Varicose Veins and Venous Insufficiency (Part 2)

In our last post titled, “Varicose Veins and Vascular Insufficiency (Part 1),” we talked about the anatomy of the veins and the meaning of varicose veins and venous insufficiency.  In today’s post, we will talk about causes, risk factors, symptoms, diagnosis, and treatment of venous insufficiency.

Causes

• The natural absence of valves in the veins or having weak valves, this is referred to as Primary insufficiency.
• Damage to the valves caused by a previous blood clot, and this is referred to as Secondary insufficiency.

Risk Factors 

• Age: Risk increases with age.
• Having a history of a previous deep vein thrombosis (a DVT or a vein clot).
• Being female.
• Pregnancy.
• Family history of venous insufficiency or varicose veins.
• Obesity or over weight.
• Long periods of sitting or standing.

Symptoms

• Repeated swelling of the foot, ankle, or calf.
• Varicose veins.
• Heaviness and pain in the legs with standing or sitting.
• Skin changes and discoloration in the lower legs.
• The development of wounds and ulcers.
• Chronic and prolonged swelling of the leg.

Diagnosis

The diagnosis of venous insufficiency is based on the patient’s history and physical examination.  The doctor might also order a duplex ultrasound study of the the veins in the legs.  This diagnostic testing helps determine the presence or absence of blood clots and evaluates for venous reflux, the backflow direction of blood in the veins.

Treatment

The treatment plan depends on the patient’s condition.  It could range from conservative measures to surgical procedures.  Conservative measures include leg elevation and wearing compression stockings for example.  More invasive procedures include incompetent vein closures (ablation) by laser or radiofrequency or vein stripping.  The different treatment plans and details are should be discussed with the treating doctor.  Outcomes, side effects, and risk factor should also be discussed.

If you suspect you have venous insufficiency, please talk to your doctor for appropriate treatments and referrals.  It is important you get treated by vascular specialists and accredited facilities to ensure the highest standards of vascular care.

Vascular Associates of Northern Virginia, P.C.

Our Vascular Surgeons:
Robert S. Podolsky, M.D.
Avisesh Sahgal, M.D.

References

Daigle, R. J., & Daigle, R. J. (2011). Techniques in noninvasive vascular diagnosis: An encyclopedia of vascular testing (3rd ed.). Littleton, CO: Summer Pub.

Size, G. P., Lozanski, L., & Russo, T. (2013). Inside Ultrasound Vascular Reference Guide. Pearce, AZ: Inside Ultrasound, Inc.