Patients complain of heaviness at the end of the day. They may also have ulcerations, often on the inner calf right above the ankle. Many people have visible, rope-like, varicose veins. Other people have smaller, reddish or bluish veins that may or may not be sore at the end of the day. These are referred to as “reticular” or spider veins.
Many people have venous disease due to poorly functioning valves within their superficial veins. Sometimes this is genetic. Other times this can be made worse secondary to a previous DVT. Lifestyle, such as standing for long periods of time, can also worsen symptoms. Some people have veins that no longer function due to a central blockage. This makes it difficult for the vein to function effectively.
A patient’s history is very telling of venous disease. However, to determine the best form of treatment an ultrasound is performed to find those vessels that are not performing appropriately. An ultrasound also will determine if there is any evidence of previous DVT or a poorly formed deep venous system. Both of these entities will help determine the most appropriate form of treatment. Sometimes if a central blockage or stenosis is suspected a venogram or ct scan is necessary.
Most patients initially try compression garments to help with their symptoms. In some patients their symptoms are relieved. However, most people require a procedure to resolve their symptoms. Many people have disease of their superficial veins. These can be treated with ablation. These can also be treated with a special glue or foam combined with a special device that irritates the vein. All of these procedures are performed as an outpatient. Most people get back to work within a day or two. Your vascular surgeon will help you determine the procedure that best fits your expectations and lifestyle. Deeper vein blockage will sometimes require stenting. This can be done with wires and catheters. Most people are back to work within a day or two.