer is much more common than a diabetic or arterial ulcer.  It is caused by long-standing pressure within the leg veins, resulting from 1) venous reflux through faulty valves, 2) a blockage within the deep veins or 3) from the inability to use the calf muscles or a combination.  Venous reflux is the most common cause of a venous leg ulcer.  The increased pressure within the leg veins (we call this venous hypertension) causes an inflammatory response. Inflammation then causes changes in the skin, usually around the ankles (this is where pressure is the greatest).  The inflammatory process will cause the skin around the ankles to become brown or discolored, and eventually, the skin will break open.  The leg wound can be healed by treating the underlying vein condition.  Venous leg ulcers can also be prevented by early intervention with non-invasive procedures.  If you have signs of chronic venous insufficiency (such as skin discoloration around the ankles) you should address your underlying vein condition to prevent the skin from breaking open.

Complications of Untreated Varicose Veins #4: Leg Ulceration2021-11-04T16:09:57-07:00

30, 5, 2014

Can Varicose Veins Cause Leg Ulcers?

2021-11-03T23:17:13-07:00
ulcer-before-1

VENOUS LEG ULCER, BEFORE: This is a venous leg ulcer, caused by venous reflux or venous insufficiency. In this picture, you can see varicose veins above the wound.

After

VENOUS LEG ULCER, AFTER: Because this individual had reflux only in the superficial varicose veins, treatment consisted of foam sclerotherapy of the varicosities and compression with unna boot dressing. The wound healed rapidly and note that the varicose veins are gone.

A venous leg ulcer is an open wound on the leg, caused by long-standing vein problems. It is the most severe form of chronic venous insufficiency (CVI). Venous leg ulcers are common, accounting for over 70% of all leg wounds. It affects 1% of Americans and is the seventh leading cause for disability in the United States.

It is usually located around the ankle (on the inner or outer sides). It is caused by underlying venous insufficiency, or venous reflux.  The persistent venous reflux (back flow of blood through faulty valves) causes high pressure within the leg veins.  The high pressure, is then exerting outward on the skin, causing an inflammatory response, eventually causing the skin to break down.  Visible signs of venous disease are varicose veins, ankle swelling, skin discoloration around the ankle and usually precede the leg wound.  Underlying venous insufficiency can be detected by duplex ultrasound imaging (a non-painful study).

The treatment of venous leg ulcers is to correct the underlying problem: the faulty veins. Treatment of the underlying non-functional veins will reduce pressure from venous hypertension, allowing the wound to heal.  There are a number of non-surgical treatment options that can accomplish this including foam sclerotherapy and endovenous ablation, depending on the affected veins. To determine if your leg wound is related to a vein problem or for treatment options, call us for more information.

Can Varicose Veins Cause Leg Ulcers?2021-11-03T23:17:13-07:00
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