Our Vascular Surgeons, Dr. Scott Reid and Dr. Brian Heywood, are devoted to the care and treatment of arteries and veins. They have been trained in the diagnosis and management of diseases affecting all parts of the vascular system except that of the heart and brain.
Our surgeons can perform several minimally invasive treatment options and procedures that provide a shorter recovery and less pain as opposed to conventional surgery, which usually leads to a longer healing process.
Vein problems are quite common and more familiar than artery disease! Problems with veins can affect men and women of all ages, but our health conditions and lifestyle behaviors we conduct daily are contributing factors that increase our risk for developing problems.
Seldom do vein problems go away completely, so your ongoing commitment to self-care must be a priority!
Most common vein diseases are:
- Varicose Veins and Varicosities
- Deep Vein Thrombosis (DVT) and Thrombophlebitis
- Chronic Venous Insufficiency (CVI) and Ulcers
- Venous Malformations
What Do Veins Do?
Did you know our human body has enough blood vessels to go around the earth's equator 2 and half times....that is about 62,000 miles of blood vessels! This ongoing flow of blood from the heart to the body and back is called circulation. Without good circulation, our bodies can not function properly. Poor circulation can cause legs to begin to ache, burn or swell.
Your veins carry blood from your feet back to your heart. Without good return to the heart, your legs/feet will show signs that can't be ignored. Most vein problems are cosmetic, yet blood clots or damaged tissue can happen when treatment isn't conducted.
Three types of veins include:
- superficial veins - collect blood just beneath the skin
- deep veins - larger veins located deep in the legs, run through the muscles & carry 90% of blood back to the heart
- communicating veins, or "perforator" - carry blood from superficial veins to deep veins
Veins have a cuplike flap called valves inside the vein walls, which open (blood moves upward) and close (keeps blood falling back downward). Your muscles help squeeze blood upward in the veins, yet when valves cannot support the flow upon muscle relaxation, blood will put extra pressure on those valves below....over time valves become weaker.
Weak valves may develop:
- Damaged Veins - valve begins to sag & blood moves in both directions even when muscles are relaxed
- Ropy Veins - saggy wall from increased pressure to cause bulging or twisting, like a rope, causing blood to pool and/or clot.
- Pooling blood - valve doesn't close when muscle relaxes & blood drops downward to next healthy value which can cause blood to back up into the communicating or superficial veins.
- Clotting blood - blood moves slowly and collects in one or both valves while becoming sticky & can grow in size to close off blood supply
Ways to Manage Your Vein Condition
Heredity, surgery, injury and pregnancy are risk factors that can't be controlled. However, you can control other areas of your life to prevent vein problems.
1. consume healthy meals to control your waistline
2. losing excess body weight
3. avoid standing on hard surfaces for long periods
4. keep moving & shifting your body weight
5. quit smoking
begin exercising consistently for 30 mins. daily (i.e. walking, biking, swimming). Extra activity is beneficial as well, such as yard work.
7. elevate your legs - (5-6 inches) increase blood flow back to your heart, especially if they are swollen.
8. elastic stockings - help support sagging veins, pain and swelling
Vein Screening and Treatment
Our vascular specialist, Dr. Scott Reid and Dr. Brian Heywood, typically will perform a full medical evaluation involving your medical history, physical examination of the legs/feet and may order tests to helps determine the severity of your condition such as:
- Doppler - special stethoscope to listen to changes in blood flow to determine clotting and/or valve problems.
- Duplex Imaging - sound waves to create an image to show size/shape of veins and amount of blood flowing through.
- Venogram - (invasive test) where dye is injected into the vein to x-ray. This will help locate clots and/or damaged valves.
Keeping a personal journal is very helpful consisting of:
- list your symptoms on a calendar as they occur (i.e. pain, swelling, skin color or fluid drainage)
- exercise routine - "frequency, intensity, time and type" of activity?
- if standing for long periods - "how long until pain occurs"?
- list family history
- previous blood clots
- leg injuries (when/where?)
- recent illness, or surgery (when/where?)
