Varicose Veins: More
Than Just a Cosmetic
Problem
Jeffrey Stein, MD
Charlotte Radiology Vein and Vascular Center
Vascular and Interventional Radiology
Charlotte Radiology
February 8, 2012
What are Varicose Veins?
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abnormally enlarged superficial veins
tortuous, twisted, widened or lengthened
bulging under skin surface
due to a defect in the valves within the veins
themselves (venous valve insufficiency)
blood pools in sections of the vein causing the
vein to bulge and swell
What are Varicose Veins?
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Normal vein:
cusps of valves close
& prevent backward
flow of blood
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Varicose vein:
cusps cannot close
because vein
abnormally widened
and blood can flow in
the wrong direction
Introduction
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may be no symptoms
for some a problem in terms of appearance
may result in mild discomfort
may cause severe pain
may result in additional medical problems
Introduction
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Images of varicosities:
Introduction
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Telangiectasia, more commonly known as spider veins:
Spider veins on the leg
usually appear in one
of three patterns:
(a)
simple linear
(b) arborizing, which
appear branch-like
(c) spider, which appear as
a cartwheel shape with
a dark center point.
Incidence and prevalence
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15% of males over 18
30% of women over 18
increases with age, being present in more than
half the population by age 65
20 Million adults with varicose veins or chronic
venous insufficiency (CVI)
Risk Factors
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Genetics / Hereditary - those with a family
history are at greater risk
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family history of varicose veins 15 % of patients
Increasing Age
Gender - women are at greater risk than men
related to female sex hormones estrogen and progesterone
which relax blood vessels, allowing the vein valves to
separate
 pregnancy
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Risk Factors
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Obesity- excess weight increases pressure on
the saphenous vein valves, causing them to
weaken
Pregnancy
varicose veins may surface for the first time during
pregnancy
 progesterone smooth muscle relaxation
 later in pregnancy the uterus exerts greater pressure on the
pelvic and leg veins and may cause or worsen varicose
veins
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Risk Factors
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Standing and sitting- those who have jobs that
require them to stand or sit for long periods also
are at increased risk
prolonged standing can weaken the walls of veins
 prolonged sitting can aggravate inflamed veins
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Symptoms
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pain
leg heaviness
aching or tension
tenderness along the
course of a vein
burning sensations
pruritus / itching
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exercise
intolerance
restless legs
paresthesias
night cramps
edema
skin changes
Complications
Thrombophlebitis
Complications
Stasis Dermatitis/
Varicose eczema
Complications
Stasis Dermatitis/
Varicose eczema &
Lipodermatosclerosis
Management of Varicose Veins and
Venous Reflux
Conservative treatment (will not solve the problem
but will help with symptoms):
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elevation
avoid prolonged sitting/standing
no leg crossing
exercise
weight reduction
compression stocking therapy
Management
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Compression Stocking Therapy
Management
Treatment options:
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Surgical stripping: old way of removing the vein.
Typically required a hospital stay and weeks of
recovery time.
Injection sclerotherapy: often treats the surface
veins, but does not treat the underlying problem.
Endovenous laser treatments: much less
invasive way of “eliminating” the vein. The
procedure seals off the vein while leaving it inside
of your leg.
Management
Benefits of laser treatments vs. traditional
stripping:
Minimally invasive, in-office treatment alternative to
surgical stripping of the great saphenous vein
 No sedation
 Most procedures take less than 30 minutes
 Patients are able to walk immediately after the procedure
and most individuals are able to return to work the next
day
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Ultrasound Evaluation: Before
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During a consultation, you
will meet with the doctor and
have an ultrasound to
determine which veins are
not functioning properly.
Your doctor will then discuss
your treatment plan and
review your insurance
requirements. Most
procedures are covered by
insurance.
Varicose Veins: More
Than Just a Cosmetic
Problem
If you are interested in a consult, please give us a call. We accept all
major insurances.
Southpark: 4525 Cameron Valley Parkway
Charlotte, NC 28211
704.333.3794 ext. 2220
Concord: 212 LePhillip Court NE
Concord, NC 28205
704.786.0052
www.crveins.com