When the valves of your veins become weakened and damaged, blood is unable to travel from the lower extremities back up to the heart. As a result, blood reverses it course and settles in the leg veins, which can lead to a variety of venous diseases like:

• Blood clots (platelets stick together and form a mass)
• Deep vein thrombosis (a blood clot found in a deep vein)
• Chronic venous insufficiency (condition whereby blood pools in the veins, causing a variety of physical symptoms)
• Superficial venous thrombosis or phlebitis (a blood clot that forms in a vein near the surface of the skin)
• Spider veins (thin veins that are blue, red or purple in color)
• Varicose veins (twisted, enlarged veins)
• Ulcers (wounds or open sores that are slow to heal)

Diagnosing Venous Disease

In order to conclude which type of venous disease you have, you vein specialist will begin by conducting a physical examination and examining your medical history. He or she will also perform imaging studies like duplex ultrasound and a venogram to understand your valve structure, evaluate valve function, determine if blood clots are present in the veins and assess the amount of blood that is flowing back into the legs. All of this information will be used to help your vein doctor choose the proper course of treatment. 

Managing Venous Disease

Initial management typically consists of conservative measures like:

• Wearing compression stockings
• Avoiding sitting or standing for prolonged periods of time
• Elevating your legs when resting
• Exercising regularly
• Medication

However, if your venous disease is severe enough and complications have developed (e.g. ulcers, severe pain and swelling), then one or more of the following treatments may be implemented.

Sclerotherapy – a chemical solution is injected into your vein with a fine needle. The chemical aggravates the lining of the vein, causing it to inflame and harden into scar tissue.  The hardened tissue shuts down the vein and later the scar tissue is absorbed by the body. Through absorption, the vein shrinks, making it no longer visible at the surface. Blood that had come through the faulty vein is now re-routed to the heart through healthy, functioning veins that reside deep within the venous system. 

Phlebectomy – Veins are removed through tiny punctures made in the skin. 

Endovenous laser ablation (ELA) - a laser fiber is inserted through the skin and into your faulty vein. The laser heats the lining of the vein, causing it to collapse, shrink and later disappear. 

Vein stripping and ligation – this outpatient procedure involves tying the veins shut and removing them through incisions in your skin.

Valve repair – the valves are surgically repaired using a long, hollow catheter through which small instruments can be passed through and used to make the surgical repair, or via an open incision in the skin or by. Repairs can include, but are not limited to, using sutures or a piece of healthy tissue (graft) to seal off areas where blood is leaking through the vein, or inserting a stent to keep the valve propped open.

Vein transplant – the diseased vein is replaced with a healthy vein that is taken from another area of the body.

Laser and light treatment – a beam of light is directed at the veins, causing them to heat up. The heat disrupts the lining of the veins, triggering it to become inflamed and harden. The scar tissue shuts down the vein and is later absorbed by the body. Absorption causes the vein to shrink and disappear over time.