- bring a list of current medications/dosages
*Please bring this journal with you during your consultation!
*This information is not intended to substitute professional medical care, diagnosis or treatment. It is for informational purposes only. All procedures have risk of complications. Please contact your healthcare provider for better guidance regarding your individual situation.
Varicose Veins
Varicose veins are "bulging superficial veins" that often run in the family. These types of veins can worsen during pregnancy, or any type of weight gain. Varicose veins are known to cause an "unhappy appearance" in most people. However reports of discomfort in need of medical/surgical treatment may be desired. Varicosities is a vein which has become distented with blood and no longer functions as well as it is designed to be in returning blood to the heart. Varicosities generally occur in the lower parts of the body, commonly the legs. However varicosities can occur in the vulva, rectal or anal area of the body, known as hemorrhoids.
There are all types of varicose veins that can cause discomfort, but usually pose little threat to your health!
Recognizing Types of Varicose Veins
1. Spider veins - are the most common type of superficial vein, which usually appear:
- small
- red or purple bursts under the skins surface
- location behind your knee, calves and/or thighs that form bluish ropes
2. Ropy veins - damaged vein creating a "saggy wall" from increased pressure causing a bulge or twist, like a rope. Pooling of blood and/or even blood clots can form.
Symptoms may include:
- swelling
- "stinging" sensation
- legs feel "heavy"
- sense of feeling "full" after standing for long periods
- location same as spider veins
3. Superficial phlebitis - more severe case where blood may clot in the varicose vein. The symptoms and location site are similar to Ropy veins.
Ways to Manage Your Varicose Vein Condition
Heredity and pregnancy are risk factors that can't be controlled. However, you can control other areas of your life to prevent vein problems.
1. consume healthy meals to control your waistline
2. losing excess body weight
3. avoid standing on hard surfaces for long periods
4. keep moving & shifting your body weight
5. quit smoking
6. elevate the legs frequently
7. begin an exercise program including swimming or stationary biking to provide circulation
8. keep legs uncrossed when sitting
9. avoid tight constrictive clothing
10. elevate legs to help with swelling
The Three E's to Live By:
- begin exercising consistently 30 mins. daily (i.e. walking, biking, swimming) moving both legs. Wiggle your toes and stretch your calves too.
- elevate your legs - (5 to 6 inches) to increase blood flow back to your heart, especially if they are swollen
- elastic stockings - help support sagging veins, pain and/or swelling
Want more? Check out "In the News" to read article by Dr. Scott Reid
*This information is not intended to substitute professional medical care, diagnosis or treatment. It is for informational purposes only. All procedures have risk of complications. Please contact your healthcare provider for better guidance regarding your individual situation.
What are My Varicose Vein Options?
The two most common ways to treat superficial vein problems are:
- sclerotherapy
- VNUS - radio-frequency (RF)
Other treatments for varicose veins:
- vein removal
- vein stripping
- phlebectomy
Again, our highly skilled surgeon will determine the best and safest option for you!
Spider veins and other small varicose veins can be treated as an outpatient procedure conducted in our office known as, sclerotherapy. This procedure uses special chemicals to seal off damaged veins, detouring blood to other veins nearby and provides an improved appearance of the varicose veins. Before going home, elastic bandage(s) or support stockings will be placed to treat the legs by pressing the vein walls together, reduce bleeding and bruising. Although minimally invasive and most preferred as a sufficient way of treating varicose veins, the old-fashioned vein stripping may still be required in some cases.
Another newer technique and office-based alternative procedure known as, VNUS Closure™ Procedure is a radio-frequency (RF) performed with a local anesthetic and no real down time. Technique consisting of a small incision made for a tiny catheter to be powered by RF energy. This energy will deliver heat to the vein wall, which will shrink the vein wall and allow the vein to seal closed. Once the diseased vein is closed, it is left in place. The blood is re-routed to other healthy valves. A simple bandage is placed over the insertion site and additional compression may be provided to aid in healing. However smaller varicosities not treatable with vein stripping, or RFA, may still be treated with direct injections in our office.
