The Different Types of Veins
Veins are important because they transport blood to the heart. Superficial veins collect blood in the legs, beneath the surface of the skin. This blood is sent to the deeper veins in the calf muscles. As the muscles in the calves are used, the blood is pumped towards the heart against the flow of gravity. The blood is unable to travel backward because the veins contain one-way valves. In some instances, these valves do not close correctly. This leads to a pooling of blood in the superficial veins. As time passes, the impacted veins become distended with blood. The dark blue, twisted and knobbly veins resulting are called varicose veins.
The most common symptoms of varicose veins are aching, heavy and tired limbs. If the case is severe, the vein can rupture. This causes the formation of an ulcer or open sore on the skin. Spider veins are closer to the skin’s surface and much smaller than varicose veins. There are usually blue or red with an appearance resembling spider webs, starburst clusters or tree branches. In most instances, spider veins appear on the thighs, ankles, feet, calves or the face. They can cover either a large or a small area. There are two different types of spider vein treatment. Smaller veins often respond to sclerotherapy while larger varicose veins usually require surgery.
Spider vein treatment and varicose veins treatment are not only for cosmetic reasons. Numerous health issues can result from varicose vein disease including venous eczema, ulceration, blood clots, skin breakdown and in rare cases, even skin cancers. Additional issues may include skin rashes including eczema or a brown stain on the surface of the skin resulting from the eruption of capillaries. In some cases, thrombophlebitis can develop. This is when the formation of blood clots occurs within the veins. Chronic venous insufficiency is generally referred to as CVI. This condition is caused when the valves in the veins of the leg fail to work properly.
CVI makes it extremely difficult for the blood to return from the legs to the heart. This results in the blood collecting or pooling in these veins. This is referred to as stasis. Both spider and varicose veins can develop in women and men at any age. The individuals most often impacted are females of childbearing age or older. The risk of developing spider and varicose veins can increase due to the family history of the individual.
The Causes of Damaged Veins
The causes of spider and varicose veins and still not completely understood. In some cases, the valves in the veins are either weak or absent. This prevents the blood from flowing backward and away from the heart. This may be what causes poor circulation. In other instances, the vein walls themselves may be weak. This may be what results in a pooling of blood. Although it is not as common, certain diseases can cause the individual to develop varicose veins. This includes veins with congenital abnormalities and phlebitis. This is simply when the veins are inflamed. Venous disease is unable to be completely prevented because it is usually progressive.
Varicose Veins Treatment
Varicose veins treatment is often performed by a vein specialist. This involves eliminating the veins that have been affected. The flow of blood is then forced into the remaining healthy veins. There are different types of varicose veins treatment although the most frequently used are sclerotherapy or surgery. Surgery is an effective varicose veins treatment because the veins can either be removed or closed down. Only the smallest of spider veins can be treated using electrocautery or laser treatments. Varicose veins treatment is often called stripping. In most cases, the individual will receive partial or local anesthesia. This may be an epidural.
A flexible device is used to strip the veins causing the issues. During surgery, the device is passed through the vein. This enables the vein to be removed through an incision close to the ankle or groin area. A series of incisions are used to strip the smaller tributaries using the same device. The veins with the connection to the deeper veins can then be tied off by the vein specialist. This method of stripping has been used effectively since the 1950s.
Spider Vein Treatment
Surgery is not usually an option for a spider vein treatment because this type of vein may not be able to be removed through surgery. In some cases, the spider veins may disappear once the bigger varicose veins have been removed. This is because spider veins can be fed by varicose veins. Sclerotherapy is an effective spider vein treatment available through Dr. Batra at Dallas Vein Institute. Sclerotherapy is performed when a solution is injected through a fine needle right into the affected vein. The solution causes a deliberate irritation in the lining of the vein. This forces the vein to swell resulting in the blood clotting. The vein is transformed into scar tissue prior to fading from view.
A vein specialist may treat both spider and varicose veins using sclerotherapy. The most common substances currently being used for spider vein treatment in the United States include hypertonic saline, (Polidocanol) aethoxysklerol/Asclera and (Sotradecol) sodium tetradecyl sulfate. During sclerotherapy, the surrounding tissue of the vein is usually wrapped using compression bandages once the solution has been injected. The bandages need to remain for a few days to enable the walls of the vein to stick together. If the procedure was performed on the legs, the individual will be placed on a walking regimen.
This is what forces the flow of blood into the other veins in addition to preventing blood clots. Both variations and the main method have been in use since the 1920s. The majority of patients will require more than one treatment session.
Treatment for Chronic Venous Insufficiency
CVI is similar to other diseases because treatments are the most beneficial during the earliest stages. A vascular surgery specialist or a vein specialist usually recommends a combination of different treatments for individuals with CVI. In some cases, an individual with venous disease can benefit by exercising on a regular basis, maintaining their correct weight and wearing specific support hosiery. The main cause of venous insufficiency is usually either varicose veins or blood clots. The backflow of blood is meant to be prevented by the vein valves in the legs.
