Health & Disease Info
Newsletter

Because You Asked…
Vol. I No. 3

Can I do anything about my chronic venous disease?

Many persons, both male and female, are afflicted with chronic venous insufficiency. Symptoms can be as minor as some small blue "spider" veins primarily around the ankle area, or as incapacitating large varicose veins that cause pain with walking or standing for long periods of time.

The basic principle of venous insufficiency is that there is ineffectiveness of the valves within the veins. These valves are necessary to keep blood flowing upward toward your heart against gravity. When the valves do not function properly, blood will have a tendency to remain in the lower extremity causing inflammation of the involved vessel. The end result is lower leg venous hypertension with consequential inflammation and discomfort. Symptoms can also be the consequence of incompetent perforator veins. Perforator veins are small connections between the deeper veins and the superficial vessels.

The causes if valvular incompetence include familial genetics (of which you haven't any control over), and sometimes there has been injury to the vessels and valves. The damage to the valves can occur after an experience with deep vein thrombosis (DVT) or from traumatic injury to the lower extremity. Additionally, the hormonal influence of estrogen can cause dilation of the smooth muscle surrounding the veins-again resulting in discomfort.

So, what can you do about it?
Because the problem is typically due to venous hypertension, the mainstay of treatment is with compression support stockings and elevation of the extremity above the level of the heart. These measures aid in reducing the pressure within the limb. Particular skin care is also a key element of venous disease. Utilization of these management techniques may well help to reduce the potential complications of the venous insufficiency which include discoloration of the skin to a brawny color, skin breakdown and/or ulceration.

The discoloration of the skin is caused by a breakdown of red blood cells and a resultant permanent brawny color staining of the skin. Ulcerations occur from excessive pressure exerted on the tissues by the distended vessels and subsequent edema. Venous stasis ulcers can be uncomfortable and have the potential for infection due to exposed subcutaneous tissue. Should the disease progress to this level, there are other treatments available that may be recommended by your provider.

What is the prognosis?
Just as with many medical maladies, controlling the problem before it becomes more involved is the best recommendation. This can be done with the above named interventions…support stockings, elevation of the extremity, good skin care. Should an ulceration occur, there are several effective treatments that we utilize. Some of which include topical ointments and/or compression wraps. In some instances there is the possibility of surgical repair of small perforator veins with a relatively new procedure called SEPS ( Subfascial Endoscopic Perforator Surgery ). Should the key element of your symptoms be caused by varicosities, there is the option of ligation and stripping of these vessels. Surgical intervention can be discussed with one of our surgeons.

If you have any questions, don't hesitate to ask!