After undergoing the VNUS Closure™ Procedure you will typically resume to normal activities within a day! We encourage walking, refrain from extended standing and refrain from strenuous activities until following up with our physician.
The VNUS Closure™ Procedure is known to have:
-
- immediate relief of symptoms
- have good cosmetic outcome with minimal to no scarring, bruising
and swelling
- full benefits of procedure may take 1-2 weeks
*Most major health insurance cover the Venefit Procedure by Covidien.
- Vein removal is a surgical procedure conducted at a hospital as an outpatient procedure. Anesthesia will be administered and an excision, or ligation. This procedure will be used to take out sections of larger varicose veins (i.e. ropy, or twisted). Removal of vein may require one or two incisions.
- Stripping removes an entire vein in one piece. After surgery, legs are bandaged and swelling may last 6 - 8 weeks.
- Phlebectomy is an office procedure that is minimally invasive. This procedure is used to remove variocose veins on the surface of the leg with tiny incisions that usually do not require stitching. After procedure the legs are wrapped and you will need to wear compression stocking for approximately 2 - 3 weeks after the procedure. This will also allow you to resume to daily activities within 24 hours following procedure. Strenuous activities will need to be modified for approximately two weeks, unless otherwise advised by our surgeon.
For either procedure, please be sure to elevate your legs, walk to increase blood flow and wear elastic stockings are directed until all bruising and tenderness is gone!
*This information is not intended to substitute professional medical care, diagnosis or treatment. It is for informational purposes only. All procedures have risk of complications. Please contact your healthcare provider for better guideance regarding your individual situation.
Thrombophlebities
Thrombophlebitis is swelling (inflammation) of the vein caused by a blood clot.
You may experience:
- pain and/or swelling in the part of the body being affected
- skin redness (not always present)
- warmth and tenderness over the vein site
The chances of thrombophlebitis from occurring may be due to:
- being hospitalized for a major surgery, or major illness
- sitting for long period of time (i.e. long airplane trip or car ride)
- medical disorder that put you at higher riks to develop blood clots
Two types of thrombophlebitis:
- deep venous thrombosis (DVT) - affects the deeper larger veins
- superficial thrombophlebitis - affect veins near the skin surface
Our vascular specialist, Dr. Scott Reid and Dr. Brian Heywood, typically will perform a full medical evaluation involving your medical history, physical examination of the legs/feet and may order tests to helps determine the severity of your condition.
*This information is not intended to substitute professional medical care, diagnosis or treatment. It is for informational purposes only. All procedures have risk of complications. Please contact your healthcare provider for better guidance regarding your individual situation.
Deep Vein Thrombosis (DVT)
A deep vein thrombosis (DVT) is when a blood clot in the valve cup occurs in the deep vein that may grow big enough to completely block the vein. If part of the clot breaks off...it can travel to your lungs which can be very serious to your health!
Hospital and home treatments for DVT can include medications (i.e. anticoagulants) to keep the clot from growing. The size of the clot can be controlled; however some clots never fully go away.
DVT is known to usually affect only one leg and depending on the location of the clot, you may experience pain and/or swelling. A sudden continuous pain deep in the muscle is quit common. With increased physical activity or standing for long periods of time, it may worsen.
Depending your condition, you may treated with an anticoagulant, known as a "blood thinner" to help control the blood's ability to clot. Anticoagulants can be administrated by an IV (intravenous) line or in a pill form, which will be determined by our physician.
Note: anticoagulant medication should be taken at the same time every day with a meal. It is important not to use over-the-counter or herbal treatments unless discussed with our physician because a combined effect of medications can be harmful!
Frequent blood tests will be ordered to monitor how well your medication is controlling the clotting. Don't miss these tests! Having to much anticoagulant can cause bleeding while having too little may cause clots. If you experience bruising or bleeding gums, be sure to call our office and have a test ordered. Your anticoagulant dosage may need to be changed for your health and safety.