The treatment goals are the prevention of leg ulcers and a reduction in the pooling of blood. The most common recommendations for individuals with CVI include:
- Losing any excess weight.
- Wearing compression stockings
- Exercising on a regular basis. Walking is extremely beneficial.
- Taking antibiotics as prescribed for the treatment of skin infections.
- Elevating the legs above the heart while lying down or sitting.
- Following good skin hygiene practices.
- Sitting or standing should be avoided for long periods of time. If the individual has no choice other than remaining seated for a long time, the ankles, feet and legs should be extended and flexed. This should be done approximately ten times every thirty minutes. This ensures the blood in the leg veins continues to flow. If the individual must stand for a lengthy period of time, breaks should be taken often to sit down so the feet can be elevated.
The Importance of Skin Care
It is extremely important to practice good skin hygiene. The skin should be kept moisturized so it does not crack or flake easily. In some cases, the skin may be inflamed as opposed to leaking fluid or broken. The vein specialist may recommend using antifungal cream for the prevention of fungal infections, protecting the skin with a zinc oxide cream or using an anti-itch cream containing hydrocortisone. Wet compresses should be used to treat skin leaking fluids. If there are ulcers on the legs, the vein specialist will teach their patient how to maintain blood flow and protect their skin by applying layered compression bandages.
Compression Stockings
One of the best approaches is wearing compression stockings or support hose. It is critical these garments fit properly. Medical supply stores and some pharmacies offer compression stockings for sale. They are available in different styles including pantyhose, above the knee and below the knee. There are also a variety of compressions available. The compression right for each individual is recommended by a medical specialist. If the compression exceeds twenty mm Hg, a prescription is required. Anyone wearing compression stockings needs to remove them when the day ends.
The skin must be checked and cleaned and the stockings washed and dried. When the stockings fit properly, there will not be any bunching. When the stockings have a poor fit, the condition can actually become worse. This is because the bunched up areas will block the flow of blood. There have been studies conducted showing a combination of prescription medication and elastic stockings can effectively improve the flow of blood. This is especially true when the symptoms have not been controlled by the stockings alone.
The Uses of Different Medications
The vein specialist may prescribe antibiotics to treat skin conditions related to or resulting from CVI. In order to prevent the skin condition from recurring, the underlying cause must be treated. Antibiotics may also be used for the treatment of ulcers and deeper infections. Medications may be prescribed for individuals with post-thrombotic syndrome to prevent additional blood clots from forming. One of the other options is an Unna Boot. This wrap is specially medicated using a combination of a gel wound cover with a zinc oxide base and multilayer compression. The result is a semi-rigid bandage.
There are different combinations of products for topical wound care and multilayer compression systems that are frequently used. Some individuals have found dietary herbal supplements containing a type of horse chestnut extract beneficial. It is important to note no herbal medication should be used prior to consulting with a medical specialist, instead of prescription medications or without the proper caution. Herbal supplements can cause an interaction with prescription medications. A pharmacist or physician will be aware of any possible drug interactions.
Nonsurgical Vein Treatments
The nonsurgical treatments include endovenous thermal ablation and sclerotherapy. Sclerotherapy results in the collapse and disappearance of small varicose veins and spider veins once the solution has been injected. More than one treatment will most likely be necessary to obtain optimal results. Sclerotherapy is a fairly inexpensive and simple treatment usually performed in the office of the medical professional. This treatment can eliminate the discomfort and pain caused by the veins in addition to helping to prevent complications including ulceration and venous hemorrhage. Sclerotherapy is commonly used for cosmetic reasons.
One of the newer techniques is the endovenous thermal ablation. High-frequency radio waves or a laser are used for the creation of intense localized heat in the impacted vein. Although each energy source requires a different type of technology, both types result in the targeted vessel being closed. The treatment closes the affected veins but minimizes bruising and bleeding by leaving the vein in place. In comparison to stripping and ligation, endovenous thermal ablation provides similar cosmetic results, the ability to resume normal activities quicker and is less painful.
Surgical Vein Treatments
Fewer than ten percent of all patients will need to have surgery. The options include bypass surgery, microincision/ambulatory phlebectomy, vein stripping and ligation. The vein specialist will recommend the best treatment for each individual. Stripping and ligation are often used together. During a vein ligation, the problematic veins are cut and tied off by the vascular surgeon. The majority of individuals only need a few days to recover and resume their regular routine. Stripping is when two small incisions are made to surgically remove the larger veins. Stripping is more extensive with a recovery period as long as ten days. This procedure generally results in bruising.
One of the minimally invasive procedures is a Microincision/ambulatory phlebectomy. This is when small needle punctures or incisions are made directly over the veins. The problem veins can then be removed using a phlebectomy hook. Heart bypass surgery and a vein bypass are similar but they are performed in different locations. During the procedure, part of a healthy vein is taken from somewhere else in the body for transplantation. The blood around the impacted vein is then rerouted. A bypass is only used for the most severe cases of CVI, when no other treatments worked and only when the vein is located in the upper thigh.