Are your legs heavy or in pain?

The Vein Clinic here at Cardiovascular Interventions provides the ability to find the root cause of patient’s long-standing pain and swelling in their legs. The most common cause is venous disease.

Are your legs heavy or in pain?

The Vein Clinic here at Cardiovascular Interventions provides the ability to find the root cause of patient’s long-standing pain and swelling in their legs. The most common cause is vein disease.

What is Venous Disease (Chronic Venous Insufficiency or CVI)?

Illustration courtesy of Medtronic

When the valves that keep blood flowing out of the legs and back to the heart no longer function, blood begins to pool in the legs. Initially varicose veins appear. It is possible if left untreated this progress can develop into a more serious condition called vein disease (chronic venous insufficiency or CVI).

Why is venous disease diagnosis workup and treatment so important in cardiology?

Firstly, it is part of the circulatory system, and therefore, symptoms of venous disease in the lower extremities may look like they are related to cardiac issues such as congestive heart failure. One of the cardinal symptoms of heart disease is swelling of the lower extremities. So very often, the patients are given an intensive cardiac workup, and even diuretics for a problem that is actually venous. The lower extremity swelling and edema needs a thorough workup to determine how much of it is due to venous disease and how much is due to cardiac disease.

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What are the Symptoms of Venous Disease?

  • Dull aching, heaviness, or cramping in the legs
  • Pain relieved with leg elevation and aggravated while standing
  • Swelling of the legs (Edema)
  • Skin discoloration
  • Varicose veins
  • Skin ulcers
  • Itching, tingling, burning, or throbbing sensation in the legs or feet
  • Leg weakness

How is Vein Disease Diagnosed?

BruceBlausVaricose Veins (Echogram)CC BY-SA 4.0

Venous Reflux Study

At Cardiovascular Interventions we use a duplex ultrasound that evaluates the how your veins are functioning. This is a non-invasive procedure that uses sound waves to detect blood flow. The direction of travel is shown on screen with different colors. This allows us to see if your symptoms are from vein disease and diagnose the severity to ultimately find the best treatment options.

How is Vein Disease Treated?

Radiofrequency Venous Ablation

We treat venous disease with radiofrequency energy that is directed through a thin tube (catheter) inserted through a small incision in the vein. Effective on large veins in the leg and is done in our office using local anesthesia. You will be able to walk following the treatment and recovery typically is short.  After treatment, you will wear compression stockings for 1 week or more. To follow up, your doctor will use duplex ultrasound to make sure that the vein is closed.

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Varithena Venous Ablation

This method is used for treating veins below the knee, where there are nerve endings, to protect you from numbness. It is also
used for veins that are curly or have many large branches. Varithena is a foam medication. Like Radio Frequency, we gain access to
the vein similar to starting an I.V. Once we have access, we elevate the leg we are treating and push the foam through the I.V.
catheter. The foam will work on the walls of the vein to close it. It is very effective at treating these curly veins and veins with many
branches.

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Sclerotherapy

Sclerotherapy is a minimally invasive procedure using chemical irritants to close unwanted veins. Sclerotherapy is the treatment of choice treatment for small varicose and spider veins that may or may not be symptomatic and a source of significant distress. The procedure will be carried out in our clinic in our procedure room. During the procedure you will lay on a table positioned on your back. Under sterile precautions, a fine needle is inserted into the effected vein. The sclerosing agent will directly be injected into the vein. After 2 weeks of the procedure, a follow up is required to confirm whether all sites have been treated, whether more sessions are required, and whether the procedure was successful.

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Venous Stenting

The venous stenting procedure is performed under conscious sedation and pain management by Dr. Jamnadas, and his Cath lab team at CVI. After using ultrasound guidance to access the veins in the groin or neck, an intravascular ultrasound is used to view the architecture of the blood vessel from the inside, determining the points of narrowing and allowing Dr. Jamnadas to determine whether to stent the vein. Venous stenting is similar to that of arteries, in that a thin tube will be placed in the veins of the groin or neck, over which a balloon will be deployed to the narrowed portion of the blood vessel. This balloon is then expanded, compressing the fibrous bands within the vein to the wall, returning the vessel to a size which is close to its original dimensions. Following this, a metal stent is placed to act as scaffolding, keeping the vessel open.

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