Ways to Manage Your DVT Condition
- exercise both legs, even when you are sitting. Wiggle your toes and stretch your calves too. Try to walk every hour on the hour, even if it is for 5 - 8 mins. each trip.
- elevate your legs - (5 to 6 inches) to increase blood flow back to your heart, especially if they are swollen
- elastic stockings - help support sagging veins, pain and/or swelling
*This information is not intended to substitute professional medical care, diagnosis or treatment. It is for informational purposes only. All procedures have risk of complications. Please contact your healthcare provider for better guidance regarding your individual situation.
Chronic Venous Insufficiency (CVI)
When deep thrombosis (DVT) or damaged valves cause ongoing leg swelling and pooling of blood in the veins...eventually chronic venous insufficiency (CVI) can occur. CVI can't be cured, but you can limit the effects of CVI by controlling the swelling in the legs to reduce the likelihood of ulcers (open wounds).
As swelling increases the skin over and around the ankles may show red spots, or brownish tinge, while feeling leathery and/or scaly and may start to itch. If swelling isn't controlled, blood will begin to pool in the ankles appearing puffy or swollen. Skin may dimple when pressed. Fluid leaks from the veins into surrounding tissue which will cause the ankle to bulge and skin will appear glistened. Skin tissue broken down by a bump, or scratch, will begin to form an ulcer (open wound). Ulcers appear watery and may seep fluid, vary in shape and size, but usually appear on the inside of the ankle.
Ways to Manage Ulcers
Ulcers often need frequent medical care and daily attention from you! Special dressings are used to absorb drainage, yet keeping the ulcer moist to heal. Antibiotics may be prescribed to fight any infection noted. You will be expected to wear an elastic bandage, support stockings and/or compression boot daily. Elevate your legs as much as possible!
It is very important to follow-up with our physician consistently to treat ulcers as they occur. Be sure to attend those appointments and make your legs a priority!
*This information is not intended to substitute professional medical care, diagnosis or treatment. It is for informational purposes only. All procedures have risk of complications. Please contact your healthcare provider for better guidance regarding your individual situation.
Venous Malformations
Venous malformations can be either superficial or deep veins (or both components), which are the most common type. They are abnormally formed and dilated as the vessel walls become thin due to lack of smooth muscle support. Although usually present at birth, they may not become a problem until years later.
Understanding Venous Malformations
The nature of venous malformation is a slow and steady enlargement.
Events that may cause rapid growth:
- surgery
- trauma
- infection
- hormonal changes (i.e puberty, pregnancy, menopause)
Lesions (abnormal tissue on the body) can be localized, or diffuse, and occur in more than one site. The exact cause of these lesions have not yet been determined, however the lack of the smooth muscle cells in the vein walls has been known as a critical factor. The color will depend on the depth and amount of expansion of the affected vessel(s).
Superficial lesion tends to have a maroonish-red appearance. Deep lesion may appear bluish hue, yet very deep lesion may have no color but reveal itself as a "protruding mass". Venous malformations are soft to the touch, yet when compressed the color changes as the blood empties out.
Venous Malformation Screenings and Treatments
There is a wide variety in the presentations of these lesions, and treatment will vary. Depth, location, and extent of lesion are all considered for proper testing and treatment to be conducted.
The following may consist of:
- Observation - of smaller lesions that are minimally cosmetic, or functional upset, are often followed up upon over a period of time without treatment.
- Compression Garments - used to control swelling and pain in extremity lesions.
- Sclerotherapy - injecting an solution into the lesion to help shrink the abnormal veins. For larger veins, sclerotherapy may be performed in conjunction with surgical excision.
- Surgical Excision - removal of lesions and most successful when lesions are localized and accessible. Extensive lesions may be partially removed based on surgeons assessment.
- Laser Therapy - treats comprised venous malformations affected by larger vessels, but generally several treatments consisting of 6 - 8 week visits apart may be necessary.
*This information is not intended to substitute professional medical care, diagnosis or treatment. It is for informational purposes only. All procedures have risk of complications. Please contact your healthcare provider for better guidance regarding your individual situation.
