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What Your Ankles Say About Your Health

5 signs of venous reflux disease were found on the ankles

venous reflux disease were found on the ankles

Venous reflux disease refers to ‘leaky valves in the leg veins. It is also referred to as venous insufficiency. When the one-way valves that help blood in the veins flow from the feet to the heart, no longer work properly, blood begins to pool around the ankles. Over time, the pooling of blood causes increased hydrostatic pressure within the blood vessels. This is referred to as venous hypertension in the medical community. Venous hypertension is associated with chronic venous insufficiency, which means the vein valves have become leaky for a long time before physical signs are apparent. An ultrasound examination can first identify if the underlying veins are weak and leaky not visible to the naked eye, long before physical signs become apparent. Some signs you may see that may indicate underlying venous reflux disease include:

chronic venous insufficiency or venous reflux disease

Darkening of skin, and itchiness are a sign of chronic venous insufficiency or venous reflux disease

  1. Skin darkening around the ankle (hyperpigmentation). This is also referred to as venous stasis. This is a result of long-standing venous reflux or pooling of blood.
  2. Itchy, scaly skin around the ankles. This is referred to as venous eczema. This skin becomes itchy and scaly from chronic inflammation.
  3. spider veins in the inner ankle. These are commonly associated with venous reflux in the great saphenous vein. The great saphenous vein courses the ankle all the way to the groin. When blood pools from thigh upper thigh all the way to the ankle, small spider veins may appear in the ankle. These are commonly perceived as cosmetic because most people don’t realize there is an underlying problem.
  4. ankle swelling (edema). There are many causes for ankle swelling. Some are serious like heart conditions where others are less serious like a salty diet. When ankle swelling is present talk to your doctor about the various causes. However, one of the most common causes of ankle swelling is venous reflux disease. Anyone who has ankle swelling can benefit from an ultrasound examination to determine if venous reflux disease is present.
  5. skin ulceration and breakdown in the ankle. Over time, pooling of blood in the ankles and venous hypertension causes the skin to darken, it can become scaly and itchy and eventually ulcerate because the skin breaks down from chronic inflammation. This is called a venous leg ulcer. Venous leg ulcers are treated by treating the underlying venous reflux disease.

All of these signs and symptoms can be reduced by treating the underlying problem, venous reflux disease. See our treatments page to better understand treatment options.

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VARITHENA® CHEMICAL ABLATION

illustration of varithena foam injection
Varithena® may be recommended based on your vein location, size, anatomy and vein tortuosity.
Varithena® is:
• Effective to treat veins of different sizes above and below the knee
• Requires no incisions, sedation or general anesthesia
• Does not require a wire to be inserted along the length of your vein
• Does not use heat, eliminating the risk of thermal injury
WHAT IS VARITHENA®?
Varithena® is a "microfoam" formulation of polidocanol (sclerosing agent) and CO2. The result is a microfoam that has an appearance and consistency similar to white, foamy shave cream.
Ultrasound guidance is used to inject Varithena® microfoam into the vein. The microfoam fills the lumen for circumferential contact where it's designed to displace blood and destroy the endothelial lining efficiently.
cross section of Illustration of a vein with foam sclerotherapy injection
Video below shows the proceedure.
How many treatments will I need?
The number and frequency of treatments depends on a patient's anatomy, how quickly the veins respond, and the patient's treatment goals. There is a limit on the amount of medication we can give you each day to avoid causing side effects. Some larger or resistant veins may require two treatments to respond completely but most veins respond to Varithena® after one treatment.
What should I expect on my treatment days?
You will sign your consent form then change into shorts provided by the office. We will clean your skin with alcohol, then use ultrasound to localize the veins. The foam medication will then be injected into your veins with a fine needle. The foam fills and treats the desired section of the vein. The diseased vein collapses and the foam is deactivated. Your legs will be elevated on a comfortable wedge pillow for approximately 15 minutes. After your treatment, we will help you into your compression stockings, then you will walk for 30 minutes prior to getting in your car.

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Dr. Amanda Steinberger is a Harvard-trained, board-certified vascular interventional radiologist. She specializes in a broad range of superficial vein disease including varicose veins, spider veins, venous leg ulcers, lymphedema and cosmetic laser vein treatments. Dr. Steinberger sees patients in our La Jolla Office.

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